Patrones y estrategias de regulación emocional empleadas en personas mayores de 60 años con deterioro cognitivo.

Introducción. Son escasos los estudios científicos sobre los patrones cognitivos y estrategias empleadas en personas mayores con deterioro cognitivo (DC). Objetivo. El objetivo fue comparar 2 grupos de personas mayores, con DC y sin DC, la refocalización de planes, catastrofización, autoculpa, refoca-lización positiva y reinterpretación positiva para observar diferencias y establecer patrones cognitivos adaptados al perfil para la mejora en la atención profesional. Método. Para ello en este estudio de corte transversal con diseño correlacional y muestreo no probabilístico por conveniencia se empleó el Cog-nitive Emotion Regulation Questionnaire (CERQ) y Geriatric Depression Scale (GDS) en 196 personas mayores de 60 años pertenecientes a centros de día y residencias (M= 75,95 DT= 10,08). Resultados. Se han obtenido resultados estadísticamente significativos en refocalización de planes (p <. 00); catas-trofización (p= .00); autoculpa (p <. 00); refocalización positiva (p <. 00) reinterpretación positiva (p <. 00). Conclusiones. Es uno de los escasos estudios de este campo que contribuye a enfatizar la necesidad de estudio de variables emocionales adaptativas o desadaptativas para la vida del adulto mayor con DC inexistentes en el ámbito científico, además, muestra diferentes patrones cognitivos y estrategias adaptativas empleadas en DC y sin DC. Su conocimiento ayudaría a personalizar intervenciones en función de los patrones cognitivos presentes en esta publicaciónScientific studies on cognitive patterns and strategies used in older people with cognitive impair-ment (CD) are scarce. Objective: The objective was to compare 2 groups of older people, with CD and without CD, the refocusing of plans, catastrophizing, self-blame, positive refocusing and positive rein-terpretation to observe differences and establish cognitive patterns adapted to the profile for the impro-vement in professional care. Method: For this, in this cross-sectional study with correlational design and probability sampling by not convenience, the Cognitive Emotion Regulation Questionnaire (CERQ) and Geriatric Depression Scale (GDS) were used in 196 people over 60 years old belonging to day centers and residences (M=75.95 SD= 10.08) Results: Statistically significant results have been obtained in re-focusing plans (p<.00); catastrophizing (p=.00); self-blame (p<.00); positive refocusing (p<.00); positive reinterpretation (p<.00). Conclusions: It is one of the few studies in this field that contributes to empha-size the need to study adaptative or maladaptative emotional variables for the life of the elderly with CD that do not exist in the scientific field, in addition, it shows different cognitive patterns and adaptative strategies used in CD and without DC. Their knowledge would help to personalize interventions based on the cognitive patterns present in this publicatio

Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis. Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting. Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis. Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries. © 2014 Wolters Kluwer Health | Lippincott Williams &amp; Wilkins