Vida moderna y déficit de sueño : la fisiología no se globaliza

Fil: Cardinali, Daniel P. Universidad de Buenos Aires. Facultad de Medicina; Argentina.Para tener una buena vida resulta indispensable disfrutar de un buen sueño. Sin embargo, las\nexigencias propias de la vida moderna, impuestas por un modelo productivo que da lugar a una\nsociedad que está en marcha las 24 horas de manera permanente, está alterando nuestros ciclos\nnaturales de sueño y vigilia. Los seres humanos estamos durmiendo menos horas que las que\nnecesitamos y cada vez sufrimos más trastornos del sueño. Esta situación está provocando graves\nconsecuencias, tanto en el orden individual como en el social

The caregiving experiences of fathers and mothers of children with rare diseases in Italy: Challenges and social support perceptions

Family caregiving is a growing phenomenon with the increased prevalence of chronic illness and shorter hospitalizations. Rare diseases pose significant challenges not only to patients living with these kinds of pathologies but also to those who care for these patients. The caregiving role has specific characteristics. The present work aims to increase knowledge of the challenges that are common or specific to fathers and mothers of children diagnosed with a rare disease. Moreover, the paper analyses the kinds of social support they experience according to gender. A descriptive study was conducted using grounded theory methodology. A semi-structured interview with open-ended questions was conducted with 15 parents of children with a rare disease. The interview was organized into three main areas: personal experiences in caring for a child with a rare disease, family changes and perceived social support. The transcriptions were analyzed using NVivo 11 software. From data analysis, themes emerged regarding the challenges shared by fathers and mothers, but some aspects also emerged that were gender-specific. The analyses of differences between mothers' and fathers' narratives showed that there is a specific experience of the impact that caregiving has on parents' relationships with their jobs and on their worries. Self-help group is the main source of social support for all respondents. We discuss these findings in relation to possible appropriate specific interventions and support for family caregiving

How could self-determination theory be useful for facing health innovation challenges?

This paper offers a presentation of the characteristics of self-determination theory (SDT) in the health context as well as attempts to identify how this theory could be useful for facing health innovation challenges. Health innovation is based on scientific advances that have more complex relationships with health. This paper encourages the use of the SDT approach to face health innovation, both for physiological and pathological processes. In particular, the focus is on the changes and lifestyle choices related to physiological pregnancy and birth and to oncological genetic tests in the Italian context. The health innovation paradigm focuses on patients taking responsibility for making important health-related choices, and we think that SDT can offer new stimuli in light of the changes implemented from innovations in the field of health. The aim is that this manuscript will stimulate researchers to test the potential of this theory in the field of changing health-related processes. Practitioners are called upon to revise their orientation toward patients and, according to SDT, they should support autonomy rather than control the promotion of health-related change

Neuroimmunoendocrinology of the cervical autonomic nervous system

This article reviews several peripheral neuroendocrine relationships in the cervical region, namely the effect of the sympathetic innervation on adenohypophysial, thyroid and parathyroid hormone release, and the effect of parasympathetic innervation in thyroid and parathyroid glands. The possible pathways through which the central nervous system modulates the circadian organization of the immune response are also reviewed and the relative importance of circadian control of immune reactivity through local sympathetic and parasympathetic nerves and of neuroendocrine signals, like melatonin, is also discussed. Altogether the present article argues in favor of the concept that nerves arriving to the endocrine and lymphoid tissue constitute alternate pathways through which the brain controls immunoendocrine phenomena.Biomedical Reviews 1998; 9: 47-59

Trastornos del sueño y seguridad vial : un tema no resuelto

Fil: Cardinali, Daniel P. Universidad de Buenos Aires. Facultad de Medicina; Argentina.Fil: Pérez Chada, Daniel. Hospital Universitario Austral. Departamento de Medicina Interna; ArgentinaLos mayores accidentes industriales y vehiculares de nuestros días pueden vincularse a la utilización de\n"las máquinas humanas" más allá de sus especificaciones naturales. En nuestro país, y a pesar de la\ncreciente preocupación pública por la seguridad vial, se presta poco interés al hecho de que la influencia\ndel sueño insuficiente es causa en una importante proporción de accidentes vehiculares

Lyapunov Pairs in Semilinear Differential Problems with State-Dependent Impulses

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Cadmium-Induced Disruption in 24-h Expression of Clock and Redox Enzyme Genes in Rat Medial Basal Hypothalamus: Prevention by Melatonin

In a previous study we reported that a low daily p.o. dose of cadmium (Cd) disrupted the circadian expression of clock and redox enzyme genes in rat medial basal hypothalamus (MBH). To assess whether melatonin could counteract Cd activity, male Wistar rats (45 days of age) received CdCl2 (5 ppm) and melatonin (3 μg/mL) or vehicle (0.015% ethanol) in drinking water. Groups of animals receiving melatonin or vehicle alone were also included. After 1 month, MBH mRNA levels were measured by real-time PCR analysis at six time intervals in a 24-h cycle. In control MBH Bmal1 expression peaked at early scotophase, Per1 expression at late afternoon, and Per2 and Cry2 expression at mid-scotophase, whereas neither Clock nor Cry1 expression showed significant 24-h variations. This pattern was significantly disrupted (Clock, Bmal1) or changed in phase (Per1, Per2, Cry2) by CdCl2 while melatonin counteracted the changes brought about by Cd on Per1 expression only. In animals receiving melatonin alone the 24-h pattern of MBH Per2 and Cry2 expression was disrupted. CdCl2 disrupted the 24-h rhythmicity of Cu/Zn- and Mn-superoxide dismutase (SOD), nitric oxide synthase (NOS)-1, NOS-2, heme oxygenase (HO)-1, and HO-2 gene expression, most of the effects being counteracted by melatonin. In particular, the co-administration of melatonin and CdCl2 increased Cu/Zn-SOD gene expression and decreased that of glutathione peroxidase (GPx), glutathione reductase (GSR), and HO-2. In animals receiving melatonin alone, significant increases in mean Cu/Zn and Mn-SOD gene expression, and decreases in that of GPx, GSR, NOS-1, NOS-2, HO-1, and HO-2, were found. The results indicate that the interfering effect of melatonin on the activity of a low dose of CdCl2 on MBH clock and redox enzyme genes is mainly exerted at the level of redox enzyme gene expression

Clinical Aspects of Melatonin Intervention in Alzheimer’s Disease Progression

Melatonin secretion decreases in Alzheimer´s disease (AD) and this decrease has been postulated as responsible for the circadian disorganization, decrease in sleep efficiency and impaired cognitive function seen in those patients. Half of severely ill AD patients develop chronobiological day-night rhythm disturbances like an agitated behavior during the evening hours (so-called “sundowning”). Melatonin replacement has been shown effective to treat sundowning and other sleep wake disorders in AD patients. The antioxidant, mitochondrial and antiamyloidogenic effects of melatonin indicate its potentiality to interfere with the onset of the disease. This is of particularly importance in mild cognitive impairment (MCI), an etiologically heterogeneous syndrome that precedes dementia. The aim of this manuscript was to assess published evidence of the efficacy of melatonin to treat AD and MCI patients. PubMed was searched using Entrez for articles including clinical trials and published up to 15 January 2010. Search terms were “Alzheimer” and “melatonin”. Full publications were obtained and references were checked for additional material where appropriate. Only clinical studies with empirical treatment data were reviewed. The analysis of published evidence made it possible to postulate melatonin as a useful ad-on therapeutic tool in MCI. In the case of AD, larger randomized controlled trials are necessary to yield evidence of effectiveness (i.e. clinical and subjective relevance) before melatonin´s use can be advocated

Impact of mapping errors on the reliability of landslide hazard maps

International audienceIdentification and mapping of landslide deposits are an intrinsically difficult and subjective operation that requires a great effort to minimise the inherent uncertainty. For the Staffora Basin, which extends for almost 300 km2 in the northern Apennines, three landslide inventory maps were independently produced by three groups of geomorphologists. In comparing each map with the others, large positional discrepancies arise (in the range of 55?65%). When all three maps are overlain, the locational mismatch of landslide deposit polygons increases to over 80%. To assess the impact of these errors on predictive models of landslide hazard, for the study area discriminant models were built up from the same set of geological-geomorphological factors as predictors, and the occurrence of landslide deposits within each terrain-unit, derived from each inventory map, as dependent variable. The comparison of these models demonstrates that statistical modelling greatly minimises the impact of input data errors which remain, however, a major limitation on the reliability of landslide hazard maps

Identification and mapping of recent rainfall-induced landslides using elevation data collected by airborne Lidar

International audienceA high resolution Digital Elevation Model with a ground resolution of 2 m×2 m (DEM2) was obtained for the Collazzone area, central Umbria, through weighted linear interpolation of elevation points acquired by Airborne Lidar Swath Mapping. Acquisition of the elevation data was performed on 3 May 2004, following a rainfall period that resulted in numerous landslides. A reconnaissance field survey conducted immediately after the rainfall period allowed mapping 70 landslides in the study area, for a total landslide area of 2.7×105 m2. Topographic derivative maps obtained from the DEM2 were used to update the reconnaissance landslide inventory map in 22 selected sub-areas. The revised inventory map shows 27% more landslides and 39% less total landslide area, corresponding to a smaller average landslide size. Discrepancies between the reconnaissance and the revised inventory maps were attributed to mapping errors and imprecision chiefly in the reconnaissance field inventory. Landslides identified exploiting the Lidar elevation data matched the local topography more accurately than the same landslides mapped using the existing topographic maps. Reasons for the difference include an incomplete or inaccurate view of the landslides in the field, an unfaithful representation of topography in the based maps, and the limited time available to map the landslides in the field. The high resolution DEM2 was compared to a coarser resolution (10 m×10 m) DEM10 to establish how well the two DEMs captured the topographic signature of landslides. Results indicate that the improved topographic information provided by DEM2 was significant in identifying recent rainfall-induced landslides, and was less significant in improving the representation of stable slopes