Practice recommendation for the detection and diagnosis of patients with alzheimer’s disease dementia at Buenos Aires City

La Enfermedad de Alzheimer es la causa más frecuente de trastornos cognitivos y demencia en adultos mayores, y es considerada una nueva epidemia. Por sus diferentes manifestaciones cognitivas, conductuales y funcionales, la detección, diagnóstico y tratamiento de los pacientes con Demencia debida a Enfermedad de Alzheimer puede representar un desafío. En las presentes recomendaciones se dan pautas de manejo con niveles de recomendación basados en la mejor evidencia científica disponible. Asimismo, se presentan indicaciones y sugerencias de estudio, o derivación a un nivel superior de asistencia según la complejidad de cada caso. De este modo, se brinda un conjunto de recomendaciones prácticas de apoyo para la toma de decisiones por parte de los profesionales de la salud en cada nivel sanitario, desde la asistencia primaria hasta los médicos especialistas. Mediante un enfoque operativo y dinámico, estas Recomendaciones proponen un enfoque global basado en la evidencia para los pacientes, familiares y agentes de Salud involucrados en esta patología, de enorme relevancia a nivel social.Alzheimer’s disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epidemic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer’s Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations proposes a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.Fil: Demey, Ignacio. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Hospital Británico de Buenos Aires; ArgentinaFil: Ollari, Juan A.. Hospital Británico de Buenos Aires; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital Municipal "José Tiburcio Borda"; ArgentinaFil: Rojas, Galeno. Hospital Británico de Buenos Aires; Argentina. Fundación Favaloro; Argentina. Ministerio de Salud. Administración Nacional de Medicamentos, Alimentos y Tecnología Médica; ArgentinaFil: Bagnati, Pablo. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Sarasola, Diego. No especifíca;Fil: Román, Fabián. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; Argentina. Universidad de la Costa.; ColombiaFil: Tarulla, Adriana. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; Argentina. Universidad de la Costa.; ColombiaFil: Blake, Andre. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; ArgentinaFil: Sevlever, Gustavo. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Caridi, Aldo. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; ArgentinaFil: Allegri, Ricardo Francisco. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; Argentina. Universidad de la Costa.; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Consecuencias Neurológicas y Psiquiátricas a largo plazo (6 meses) en pacientes con COVID leve de la comunidad.: Long-term (6 months) neurological and psychiatric consequences in mild COVID community patients

Long-term neurological complications of coronavirus infection have been described in the acute episode in hospitalized patients. 63% had fatigue and muscle weakness, 26% sleep disorders; 24% gait disorders and 23% anxiety and depression. The greater the severity of the acute episode, the greater the probability of long-term neurological symptoms. The objective of this work was to study the prevalence at 6 months in a cohort of mostly mild outpatients. 96 subjects with a mean age of 48 years, 54% women, and 86% mild outpatients were evaluated by means of a telephone interview. Of these, at 6 months, 32% of the population presented neurological or psychiatric symptoms. Anxiety (31%), Fatigue (26%), Mental fog (24%), Insomnia (22%), Depression (21%), Headache (19%) among others. Conclusions: In this work with subjects who suffered from mild COVID, neurological and psychiatric symptoms were still prominent as reported in acute severs ones.Las complicaciones neurológicas a largo plazo de la infección por coronavirus han sido descriptas en los pacientes hospitalizados en el episodio agudo. De ellos el 63% presentaron fatiga y debilidad muscular, el 26% trastornos del sueño; 24% trastornos en la marcha y 23% ansiedad y depresión. A mayor severidad del episodio agudo mayor probabilidad de sintomatología neurológica a largo plazo. El objetivo de este trabajo fue estudiar la prevalencia de síntomas neurológicos y psiquiátricos a los 6 meses en una cohorte de pacientes adultos, principalmente ambulatorios. Fueron evaluados mediante una entrevista telefónica 96 sujetos con una media de edad de 48 años, 54% mujeres, y el 86 % ambulatorios leves. De ellos a los 6 meses el 32% de la población presentaba aun síntomas neurológicos o psiquiátricos. Ansiedad (31%), fatiga (26%), niebla mental (24%), insomnio (22%), depresión (21%), y cefalea (19%) entre otros. Conclusiones: en el presente trabajo con sujetos que sufrieron COVID leve los síntomas neurológicos y psiquiátricos post COVID continuaron prominentes como lo reportado en otros trabajos en las formas agudas más graves

Ancora il postmoderno?

Moderno e Postmoderno sono lemmi che attraversano da quasi un quarantennio la cultura europea nelle sue varie declinazioni disciplinari, senza che possano trovare una chiara e distinta sistemazione storiografica, come se si trattasse di una dicotomia mal posta. Che cosa è moderno? Che cosa è postmoderno? E si potrebbe continuare: quanto è davvero moderno il moderno e di quanto esso stesso è già posteriore? E quanto, nel suo voler esser postumo, il postmoderno si rivela invece moderato, a modo, autenticamente “moderno”? E ancora: Quanto siamo stati davvero moderni? Lo siamo mai davvero diventati prima e nonostante i superamenti ipotetici o le cessazioni che ci attribuiamo ex post? Se "modernus" è attestato per la prima volta in Cassiodoro, quel "modus" che indica la misura e quel "modo" che dice il “proprio ora” rimandano senza ombra di dubbi alla moderazione e alla modestia, ricordando peraltro che il moderno vive al presente e al futuro, ma parassitando l’antico, forse dissipandolo

Long-term (6 months) neurological and psychiatric consequences in mild COVID community patients

Las complicaciones neurológicas a largo plazo de la infección por coronavirus han sido descriptas en los pacientes hospitalizados en el episodio agudo. De ellos el 63% presentaron fatiga y debilidad muscular, el 26% trastornos del sueño; 24% trastornos en la marcha y 23% ansiedad y depresión. A mayor severidad del episodio agudo mayor probabilidad de sintomatología neurológica a largo plazo. El objetivo de este trabajo fue estudiar la prevalencia de síntomas neurológicos y psiquiátricos a los 6 meses en una cohorte de pacientes adultos, principalmente ambulatorios. Fueron evaluados mediante una entrevista telefónica 96 sujetos con una media de edad de 48 años, 54% mujeres, y el 86 % ambulatorios leves. De ellos a los 6 meses el 32% de la población presentaba aun síntomas neurológicos o psiquiátricos. Ansiedad (31%), fatiga (26%), niebla mental (24%), insomnio (22%), depresión (21%), y cefalea (19%) entre otros. Conclusiones: en el presente trabajo con sujetos que sufrieron COVID leve los síntomas neurológicos y psiquiátricos post COVID continuaron prominentes como lo reportado en otros trabajos en las formas agudas más gravesLong-term neurological complications of coronavirus infection have been described in the acute episode in hospitalized patients. 63% had fatigue and muscle weakness, 26% sleep disorders; 24% gait disorders and 23% anxiety and depression. The greater the severity of the acute episode, the greater the probability of long-term neurological symptoms. The objective of this work was to study the prevalence at 6 months in a cohort of mostly mild outpatients. 96 subjects with a mean age of 48 years, 54% women, and 86% mild outpatients were evaluated by means of a telephone interview. Of these, at 6 months, 32% of the population presented neurological or psychiatric symptoms. Anxiety (31%), Fatigue (26%), Mental fog (24%), Insomnia (22%), Depression (21%), Headache (19%) among others. Conclusions: In this work with subjects who suffered from mild COVID, neurological and psychiatric symptoms were still prominent as reported in acute severs one

Insight from an Italian Delphi Consensus on EVAR feasibility outside the instruction for use: the SAFE EVAR Study

Background: The SAfety and FEasibility of standard EVAR outside the instruction for use (SAFE-EVAR) Study was designed to define the attitude of Italian vascular surgeons towards the use of standard endovascular repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA) outside the instruction for use (IFU) through a Delphi consensus endorsed by the Italian Society of Vascular and Endovascular Surgery (Società Italiana di Chirurgia Vascolare ed Endovascolare - SICVE). Methods: A questionnaire consisting of 26 statements was developed, validated by an 18-member Advisory Board, and then sent to 600 Italian vascular surgeons. The Delphi process was structured in three subsequent rounds which took place between April and June 2023. In the first two rounds, respondents could indicate one of the following five degrees of agreement: 1) strongly agree; 2) partially agree; 3) neither agree nor disagree; 4) partially disagree; 5) strongly disagree; while in the third round only three different choices were proposed: 1) agree; 2) neither agree nor disagree; 3) disagree. We considered the consensus reached when ≥70% of respondents agreed on one of the options. After the conclusion of each round, a report describing the percentage distribution of the answers was sent to all the participants. Results: Two-hundred-forty-four (40.6%) Italian Vascular Surgeons agreed to participate the first round of the Delphi Consensus; the second and the third rounds of the Delphi collected 230 responders (94.3% of the first-round responders). Four statements (15.4%) reached a consensus in the first rounds. Among the 22 remaining statements, one more consensus (3.8%) was achieved in the second round. Finally, seven more statements (26.9%) reached a consensus in the simplified last round. Globally, a consensus was reached for almost half of the proposed statements (46.1%). Conclusions: The relatively low consensus rate obtained in this Delphi seems to confirm the discrepancy between Guideline recommendations and daily clinical practice. The data collected could represent the source for a possible guidelines' revision and the proposal of specific Good Practice Points in all those aspects with only little evidence available