L’activitat física i altres factors de reserva cognitiva en l’envelliment

Aquest capítol té com a objectiu principal promoure un envelliment cognitiu saludable, reeixit o òptim. Atès que les persones grans presenten canvis a nivell cerebral i un cert declivi dels processos cognitius relacionats amb aquests canvis estructurals, és important identificar els factors que permetin reduir o compensar aquests dèficits. Aquest enfocament s’inscriu dins d’una perspectiva neuropsicològica que pretén potenciar la reserva cognitiva de les persones per millorar la seva qualitat de vida durant l’envelliment. Un factor determinant en la preservació de les principals funcions cognitives pot ser l’estil de vida. En aquest capítol, primer introduirem el concepte de reserva cognitiva i els principals factors que l’afavoreixen a fi de presentar després un resum dels estudis realitzats fins a l’actualitat i que han demostrat els efectes positius de l’activitat física com a factor protector del funcionament neurocognitiu.El presente capítulo tiene como objetivo principal promover un envejecimiento cognitivo saludable, exitoso u óptimo. Dado que las personas mayores presentan cambios a nivel cerebral y cierto declive de los procesos cognitivos relacionados con estos cambios estructurales, es importante identificar los factores que permitirán reducir o compensar estos déficits. Este enfoque se inscribe dentro de una perspectiva neuropsicológica que pretende potenciar la reserva cognitiva de las personas para así mejorar su calidad de vida durante el envejecimiento. Un factor determinante en la preservación de las principales funciones cognitivas puede ser el estilo de vida. En este capítulo primero introduciremos el concepto de reserva cognitiva y los principales factores que la favorecen para después presentar un resumen de los estudios realizados hasta la actualidad y que han demostrado los efectos positivos de la actividad física como factor protector del funcionamiento neurocognitivo

Mycobacterium tuberculosis and Cytomegalovirus Colitis in a Renal Transplant Patient: A Case Report

Q3Q2Pacientes con trasplante de riñónPacientes con Infección por citomegalovirusPacientes con Diarrea crónicaChronic diarrhea is a common reason for consultation in renal transplant patients. Cytomegalovirus infection is the cause of chronic diarrhea of infectious origin in 50% of cases, but coinfection with tuberculosis is rare. We present the case of a renal transplant patient with chronic diarrhea, with a finding of left colon colitis and positive microbiological studies in biopsy for tuberculosis and cytomegalovirus. The patient received valganciclovir and anti-tubercular treatment with adequate evolution. Immunosuppressed patients may have diarrhea secondary to opportunistic infections; therefore, an algorithm for early diagnosis and treatment is recommended.https://orcid.org/0000-0002-8892-9652https://orcid.org/0000-0001-9852-749Xhttps://orcid.org/0000-0002-4069-3230https://orcid.org/0000-0002-6772-2943https://orcid.org/0000-0002-4100-3529Revista Internacional - IndexadaBS

Análisis Psicométrico del Staxi-2 Y Ml-Staxi en Adultos del Área Metropolitana de Bucaramanga

This study aims to determine the psychometric properties of the State-Trate Anger Expression Inventory (STAXI-2) and the Multicultural Latin American Anger Expression Inventory (ML-STAXI) in a sample of 200 participants between 18 and 50 years old of the metropolitan area of Bucaramanga. It was performed a gender comparison using a two-way ANOVA, which showed signiicant differences in STAXI-2 for the subscales External Control and Internal Control of Anger. The analysis of internal consistency Cronbach Alpha showed appropriate indexes, ranging between 0.67 and 0.86 for STAXI- 2 and between 0.65 and 0.88 for ML-STAXI. When the exploratory factor analysis was performed, STAXI-2 showed an eight-factor structure while ML-STAXI presented a seven-factor structure, showing similarity with the originals. These indings indicate that both instruments are reliable and valid

Experiencia del Sistema Nacional de Salud Mexicano en el desarrollo de guías de práctica clínica

ResumenAntecedentesLas guías de práctica clínica son herramientas que han demostrado hacer más racionales las decisiones en salud y disminuir la brecha entre la acción clínica y la evidencia científica.ObjetivoEl estudio tiene como objetivo compartir la experiencia en el desarrollo y actualización de guías por el Sistema Nacional de Salud de México.Material y métodosLa metodología en el desarrollo de guías consta de 5 fases: priorización, conformación de grupos de trabajo, desarrollo por adopción de guías internacionales o de novo, validación e integración en el Catálogo maestro de guías de práctica clínica para su difusión.ResultadosEl Catálogo maestro de guías de práctica clínica aloja 664 guías, distribuidas de la siguiente forma: 42% son de Medicina Interna, 22% de Cirugía, 24% de Pediatría y el 12% de Ginecología y Obstetricia. Del total de las guías, se da cobertura al 85% del Catálogo universal de servicios de salud, al 84% del Fondo de protección contra gastos catastróficos y al 61% del Seguro Médico Siglo XXI de la Comisión Nacional de Protección Social en Salud.DiscusiónEl resultado es la suma de un esfuerzo de coordinación y cooperación de las instituciones del Sistema Nacional de Salud, de las voluntades políticas y del compromiso de 3,477 profesionales de la salud que participan en el desarrollo y actualización de las guías.ConclusionesLa integración, difusión e implantación de las guías del Catálogo maestro mejora la calidad de la atención y seguridad de los usuarios del Sistema Nacional de Salud.AbstractBackgroundClinical practice guidelines are tools that have been able to streamline decisions made in health issues and to decrease the gap between clinical action and scientific evidence.ObjectiveThe objective of the study is to share the experience in the development and to update the guidelines by the National Health System of Mexico.Material and methodsThe methodology in the development of the guidelines consists of 5 phases: prioritisation, establishment of work groups, development by adoption of international guidelines of de novo, validation and integration in the Master catalogue of clinical practice guidelines for its dissemination.ResultsThe Master catalogue of clinical practice guidelines contains 664 guidelines, distributed in 42% Internal Medicine, 22% Surgery, 24% Pediatrics and 12% Gynecology. From the total of guidelines coverage is granted at an 85% of the Universal catalogue of health services, an 84% of the Catastrophic expenses protection fund and a 61% of the XXI Century Medical Insurance of the National Commission of Social Protection in Health.DiscussionThe result is the sum of a great effort of coordination and cooperation between the institutions of the National Health System, political wills and a commitment of 3,477 health professionals that participate in guidelines’ development and update.ConclusionMaster catalogue guidelines’ integration, diffusion and implantation improve quality of attention and security of the users of the National Health System

The mediating role of the entrepreneurial ecosystem in the entrepreneurial personality and green entrepreneurship : the case of Peruvian's university students.

Nowadays, the value of innovation, green behavior, and entrepreneurship have grown, which is essential for a country's sustainable development. However, there has been no in-depth study of what the ecosystem should be to promote entrepreneurship and, thus, care for the environment. For this reason, this study aims to explore the entrepreneurial ecosystem's effect on Peruvian university students' entrepreneurial personality and green entrepreneurship. This study uses a duly validated instrument that includes the three variables divided by dimensions and was applied to a population of university students in Peru. Using a simple random sampling technique, the data were collected from 384 students of Peruvian universities. This study used the Smart-PLS to examine the reliability of the data and the correlation of the dimensions and items of the variables. In conclusion, providing entrepreneurship tools can help students develop desirable personality traits to generate sustainable businesses. The job of universities is to improve education for sustainable development. This means that students should learn the skills and knowledge they need to use environmental practices in their businesses.Edwerson William Pacori Paricahua (Universidad nacional de Juliaca), Jorge Martín Cruz Padilla (Universidad Norbert Wiener), Soraya del Pilar Carranco (Madrid Universidad Central del Ecuador), Jose Omar García Tarazona (Universidad Nacional de educación), Sonia Alejandrina Sotelo Muñoz (Universidad científica del Sur), Jesus Enrique Reyes Acevedo (Universidad Nacional Autónoma de Alto Amazonas), Jose Daniel Sanchez Fernandez (Universidad Católica de Santa María), Isaac Merino Quispe (Universidad Nacional Jose Maria Arguedas), José Luis Arias-Gonzáles (Pontificia Universidad Católica del Perú), Roxana Yolanda Castillo-Acobo (Universidad Nacional de San Agustín), Milagros del Rosario Cáceres-Chávez (Camosun College)Includes bibliographical references

Aquatic mammals from the Mexican Caribbean; a review

We present a review of the aquatic mammal species occurring in the Mexican Caribbean. Several published sources were reviewed to find information about aquatic mammals reported for the Mexican Caribbean. Additionally, we consulted 29 national and international collections and museums. Based on documents, collections, direct records and local news, we analyzed 18 confirmed species of aquatic mammals for the study area [Tursiops truncatus, Stenella clymene, S. frontalis, S. longirostris, Steno bredanensis, Grampus griseus, Globicephala macrorhynchus, Peponocephala electra; Pseudorca crassidens, Orcinus orca, Physeter macrocephalus, Kogia breviceps, K. sima, Ziphius cavirostris, Mesoplodon europaeus, Trichechus manatus manatus, Lontra longicaudis annectens and Monachus tropicalis (extinct)]. In order to gather solid baseline information that enhances efficient long-term management, regular and systematic population censuses of the aquatic mammal community are recommended. We recommend the use of the Mexican Caribbean area as a separate unit of management and conservation, differently as has been included in the macro region Gulf of Mexico/Mexican Caribbean

Modelos in vitro e in vivo para el estudio del desarrollo del injerto en pistacho

Resumen del trabajo presentado en la X Reunión de la Sociedad Española de Cultivo In Vitro de Tejidos Vegetales, celebrada en Zaragoza(España), del 23 al 24 de octubre de 2013Este trabajo profundiza en el estudio de los problemas que afectan al injerto de pistacho en campo, donde los injertos muestran baja tasa de éxito y un alto porcentaje de necrosis. Los injertos in vitro han demostrado ser un buen modelo para el estudio del injerto. Se realizaron dos tipos de injerto: de hendidura y bisel, utilizando cornicabra (P. terebinthus) como patrón y pistacho (P. vera) como variedad. Homoinjertos del patrón fueron utilizados como control. Los homoinjertos in vivo de cornicabra (P. terebinthus) han mostrado que el injerto de bisel con yemas subapicales es el más adecuado con un 35% de éxito y un 20% de necrosis tras 6 semanas frente al de escudete (0% de éxito y 100% de necrosis). In vitro, porciones de brotes de P. vera de 10-20 mm de longitud, con o sin ápice, fueron injertados en brotes de cornicabra con o sin raíces. Más del 70% de los brotes injertados sobrevivieron tras 3-5 semanas de cultivo, pero con escaso crecimiento de las yemas injertadas. Los tejidos del injerto mostraron uniones, que pudieron ser observadas histológicamente 15 días después del injerto. In vivo, estudios iniciales de heteroinjertos P. vera/P. terebinthus mostraron resultados prometedores, ya que 5 injertos de 12 realizados (42%) seguían creciendo 2 meses después el injerto. Se realizaron estudios sobre el crecimiento de plantas de semilla del patrón cornicabra en diferentes condiciones para identificar los factores que influyen en el desarrollo posterior de la planta injertada. Las plantas mostraron crecimiento continuado y mayor vigor en condiciones de invernadero con luz continua.Este trabajo ha sido parcialmente financiado por el proyecto INIA-FEDER RTA2010-00053-C03-02 y RTA2010-00053-C03-03 y por el Grupo de Excelencia A43 (Gobierno de Aragón). M.Y.G.P. Ha disfrutado de un beca del subprograma FPI INIA-CCAA

Staging Parkinson’s Disease According to the MNCD (Motor/Non-motor/Cognition/Dependency) Classification Correlates with Disease Severity and Quality of Life

Background: Recently, a novel simple classification called MNCD, based on 4 axes (Motor; Non-motor; Cognition; Dependency) and 5 stages, has been proposed to classify Parkinson's disease (PD). Objective: Our aim was to apply the MNCD classification in a cohort of PD patients for the first time and also to analyze the correlation with quality of life (QoL) and disease severity. Methods: Data from the baseline visit of PD patients recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD classification. Three instruments were used to assess QoL: 1) the 39-item Parkinson's disease Questionnaire [PDQ-39]); PQ-10; the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Results: Four hundred and thirty-nine PD patients (62.05 +/- 7.84 years old; 59% males) were included. MNCD stage was: stage 1, 8.4% (N = 37); stage 2, 62% (N = 272); stage 3, 28.2% (N = 124); stage 4-5, 1.4% (N = 6). A more advanced MNCD stage was associated with a higher score on the PDQ39SI (p < 0.0001) and a lower score on the PQ-10 (p < 0.0001) and EUROHIS-QOL8 (p < 0.0001). In many other aspects of the disease, such as disease duration, levodopa equivalent daily dose, motor symptoms, non-motor symptoms, and autonomy for activities of daily living, an association between the stage and severity was observed, with data indicating a progressive worsening related to disease progression throughout the proposed stages. Conclusion: Staging PD according to the MNCD classification correlated with QoL and disease severity. The MNCD could be a proper tool to monitor the progression of PD

Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group

COPPADIS Study Group.[Background and objective] The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD).[Patients and Methods] PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab & England Activities of Daily Living Scale (S&E-ADLS) at V0 and V2. FD was defined as an S&E-ADLS score less than 80%.[Results] In the PD group, a significant decrease in the S&E-ADLS score from V0 to V2 (N = 507; from 88.58 ± 10.19 to 84.26 ± 13.38; p < 0.0001; Cohen’s effect size = −0.519) was observed but not in controls (N = 124; from 98.87 ± 6.52 to 99.52 ± 2.15; p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908; p = 0.009), have longer disease duration (OR = 1.152; p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574; p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244; p < 0.0001) and BDI-II (OR = 1.080; p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963; p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168; p = 0.0.29), FOGQ (OR = 1.348; p < 0.0001) and VAFS-Mental (OR = 1.177; p = 0.013) (adjusted R-squared 0.52; Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2.[Conclusions] In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.Fundación Curemos el Parkinson (www.curemoselparkinson.org).Peer reviewe

Staging Parkinson’s Disease Combining Motor and Nonmotor Symptoms Correlates with Disability and Quality of Life

COPPADIS Study Group.[Introduction] In a degenerative disorder such as Parkinson’s disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr’s motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient’s quality of life (QoL) with regard to a defined clinical stage.[Materials and Methods] Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0–20; B: NMSS = 21–40; C: NMSS = 41–70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale.[Results] A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB (). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively (; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; ).[Conclusion] The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the H&Y. Patients with a lower H&Y stage may be more affected if they have a greater NMS burden.Peer reviewe