Fibrilación auricular no valvular en pacientes ancianos hospitalizados en medicina interna: características clínicas, tratamiento antitrombótico, mortalidad intrahospitalaria y al año de seguimiento

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 24-06-201

The problem of underdosing with direct-acting oral anticoagulants in elderly patients with nonvalvular atrial fibrillation

Unless contraindicated, anticoagulant therapy should be prescribed to elderly patients with atrial fibrillation. Direct-acting oral anticoagulants (DOACs) are superior to vitamin K antagonists for preventing stroke. This, together with their higher net clinical benefit, makes DOACs the treatment of choice in this population. However, due to the concerns about bleeding and the need for dose adjustment based on clinical variables, underdosing of DOACs is common and the risk of stroke high. Drugs with more easily adjusted doses are likely associated with a lower risk of dosing errors and, therefore, a greater protective effect. Correct dosing can ensure a maximal net benefit of DOACs in elderly patients with atrial fibrillation

Parenting Styles and Creativity in School Children

El siguiente trabajo tuvo como objetivo analizar si los estilos parentales predicen la creatividad en tareas de papel y lápiz, y la percepción que tiene el niño de sí mismo sobre su creatividad. Se trabajó con una muestra de 219 niños de 9 a 12 años de edad de diferentes centros educativos de la provincia de Entre Ríos, Argentina. Se administró una adaptación de la Escala Argentina de Percepción de la Relación con los Padres para niños de Richaud de Minzi (2007a) basada en el modelo Schaefer, la prueba de figuras del Test de Pensamiento Creativo de Torrance (Test of Torrance CreativeThinking) Forma B y la Escala de Personalidad Creadora heteroevaluación de Garaigordobil (2004). En forma general, los resultados mostraron que la aceptación parental sería un predictor positivo de la creatividad. Además, la disciplina laxa sería un factor inhibidor del proceso creativo del niño. Finalmente, el control patológico desde los estilos parentales se relacionó negativamente con la creatividad.Fil: Krumm, Gabriela Liliana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones En Psicología Matemática y Experimental "Dr. Horacio Rimoldi"; Argentina;Fil: Gullón, Silvana. Universidad Adventista del Plata;Fil: Vargas Rubilar, Jael Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones En Psicología Matemática y Experimental "Dr. Horacio Rimoldi"; Argentina

Oral anticoagulant use and appropriateness in elderly patients with atrial fibrillation in complex clinical conditions: CONVENIENCE study

Non-valvular atrial fibrillation (NVAF) is the most common arrhythmia in older patients. Although direct-acting oral anticoagulants (DOAC) are the antithrombotic treatment of choice, irrespective of age, certain factors may limit their use. The aim of the ACONVENIENCE study was to consult the opinion of a multidisciplinary panel of experts on the appropriateness of using OACs in elderly patients (>75 years) with NVAF associated with certain complex clinical conditions. A consensus project was performed on the basis of a systematic review of the literature, and application of a two-round Delphi survey. The agreement of 79 panellists on 30 Delphi-type statements was evaluated, and their opinion on the appropriateness of different oral anticoagulants in 16 complex clinical scenarios was assessed. A total of 27 consensus statements were agreed upon, including all statements addressing anticoagulation in older patients and in patients at high risk of bleeding complications, and most of those addressing frailty, dementia, risk of falling, and complex cardiac situations. It was almost unanimously agreed upon that advanced age should not influence the anticoagulation decision. Apixaban was the highest-rated therapeutic option in 14/16 situations, followed by edoxaban. There is a high degree of agreement on anticoagulation in older patients with NVAF. Age should not be the single limiting factor when prescribing OACs, and the decision should be made based on net clinical benefit and a comprehensive geriatric assessment. Apixaban, followed by edoxaban, was considered the most appropriate treatment in the various complex clinical situations examined

Effects of hemicellulose-derived saccharides on behavior of Lactobacilli under simulated gastrointestinal conditions

Four types of purified xylooligosaccharides (XOS) from several lignocellulosic materials, showing different structural features (including chain length, branching, and linkage types), obtained from different feedstocks (Eucalyptus globuluswood, rice husks,wheat bran or barley wastes), were assessed (using fructooligosaccharides as reference substrate) for their effects on the growth of six different probiotic Lactobacillus strains in basal MRS media and survival in different simulated gastrointestinal tract (GIT) conditions. The hydrophobicity of bacterial cells, which measures their potential for epithelial adhesion, was also evaluated. Improved growth of Lactobacillus strains was observed for media containing XOS as the single source of carbohydrate, confirming their role as prebiotics. These oligosaccharides also led to improvement in the resistance of the target Lactobacillus to the simulated GIT environment. The enhancement of the survival rates depended on the type of oligosaccharide. This is the first comparative study of the effects in lactobacilli involving four types of XOS obtained from different lignocellulosic materials. The obtained results show that these oligosaccharides manufactured from alternative sources could be interesting prebiotic substrates with different structures in comparison with the available commercially and with interesting potential towards the development of synbiotic products.info:eu-repo/semantics/publishedVersio

Clinical characteristics associated with elevated levels of lipoprotein(a) in patients with vascular risk

Lipoprotein(a) (Lp(a)) is increasingly used in the evaluation of patients with vascular risk due to its association with cardiovascular events. The purpose of this study was to identify the clinical characteristics of patients with elevated levels of Lp(a) attended in an outpatient vascular risk unit

Características clínicas asociadas a niveles elevados de lipoproteína(a) en pacientes atendidos por riesgo vascular

La lipoproteína(a) (Lp(a)) es cada vez más relevante en la evaluación de pacientes con riesgo vascular debido a su asociación con una mayor incidencia de eventos cardiovasculares. Este estudio tiene como objetivo identificar las características clínicas de los pacientes con niveles elevados de Lp(a) atendidos en consultas externas por riesgo vascular

Aprendemos descubriendo

Ejemplar fotocopiado. Fecha aproximada, no constan datos de publicaciónEl presente trabajo recoge un material práctico que consta de fichas de laboratorio para realizar prácticas sobre los temas siguientes: el cuerpo humano, biología, botánica, zoología y física. Esta experiencia está destinada a atender las necesidades de las escuelas rurales y el sistema de investigación a seguir recoge lo analítico y lo sintético, lo inductivo y lo deductivo con el fin de motivar al alumno que parte de lo desconocido buscando él lo que pueda haber de interés en la investigación.Castilla y LeónBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]