Consecuencias del consumo de drogas en las Funciones Ejecutivas en adolescentes y jóvenes adultos

The prolonged use of different types of drugs results in, among some, the deterioration of various cognitive capacities, among which the Executive Functions stand out for their clinical importance. These neuropsychological functions are considered as those that allow the human being to foresee, organize information, reason, generate goals and plans, inhibit behaviors, among others, to build both cognitive, behavioral and emotional strategies necessary to solve problems. The main objective of this article is to find out about the executive abilities altered due to drug consumption in people who attend the Intensive Outpatient Area of ​​the Health Center of the city of Latacunga, Ecuador. A descriptive quantitative methodology was used, with a sample of 20 people. The applied psychometric instrument was the Neuropsychological Battery of Executive Functions and Frontal Lobes (BANFE-1). Within the results, 50% of individuals presented severe alteration in the global functioning of executive functions. Specifically, 40% of these evidenced severe alteration of the dorsolateral cortex, where the executive skills that were affected by drug use are: inhibitory control, cognitive flexibility, working or working memory, impulse control or self-control, planning and organization sequential.El consumo prolongado de diferentes tipos de drogas trae como consecuencia, entre algunas, el deterioro de diversas capacidades cognitivas, entre las que resaltan por su importancia clínica, las Funciones Ejecutivas. Estas funciones neuropsicológicas son consideradas como aquellas que permiten al ser humano prever, organizar información, razonar, generar metas y planes, inhibir conductas, entre otras, para construir estrategias tanto cognitivas, conductuales y emocionales necesarias para resolver problemas. El presente artículo tiene como objetivo principal conocer las habilidades ejecutivas alteradas debido al consumo de drogas en las personas que asisten al Área Ambulatorio Intensiva del Centro de Salud de ciudad de la Latacunga, Ecuador. Se empleó una metodología cuantitativa de tipo descriptivo, con una muestra de 20 personas. El instrumento psicométrico aplicado fue la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales (BANFE-1). Dentro de los resultados, el 50% de individuos presentó alteración severa en el funcionamiento global de las funciones ejecutivas. Específicamente, el 40% de estos, evidenciaron alteración severa del córtex dorsolateral, donde las habilidades ejecutivas que fueron afectadas por el consumo de drogas son: control inhibitorio, flexibilidad cognitiva, memoria operativa o de trabajo, control de impulsos o autocontrol, planificación y organización secuencial

Total Intravenous Anesthesia Including Ketamine versus Volatile Gas Anesthesia for Combat-related Operative Traumatic Brain Injury

Background: Traumatic brain injury is a leading cause of death and severe neurologic disability. The effect of anesthesia techniques on neurologic outcomes in traumatic brain injury and potential benefits of total intravenous anesthesia (TIVA) compared with volatile gas anesthesia (VGA), although proposed, has not been well evaluated. The purpose of this study was to compare TIVA versus VGA in patients with combatrelated traumatic brain injury. Methods: The authors retrospectively reviewed 252 patients who had traumatic brain injury and underwent operative neurosurgical intervention. Statistical analyses, including propensity score and matched analyses, were performed to assess differences between treatment groups (TIVA vs. VGA) and good neurologic outcome. Results: Two hundred fourteen patients met inclusion criteria and were analyzed; 120 received VGA and 94 received TIVA. Good neurologic outcome (Glasgow Outcome Score 4 -5) and decreased mortality were associated with TIVA compared with VGA (75% vs. 54%; P ‫؍‬ 0.002 and 5% vs. 16%; P ‫؍‬ 0.02, respectively). Multivariate logistic regression found admission Glasgow Coma Scale score of 8 or greater (odds ratio, 13.3; P < 0.001) and TIVA use (odds ratio, 2.3; P ‫؍‬ 0.05) to be associated with good neurologic outcomes. After controlling for confounding factors using propensity analysis and repeated one-to-one matching of patients receiving TIVA with those receiving VGA with regard to Injury Severity Score, Glasgow Coma Scale score, base deficit, Head Abbreviated Injury Score, and craniectomy or craniotomy, the authors could not find an association between treatment and neurologic outcome. Conclusion: Total intravenous anesthesia often including ketamine was not associated with improved neurologic outcom