Permutation entropy and irreversibility in gait kinematic time series from patients with mild cognitive decline and early Alzheimer’s dementia

Permutation entropy; Irreversibility; Mild cognitive impairmentEntropía de permutación; Irreversibilidad; Defecto cognitivo leveEntropia de permutació; Irreversibilitat; Deteriorament cognitiu lleuGait is a basic cognitive purposeful action that has been shown to be altered in late stages of neurodegenerative dementias. Nevertheless, alterations are less clear in mild forms of dementia, and the potential use of gait analysis as a biomarker of initial cognitive decline has hitherto mostly been neglected. Herein, we report the results of a study of gait kinematic time series for two groups of patients (mild cognitive impairment and mild Alzheimer’s disease) and a group of matched control subjects. Two metrics based on permutation patterns are considered, respectively measuring the complexity and irreversibility of the time series. Results indicate that kinematic disorganisation is present in early phases of cognitive impairment; in addition, they depict a rich scenario, in which some joint movements display an increased complexity and irreversibility, while others a marked decrease. Beyond their potential use as biomarkers, complexity and irreversibility metrics can open a new door to the understanding of the role of the nervous system in gait, as well as its adaptation and compensatory mechanisms.This research was funded through the Premio del Ilustre Colegio Profesional de Fisioterapeutas de la Comunidad De Madrid, prize number ICPFM-IX-2013

ANALYSIS OF THE CASE MANAGEMENT MODEL FOR PEOPLE WITH MULTIMORBIDITY AND FAMILY CAREGIVERS

Objective: To understand the experience of nurses and decision-makers when implementing the case management model in the care of patients with multimorbidity and their family caregivers.Method: Qualitative descriptive study including nurses and decision-makers and conducted in Bogotá, Colombia. Content analysis of field journals and semi-structured interviews carried out in 2019-2020 was performed. ATLAS-TI was used for data processing and analysis.Results: Six nurses and two decision-makers participated in the study. The following categories emerged: Nursing perception of care provided to patents with multimorbidity and their social environment; Nursing care experience in case management: role, contributions, and difficulties; and Implementation of the case management model in the Colombian context: implementation, impact, and role of providers.Conclusions: The case manager requires experience and skills to communicate properly. Case management improves quality of life, therapeutic adherence, use of health services and reduces overload.Objetivo: compreender a experiência de Enfermeiros e tomadores de decisão na implementação do modelo de gerenciamento de caso no cuidado a pacientes com PLURIPATOLOGIAs e seus cuidadores familiares. Método: estudo descritivo qualitativo com enfermeiras e profissionais tomadores de decisão, Bogotá - Colômbia. Análise de conteúdo de diários de campo e entrevistas semiestruturadas em 2019-2020. Processamento e análise de dados com ATLASTi. Resultados: participaram seis enfermeiras e dois profissionais tomadores de decisão. Categorias emergentes:Percepção da enfermagem sobre a temática do cuidado patológico múltiplo e seu meio social; Experiência assistencial de enfermagem no gerenciamento de casos: papéis, contribuições e dificuldades; Implementação do modelo de gestão de casos no contexto colombiano: implementação, efetivação e papel dos profissionais. Conclusões: Os gestores de casos requer experiência e habilidades para se comunicar adequadamente. O gerenciamento de casos melhora a qualidade de vida, a adesão terapêutica, a utilização de serviços de saúde e reduz a sobrecarga.Objetivo: comprender la experiencia de Enfermeras y tomadores de decisión frente a la implementación del modelo de gestión de casos en la atención de pacientes pluripatológicos y sus cuidadores familiares.Método: estudio descriptivo cualitativo con enfermeras y profesionales tomadores de decisión, Bogotá - Colombia. Análisis de contenido de diarios de campo y entrevistas semiestructuradas en 2019-2020. Procesamiento y análisis de datos con ATLAS-Ti.Resultados: participaron seis enfermeras y dos profesionales tomadores de decisión. Categorías emergentes: Percepción de enfermería sobre el sujeto de cuidado pluripatológico y su entorno social; Experiencia de cuidado enfermero en la gestión de casos: rol, aportes y dificultades; Implementación del modelo de gestión de casos en el contexto colombiano: implementación, efecto y rol de los prestadores.Conclusiones: La gestora de casos requiere experiencia y competencias para comunicarse adecuadamente. La gestión de casos mejora calidad de vida, adherencia terapéutica, utilización de servicios sanitarios y reduce la sobrecarga

Farmacovigilancia y la relación con el regente de farmacia

Este documento recopila, documenta y resume de una manera muy concreta, la información relacionada con la Farmacovigilancia (FV), en el marco del diplomado de profundización de dicho tema. A lo largo del curso se abordaron diferentes aspectos de la FV como sus generalidades, los métodos y programas de vigilancia, las reacciones adversas, su clasificación y los tipos de reacciones adversas a medicamentos (RAM), las interacciones entre medicamentos, el quehacer del regente de farmacia, la promoción del uso racional de medicamentos, la efectividad de los mismos y las enfermedades de mayor prevalencia e incidencia en la sociedad.This document compiles, documents and summarizes in a very concrete way, the information related to Pharmacovigilance (VF), around the course. Throughout the course, different aspects of VF were addressed, such as its generalities, surveillance methods and programs, adverse reactions, their classification and the types of adverse drug reactions (ADRs), drug interactions, the regent's work of pharmacy, the promotion of the rational use of medicines, their effectiveness and the diseases with the highest prevalence and incidence in society

Experiences of women in the care of their children diagnosed with severe and/or moderate sympto-matic haemophilia

Objetivo: describir las experiencias de las mujeres frente al cuidado de sus hijos diagnosticados con hemofilia severa y/o moderada sintomática qué han recibido atención en el Servicio de Hematología del Hospital de San José (HSJ), Bogotá, Colombia. Metodología: estudio cualitativo de tipo fenomenológico-hermenéutico. La técnica de recolección de datos fue la entrevista a profundidad. La muestra se determinó por saturación de los datos, para la inclusión de los participantes se utilizó muestreo intencional. La información se analizó a partir de la propuesta de Strauss y Corbin quienes consideran la codificación abierta, axial y selectiva. Resultados: participaron en total nueve mujeres cuidadoras de hijos con hemofilia. La información fue reducida y analizada para establecer dos categorías: Experiencia de atención con un hijo hemofílico: desconocimiento, cambios y dificultades, y Trayectoria de la hemofilia en la vida de la mujer: implicaciones derivadas del cuidado. Conclusiones: existe un desconocimiento del sector salud y de la sociedad por ser una enfermedad huérfana dificultando el diagnostico, se evidencia situaciones que incrementan la desigualdad de género y repercuten negativamente en el desarrollo de la mujer física y socialmente.Objective: To describe the experiences of women in the care of their children diagnosed with severe and/or moderate symptomatic haemophilia who have re-ceived care at the Hematology Service of the Hospital de San José (HSJ), Bogotá, Colombia.Methods: Qualitative phenomenological-hermeneutic study. The technique of data collection was the in-depth interview. The sample was determined by saturation of the data, non-probabilistic sampling was used. The infor-mation was analyzed from the proposal of Strauss and Corbin, who considered it open, axial and selective.Results: A total of nine female caregivers of children with hemophilia participated. The information was reduced and analyzed for the category of: experien-ce of care with hemophilia: ignorance, changes and difficulties, and Hemophilia trajectory in the life of women: implications derived from care. Conclusion: There is an ignorance of the health sec-tor and society by the human being and the difficulty of diagnosis, it is evident that the increase of gender inequality and negatively affects the development of women physically and socially

Novel SCN5A mutation associated with idiopathic ventricular fibrillation due to subclinical Brugada syndrome

Idiopathic ventricular fibrillation can be caused by subclinical channelopathies such as Brugada syndrome. Our objective is to study the clinical behaviour of a new SCN5A mutation found in a woman with idiopathic ventricular fibrillation. A 53-year-old woman presented with multiple episodes of ventricular fibrillation, a structurally normal heart and normal baseline electrocardiogram. Genetic testing included KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2 and KCNJ2 and identified a mutation in SCN5A (D1816fs/g98747-98748insT). We studied 15 immediate family members by means of electrocardiogram, echocardiogram, flecainide challenge test and genetic study. Eight subjects had the mutation. The flecainide challenge test was positive for Brugada syndrome in two subjects in the case group and none in the control group. The PR and QRS intervals on the baseline electrocardiogram were longer in the case group. The left atrial volume indexed to body surface was higher in the case group, likely due to the fact that two patients with the mutation had atrial fibrillation and none had it in the control group. The D1816fs/g98747-98748insT mutation in SCN5A may be associated with idiopathic ventricular fibrillation and Brugada syndrome with a broad phenotypic spectrum and incomplete penetrance. Genetic testing may be useful to identify the etiology of idiopathic ventricular fibrillation in patients with a negative thorough clinical evaluation

Matrix-isolation FTIR study of azidoacetone and azidoacetonitrile

Azidoacetonitrile (N₃CH₂CN) and azidoacetone (N₃CH₂COCH₃) were studied by matrix-isolation FTIR spectroscopy in solid neon, argon and nitrogen. The IR spectra calculated using the density fuctional theoretical method are discussed in comparison with the experimental data. Significant broadening of the recorded azide bands indicate an awkward fit of these compounds into the solid environment. The strongest absorption is observed for both compounds in the regions of asymmetric and symmetric stretches of the N₃ azide group. Strong band splittings in the N₃ asymmetric stretch region can be most likely explained by very strong Fermi resonances with the CN stretch and combinations and overtones of the numerous lower frequency vibrational modes

Artificial intelligence for neurodegenerative experimental models

INTRODUCTION: Experimental models are essential tools in neurodegenerative disease research. However, the translation of insights and drugs discovered in model systems has proven immensely challenging, marred by high failure rates in human clinical trials. METHODS: Here we review the application of artificial intelligence (AI) and machine learning (ML) in experimental medicine for dementia research. RESULTS: Considering the specific challenges of reproducibility and translation between other species or model systems and human biology in preclinical dementia research, we highlight best practices and resources that can be leveraged to quantify and evaluate translatability. We then evaluate how AI and ML approaches could be applied to enhance both cross-model reproducibility and translation to human biology, while sustaining biological interpretability. DISCUSSION: AI and ML approaches in experimental medicine remain in their infancy. However, they have great potential to strengthen preclinical research and translation if based upon adequate, robust, and reproducible experimental data. Highlights: There are increasing applications of AI in experimental medicine. We identified issues in reproducibility, cross-species translation, and data curation in the field. Our review highlights data resources and AI approaches as solutions. Multi-omics analysis with AI offers exciting future possibilities in drug discovery.</p

Cross-cultural validation of the HypoA-Q to measure hypoglycemic awareness in diabetic patients

Introducción: La hipoglucemia inadvertida incrementa el riesgo de la hipoglucemia severa en pacientes con diabetes. Una medición objetiva de la misma requiere instrumentos como el HypoA-Q, que, a diferencia de otros, mide conciencia de episodios nocturnos; sin embargo, no se dispone de una versión en español. Objetivo: Traducir y adaptar culturalmente la escala HypoA-Q para la medición de conciencia de la hipoglucemia en pacientes colombianos con Diabetes Mellitus. Metodología: Estudio de Adaptación transcultural del instrumento HypoA-Q. Se obtuvo la autorización de la autora para su traducción y adaptación a la población colombiana. Se siguió la metodología de la European Organisation for Research and Treatment for Cancer (EORTC). Al respecto, se realizaron dos traducciones directas por hablantes nativos del español, una versión reconciliada, dos traducciones inversas por dos hablantes nativos del inglés y una prueba piloto en 15 pacientes con diagnóstico de diabetes. Resultados: Aunque las traducciones directas al español fueron similares, se hicieron ajustes para obtener una versión reconciliada con palabras más fáciles de comprender cambiando las unidades de mmol/L a mg/dl. Las traducciones inversas fueron similares al original en inglés. La prueba piloto, realizada en 15 pacientes, no requirió ajustar ningún ítem, pues la frecuencia de ítems con dificultades de comprensión, confusión o palabras ofensivas fue menor al 15%. Conclusiones: Se dispone de la versión en español para Colombia de la escala HypoA-Q. Se aconseja realizar un estudio de evaluación de sus propiedades psicométricas antes de ser usada en investigaciones o en la práctica clínica.Pacientes con DiabetesIntroduction: hypoglycemia unawareness increases the risk of severe hypoglycemia in pa-tients with diabetes. HypoA-Q is a questionnaire which allows us to evaluate hypoglycemia awareness including night time. However, a Spanish version is not available. Our objective is to translate and culturally adapt the HypoA-Q in order to be able to measure hypoglycemia awareness in Colombian patients with diabetes. Methodology: It is a cross-cultural adaptation study of the HypoA-Q instrument. Authorization was obtained from the author for its translation and adaptation to the Colombian population. The European Organization for Research and Treatment of Cancer (EORTC) methodology was followed. The researchers obtained a reconciled Spanish version with simple vocabulary. Two direct translations were performed by native Spanish speakers, one reconciled version, two reverse translations by two native English speakers, and a pilot test in 15 patients diagnosed with diabetes. Results: The direct translations into Spanish were similar. Adjustments were made to obtain a reconciled version with simple words. Also, glucose units were changed from mmol/L to mg/dl. The reverse translations were similar to the original in English. 15 patients older than 18 years read the Spanish version of HypoA-Q and answered a questionnaire to verify if each of the items were understandable, confusing, annoying or if it had difficult words. It did not require adjusting any item, since the frequency of items with comprehension difficulties, confusion or offensive words was less than 15%. Conclusions: The Spanish version of the HypoA-Q is available. An evaluation study of its psychometric properties must be carried out before being used in research studies or in clinical practice.https://orcid.org/0000-0002-1353-148Xhttps://orcid.org/0000-0002-8907-3470Revista Nacional - IndexadaN