Calidad de vida, relaciones familiares y depresión en pacientes con demencia. Revisión sistemática.

La demencia , es en la actualidad un gran problema de la salud pública, pues disminuye de manera significativa la calidad de vida de quien la padece, debido a la pérdida de la capacidad de realizar ABVD , la aparición de síntomas depresivos, los problemas de sueño y comportamiento y el dolor. Objetivos del estudio: El objetivo principal de esta revisión es investigar como se ve afectada la calidad de vida de los pacientes con demencia y si existen síntomas depresivos. Se revisarán que tipo de tratamientos (farmacológicos o no) mejoran ambas cosas. También se revisará sobre qué tipo de relaciones familiares tienen los pacientes con demencia. Metodología utilizada: Revisión bibliográfica entre Noviembre de 2018 y Marzo de 2019 en las siguientes bases de datos: PudMed, ScienceDirect,Scielo, Medigraphic,DialNet, Cocharne, LILACS, BioMedCentral, ReserachGate, Redalyc,Psychosomatic Medicine, Elsevier, Academia.edu, BMJ , Gestor documental de ISCIII,SAGE Journals. Para ello se siguió la estrategia PICO. Se han incluido únicamente estudios con año de publicación posterior al 2010, que tratan todo tipo de demencias. Se incluyeron un total de 37 artículos que se adaptan a los criterios de inclusión. Las personas con demencia experimentan una calidad de vida disminuida y una sintomatología depresiva. La musicoterapia ha resultado muy eficaz en el tratamiento de la depresión en este tipo de población. Por su parte, los programas de manejo de ABVD, la evaluación y tratamiento del dolor, la no institucionalización y la mejora del sueño mejoran significativamente la calidad de vida .Dementia is currently the biggest problem of public health, since it significantly decreases the quality of life. This due to loss of the ability to perform basic daily life activities , the onset of depressive symptoms, the problems of sleep and behavior and the pain. Objetivos del estudio: The main objective of this review is to investigate as is affected the quality of life of patients with dementia and if there are depressive symptoms. It will review what type of treatments (pharmacological or not) improve both problems. It will also review what kind of family relationships have the patients with dementia. Literature review between November 2018 and March 2019 in the following databases: PudMed, ScienceDirect,Scielo, Medigraphic,DialNet, Cocharne, LILACS, BioMedCentral, ReserachGate, Redalyc,Psychosomatic Medicine, Elsevier, Academia.edu, BMJ , Gestor documental de ISCIII,SAGE Journals. For it was followed the PICO strategy. Only have been included studies with a year of publication after 2010, with all kinds of dementias. A total of 37 items were included and all of them meet the inclusion criteria. People with dementia experience a decreased quality of life and depressive symptomatology. Music therapy has proved efficiency in the treatment of depression in this type of population. The programs of management of basic activities of daily life (ADLs), the evaluation and treatment of pain, non-institutionalization and the improvement of the sleep, improve quality of life.Enfermerí

Relación entre nutrición y desarrollo de úlceras por presión

Objective: To carry out a review on the relationship between nutrition and the risk of developing pressure ulcers. Methodology: Bibliographic review from PubMed and ScienceDirect databases, using the keywords “Pressure Ulcer” and “Nutrition” with the Boolean operator “AND”. Open access articles were selected, written in English and Spanish and published between 2011 and 2019. All articles that did not relate pressure ulcers and nutrition were excluded. Results: Of 1,202 documents located, 14 articles were eligible. All of them were thoroughly reviewed and their quality methodology was determined through the GRADE scale (Grading of Recommendations, Assess-ment, Development and Evaluation). Conclusion: The appearance of pressure ulcers is directly related to malnutrition, one of the most important and influential factors in this type of injury. The use of nutritional assessment with as a working tool to define the nutritional status of the patient, it predicts the risk of developing pressure ulcers. Protein and amino acid supplementation for their treatment lack clear scientific evidence.Objetivo: Realizar una revisión sobre la relación entre la nutrición y el riesgo de desarrollar úlceras por presión. Metodología: Revisión bibliográfica a partir de las bases de datos PubMed y ScienceDirect, utilizado las palabras clave “Pressure Ulcer” y “Nutrition” con el operador boo-leano “AND”. Se seleccionaron artículos de acceso libre, escritos en los idiomas inglés y español y publicados en-tre 2011 y 2019. Se excluyeron todos los artículos que no relacionaban úlceras por presión y nutrición. Resultados De un total de 1.202 documentos localiza-dos, fueron elegibles 14 artículos. Todos ellos se revisa-ron en profundidad y fue determinada su calidad meto-dológica mediante la escala del sistema GRADE (Gra-ding of Recommendations, Assessment, Development and Evaluation). Conclusión: La aparición de úlceras por presión está directamente relacionada con la malnutrición, un factor de los más importantes e influyentes sobre este tipo de lesiones. La utilización de la valoración nutricional como herramienta de trabajo para definir el estado nutricional del paciente, predice el riesgo de desarrollar úlceras por presión. Las suplementaciones de proteínas y aminoáci-dos para su tratamiento carecen de evidencia científica clara

Paleoclimatic variations in foraminifer assemblages from the Alboran Sea (Western Mediterranean) during the last 150 ka in ODP Site 977

19 pages, 5 figures, 4 tables.-- Printed version published Nov 30, 2004.Detailed analysis of the planktonic foraminifera assemblages of ODP Site 977, situated in the Alboran Sea (36°1,9′N; 1°57,3′W), led us to recognize 42 planktonic foraminiferal events that occurred during marine isotope stages (MIS) 4 and 5. These events were defined by changes in the abundances of Neogloboquadrina pachyderma (right and left coiling), Turborotalita quinqueloba, Globorotalia scitula, Globorotalia inflata, Globigerina bulloides and Globigerinoides ruber (white and pink varieties). Foraminiferal assemblages changed in response to glacial–interglacial and millennial climate variability throughout the last 150 ka. Based on the estimation of sea surface temperatures (SST) using the modern analog technique and the oxygen isotope data measured in G. bulloides, we inferred the oxygen isotopic composition of sea water (δw). SST increased in the Alboran Sea during the main Dansgaard–Oeschger Interstadials, such as interstadial 19 to 24. Even though N. pachyderma (left coiling) is very scarce before Heinrich Event (HE) 6, three cold pulses can be identified, between 65 and 85 ka ago. Moreover, increases in abundance of T. quinqueloba and G. scitula are recorded during D–O Stadials 20 and 21.The maximum temperature, which was attained during the Last Interglacial, was about 2 °C higher than recent temperature and that reached over the Holocene. Planktic foraminifera assemblages and paleotemperatures remained cold 3 ka after the beginning of Termination II (T-II), 130 ka ago, probably in connection with the occurrence of Heinrich event 11 in the North Atlantic.The abundance of G. bulloides during the deposition of organic rich layers (ORLs) of MIS 5, accompanied by lower isotope values in surface waters (δw), could indicate the presence of a fresher surface layer associated with an increase in marine surface productivity.This work was funded by DGCYT projects PB-98-0288, FEDER 1FD1997-1148 (CLI) and BTE2002-04670, and by the Spanish Government FPI Grant FP96 11964731.Peer reviewe

A Sediment-Nutrient-Oxygen Feedback Responsible for Productivity Variations in Late Miocene Sapropel Sequences of the Western Mediterranean

Cyclic sediments observed throughout the Mediterranean during the Late Miocene have been related to precessional forcing of ocean stratification. Individual couplets, typically 2-m-thick sequences of sapropels and diatom-rich marls, can be reliably traced from western Spain to Crete, and were formed in restricted marginal basins. Micropaleontological evidence indicates paradoxically that the organic carbon-rich sapropels were formed under low productivity conditions marked by surface water stratification and deep anoxia, whereas the diatom-rich marls were formed under high productivity conditions marked by upwelling. Here we present geochemical evidence, mainly from detailed phosphorus determinations and paleo-redox proxies, indicating that a sediment–nutrient–oxygen feedback (herein dubbed the SNO Effect) is in part responsible for driving the observed productivity variations. During stratification, anoxic conditions in these basins cause the release of the limiting nutrient phosphorus from reducible oxide phases in the sediments. Basin stagnation causes the buildup of phosphorus below the photic zone. Subsequent overturn driven by precessionally-driven winds injects phosphorus-rich bottom waters into the photic zone. The biotic response to this overturn is high productivity in marls directly overlying the sapropels culminating in diatom mat formation. Exhaustion of the stored excess phosphorus results in lower productivity marls, which grade back into sapropels due to lower wind stresses and the return of stagnant basin conditions. These findings indicate that the SNO Effect may in part be responsible for precessional-scale productivity variations observed in parts of the Mediterranean, and perhaps present in other restricted ocean basins, like the Miocene Monterey Formation and the modern Santa Barbara Basin.We thank the donors of the Petroleum Research Fund,administered by the American Chemical Society,the US National Science Foundation (Grant OCE9711957 to G.M.F.),the Fulbright Organization,and the DGCYES project PB98^0288 for support of this research.Peer Reviewe