Decision making and model M. Mishel. Accept or not accept replacement surgery knee prosthetic

Introducción: La artroplastia total de rodilla (PTR) es eficaz en el alivio del dolor y la función en los casos de artrosis de rodilla (AR) grave. Representa un problema de salud pública por su prevalencia. A pesar de los resultados clínicos obtenidos con la PTR, diversos estudios refieren que entre un 14-30% de pacientes se muestran insatisfechos con el resultado, al no alcanzar los beneficios esperados, lo que conlleva que otros desestimen el tratamiento quirúrgico. El modelo de cuidados de M. Mishel pertenece al paradigma de la transformación, parte de la teoría social crítica e incorpora principios de la teoría del caos para elaborar su teoría de la incertidumbre; la enfermedad crónica desencadena un desequilibrio y las personas que la experimentan pueden incorporar esta incertidumbre para adquirir un nuevo sentido de la vida

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele. © 2022, The Author(s)