Nosological advances in dementias. Characterization of patients with frontotemporal dementia

En la última década se ha dado un marcado avance en el conocimiento de la enfermedad de Alzheimer (EA), pero no en otras demencias. Es así como las características clínicas y psicométricas de los pacientes con demencia frontotemporal (DFT) -segunda causa de demencias degenerativas primarias-, empiezan a ser descritas en series de casos de los principales centros del mundo, donde se tiene la posibilidad de realizar diagnóstico por consenso por grupos de expertos. Por tal motivo se analizó una muestra de pacientes de la Clínica de Memoria del Hospital Universitario de San Ignacio (Bogotá, Colombia), en donde fueron evaluadas en forma protocolizada 348 personas, de las cuales 45 cumplían criterios de DFT, 259 para EA y 44 eran controles. El análisis estadístico se realizó con la prueba de comparación Kruskal Wallis (significación del 5 por ciento), teniendo como medida de análisis el rango intercuartílico. Todas las diferencias señaladas fueron el producto de pruebas con valores de p< 0.017. Los hallazgos que mejor definían al los pacientes con DFT eran: mayor predominio de hombres (73 por ciento vs. 31 por ciento en los que tenían EA), edad menor (mediana 65 años vs. mediana de 76 años en los que tenían EA), escala comportamental de Columbia más comprometida (mediana de 10 vs. 7 en pacientes con EA y 1 en los controles) y minimental más deteriorado en comparación con el grupo control (mediana de 24 vs. 27) pero mejor que los pacientes que tenían EA (mediana de 24 vs. 20). Estos hallazgos nos ayudan a poder definir mejor el perfil clínico y psicométrico de los pacientes con DFT, pero a su vez nos abren nuevos interrogantes que iremos despejando en la medida en que podamos hacer un seguimiento longitudinal de estas personas.[Cano CA, Ramírez CA. Avances nosológicos de las demencias. Caracterización de los pacientes con demencia frontotemporal. MedUNAB 2004; 7:84-8]In the last decade there has been a marked advance in the knowledge of Alzheimer's disease (AD), but not in other dementias. This is how the clinical and psychometric characteristics of patients with frontotemporal dementia (FTD) -second cause of primary degenerative dementias-, begin to be described in series of cases from the main centers of the world, where it is possible to perform diagnosis by consensus by expert groups. For this reason, a sample of patients from the Memory Clinic of the San Ignacio University Hospital (Bogotá, Colombia) was analyzed, where 348 people were evaluated in a protocolized way, of which 45 met FTD criteria, 259 for AD and 44 they were controls. Statistical analysis was performed with the Kruskal Wallis comparison test (5% significance), taking the interquartile range as the analysis measure. All the differences indicated were the product of tests with values ​​of p <0.017. The findings that best defined the patients with FTD were: greater predominance of men (73 percent vs. 31 percent in those with AD), younger age (median 65 years vs. median of 76 years in those with AD) , Columbia behavioral scale more compromised (median of 10 vs. 7 in patients with AD and 1 in controls) and minimental more impaired compared to the control group (median of 24 vs. 27) but better than patients who had AD (median of 24 vs. 20). These findings help us to better define the clinical and psychometric profile of patients with FTD, but at the same time they open up new questions that we will clear up to the extent that we can do a longitudinal follow-up of these people. [Cano CA, Ramírez CA . Nosological advances in dementias. Characterization of patients with frontotemporal dementia. MedUNAB 2004; 7: 84-8

Movilidad cambio en el metabolismo de la ciudad

Con la necesidad en Manizales de plantear una propuesta de reestructuración del sistema de transporte masivo, se genera otro conflicto urbano reflejado en la congestión y saturación de los espacios periféricos, destinados al arribo de las cotas alimentadoras donde se encontraran las estaciones de transferencia. Teniendo en cuenta el sentido protagónico de esta arquitectura como elemento primordial en la vivencia cotidiana de todos, ya que es un lugar en donde en algún momento del día tenemos que habitarlo, vivirlo, es por eso que estos espacios nacen para convertirse en un espacio público al igual que las plazas, parques. Observando lo anterior se hace necesaria la articulación de estos servicios a nivel de espacio publico, ofreciendo diferentes posibilidades a los habitantes para el desarrollo de actividades cotidianas de integración y caracterización necesarias para lograr una imagen urbana significativa. Es por lo anterior que la estación de transferencia no solo es un paréntesis en la ciudad, sino una de sus imágenes. / Abstract. With the necessity in Manizales, of planyear a proposal of restructuring of the system of massive transport, another urban conflict is generated reflected in the congestion saturation of the ootlying spaces, dedicated to the arrival of the routers alimentadors where they were the transfer stations keeping in mind protagonist sense of this architecture like primordial element in the daily vivencial of all, since it is a lugaren where in some moment of the day we have to inhabit it, to live him is for that reason that these spaces are born for convertirsenen a public space the some the some squares, the park. Observing the above mentioned becomes necessary the articulation of the services at space publics level, offering different possibilities to the inhabitants for development of daily activities of integration an necessary characterization to achieve a significant urban image it is for the above mentioned that the non alone transfer station is a parenthesis in the city, but one of its images P.C: stations, transfer, transport, tranvia massive, integration urban.Pregrad

Análisis de la percepción sobre impuesto al consumo de bolsas plásticas cobrado en los establecimientos del centro de Florencia-Caquetá: Analysis of the perception of tax on the consumption of plastic bags charged in large and medium-sized establishments from the center of Florence

The tax on the consumption of plastic bags, as part of the environmental taxes, is a legislative measure generated as a strategy to discourage the use of plastic by end consumers, which, although it has associated costs, has the fundamental purpose of generating social conscience over collection. In this way, the present manuscript, with a mixed approach and descriptive scope, presents the results of the research carried out from the Specialization program in Tax Management of the University of the Amazon, regarding the perception of merchants of large and medium-sized areas of the center of Florencia, Caquetá, around the tax in question. The findings show, for the most part, that there is social awareness and respect for nature. However, cementing an environmental culture demands solid and constant efforts where, beyond legislative contexts, the intervention of dynamic actors of society is necessary, as is the case of higher education institutions.        El impuesto al consumo de bolsas plásticas, como parte de los tributos ambientales, es una medida legislativa generada como estrategia para desincentivar el uso del plástico por parte de los consumidores finales, la cual, si bien tiene unos costos asociados, tiene como propósito fundamental generar conciencia social por encima de recaudo. De esta manera, el presente manuscrito, de enfoque mixto y alcance descriptivo, expone los resultados de la investigación realizada desde el programa de Especialización en Gerencia Tributaria de la Universidad de la Amazonia, respecto a la percepción de los comerciantes de grandes y medianas superficies del centro de Florencia, Caquetá, alrededor del impuesto en cuestión. Los hallazgos demuestran, mayoritariamente, que existe conciencia social y respeto por la naturaleza. Sin embargo, cimentar una cultura ambiental demanda de esfuerzos sólidos y constantes donde, más allá de contextos legislativos, se hace necesario la intervención de actores dinamizadores de la sociedad, como es el caso de las instituciones de educación superior

Glucose Levels as a Mediator of the Detrimental E ect of Abdominal Obesity on Relative Handgrip Strength in Older Adults

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation e ect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative e ect on fasting glucose ( ß = 9.04, 95% CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related ( ß = -0.003, 95% CI = -0.005 to -0.001), p < 0.001. The direct e ect of abdominal obesity on relative HGS was statistically significant ( ß = -0.069, 95% CI = -0.082 to -0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental e ect of abdominal obesity on relative HGS (indirect effect = -0.002, 95% CI = -0.004 to -0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass

EL SECTOR ENERGÉTICO COLOMBIANO: EL CASO DE LAS ZONAS NO INTERCONECTADAS VISTO A TRAVÉS DE LA INNOVACIÓN LIGERA

Las necesidades energéticas de un país, en conjunto con la forma en la ellas se suplen, determinan en gran medida las posibilidades de desarrollo que tiene el mismo. Sin embargo, no basta con simplificar el problema a un balance entre oferta y demanda energética, sino que un análisis en donde se contemple el tipo de fuentes y usos que se le dé a la misma permite identificar fortalezas en varios frentes, así como también la detección de alertas que pueden contribuir a atender carencias que enfrentan algunos sectores de la sociedad, a través del refinamiento de políticas que surgen de los tomadores de decisiones

Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

Background Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. Methods A cross-sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to ‘SABE Survey 2015’. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). Results Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and nonsarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non-sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (β = 0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect ( 0.009 to 0.004). Conclusions The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia

Uso de patrones de difracción de luz láser y análisis de imagenes para diferenciación de tres tipos de colonias bacterianas

La diferenciación rápida de colonias bacterianas es esencial en muchos campos industriales, científicos y de salud humana y animal. Generalmente esa diferenciación se logra por técnicas microscópicas, bioquímicas o genéticas muy elaboradas que requieren tiempo y entrenamiento. En este estudio se utilizaron técnicas de análisis de imágenes sobre patrones de difracción de luz láser para evaluar su sensibilidad en la diferenciación de colonias bacterianas. Adicionalmente se estudió el efecto del tiempo de crecimiento de las colonias en la generación de estos patrones y se determinó la influencia de la cantidad de medio de cultivo en la difracción de luz láser. Los patrones de difracción del láser se obtuvieron sobre cultivos puros de cinco aislamientos bacterianos B1, B2, B3, B2Ca y B2Cb. En la primera prueba de diferenciación se utilizaron colonias de B2, B3, B2Ca. En el estudio del efecto del tiempo de crecimiento sobre patrones de difracción, las bacterias B1 y B2Cb con uno o dos días de crecimiento. Finalmente, el efecto de la cantidad de medio de cultivo en la difracción de la luz, se evaluó en una prueba en cajas petri con 10, 15 o 20 ml de medio de cultivo estéril sin colonias de bacterias. Mediante un análisis de escalado multidimensional realizado con los parámetros de textura extraídos de las imágenes de los patrones, se obtuvo un agrupamiento adecuado de los patrones asociados a las colonias de cada bacteria evaluada, lo cual indicó que las colonias bacterianas se pueden diferenciar por sus patrones de difracción. Adicionalmente se encontró que no hay variaciones significativas en los patrones de difracción obtenidos de dos aislamientos bacterianos en dos tiempos de crecimiento. El espesor del medio de cultivo afectó la difracción del haz de luz pues patrones obtenidos de cajas petri con 10 ml se separan completamente de los patrones obtenidos con 15 y 20 ml, aunque no hay diferencias entre los dos últimos volúmenes. Los resultados indican que esta técnica sencilla parece ser altamente sensible para diferenciar colonias bacterianas en medios de cultivo, y su refinamiento e implementación para investigación o uso industrial podría lograrse a partir de materiales fácilmente disponibles a nivel local

Role for physical fitness in the association between age and cognitive function in older adults: a mediation analysis of the SABE colombia study

Objectives. We investigated the association between physical fitness and cognitive status. Further, we examined whether physical fitness mediates the association between cognitive functioning and aging. Design. Cross-sectional study. Setting. Urban and rural Colombian older adults. Methods. 4416 participants from the SABE study were included in the current analysis. Physical fitness was assessed with the handgrip test and the usual gait speed test. Cognitive status was evaluated through the Folstein Mini-Mental State Examination. A parallel mediation path was used to test the possible mediator role of physical fitness between aging and cognitive functioning. Results. Older adults with lower handgrip strength (HGS) were more likely to have mild-cognitive status than older adults with healthy HGS (OR = 1.53, 95% CI = 1.15; 2.02). In addition, older adults with a slower gait speed were more likely to have mild cognitive impairment (OR = 2.05, 95% CI = 1.54; 2.78). Age had an inverse relationship with cognitive function (β = -0.110, 95% CI = -0.130; -0.100) and it was also inversely associated with HGS (β = -0.003, 95% CI = -0.005; -0.002) and gait speed (β = -0.010, 95% CI = -0.011; -0.009). The indirect effects, which indicate that the effect of age on cognitive function is transmitted through mediators, showed that both gait speed (β = -0.028, 95% CI = -0.036; -0.020) and HGS (β = -0.014, 95% CI = -0.024; -0.005) were independent mediators of the detrimental effect of aging on cognitive function. Conclusions. Physical fitness mediates the effects of aging on cognitive functioning. Our findings suggest that physical activity can be a key factor to prevent cognitive deterioration during aging process.The study was funded by the Ministry of Health and Social Protection of Colombia Colciencias contract No. 764 of 2013. Robinson Ramírez-Vélez training grant (ID420) as a postdoctoral research fellow with the Universidad Pública de Navarra (UPNA)

Validation of surrogate anthropometric indices in older adults: what is the best indicator of high cardiometabolic risk factor clustering?

Incluye correccionesThe present study evaluated the ability of five obesity-related parameters, including a body shape index (ABSI), conicity index (CI), body roundness index (BRI), body mass index (BMI), and waist-to-height ratio (WtHR) for predicting increased cardiometabolic risk in a population of elderly Colombians. A cross-sectional study was conducted on 1502 participants (60.3% women, mean age 70 ± 7.6 years) and subjects’ weight, height, waist circumference, serum lipid indices, blood pressure, and fasting plasma glucose were measured. A cardiometabolic risk index (CMRI) was calculated using the participants’ systolic and diastolic blood pressure, triglycerides, high-density lipoprotein and fasting glucose levels, and waist circumference. Following the International Diabetes Federation definition, metabolic syndrome was defined as having three or more metabolic abnormalities. All surrogate anthropometric indices correlated significantly with CMRI (p < 0.01). Receiver operating characteristic curve analysis of how well the anthropometric indices identified high cardiometabolic risk showed that WtHR and BRI were the most accurate indices. The best WtHR and BRI cut-off points in men were 0.56 (area under curve, AUC 0.77) and 4.71 (AUC 0.77), respectively. For women, the WtHR and BRI cut-off points were 0.63 (AUC 0.77) and 6.20 (AUC 0.77), respectively. In conclusion, BRI and WtHR have a moderate discriminating power for detecting high cardiometabolic risk in older Colombian adults, supporting the idea that both anthropometric indices are useful screening tools for use in the elderly

Escalas de uso frecuente en geriatría

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