158 research outputs found

    Comportamiento de la escala Parkinsońs Disease - Cognitive Rating Scale (PD - CRS) en patologías diferentes a la enfermedad de Parkinson

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    En el presente estudio se han llevado a cabo dos líneas de investigación con el objetivo de comprobar cómo se comportan dos escalas diseñadas originariamente para pacientes con enfermedad de Parkinson (EP). En la primera línea de investigación hemos analizado cómo se comporta la escala Parkinsońs Disease Cognitive Rating Scale (PD - CRS) en condiciones de deterioro cognitivo diferentes a la EP (Deterioro Cognitivo Leve (DCL) en tres subtipos DCL amnésico, DCL Multidominios y DCL en EP) y en demencia (enfermedad de Alzheimer (EA), Demencia Vascular (DV) y Demencia en EP (EPD)). Si la escala PD - CRS ha demostrado su sensibilidad tanto a la disfunción fronto - subcortical como cortical en la EP, se espera que actúe de la misma manera en otras patologías diferentes, tanto en aquellas que presentan un patrón cortical como en aquellas que el perfil característico es más subcortical. Por tanto, hemos explorado si la escala detectaba el patrón de alteración neuropsicológica típica de la EP o por el contrario, era capaz de detectar el perfil de alteración cognitiva en diferentes patrones de deterioro cognitivo. Para ello, hemos comparado la precisión diagnóstica de la PD - CRS con otras escalas cognitivas no específicas para capturar el deterioro cognitivo en una muestra amplia de sujetos. Los resultados obtenidos han demostrado que la escala PD-CRS es un instrumento válido, es decir, presenta alta sensibilidad y especificidad para evaluar las disfunciones cognitivas presentes en EA, DV, DCL-A y DCL-MD, junto con DCL en EP y EPD. Además, permite distinguir entre dos grandes grupos: pacientes con demencia frente a pacientes que no cumplen criterios diagnósticos de demencia. En la segunda línea de investigación hemos analizado cómo se comporta la escala Parkinsońs Disease Cognitive Functional Rating Scale (PD - CFRS) en condiciones de deterioro cognitivo diferentes a la EP (Deterioro Cognitivo Leve (DCL) en tres subtipos DCL amnésico, DCL Multidominios y DCL en EP) y en demencia (enfermedad de Alzheimer (EA), Demencia Vascular (DV) y Demencia en EP (EPD)). La escala PD - CFRS fue originariamente diseñada para capturar el espectro completo de deterioro funcional asociado al deterioro cognitivo en la EP con el fin de discriminar la funcionalidad en pacientes intactos cognitivamente, con DCL y con demencia. La escala fue creada con el propósito de discriminar la funcionalidad asociada al deterioro cognitivo, minimizando el sesgo que puedan producir los aspectos motores intrínsecos a la enfermedad. La escala ha demostrado ser un instrumento válido y fiable para capturar los cambios funcionales relevantes relacionados con el deterioro cognitivo en la EP. Por lo tanto, en nuestra investigación se comparó la habilidad y precisión diagnóstica de la escala PD - CFRS con la de otras escalas no específicas de AIVD́s en la captura del deterioro funcional relacionado con la disfunción cognitiva en una muestra amplia de individuos con diversos grados y diagnósticos de deterioro cognitivo. Los resultados obtenidos han demostrado que la escala PD-CFRS es un instrumento útil para detectar las alteraciones funcionales que tienen lugar en diferentes condiciones que cursan con deterioro cognitivo y que se comporta de forma similar en los pacientes con alteraciones cognitivas cuando se compara con escalas de reconocida validez. Por lo tanto, podemos concluir a partir de los datos obtenidos en el presente estudio que tanto la escala PD-CRS como la escala PD-CFRS son herramientas útiles y su utilización en la praxis clínica diaria puede suponer un avance científico y clínico.In the present study we have carried out two lines of research in order to check how two scales designed originally for patients with Parkinson's disease (PD) behave. At the first line of research has been analyzed how the Parkinson's disease Cognitive Rating Scale (PD - CRS) behaves under other cognitive impairment conditions different than PD. These conditions are three mild cognitive impairment types (MCI) (amnestic, multidomains, and MCP-PD) and three dementia types (Alzheimer's disease (AD), vascular dementia (DV) and dementia at Parkinson's disease (EPD) The PD-CRS has demonstrated sensitivity to both fronto-subcortical and cortical dysfunctions at Parkinson's disease that is why we expect the same results at other pathologies that have subcortical or cortical profiles. In summary, we have explored if the PD-CRS only detects the PD's typical neuropsychological profile or is able to detect different types patterns of cognitive impairment. In order to evaluate this hypothesis we have compared the PD-CRS accuracy to detect cognitive impairment with other non-specific cognitive scales at a large patients sample. The results have shown that PD-CRS is a valid instrument (has high sensitivity and specificity) to evaluate the cognitive dysfunctions present in AD, VD, MCIa, MCImd, MCI-PD and PDD. Also, allows us to differentiate between two diagnostic categories: patients with dementia versus patients without dementia or patients that not meet dementia's criteria. At the second line of research we have analyzed how the Parkinson's Disease Cognitive Functional Rating Scale (PD-CFRS) behaves at others cognitive impairment conditions different than PD. The pathologies included at this part of the study are the same that ones included at the first part (mild cognitive impairment MCI amnesic, multidomain, MCI-PD, Alzheimer's disease, vascular dementia, and PDD). The PD-CFRS was originally designed to capture the full spectrum of functional impairment associated to Parkinson's disease in order to discriminate the functionality of patients cognitively intact from those with mild cognitive impairment or dementia. This scale was created to discriminate the functionality associated with cognitive impairment avoiding some biases caused by the intrinsic motor aspects of the disease. The scale has proven to be a valid and reliable instrument to capture the relevant functional changes associated to cognitive impairment at PD. Our research compared the PD-CFRS's ability and diagnostic precision to detecting functional impairment at to cognitive dysfunction with other scales not AIVD specifics in a large sample of individuals with varying diagnostics and degrees of cognitive impairment. The results have shown that PD-CFRS scale is a useful instrument to detect functional alterations that occur in different conditions with cognitive impairment. Also has similar results that others scales with recognized validity when evaluate at cognitive impairment's patients. Therefore, we are able to conclude that both the PD-CRS scale and the PD-CFRS are useful tools and their use in daily clinical practice can be a scientific and clinical advancement

    Unexpected online gambling disorder in late-life : a case report

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    Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date. Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy. Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed

    Entrepreneurial intentions and entrepreneurship education to University students in Portugal

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    [EN] This article analyzes entrepreneurial intentions and motivations that encourage university students of Tourism to create their own company. Methodology is based on an empirical study, using a questionnaire adapted from a model of Veciana and Urbano (Actitudes de los estudiantes universitarios hacia la creación de empresas: un estudio empírico comparativo entre Catalunya y Puerto Rico. El emprendedor innovador y la creación de empresas de I + D + I, University of Valencia, pp 35 58, 2004), including the desirability and viability concepts. One hundred and sixty students answered the questionnaire from a total study population of 243 official Tourism degree students of the Superior Institute of Accounting and Management of Porto. This research finds out that the university students have a very positive perception about the desire to create their own company; a 90 % of students express their desire to do it, and 83.5 % express their intention. Moreover, a 57.5 % think that within actual crisis it is more difficult to do than before it. This research lets us get an in-depth study of a student of Tourism degree, finding out his entrepreneurial attitudes. It can be the first step to wake up and encourage students interest for starting up their own business.Del Rio-Rama, MDLC.; Peris-Ortiz, M.; Álvarez García, J.; Rueda Armengot, C. (2016). Entrepreneurial intentions and entrepreneurship education to University students in Portugal. Technology, Innovation and Education. 2(7):1-11. doi:10.1186/s40660-016-0013-5S11127Ajzen I (1991) The theory of plannes behavior. Organ Behav Hum Decis Process 50:179–211Aponte M (2002) Factores condicionantes de la creación de empresas en Puerto Rico: un enfoque institucional. Doctoral dissertation, Autonomous University of BarcelonaAponte M, Urbano D, Veciana JM (2006) Actitudes hacia la creación de empresas: un estudio comparativo entre Catalunya y Puerto Rico. 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    Monolayer Self-Assembly at Liquid-Solid Interfaces: Chirality and Electronic Properties of Molecules at Surfaces

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    peer reviewedThe spontaneous formation of supramolecular assemblies at the boundary between solids and liquids is a process which encompasses a variety of systems with diverse characteristics: chemisorbed systems in which very strong and weakly reversible bonds govern the assembly and physisorbed aggregates which are dynamic thanks to the weaker interactions between adsorbate and surface. Here we review the interest and advances in the study of chiral systems at the liquid-solid interface, and also the application of this configuration for the study of systems of interest in molecular electronics, self-assembled from the bottom up

    Prognostic value of cortically induced motor evoked activity by TMS in chronic stroke: caveats from a very revealing single clinical case

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    Background: We report the case of a chronic stroke patient (62 months after injury) showing total absence of motor activity evoked by transcranial magnetic stimulation (TMS) of spared regions of the left motor cortex, but near-to-complete recovery of motor abilities in the affected hand. Case presentation: Multimodal investigations included detailed TMS based motor mapping, motor evoked potentials (MEP), and Cortical Silent period (CSP) as well as functional magnetic resonance imaging (fMRI) of motor activity, MRI based lesion analysis and Diffusion Tensor Imaging (DTI) Tractography of corticospinal tract (CST). Anatomical analysis revealed a left hemisphere subinsular lesion interrupting the descending left CST at the level of the internal capsule. The absence of MEPs after intense TMS pulses to the ipsilesional M1, and the reversible suppression of ongoing electromyographic (EMG) activity (indexed by CSP) demonstrate a weak modulation of subcortical systems by the ipsilesional left frontal cortex, but an inability to induce efficient descending volleys from those cortical locations to right hand and forearm muscles. Functional MRI recordings under grasping and finger tapping patterns involving the affected hand showed slight signs of subcortical recruitment, as compared to the unaffected hand and hemisphere, as well as the expected cortical activations. Conclusions: The potential sources of motor voluntary activity for the affected hand in absence of MEPs are discussed. We conclude that multimodal analysis may contribute to a more accurate prognosis of stroke patients
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