issue_article
Publicar Desde América Latina: Hay un Grado de Dificultad Mucho Mayor. Experiencias de un Investigador Extranjero en el Ecuador. Publishing From Latin America, A Difficult Endeavor. Experience From A Foreigner In Ecuador.
Palabras clave: Publicaciones,
Síndrome de Guillain-Barré: Comportamiento Actual En El Perú Guillain-Barré Syndrome: Current Behavior In Peru.
Palabras clave: Guillain Barré,
Influencia del Estrés Crónico y de la Masticación Sobre el Dolor. Influence Of Chronic Stress And Chewing Over Pain.
Introduction: Chronic stress and mastication affect the response to pain; however, there is little knowledge about the relationship between these variables.
Objective: Determine the influence of chronic stress and mastication on the response to pain.
Methods: thirty-two 8-week-old male Balb/c mice were used. The sample was divided into 4 equal groups: Group N: normal mastication without stress; Group NE: Normal chewing + stress, Group D: deficient chewing without stress and Group DE: Poor chewing + stress. The response to the painful stimulus was evaluated through the tail withdrawal assay due to a thermal stimulus.
Results: By comparing the 4 experimental groups to the fourth and the eighth week through the ANOVA test yielded a value of p = 0.982 and p = 0.176; respectively. By applying the ‘t’ student, within each group, in comparison of the variation of the pain response between the fourth and eighth week, the values of p = 0.52; p = 0.17; p = 0.84 and p = 0.069 were obtained for the group N, NE, D and DE respectively.
Conclusion: Chronic stress and mastication do not modify the response to pain in albino Balb/c mice.
Leer artículo completo
Palabras clave: dolor,
Estrés crónico,
masticación,
neurociencias experimentales,
respuesta dolorosa,
Arterial Stiffness Is Not Independently Associated With Nighttime Sleep Duration In Community-Dwelling Older Adults. Results From The Atahualpa Project. La Rigidez Arterial no se Encuentra Asociada con la Duración del Sueño Nocturno en Adultos Añosos Que Viven en la Comunidad. Resultados del Proyecto Atahualpa.
Objectives: We aimed to assess the association between arterial stiffness and nighttime sleep duration in community-dwelling older adults living in rural Ecuador.
Methods: Aortic pulse wave velocity (PWV) determinations were used to assess arterial stiffness. Nighttime sleep duration was assessed by a single question. A generalized linear model—adjusted for demographics, cardiovascular risk factors and psychological distress—was fitted to assess the independent association between the aortic PWV and nighttime sleep duration (dependent variable).
Results: A total of 303 individuals were enrolled. Univariate analysis showed a significant association between the aortic PWV and long sleep duration (p=0.034), which vanished in a multivariate linear model (p=0.524). The single covariable remaining significant was anxiety (p=0.013).
Conclusion: Lack of independent association between arterial stiffness and nighttime sleep duration might be more likely related to lack of reliability of evaluation of sleep duration by means of a single question.
Leer artículo completo
Escala Reducida Para Valorar el Sentido de Coherencia: SOC 15 Scale Reduced To Value The Sense Of Coherence: SOC 15
Introduction: The sense of coherence is a construct of health that allows the individual to face difficult situations of life. It is configured by three factors: meaning, understanding and management. As a method of assessment of this construct, has been proposed the SOC scale with 29 items in its original version.
Objective: The objective of this study is to propose a reduced SOC scale.
Methods: We worked with a sample of 445 healthy participants from Quito-Ecuador, 145 men (32.5%) and 300 women (67.4%).
Results: It was obtained that the reduced scale of 15 items presents an adequate internal consistency in its three factors: understanding α= .74, management α= .82 and meaning α= .82. In the confirmatory factor analysis, an acceptable adjustment of the reduced model was found (SOC-15) x2= 317.90, DF= 87, p= <. 001, CFI= .92, RMSEA= .07 (.06-.08) and SRMR= .04.
Conclusions: The data is discussed in relation to the benefits of counting with a reduced scale for its future application in the clinical and health scientific context.
Leer artículo completo
Palabras clave: Comprensión,
psicometría,
salutogénesis,
sentido de coherencia,
significado,
SOC-15,
Meningitis Criptocócica. Diferentes Contextos Clínicos y Complicaciones. Serie de 7 Casos. Cryptococal Meningitis. Different Clinical Context And Complications. Seven Cases.
Introduction. Cryptococcal meningitis (CM) is a serious infection of the Central Nervous System. The diagnosis and treatment of these patients is often complex, due to the severity of the clinical manifestations and their complications. The aim of this study is to describe the different clinical contexts, the neuroradiological characteristics and the complications of patients with CM.
Patients. We performed a retrospective review of clinical and radiological factors of 7 patient’s diagnosis and treated with CM during the period October 2016 and September 2017, at the Eugenio Espejo Hospital.
Results. Male sex was predominant (6/7), with an average age of 31.6 years (Range 19-44). The average time for the diagnosis was 8.1 weeks. Immunosuppression causes were evidenced in 5 patients, two HIV positive, one case with Acute Lymphoblastic Leukemia, CD4 idiopathic lymphopenia and Primary Intestinal Linfagectasia respectively. Three patients developed complications as disseminated cryptococcosis, visual acuity and hearing loss, mortality rate reach 26.8% of patients. Hypoglycorrhachia was a relevant feature with average 12.7mmg / dl. In MRI, the most common lesion was dilatation of Virchow Robins spaces (5/7), followed by ischemic lesions.
Conclusions. CM is characterized for high morbidity and mortality, initial symptoms may be nonspecific and delays the diagnosis as well as initiation of antifungal agents. Several predisposing immunosuppressive conditions can be found and sometimes a diagnostic challenge.
Leer artículo completo
La Autorregulación en la Primera Infancia: Avances Desde la Investigación. Self-Regulation In Early Childhood: Advances From Research.
A robust body of literature confirms the importance of developing the skills of self-regulation (working memory, attention and inhibitory control) from the early years, considering their impact on the achievements of the present and future success (eg adaptation to the school context, academic achievements, social participation). The aim of this review is to summarize the information on neuroscientific research on the topic of self-regulation, between 2000 and 2019, which has provided information to better understanding: (1) development processes between 0 and 8 years of age, each of these skills mentioned and (2) some of the factors involved in this process. The results confirm that both the chronological maturity and the experiences of the children will favor the optimal development of these skills. Additionally, each skill emerges and takes roots according to its own processes and time frames, turning into behavioral and neurological manifestations. Relevant factors can be either biological or contextual/social that will influence how these skills are developed and expressed in everyday life.
Leer artículo completo
Palabras clave: autorregulación; primera infancia; desarrollo,
neurociencia cognitiva,
Relación del Estado Nutricional con el Desarrollo Cognitivo y Psicomotor de los Niños en la Primera Infancia. Relationship Between Nutritional Status And Cognitive And Psychomotor Development Of Children In Early Childhood.
Gestation, the first years of life and nutritional status are important role in physical, psychosocial, emotional and cognitive development in childhood and adolescence. Different investigations have found a relationship between nutritional status with better cognitive performance, although conversely, malnutrition in these stages can cause imbalances between nutritional needs that could lead to obesity or malnutrition and influence cognitive development. The aim of this article was to review the relationship between nutritional status and cognitive and psychomotor development of children in early childhood. The method was systematic review in the databases ProQuest, Redalyc, Science Direct and Scopus in the years 2013-2018. This article concludes that both the intellectual capacity and the development of fine and gross motor skills depend on the nutritional status of infants and therefore a relationship between nutrition and psychomotor and cognitive development is suggested.
Leer artículo completo
El Perfil Epidemiológico y Clínico de la Esclerosis Múltiple en el Ecuador. The Clinical And Epidemiological Profile Of Multiple Sclerosis In Ecuador.
In recent years, the number of publications on Multiple Sclerosis (MS) from Ecuador has seen a significant increase. As a result, the research on the clinical and epidemiological behaviour of the disease has allowed us to make comparisons with other cohorts of patients with MS that come from regions where the prevalence of the disease is high. Nevertheless, Ecuador is still a country in which the prevalence of MS is low with a prevalence that fluctuates between 3 to 5 cases per 100,000 inhabitants. The epidemiological behaviour of MS is very similar to that of european cohorts, for example female patients are the most affected. However, the clinical behaviour of multiple sclerosis differs in terms of cognitive impairment and fatigue being less frequent. The impact of vitamin D on patients with MS is still unknown as only one study has been carried out. This study show that there is a high prevalence of vitamin D deficiency and insufficiency in ecuadorian patients, but this does not translate into an increase in prevalence or disability as it does in european populations. Although we have a better understanding of the disease in the country, more studies are necessary, and it is imperative that all ecuadorian patients with MS be included in future studies in order to improve our knowledge about the behaviour of this disease in our region.
Leer artículo completo
Infección por el Virus Linfotrópico de Células T Humano HTLV-1 y Paraparesia Espástica Tropical en Ecuador: Paradigma de Enfermedad Tropical Desatendida. Human T-Lymphotrophic Virus Infection (HTLV-1) And Tropical Spastic Paraparesis: Paradigms Of An Overlooked Tropical Disease.
The human T cell lymphotropic virus (HTLV-1) infection is considered endemic in South America. For more than two decades clinical cases of HTLV-1 associated mielopaties have been reported in Ecuador, pathology known as tropical spastic paraparesis. There is only two studies about HTLV-1 seroprevalence in Ecuador, both of them with small sample size but showing a high prevalence of HTLV-1 infection, at least for afrodescendants and indigenous communities. However, there is not a currently screening for blood and organ banks carried out by ecuadorian public health authorities. This scenario makes HTLV-1 infection and associated pathologies (like tropical spastic paraparesis) neglected diseases in Ecuador. More epidemiological studies need to be implemented in order to develop control and prevention strategies in the country.
Leer artículo completo
Las Aquaporinas y el Sistema Nervioso Central. Aquaporins and Central Nervous System.
The discovery of aquaporins, which constitute a family of integral membrane proteins, has meant a change with respect to the understanding of water transport in biological membranes. The most important is aquaporin 4 (AQP4) which we will focus on below, although there are two other aquaporins, 1 and 9. These aquaporins are of great importance in the physiology of cell volume control and osmotic control mechanisms of the cells. Also in the control of the flow of glycerol and other solutes. In addition, alterations in its functioning have been related to various diseases of the central nervous system such as neuromyelitis optics, cerebral edema, idiopathic intracranial hypertension or chronic hydrocephalus of the adult among others. A review is made on this topic.
Leer artículo completo
Palabras clave: Aquaporin 1,
Aquaporin 4,
Aquaporins,
central nervous system,
Cerebrospinal fluid,
Intracranial hypertension,
Escala de Observación Clínica Para Valorar la Tercera Unidad Funcional de la Teoría de Luria: EOCL-1. Scale Of Clinical Observation To Valuate The Third Functional Unit Of The Luria Theory: EOCL-1.
Luria’s brain organization model proposes the interaction of three functional units to understand the work performed by the human brain. The first of them is responsible for the regulation of tone and wakefulness. The second one to receive, process and store the information. The third, and of central interest of the investigation, is responsible for programming, executing and verifying mental activity. To evaluate this theory, a series of experimental neuropsychological tests have been developed, however, a scale has not been proposed that, based on the theoretical precepts on the third functional unit, allows to assess it based on the behaviors of the daily life of the human being. This research proposes a scale that will allow the clinician to assess the mental abilities associated with the ability to program, execute and verify the most complex form of mental activity; integrated in the third functional unit of Luria. The proposal is discussed, based on the benefit that is generated by having a scale that will allow to assess this theory, in the different environments where the individual develops through the action of the cerebral abilities of the third functional unit.
Leer artículo completo
Funcionalidad de la Marcha en la Calidad de Vida Relacionada con la Salud en Adultos con Enfermedad Cerebro Vascular: Revisión Sistemática – Metaanálisis. Functionality Of The Gait In The Quality Of Life Related To Health In Adults With Stroke: Systematic Review – Metaanalysis.
Introduction: Stroke causes deficiencies that affect movement; these include deficit in motor function, reflex integrity, sensory integrity, and gait.
Objective: determine the effect of gait functionality on health-related quality of life in adults with Stroke.
Method: databases PUBMED / MEDLINE, EMBASE, LILACS, SCIELO, Central Cochrane Registry of Controlled Trials (CENTRAL) were consulted between November 2016 and February 2017. Randomized clinical trials were selected. For the analysis, the methodological quality was evaluated using the Physiotherapy Evidence Database, PEDro score and the Risk of bias with the Review Manger 5.3 (RevMan) criterias, also RevMan was being used for analysis and data extraction according to the eligibility criteria.
Results: Lokomat as a rehabilitation strategy for gait functionality has a positive effect on improving the quality of life in people with stroke. The analysis of the included studies demonstrated a low level of statistical heterogeneity based on I2 and Chi2, for the global scale of quality of life. The results obtained for quality of life related to health, when the proposed intervention is carried out with the use of Lokomat and measured with the SF-36 scale, an increase of 1.83 points.
Conclusions: The rehabilitation of gait functionality through different protocols and intervention strategies does not present differences, due to its variability in terms of technique, application method, clinical involvement of stroke and the duration of its application. However, clinical changes that favor quality of life related to health are observed.
Leer artículo completo
Palabras clave: Accidente Cerebrovascular,
Adulto,
Anciano,
Balance postural,
calidad de vida,
marcha,
Persona de mediana edad,
Síndrome de Sturge-Weber: Reporte de un Caso y Revisión de la Literatura. Sturge-Weber Syndrome: A Case Report And Literature Review.
Sturge-Weber Syndrome is a rare developmental neuroectodermical disorder. It is characterized by a facial port-wine stain and a leptomeningeal angiomata, frequently localized ipsilateral to the facial port-wine stain. This syndrome predisposes either to brain atrophy, calcifications and refractory seizures.
In this paper a Sturge-Weber Syndrome literature review was made and a 18 month aged child case with this diagnosis is reported. He was admitted to the emergency department of a local hospital with a history of three days of fever and tonic-clonic seizures localized on the right side and refractory to conventional treatment.
This review highlights the importance of an early diagnosis and an appropriate follow up. To carry out this review a search in PubMed, Science Direct and Scielo databases was done, confirming that there are some issues about this disorder that are still unknown. However, with the GNAQ somatic mutation discovery, there is an open field for new researches. It is very important in medical practice not to understimate a facial port-wine stain over trigeminal territory in newborns in order to make an early diagnosis and try to achieve a better future neurodevelopment.
Leer artículo completo
Síndrome de Fahr Secundario a Hiperparatiroidismo Primario e Isquemia Cerebral: A Propósito de un Caso. Fahr Syndrome Secondary To Primary Hyperparathyroidism And Cerebral Ischemia: A Case Report.
Fahr’s syndrome (FS) is a rare neurodegenerative condition, characterized by cerebral calcifications mainly in the basal ganglia. Although its most common presentation are the disorders of movement, cognition, behavior and epilepsy, in recent years cases of cerebrovascular disease (CVD) related to this entity have been appearing.
We report a 59-year-old male patient who presented 2 transitory ischemic attacks (TIAs), the 1st of 5 minutes, of speech alteration what happened unnoticed, and the second of 45 minutes, 2 weeks later, of speech alteration, loss of muscle strength and tingling sensation in the left side of the body. Brain computed tomography and magnetic resonance imaging revealed calcifications suggestive of FS and a treatable cause was found (primary hyperparathyroidism with hypovitaminosis D). The patient was treated with aspirin, atorvastatin and colecalciferol without vascular recurrence and the levels of vitamin D and PTH normalized. Although the association between CVD in young people and SF has not yet been determined, the occurrence of these cases leads us to suspect that ischemic CVD could be part of the natural history of this entity. Being the prevalence of FS unknown, we alert clinicians to keep CVD in mind as a form of presentation of this condition. We review the association between FS and ischemic CVD (without in clusion of aneurysmal disease).
Leer artículo completo
Revistas Predatorias, Que Son y Como Evitarlas. Predatory Journals: What They Are And How To Avoid Them.
The progress of humanity goes hand in hand with the production of new scientific knowledge. To carry out an investigation has as its ultimate purpose to fill an information gap in the endless and dynamic universe of knowledge. It is said that unpublished information is non-existent information and this assertion is the one that provokes a frenzy within the researchers to look for opportunities to publish their results. This growing demand becomes an opportunity for those who seek to profit from the needs of teachers, researchers, students and professionals in general who try to publish their results every day.
It is currently estimated that there are more than 10,000 journals that seek to publish results in exchange for money, with a non-existent or a very brief peer review, known as predatory journals. They multiply exponentially and endanger the credibility of the science worldwide. In this brief editorial we seek to explain what predatory journals are, how to identify them and how to avoid them within the context of scientific production in the medical field.
Leer artículo completo
Factores Asociados a la Mortalidad de la Hemorragia Cerebral Intraparenquimatosa Espontánea en Pacientes Mayores de 50 Años de Edad que Acudieron al Hospital Teodoro Maldonado Carbo Durante el Año 2017. Factors Associated With Mortality Of Spontaneous Intraparenchymal Cerebral Hemorrhage In Patients Over 50 Years Old Who Attended The Teodoro Maldonado Carbo Hospital During 2017.
Objective. To determine the factors associated with the mortality of spontaneous intraparenchymal cerebral hemorrhage in patients over 50 years old who attended the Teodoro Maldonado Carbo Hospital during 2017.
Methods: A retrospective analytical observational study of 92 patients of diagnosis of spontaneous primary intraparenchymal hemorrhage, 30-day mortality was evaluated according to demographic characteristics, risk factors and poor prognostic factors. The Intracerebral Hemorrhage Grading Scale (ICH-GS) scale was applied in our population to evaluate the correlation of the scores obtained with the 30-day mortality.
Results: From 92 patients (mean age: 69 years, mean Glasgow Coma Scale [GCS] on admission: 10, mean supratentorial and infratentorial volume, respectively 36.63 and 13.92 ml, most common hematoma location: thalamus (21.74%). at 30 days it was [31.40%]). In a univariate analysis, GCS (odds ratio [OR] = 2.20, 95% confidence interval [CI] = 1.04- 4.65, p <0.04), infratentorial volume (OR) = 3.74 per ml, 95% CI = 1.25 to 11,120, p <0.02) and the ventricular extension was (OR = 5.43, 95% CI = 1.40-22.35, P = 0.02) were significant predictors for 30-day mortality The Pearson correlation showed correlations of 0.6556 between the IC-GS score and the 30-day mortality (P <0.001).
Conclusions: The GCS score at admission together with infratentorial volume and intraventricular extension are significant predictors of 30-day mortality in patients with primary spontaneous Intracerebral Hemorrhage (ICH) being useful for identifying high-risk patients in the short term.
Leer artículo completo
Palabras clave: escala de ICH-GS,
Hemorragia cerebral; pronóstico; factores de riesgo,
Ausencia de Asociación Entre la Posición de la Lengua Tipo IV de Friedman y Apnea Obstructiva de Sueño en Adultos Mayores con Ancestro Amerindio. Lack Of Association Between The Friedman’s Tongue Position Type IV And Obstructive Sleep Apnea In Older Adults Of Amerindian Ancestry.
Background: The burden of obstructive sleep apnea (OSA) in rural settings is unknown. In these regions, devices needed for OSA diagnosis are not available, and mass screening with field instruments may be complicated due to cross-cultural factors and illiteracy. The association between the Friedman’s tongue position (FTP) and OSA has been assessed in people from different ethnic groups but not in Amerindians.
Objective: We aimed to assess whether a FTP type IV is associated with OSA severity and with the apnea-hypopnea index (AHI) in community-dwelling older adults of Amerindian ancestry living in rural Ecuador.
Methods: A total of 201 Atahualpa residents aged ≥60 years, who underwent tongue position assessment, brain MRI, and polysomnography were included. After adjusting for relevant confounders, ordinal logistic regression models were fitted to assess the association between the presence of a FTP type IV and OSA categories (none, mild, and moderate-to-severe), and generalized linear models with a Gaussian link were fitted to assess the association between the presence of a FTP type IV and the continuous AHI.
Results: A FTP type IV was identified in 153 (76%) individuals, the mean AHI per hour was 11.9 ± 12.4, and 49 (24%) individuals had moderate-to-severe OSA, 88 (44%) had mild OSA, and the remaining 64 (32%) had no OSA. Fully-adjusted generalized linear models showed no independent association between the investigated exposure and the AHI (β: 0.09; 95% C.I.: -1.56 – 1.76; p=0.909). Likewise, ordinal logistic regression models showed no independent association between the investigated exposure and categories of OSA (β: 0.42; 95% C.I.: -0.47 – 1.31; p=0.357).
Conclusion: A FTP type IV is not associated with the AHI or the severity of OSA in this population of Amerindians. This lack of association could be related to phenotypic characteristics of people from this ethnic group (mostly their elliptic hard palate).
Leer artículo completo
Adherencia al Tratamiento Antiepiléptico en Pacientes Pediátricos del Hospital Roberto Gilbert Elizalde en el Año 2014. Adherence To Antiepileptic Treatment In Pediatric Patients At Hospital Roberto Gilbert Elizalde During 2014.
Introduction: Epilepsy in the pediatric population is an entity that mostly affects underdeveloped countries. In Ecuador, hospital admissions due to poor control are increasing and the main cause is poor adherence to antiepileptic treatment.
Objective: To demonstrate the incidence of nonadherence to the antiepileptic regimen and determine the factors that contributes to it.
Materials and methods: A cross-sectional study was conducted in which 119 patients were included with ages between 6 months and 17 years. The parents or legal guardians were questioned regarding the degree of adherence to antiepileptic treatment using the Morisky questionnaire. A logistic regression model was used to measure the strength of association between variables.
Results: An incidence of non-adherence to antiepileptic treatment of 36.97% was found. The significantly associated variables were the mother’s schooling (x2=11.83, IC= 10.13 – 13.53, p=0.018), previous medical information (x2=9.35, IC= 7.95 – 10.75, p=0.02) and the failure to obtain medication due to lack of money (x2=5.98, IC= 5.29 – 6.67, p=0.01).
Conclusion: The incidence of nonadherence in this study was high; control over sociodemographic factors and related to treatment can have a great impact on these patients.
Leer artículo completo
Frecuencia de Casos Juveniles con Enfermedad de Huntington en Población Mexicana. Frequency Of Juvenile Huntington’s Disease In A Mexican Population.
Objective. The purpose of this study is to know the prevalence of juvenile cases in a sample of mexican subjects with confirmed Huntington Disease (HD).
Methods. Patients with clinical debut before 21 years of age were included who attended at movement disorders clinic of the National Institute of Neurology and Neurosurgery. The demographic and clinical information was obtained from the review of files.
Results. A total of 198 cases of patients diagnosed with HD were reviewed, of which 6.5% (n = .13) corresponded to juvenile forms. The mean age for the onset of symptoms was 17.8 ± 3.9 years. The mean score of the UHDRS-motor was 46.2 ± 17.4 points. The predominant motor symptom was chorea in (53.8%) of the cases. 84.6% of those affected presented at least one neuropsychiatric disorder.
Conclusion. It was detected that the dominant motor phenotype of these patients was chorea compared to the world reports until now, accordingly to that, our group of juvenile HD shows atypical motor clinical.
Leer artículo completo
Fibrinólisis Farmacológica en el Ictus Isquémico Agudo. Experiencia en un Hospital Terciario del Ecuador. Pharmacological Thrombolysis In Ischemic Stroke. Experience In A Tertiary Hospital From Ecuador.
Introduction. Pharmacological thrombolysis in ischemic stroke is associated with a better recovery.
Objective. Describe the thrombolysis results after using r-Tpa applying an intrahospital stroke code, during one year.
Methods. A prospective, longitudinal study was performed in patients with cerebral infarction admitted to the stroke unit, with clinical follow-up up to 3 months after hospital discharge. The variables evaluated were compared in two groups of patients (only one group received the treatment).
Results. 107 patients were studied: 16 (14.9%) were thrombolyzed, 29 (27.1%) arrived in the therapeutic window period and 76 (71%) arrived after 4.5 hours. The average age was 68, 8 years and women predominated. The greatest impact of thrombolysis was on the difference in score between the initial assessment and the discharge on the NIHSS scale. At three months of evolution, the percentage of patients with mild disability (Rankin 0-2) was almost equal in the two groups. Mortality increased in patients with more severe disability (Rankin 3-5).
Conclusions. Treatment with r-Tpa shows benefits at hospital discharge. Further analysis is required with a greater number of cases.
Leer artículo completo
Palabras clave: Accidente Cerebrovascular,
Ecuador,
Fibrinólisis,
infarto cerebral,
Terapia Trombolítica,
Efectividad del Foto-Test Frente al MMSE, Para el Cribado del Deterioro Cognitivo en Población Peruana. Effectiveness Of The Photo-Test Front Of The MMSE, For The Screening Of Cognitive Deterioration In Peruvian Population.
The progressive increase of Alzheimer’s disease has generated interest in its early detection with cognitive screening tests being a useful tool, however, they need to be culturally adapted, objective and reliable. In Peru, this need is greater since the educational level of the elderly population is mostly low. The aim of the present study is to know the estimate sensitivity and specificity of FOTOTEST against MMSE for the screening/detection of cognitive impairment, analyzing the relationship of these cognitive tests with one of functional activity. 107 elderly people, aged 60-89 years, were evaluated. The Yesavage scale for geriatric depression was used, the functional activities questionnaire of Pfeffer, MMSE, and FOTOTEST. Pearson’s analysis showed a significant positive correlation between MMSE/FOTOTEST (Pearson 0.386, p <0.003), whereas only MMSE showed a significant negative correlation with PFAQ (Pearson -0.320, p <0.013). However, FOTOTEST did not show a significant correlation with PFAQ (Pearson -0.067, p <0.613). In addition, the percentage of effectiveness and specificity estimated for FOTOTEST was 100.00% and 92.68%, respectively, higher than the MMSE, with an estimated percentage of effectiveness being 83.33%, and specificity of 34.14%. We conclude that FOTOTEST would be a more useful test for the detection of cognitive impairment than MMSE.
Leer artículo completo
Las Curvas Para Medir Circunferencia Cefálica y las Potenciales Diferencias Antropométricas en Latinoamérica y el Mundo. Cephalic Circumference Curves And Potential Anthropometric Differences In Latin America And The World.
The cephalic circumference (CC) is a measurement that detects alterations in the proper growth of the brain. CC curves most used worldwide are those proposed by the CDC, NCHS and WHO. Despite criticism of the methodology used to create them, updates have been made to correct inconsistencies, and that has helped to detect and treat on time problems of cranial size at both the small (microcephaly) and large (macrocephaly) ends. Several authors have suggested that regional reference curves should be made, and others, like Kenton Holden and colleagues, have proposed new curves that consolidate different databases, aiming to reduce the risk of errors in the diagnosis of microcephaly or mild macrocephaly. It is necessary to study what the normal cranial growth pattern of Latin American children is for each region or country, as well as to determine the interethnic differences.
Leer artículo completo
La Actividad Embrionaria Espontánea de las Redes Neuronales y su Función en la Maduración Sináptica. Embryonic Spontaneous Network Activity And Its Role On Synaptic Development.
Embrionic neural networks exibit a temporary special form of electrical activity known as Spontaneous Network Activity (SNA). SNA occurs as soon as synaptic conections are stablished and consists on synchronized action potential firing for most of the neurons on the network, followed by long silents periods where network excitability is gradually recovered till a new SNA episode can happen. This kind of neural activity allows a high level of synchronization among neurons on developing networks, contributing to synaptic connection and maturation. SNA has been described in several regions of the developing nervous system due to conserved properties among developing neural networks: redundant intercellular connectivity and the fact that the neurotransmitter gamma-aminobutiric acid (GABA) is excitatory during early embryonic development (GABA is inhibitory in the adult nervous system).In this review we discuss the hypothesis that SNA contributes to synaptic strenght for glutamatergic and gabaergic synapsis while both of them are excitatory, by using the same synaptic plasticity mechanism known as homeostatic plasticity.
Leer artículo completo
Telesalud y Telemedicina para el Manejo de la Epilepsia. Telehealth and Telemedicine for the Management of Epilepsy.
Introduction. Epilepsy is one of the most frequent chronic neurological diseases, with figures close to 70 million cases worldwide; for which telehealth and telemedicine are framed as promising models that can bring multiple benefits.
Objective. To evaluate the initial schemes that have been proposed from telemedicine and telehealth in the management of the patient with epilepsy and the benefits that they have in the management.
Methods. A search of scientific literature was carried out in (PubMed, Cochrane library and LILACS). Different models of telehealth and telemedicine implemented in the management of patients with epilepsy are presented and the main benefits in terms of acceptability, costs and clinical results are described.
Conclusions. Current research of these models of care for the management of patients with epilepsy has the potential to effectively reduce the diagnostic and treatment gap, with the possibility of reducing costs in care for the institutions, the health system, patients and their families and harmoniously integrate with education in the self-control of the disease. Proving that there is a need for a more personalized approach to stimulate the use of these tools.
Leer artículo completo
Palabras clave: ensayos clínicos,
Epilepsia,
estudios observacionales,
Telemedicina,
teleneurología,
telesalud,
Pruebas Terapéuticas con Fines Diagnósticos en Trastornos del Movimiento. Therapeutic Tests For The Diagnosis Of Movement Disorders.
El diagnóstico en medicina tiene su piedra angular en la obtención de la historia clínica y la exploración física; sin embargo, en algunas de las patologías el uso de pruebas diagnósticas es de gran utilidad como apoyo para confirmar o descartar una enfermedad. Las pruebas diagnósticas incluyen una amplia variedad de procedimientos y dentro de estas se incluyen las pruebas terapéuticas, también llamadas desafíos o retos, en los que se administra una sustancia activa para evaluar la respuesta y apoyar la impresión diagnóstica. En el contexto de los trastornos del movimiento las pruebas terapéuticas más frecuentemente utilizadas son la de levodopa, apomorfina y etanol. En esta revisión se presenta, describe y discute el alcance y utilidad de estas.
Leer artículo completo
Estimulación Magnética Transcraneal “Theta-Burst Intermitente” en un Paciente con Trastorno del Espectro Autista: Reporte de un Caso. Transcranial Magnetic Stimulation “Theta-Burst Intermittent” In A Patient With Autism Spectrum Disorder: Case Report.
Background. Transcranial magnetic stimulation (TMS) is a potential treatment option for autism spectrum disorder (ASD) symptomatology.
Objectives. To determine the efficacy of the TMS intermittent theta-burst stimulation (iTBS) protocol over the left dorsolateral prefrontal cortex (DLPFC) in the management of pathological behaviors associated with ASD.
Patient/Methods. A 10-year-old male diagnosed with ASD by the Autism Diagnostic Observation Schedule (ADOS) presented with a family history of ASD with a younger sister diagnosed with the same disorder. Both magnetic resonance imaging (MRI) and functional MRI (fMRI) scans for emotional paradigms were performed before the iTBS treatment, immediately after the iTBS treatment, and after 6 months of iTBS treatment.
Results. The Autism Treatment Evaluation Checklist (ATEC) reports revealed improvement in communication, cognition, sociability, and behavior scales by 83%, 81%, 72%, and 52%, respectively. The overall score improved by 66% immediately after the treatment and by 55% lasting over a 6-month period. The fMRI revealed the activation of the frontal, parietal, and occipital cortex before iTBS treatment, and a better integration and activation of the frontal, temporal, and occipital cortex after iTBS treatment and persisted after 6 months.
Conclusions. iTBS is a well-tolerated, non-invasive neuromodulation technique that requires relatively less administration than the standard treatment.
Leer artículo completo
Agenesia de la Arteria Carótida Interna: Presentación de dos Casos y Revisión de la Literatura. Agenesis Of The Internal Carotid Artery: Presentation Of Two Cases And Review Of The Literature.
Introduction: Two cases of patients with left internal carotid artery agenesis are presented, the first case with symptoms of open angle glaucoma and ipsilateral cataract and the second case of a patient with tension headache, as well as a review of the literature due to the Low frequency of this development anomaly.
Clinical cases: case 1, A 66-year-old woman with visual disorders associated with cataract and glaucoma in whom, due to suspicion of a carotid fistula, a left internal carotid agenesis was documented, with collaterality through the posterior system, case 2, patient A 58-year-old man with tension headache underwent an MRI where the agenesis of the left carotid artery, segments from C3 to C7, was documented.
Conclusion: Abnormalities in the development of the carotid system occur early in embryogenesis. In relation to the moment in which the alteration occurs, different circulatory patterns have been described. It is possible that the presence of collateral circulation is the reason that the majority of cases are reported asymptomatic from the vascular neurological point of view. Despite being a rare entity, it must be known in order to differentiate it from other conditions and monitor the appearance of associated complications.
Leer artículo completo
Meningioma Intraventricular. Intraventricular Meningioma.
Intraventricular meningioma is an infrequent disorder. We report a case of a 20 years old woman with a clinical picture of headache, nausea, vomiting and gait disorder. Intraventricular meningioma was diagnosed with magnetic resonance and histopathology. A transcortical right parietal surgical approach was performed through ventricular trigone. The procedure was done without complications or sequelae.
