Efectos del Modelo de Atención Centrado en la Persona en la calidad de vida de personas con deterioro cognitivo de centros gerontológicos

Introduction

The Model of Person Centered Care has attracted increasing interest for use in gerontology centers. Therefore, the contributions about its impact are scarce in our context. The objective of this paper is to establish the impact that the interventions associated with the Model of Person Centered Care in the «Etxean Ondo» Project have on the quality of life of residents with cognitive impairment.

Material and methods

One hundred and ninetten residents with cognitive impairment were selected: 59 in the control group and 60 in the experimental group. Subjects in each group were sorted by cognitive impairment: mild or severe. Changes were implemented in the physical and organizational environments for the promotion of autonomy and wellbeing. Quality of life was assessed before and 6 months after intervention using the Fumat Scales (mild cognitive impairment) and Qualid (severe cognitive impairment). The t-Student test was used for comparison of means.

Results

In intergroup comparisons, significant differences in the Fumat Scale for the control group with mild cognitive impairment were initially identified. These differences were not recorded in the post assessment. The experimental group with severe cognitive impairment was significantly improved in the Qualid Scale post assessment. In intragroup comparisons, significant improvements were evident in the quality of life of experimental subjects, both with severe cognitive impairment (Qualid) and mild (Fumat).

Conclusions

The findings support the effectiveness of the interventions and identify methodological and conceptual issues that have been considered to analyze the Model of Person Centered Care efects.     

Suplementación con yodo durante el embarazo y la lactancia. Toma de posición del Grupo de Trabajo de Trastornos relacionados con la Deficiencia de Yodo y Disfunción Tiroidea de la Sociedad Española de Endocrinología y Nutrición

Severe and mild iodine deficiency during pregnancy and lactation affects thyroid function of the mother and neonate as well as the infant's neuropsychological development. Studies performed in Spain confirm that most women are iodine deficient during pregnancy and lactation. Pregnant and breast feeding women and women planning to become pregnant should take iodine supplements.     

Histoplasmosis en un varón inmunocompetente manifestada 45 años después de la infección

We report a case of a lung reactivation of a latent histoplasmosis in a 68 year-old patient without immunologic dysfunction living in Barcelona (Spain).The Histoplasma capsulatum var. capsulatum infection was probably acquired in a previous stay in Equatorial Guinea 48 years before.Diagnosis of mild chronic pulmonary histoplasmosis was performed by histopathology of lung biopsy plus antibodies detection against H. capsulatum. Treatment with oral itraconazol during three months leaded to a complete clinical cure, and antibodies disappeared after four years of follow up.     

Papel de los biomarcadores en el diagnóstico precoz de la enfermedad de Alzheimer

Alheimer's disease is the most frequent cause of cognitive decline and behavioral abnormalities in adults. Diagnosis is currently made in the advanced phases. An an early diagnosis in the prodromal phase (or earlier if possible) is required for the prevention of this disease, its early management and the development of potential therapies that could alter its natural course. The syndromic concept of mild cognitive impairment (the presence of detectable and quantifiable deterioration in one of the cognitive domains but without affecting -or without substantially affecting- autonomic performance of instrumental function) and its variants has aided understanding of the predementia stages of Alheimer's disease, even though its etiology may involve multiple factors. The use of biomarkers such as determination of the proteins involved in the disease in cerebrospinal fluid (Aβ42-amyloid, total and phosphorylated tau) and measurement of the hippocampus and entorhinal cortex with magnetic resonance imaging and positron emission tomography (both glucose and amyloid measurements), alone or combined, could allow early and etiologic diagnosis. Patients with Alzheimer's disease show reduced Aβ42-amyloid levels and increased total and phosphorylated tau levels in cerebrospinal fluid.     

Sur la vascularisation de la lame terminale humaine

Résumé La lame terminale de l'homme, comme celle de nombreuses classes de vertébrés, est occupée par un système vasculaire remarquable.A partir de sources artérielles constituées dans les cas les plus typiques de quatre pédicules, un réseau capillaire superficiel tapisse la face pie-mérienne ou antérieure de la lame terminale; le sang de ce réseau est drainé dans un réseau profond formé de capillaires sinusoides groupés en anses ou en boucles dans la partie haute de l'organe, tandis que sa partie basse est occupée par un vaste plexus. Le sang du réseau profond gagne ensuite des veines communes à d'autres régions hypothalamiques qui se déversent dans le système des veines cérébrales antérieures.L'aspect des vaisseaux de la lame terminale et leur organisation particulière permet de penser qu'ils interviennent dans la fonction encore inconnue de l'organe vasculaire de la lame terminale.

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On the vascularisation of the lamina terminalis in the human

Summary The human supra-optic crest like that of numerous classes of vertebrates, has a highly differentiated vascular system.From the arterial supply usually consisting of four pedicles, a superficial capillary network covers the pia-mater or anterior side of the supra-optic crest. The blood in this superficial network is drained into a deep network made up of sinusoidal capillaries in loops or whirls, situated in the upper part of the organ, whereas in the lower part a vast plexus is to be found. The blood from the deep network then flows into veins which also drain other hypothalamic regions and then flow into the anterior cerebral veinous system.The appearance of the vessels of the supra-optic crest and their special arrangement seems to indicate that they play a part in the as yet unknown function of the vascular organ of the supra-optic crest.

     

Apport de la biochimie flavonique à la systematique du genre Lycopodium

A systematic study of Lycopodium s.l. shows that only flavones occur in the four genera Huperzia, Lepidotis, Lycopodium s.s. and Diphasium. The arrangement of these taxa is discussed on the basis of the distribution of tricin, selgin, chrysoeriol, luteolin and apigenin. The evolutionary significance of these results and the uniqueness of Lycopodium phenolic metabolism are outlined.     

Analyse comparative de la séquence sexuelle chez les Ipopodes Oniscoidea de la série ligienne en relation avec le développement de la volvation chez les Armadillidiidae et les Armadillidae

A comparative study of the sexual sequence is carried out in four Oniscoidea of the ligiid series Porcellio laevis, Metoponorthus sexfasciatus (Porcellionidae), Armadillidium vulgare (Armadillidiidae) and Armadillo officinalis (Armadillidae). The differences between the four species chiefly appear in the precopulatory manoeuvres. The integration of coiling or uncoiling reactions in the sexual sequence of coiling forms is studied in two genera: Armadillidium and Armadillo. Results of the behavioral study provide information about the evolution of the group.     

Structures de la cabuamine et de la vincorine

Cabuamine is identified as O-methyl-hydrogeno akuammine.     

Action de la chlorhexidine sur l'expression de la virulence de Candida albicans

Candida albicans is an opportunistic yeast. Its pathogenicity is linked to the susceptibility of the host surface as well as to particular factors of the strain: adhesion, filamentous growth and secretion of proteolytic enzymes. Chlorhexidine digluconate is an antiseptic with fungicidal properties. The action of the antiseptic on the growth of the yeast shows a minimal inhibitory concentration (MIC) at 50 μg·mL⁻¹ and a minimal fungicidal concentration (MFC) at 100 μg·mL⁻¹. The consequences of antiseptic treatment are studied using two indicators of pathogenicity: filamentation and the secretion of acid proteinase. Concerning the morphological indicator, a complete inhibition of filamentation for antiseptic concentration far below the MIC is observed; concerning the biochemical indicator, the results show a maintenance of proteolytic activity for concentration equal to the MIC and a disappearance of this activity between the MIC and the MFC. Concerning the proteolytic activity, Skim Milk (Difco) was substituted for bovine serum albumin with success. This mixture of casein allows to use a cheaper and more easily available substrate.     

Controle de la chaine de biosynthese de la threonine chezE. coli

Resume Le travail décrit dans cet article s'appuie sur la théorie du contrôle du métabolisme et a pour but la mesure des coefficients de contrôle des différentes étapes sur le flux de production de thréonine. Le coefficient de contrôle d'une étape sur un flux mesure quantitativement la réponse du flux aux variations de l'étape. Cette notion est donc particulièrement importante aussi bien dans les situations pathologiques (diminution de l'activité d'une étape) qu'en biotechnologies où au contraire les étapes sont amplifiées.La mesure des coefficients de contrôle des étapes d'une chaîne métabolique permet donc de connaître celle(s) dont l'amplification doit entraîner une augmentation concomitante du flux.Nous avons appliqué ces concepts à l'étude de la voie de biosynthèse de la thréonine à partir de l'aspartate.La voie de la biosynthèse de la thréonine à partir de l'aspartate est constituée de cinq étapes catalysées par cinq activités enzymatiques: l'aspartokinase (AK), l'aspartate semi-aldéhyde déshydrogénase (ASA-DH), l'homosérine déshydrogénase (HDH), l'homosérine kinase (HK) et la thréonine synthase (TS).La mesure du coefficient de contrôle de la première étape (AK, insensible à la rétro-inhibition par la thréonine dans la souche étudiée) a montré qu'elle était faiblement contrôlante. L'étude a révélé la présence d'une inhibition jusqu'alors inconnue de l'homosérine kinase par la lysine.Un début de modélisation de cette chaîne de biosynthèse permet d'expliquer les résultats expérimentaux.

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This paper deals with the application of the metabolic control theory, especially the measurement of control coefficients, to the threonine pathway inE. coli. The control coefficient of a step on a metabolic flux quantitatively assesses the flux response to the step variations. This concept is particularly relevant both in pathological situations (decrease in the activity of an enzymatic step in the metabolism) and in biotechnologies, where, on the contrary steps are amplified.Measurement of the control coefficients of the steps of a metabolic network makes it possible to know those whose amplification should lead to a simultaneous increase in the fluxes.We have applied these concepts to threonine biosynthesis from aspartate inE. coli. The threonine pathway starting from aspartate involves five steps catalyzed by five enzyme activities: aspartokinase (AK), aspartate-semialdehyde-dehydrogenase (ASA-DH), homoserine dehydrogenase (HDH), homoserine kinase (HK) and hreonine synthetase activity (TS).Measurement of the control coefficient of the first step (AK, insensitive to threonine inhibition in the studied strain) has shown that it controls threonine production weakly. Our study has revealed a hitherto unknown inhibition of homoserine kinase activity by lysine.Mathematical modeling of this metabolic pathway has been undertaken to better understand our experimental results.

     

Brote de histoplasmosis en la provincia de Neuquén,Patagonia Argentina

BackgroundIn Argentina, there are no reports of autochthonous cases of histoplasmosis in the southern regions of the country.AimTo report a histoplasmosis outbreak in Zapala town, Province of Neuquén, Patagonia Argentina.MethodsWe evaluated the clinical and epidemiological characteristics of 5 patients involved in the outbreak. Environmental studies were conducted to determine the source of infection. The genetic profile of Histoplasma capsulatum strains isolated from the index case (IC) were compared with clinical isolates from Argentinean patients not related to the outbreak, using RAPD-PCR with primers 1281-1283.ResultsThe patients were residents of Zapala, and had not visited other geographical areas before. All patients had an influenza-like syndrome, and X-ray revealed disseminated micronodular images throughout the lung parenchyma. The IC needed specific antifungal therapy; the remaining 4 patients had mild symptoms, and did not require therapy. All of them had a good clinical outcome. Strains of H. capsulatum isolated from blood culture and lung biopsy of the IC showed a genetic profile different from other strains analyzed. The presence of the fungus in the environment was demonstrated by the detection of anti-Histoplasma antibodies in BALB/c mice inoculated with soil obtained in a culvert where workers had dug up earth after a landslide.ConclusionsThis outbreak suggests the histoplasmosis endemic area is under the 38° S parallel. Patients from Neuquén, Patagonia Argentina, with compatible symptoms of histoplasmosis should be tested, regardless of their travel or exposure history.     

Evolution de la temperature de l'oxygene dissous et de la transparence dans la baie Nord du lac Tanganika

Resume Nous décrivons dans ce travail l'évolution de la température de l'oxygène dissous et de la transparence dans le bassin N. du lac Tanganika.La température de l'eau ne subit des fluctuations intéressantes au cours de l'année que dans les 100 premiers mètres de la surface. Les eaux du Tanganika offrent une temperature élevée jusqu' à ses plus grandes profondeurs; à 1.400 m. la température de l'eau est encore de 23.35° C. La température des eaux superficielles dépend de l'insolation journalière et les variations saisonnières n'affectent qu'une épaisseur d'eau d'une centaine de mètres. La couche oxygénée de l'eau est très faible par rapport aux énormes profondeurs du lac. Dans le bassin N. elle varie au cours de l'année entre les extrêmes de 45 m. et de 115 m.; la plupart du temps la limite de l'oxygène dissous se situant à 75–80 m de profondeur.Les eaux superficielles sont fortement oxygénées, leur teneur en oxygène dissous oscille autour de 100% de satuation, jusqu'au thermocline elles sont encore oxygénées à 80–90%.Le thermocline est toujours plus haut que la limite de l'oxygène dissous et ne présente absolument pas une barrière biologique comme c'est le cas dans la plupart des lacs des régions tempérées.La transparence des eaux du lac Tanganika est considérable, elle atteint souvent 20 m; la moyenne au cours de l'année se situant aux environs de 15 m.

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Summary The author describes the temperature, oxygen and transparency conditions in the Northern basin of Lake Tanganyika.The fluctuations in the temperature of the waters in the course of the year is of interest only down to a depth of 100 m.The temperature of water in Lake Tanganyika is high even in the greatest depths; at 1.400 m depth the temperature of the water is still 23.35° C. The temperature of surface water depends on the daily solar radiation. The influence of seasonal variations is felt only down to a depth of about one hundred meters.The oxygenated layer of water is very thin in comparison with the very great depth of the lake. In the northern basin, this layer varies in thickness between 45 and 115 m, the limit of dissolved oxygen being at a depth of about 75 m most of the time.The oxygen concentration in superficial waters is very high and nearly reaches the saturation point. Down to the thermoclinal point, the concentration is still 80–90 % The thermocline is always higher than the limit of dissolved oxygen, it does not at all constitute a biological barrier as it does in most lakes in temperate climates. The waters of Lake Tanganyika are very transparent, their transparency often reaches the depth of 20 m, the average for the year being 15 m.

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Centre de Recherches du Tanganika (Uvira) Institut pour la Recherche Scientifique en Afrique Centrale I.R.S.A.C.     

Estudio preliminar de la efectividad de la terapia asistida con perros en personas de la tercera edad

IntroductionAnimal-assisted therapy is increasingly present in several educational and health areas. The aim of this study is to assess the effectiveness of such interventions in the elderly population living in residential settings.Materials and methodsA 12-week dog-assisted intervention program was designed, with 16 participants from a nursing home divided into an experimental group and a control group.ResultsSeveral physical and psychological variables were assessed before and after the intervention. While there were no significant differences in the control group, the experimental group improved significantly after participating in the program.DiscussionThe results support the hypothesis that animal-assisted interventions may be beneficial for residents in elderly care homes.     

Contribution à la connaissance de la faune marine de la côte belge

Summary The difference of phototropism and phototaxis of both molluscs influenced their fixation.The orientation of both molluscs is towards the incoming light-direction, less pronounced when the light-intensity to the center of the tile is decreasing. The density of the populations of oysters is increasing towards the center of the tiles by decreasing light-intensity, the density of the Crepidula-population decreasing towards the center of the collector.The competition of both organisms in relation to space, is, under the opposed influence of the light, less than described in the literature.Theoretically it is possible to separate Crepidula and oyster-fixation, using this property.Statistical analysis corroborated our observations.     

Absceso tiroideo. Serie de casos y revisión de la literatura

Thyroid abscess is rare in children but the presence of previous thyroid disease, and congenital remanants such as a pyriform sinus fistula, are predisposing factors. The classical presentation consists of fever, cervical pain and a painful mass. The diagnosis is confirmed through clinical findings, and by diagnostic imaging (ultrasound and computerized axial tomography). A barium swallow must be performed in order to detect a fistula and to consider surgical drain. We present the cases of thyroid abscess in five patients who were admitted in four medical centers (Fundación Cardioinfantil, Hospital Universitario San Ignacio, Clínica infantil de Colsubsidio and Hospital de la Misericordia) in Bogotá, Colombia between 2000 and 2010.     

Efectos de la actividad física de intensidad suave sobre las condiciones físicas de los adultos mayores: revisión sistemática

Physical activity can improve function in people over 65. The aim of the study was to evaluate the efficacy of mild intensity exercise interventions on the functional health and quality of life of this population. A systematic review was conducted using WOS (n = 20), Scopus (n = 235), PubMed (n = 15), and PEDro (n = 20) databases. Eight studies met the inclusion criteria. Six hundred and nineteen subjects with an age range of 60-103 years were evaluated. Interventions included endurance, aerobic, and vibration exercises. Those who used pedometers, telephone calls and follow-up controls showed positive effects in increasing physical activity. Five studies evaluated strength and showed that increasing strength also improved balance and walking speed. The results indicate that applying mild intensity physical activity interventions is a way of ensuring improved functional health and quality of life in older people.     

La Cryoconservation de la laitance de la carpe, Cyprinus carpio

Cryo-preservation of carp, Cyprinus carpio, sperm Deep-freezing trials of carp sperm were carried out by varying several factors such as the basic saline solution, the cryoprotectors added (glycerol, propanediol, ethylene glycol and DMSO), the media (Menezo-INRA B², egg yolk, urea) and the deep-freezing and dilution rates. The success of deepfreezing was judged by the percentage of motile spermatozoa, intensity of motility, fertilizing ability and morphological integrity of the spermatozoa studied under the scanning electron microscope. DMSO was the best cryoprotector and the mineral composition of the dilution medium the least important factor, but there was noticeable improvement after organic compounds were added. The following mixture has been proposed: NaCl 100 mM + KC1100 mM, Tris 20 mM, pH 8: 37%, Menezo medium B² INRA: 15%, urea 5%, DMSO: 10%, fresh sperm: 33%. Optimal deep-freezing rate was: 5°C/min from 2 to-7°C and 25°C/min from-7 to-70°C. In these conditions, about 70 to 80% of the spermatozoa were motile after thawing compared to fresh control sperm, but fertilizing ability was not more than 30 to 40% of that with fresh sperm. The percentage of spermatozoa considered intact was 66% after thawing as against 83% for fresh control sperm. The motility and fertilizing ability of deep-frozen sperm were significantly improved when the dilution rate at insemination was reduced from ¹/₁₀₀ to 1/2.     

Cancer de la prostate : utilité de la TEP-TDM à la F-fluorocholine

In oncology, positron emission computed tomography (PET/CT) has become an essential tool for initial staging, response evaluation and follow-up of cancer patients. Most of the frequent tumors (lung, breast, esophagus, and lymphomas) are highly avid for ¹⁸F-fluorodeoxyglucose (¹⁸FDG), but prostate cancer has not demonstrated significant uptake of FDG. The development of new tracers labeled with ¹⁸F such as choline analogs allowed already to obtain interesting results particularly in patients with biological relapse and inconclusive conventional imaging work-up. The impact of ¹⁸F-flurocholine PET/CT on patient management needs to be validated in large studies, but many centers use already this examination in order to guide further management, including radiotherapy planning.