Efecto del Heliox sobre la resistencia en la vía aérea en niños con patología bronquial obstructiva que requieren ventilación mecánica

Efecto del heliox sobre la resistencia en la vía área en niños con patología bronquial obstructiva que requieren ventilación mecánica Contreras, MA; Angarita, D; Fernandez, J; Godoy, J; Mullet, H; Briceño, G. Resumen: Los pacientes con enfermedad bronquial obstructiva que requieren ventilación mecánica presentan un aumento en la resistencia de la vía aérea que produce efectos deletéreos sobre la mecánica respiratoria. El uso de Heliox ha sido propuesto como una terapia en patología bronquial obstructiva, ya que gracias a sus propiedades físicas disminuye la resistencia en la vía aérea, mejorando el intercambio gaseoso y reduciendo el tiempo de soporte ventilatorio. El objetivo de este estudio Cuasi-experimental, fue medir y comparar antes y después la resistencia de la vía aérea en niños con patología bronquial obstructiva en quienes se usó Heliox durante la ventilación mecánica. Métodos: Se incluyeron niños que requirieron ventilación mecánica, realizando mediciones de la resistencia inspiratoria y espiratoria de la vía aérea con el ventilador Hamilton G5. Las mediciones fueron realizadas antes y desde los 30 minutos del inicio de la ventilación mecánica, hasta lograr extubación. Para el análisis de las diferencias de todas las medidas se usó la prueba de comparaciones múltiples de Friedman y el coeficiente concordancia de Kendall. Resultados: En una muestra de 17 pacientes, se encontró una disminución con significancia estadística, en las mediciones de la resistencia inspiratoria y espiratoria, a partir de la segunda hora (p 0.0004), después del inicio de la ventilación mecánica con heliox, efecto que mantuvo hasta el momento de la extubación.

A psychological treatment programme for traumatised exmilitary personnel in the UK

A large proportion of homeless people in the UK are former members of the armed services and suffer from a mental illness. In fact, homelessness itself can be considered a symptom or manifestation of other underlying psychological difficulties. For these reasons Community Housing and Therapy (CHT) considers that providing psychological therapies to treat the homeless population is a more effective way of tackling the problem of homelessness, as it addresses the roots of the problem. This approach is one which is beginning to be recognized by leading agencies in the field. At the same time, the provision of psychological therapies for symptoms such as depression and anxiety has become accepted through the Department of Health’s (DoH) Increased Access to Psychological Therapies ( IAPT) initiative. Depression is the most common psychiatric disorder that homeless people suffer and it is well documented that psychological treatments for depression can be extremely effective. As well as approaching homelessness from the angle of psychological therapies, CHT in its work with the ex-service community has become increasingly aware that there are a large number of non statutory homeless that do not get the same attention as rough sleepers.

Assessment of social cognition in schizophrenia through the “Reading the Mind in the Eyes” test. Implications for rehabilitation

Introduction: Schizophrenia is a serious and chronic mental illness that has effect on cognitive and social functioning of a person who suffers it. Recent research points out that social cognition subprocesses, such as Theory of Mind, social perception or emotional processing, have to do with some problems that patients show in their social adjustment. Aim: Assessing ability of recognizing mental states from facial expressions in schizophrenia patients compared to a control group. Subjects and methods: 17 stable schizophrenia patients who are aware of the illness and 17 healthy people, with the same age and sociocultural level, took the “Reading the Mind in the Eyes” Test Revised Version of Baron- Cohen. Results: Compared with the control group, subjects with schizophrenia showed much lower scores. Conclusions: It is confirmed that schizophrenia patients have impairments to understand facial expressions, especially from the eyes. That is typical of this illness, so it is necessary to do interventions at that point. Furthermore, inability to recognize emotions, as a domain of social cognition, contributes to deficit in functional outcome in schizophrenia. Finally, some treatment programs are put forward.

Description of the risk factors for relapse in patients diagnosed with severe mental disorders

Objective: The objective of this paper is to describe the population served in mental health institutionsfor mental illness relapse, and the process of identifying risk factors in relapsing patientsdiagnosed with severe mental illness. To this end a descriptive exploratory multicenter, multistageepidemiological study was carried out in mental health institutions of the Order of San Juan deDios Hospital (OHSJD) with hospitalized relapsing patients with a diagnosis of severe mentaldisorder. This study comes from a working network of Psychology professionals in the OHSJDnationwide. Materials and methods: The population sample was of 1005 patients diagnosed withsevere mental disorders, who had presented relapse during the last year. First, the characterizationof the general population was conducted; then, it was narrowed down to the centers, taking intoaccount similarities and differences found according to the clinical and demographic variables.Results: Major risk factors for relapse found in patients diagnosed with severe mental disorderswere: having between 38 and 58 years of age, being female, single, graduates, unemployed, witha prevalence of bipolar affective disorder diagnosis, number of hospitalizations between 2 and10, number of drugs at the time of leaving hospital 2 to 6, with severe difficulties relating withothers and difficulties in adherence to treatment. The need for a caregiver was also found, as wellas a limited number of received psychological interventions. How the system of beliefs affects thedisease and the poor adherence to treatment was identified. Conclusions: These results indicatethe requirement of a design of team intervention strategies, ranging from the assessment team(home), definition of therapeutic action plans (for) and the posthospitalizacion (egress) following.There is a poor support network and limited adherence to comprehensive treatment.

Deletion Analysis of 15 exons located outside and inside a “Hot Spot” in the Duchenne Muscular Dystrophy gene in Duchenne’s Muscular dystrophy patients

Introduction. Duchenne and Becker Muscular Dystrophies (DMD/DMB) are X-linked recessive diseases characterized by progressive muscle weakness and wasting, loss of motor skills and death after the second decade of life. Deletions are the most prevalent mutations that affect the dystrophin gene, which spans 79 exons.Objective: Identify deletions on the dystrophin gene in 58 patients affected with DMD.Methods: Through multiplex PCR identify deletions on the dystrophin gene in 58 patients with DMD and observe the frequency of this mutation in our population.Results: We found deletions in 1.72% of patients (1 of 58 persons). Deletions were not the principal cause of disease in our population. It is possible that duplications and point mutations caused this illness in our patients.Conclusions: The frequency of deletions in the 15 exons analyzed from the dystrophin gene was low. The predominant types of mutation in our patients` samples were not deletions as has been observed in the literature worldwide, therefore, it is important to determine other types of mutations as are duplications and point mutations.

The determinants of the health status in a developing country: results from the Colombian case

El artículo busca encontrar evidencia empírica de los determinantes de la salud, como una medición de capital salud en un país en desarrollo después de una profunda reforma en el sector salud. Siguiendo el modelo de Grossman (1972) y tomando factores institucionales, además de las variables individuales y socioeconómicas. Se usaron las encuestas de 1997 y 2000 donde se responde subjetivamente sobre el estado de salud y tipo de afiliación al sistema de salud. El proceso de estimación usado es un probit ordenado. Los resultados muestran una importante conexión entre las variables individuales, institucionales y socioeconómicas con el estado de salud. El efecto de tipo de acceso al sistema de salud presiona las inequidades en salud.