Influencia de la enfermedad periodontal en el control metabólico de pacientes con diabetes mellitus tipo 2: revisión de la literatura

There may be an interaction between periodontal disease and sonic systemic diseases such as diabetes mellitus The objective of this review was to verify by means of a review of clinical trials if is a positive association between periodontal disease and the glycerine control of type 2 diabetes mellitus (DM 2) patients Eleven articles that fit the study criteria were revised It was concluded that periodontal disease may influence the metabolic control of 2 Additional studies with larger sample sizes and longer follow up are necessary for a better clarification of this issue (Rev Med Chile 2010 138 1172 1178)

Síntomas depresivos y trastorno motor en pacientes con enfermedad de Parkinson

Introduction. Complex relations between brain and psychopathology have attracted the interest of researchers, aiming to clarify the neurobiological mechanisms of depression in Parkinson's disease, obviously in addiction to mental features. Aims. The association of motor impairment and decline of personal autonomy with severity of depressive symptoms was the hypothesis of the present study. Aiming to check this hypothesis, the objective of this study consisted in investigating relationships between the severity of depressive symptoms and motor characteristics of Parkinson's disease. Patients and methods. Thirty patients (53 to 80 year-old) with medical diagnosis of idiopathic Parkinson's disease in initial clinic stages were studied. The Unified Parkinson's Disease Rating Scale, Hoehn-Yahr Scale, and Schwab & England Scale were used to assess the clinic signs and symptoms. The depressive symptoms were identified by complete anamnesis, examination of mental condition, and the Hamilton Rating Scale for Depression and the Anxiety and Depression Scale. Statistical analysis was performed by Pearson's correlation and multiple regression analysis. Results. A significant correlation of severity of depression symptoms with disease stage (p < 0.02), with motor signs (p < 0.008), and with functional performance (p < 0.007) was found. Conclusion. There was significant association between motor impairment and severity of depressive symptoms, and between depression and early disease onset or prolonged duration of Parkinson's disease. © 2007, Revista de Neurología.

Influencia de la actividad física en la enfermedad de Alzheimer: un caso clínico

Alzheimer's dementia (AD) is a neurodegenerative disorder that causes motor and cognitive decline. The aim of this study was to analyze the influence of a specific physical activity program on the cognitive, depressive symptoms and functional capacity of patients with diagnosis of probable AD. The subject, a 79-year old woman, participated in this program for three months, with 50 min sessions three times a week. The instruments used were the Cambridge Cognitive Examination; the Geriatric Depression Scale; and the Battery of the American Alliance for Health Physical Education, Recreation and Dance. The results in relationship with the depressive symptoms and functional capacity were significantly positive. There were no changes in regards to the patient's cognitive functions. In conclusion, this physical activity program seems to be an important part of the treatment for patients with AD, as it improves the functional capacity and also stimulates cognitive tasks. © 2008 Asociación Española de Fisioterapeutas.

Anestesia para colecistectomía videolaparoscópica en paciente portador de enfermedad de Steinert. Relato de caso y revisiõn de la literatura

BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.

El papel del óxido nítrico en la modulación del proceso inflamatorio de la enfermedad periodontal

Nitric oxide (NO) is a free radical with participation in almost all physiologic host processes; however, in high concentrations it may damage the tissues. Its immunoregulatory action is present in the inflammation and in auto-immune mechanisms, being intensively studied in the medical area. Recently, some studies have also reported that NO could play a role as etiopathogenic factor of the periodontal disease, which shows inflammatory and multifactorial course. Due to beneficial or damage effects of NO, according to its concentrations, some studies have been focused in the evaluation of inhibitor of NO-Synthase (NOS) as therapeutic agents in inflammatory processes. In this context, the aim of this study was to report the role of NO and NOS inhibition in the periodontal disease modulation process. In conclusion, it could be suggested that NO seems to play an essential role in evolution of inflammatory periodontal disease, and that the NOS inhibition may be considered as a promising therapeutic in modulation of inflammatory process.

Los predictores psiconeuroinmunológicos de la sobrecarga de cuidado en ancianos cuidadores de pacientes con enfermedad de Alzheimer

Introduction: The responsibility of giving care to patients with Alzheimer’s disease (AD) may result in health changes in the older caregiver. It is important to explore the factors which influence the presence of care burden and to create strategies to face this condition. In this context, the aims of present study were to investigate the relationships between psychoneuroimmunological parameters and determine the predictors to burden in older caregivers of patients with AD. Material and methods: A total of 30 AD older caregivers participating in the «Cognitive and Functional Kinesiotherapy Program in Elderly with Alzheimer’s disease«(PRO-CDA)», de Rio Claro, SP-Brazil, were submitted to an assessment protocol to evaluate the psychoneuroimmunological parameters. A descriptive statistical analysis, Pearson correlation and multiple linear regressions were performed.