Aplicación de técnicas psicodiagnósticas para la detección de rasgos predictores de demencia, a una muestra de adultos mayores de 50 años de la ciudad de Córdoba

La evaluación psico-diagnóstica con técnicas y escalas psicométricas de los diversos rasgos cognitivos y comportamentales, está teniendo una creciente utilidad clínica, muy particularmente para la detección temprana de trastornos que permiten predecir procesos demenciales. Esta detección, a su turno, facilita la puesta en práctica de abordajes terapéuticos preventivos que brindarán potencialmente un mejor estilo de vida al afectado y su familia. En este contexto, y a modo de actividad de extensión, el objetivo de este trabajo es el de detectar rasgos predictores de demencia, utilizando escalas e inventarios de medición psicodiagnóstica que valoren aspectos cognitivos y conductuales. Para ello, se aplicarán a los evaluados una batería diseñada con distintas pruebas y escalas que permiten la valoración general de los rasgos cognitivos y conductuales del sujeto. Los sujetos que integren la muestra serán los derivados por el Servicio de Psicopatología del Hospital Nacional de Clínicas, todos mayores de 50 años como único criterio de exclusión aplicado. Los datos obtenidos serán procesados para determinar la distribución de la población en los cuadros que eventualmente se presenten y que son reconocidos en la literatura como eventos pre-mórbidos de las demencias. Ante el eventual diagnóstico de “demencia probable” de algún sujeto evaluado, los médicos del Servicio mencionado se encargarán del tratamiento farmacológico. Este servicio de evaluación psico-diagnóstica incluye la formación práctica de alumnos de la Carrera de Psicología de la UCC en base a prácticas de investigación y permite volcar los conocimientos obtenidos en situaciones prácticas relacionadas con la docencia activa

Efeitos cardiovasculares da anestesia local com vasoconstritor durante exodontia em coronariopatas

OBJETIVO: Avaliar a ocorrência de variáveis detectoras de isquemia miocárdica, durante ou após o tratamento odontológico, sob anestesia com vasoconstritor (adrenalina). MÉTODOS: Foram incluídos 54 pacientes coronariopatas submetidos a exodontia sob anestesia local com ou sem vasoconstritor, divididos em dois grupos (sorteio por envelope): grupo I, composto por 27 que receberam anestésico com vasoconstritor; e grupo II, composto por 27 que receberam anestésico sem vasoconstritor. Todos os pacientes foram submetidos a monitoração eletrocardiográfica com Holter por 24 horas, a Doppler-ecocardiografia realizada antes e após intervenção odontológica, e a dosagem dos marcadores bioquímicos antes e 24 horas após a exodontia (creatina cinase fração MB [CK-MB] massa, CK-MB atividade e troponina T). A freqüência cardíaca e a pressão arterial nas fases pré-anestesia, pós-anestesia e pós-exodontia também foram aferidas. A Doppler-ecocardiografia teve como objetivo avaliar a contratilidade segmentar do ventrículo esquerdo e a eventual ocorrência de insuficiência mitral. Em todos os casos foi mantido o protocolo farmacológico habitual prescrito pelo cardiologista. RESULTADOS: Três pacientes do grupo I apresentaram depressão do segmento ST (1,0 mm) durante a aplicação da anestesia, dois outros pacientes do mesmo grupo tiveram elevação da CK-MB massa, e em nenhum caso foi verificada presença de isquemia avaliada pelos demais métodos. Não houve registro, neste estudo, de precordialgia, arritmias e ocorrência ou agravamento de hipocontratilidade segmentar do ventrículo esquerdo ou insuficiência mitral. CONCLUSÃO: A exodontia praticada sob uso de anestesia com adrenalina 1:100.000 não implica riscos isquêmicos adicionais quando realizada com boa técnica anestésica e manutenção do tratamento farmacológico prescrito pelo cardiologista.

Estudios cariosistemáticos en Solanáceas sudamericanas, con especial referencia a Capsicum y Nierembergia

Solanaceae , aunque cosmopolita, presenta la mayor concentración de géneros y especies en Sudamérica, donde se habría originado. Esta familia tiene gran interés ya que incluye especies económicamente importantes por su valor alimenticio (por ejemplo ajíes, papa, tomate), de consumo (tabaco) o como medicinales y ornamentales; comprende también plantas tóxicas y malezas. Fuera de representantes del hemisferio boreal, los estudios cariológicos existentes se concentran en algunas especies de gran utilidad económica. De este modo, la gran diversidad de Solanáceas presente en nuestro subcontinente apenas ha sido considerada en lo que se refiere a aspectos cariológicos básicos como el estudio del cariotipo y del contenido de ADN nuclear. Además, en el caso de las contribuciones referidas a cromosomas generalmente se emplean técnicas convencionales de tinción. En particular, los datos citológicos en Solanaceae de Argentina se refieren sobre todo a cromosomas meióticos. En consecuencia, se propone estudiar los cromosomas de entidades sudamericanas de Solanáceas, poniendo énfasis en el análisis cariotípico mediante el empleo de técnicas de bandeo cromosómico; dicho método posibilitan un análisis cariotípico más preciso y completo, ya que permiten individualizar los cromosomas no sólo por la forma sino por su estructura interna. (...) El estudio se centra en dos géneros: Capsicum L. y Nierembergia R. et P. Los objetivos generales son: 1. Contribuir a un mejor conocimiento de las relaciones entre los taxones y con ello, posibilitar un eventual mejoramiento del sistema clasificatorio de la familia, especialmente en Capsicum y Nierembergia . 2. Trazar las posibles tendencias evolutivas en dichos géneros. 3. En Capsicum , acrecentar el conocimiento de los recursos genéticos tanto en las especies cultivadas como de las silvestres.

Estudios básicos y aplicados acerca el rol de fitohormonas como intermediarios entre ambiente y morfogénesis

Resultados previos obtenidos por nuestro grupo de trabajo, nos llevaron a proponer a las fitohormonas como mensajeros entre señal ambiental (abiótica y biótica) y morfogénesis. El presente proyecto abarca dos temas: Tema 1. Alargamiento caulinar y brotación en lechuga, arabidopsis y yerba mate. La finalidad es regular brotación en yerba mate (aumentar producción) y tener información básica respecto del control del alargamiento caulinar. Tema 2. Actividad hidrolasa de bacterias endofíticas y acumulación de sacarosa en zorgo azucarado. La finalidad es aumentar la producción de azúcares en cultivos destinados a forraje fresco o ensilado así como eventual producción de alcohol, o clonar genes que puedan ser incorporados para incrementar productividad (por ejemplo aumento del contenido de sacarosa en sorgo). Objetivo General: Estudiar el papel de Gas, AIA, ABA, etileno y Brs como intermediarios entre señal ambiental (calidad y cantidad de luz) y morfogénesis (alargamiento caulinar, brotación de yemas vegetativas) en arabidopsis, lechuga y yerba mate, y el de Gas y AIA como intermediarios entre microorganismos endofíticos y la acumulación de sacarosa en sorgo azucarado.

Choques inapropriados em portadores de CDI VR versus DR: meta-análise de ensaios clínicos randomizados

FUNDAMENTO: Apesar da evolução tecnológica do cardiodesfibrilador implantável, uma das questões que permanece em aberto é sobre o eventual benefício do cardiodesfibrilador implantável de dupla câmara comparativamente ao de câmara única, para diminuir os choques inapropriados. OBJETIVO: Avaliar, em pacientes com cardiodesfibrilador implantável, qual é o tipo de dispositivo que proporciona menor número de choques inapropriados (câmara dupla versus câmara única). MÉTODOS: Meta-análise da literatura publicada, de estudos randomizados, comparando cardiodesfibrilador implantável de câmara dupla ao de câmara única, que tenham, como endpoint avaliado, a ocorrência de choques inapropriados. RESULTADOS: O cardiodesfibrilador implantável de câmara dupla não mostrou benefícios na redução do número de pacientes com choques inapropriados. Pelo contrário, na análise de efeitos fixos, a associação foi tendencialmente favorável ao cardiodesfibrilador implantável de câmara única (OR = 1,53; IC95%: 0,91-2,57), não obstante a ausência de significado estatístico (p = 0,11). Merece destaque a heterogenia observada nos resultados (I2 = 53%), o que motivou a replicação da análise utilizando um modelo de efeitos aleatórios. No entanto, as diferenças significativas permaneceram na ocorrência de choques inapropriados em ambos os grupos (OR = 1,1; IC95%: 0,37-3,31; p = 0,86). Para complementar a análise, procedeu-se à análise de sensibilidade, na qual se verificou que a exclusão de um estudo resultava na mais baixa heterogenia observada (I2=24%) e na associação com os choques inapropriados significativamente favorável ao cardiodesfibrilador de câmara única (OR = 1,91; IC95%: 1,09-3,37; p = 0,27). CONCLUSÕES: Verificou-se a não existência de evidência clara de superioridade de qualquer um dos dispositivos avaliados.

Validation of a Brazilian Portuguese Version of the Walking Estimated-Limitation Calculated by History (WELCH)

Abstract Background: The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has been proposed to evaluate walking impairment in patients with intermittent claudication (IC), presenting satisfactory psychometric properties. However, a Brazilian Portuguese version of the questionnaire is unavailable, limiting its application in Brazilian patients. Objective: To analyze the psychometric properties of a translated Brazilian Portuguese version of the WELCH in Brazilian patients with IC. Methods: Eighty-four patients with IC participated in the study. After translation and back-translation, carried out by two independent translators, the concurrent validity of the WELCH was analyzed by correlating the questionnaire scores with the walking capacity assessed with the Gardner treadmill test. To determine the reliability of the WELCH, internal consistency and test–retest reliability with a seven-day interval between the two questionnaire applications were calculated. Results: There were significant correlations between the WELCH score and the claudication onset distance (r = 0.64, p = 0.01) and total walking distance (r = 0.61, p = 0.01). The internal consistency was 0.84 and the intraclass correlation coefficient between questionnaire evaluations was 0.84. There were no differences in WELCH scores between the two questionnaire applications. Conclusion: The Brazilian Portuguese version of the WELCH presents adequate validity and reliability indicators, which support its application to Brazilian patients with IC.

Reproducibility and Reliability of the Quality of Life Questionnaire in Patients With Atrial Fibrillation

Abstract Background: Studies have shown the impact of atrial fibrillation (AF) on the patients' quality of life. Specific questionnaires enable the evaluation of relevant events. We previously developed a questionnaire to assess the quality of life of patients with AF (AFQLQ version 1), which was reviewed in this study, and new domains were added. Objective: To demonstrate the reproducibility of the AFQLQ version 2 (AFQLQ v.2), which included the domains of fatigue, illness perception and well-being. Methods: We applied 160 questionnaires (AFQLQ v.2 and SF-36) to 40 patients, at baseline and 15 days after, to measure inter- and intraobserver reproducibility. The analysis of quality of life stability was determined by test-retest, applying the Bartko intraclass correlation coefficient (ICC). Internal consistency was assessed by Cronbach's alpha test. Results: The total score of the test-retest (n = 40) had an ICC of 0.98 in the AFQLQ v.2, and of 0.94 in the SF36. In assessing the intra- and interobserver reproducibility of the AFQLQ v.2, the ICC reliability was 0.98 and 0.97, respectively. The internal consistency had a Cronbach's alpha coefficient of 0.82, compatible with good agreement of the AFQLQ v.2. Conclusion: The AFQLQ v.2 performed better than its previous version. Similarly, the domains added contributed to make it more comprehensive and robust to assess the quality of life of patients with AF.

When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?

Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.

Taxonomic redescription of the Portuguese man-of-war, Physalia physalis (Cnidaria, Hydrozoa, Siphonophorae, Cystonectae) from Brazil

Although Physalia physalis (Linnaeus, 1758) is widely known from the Brazilian waters, specimens from this coast were never properly described. We describe Brazilian specimens of P. physalis including information on morphology, cnidome, SEM, and histological studies. Taxonomical issues concerning the development of the colonies and eventual synonymy with Physalia utriculus (La Martinière, 1787) are also added.

Aging and growth parameter from the Piaractus mesopotamicus (pacu) from the Cuiabá river, Mato Grosso, Brazil

This study has aims to determine the age and to estimate the growth parameters using scales of the species. Individuals of Piaractus mesopotamicus (Holmberg, 1887) used in this study were captured in the commercial fishery conducted in the region, along the year 2006. The model selected to express the growth of the species was the von Bertalanffy Sl= Sl∞*[1-exp-k(t-to)]. To determine if scales are suitable for studying the growth of pacu, we analyzed the relation between standard length (Sl) and the radius of the scales through linear regression. The period of annuli formation was determined analyzing the variations in the marginal increment and evaluating the consistency of the readings through the analysis of the coefficient of variations (CVs) for the average standard lengths of each age (number of rings) observed in the scales. The relationship between Ls of the fish and the radius of the scales showed that scales can be used to study the age and growth of P. mesopotamicus (R= 0.79). CVs were always below 20%, demonstrating the consistency of the readings. Annuli formation occurred in February, probably related to trophic migration that occurs in this month in the region. Equations that represents the growth in length obtained for P. mesopotamicus are Sl=50.00*[1-exp-0.18(t-(-3.00)] for males and Sl=59.23*[1-exp-0.14(t-(-3.36)] for females. The growth parameters obtained in this study were lower compared to other studies previously conducted for the same species and can related to overexploitation that species is submitted by fishing in the region. These values show also that females of pacu attain greater asymptotic length than males that growth faster.

Climate and land-use changes effects on the distribution of a regional endemism: Melanophryniscus sanmartini (Amphibia, Bufonidae)

ABSTRACT Amphibians are the most threatened vertebrate group according to the IUCN. Land-use and land cover change (LULCC) and climate change (CC) are two of the main factors related to declining amphibian populations. Given the vulnerability of threatened and rare species, the study of their response to these impacts is a conservation priority. The aim of this work was to analyze the combined impact of LULCC and CC on the regionally endemic species Melanophryniscus sanmartini Klappenbach, 1968. This species is currently categorized as near threatened by the IUCN, and previous studies suggest negative effects of projected changes in climate. Using maximum entropy methods we modeled the effects of CC on the current and mid-century distribution of M. sanmartini under two IPCC scenarios - A2 (severe) and B2 (moderate). The effects of LULCC were studied by superimposing the potential distribution with current land use, while future distribution models were evaluated under the scenario of maximum expansion of soybean and afforestation in Uruguay. The results suggest that M. sanmartini is distributed in eastern Uruguay and the south of Brazil, mainly related to hilly and grasslands systems. Currently more than 10% of this species' distribution is superimposed by agricultural crops and exotic forest plantations. Contrasting with a recent modelling study our models suggest an expansion of the distribution of M. sanmartini by mid-century under both climate scenarios. However, despite the rise in climatically suitable areas for the species in the future, LULCC projections indicate that the proportion of modified habitats will occupy up to 25% of the distribution of M. sanmartini. Future change in climate conditions could represent an opportunity for M. sanmartini, but management measures are needed to mitigate the effects of habitat modification in order to ensure its survival and allow the eventual expansion of its distribution.

Contribuição ao estudo das doenças hereditárias

Em revisão de conhecimentos sobre doenças hereditárias foi verificada em várias dessas heredopatias (anemia de hemátias em alvo, icterícia hemolítica heredo-familiar. anemia ovalocítica, anemia perniciosa de BIERMER, trombopatia constitucional, distrofia miotônica — compreendendo a doença de TNOMSEN e paramiotonia -, doença de FRIEDREICH, doença de CHARCOT-MARIE, epilepsia, keratosis follicularis ou doença de DARIER. braquidactilia, e câncer gástrico) a existência de indivíduos de comportamento semelhante ao siclêmico na anemia drepanocítica. Tais indivíduos são identificáveis por apresentarem precocemente algum dos sinais clínicos da doença. Provas especiais para cada entidade mórbida são necessárias para essa identificação.Essas verificações indicam a possibilidade de se identificarem os portadores de caráter patogênico hereditário na fase de latência (indivíduos “aparentemente sãos" ou "carrier") e que a existência de tais indivíduos é uma das características das doenças hereditárias, talvez excetuadas, as deformidades congênitas. Sugerem também que se deve relacionar o fenômeno de salteamento de gerações (skipping) na incidência das heredopatias com êsses portadores. E' sugerido o recenseamento e exames periódicos dêsses indivíduos no sentido da aquisição de dados sôbre os fatores responsáveis pela passagem da condição de "latente" para a de doente. Possivelmente, êsses conhecimentos forneceriam as bases de eventual profilaxia das doenças acima mencionadas. Na anemia perniciosa a hepatoterapia, como aconselha ASKEY, deve ser aplicada aos acloridricos, como medida preventiva.

An ordinal shapley value for economic environments (Revised version)

We propose a new solution concept to address the problem of sharing a surplus among the agents generating it. The problem is formulated in the preferences-endowments space. The solution is defined recursively, incorporating notions of consistency and fairness and relying on properties satisfied by the Shapley value for Transferable Utility (TU) games. We show a solution exists, and call it the Ordinal Shapley value (OSV). We characterize the OSV using the notion of coalitional dividends, and furthermore show it is monotone and anonymous. Finally, similarly to the weighted Shapely value for TU games, we construct a weighted OSV as well.

An ordinal shapley value for economic environments

We propose a new solution concept to address the problem of sharing a surplus among the agents generating it. The sharing problem is formulated in the preferences-endowments space. The solution is defined in a recursive manner incorporating notions of consistency and fairness and relying on properties satisfied by the Shapley value for Transferable Utility (TU) games. We show a solution exists, and refer to it as an Ordinal Shapley value (OSV). The OSV associates with each problem an allocation as well as a matrix of concessions ``measuring'' the gains each agent foregoes in favor of the other agents. We analyze the structure of the concessions, and show they are unique and symmetric. Next we characterize the OSV using the notion of coalitional dividends, and furthermore show it is monotone in an agent's initial endowments and satisfies anonymity. Finally, similarly to the weighted Shapley value for TU games, we construct a weighted OSV as well.

Self-selection consistent functions

This paper studies collective choice rules whose outcomes consist of a collection of simultaneous decisions, each one of which is the only concern of some group of individuals in society. The need for such rules arises in different contexts, including the establishment of jurisdictions, the location of multiple public facilities, or the election of representative committees. We define a notion of allocation consistency requiring that each partial aspect of the global decision taken by society as a whole should be ratified by the group of agents who are directly concerned with this particular aspect. We investigate the possibility of designing envy-free allocation consistent rules, we also explore whether such rules may also respect the Condorcet criterion.