Tumor-derived hypoxic small extracellular vesicles promote endothelial cell migration and tube formation via ALS2/Rab5/ß-catenin signaling.

Tumor hypoxia has been associated with cancer progression, angiogenesis, and metastasis via modifications in the release and cargo composition of extracellular vesicles secreted by tumor cells. Indeed, hypoxic extracellular vesicles are known to trigger a variety of angiogenic responses via different mechanisms. We recently showed that hypoxia promotes endosomal signaling in tumor cells via HIF-1α-dependent induction of the guanine exchange factor ALS2, which activates Rab5, leading to downstream events involved in cell migration and invasion. Since Rab5-dependent signaling is required for endothelial cell migration and angiogenesis, we explored the possibility that hypoxia promotes the release of small extracellular vesicles containing ALS2, which in turn activate Rab5 in recipient endothelial cells leading to pro-angiogenic properties. In doing so, we found that hypoxia promoted ALS2 expression and incorporation as cargo within small extracellular vesicles, leading to subsequent transfer to recipient endothelial cells and promoting cell migration, tube formation, and downstream Rab5 activation. Consequently, ALS2-containing small extracellular vesicles increased early endosome size and number in recipient endothelial cells, which was followed by subsequent sequestration of components of the ß-catenin destruction complex within endosomal compartments, leading to stabilization and nuclear localization of ß-catenin. These events converged in the expression of ß-catenin target genes involved in angiogenesis. Knockdown of ALS2 in donor tumor cells precluded its incorporation into small extracellular vesicles, preventing Rab5-downstream events and endothelial cell responses, which depended on Rab5 activity and guanine exchange factor activity of ALS2. These findings indicate that vesicular ALS2, secreted in hypoxia, promotes endothelial cell events leading to angiogenesis. Finally, these events might explain how tumor angiogenesis proceeds in hypoxic conditions.

Co-Culture of P. gingivalis and F. nucleatum Synergistically Elevates IL-6 Expression via TLR4 Signaling in Oral Keratinocytes.

Periodontitis, characterized by persistent inflammation in the periodontium, is intricately connected to systemic diseases, including oral cancer. Bacteria, such as Porphyromonas gingivalis and Fusobacterium nucleatum, play a pivotal role in periodontitis development because they contribute to dysbiosis and tissue destruction. Thus, comprehending the interplay between these bacteria and their impacts on inflammation holds significant relevance in clinical understanding and treatment advancement. In the present work, we explored, for the first time, their impacts on the expressions of pro-inflammatory mediators after infecting oral keratinocytes (OKs) with a co-culture of pre-incubated P. gingivalis and F. nucleatum. Our results show that the co-culture increases IL-1ß, IL-8, and TNF-α expressions, synergistically augments IL-6, and translocates NF-kB to the cell nucleus. These changes in pro-inflammatory mediators-associated with chronic inflammation and cancer-correlate with an increase in cell migration following infection with the co-cultured bacteria or P. gingivalis alone. This effect depends on TLR4 because TLR4 knockdown notably impacts IL-6 expression and cell migration. Our study unveils, for the first time, crucial insights into the outcomes of their co-culture on virulence, unraveling the role of bacterial interactions in polymicrobial diseases and potential links to oral cancer.

Continuity and discontinuity in evolutionary processes with emphasis on plants.

The present work is aimed to review the concepts of continuity and discontinuity in the reproductive processes and their impact on the evolutionary outcome, emphasizing on the plant model. Let be stated that evolutionary changes need to pass down generation after generation through the cellular reproductive mechanisms, and these mechanisms can account for changes from single nucleotide to genome-wide mutations. Patterns of continuity and discontinuity in sexual and asexual species pose notorious differences as the involvement of the cellular genetic material from single or different individuals, the changes in the ploidy level, or the independence between nuclear and plastid genomes. One relevant aspect of the plant model is the open system for pollen donation, which can be driven from every male flower to every female flower in the neighborhood, as well as the facilitated seed dispersal patterns, that may break or restore the contact between populations. Three significative processes are distinguishable, syngenesis, anagenesis, and cladogenesis. The syngenesis refers to the reproduction between individuals, either if they pertain to the same species, from different populations or even from different species. The anagenesis refers to the pursuit of all the possible rearrangements of genes and alleles pooled in a population of individuals, and the cladogenesis represents the absence of reproduction that leads to differentiation. Recent developments on the genomic analysis of single cells, single chromosomes and fragments of homologous chromosomes could bring new insights into the processes of the evolution, in generational time and in a broad spectrum of spatial/geographic extents.

Black-Box Mathematical Model for Net Photosynthesis Estimation and Its Digital IoT Implementation Based on Non-Invasive Techniques: Capsicum annuum L. Study Case.

Photosynthesis is a vital process for the planet. Its estimation involves the measurement of different variables and its processing through a mathematical model. This article presents a black-box mathematical model to estimate the net photosynthesis and its digital implementation. The model uses variables such as: leaf temperature, relative leaf humidity, and incident radiation. The model was elaborated with obtained data from Capsicum annuum L. plants and calibrated using genetic algorithms. The model was validated with Capsicum annuum L. and Capsicum chinense Jacq. plants, achieving average errors of 3% in Capsicum annuum L. and 18.4% in Capsicum chinense Jacq. The error in Capsicum chinense Jacq. was due to the different experimental conditions. According to evaluation, all correlation coefficients (Rho) are greater than 0.98, resulting from the comparison with the LI-COR Li-6800 equipment. The digital implementation consists of an FPGA for data acquisition and processing, as well as a Raspberry Pi for IoT and in situ interfaces; thus, generating a useful net photosynthesis device with non-invasive sensors. This proposal presents an innovative, portable, and low-scale way to estimate the photosynthetic process in vivo, in situ, and in vitro, using non-invasive techniques.

Neuroendocrine tumors in Panama: A nationwide database analysis.

Neuroendocrine tumors (NETs) comprise a heterogenous group of rare malignancies, which are increasing in incidence worldwide. To further understand the epidemiology of NETs in the Republic of Panama, the present study used two study groups, which included patients from several hospitals and clinics throughout the country, who were referred to the three largest national reference centers: The Complejo Hospitalario Metropolitano, Hospital Santo Tomas and Instituto Oncologico Nacional. These two groups comprised a retrospective cohort, which included cases reported between 2016 and 2017, and a second cohort, which was retrospective, but data were continuously collected from patients diagnosed with NETs between 2018 and 2019. Data from 157 patients with NETs reported that 83% of patients were in the 40-80 years old age group. The majority of cases (46%) presented as grade G1 tumors, while 29% were G3. Computerized tomography scans with contrast, and analysis of the Ki-67 biomarker and immunohistology markers (chromogranin A and synaptophysin) was performed in the majority of the cases. The results revealed that the most frequent anatomical sites for the primary tumor were the colorectum (17.2%), pancreas (12.7%) and stomach (12.1%), and the most frequent organ with metastasis was the liver, accounting for 34% of all cases. In conclusion, the present study is the first comprehensive study of NET in Panama to the best of our knowledge, which provides evidence of the demographic characteristics of the population, clinical features and overall survival for the affected population in this Central American country.

Effectiveness of Abdominal and Gluteus Medius Training in Lumbo-Pelvic Stability and Adductor Strength in Female Soccer Players. A Randomized Controlled Study.

BACKGROUND: Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. METHODS: In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength. RESULTS: After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: -2.48; p < 0.001 in the left adductor; MD: -1.48; p < 0.01 in right adductor) and control group (MD: -1.68; p < 0.001 in the left adductor; MD: -2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength. CONCLUSIONS: An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.

Evaluación del Riesgo, Tamizaje, Diagnóstico Clínico ­ Patológico y Estadificación del Cáncer de Mama: 1er Consenso Nacional del Cáncer de Mama de la Sociedad Panameña de Oncología (SPO) / Risk Assessment, Screening, Clinical ­ Pathological Diagnos is and Staging of Breast Cancer: 1st National Consensus of Breast Cancer of the Panamanian Society of Oncology

El cáncer de Mama es el tumor más frecuente de la mujer y su incidencia va en aumento. En la atención primaria del paciente, se debe establecer el riesgo de padecer cáncer de mama durante la vida, a través de una historia clínica orientada a los factores de riesgo familiares e individuales, de tal forma que podamos implementar las estrategias de tamizaje apropiadas. Las estrategias de ta­mizaje deben ser aplicadas de manera sistemáticas, y los resultados anormales referidos a un cen­tro con experiencia en el diagnóstico. Los pacientes diagnosticados deben ser evaluador por un equipo multidisciplinario con experiencia en el manejo de la muestra, estadificación y tratamiento del cáncer de mama.

Breast cancer is the most frequent tumor in women and its incidence is increasing. In the primary care of the patient, the risk of suffering from breast cancer should be established during life, through a clinical history focused on family and individual risk factors, in such a way that we can implement the appropriate screening strategies. Screening strategies should be applied systematically, and ab­normal results referred to a center with experience in diagnosis . Patients diagnosed should be eva­luated by a multidisciplinary team with experience in the management of the sample, staging and treatment of breast cancer.

Prevalence and incidence of perinatal depression and depressive symptoms among Mexican women.

BACKGROUND: The aim of this study was to assess point and period prevalence and incidence of perinatal depression in Mexican women. METHODS: The Structured Clinical Interview for DSM-IV and the Patient Health Questionnaire (PHQ-9) were administered at three points in time to 210 women: during the third trimester of pregnancy, at six weeks and at six months after delivery. RESULTS: Prevalence of prenatal depression was 9.0%, and 13.8% at six weeks and 13.3% at six months postpartum. Incidence of postpartum depression (PPD) was 10.0% at six weeks and 8.2% at six months. Prevalence of prenatal depressive symptoms was 16.6%; and 17.1% at six weeks and 20.0% at six months postpartum. Incidence of postpartum depressive symptoms (PPDS) was 11.4% at six weeks and 9.0% at six months. At six months postpartum, women with depression were younger (OR=2.45, p=0.02), had fewer years׳ schooling (OR=5.61, p=0.00), were unpartnered (OR=3.03, p=0.01), unemployed (OR=3.48, p=0.00) and poorer (OR=4.00, p=0.00) than women without depression. LIMITATIONS: 25% of the initial sample was not retained to complete the three assessments. Non completers were younger, less educated and reported more depressive symptoms. This may have resulted in an underestimation of prevalence. CONCLUSIONS: This is the first longitudinal study in Latin America to assess perinatal depression at three different points in times, reporting point and period prevalence and incidence of clinical depression and depressive symptoms. Most LA countries have yet to recognize the importance of providing mental health care for expectant and postpartum mothers to reduce disability in mothers and infants.

Is the Puerto Rican racer, Alsophis portoricensis, really harmless? A case report series.

Puerto Rico (PR) is home to 10 indigenous species of snake. Alsophis portorricensis has traditionally been considered harmless. In 1961, Hageman classified A portorricensis as somewhere between "venomous" and "nonvenomous." In 1966, Heatwole and Banuchi reported the only case found in the literature of a "venomous" bite from Alsophis portorricensis. Only 6 cases of snakebite were reported to the PR Department of Health from 1998 to 2007; ecchymosis, swelling, and abnormal vital signs were noted in all of the cases. In 5 of these 6 cases, the captured snake was, in fact, identified as Alsophis portorricensis of the Colubridae family; in the remaining case, the description strongly suggests that it was the same species as the others. All bites were inflicted on fingers, which were presented for evaluation from 2 to 24 hours after the event. All documented cases report that the bite lasted from 1 to 4 minutes. All of the victims presented with localized pain and ecchymosis. Localized edema extended from the hand to the elbow in 4 cases, and up to the shoulder in 2 cases. All patients were treated symptomatically, observed at the Emergency Department (ED), and discharged home within 24 hours after the ED evaluation. All patients reported the resolution of symptoms within 1 week. Traditionally, PR has not been associated with any dangerous species of snake. These cases show that the second most abundant snake on the island can inflict a venomous bite, with local and systemic symptoms that warrant adequate preparation by the medical community.

Características de la calidad de vida en enfermos crónicos y agudos / Quality of life characteristics in chronic and acute patients

La calidad de vida ha sido objeto de investigación en padecimientos crónicos, sin embargo no se considera porsí mismo el efecto de perder la salud, especialmente en el contexto de los padecimientos agudos. En Latinoamérica continúan siendo frecuentes, recurrentes y contribuyen de manera importante a las tasas de mortalidad. En el presente estudio se abordaron las diferencias en calidad de vida a partir de la condición crónica o aguda del padecimiento. Se utilizó el Inventario de Calidad de Vida y Salud (InCaViSa) que incluye áreas poco consideradas en la literatura como la interacción médico-paciente. Respondieron el inventario un total de 449 participantes divididos en tres grupos: enfermos crónicos, agudos y aparentemente sanos, como grupo de contraste. Los resultados revelaron propiedades psicométricas sólidas en el inventario y diferencias en Calidad de Vida entre los tres grupos, destacando las áreas relativas a la interacción con el médico, y preocupaciones. Se concluye que hay un efecto diferencial por la condición, en el que los padecimientos curables también impactan la calidad de vida.

Quality of Life (QOL) has been a research subject in chronic diseases mainly. However, research on health lossis relatively scarce, especially in the realm of acute diseases, those in Latin American are frequent, recurrent, and increases notably the mortality burden. The present study evaluated the QOL differences by disease duration. Health Inventory (INCAVISA for its initials in Spanish) was used, including some variables unattended at literature as patient physician interaction. A total of 449 participants separated in three groups defined by their type of health condition or status: chronic, acute or apparently healthy. Results revealed solid psychometrical properties of the Inventory as well as QOL differences among the three groups, specially patient-physician relationship related and concerns. Conclusions point out that exist a differential effect by condition and recoverable diseases also has an impact on QOL.

Treatment of idiopathic retroperitoneal fibrosis with colchicine and steroids: a case series.

BACKGROUND: Idiopathic retroperitoneal fibrosis (IRPF) is an uncommon, but increasingly recognized, disease. Autoimmune mechanisms probably participate in its pathogenesis. Patients have been treated with high-dose steroids and sometimes immunosuppressive drugs, resulting in toxicity risk during prolonged treatments; thus, it would be wise to look for safer drugs. Colchicine has antifibrotic, anti-inflammatory, and immunosuppressive effects. Hence, it is a potential therapeutic resource. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: 7 consecutives patients with IRPF diagnosed since 1993 at a navy hospital were prescribed colchicine plus prednisone or deflazacort. After reaching a clinical response, the steroid dose was tapered, maintaining daily colchicine therapy. OUTCOMES & MEASUREMENTS: Symptomatic improvement was defined as time to relief of symptoms; clinical improvement, time to normalization of inflammatory parameters with symptomatic improvement; radiological changes, percentage of decrease in retroperitoneal mass; recurrence, as the need to increase steroid dose or add immunosuppressors because of reactivation of inflammation; and treatment failure, as persistence of signs of active inflammation and/or decrease in retroperitoneal mass less than 50% and/or deterioration in kidney function at the last visit. RESULTS: At month 3 of treatment, all patients had symptomatic improvement and 67% had clinical improvement. Between 8 and 12 months, 67% of patients had a decrease in retroperitoneal mass greater than 50%. No recurrence or treatment failure was observed during follow-up (mean, 72.5 months). At the last visit, all patients had a significant decrease in retroperitoneal mass (mean, 79.8% +/- 19.7%). One patient died of septic shock on day 21 of treatment. LIMITATIONS: This series did not have a control group. CONCLUSIONS: Colchicine in association with a low induction dose of steroids (<0.5 mg/kg/d) produced remission rates in patients with IRPF similar to those for regimens using greater steroid doses alone or in combination with immunosuppressive drugs. In addition, colchicine may have contributed to recurrence prevention.

[Open vs. laparoscopic loop ileostomy clousure after colorectal surgery: retrospective analysis]. / Análisis del cierre de ileostomía en asa subsecuente a cirugía colorrectal laparoscópica vs. abierta.

INTRODUCTION: A protective loop ileostomy for a distal anastomosis of the rectum or anus, decreases the risk of sepsis secondary to anastomotic leak or dehiscence. This study examines whether the surgical technique employed in the construction of the anastomosis (open vs. laparoscopic) alters the subsequent closure of ileostomy. OBJECTIVE: The goal of this study is to determine whether at the time of a protective ileostomy closure, the fact of doing an initial laparoscopic surgery has advantages over those who underwent open surgery. MATERIAL AND METHODS: This is a comparative and retrospective analysis of the results of an ileostomy closure with prior open surgery (ICPOS) vs those performed with a prior laparoscopic surgery (ICPLS). Demographic and surgical results were analyzed. Fisher's test and Chi square tests were used. A statistically significant results was defined as p < 0.05. RESULTS: A total of 71 patients were included: 42 (59.2%) ICPOS and 29 (40.8%) ICPLS. Surgical time and hospital stay were less in the ICPLS group when compared with the ICPOS group. 79 vs. 133 min (p = 0.0001) and 3 vs. 5 days (p = 0.0001). Four patients (66.7%) from the ICPOS group developed ileum, whereas only 2 (33.3% from the ICPLS presented it (p = 0.04). Six patients had surgical wound infection, 5 (83.3%) of them represented the ICPOS group and only 1 (16.7%) represented the ICPLS group (p = 0.01). Four patients (5.6%) had anastomotic dehiscence, all of them were from the ICPOS group (p = 0.0037). On the ICPOS group 6 patients were reinterveined after the ileostomy closure, whereas none from the ICPLS required it (p = 0.01). CONCLUSIONS: An ICPLS seems to have advantages over a ICPOS when analyzing surgical time, hospital stay and surgical ileum development, a lesser infection rate and a lesser re intervention rate at last.

Correlatos psicopatológicos del trastorno obsesivo compulsivo y trastornos extrapiramidales / Psychopathological correlates of obsessive-compulsive disorder and extrapyramidal illnessi

El presente estudio tiene como propósito estudiar la relación entre la sintomatología obsesivo compulsiva en la Distonia Muscular Deformante Para ello se seleccionó una muestra de 24 pacientes de la clínica de Discinesias del INNN, a los cuales se les aplicó un Cuestionario demográfico, y una evaluación psicológica mediante el MMPI, la Escala de Obsesiones y Compulsiones de Maudsley (MOCI) y la de YaIe Brown (YB) El análisis estadístico indica sintomatología Obsesiva-compulsiva en un grado de leve a moderado en el test de MOCI y el de Yale-Brown Así mismo, se observó en la escala de Psicastenia del MMPI, los hombres presentaron un perfil de personalidad obsesiva fuera de la norma estadística, mientras que las mujeres tienen puntajes menores A pesar de esto no se encontraron diferencias estadísticamente significativas con respecto al sexo

Aspectos psicosociales de pacientes psiquiátricos crónicos para un programa de rehabilitación psicosocial / Importance of psychosocial characteristics in rehabilitation of chronic psychiatric patients

Las variables más importantes que inciden en la recaída del paciente psiquiátrico crónico son: su frecuente hospitalización, la falta de adherencia terapéutica y la suspensión del tratamiento. Dentro de los aspectos psicosociales relacionados con este problema se encontraron pacientes esquizofrénicos, con bajas escolaridad, desocupados, solteros en promedio en edad adulta joven, con ocho años de evolución. Las familias son nucleares, desintegradas y extensas con padres de bajo nivel de escolaridad, ocupacional y económica, el cual no corresponde; sin embargo, a los pacientes de más bajos recursos atendidos institucionalmente. Hay marcada falta de educación médica e ignorancia acerca de la enfermedad del paciente

Evaluación psicométrica de algunos aspectos de disfunción cerebral en delicuentes adultos / Psychometric assessment of brain dysfunction in adult infractors

El estudio de una muestra de 60 sujetos sentenciados, formado principalmente por jóvenes adultos, de nieve socioeconómico bajo, muestran como antecedentes problemas de aprendizaje escolar y conducta asociar en la infancia, y antisocial en la adolescencia, teniendo indicadores de organicidad obtenidos a través de la prueba de Bender calificado objetivamente. Se puede considerar que cerca de la tercera parte de sujetos adultos con conducata delictiva tienen claros indicadores clínicos y conductuales de disfunción cerebral desde la infancia. No existen diferencias entre los convictos por homicidio o robo en todas las variables

Premisas socioculturales y psicopatología / Sociocultural and psychopathology premises

En el presente trabajo, se compararon las respuestas a premisas socioculturales, en un grupo de 100 pacientes psiquiátricos y otro control del mismo número, sexo, ocupación, escolaridad y nivel socioeconómico, dentro de un sistema de seguridad social. En el grupo total sólo se encontró aceptación o negación en 11 de las 46 premisas estudiadas, existiendo diferencias significativas en el grupo psiquiátrico, respecto al control en 10 de ellas. El grupo psiquiátrico acepta más la infidelidad del esposo y rechaza más el predominio del sexo masculino, con más problemas respecto al papel de la mujer tradicional que rechaza; ascepta más rígidamente el respeto a los padres, que la mujer trabaje, más la opinión de otras personas "el qué dirán", y es más tendiente a aceptar las actividades solos. Estas diferencias son más marcadas en las mujeres

Disfunción cerebral y conducta delictiva en un grupo de infractores juveniles / Cerebral disfunction and delicitive behavior in a young transgressors

El estudio de un grupo de menores infractores, comparativamente con un grupo de menores no infractores con problemas de aprendizaje, del mismo nivel socioeconómico, edad y sexo, muestra características similares en ambos, respecto a la estructura familiar deficiente, problemas de aprendizaje y reprobación escolar. Clínicamente se encuentra una elevada proporción de antecedentes de síndrome de disfunción cerebral infantil en su variedad de hiperquinesia en ambos grupos, así como antecedentes de riesgo de daño cerebral, sin discrepancia entre ambos grupos. Las diferencias fundamentales se encuentran en la salida de la madre del hogar por motivos laborales y económicos y la deserción escolar en el grupo de infractores, en los cuales se encuentra como delito predominante: el robo, la conducta agresiva, farmacodependencia y alteraciones de conducta sexual. Estas características del delito son similares a las referidas para poblaciones de infractores juveniles en la República Mexicana y mencionadas en otros países. Los resultados permiten concluir la existencia de un importante número de casos de disfunción cerebral en menores infractores, responsable de fallas de aprendizaje tanto escolar como social, así como en sus procesos cognoscitivos, y antecedentes de conducta asocial desde la niñez. También la probabilidad de prevención de la conducta delictiva desde pequeños en el ambiente escolar, donde se puede señalar una población de alto riesgo de conducta delictiva precozmente, incluyendo estos factores en programas de prevención de la delincuencia y la farmacodependencia

Algunas características de evolución de pacientes psiquiátricos crónicos hospitalizados / Characteristics of disease progression in chronic psychiatric patients

El presente estudio analizar los factores que inciden en la cronicidad y problema en el manejo de pacientes psiquiátricos crónicos, así como los motivos de la frecuente hospitalización de éstos, y las características de la asistencia médica a los mismos, con objeto de realizar intervenciones de rehabilitación psicosocial. Para ello se estudiaron 90 pacientes psicóticos crónicos, con trastornos esquizofrénicos, afectivos, o mentales orgánicos, durante seis meses, incluyendo un análisis retrospectivo de ocho años. Los resultados muestran una población adulta joven con mayor cronicidad en trastornos esquizofrénicos y afectivos, con promedio de tres hospitalizaciones en el curso de la enfermedad, con promedio de 32 días de internamiento, significativamente mayor que en los enfermos agudos, y con intervalos de recaída de 2.73 años, siendo más prolongado en los trastornos afectivos y más reducido en los trastornos mentales orgánicos. El promedio de consultas es de una por cada año de evolución, en los servicios de urgencias con mala adherencia terapéutica y por suspensión de medicamentos. La respuesta farmacológica es progresivamente más pobre y por ello con utilización de terapia electroconvulsiva frecuente. De acuerdo a estos resultados se indican las acciones dirigidas para tratar de resolver estos problemas, como son: un programas de educación para la salud y la vigilancia periódica por parte de las trabajadoras sociales

Alteraciones psiquiátricas en la insuficiencia vascular cerebral / Psychiatrics symptoms in patients with cerebrovascular disease

La comparación de cuatro grupos de sujetos: normal neurológico, y depresivo, controles de un grupo con enfermedad vascular cerebral crónica principalmente, tanto en los datos clínicos como en los registros conductuales de depresión y sintomatología psiquiátrica, así como una escala estructurada neurológica, permite discriminar cuando las alteraciones psiquiátricas son debidas a la edad, el flujo sanguíneo cerebral deficiente, o problemas correlacionados, entidades nosológicas psiquiátricas sin influencia de lo anterior, facilitando al clínico un mejor análisis semiológico para la terapéutica y profilaxis de estas alteraciones. Las alteraciones psiquiátricas principales se refieren a estados depresivos y ansiosos, que se correlacionan en forma significativa con los trastornos clínicos circulatorios, la edad y el tiempo de evolución del cuadro, afectando principalmente la memoria, el lenguaje y la funciones motoras. También existe una correlación alta significativa entre la escala EEVC, la BPRS y la escala de automedición de la depresión, y con las variables clínicas comprendidas en las tres

Clasificación psiquiátrica de los problemas de aprendizaje y conducta en niños / The psychiatric classification of learning and behavioral disorder in children

La clasificación nosológica de los grupos psicopatológicos incluídos en la población escolar estudiada, muestra la gran diversidad de estos trastornos, inclusive en la población escolar aparentemente normal, cayendo en múltiples categorías diagnósticas, encontrándose afectado el 17.45 por ciento de la población de 1,719 menores de la escuela estudiada, principalmente con problemas de etiología orgánica cerebral. Las principales entidades nosológicas son: los trastornos del sueño del tipo de las parasomnias, el síndrome hiperquinético y los trastornos selectivos del desarrollo, además del retraso mental. Los menores afectados presentan en un 50 por ciento problemas escolares, con reprobación escolar en el 20 por ciento. La mayor incidencia se encuentra en el tercer escolar. Los trastornos psicopatológicos se acompañan de alteraciones importantes de conducta social en forma individual o en grupo. Se discuten las medidas terapéuticas y preventivas derivadas de estos resultados.