Patogenia y tratamientos actuales de la enfermedad de Alzheimer / Pathogenesis and current treatment of Alzheimer's disease

El Alzheimer es una enfermedad neurodegenerativa que se manifiesta como deterioro cognitivo y trastornos conductuales. En Cuba, junto a la demencia, ocupa el lugar número 6 en el cuadro de principales causas de muerte. No hay tratamiento eficaz para detener la progresión del Alzheimer. Sin embargo, algunas terapias detienen o ralentizan temporalmente el deterioro cognitivo, funcional y conductual de la enfermedad. En el trabajo se presenta una revisión actualizada a partir de la base de datos MEDLINE (2008-2013) sobre los mecanismos patológicos y los medicamentos usados en el tratamiento de los pacientes con la referida afección(AU)

Alzheimer disease is a neurodegenerative illness that manifests as cognitive deterioration and behavioral disorders. It holds the 6th place, like dementia, in the list of main causes of death in Cuba. There is no effective treatment to stop progression of Alzheimer's disease. However, some therapies manage to halt or to slow at least temporarily the cognitive, functional and behavioral deterioration of the disease. This paper presented an updated review on the pathological mechanisms and the drugs used in the treatment of Alzheimer patients, using MEDLINE database(AU)

Patogenia y tratamientos actuales de la enfermedad de Alzheimer / Pathogenesis and current treatment of Alzheimer's disease

El Alzheimer es una enfermedad neurodegenerativa que se manifiesta como deterioro cognitivo y trastornos conductuales. En Cuba, junto a la demencia, ocupa el lugar número 6 en el cuadro de principales causas de muerte. No hay tratamiento eficaz para detener la progresión del Alzheimer. Sin embargo, algunas terapias detienen o ralentizan temporalmente el deterioro cognitivo, funcional y conductual de la enfermedad. En el trabajo se presenta una revisión actualizada a partir de la base de datos MEDLINE (2008-2013) sobre los mecanismos patológicos y los medicamentos usados en el tratamiento de los pacientes con la referida afección(AU)

Alzheimer disease is a neurodegenerative illness that manifests as cognitive deterioration and behavioral disorders. It holds the 6th place, like dementia, in the list of main causes of death in Cuba. There is no effective treatment to stop progression of Alzheimer's disease. However, some therapies manage to halt or to slow at least temporarily the cognitive, functional and behavioral deterioration of the disease. This paper presented an updated review on the pathological mechanisms and the drugs used in the treatment of Alzheimer patients, using MEDLINE database(AU)

Eficiencia de dos intervenciones motivacionales para la deshabituación tabáquica en adolescentes (breve e intensiva) realizadas en Institutos de Educación Secundaria / Efficiency of two motivational interventions for adolescent smokers (brief and intensive) conducted in High Schools

Se desea determinar la eficiencia de dos intervenciones motivacionales en adolescentes, basadas en el uso de disonancias cognitivas, para conseguir el cese del tabaquismo. Se realiza un estudio experimental aleatorizado multicéntrico en 5 Institutos de Educación Secundaria. Se proponen intervenciones individuales en los institutos participando adolescentes fumadores (≤20 años) que desean dejar de fumar, con exclusión de embarazadas, trastornos graves de salud mental o uso de drogas antitabaco. Se recogió el consentimiento informado y un cuestionario previo (variables demográficas, consumo de tabaco/alcohol/drogas, apoyo familiar/social). Se desarrollan dos intervenciones por médicos de familia en el propio instituto mediante un muestreo aleatorio estratificado: intensiva (cuatro sesiones de 15 minutos, reducción progresiva del consumo) y breve (sesión única de 15 minutos, cese inmediato del consumo). Se confirma la abstinencia mediante cooximetría el primer, sexto y duodécimomes tras la intervención, con análisis por intención de tratar. Participan92 adolescentes, con edad media 15,4±1,0 años, sin diferencias al principio de las intervenciones: 82% fuman a diario, con baja dependencia (62%) y motivación alta/moderada para el cese (88%), 78% consumen alcohol y 21% drogas. La función familiar y el apoyo social son normales en la mayoría. 47% recibe la intervención intensiva. Se consigue la abstinencia del 64%±5,0 el primer mes (20% mejor en intervención intensiva, p<0,05 x2); 42% ±5,2 el sexto mes y 27% ±4,6 al año (sin diferencias). La intervención breve parece ser más eficiente, mientras que serían precisas más investigaciones para determinar el perfil del adolescente que se beneficiaría de una intervención intensiva (AU)

We set out to determine the efficiency of two motivational interventions (brief and intensive) in adolescent smokers, based on obtaining cognitive dissonance and seeking to help them stop smoking. A multicenter randomized experimental study was carried out at five high schools. Individual anti-smoking interventions were applied at the schools, the participants being adolescent smokers (minor, or 20 years) who wished to quit smoking. Exclusion criteria were use of anti-smoking drugs, severe psychiatric illness and pregnancy. Informed consent was obtained and a questionnaire recorded demographic variables and alcohol/tobacco/other drug use. Two motivational interventions were carried out at each school by GP, in accordance with a stratified randomization procedure: intensive (four sessions, progressive reduction of smoking) and brief (single session, immediate cessation of smoking). Smoking abstinence was confirmed by co-oximetry at 1, 6 and 12 months after the intervention, with analysis by intention to treat. A total of 92 adolescents participated, with a mean age of 15.4+1.0years; no differences at the beginning of the interventions: daily smokers accounted for 82% of the sample, with low dependence (62%) and moderate-high motivation to quit smoking (88%). Seventy-eight per cent used alcohol and 21% other drugs. Family functioning and social support were normal in the majority. 47% received the intensive intervention. Abstinence was achieved by 64%+5.0 by the first month (20% better in intensive intervention), 42%+5.2 by the sixth month and 27%+4.6 by the twelfth month (without differences). The brief intervention appears to be more efficient, while more research is needed to determine the profile of those adolescents who would benefit from intensive intervention (AU)

[Efficiency of two motivational interventions for adolescent smokers (brief and intensive) conducted in high schools]. / Eficiencia de dos intervenciones motivacionales para la deshabituación tabáquica en adolescentes (breve e intensiva) realizadas en Institutos de Educación Secundaria.

We set out to determine the efficiency of two motivational interventions (brief and intensive) in adolescent smokers, based on obtaining cognitive dissonance and seeking to help them stop smoking. A multicenter randomized experimental study was carried out at five high schools. Individual anti-smoking interventions were applied at the schools, the participants being adolescent smokers (≤ 20 years) who wished to quit smoking. Exclusion criteria were use of anti-smoking drugs, severe psychiatric illness and pregnancy. Informed consent was obtained and a questionnaire recorded demographic variables and alcohol/tobacco/other drug use. Two motivational interventions were carried out at each school by GP, in accordance with a stratified randomization procedure: intensive (four sessions, progressive reduction of smoking) and brief (single session, immediate cessation of smoking). Smoking abstinence was confirmed by co-oximetry at 1, 6 and 12 months after the intervention, with analysis by intention to treat. A total of 92 adolescents participated, with a mean age of 15.4 ± 1.0 years; no differences at the beginning of the interventions: daily smokers accounted for 82% of the sample, with low dependence (62%) and moderate-high motivation to quit smoking (88%). Seventy-eight per cent used alcohol and 21% other drugs. Family functioning and social support were normal in the majority. 47% received the intensive intervention. Abstinence was achieved by 64% ± 5.0 by the first month (20% better in intensive intervention), 42% ± 5.2 by the sixth month and 27% ± 4.6 by the twelfth month (without differences). The brief intervention appears to be more efficient, while more research is needed to determine the profile of those adolescents who would benefit from intensive intervention.