Chronic Inhibition of FAAH Reduces Depressive-Like Behavior and Improves Dentate Gyrus Proliferation after Chronic Unpredictable Stress Exposure.

Symptoms of depressive disorders such as anhedonia and despair can be a product of an aberrant adaptation to stress conditions. Chronic unpredictable stress model (CUS) can generate an increase in the activity of the hypothalamic-pituitary-adrenal axis (HPA) and induce a reduction of neurotrophin signaling and the proliferation of neural progenitors in the adult dentate gyrus, together with increased oxidative stress. Levels of the endocannabinoid anandamide (AEA) seem to affect these depression-by-stress-related features and could be modulated by fatty acid amide hydrolase (FAAH). We aimed to evaluate the effects of FAAH inhibitor, URB597, on depressive-like behavior and neural proliferation of mice subjected to a model of CUS. URB597 was administered intraperitoneally at a dose of 0.2 mg/kg for 14 days after CUS. Depressive-like behaviors, anhedonia, and despair were evaluated in the splash and forced swimming tests, respectively. Alterations at the HPA axis level were analyzed using the relative weight of adrenal glands and serum corticosterone levels. Oxidative stress and brain-derived neurotrophic factor (BDNF) were also evaluated. Fluorescence immunohistochemistry tests were performed for the immunoreactivity of BrdU and Sox2 colabeling for comparison of neural precursors. The administration of URB597 was able to reverse the depressive-like behavior generated in mice after the model. Likewise, other physiological responses associated with CUS were reduced in the treated group, among them, increase in the relative weight of the adrenal glands, increased oxidative stress, and decreased BDNF and number of neural precursors. Most of these auspicious responses to enzyme inhibitor administration were blocked by employing a cannabinoid receptor antagonist. In conclusion, the chronic inhibition of FAAH generated an antidepressant effect, promoting neural progenitor proliferation and BDNF expression, while reducing adrenal gland weight and oxidative stress in mice under the CUS model.

ß-Caryophyllene exerts protective antioxidant effects through the activation of NQO1 in the MPTP model of Parkinson's disease.

Parkinson's disease (PD) is a neurodegenerative disorder, caused by the selective death of dopaminergic neurons in the substantia nigra pars compacta. ß-caryophyllene (BCP) is a phytocannabinoid with several pharmacological properties, producing anti-inflammatory and antihypertensive effects. In addition, BCP protects dopaminergic neurons from neuronal death induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), yet it remains unclear if this effect is due to its antioxidant activity. To assess whether this is the case, the effect of BCP on the expression and activity of NAD(P)H quinone oxidoreductase (NQO1) was evaluated in mice after the administration of MPTP. Male C57BL/6 J mice were divided into four groups, the first of which received saline solution i.p. in equivalent volume and served as a control group. The second group received MPTP. The second group received MPTP hydrochloride (5 mg/kg, i.p.) daily for seven consecutive days. The third group received BCP (10 mg/kg) for seven days, administered orally and finally, the fourth group received MPTP as described above and BCP for 7 days from the fourth day of MPTP administration. The results showed that BCP inhibits oxidative stress-induced cell death of dopaminergic neurons exposed to MPTP at the same time as it enhances the expression and enzymatic activity of NQO1. Also, the BCP treatment ameliorated motor dysfunction and protected the dopaminergic cells of the SNpc from damage induced by MPTP. Hence, BCP appears to achieve at least some of its antioxidant effects by augmenting NQO1 activity, which protects cells from MPTP toxicity. Accordingly, this phytocannabinoid may represent a promising pharmacological option to safeguard dopaminergic neurons and prevent the progression of PD.

Sensory neuronopathy is a specific and disabling neurological manifestation of autoimmune hepatitis.

BACKGROUND AND PURPOSE: Neurological manifestations have been identified in the context of autoimmune hepatitis (AIH). Previous case reports highlighted the association between AIH and sensory neuronopathy (SN). Despite that, little is known about the frequency of AIH-related SN and its clinical/neurophysiological profile. Moreover, it is not clear whether SN is an AIH-specific manifestation or related to chronic liver damage. METHODS: Seventy consecutive AIH patients were enrolled and their characteristics were compared with 52 consecutive patients with chronic active hepatitis B. All subjects underwent clinical and neurophysiological evaluation. Further comparisons were performed between AIH SN and AIH non-SN patients. RESULTS: Mean ages and male:female proportions in the AIH and chronic active hepatitis B groups were 42.2 ± 16.3/51.7 ± 13.6 years and 14:56/29:23, respectively. The frequencies of carpal tunnel syndrome, radiculopathy and polyneuropathy were similar between groups. In contrast, SN was identified only in AIH patients (5/70 vs. 0/52, P = 0.04); the overall prevalence of AIH-related SN was 7% with an average profile of a woman in her 40s with asymmetric onset of sensory deficits that chronically evolved to disabling proprioceptive ataxia associated with marked dysautonomia. Neurological disability and hepatocellular damage did not follow in parallel. Anti-fibroblast growth factor receptor type 3 antibodies were found in 3/5 (60%) of the patients with AIH-related SN. Clinical or demographic predictors of SN in the context of AIH could not be identified. CONCLUSION: Sensory neuronopathy, but not other peripheral nervous system diseases, is a specific AIH neurological manifestation. It is often disabling and, in contrast to hepatocellular injury, does not respond to immunosuppression.

Effect of inhibition of fatty acid amide hydrolase on MPTP-induced dopaminergic neuronal damage. / Efecto del inhibidor de amida hidrolasa de ácidos grasos en el daño neuronal dopaminérgico inducido por MPTP.

INTRODUCTION: Parkinson's disease (PD) is a neurodegenerative disorder characterised by balance problems, muscle rigidity, and slow movement due to low dopamine levels and loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). The endocannabinoid system is known to modulate the nigrostriatal pathway through endogenous ligands such as anandamide (AEA), which is hydrolysed by fatty acid amide hydrolase (FAAH). The purpose of this study was to increase AEA levels using FAAH inhibitor URB597 to evaluate the modulatory effect of AEA on dopaminergic neuronal death induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). METHODS: Our study included 4 experimental groups (n = 6 mice per group): a control group receiving no treatment, a group receiving URB597 (0.2mg/kg) every 3 days for 30 days, a group treated with MPTP (30mg/kg) for 5 days, and a group receiving URB597 and subsequently MPTP injections. Three days after the last dose, we conducted a series of behavioural tests (beam test, pole test, and stride length test) to compare motor coordination between groups. We subsequently analysed immunoreactivity of dopaminergic cells and microglia in the SNpc and striatum. RESULTS: Mice treated with URB597 plus MPTP were found to perform better on behavioural tests than mice receiving MPTP only. According to the immunohistochemistry study, mice receiving MPTP showed fewer dopaminergic cells and fibres in the SNpc and striatum. Animals treated with URB597 plus MPTP displayed increased tyrosine hydroxylase immunoreactivity compared to those treated with MPTP only. Regarding microglial immunoreactivity, the group receiving MPTP showed higher Iba1 immunoreactivity in the striatum and SNpc than did the group treated with URB597 plus MPTP. CONCLUSION: Our results show that URB597 exerts a protective effect since it inhibits dopaminergic neuronal death, decreases microglial immunoreactivity, and improves MPTP-induced motor alterations.

Autonomic dysfunction in hereditary spastic paraplegia type 4.

BACKGROUND AND PURPOSE: SPAST mutations are the most common cause of hereditary spastic paraplegia (SPG4-HSP), which is characterized by progressive lower limb weakness, spasticity and hyperreflexia. There are few studies about non-motor manifestations in this disease and none about autonomic involvement. Therefore, the aim was to determine the frequency and pattern of autonomic complaints in patients with SPG4-HSP, as well as to determine the clinical relevance and the possible factors associated with these manifestations. METHODS: Thirty-four molecularly confirmed SPG4 patients were recruited in a multicenter cross-sectional study, of whom 26 underwent detailed neurophysiological testing (heart rate variability, sympathetic skin response and the Quantitative Sudomotor Axonal Reflex Test). The Scales for Outcomes in Parkinson's Disease - Autonomic Questionnaire (SCOPA-AUT) was applied to quantify the severity of autonomic symptoms. Results were compared with 44 age- and gender-matched healthy controls using non-parametric tests. P values <0.05 were considered significant. RESULTS: In the SPG4-HSP group, there were 18 men with a mean age of 47.7 ± 12.6 years. SCOPA-AUT scores were similar between patients and controls (P = 0.238). Only the urinary domain subscore was significantly higher amongst patients (4 vs. 2.5, P = 0.05). Absent sympathetic skin response in the hands and feet was more frequent amongst patients (20% vs. 0%, P < 0.001, and 64% vs. 0%, P = 0.006, respectively). Quantitative Sudomotor Axonal Reflex Test responses were also smaller throughout all recording regions in the SPG4-HSP group. CONCLUSION: Our results indicate that SPG4-HSP patients have sudomotor dysfunction caused by damaged small post-ganglionic cholinergic fibers. Damage in SPG4-HSP extends to the peripheral nervous system.

Developmental and neurodegenerative damage in Friedreich's ataxia.

BACKGROUND AND PURPOSE: Friedreich's ataxia (FRDA) is the most common autosomal-recessive ataxia worldwide. It is characterized by early onset, sensory abnormalities and slowly progressive ataxia. All magnetic resonance imaging (MRI)-based studies have focused on the evaluation of adult patients. Therefore, we designed a cross-sectional multimodal MRI-based study to investigate the anatomical substrates involved in the early stages of FRDA. METHODS: We enrolled 37 patients (12 children) and 38 controls. All subjects underwent MRI in a 3T device to assess gray and white matter. We used measures from FreeSurfer and CERES to evaluate the cerebral and cerebellar cortices. The T1 multiatlas assessed deep gray matter. The diffusion tensor imaging multiatlas was used to investigate microstructural abnormalities in brain white matter and SpineSeg was used to assess the cervical spinal cord. All analyses were corrected for multiple comparisons. RESULTS: Comparison with age-matched controls showed that pediatric patients have spinal cord, inferior cerebellar peduncle and red nucleus damage. In contrast, adult patients showed more widespread white matter damage than pediatric patients. With regard to gray matter, we found cortical thinning at the left central sulcus and volumetric reduction in the thalami and hippocampi only in adult patients. Finally, values of fractional anisotropy in adult patients and radial diffusivity in pediatric patients from the inferior cerebellar peduncle correlated with disease duration and ataxia severity, respectively. CONCLUSIONS: Structural damage in FRDA begins in the spinal cord and inferior cerebellar peduncle as well as the red nucleus, and progresses to cerebral areas in adulthood. These results shed some light on the early stages of FRDA and highlight potential neuroimaging markers for therapeutic trials.

Effects of extraction solvents on photoluminescent properties of eysenhardtia polystachia and their potential usage as biomarker.

Currently, nanomaterials had been used for several applications; one of them is as bio-markers. These nanomaterials contain fluorescent compounds as effective indicators for imaging and other applications in Biotechnology. In previous studies, we proposed a functionalized nanomaterial-based biomarker from silica and Eysenhardtia Polystachia, a medicinal tree known in Mexico as "palo azul" (Kidneywood). Our previous results showed the feasibility of the nanomaterial obtained as bio-marker. In this article, our purpose is to evaluate the effects of extraction solvents on fluorescence of that biomarker. The photoluminescence (PL) effect was evaluated at different pH (4, 7.4 and 8); four extraction solvents, ethanol, methanol, methanol-ethanol and methanol-ethanol-water were evaluated. A molecular dynamics simulation was performed to recognize molecular interaction between the compounds of the extracts with solvent molecules and to investigate the solvent molecules effect on photoluminescence spectra. The results were also compared with rhodamine 6G and we found that, at physiological pH (7.4), the fluorescent-coated silica nanoparticles obtained were also stable. We found that extraction solvents could be used for obtaining different nanomaterials for specific applications, and also found the best extraction solvent for obtaining EP nanomaterials for health care applications, specifically for imaging techniques.

Development of meniscus substitutes using a mixture of biocompatible polymers and extra cellular matrix components by electrospinning.

Despite the significant advances in the meniscus tissue engineering field, it is difficult to recreate the complex structure and organization of the collagenous matrix of the meniscus. In this work, we developed a meniscus prototype to be used as substitute or scaffold for the regeneration of the meniscal matrix, recreating the differential morphology of the meniscus by electrospinning. Synthetic biocompatible polymers were combined with the extracellular matrix component, collagen and used to replicate the meniscus. We studied the correlation between mechanical and structural properties of the polymer blend as a function of collagen concentration. Fibers were collected on a surface of a rapidly rotating precast mold, to accurately replicate each sectional morphology of the meniscus; different electro-tissues were produced. Detailed XRD analyses exhibited structural changes developed by electrospinning. We achieved to integrate all these electro-tissues to form a complete synthetic meniscus. Vascularization tests were performed to assess the potential use of our novel polymeric blend for promising meniscus regeneration.

Neumonía por herpes virus simple tipo 1. Entidad infrecuente de difícil diagnóstico y mal pronóstico en trasplantados pulmonares / Pneumonia due to herpes simplex virus type 1: A diffi cult to diagnose condition with a poor prognosis in lung transplants

La neumonía herpética es una rara enfermedad que afecta casi con exclusividad apersonas con un déficit de inmunidad. Con frecuencia tiene un desenlace fatal. Su aparición está descrita en los primeros 2 meses luego del trasplante pulmonar, pero en nuestra experiencia se evidenció después de los 10 meses, 1 año y medio, 8 y 19 años. Describimos los hallazgos tomográficos detectados en 4 pacientes con trasplantes pulmonares que cursaron neumonía herpética. Presentaban fiebre, tos, expectoración y disnea, con empeoramiento progresivo de su clase funcional, y todos fallecieron tras la aparición de la enfermedad. El diagnóstico histológico se realiza mediante lavado bronquioalveolar o biopsia transbronquial,con posterior tinción con hematoxilina-eosina y/o marcación inmunohistoquímica. Los hallazgos tomográficos destacados fueron: opacidades en vidrio esmerilado de distribución parcheada, consolidación del espacio aéreo, derrame pleural y bronquiectasias. Debido a su baja frecuencia y mal pronóstico, es importante conocer y tener presente esta entidad en personas trasplantadas de pulmón para no demorar el diagnóstico y actuar lo más rápidamente posible...

Neumonía por herpes virus simple tipo 1: Entidad infrecuente de difícil diagnóstico y mal pronóstico en trasplantados pulmonares

La neumonía herpética es una rara enfermedad que afecta casi con exclusividad a personas con un déficit de inmunidad. Con frecuencia tiene un desenlace fatal. Su aparición está descrita en los primeros 2 meses luego del trasplante pulmonar, pero en nuestra experiencia se evidenció después de los 10 meses, 1 año y medio, 8 y 19 años. Describimos los hallazgos tomográficos detectados en 4 pacientes con trasplantes pulmonares que cursaron neumonía herpética. Presentaban fiebre, tos, expectoración y disnea, con empeoramiento progresivo de su clase funcional, y todos fallecieron tras la aparición de la enfermedad. El diagnóstico histológico se realiza mediante lavado bronquioalveolar o biopsia transbronquial, con posterior tinción con hematoxilina-eosina y/o marcación inmunohistoquímica. Los hallazgos tomográficos destacados fueron: opacidades en vidrio esmerilado de distribución parcheada, consolidación del espacio aéreo, derrame pleural y bronquiectasias. Debido a su baja frecuencia y mal pronóstico, es importante conocer y tener presente esta entidad en personas trasplantadas de pulmón para no demorar el diagnóstico y actuar lo más rápidamente posible.(AU)

Pneumonia due to herpes simplex virus type 1: A difficult to diagnose condition with a poor prognosis in lung transplants Abstract Herpetic pneumonia is a rare disease that mostly affects people with immune deficiency whose outcome is frequently fatal. Its appearance is described in the first two months after surgery. In our experience it was evidenced in the post transplant apart since 10 months, 1 ¢ years, 8 years and 19 years after the transplant. We described the CT findings detected in 4 lung transplant recipient that had evolved with herpetic pneumonia. Patients presented fever, cough, sputum and dyspnea with progressive worsening of functional class, four died after the disease. The histological diagnosis is made by bronchoalveolar lavage or transbronchial biopsy with subsequent staining with hematoxylin - eosin and / or immunohistochemistry procedure. The highlighted CT findings were ground-glass opacities patchy distribution, airspace consolidation, pleural effusion and bronchiectasis. Due to its low frequency and poor prognosis is important to know this entity in lung transplant recipients to avoid a delayed diagnosis and treatment.(AU)

First Report of Homothallic Isolates of Phytophthora infestans in Commercial Potato Crops (Solanum tuberosum) in the Toluca Valley, Mexico.

Phytophthora infestans causes severe symptoms of wilt disease on potato crops (Solanum tuberosum) in the Toluca Valley (Mexico) despite the use of fungicides. P. infestans oospores produced by sexual reproduction can survive in the soil for many years, resisting harsh environments. In many agroecosystems, oospores germinate in the beginning of a season, which represents the initial inoculum for epidemics. The sexual cycle of the pathogen allows the generation of recombinant genotypes that can be more pathogenic or even resistant to chemicals. This paper presents a study of 20 isolates of P. infestans collected from potato crops in the Toluca Valley within the municipality of Zinacantepec (Mexico State). Isolates were obtained from potato foliar infected tissues. The pathogen was confirmed as P. infestans on the basis of morphological characters (1). Sporangia were caducous, ovoid, limoniform, semipapillate, and were 28.4 ± 1.3 × 17.6 ± 1.2 µm (height × width). Mycelium was coenocytic with hyphal diameter of 5 to 8 µm. Five isolates were collected in 2011, and 15 in 2012. Isolates were transferred by hyphal tip to culture medium plates with V8 juice agar and incubated at 19°C. All the isolates were mated to determine the mating type with the reference isolates J104 (A1) and J204 (A2), which were provided by the Michoacana University of San Nicolás de Hidalgo (Mx). Isolates that produced oospores with both A1 and A2 testers (J104 and J204) and in a single culture were designated homothallic. Results show that two out of the five isolates collected in 2011 were homothallic and the other three were type A1. Regarding the 15 isolates collected in 2012, six were typed as A1, five as A2, and four were homothallic. The heterothallic isolates only produce oospores when mated with the opposite mating type. The homothallic isolates possessed the ability to act as A1 and A2 during heterothallic mating and were found capable of producing sexual structures (oogonia and amphigynous antheridia) in a single culture, a phenomenon not observed in isolates that are strictly A1 or A2. Oospores formed were aplerotic and measured 32.2 ± 3.3 µm in diameter. Single-sporangium progeny were produced from the six homothallic isolates to be analyzed to confirm the occurrence of the self-fertility. Assessment of 48 single-sporangium progeny from the homothallic isolates resulted in 22 homothallic, 12 A1, 10 A2, and four sterile. These results differ from those found by Grünwald et al. (3), who conducted a study with isolates collected from the Toluca Valley region in 1997 and 1998, finding a 1:1 frequency between compatibility types A1 and A2. Fernandez et al. (2) studied a broad population of 27 isolates from potato crops in the state of Michoacán (Mx), and found two homothallic isolates among heterothallic isolates; the ratio was 1:1. Also, homothallic isolates have been found in Spain and China (4). To our knowledge, this is the first report of the occurrence of homothallic P. infestans isolates in commercial potato crops (S. tuberosum) in the Toluca Valley, Mexico. References: (1) D. C. Erwin and O. K. Ribeiro, Page 346 in: Phytophthora Diseases Worldwide. The American Phytopathological Society. St. Paul, MN, 1996. (2) S. P. Fernández et al. Rev. Mexicana Fitopatol. 23:191, 2005. (3) N. J. Grünwald et al. Phytopathology 91:883, 2001. (4) M. Han et al. J. Eukaryotic Microbiol. 60:79, 2013.

Characterization of the Streptococcus sobrinus acid-stress response by interspecies microarrays and proteomics.

Streptococcus mutans and Streptococcus sobrinus are considered the primary organisms responsible for human dental caries. The ability to generate acids and to adapt to low pH conditions is directly associated with the cariogenic potential of these bacteria. To survive acidic conditions, both species have been shown to mount an acid-tolerance response (ATR). However, previous characterization of the S. sobrinus ATR identified critical differences in the mechanisms of acid adaptation between S. mutans and S. sobrinus. Here, interspecies microarray and proteomic approaches were used to identify novel, previously unrecognized genes and pathways that participate in the S. sobrinus acid-stress response. The results revealed that, among other things, metabolic alterations that enhance energy generation and upregulation of the malolactic fermentation enzyme activity constitute important acid-resistance properties in S. sobrinus. Some of these acid adaptive traits are shared by S. mutans and might be considered optimal targets for therapeutic treatments designed to control dental caries.

Characterization of brain tumors by MRS, DWI and Ki-67 labeling index.

With the advent of fast imaging hardware and specialized software, additional non-invasive magnetic resonance characterization of tumors has become available through proton magnetic resonance spectroscopy (MRS), hemodynamic imaging and diffusion-weighted imaging (DWI). Thus, patterns could be discerned to discriminate different types of tumors and even to infer their possible evolution in time. The purpose of this study was to investigate the correlation between MRS, DWI, histopathology and Ki-67 labeling index in a large number of brain tumors. Localized proton spectra were obtained in 47 patients with brain tumors who subsequently underwent surgery (biopsy or tumor removal). We performed MRS with short echo-time (30 ms) and metabolic values in spectra were measured using an external software with 25 peaks. In all patients who had DWI, we measured apparent diffusion coefficients (ADC) in the same region of interest (ROI) where the voxel in MRS was located. In most tumors the histological diagnosis and Ki-67 labeling index had been determined on our original surgical specimen. Cho/Cr, (Lip+Mm)/Cr, NAA/(Cho+Cr) and Glx/Cr indexes in MRS allowed discriminating between low- and high-grade gliomas and metastases (MTs). Likewise, absolute ADC values differentiated low- from high-grade gliomas expressed by Ki-67 labeling index. A novel finding was that high Glx/Cr in vivo MRS index (similar to other known indexes) was a good predictor of tumor grading.

[Neuropsychiatric symptoms in dementia syndrome]. / Sintomas neuropsiquiatricos en el sindrome demencial.

AIMS: The aim of this study was to describe the neuropsychiatric disorders that present in dementia and the differences they show at each stage as the disease progresses. PATIENTS AND METHODS: The study involved a total of 175 patients from a psychogeriatric clinic who had been diagnosed as suffering from dementia at distinct stages of the disease: 66 had mild dementia, 56 were with moderate dementia and 53 were suffering from severe dementia. The following instruments were used to collect both socio demographic and clinical data: the Spanish version of the Mini Mental State Examination (miniexamen cognitivo: MEC) for cognitive impairment, the Barthel index for functional deterioration and the neuropsychiatric inventory (NPI) for the non cognitive symptoms. RESULTS: There were no significant differences in the NPI according to the degree of cognitive impairment and the most frequently seen symptoms were anomalous motor activity, apathy and irritability; the neuropsychiatric disorder that was least often present was euphoria. The presence of disinhibition, irritability, depression, hallucinations and anomalous motor activity varied significantly in the different phases of dementia. Thus, disinhibition, irritability and depression were more frequent in the initial stages of the disease whereas hallucinations and anomalous motor activity were seen more often when the cognitive impairment was severe. CONCLUSIONS: Neuropsychiatric disorders appear throughout the whole course of dementia and symptoms vary according to the stage of the disease.

Relación entre síntomas cognitivos y no cognitivos en lademencia / Relationship between the cognitive and non cognitive sympotoms of dementia

Objetivo: analizar la influencia en las distintas funciones neuropsicológicas de los síntomas no cognitivos de la demencia. Material y método: se estudiaron 79 pacientes diagnosticados de síndrome demencial e ingresados en un Centro de Día Psicogeriátrico. Se recogieron variables sociodemográficas y clínicas, incluyendo en éstas las alteraciones neuropsiquiátricas (INP) y el deterioro cognitivo medido a través de MEC y Test Barcelona abreviado (TBA). Resultados: las distintas funciones neuropsicológicas exploradas a través del protocolo se relacionaban con ciertos síntomas psiquiátricos como eran los delirios (p=0,02; r=-0,25), depresión, euforia, apatía, desinhibición e irritabilidad (p=0,007; r=0,30). El diagnóstico de demencia tipo Alzheimer determinaba mayor deterioro cognitivo (p=0,001; F=4,95) que otras demencias. El deterioro no correlacionaba con la edad del paciente, con los años de escolarización ni con la duración de la enfermedad. El sexo tampoco determinaba diferencias. Conclusión: el deterioro cognitivo de los pacientes con demencia empeoraba con la frecuencia y severidad de ciertos síntomas neuropsiquiátricos como eran los delirios, depresión, euforia, apatía, desinhibición e irritabilidad (AU)

Deterioro funcional del paciente con demencia: influencia del grado de deterioro cognitivo, la comorbilidad física y las alteraciones neuropsiquiátricas / Functional impairment of the patient with dementia: influence of cognitive impairment, physical comorbidity and neuropsychiatric symptoms

OBJETIVO: Analizar la influencia en el deterioro funcional del paciente con demencia del grado de deterioro cognitivo, la comorbilidad física y las alteraciones neuropsiquiátricas. MATERIAL Y MÉTODO: Se estudiaron 144 pacientes con demencia que fueron evaluados para su ingreso en un Centro de Día Psicogeriátrico. Se registraron variables sociodemográficas y clínicas, incluyendo en éstas últimas el deterioro cognitivo (MEC), la comorbilidad física (Escala de Burvill) y alteraciones neuropsiquiátricas (INP).RESULTADOS: La capacidad funcional se relacionaba con el grado de deterioro cognitivo, con el tipo de demencia y con la presencia de alucinaciones, de apatía y de depresión, explicando estas variables el 25 per cent de la variabilidad en la capacidad funcional (R2= 0,25; F= 9,38; p= 0,0000). Así, una menor capacidad funcional se relacionaba con un mayor deterioro cognitivo, con la demencia no Alzheimer y con la presencia de alucinaciones y apatía. Por el contrario, la demencia tipo Alzheimer y la depresión se relacionaban con una mayor capacidad funcional. Por otra parte, la edad del paciente, la duración de la demencia y la comorbilidad física no se relacionaban con la capacidad funcional. CONCLUSIÓN: La capacidad funcional de los pacientes con demencia empeora con la intensidad del deterioro cognitivo, en la demencia no Alzheimer y con la presencia de alucinaciones y apatía (AU)

Sobrecarga del cuidador informal del paciente con demencia institucionalizado / The burden of informal caregiver of the patient with dementia in institutional Setting

Objetivo: analizar el nivel de sobrecarga del cuidador informal del paciente con demencia ingresado en una residencia y la relación de la misma con los síntomas de la enfermedad. Material y método: se estudiaron 35 cuidadores familiares de pacientes residenciales y se registraron variables sociodemográficas, asistenciales y clínicas. Los instrumentos utilizados para la medición de éstas últimas fueron: el Miniexamen cognoscitivo para el deterioro cognitivo, el índice de Barthel para la capacidad funcional, el NPI para los síntomas neuropsiquiátricos y la “Escala de sobrecarga del cuidador” para la sobrecarga. Resultados: no se encontró sobrecarga en el grupo de cuidadores estudiado y ésta no se relacionaba con los síntomas de la enfermedad. La duración del ingreso se correlacionaba inversamente con el nivel de tensión en el papel de cuidador. Conclusión: el cuidador familiar del paciente con demencia ingresado en una residencia no experimenta sobrecarga, aunque esto no implica una desvinculación del paciente y la ausencia de otro tipo de repercusión emocional. (AU)

Valoración funcional directa e indirecta del paciente con demencia / Direct and indirect assesment of the patient with dementia

El objetivo de este estudio es analizar el nivel de concordancia entre la valoración funcional del paciente con demencia medida por los profesionales y la medida por los cuidadores familiares, así como estudiar distintas variables del cuidador que pudieran influir en dicha concordancia. Para ello, se estudiaron 53 pacientes y sus respectivos cuidadores familiares. Se registraron variables sociodemográficas y clínicas, utilizando el índice de Barthel para la valoración de la capacidad funcional y la “ Escala de Sobrecarga del Cuidador” para la medición de la sobrecarga. Los resultados muestran un índice de concordancia muy bajo para todas las actividades, siendo mejor el acuerdo en cuanto a las funciones motoras. Los cuidadores familiares tienden a valorar a los pacientes como más independientes que los profesionales de enfermería, no influyendo en dicha discordancia ni el tipo de parentesco, ni el nivel de sobrecarga ni el sexo del cuidador (AU)