Prevención de la muerte súbita en la epilepsia fármaco resistente: investigaciones de enfermería / Prevention of sudden death in drug-resistant epilepsy: nursing research

Introducción: Una muerte súbita en epilepsia (SUDEP) ocurre cada diez minutos en todo el mundo. El 30 por ciento de los pacientes epilépticos padecen de epilepsia fármaco resistente (EFR), no logran el control de sus crisis y esto aumenta el riesgo de SUDEP. Muchos aún desconocen los factores de riesgo SUDEP y cómo prevenirlos. Los tratamientos para evitarla aún son insuficientes. Las investigaciones enfermeras aportan resultados positivos en el manejo de la enfermedad. Objetivo: Revisar el estado sobre mortalidad, autogestión de epilepsia e investigaciones enfermeras para prevenir la SUDEP en adolescentes y adultos con EFR. Material y Métodos: Revisión sistemática y búsqueda bibliográfica en las bases de datos PubMed SciELO, SCOPUS, ElSEVIER, MEDES, Organización Panamericana de la Salud (OPS), INFOMED y Google académico. Los criterios de selección: trabajos de la última década en adolescentes y adultos publicados en Cuba y el mundo, enfatizando en las investigaciones enfermeras. Búsqueda de palabras claves en español e inglés, sin restricciones de idioma. Desarrollo: Entre los tratamientos para evitar la SUDEP, destacan los dispositivos de detección de crisis y programas de ayuda online, pero aún son necesarias nuevas opciones. En los factores de riesgo, destacan aquellos relacionados con el sueño. Otros factores de riesgo SUDEP pudieran ser modificables con programas educativos. A pesar de que aún se debaten las formas más adecuadas de ofrecer información sobre SUDEP, los programas educativos enfermeros han evidenciado mayor autogestión, conocimiento de la enfermedad y apego al tratamiento. Conclusiones: El enfermero es el potencial humano ideal, para implementar acciones de autocuidado en las personas con EFR, y empoderarlas con habilidades para el manejo de su enfermedad y prevención de SUDEP(AU)

Introduction: A sudden death in epilepsy (SUDEP) occurs every ten minutes worldwide. Also, 30 percent of epileptic patients who suffer from drug-resistant epilepsy (DRE) fail to control their seizures, so the risk of SUDEP increases. Many epileptic patients are unaware of the risk factors for SUDEP and the ways to prevent it. Treatments to avoid SUDEP are still insufficient. Nursing research provide positive results in the management of the disease. Objective: To review the mortality status, self-management of epilepsy and nursing research to prevent SUDEP in adolescents and adults with DRE. Material and Methods: A systematic review and bibliographic search was carried out in the PubMed SciELO, SCOPUS, ELSEVIER, MEDES, Pan American Health Organization (PAHO), INFOMED and Google Scholar databases. Selection criteria included studies on nursing research conducted in adolescents and adults during the last decade that have been published in Cuba and other countries of the world. Keywords in Spanish and English without language restrictions were used to carry out the search. Development: Crisis detection devices and online help programs stand out among the treatments to avoid SUDEP, but new options are still necessary. Among the risk factors for SUDEP, those related to sleep are highlighted. Other risk factors for SUDEP could be modified with educational programs. Despite the most appropriate ways of offering information about SUDEP are still debated, nursing educational programs have shown greater self-management, knowledge of the disease, and adherence to treatment. Conclusions: The Nurse is the ideal human potential to implement self-care actions in people with EFR. These actions aim to learn new skills for managing their disease and preventing SUDEP(AU)

Trastornos del sueño en pacientes con enfermedad de Parkinson / Sleep disorders in patients with Parkinson's disease

Objetivo: Evaluar la frecuencia de presentación de los trastornos del sueño según edad, sexo y tiempo de evolución.Métodos: Se realizó un estudio descriptivo de corte transversal por medio de una entrevista, examen clínico y estudio de polisomnografía a 77 pacientes con diagnóstico de enfermedadde Parkinson, remitidos al Centro Internacional de Restauración Neurológica, La Habana, Cuba, en el periodo comprendido entre septiembre de 2014 a enero de 2018. Se evaluóla edad, sexo y el tiempo de evolución de la enfermedad de Parkinson en función de los trastornos del sueño diagnosticados por polisomnografía. Se empleó la estadística descriptiva, así como el análisis no paramétrico (Kruskal-Wallis).Resultados: La evaluación mostró resultados dentro de parámetros normales en 6,49 Por ciento de los pacientes, trastorno del comportamiento del sueño de movimientos oculares rápidos en 29,87 Por ciento, insomnio en 29,87 Por ciento (principalmente, el tipo de mantenimiento del sueño),síndrome de apnea obstructiva del sueño en 25,97 Por ciento y el síndrome de piernas inquietas asociado con el movimiento periódico de las piernas durante el sueño en 7,79 Por ciento. Estos trastornos presentaron un comportamiento similar entre ambos sexos, así como una tendencia a empeorar con la edad y el tiempo de evolución.Conclusiones: Se detectó una alta prevalencia de trastornos del sueño en pacientes con enfermedad de Parkinson, los cuales no reflejan variaciones de acuerdo con el sexo; sin embargo, fueron más frecuentes en los pacientes de mayor edad o de mayor tiempo deevolución(AU)

Objective: To evaluate the frequency of sleep disorders occurrence according to age, sex and period of evolution.Methods: A descriptive cross-sectional study was conducted through interview, clinical examination and polysomnography study of 77 patients diagnosed with Parkinson's disease,these subjects were referred to the International Center for Neurological Restoration, Havana, Cuba, from September 2014 to January 2018. Age, sex, and evolution time of Parkinson's disease were evaluated based on sleep disorders diagnosed by polysomnography. Descriptive statistics were used, as well as non-parametric analysis (Kruskal-Wallis).Results: The evaluation showed results within normal parameters in 6.49 Per cent of the patients, rapid eye movement sleep behavior disorder in 29.87 Per cent, insomnia in 29.87 Per cent (mainly, type of sleep maintenance insomnia) , obstructive sleep apnea syndrome in 25.97 Per cent and restlesslegs syndrome associated with periodic movement of the legs during sleep in 7.79 Per cent. These disorders showed similar behavior in both sexes, as well as a tendency to worsen with ageand time of evolution.Conclusions: High prevalence of sleep disorders was detected in patients with Parkinson's disease, which do not reflect variations according to sex; however, they were more frequentin older patients or patients with a longer evolution period(AU)

Potencial P300 durante una tarea de atención sostenida en pacientes conenfermedad de Parkinson / P300 event-related potential during sustained attention in Parkinson's disease patients

Objetivo: Evaluar la relación entre el potencial relacionado a eventos P300 con significado atencional visual y los resultados de la evaluación neuropsicológica en pacientes conenfermedad de Parkinson en estadios II y III de Hoehn y Yahr.Métodos: Se realizó un estudio analítico transversal donde se evaluaron 57 pacientes con enfermedad de Parkinson idiopática, atendidos entre diciembre de 2017 y abril de 2018, en el Centro Internacional de Restauración Neurológica, de La Habana. Se realizó el registro de P300, durante la ejecución de una tarea de atención sostenida visual. Se midió latencia y amplitud de la P300, lo que se correlacionó (test de correlaciones de Spearman, p< 0,01)con las variables demográficas, variables de eficiencia en la tarea de atención sostenida y variables neuropsicológicas. Se compararon los resultados de los grupos II y III de Hoehn y Yahr con respecto a todas las variables estudiadas (test de la U de Mann Whitney, p< 0,05).Resultados: Se constató una significativa diferencia de latencia entre grupos del componente P300 en el electrodo Pz. Fue más prolongado en el grupo III de Hoehn y Yahr.Se evidenciaron en el grupo II correlaciones negativas entre la latencia de P300 y el test de batería de evaluación frontal, y positivas entre la latencia de P300 y la prueba de Stroop.Las correlaciones entre el test de ba(AU)

Objective: To evaluate the relationship between the P300 event-related potential with visual attention significance and the results of neuropsychological evaluation in patientswith Parkinson's disease in Hoehn and Yahr stages II and III.Methods: A cross-sectional analytical study was carried out evaluating 57 patients with idiopathic Parkinson's disease, who were treated from December 2017 to April 2018 at theInternational Center for Neurological Restoration, in Havana. P300 was recorded during the execution of a visual sustained attention task. The latency and amplitude of P300 weremeasured, which was correlated (Spearman's correlation test, p <0.01) with demographic variables, efficiency variables in the sustained attention task and neuropsychological variables. The results of Hoehn and Yahr groups II and III were compared with respect to all the variables studied (Mann Whitney U test, p <0.05).Results: Significant latency difference was found between groups of P300 component in Pz electrode. It was more prolonged in Hoehn and Yahr group III. Negative correlations were found in group II between P300 latency and the frontal evaluation battery test, andpositive correlations between P300 latency and Stroop test. The correlations between the frontal evaluation battery test and P300 amplitude were positive, and between Stroop test and P300 amplitude were negative. Similar results were evident in group III regarding P300 amplitude, which corresponded to worse performance in the neuropsychological evaluation.Conclusions: A close relationship between P300 event-related potential with visual attention significance and the results of the neuropsychological evaluation in Parkinson's disease patients, in Hoehn and Yahr stages II and III, was verified. P300 potential was an objective examination that reinforced the validity of the neuropsychological evaluationresults(AU)

Validación al Español de un cuestionario de hábitos de sueño en los niños / Validation to Spanish version of the Children's Sleep Habits Questionnaire

Introducción: Los trastornos del sueño en la infancia constituyen un fenómeno de elevada frecuencia. Los cuestionarios de sueño constituyen un instrumento de innegable valor que complementa los estudios objetivos del sueño. Objetivo: Validar al español un cuestionario que indaga acerca de los hábitos de sueño en niños en el contexto sociocultural cubano. Métodos: Se seleccionó el cuestionario CHILDREN'S SLEEP HABITS QUESTIONNAIRE (NICHD SECCYD-Wisconsin) para su uso en el laboratorio de neurofisiología del Centro Internacional de Restauración Neurológica. En una primera etapa del estudio, el cuestionario se tradujo y adaptó al español según las reglas internacionales. Se entregaron 330 cuestionarios a los padres en una muestra poblacional cubana de niños en edades comprendidas entre los 2 a 10 años. Estos se distribuyeron en escuelas y círculos infantiles con una tasa de respuesta de 93 por ciento. Se recuperaron 295 (96 por ciento) cuestionarios útiles, 25 atendieron a los criterios de exclusión, 270 se aceptaron para estudios de validación. Resultados: La consistencia interna del cuestionario (alfa de Cronbach) fue de 0,67 para la escala completa y varió de 0,42 a 0,61 para las subescalas. Para la confiabilidad test-retes de las subescalas se aplicó una t de students para muestras dependientes, con una n= de 86. Las diferencias fueron significativas en las subescalas 3 y 8 (p= 0,04) Conclusiones: El cuestionario según su versión original y en comparación con la de otros países presentó propiedades psicométricas adecuadas para evaluar los problemas de sueño en niños cubanos entre 2 y 10 años de edad(AU)

Introduction: Sleep disorders in childhood constitute a highly frequent phenomenon. The sleep habits´ questionnaires are instruments of undeniable value that complement the sleep's objective studies. Objective: To validate the Spanish version of a Questionnaire (NICHD SECCYD-Wisconsin) and compare it with the results of previous studies in other countries. Methods: It was selected the Children's Sleep Habits Questionnaire for its use in the neurophysiology laboratory of the International Center of Neurological Restoration (CIREN, by its acronym in Spanish). In the first stage of the study, the questionnaire was translated and adapted to Spanish according to the international standards. 330 questionnaires were delivered to the parents of a Cuban community sample of children aged 2 to10 years old, with a response rate of 93 percent. 295 (96 percent) useful questionnaires were obtained, 25 met the exclusion criteria, 270 were accepted for validation studies. The results were compared with the results of other countries. Results: The Children's Sleep Habits Questionnaire´s internal consistency (Cronbach) was 0.67 for the total scale and ranged from 0.42 to 0.61 for subscales. The test-retest reliability for subscales used t for students in dependent samples, being n= 86.The differences were meaningful for subscales 3 y 8 (p= 0,4). Conclusion: The questionnaire according to its original version and in comparison with that of other countries has adequate psychometric properties to evaluate sleep problems in Cuban children between 2 and 10 years(AU)

Analysis of Sleep Macrostructure in Patients Diagnosed with Parkinson's Disease.

Patients diagnosed with Parkinson's disease present sleep disorders with a higher frequency than the general population. The sleep architecture in these patients shows variations with respect to the normal population, so in this work it was decided to investigate the characteristics of the macroarchitecture of sleep in patients diagnosed with Parkinson's disease. A polysomnographic study was carried out on 77 patients diagnosed with Parkinson's disease. All the studies were processed according to the AASM Manual for the Scoring of Sleep and Associated Events v.2.2, and to the criteria of the International Classification of Sleep Disorders 3rd ed. (2014). Processing was carried out using descriptive statistics, as well as non-parametric analysis for comparison between cases and controls. The group of patients showed significant reductions of the N2, N3, and REM sleep stages when compared with a control group, as well as a significant increase in intra-sleep wakefulness. The number of REM⁻NoREM sleep cycles and sleep efficiency showed marked reduction compared to the control group. There was a statistically significant difference in the macroarchitecture of sleep between patients diagnosed with Parkinson's disease and healthy controls.

Subjective Assessment of Sleep in Infantile Autism: A Comparative Study.

Sleep disturbances are very common in children with autism; it is for this reason that instruments that facilitate their evaluation are necessary. OBJECTIVES: Perform sleep assessment from a subjective perspective in a group of children with primary autism and compare them with a control group, using the Sleep Habits in Children Survey (CSHQ), with the purpose of determining sleep disturbances according to the subscales used. METHOD: A prospective cross-sectional study was conducted in a group of 21 patients with primary autism. For the evaluation of sleep disturbances, we chose the CSHQ survey. The differences between the independent groups were calculated by applying a Mann⁻Whitney U test. RESULTS: In the group of children with autism, higher values of the total scale were observed in comparison with the control group (p = 0.00) which It is congruent with a large sleep dysfunction. Significant differences were observed for all subscales (p = 0.00), with the exception of the subscale number 7. CONCLUSIONS: A high presence of sleep disturbances was observed in children with primary autism, with the exception of sleep breathing disorders, which did not show significant differences between the groups.