NHANES 2011-2014 Reveals Decreased Cognitive Performance in U.S. Older Adults with Metabolic Syndrome Combinations.

A relationship between metabolic syndrome and cognitive impairment has been evidenced across research; however, conflicting results have been observed. A cross-sectional study was conducted on 3179 adults older than 60 from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) to analyze the relationship between metabolic syndrome and cognitive impairment. In our results, we found that adults with abdominal obesity, high triglycerides, and low HDL cholesterol had 4.39 fewer points in the CERAD immediate recall test than adults without any metabolic syndrome factors [Beta = -4.39, SE = 1.32, 17.75 (1.36) vs. 22.14 (0.76)]. In addition, people with this metabolic syndrome combination exhibited 2.39 fewer points in the CERAD delayed recall test than those without metabolic syndrome criteria [Beta = -2.39, SE = 0.46, 4.32 (0.49) vs. 6.71 (0.30)]. It was also found that persons with high blood pressure, hyperglycemia, and low HDL-cholesterol levels reached 4.11 points less in the animal fluency test than people with no factors [Beta = -4.11, SE = 1.55, 12.67 (2.12) vs. 16.79 (1.35)]. These findings suggest that specific metabolic syndrome combinations are essential predictors of cognitive impairment. In this study, metabolic syndrome combinations that included obesity, fasting hyperglycemia, high triglycerides, and low HDL-cholesterol were among the most frequent criteria observed.

Psycho-Neuro-Endocrine-Immunological Basis of the Placebo Effect: Potential Applications beyond Pain Therapy.

The placebo effect can be defined as the improvement of symptoms in a patient after the administration of an innocuous substance in a context that induces expectations regarding its effects. During recent years, it has been discovered that the placebo response not only has neurobiological functions on analgesia, but that it is also capable of generating effects on the immune and endocrine systems. The possible integration of changes in different systems of the organism could favor the well-being of the individuals and go hand in hand with conventional treatment for multiple diseases. In this sense, classic conditioning and setting expectations stand out as psychological mechanisms implicated in the placebo effect. Recent advances in neuroimaging studies suggest a relationship between the placebo response and the opioid, cannabinoid, and monoaminergic systems. Likewise, a possible immune response conditioned by the placebo effect has been reported. There is evidence of immune suppression conditioned through the insular cortex and the amygdala, with noradrenalin as the responsible neurotransmitter. Finally, a conditioned response in the secretion of different hormones has been determined in different studies; however, the molecular mechanisms involved are not entirely known. Beyond studies about its mechanism of action, the placebo effect has proved to be useful in the clinical setting with promising results in the management of neurological, psychiatric, and immunologic disorders. However, more research is needed to better characterize its potential use. This review integrates current knowledge about the psycho-neuro-endocrine-immune basis of the placebo effect and its possible clinical applications.

Didática de professores e habilidades cognoscitivas de crianças no início de idade escolar / Didáctica de maestros y habilidades cognoscitivas de niños en inicio de edad escolar / Teacher didactics and children's cognitive skills in early school age

RESUMEN El estudio analizó el vínculo entre la didáctica de maestros y las habilidades cognoscitivas de atención, memoria, velocidad y fluidez verbal en estudiantes de primeros grados de un colegio público en Cúcuta-Colombia. Se propuso un diseño exploratorio concurrente con análisis cualitativo y recolección de datos de fuente mixta, con muestreo intencional de 22 estudiantes y 4 maestras. Se evaluaron habilidades cognoscitivas mediante pruebas neuropsicológicas estandarizadas para Colombia y la didáctica fue explorada mediante entrevista semiestructurada siguiendo categorías de enseñanza, aprendizaje y técnicas. Las habilidades cognoscitivas se analizaron mediante estadística descriptiva y las entrevistas por análisis de triangulación categorial, concluyendo en los niños sobresaliente memoria-velocidad y disminuida atención y fluidez verbal, hallazgos sobresalientes vinculados a didácticas basadas en uso de fichas de aprendizaje, repetición, mecanización, mientras que los resultados inferiores se asociaron al uso de video y pasatiempos.

RESUMO O estudo analisou a relação entre a didática de professores e as habilidades cognoscitivas de atenção, memória, velocidade e fluidez verbal em estudantes de primeiros anos de uma escola pública em Cúcuta - Colômbia. Utilizou-se um roteiro exploratório junto com análises qualitativa e levantamento de dados de fonte mista, com amostra intencional de 22 estudantes e 4 professores. Avaliaram-se habilidades cognoscitivas mediante testes neuropsicológicos normatizados para Colômbia e a didática foi explorada mediante entrevista semiestruturada seguindo categorias de ensino, aprendizagem e técnicas. As habilidades cognoscitivas foram analisadas mediante estatística descritiva e as entrevistas por análise de triangulação categorial, concluindo-se nas crianças importantes memória-velocidade e diminuída atenção e fluidez verbal, achados marcantes vinculados a didáticas baseadas no uso de fichas de aprendizagem, repetição, mecanização, enquanto os resultados inferiores foram associados ao uso de vídeo e passatempos.

ABSTRACT The study analyzed the relationship between teacher didactics and cognitive skills of attention, memory, speed and verbal fluidity in first-year students of a public school in Cúcuta-Colombia. An exploratory script was used, together with qualitative analysis and mixed-source data collection, with an intentional sample of 22 students and 4 teachers. Cognitive abilities were evaluated through neuropsychological tests standardized for Colombia, and didactics were explored through semi-structured interviews following categories of teaching, learning and techniques. Cognitive skills were analyzed using descriptive statistics and interviews by categorical triangulation analysis, concluding in important children memory-speed and reduced attention and verbal fluidity, remarkable findings linked to didactics based on the use of learning sheets, repetition, mechanization, while lower results were associated with the use of video and hobbies.

Metabolic Syndrome: Is It Time to Add the Central Nervous System?

Metabolic syndrome (MS) is a set of cardio-metabolic risk factors that includes central obesity, hyperglycemia, hypertension, and dyslipidemias. The syndrome affects 25% of adults worldwide. The definition of MS has evolved over the last 80 years, with various classification systems and criteria, whose limitations and benefits are currently the subject of some controversy. Likewise, hypotheses regarding the etiology of MS add more confusion from clinical and epidemiological points of view. The leading suggestion for the pathophysiology of MS is insulin resistance (IR). IR can affect multiple tissues and organs, from the classic "triumvirate" (myocyte, adipocyte, and hepatocyte) to possible effects on organs considered more recently, such as the central nervous system (CNS). Mild cognitive impairment (MCI) and Alzheimer's disease (AD) may be clinical expressions of CNS involvement. However, the association between MCI and MS is not understood. The bidirectional relationship that seems to exist between these factors raises the questions of which phenomenon occurs first and whether MCI can be a precursor of MS. This review explores shared pathophysiological mechanisms between MCI and MS and establishes a hypothesis of a possible MCI role in the development of IR and the appearance of MS.

Alzheimer's disease and type 2 diabetes mellitus: Pathophysiologic and pharmacotherapeutics links.

At present, Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) are two highly prevalent disorders worldwide, especially among elderly individuals. T2DM appears to be associated with cognitive dysfunction, with a higher risk of developing neurocognitive disorders, including AD. These diseases have been observed to share various pathophysiological mechanisms, including alterations in insulin signaling, defects in glucose transporters (GLUTs), and mitochondrial dysfunctions in the brain. Therefore, the aim of this review is to summarize the current knowledge regarding the molecular mechanisms implicated in the association of these pathologies as well as recent therapeutic alternatives. In this context, the hyperphosphorylation of tau and the formation of neurofibrillary tangles have been associated with the dysfunction of the phosphatidylinositol 3-kinase and mitogen-activated protein kinase pathways in the nervous tissues as well as the decrease in the expression of GLUT-1 and GLUT-3 in the different areas of the brain, increase in reactive oxygen species, and production of mitochondrial alterations that occur in T2DM. These findings have contributed to the implementation of overlapping pharmacological interventions based on the use of insulin and antidiabetic drugs, or, more recently, azeliragon, amylin, among others, which have shown possible beneficial effects in diabetic patients diagnosed with AD.

Acompanhamento psicológico e permanência em estudantes universitários / Acompañamiento psicológico y permanencia en estudiantes universitarios / Psychological accompaniment and permanence in university students

El estudio tiene como objetivo establecer la relación entre el acompañamiento psicológico y la permanencia estudiantil, mediante el análisis de las variables individuales, académicas y sociodemográficas. El estudio siguió un diseño Ex post-facto, de tipo descriptivo correlacional con un muestreo censal de 520 estudiantes quienes han asistido a acompañamiento psicológico de manera voluntaria. La información fue obtenida mediante un cuestionario que explora características sociodemográficas, académicas y específicas de seguimiento psicológico. Se realizaron análisis comparativos y correlaciónales encontrando una relación positiva entre la permanencia y el acompañamiento psicológico breve ante crisis situacionales. Adicionalmente, se concluyó que la permanencia estudiantil se relaciona con la edad, el género, el semestre, el promedio, el motivo de consulta y el método terapéutico desarrollado en el proceso de acompañamiento psicológico. Se discutieron los resultados a la luz de antecedentes que han explicado los fenómenos de la permanencia y la deserción en contexto escolares.

O estudo tem como objetivo estabelecer a relação entre o acompanhamento psicológico e a permanência estudantil, mediante a análise das variáveis individuais, acadêmicas e sóciodemográficas. O estudo seguiu um modelo Ex post-facto, de tipo descritivo com uma amostra de censo de 520 estudantes os quais se submeteram a acompanhamento psicológico de maneira voluntária. A informação foi obtida mediante um questionário que explora características sóciodemográficas, acadêmicas e específicas de seguimento psicológico. Realizaram-se análises comparativas e correlacionais encontrando uma relação positiva entre a permanência e o acompanhamento psicológico breve ante crises situacionais. Adicionalmente, concluiu-se que a permanência estudantil se relaciona com a idade, o gênero, o semestre, a média, o motivo de consulta e o método terapêutico desenvolvido no processo de acompanhamento psicológico. Discutiram-se os resultados à luz de antecedentes que explicam os fenômenos da permanência e a deserção em contextos escolares.

The study aims to establish the relationship between psychological support and university permanence, through the analysis of individual, academic and sociodemographic variables. The study followed an ex post-facto, descriptive correlational design with a census sampling of 520 students who have voluntarily attended psychological support. The information was obtained through a questionnaire that explores sociodemographic, academic and specific characteristics of psychological follow-up. Comparative and correlational analyzes were performed finding a positive relationship between permanence and brief psychological accompaniment in the face of situational crises. Additionally, it was concluded that university permanence is related to age, gender, semester, average, the reason for consultation and the therapeutic method developed in the psychological accompaniment process. The results were discussed in the light of background that have explained the phenomena of permanence and dropout in school context.

Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela.

Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.

Perfil neuropsicológico en un paciente con esquizofrenia / Neuropsychological profile in a patient with schizophrenia

La investigación describe el perfil neuropsicológico de un paciente con esquizofrenia en Cúcuta, Colombia. Se utilizó un diseño de investigación tipo ensayo clínico con fin diagnóstico y alcance descriptivo basado en un paciente de 52 años diagnosticado con esquizofrenia paranoide desde los 17 años, quien actualmente es tratado con antipsicótico atípico (risperidona 4,5 mg/día) y antidepresivo tricíclico (clorimipramina 300 mg/día). Se evaluó mediante un protocolo neuropsicológico conformado por Evaluación Cognitiva Montreal (MOCA, del acrónimo en inglés Montreal Cognitive Assessment), Test del Trazo (Trail Making, en inglés) A y B, subpruebas del Test Barcelona, curva de aprendizaje del Test Verbal de California, Figura Compleja de Rey­Osterrieth, y subpruebas de WAIS III, cuyas respuestas generaron indicadores globales asociados con deterioro cognitivo leve, compromiso de la capacidad de atención alternante, memoria de trabajo, conversión acústico-fonológica y memoria declarativa de largo plazo, al igual que sus funciones ejecutivas.

This research aims to describe the neuropsychological profile in a patient with schizophrenia in the city of Cucuta, Colombia. A clinical trial type research design with a diagnostic purpose and descriptive scope was used in a patient aged 52 diagnosed with paranoid schizophrenia since age 17, currently being treated with atypical antipsychotic (Risperidone 4.5 mg/day) and tricyclic antidepressants (Clomipramine 300 mg/day). A neuropsychological protocol consisting of Montreal Cognitive Assessment (MOCA), Trail Making Test A and B, subtest of Barcelona Test, learning curve of the California Verbal Learning ​​Test, Rey­Osterrieth Complex Figure Test, and WAIS III subtests, recorded global indicators associated with mild cognitive impairment, commitment in the capacity of alternating attention, working memory, acoustic-phonemic conversion, and long-term declarative memory, as well as his executive functions.

Alteraciones neuropsicológicas de un paciente con enfermedad de Parkinson y antecedentes de consumo de sustancias Psicoactivas / Neuropsychological alterations of a patient with Parkinson's disease and background psychoactive substance use

El objetivo de esta investigación fue describir el desempeño cognoscitivo de un paciente de sexo masculino, de 51 años, con 9 años de evolución de Enfermedad de Parkinson (EP) y antecedentes de consumo de sustancias psicoactivas, para lo cual se utilizó un protocolo neuropsicológico encontrando en el test de trazados (TMT-A 24/24 y TMT-B 24/24), prueba de Denominación de Boston (58/60), F.A.S- COWAT (28), Curva de Memoria California (Ascendente), copia (34/36) y evocación (26/36) de la Figura Compleja de Rey Osterrieth, Torre de Londres, Stroop de Colores (C 16", P 31", C-P 57"). Adicionalmente se aplicaron subpruebas del Test de Inteligencia Wechsler para adultos (WAIS-III) (Retención de dígitos 9, sucesión letras-números 10, aritmética 11, dígito-símbolo 10, figuras incompletas 6, diseño con cubos 10, semejanzas 9), el perfil cognoscitivo se encuentra dentro de los parámetros normales para los procesos de lenguaje, memoria, praxias, y habilidades viso-construccionales; se evidencian leves alteraciones en atención, memoria de trabajo y funciones ejecutivas. El consumo prolongado de sustancias psicoactivas es un posible factor de riesgo en el desarrollo temprano de la EP, pero con un perfil cognoscitivo conservado que se puede explicar por su nivel académico previo y su continuo ejercicio intelectual en su profesión, que le exigen constantes actividades cognitivas.

The objective of this research was to describe the cognitive performance of a male patient, aged 51, with 9 years of evolution of Parkinson's disease (PD) and a history of psychoactive substance use, for which a protocol was used neuropsychological finding paths in the test (TMT-A 24/24 and TMT-B 24/24), Boston denomination (58/60), FAS-COWAT (28), Curve Memory California (ascending), copy (34 / 36) and evocation (26/36) of the Rey Osterrieth Complex Figure, Tower of London, Stroop Color (C 16 " W 31", CW 57 "). Additionally applied subtests Wechsler Intelligence Test for Adults (WAIS-III) (retention of digits 9, letter-number sequence 10, arithmetic 11, digit-symbol 10, incomplete figures 6, design with cubes10, similarities 9), cognitive profile is within normal parameters for the processes of language, memory, praxis, visual-constructional and skills, are demonstrated slight alterations in attention, working memory and executive functions. Prolonged use of psychoactive substances is a possible risk factor in early development of PD, but with preserved cognitive profile that can be explained by their prior academic and intellectual exercise continued in his profession, which require constant cognitive activities.