Relación del insomnio con la calidad de vida en una población de adultos mayores / Relationship of insomnia with quality of life in a population of older adults

Antecedentes: el insomnio es considerado un problema de salud pública por su alta prevalencia, se manifiesta por una percepción subjetiva de insatisfacción por la cantidad del sueño, dificultad para iniciar o mantener el sueño, despertar antes de lo deseado, incapacidad para volver a dormir y que ocurre a pesar de contar con las condiciones adecuadas, presentándose con frecuencia en adultos mayores afectando la calidad de vida, además, altera la funcionalidad física, mental y social de las personas mayores , y es un factor predisponente para deterioro cognitivo y depresión. Objetivo: determinar la relación del insomnio con la calidad de vida en una población de adultos mayores. Metodología: estudio analítico, transversal y comparativo, en una población de 107 adultos mayores de la Ciudad de México, con insomnio y sin insomnio, a los cuales se les aplicó la escala de Atenas para diagnosticar insomnio; como pruebas de tamizaje para deterioro cognitivo el MiniMental de Folstein, la Escala de Depresión Geriátrica Yesavage para probable depresión, y para calidad de vida el Cuestionario WHOQoL-BrefdelaOMS. Los datos fueron analizados a través de X2y t de Student y como estimador de riesgos razón de momios con un intervalo de confianza al 95%. Resultados:laprevalenciadeinsomniofuedel57%;enlascaracterísticassociodemográficas no se encontraron diferencias significativas; en las pruebas de tamizaje, se observó una relación estadísticamente significativa entre la presencia de insomnio y depresión (p<0.05); se encontró que los adultos mayores con insomnio tienen 6 veces mayor riesgo de presentar depresión en comparación con los que no lo presentan (RM 7.292.9, IC95%=2.319-22.925, p<0.05); respecto a la relación del insomnio con la calidad de vida, en los pacientes con insomnio fue estadísticamente significativa con un puntaje menor en la calidad de vida global(con insomnio 93 ± 13.7 vs. sin insomnio 102 ± 11.9, p<0.05); en la relación del insomnio y el nivel de calidad de vida, se encontró que los adultos mayores sin insomnio presentan una calidad de vida alta, en comparación con los adultos mayores con insomnio, donde se observó que es promedio (con Insomnio 70% vs. sin insomnio 30%, p<0.05); de acuerdo con los valores promedio de las diferentes dimensiones de la calidad de vida y su relación con el insomnio, se detectó que el grupo con insomnio obtuvo puntajes menores en las dimensiones salud física, aspectos psicológicos, relaciones sociales y medio ambiente observándose diferencias estadísticamente significativas entre los dos grupos; se detectó que el insomnio aumenta el riesgo de percibir la calidad de vida como promedio-mala, primordialmente en las dimensiones salud física, aspectos psicológicos y relaciones sociales. Conclusiones: La población de estudio con insomnio presentó alteración en las 4 dimensiones de la calidad de vida (salud física, aspectos psicológicos, relaciones sociales y medio ambiente).

Background: insomnia is considered as a public health problem because of its high prevalence, is manifested by a subjective perception of dissatisfaction with the amount of sleep, difficulty initiating or maintaining sleep, to wake up earlier than desired , inability to go back to sleep. These events happen despite having the suitable conditions, occurring frequently in older adults affecting the quality of life, also alters the physical, mental and social functionality of older people, and it's a predisposing factor for cognitive impairment and depression. Objective: to determine the relationship of insomnia with quality of life in a population of older adults. Methodology: analytical, cross-sectional and comparative study in a population of 107older adults in Mexico City, with insomnia and without insomnia, to which the Athenas scale was applied to diagnose insomnia; as screening tests for cognitive impairment the Folstein Mini Mental, the Yesavage Geriatric Depression Scale for probable depression, and the WHOQoL-Bref Questionnaire of WHO, for quality of life were used. The data were analyzed using X2and Student's t test,and as an estimator odds ratio risks with a 95%confidence interval. Results: the prevalence of insomnia was 57%; no significant differences were found in sociodemographic characteristics; in the screening tests, a statistically significant relationship was observed between the presence of insomnia and depression (p<0.05); it was found that older adults with insomnia have a 6times greater risk of presenting depression compared to those without it (OR 7,292.9, 95% CI = 2,319-22,925, p<0.05); with respect to the relationship between insomnia and quality of life, in patients with insomnia it was statistically significant with a lower score in global quality of life (with insomnia 93 ± 13.7vs. without insomnia 102 ± 11.9, p <0.05); in the relationship between insomnia and the level of quality of life, it was found that older adults without insomnia have a high quality of life, compared to older adults with insomnia, where it was observed that it is average (with insomnia 70%vs. without insomnia 30%, p<0.05); according to the average values of the different dimensions of quality of life and their relationship with insomnia, it was detected that the group with insomnia obtained lower scores in the dimensions of physical health, psychological aspects, social relations,and environment, observing statistically significant differences between the two groups. Insomnia was found to increase the risk of perceiving quality of life as average-poor, primarily in the dimensions of physical health, psychological aspects, and social relationships. Conclusions: The study population with insomnia presented alteration in the 4dimensions of quality of life (physical health, psychological aspects, social relationships,and environment).

New approaches to identification and characterization of tioconazole in raw material and in pharmaceutical dosage forms / 药物分析学报

Tioconazole (TCZ), a broad-spectrum antifungal agent, has significant activity against Candida albicans and other Candida species, and therefore, it is indicated for the topical treatment of superficial mycoses. The main goal of this work is to report an exhaustive identification and characterization procedure to improve and facilitate the online quality control and continuous process monitoring of TCZ in bulk material and loaded in two different dosage forms: ovules and nail lacquer. The methodologies were based on thermal (differential scanning calorimetry (DSC), melting point, and thermogravimetry (TG)), spectroscopic (ultraviolet (UV), Raman, near infrared (NIR), infrared spectroscopy coupled to attenuated total reflectance (FTIR-ATR), and nuclear magnetic resonance (NMR)), microscopic and X-ray diffraction (XRD). The TCZ bulk powder showed a high crystallinity, as observed by XRD, with a particles size dis-tribution (3–95 mm) resolved by microscopic measurements. TCZ melting point (82.8℃) and a de-gradation peak centered at 297.8 ℃ were obtained by DSC and DTG, respectively. An unambiguous structure elucidation of TCZ was obtained by mono- and two- dimensional 1H and 13C NMR spectral data analysis. The FTIR-ATR, Raman and NIR spectra of both the raw material and the commercial products were analyzed and their characteristic bands were tabulated. The best methods for TCZ identification in ovules were DSC, TG, XRD, NIR and Raman, while NIR and FTIR-ATR were the most appropriate tech-niques to analyze it in the nail lacquer. DSC, TG, DRX, Raman, FTIR-ATR and NIR spectroscopy are effective techniques to be used in online process analysis, because they do not require sample preparation, and they are considerably sensitive to analyze complex samples.