Validación del cuestionario CTM-3-modificado sobre satisfacción con la continuidad de cuidados: un estudio de cohortes / Validation of the CTM-3-Modified Questionnaire on Satisfaction with Continuity of Care: A Cohort Study / Validação do questionário CTM-3-modificado sobre a satisfação com a continuidade de cuidados: um estudo de coortes

RESUMEN Objetivos: validar el contenido y constructo de la encuesta CTM-3 (Care Transitions Measure- 3 preguntas) modificada. Determinar el nivel de satisfacción de los usuarios con la continuidad de cuidados de enfermería interniveles y relacionarlo con la presencia de Informe de Cuidados de Enfermería tras su última hospitalización. Material y método: estudio de cohortes retrospectivo, con 131 pacientes hospitalizados en el Complejo Hospitalario de Cartagena (España).La satisfacción con la continuidad de cuidados se valoró con el cuestionario CTM-3-modificado, resultado de un proceso de validación realizado sobre el mismo. Resultados: un 94% de los encuestados presenta una satisfacción aceptable con el proceso de continuidad de cuidados. Los pacientes con Informe de Cuidados tienen un nivel alto de satisfacción con la continuidad de cuidados, RR= 0,90 (IC 95%: 0,831-0,990). Conclusiones: La validez de contenido y constructo realizadas, han permitido medir la satisfacción de los usuarios con la continuidad y su correlación con la presencia de informe, obteniendo como resultado que la realización de Informe de Cuidados influye ligeramente en la satisfacción con el proceso de continuidad de cuidados. Sin embargo, el hecho de que el informe se entregue en mano y/o se explique no parece afectar a la misma.

ABSTRACT Objectives: validate the content and construction of the modified CTM-3 survey (Care Transitions Measure - 3 questions). Determine the level of user satisfaction with the continuity of intermediate-level nursing care and relate it to the presence of a nursing care report after the most recent hospitalization. Material and method: A retrospective cohort study was conducted with 131 patients hospitalized at the Cartagena Hospital Complex (Spain). Satisfaction with the continuity of care was assessed with the CTM-3-modified questionnaire, which is the result of an earlier validation process. Results: Ninety-four percent (94%) of those who responded to the questionnaire indicated acceptable satisfaction with the continuity-of-care process. Patients with a care report have a high level of satisfaction with the continuity of care: RR = 0.90 (95% CI: 0.831-0.990). Conclusions: The content and construct validity of the questionnaire make it possible to measure user satisfaction with the continuity of care and its correlation to the presence of a care report, the result being that preparation of a care report slightly influences the level of satisfaction with the continuity-of-care process. On the other hand, the fact that the report is delivered by hand and/or explained appears to have no effect.

RESUMO Objetivos: validar o conteúdo e constructo do questionário CTM-3 (Care Transitions Measure - três perguntas) modificado. Determinar o nível de satisfação dos usuários com a continuidade de cuidados de enfermagem interníveis e relacioná-lo com a presença de relatório de cuidados de enfermagem após sua última hospitalização. Material e método: estudo de coortes retrospectivo, com 131 pacientes hospitalizados no Complexo Hospitalar de Cartagena (Espanha). A satisfação com a continuidade de cuidados foi avaliada com o questionário CTM-3-modificado, resultado de um processo de validação realizado sobre este. Resultados: 94 % dos entrevistados apresentam satisfação aceitável com o processo de continuidade de cuidados. Os pacientes com relatório de cuidados têm nível alto de satisfação com a continuidade de cuidados, RR= 0,90 (IC 95 %: 0,831-0,990). Conclusões: a validade de conteúdo e constructo realizada permite medir a satisfação dos usuários com a continuidade e sua correlação com a presença de relatório, obtendo como resultado que a realização de relatório de cuidados influencia levemente na satisfação com o processo de continuidade de cuidados. Contudo, o fato de que o relatório seja entregue em mãos e/ou seja explicado não parece afetá-la.

Adolescent support networks in a health care context: the interface between health, family and education / Redes de apoyo al adolescente en el marco del cuidado sanitario: interfaz entre salud, familia y educación / Redes de apoio ao adolescente no contexto do cuidado à saúde: interface entre saúde, família e educação

AbstractOBJECTIVEAnalyze adolescents' perceptions about support networks and their health needs.METHODAnalytical and interpretive study using focus groups conducted in municipal state schools in Fortaleza, in the State of Ceará during the first semester of 2012. The sample comprised 36 male and female adolescents aged between 13 and 16 years attending the ninth grade of the second phase of elementary school.RESULTSThematic analysis revealed that the health care support network and interaction between health professionals, education professionals and family members was insufficient, constituting a lack of an integrated network to enable and provide support for health promotion.CONCLUSIONCoordination between education, health and family services has the potential to act as a support network to help meet adolescents' healthcare needs and demands.

ResumenOBJETIVOAnalizar las percepciones de los adolescentes acerca de las redes de apoyo a sus necesidades de salud.MÉTODOEstudio analítico interpretativo, llevado a cabo en escuelas del Municipio de Fortaleza, CE, en el primer semestre de 2012, por medio de grupos focales. Los sujetos de la investigación fueron 36 adolescentes de ambos sexos con edades entre 13 y 16 años y que cursaban el último año de la educación básica brasileña.RESULTADOSEl análisis por categorización temática permitió la comprensión del fenómeno, desvelando que la red de apoyo a los cuidados sanitarios de los adolescentes y la interrelación entre los profesionales sanitarios, la escuela y los familiares es insuficiente, configurándose la ausencia de una red integrada que favorezca y dé soporte a la promoción de su salud.CONCLUSIÓNLa articulación entre los sectores educativo, familiar y sanitario puede funcionar como red de apoyo a las necesidades y demandas de cuidados de los adolescentes.

ResumoOBJETIVOAnalisar as percepções dos adolescentes sobre as redes de apoio a suas necessidades de saúdeMÉTODOEstudo analítico interpretativo, realizado em escolas do Município de Fortaleza, CE, no primeiro semestre de 2012, por meio de grupos focais. Os sujeitos da pesquisa foram 36 adolescentes de ambos os sexos com idades entre 13 e 16 anos e que cursavam o 9oano do ensino fundamental II.RESULTADOSA análise por categorização temática permitiu a compreensão do fenômeno, revelando que a rede de apoio aos cuidados à saúde dos adolescentes e a inter-relação entre os profissionais da saúde, da escola e familiares é insuficiente, configurando a ausência de uma rede integrada que favoreça e dê suporte à promoção de sua saúde.CONCLUSÃOA articulação entre os setores educacional, familiar e de saúde pode funcionar como rede de apoio às necessidades e demandas de cuidados dos adolescentes.

Accidente de trabajo por crisis epiléptica y traumatismo craneoencefálico con resultado de muerte Una revisión desde la jurisprudencia y legislación en España / Work related injury due to epileptic crisis and craneoencephalic trauma resulting in death A revision done from jurisprudence and legislation in Spain

El concepto de "daño laboral" es objeto de controversia en todos los países y la forma de entenderse varía en función de las diferentes normativas legales. Es objetivo de este trabajo valorar las circunstancias de un caso de reclamación de accidente de trabajo con resultado de muerte en un trabajador epiléptico y en el que, como consecuencia de una crisis, se produce un traumatismo craneoencefálico de consecuencias fatales. En el caso se reclama la contingencia de accidente laboral, denegada en primera instancia por la Mutua de accidentes laborales y enfermedades profesionales. En España la definición legal de accidente de trabajo ha sido desarrollada por la jurisprudencia prácticamente en todos los elementos que lo configuran; comprende el concepto de trabajo por cuenta ajena, la lesión, el daño o perjuicio ocasionado físico- psíquico y considera lesión constitutiva de accidente, no sólo la que deriva de es la acción súbita y violenta de un agente exterior sobre el cuerpo humano, sino también el daño que proviene de determinadas enfermedades, como procesos de actuación interna, súbita o lenta, que se produzcan o tengan su origen en el trabajo. En enfermedades comunes como la epilepsia, la falta de un vínculo causal estricto o directo entre la epilepsia y el trabajo no impide que se aplique la presunción legal a los resultados lesivos ocasionados por las crisis comiciales en el lugar y tiempo de trabajo (fallecimiento o lesiones sufridas por caídas originadas por la crisis), dado que los mismos pueden haberse producido con ocasión del trabajo.

The concept of "work-related injury" is controversial in all countries and its design varies depending on the different legal precepts of each one. The objective of this study is to assess the circumstances of a case of a work accident claim resulting in the death of employee suffering from epilepsy and in which, as the result of a crisis, a brain trauma occurs with fatal consequences. Laborer contingency is claimed, but it is denied in the first instance by the Mutual of occupational accidents and diseases. In Spain, the legal definition of an accident at work has been developed by case-law in virtually all the elements that constitute it. It contemplates the concept of gainful employment, damage or injury caused, of physical and mental injury, and it deems as injury or accident not only what results from the sudden and violent action of an external agent on the human body, but also the damage that comes from certain diseases such as internal processes, sudden or slow action, or arising or originating from the job. With common diseases such as epilepsy, the lack of a strict or direct causal link between epilepsy and work does not preclude any legal presumption to the harmful results caused by seizures in the place and time of the job (death or injuries from falls caused by the crisis), as these may have occurred during work.

Determinación del riesgo de fracturaosteoporótica en población laboralespañola mediante la herramientaFRAX / Osteoporotic risk of hip fracture calculated using the FRAX toolfor the Spanish population

Introducción: las fracturas osteoporóticas constituyen una problemática de creciente trascendenciaen salud pública, por lo que la utilización de herramientas que permitan una valoraciónprecoz y adecuada del riesgo de fractura y el establecimiento de políticas preventivas deberíanser prioritarios. En este trabajo se valora el riesgo de sufrir diferentes tipos Materiales y métodos: se realizó un estudio descriptivotransversal en población general trabajadora delsector socio-sanitario español con edades comprendidasentre 40 y 65 años. El riesgo de fractura de cadera ymayor osteoporótica se calculó mediante la herramientaFRAX para población española. Se incluyeron en elestudio 749 trabajadores seleccionados aleatoriamente:251 varones, 251 mujeres no menopáusicas y 247 mujeresmenopáusicas.Resultados: las edades medias fueron de 46,8 años envarones, 43,9 años en mujeres no menopáusicas y 52,3años en las menopáusicas. El riesgo medio de fracturade cadera y mayor osteoporótica fue de 2,1±1,33 y de0,22±0,36 en varones, 2,65±2,16 y 0,27±0,94 enmujeres no menopáusicas y 3,1±2,93 y 0,44±0,88en mujeres menopáusicas. Presentaron criterios positivosde tratamiento según la National Osteoporosis Foundationel 0,8 % de las mujeres no menopáusicas, un 2 %de las menopáusicas y ninguno de los hombres.Conclusiones: el riesgo de sufrir fracturas osteoporóticasen este colectivo es muy bajo, sin embargo, el uso dela herramienta FRAX puede ser muy útil para detectarel riesgo en sus estadios iniciales y establecer políticas deprevención y actuación precoz que permitan un ahorroen costes y mejorar la salud de nuestra población generalmediante captación en su etapa laboral.

Purpose: Osteoporotic fractures are a significantgrowing problem of public health, so theuse of tools that allow a proper risk assessmentand establishing preventive policies should be apriority. This paper assesses the risk of differenttypes of fractures as much in men as in menopausaland non menopausal women.Patients and methods: A descriptive crosssectionalstudy in working population from theSpanish health system aged between 40 and65. The risk of increased osteoporotic hip fractureis calculated using the FRAX tool for the Spanishpopulation. 749 randomly selected workerswere included in the study, 251 men, 251 nonmenopausal women and 247 post-menopausalwomen.Results: Mean ages were 46.8 years in men, 43.9years in non-menopausal women and 52.3 yearsin the menopausal. The average risk of hip fractureand major osteoporotic was 2.1 ± 1.33 and0.22 ± 0.36 in males, 2.65 ± 2.16 and 0.27 ±0.94 in non-menopausal women 3.1 ± 2.93 and0.44 ± 0.88 in menopausal women. No men, 0.8% of menopausal women and 2 % of menopausaltreatment had positive criteria for treatmentaccording to the National OsteoporosisFoundation.Conclusion: The risk of osteoporotic fracturesin this group is very low, however the use of theFRAX tool can be very useful to detect the riskin its early stages and establishing preventionpolicies that allow cost savings and improve thehealth of our workforce.

Análisis de la tasa de detección mediante ecografía de fetos con crecimiento intrauterino restringido y pequeño para la edad gestacional / Detection rate by ultrasound in fetuses with intrauterine growth restriction and small for gestational age

Objetivo: Analizar la tasa de detección de fetos pequeños para la edad gestacional (PEG) y crecimiento intrauterino restringido (CIR) mediante exploración ecográfica. Método: Estudio retrospectivo de casos y controles. Recién nacidos (RN) de gestaciones únicas a término (entre la semana 37-42) en el Hospital Universitario San Cecilio entre 2009 y 2010. Grupo casos: 98 RN a término con peso al nacer < 2500 g, con peso fetal estimado (PFE) por ecografía en el III trimestre. Grupo control: 100 RN durante el mismo período con peso al nacer entre 3000-4000 g, con PFE por ecografía en el III trimestre obtenido de forma aleatoria. Resultados: La tasa de detección de CIR tipo I fue de un 11,1 por ciento con una incidencia del 0,1 por ciento y la tasa de detección de pequeños para edad gestacional fue de un 56,5 por ciento con una incidencia del 2 por ciento respecto al total de RN. Conclusión: En nuestra experiencia la EPF mediante ecografía en fetos con peso bajo el p10 tiene un error de 6 por ciento respecto al peso neonatal, esto permite una adecuada identificación de fetos con PEG y CIR.

Objective: To analyze the detection rate of small for gestational age (SGA) fetuses and intrauterine growth restriction (IUGR) fetuses by ultrasound exploration. Methods: Cases and controls retrospective study. Material: Newborn (NB) of singleton pregnancies at term (between 37 and 42 weeks) at the Hospital Universitario San Cecilio between 2009 and 2010 both inclusive. Cases group: 98 at term NB with a birth weight < 2500 g; and an estimated fetal weight (EFW) by ultrasound in the 3rd trimester. Controls Group: 100 NB during the same period of time with birth weight between 3000-4000g, with EFW by ultrasound in the 3rd trimester randomly extracted. Results: The detection rate of small for gestational age infants born was 56.5 percent with 2 percent of incidence and the detection rate of intrauterine growth restriction type I was 11.1 percent with 0.1 percent of incidence within the total number of newborns in the period from 2009 to 2010. Conclusion: In our experience, EPF ultrasound in fetuses with weight below the 10th percentile has an error of 6 percent compared to birth weight, this allows proper identification of fetuses with SGA and IUGR.

El paciente diabético como trabajador especialmente sensible en medicina del trabajo: [revisión] / The diabetic patient as a restricted Worker in occupational medicine: [review]

El concepto de Trabajador especialmente Sensible, recogido en lanormativa Española de Prevención de Riesgos Laborales, es uno de los campos más atractivos para el Médico del Trabajo y, de forma especial, en aquellas patologías que, como la diabetes, cursan de forma crónica y generan complicaciones evolutivas limitantes en las personas que la sufren. Conviene por ello revisar la legislaciónactual y contrapesarla con los puestos de trabajo y tareas en las que el trabajador diabético puede tener una especial peligrosidad para sí mismo o para su entorno o bien generar un mayor número de complicaciones evolutivas en su proceso, con repercusión laboral, personal y social y jurídica.

The "Restricted Worker" concept, enclosed in the Spanish norm of Occupational Risk Prevention, is one of the most attractive fields for the Occupational Medicine Doctor and specially, in pathologies, like diabetes, that has chronic progress and evolutive causes, limiting complications in those patients. For that reason, it could be good, to review the current legislation and link it with the jobs and tasks that the diabetic worker has a special danger for itself or its surroundings or generate a greater number of evolutive limiting complications in his disease with work, personal and social repercussion.

Toma de perspectiva y teoría de la mente: aspectos conceptuales y empíricos. Una propuesta complementaria y pragmática

resumen está disponible en el texto completo

Abstract: The present work completes an exhaustive revisión of the delimitation of the ability of perspective taking from different points of view. First, perspective taking is defined as the ability of an individual to interpret his/hers emotional and mental states and those of others. Additionally, the term has also been used in medical settings to refer to a tactic intended to stop certain limiting feeling and/or thoughts and instead move feelings and thoughts towards a different direction. At the same time, perspective taking is considered to be at the heart of psychological phenomena such as empathy, that is, the capacity to distinguish what individuals know about themselves in a certain situation (how someone thinks, feels and behaves), self-awareness, interpersonal relations, and various social skills deficits. Second, this ability is conceptualized as a metacognition and it is assumed that the object of study is the theory of the mind. Third, from a developmental perspective, data have shown that children four to five years old, without any psychological disabilities, have the ability to take somebody else's perspective. We reviewed different studies regarding the development of the abilities to express and interpret emotions as precursors to perspective taking. Subsequently, we revised and analyzed the tests or strategies most commonly used to evaluate the ability of perspective taking. Typically, the capacity of an individual to have "a theory of the mind" is determined through tests of false beliefs (such as the classic test of Sally-Anne, the "Smarties" test, "M&M's", and the "Maxi's" Test). Múltiple variations of the tests of false beliefs have been conducted with flashcards or photographs, with characters in oral stories, and through the use of games. Additionally, over the last few years the focus of this body of research has evolved towards the elaboration and validation instruments to measure empathy. Among them are the tests of Empathy Quotient (EQ), the Friendship Questionnaire (FQ), and reading the "mind" in the eyes. It is important to note that these efforts have been focused mostly on individuals with Asperger" s Syndrome or those with higher verbal capabilities. From this latter perspective, we propose empirical evidence that points out to differences in the ability of perspective taking between children with or without autism. This is also shown in the results of previous studies, in which different levels of perspective taking skills were seen between children diagnosed with autism, and those diagnosed with Down Syndrome. It is important to note that this was not true when their verbal skills were not considered as a variable. Likewise, other studies showed that children with autism were not the only ones that failed the theory of the mind tests, but that these tests were also failed by those children with deficits in language and cognitive skills. In this article, we present the results of a study that replicates previous findings which show that typical developing children per-form better in perspective taking tests, followed by children diag-nosed with Down Syndrome, and subsequently by children with autism. It was also noted that the typical developing children showed the highest level of verbal discrimination, followed by the children diagnosed with Down Syndrome, and finally the children diagnosed with autism. One important finding in this study is that all children benefited from the use of contextual prompts, which improved the number of correct responses across all the theory of the mind tests. Additionally, the data varied depending on the type of tests utilized to measure perspective taking skills. In this article, we have also reviewed the different explanations for the origins and development of perspective taking, among which the theory of the mind prevails. The ability to take some-one else's perspective is explained by the development or matura-tion of an innate and specialized module of representations and knowledge, and the formation of conceptual structures of a higher order or meta-representations. Additionally, the ability to ignore perceptual information, salient or not, and to combine simultaneously various contexts are considered prerequisites. In other words, perspective taking speaks to the relationship between psychological constructs such as perception and knowledge. Additionally, it has been hypothesized that shared, joint, or independent attention can be a prerequisite for conversation, and may be the basis of a theory of the mind. In any case, the origins of the development of such a theory have been especially ubiquitous in terms of the executive function and possible relations with cerebral lesions or alterations. However, some authors consider that the process of central coherence may be relatively independent of a theory of the mind. The research of Baron-Cohen et al. has concentrated on identifying existing neurological deficits or organic changes such as bilateral lesions or the role of testosterone on the quality of social interactions and the restrictive social interests of individuals with autism. A similar interest exists in researching the difference in perspective taking and empathy abilities exhibited by members of the opposite sex. Continuing with the neurological foundations of the empathy is of full present time the discoveries regarding «mirror neurons¼ and this recent study with monkeys proposes a specific cerebral area for the formation of the meta-representation. These neurons discharge both when the individual performs an action and when the individual observes another person performing the same action. Finally, even in the light of all the above, other sources point toward the social root of perspective taking skills. Additionally, as indicated by the research of Howlin, Baron-Cohen & Hadwin, it is considered perspective taking includes five different levels: a) simple visual perspective taking, b) the knowl-edge that different individuals can have separately the same thoughts, and c) understanding that "seeing leads to learning," followed by d) the ability to predict actions based on valid beliefs, and finally e) the ability to predict false beliefs. In the light of all of the above, once the radical conclusions of these investigations are viewed critically, the theory of the mind is viewed as a disputable theory of the delimitation of the cause and development of such skills. In addition, to the perspective taking tests themselves, the pre-requisite skills of perspective taking need to be extensively ana-lyzed. In fact, it has been shown that, in order to have an adequate performance on these tests of false beliefs, individuals should be able: 1. to remember and adequately retell their own past desires, thoughts, and past actions; 2. to retain an object in their mind, perceive a second object, and form a relationship between the two, as in a "symbolic function"; 3. to demonstrate the ability to pretend; and 4. to identify the role of age and verbal abilities in children as pre-requisites for an accurate performance on tests of false beliefs, and interpretations of the world. Lastly, we propose a pragmatic and complementary analysis the Theory of Mind based in the functional-contextual analysis of behavior. First, it is considered that perspective taking requires or is closely related to other social behaviors (such as taking turns when talking, initiating verbal responses in interpersonal relations, and the capacity for empathy). In the same manner, theory of mind requires an adequate level of simple and complex conditional discriminations, and these should be analyzed in terms of stimulus control and equivalence relations. In other words, this ability to infer thoughts, feeling, and emotions of others exists if the following prerequisites are present: 1. the processes of the classical conditioning of the emotions, 2. a generalized imitation, and 3. the development of functional classes. Without these experiences or the capability to be affected by them, children (i.e. children with generalized autism) do not develop language adequately. Second, perspective taking implies that an observer's previous experiences and observations with certain events determine his/ her reaction to responses emitted by others in similar circumstances. Finally, from a contextual perspective, it is considered that a speaker's relational frames play a role in this process (for the discriminations I/you, here/there, now/later). These relational properties are abstracted through multiple exemplars or multiple learning opportunities to speak from one's own perspective in relation to others.

Distribución de patrones PRA en aislamientos clínicos del complejo Mycobacterium avium procedentes de España y Suramérica

La infección por el complejo Mycobacterium avium (MAC) es la infección sistémica más frecuente en la fase terminal del SIDA. Las sondas de ADN disponibles en el mercado para la identificación de micobacterias son muy precisas pero extremadamente costosas. Por eso, la mayoría de los laboratorios clínicos de Latinoamérica aún tipifican micobacterias mediante pruebas fenotípicas que son lentas, laboriosas y poco precisas. En este trabajo se aplicó el análisis del polimorfismo de los fragmentos de restricción del gen hsp65 (PRA) a la identificación de MAC en 163 aislamientos clínicos procedentes de España y Suramérica. El genotipo PRA predominante en cada país fue: M. avium tipo I en Argentina (23/42, 55%) y Brasil (48/72, 67%), M. avium tipo II en España (18/26, 69%) y M. avium tipo III en Colombia (10/23, 43%). Este último genotipo, que aún no fue descrito fuera del continente americano, resultó muy infrecuente en los otros tres países del estudio. Se discuten ventajas e inconvenientes de la aplicación del PRA al diagnóstico micobacteriológico.

Distribution of PRA patterns of clinical isolates of the Mycobacterium avium complex from Spain and South America Mycobacterium avium complex (MAC) infections are the most frequent systemic infections associated with advanced AIDS. DNA probes for accurate identification of mycobacteria are available but are very expensive in many Latin American settings. Consequently, most Latin American diagnostic laboratories employ inaccurate and outdated tests for mycobacteria identification. Therefore, PCR restriction analysis (PRA) of the hsp65 gene was evaluated for the identification of 163 MAC human isolates originated from Spain and South America. The predominant PRA type in each country was: M. avium type I in Argentina (23/42, 55%) and Brazil (48/72, 67%), M. avium type II in Spain (18/26, 69%) and M. avium type III in Colombia (10/ 23, 43%). The Colombia frequency is noteworthy, since the PRA type III was quite infrequent in the other three countries. Furthermore, its presence has not been reported outside the Americas. The advantages and disadvantages of PRA in diagnostic mycobacteriology are discussed.

Influencia del ácido oleico sobre la actividad angiotensinasa de astroglía cortical de rata / Influence of oleic acid in the angiotensinase activity in the cortical astroglia in rats

Objetivo. Las dietas elevadas en grasa están asociada con el desarrollo de enfermedades cerebrovasculares de distinto tipo. Distintos estudios epidemiológicos ha demostrado que la población de los países mediterráneos tienen menor porcentaje de enfermedades cerebro vasculares que la población del norte de Europa o de Estados Unidos de Norteamérica. En los países mediterráneos, la dieta habitual contiene una gran proporción de ácidos grasos monoinsaturados, mientras que en los países mas industrializados, el componente graso está constituido principalmente por grasas saturadas. Las aminopeptidasas (AP) son especialmente importantes por que están implicadas en el metabolismo y regulación de hormonas circulantes y péptidos biológicamente activos de numerosos tejidos. Algunas aminopeptidasas están relacionadas con el metabolismo de las angiotensinas en el sistema renina-angiotensina (RAS), y por tanto participan en la regulación de la presión sanguínea, tanto a nivel sistémico como local. El sistema nervioso es, probablemente, uno de los órganos mas sensibles a las alteraciones de la presión arterial. El presente trabajo se ha diseñado para estudiar el comportamiento de la actividad angiotensinasa en astrocitos de corteza frontal de rata, cultivados en presencia de distintas concentraciones de ácido oleico en el medio de cultivo. Material y métodos. La actividad angiotensinasa (aspartato-glutamato-aminopeptidasa) se analizó en cultivos primarios de astrocitos de rata, utilizando b -naftilamidas como sustratos. Resultados y conclusiones. Las disminuciones observadas en la actividad aminopeptidasa ponen de manifiesto la posible influencia del ácido oleico sobre algunos de los factores implicados en la regulación del flujo sanguíneo local o la homeostasis de líquidos y electrólitos locales en el sistema nervioso. Se discute que esta acción puede ser debida a la modificación de los procesos de comunicación intercelular mediados por uniones de tipo GAP o bien, a la modulación de los sistemas de comunicación intracelular mediados por el fosfatidilinositol y posterior activación de la proteinkinasa C, entre otros