ABSTRACT
ABSTRACT Background: Self-efficacy is the individual's assessment of his or hers ability to complete a specific task successfully and has been closely related to self-management and quality of life in several diseases. Objective: To investigate self-efficacy in a population of Parkinson's disease (PD) patients in Mexico and study the factors that are associated with this measure. Methods: We carried out a cross-sectional observational study involving patients with PD in an outpatient neurology clinic in Mexico, using the following instruments: Spanish version of the Chronic Disease Self-Efficacy Scale (CDSES), Quality of Life Questionnaire PDQ-8, Movement Disorders Society-Unified Parkinson's disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment (MoCA), and Non-Motor Symptom Scale (NMSS). Clinical and demographic variables were also recorded. Results: We included 73 patients with a mean age of 65 years and most patients were male. Patients with lower CDSES scores (<7.75) had worse scores in MDS-UPDRS, NMSS, and PDQ-8 scales. CDSES scores were significantly correlated with MDS-UPDRS Part I (r=-0.497, p=<0.001), Part II (r= -0.271, p=0.020), Part III (r=-0.304, p=<0.001), PDQ-8 (r=-0.472, p=<0.001), and NMSS (r=-0.504, p=<0.001). Furthermore, when assessing the simultaneous effect of covariates associated with CDSES score, only Mood/Apathy domain of NMSS was significant (beta= -0.446, t= -3.807, p= 0.012). Conclusions: PD patients with lower self-efficacy scores had worse motor and non-motor symptomatology and quality of life. Mood/Apathy disorders were negatively associated with self-efficacy and contributed significantly to this measure.
RESUMEN Antecedentes: La autoeficacia es la autoevaluación de un individuo sobre su capacidad para completar una tarea con éxito y se ha relacionado con automanejo y calidad de vida en otras enfermedades. Objetivo: Investigar la autoeficacia en una población de pacientes con enfermedad de Parkinson (EP) en México y estudiar factores asociados con esta medida. Métodos: Realizamos un estudio observacional transversal con pacientes con EP en una clínica de neurología en México. Se registraron datos demográficos y escalas que evalúan la función motora (MDS-UPDRS), no motora (NMSS) y cognitiva (MoCA), así como la calidad de vida (PDQ-8). Para valorar autoeficacia se utilizó la versión en español de la Escala de autoeficacia de enfermedades crónicas (CDSES). Resultados: Se incluyeron 73 pacientes, con una edad media de 65 años y la mayoría eran hombres. Pacientes con puntajes CDSES más bajos (<7.75) tuvieron peores puntajes en las escalas MDS-UPDRS, NMSS y PDQ-8. Las puntuaciones de CDSES se correlacionaron significativamente con la escala MDS-UPDRS Parte I (r=-0.497, p=<0.001), Parte II (r= -0.271, p=0.020), Parte III (r=-0.304, p=<0.001), PDQ-8 (r= -0.472, p=<0.001), y NMSS (r=-0.504, p=<0.001). Al evaluar el efecto simultáneo de covariables asociadas con la escala CDSES, solo el dominio estado de ánimo/apatía del NMSS resultó significativo (Beta = -0.449, t = -3.783, p = <0.001). Conclusiones: Los pacientes con menores puntajes de autoeficacia tienen peor calidad de vida y sintomatología motora y no motora. Los trastornos del estado de ánimo contribuyen negativamente a la autoeficacia.
Subject(s)
Humans , Male , Female , Aged , Parkinson Disease , Quality of Life , Severity of Illness Index , Cross-Sectional Studies , Self EfficacyABSTRACT
OBJECTIVE: It is essential to identify a serological marker of injury in order to study the pathophysiology of intestinal ischemia reperfusion. In this work, we studied the evolution of several serological markers after intestinal ischemia reperfusion injury in rats. The markers of non-specific cell damage were aspartate aminotransferase, alanine aminotransaminase, and lactic dehydrogenase, the markers of inflammation were tumor necrosis factor alpha, interleukin-6, and interleukin-1 beta, and the markers of intestinal mucosal damage were intestinal fatty acid binding protein and D-lactate. We used Chiús classification to grade the histopathological damage. METHODS: We studied 35 Wistar rats divided into groups according to reperfusion time. The superior mesenteric artery was clamped for 30 minutes, and blood and biopsies were collected at 1, 3, 6, 12, 24, and 48 hours after reperfusion. We plotted the mean ± standard deviation and compared the baseline and maximum values for each marker using Student's t-test. RESULTS: The maximum values of interleukin-1 beta and lactic dehydrogenase were present before the maximal histopathological damage. The maximum tumor necrosis factor alpha and D-lactate expressions coincided with histopathological damage. Alanine aminotransaminase and aspartate aminotransferase had a maximum expression level that increased following the histopathological damage. The maximum expressions of interluken-6 and intestinal fatty acid binding protein were not significantly different from the Sham treated group. CONCLUSION: For the evaluation of injury secondary to acute intestinal ischemia reperfusion with a 30 minute ischemia period, we recommend performing histopathological grading, quantification of D-lactate, which is synthesized by intestinal bacteria and is considered an indicator of mucosal injury, and quantification of tumor necrosis ...
Subject(s)
Animals , Female , Rats , Biomarkers/blood , Intestines/blood supply , Reperfusion Injury/blood , Aspartate Aminotransferases/blood , Biopsy , Cytokines/blood , Disease Models, Animal , Fatty Acid-Binding Proteins/blood , Intestines/pathology , Lactate Dehydrogenases/blood , Rats, Wistar , Reference Values , Time FactorsABSTRACT
Introducción. El dengue es una enfermedad infecciosa causada por un flavivirus y transmitida por un vector. Puede originar cuadros febriles inespecíficos, fiebre hemorrágica por dengue (FHD) o, incluso, síndrome de choque. El tratamiento se basa en el control hemodinámico y control del balance hídrico. Caso clínico. Paciente femenino de 4 meses, inicia con fiebre y desarrolla síntomas y signos, primero de FHD y posteriormente síndrome de choque. Se corroboró el diagnóstico serológico de primoinfección por dengue. No existió evidencia de infección previa en la madre. Con tratamiento de soporte mejora y posteriormente se egresa asintomática. Conclusiones. Según algunas teorías, la FHD en lactantes se asocia a anticuerpos no neutralizantes, transmitidos de manera pasiva por una madre previamente infectada, que ocasionan en el lactante una reacción severa ante una primoinfección. En este caso, otros factores independientes del huésped, como virulencia del virus infectante, pudieran ser los responsables.
Background. Dengue fever is an infectious disease caused by a flavivirus and transmitted by a vector. It causes dengue fever, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). When one of these last two appears, treatment consists of intensive fluid balance control. Case report. A 4-month-old female infant presented fever. She was admitted and later showed signs and symptoms of DHF followed by DSS. Serological diagnosis was confirmed, and appropriate treatment offered. The mother does not have evidence of prior infection. Discussion. One theory proposes that DHF occurs in infants when passively transferred maternal antibodies from a previous infection cause an enhanced immune response when the infant is infected by a different type of dengue virus. This theory does not explain the occurrence of DHF in our report. Factors not dependent on the host, such as virological factors, may be responsible.