Conocimientos y habilidades del cuidador familiar del adulto mayor con demencia / Knowledge and skills of the family caregiver of the elderly adult with dementia

Introducción: la demencia es la alteración cognitiva con mayor incidencia. Provoca una disminución de las capacidades físicas y mentales. Las habilidades y conocimientos del cuidador familiar tienen un papel importante para entender las necesidades, fortalezas y limitaciones en el cuidado. Objetivo: establecer la relación entre los conocimientos y las habilidades en cuidados del cuidador familiar del adulto mayor con demencia. Metodología: estudio cuantitativo, transversal, prospectivo y con alcance correlacional. Muestra no aleatoria por disponibilidad de 26 cuidadores. Se aplicó la Escala de conocimientos sobre demencia DKAT2-sp con alfa de Cronbach de 0.79 y el Inventario de habilidad de cuidado-CAI con alfa de Cronbach de 0.84. Resultados: el género predominante fue el femenino. Los resultados de la prueba Rho de Spearman (p = 0.149) comprobaron que no existe relación y mostraron un nivel de significación mayor que lo esperado entre el conocimiento y la habilidad. Los familiares de personas con demencia cumplen con otros roles diferentes, además de que no reciben capacitación; tienen conocimientos altos y moderados con habilidades de cuidado medias y altas. Conclusión: los niveles de habilidad y conocimiento no son insuficientes; no existe una relación entre las variables de estudio.

Introduction: Dementia is the cognitive disorder with the higher incidence. It causes a decrease in physical and mental abilities. The skills and knowledge of the family caregiver comprise an important role in understanding the needs, strengths and limitations in care. Objective: To establish the relationship between knowledge and skills of the family caregiver of the elderly with dementia. Methodology: Study with a quantitative, cross-sectional, prospective approach and correlational scope. Non-random sample due to availability of 26 caregivers. The DKAT2-sp Dementia Knowledge Scale (with 0.79 Cronbach's alpha) and the Care Skills Inventory-CAI instrument (0.84 Cronbach's alpha) were applied. Results: The predominant gender was female. The results of the Spearman's Rho test (p = 0.149) confirmed that there is no relationship, showing a higher level of significance than expected between knowledge and ability. Family members of people with dementia fulfill other different roles, in addition to not receiving training; they have high and moderate knowledge with medium and high care skills. Conclusion: The skill and knowledge levels are not insufficient, demonstrating that there is no relationship between the variables.

Genetic diversity of Hepatozoon spp. in rodents from Chile / Diversidade genética de Hepatozoon spp. em roedores do Chile

Abstract This study aimed to investigate the genetic diversity of Hepatozoon spp. in rodents from Valdivia, Chile. A total of 74 rodents (synanthropic n=38; wild n=36) were trapped in Valdivia. We performed conventional PCR assays for Apicomplexa organisms targeting two overlapping 18S rDNA gene fragments (600 bp and 900 bp) followed by sequencing of selected amplicons. Hepatozoon spp. occurrence was 82.43% (61/74). Twelve sequences obtained from the 600 bp and ten from the 900 bp 18S rDNA fragments were identified as Hepatozoon sp. Six sequences obtained from 18S rDNA-based overlapping PCR protocols were used for concatenated (1,400 bp) phylogenetic, haplotype and distance analyses. Hepatozoon spp. 18S rDNA concatenated sequences from the present study were detected in Oligoryzomys longicaudatus, Rattus norvegicus, Mus musculus, and Abrothrix longipilis grouped with Hepatozoon species earlier described in rodents and reptiles from Chile and Brazil. Nucleotide polymorphism of the six 18S rDNA sequences (1,400 bp) from this study, and other Chilean sequences from rodents and rodent's ticks, showed high diversity with a total of nine Chilean haplotypes. Three haplotypes from Valdivia were identified for the first time in this study, suggesting the circulation of novel haplotypes in rodents from southern Chile.

Resumo Este estudo teve como objetivo investigar a diversidade genética de Hepatozoon spp. em roedores de Valdivia, Chile. Um total de 74 roedores (sinantrópicos n=38; selvagens n=36) foram capturados. PCR convencional foi realizada para organismos Apicomplexa, visando dois fragmentos sobrepostos do gene 18S rDNA (600 bp e 900 bp), seguida pelo sequenciamento de amplicons selecionados. A ocorrência de Hepatozoon spp. foi de 82,43% (61/74). Doze sequências obtidas dos fragmentos de 18S rDNA de 600 pb e dez dos fragmentos de 18S rDNA de 900 pb foram identificadas como Hepatozoon sp. Seis sequências obtidas, a partir de protocolos de PCR sobrepostos, foram usadas para análises filogenéticas (1.400 bp), de haplótipos e de distância. Sequências concatenadas 18S rDNA do presente estudo foram detectadas em Oligoryzomys longicaudatus, Rattus norvegicus, Mus musculus e Abrothrix longipilis e agrupadas com Hepatozoon descrito em roedores e répteis do Chile e do Brasil. A análise de polimorfismos das seis sequências deste estudo, junto com outras sequências chilenas de roedores e carrapatos de roedores, mostrou alta diversidade com um total de nove haplótipos no Chile. Três haplótipos detectados em Valdivia foram identificados pela primeira vez neste estudo, sugerindo que novos haplótipos circulam em roedores do sul do Chile.

Evaluation of terrestrial gastropods as possible intermediate hosts of Gurltia paralysans in southern Chile / Avaliação de gastrópodes terrestres como possíveis hospedeiros intermediários de Gurltia paralysans no sul do Chile

Abstract Gurltia paralysans is the causal agent of gurltiosis in domestic cats in South America. Although the life cycle of G. paralysans is unknown, it is thought that gastropods could act as intermediate hosts (IHs), as is the case for several nematodes in the Angiostrongylidae family. The aim of this study was to search for G. paralysans larvae in terrestrial gastropods and determine their role in the life cycle of this nematode species. Terrestrial gastropod samples (n=835) were collected in Punucapa, Valdivia, southern Chile, where cases of gurltiosis had been reported before. The samples included species from the families Arionidae, Limacidae, Helicidae and Milacidae. All gastropods were subjected to enzymatic digestion to isolate G. paralysans larvae. Ten percent of the gastropod samples were analyzed using seminested PCR targeting the 28S rRNA gene, while 2.6% were analyzed by histopathological examination. The results indicated the absence of G. paralysans when using any of the three methods. In conclusion, further studies are needed to evaluate specific species of aquatic or native gastropods acting as possible IHs (in this geographic location).

Resumo Gurltia paralysans é o agente etiológico da gurltiose em gatos domésticos na América do Sul. Embora o ciclo biologico de G. paralysans seja desconhecido, provavelmente é indireto com gastrópodes atuando como hospedeiros intermediários (HIs), como no caso de vários nematoides da família Angiostrongylidae. O objetivo deste estudo foi investigar a presença de larvas de G. paralysans em gastrópodes terrestres para avaliar seu papel no ciclo de vida do parasito. Amostras de gastrópodes terrestres (n = 835) foram coletadas em Punucapa, Valdivia, sul do Chile, onde casos de gurltiose foram relatados anteriormente. As amostras incluíram espécies das famílias Arionidae, Limacidae, Helicidae e Milacidae. Todos os gastrópodes foram submetidos à digestão enzimática para isolar as larvas de G. paralysans. 10% das amostras foram analisadas, utilizando-se seminested PCR para o gen 28S RNAr de G. paralysans, enquanto 2,6% foram analisados ​​por exame histopatológico. Os resultados indicaram ausência de G. paralysans em todos os três métodos. Os dados permitem concluir que são necessários mais estudos para avaliar espécies específicas de gastrópodes aquáticos ou nativos, que atuam como possíveis hospedeiros intermediários nessa localização geográfica.

First case report of nematode parasitic myelopathy in a wild feline in Brazil / Primeiro relato de caso de mielopatia parasitária causada por nematódeo em um felídeo selvagem no Brasil

Abstract Parasitic myelopathy caused by Gurltia paralysans in domestic cats is a disease commonly reported in several South American countries. The adult parasite is lodged in the meningeal veins and spinal cord, often causing clinical manifestations of vascular proliferation, thrombophlebitis, and medullary compression. Wild felines are believed to be the definitive hosts of this parasite. The infection occurs through the ingestion of paratenic hosts, but the life cycle of G. paralysans is not yet clearly understood. In this paper, we discuss a case of parasitic myelopathy in a margay (Leopardus wiedii) that died during post-surgical care. Necropsy revealed focal hemorrhages in the thoracolumbar spinal cord. A microscopic examination revealed adult nematodes and eggs inside the veins of subarachnoid space in spinal cord, suggesting G. paralysans infection. This is first description of parasitic myelopathy in a margay in Brazil.

Resumo Mielopatia parasitária causada por Gurltia paralysans em gatos domésticos é uma doença comumente relatada em vários países da América do Sul. O parasita adulto aloja-se nas veias das meninges e da medula espinhal, muitas vezes causando proliferação vascular, tromboflebite e compressão medular, que se manifestam como sinais clínicos. Acredita-se que os felídeos selvagens sejam hospedeiros definitivos deste parasita e que a infecção ocorre por ingestão de hospedeiros paratênicos, entretanto seu ciclo de vida completo é desconhecido. Aqui, apresentamos um caso de um gato-maracajá (Leopardus wiedii) que morreu durante a assistência pós-cirúrgica. Na necropsia, foram observadas hemorragias focais na medula espinhal toracolombar. A microscopia revelou presença de nematódeos adultos e ovos, localizados dentro das veias do espaço subaracnoide da medula espinhal, o que sugeriu a infecção por G. paralysans. Esta é a primeira descrição de mielopatia parasitária em um gato-maracajá no Brasil.

Asociación de dislalias y anomalías dentomaxilares en niños: revisión de la literatura / Association of dyslalias and dentomaxillary anomalies in children: review of the literature

Es frecuente encontrar niños con problemas para comunicarse y esto puede ser producto de un trastorno del habla, que corresponde a una alteración que involucra la pronunciación o producción de sonidos. El trastorno del habla más frecuente entre los escolares lo constituyen las dislalias, con una prevalencia de 70%. Las maloclusiones ocupan el tercer lugar de prevalencia dentro de los problemas de salud bucodental, luego de la caries dental y la enfermedad periodontal. Latinoamérica tiene una situación preocupante al respecto, con altos niveles de incidencia y prevalencia de maloclusiones que superan el 85% de la población. El objetivo de este estudio es revisar la asociación existente en las anomalías dentomaxilares y dislalias en niños, descritas en la literatura para población infantil y adolescente. En términos generales, existen pocos estudios que hayan evaluado esta asociación. Existe una asociación positiva entre la presencia de anomalías dentomaxilares y la presencia de dislalias. A pesar de lo anterior, son escasos los estudios que han evaluado esta asociación, por lo que se hace necesaria la realización de más estudios en esta materia

It is common to find children with problems to communicate and this can be the product of a speech disorder, which corresponds to an alteration that involves the pronunciation or production of sounds. The most frequent speech disorder among school children is dislalias, with a prevalence of 70%. The malocclusions occupy the third place of prevalence within oral health problems, after dental caries and periodontal disease. Latin America has a worrying situation in this regard, with high levels of incidence and prevalence of malocclusions that exceed 85% of the population. The aim of this study is to review the existing association between dentomaxillary anomalies and dyslalias in children described in the literature for children and adolescents. In general terms, there are few studies that have evaluated this association. There is a positive association between the presence of dentomaxillary anomalies and the presence of dyslalias. Despite the above, there are few studies that have evaluated this association, so it is necessary to conduct more studies in this area

Aspectos legales de la transfusión de hemoderivados en el paciente crítico pediátrico hijo de padres Testigos de Jehová, a propósito de un caso mediáticamente relevante / Legal aspects of blood-derived transfusion in a pediatric critical patient whose parents are Jehova Witness: with regard to a medically relevant case

Caso: en el mes de agosto del año 2013, se dio lugar un caso en la ciudad de Guayaquil, que llamó la atención a los medios de comunicación. Una jueza, dictaminó una orden judicial (medida cautelar) para la administración de sangre a un neonato ingresado en Unidad de Cuidados Intensivos Neonatales, que requería transfusión sanguínea urgente y que era hijo de padres que negaban la transfusión al menor de edad aduciendo motivos religiosos. Este artículo tiene como objetivos verificar fuentes sobre el caso y realizar una revisión bibliográfica sobre los fundamentos religiosos, bioéticos y legales que sustenten el evento. Para el desarrollo del mismo se realizó entrevistas tanto a la Jueza involucrada, como al procurador jurídico de la Congregación de los Testigos de Jehová del Ecuador, al Asesor Jurídico de la Jefatura de la DINAPEN (Dirección Nacional de la Policía especializada en Niños, Niñas y Adolescentes), y al Director Nacional Tutelar de la Defensoría del Pueblo del Ecuador. Este reporte de caso, además cuenta con una revisión actualizada del tema con el fin de esclarecer las condiciones en las que se debe recurrir a instancias judiciales ante la negativa de los padres de transfusión a menores de edad en condiciones críticas.

Case: in august 2013, a particular medical case called the attention of the Media in the city of Guayaquil. A Judge granted a judicial order (interim measure) for blood transfusion to a newborn child who was an inpatient in the Newborn Intensive Care Unit and needed the treatment urgently. The parents of the Child refused the blood transfusion due to their religious beliefs. The objectives of the present article are to share the interviews of the sources of the case and confirm the event. In addition, a review of the religious, bioethical and legal issues behind the event has been portrayed. Interviews to the Judge involved, the Jehovah's Witness of Ecuador Attorney, the Legal Adviser of DINAPEN (Police Specialized in Children National Management Office), and the National Tutelary Attorney of the Public Defense Office of Ecuador were performed. Furthermore, the article will set the procedure in which legal action shall be sought for the administration of blood transfusions in critical situations when parents deny a blood transfusion in children.

Impacto de un programa de psicología positiva en sintomatologia depresiva y satisfaccion vital en adultos mayores / Effects of a positive psychology program in depressive symptoms and life satisfaction in the elderly

La presente investigación estudia la efectividad de talleres basados en Psicología Positiva en adultos mayores, mediante el análisis de las variaciones pre-post del niveles de Satisfacción Vital y Sintomatología Depresiva. Se conformó tres grupos: el primero, un grupo cuasi experimental, basado en Psicología Positiva; el segundo, un grupo cuasi control activo, basado en actividades recreativas; y el tercero, un grupo cuasi control inactivo, sin intervención. Se utilizó la Escala de Depresión Geriátrica de Yesavage y Escala de Satisfacción Vital de Diener. Los resultados indican que sólo el grupo con taller basado en Psicología Positiva disminuye significativamente su Sintomatología Depresiva y aumenta significativamente sus niveles de Satisfacción Vital, luego de la intervención. Estos resultados se discuten a la luz de las investigaciones actuales en Psicología Positiva...

This research examines the effectiveness of workshops based on positive psychology for the elderly by analyzing pre-post changes in levels of life satisfaction and depressive symptomatology. Three groups were formed: the first, a quasi-experimental group based on positive psychology; the second, a quasi-active control group based on recreational activities; and the third, a quasi-inactive control group without intervention. The instruments used were: Yesavage Geriatric Depression Scale and Life Satisfaction Scale of Diener. Results indicated that only the group that attended positive psychology-based workshops significantly decreased depressive symptoms and significantly increased their levels of life satisfaction after the intervention. These results are discussed in the light of current researches in positive psychology...

Bioética y profesiones sanitarias / Bioethics and health professions

Para hablar de las profesiones sanitarias y su relación con la Bioética, creo conveniente empezar delineando de alguna manera lo que es profesión en su conjunto, Ia medicina como una de las profesiones sanitarias, para posteriormente hacer referencia a la persona que ejercita dicho quehacer que constituye su ser en Ia sociedad.

In order to talk about the health professions and their relationship with Bioethics, I think it convenient to begin by outlining in some way what is a profession as a whole, medicine as one of the health professions, to later refer to the person who exercises this task that constitutes their being in society.