Complicaciones de la enfermedad de Parkinson relacionadas con la infección por SARS-CoV-2

El SARS-CoV-2 fue registrada en la ciudad de Wuhan-China, por primera vez en diciembre de 2019. El impacto de esta nueva patología en pacientes con Enfermedad de Parkinson fue negativo, por cuanto puso al descubierto el desarrollo de complicaciones graves posteriores a esta infección, Además, el virus puede afectar indirectamente el sistema nervioso central a través de la respuesta inflamatoria y la liberación de citocinas, lo que puede tener un impacto negativo en la función neuronal, conduciendo a una mayor afectación en la calidad de vida de estos pacientes. Objetivo. Describir las complicaciones de la Enfermedad de Parkinson relacionadas con la infección por SARS-CoV-2. Metodología. Se realizó una revisión sistemática, a través de una búsqueda en bases de datos. En donde se incluyeron estudios publicados entre 2019 y 2022, que cumplan criterios de inclusión y exclusión, e informen sobre las complicaciones en pacientes con enfermedad de Parkinson. Resultados. Se procedió a la lectura de texto completo de cada artículo, siendo excluidos 13 artículos, debido a que no cumplían totalmente con criterios de inclusión, presentaban otra temática o tenían una metodología poco clara, resultados 17 como resultado. Conclusión. Es importante reconocer que el COVID-19 es una enfermedad multifacética que afecta principalmente al sistema respiratorio, pero también puede tener impactos en otros sistemas del cuerpo, incluido el sistema nervioso. Si bien se ha observado que algunos pacientes con Parkinson experimentan un empeoramiento de los síntomas motores y no motores durante la infección por COVID-19, entre los síntomas que más mayor prevalencia de complicaciones presentaron se encuentran las alteraciones del sueño, alteraciones del estado de ánimo, bradicinesia, rigidez, temblor, alteraciones de la marcha.

SARS-CoV-2 was recorded in Wuhan City-China for the first time in December 2019. The impact of this new pathology in patients with Parkinson's Disease was negative, in that it uncovered the development of severe complications following this infection, in addition, the virus may indirectly affect the central nervous system through inflammatory response and cytokine release, which may have a negative impact on neuronal function, leading to further impairment in the quality of life of these patients. Objective. To describe the complications of Parkinson's disease related to SARS-CoV-2 infection. Methodology. A systematic review was carried out through a database search. We included studies published between 2019 and 2022 that met inclusion and exclusion criteria and reported on complications in patients with Parkinson's disease. Results. We proceeded to read the full text of each article, being excluded 13 articles, because they did not fully meet inclusion criteria, presented another subject or had an unclear methodology, 17 as a result. Conclusion. It is important to recognize that COVID-19 is a multifaceted disease that primarily affects the respiratory system, but can also have impacts on other body systems, including the nervous system. While it has been observed that some Parkinson's patients experience worsening of motor and non-motor symptoms during COVID-19 infection, among the symptoms with the highest prevalence of complications were sleep disturbances, mood disturbances, bradykinesia, rigidity, tremor, gait disturbances.

O SARS-CoV-2 foi registrado na cidade de Wuhan, na China, pela primeira vez em dezembro de 2019. O impacto dessa nova patologia em pacientes com doença de Parkinson foi negativo, pois revelou o desenvolvimento de complicações graves após essa infecção. Além disso, o vírus pode afetar indiretamente o sistema nervoso central por meio da resposta inflamatória e da liberação de citocinas, o que pode ter um impacto negativo na função neuronal, levando a um maior comprometimento da qualidade de vida desses pacientes. Objetivo. Descrever as complicações da doença de Parkinson relacionadas à infecção pelo SARS-CoV-2. Metodologia. Foi realizada uma revisão sistemática por meio de uma pesquisa em banco de dados. Foram incluídos estudos publicados entre 2019 e 2022 que atenderam aos critérios de inclusão e exclusão e relataram complicações em pacientes com doença de Parkinson. Resultados. Prosseguimos com a leitura do texto completo de cada artigo e excluímos 13 artigos porque eles não atendiam totalmente aos critérios de inclusão, apresentavam um tópico diferente ou tinham uma metodologia pouco clara, resultados 17 Conclusão. É importante reconhecer que a COVID-19 é uma doença multifacetada que afeta principalmente o sistema respiratório, mas também pode ter impactos em outros sistemas do corpo, incluindo o sistema nervoso. Embora alguns pacientes com Parkinson tenham apresentado piora dos sintomas motores e não motores durante a infecção por COVID-19, os sintomas com maior prevalência de complicações incluem distúrbios do sono, distúrbios do humor, bradicinesia, rigidez, tremor e distúrbios da marcha.

Atribuciones hacia la timidez y la soledad en niños y niñas de diferentes contextos sociales argentinos / Attributions towards shyness and unsociability in Argentinian children from different social contexts

Resumen Las atribuciones de los niños y las niñas hacia los comportamientos de retraimiento social suelen estar determinadas por el entorno sociocultural particular en el que se desarrollan e influyen en la forma en que reaccionan a las conductas de sus pares durante las interacciones sociales. El objetivo de este trabajo fue comparar dichas atribuciones hacia dos subtipos de retraimiento social (timidez y preferencia por la soledad) referidas por niños y niñas de tres contextos diferentes de Mendoza (Argentina): urbano, urbano-marginado y rural. Se llevó a cabo un estudio con 221 niños y niñas abordando jardines de infantes estatales de cada ámbito (urbano: . = 82, Mmeses= 62.33; urbano-marginado: . = 72, Mmeses= 60.47; rural: . = 67, Mmeses= 63.07). Los escolares fueron entrevistados individualmente con una serie de viñetas gráficas con personajes hipotéticos desplegando conductas sociables, tímidas, solitarias y agresivas frente a las cuales respondieron preguntas sobre sus atribuciones y percepciones en distintos aspectos. Las diferentes pruebas no paramétricas realizadas señalaron que el personaje tímido fue percibido con mayor motivación social y menor intencionalidad en su conducta que el personaje solitario en todos los grupos. No se encontraron diferencias entre los contextos en la atribución de consecuencias sociales negativas para estas conductas, aunque el grupo de escolares rurales reportó mayor preferencia afiliativa y compasión por el personaje tímido en comparación con el grupo urbano. Se discuten estos resultados considerando cómo las expectativas de socialización de cada contexto podrían influir en las percepciones de los escolares hacia el retraimiento social.

Abstract Children's attributions towards withdrawn behaviors are usually determined by the particular social milieu in which they develop and tend to influence their behaviors and reactions. The aim of this work was to compare the attributions towards two subtypes of social withdrawal (shyness and unsociability) referred by children from three different contexts in Mendoza, Argentina: urban, urban-marginalized and rural. Participants were 221 kindergarten children from these contexts (urban: n = 82, Mmonths = 62.33; urban-marginalized: n = 72, Mmonths = 60.47; rural: n = 67, Mmonths = 63.07). Children were individually interviewed with a series of graphic vignettes with hypothetical characters displaying shy and unsociable behaviors, and for comparison purposes were also assessed aggressive and socially competent behaviors. After each vignette, children were asked a series of questions designed to assess their attributions toward each behavior in six dimensions: intentionality, social motivation, affiliative preference, social status, negative impact and sympathy. The results of this study showed that young children in the three contexts were able to distinguish social withdrawal from other types of behaviors (i.e., aggressiveness and sociability). Overall, withdrawn behaviors received more positive attributions (greater affiliative preference, better social position and less negative impact) than aggressive behaviors, although they were also perceived negatively in relation to more socially competent behaviors (the latter were attributed greater affiliative preference and best position within the peer group). Furthermore, it was observed that children from the three contexts made clearly distinctions among the different forms of social withdrawal in terms of intentionality and social motivation. Specifically, they reported that compared with unsociable characters, shy ones are more socially motivated and less intentional in their behavior, evocating greater feelings of compassion. However, some peculiarities can be appreciated in each context. The results indicated that children in the urban group reported greater feelings of sympathy for the shy character in relation to the unsociable, which was not evidenced in the other groups. In addition, children from the rural sample showed a greater preference for interact with the hypothetical shy peer than with the unsociable character and this inclination was also greater when compared with the urban sample. Taken together, these results may suggest that different socialization norms and expectations would evoke different meanings and implications to the socially withdrawn manifestations. It might be possible that in urban contexts children's socialization expectations highlight extraversion and self-affirming behaviors which generate more empathetic reactions in front of passive or fearful manifestations as shyness. On the other hand, rural children may prefer peers who display shy behaviors possibly because it is in line with expectations of social cohesion and modesty that are value in this milieu. Nevertheless, no differences were found between shy and unsociable behaviors in any of the contexts in terms of social position and negative impact that they anticipated for the peer group. These results could provide some support for the idea that social withdrawal tends to be globally perceived as benign at an early age, and especially in the rural context, where it is a frequent and valued behavior. Although it is not possible with the limited variables included in this study to know which are the specific contextual aspects that affect some attributions and through what mechanisms they do so, these findings are an important starting point to continue deepening the socialization processes in urban, urban-marginalized and rural young children. This study is also one of the first to evaluate the knowledge and attributions of Argentinean children from different social context toward social withdrawal and provides new evidence on the differences in the cultural meaning and implications of withdrawn behaviors in early childhood.

Embarazo ectópico en cuerno rudimentario izquierdo de útero unicorne con embarazo de 15 semanas: reporte de un caso / Ectopic pregnancy in rudimentary left horn of unicorne uterus with pregnancy of 15 weeks: a case report

INTRODUCCIÓN: El embarazo ectópico en el cuerno rudimentario de un útero unicorne tiene una incidencia de 1 en 76.000 embarazos. La aproximación diagnóstica se realiza con la ecografía y como estudio complementario con la resonancia magnética. El diagnóstico temprano con tratamiento oportuno es fundamental para la prevención de la morbimortalidad materna asociada. El objetivo es describir el diagnóstico y el tratamiento temprano de un caso de embarazo ectópico de 15 semanas en cuerno rudimentario no comunicante de útero unicorne. CASO CLÍNICO: Mujer de 38 años con embarazo de 15 semanas, asintomática, que ingresa al servicio de urgencias referida desde el servicio de ecografía por sospecha de embarazo ectópico. Se realizan ecografía y resonancia magnética que muestran embarazo con feto único de 15 semanas en cuerno uterino izquierdo rodeado de miometrio, sin comunicación con la cavidad endometrial. Con impresión diagnóstica de embarazo ectópico cornual en paciente con malformación mülleriana, se realizó manejo quirúrgico que confirmó útero unicorne con embarazo ectópico en cuerno rudimentario no comunicante. CONCLUSIONES: El embarazo ectópico en un cuerno rudimentario de útero unicorne es infrecuente y presenta un alto riesgo de rotura, con aumento de la morbimortalidad obstétrica. El tratamiento estándar, al igual que la confirmación diagnóstica, es la escisión quirúrgica completa.

INTRODUCTION: Ectopic pregnancy in the rudimentary horn of a unicornuate uterus has an incidence of 1 in 76,000 pregnancies; the diagnostic approach is carried out with ultrasound and magnetic resonance imaging as a complementary study; Early diagnosis with timely treatment is essential for the prevention of associated maternal morbidity and mortality. The objective is to describe the early diagnosis and treatment of a case of 15-week ectopic pregnancy in a rudimentary non-communicating horn of the unicornuate uterus. CASE REPORT: A 38-year-old patient with an asymptomatic 15-week pregnancy was admitted to the emergency department, referred to the ultrasound service for suspected ectopic pregnancy. Ultrasound and magnetic resonance imaging were performed with pregnancy with a single fetus of 15 weeks in the left uterine horn surrounded by myometrium, without communication with the endometrial cavity. With a diagnostic impression of cornual ectopic pregnancy in a patient with a Müllerian malformation, a surgical management was performed where a unicornuate uterus with a rudimentary non-communicating ectopic horn was confirmed. CONCLUSIONS: Ectopic pregnancy in rudimentary horn of the unicornuate uterus is rare, it presents a high risk of rupture with increased obstetric morbidity and mortality. The standard treatment as well as the diagnostic confirmation is complete surgical excision.

Efecto de la empatía afectiva sobre el procesamiento cortical de emojis / Effect of Affective Empathy on the Cortical Processing of Emojis / Effect of Affective Empathy on the Cortical Processing of Emojis

Resumen Objetivo. Identificar las diferencias en el procesamiento cortical de emojis en personas con alta y baja empatía afectiva. Método. El estudio se llevó a cabo con 69 participantes, distribuidos en dos grupos -baja y alta empatía afectiva-, según su puntaje en el Índice de Reactividad Interpersonal. Cada participante observó emojis con expresiones de alegría, ira y neutros. Se registraron los potenciales relacionados a eventos (PRE) P100, N170 y LPP. Resultados. Se encontró una mayor amplitud del N170 en el grupo de personas con alta empatía afectiva y, en general, mayor magnitud del LPP ante emojis de ira. Conclusión. Los resultados sugieren que los emojis son procesados corticalmente de forma similar al rostro humano y que la empatía afectiva modula la codificación del emoji, pero no la atención temprana y el enganche atencional hacia estos estímulos.

Abstract Objective. The objective of this research was to identify the differences in the cortical processing of emojis in people with high and low affective empathy. Method. The study was carried out with 69 participants divided into two groups, low and high affective empathy, according to their score in the Interpersonal Reactivity Index. Each participant observed emojis with happy, neutral and angry expressions. Events related potential (ERP) P100, N170 and LPP were recorded. Results. An amplitude greater than N170 in the high affective empathy group, and a generally greater magnitude of the LPP in response to angry emoji were found. Conclusion. The results suggest that the emojis are processed cortically in a similar way to the human face and that affective empathy modulates the coding of the emoji but not the early attention and the attentional attachment to these stimuli.

Resumo Escopo. Identificar as diferencias no processamento cortical de emojis em pessoas com alta e baixa empatia afetiva. Metodologia. O estudo foi feito com 69 participantes, distribuídos em dois grupos, baixa e alta empatia afetiva, segundo sua pontuação no Índice de Reatividade Interpessoal. Cada participante observou emojis com expressões de alegria, neutrais e ira. Foram registrados os potenciais relacionados a eventos (PREs) P100, N170 e LPP. Resultados. Foi achada uma maior amplitude do N170 em um grupo de pessoas com alta empatia afetiva e, em geral, maior magnitude do LPP frente a de emoji com ira. Conclusão. Os resultados sugerem que os emojis são processados corticalmente de forma similar ao rosto humano e que a empatia afetiva modula a codificação do emoji mas não a atenção precoce e o engajamento atencional para estes estímulos.

Eficacia de las etiquetas de advertencia en las cajetillas de cigarrillo / Effectiveness of cigarette-pack warning labels in capturing the attention of smokers and nonsmokers / Eficácia das tarjas de advertência em maços de cigarro para atrair a atenção de fumantes e não fumantes

RESUMEN Objetivo Establecer la capacidad que tienen las etiquetas de advertencia con el tamaño mínimo exigido por la Organización Mundial de la Salud para capturar la atención en fumadores y no fumadores. Métodos En el estudio se incluyeron 30 fumadores y 30 no fumadores, quienes realizaron una prueba de detección del punto (dot-probe) en la cual observaron, de manera simultánea, imágenes de cajetillas de cigarrillo divididas en dos: la parte superior contenía la marca de los cigarrillos y la parte inferior contenía la etiqueta de advertencia. Durante la tarea, se registró la actividad cerebral a través de los potenciales relacionados a eventos del tipo potencial negativo que ocurre aproximadamente a los 200 ms en la zona posterior contralateral al estímulo (N2pc) y negatividad contralateral posterior sostenida (SPCN, por sus siglas en inglés), los cuales son indicadores de atención temprana y sostenida. Resultados En ambos grupos se encontró mayor amplitud de los potenciales N2pc y SPCN hacia la porción de la cajetilla que contiene la marca de cigarrillos. Sin embargo, el tiempo de reacción fue menor ante la etiqueta de advertencia en la tarea dot-probe. Conclusiones Los resultados sugieren que, al inicio, la atención se dirige hacia la marca de los cigarrillos y luego hacia la etiqueta de advertencia. La incapacidad de las etiquetas de advertencia para capturar la atención en las primeras fases disminuye su eficacia, sobre todo en fumadores. Se sugiere aumentar el tamaño de las etiquetas de advertencia para favorecer un incremento en la respuesta de atención.

ABSTRACT Objective To determine the ability of cigarette-pack warning labels, of the minimum size required by the World Health Organization, to capture the attention of smokers and nonsmokers. Methods In this study, 30 smokers and 30 nonsmokers completed a dot-probe task in which they simultaneously observed images of cigarette packs split in two: the top contained the cigarette brand and the bottom contained the warning label. During the task, brain activity was recorded through two event-related potentials of the negative-polarity type--the potential that occurs in the posterior-contralateral zone approximately 200 ms after a stimulus (N2pc) and the sustained posterior contralateral negativity (SPCN) response--which are indicators of early and sustained attention. Results In both groups, a greater amplitude of N2pc and SPCN potentials was found for the part of the pack containing the cigarette brand. However, during the dot-probe task, reaction times were shorter for the warning label. Conclusions These results suggest that, initially, attention is focused on the cigarette brand, and only then on the warning label. The inability of warning labels to capture early-phase attention decreases their effectiveness, especially in smokers. We suggest that warning labels be enlarged to facilitate increased attention response.

RESUMO Objetivo Determinar a capacidade das tarjas de advertência com o tamanho mínimo exigido pela Organização Mundial da Saúde (OMS) de atrair a atenção de fumantes e não fumantes. Métodos A amostra do estudo consistiu de 30 fumantes e 30 não fumantes que foram testados com uma tarefa de sondagem (dot-probe task) em que tiveram de observar simultaneamente imagens de um maço de cigarro dividido ao meio: a parte superior continha a marca do cigarro e a parte inferior continha a tarja de advertência. Durante o teste, foi registrada a atividade cerebral com a análise de potenciais evocados relacionados a eventos do tipo potencial negativo que ocorre em cerca de 200 ms na área posterior contralateral ao estímulo (N2pc) e da ocorrência de negatividade contralateral posterior sustentada (SPCN, em inglês), que são indicadores de atenção mais rápida e sustentada. Resultados Em ambos os grupos de participantes foi observada maior amplitude dos potenciais N2pc e SPCN na parte do maço que continha a marca. Porém, o tempo de reação na tarefa de sondagem foi menor diante da tarja de advertência. Conclusões Os resultados deste estudo sugerem que, ao início, a atenção é dirigida à marca do cigarro e depois à tarja de advertência. A incapacidade da tarja de advertência de atrair a atenção nas primeiras fases diminui sua eficácia, sobretudo entre os fumantes. Recomenda-se aumentar o tamanho das tarjas de advertência para estimular um incremento na resposta de atenção.

Tuberculosis: características epidemiológicas en un hospital tipo IV / Tuberculosis: epidemiological characteristics in a type IV hospital

La tuberculosis (TB) es un problema de salud pública. Analizar la epidemiologia de la tuberculosis en los últimos 10 años. Se diseñó un estudio de casos, descriptivo y analítico, observacional, transversal y retrospectivo en una muestra no probabilística, que incluye 100% de las historias de pacientes mayores de 14 años de edad, de cualquier sexo, con diagnóstico de TB en cualquiera de sus formas clínicas, atendidos en el Hospital General del Oeste, Dr. José Gregorio Hernández, de Caracas, durante el periodo comprendido entre enero de 2004 y diciembre 2013, divididos en dos grupos de 5 años consecutivos denominados A y B. Se analizaron 475 historias médicas, correspondientes a 241 pacientes del grupo A y 234 del B. La edad promedio del grupo total fue 38,97 ± 15,97 con un predominio del género masculino en 60.6%. La mayor parte de la muestra fueron personas que provienen de Caracas en ambos grupos. El estrato socioeconómico fue predominantemente IV de la clasificación de Graffar y representó el 41% en el grupo A y a 73,9% en el B con diferencia estadísticamente significativa. Se identificaron14, 1% y 19,7% de pacientes con enfermedad relacionada con el VIH en los Grupos A y B. Pocos sujetos tenían enfermedades debilitantes crónicas predisponentes y la más importante fue la desnutrición que duplicó la frecuencia en el grupo B (26,5%) vs (12%) en el A , estadísticamente significativa. La radiología de tórax fue el método más utilizado. En el Grupo A recibieron Prueba Terapéutica 52 pacientes mientras que en grupo B, 70. El grupo representó tuberculosis pulmonar en 71,78% para el grupo A y 68,37% para el B: el resto fue en diversas localizaciones extra pulmonares donde predominaron la pleura y los ganglios. Se cumplió la meta terapéutica en 77,1% de grupo A y 80.36% del grupo B y los restantes en ambos grupos correspondieron al abandono de tratamiento o fallecimiento. La desnutrición fue muy importante en el grupo de estudio reciente y el VIH se mantuvo...

Tuberculosis is a public health problem. To analyze the epidemiology of tuberculosis in the last 10 years. A case study, descriptive and analytical, observational, cross-sectional and retrospective in a non random sample, which includes 100% of the records of patients over 14 years of age, of any gender, diagnosed with TB in any one of its clinical forms, treated in the Hospital Dr. José Gregorio Hernández, Caracas, during the period between January 2004 and December 2013 divided in two groups of 4 consecutive years called A and B. 475 medical records were analyzed corresponding to 241 patients in group A and 234 in B. The average age of the total group was 38.97 ± 15.97 with a predominance of the male gender in 60.6%. The majority of the sample belonged to people coming from Caracas in both groups. Socioeconomic level classification Graffar IV was predominant and accounted for 41% in group A and 73.9% in group B with significant statistical difference. 14.1% and 19.7% of patients were identified with HIV-related in Groups A and B. Few patients had chronic debilitating diseases and malnutrition was the most important and it doubled its frequency in group B (26.5%) vs (12%) with a statistically significant difference. The chest x-ray was the most used method. In Group A, 52 patients received therapeutic test while in group B were 70. The group accounted for pulmonary tuberculosis in 71.78% in group A and 68.37% for the B: the rest were in various extrapulmonary sites where it dominated in pleura and ganglia. The therapeutic goal was fulfilled in 77, 1% of group A and 80, 36% in group B and the rest in both groups corresponded to treatment abandonment or death. Malnutrition was very important in the second study group and HIV remained with similar frequency in both groups

Effect of iron on the activation of the MAPK/ERK pathway in PC12 neuroblastoma cells

Recent evidence suggests that reactive oxygen species function as second messenger molecules in normal physiological processes. For example, activation of N-Methyl-D-Aspartate receptor results in the production of ROS, which appears to be critical for synaptic plasticity, one of the cellular mechanisms that underlie learning and memory. In this work, we studied the effect of iron in the activation of MAPK/ERK pathway and on Ca2+ signaling in neuronal PC12 cells. We found that iron-dependent generation of hydroxyl radicals is likely to modulate Ca2+ signaling through RyR calcium channel activation, which, in turn, activates the MAPK/ERK pathway. These findings underline the relevance of iron in normal neuronal function.