ABSTRACT
Introducción. La andragogía está orientada hacia la educación de los adultos; los cuidadores como adulto responsables de un enfermo de Alzheimer deben contar con herramientas didácticas que mejoren su calidad de vida y desempeño. Objetivo. Determinar el enfoque para un modelo andragógico que incremente la capacidad del cuidador de un enfermo de Alzheimer basado en el significado de su experiencia. Metodología. Se trata un estudio observacional, descriptivo, exploratorio; la muestra fue de 29 cuidadores de enfermos de Alzheimer, siendo adultos, mujeres y familiares cercanos del paciente. A dichos cuidadores se le aplicó un cuestionario de 22 ítems de sobrecarga del cuidador propuesta por Zarit sobre la relación del cuidador con el enfermo, las relaciones sociales del cuidador, el efecto del cuidado en el estrés, capacidad y su salud, teniendo un alfa de Cronbach de .93. Resultados. Los resultados del estudio señalaron que el modelo andragógico debe orientarse de manera particular hacia conocimientos, habilidades e información que forme e instruya al cuidador sobre su capacidad para hacer frente al cuidado de un enfermo de Alzheimer, elementos como salud, relaciones con el paciente y con otras personas son afectados por razón del cuidado. De los resultados de otras investigaciones donde está presente un cuidador y un paciente, el presente documento coincide en señalar una incidencia sobre la vida cotidiana del cuidador por efecto de las relaciones y la gravedad de la enfermedad del paciente. Conclusiones: Es factible diseñar un modelo andragógico fundamentado en: conocimientos, habilidades e información que instruyan al cuidador sobre su capacidad para hacer frente al cuidado de un enfermo de Alzheimer.
Subject(s)
Humans , Male , Female , Adult , Caregivers , Alzheimer Disease , Quality of LifeABSTRACT
We describe the clinical case of a patient with acute myocardial infarction treated with t-PA fibrinolysis, who developed renal failure and cutaneous lesions of the livedo reticularis type, probably caused by embolization of cholesterol crystals. The main characteristics of this rare clinical entity are reviewed.
Subject(s)
Embolism, Cholesterol/complications , Myocardial Infarction/drug therapy , Renal Insufficiency/etiology , Skin Diseases, Vascular/etiology , Humans , Male , Middle Aged , Myocardial Infarction/complications , Thrombolytic TherapyABSTRACT
This paper is about the effort to measure the assistance load at the first level of attention given by arterial hypertension and care risk factors. It is been worked as a demonstration project to initiate activities within the setting of a Health Center. The risk factors are explored from the proportions of patients with the problems of obesity, smoking, hyperlipidemia, diabetes mellitus and alcoholism. The information was obtained from 395 consecutive cases out of 1100 persons who came to the center in a month period. They were 325 women (82.2%) and 70 men (17.2%) with a range of 18 to 85 years, average 40 +/- 17 and a median of 36. Obesity was encountered in 35.7% in men and 48.8% in women. Diabetes was found in 9.1% both sexes. Hypercholesterolemia > 200 mg/dl in 30.4% and > 240 mg/dl in 19.6%. Alcohol abuse was encountered in 14%, 9.2% in women and 37.7% in men. Smoking was present in 22.3% of them, 16.3% in women and 50% in men. High blood pressure > 140/90 mm Hg or hypertension history was present in 21% of the cases. Controlled cases were 6.6%. In the whole group 34% showed at least one risk factor, 57% showed two factors and 66% showed three factors. Therefore, the best estimate of assistance load, on the fight of risk factors associated to hypertension should not consider less than 70% among the regular subjects coming to this health center.
Subject(s)
Coronary Disease/epidemiology , Hypertension/epidemiology , Primary Health Care , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Mexico/epidemiology , Middle Aged , Primary Health Care/statistics & numerical data , Risk Factors , Sex DistributionABSTRACT
Flexible fiberoptic bronchoscopy with bronchoalveolar lavage was performed in 16 pediatric patients with the acquired immunodeficiency syndrome (AIDS) and deterioration in pulmonary function suggestive of opportunistic infection. In 62% of the patients Pneumocystis carinii was identified. Culture results showed a pure growth of Pseudomonas aeruginosa for one patient in addition to the Pneumocystis carinii. Bronchoscopy with lavage was well tolerated, with few complications even among patients with significant tachypnea and hypoxia. Because of its relative safety and effectiveness, this procedure should be considered the first invasive measurement used for evaluation of parenchymal lung disease in this population of patients.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Bronchoalveolar Lavage Fluid/microbiology , Opportunistic Infections/diagnosis , Pneumonia, Pneumocystis/diagnosis , Acquired Immunodeficiency Syndrome/ethnology , Adolescent , Bronchoscopy , Child, Preschool , Fiber Optic Technology , Humans , Infant , Male , Opportunistic Infections/complications , Opportunistic Infections/ethnology , Pneumocystis/isolation & purification , Pneumonia, Pneumocystis/complications , Pneumonia, Pneumocystis/ethnologyABSTRACT
Left ventricular hypertrophy, a known consequence of hypertension, is associated with an excess mortality independent of other known cardiovascular risk factors. There are multiple mechanisms in which left ventricular hypertrophy may account for this excess mortality including increased incidence of arrhythmias, systolic an diastolic dysfunction, relative ischemia, and associated coronary artery disease. Diastolic dysfunction, manifested by reduced ventricular distensibility of the hypertrophic left ventricle, appears to be an early characteristic of the hypertensive heart since echocardiographic techniques have demonstrated diastolic filling abnormalities in untreated essential hypertensives even before significant left ventricular hypertrophy appears. The presence of left ventricular hypertrophy is difficult to detect by electrocardiography. Echocardiography seems to be the best non-invasive method for the detection of hypertensive heart disease: it shows early abnormalities of left ventricular compliance, frequently left ventricular hypertrophy and late abnormalities of myocardial contractility.
Subject(s)
Cardiomegaly/etiology , Hypertension/complications , Arrhythmias, Cardiac/etiology , Cardiomegaly/classification , Cardiomegaly/complications , Cardiomegaly/physiopathology , Coronary Circulation , Coronary Disease/etiology , Echocardiography , Electrocardiography , Electrocardiography, Ambulatory , Exercise Test , Heart Failure/etiology , Humans , Hypertension/physiopathology , Risk FactorsABSTRACT
The aminoglycoside modifying enzyme aminoglycoside 3'-phosphotransferase II (APH(3')II) is encoded for on transposon Tn5 by the aphA gene, in the same operon as the ble gene determining bleomycin resistance. To document this linkage 82 kanamycin-resistant Escherichia coli strains of clinical origin were studied; all 18 isolates presenting bleomycin-kanamycin resistance were shown by an enzymatic assay to produce APH(3')II, and the presence of Tn5 was demonstrated by gene hybridization. Similarly, bleomycin-kanamycin resistance was shown to be linked to APH(3')II production in Salmonella spp. The epidemiology of strains with Tn5-encoded APH(3')II may thus be studied, at least in Escherichia coli, by a simple diffusion test using bleomycin and kanamycin discs.
