Deterioro cognitivo asociado a radioterapia en tumores cerebrales / No disponible

Introducción: Existe un limitado conocimiento acerca de la influencia sobre las funciones cognitivas de los tratamientos para los tumores cerebrales basados en la radioterapia (RT). Objetivo: Realizar una revisión actualizada de los trabajos desarrollados en los últimos años acerca de los efectos de la RT sobre la cognición en los tumores cerebrales. Método: Mediante el software EndNote X5 se extrajeron los artículos que contenían “radiotherapy” y “cognition” tanto en su título, como en palabras claves, abstracts o contenidos en los años 2009-2011. Asimismo, se realizó una búsqueda ampliada a través de las referencias de los artículos extraídos. Se descartaron aquellos artículos en los que no se reflejase la relación entre RT y el desarrollo de alteraciones cognitivas o no se centraran en tumores cerebrales. Resultados: 14 artículos fueron seleccionados: 7 originales, 6 revisiones y 1 artículo de opinión. Los hallazgos se centraron en 3 aspectos: a) alteraciones cognitivas debidas a la RT; b) factores de riesgo para el desarrollo de deterioro cognitivo inducido por la RT; c) tiempo transcurrido desde la aplicación de la RT hasta la aparición de las alteraciones cognitivas. Conclusiones: Los nuevos estudios confirman hallazgos de las últimas décadas, principalmente que las funciones más comúnmente afectadas son la atención, la memoria y el aprendizaje, la psicomotricidad y las funciones ejecutivas; que existen algunos factores de riesgo identificables para el desarrollo de deterioro cognitivo asociado a la RT; así como que las alteraciones en la función cognitiva tras la RT suelen aparecer de manera evidente después un largo período de tiempo (AU)

Introduction: There is limited knowledge about the influence on cognitive functions of the treatments for brain tumors based on radiotherapy (RT). Objective: To review the works conducted in recent years about the effects of RT on cognition in brain tumors. Method: Using EndNote software X5, articles containing “radiotherapy” and “cognition” in its title, keywords, abstracts or main text in the years 2009-2011 were extracted. Also, an extensive search through the references of articles taken was done. Those works that did not reflect the relationship between RT and the development of cognitive impairment or did not focus on brain tumors were disregarded. Results: 14 articles were selected: 7 originals, 6 reviews, and 1 opinion article. The findings focused on three aspects: a) cognitive impairment due to the RT, b) risk factors for cognitive impairment induced by RT c) time from the application of RT to the onset of cognitive impairment. Conclusions: The new studies confirm findings of recent decades, namely that the functions most commonly affected are attention, memory and learning, psychomotor and executive functions; that there are identifiable risk factors for cognitive impairment associated to RT; and that alterations in cognitive function after RT usually occur after a long period of time (AU)

The role of the pediatrician in preventing suicide in adolescents with alcohol use disorders.

Worldwide, suicide is among the top five causes of mortality in the 15- to 19- year age group. Pediatricians and primary care providers are in a distinctive position to help prevent suicide in adolescents. According to the Guidelines for Adolescent Preventive Services, all adolescents should have at least an annual preventive services visit, which should address both the biomedical and psychosocial aspects of health. Suicide prevention may best be accomplished by detection and management of specific risk factors, rather than by attempting to recognize those youth who are considered most likely to commit suicide. Alcohol use has been regarded as an important risk factor for adolescent suicidal behavior and the diagnosis of an alcohol use disorder indicates an elevated risk for adolescent suicide. Although the causal relationship between alcohol use and suicide remains unknown, a clear and strong relationship exists. Pediatricians and other health care providers should be skilled to recognize risk factors for adolescent suicide, including alcohol and drug misuse, depression, major loss, and recent suicides within a community. The relative frequency of suicidal behavior among adolescents suffering from alcohol use disorders and its distressing effects on individuals, families and society merits further research and development of prevention strategies in general pediatric settings.