COVID-19 y la pandemia olvidada: el seguimiento de las enfermedades neurocognitivas durante la cuarentena en Argentina / COVID-19 and the forgotten pandemic: follow-up of neurocognitive disorders during lockdown in Argentina

INTRODUCCIÓN: Varios países del mundo padecen una grave carga en sus sistemas de salud como consecuencia de la pandemia por COVID-19. Esta realidad pone en riesgo el seguimiento de patologías crónicas como las demencias. Asimismo, la atención de las posibles complicaciones neuropsiquiátricas relacionadas con el aislamiento preventivo de la población (cuarentena), que en el caso de Argentina se considera la más prolongada de Latinoamérica. El objetivo del presente trabajo es determinar la frecuencia de las distintas modalidades de consulta médica en relación con la patología neurocognitiva del paciente y las variables predictoras de consulta desde el inicio de la cuarentena. MÉTODOS: Estudio descriptivo observacional y transversal basado en la recolección de datos a través de una encuesta. RESULTADOS: Hubo 324 participantes, 165 (50,9%) de los cuales realizaron al menos una consulta médica. Frecuencia de modalidades de consulta: teléfono, 109 (33,6%); correo electrónico, 62 (19,1%); videoconsulta, 30 (9,3%); servicio de emergencias, 23 (7,1%). Predictores de consulta: Clinical Dementia Rating ≥ 1 (p < 0,001); diagnóstico: Alzheimer (p = 0,017). Se encontraron puntajes más altos del Inventario Neuropsiquiátrico (NPI) en el grupo que ha realizado consultas médicas (p < 0,001). Dicha diferencia no fue observada en el puntaje de la escala de carga del cuidador (Zarit). CONCLUSIÓN: Evidenciamos alta prevalencia de trastornos conductuales en pacientes y de sobrecarga en cuidadores durante la cuarentena. Solamente el 50% accedió a una consulta médica (52,7% por modalidad telefónica y correo electrónico). Es necesario extremar los cuidados en personas con demencia, garantizando el seguimiento de su patología

INTRODUCTION: Health systems in numerous countries around the world are suffering a serious burden as a consequence of the COVID-19 pandemic. As a result of this situation, the follow-up of such chronic diseases as dementia may be at risk. Similarly, neuropsychiatric complications related to lockdown measures may also be neglected; Argentina's lockdown has been the longest implemented in Latin America. This study aims to determine the frequency of the different types of medical consultations for neurocognitive disorders and the predictors for requiring consultation since the beginning of the lockdown. METHODS: We performed a descriptive, observational, cross-sectional study based on data collected through an online survey. RESULTS: Data were collected on 324 participants, with 165 (50.9%) having had at least one medical consultation. Consultations were held by telephone in 109 cases (33.6%), by e-mail in 62 (19.1%), by video conference in 30 (9.3%), and at the emergency department in 23 (7.1%). Predictors of requiring consultation were Clinical Dementia Rating scores ≥1 (P < .001) and diagnosis of Alzheimer disease (P = .017). Higher Neuropsychiatric Inventory scores were found in the group of respondents who did require medical consultation (P < .001), but no significant differences were found between groups for Zarit Burden Interview scores. CONCLUSION: We identified a high prevalence of behavioural disorders and caregiver burden during lockdown. Nevertheless, only 50% of respondents had sought medical consultation (by telephone or email in 52.7% of cases). Care of people with dementia must be emphasised, guaranteeing follow-up of these patients

COVID-19 and the forgotten pandemic: follow-up of neurocognitive disorders during lockdown in Argentina. / COVID-19 y la pandemia olvidada: el seguimiento de las enfermedades neurocognitivas durante la cuarentena en Argentina.

INTRODUCTION: Health systems in numerous countries around the world are suffering a serious burden as a consequence of the COVID-19 pandemic. As a result of this situation, the follow-up of such chronic diseases as dementia may be at risk. Similarly, neuropsychiatric complications related to lockdown measures may also be neglected; Argentina's lockdown has been the longest implemented in Latin America. This study aims to determine the frequency of the different types of medical consultations for neurocognitive disorders and the predictors for requiring consultation since the beginning of the lockdown. METHODS: We performed a descriptive, observational, cross-sectional study based on data collected through an online survey. RESULTS: Data were collected on 324 participants, with 165 (50.9%) having had at least one medical consultation. Consultations were held by telephone in 109 cases (33.6%), by e-mail in 62 (19.1%), by video conference in 30 (9.3%), and at the emergency department in 23 (7.1%). Predictors of requiring consultation were Clinical Dementia Rating scores ≥1 (P<.001) and diagnosis of Alzheimer disease (P=.017). Higher Neuropsychiatric Inventory scores were found in the group of respondents who did require medical consultation (P<.001), but no significant differences were found between groups for Zarit Burden Interview scores. CONCLUSION: We identified a high prevalence of behavioural disorders and caregiver burden during lockdown. Nevertheless, only 50% of respondents had sought medical consultation (by telephone or email in 52.7% of cases). Care of people with dementia must be emphasised, guaranteeing follow-up of these patients.

Conducta adaptativa y calidad de vida en niños de 3 a 6 años con cardiopatías congénitas. Su relación con el medio ambiente de crianza. / Adaptative behavior and quality of life in 3-6-year-old children with congenital heart defects. Association with rearing environment.

Los niños con cardiopatías congénitas tienden a presentar dificultades en la adquisición de pautas madurativas y en su conducta adaptativa. Se estudió su relación con los estilos de crianza generados por el estrés que genera la enfermedad. Objetivo: Evaluar calidad de vida y conducta adaptativa de niños de edad preescolar con diagnóstico de cardiopatías congénitas atendidos por el equipo de Seguimiento de Recién Nacidos de Alto Riesgo del Hospital Garrahan. Diseño: observacional, prospectivo, transversal. Población: niños con cardiopatías congénitas, que cumplan con los criterios de inclusión y brinden consentimiento. Instrumentos de medición: Cuestionario PedsQ 4.0, Adaptative Behavior Scales, Vineland-II. Adicionalmente se registraron datos obtenidos en entrevistas con niños y cuidadores. Los datos se analizaron con STATA 9.0. Resultados: muestra constituida por 47 pacientes, mediana de 3,9 años, 57% masculinos, 74% procedentes del conurbano, 34% resolución quirúrgica completa, 98% con necesidades básicas satisfechas, 72% madre ama de casa, con dedicación exclusiva al cuidado del hijo, 97,87% con redes de apoyo. La percepción de calidad de vida fue alta. La conducta adaptativa arrojó puntuaciones bajas en las áreas Comunicación 95,74%, Socialización 53,19% y Motricidad 100%, en área Habilidades de la vida cotidiana el 51% tuvo puntajes adecuados. En las entrevistas se evidenció que las familias conviven con temor a que su hijo se descompense, la enfermedad condiciona la relación con la familia, los niños reciben trato privilegiado y crianza permisiva. Los padres tienen dificultades para delegar los cuidados en otra persona y los niños son tímidos e inseguros con baja tolerancia a la frustración (AU)

Children with congenital heart defects have difficulties attaining developmental milestones and in their adaptive behavior. Association between these difficulties and styles of child rearing generated by disease-related stress was studied. Aim: To evaluate quality of life and adaptive behavior of preschool children with congenital heart defects seen by the team of Follow-up of High-Risk Neonates at Hospital Garrahan. Design: Observational, prospective, cross-sectional. Population: Children with congenital heart defects that met the inclusion criteria and signed informed consent. Measurement instruments: PedsQL questionnaire 4.0, Adaptive Behavior Scales, VinelandII. Additionally, data obtained from interviews with the children and caregivers were recorded. Data were analyzed using STATA 9.0. Results: The sample consisted of 47 patients; median age 3.9 years; 57% were male, 74% came from Greater Buenos Aires; in 34% the defect was corrected with complete surgical repair. In 98% basic needs were satisfied, in 72% the mother was a housewife taking exclusive care of the child, 97.87% had access to support networks. The perception of quality of life was good. Adaptive behavior yielded low scores in the area of Communication in 95.74%, Socialization in 53.19%, and Motor skills in 100%; in the area of Skills of daily living 51% had an adequate score. The interviews showed that the families lived in the fear that the child would decompensate, that the disease conditioned family relationships, that the children received a privileged treatment and were raised permissively. The parents have difficulties delegating the care to other persons and the children are shy and insecure with a low frustration threshold (AU)

Population polymorphism of the GLO1 enzyme. Identification of two new variants.

A new electrophoretic technique for the determination of the glyoxalase I (GLO1) polymorphism on mixed agarose and starch gel is applied to the genetic study of "Provinces Françaises" and some other human populations. Four rare electrophoretic variants are revealed; two of them (GLO1*4, GLO1*5), both new, are discussed. In the "Provinces Françaises" the mating GLO1 2-1 x GLO1 2-1 shows an irregular segregation of the GLO1 alloenzymes.