5,170 research outputs found
El gran enemigo
No full textRelato de Marcos Pedrosa Serrano para la revista Sci-FdI.
Finalista del premio BYTE.Depto. de Sistemas Informáticos y ComputaciónFac. de InformáticaTRUEpu
Evaluation of the metric properties of the WHODAS 2.0, WHODAS-S, and RADS in the assessment of disability in Parkinsonian patients
No full textObjectives: Parkinson's disease is the second most prevalent progressive neurodegenerative disease and causes considerable disability in patients. We conducted a cross-sectional analytical study to examine the metric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2); the 12-item World Health Organization Disability Assessment Schedule (WHODAS-S) and the Rapid Assessment of Disability Scale (RADS) in assessing disability in Parkinsonian patients. Patients and methods: Patients with cognitive impairment, neurological disorder, or disability due to any condition other than PD were excluded. One hundred sixty-eight consecutive patients were assessed in ON state. The following attributes were evaluated: data quality and acceptability, reliability, and construct (convergent and known-groups) validity. Testretest reliability was analyzed in fifty-six patients. Results: Out of 168 patients, 65.4% were men's, 96 (57.1%) at stage III of Hoehn and Yahr. One hundred fifty-one patients lived independently in the community, 102 lived with their spouses, 108 were retired, and 48 were still working. Cronbach's alpha exceeded the minimum requirement of 0.70 for the three scales. The SEM obtained was, also for the three scales, higher than the ½ of the standard deviation value. The validity for known groups showed that all domains were significantly different in both WHODAS-S and RADS. The stability of the scale was evaluated with the test-retest (ICC). The results for the WHODAS-2 ≤ 0.002; for the WHODAS-S were p ≤ 0.000]; and for the RADS were p ≤ 0.000]. Conclusion: The RADS is by far the fastest scale to use. All three scales showed suitable metric properties. Based on the results obtained, a one-way analysis of variance (ANOVA) was performed. Isolates 1 and 2 produced a higher amount of EPS with molasses, isolate 3 with glycerol and isolate 4 with sucrose as a carbon source. In terms of temperature, isolates 1, 3 and 4 produced a greater amount of EPS between 27-35 ° C, while isolate 2 at 42 ° C. According to the pH, the best production was observed at a neutral and slightly acidic pH. Finally, regarding salinity, it was observed that isolate 1 and 2 produced a higher amount of EPS at a concentration of 0.5 M sodium chloride, and isolate 3 and 4 with 0 M sodium chloride. The results show that EPS production is influenced by the source of carbon and environmental conditions. The best performance in EPS production is obtained at least under an abiotic stress condition. These changes represent adaptive changes of bacteria against conditions of abiotic stress. Their tolerance depends on the fact that these microorganisms can be used in the improvement of the clay soil structure to favor bioremediation processes in the Amazon
Parkinson's disease gravity index: a method by means of optimal scaling
No full textObjective: This study has been designed with the aim of using optimal scaling to perform the allocation of scores and to be able to construct an indicator of the Parkinson's Disease Gravity Index. Scores were assigned to interrelated dimensions that share information about the patient's situation, to have an objective, holistic tool which integrates scores so that doctors can have a comprehensive idea of the patient's situation. Patients and Methods. 120 consecutive patients with Parkinson's diagnosis were chosen according to the United Kingdom Parkinson's Disease Society Brain Bank criteria. Subsequently, all the chosen dimensions were transformed into interval variables for which the formula proposed by Sturges was used. Once the dimensions were transformed into interval variables, optimal scaling was carried out. Subsequently, the following attributes were analyzed: quality and acceptability of the data; reliability: internal consistency, reliability index, Cronbach's alpha, and standard error of measurement; finally, validity: convergent validity and validity for known groups. Results: There were no missing data. An appropriate Cronbach's alpha value of 0.71 was gathered, and all items were found to be pertinent to the scale. The item homogeneity index was 0.36. Precision evaluated with the standard error of measurement was 7.8. The Parkinson's Disease Gravity Index discriminant validity (validity for known groups), assessed among the different stages of Hoehn and Yahr scale by the Kruskal-Wallis test, showed major significance (X 2 = 32.7, p ≤ 0.001). Conclusions: The Parkinson's Disease Gravity Index has shown adequate metric properties
Fatigue in Parkinson’s disease: Metric properties of the fatigue impact scale for daily use (D-FIS), and its impact on quality of life
No full textObjective: In Parkinson's disease patients, fatigue is a disabling non-motor symptom whose prevalence ranges from 28% to 58%. The Fatigue Impact Scale for Daily Use (D-FIS), one of the various scales for quantifying fatigue. The aim of our study was to analyze the metric properties of the D-FIS in PD subjects and assess the impact of fatigue on their quality of life. Patients and Methods: The cohort in this study was comprised of 211 consecutive patients with a PD diagnosis regularly followed up at the Movement Disorders Unit of the Neurology Department at Carlos Andrade Marín Hospital (HCAM) in Quito, Ecuador, according to the United Kingdom PD Society Brain Bank criteria. Data Quality, Acceptability, Reliability, Stability (test-retest), Validity and Multiple linear regression analysis were determined. Results: The final sample consisted of 138 men (65.4%) and 73 women. Forty-six percent of these (98 patients) were in stage II of H&Y. We obtained a Cronbach's α value of 0.912 and an ICC value of 0.79. D-FIS was strongly correlated with depression (Spearman rho [Srho] 0.60), anxiety (Srho 0.59), quality of life (Srho 0.67), and non-motor symptoms (Srho 0.66). The scale’s discriminant validity, assessed among the different stages of H&Y by the Kruskal-Wallis test, showed major significance (X2 = 23.183, p ≤ 0.001). In the Multiple linear regression study, the resulting model proves that fatigue has a determining effect on quality of life. Conclusions: The D-FIS has good metric properties and demonstrates that fatigue significantly affects PD patients’ quality of life and that its impact is independent from that of anxiety, depression, and sleep disorders
Case series of Creutzfeldt-Jakob disease in a third-level hospital in Quito
No full textBackground: Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder that affects mammals and humans. The prevalence of this disease in the United States is 0.5 to 1 per million inhabitants. So far in Ecuador, we do not know what the prevalence or incidence is, and only one case report has been written. Case presentation: We present a case series of Creutzfeldt-Jakob disease in a third-level hospital in Quito. The average age of symptom onset in our patients was 58.8 years. The male to female ratio was 1:1. Two patients began with cognitive/behavioral symptoms, while 4 patients began with focal neurological signs; 1 case with ataxia, 2 with gait disorders and 1 with vertigo and headache. All of the patients had the clinical features established by the World Health Organization. In addition, the entire cohort was positive for the 14-3-3 protein in cerebrospinal fluid, and had high signal abnormalities in caudate and putamen nucleus in DWI and FLAIR IRM. Only in one case, did we reach a definitive diagnosis through a pathological study. All other cases had a probable diagnosis. In this series of cases, 6 out of 6 patients died. The average time from the onset of the symptoms to death in this cohort was 13 months. Conclusion: This is the first report of a series of cases of Creutzfeldt-Jakob disease in Quito. Although definitive diagnosis must be histopathological, there are ancillary tests currently available that have allowed us to obtain a diagnosis of the disease
Clinical and radiological profile of neuromyelitis optica spectrum disorders in an Ecuadorian cohort
No full textBackground: Neuromyelitis optica spectrum disorder (NMOSD) is a complex disease characterized by a severe inflammation of the central nervous system (CNS). This disease typically manifests with recurrent optic neuritis (ON) and acute transverse myelitis (ATM). The clinical and radiological spectrum of NMOSD is little known in Latin America (LATAM) and few reports have been published in the literature so far. In Ecuador, no reports on NMOSD have been published. For this reason we aimed to assess the demographic, clinical and imaging characteristics of patients with NMOSD from third level hospitals from Ecuador. Methods: This is a descriptive study in which we assessed medical reports of patients with inflammatory demyelinating diseases who were attended in third level hospitals from Ecuador in 2017. Then we applied the 2015 diagnostic criteria, those patients who met the new NMOSD diagnostic criteria were selected and analyzed. Additionally, exploratory sub-analyses were subsequently carried out. Results: We identified 59 patients with NMOSD, the relative frequency of NMOSD was 15.9%. The multiple sclerosis (MS) /NMOSD ratio was 5.2:1. Twenty four percent of patients were newly defined as having NMOSD when 2015 criteria was applied. The median time to diagnoses was shorter by the 2015 criteria than 2006 criteria (p<0.001). NMOSD was more prevalent in women (female/male ratio 4.4:1). The disease onset was more frequent at the fourth decade of life. The most common symptoms at the disease onset were ON and the association of ON with ATM. The mean of expanded disability status scale (EDSS) was 4.8 (SD±1.8). Concomitant autoimmune diseases were infrequent in this population (11.9%). The brain magnetic resonance imaging (MRI) abnormalities were present in 25.7% of patients at disease onset. Spinal cord MRI showed longitudinally extensive transverse myelitis (LETM) in 91.5% of cases. Recurrent NMOSD was frequent in this cohort (88%). Positivity for antibodies against aquaporin-4 (AQP4-IgG) which was measured through indirect immunofluorescence assay (IIF) was identified in 81% of the patients tested. Patients with seronegative AQP4-IgG had higher grade of disability than seropositive patients (p<0.05). Ninety eight percent of patients received treatment with immunosuppressive drugs. Three patients died due to gastric cancer (1 patient) and infectious diseases (2 patients). Conclusions: This is the first descriptive study in an Ecuadorian cohort of patients with NMOSD. We show a wide epidemiological, clinical and radiological spectrum of NMOSD
New diagnostic criteria for neurocysticercosis: reliability and validity.
No full textObjective:
The diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease.
Methods:
A group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed-effects logistic regression models were used to estimate sensitivity and specificity.
Results:
Inter-rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC versus no NCC, the new criteria had a sensitivity of 93.2% and specificity of 81.4%. For parenchymal NCC, the new criteria had a sensitivity of 89.8% and specificity of 80.7% and for extraparenchymal NCC, the new criteria had a sensitivity of 65.9% and specificity of 94.9%.
Interpretation:
These criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (ie, parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis
HUSSERL, Edmund (2019). Textos Breves (1887-1936). Coord.: Agustín Serrano de Haro y Antonio Zirión Quijano. Salamanca: Sígueme.
No full textReseña de:
HUSSERL, Edmund (2019). Textos Breves (1887-1936). Coord.: Agustín Serrano de Haro y Antonio Zirión Quijano. Salamanca: Sígueme
Supplemental Material - Identifying the Core Indicators of Migrant and Refugee Children’s Integration Using the Delphi Method: A Multi-Input Strategy for Definition of Consensus
No full textSupplemental Material for Identifying the Core Indicators of Migrant and Refugee Children’s Integration Using the Delphi Method: A Multi-Input Strategy for Definition of Consensus by Eva Bajo Marcos, Ángela Ordóñez-Carabaño, Elena Rodríguez-Ventosa Herrera, and Inmaculada Serrano in International Journal of Qualitative Methods.</p
LOPEZ JIMENEZ, Marcos
No full textMarcos López Jiménez writes to Gen. Arturo Lazo de la Vega, Secretary of the Pro-Serrano Committee, congratulating him on his position and analyzing the political situation in the country, concluding that, in order to present a unified front against Obregonism, it is necessary for one of the anti-reelection candidates to concede in favor of the other. While there are two candidates, it will be very difficult for one to win. / Marcos López Jiménez escribe al Gral. Arturo Lazo de la Vega, Secretario del Comité Pro-Srrano, felicitándolo por su puesto y haciéndole un análisis de la situación política del país del que concluye que para poder presentar un frente fuerte al obregonismo es necesario que uno de los candidatos anti-reeleccionistas ceda en favor del otro porque mientras haya dos candidatos es muy difícil que uno gane
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