RESUMO
Temporal processing (TP) is associated with functions such as perception, verbal skills, temporal perspective, and future planning, and is intercorrelated with working memory, attention, and inhibitory control, which are highly impaired in individuals with attention deficit hyperactivity disorder (ADHD). Here we evaluate TP measures as potential endophenotypes in Caribbean families ascertained from probands affected by ADHD. A total of 232 individuals were recruited and clinically evaluated using an extensive battery of neuropsychological tasks and reaction time (RT)-based task paradigms. Further, the heritability (genetic variance underpinning phenotype) was estimated as a measure of the genetics apportionment. A predictive framework for ADHD diagnosis was derived using these tasks. We found that individuals with ADHD differed from controls in neuropsychological tasks assessing mental control, visual-verbal memory, verbal fluency, verbal, and semantic fluency. In addition, TP measures such as RT, errors, and variability were also affected in individuals with ADHD. Moreover, we determined that only omission and commission errors had significant heritability. In conclusion, we have disentangled omission and commission errors as possible TP endophenotypes in ADHD, which can be suitable to assess the neurobiological and genetic basis of ADHD. A predictive model using these endophenotypes led to remarkable sensitivity, specificity, precision and classification rate for ADHD diagnosis, and may be a useful tool for patients' diagnosis, follow-up, and longitudinal assessment in the clinical setting.
RESUMO
RESUMEN Las manifestaciones oculares de la artritis reumatoide son manifestaciones graves que requieren manejo agresivo. En el presente reporte presentamos un caso de queratitis asociada a derretimiento corneal desencadenado por suspensión abrupta de su medicación reumatológica y cirugía no ocular, que respondió de forma favorable al manejo con metil-prednisolona y ciclofosfamida.
ABSTRACT Ocular signs of rheumatoid arthritis are severe extra-articular manifestations, which usually require aggressive management. In this report, A case is presented here of patient with peripheral ulcerative keratitis associated with corneal melt syndrome triggered by abrupt suspension of antirheumatic medication and non-ocular surgery. They symptoms responded favourably to methylprednisolone and cyclophosphamide.
Assuntos
Humanos , Masculino , Idoso , Artrite Reumatoide , Úlcera da Córnea , Manifestações Oculares , Terapêutica , DiagnósticoRESUMO
Children with attention-deficit/hyperactivity disorder (ADHD) present a deficit in inhibitory control. Still, it remains unclear whether it comes from a deficit in reactive inhibition (ability to stop the action in progress), proactive inhibition (ability to exert preparatory control), or both.We compared the performance of 39 children with ADHD and 42 typically developing children performing a Simon choice reaction time task. The Simon task is a conflict task that is well-adapted to dissociate proactive and reactive inhibition. Beyond classical global measures (mean reaction time, accuracy rate, and interference effect), we used more sophisticated dynamic analyses of the interference effect and accuracy rate to investigate reactive inhibition. We studied proactive inhibition through the congruency sequence effect (CSE).Our results showed that children with ADHD had impaired reactive but not proactive inhibition. Moreover, the deficit found in reactive inhibition seems to be due to both a stronger impulse capture and more difficulties in inhibiting impulsive responses. These findings contribute to a better understanding of how ADHD affects inhibitory control in children.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Criança , Humanos , Comportamento Impulsivo , Inibição Psicológica , Inibição Proativa , Tempo de Reação/fisiologiaRESUMO
Introducción: La enfermedad de ojo seco ha sido definida como una entidad multifactorial en la cual se pierde la homeostasis de la película lagrimal. Objetivo: Caracterizar a los pacientes con enfermedad de ojo seco atendidos en la unidad de ojo seco de la Clínica de Oftalmología Sandiego. Materiales y métodos: Estudio observacional, descriptivo, de cohorte retrospectiva. Se documentaron pruebas cualitativas, cuantitativas, cuestionario OSDI y tipo de ojo seco de los pacientes que consultaron en el periodo de marzo de 2016 a diciembre de 2017 con diagnóstico confirmado de enfermedad de ojo seco. Resultados: En 107 pacientes se confirmó el diagnóstico de ojo seco, 80.4% fueron mujeres. La mediana de edad fue 53 años (38-69). El 64.5% tenía ojo seco evaporativo, 12.2% acuodeficiente y 23.4% mixto. El OSDI fue mayor a 33 en 67 pacientes. La osmolaridad lagrimal y la MMP-9 estuvieron alteradas en 78.5 y 76.6%, respectivamente. Conclusión: La realización de pruebas clínicas, laboratorio y cuestionarios de síntomas, permiten realizar el diagnóstico integral de la enfermedad ojo seco según las recomendaciones del DEWS II, apoyando la clasificación del mismo, reconocimiento de factores de riesgo y planteamiento de posibles etiologías que ayudan en el tratamiento.
ackground: Dry eye disease has been defined by DEWS II as a multifactorial entity in which tear film homeostasis is altered. Objective: To characterize patients with dry eye disease evaluated in the dry eye unit of Clínica de Oftalmología Sandiego. Materials and methods: Observational, descriptive, retrospective cohort study. Information was collected from patients who consulted the dry eye unit in the period from March 2016 to December 2017 and who were diagnosed with dry eye disease. The results of qualitative and quantitative tests, as well as the dry eye symptoms questionnaire, were documented.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , ColômbiaRESUMO
We compared the performance of children with ADHD and typically developing children on two temporal tasks, a bisection task and a reproduction task, in auditory and visual modalities. Children with ADHD presented a larger variability when performing auditory and visual temporal tasks. Moreover, they overestimated the durations in bisection tasks and underproduced duration intervals in the visual reproduction task. In the context of the pacemaker-accumulator model, these results suggest that temporal deficits might result from a dysfunction in the switch and/or memory impairment.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos da Memória/fisiopatologia , Adolescente , Atenção , Limiar Auditivo/fisiologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , MasculinoRESUMO
Objetivo Establecer la capacidad predictiva para infección del sitio quirúrgico (ISQ) de los índices de riesgo del National Nosocomial Infections Surveillance System (NNIS) y Study on the Efficacy of Nosocomial Infection Control (SENIC) en cinco hospitales y, evaluar la capacidad predictiva de otros factores de riesgo. Métodos Cohorte prospectiva de pacientes sometidos a cirugía entre julio de 2006 a febrero de 2007 en cinco hospitales de Colombia. Se definió ISQ según los criterios del CDC. Se evaluaron variables como: edad, género, coomorbilidad, tipo de cirugía, herida, especialidad, tiempo quirúrgico y desenlace. Se evaluó el desempeño operativo de los índices usando el área bajo la curva operador receptor; se construyó un modelo predictivo usando un modelo de regresión logística incondicional con las variables asociadas a infección en el análisis bivariado y/o aquellas conocidas por estudios previos. Resultados Fueron evaluados 7 022 procedimientos quirúrgicos con una tasa de ISQ de 2,9 por ciento. El rendimiento de los índices de riesgo NNIS y SENIC fue muy similar para predecir ISQ (área bajo la curva de 0,682 IC95 por ciento 0,641-0,710 y 0,668 IC95 por ciento 0.641-0.722, respectivamente). Se construyó un modelo predictivo que incluía variables del NNIS y SENIC, además de edad, antecedente de diabetes, transfusiones y especialidad quirúrgica el cual mostró un desempeño de 0,746 (IC95 por ciento 0,709-0,783), en ISQ superficial de 0,70 (IC95 por ciento 0,659-0,741), en ISQ profunda de 0,712 (IC95 por ciento 0,673-0,751) y en ISQ órgano espacio de 0,719 (IC95 por ciento 0,683-0,755). Conclusiones Los modelos de predicción existentes para ISQ tienen una moderada capacidad discriminativa pero pueden ser mejorados con algunos factores locales.
Objective Establishing the effectiveness of the National Nosocomial Infection Surveillance System (NNIS) and Study of the Efficacy of Nosocomial Infection Control's (SENIC) prognostic surgical site infection (SSI) indices in Colombian hospitals and assessing the influence of other risk factors. Methods A prospective, multicentre cohort study was conducted in five Colombian hospitals. All patients undergoing surgery requiring hospitalisation or ambulatory surgeries having a greater risk of infection were enrolled. A case was defined as being those subjects who presented the CDC diagnostic criteria of incisional superficial, deep incisional or organ-space SSI. Age, gender, co-morbidities, type of surgery, procedures, medical specialty, type of wound, surgical time, antibiotic prophylaxis and patient outcome were used for developing a predictive model of SSI using logistical regression analysis. The indexes' predictive ability was assessed by using the area under the receiver operating curve (ROC). Results 7,022 surgical procedures were evaluated and SSI rate was 2.9 percent. NNIS and SENIC risk index performance was similar to that for predicting SSI (0.68 cf 0.66 area under ROC, respectively). The new predictive model involved other factors such as age, diabetes mellitus, transfusions and surgical specialty showing 0.74 operating performance. Conclusions Existing SSI predictive models have a moderate ability for predicting SSI but this can be improved with some local factors.
Assuntos
Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Hospitais/estatística & dados numéricos , Infecção da Ferida Cirúrgica/epidemiologia , Colômbia/epidemiologia , Prognóstico , Estudos Prospectivos , Cicatrização , Adulto JovemRESUMO
Objetivo: caracterización de un brote de infección por Acinetobacter baumannii y determinación de los factores asociados. Diseño: estudio de casos y controles anidado en una cohorte de pacientes críticos entre octubre de 2003 y marzo de 2004. Criterios de inclusión: haber estado hospitalizado en la unidad de cuidados intensivos en el mismo periodo y ser sometidos a procedimientos invasivos. Se excluyeron los pacientes que fallecieron en las primeras 24 horas de haber ingresado a la unidad de cuidados intensivos o que habían sido remitidos de otras instituciones. Se evaluó edad, sexo, antecedentes de enfermedad crónica, índice de intervención terapéutica (therapeutic index score system, TISS), tiempo de uso de dispositivos invasivos, tipo de nutrición, exposición previa a antibióticos, procedimiento quirúrgico, tiempo de uso de exposición y estancia. La investigación epidemiológica de los aislamientos incluyó la tipificación molecular mediante electroforesis en gel de campo pulsado. Resultados: los aislamientos de A baumannii provenientes de los pacientes infectados y de los cultivos de vigilancia fueron resistentes a múltiples antibióticos. Los aislamientos se encontraron relacionados genéticamente con un porcentaje de similitud mayor del 97 por ciento. Se encontró asociación estadísticamente significativa entre la infección de A. baumannii y un mayor puntaje de intervención terapéutica durante la hospitalización (p=0,030), uso de nutrición parenteral (0=0,030) y tiempo de exposición (p=0,02 super índice 2). Conclusiones: la infección por A baumannii, Se asoció a un mayor índice de intervención terapeútica, al uso de nutrición parenteral y al tiempo de exposición. Los aislamientos se encontraron relacionados genéticamente.
Assuntos
Humanos , Cuidados Críticos , Infecções por Acinetobacter , Fatores de Risco , Nutrição ParenteralRESUMO
OBJECTIVE: Establishing the effectiveness of the National Nosocomial Infection Surveillance System (NNIS) and Study of the Efficacy of Nosocomial Infection Control's (SENIC) prognostic surgical site infection (SSI) indices in Colombian hospitals and assessing the influence of other risk factors. METHODS: A prospective, multicentre cohort study was conducted in five Colombian hospitals. All patients undergoing surgery requiring hospitalisation or ambulatory surgeries having a greater risk of infection were enrolled. A case was defined as being those subjects who presented the CDC diagnostic criteria of incisional superficial, deep incisional or organ-space SSI. Age, gender, co-morbidities, type of surgery, procedures, medical specialty, type of wound, surgical time, antibiotic prophylaxis and patient outcome were used for developing a predictive model of SSI using logistical regression analysis. The indexes' predictive ability was assessed by using the area under the receiver operating curve (ROC). RESULTS: 7,022 surgical procedures were evaluated and SSI rate was 2.9%. NNIS and SENIC risk index performance was similar to that for predicting SSI (0.68 cf 0.66 area under ROC, respectively). The new predictive model involved other factors such as age, diabetes mellitus, transfusions and surgical specialty showing 0.74 operating performance. CONCLUSIONS: Existing SSI predictive models have a moderate ability for predicting SSI but this can be improved with some local factors.