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The authors wish to thank the PREDIMED-Plus participants and staff for their engagement, as well as to the primary care centers involved in the study. We also thank the Cerca Programme of the Generalitat de Catalunya, and the CIBEROBN, CIBERESP and CIBERDEM initiatives of Instituto de Salud Carlos III in Spain, and the collaborators in the PRIME consortium for helpful input. The first version of the present article has been published in the public repository Research Square as a preprint publication of our work (44). We particularly thank Stephanie Nishi for her assistance with manuscript language revision., Introduction: Type 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA1c diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relationships in short-term studies. Thus, we aimed to examine 2-year associations between baseline diabetes/glycemic status and changes in cognitive function in older participants at high risk of cardiovascular disease. Methods: We conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. At baseline, participants were categorized by diabetes status (no-diabetes, prediabetes, and, CIBERESP, Generalitat de Catalunya, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición

La hipoglicemia es el signo de presentación de una gran lista de desórdenes, entre los cuales se incluyen formas transitorias y permanentes causadas por trastornos metabólicos o endocrinos. La glucosa es el principal sustrato metabólico del cerebro humano y a concentraciones sanguíneas por debajo de 36 mg/dL su utilización cerebral supera el transporte hacia el interior de las células neuronales, por lo que el cerebro se queda sin el suministro suficiente de esta. La disminución progresiva de la glicemia genera una secuencia de respuestas fisiológicas típicas, las cuales se encuentran totalmente activas cuando la glicemia cae por debajo de 50 mg/dL. El análisis de estos cambios es el fundamento principal del enfoque diagnóstico de la hipoglicemia. Tradicionalmente la definición de hipoglicemia se basa en la triada de Whipple, la cual no aplica en lactantes y recién nacidos, quienes no pueden comunicar adecuadamente sus síntomas. De esta manera, el enfoque diagnóstico para establecer las causas de la hipoglicemia requiere la conjunción de datos obtenidos de la historia clínica, el examen físico y los hallazgos de laboratorio, específicamente, las respuestas hormonales y de sustratos que ocurren durante la adaptación al ayuno y que se analizan mediante la toma de una muestra crítica.

Patients undergoing a surgical intervention for the first time are unfamiliar with the perioperative context, and they usually have no knowledge of postoperative pain management. In the preoperative circuit, there is no time to educate the patient in these terms. The professional profile of nurses allows this need to be addressed, and provides a regulated language to evaluate their effectiveness. This study evaluates the effectiveness of nursing counseling during a preoperative consultation for the management of postoperative pain and its effects on patient satisfaction at hospital discharge. This quasi-experimental study assesses the efficacy of preoperative nursing intervention in two groups, control (n = 185) and intervention (n = 195). Those in the intervention group attended a preoperative session during which they received information from nursing staff and took part in activities to learn about postoperative pain management and the perioperative circuit. Control group patients underwent the standard preoperative protocol. Data were compiled from January to December 2009. Statistically significant differences existed between the two groups regarding postoperative pain (visual analogue scale >3, 20.5% versus 11.5%; p = .023), patient satisfaction (87.1% versus 78.7%; p = .041), and surgical wound complications (13.9% versus 5.5%; p = .010). The results confirm the benefits of applying the nursing methodology in preoperative clinics.

Objetivo general: Determinar la adquisición de conocimientos de un programa de intervención multicomponente dirigido a cuidadoras inmigrantes (CI) y la influencia de la intervención grupal en sobrecarga de cuidadores inmigrantes (SCI) y apoyo social percibido (AS). Objetivo específico: Describir el perfil y situación sociolaboral de CI. Metodología Diseño: estudio descriptivo transversal. Intervención multicomponente en seminario-taller con pre/pos test, entrega de material de soporte. Cuatro sesiones de 1,30h. Población de estudio: 50 CI del grupo intervención. Variables: Nivel de conocimiento (variable resultado), variables sociodemográficas, las escalas de AS de Duke-UNC, SCI de Zarit. Análisis: Para conseguir una potencia del 90% y poder detectar diferencias en el contraste de la hipótesis nula H0:p1=p2 mediante una prueba ?² bilateral para dos muestras independientes, teniendo en cuenta que el nivel de significación es 5%, será necesario incluir 50 CI del grupo intervención. Resultados: El 41,3% (n: 20), presentaban apoyo social, sobrecarga del cuidador 38% (n: 19), poseen conocimientos suficientes para el cuidado 30% (n: 15), antes de la intervención. Se encontraron diferencias significativas después de la intervención, en el nivel de conocimientos del 90.4% (n: 43). No se encontró diferencia significativa en la SCI, ni en AS. Discusión y conclusiones: Los talleres educativos han mejorado los niveles de conocimiento de CI. Diferentes estudios evidencian que el cansancio del cuidador@ es más “resistente” a este tipo de intervenciones. Puede influir en la falta de significación del SCI y AS, la escasa muestra de participantes. Abstract General Objectives: determine the acquisition of knowledge of a program aimed at inmigrant caregivers multicomponent intervention and the influence of group intervention in the immigrant, caregiver burden and perception of social support. Specific objectives: profile and socio-labour situation of immigrant caregivers. Methodology Design: cross-transverse descriptive study. Intervention multicomponent in seminar-workshop with pre/post test, delivery of support materials. Four sessions of 1 h 30. Study population: 50 IC of the intervention group. Variables: Level of knowledge (variable result), socio-demographic variables, the scales as Duke-UNC, SCI of Zarit. Analysis: To achieve a 90% power to detect differences in the contrast of the null hypothesis H0:p1 = p2 through a bilateral chi-squared test for two independent samples, taking into account the level of significance is 5%, it will be necessary to include 50 CI of the intervention group. Results: The 41.3% (n 20), presented social support, caregiver 38% (n 19) overload, with sufficient care 30% (15 n) knowledge, prior to intervention. Differences after the intervention, were found in the level of knowledge of the 90.4% (n 43). Significant difference was not found in the overload of the carers immigrants, or in social support. Discussion and conclusions: educational workshops have improved levels of knowledge of CI. Different studies show caregivers overload is more ""resistant"" to this type of intervention. You can influence the lack of significance of the overload of immigrant caregivers and social support, the little sample of participants. Centro de Trabajo: (1) Enfermera Gestora de Casos UGC; (2) Enfermera familia UGC; (3) Enfermera familia UGC; (4) Enfermera Gestora de Casos, UGC; (5) Enfermera, Fisioterapeuta...(6) Profesor Universitario, Dpto. De Medicina preventiva y Salud Publica. Fecha del Trabajo: 16/10/2012 Palabra Clave: Cuidadores; inmigrantes; apoyo social; sobrecarga del cuidador; educación para la Salud. Key Words: Caregivers; immigrant; social support; caregiver burden; health education.

General Objectives: determine the acquisition of knowledge of a program aimed at inmigrant caregivers multicomponent intervention and the influence of group intervention in the immigrant, caregiver burden and perception of social support.Specific objectives: profile and socio-labour situation of immigrant caregivers.MethodologyDesign: cross-transverse descriptive study.Intervention multicomponent in seminar-workshop with pre/post test, delivery of support materials. Four sessions of 1 h 30. Study population: 50 IC of the intervention group.Variables: Level of knowledge (variable result), socio-demographic variables, the scales as Duke-UNC, SCI of Zarit.Analysis: To achieve a 90% power to detect differences in the contrast of the null hypothesis H0:p1 = p2 through a bilateral chi-squared test for two independent samples, taking into account the level of significance is 5%, it will be necessary to include 50 CI of the intervention group.Results: The 41.3% (n 20), presented social support, caregiver 38% (n 19) overload, with sufficient care 30% (15 n) knowledge, prior to intervention. Differences after the intervention, were found in the level of knowledge of the 90.4% (n 43). Significant difference was not found in the overload of the carers immigrants, or in social support.Discussion and conclusions: educational workshops have improved levels of knowledge of CI. Different studies show caregivers overload is more "resistant" to this type of intervention. You can influence the lack of significance of the overload of immigrant caregivers and social support, the little sample of participants.

Objectives. To determine heart rate influence on voice fundamental frequency under stress conditions. Methods. In 14 healthy volunteers, heart rate and blood pressure variables were analyzed during three classical autonomic tasks. Sustained voice samples were obtained to analyze F0. Results. Cold pressure test increased mean blood pressure, without effect on heart rate; isometric and mental tasks increased heart rate and blood pressure. Voice F0 was only affected by mental and cold ice tasks; it significantly correlated with the heart rate that occurred before and during every vocal emission. Discussion. Cardiovascular changes showed that subjects were significantly stressed during autonomic tasks. Heartbeat variations had a regular and significant influence on phonatory frequency, and this effect occurred during baseline and stress conditions.

Signet-ring cell carcinoma presenting in the uterine cervix is an uncommon neoplasm. It is usually a metastasis from a primary gastric tumor; only rarely, cervical involvement is the first manifestation of the disease. Primary signet-ring carcinoma of the cervix is extremely unusual, and it is always necessary to rule out a metastatic neoplasm. We report 3 cases of signet-ring cell carcinoma diagnosed in cervical biopsies. All cases were initially considered as metastatic, but a primary site other than the cervix could be confirmed in only 2 cases. Although autopsy was not authorized, a very comprehensive clinical workup and the evolution of the disease support the interpretation of the third case as a primary neoplasm. Primary signet-ring cell carcinoma of the cervix is an extraordinary event-the diagnosis of which requires excluding a metastasis from the gastrointestinal tract (usually the stomach), the ovary, or the breast.