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El deterioro cognitivo vascular es una de las causas principales de demencia y de discapacidad en el paciente adulto. La enfermedad de pequeño vaso cerebral (EPVC) representa la etiología más frecuente. El objetivo es cuáles pueden ser los mejores test neuropsicológicos para el diagnóstico y el seguimiento del deterioro cognitivo por EPVC en poblaciones que hablam francés o español (incluyendo pacientes iletrados). Se ha realizado una revisión sistemática según la metodología PRISMA. Se ha tomado como referencia los criterios diagnósticos de deterioro cognitivo del manual DSM-5 de 2013. Como test de cribado, la escala de Mattis (validada en castellano y francés) presenta buen rendimiento diagnóstico. En pacientes iletrados de habla castellana, la mejor escala de cribado validada es el Fototest. Para la evaluación de funciones ejecutivas y atención, se han demostrado sensibles las siguientes pruebas: Test del trazo A y B, Test de los 5 dígitos, Test de los símbolos y dígitos y el Test cubos de Corsi Wechsler no verbal. Nuestra batería aplicada por neuropsicólogos puede estandarizar el diagnóstico precoz y seguimiento adecuado de la EPVC en países en los que se habla francés o español.

Temperature is a vital sign that is closely regulated by the hypothalamus. Perioperative hypothermia is a common event; as peripheral heat redistribution occurs, thermoregulation is altered by anesthesia and exposure to a cold environment (operating room). Hypothermia is defined as core body temperature below 36°C. The aim of this systematic review was to analyze the main risk factors and complications of perioperative hypothermia and, at the same time, find out which warming method is most useful in the perioperative period. Of the 20 articles that were analyzed, 17 of them indicate that the patients present hypothermia in the perioperative period, with a range of mean temperatures ranging from 32.89 to < 36.0°C; three of them mention that the mean temperature ranges ≥ 36.0°C. The mean complications associated with hypothermia are shivering and thermal discomfort. Perioperative temperature is still one of the least commonly monitored vital parameters during anesthesia and surgery. A combined approach through active and passive warming measures is the key to preventing its complications.

Background: The values of arterial blood gases (ABG) change with altitude above sea level; empirical verification is essential because ventilatory acclimatization varies with ethnicity and a population’s adaptation. Objective: The aim of the study was to describe ABG in a healthy population residing at 2,240 meters above sea level, to identify the mean level of alveolar ventilation (PaCO2), and to know whether a progressive increase in PaCO2 occurs with age and the impact of increasing body mass index (BMI). Methods: We conducted a cross-sectional study in a referral center for respiratory diseases in Mexico City. Associations among variables with correlation coefficient and regression models of PaO2, SaO2, and P(A-a)O2 as dependent variables as a function of age, BMI, minute ventilation, or breathing frequency were explored. Results: Two hundred and seventeen healthy subjects were evaluated with a mean age of 40 ± 15 years, mean of the PaO2 was 71 ± 6 mmHg, SaO2 94% ± 1.6%, PaCO2 30.2 ± 3.4 mmHg, HCO3 20 ± 2 mmol/L, BE-2.9 ± 1.9 mmol/L, and the value of pH was 7.43 ± 0.02. In a linear regression, the main results were PaO2 = 77.5-0.16*age (p < 0.0001) and with aging P(A-a)O2 tended to increase 0.12 mmHg/year. PaCO2 in women increased with age by 0.075 mmHg/year (p = 0.0012, PaCO2 =26.3 + 0.075*age). SaO2 and PaO2 decreased significantly in women with higher BMI 0.14% and 0.52 mmHg per kg/m2, (p = 0.004 and 0.002 respectively). Conclusion: Mean PaCO2 was 30.7 mmHg, implying a mean alveolar ventilation of around 30% above that at sea level.