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BackgroundWorld population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures.MethodsThis cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60–98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel’s Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale.ResultsWHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05).ConclusionsBMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.

Introducción: La calidad de sueño y los síntomas de insomnio pueden afectar habilidades para trabajar o aprender. La licenciatura de médico cirujano, incluye gran cantidad de contenido teórico y memorístico. Los trastornos del sueño pueden alterar el rendimiento académico. Tabaco, alcohol, drogas, edad, obesidad, hormonas y otros factores biológicos, mentales, ambientales y sociales pueden incrementar la mala calidad de sueño y la incidencia de síntomas de insomnio. Los universitarios son una población vulnerable para desarrollar trastornos del sueño. Objetivo: El objetivo fue relacionar la calidad de sueño y los síntomas de insomnio con el rendimiento académico de los estudiantes de primer año de la carrera de Médico Cirujano en Yucatán. Método: Se realizó un estudio transversal que incluyó 118 estudiantes del primer año de la carrera de Médico Cirujano de la Facultad de Medicina de la Universidad Autónoma de Yucatán. Los participantes respondieron los cuestionarios: calidad de sueño de Pittsburgh (PSQI), índice de severidad de insomnio (ISI), AUDIT y datos epidemiológicos. El rendimiento académico fue evaluado mediante el promedio numérico de calificaciones obtenidas de los exámenes escritos y cursos aprobados. Resultados: 65 hombres (19.15 ± 1.60 años) y 53 mujeres (18.98 ± 1.23 años) fueron incluidos. 98.11% de las mujeres y 90.76% de los hombres se percibieron con mala calidad de sueño. No se encontró asociación entre la calidad de sueño y el rendimiento académico. 73% de las mujeres y 66% de los hombres fueron clasificados con insomnio. Los niveles de síntomas insomnio moderado y severo fueron mayores en mujeres (p = 0.02). 50.94% de las mujeres y 44.61% de los hombres tuvieron pobre rendimiento académico. El pobre rendimiento académico se relacionó con síntomas de insomnio leve (p = 0.0035) y moderado (p = 0.03) únicamente en el grupo de mujeres. En hombres los síntomas de insomnio se relacionaron con el índice de masa corporal y con vivir fuera del domicilio familiar. Conclusiones: La gran mayoría de los estudiantes se percibieron con mala calidad de sueño y síntomas de insomnio. En las mujeres, los síntomas de insomnio afectan negativamente el rendimiento académico.

Objective. To provide a brief and comprehensive summary of recent research regarding psychological interventions for patients surviving a traumatic brain injury. Methods. A bibliographical search was performed in PubMed, Cochrane Library, PsycNET, Scopus, ResearchGate, and Google Scholar online databases. Analysis included distribution by year of publication, age stage of participants (paediatric, adult), location of the research team, study design, type of intervention, and main outcome variables. Results. The initial search eliciting 1541 citations was reduced to 62 relevant papers. Most publications had adult samples (88.7%). The United States outstands as the country with more research (58.1%); Latin America countries provided no results. Cognitive behavioural therapy (CBT) was the most widely used approach for treatment of (sub)clinical mental disturbances (41.9%). Neuropsychological interventions were scarce (4.8%). Outcome measures included psychiatric disorders (e.g., posttraumatic stress disorder (PTSD), depression, and anxiety) (37.1%), postconcussive symptoms (16.1%), cognitive and functional deficits (48.1%), and social and psychological dimensions (62.9%). Conclusions. CBT outstands as the preferred therapeutic approach for treating behavioural and emotional disturbances. Also, other related therapies such as dialectical behaviour, mindfulness, and acceptance and commitment therapies have been proposed, and probably in the years to come, more literature regarding their effectiveness will be available. On the other hand, evidence showed that interventions from the field of neuropsychology are minimal if compared with its contribution to assessment. Future research should be aimed at performing studies on more diverse populations (e.g., nonmilitary communities and paediatric and Latin American populations) and at controlling designs to examine the therapeutic efficacy of psychotherapeutic and neurocognitive rehabilitation interventions and compare amelioration by injury severity, age of patients, and clinical profile, in the hopes of creating better guidelines for practitioners.

Objective. To provide a brief and comprehensive summary of the recent evidence from clinical trials testing psychotherapeutic interventions in patients with fibromyalgia with particular interest in their possible effect on physical pain. Methods. Bibliographical search was performed in PubMed, PsycInfo, Web of Science, Scopus, and Cochrane Library databases. Content of the manuscripts was studied to obtain, if available, the following information: year of publication, location of the research team, design, type of psychotherapeutic intervention tested, pain measures, and a brief description of the psychotherapy, groups, and outcomes regarding physical pain. Results. Initial search eliciting 475 citations got reduced to 13 relevant papers. Most research studies from Spain (n = 8) are randomized control trials (n = 10) and used guided imagery (n = 5) or cognitive behavioral therapy (n = 4). The Visual Analogue Scale (n = 4) and the Fibromyalgia Impact Questionnaire (n = 4) were the physical pain measures mostly used. Improvements on physical pain were reported on all studies with published results; nevertheless, only in five cases, differences were significant. Conclusions. Evidence on the effect of psychotherapy on physical pain in patients with FS was divergent; though most studies report a reduction in pain, this was not always lasting and/or significant. Diversity of the results might be due to the selected psychotherapeutic approaches, assessment tools, and other internal (e.g., personality traits, (sub)clinical psychiatric symptoms, and treatment adherence) and external (e.g., family environment and social support) variables worth to be considered in the future research.

Introducción: La diabetes mellitus (DM) se ha convertido en una epidemia; en México las cifras ascienden a 12 millones de adultos. La debilidad muscular y pérdida de equilibrio que presentan los pacientes con diabetes mellitus tipo 2 (DT2) afecta el ciclo de la marcha lo que aumenta el riesgo de caídas (RC). Una de las estrategias que ha logrado reducir el RC en las personas que viven con DT2 son las intervenciones fisioterapéuticas. Objetivo: Determinar el efecto de una intervención fisioterapéutica en la marcha, sobre el puntaje de RC (PRC) en adultos con DT2. Material y Métodos: Estudio prospectivo, longitudinal, cuasi experimental. Se realizó una intervención fisioterapéutica en la marcha a adultos con DT2, que incluyó ejercicios de fortalecimiento, estiramientos, de equilibrio y coordinación; se calcularon los rangos de movimiento articular (RDM) fuerza muscular (FM) (escala de Daniels-Worthingham), huella plantar mediante el índice de Hernández-Corvo (IHC) de los miembros inferiores y PRC (TINETTI). Resultados: Participaron 21 adultos, mayores de 40 años, con un tiempo de evolución de DT2 de 13±8 años; el 85.76% fueron mujeres, y 61.91% presentó obesidad. Se registró un aumento en los RDM y se observó una diferencia significativa en la comparación de rangos de las variables de FM en ambos miembros inferiores. La huella plantar registró un cambio a pie tipo normal de un 34% en el derecho y en el izquierdo de 14%. El PRC disminuyó un 25% (p˂0.005). Conclusión: El aumento de los RDM, FM, equilibrio, coordinación y la modificación de la huella plantar disminuyó el PRC en los participantes del presente estudio.

Objective:The objective was to compare the executive functions between hypertensive and non-hypertensive middle-aged Mexican adults. Methods: An observational and analytic study was designed. Participants were men and women residents of Southeastern Mexico, aged between 40 and 60 years, with at least 5 years of hypertension diagnosis. The control group was people without hypertension. All participants completed a digit symbol substitution test (DSST), clinical and epidemiological data. Statistical analysis unpaired Student's t-test, p < 0.05. Results:

Introduction: Transradial approach (TRA) is a well-established technique for settings of coronary intervention, showing superiority above transfemoral approach (TFA). Most of the benefits of TRA approach can be reproduced to peripheral vascular approaches, despite the absence of scientific evidences in this setting. TRA access has been gradually emerging as an alternative and effective way for arteriographies and vascular interventions comparing to TFA. Our objective is to demonstrate the feasibility and safety of TRA access for the accomplishment of peripheral arteriographies and to provide a guide for those who look for a new TRA peripheral program. Method: series of 40 consecutive cases, with description of the technique, complications and immediate and short term results of peripheral and visceral arteriographies through TRA access in Hospital Regional do Coração , in the South of Minas Gerais.