Revista de neurologia
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Revista de neurologia · Feb 2008
Review[Adult learning, professional autonomy and individual commitment].
The concept of 'andragogy' is the basis of the adult education which is different from pedagogy in several aspects, particularly in the autonomy of the adult learner in choosing the educational programmes and the methodologies and sites in where learning occurs. This happens very often in the worksite. The professionals have to learn permanently during their active lives in order to maintain their competence updated. In this sense, continuing education correlates with continuing professional development, which is an attempt to enlarge the traditional domains of continuing education. Continuing education must be clearly differentiated from formal education, which is a requirement for granting professional degrees or titles. Very often it arises from the changing health needs and for this reason is necessary to avoid the institutionalization of continuing education programmes. ⋯ Professional associations should be actively involved in providing and accrediting continuing education-continuing professional development programmes, because this involvement is an essential component of the professionals' self-regulation in the context of the current medical professionalism ideology.
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Transient global amnesia (TGA) is a neuropsychological syndrome in which a sudden, temporary loss of the capacity of creating new memories and a retrograde amnesia of variable intensity occur, whereas consciousness, personal identity and attention are preserved. ⋯ There are data and arguments in favour and against the hypotheses regarding etiology of TGA, but there is no current consensus on a theory which explains in a satisfactory way the nature of this kind of amnesia.
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Revista de neurologia · Dec 2007
Review[Brain regulation of food intake and expenditure energy: molecular action of insulin, leptin and physical exercise].
Overweight and obesity present significant public health concerns because of the link with numerous chronic health conditions. During the last ten years, since the discovery of leptin, great advances were obtained in the characterization oh the hypothalamic mechanisms involved in the control of food intake and thermogenesis. ⋯ The physical activity is an important component on long-term weight control. The exercise markedly increased phosphorylation activity of several proteins involved in leptin and insulin signal transduction in the hypothalamus. Recently our laboratory showed that physical activity increase in sensitivity to leptin- and insulin-induced anorexia after enhances interleukin-6 production. These findings provide support for the hypothesis that the appetite-suppressive actions of exercise may be mediated by the hypothalamus.
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Revista de neurologia · Oct 2007
Review[Lumbar puncture: its indications, contraindications, complications and technique].
Although first described over 100 years ago, lumbar puncture is still an important tool in the diagnosis of neurological diseases. In this article we review its indications, contraindications, the technique for carrying it out, the analysis of the cerebrospinal fluid and possible complications. ⋯ The lumbar puncture in expert hands is a safe test. The health professional should be suitably familiar with its contraindications, the regional anatomy and the technique used to perform it.
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In neuropathic pain, as occurs in epilepsy, researchers are striving to find a drug capable of inhibiting the pain-generating ectopic discharges that are produced as a result of neuronal hyperexcitability. This is mediated by ionic exchanges across the channels of the synaptic membrane. This is why the drugs that act on the different types of channels involved in this transmission can regulate neuronal hyperexcitability and therefore have an effect on the pain. ⋯ Zonisamide acts on several types of channels and it is known to have four different mechanisms of action, which means it can be effective in treating these patients, although further studies are required (above all randomised double-blind trials) in order to really evaluate the usefulness of these drugs in the treatment of neuropathic pain.