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Objective To describe the presence of homozygous c.del35G mutation in the _GJB2_ gene in a Mexican family with SNHL. Materials and methods A Mexican family with SNHL was included in the study. Analysis of the _GJB2_ gene was performed through whole exome sequencing (WES) and DNA direct sequencing analysis in all members of the family and in 100 normal controls.
S0185106316300798
Exome sequencing analysis reveals homozygous GJB2 gene mutation in a Mexican family with profound hearing loss
Keywords GJB2 gene Hypoacusia Gene mutations Connexins Homozygous
Abstract Background <dis>Sensorineural hearing loss</dis> (<dis>SNHL</dis>) is a clinically and genetically heterogeneous disease. In some populations, c.365delG mutation in the _GJB2_ gene represents the most frequent cause of <dis>hereditary SNHL</dis>. The great diversity of mutations in the _GJB2_ gene worldwide highlights the participation of ethnic background in <dis>SNHL</dis>. Objective To describe the presence of homozygous c.del35G mutation in the _GJB2_ gene in a Mexican family with <dis>SNHL</dis>. Materials and methods A Mexican family with <dis>SNHL</dis> was included in the study. Analysis of the _GJB2_ gene was performed through whole exome sequencing (WES) and DNA direct sequencing analysis in all members of the family and in 100 normal controls. Results Affected sibs showed the homozygous c.del35G mutation in the _GJB2_ gene. Parents of the families were heterozygous for the molecular defect and had normal audition. Conclusion We describe a homozygous c.del35G mutation in the _GJB2_ gene through WES analysis, a homozygous mutation with a very low occurrence in Mexican population.
Abstract Background Sensorineural hearing loss (SNHL) is a clinically and genetically heterogeneous disease. In some populations, c.365delG mutation in the _GJB2_ gene represents the most frequent cause of hereditary SNHL. The great diversity of mutations in the _GJB2_ gene worldwide highlights the participation of ethnic background in SNHL. Objective To describe the presence of homozygous c.del35G mutation in the _GJB2_ gene in a Mexican family with SNHL. Materials and methods A Mexican family with SNHL was included in the study. Analysis of the _GJB2_ gene was performed through whole exome sequencing (WES) and DNA direct sequencing analysis in all members of the family and in 100 normal controls. Results Affected sibs showed the homozygous c.del35G mutation in the _GJB2_ gene. Parents of the families were heterozygous for the molecular defect and had normal audition. Conclusion We describe a homozygous c.del35G mutation in the _GJB2_ gene through WES analysis, a homozygous mutation with a very low occurrence in Mexican population.
Objective To describe the presence of homozygous c.del35G mutation in the _GJB2_ gene in a Mexican family with <dis>SNHL</dis>. Materials and methods A Mexican family with <dis>SNHL</dis> was included in the study. Analysis of the _GJB2_ gene was performed through whole exome sequencing (WES) and DNA direct sequencing analysis in all members of the family and in 100 normal controls.
[ { "offsets": [ 111, 115 ], "text": "SNHL", "type": "DISABILITY" }, { "offsets": [ 161, 165 ], "text": "SNHL", "type": "DISABILITY" } ]
Abstract Introduction We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of neuropsychiatric disorders in Spain. Materials and methods The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs).
S1888989114001050
The Spanish Burden of Disease 2010: Neurological, mental and substance use disorders
Keywords Burden of disease Neurological disorders Mental disorders Substance use disorders Disability-adjusted life-years Spain
Abstract Introduction We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of <dis>neuropsychiatric disorders</dis> in Spain. Materials and methods The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs). DALYs were adjusted for comorbidity and estimated with 95% uncertainty intervals. Results The burden of <dis>neuropsychiatric disorders</dis> accounted for 18.4% of total all- cause DALYs generated in Spain for 2010. Within this group, the top five leading causes of DALYs were: depressive disorders, Alzheimer's disease, migraine, substance-use disorders, and anxiety disorder, which accounted for 70.9% of all DALYs due to <dis>neuropsychiatric disorders</dis>. Neurological disorders represented 5.03% of total all cause YLLs, whereas <dis>mental and substance-use disorders</dis> accounted for 0.8%. <dis>Mental and substance-use disorders</dis> accounted for 22.4% of total YLDs, with depression being the most disabling disorder. Neurological disorders represented 8.3% of total YLDs. Conclusions <dis>Neuropsychiatric disorders</dis> were one of the leading causes of disability in 2010. This finding contributes to our understanding of the burden of <dis>neuropsychiatric disorders</dis> in the Spanish population and highlights the importance of prioritising <dis>neuropsychiatric disorders</dis> in the Spanish public health system.
Abstract Introduction We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of neuropsychiatric disorders in Spain. Materials and methods The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs). DALYs were adjusted for comorbidity and estimated with 95% uncertainty intervals. Results The burden of neuropsychiatric disorders accounted for 18.4% of total all- cause DALYs generated in Spain for 2010. Within this group, the top five leading causes of DALYs were: depressive disorders, Alzheimer's disease, migraine, substance-use disorders, and anxiety disorder, which accounted for 70.9% of all DALYs due to neuropsychiatric disorders. Neurological disorders represented 5.03% of total all cause YLLs, whereas mental and substance-use disorders accounted for 0.8%. Mental and substance-use disorders accounted for 22.4% of total YLDs, with depression being the most disabling disorder. Neurological disorders represented 8.3% of total YLDs. Conclusions Neuropsychiatric disorders were one of the leading causes of disability in 2010. This finding contributes to our understanding of the burden of neuropsychiatric disorders in the Spanish population and highlights the importance of prioritising neuropsychiatric disorders in the Spanish public health system.
Abstract Introduction We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of <dis>neuropsychiatric disorders</dis> in Spain. Materials and methods The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs).
[ { "offsets": [ 136, 162 ], "text": "neuropsychiatric disorders", "type": "DISABILITY" } ]
Abstract Anaemia is common in the elderly and is associated with an increased risk of physical, functional, and cognitive impairment, hospitalisation and mortality. Although it is unknown whether anaemia is a causal factor or a subrogated marker of worse health status, its correction can improve the patients’ physical and functional capacity. Detection, classification, and treatment of anaemia should be a priority for the health system.
S0025775317305110
Anaemia in the elderly
Keywords Anaemia Elderly Nutritional deficiencies Erythropoietin Inflammation Indeterminate anaemia
Abstract Anaemia is common in the elderly and is associated with an increased risk of <dis>physical, functional, and cognitive impairment</dis>, hospitalisation and mortality. Although it is unknown whether anaemia is a causal factor or a subrogated marker of worse health status, its correction can improve the patients’ physical and functional capacity. Detection, classification, and treatment of anaemia should be a priority for the health system. The main causes of anaemia in the elderly are nutritional deficiencies and chronic disease, with or without kidney failure, although some cases are of indeterminate origin. Medical history and physical examination help to clarify its aetiology. A diagnostic algorithm based on data from the lab allows anaemia classification with a therapeutic orientation. Supplements of iron and maturation factors, as well as erythropoiesis-stimulating agents, constitute the mainstay of treatment, along with that of the underlying disease, whereas red blood cell transfusion should be reserved for severe cases.
Abstract Anaemia is common in the elderly and is associated with an increased risk of physical, functional, and cognitive impairment, hospitalisation and mortality. Although it is unknown whether anaemia is a causal factor or a subrogated marker of worse health status, its correction can improve the patients’ physical and functional capacity. Detection, classification, and treatment of anaemia should be a priority for the health system. The main causes of anaemia in the elderly are nutritional deficiencies and chronic disease, with or without kidney failure, although some cases are of indeterminate origin. Medical history and physical examination help to clarify its aetiology. A diagnostic algorithm based on data from the lab allows anaemia classification with a therapeutic orientation. Supplements of iron and maturation factors, as well as erythropoiesis-stimulating agents, constitute the mainstay of treatment, along with that of the underlying disease, whereas red blood cell transfusion should be reserved for severe cases.
Abstract Anaemia is common in the elderly and is associated with an increased risk of <dis>physical, functional, and cognitive impairment</dis>, hospitalisation and mortality. Although it is unknown whether anaemia is a causal factor or a subrogated marker of worse health status, its correction can improve the patients’ physical and functional capacity. Detection, classification, and treatment of anaemia should be a priority for the health system.
[ { "offsets": [ 87, 133 ], "text": "physical, functional, and cognitive impairment", "type": "DISABILITY" } ]
Conclusions We describe rCBF changes in PD in neural circuits related with control of movements. These changes are more manifest in patients with a longer duration of the disease.
S0212698209713539
Regional cerebral blood flow changes in Parkinson's disease: correlation with disease duration
Keywords Parkinson's disease Brain SPECT Disease duration Regional cerebral blood flow
Abstract Introduction Changes in regional cerebral blood flow (rCBF) have been reported in idiopathic Parkinson's disease (PD). Nonetheless, their typical pattern still remains controversial regarding some features, such as basal ganglia involvement and the main cortical regions affected. Functional neuroimaging makes it possible to identify the brain dysfunctions of the neural circuits underlying the disease. Voxel-based analysis methods make it possible to increase the reliability of the results. Objective To assess the rCBF changes in patients with PD and their relation with disease duration. Materials and methods Thirty PD adult patients <scp><neg>without</neg> <dis>dementia</dis></scp> underwent evaluation with 99mTc-ECD SPECT. SPM5 was used for statistical comparison with 25 normal controls of similar ages. The disease course duration in years was added as a covariate. Additionally, patients with a 6-year evolution or less and those with more than 6 years were compared separately with normal controls. Results Significant hypoperfusion was detected in bilateral premotor and posterior parietal cortex and increase of perfusion was present in the cerebellum. These changes correlated with the years of evolution of the illness. Patients with longer evolution also presented thalamic, subthalamic and basal ganglia hypoperfusion. Conclusions We describe rCBF changes in PD in neural circuits related with control of movements. These changes are more manifest in patients with a longer duration of the disease.
Abstract Introduction Changes in regional cerebral blood flow (rCBF) have been reported in idiopathic Parkinson's disease (PD). Nonetheless, their typical pattern still remains controversial regarding some features, such as basal ganglia involvement and the main cortical regions affected. Functional neuroimaging makes it possible to identify the brain dysfunctions of the neural circuits underlying the disease. Voxel-based analysis methods make it possible to increase the reliability of the results. Objective To assess the rCBF changes in patients with PD and their relation with disease duration. Materials and methods Thirty PD adult patients without dementia underwent evaluation with 99mTc-ECD SPECT. SPM5 was used for statistical comparison with 25 normal controls of similar ages. The disease course duration in years was added as a covariate. Additionally, patients with a 6-year evolution or less and those with more than 6 years were compared separately with normal controls. Results Significant hypoperfusion was detected in bilateral premotor and posterior parietal cortex and increase of perfusion was present in the cerebellum. These changes correlated with the years of evolution of the illness. Patients with longer evolution also presented thalamic, subthalamic and basal ganglia hypoperfusion. Conclusions We describe rCBF changes in PD in neural circuits related with control of movements. These changes are more manifest in patients with a longer duration of the disease.
Conclusions We describe rCBF changes in PD in neural circuits related with control of movements. These changes are more manifest in patients with a longer duration of the disease.
[]
We analyzed the demographic characteristics, mean age to diagnosis, the latencies of progression to Hoehn and Yahr (H&Y) I to II, HY II to III, and III to IV. Time of onset of the hallucinations, falls, cognitive impairment and care needed for activities of daily living (ADL), as milestones of advanced disease. Results We found similar interval times between the different H&Y stages.
S1853002816300295
Clinical progression of Parkinson's disease: A retrospective analysis in a specialized consulting room in movement disorders
Keywords Activities of daily living Cognitive impairment Parkinson's disease Hoehn and Yahr stages Milestones advanced disease
Abstract Introduction Parkinson's Disease diagnosis is supported in clinical criteria, it is frequently observed that the progression of PD varies among different individuals. Objective To evaluate the clinical progression in 100 PDp with more than five years of follow up in a Movement Disorders Section. Materials and methods We reviewed 100 Medical records of PDp with more than five years of follow-up. We analyzed the demographic characteristics, mean age to diagnosis, the latencies of progression to Hoehn and Yahr (H&Y) I to II, HY II to III, and III to IV. Time of onset of the hallucinations, falls, <dis>cognitive impairment</dis> and care needed for activities of daily living (ADL), as milestones of advanced disease. Results We found similar interval times between the different H&Y stages. We observed a faster progression to <dis>cognitive impairment</dis> and needed of care in ADL in patients over 50 years old at the onset of PD _(P_ <.05). Falls were the most frequent complaint found as an advanced disease's milestone (43%). <dis>Cognitive impairment</dis>, hallucinations and falls were associated to higher needs of care in ADL. Conclusions The progression of PD and the severity of parkinsonian signs and symptoms differ widely among patients. Falls, hallucinations and <dis>cognitive impairment</dis> were related to higher needs of care in ADL, suggesting they may be considered risk factors in the progression of the disease.
Abstract Introduction Parkinson's Disease diagnosis is supported in clinical criteria, it is frequently observed that the progression of PD varies among different individuals. Objective To evaluate the clinical progression in 100 PDp with more than five years of follow up in a Movement Disorders Section. Materials and methods We reviewed 100 Medical records of PDp with more than five years of follow-up. We analyzed the demographic characteristics, mean age to diagnosis, the latencies of progression to Hoehn and Yahr (H&Y) I to II, HY II to III, and III to IV. Time of onset of the hallucinations, falls, cognitive impairment and care needed for activities of daily living (ADL), as milestones of advanced disease. Results We found similar interval times between the different H&Y stages. We observed a faster progression to cognitive impairment and needed of care in ADL in patients over 50 years old at the onset of PD _(P_ <.05). Falls were the most frequent complaint found as an advanced disease's milestone (43%). Cognitive impairment, hallucinations and falls were associated to higher needs of care in ADL. Conclusions The progression of PD and the severity of parkinsonian signs and symptoms differ widely among patients. Falls, hallucinations and cognitive impairment were related to higher needs of care in ADL, suggesting they may be considered risk factors in the progression of the disease.
We analyzed the demographic characteristics, mean age to diagnosis, the latencies of progression to Hoehn and Yahr (H&Y) I to II, HY II to III, and III to IV. Time of onset of the hallucinations, falls, <dis>cognitive impairment</dis> and care needed for activities of daily living (ADL), as milestones of advanced disease. Results We found similar interval times between the different H&Y stages.
[ { "offsets": [ 203, 223 ], "text": "cognitive impairment", "type": "DISABILITY" } ]
Methods We conducted an observational, longitudinal, retrospective study of 57 children suffering profound prelingual bilateral sensorineural hearing loss who had received Advanced Bionics implants at our ENT department between June, 1998, and November, 2006. Data on their audiometric thresholds, the disyllabic word test adapted to children, open-set sentences recognition test and the Nottingham scale were analyzed.
S0001651909000454
Paediatric cochlear implantation in the critical period of the auditory pathway, our experience
Keywords Brain plasticity Early implantation Critical period Sensitive period Cochlear implant results
Abstract Introduction Numerous experimental and clinical studies have suggested a critical or sensitive period in which the auditory pathway develops its greatest potential in terms of plasticity and learning. Early cochlear implantation performed in <dis>prelingual deaf</dis> children in this period provides a better prognosis for language acquisition. The aim of this study is to show the importance of cochlear implantation before this critical period ends. Methods We conducted an observational, longitudinal, retrospective study of 57 children suffering <dis>profound prelingual bilateral sensorineural hearing loss</dis> who had received Advanced Bionics implants at our ENT department between June, 1998, and November, 2006. Data on their audiometric thresholds, the disyllabic word test adapted to children, open-set sentences recognition test and the Nottingham scale were analyzed. Results The analysis of audiometric thresholds showed no differences between children receiving the implants at different ages. However, statistically significant differences (p<0.05) were found in speech tests between groups of children receiving the implants before and after 4 years of age. Conclusions Our results are in line with other publications showing differences in auditory performance when comparing children with early implants versus children receiving the implants at a later age. We found the greatest differences at 4 years of age. Nevertheless, these findings should not exclude children over this age from implantation.
Abstract Introduction Numerous experimental and clinical studies have suggested a critical or sensitive period in which the auditory pathway develops its greatest potential in terms of plasticity and learning. Early cochlear implantation performed in prelingual deaf children in this period provides a better prognosis for language acquisition. The aim of this study is to show the importance of cochlear implantation before this critical period ends. Methods We conducted an observational, longitudinal, retrospective study of 57 children suffering profound prelingual bilateral sensorineural hearing loss who had received Advanced Bionics implants at our ENT department between June, 1998, and November, 2006. Data on their audiometric thresholds, the disyllabic word test adapted to children, open-set sentences recognition test and the Nottingham scale were analyzed. Results The analysis of audiometric thresholds showed no differences between children receiving the implants at different ages. However, statistically significant differences (p<0.05) were found in speech tests between groups of children receiving the implants before and after 4 years of age. Conclusions Our results are in line with other publications showing differences in auditory performance when comparing children with early implants versus children receiving the implants at a later age. We found the greatest differences at 4 years of age. Nevertheless, these findings should not exclude children over this age from implantation.
Methods We conducted an observational, longitudinal, retrospective study of 57 children suffering <dis>profound prelingual bilateral sensorineural hearing loss</dis> who had received Advanced Bionics implants at our ENT department between June, 1998, and November, 2006. Data on their audiometric thresholds, the disyllabic word test adapted to children, open-set sentences recognition test and the Nottingham scale were analyzed.
[ { "offsets": [ 98, 154 ], "text": "profound prelingual bilateral sensorineural hearing loss", "type": "DISABILITY" } ]
Conclusions The satisfactory psychometric behaviour of the ENAR-TMG makes the scale a promising tool to assess global functioning in people with a severe mental disorder.
S1888989116000379
Psychometric study of the Required Care Levels for People with Severe Mental Disorder Assessment Scale (ENAR-TMG)
Keywords Severe mental disorder Psychosocial functioning Assessment scale Psychometric study
Introduction People with <dis>severe mental disorder</dis> have <dis>significant difficulties in everyday life that involve the need for continued support</dis>. These needs are not easily measurable with the currently available tools. Therefore, a multidimensional scale that assesses the different levels of need for care is proposed, including a study of its psychometric properties. Method One-hundred and thirty-nine patients (58% men) with a <dis>severe mental disorder</dis> were assessed using the Required Care Levels for People with Severe Mental Disorder Assessment Scale (ENAR-TMG), the Camberwell Assessment of Need scale, and the Health of the Nation Outcome Scales. ENAR-TMG's psychometric features were examined by: a) evaluating 2 sources of validity evidence (evidence based on internal structure and evidence based on relations to other variables), and b) estimating the internal consistency, temporal stability, inter-rater reliability, and sensitivity to change of scores of the ENAR-TMG's subscales. Results Exploratory factor analyses revealed a one-factor structure for each of the theoretical dimensions of the scale, in which all but one showed a significant and positive correlation with the Camberwell Assessment of Need (range of r: 0.143-0.557) and Health of the Nation Outcome Scales (range of r: 0.241-0.474) scales. ENAR-TMG subscale scores showed acceptable internal consistency (range of ordinal α coefficients: 0.682-0.804), excellent test-retest (range of intraclass correlation coefficients: 0.889-0.999) and inter-rater reliabilities (range of intraclass correlation coefficients: 0.926-0.972), and satisfactory sensitivity to treatment-related changes (range of η2: 0.003-0.103). Conclusions The satisfactory psychometric behaviour of the ENAR-TMG makes the scale a promising tool to assess global functioning in people with a <dis>severe mental disorder</dis>.
Introduction People with severe mental disorder have significant difficulties in everyday life that involve the need for continued support. These needs are not easily measurable with the currently available tools. Therefore, a multidimensional scale that assesses the different levels of need for care is proposed, including a study of its psychometric properties. Method One-hundred and thirty-nine patients (58% men) with a severe mental disorder were assessed using the Required Care Levels for People with Severe Mental Disorder Assessment Scale (ENAR-TMG), the Camberwell Assessment of Need scale, and the Health of the Nation Outcome Scales. ENAR-TMG's psychometric features were examined by: a) evaluating 2 sources of validity evidence (evidence based on internal structure and evidence based on relations to other variables), and b) estimating the internal consistency, temporal stability, inter-rater reliability, and sensitivity to change of scores of the ENAR-TMG's subscales. Results Exploratory factor analyses revealed a one-factor structure for each of the theoretical dimensions of the scale, in which all but one showed a significant and positive correlation with the Camberwell Assessment of Need (range of r: 0.143-0.557) and Health of the Nation Outcome Scales (range of r: 0.241-0.474) scales. ENAR-TMG subscale scores showed acceptable internal consistency (range of ordinal α coefficients: 0.682-0.804), excellent test-retest (range of intraclass correlation coefficients: 0.889-0.999) and inter-rater reliabilities (range of intraclass correlation coefficients: 0.926-0.972), and satisfactory sensitivity to treatment-related changes (range of η2: 0.003-0.103). Conclusions The satisfactory psychometric behaviour of the ENAR-TMG makes the scale a promising tool to assess global functioning in people with a severe mental disorder.
Conclusions The satisfactory psychometric behaviour of the ENAR-TMG makes the scale a promising tool to assess global functioning in people with a <dis>severe mental disorder</dis>.
[ { "offsets": [ 147, 169 ], "text": "severe mental disorder", "type": "DISABILITY" } ]
This, in combination with 18F-FDG PET, is the basis of molecular neuroimaging as a biomarker. At present, its prognostic value is being evaluated in longitudinal studies. 11C-PIB-PET has become the reference radiotracer to evaluate the presence of cerebral amyloid. However, its availability is limited due to the need for a nearby cyclotron. Therefore, 18F labeled radiotracers are being introduced.
S2253654X13001182
Molecular neuroimaging in degenerative dementias
Keywords 11 C-PIB Positron emission tomography Dementia Molecular imaging Amyloid imaging Alzheimer's disease
Abstract In the context of the limitations of structural imaging, brain perfusion and metabolism using SPECT and PET have provided relevant information for the study of <dis>cognitive decline</dis>. The introduction of the radiotracers for cerebral amyloid imaging has changed the diagnostic strategy regarding Alzheimer's disease, which is currently considered to be a «continuum». According to this new paradigm, the increasing amyloid load would be associated to the preclinical phase and <dis>mild cognitive impairment</dis>. It has been possible to observe «in vivo» images using 11C-PIB and PET scans. The characteristics of the 11C-PIB image include specific high brain cortical area retention in the positive cases with typical distribution pattern and no retention in the negative cases. This, in combination with 18F-FDG PET, is the basis of molecular neuroimaging as a biomarker. At present, its prognostic value is being evaluated in longitudinal studies. 11C-PIB-PET has become the reference radiotracer to evaluate the presence of cerebral amyloid. However, its availability is limited due to the need for a nearby cyclotron. Therefore, 18F labeled radiotracers are being introduced. Our experience in the last two years with 11C-PIB, first in the research phase and then as being clinically applied, has shown the utility of the technique in the clinical field, either alone or in combination with FDG. Thus, amyloid image is a useful tool for the differential diagnosis of <dis>dementia</dis> and it is a potentially useful method for early diagnosis and evaluation of future treatments.
Abstract In the context of the limitations of structural imaging, brain perfusion and metabolism using SPECT and PET have provided relevant information for the study of cognitive decline. The introduction of the radiotracers for cerebral amyloid imaging has changed the diagnostic strategy regarding Alzheimer's disease, which is currently considered to be a «continuum». According to this new paradigm, the increasing amyloid load would be associated to the preclinical phase and mild cognitive impairment. It has been possible to observe «in vivo» images using 11C-PIB and PET scans. The characteristics of the 11C-PIB image include specific high brain cortical area retention in the positive cases with typical distribution pattern and no retention in the negative cases. This, in combination with 18F-FDG PET, is the basis of molecular neuroimaging as a biomarker. At present, its prognostic value is being evaluated in longitudinal studies. 11C-PIB-PET has become the reference radiotracer to evaluate the presence of cerebral amyloid. However, its availability is limited due to the need for a nearby cyclotron. Therefore, 18F labeled radiotracers are being introduced. Our experience in the last two years with 11C-PIB, first in the research phase and then as being clinically applied, has shown the utility of the technique in the clinical field, either alone or in combination with FDG. Thus, amyloid image is a useful tool for the differential diagnosis of dementia and it is a potentially useful method for early diagnosis and evaluation of future treatments.
This, in combination with 18F-FDG PET, is the basis of molecular neuroimaging as a biomarker. At present, its prognostic value is being evaluated in longitudinal studies. 11C-PIB-PET has become the reference radiotracer to evaluate the presence of cerebral amyloid. However, its availability is limited due to the need for a nearby cyclotron. Therefore, 18F labeled radiotracers are being introduced.
[]
Due to the implementation of vaccination schemes against H. influenza and S. pneumoniae since the 90s, the cases by these pathogens have decreased, causing new bacteria to take place as the cause of the infection. The importance of considering S. pyogenes as an etiology of orbital cellulitis comes from its rapid progression to abscess formation, and the few cases described in the literature.
S2444340917000541
Orbital cellulitis complicated by subperiosteal abscess due to Streptococcus pyogenes infection
Keywords Orbital cellulitis subperiosteal abscess Streptococcus pyogenes Vaccines
Background. Orbital cellulitis is an infectious disease that is very common in pediatric patients, in which severe complications may develop. Etiological agents related to this disease are Haemophilus influenzae B, Staphylococcus aureus, Streptococcus pneumoniae and Moraxella catarrhalis, 95% of the cases. Streptococcus beta-hemolytic and anaerobic microorganisms may also be present and cause <5% of the cases. We present an uncommon case of orbital cellulitis complicated by a subperiosteal abscess caused Streptococcus pyogenes. Case Report. A 9-year-old male patient with a history of <dis>attention deficit disorder</dis> and <dis>hyperactivity disorder</dis> since he was five years old. His illness started with erythema on the outer edge of the right eye, increase in the peri-orbicular volume with limitation of eyelid opening, progression to proptosis, pain with eye movements and conjunctival purulent discharge. Image studies reported a subperiosteal and pre-septal right abscess with extraocular cellulitis. Empirical antibiotic treatment was started, surgical drainage was performed, and Streptococcus pyogenes was isolated from the culture of the obtained purulent material. Conclusions. Due to the implementation of vaccination schemes against H. influenza and S. pneumoniae since the 90s, the cases by these pathogens have decreased, causing new bacteria to take place as the cause of the infection. The importance of considering S. pyogenes as an etiology of orbital cellulitis comes from its rapid progression to abscess formation, and the few cases described in the literature.
Background. Orbital cellulitis is an infectious disease that is very common in pediatric patients, in which severe complications may develop. Etiological agents related to this disease are Haemophilus influenzae B, Staphylococcus aureus, Streptococcus pneumoniae and Moraxella catarrhalis, 95% of the cases. Streptococcus beta-hemolytic and anaerobic microorganisms may also be present and cause <5% of the cases. We present an uncommon case of orbital cellulitis complicated by a subperiosteal abscess caused Streptococcus pyogenes. Case Report. A 9-year-old male patient with a history of attention deficit disorder and hyperactivity disorder since he was five years old. His illness started with erythema on the outer edge of the right eye, increase in the peri-orbicular volume with limitation of eyelid opening, progression to proptosis, pain with eye movements and conjunctival purulent discharge. Image studies reported a subperiosteal and pre-septal right abscess with extraocular cellulitis. Empirical antibiotic treatment was started, surgical drainage was performed, and Streptococcus pyogenes was isolated from the culture of the obtained purulent material. Conclusions. Due to the implementation of vaccination schemes against H. influenza and S. pneumoniae since the 90s, the cases by these pathogens have decreased, causing new bacteria to take place as the cause of the infection. The importance of considering S. pyogenes as an etiology of orbital cellulitis comes from its rapid progression to abscess formation, and the few cases described in the literature.
Due to the implementation of vaccination schemes against H. influenza and S. pneumoniae since the 90s, the cases by these pathogens have decreased, causing new bacteria to take place as the cause of the infection. The importance of considering S. pyogenes as an etiology of orbital cellulitis comes from its rapid progression to abscess formation, and the few cases described in the literature.
[]
Abstract Introduction Fragile X syndrome is an inherited form of mental retardation. It results from an abnormally expanded number of trinucleotide CGG repeats. Some grandfathers of these children become forgetful, have frequent falls and other neurological problems. Researchers have found a connection between fragile X syndrome and the neurological symptoms in elderly men.
S0213485310000022
Neurological signs in the adult with fragile-X premutation
Keywords Fragile X permutation Tremor/ataxia syndrome Parkinsonism Cognitive deficit
Abstract Introduction Fragile X syndrome is an inherited form of <dis>mental retardation</dis>. It results from an abnormally expanded number of trinucleotide CGG repeats. Some grandfathers of these children become forgetful, have frequent falls and other neurological problems. Researchers have found a connection between fragile X syndrome and the neurological symptoms in elderly men. This resulted in the recognition of a syndrome originally referred to as “intention tremor, parkinsonism and generalised brain atrophy in carriers of a fragile X premutation”. This premutation is also associated with premature ovarian failure. Methodology This paper reviews the literature on the neurological signs of fragile X premutation. Conclusions Fragile X premutation is a risk for <dis>movement disorders</dis> and <dis>cognitive dysfunction</dis> and it should be considered in patients with a family history of <dis>mental retardation</dis> or <dis>autism</dis>, and particularly in those females with premature ovarian failure.
Abstract Introduction Fragile X syndrome is an inherited form of mental retardation. It results from an abnormally expanded number of trinucleotide CGG repeats. Some grandfathers of these children become forgetful, have frequent falls and other neurological problems. Researchers have found a connection between fragile X syndrome and the neurological symptoms in elderly men. This resulted in the recognition of a syndrome originally referred to as “intention tremor, parkinsonism and generalised brain atrophy in carriers of a fragile X premutation”. This premutation is also associated with premature ovarian failure. Methodology This paper reviews the literature on the neurological signs of fragile X premutation. Conclusions Fragile X premutation is a risk for movement disorders and cognitive dysfunction and it should be considered in patients with a family history of mental retardation or autism, and particularly in those females with premature ovarian failure.
Abstract Introduction Fragile X syndrome is an inherited form of <dis>mental retardation</dis>. It results from an abnormally expanded number of trinucleotide CGG repeats. Some grandfathers of these children become forgetful, have frequent falls and other neurological problems. Researchers have found a connection between fragile X syndrome and the neurological symptoms in elderly men.
[ { "offsets": [ 66, 84 ], "text": "mental retardation", "type": "DISABILITY" } ]
No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Conclusions Patients with rheumatoid arthritis had a high prevalence of sensorineural hearing loss for high and very high frequencies.
S2444050715001059
Subclinical sensorineural hearing loss in female patients with rheumatoid arthritis
Keywords Sensorineural hearing loss High frequency audiometry Rheumatoid arthritis
Abstract Background The rheumatoid arthritis is a clinical entity capable to cause <dis>hearing impairment</dis> that can be diagnosed promptly with high frequencies audiometry. Objective To detect <dis>subclinical sensorineural hearing loss</dis> in patients with rheumatoid arthritis. Material and methods Cross-sectional study on patients with rheumatoid arthritis performing high frequency audiometry 125 Hz to 16,000 Hz and tympanometry. The results were correlated with markers of disease activity and response to therapy. Results High frequency audiometry was performed in 117 female patients aged from 19 to 65 years. <dis>Sensorineural hearing loss</dis> was observed at a sensitivity of pure tones from 125 to 8000 Hz in 43.59%, a tone threshold of 10,000 to 16,000 Hz in 94.02% patients in the right ear and in 95.73% in the left ear. Hearing was normal in 8 (6.84%) patients. <dis>Hearing loss</dis> was observed in 109 (93.16%), and was asymmetric in 36 (30.77%), symmetric in 73 (62.37%), bilateral in 107 (91.45%), unilateral in 2 (1.71%), and no conduction and/or <dis>mixed hearing loss</dis> was encountered. Eight (6.83%) patients presented vertigo, 24 (20.51%) tinnitus. Tympanogram type A presented in 88.90% in the right ear and 91.46% in the left ear, with 5.98–10.25% type As. Stapedius reflex was present in 75.3–85.2%. Speech discrimination in the left ear was significantly different ( _p_ = 0.02) in the group older than 50 years. No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Conclusions Patients with rheumatoid arthritis had a high prevalence of <dis>sensorineural hearing loss</dis> for high and very high frequencies.
Abstract Background The rheumatoid arthritis is a clinical entity capable to cause hearing impairment that can be diagnosed promptly with high frequencies audiometry. Objective To detect subclinical sensorineural hearing loss in patients with rheumatoid arthritis. Material and methods Cross-sectional study on patients with rheumatoid arthritis performing high frequency audiometry 125 Hz to 16,000 Hz and tympanometry. The results were correlated with markers of disease activity and response to therapy. Results High frequency audiometry was performed in 117 female patients aged from 19 to 65 years. Sensorineural hearing loss was observed at a sensitivity of pure tones from 125 to 8000 Hz in 43.59%, a tone threshold of 10,000 to 16,000 Hz in 94.02% patients in the right ear and in 95.73% in the left ear. Hearing was normal in 8 (6.84%) patients. Hearing loss was observed in 109 (93.16%), and was asymmetric in 36 (30.77%), symmetric in 73 (62.37%), bilateral in 107 (91.45%), unilateral in 2 (1.71%), and no conduction and/or mixed hearing loss was encountered. Eight (6.83%) patients presented vertigo, 24 (20.51%) tinnitus. Tympanogram type A presented in 88.90% in the right ear and 91.46% in the left ear, with 5.98–10.25% type As. Stapedius reflex was present in 75.3–85.2%. Speech discrimination in the left ear was significantly different ( _p_ = 0.02) in the group older than 50 years. No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Conclusions Patients with rheumatoid arthritis had a high prevalence of sensorineural hearing loss for high and very high frequencies.
No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Conclusions Patients with rheumatoid arthritis had a high prevalence of <dis>sensorineural hearing loss</dis> for high and very high frequencies.
[ { "offsets": [ 213, 239 ], "text": "sensorineural hearing loss", "type": "DISABILITY" } ]
Doppler ultrasound recording was performed on the LL and the results showed aneurysmal dilatation measuring 72 × 35 mm in the right SFA and 63 × 28 mm in the left SFA. The angiography study of the LL confirmed the presence of aneurysms at that level. Elective surgery was performed involving resection of the aneurysm and end-to- end placement of an 8-mm PTFE graft.
S0003317008020117
Aneurismas verdaderos de la femoral superficial: a propósito de un caso
Key words Aneurysm of the superficial femoral artery Distal embolism Endovascular treatment Rupture Surgical treatment Thrombosis
TRUE ANEURYSMS OF THE SUPERFICIAL FEMORAL ARTERY: A CASE REPORT Summary Introduction. _True aneurysms of the superficial femoral artery (SFA) are rare entities. Fewer than 50 cases have been reported in PubMed and the largest series consists of 13 patients. Here we report the case of a patient with bilateral true aneurysms in the SFA and the surgical treatment that was performed to treat them._ Case report. _A 78-yearold male with a history of chronic obstructive pulmonary disease, benign hypoplasia of the prostate and <dis>blindness</dis> since infancy due to pigmentary retinitis. The patient visited the emergency department after having lumps on the inner side of both thighs for several years and claudication of the soleus-gastrocnemius muscle in the left lower limb at 300 m. Examination revealed the presence of pulsatile masses with systolic murmurs in the mid-third of the thigh in both lower limbs (LL) and a distal to popliteal occlusion in the left lower limb. Doppler ultrasound recording was performed on the LL and the results showed aneurysmal dilatation measuring 72 × 35 mm in the right SFA and 63 × 28 mm in the left SFA. The angiography study of the LL confirmed the presence of aneurysms at that level. Elective surgery was performed involving resection of the aneurysm and end-to- end placement of an 8-mm PTFE graft. The aneurysms presented a thrombus and arteriosclerotic thickening of their walls. Anti-aggregating treatment consisting in 150 mg of acetylsalicylic acid was established and the patient was discharged from hospital five days after surgery._ Conclusions. _True aneurysms of the SFA are rare. They are associated with a high rate of thromboembolic complications and rupture. Preferred treatment consists in resection and placement of a prosthetic or venous graft. [ANGIOLOGIA 2008; 60: 149-54]_
TRUE ANEURYSMS OF THE SUPERFICIAL FEMORAL ARTERY: A CASE REPORT Summary Introduction. _True aneurysms of the superficial femoral artery (SFA) are rare entities. Fewer than 50 cases have been reported in PubMed and the largest series consists of 13 patients. Here we report the case of a patient with bilateral true aneurysms in the SFA and the surgical treatment that was performed to treat them._ Case report. _A 78-yearold male with a history of chronic obstructive pulmonary disease, benign hypoplasia of the prostate and blindness since infancy due to pigmentary retinitis. The patient visited the emergency department after having lumps on the inner side of both thighs for several years and claudication of the soleus-gastrocnemius muscle in the left lower limb at 300 m. Examination revealed the presence of pulsatile masses with systolic murmurs in the mid-third of the thigh in both lower limbs (LL) and a distal to popliteal occlusion in the left lower limb. Doppler ultrasound recording was performed on the LL and the results showed aneurysmal dilatation measuring 72 × 35 mm in the right SFA and 63 × 28 mm in the left SFA. The angiography study of the LL confirmed the presence of aneurysms at that level. Elective surgery was performed involving resection of the aneurysm and end-to- end placement of an 8-mm PTFE graft. The aneurysms presented a thrombus and arteriosclerotic thickening of their walls. Anti-aggregating treatment consisting in 150 mg of acetylsalicylic acid was established and the patient was discharged from hospital five days after surgery._ Conclusions. _True aneurysms of the SFA are rare. They are associated with a high rate of thromboembolic complications and rupture. Preferred treatment consists in resection and placement of a prosthetic or venous graft. [ANGIOLOGIA 2008; 60: 149-54]_
Doppler ultrasound recording was performed on the LL and the results showed aneurysmal dilatation measuring 72 × 35 mm in the right SFA and 63 × 28 mm in the left SFA. The angiography study of the LL confirmed the presence of aneurysms at that level. Elective surgery was performed involving resection of the aneurysm and end-to- end placement of an 8-mm PTFE graft.
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Abstract We report two cases of sudden deafness which appeared during vaso-occlusive crisis of a sickle cell anaemia (homozygous form of disease) and a sickle cell trait (heterozygous form) in two males aged sixteen and twenty-two, respectively. A high erythrocyte aggregability and low deformability were proved in both young men. Although hearing disorders have been reported in this disease, a sudden onset is not common.
S0001651902783222
Report of two cases os sudden deafness in patients bearing of sickle cell anaemia and trait
Key words Sudden deafness Sickle cell disease
Abstract We report two cases of <dis>sudden deafness</dis> which appeared during vaso-occlusive crisis of a sickle cell anaemia (homozygous form of disease) and a sickle cell trait (heterozygous form) in two males aged sixteen and twenty-two, respectively. A high erythrocyte aggregability and low deformability were proved in both young men. Although <dis>hearing disorders</dis> have been reported in this disease, a sudden onset is not common. The treatment used was useful in the removal of painful crisis and infections, but <dis>deafness</dis> did not improve in either of then.
Abstract We report two cases of sudden deafness which appeared during vaso-occlusive crisis of a sickle cell anaemia (homozygous form of disease) and a sickle cell trait (heterozygous form) in two males aged sixteen and twenty-two, respectively. A high erythrocyte aggregability and low deformability were proved in both young men. Although hearing disorders have been reported in this disease, a sudden onset is not common. The treatment used was useful in the removal of painful crisis and infections, but deafness did not improve in either of then.
Abstract We report two cases of <dis>sudden deafness</dis> which appeared during vaso-occlusive crisis of a sickle cell anaemia (homozygous form of disease) and a sickle cell trait (heterozygous form) in two males aged sixteen and twenty-two, respectively. A high erythrocyte aggregability and low deformability were proved in both young men. Although <dis>hearing disorders</dis> have been reported in this disease, a sudden onset is not common.
[ { "offsets": [ 33, 48 ], "text": "sudden deafness", "type": "DISABILITY" }, { "offsets": [ 342, 359 ], "text": "hearing disorders", "type": "DISABILITY" } ]
Objective The objective of this paper is to make a retrospective analysis in patients with glomus tumours of temporal bone origin. We present the results according to the surgical approach applied in each case. Patients and method This retrospective study presents the findings in 17 patients with diagnosis of glomus jugulare of the temporal bone, who were observed and treated in our department over a 5-year period (1999 to 2004). We performed a general otolaryngology exam, systemic evaluation and radiological exam.
S0001651907749452
Glomus tumours of temporal bone origin. study of 17 cases
Key words Tumours of the temporal bone Glomus jugulare Glomus tumours
Objective The objective of this paper is to make a retrospective analysis in patients with glomus tumours of temporal bone origin. We present the results according to the surgical approach applied in each case. Patients and method This retrospective study presents the findings in 17 patients with diagnosis of glomus jugulare of the temporal bone, who were observed and treated in our department over a 5-year period (1999 to 2004). We performed a general otolaryngology exam, systemic evaluation and radiological exam. Surgical treatment was performed in 16 cases out of 17. In 1 case treatment with stereotaxic surgery was performed. Results The surgical approaches were: retroauricular transcanal approach, radical or modified mastoidectomy through facial recess, and infratemporal fossa approach. Pre-operative embolization was used in 11 of our cases. In all cases the diagnosis of glomus tumour was confirmed. The most frequent post-operative complications found were: transitory paralysis of the facial nerve, <dis>sensorineural hearing loss</dis>, imbalance, paralysis of the IXth and XIth cranial nerves, and salivary fistula. No recurrences were found after 8 years of follow-up. One case of persistence was found in the case treated with radiosurgery. Conclusions In our series surgery was found as the elective therapy for patients with glomus tumour of the temporal bone with no recurrences after 8 years of follow-up. Pre-operative embolization diminishes surgery time and intraoperative bleeding. Stereotaxic therapy cannot provide tumour growth control. Complications are discussed and compared with the bibliography.
Objective The objective of this paper is to make a retrospective analysis in patients with glomus tumours of temporal bone origin. We present the results according to the surgical approach applied in each case. Patients and method This retrospective study presents the findings in 17 patients with diagnosis of glomus jugulare of the temporal bone, who were observed and treated in our department over a 5-year period (1999 to 2004). We performed a general otolaryngology exam, systemic evaluation and radiological exam. Surgical treatment was performed in 16 cases out of 17. In 1 case treatment with stereotaxic surgery was performed. Results The surgical approaches were: retroauricular transcanal approach, radical or modified mastoidectomy through facial recess, and infratemporal fossa approach. Pre-operative embolization was used in 11 of our cases. In all cases the diagnosis of glomus tumour was confirmed. The most frequent post-operative complications found were: transitory paralysis of the facial nerve, sensorineural hearing loss, imbalance, paralysis of the IXth and XIth cranial nerves, and salivary fistula. No recurrences were found after 8 years of follow-up. One case of persistence was found in the case treated with radiosurgery. Conclusions In our series surgery was found as the elective therapy for patients with glomus tumour of the temporal bone with no recurrences after 8 years of follow-up. Pre-operative embolization diminishes surgery time and intraoperative bleeding. Stereotaxic therapy cannot provide tumour growth control. Complications are discussed and compared with the bibliography.
Objective The objective of this paper is to make a retrospective analysis in patients with glomus tumours of temporal bone origin. We present the results according to the surgical approach applied in each case. Patients and method This retrospective study presents the findings in 17 patients with diagnosis of glomus jugulare of the temporal bone, who were observed and treated in our department over a 5-year period (1999 to 2004). We performed a general otolaryngology exam, systemic evaluation and radiological exam.
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The intention is to initiate co-operation and shared care between the different health care professionals and to increase the awareness of psychiatrists caring for patients suffering from severe mental illness to screen and treat increased cardiovascular risk factors and diabetes.
S1888989109707141
Cardiovascular disease and diabetes in people with severe mental illness
Keywords Severe mental illness Schizophrenia Depression Bipolar disorder Physical health Weight gain Cardiovascular disease Diabetes
Abstract Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). People with <dis>severe mental illnesses</dis>, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed to an increased risk of the modifiable coronary heart disease risk factors, obesity, smoking, diabetes, hypertension, and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain and further increase the risk of adverse metabolic effects which may result in further increased incidence of cardiovascular disease. Patients have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non- psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement aiming to improve the care of patients suffering from <dis>severe mental illness</dis>. The intention is to initiate co-operation and shared care between the different health care professionals and to increase the awareness of psychiatrists caring for patients suffering from <dis>severe mental illness</dis> to screen and treat increased cardiovascular risk factors and diabetes.
Abstract Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed to an increased risk of the modifiable coronary heart disease risk factors, obesity, smoking, diabetes, hypertension, and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain and further increase the risk of adverse metabolic effects which may result in further increased incidence of cardiovascular disease. Patients have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non- psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement aiming to improve the care of patients suffering from severe mental illness. The intention is to initiate co-operation and shared care between the different health care professionals and to increase the awareness of psychiatrists caring for patients suffering from severe mental illness to screen and treat increased cardiovascular risk factors and diabetes.
The intention is to initiate co-operation and shared care between the different health care professionals and to increase the awareness of psychiatrists caring for patients suffering from <dis>severe mental illness</dis> to screen and treat increased cardiovascular risk factors and diabetes.
[ { "offsets": [ 188, 209 ], "text": "severe mental illness", "type": "DISABILITY" } ]
The predictive factors of the functional results are related with the severity of the injury, age of the child and prelesional circumstances. A rehabilitation program aimed at treating both the motor as well as neuropsychological sequels early should be established. In this paper, we approach cranioencephalic traumatism in the child and adolescent globally, analyzing the sequels and their treatment, and giving special attention to the repercussion of them on growth, due to the typical characteristics of age.
S0048712002733069
Cranioencephalic traumatism in the child and adolescent
Key words Cranioencephalic traumatism Infant Prognostic factors Neuropsychological sequels Disability
Summary Cranioencephalic traumatism is an important cause of morbidity-mortality between the infant and child population and a frequent cause of acquired disability in this population. In small children, it generally occurs due to falls, being hit by a car or bicycle accidents and in adolescents due to traffic accidents. The most common neurological complications are spacticity, <dis>ataxia</dis>, tremor and <dis>hemiparesis</dis>. Speech disorders, principally in form of <dis>expression deficits</dis> and performance of verbal response, can be observed. <dis>Neuropsychological disorders</dis> such as <dis>attention, memory and concentration deficits</dis> are frequent and <dis>behavior disorders</dis> such as apathy, lack of initiative, emotional lability, depression and aggresivity among others can be associated. In general, there is good motor recovery, however neuropsychological deficits generally persist for a prolonged time. The predictive factors of the functional results are related with the severity of the injury, age of the child and prelesional circumstances. A rehabilitation program aimed at treating both the motor as well as neuropsychological sequels early should be established. In this paper, we approach cranioencephalic traumatism in the child and adolescent globally, analyzing the sequels and their treatment, and giving special attention to the repercussion of them on growth, due to the typical characteristics of age.
Summary Cranioencephalic traumatism is an important cause of morbidity-mortality between the infant and child population and a frequent cause of acquired disability in this population. In small children, it generally occurs due to falls, being hit by a car or bicycle accidents and in adolescents due to traffic accidents. The most common neurological complications are spacticity, ataxia, tremor and hemiparesis. Speech disorders, principally in form of expression deficits and performance of verbal response, can be observed. Neuropsychological disorders such as attention, memory and concentration deficits are frequent and behavior disorders such as apathy, lack of initiative, emotional lability, depression and aggresivity among others can be associated. In general, there is good motor recovery, however neuropsychological deficits generally persist for a prolonged time. The predictive factors of the functional results are related with the severity of the injury, age of the child and prelesional circumstances. A rehabilitation program aimed at treating both the motor as well as neuropsychological sequels early should be established. In this paper, we approach cranioencephalic traumatism in the child and adolescent globally, analyzing the sequels and their treatment, and giving special attention to the repercussion of them on growth, due to the typical characteristics of age.
The predictive factors of the functional results are related with the severity of the injury, age of the child and prelesional circumstances. A rehabilitation program aimed at treating both the motor as well as neuropsychological sequels early should be established. In this paper, we approach cranioencephalic traumatism in the child and adolescent globally, analyzing the sequels and their treatment, and giving special attention to the repercussion of them on growth, due to the typical characteristics of age.
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Abstract Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value.
S1697260013700127
Prediction of treatment outcomes and longitudinal analysis in children with autism undergoing intensive behavioral intervention
Keywords Autism Predictors Applied behavior analysis Quasi-experiment (interrupted time-series with one group)
Abstract Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with <dis>autism spectrum disorder</dis>. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with <dis>autism</dis> underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.
Abstract Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with autism underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.
Abstract Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with <dis>autism spectrum disorder</dis>. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value.
[ { "offsets": [ 333, 357 ], "text": "autism spectrum disorder", "type": "DISABILITY" } ]
At one year he had signs of psychomotor retardation and hypotonia. The magnetic resonance revealed frontal-temporal atrophy and a decrease in the corpus callosum. Testicular biopsy was compatible with gonadal dysgenesis. A preoperative cystography showed a vaginal remnant.
S1695403309006821
Chromosome 9P deletion: Gonadal dysgenesis associated with mental retardation and hypoplasia of the corpus callosum: A contiguous gene syndrome?
Keywords Gonadal dysgenesis 9p deletion Mental retardation Corpus callosum Sexual differentiation DMRT1 and DMRT2
Abstract Background Many genes are involved in testicular differentiation. The alterations of these genes are responsible for sexual differentiation disorders with 46 XY karyotype. Case We report the case of a newborn who had an interscrotal hypospadias, palpable gonads and hypoplastic penis. Karyotype 46 XY. Abdominal ultrasound revealed testes and absence of Müllerian remnants. There was a good response to the short gonadotrophin test. At one year he had signs of <dis>psychomotor retardation</dis> and hypotonia. The magnetic resonance revealed frontal-temporal atrophy and a decrease in the corpus callosum. Testicular biopsy was compatible with gonadal dysgenesis. A preoperative cystography showed a vaginal remnant. Due to the presence of a sexual differentiation disorder, <dis>psychomotor retardation</dis> and facial dysmorphism, we requested a high-resolution karyotype: deletion 46, XY, del (9p) (p23-pter). Ish tel (9p-). Discussion Many genes are involved in testicular differentiation, some of which also affect the development of other tissues. In the short arm of chromosome 9, two genes, DMRT1 and DMRT2, are involved in sexual differentiation. Their alterations have also been described as causing <dis>mental retardation</dis>. In the evaluation of 46,XY disorders of sex differentiation, the accompanying signs are very important for guiding the genetic study.
Abstract Background Many genes are involved in testicular differentiation. The alterations of these genes are responsible for sexual differentiation disorders with 46 XY karyotype. Case We report the case of a newborn who had an interscrotal hypospadias, palpable gonads and hypoplastic penis. Karyotype 46 XY. Abdominal ultrasound revealed testes and absence of Müllerian remnants. There was a good response to the short gonadotrophin test. At one year he had signs of psychomotor retardation and hypotonia. The magnetic resonance revealed frontal-temporal atrophy and a decrease in the corpus callosum. Testicular biopsy was compatible with gonadal dysgenesis. A preoperative cystography showed a vaginal remnant. Due to the presence of a sexual differentiation disorder, psychomotor retardation and facial dysmorphism, we requested a high-resolution karyotype: deletion 46, XY, del (9p) (p23-pter). Ish tel (9p-). Discussion Many genes are involved in testicular differentiation, some of which also affect the development of other tissues. In the short arm of chromosome 9, two genes, DMRT1 and DMRT2, are involved in sexual differentiation. Their alterations have also been described as causing mental retardation. In the evaluation of 46,XY disorders of sex differentiation, the accompanying signs are very important for guiding the genetic study.
At one year he had signs of <dis>psychomotor retardation</dis> and hypotonia. The magnetic resonance revealed frontal-temporal atrophy and a decrease in the corpus callosum. Testicular biopsy was compatible with gonadal dysgenesis. A preoperative cystography showed a vaginal remnant.
[ { "offsets": [ 28, 51 ], "text": "psychomotor retardation", "type": "DISABILITY" } ]
Very advanced age, higher social precariousness and severe disability after discharge are associated with higher risk of institutionalization.
S0014256504715507
Variables associated with functional recovery and post-discharge institutionalization of elderly cared in an average stay geriatric unit
Key Words comprehensive geriatric assessment elderly rehabilitation outcomes prognosis
Basis . To describe the evolution and results of the rehabilitation of elderly disabled cared in an average stay geriatric unit, and to define the factors associated with functional improvement and post-discharge institutionalization. Patients and method . Observational longitudinal study in 459 patients with <dis>functional disability</dis> consecutively hospitalized between May 2000 and December 2001. Basal variables collected included the clinical, functional, mental, and sociodemographic manifestations previous to the admission. The favorable functional response (defined as a functional gain during the admission of ≥ 20 points in the Barthel index) and the post-discharge institutionalization were regarded the main result variables. Results . The average age of patients was 80.56 (SD:± 7.45) years, 64.9% were women and 81% came from acute hospital units; the main cause of disability was stroke (48.5%) followed by orthopedic pathology (26.2%) and immobility for different causes (23.5%). 72.5% of patients get functional improvement and 16.4% were institutionalized after the discharge. The main independent risk factors for poor functional response found in the multivariate analysis were a scoring in Pfeiffer's cognitive test of 5-7 points (OR: 0.42; 95% CI: 0,22-0.78) and ≥ 8 (OR: 0.29; 95% CI: 0.12-0.71), and a scoring in Barthel's index < 60 prior to the deterioration (OR: 0.36; 95% CI: 0.14-0.93). Independent risk factors for institutionalization after the discharge were age (OR: 1.06; 95% CI: 1.01-1.12), and a scoring in the Gijon's sociofamiliar scale ≥ 9 (OR: 6.83; 95% CI: 1.91-24.47). A <dis>functional disability</dis> after the discharge in the Barthel's index < 40 also was independently associated to post-discharge institutionalization (OR: 3,07; 95% CI: 1.04-10.06). Conclusions . Most of elderly with recent disability benefit functionally from care in specific hospital geriatric units. <dis>Moderate or severe cognitive deterioration</dis> after hospitalization is associated to lower recovery probability. Very advanced age, higher social precariousness and severe disability after discharge are associated with higher risk of institutionalization.
Basis . To describe the evolution and results of the rehabilitation of elderly disabled cared in an average stay geriatric unit, and to define the factors associated with functional improvement and post-discharge institutionalization. Patients and method . Observational longitudinal study in 459 patients with functional disability consecutively hospitalized between May 2000 and December 2001. Basal variables collected included the clinical, functional, mental, and sociodemographic manifestations previous to the admission. The favorable functional response (defined as a functional gain during the admission of ≥ 20 points in the Barthel index) and the post-discharge institutionalization were regarded the main result variables. Results . The average age of patients was 80.56 (SD:± 7.45) years, 64.9% were women and 81% came from acute hospital units; the main cause of disability was stroke (48.5%) followed by orthopedic pathology (26.2%) and immobility for different causes (23.5%). 72.5% of patients get functional improvement and 16.4% were institutionalized after the discharge. The main independent risk factors for poor functional response found in the multivariate analysis were a scoring in Pfeiffer's cognitive test of 5-7 points (OR: 0.42; 95% CI: 0,22-0.78) and ≥ 8 (OR: 0.29; 95% CI: 0.12-0.71), and a scoring in Barthel's index < 60 prior to the deterioration (OR: 0.36; 95% CI: 0.14-0.93). Independent risk factors for institutionalization after the discharge were age (OR: 1.06; 95% CI: 1.01-1.12), and a scoring in the Gijon's sociofamiliar scale ≥ 9 (OR: 6.83; 95% CI: 1.91-24.47). A functional disability after the discharge in the Barthel's index < 40 also was independently associated to post-discharge institutionalization (OR: 3,07; 95% CI: 1.04-10.06). Conclusions . Most of elderly with recent disability benefit functionally from care in specific hospital geriatric units. Moderate or severe cognitive deterioration after hospitalization is associated to lower recovery probability. Very advanced age, higher social precariousness and severe disability after discharge are associated with higher risk of institutionalization.
Very advanced age, higher social precariousness and severe disability after discharge are associated with higher risk of institutionalization.
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Results 12 patients were included (5 women) with ages of 62.4 ± 12.7 years (media ± DE), history of PD was14.2 ± 5.3 years, with Hoehn and Yahr stages within II and IV. UPDRS III score in OFF- medication of 73 ± 11.3.
S0185106314000468
Clinical experience in the Hospital Central Militar with bilateral deep brain stimulation of ventro-medial globus pallidus in patients with Parkinson's disease
Key words Deep brain stimulation Parkinson's disease Globus pallidus Neuromodulation
Abstract Deep brain electrical stimulation of the ventro-medial globus pallidus in Parkinson's disease (PD) is an alternative in the treatment of rigidity in advanced cases which do not response to conventional pharmacological treatment. Objective To measure the clinical changes and collateral effects of bilateral electric stimulation of the ventro-medial globus pallidus, in a sample of patients suffering from Parkinson's disease with predominance of rigidity. Methodology An auto-control study of direct assignation was carried out, open to evaluate the changes according to the Unified Parkinson Disease Rating Scale III (UPDRS III) in a basal period, within 6 and 12 months of follow up same as the collateral effect and the medicament doses. Results 12 patients were included (5 women) with ages of 62.4 ± 12.7 years (media ± DE), history of PD was14.2 ± 5.3 years, with Hoehn and Yahr stages within II and IV. UPDRS III score in OFF- medication of 73 ± 11.3. Beyond 6 months of follow up, a significant statistical change towards tremor, rigidity, bradykinesia, posture and gait, can be appreciated (p < 0.05). The best effect can be observed in the qualification of UPDRS III after implantation (35 to 38 delta points of the scale) and for stimulation particularly for bradykinesia (delta of 11 points). There were no significant changes in levodopa doses. The collateral effects such as phosphenes, contralateral paresthesias, deviation of labial commissure and <dis>dysarthria</dis>, were avoided with the adjustment of stimulation parameters during the surgery. Conclusion This study suggest that bilateral implantation of the ventro-medial globus pallidus is an efficient and safe method in patients PD with rigidity implanted in the Hospital Central Militar.
Abstract Deep brain electrical stimulation of the ventro-medial globus pallidus in Parkinson's disease (PD) is an alternative in the treatment of rigidity in advanced cases which do not response to conventional pharmacological treatment. Objective To measure the clinical changes and collateral effects of bilateral electric stimulation of the ventro-medial globus pallidus, in a sample of patients suffering from Parkinson's disease with predominance of rigidity. Methodology An auto-control study of direct assignation was carried out, open to evaluate the changes according to the Unified Parkinson Disease Rating Scale III (UPDRS III) in a basal period, within 6 and 12 months of follow up same as the collateral effect and the medicament doses. Results 12 patients were included (5 women) with ages of 62.4 ± 12.7 years (media ± DE), history of PD was14.2 ± 5.3 years, with Hoehn and Yahr stages within II and IV. UPDRS III score in OFF- medication of 73 ± 11.3. Beyond 6 months of follow up, a significant statistical change towards tremor, rigidity, bradykinesia, posture and gait, can be appreciated (p < 0.05). The best effect can be observed in the qualification of UPDRS III after implantation (35 to 38 delta points of the scale) and for stimulation particularly for bradykinesia (delta of 11 points). There were no significant changes in levodopa doses. The collateral effects such as phosphenes, contralateral paresthesias, deviation of labial commissure and dysarthria, were avoided with the adjustment of stimulation parameters during the surgery. Conclusion This study suggest that bilateral implantation of the ventro-medial globus pallidus is an efficient and safe method in patients PD with rigidity implanted in the Hospital Central Militar.
Results 12 patients were included (5 women) with ages of 62.4 ± 12.7 years (media ± DE), history of PD was14.2 ± 5.3 years, with Hoehn and Yahr stages within II and IV. UPDRS III score in OFF- medication of 73 ± 11.3.
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Intralabyrinthine schwannomas are uncommon tumours that arise from neural elements in distal branches of the 8th cranial nerve thus they are confined to or have arisen from the vestibule, the semi-circular canals, or the cochlea. The most common presenting symptom is progressive sensory neural hearing loss with or without tinnitus and vestibular symptoms. The diagnostic procedure of choice is gadolinium-enhanced magnetic resonance imaging. Most of these patients can be managed with observation.
S217357350770306X
Intra-Labyrinthine Schwannoma: Two-Cases Report
Key words Intralabyrinthine schwannoma Vestibular schwannoma Cochlear schwannoma Hearing loss Magnetic resonance imaging
Intralabyrinthine schwannomas are uncommon tumours that arise from neural elements in distal branches of the 8th cranial nerve thus they are confined to or have arisen from the vestibule, the semi-circular canals, or the cochlea. The most common presenting symptom is <dis>progressive sensory neural hearing loss with or without tinnitus and vestibular symptoms</dis>. The diagnostic procedure of choice is gadolinium-enhanced magnetic resonance imaging. Most of these patients can be managed with observation. The indications for surgery are limited. We present 2 patients with a diagnosis of intralabyrinthine schwannoma. A discussion of the management of the intralabyrinthine schwannoma follows.
Intralabyrinthine schwannomas are uncommon tumours that arise from neural elements in distal branches of the 8th cranial nerve thus they are confined to or have arisen from the vestibule, the semi-circular canals, or the cochlea. The most common presenting symptom is progressive sensory neural hearing loss with or without tinnitus and vestibular symptoms. The diagnostic procedure of choice is gadolinium-enhanced magnetic resonance imaging. Most of these patients can be managed with observation. The indications for surgery are limited. We present 2 patients with a diagnosis of intralabyrinthine schwannoma. A discussion of the management of the intralabyrinthine schwannoma follows.
Intralabyrinthine schwannomas are uncommon tumours that arise from neural elements in distal branches of the 8th cranial nerve thus they are confined to or have arisen from the vestibule, the semi-circular canals, or the cochlea. The most common presenting symptom is <dis>progressive sensory neural hearing loss with or without tinnitus and vestibular symptoms</dis>. The diagnostic procedure of choice is gadolinium-enhanced magnetic resonance imaging. Most of these patients can be managed with observation.
[ { "offsets": [ 268, 356 ], "text": "progressive sensory neural hearing loss with or without tinnitus and vestibular symptoms", "type": "DISABILITY" } ]
The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMHCIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. Results 19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime- prevalence) and 8.4% in the last 12 months (12 month- prevalence).
S0025775306719698
Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study
Key words Epidemiology Mental disorders Europe Age of onset Depressive disorders Anxiety disorders
Background and objective The ESEMeD-Spain project is an epidemiological study about <dis>mental disorders</dis> in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders. Subjects and method Cross-sectional household survey of a representative sample of the population of Spain 18 years or older. Sample size was 5.473 individuals. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMHCIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. Results 19.5% of the individuals presented a <dis>mental disorder</dis> sometime in their lifetime (lifetime- prevalence) and 8.4% in the last 12 months (12 month- prevalence). The most frequent <dis>mental disorder</dis> was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime- prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and disthymia. Factors associated to presenting a <dis>mental disorder</dis> were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life. Conclusions The ESEMeD-Spain study can provide careful outcomes to understand the impact of <dis>mental disorders</dis> in Spain.
Background and objective The ESEMeD-Spain project is an epidemiological study about mental disorders in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders. Subjects and method Cross-sectional household survey of a representative sample of the population of Spain 18 years or older. Sample size was 5.473 individuals. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMHCIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. Results 19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime- prevalence) and 8.4% in the last 12 months (12 month- prevalence). The most frequent mental disorder was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime- prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and disthymia. Factors associated to presenting a mental disorder were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life. Conclusions The ESEMeD-Spain study can provide careful outcomes to understand the impact of mental disorders in Spain.
The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMHCIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain. Results 19.5% of the individuals presented a <dis>mental disorder</dis> sometime in their lifetime (lifetime- prevalence) and 8.4% in the last 12 months (12 month- prevalence).
[ { "offsets": [ 261, 276 ], "text": "mental disorder", "type": "DISABILITY" } ]
Conclusions The results suggest that elaboration of positive and negative autobiographical memories, stimulation of instrumental and integrative reminiscences and narration of specific and positive autobiographical memories using the reminiscence program, as designed and analyzed in this study, may be a tool for psychological intervention to reduce depressive symptomatology in old age.
S0211139X09001334
Effects of a reminiscence program on depressive symptomatology in an elderly population in Portugal
Keywords Depressive symptomatology Autobiographical memory Instrumental reminiscence Integrative Reminiscence
Abstract Introduction This study analyzed the effectiveness of an individual, delimited, semi- structured reminiscence program as an intervention strategy to reduce depressive symptomatology in a population of Portuguese old people. Material and methods A semi-structured reminiscence program was developed in 5 individual sessions. The program's impact on depressive symptomatology was tested in 90 subjects aged over 65 years with depressive symptoms, no antidepressive medication, and <scp><neg>no</neg> signs of <dis>dementia</dis></scp>. In a randomized experimental design, participants were assigned to one of 3 groups: _a)_ experimental group (exposed to the program); _b)_ control group, or _c)_ placebo-control group (with weekly relaxation sessions). Pre and post-test score differences in Center for Epidemiologic Studies Depression Scale (CES-D) (adapted by Gonçalves and Fagulha, 2000-2001, from the original developed by Radloff, 1977), were analyzed in all participants at the same time intervals. Results In the experimental group, significant improvements were found in depressive symptomatology (t [29]=19.70, _p_ <0.01); the mean values decreased from 39.87 (standard deviation [SD]=7.90) to 13.60 (SD=5.14). In the control group, a significant increase in depressive symptomatology was observed (z=−2.83; _p_ <0.001); the mean values rose from 30.93 (SD=7.07) to 34.10 (SD=8.76). In the placebo-control group, depressive symptomatology was reduced (t [29]=2,52; _p_ <0.05) from 33.967 (SD=7.37) to 30.57 (SD=9.94), although the difference was less significant than that observed in the experimental group. Conclusions The results suggest that elaboration of positive and negative autobiographical memories, stimulation of instrumental and integrative reminiscences and narration of specific and positive autobiographical memories using the reminiscence program, as designed and analyzed in this study, may be a tool for psychological intervention to reduce depressive symptomatology in old age.
Abstract Introduction This study analyzed the effectiveness of an individual, delimited, semi- structured reminiscence program as an intervention strategy to reduce depressive symptomatology in a population of Portuguese old people. Material and methods A semi-structured reminiscence program was developed in 5 individual sessions. The program's impact on depressive symptomatology was tested in 90 subjects aged over 65 years with depressive symptoms, no antidepressive medication, and no signs of dementia. In a randomized experimental design, participants were assigned to one of 3 groups: _a)_ experimental group (exposed to the program); _b)_ control group, or _c)_ placebo-control group (with weekly relaxation sessions). Pre and post-test score differences in Center for Epidemiologic Studies Depression Scale (CES-D) (adapted by Gonçalves and Fagulha, 2000-2001, from the original developed by Radloff, 1977), were analyzed in all participants at the same time intervals. Results In the experimental group, significant improvements were found in depressive symptomatology (t [29]=19.70, _p_ <0.01); the mean values decreased from 39.87 (standard deviation [SD]=7.90) to 13.60 (SD=5.14). In the control group, a significant increase in depressive symptomatology was observed (z=−2.83; _p_ <0.001); the mean values rose from 30.93 (SD=7.07) to 34.10 (SD=8.76). In the placebo-control group, depressive symptomatology was reduced (t [29]=2,52; _p_ <0.05) from 33.967 (SD=7.37) to 30.57 (SD=9.94), although the difference was less significant than that observed in the experimental group. Conclusions The results suggest that elaboration of positive and negative autobiographical memories, stimulation of instrumental and integrative reminiscences and narration of specific and positive autobiographical memories using the reminiscence program, as designed and analyzed in this study, may be a tool for psychological intervention to reduce depressive symptomatology in old age.
Conclusions The results suggest that elaboration of positive and negative autobiographical memories, stimulation of instrumental and integrative reminiscences and narration of specific and positive autobiographical memories using the reminiscence program, as designed and analyzed in this study, may be a tool for psychological intervention to reduce depressive symptomatology in old age.
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Factors such as diabetes, hyperinsulinemia, overweight or obesity, metabolic syndrome, education, physical activity, cognitive stimulation, marital status and diet, could be related to cognitive decline before 65 years of age. Conclusions Cardiovascular risk factors and lifestyle conditions may be associated with cognitive decline before 65 years of age. However, the quality of the evidence was low.
S0034745014000250
Factors Associated with Cognitive Decline in a Population Less than 65 Years Old. A Systematic Review
Keywords Cognitive decline Risk factors Dementia Systematic review
Abstract Introduction <dis>Cognitive decline</dis> could begin 20 years before the diagnosis of <dis>dementia</dis>. Besides age, several factors related to medical, socioeconomic, and behavioral and genetic condition may be associated with <dis>cognitive decline</dis>. The aim of this systematic review was to summarize evidence on the risk and protective factors for <dis>cognitive decline</dis> in people under 65 years old. Methods A systematic review was conducted using a search strategy in MEDLINE and Embase, including longitudinal studies to analyze the effect of protective or risk factors on <dis>cognitive decline</dis> in a population under 65 years old. Results A total of 22 studies were included in this review. Factors such as diabetes, hyperinsulinemia, overweight or obesity, metabolic syndrome, education, physical activity, cognitive stimulation, marital status and diet, could be related to <dis>cognitive decline</dis> before 65 years of age. Conclusions Cardiovascular risk factors and lifestyle conditions may be associated with <dis>cognitive decline</dis> before 65 years of age. However, the quality of the evidence was low.
Abstract Introduction Cognitive decline could begin 20 years before the diagnosis of dementia. Besides age, several factors related to medical, socioeconomic, and behavioral and genetic condition may be associated with cognitive decline. The aim of this systematic review was to summarize evidence on the risk and protective factors for cognitive decline in people under 65 years old. Methods A systematic review was conducted using a search strategy in MEDLINE and Embase, including longitudinal studies to analyze the effect of protective or risk factors on cognitive decline in a population under 65 years old. Results A total of 22 studies were included in this review. Factors such as diabetes, hyperinsulinemia, overweight or obesity, metabolic syndrome, education, physical activity, cognitive stimulation, marital status and diet, could be related to cognitive decline before 65 years of age. Conclusions Cardiovascular risk factors and lifestyle conditions may be associated with cognitive decline before 65 years of age. However, the quality of the evidence was low.
Factors such as diabetes, hyperinsulinemia, overweight or obesity, metabolic syndrome, education, physical activity, cognitive stimulation, marital status and diet, could be related to <dis>cognitive decline</dis> before 65 years of age. Conclusions Cardiovascular risk factors and lifestyle conditions may be associated with <dis>cognitive decline</dis> before 65 years of age. However, the quality of the evidence was low.
[ { "offsets": [ 185, 202 ], "text": "cognitive decline", "type": "DISABILITY" }, { "offsets": [ 315, 332 ], "text": "cognitive decline", "type": "DISABILITY" } ]
The definition of the negative response of the full field electroretinogram is the presence of a b-wave with less amplitude than the a-wave (b/a ratio<1) in the combined response of cones and rods. The presence of this pattern reflects an alteration in the bipolar cells, the Müller cells, or in the transmission of the stimulus from the photoreceptors to the bipolar cells, with preserved photoreceptor function.
S0365669117302939
The diagnostic usefulness of the negative electroretinogram
Keywords Birdshot chorioretinopathy Congenital stationary night blindness Electroretinography Ocular paraneoplastic syndromes Retinoschisis
The definition of the negative response of the full field electroretinogram is the presence of a b-wave with less amplitude than the a-wave (b/a ratio<1) in the combined response of cones and rods. The presence of this pattern reflects an alteration in the bipolar cells, the Müller cells, or in the transmission of the stimulus from the photoreceptors to the bipolar cells, with preserved photoreceptor function. This finding can be seen bilaterally and symmetrically in different hereditary conditions, such as <dis>congenital stationary night blindness</dis>, juvenile X-linked retinoschisis, and Duchenne and Becker muscular dystrophies. On the other hand, it can also be found unilaterally (or asymmetrically) in acquired pathologies, such as some types of immuno-mediated retinitis (Birdshot retinochoroiditis), autoimmune retinopathies, cancer/melanoma associated retinopathy, or retinal toxicity. The objective of this review is to summarise the characteristics of the pathologies in which this finding can be observed, in order to highlight its usefulness in the differential diagnosis of retinal conditions.
The definition of the negative response of the full field electroretinogram is the presence of a b-wave with less amplitude than the a-wave (b/a ratio<1) in the combined response of cones and rods. The presence of this pattern reflects an alteration in the bipolar cells, the Müller cells, or in the transmission of the stimulus from the photoreceptors to the bipolar cells, with preserved photoreceptor function. This finding can be seen bilaterally and symmetrically in different hereditary conditions, such as congenital stationary night blindness, juvenile X-linked retinoschisis, and Duchenne and Becker muscular dystrophies. On the other hand, it can also be found unilaterally (or asymmetrically) in acquired pathologies, such as some types of immuno-mediated retinitis (Birdshot retinochoroiditis), autoimmune retinopathies, cancer/melanoma associated retinopathy, or retinal toxicity. The objective of this review is to summarise the characteristics of the pathologies in which this finding can be observed, in order to highlight its usefulness in the differential diagnosis of retinal conditions.
The definition of the negative response of the full field electroretinogram is the presence of a b-wave with less amplitude than the a-wave (b/a ratio<1) in the combined response of cones and rods. The presence of this pattern reflects an alteration in the bipolar cells, the Müller cells, or in the transmission of the stimulus from the photoreceptors to the bipolar cells, with preserved photoreceptor function.
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The issues included are obesity and its consequences, cardiovascular risk factors and diabetes, respiratory abnormalities, sleep disorders, hypogonadism, osteoporosis, and behavioral and psychiatric disorders.
S1575092206710865
Overall management of prader-willi syndrome in adulthood
Key words PWS Prader-Willi syndrome Adulthood
Prader-Willi Syndrome (PWS) is a genetic disorder with features that change with age. In infancy, PWS is characterized by hypotonia, <dis>feeding difficulties</dis>, <dis>developmental delay</dis>, and genital hypoplasia. In adolescence and adulthood, problems are centered on <dis>behavioral disorders</dis>, absence of satiety, and <dis>mild to moderate mental retardation</dis>. In the past two decades remarkable progress has been made in the understanding of its clinical manifestations and natural history, and treatments have been developed, such as growth hormone therapy and the use of psychoactive drugs, which can improve quality of life in these patients. However, knowledge about the management of PWS in adulthood is still poor. This article aims to provide an overall view of the most important clinical problems in adults with PWS. The issues included are obesity and its consequences, cardiovascular risk factors and diabetes, respiratory abnormalities, <dis>sleep disorders</dis>, hypogonadism, osteoporosis, and <dis>behavioral and psychiatric disorders</dis>.
Prader-Willi Syndrome (PWS) is a genetic disorder with features that change with age. In infancy, PWS is characterized by hypotonia, feeding difficulties, developmental delay, and genital hypoplasia. In adolescence and adulthood, problems are centered on behavioral disorders, absence of satiety, and mild to moderate mental retardation. In the past two decades remarkable progress has been made in the understanding of its clinical manifestations and natural history, and treatments have been developed, such as growth hormone therapy and the use of psychoactive drugs, which can improve quality of life in these patients. However, knowledge about the management of PWS in adulthood is still poor. This article aims to provide an overall view of the most important clinical problems in adults with PWS. The issues included are obesity and its consequences, cardiovascular risk factors and diabetes, respiratory abnormalities, sleep disorders, hypogonadism, osteoporosis, and behavioral and psychiatric disorders.
The issues included are obesity and its consequences, cardiovascular risk factors and diabetes, respiratory abnormalities, <dis>sleep disorders</dis>, hypogonadism, osteoporosis, and <dis>behavioral and psychiatric disorders</dis>.
[ { "offsets": [ 123, 138 ], "text": "sleep disorders", "type": "DISABILITY" }, { "offsets": [ 172, 208 ], "text": "behavioral and psychiatric disorders", "type": "DISABILITY" } ]
Results showed that all subjects presented at least one progress index and that 96% of them presented progress in the Functional Communicative Profile. These results suggest that it is possible to identify objective improvement indexes after a relatively short period of language therapy with individuals of the autism spectrum. Objective information about therapeutic results may favor better integration of intervention procedures and therefore enhance the possibilities of further improvements.
S0214460312000058
Language therapy results with children of the autism spectrum
Keywords Autism Communication Language therapy Speech-language pathology
Abstract <dis>Communication disorders</dis> of children with <dis>autism spectrum disorders</dis> will probably follow them throughout life if they are not included in remediation and communication intervention programs. The aim of this research was to identify observed changes in the Functional Communicative Profile (initiative, interaction, functions and means) and in the Social Cognitive Performance (vocal and gestural communicative intent, vocal and gestural imitation, tool use, combinatory and symbolic play) after 6 months of language therapy. Subjects were 50 children and adolescents (mean age 9:3y), with diagnosis within the <dis>autistic spectrum</dis> attributed by a child psychiatrist, enrolled in a specialized language therapy program at the University of Sao Paulo, Brazil. All subjects were filmed twice, with a six-month interval, after the first six-months of the therapy onset. Statistical analysis of data used non- parametric tests with a significance level of 0.5%. Results showed that all subjects presented at least one progress index and that 96% of them presented progress in the Functional Communicative Profile. These results suggest that it is possible to identify objective improvement indexes after a relatively short period of language therapy with individuals of the <dis>autism spectrum</dis>. Objective information about therapeutic results may favor better integration of intervention procedures and therefore enhance the possibilities of further improvements.
Abstract Communication disorders of children with autism spectrum disorders will probably follow them throughout life if they are not included in remediation and communication intervention programs. The aim of this research was to identify observed changes in the Functional Communicative Profile (initiative, interaction, functions and means) and in the Social Cognitive Performance (vocal and gestural communicative intent, vocal and gestural imitation, tool use, combinatory and symbolic play) after 6 months of language therapy. Subjects were 50 children and adolescents (mean age 9:3y), with diagnosis within the autistic spectrum attributed by a child psychiatrist, enrolled in a specialized language therapy program at the University of Sao Paulo, Brazil. All subjects were filmed twice, with a six-month interval, after the first six-months of the therapy onset. Statistical analysis of data used non- parametric tests with a significance level of 0.5%. Results showed that all subjects presented at least one progress index and that 96% of them presented progress in the Functional Communicative Profile. These results suggest that it is possible to identify objective improvement indexes after a relatively short period of language therapy with individuals of the autism spectrum. Objective information about therapeutic results may favor better integration of intervention procedures and therefore enhance the possibilities of further improvements.
Results showed that all subjects presented at least one progress index and that 96% of them presented progress in the Functional Communicative Profile. These results suggest that it is possible to identify objective improvement indexes after a relatively short period of language therapy with individuals of the <dis>autism spectrum</dis>. Objective information about therapeutic results may favor better integration of intervention procedures and therefore enhance the possibilities of further improvements.
[ { "offsets": [ 312, 327 ], "text": "autism spectrum", "type": "DISABILITY" } ]
Abstract Introduction and objective To determine the clinical and audiological behaviour per age group in Sjögren's Syndrome (SS), considering that it is the second most frequent autoimmune rheumatic disease. Material and method The study included 29 patients with SS with clinical history and audiological studies. The design was prospective, descriptive and transversal. Results Average patient age was 41 years. All the patients with hearing loss in conventional tone audiometry were of the sensory type.
S2173573510700612
Sjögren's syndrome: Audiological and clinical behaviour in terms of age
Keywords Sjögren's syndrome Hyperacusis Auditory damage Audiometry High frequencies
Abstract Introduction and objective To determine the clinical and audiological behaviour per age group in Sjögren's Syndrome (SS), considering that it is the second most frequent autoimmune rheumatic disease. Material and method The study included 29 patients with SS with clinical history and audiological studies. The design was prospective, descriptive and transversal. Results Average patient age was 41 years. All the patients with <dis>hearing loss</dis> in conventional tone audiometry were of the sensory type. At high frequencies, 66% of the patients did not respond at 20 KHz, and 48% at the frequency of 16 KHz. In logoaudiometry and impedancemetry, the results were the ones expected for the auditory thresholds. Conclusions Auditory damage related to SS is located in the inner ear. Patients must be informed by their physician of the risk of having auditory damage as a complication of the disease. Audiological evaluation must be performed periodically to identify possible audiological damage.
Abstract Introduction and objective To determine the clinical and audiological behaviour per age group in Sjögren's Syndrome (SS), considering that it is the second most frequent autoimmune rheumatic disease. Material and method The study included 29 patients with SS with clinical history and audiological studies. The design was prospective, descriptive and transversal. Results Average patient age was 41 years. All the patients with hearing loss in conventional tone audiometry were of the sensory type. At high frequencies, 66% of the patients did not respond at 20 KHz, and 48% at the frequency of 16 KHz. In logoaudiometry and impedancemetry, the results were the ones expected for the auditory thresholds. Conclusions Auditory damage related to SS is located in the inner ear. Patients must be informed by their physician of the risk of having auditory damage as a complication of the disease. Audiological evaluation must be performed periodically to identify possible audiological damage.
Abstract Introduction and objective To determine the clinical and audiological behaviour per age group in Sjögren's Syndrome (SS), considering that it is the second most frequent autoimmune rheumatic disease. Material and method The study included 29 patients with SS with clinical history and audiological studies. The design was prospective, descriptive and transversal. Results Average patient age was 41 years. All the patients with <dis>hearing loss</dis> in conventional tone audiometry were of the sensory type.
[ { "offsets": [ 438, 450 ], "text": "hearing loss", "type": "DISABILITY" } ]
Introduction Gait impairment, a frequent sign in multiple sclerosis (MS), places a major burden on patients since it results in progressive loss of personal and social autonomy, along with work productivity. This guide aims to provide recommendations on how to evaluate gait impairment and use prolonged-release fampridine (PR-fampridine) as treatment for MS patients with gait impairment in Spain.
S0213485315002698
A guide to treating gait impairment with prolonged-release fampridine (Fampyra®) in patients with multiple sclerosis
Keywords Fampridine Gait impairment Quality of life Multiple sclerosis T25FW MSWS-12
Introduction <dis>Gait impairment</dis>, a frequent sign in multiple sclerosis (MS), places a major burden on patients since it results in <dis>progressive loss of personal and social autonomy, along with work productivity</dis>. This guide aims to provide recommendations on how to evaluate <dis>gait impairment</dis> and use prolonged-release fampridine (PR-fampridine) as treatment for MS patients with <dis>gait impairment</dis> in Spain. Development PR-fampridine dosed at 10mg every 12hours is currently the only drug approved to treat <dis>gait impairment</dis> in adults with MS. Additionally, PR-fampridine has been shown in clinical practice to significantly improve quality of life (QoL) in patients who respond to treatment. Treatment response can be assessed with the Timed 25-Foot Walk (T25FW) or the 12-item MS Walking Scale (MSWS-12); tests should be completed before and after starting treatment. The minimum time recommended for evaluating treatment response is 2 weeks after treatment onset. Patients are considered responders and permitted to continue the treatment when they demonstrate a decrease in their T25FW time or an increase in MSWS-12 scores. A re-evaluation is recommended at least every 6 months. The SF-36 (Short Form-36) and the MSIS-29 (MS Impact Scale-29) tests are recommended for clinicians interested in performing a detailed QoL assessment. This drug is generally well-tolerated and has a good safety profile. It should be taken on an empty stomach and renal function must be monitored regularly. Conclusions These recommendations will help ensure safer and more efficient prescription practices and easier management of PR-fampridine as treatment for <dis>gait impairment</dis> in Spanish adults with MS.
Introduction Gait impairment, a frequent sign in multiple sclerosis (MS), places a major burden on patients since it results in progressive loss of personal and social autonomy, along with work productivity. This guide aims to provide recommendations on how to evaluate gait impairment and use prolonged-release fampridine (PR-fampridine) as treatment for MS patients with gait impairment in Spain. Development PR-fampridine dosed at 10mg every 12hours is currently the only drug approved to treat gait impairment in adults with MS. Additionally, PR-fampridine has been shown in clinical practice to significantly improve quality of life (QoL) in patients who respond to treatment. Treatment response can be assessed with the Timed 25-Foot Walk (T25FW) or the 12-item MS Walking Scale (MSWS-12); tests should be completed before and after starting treatment. The minimum time recommended for evaluating treatment response is 2 weeks after treatment onset. Patients are considered responders and permitted to continue the treatment when they demonstrate a decrease in their T25FW time or an increase in MSWS-12 scores. A re-evaluation is recommended at least every 6 months. The SF-36 (Short Form-36) and the MSIS-29 (MS Impact Scale-29) tests are recommended for clinicians interested in performing a detailed QoL assessment. This drug is generally well-tolerated and has a good safety profile. It should be taken on an empty stomach and renal function must be monitored regularly. Conclusions These recommendations will help ensure safer and more efficient prescription practices and easier management of PR-fampridine as treatment for gait impairment in Spanish adults with MS.
Introduction <dis>Gait impairment</dis>, a frequent sign in multiple sclerosis (MS), places a major burden on patients since it results in <dis>progressive loss of personal and social autonomy, along with work productivity</dis>. This guide aims to provide recommendations on how to evaluate <dis>gait impairment</dis> and use prolonged-release fampridine (PR-fampridine) as treatment for MS patients with <dis>gait impairment</dis> in Spain.
[ { "offsets": [ 13, 28 ], "text": "Gait impairment", "type": "DISABILITY" }, { "offsets": [ 128, 206 ], "text": "progressive loss of personal and social autonomy, along with work productivity", "type": "DISABILITY" }, { "offsets": [ 270, 285 ], "text": "gait impairment", "type": "DISABILITY" }, { "offsets": [ 373, 388 ], "text": "gait impairment", "type": "DISABILITY" } ]
Abstract Objective to verify if cognitive impairment can affect the total score obtained on the Freezing of Gait score (FOG-score) test in patients with Parkinson's disease (PD). Material and method A sectional, correlational non-exploratory study was carried out on thirty- four subjects, with mild to moderate PD disease.
S0211563816300748
Influence of the cognitive impairment on the fog-score test: A pilot study
Keywords Parkinson's disease Gait Cognitive impairment Neuropsychological tests
Abstract Objective to verify if <dis>cognitive impairment</dis> can affect the total score obtained on the Freezing of Gait score (FOG-score) test in patients with Parkinson's disease (PD). Material and method A sectional, correlational non-exploratory study was carried out on thirty- four subjects, with mild to moderate PD disease. The participants carried out the FOG-score test and cognitive evaluation: the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) and the Fuld Object Memory Evaluation (FOME). Motor function was assessed by the motor subscale of Unified Parkinson's Disease Rating Scale (UPDRS) (part III). Results there was a significant negative correlation between the FOG-score test and global cognition (MMSE) (r = .68; p < .001), memory-related parameters (FOME) (r = .64; _P_ < .001) and executive functions (FAB) (r = .57; _P_ < .001). The motor scores held lower relation with FOG parameters (r = .35; _P_ > .005). Conclusions the results of this study suggest that <dis>cognitive impairment</dis> can strongly affect task performance of the FOG-score test. This suggests the need to adjust the cut-off point when assessing PD patients suffering from <dis>cognitive dysfunction</dis>. This could prevent the examiner from overestimating the existence and recurrence of freezing episodes in this population.
Abstract Objective to verify if cognitive impairment can affect the total score obtained on the Freezing of Gait score (FOG-score) test in patients with Parkinson's disease (PD). Material and method A sectional, correlational non-exploratory study was carried out on thirty- four subjects, with mild to moderate PD disease. The participants carried out the FOG-score test and cognitive evaluation: the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) and the Fuld Object Memory Evaluation (FOME). Motor function was assessed by the motor subscale of Unified Parkinson's Disease Rating Scale (UPDRS) (part III). Results there was a significant negative correlation between the FOG-score test and global cognition (MMSE) (r = .68; p < .001), memory-related parameters (FOME) (r = .64; _P_ < .001) and executive functions (FAB) (r = .57; _P_ < .001). The motor scores held lower relation with FOG parameters (r = .35; _P_ > .005). Conclusions the results of this study suggest that cognitive impairment can strongly affect task performance of the FOG-score test. This suggests the need to adjust the cut-off point when assessing PD patients suffering from cognitive dysfunction. This could prevent the examiner from overestimating the existence and recurrence of freezing episodes in this population.
Abstract Objective to verify if <dis>cognitive impairment</dis> can affect the total score obtained on the Freezing of Gait score (FOG-score) test in patients with Parkinson's disease (PD). Material and method A sectional, correlational non-exploratory study was carried out on thirty- four subjects, with mild to moderate PD disease.
[ { "offsets": [ 33, 53 ], "text": "cognitive impairment", "type": "DISABILITY" } ]
In patients with bipolar disorder transportation and communication Sp-UPSA subscales entered first and second at p < 0.0001 (R2 = 0.87, model df = 2, F = 132.32). Cronbach's _alpha_ was 0.78 in schizophrenia and 0.64 in bipolar patients. Test-retest was 0.66 and 0.64 (p < 0.0001) respectively.
S1888989114000597
Development of the Spanish Brief-version of the University of California Performance Skills Assessment (Sp-UPSA-Brief) in patients with schizophrenia and bipolar disorder
Keywords Sp-UPSA-Brief Functional capacity Psychometric properties Schizophrenia Bipolar disorder
Abstract Introduction In patients with <dis>severe mental disorders</dis> outcome measurement should include symptoms, cognition, functioning and quality of life at least. Shorter and efficient instruments have greater potential for pragmatic and valid clinical utility. Our aim was to develop the Spanish UPSA Brief scale (Sp-UPSA-Brief). Material and methods Naturalistic, 6-month follow-up, multicentre study. 139 patients with schizophrenia, 57 with bipolar disorder and 31 controls were evaluated using the Sp-UPSA, CGI-S, GAF, and PSP. We conducted a multivariate linear regression model to identify candidate subscales for the Sp-UPSA-Brief. Results The stepwise regression model for patients with schizophrenia showed that communication and transportation Sp-UPSA subscales entered first and second at p < 0.0001 (R2 = 0.88, model _df_ = 2, F = 395.05). In patients with bipolar disorder transportation and communication Sp-UPSA subscales entered first and second at p < 0.0001 (R2 = 0.87, model df = 2, F = 132.32). Cronbach's _alpha_ was 0.78 in schizophrenia and 0.64 in bipolar patients. Test-retest was 0.66 and 0.64 (p < 0.0001) respectively. Pearson correlation coefficients between Sp-UPSA and Sp-UPSA-Brief were 0.93 for schizophrenia and 0.92 for bipolar patients (p < 0.0001). The Sp-UPSA-Brief discriminated between patients and controls. In schizophrenia patients it also discriminated among different levels of illness severity according to CGI-S scores. Conclusion The Sp-UPSA-Brief is an alternate instrument to evaluate functional capacity that is valid and reliable. Having a shorter instrument makes it more feasible to assess functional capacity in patients with <dis>severe mental disorders</dis>, especially in everyday clinical practice.
Abstract Introduction In patients with severe mental disorders outcome measurement should include symptoms, cognition, functioning and quality of life at least. Shorter and efficient instruments have greater potential for pragmatic and valid clinical utility. Our aim was to develop the Spanish UPSA Brief scale (Sp-UPSA-Brief). Material and methods Naturalistic, 6-month follow-up, multicentre study. 139 patients with schizophrenia, 57 with bipolar disorder and 31 controls were evaluated using the Sp-UPSA, CGI-S, GAF, and PSP. We conducted a multivariate linear regression model to identify candidate subscales for the Sp-UPSA-Brief. Results The stepwise regression model for patients with schizophrenia showed that communication and transportation Sp-UPSA subscales entered first and second at p < 0.0001 (R2 = 0.88, model _df_ = 2, F = 395.05). In patients with bipolar disorder transportation and communication Sp-UPSA subscales entered first and second at p < 0.0001 (R2 = 0.87, model df = 2, F = 132.32). Cronbach's _alpha_ was 0.78 in schizophrenia and 0.64 in bipolar patients. Test-retest was 0.66 and 0.64 (p < 0.0001) respectively. Pearson correlation coefficients between Sp-UPSA and Sp-UPSA-Brief were 0.93 for schizophrenia and 0.92 for bipolar patients (p < 0.0001). The Sp-UPSA-Brief discriminated between patients and controls. In schizophrenia patients it also discriminated among different levels of illness severity according to CGI-S scores. Conclusion The Sp-UPSA-Brief is an alternate instrument to evaluate functional capacity that is valid and reliable. Having a shorter instrument makes it more feasible to assess functional capacity in patients with severe mental disorders, especially in everyday clinical practice.
In patients with bipolar disorder transportation and communication Sp-UPSA subscales entered first and second at p < 0.0001 (R2 = 0.87, model df = 2, F = 132.32). Cronbach's _alpha_ was 0.78 in schizophrenia and 0.64 in bipolar patients. Test-retest was 0.66 and 0.64 (p < 0.0001) respectively.
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In order to differentiate among the different types of cognitive impairment, the alterations in imaging and spectroscopy findings were graded from 0 to 4, as was the mean combination of the two, and then ROC curves were obtained.
S0033833806751396
Cognitive impairment: classification by proton magnetic resonance spectroscopy and the contributions of conventional magnetic resonance imaging
Key words mild cognitive impairment magnetic resonance image magnetic resonance in vivo spectroscopy Alzheimer's disease vascular dementia
Objective To analyze the diagnostic accuracy of protón magnetic resonance spectroscopy (1H MRS) in patients with <dis>cognitive impairment</dis> and to establish the usefulness of complementary information provided by conventional magnetic resonance imaging (MRI). Material and methods 64 patients with <dis>cognitive impairment</dis>, including Alzheimer's disease (AD) (n=31), <dis>vascular dementia</dis> (n=6), <dis>mild cognitive impairment</dis> (<dis>MCI</dis>) (n=9), and major depression (n=18), were studied. All patients underwent cerebral MRI and single-volume 1H MRS using two echo times (TE, 31 and 136 ms) in the posterior cingulate gyrus and right temporal lobe. The metabolites analyzed were N-acetylaspartate (NAA), myo-Inositol (mi), choline (Ch), and ere-atine (Cr), and the ratios of Ch/Cr, mI/Cr, NAA/mIand NAA/Cr were calculated. In order to differentiate among the different types of <dis>cognitive impairment</dis>, the alterations in imaging and spectroscopy findings were graded from 0 to 4, as was the mean combination of the two, and then ROC curves were obtained. Results Statistically significant differences were found between the spectra of patients with <dis>dementia</dis> (AD and <dis>vascular dementia</dis>) and those <scp><neg>without</neg> <dis>dementia</dis> (<dis>MCI</dis> and depression) in the posterior cingulate gyrus</scp>. The NAA/ml ratio yielded the best área under the ROC curve, with the best sensitivity (82.5%) and specificity (72.7%) in the diagnosis of AD. The NAA/mI and ml/Cr quotients differentiated between the four degenerative pathologies causing the <dis>cognitive impairment</dis>. The combination of MRI and 1H MRS significantly improved the accuracy of the diagnosis of AD. Conclusions The metabolic differences found among patients with <dis>cognitive impairment</dis> using 1H MRS can be useful for differentiating AD, <dis>vascular dementia</dis>, <dis>MCI</dis>, and depression. The combination of spectroscopy and MRI findings is useful in the diagnosis of AD.
Objective To analyze the diagnostic accuracy of protón magnetic resonance spectroscopy (1H MRS) in patients with cognitive impairment and to establish the usefulness of complementary information provided by conventional magnetic resonance imaging (MRI). Material and methods 64 patients with cognitive impairment, including Alzheimer's disease (AD) (n=31), vascular dementia (n=6), mild cognitive impairment (MCI) (n=9), and major depression (n=18), were studied. All patients underwent cerebral MRI and single-volume 1H MRS using two echo times (TE, 31 and 136 ms) in the posterior cingulate gyrus and right temporal lobe. The metabolites analyzed were N-acetylaspartate (NAA), myo-Inositol (mi), choline (Ch), and ere-atine (Cr), and the ratios of Ch/Cr, mI/Cr, NAA/mIand NAA/Cr were calculated. In order to differentiate among the different types of cognitive impairment, the alterations in imaging and spectroscopy findings were graded from 0 to 4, as was the mean combination of the two, and then ROC curves were obtained. Results Statistically significant differences were found between the spectra of patients with dementia (AD and vascular dementia) and those without dementia (MCI and depression) in the posterior cingulate gyrus. The NAA/ml ratio yielded the best área under the ROC curve, with the best sensitivity (82.5%) and specificity (72.7%) in the diagnosis of AD. The NAA/mI and ml/Cr quotients differentiated between the four degenerative pathologies causing the cognitive impairment. The combination of MRI and 1H MRS significantly improved the accuracy of the diagnosis of AD. Conclusions The metabolic differences found among patients with cognitive impairment using 1H MRS can be useful for differentiating AD, vascular dementia, MCI, and depression. The combination of spectroscopy and MRI findings is useful in the diagnosis of AD.
In order to differentiate among the different types of <dis>cognitive impairment</dis>, the alterations in imaging and spectroscopy findings were graded from 0 to 4, as was the mean combination of the two, and then ROC curves were obtained.
[ { "offsets": [ 55, 75 ], "text": "cognitive impairment", "type": "DISABILITY" } ]
The questionnaire was sent to 166 Nuclear Medicine departments. Results A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment.
S2253654X16301901
A new era for Nuclear Medicine neuroimaging in Spain: Where do we start from in Spain?
Keywords Neuroimaging Nuclear Medicine PET SPECT
Abstract Objective To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methods A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. Results A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were <dis>cognitive impairment</dis> followed by <dis>movement disorders</dis>. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest. Conclusions These results reflect the clinical activity of 2013 and first quarter of 2014. The main indications of the studies were <dis>cognitive impairment</dis> and <dis>movement disorders</dis>. Variability in the evaluation of the studies is among the challenges that will be faced in the coming years.
Abstract Objective To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methods A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. Results A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest. Conclusions These results reflect the clinical activity of 2013 and first quarter of 2014. The main indications of the studies were cognitive impairment and movement disorders. Variability in the evaluation of the studies is among the challenges that will be faced in the coming years.
The questionnaire was sent to 166 Nuclear Medicine departments. Results A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment.
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The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI≤75 at admission (n=54) or with a missing BI value were excluded (n=1). Multivariate logistic regression analyses were conducted to explore predictive factors with functional decline (BI≤75) from admission to discharge, and 1-month later.
S0211139X17301294
Functional impairment associated with cognitive impairment in hospitalised elderly
Keywords Delirium Cognitive impairment Functional decline Hospitalised older
Introduction The aim of this study was to analyse the effect of <dis>cognitive impairment</dis> on <dis>functional decline</dis> in hospitalised patients aged ≥60 years. Methods Measurements at admission included demographic data, Charlson's comorbidity index, and <dis>cognitive impairment</dis> (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI≤75 at admission (n=54) or with a missing BI value were excluded (n=1). Multivariate logistic regression analyses were conducted to explore predictive factors with <dis>functional decline</dis> (BI≤75) from admission to discharge, and 1-month later. Results Of the 133 patients included, 24.8% and 19.6% had a BI≤75 at discharge and at 1-month, respectively. Compared with men, women had more than double risk for <dis>functional decline</dis> at discharge and 1-month (P<.05). Compared with those without delirium and <scp><neg>without</neg> <dis>cognitive impairment</dis></scp>, those with delirium and <dis>cognitive impairment</dis> had an increased risk for <dis>functional decline</dis> (BI≤75) at discharge (OR 5.15, 95% CI; 1.94-13.67), and at 1-month (OR 6.26, 95% CI; 2.30-17.03). Similarly, those with comorbidity (≥2) had increased <dis>functional decline</dis> at discharge (OR 2.36, 95% CI; 1.14-4.87), and at 1-month after discharge (OR 2.71, 95% CI; 1.25-5.89). Conclusion Delirium during hospitalisation, together with <dis>cognitive impairment</dis> on admission, was a strong predictor of <dis>functional decline</dis>.
Introduction The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥60 years. Methods Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI≤75 at admission (n=54) or with a missing BI value were excluded (n=1). Multivariate logistic regression analyses were conducted to explore predictive factors with functional decline (BI≤75) from admission to discharge, and 1-month later. Results Of the 133 patients included, 24.8% and 19.6% had a BI≤75 at discharge and at 1-month, respectively. Compared with men, women had more than double risk for functional decline at discharge and 1-month (P<.05). Compared with those without delirium and without cognitive impairment, those with delirium and cognitive impairment had an increased risk for functional decline (BI≤75) at discharge (OR 5.15, 95% CI; 1.94-13.67), and at 1-month (OR 6.26, 95% CI; 2.30-17.03). Similarly, those with comorbidity (≥2) had increased functional decline at discharge (OR 2.36, 95% CI; 1.14-4.87), and at 1-month after discharge (OR 2.71, 95% CI; 1.25-5.89). Conclusion Delirium during hospitalisation, together with cognitive impairment on admission, was a strong predictor of functional decline.
The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI≤75 at admission (n=54) or with a missing BI value were excluded (n=1). Multivariate logistic regression analyses were conducted to explore predictive factors with <dis>functional decline</dis> (BI≤75) from admission to discharge, and 1-month later.
[ { "offsets": [ 279, 297 ], "text": "functional decline", "type": "DISABILITY" } ]
Conclusions It can be highlighted that healthcare professionals lack knowledge of all aspects of deafblindness, sign language in particular, and there is a shortage of signs and information for the deafblind. Moreover, alternatives are required to reduce waiting times and improve direct communication with health professionals.
S2445147917300723
Experiences of deafblind people about health care
Keywords Deafblind disorders Sensation disorders Nursing care Health services
Abstract <dis>Deafblindness</dis> is a disability resulting from the combination of <dis>visual and auditory sensory impairments</dis>, which can manifest in different levels causing <dis>special communication problems</dis>. <dis>Deafblind</dis> people have special needs that derive from <dis>difficulties in sensing, understanding, attention</dis> and a <dis>lack of the skills required to function effectively in society</dis>. <dis>Deafblindness</dis> requires specialised services, personnel specifically trained in its care and special methods for communication. Objective The main objective of this study is to explore the experiences of <dis>deafblind</dis> people in relation to health care throughout their lives. This study was developed at the St. Ángela de la Cruz Centre, belonging to the Association of Parents of Deafblind People in Spain. Method Phenomenological qualitative study, through semi-structured interviews with <dis>deafblind</dis> people at the St. Ángela de la Cruz Centre, Salteras (Seville), carried out in 2015, with the help of interpreters in Spanish sign language. Topics covered in the interviews refer to facilities, human resources, time waiting and health care. Results Coinciding statements were obtained, where the participants point out architectural and educational barriers in health care and stand out better if the professionals know sign language. Conclusions It can be highlighted that healthcare professionals lack knowledge of all aspects of <dis>deafblindness</dis>, sign language in particular, and there is a shortage of signs and information for the <dis>deafblind</dis>. Moreover, alternatives are required to reduce waiting times and improve direct communication with health professionals.
Abstract Deafblindness is a disability resulting from the combination of visual and auditory sensory impairments, which can manifest in different levels causing special communication problems. Deafblind people have special needs that derive from difficulties in sensing, understanding, attention and a lack of the skills required to function effectively in society. Deafblindness requires specialised services, personnel specifically trained in its care and special methods for communication. Objective The main objective of this study is to explore the experiences of deafblind people in relation to health care throughout their lives. This study was developed at the St. Ángela de la Cruz Centre, belonging to the Association of Parents of Deafblind People in Spain. Method Phenomenological qualitative study, through semi-structured interviews with deafblind people at the St. Ángela de la Cruz Centre, Salteras (Seville), carried out in 2015, with the help of interpreters in Spanish sign language. Topics covered in the interviews refer to facilities, human resources, time waiting and health care. Results Coinciding statements were obtained, where the participants point out architectural and educational barriers in health care and stand out better if the professionals know sign language. Conclusions It can be highlighted that healthcare professionals lack knowledge of all aspects of deafblindness, sign language in particular, and there is a shortage of signs and information for the deafblind. Moreover, alternatives are required to reduce waiting times and improve direct communication with health professionals.
Conclusions It can be highlighted that healthcare professionals lack knowledge of all aspects of <dis>deafblindness</dis>, sign language in particular, and there is a shortage of signs and information for the <dis>deafblind</dis>. Moreover, alternatives are required to reduce waiting times and improve direct communication with health professionals.
[ { "offsets": [ 97, 110 ], "text": "deafblindness", "type": "DISABILITY" }, { "offsets": [ 198, 207 ], "text": "deafblind", "type": "DISABILITY" } ]
Conclusions nonagenarians with recent onset of functional impairment also benefit from rehabilitation in a medium-stay geriatric unit; those with better functional and cognitive status can achieve results similar to those in younger patients.
S0211139X06729572
Nonagarians’ response to multidisciplinary rehabilitation in a medium-stay geriatric unit
Key words Nonagenarian Rehabilitation Geriatric assessment
Abstract Objective to determine the clinical, functional and mental characteristics of nonagenarians admitted to a medium-stay geriatric unit for hospital-based rehabilitation and to review outcomes at dischargeand 1 year later. Patients and method we performed a longitudinal observational study of nonagenarians consecutively hospitalised in a medium-stay geriatric unit over a 16-month period. On admission, the variables collected were diagnoses, functional and cognitive status, household composition, comorbidity, and serum albumin. The global and relative functional gain and rate of institutionalization at discharge were also evaluated. After 12 months, the patients were telephoned to establish mortality, functional status, and new admissions. Results the mean age of the 51 patients studied was 92.06 (SD 2.42) years and 75% were women. The mean functional gain at discharge was 23.27 (SD 14.06) in the Barthel Index (BI), with a relative functional gain of 45.4% from impairment at admission. At 1 year 31% of the patients were alive and living at home and showed a functional gain of ≥ 20 in the BI from admission. These outcomes increased to 59% in patients with better functional status before admission (previous BI ≥ 80) and <scp><neg>absence of</neg> <dis>severe functional and cognitive impairment</dis> at admission</scp> (BI < 20 and Pfeiffer ≥ 5 at admission, respectively). Conclusions nonagenarians with recent onset of <dis>functional impairment</dis> also benefit from rehabilitation in a medium-stay geriatric unit; those with better functional and cognitive status can achieve results similar to those in younger patients.
Abstract Objective to determine the clinical, functional and mental characteristics of nonagenarians admitted to a medium-stay geriatric unit for hospital-based rehabilitation and to review outcomes at dischargeand 1 year later. Patients and method we performed a longitudinal observational study of nonagenarians consecutively hospitalised in a medium-stay geriatric unit over a 16-month period. On admission, the variables collected were diagnoses, functional and cognitive status, household composition, comorbidity, and serum albumin. The global and relative functional gain and rate of institutionalization at discharge were also evaluated. After 12 months, the patients were telephoned to establish mortality, functional status, and new admissions. Results the mean age of the 51 patients studied was 92.06 (SD 2.42) years and 75% were women. The mean functional gain at discharge was 23.27 (SD 14.06) in the Barthel Index (BI), with a relative functional gain of 45.4% from impairment at admission. At 1 year 31% of the patients were alive and living at home and showed a functional gain of ≥ 20 in the BI from admission. These outcomes increased to 59% in patients with better functional status before admission (previous BI ≥ 80) and absence of severe functional and cognitive impairment at admission (BI < 20 and Pfeiffer ≥ 5 at admission, respectively). Conclusions nonagenarians with recent onset of functional impairment also benefit from rehabilitation in a medium-stay geriatric unit; those with better functional and cognitive status can achieve results similar to those in younger patients.
Conclusions nonagenarians with recent onset of <dis>functional impairment</dis> also benefit from rehabilitation in a medium-stay geriatric unit; those with better functional and cognitive status can achieve results similar to those in younger patients.
[ { "offsets": [ 47, 68 ], "text": "functional impairment", "type": "DISABILITY" } ]
The OSAHS syndrome appears in greater proportion than in the general child population, and recurrences may occur more frequently after surgery. Such children can also be risk patients in airway management.
S2173573511000937
Hearing Loss and Airway Problems in Children With Mucopolysaccharidoses
Keywords Mucopolysaccharidoses Hearing loss Airway
Abstract Introduction Mucopolysaccharidoses (MPS) are a group of systemic diseases characterised by a genetic deficiency of lysosomal enzymes that cause the accumulation of glycosaminoglycans in different tissues. The onset of symptoms usually occurs in early childhood, causing problems of otitis media, <dis>hearing loss</dis> and airway obstruction in the ENT area. Objective Describing the audiological findings and airway pathology found in 9 children diagnosed as having MPS. Methods A retrospective review was performed of the clinical and audiological findings, exploratory results and therapeutic ENT procedures for 9 children diagnosed with MPS in an ENT service at a tertiary paediatric public centre in the period 2007–2010. Results Subtypes found were 4 MPS type I, 2 moderate MPS type II, 1 severe MPS type II, 1 MPS type IV and 1 MPS type VI. All patients presented chronic middle ear effusions. A child developed <dis>mild bilateral sensorineural hearing loss</dis>; another case was diagnosed as <dis>mixed hearing loss</dis>. The remaining auditory pattern was <dis>moderate bilateral conductive hearing loss</dis>. Four patients showed secondary obstructive sleep apnoea/hypopnoea syndrome (OSAHS) due to Waldeyer ring hyperplasia; surgery could not be performed on one of them because of cervical spinal cord compression from mucopolysaccharide deposits. In 2 cases, there was OSAHS relapse. Conclusions Children with MPS are at increased risk for developing <dis>sensorineural hearing loss</dis>. The OSAHS syndrome appears in greater proportion than in the general child population, and recurrences may occur more frequently after surgery. Such children can also be risk patients in airway management.
Abstract Introduction Mucopolysaccharidoses (MPS) are a group of systemic diseases characterised by a genetic deficiency of lysosomal enzymes that cause the accumulation of glycosaminoglycans in different tissues. The onset of symptoms usually occurs in early childhood, causing problems of otitis media, hearing loss and airway obstruction in the ENT area. Objective Describing the audiological findings and airway pathology found in 9 children diagnosed as having MPS. Methods A retrospective review was performed of the clinical and audiological findings, exploratory results and therapeutic ENT procedures for 9 children diagnosed with MPS in an ENT service at a tertiary paediatric public centre in the period 2007–2010. Results Subtypes found were 4 MPS type I, 2 moderate MPS type II, 1 severe MPS type II, 1 MPS type IV and 1 MPS type VI. All patients presented chronic middle ear effusions. A child developed mild bilateral sensorineural hearing loss; another case was diagnosed as mixed hearing loss. The remaining auditory pattern was moderate bilateral conductive hearing loss. Four patients showed secondary obstructive sleep apnoea/hypopnoea syndrome (OSAHS) due to Waldeyer ring hyperplasia; surgery could not be performed on one of them because of cervical spinal cord compression from mucopolysaccharide deposits. In 2 cases, there was OSAHS relapse. Conclusions Children with MPS are at increased risk for developing sensorineural hearing loss. The OSAHS syndrome appears in greater proportion than in the general child population, and recurrences may occur more frequently after surgery. Such children can also be risk patients in airway management.
The OSAHS syndrome appears in greater proportion than in the general child population, and recurrences may occur more frequently after surgery. Such children can also be risk patients in airway management.
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The most sensitive parameter for differentiating between stroke and epilepsy in our series was increased time to peak in multilobar cortical locations in the absence of large-vessel occlusion and basal ganglia involvement. Multiparametric CT is a fast, readily available, and useful tool for the differential diagnosis of acute-onset neurological signs of epileptic origin in patients initially attended after code stroke activation.
S0213485316302390
Usefulness of multiparametric computerized tomography findings in the differential diagnosis of stroke mimics of epileptic origin: A preliminary study
Keywords Stroke mimics Cerebral perfusion Computerized Tomography Multiparametric Computerized Tomography Epilepsy Stroke
Objective. Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events. Material and methods. We conducted a retrospective observational study; data were gathered prospectively during one year. We studied multiparametric CT images of patients admitted following code stroke activation and finally diagnosed with epilepsy. Results. The study included a total of 11 patients; 36% were men and mean age was 74.5 years. Three patients had right hemisphere syndrome, 4 displayed left hemisphere syndrome, and the remaining 4 had <dis>isolated aphasia</dis>. Maximum time from symptom onset to multiparametric CT study was 8.16hours. Perfusion CT results were normal in 2 patients. Nine patients showed longer or shorter times to peak (Tmax); cerebral blood volume (CBV) and cerebral blood flow (CBF) maps varied. EEG was performed a maximum of 47.6hours after symptom onset. Four patients showed findings compatible with status epilepticus, 2 displayed focal epileptiform activity, and 5 showed post-ictal slowing ipsilateral to perfusion CT abnormalities. Conclusion. The most sensitive parameter for differentiating between stroke and epilepsy in our series was increased time to peak in multilobar cortical locations in the absence of large-vessel occlusion and basal ganglia involvement. Multiparametric CT is a fast, readily available, and useful tool for the differential diagnosis of acute-onset neurological signs of epileptic origin in patients initially attended after code stroke activation.
Objective. Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events. Material and methods. We conducted a retrospective observational study; data were gathered prospectively during one year. We studied multiparametric CT images of patients admitted following code stroke activation and finally diagnosed with epilepsy. Results. The study included a total of 11 patients; 36% were men and mean age was 74.5 years. Three patients had right hemisphere syndrome, 4 displayed left hemisphere syndrome, and the remaining 4 had isolated aphasia. Maximum time from symptom onset to multiparametric CT study was 8.16hours. Perfusion CT results were normal in 2 patients. Nine patients showed longer or shorter times to peak (Tmax); cerebral blood volume (CBV) and cerebral blood flow (CBF) maps varied. EEG was performed a maximum of 47.6hours after symptom onset. Four patients showed findings compatible with status epilepticus, 2 displayed focal epileptiform activity, and 5 showed post-ictal slowing ipsilateral to perfusion CT abnormalities. Conclusion. The most sensitive parameter for differentiating between stroke and epilepsy in our series was increased time to peak in multilobar cortical locations in the absence of large-vessel occlusion and basal ganglia involvement. Multiparametric CT is a fast, readily available, and useful tool for the differential diagnosis of acute-onset neurological signs of epileptic origin in patients initially attended after code stroke activation.
The most sensitive parameter for differentiating between stroke and epilepsy in our series was increased time to peak in multilobar cortical locations in the absence of large-vessel occlusion and basal ganglia involvement. Multiparametric CT is a fast, readily available, and useful tool for the differential diagnosis of acute-onset neurological signs of epileptic origin in patients initially attended after code stroke activation.
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Results Twenty-one elders, average age 73.5 years (SD: 7.3 years), range: 57-82, 90.5% female; 71.4% reported no current marital relationship, in 66.5% educational level ranged from 1 to 5 years, 42.9% assiduously attended the activities during the last 6 years, 76.2% had no cognoscitive impairment, 90.5% no somatic symptoms, 90.5% no anxiety, 95.2% no social dysfunction, 95.2% no depression and 76.1% reported being satisfied with their life.
S012173721730105X
Memory maintenance and conservation activities in an elders group
Keywords Cognoscitive Deterioration Elder Cognoscitive Stimulation
Objective To obtain a clinical and socio-demographic profile of a group of elders of the community who participated in Memory Maintenance and Conservation activities. Materials and methods A series of 21 elders in whom cognoscitive status was determined applying the NEUROPSI Test and the presence of somatic symptoms, anxiety, <dis>social dysfunction</dis> and depression using the General Health Questionnaire (GHQ-28). Life satisfaction was assessed with the Satisfaction with Life Scale. Results Twenty-one elders, average age 73.5 years (SD: 7.3 years), range: 57-82, 90.5% female; 71.4% reported no current marital relationship, in 66.5% educational level ranged from 1 to 5 years, 42.9% assiduously attended the activities during the last 6 years, 76.2% <scp>had <neg>no</neg> <dis>cognoscitive impairment</dis></scp>, 90.5% no somatic symptoms, 90.5% no anxiety, 95.2% <scp><neg>no</neg> <dis>social dysfunction</dis></scp>, 95.2% no depression and 76.1% reported being satisfied with their life. Conclusions <scp><neg>Absence of</neg> <dis>cognoscitive deterioration</dis></scp> is similar to that within the general population. Participants did not report depression, anxiety or somatic complaints, showed good social functioning and integration level and were satisfied with their life. Despite the limitations associated with small sample size, the results encourage us to continue this work and to engage in more rigorous research.
Objective To obtain a clinical and socio-demographic profile of a group of elders of the community who participated in Memory Maintenance and Conservation activities. Materials and methods A series of 21 elders in whom cognoscitive status was determined applying the NEUROPSI Test and the presence of somatic symptoms, anxiety, social dysfunction and depression using the General Health Questionnaire (GHQ-28). Life satisfaction was assessed with the Satisfaction with Life Scale. Results Twenty-one elders, average age 73.5 years (SD: 7.3 years), range: 57-82, 90.5% female; 71.4% reported no current marital relationship, in 66.5% educational level ranged from 1 to 5 years, 42.9% assiduously attended the activities during the last 6 years, 76.2% had no cognoscitive impairment, 90.5% no somatic symptoms, 90.5% no anxiety, 95.2% no social dysfunction, 95.2% no depression and 76.1% reported being satisfied with their life. Conclusions Absence of cognoscitive deterioration is similar to that within the general population. Participants did not report depression, anxiety or somatic complaints, showed good social functioning and integration level and were satisfied with their life. Despite the limitations associated with small sample size, the results encourage us to continue this work and to engage in more rigorous research.
Results Twenty-one elders, average age 73.5 years (SD: 7.3 years), range: 57-82, 90.5% female; 71.4% reported no current marital relationship, in 66.5% educational level ranged from 1 to 5 years, 42.9% assiduously attended the activities during the last 6 years, 76.2% <scp>had <neg>no</neg> <dis>cognoscitive impairment</dis></scp>, 90.5% no somatic symptoms, 90.5% no anxiety, 95.2% <scp><neg>no</neg> <dis>social dysfunction</dis></scp>, 95.2% no depression and 76.1% reported being satisfied with their life.
[ { "offsets": [ 276, 299 ], "text": "cognoscitive impairment", "type": "DISABILITY" }, { "offsets": [ 355, 373 ], "text": "social dysfunction", "type": "DISABILITY" } ]
Discussion In our sample, DBS-SN did not result in global cognitive impairment 5 years after surgery. Verbal function was found to be significantly impaired one year after the procedure. Impaired learning and visuospatial function may be attributed to degeneration associated with PD.
S0213485317302232
Long-term impact of subthalamic stimulation on cognitive function in patients with advanced Parkinson's disease
Keywords Cognitive impairment Deep brain stimulation Depression Parkinson's disease Quality of life Subthalamic nucleus
Objective The aim of this study was to evaluate the effects of deep brain stimulation of the subthalamic nucleus (DBS-SN) on cognitive function in patients with Parkinson's disease (PD) 5 years after surgery. Material and methods We conducted a prospective study including 50 patients with PD who underwent DBS-SN (62.5% were men; mean age of 62.2±8.2 years; mean progression time of 14.1±6.3 years). All patients were assessed before the procedure and at one year after surgery; 40 patients were further followed up until the 5-year mark. Follow-up assessments included the following neuropsychological tests: Mini–Mental State Examination (MMSE), Mattis Dementia Rating Scale (MDRS), letter-number sequencing of the WAIS-III (WAIS-III-LN), clock-drawing test, Rey auditory verbal learning test (RAVLT), Benton Visual Retention Test (BVRT), Judgment of Line Orientation (JLO) test, FAS Phonemic Verbal Fluency Test, Stroop test, and the Montgomery-Asberg Depression Rating Scale (MADRS). Results Patients were found to score lower on the MMSE (−0.89%), clock-drawing test (−2.61%), MDRS (−1.72%), and especially phonemic (−13.28%) and sematic verbal fluency tests (−12.40%) at one year after surgery. Delayed recall on the RAVLT worsened one year after the procedure (−10.12%). At 5 years, impairment affected mainly verbal fluency; scores decreased an additional 16.10% and 16.60% in semantic and phonemic verbal fluency, respectively. Moderate decreases were observed in immediate recall (−16.87%), WAIS-III-LN (−16.67%), and JLO test (−11.56%). Discussion In our sample, DBS-SN did <scp><neg>not</neg> result in <dis>global cognitive impairment</dis> 5 years after surgery</scp>. <dis>Verbal function was found to be significantly impaired</dis> one year after the procedure. <dis>Impaired learning and visuospatial function</dis> may be attributed to degeneration associated with PD.
Objective The aim of this study was to evaluate the effects of deep brain stimulation of the subthalamic nucleus (DBS-SN) on cognitive function in patients with Parkinson's disease (PD) 5 years after surgery. Material and methods We conducted a prospective study including 50 patients with PD who underwent DBS-SN (62.5% were men; mean age of 62.2±8.2 years; mean progression time of 14.1±6.3 years). All patients were assessed before the procedure and at one year after surgery; 40 patients were further followed up until the 5-year mark. Follow-up assessments included the following neuropsychological tests: Mini–Mental State Examination (MMSE), Mattis Dementia Rating Scale (MDRS), letter-number sequencing of the WAIS-III (WAIS-III-LN), clock-drawing test, Rey auditory verbal learning test (RAVLT), Benton Visual Retention Test (BVRT), Judgment of Line Orientation (JLO) test, FAS Phonemic Verbal Fluency Test, Stroop test, and the Montgomery-Asberg Depression Rating Scale (MADRS). Results Patients were found to score lower on the MMSE (−0.89%), clock-drawing test (−2.61%), MDRS (−1.72%), and especially phonemic (−13.28%) and sematic verbal fluency tests (−12.40%) at one year after surgery. Delayed recall on the RAVLT worsened one year after the procedure (−10.12%). At 5 years, impairment affected mainly verbal fluency; scores decreased an additional 16.10% and 16.60% in semantic and phonemic verbal fluency, respectively. Moderate decreases were observed in immediate recall (−16.87%), WAIS-III-LN (−16.67%), and JLO test (−11.56%). Discussion In our sample, DBS-SN did not result in global cognitive impairment 5 years after surgery. Verbal function was found to be significantly impaired one year after the procedure. Impaired learning and visuospatial function may be attributed to degeneration associated with PD.
Discussion In our sample, DBS-SN did <scp><neg>not</neg> result in <dis>global cognitive impairment</dis> 5 years after surgery</scp>. <dis>Verbal function was found to be significantly impaired</dis> one year after the procedure. <dis>Impaired learning and visuospatial function</dis> may be attributed to degeneration associated with PD.
[ { "offsets": [ 51, 78 ], "text": "global cognitive impairment", "type": "DISABILITY" }, { "offsets": [ 102, 156 ], "text": "Verbal function was found to be significantly impaired", "type": "DISABILITY" }, { "offsets": [ 187, 230 ], "text": "Impaired learning and visuospatial function", "type": "DISABILITY" } ]
Abstract Like anyone else, people with Down syndrome can suffer mental health problems that require diagnosis, treatment and prevention. The higher number of depressions seen in recent years is a cause for concern and must be taken on by health professionals and families. Depression is difficult to diagnose in people with Down syndrome as its symptoms can be mistaken with those of other conditions. This paper sets out to define depression, highlight the specific manifestation of symptoms and give guidelines on how it can be diagnosed and treated. Importance is also placed on prevention.
S1138207410700671
Depression and Down syndrome
Keywords Depression Down syndrome Affective disorders Psychotherapy
Abstract Like anyone else, people with Down syndrome can suffer <dis>mental health problems</dis> that require diagnosis, treatment and prevention. The higher number of depressions seen in recent years is a cause for concern and must be taken on by health professionals and families. Depression is difficult to diagnose in people with Down syndrome as its symptoms can be mistaken with those of other conditions. This paper sets out to define depression, highlight the specific manifestation of symptoms and give guidelines on how it can be diagnosed and treated. Importance is also placed on prevention.
Abstract Like anyone else, people with Down syndrome can suffer mental health problems that require diagnosis, treatment and prevention. The higher number of depressions seen in recent years is a cause for concern and must be taken on by health professionals and families. Depression is difficult to diagnose in people with Down syndrome as its symptoms can be mistaken with those of other conditions. This paper sets out to define depression, highlight the specific manifestation of symptoms and give guidelines on how it can be diagnosed and treated. Importance is also placed on prevention.
Abstract Like anyone else, people with Down syndrome can suffer <dis>mental health problems</dis> that require diagnosis, treatment and prevention. The higher number of depressions seen in recent years is a cause for concern and must be taken on by health professionals and families. Depression is difficult to diagnose in people with Down syndrome as its symptoms can be mistaken with those of other conditions. This paper sets out to define depression, highlight the specific manifestation of symptoms and give guidelines on how it can be diagnosed and treated. Importance is also placed on prevention.
[ { "offsets": [ 65, 87 ], "text": "mental health problems", "type": "DISABILITY" } ]
Abstract To assess the functional hearing ability of a small child with hearing loss, it is necessary to resort to different indirect tests that can reflect the information being provided by hearing aids, or by exploring what the child is doing with this acoustic information, mainly as regards the abilities in the acquisition and development of language.
S1137817412700596
Assessment of functional hearing ability in children with hearing impairments
Keywords Children's hearing Speech acoustics Hearing impairment Hearing development Deaf children Speech perception Functional assessment of hearing
Abstract To assess the functional hearing ability of a small child with <dis>hearing loss</dis>, it is necessary to resort to different indirect tests that can reflect the information being provided by hearing aids, or by exploring what the child is doing with this acoustic information, mainly as regards the abilities in the acquisition and development of language. From the results of this assessment, it can be determined if the adjustment is the best that this child can achieve at that time, or if modifications need to be made to optimise it and thus achieve the best intelligibility of speech in a variety of communication environments and situations.
Abstract To assess the functional hearing ability of a small child with hearing loss, it is necessary to resort to different indirect tests that can reflect the information being provided by hearing aids, or by exploring what the child is doing with this acoustic information, mainly as regards the abilities in the acquisition and development of language. From the results of this assessment, it can be determined if the adjustment is the best that this child can achieve at that time, or if modifications need to be made to optimise it and thus achieve the best intelligibility of speech in a variety of communication environments and situations.
Abstract To assess the functional hearing ability of a small child with <dis>hearing loss</dis>, it is necessary to resort to different indirect tests that can reflect the information being provided by hearing aids, or by exploring what the child is doing with this acoustic information, mainly as regards the abilities in the acquisition and development of language.
[ { "offsets": [ 73, 85 ], "text": "hearing loss", "type": "DISABILITY" } ]
Abstract Rubinstein–Taybi syndrome (RTS) is a chromosomopathy associated to molecular mutations or microdeletions of chromosome 16. It has an incidence of 1:125,000–700,000 live births. RTS patients present craniofacial and thoracic anomalies that lead to a probable difficult-to-manage airway and ventilation.
S0034935616000499
Anesthetic management for thoracic surgery in Rubinstein–Taybi syndrome
Keywords Rubinstein–Taybi syndrome Chromosome disorders Airway management One-lung ventilation Esophageal perforation
Abstract Rubinstein–Taybi syndrome (RTS) is a chromosomopathy associated to molecular mutations or microdeletions of chromosome 16. It has an incidence of 1:125,000–700,000 live births. RTS patients present craniofacial and thoracic anomalies that lead to a probable difficult-to-manage airway and ventilation. They also present <dis>mental retardation</dis> and comorbidity, such as congenital cardiac defects, pulmonary structural anomalies and recurrent respiratory infections, which increase the risk of aspiration pneumonia. Cardiac arrhythmias have been reported after the use of certain drugs such as succinylcholine and atropine, in a higher incidence than in general population. There is an increased risk of postoperative apnea–hypopnea in these patients. We report the anesthetic management in a RTS patient undergoing emergent thoracic surgery due to oesophageal perforation and mediastinitis. Lung isolation was achieved with a bronchial blocker guided with a fiberoptic bronchoscope and one-lung ventilation was performed successfully.
Abstract Rubinstein–Taybi syndrome (RTS) is a chromosomopathy associated to molecular mutations or microdeletions of chromosome 16. It has an incidence of 1:125,000–700,000 live births. RTS patients present craniofacial and thoracic anomalies that lead to a probable difficult-to-manage airway and ventilation. They also present mental retardation and comorbidity, such as congenital cardiac defects, pulmonary structural anomalies and recurrent respiratory infections, which increase the risk of aspiration pneumonia. Cardiac arrhythmias have been reported after the use of certain drugs such as succinylcholine and atropine, in a higher incidence than in general population. There is an increased risk of postoperative apnea–hypopnea in these patients. We report the anesthetic management in a RTS patient undergoing emergent thoracic surgery due to oesophageal perforation and mediastinitis. Lung isolation was achieved with a bronchial blocker guided with a fiberoptic bronchoscope and one-lung ventilation was performed successfully.
Abstract Rubinstein–Taybi syndrome (RTS) is a chromosomopathy associated to molecular mutations or microdeletions of chromosome 16. It has an incidence of 1:125,000–700,000 live births. RTS patients present craniofacial and thoracic anomalies that lead to a probable difficult-to-manage airway and ventilation.
[]
Methods We used female 3xTg-AD mice aged 11 months and compared them to non-transgenic mice of the same age. In both groups, we assessed motor performance (open field test) and neuronal damage in M1 using specific markers: BAM10 (extracellular Aβ aggregates), tau 499 (hyperphosphorylated tau protein), GFAP (astrocytes), and Klüver-Barrera staining (neurons).
S0213485317301548
Primary motor cortex alterations in Alzheimer disease: A study in the 3xTg-AD model
Keywords Alzheimer disease Triple transgenic mouse model Primary motor cortex Neuron Glia
Introduction In humans and animal models, Alzheimer disease (AD) is characterised by accumulation of amyloid-β peptide (Aβ) and hyperphosphorylated tau protein, neuronal degeneration, and astrocytic gliosis, especially in vulnerable brain regions (hippocampus and cortex). These alterations are associated with <dis>cognitive impairment</dis> (<dis>loss of memory</dis>) and <dis>non-cognitive impairment</dis> (<dis>motor impairment</dis>). The purpose of this study was to identify cell changes (neurons and glial cells) and aggregation of Aβ and hyperphosphorylated tau protein in the primary motor cortex (M1) in 3xTg-AD mouse models at an intermediate stage of AD. Methods We used female 3xTg-AD mice aged 11 months and compared them to non-transgenic mice of the same age. In both groups, we assessed motor performance (open field test) and neuronal damage in M1 using specific markers: BAM10 (extracellular Aβ aggregates), tau 499 (hyperphosphorylated tau protein), GFAP (astrocytes), and Klüver-Barrera staining (neurons). Results Female 3xTg-AD mice in intermediate stages of the disease displayed motor and cellular alterations associated with Aβ and hyperphosphorylated tau protein deposition in M1. Conclusions Patients with AD display signs and symptoms of <dis>functional impairment</dis> from early stages. According to our results, M1 cell damage in intermediate-stage AD affects motor function, which is linked to progression of the disease.
Introduction In humans and animal models, Alzheimer disease (AD) is characterised by accumulation of amyloid-β peptide (Aβ) and hyperphosphorylated tau protein, neuronal degeneration, and astrocytic gliosis, especially in vulnerable brain regions (hippocampus and cortex). These alterations are associated with cognitive impairment (loss of memory) and non-cognitive impairment (motor impairment). The purpose of this study was to identify cell changes (neurons and glial cells) and aggregation of Aβ and hyperphosphorylated tau protein in the primary motor cortex (M1) in 3xTg-AD mouse models at an intermediate stage of AD. Methods We used female 3xTg-AD mice aged 11 months and compared them to non-transgenic mice of the same age. In both groups, we assessed motor performance (open field test) and neuronal damage in M1 using specific markers: BAM10 (extracellular Aβ aggregates), tau 499 (hyperphosphorylated tau protein), GFAP (astrocytes), and Klüver-Barrera staining (neurons). Results Female 3xTg-AD mice in intermediate stages of the disease displayed motor and cellular alterations associated with Aβ and hyperphosphorylated tau protein deposition in M1. Conclusions Patients with AD display signs and symptoms of functional impairment from early stages. According to our results, M1 cell damage in intermediate-stage AD affects motor function, which is linked to progression of the disease.
Methods We used female 3xTg-AD mice aged 11 months and compared them to non-transgenic mice of the same age. In both groups, we assessed motor performance (open field test) and neuronal damage in M1 using specific markers: BAM10 (extracellular Aβ aggregates), tau 499 (hyperphosphorylated tau protein), GFAP (astrocytes), and Klüver-Barrera staining (neurons).
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The inter-rater reliability and test- retest reliability of the SPMSQ Spanish version were 0.738 (p < 0.001), and 0.925 (p < 0.001), respectively, with a convergent validity of 0.74 (p < 0.001) and a discriminant validity of 0.230 (p < 0.001). The internal consistency was high with an αvalue of 0.82.
S0025775301720404
Cross-cultural adaptation and validation of Pfeiffer’s test (Short Portable Mental Status Questionnaire [SPMSQ]) to screen cognitive impairment in general population aged 65 or older
Keywords Elderly Cognitive impairment SPMSQ Cross-cultural adaptation Validation
Background Our aims were to develop a Spanish version of the short portable mental status questionnaire (SPMSQ) (Pfeiffer’s test) and to validate the resultant Spanish version of the test among a general population aged 65 years or older. Patients, Material And Methods First, we developed the Spanish version of the SPMSQ by means of a cross- cultural adaptation methodology. Patients were the assessed by independent teams in two sessions the same day. The first team (two trained psychiatrists and one trained family physician) carried out a standardised neuropsychological assessment to diagnose <dis>cognitive impairment</dis>/<dis>dementia</dis> according to ICD-10 criteria wich was regarded as the reference “gold standard” to calculate validity parameters (sensitivity and specificity). The second team (family physicians/nurses) assessed the presence of <dis>cognitive impairment</dis> with the Spanish version of the SPMSQ. Results 255 subjects (66.7%, females) underwent the assessment. Mean age was 74.5 years and 65.5% of them were illiterate. The inter-rater reliability and test- retest reliability of the SPMSQ Spanish version were 0.738 (p < 0.001), and 0.925 (p < 0.001), respectively, with a convergent validity of 0.74 (p < 0.001) and a discriminant validity of 0.230 (p < 0.001). The internal consistency was high with an αvalue of 0.82. The area under the ROC curve was 0.89. Sensitivity and specificity were 85.7 and 79.3, respectively (cut-off of 3 or more). Conclusions The Spanish version of the SPMSQ test has a good reliability and validity. For clinical use, a cut-off of 3 appears to be most useful. When illiterate patients are assessed, the it is recommended to employ a cut-off of 4 or more.
Background Our aims were to develop a Spanish version of the short portable mental status questionnaire (SPMSQ) (Pfeiffer’s test) and to validate the resultant Spanish version of the test among a general population aged 65 years or older. Patients, Material And Methods First, we developed the Spanish version of the SPMSQ by means of a cross- cultural adaptation methodology. Patients were the assessed by independent teams in two sessions the same day. The first team (two trained psychiatrists and one trained family physician) carried out a standardised neuropsychological assessment to diagnose cognitive impairment/dementia according to ICD-10 criteria wich was regarded as the reference “gold standard” to calculate validity parameters (sensitivity and specificity). The second team (family physicians/nurses) assessed the presence of cognitive impairment with the Spanish version of the SPMSQ. Results 255 subjects (66.7%, females) underwent the assessment. Mean age was 74.5 years and 65.5% of them were illiterate. The inter-rater reliability and test- retest reliability of the SPMSQ Spanish version were 0.738 (p < 0.001), and 0.925 (p < 0.001), respectively, with a convergent validity of 0.74 (p < 0.001) and a discriminant validity of 0.230 (p < 0.001). The internal consistency was high with an αvalue of 0.82. The area under the ROC curve was 0.89. Sensitivity and specificity were 85.7 and 79.3, respectively (cut-off of 3 or more). Conclusions The Spanish version of the SPMSQ test has a good reliability and validity. For clinical use, a cut-off of 3 appears to be most useful. When illiterate patients are assessed, the it is recommended to employ a cut-off of 4 or more.
The inter-rater reliability and test- retest reliability of the SPMSQ Spanish version were 0.738 (p < 0.001), and 0.925 (p < 0.001), respectively, with a convergent validity of 0.74 (p < 0.001) and a discriminant validity of 0.230 (p < 0.001). The internal consistency was high with an αvalue of 0.82.
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This paper advocates that we consider the importance of interaction and communication in early language acquisition from a functional perspective, bearing in mind the complexity of the language system and the interconnections between cognitive, emotional and social aspects in the acquisition process, in addition to the specificities of children with DS in their overall development. As the focus in this case is early childhood, rather than working directly with the child the proposed intervention seeks to help parents find communicative strategies that enhance the interactions they have with their children.
S1138207408700265
The role of interaction and communication in early language acquisition among children with DS
Keywords Down Syndrome Mental Retardation Early childhood Language development Interaction and communication Communicative strategies
Abstract Children with Down Syndrome (DS) are children who grow and have interests, desires and needs just like any other child in their age group. Although <dis>mental retardation</dis> (<dis>MR</dis>) does give rise to certain syndrome-specific characteristics in their language development, these must not be treated in isolation because they have a bearing on other global development acquisitions. This paper advocates that we consider the importance of interaction and communication in early language acquisition from a functional perspective, bearing in mind the complexity of the language system and the interconnections between cognitive, emotional and social aspects in the acquisition process, in addition to the specificities of children with DS in their overall development. As the focus in this case is early childhood, rather than working directly with the child the proposed intervention seeks to help parents find communicative strategies that enhance the interactions they have with their children.
Abstract Children with Down Syndrome (DS) are children who grow and have interests, desires and needs just like any other child in their age group. Although mental retardation (MR) does give rise to certain syndrome-specific characteristics in their language development, these must not be treated in isolation because they have a bearing on other global development acquisitions. This paper advocates that we consider the importance of interaction and communication in early language acquisition from a functional perspective, bearing in mind the complexity of the language system and the interconnections between cognitive, emotional and social aspects in the acquisition process, in addition to the specificities of children with DS in their overall development. As the focus in this case is early childhood, rather than working directly with the child the proposed intervention seeks to help parents find communicative strategies that enhance the interactions they have with their children.
This paper advocates that we consider the importance of interaction and communication in early language acquisition from a functional perspective, bearing in mind the complexity of the language system and the interconnections between cognitive, emotional and social aspects in the acquisition process, in addition to the specificities of children with DS in their overall development. As the focus in this case is early childhood, rather than working directly with the child the proposed intervention seeks to help parents find communicative strategies that enhance the interactions they have with their children.
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Abstract Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population.
S1888989109707141
Cardiovascular disease and diabetes in people with severe mental illness
Keywords Severe mental illness Schizophrenia Depression Bipolar disorder Physical health Weight gain Cardiovascular disease Diabetes
Abstract Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). People with <dis>severe mental illnesses</dis>, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed to an increased risk of the modifiable coronary heart disease risk factors, obesity, smoking, diabetes, hypertension, and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain and further increase the risk of adverse metabolic effects which may result in further increased incidence of cardiovascular disease. Patients have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non- psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement aiming to improve the care of patients suffering from <dis>severe mental illness</dis>. The intention is to initiate co-operation and shared care between the different health care professionals and to increase the awareness of psychiatrists caring for patients suffering from <dis>severe mental illness</dis> to screen and treat increased cardiovascular risk factors and diabetes.
Abstract Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed to an increased risk of the modifiable coronary heart disease risk factors, obesity, smoking, diabetes, hypertension, and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain and further increase the risk of adverse metabolic effects which may result in further increased incidence of cardiovascular disease. Patients have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non- psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement aiming to improve the care of patients suffering from severe mental illness. The intention is to initiate co-operation and shared care between the different health care professionals and to increase the awareness of psychiatrists caring for patients suffering from severe mental illness to screen and treat increased cardiovascular risk factors and diabetes.
Abstract Position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). People with <dis>severe mental illnesses</dis>, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population.
[ { "offsets": [ 207, 230 ], "text": "severe mental illnesses", "type": "DISABILITY" } ]
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