NeuroBel: Spanish screening test for oral psycholinguistics disabilities in elderly people with mild cognitive impairment and early-stage Alzheimer's disease.

INTRODUCTION: The NeuroBel is a short test that allows for psycholinguistic assessment of basic processes of oral comprehension and language production deterioration in the elderly. The objective is to carry out a pilot study of the initial reference values and cut-off points of this battery using a sample of Spanish elderly adults, with and without cognitive impairment, and detecting performance differences among them. METHOD: NeuroBel consists of 8 tasks that analyze oral language functioning from the theoretical model proposed by the Psycholinguistic approach. Seventy-five Spanish monolingual adult-elderly participants of both genders. Of those, 25 with Alzheimer's disease (AD) in the initial phase, 25 with mild cognitive impairment (MCI) and 25 participants without cognitive impairment (Controls). All subjects were evaluated using NeuroBel. RESULTS: There are significant differences between the three groups. The participants with AD are significantly worse in the total score of NeuroBel. A discriminant analysis shows that 86.7% of the cases appear correctly classified in the groups originally selected. Likewise, participants with MCI obtained results that are statistically significantly worse than the control group. NeuroBel shows a high correlation with the MMSE (.89) and Sensitivity (.96) in the determination of AD and cognitive deterioration (AD + MCI vs. Controls). The area under the ROC curve is .97 in the contrast of AD vs. Controls and .98 in the determination of cognitive deterioration (AD + MCI vs. Controls). The canonical discriminant functions and the precision cut-offs from the ROC analyses are also shown in the results. CONCLUSIONS: NeuroBel is shown as a "very good" test in the detection of cognitive-linguistic impairment in elderly-adults.

Effects of rho-kinase inhibition on pulmonary hypertension, lung growth, and structure in neonatal rats chronically exposed to hypoxia.

Rho-kinase (ROCK) inhibitors prevent pulmonary hypertension (PHT) in adult rodents, but little is known about their effects on the neonatal lung. Our objective was to examine the effects of ROCK inhibition on chronic hypoxia (CH)-induced PHT and abnormal lung structure in the neonatal rat. Pups were exposed to air or CH from postnatal d 1-14 while receiving Y-27632 (5 or 10 mg x kg(-1) x d(-1)), fasudil (20 mg x kg(-1) x d(-1)), or saline intraperitoneally. Relative to air, CH-exposed pups had increased pulmonary vascular resistance, right ventricular hypertrophy, arterial medial wall thickening, and abnormal distal airway morphology characterized by septal thinning and decreased secondary septation. Treatment with 10 mg/kg Y-27632 or fasudil attenuated the structural and hemodynamic changes of PHT while having no effect on septal thinning or inhibited secondary septation. In addition, Y-27632 (10 mg/kg) and fasudil augmented CH-induced somatic growth restriction. Pulmonary arteries of CH-exposed pups had increased ROCK activity, up-regulated expression of PDGF-BB and increased smooth muscle DNA synthesis, all of which were attenuated by treatment with 10 mg/kg Y-27632. Systemically administered ROCK inhibitors prevented PHT in the CH-exposed neonatal rat but at the cost of inhibited somatic growth. Limiting effects on vascular remodeling likely resulted, in major part, from attenuated vascular PDGF-BB/beta-receptor signaling.

Voice therapy used to test a basic protocol for multidimensional assessment of dysphonia.

The aim of this study was the elaboration of a basic voice protocol to discover which combination of tests and measures (multidimensional evaluation) provide decisive and essential data for the diagnosis of voice pathology and its prognosis. Voices of 21 patients with dysphonia and 21 subjects in a control group were evaluated and compared. Vocal function was assessed using a multiparametric set of videolaryngostroboscopic, perceptual, acoustic, spectrographic, aerodynamic, and subjective basic measurements (Multidimensional "Teatinos" Protocol). The dysphonic group received voice therapy for two sessions/week during 3 months. The results of the study were the following-(1) alterations in vocal function were reflected in the indicators: maximum phonation time (MPT) /a/, maximum exhalation time (MET) /s/, MPT during connect speech (MPTS), jitter, shimmer, harmonic-to-noise ratio, vocal well being (WB), self-voice assessment (SELF), vocal hygiene (HYGIENE), anxiety (ANX) and perceptual, laryngoscopic, and spectrographic explorations; (2) the indicators which are most sensitive to voice therapy are the following: MPT /a/, MET /s/, MPTS, jitter, WB, SELF, HYGIENE, ANX and perceptual, laryngoscopic, and spectrographic explorations; and (3) these positive effects were maintained or increased 4 months after termination of the treatment. Multidimensional "Teatinos" Protocol makes it possible to detect significant differences in mean values of subjective, qualitative, and objective voice assessments between dysphonic patients and control group at pre- and posttreatment stages. Therefore, multidimensional voice evaluation is a useful tool in the diagnostics of dysphonia in clinical and speech-language-therapy contexts.

Estudio piloto de la validez, fiabilidad y valores de referencia normativos de la escala PRO-NEURO en adultos mayores sin alteraciones cognitivas / Pilot study of the validity, reliability and normative data for PRO-NEURO scale in adult-elderly people without cognitive impairments

Introducción. Se presentan datos preliminares de la validez,fiabilidad y valores normativos del protocolo de evaluaciónneuropsicológica (PRO-NEURO), que incluye las siguientesfunciones cognitivas: orientación, atención ymemoria, cálculo mental, comprensión verbal, escritura, denominación,razonamiento, fluidez verbal, praxias y gnosiascon el propósito de equilibrar el tiempo de aplicación y laextensión de las áreas evaluadas.Material y métodos. Se aplicaron el Mini-Mental StateExamination (MMSE), la Escala de Depresión Geriátrica deYesavage, el Test de Acentuación de Palabras, los subtests deFiguras Incompletas y Vocabulario del Wechsler Adult IntelligenceScale (WAIS) y la escala PRO-NEURO a una muestrade 273 voluntarios (137 hombres y 136 mujeres) cognitivamentesanos mayores de 55 años. Los datos normativos seobtuvieron para tres grupos de edad (55-65, 66-75 y>75 años) y dos niveles educativos: bajo (hasta 6 años de escolarización)y medio/alto (más de 7 años de escolarización).Resultados. La validez de PRO-NEURO según la pruebaMorillama de acuerdo interjueces es del 93 %, la fiabilidadtest-retest es de r=0,74 y la consistencia interna (alfa deCronbach) es de 0,79. El grupo de menor edad (55-65) y losde nivel educativo más alto puntúan significativamente mejory tardan menos en realizar PRO-NEURO. No aparecen diferenciasdependiendo del sexo. Se presentan los datos descriptivosde PRO-NEURO en esta muestra normativa.Conclusiones. PRO-NEURO puede ser una herramientaútil para una primera evaluación de algunas de las más importantesfunciones cognitivas en la práctica clínica (AU)

Introduction. We present preliminary data on validity,reliability and normative values of a short neuropsychologicalprotocol in Spanish called PRO-NEURO includingdifferent cognitive functions: orientation,attention and memory, mental calculation, verbal comprehension,writing, naming, reasoning, verbal fluency,praxias, and gnosias. The purpose is to more suitably balancethe time of application and the extension of thecognitive areas to be evaluated.Material and methods. Different Spanish versions ofclassical measurements (used as control) and PRO-NEUROwere applied of a sample of 273 (137 men and 136women) volunteers, cognitive healthy («normal subjects»)adult and elderly people over 55. Normative data were obtainedfor three age groups (55-65, 66-75 and >75 years)and two educational levels: low (to 6 years of school)and medium/high (more than 7 years of school).Results. The validity of PRO-NEURO according toMorillama’s method is 93% interrater agreement, test-retestreliability is r=0.74 and internal consistency reliability(Cronbach’s alpha) is 0.79. The age-group of younger-elderly subjects (55-65) and those with highereducational level score significantly better and theyspend less time in PRO-NEURO performance. Conversely,no-significant differences by sex are observed. Descriptivedata of PRO-NEURO for this normative sample areshown.Conclusions. The PRO-NEURO scale can be useful asscreening protocol and help for short and reliable assessmentof some important cognitive functions in clinicalpractice (AU)

[Pilot study of the validity, reliability and normative data for PRO-NEURO scale in adult-elderly people without cognitive impairments]. / Estudio piloto de la validez, fiabilidad y valores de referencia normativos de la escala PRO-NEURO en adultos mayores sin alteraciones cognitivas.

INTRODUCTION: We present preliminary data on validity, reliability and normative values of a short neuropsychological protocol in Spanish called PRO-NEURO including different cognitive functions: orientation, attention and memory, mental calculation, verbal comprehension, writing, naming, reasoning, verbal fluency, praxias, and gnosias. The purpose is to more suitably balance the time of application and the extension of the cognitive areas to be evaluated. MATERIAL AND METHODS: Different Spanish versions of classical measurements (used as control) and PRO-NEURO were applied of a sample of 273 (137 men and 136 women) volunteers, cognitive healthy (<>) adult and elderly people over 55. Normative data were obtained for three age groups (55-65, 66-75 and >75 years) and two educational levels: low (to 6 years of school) and medium/high (more than 7 years of school). RESULTS: The validity of PRO-NEURO according to Morillama's method is 93% interrater agreement, test-retest reliability is r=0.74 and internal consistency reliability (Cronbach's alpha) is 0.79. The age-group of younger- elderly subjects (55-65) and those with higher educational level score significantly better and they spend less time in PRO-NEURO performance. Conversely, no-significant differences by sex are observed. Descriptive data of PRO-NEURO for this normative sample are shown. CONCLUSIONS: The PRO-NEURO scale can be useful as screening protocol and help for short and reliable assessment of some important cognitive functions in clinical practice.

[Present situation of the otorhinolaryngology departments in the Spanish Hospitals. Heterogeneity in handling voice disorders]. / Estado actual de los Servicios ORL españoles. Heterogeneidad en el manejo de los problemas de voz.

The study of voice disorders present some specific difficulties such as the aetiological variability of this kind of disorders or the heterogeneity and the poor data we have about the effectiveness of certain treatments used. Research has performed different types of questionnaires in this area to obtain data about the treatments used in clinical practice. These studies have shown lack or scarce of evaluation and control methods in the rehabilitation programs that the specialists commonly use. In this report, a screening questionnaire was sent to the Otorhinolaryngology Departments of the Spanish Hospitals to obtain information about evaluation and treatment resources in voice pathologies. The results show great variability in clinical voice disorders in Spain. However we can observe a full agreement in the need to systematize this evaluation and the collaboration of the speech-therapists in the treatment of the voice disorders.

Rehabilitación neurocognitiva de los déficit de denominación en pacientes con afasia: efectividad de un programa asistido por ordenador / Neurocognive rehabilitation in naming deficits with aphasic patients: computer-assisted therapy effectiveness

Existe un gran desacuerdo en relación a cuáles son las estrategiasmás adecuadas en el tratamiento de la anomia. El usode ordenadores parece brindar ventajas considerables al trabajodiario de los terapeutas del lenguaje. Sin embargo, todavíase discute hasta qué punto los ordenadores pueden ayudar alos pacientes a alcanzar los objetivos marcados en la rehabilitación,y si estos realmente asisten al especialista para que lospacientes alcancen el máximo de sus posibilidades potenciales.Este trabajo describe los resultados alcanzados en ungrupo de 10 pacientes afásicos con trastornos de denominaciónusando un Programa de rehabilitación asistido por ordenador(llamado CARP2). El programa utiliza como procedimientouna serie de pistas semánticas, fonológicas, escritas ysemánticas/fonológicas para favorecer la denominación deobjetos y acciones seleccionadas. Mediante un diseño ABA,llevamos a cabo la intervención asistida por ordenador duranteun periodo de alrededor de 4 meses por paciente. Los resultadosmuestran una efectividad significativa del programaCARP2 en la recuperación de los problemas de denominacióndel grupo de pacientes afásicos, al comparar el nivel de respuestascorrectas en pre frente a post tratamiento (35.8% vs.63.5%). Es más, los resultados positivos alcanzados en subtestsde denominación (del EPLA y el Boston), no directamenteinfluenciados por CARP2, podrían relacionarse con unainternalización de las estrategias proporcionadas durante el tratamiento y su aplicación a otros estímulos similares no tratados.Por otra parte, no se aprecia ninguna mejora significativaen otras áreas de la cognición tomadas como control usandoel test de Raven y el Mini Examen Cognoscitivo (Minimental).En conclusión, se sugiere que los programas basados enlos ordenadores pueden ser válidos en el tratamiento de lostrastornos anómicos

There is disagreement regarding the most appropriatestrategies for the treatment of anomic problems. The useof computers seems to offer considerable advantages forthe daily work of speech-therapists, however there is stilldiscussion as to whether or not computers can helppatients achieve goals in therapy, and whether computersreally can assist therapists in helping their patients’ toreach their full potential. This paper describes the resultsof the Computer-Assisted Anomia Rehabilitation Program(CARP2) treating naming disorders in a group of 10-aphasicpatients with naming disorders. The program usessemantic, phonological, written and semantic/phonologicalcueing procedures to promote the naming of objects andactions. Using ABA design, we carried out a computerassistedintervention procedure over a 4-months periodper patient. The results show the significant effectivenessof the CARP2 in naming recovery comparing pre-post treatmentnumber of correct responses (35.8% vs. 63.5%).Even more, positive results in a group of stimuli fromPALPA-Oral Picture Naming test and Boston-test, notdirectly influenced by CARP2, could be related to thepatient’s internalization of strategies provided during treatmentand its application to untreated items. On the otherhand, no significant gains were observed in other areas ofcognition taken as control, using (IQ Raven’s Matrices test and Mini-Mental State Examination (Spanish version). Inconclusion, it suggests that computer based programs canbe valid in the treatment of anomic disorders

Disponibilidad y fluidez oral de palabras por categorías semánticas: un estudio prospectivo en adultos de más de 55 años con diferente nivel de escolarización / Availability and semi-spontaneous spoken word production by semantic categories: A prospective study in adults older than 55 years old with different educational level

Este estudio presenta las diferencias obtenidas en un grupo de sujetos sanos considerando su edad, sexo y nivel de escolarización al analizar su disponibilidad semiespontánea de producción oral (fluidez de palabras). Los participantes debían evocar durante 1 minuto de tiempo el mayor número posible de palabras de una categoría solicitada. Los resultados ponen de manifiesto una significativa mayor capacidad de los adultos de rango de edad menor (55-65) y de más nivel de escolarización en la producción de palabras válidas, en las 9 categorías exploradas. No se aprecian diferencias significativas por sexo. Asimismo, un corpus básico de vocabulario perteneciente a las distintas categorías, según la frecuencia obtenida y la disponibilidad oral del grupo de participantes evaluados se describe al final de este trabajo (Apéndice) (AU)

Evaluación funcional y tratamiento logopédico de pacientes con disfonía: resultados de una intervención interdisciplinar de la voz en el ámbito hospitalario / Functional Assessment and speech-therapy treatment of diphonic patients: Interdisciplinary voice intervention results in a hospital enviroment

Este trabajo presenta los primeros resultados empíricos obtenidos al utilizar un protocolo interdisciplinar ("Teatinos") en la evaluación funcional de pacientes con trastornos de la voz. El objetivo es propiciar una mejor detección de las variables de pronóstico, recuperación y prevención de las disfonías. Los resultados del estudio, llevado a cabo en 8 pacientes con nódulos bilaterales y disfonía, muestran los efectos de los distintos parámetros e índices multidimensionales valorados en la fase pre-tratamiento. Todos los pacientes manifestaron tras la rehabilitación funcional (fase post-tratamiento) una mejoría subjetiva en el bienestar vocal, en el grado de satisfacción con su voz, además de una disminución de la ronquera y un aumento de la extensión vocal. Asimismo, se observa una desaparición o reducción de los nódulos vocales, un menor grado perceptual de la disfonía, una mejora de los parámetros acústicos y una recuperación significativa de los índices aerodinámicos. Por ejemplo, los resultados muestran una mejora de un 22,5 por ciento en el Tiempo Máximo de Fonación (TMF) al comparar la fase pre vs. resultados en la evaluación de la efectividad del tratamiento logopédico son tratados en la discusión (AU)