Fluidez verbal semántica de animales en el deterioro cognitivo leve de tipo amnésico / Semantic verbal fluency of animals in amnesia-type mild cognitive impairment

Introducción y objetivo. El análisis cuantitativo y cualitativo de la tarea de fluidez verbal semántica ha permitido observar que las personas con demencia producen menos palabras y en grupos más pequeños que las personas sin demencia. Sin embargo, en personas con deterioro cognitivo leve de tipo amnésico (DCLa) la investigación ha mostrado resultados contradictorios respecto a la cantidad y el número de los agrupamientos semánticos que se realizan. El objetivo de este estudio consistió en aportar nuevos datos para intentar solventar dicha controversia. Sujetos y métodos. Participaron en el estudio 22 personas mayores con diagnóstico de DCLa (8 varones y 14 mujeres) y 43 adultos mayores (7 varones y 36 mujeres) con funcionamiento cognitivo normal que sirvieron de grupo control. Todos fueron evaluados en el Centro de Prevención del Deterioro Cognitivo del Ayuntamiento de Madrid, tras completar la prueba de fluidez verbal de animales además de otras pruebas neuropsicólogicas. Resultados. Como se esperaba, la producción de animales fue menor en el grupo DCLa que en el grupo control, pero no se observaron diferencias ni en el tamaño medio de las agrupaciones semánticas ni en el número de cambios entre dichas agrupaciones. Conclusiones. Los resultados son coherentes con investigaciones previas que sugieren que en el DCLa no sólo concurren déficits en la memoria episódica y la memoria operativa, sino también en la memoria semántica. Sin embargo, los datos no aclaran el papel de los procesos ejecutivos estratégicos, como parece suceder en la enfermedad de Alzheimer (AU)

Introduction and aim. The quantitative and qualitative analysis of the semantic verbal fluency task has revealed that people with dementia produced fewer words and smaller semantic clustering than people without dementia. However, in people with amnestic mild cognitive impairment (aMCI), research has shown conflicting results regarding the amount and number of semantic clusters that are made. The aim of this study was to provide new data to this controversial issue. Subjects and methods. Twenty-two older adults diagnosed with aMCI (8 men and 14 women) and 43 older adults (7 men and 36 women) with normal cognitive functioning that served as control group, participated in this study. All patients were evaluated at the Center for Prevention of Cognitive Decline of Madrid (Spain), completing the verbal fluency test (animals) besides other neuropsychological tests. Results. As expected, animal production was lower in the aMCI group than in the control group, but no differences were observed either in the average size of the semantic clusters or the number of switches between them. Conclusions. The results are consistent with previous research suggesting aMCI is not only characterized by episodic memory and working memory deficits. Semantic memory decline is also present. However, the data do not clarify how strategic executive processes are involved, as seems to be in Alzheimer’s disease (AU)

[Semantic verbal fluency of animals in amnesia-type mild cognitive impairment]. / Fluidez verbal semantica de animales en el deterioro cognitivo leve de tipo amnesico.

INTRODUCTION AND AIM: The quantitative and qualitative analysis of the semantic verbal fluency task has revealed that people with dementia produced fewer words and smaller semantic clustering than people without dementia. However, in people with amnestic mild cognitive impairment (aMCI), research has shown conflicting results regarding the amount and number of semantic clusters that are made. The aim of this study was to provide new data to this controversial issue. SUBJECTS AND METHODS: Twenty-two older adults diagnosed with aMCI (8 men and 14 women) and 43 older adults (7 men and 36 women) with normal cognitive functioning that served as control group, participated in this study. All patients were evaluated at the Center for Prevention of Cognitive Decline of Madrid (Spain), completing the verbal fluency test (animals) besides other neuropsychological tests. RESULTS: As expected, animal production was lower in the aMCI group than in the control group, but no differences were observed either in the average size of the semantic clusters or the number of switches between them. CONCLUSIONS: The results are consistent with previous research suggesting aMCI is not only characterized by episodic memory and working memory deficits. Semantic memory decline is also present. However, the data do not clarify how strategic executive processes are involved, as seems to be in Alzheimer's disease.

TITLE: Fluidez verbal semantica de animales en el deterioro cognitivo leve de tipo amnesico.Introduccion y objetivo. El analisis cuantitativo y cualitativo de la tarea de fluidez verbal semantica ha permitido observar que las personas con demencia producen menos palabras y en grupos mas pequeños que las personas sin demencia. Sin embargo, en personas con deterioro cognitivo leve de tipo amnesico (DCLa) la investigacion ha mostrado resultados contradictorios respecto a la cantidad y el numero de los agrupamientos semanticos que se realizan. El objetivo de este estudio consistio en aportar nuevos datos para intentar solventar dicha controversia. Sujetos y metodos. Participaron en el estudio 22 personas mayores con diagnostico de DCLa (8 varones y 14 mujeres) y 43 adultos mayores (7 varones y 36 mujeres) con funcionamiento cognitivo normal que sirvieron de grupo control. Todos fueron evaluados en el Centro de Prevencion del Deterioro Cognitivo del Ayuntamiento de Madrid, tras completar la prueba de fluidez verbal de animales ademas de otras pruebas neuropsicologicas. Resultados. Como se esperaba, la produccion de animales fue menor en el grupo DCLa que en el grupo control, pero no se observaron diferencias ni en el tamaño medio de las agrupaciones semanticas ni en el numero de cambios entre dichas agrupaciones. Conclusiones. Los resultados son coherentes con investigaciones previas que sugieren que en el DCLa no solo concurren deficits en la memoria episodica y la memoria operativa, sino tambien en la memoria semantica. Sin embargo, los datos no aclaran el papel de los procesos ejecutivos estrategicos, como parece suceder en la enfermedad de Alzheimer.

Late diagnosis of HIV infection among prisoners.

HIV-risk populations are over-represented in prisons. It is very important to identify late HIV infection diagnosis in this setting from a public health perspective. The objectives of this study are to estimate the prevalence of late diagnosis and identify the predictive factors among inmates of two prisons in Barcelona from 2010 to 2012, and to review late diagnosis in other prisons. A cross-sectional study design was used on inmates with newly-diagnosed HIV infection. Less than 350 CD4 lymphocytes/µl was considered late diagnosis. A Medline search was performed. Of the 3,933 total inmates, 1.2% (n = 47) were diagnosed with HIV infection, 1.7% from Prison A and 0.6% from Prison B (p < 0.001). Late diagnosis occurred in 47.7% of cases. A higher number of cases with late diagnosis were found in Prison A, among the immigrant population, and among intravenous drug users (p = 0.026, p = 0.007, p = 0.03, respectively). The proportion of late diagnosis decreased from 60% in 2010, to 44.4% in 2011 and 20% in 2012 (p = 0.05). The multivariate analysis confirmed an association between late diagnosis and immigrant status (OR: 7.85; 95% CI: 1.8-34.13) and the declining prevalence (p = 0.032). This is the first study to estimate late diagnosis in a prison population. Late diagnosis occurs mainly among the immigrant inmate population. The prison can serve as an opportunity to identify and treat HIV infection among people who have little contact with health services, thus avoiding further transmission.

Complex atheromatosis of the aortic arch in cerebral infarction.

In many stroke patients it is not possible to establish the etiology of stroke. However, in the last two decades, the use of transesophageal echocardiography in patients with stroke of uncertain etiology reveals atherosclerotic plaques in the aortic arch, which often protrude into the lumen and have mobile components in a high percentage of cases. Several autopsy series and retrospective studies of cases and controls have shown an association between aortic arch atheroma and arterial embolism, which was later confirmed by prospectively designed studies. The association with ischemic stroke was particularly strong when atheromas were located proximal to the ostium of the left subclavian artery, when the plaque was ≥ 4 mm thick and particularly when mobile components are present. In these cases, aspirin might not prevent adequately new arterial ischemic events especially stroke. Here we review the evidence of aortic arch atheroma as an independent risk factor for stroke and arterial embolism, including clinical and pathological data on atherosclerosis of the thoracic aorta as an embolic source. In addition, the impact of complex plaques (≥ 4 mm thick, or with mobile components) on increasing the risk of stroke is also reviewed. In non-randomized retrospective studies anticoagulation was superior to antiplatelet therapy in patients with stroke and aortic arch plaques with mobile components. In a retrospective case-control study, statins significantly reduced the relative risk of new vascular events. However, given the limited data available and its retrospective nature, randomized prospective studies are needed to establish the optimal secondary prevention therapeutic regimens in these high risk patients.