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Biomedical subjects

A Castro-Caldas

Publications and source records attributed to A Castro-Caldas.

At least 19 recordsLinked to original sources
PubMed1997

DYSBOT: a single-blind, randomized parallel study to determine whether any differences can be detected in the efficacy and tolerability of two formulations of botulinum toxin type A--Dysport and Botox--assuming a ratio of 4:1.

BACKGROUND: Elston and Russell discovered a difference in the biological potency of the English formulation of botulinum toxin type A or BTX-A (Dysport) and the American formulation (Botox). Potency of both is expressed in LD50 mouse units, but because of assay differences, these units are not equivalent. Since the first warning by Quinn and Hallet on the clinical importance of this issue, it has been impossible to reach a consensus on the conversion factor for the potency of these formulations. OBJECTIVE: To test the hypothesis that the conversion factor for the clinical potency of Dysport to Botox is approximately 4:1. DYSBOT is an acronym that results from adding "DYS" from Dysport with "BOT" from Botox. PATIENTS AND METHODS DESIGN: A single-blind, randomized, parallel comparison. A total of 91 patients with blepharospasm or hemifacial spasm were randomized to treatment with Dysport or Botox using a fixed potency ratio of 4:1. Clinical evaluations: The patients were evaluated at baseline (day of the treatment). 1 month after treatment, and whenever the effect was judged to be fading. Objective and functional rating scales were used as quantitative measures of the change in clinical status. Adverse reactions were collected using a systematic questionnaire. RESULTS: Using this ratio between products, both Dysport and Botox groups produced similar clinical efficacy and tolerability. For patients showing a positive response without the need of a booster, the duration of effect was 13.3 +/- 5.9 weeks for the Dysport group and 11.2 +/- 5.8 weeks for the Botox group. Of 48 patients, 11 (23%) needed booster treatment in the Dysport group compared with five (12%) of 43 in Botox group. Adverse events were noted in 24 (50%) of 48 patients in the Dysport group and 20 (47%) of 43 of the Botox-treated group. CONCLUSIONS: Using a 4:1 conversion ratio for Dysport and Botox, similar results were obtained for the two treatments in an appropriately powered study, suggesting that this conversion factor is a good estimate of their comparative clinical potencies.

Aged↗
PubMed1997

Subjective experience in brain-injured patients and their close relatives: a European Brain Injury Questionnaire study.

Results are reported from an international project the aim of which has been to develop and validate a wide-ranging questionnaire suitable for administration to brain-injured patients and their relatives. A self-report questionnaire concerning subjective experience of cognitive, emotional and social difficulties (The European Brain Injury Questionnaire, EBIQ) was administered to a group of 905 brain-injured patients, and close relatives to these competed a parallel version of the questionnaire concerning the brain-injured person. The sample was drawn from seven European countries together with Brazil. The same questionnaire was also administered to a group of 203-non-brain-injured controls, similarly in self-report and relative-report versions. Scales relating to eight specific areas of functioning, together with a global scale, are derived from the questionnaire and their internal reliability was estimated in the present data. Analyses of the 63 items of the questionnaire showed consistently greater levels of problems for the brain-injured group, especially as indicated by relatives. This pattern was substantially replicated among the nine scales. The scales discriminated well between stroke patients and those who had suffered a traumatic brain injury. There was also a tendency for reported problems to be greater for patients who were surveyed later post-injury (> or = 19 months) rather than earlier. Comparison of sets of controls derived from two countries (France and Brazil) showed small but important differences. It is concluded that the questionnaire has an acceptable reliability and validity, but that it will be necessary to obtain culturally relevant non-brain-injured control data when employing it in different countries.

Adolescent↗
PubMed1997

Botulinum toxin type A for the treatment of arm and hand spasticity in stroke patients.

BACKGROUND: Focal spasticity can be a major drawback in the rehabilitation of stroke patients. Previous studies suggest a beneficial effect for botulinum toxin A (BTX-A) for relief of spasticity. OBJECTIVE: To evaluate the safety and efficacy of BTX-A in the treatment of spasticity in a homogeneous group of stroke patients. METHODS: In this phase III open label trial 19 stroke patients stable for at least six months were enrolled (mean age 53.1 (SD 3.27) years; range 26-72). There were 16 males and 4 females. ASSESSMENTS: Clinical (Ashworth spasticity rating scale, scores for joint mobility, pain and frequency of spasms, Frenchay arm test (FAT)) and subjective (semi-quantitative rating scale filled out by the patient). Only hand and finger flexors were injected. The maximum dosage was 150 U BOTOX (25 U/muscle), the mean dosage was 92.1 +/- 31.6 U BOTOX. RESULTS: Ashworth rating scale and joint mobility scores improved from a median value of 2 at baseline to a median value of 1 one month after treatment, FAT scores also improved from a median value of 0 at baseline to a median value of 1 one month after treatment (Kruskall-Wallis test p < 0.01). Two-thirds of the patients rated their functional improvement as none or mild. CONCLUSIONS: Our study confirmed that BTX-A has an anti-spastic effect but its functional impact needs further evaluation.

Adult↗
PubMed1997

Illiteracy: a cause for biased cognitive development.

Learning to read and write generates new rules within the language processing systems. These new rules significantly change the manner in which some operations are performed. This finding was studied, by comparing the performance of literate and illiterate persons in several tasks. It was found that illiterate individuals (1) had difficulties in repeating pseudowords, (2) were worse at memorizing pairs of phonologically related words compared to pairs of semantically related words, and (3) were unable to generate words according to a formal criterion. Illiterate persons use strategies that are good for semantic processing, but inadequate for phonological analysis, while literate individuals are able to use several parallel running strategies.

Aged↗
PubMed1995

Aphasia following right hemisphere lesion in a woman with left hemisphere injury in childhood.

The case of a 56-year-old woman who became aphasic following a right temporoparietal lesion is reported. At the age of 2, this woman had an acute infantile hemiplegia on the right side of the body and it was reported by relatives that a deterioration of language was also noted. There was a slow recovery of these deficits and she was considered as having normal language only at age 7. Although it is difficult to be sure about the hand preference of the patient before the stroke at age 2, the relatives were quite positive saying, that she previously preferred the right hand and that she became left handed. The CT scan showed an old left frontal ischemic lesion and a recent right temporoparietal lesion. This case illustrates the ability of the right hemisphere to take over functions of the left when a left lesion occurs in early stages of language acquisition. Although this is an accepted model for recovery, this is the only case in the literature with a documented early focal lesion of the left hemisphere. Other evidence comes from studies performed in populations where severe epilepsy may contribute to particular functional organization.

Aphasia↗
PubMed1995

Atypical dominance for language in developmental dysphasia.

The authors report an association between developmental language disorder and acquired aphasia in a 13-year-old right-handed boy. Acquired aphasia was caused by a right-frontal abscess (crossed aphasia). It was non-fluent, with a disorder of auditory comprehension, an unusual feature of prerolandic lesions. This case shows that developmental language impairment can be associated not only with an atypical cerebral dominance, but also with unusual patterns of intrahemispheric specialization. The rapid and complete recovery of this boy's aphasia suggests that the cerebral plasticity for acquired lesions can be normal in such cases.

Adolescent↗
PubMed1995

The response of "de novo" Parkinson's disease patients to bromocriptine in a "low and slow" regimen is predictive for prognosis.

It is possible that Bromocriptine only determines a complete antiparkinson effect in a subset of P.D. patients that have a good dopaminergic reserve. Our study intent to demonstrate that a good short-term response to Bromocriptine used in a "low and slow" regimen is a marker of long term good prognosis. We studied a series of 36 sequential "de novo" P.D. patients treated with Bromocriptine in a "low and slow" regimen. The principal end-point was the introduction of Levodopa. "Good prognosis" was defined as no need of Levodopa until five years of follow-up. An improvement greater than 33% in the Columbia rating scale, at the 6th month of treatment, was the cut-off point to decide that a patient had a good short term response to Bromocriptine. Nine patients fulfilled the criteria for being good short term responders. Multiple regression analysis showed that this outcome could not be predicted by the clinical characteristics of the patients at admission. The sensitivity and the specificity of the short term response to Bromocriptine to predict a good prognosis were 70% and 90.5% respectively. We conclude that Bromocriptine in monotherapy is an efficient antiparkinson agent in 1/3 of "de novo" P.D. patients and good short term response to Bromocriptine is an acceptable marker for a good prognosis. Therefore it is possible that the response to Bromocriptine is a discriminator for a subset of P.D. patients in the early phases of the disease.

Adult↗
PubMed1994

Influence of educational level of non brain-damaged subjects on visual naming capacities.

Educational level of subjects is a variable often neglected in neuropsychological studies. However, there are pieces of evidence to suggest that illiterate subjects may perform worse than literate subjects in some tests. Visual naming is one of the tasks where a poor performance was reported in illiterate populations. The present study addresses this problem of comparing the performance in visual naming tasks of non-brain-damaged patients of different educational levels. The test materials were composed of three subtests: naming real objects, their photographs, and line drawings of the same objects. Results revealed that there is a clear influence of educational level on the ability to name photographs and line drawings of the objects. Naming line drawings is particularly difficult for the lower educated non-brain-damaged subjects. Visual analysis of two dimensional representations is a task that requires special learning. These results have to be taken into consideration in test selection for poorly educated populations.

Aged↗
PubMed1989

Partial section of the corpus callosum: focal signs and their recovery.

A 30-year-old woman underwent surgical partial callosotomy (posterior half) for removal of an arteriovenous malformation. The patient submitted to neuropsychological evaluation before and after surgery for a period of 8 months. There was transient dysfunction attributable to disconnection of parietal, temporal, and occipital connections. Because the symptoms disappeared over time, we conclude that the transcallosal surgical approach can, in the long term, be considered a relatively harmless method.

Adult↗
PubMed1986

Contrecoup injury in the misdiagnosis of crossed aphasia.

Crossed aphasia is reported to be more frequent in traumatic series than in series of patients with other pathologies. A right-handed young man suffered a closed-head trauma and became aphasic and hemiparetic on the left. CT scan revealed a right frontal-lobe hematoma. Neuropsychological examination revealed a fluent aphasia and a Gerstmann syndrome. These signs were compatible with left supramarginal gyrus syndrome. However, the presence of a right frontal-lobe lesion suggested that this patient could be a crossed aphasic. Subsequent EEG study showed a left occipitotemporal focus and a right frontal one. Aphasic signs could thus be due to the left lesion, which was the result of a contrecoup mechanism. Fluent aphasias have been reported in closed-head trauma with right frontal impact. Attention is called for the possible bias of including cases like this in series of traumatic crossed aphasia.

Adult↗
PubMed1984

Right hemifield alexia without hemianopia.

We studied a 54-year-old man who suffered a stroke in the visual-association areas of the left hemisphere. He showed no right-sided visual field defect and results of a neuropsychologic examination were normal except for his performance in several tasks presented to the right visual field. Naming of drawings was normal in both hemifields but reading of letters, words, digits, and arithmetic symbols was defective in the right field. We believe that the lesion in the visual association areas of the left hemisphere that did not interrupt interhemispheric connections disconnected the primary visual areas from temporoparietal areas of the left hemisphere, affecting reading.

Cerebrovascular Disorders↗
PubMed1984

Age and type of crossed aphasia in dextrals due to stroke.

Thirty-nine cases (37 from the literature and 2 personal) of crossed aphasia in dextrals due to stroke were reviewed concerning age, sex, and type of aphasia. Results showed that Broca's aphasics are younger than the remaining group, males predominate, and several types of aphasia have been described similarly to the aphasias due to left-hemisphere lesions in dextrals.

Age Factors↗
PubMed1984

Transient and persistent right ear extinction in dichotic listening: subcortical lesions.

Nine patients with aphasia had right ear extinction in dichotic listening to words in the first month after an ischemic stroke; they were reassessed after 3 months. Four showed complete recovery from the right ear extinction; in five, the abnormality persisted. In those who recovered, CT revealed a subcortical lesion lateral to the frontal horn of the lateral ventricle without a lesion of Heschl's gyrus or geniculo-temporal pathways; a lesion in those structures was found in patients who did not recover. As reported for subcortical aphasia, a subcortical mechanism may explain contralateral ear extinction in dichotic listening.

Adult↗