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Biomedical subjects

I Clemente

Publications and source records attributed to I Clemente.

10 recordsLinked to original sources
PubMed2006

Influence of APOE polymorphism on cognitive and behavioural outcome in moderate and severe traumatic brain injury.

AIM: To analyse the influence of apolipoprotein (APOE) epsilon4 status on the cognitive and behavioural functions usually impaired after moderate and severe traumatic brain injury (TBI). METHODS: In all, 77 patients with TBI selected from 140 consecutive admissions were genotyped for APOE. Each patient was subjected to neuropsychological and neurobehavioural assessment at least 6 months after injury. RESULTS: Performance of participants carrying the epsilon4 allele was notably worse on verbal memory (Auditory Verbal Learning Test), motor speed, fine motor coordination, visual scanning, attention and mental flexibility (Grooved Pegboard, Symbol Digit Modalities Test and part B of the Trail Making Test) and showed considerably more neurobehavioural disturbances (Neurobehavioral Rating Scale-Revised) than the group without the epsilon4 allele. CONCLUSIONS: In particular, performance on neuropsychological tasks that are presumed to be related to temporal lobe, frontal lobe and white matter integrity is worse in patients with the APOE epsilon4 allele than in those without it. More neurobehavioural disturbances are observed in APOE epsilon4 carriers than in APOE epsilon2 and epsilon3 carriers.

Apolipoprotein E4↗
PubMed1999

Apo E influences declarative and procedural learning in age-associated memory impairment.

Age-associated memory impairment (AAMI) is a clinical entity which was originally described to define memory problems linked to normal aging. Apolipoprotein E and ACE genes have both been associated with cognitive impairment in aging and dementia. The purpose of this study was to investigate memory and executive functions in AAMI according to the genetic background. We found that subjects carrying the Apo E epsilon4 allele exhibit lower memory performance on tests of both declarative and procedural memory. We did not find differences on frontal lobe tests. These findings give further support to the hypothesis concerning a genetic susceptibility for cognitive impairment in aging.

Aged↗
PubMed1999

Clinician follow-up of children screened for lead poisoning.

OBJECTIVES: This study assessed clinicians' compliance with Centers for Disease Control and Prevention recommendations for follow-up of children with blood lead (BPb) levels of 0.48 mumol/L (10 micrograms/dL) or higher. METHODS: Clinicians' success at follow-up was determined for 3 BPb ranges: > or = 0.97 mumol/L, 0.73 through 0.92 mumol/L, and 0.48 through 0.68 mumol/L (> or = 20 micrograms/dL, 15-19 micrograms/dL, and 10-14 micrograms/dL, respectively). RESULTS: A total of 410 children with elevated BPb levels were followed over a 12-month period; within 4 months, 71% of those with initial levels of 0.97 mumol/L or greater were retested and 57% and 34% of children with initial BPb levels of 0.73 through 0.92 mumol/L and 0.48 through 0.68 mumol/L, respectively, were retested. CONCLUSIONS: Follow-up of children with elevated BPb levels is inadequate within an urban ambulatory care network.

Centers for Disease Control and Prevention, U.S.↗
PubMed1997

Children with moderately elevated blood lead levels: a role for other diagnostic tests?

In this study we examined potential limitations of relying exclusively on blood lead (BPb) levels to evaluate children with moderately elevated BPb levels (1.21-2.12 micromol/l, or 25-44 microg/dl). We tested the following hypotheses: 1) such children without elevated erythrocyte protoporphyrin (EP) levels (>=0.62 micromol/l or >/= 35 microg/dl) are unlikely to respond to a chelating agent with a brisk urinary Pb diuresis; 2) those with elevated EP levels, but low hematologic indices consistent with iron deficiency, are also unlikely to respond to a chelating agent with a robust urinary Pb diuresis; and 3) those with elevated EP levels and iron sufficiency are more likely to respond to a chelating agent. To test these hypotheses, we performed retrospective analyses of the relationships between EP concentrations, hematologic indices, and urinary Pb excretion ratios (uPbr) in moderately Pb-poisoned children undergoing the CaNa2EDTA lead mobilization test (Pb-MT). Data from 122 children were available. Urinary Pb excretion was limited in children with an EP <0.62 micromol/l (<35 microg/dl); only 5% (1/21) of Pb-MTs were positive (uPbr >=0.6). In children with an EP >=0.62 micromol/l, low hematologic indices, such as a mean corpuscular hemoglobin (MCH) <23 pg, were associated with relatively little Pb excretion (0/14 positive Pb-MTs). In contrast, 32% (28/87) of Pb-MTs were positive in children with an EP >/= 0.62 micromol/l and iron sufficiency (p<0.01 by chi-square comparison between groups with EP >/= 0.62 micromol/l and either MCH <23 pg or MCH >/= 23 pg). We conclude that only a minority of moderately Pb-poisoned children will demonstrate enhanced urinary Pb excretion in response to chelation therapy. Some of the predicted nonresponders can be readily identified by adding the EP and complete blood count to the panel of tests performed.

Child↗
PubMed1993

Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non-lead-exposed suburban populations in the United States.

Measurements of lead (Pb) in bone reflect cumulative Pb exposure, whereas blood Pb levels are indices of absorption during the previous 21-30 days. This study was undertaken to estimate bone Pb concentrations by L-line x-ray fluorescence (LXRF) in a United States suburban population which was exposed to unusually high levels of Pb in emissions from an adjacent factory during 1963-1981, compared with concentrations similarly estimated in a matched suburban community without unusual Pb exposure. The mean bone Pb value in 269 residents of the highly exposed suburb (15 ppm) was 3-fold greater than that of the reference suburb (5 ppm). LXRF estimates of bone Pb identified those individuals at risk for adverse effects of Pb, whereas blood Pb levels were uninformative. Average LXRF-estimated bone Pb concentrations in residents of the unusually exposed suburb approximated estimated values in workers at Pb-processing factories.

Adolescent↗
PubMed1986

Educational intervention by computer in childhood asthma: a randomized clinical trial testing the use of a new teaching intervention in childhood asthma.

To affect asthma-related knowledge, behavior, and morbidity, researchers tested a new educational intervention for children with asthma: an asthma-specific computer game called Asthma Command, which was specifically designed for this study. Sixty-five children with moderately severe asthma were randomly assigned to one of two groups, and 54 completed the study. Both groups were seen approximately six times during the 1 year of the study. Control subjects (n = 29) played routine computer games. Experimental subjects (n = 25) played Asthma Command. Compared with children in the control group, experimental subjects showed improvement in knowledge about asthma (P less than .001), behavior related to the management of asthma (P less than .008), and a trend toward the reduction of acute visits due to asthma (P less than .13). Children in the experimental group also scored higher on the assessment of behaviors related to the management of asthma that were specifically addressed by the intervention provided by Asthma Command (P less than .01). Differences between the control and experimental groups showed a greater improvement in the experimental group in 21 (84%) of the 25 outcome variables in the study (P = .004, Sign test). The study indicates that an asthma-specific computer game can significantly affect knowledge and behavior and may potentially affect morbidity in childhood asthma.

Asthma↗
PubMedDate not supplied

[Socio-economic factors associated with preterm delivery. Results of the European project in Spain].

OBJECTIVES: The objectives of this paper were to analyse the effect of social, personal and medical risk factors on preterm birth (moderate versus very preterm) or on two preterm birth groups (spontaneous versus indicated). METHODS: Results from the Spanish collaborating centre of the European multicentre case-control study EUROPOP (European Program of Occupational Risks and Pregnancy Outcome) are presented. All preterm births (529) between 22 and 36 completed weeks of amenorrhea and 788 births of 37 or more completed weeks of amenorrhea (control group) are included. Explicative variables are divided in social, personal and medical factors. A univariate and multivariate analysis by means of a logistic regression were carried out. RESULTS: Very preterm birth risk was higher for women over 34 years, adjusted OR: 2.53 (1.42-4.52), with lower educational level, adjusted OR: 1.79 (1.07-2.98), for primigravid women or multigravid women with only first trimestre abortion, adjusted OR: 1.86 (1.13-3.04), and for multigravid women with previous preterm birth or second trimestre abortion, adjusted OR: 5.53 (2.97-10.35). A similar trend was observed for moderate preterm birth. Probability of spontaneous preterm birth was higher for mother over 34 years, adjusted OR: 1.51 (1.01-2.26), with lower income, adjusted OR: 1.75 (1.07-2.88) and for multigravid women with previous preterm birth or second trimestre abortion, adjusted OR: 2.96 (1.86-4.71). Results were similar for indicated preterm birth. CONCLUSION: Social differences were found to be related to moderate and very preterm birth. No differences were observed between risk factors and kind of preterm birth: spontaneous or indicated.

Adult↗
PubMedDate not supplied

[Cognitive changes in normal aging: nosology and current status].

INTRODUCTION AND OBJECTIVES: During the last 15 years several diagnostic categories have appeared to describe a group of adults with cognitive impairment compared to their age-matched standardized norms but without dementia. In this work, the main studies relating to these categories are reviewed and compared in order to establish if they define similar or different aged populations. DEVELOPMENT: Differences in prevalence or in prognostic values among studies are probably due to the selection of diagnostic categories or the differences in the application of inclusion/exclusion criteria. Genetic and neuroimaging data have contributed to reinforce the validity of the proposed classifications to identify the age related cognitive decline. CONCLUSIONS: The criteria used seems to be very important in the inclusion of subjects closer to normal aging or to dementia. In this respect further longitudinal studies and a consensus from previous described categories are need to reliably identify aged population with lower cognitive function compared to their age norms but different from patients in the initial stages of dementia.

Aged↗
PubMedDate not supplied

[Apolipoproteins and cognitive deterioration].

Main studies which have shown an association between the variation in apolipoprotein genes and human neuropsychological impairement are reviewed in this work. Data from literature indicate a special relevance of apolipoprotein E (ApoE) in relation to Central Nervous System (CNS) functions, basically memory. ApoE epsilon 4 is a well documented risk factor for late-onset Alzheimer's Disease (AD). Memory changes in older adults and in AD are also associated with ApoE genotype. Furthermore, ApoE may play a role in formation or degeneration of some neural structures related to memory. In some studies a relation between ApoE's alleles and cerebral vascular disorders like ischemic, haemorrhagic, Vascular (VD) and Multi-infarct (MD) Dementias is also reported. The role of the remaining apolipoproteins in cognitive impairment is still unknown, and these molecules have been considered as risk factors associated with environmental factors in CNS pathologies, essentially the vascular ones.

Aged↗