Biomedical subjects

M Pérez-García

Publications and source records attributed to M Pérez-García.

12 recordsLinked to original sources

PubMed2006

Stress as a predictor of cognitive functioning in lupus.

The objective of this study was to investigate the possible effects of the daily stress experienced during a six-month period on the cognitive functioning of patients with systemic lupus erythematosus (SLE). For this purpose, we evaluated the daily stress of 21 patients with lupus every day for six months. Later, we carried out a neuropsychological exam that included an evaluation of attention and memory. At the same time, scores on depression and anxiety were recorded with the objective of controlling other emotional variables that might be influencing these cognitive processes. The results show that daily stress was able to predict the scores on the neuropsychological variables studied. Specifically, the daily stress experienced in the previous six months is the variable with the greatest explanatory-predictive power on the scores for delayed recall visual memory, visual fluency and attention speed. This relationship proved to be negative in all three cases (R2 corr = 0.290; t = -2.712, P < 0.014); (R2 corr = 0.318; t = -2.818, P < 0.012); (R2 corr = 0.319; t = -2.906, P < 0.009), which means that the greater the daily stress, the lower the score on visual memory, fluency and total attention speed. We can state that daily stress is related to impairments in visual memory, fluency and attention in patients with SLE. This effect was not found with other emotional variables, such as depression and anxiety.

Adult↗

PubMed2006

[Neuropsychological impairment in patients with intracranial aneurysms: surgical versus endovascular treatment].

OBJECTIVES: To describe the neuropsychological status of patients with intracranial aneurysms and to compare the cognitive status of patients with intracranial aneurysm treated by surgical or endovascular methods. MATERIAL AND METHODS: Ninety-three cases with intracranial aneurysms treated with surgery (n = 56) or embolization (n = 37) were included. A neuropsychological assessment was applied to both groups retrospectively, at least one year after treatment. RESULTS: Neuropsychological impairment was found in both groups. 35.7% of the patients treated with surgery and 43.2%, of those treated with embolization did not show any cognitive impairment. Visual Memory and Cued Recall of verbal information are better in patients treated by embolization. CONCLUSIONS: Our results show that a large proportion of patients with intracranial aneurysms have cognitive impairment after treatment. Endovascular management may cause less impairment in visual and verbal memory. However, bleeding may be the most important factor to explain these cognitive impairments.

Adult↗

PubMed2006

[Quality of life in intracranial aneurysm: surgery versus endovascular treatment].

BACKGROUND: Based on earlier studies, we aimed to determine the quality of life of patients with intracranial aneurysm after their treatment by surgery or embolization and to compare the quality of life of these two groups. METHODS: The SF-36 health questionnaire was retrospectively applied to 93 patients with intracranial aneurysm treated with surgery (n=56) or embolization (n=37). RESULTS: The quality of life of some patients was impaired but 50% of patients treated with surgery and 40.5% of patients treated with embolization showed no impairment in any SF-36 domain. The quality of life in the Physical Functioning domain was higher in embolization-treated than in surgery-treated patients. CONCLUSIONS: Some patients with intracranial aneurysms treated with surgery or endovascular embolization have an impaired quality of life. Endovascular treatment may cause less limitation in physical function. The quality of life of these patients is affected by numerous factors, in addition to the type of treatment.

Adult↗

PubMed2005

Acne is not a stigma of HIV infection: a review of 36 patients.

INTRODUCTION: Several diseases with follicular occlusion have been described in HIV-infected patients and can appear isolated or associated with each other in an independent disease named 'HIV-associated follicular syndrome'. Worsening of cutaneous lesions during the course of infection in patients with previous acne vulgaris, late onset or severe forms of acne have been reported in HIV-infected patients. PATIENTS AND METHODS: A prospective study of 335 HIV-infected patients was performed in our hospital. A meticulous dermatological exploration in all patients was made, and multiple data were stored into a Microsoft Access 97 program. Patients diagnosed as having acne were considered separately, and we studied their characteristics. A statistical analysis with SPSS 9.0 (Statistical Package for the Social Sciences) was performed. RESULTS: Thirty-six patients (10.8%) were diagnosed as having acne. Papulopustular lesions were the most frequent clinical presentation. Most lesions were localized on the face or on the back, and 80% of patients had mild to moderate acne; 40% of them required no treatment and the remainder was treated with topical measures, oral antibiotics and isotretinoin. 85% of cases reported the onset of acne during adolescence or before HIV infection and without any relationship with this disease. No relation between acne intensity and stage of HIV infection was observed. A multivariate analysis showed that the most important variable was age. DISCUSSION: In contrast to previous reports, no greater intensity or modifications in acne lesions were observed in our HIV-infected patients during the course of the disease. In the majority of cases, cutaneous lesions started before HIV infection, during adolescence, and the most important factor for suffering from acne was young age. In contrast to data reported in the literature, no relation of acne lesions to CD4 lymphocyte count or AIDS case criteria was found in our patients. CONCLUSIONS: Acne in HIV-infected patients has characteristics similar to those in non-HIV-infected patients. The age is the most important factor for the appearance of lesions that usually develop during adolescence. Acne lesions are not modified by HIV infection, and no relationship with the severity of HIV infection has been observed.

Acne Vulgaris↗

PubMed2005

Effect of the pH influent conditions in fixed-film reactors for anaerobic thermophilic treatment of wine-distillery wastewater.

In anaerobic treatments, the pH conditions affect the efficacy and operation of the process. The main purpose of this research is to compare the effect of the pH influent on the performance of a high rate technology at laboratory scale, upflow anaerobic fixed-film reactor, treating distillery wastewater (wine vinasses) in thermophilic conditions. The results obtained shown that the pH influent influences the performance of the biodegradation process: the depurative efficiency is higher for the operation with alkaline influent. The operation with acid influent allows us to operate at organic loading rates (OLR) around 5.6 kgCOD/m3/d (hydraulic retention time: 1.5 days), maintaining total Chemical Oxygen Demand removals (CODr) of 77.2%; the operation with alkaline influent allows total CODr of 76.8% working at OLR around 10.5 kgCOD/m3/d. The greatest efficiency of substrate removal was 87.5% for OLR 3.2 kgCOD/m3/d and hydraulic retention time of 4.0 days operating with alkaline influent. Therefore, the operation with alkaline influent implicates senior levels of purifying efficiency for similar organic load rate.

Bacteria, Anaerobic↗

PubMed2005

High rate anaerobic thermophilic technologies for distillery wastewater treatment.

In this paper, performance of two high rate technologies, upflow anaerobic fixed-film reactor and fluidized bed laboratory-scale, treating distillery wastewater (wine vinasses) at anaerobic thermophilic conditions have been compared. The results obtained show that the stationary packed bed, with a corrugated plastic support, operated under stable conditions at organic loading rates (OLR0) around 20 kgCOD/m3/d, gives maximal total CODr of 76% at OLR0 of 6.29 kgCOD/m3/d; the fluidized bed reactor, operated on open pore sintered-glass media, gives total CODr of 96% at OLR0 of 5.88 kgCOD/m3/d. The anaerobic fluidized bed technology is more effective than the upflow anaerobic fixed-film technology due, fundamentally, to this technology favouring the transport of microbial cells from the bulk to the surface and enhancing the contact between the microorganism-substrate phases, In this sense, the stationary packed bed technology is adequate for the treatment of easily biodegradable wastewater, or for the cases where elevated percentages of CODr removal are not required, while the fluidized bed technology is especially suitable for treatment of hazardous wastes with recalcitrant compositions.

Bacteria, Anaerobic↗

PubMed1997

Very low doses of unfractionated heparin potentiate the anti-Xa activity of low molecular weight heparin (enoxaparin)

Some previous reports indicated that a minimal amount of anti-IIa is necessary for the optimal anti-Xa activity of low molecular weight heparin (LMW-H). To know if we could improve the prophylactic activity of LMW-H, providing a mild antithrombin effect, we conducted an experiment in which we administered subcutaneously to 10 volunteers, very low doses of unfractionated heparin (UFH), (1000 IU), a LMW-H (enoxaparin, 2000 IU = 20mg), or both heparins together on alternate days, and measure the anti-Xa activity before, and 4 hours after injection. We found that the anti-Xa activity in the first group (UFH), increased by 33%, over the basal values; in the second group (LMW-H), by 93%, but it increased by 282%, in the third group (UFH + LMW-H) showing clearly (p < 0.0069), that UFH could increase synergistically, more than additive, the anti-Xa activity of enoxaparin. The impact on the cost-effectiveness of antithrombotic prophylaxis and the therapeutic results with the herein combined scheme should be evaluated.

Anticoagulants↗

PubMedDate not supplied

[Changes in episodic and semantic memory associated with temporal lobectomy].

INTRODUCTION: Temporal lobectomy (TL) is an effective treatment for drug refractory temporal lobe epilepsy. The main neuropsychological consequences of the intervention are changes in episodic and semantic memory. Aim. To study the consequences of right temporal lobectomy (RTL) and left temporal lobectomy (LTL) on episodic and semantic mnemonic functioning. PATIENTS AND METHOD: 27 patients who had undergone TL in the Hospital Universitario Virgen de las Nieves in Granada were submitted to pre and post surgical evaluation by means of a battery of neuropsychological tests that included episodic and semantic memory tests for both verbal and visual material. RESULTS AND CONCLUSIONS: ANOVA analysis was employed to analyse the pre and post surgical changes for the whole group of patients, and Student s t and Wilcoxon s non parametric test were used for each group of RTL and LTL. No deterioration was found in ipsilateral memory after the intervention, that is to say, in the verbal memory of the patients submitted to LTL and in the visual memory of RTL patients. With regard to contralateral memory, that is, the visual memory of patients submitted to LTL and the verbal memory of RTL patients, the ANOVA analyses of the whole group revealed a statistically significant improvement. The analyses performed for the whole group (LTL and RTL), however, did not reveal any statistically significant changes.

Adult↗

PubMedDate not supplied

[Clinical neuropsychology of the surgery of temporal lobe epilepsy].

INTRODUCTION AND OBJECTIVES: The surgery of epilepsy has become a real alternative for the treatment of patients with drug resistant epilepsy. In this study we review the part played by Clinical Neuropsychology in programmes of surgery for epilepsy, particularly in operations designed to treat drug resistant temporal lobe epilepsy. DEVELOPMENT: Firstly we describe the function of the clinical neurologist in relation to these patients. Then we consider the main national and international forms of assessment. Finally we describe the main findings of neuropsychological investigation regarding the approach to temporal lobectomy. Thus we describe the main presurgical characteristics of candidates for surgery regarding cognition and personality. Similarly we describe what is known of the possibilities of finding the site of the epilepetogenic focus and prognosis of the results and neuropsychological consequences of the operation. Finally, we describe the cognitive results, particularly memory, after temporal lobectomy. CONCLUSIONS: Review of the literature shows how important it is for the clinical neuropsychologist to be involved in programmes of the surgery of epilepsy, studying the patients before and after surgery and assessing prognosis. Clinical neuropsychology is also important for predicting the post surgical neuropsychological results.

Amobarbital↗

PubMedDate not supplied

[The impact exerted by the severity of recreational drug abuse on the different components of the executive function].

INTRODUCTION: A number of neuropsychological studies have shown the relationship between severity of drug abuse and the executive functioning of substance abusers, along with its negative impact on treatment results. AIM: The aim of this study is to examine the relationship between severity of consumption of alcohol, cannabis, cocaine, heroin, amphetamines and ecstasy on the executive processes of fluency, working memory, response inhibition, concept formation and decision-making. PATIENTS AND METHODS: Forty poly-substance abusers participated in this study. In a series of setwise regression analyses we introduced the standardized scores of a severity index as predictor variables, and the raw scores of five indexes sensitive to executive functioning as dependent variables: the Ruff Figural Fluency Test (RFFT), the Letter Number Sequencing subtest (LyN), the 5 Digit Test (5DT), the Category Test (TC) and the Gambling Task (GT). Best subsets of predictors for each dependent variable were included in multiple regression models. RESULTS AND CONCLUSIONS: We obtained significant relationships between severity of heroin and ecstasy abuse and RFFT performance; between severity of alcohol, cocaine, heroin and amphetamines and LyN performance; between severity of alcohol, cannabis, cocaine, heroin and ecstasy and 5DT performance; and between severity of heroin and amphetamines and TC performance. These results show the significant influence of severity of drug abuse on executive impairment, which may have a negative impact on treatment results.

Adult↗

PubMedDate not supplied

[Guidelines for the scientific and professional development of forensic neuropsychology].

AIMS: The principal aims of this review are: (a) to offer a perspective of the principal challenges that forensic neuropsychology handles in its scientific and professional development, and the empirical advances that have been developed to deal with these challenges; and (b) analyze the potential effects of these advances on the application of the discipline in the Spanish legal system. DEVELOPMENT: With the purpose of reaching these challenges, a series of methodological strategies and instruments, along with specific recommendations about the use of currently available procedures and the development of new procedures, have been generated within the context of forensic neuropsychology. In this paper, we will review: the advances carried out in the different issues of interest that currently handles the development of the discipline, including: the estimation of premorbid functioning, the development of base rates and norms for forensic populations, the detection of malingerers, the ecological validity of instruments, and the creation of professional practices; we will analyze the potential application of these advances to the assessment of the Spanish forensic population; and we will study the principal application areas of forensic neuropsychology within the Spanish legal context. CONCLUSIONS: Forensic neuropsychology is an emergent discipline that is placed in a key moment of its scientific and professional development. This development should be anchored in the application of specific scientific, professional, and academic strategies.

Forensic Medicine↗

PubMedDate not supplied

[Relationship between memory tests and volumetry and relaxometry of the hippocampus].

INTRODUCTION AND AIMS: Interdisciplinary research made by neuropsychologist, neurologists and radiologists is making possible descriptions of the anatomic bases of memory. The hippocampus is one of the main structures related to memory processing. The aim of the present study was to study the relationship between verbal and visual memory, and the volumetry and relaxometry of the. PATIENTS AND METHODS: 36 patients with temporal lobe epilepsy and mesial temporal sclerosis (MTS). Fist, a neuropsychological assessment of was made the verbal and visual memory. Second, hippocampal structure were studied by magnetic resonance image (hippocampal volumetry and relaxometry). RESULTS AND CONCLUSIONS: Reactive gliosis measured by T2 relaxation time predicted poorer visual memory in patients with right or left MTS. These results indicate that structural damage in right hippocampus implies worse performance in visual memory. Moreover, MTS was found to have negative effects on contralateral memory (poorer verbal memory in right MTS, and poorer visual memory in left MTS). These results could be due to memory compensation. Thus, the memory function associated with the sclerotic hippocampus is adopted by the contralateral structure. Therefore, the more damage there is to the latter, the poorer is the memory functioning.

Epilepsy, Temporal Lobe↗