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Biomedical subjects

M Salamero

Publications and source records attributed to M Salamero.

At least 19 recordsLinked to original sources

Subjective body-image dimensions in normal and anorexic adolescents.

The subjective body dimensions of adolescent anorexic patients and adolescents from the general population were studied by means of a new technique that combines certain characteristics of the 'body-site estimation' and the 'whole-image adjustment' procedures. The technique used (Subjective Body Dimensions Apparatus-SBDA) reveals the individual's idea of the size of the different parts of his/her body, and produces a life-size global silhouette. Eighty-five female anorexic patients (ages 12 to 18) were compared with 427 adolescents from the general population. The technique showed acceptable test-retest stability. The comparison group overestimated their thorax, waist and hips, and anorexic patients overestimated all parts of their body but their thorax, waist and hips especially. For all parts of the body, the anorexic group showed greater overestimation (p < .0001) than the comparison group.

Adolescent

[Clock drawing test: qualitative and quantitative evaluation methods].

INTRODUCTION: The interest about the Clock Drawing Test (CDT) is justified because the importance of praxic disorders and especially the constructive apraxias in demented patients. Generally, this kind of deficits or intellectual losses has been less studied than aphasisas and agnosias. Nevertheless, praxias are usually affected in demential processes, even in initial stages. OBJECTIVE: We try to determine if the CDT can be useful as an assessment tool for dementia. We have used two assessment systems of the clock drawing in order to select an useful and reliable method of correction. PATIENTS AND METHODS: The sample is made up of 35 subjects older than 60 years, they were administered the Mini Cognitive Examination (MCE) and the CDT. Patients with previous diagnosis of dementia, others with physical pathology without neurological affectation and, finally, subjects without any kind of pathology were included in order to get a wide rank of punctuations. We carried out a reliability analysis between two raters and the discriminant validity of the CDT compared to the Spanish adaptation of the Mini Mental Examination. RESULTS: We achieve a high reliability inter examiner rates. Quantitative criteria of both scales are more objective than qualitative ones, therefore, these last should be more operativized. CONCLUSIONS: The results obtained in this work suggest that the clock drawing allow a rapid evaluation of cognitive function as the presence of cognitive impairment.

Aged

Atrophy of the corpus callosum in chronic alcoholism.

To determine the prevalence of corpus callosum atrophy in chronic alcoholics and its relationship to cognitive function and brain atrophy, a prospective clinicoradiologic study was carried out in 28 right-handed male patients with chronic alcoholism and 14 age- and sex-matched right-handed control subjects. Clinical evaluation, neuropsychological testing and measurement of the midsagittal corpus callosum area and thickness (genu, truncus and splenium), as well as the frontal lobe index and the width of the cortical sulci on T1- and T2-weighted magnetic resonance images were performed. Compared to controls, alcoholics had significantly decreased corpus callosum area and thickness, mainly in the genu. Two-thirds had a corpus callosum area 2 SD below the mean of the control group. The sagittal area of the corpus callosum body correlated negatively with the degree of frontal and cortical atrophies (r = -0.5579 and -0.6853, respectively p < 0.01, both). Alcoholics with corpus callosum atrophy exhibited impairment of visual and logical memories (p < 0.05 both) and those with reduced thickness of the genu showed impairment of frontal lobe tasks (p < 0.05). The reduction of corpus callosum indices (age-corrected) also correlated with the total lifetime dose of ethanol consumed (r = 0.6107, p < 0.001), but was not related to nutritional status or electrolyte imbalance. Atrophy of the corpus callosum is common among alcoholic patients and may reflect the severity and pattern of cortical damage. The degree of this atrophy also correlated with the severity of ethanol intake.

Adult

Brain impairment in well-nourished chronic alcoholics is related to ethanol intake.

To determine the influence of chronic ethanol intake on the central nervous system, we studied 40 asymptomatic, well-nourished, chronic alcoholics (mean age, 42.6 +/- 9.1 years) and 20 age-, sex-, and education-matched control subjects. Studies included neuropsychological testing, visual and short-latency auditory evoked potentials, and morphometric analysis of computed tomography scans. The mean daily ethanol consumption of the alcoholics was 204 gm over an average of 26.4 years. Compared to control subjects, chronic alcoholics exhibited a significant prolongation of the P100 latency of visual evoked potentials, and a prolongation and reduction in the amplitude of the latency of the V wave of short-latency auditory evoked potentials. These abnormalities were related to the lifetime dose of ethanol consumed. Brain morphometric analysis showed that alcoholics had a significantly greater degree of brain shrinkage with age, compared to control subjects. The cortical atrophy index correlated significantly with the lifetime ethanol consumption. Neuropsychological testing in alcoholics compared to controls revealed a significant impairment of frontal skills that was related to age, degree of scholarship, and the presence of frontal atrophy. In conclusion, well-nourished chronic alcoholics exhibited significant brain impairment, as demonstrated by neuropsychological testing, evoked potentials, and brain morphometric analysis, which was correlated with the lifetime dose of ethanol consumed.

Adult

The Kleinian Psychoanalytic Diagnostic Scale (revised version): presentation and study of reliability.

The Kleinian Psychoanalytic Diagnostic Scale (KPDS) is a psychodiagnostic instrument of assessment based on the psychoanalytical theory of object relations. It was created in order to introduce an intrapsychic and relational dimension into the clinical research on and epidemiology of psychiatric diagnosis. It consists of 15 subscales grouped into the following four dimensions: "Ego Abilities'; "Projective Identification'; "Paranoid-Schizoid'; and "Depressive'. These dimensions constitute different, relatively stable aspects of the mental life of the subject, their demarcation and description permitting the obtention of a chart and profile of the intrapsychic and relational structure. Following several free, unstructured interviews the scale is assessed on the basis of what the subject says and what the rater may detect in the relationship. The inter-rater reliability of the scale, its stability over a time lapse, as well as its internal consistency have all been shown to be high.

Adolescent

Cognitive dysfunctions in recovered melancholic patients.

Cognitive dysfunctions were studied in symptom-free patients suffering from Recurrent Depressive Disorder with melancholia. Their performances on a standard neuropsychological battery were compared with those of a healthy sample matched for age and educational level. Statistically significant differences were found in Immediate Visual Memory, Delayed Logical and Visual Memory, Paired Learning and Block Design. Results seem to indicate that the cognitive disfunctions are not likely to be only mnesic. All these data suggest that these disfunctions found in some melancholic depressives could not be state-dependent.

Adult

Factorial study of the BDI in pregnant women.

This study was carried out to investigate the significance of Beck Depression Inventory (BDI) scores and the influence of somatic items in a non-psychiatric population presenting with somatic complaints. Internal consistency, item frequency, factor dimensions, and correlation with Eysenck's 'N' were analysed in a sample of 882 non-psychiatric pregnant women. The BDI showed a high level of internal consistency (Cronbach alpha coefficient was 0.85). Factor analysis yielded two major factors. Low BDI scores were determined mainly by items related to somatic complaints or decreased activity without unequivocal depressive content. In contrast, it was unambiguous depressive items that were endorsed in high scores, and these showed higher correlations with neuroticism. It is concluded that in non-psychiatric populations the BDI may measure conditions other than depression and that low or medium range scores should not be interpreted as indicators of mild depressive symptomatology.

Adolescent

Assessment of sociocultural influences on the aesthetic body shape model in anorexia nervosa.

The prevailing aesthetic body shape model in our culture-that of slenderness-plays a leading role in eating disorders. A questionnaire (CIMEC) was prepared in an attempt to measure the influence of the agents and situations that transmit this model. The CIMEC questionnaire was applied to 59 anorectics and 59 normal girls matched by age and social class. Highly significant differences were found between the scores obtained from both groups, showing the patients to have a much greater involvement with the sociocultural agents encouraging weight loss. Factorial analysis of the discriminating items gave rise to 5 factors, each of which also significantly differentiated between anorectics and the normal group. The questionnaire, in two versions, showed satisfactory internal consistency and appropriate sensitivity and specificity and would serve as a sound instrument for screening. It calls into question the causal relationship between anorexia nervosa and sociocultural influences.

Adolescent

Regional cerebral blood flow-SPECT in chronic alcoholism: relation to neuropsychological testing.

To determine the prevalence of central nervous system damage due to ethanol, we evaluated 40 asymptomatic chronic alcoholics and 20 age-matched controls. Studies included neuropsychological testing, brain 99mTc-HMPAO SPECT, and morphometric analysis by CT scan. In the qualitative analysis, 30 of the 40 alcoholics showed hypoperfused areas on SPECT scan. In the semiquantitative analysis, alcoholics exhibited significant reduction in regional cerebral blood flow (rCBF) ratio of all brain lobes compared to controls (p < 0.001). The rCBF ratio was mainly reduced in frontal lobes (65%). Only 11 alcoholics showed significant frontal lobe atrophy in the morphometric analysis; most also had abnormalities on SPECT scan. Alcoholics exhibited significant impairment of frontal tasks and visuospatial skills. Frontal test impairment was independently related to both frontal atrophy and hypoperfusion. In a group of ten alcoholics in whom another SPECT scan was performed after 2 mo of ethanol abstinence, rCBF ratio of the frontal lobes normalized in eight, without frontal atrophy. In patients without frontal atrophy, reduced rCBF ratio of the anterior portion of the frontal lobes correlated negatively with frontal test results (r = -0.6535, p < 0.001). A significant negative correlation between cerebral perfusion and the amount of ethanol consumed in the month prior to study was observed (r = -0.6289, p < 0.001). In conclusion, asymptomatic chronic alcoholics frequently showed reversible frontal lobe hypoperfusion, which is related to recent ethanol intake, reflects brain function impairment and is independent of brain atrophy.

Adult

[Palliative care in cancer patients. Frequency and priority of symptoms].

BACKGROUND: The presence of multiple symptoms is very frequent in patients with advanced cancer disease. In this situation in which cure is not a realistic aim, the goal is to achieve symptom control and to give support to the patient and family. This study was designed to identify the most common and priority symptoms in patients with advanced cancer. METHODS: Patients were given a questionnaire with a list of symptoms and were asked to underline those they presented, and also number those they considered most distressful from 1-3. Physicians and nurse independently answered the same questionnaire. RESULTS: Asthenia was the most frequent symptom (patient evaluation 84%, nurse 82% and doctor 93%). Psychopathological disturbances showed a high prevalence. Regarding patient evaluation, dry mouth was the third symptom in frequency (73%), but it was detected by nurses in 39% and by physicians in 16%. Priority symptoms for the three groups were pain, asthenia, anorexia and anxiety. Pain was controlled in 19/22 patients (86%), while psychopathological symptoms were only controlled in 7/19 patients (27%). CONCLUSIONS: In order to optimize treatment patient participation is mandatory. An interdisciplinary team (physicians, nurses, social workers, and psychologists) is necessary to take care of these patients.

Adult

Can Karnofsky performance status be transformed to the Eastern Cooperative Oncology Group scoring scale and vice versa?

There is no consensus regarding the equivalence of performance status between the Karnofsky (KPS) and the Eastern Cooperative Oncology Group (ECOG) scales. In the present study KPS and ECOG scores were compared in 150 consecutive cancer patients. An empirical relation was established through regression analysis in a subsample of 75 patients and the results tested in the second subsample. Transformation tables including 95 and 66% confidence intervals were calculated. Both performance scales are highly correlated, but inferences about individual patients were subject to a high level of error. These results stress the difficulty of translating one score to another, especially in the range of lower performance status where a wide spread is observed.

Adult

Obsessive-compulsive disorder in childhood and adolescence: a clinical study.

The clinical records of 72 children and adolescents aged 5-18 with a diagnosis of OCD were examined. Mean age of onset was 11 years. Repeating, cleaning and checking were the most common compulsions. Twenty percent of subjects showed obsessions unrelated to compulsions. In 53% of cases stress situations preceded the disorder. Seventy-seven percent of subjects suffered some other psychiatric disorder, lifetime or current, particularly anxiety and affective disorders. The majority (57%) had some first-degree relative with a psychiatric diagnosis. Family conflicts, social withdrawal and poor school performance were also common features.

Adolescent

Factor study of the Geriatric Depression Scale.

A sample of 234 people between the ages of 60 and 95 was studied using the Brink-Yesavage Geriatric Depression Scale (GDS). The GDS has good concurrent validity with the Hamilton Rating Scale for Depression with the Melancholia Scale (r = 0.77), which confirms the clinical utility of this scale. A factor analysis of principal components with an oblimin rotation was performed. The results obtained imply that structural validation cannot be made in relation to Beck's cognitive model of depression. It can be concluded that the elimination of the somatic items does not add any theoretical correspondence with the model, as the factors tend to group the various items into one dimension.

Aged

Performance status assessment in cancer patients.

Performance status assessment, Karnofsky performance status (KPS), and Eastern Cooperative Oncology Group (ECOG) scales were performed in 100 consecutive patients independently by two physicians and by the patients themselves to evaluate the scales' validity and reliability. Findings of Kendall's correlation were highly significant between physicians (0.76 for KPS, 0.75 for ECOG) and between physicians and patients (0.65 for KPS, 0.59 for ECOG). The authors point out that patients' self evaluation could provide a valuable and reliable assessment.

Activities of Daily Living

Factor study of the Hamilton Rating Scale for Depression and the Bech Melancholia Scale.

In this study, a sample (n = 234) of elderly people between the ages of 60 and 95 was evaluated. Items from the Hamilton Rating Scale for Depression and the Bech-Rafaelsen Melancholia Scale were factorialized using the oblique rotation method oblimin. Three clinically significant factors were obtained, accounting for 41% of variance. The first was interpreted as a dimension of inhibition and melancholic depression; the second, insomnia; and the third, somatic and psychic anxiety. It is concluded that the set of items on both scales increases the capacity for evaluating melancholic aspects of depression. In the interpretation of factor analysis, the possible artifact represented by the repetition of similar items must be kept in mind. Despite the loss of simplicity oblique rotation implies, it is considered preferable to orthogonal rotation since it allows for a greater congruity with clinical situations.

Aged

Ventricular enlargement and neuropsychological testing in schizophrenia.

The Ventricular Brain Ratio was computed in a group of 42 young chronic schizophrenics (age range: 17-45). The patients also completed a battery of neuropsychological tests: four WAIS subscales, the Benton test and the Trail Making Test. Although patients as a whole showed the expected ventricular enlargement and neuropsychological impairment when compared to control groups, no correlation was found between the two measures. These results are inconsistent with previous work on the same topic that hypothesized the association of both parameters. Some tentative explanations for these conflicting results are given.

Adolescent