Ischemic aetiology, self-reported frailty, and gender with respect to cognitive impairment in chronic heart failure patients

Background: decisive information on the parameters involved in cognitive impairment in patients with chronic heart failure is as yet lacking. Our aim was to determine the functional and psychosocial variables related with cognitive impairment using the mini-mental-state examination (MMSE) with age-and education-corrected scores. Methods: a cohort study of chronic heart failure patients included in an integrated multidisciplinary hospital/primary care program. The MMSE (corrected for age and education in the Spanish population) was administered at enrolment in the program. Analyses were performed in 525 patients. Demographic and clinical variables were collected. Comprehensive assessment included depression (Yesavage), family function (family APGAR), social network (Duke), dependence (Barthel Index), frailty (Barber), and comorbidities. Univariate and multivariate logistic regression were performed to determine the predictors of cognitive impairment. Results: cognitive impairment affected 145 patients (27.6 %). Explanatory factors were gender (OR: 2.77 (1.75-4.39) p  3.5 (OR: 0.59 (0.35-0.99) p = 0.048), and beta-blocker treatment (OR: 0.36 (0.17 to 0.76, p = 0.007)). No association was found between cognitive impairment and social support or family function. Conclusion: the observed prevalence of cognitive impairment using MMSE corrected scores was 27.6 %. A global approach in the management of these patients is needed, especially focusing on women and patients with frailty, low albumin levels, and ischemic aetiology heart failure

Ischemic aetiology, self-reported frailty, and gender with respect to cognitive impairment in chronic heart failure patients

Decisive information on the parameters involved in cognitive impairment in patients with chronic heart failure is as yet lacking. Our aim was to determine the functional and psychosocial variables related with cognitive impairment using the mini-mental-state examination (MMSE) with age-and education-corrected scores. A cohort study of chronic heart failure patients included in an integrated multidisciplinary hospital/primary care program. The MMSE (corrected for age and education in the Spanish population) was administered at enrolment in the program. Analyses were performed in 525 patients. Demographic and clinical variables were collected. Comprehensive assessment included depression (Yesavage), family function (family APGAR), social network (Duke), dependence (Barthel Index), frailty (Barber), and comorbidities. Univariate and multivariate logistic regression were performed to determine the predictors of cognitive impairment. Cognitive impairment affected 145 patients (27.6 %). Explanatory factors were gender (OR: 2.77 (1.75-4.39) p 3.5 (OR: 0.59 (0.35-0.99) p = 0.048), and beta-blocker treatment (OR: 0.36 (0.17 to 0.76, p = 0.007)). No association was found between cognitive impairment and social support or family function. The observed prevalence of cognitive impairment using MMSE corrected scores was 27.6 %. A global approach in the management of these patients is needed, especially focusing on women and patients with frailty, low albumin levels, and ischemic aetiology heart failure

The Influence of Genetic and Environmental Factors among MDMA Users in Cognitive Performance

This study is aimed to clarify the association between MDMA cumulative use and cognitive dysfunction, and the potential role of candidate genetic polymorphisms in explaining individual differences in the cognitive effects of MDMA. Gene polymorphisms related to reduced serotonin function, poor competency of executive control and memory consolidation systems, and high enzymatic activity linked to bioactivation of MDMA to neurotoxic metabolites may contribute to explain variations in the cognitive impact of MDMA across regular users of this drug. Sixty ecstasy polydrug users, 110 cannabis users and 93 non-drug users were assessed using cognitive measures of Verbal Memory (California Verbal Learning Test, CVLT), Visual Memory (Rey-Osterrieth Complex Figure Test, ROCFT), Semantic Fluency, and Perceptual Attention (Symbol Digit Modalities Test, SDMT). Participants were also genotyped for polymorphisms within the 5HTT, 5HTR2A, COMT, CYP2D6, BDNF, and GRIN2B genes using polymerase chain reaction and TaqMan polymerase assays. Lifetime cumulative MDMA use was significantly associated with poorer performance on visuospatial memory and perceptual attention. Heavy MDMA users (>100 tablets lifetime use) interacted with candidate gene polymorphisms in explaining individual differences in cognitive performance between MDMA users and controls. MDMA users carrying COMT val/val and SERT s/s had poorer performance than paired controls on visuospatial attention and memory, and MDMA users with CYP2D6 ultra-rapid metabolizers performed worse than controls on semantic fluency. Both MDMA lifetime use and gene-related individual differences influence cognitive dysfunction in ecstasy users

Practical application of brief cognitive tests

RESUMEN Introducción.- Los test cognitivos breves (TCB) pueden ayudar a detectar el deterioro cognitivo (DC) en el ámbito asistencial. Se han desarrollado y/o validado varios TCB en nuestro país, pero no existen recomendaciones específicas para su uso. Desarrollo.- Revisión de estudios de rendimiento diagnóstico llevados a cabo en España con TCB que requieran menos de 20 minutos. Recomendaciones de uso consensuadas por expertos sobre la base de las características de los TCB y de los estudios disponibles. Conclusión.- El Fototest, el Memory Impairment Screen (MIS) y el Mini-Mental State Examination (MMSE) son las opciones más recomendables para el primer nivel asistencial, pudiendo añadirse otros test (Test del Reloj [TR], test de fluidez verbal [TFV]) en caso de resultado negativo y queja o sospecha persistente (aproximación escalonada). En el segundo nivel asistencial es conveniente una evaluación sistemática de las distintas áreas cognitivas, que puede llevarse a cabo con instrumentos como el Montreal Cognitive Assessment, MMSE, Rowland Universal Dementia Assessment o Addenbrooke's Cognitive Examination, o bien mediante el uso escalonado o combinado de herramientas más simples (TR, TFV, Fototest, MIS, Test de Alteración de la Memoria, Eurotest). El uso asociado de cuestionarios cumplimentados por un informador (CCI) aporta valor añadido a los TCB en la detección del DC. La elección de los instrumentos vendrá condicionada por las características del paciente, la experiencia del clínico y el tiempo disponible. Los TCB y CCI deben reforzar -pero nunca suplantar- el juicio clínico, la comunicación con el paciente y el diálogo interprofesional

Dataset on the RETRO-BMC cruise onboard the R/V Hespérides, April 2017, Brazil-Malvinas Confluence

This dataset, gathered during the RETRO-BMC cruise, reports multiple-scale measurements at the Confluence of the Brazil and Malvinas Currents. The cruise was carried out between 8 and 28 April 2017 onboard R/V Hespérides, departing from Ushuaia and arriving to Santos. Along its track, the vessel recorded near-surface temperature and salinity, as well as the horizontal flow from 20 m down to about 800 m. A total of 33 hydrographic stations were completed in a region off the Patagonian Shelf, within 41.2°S-35.9°S and out to 53.0°W. At each station, a multiparametric probe and velocity sensors were deployed inside the frame of a rosette used to collect water samples at selected depths; these samples were later used for several water analyses, including inorganic nutrient concentrations. Microstructure measurements were carried out in 11 of these hydrographic stations. In addition, two high-resolution three-dimensional surveys were conducted with an instrumented undulating vehicle between 40.6°S-39.0°S and 55.6°W-53.8°W. Lastly, eight high-frequency vertical profilers were deployed in the region and five position-transmitting drifters were launched. These data allow the description of the Confluence from the regional scale to the microscale, and provide a view of the variability of the frontal region on time scales from days to weeks

A view of the Brazil-Malvinas confluence, March 2015

The encountering of the subtropical Brazil Current (BC) and the subantarctic Malvinas Current (MC) along the western margin of the Argentine Basin forms the Brazil-Malvinas Confluence (BMC), one of the most intense open-ocean fronts in the world ocean and a site for the formation of intermediate water masses. Here, we provide a comprehensive description of the BMC based on physical and biogeochemical data – hydrographic stations, profiling floats and subsurface drifters – gathered in March 2015. We use these data in order to characterize the impinging and outflowing currents and to describe the cross- and along-frontal thermohaline structure. In addition, we compare the in-situ measurements with both climatological data and the Mercator Ocean eddy-resolving reanalysis. The hydrographic sections illustrate the contrasting properties between the two western boundary currents: warm, salty, nutrient- and oxygen-poor oligotrophic subtropical waters carried southward by the BC and the cold, fresh, oxygen- and nutrient-rich subantarctic waters carried northward by the MC. The frontal system is also characterized by the presence of thermohaline intrusions, with the cross-frontal gradients and along-front velocities sharpening as the colliding currents shape the frontal system. We also observe brackish waters spreading on top of the frontal jet as a result of both the confluence dynamics and off-shelf advection favored by north-easterly winds. These low-salinity waters are positively correlated with surface ageostrophic speeds over the frontal jet. The cruise data illustrates the high regional and mesoscale variability as compared with climatological conditions, and further document the submesoscale subsurface complexity, which is not properly captured by available operational models.Fil: Orúe Echevarría, Dorleta. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Pelegrí, Josep L.. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Alonso González, Iván J.. Oceomic, Marine Bio And Technology S.L; EspañaFil: Benítez Barrios, Verónica M.. Oceomic, Marine Bio And Technology S.L; EspañaFil: Emelianov, Mikhail. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: García Olivares, Antonio. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Gasser i Rubinat, Marc. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: De La Fuente, Patricia. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Herrero, Carmen. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Isern Fontanet, Jordi. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Masdeu Navarro, Marta. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Peña Izquierdo, Jesús. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Piola, Alberto Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; ArgentinaFil: Ramírez Garrido, Sergio. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Rosell Fieschi, Miquel. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Salvador, Joaquín. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Saraceno, Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Universidad de Barcelona; EspañaFil: Valla, Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias de la Atmósfera y los Océanos; ArgentinaFil: Vallès Casanova, Ignasi. Consejo Superior de Investigaciones Científicas. Instituto de Ciencias del Mar; EspañaFil: Vidal, Montserrat. Universidad de Barcelona; Españ

Clinical Presentation, Management, and Evolution of Lymphomas in Patients with Inflammatory Bowel Disease: An ENEIDA Registry Study

Simple Summary An increased risk of hematological malignancies, mainly lymphomas, has been described in patients with inflammatory bowel disease (IBD). Because there are scarce data about the management and evolution of lymphomas in patients with IBD, the aim of our study was to analyze these points in those patients with IBD and lymphoma diagnosis included in the prospectively maintained ENEIDA registry of GETECCU. We identified 52 patients (2.4 cases of lymphoma/1000 patients with IBD). We found that most IBD patients had been treated with thiopurines and/or anti-TNF agents before lymphoma diagnosis, and these patients were younger at diagnosis of lymphoma than those not treated with these drugs. Relapse and mortality of lymphoma were not related with these therapies. The five-year survival rate was 85% for non-Hodgkin lymphoma and 84% in patients with Hodgkin lymphoma. An increased risk of lymphoma has been described in patients with inflammatory bowel disease (IBD). The aims of our study were to determine the clinical presentation, the previous exposure to immunosuppressive and biologic therapies, and the evolution of lymphomas in patients with IBD. IBD patients with diagnosis of lymphoma from October 2006 to June 2021 were identified from the prospectively maintained ENEIDA registry of GETECCU. We identified 52 patients (2.4 cases of lymphoma/1000 patients with IBD; 95% CI 1.8-3.1). Thirty-five were men (67%), 52% had ulcerative colitis, 60% received thiopurines, and 38% an anti-TNF drug before lymphoma diagnosis. Age at lymphoma was lower in those patients treated with thiopurines (53 +/- 17 years old) and anti-TNF drugs (47 +/- 17) than in those patients not treated with these drugs (63 +/- 12; p < 0.05). Five cases had relapse of lymphoma (1.7 cases/100 patient-years). Nine patients (17%) died after 19 months (IQR 0-48 months). Relapse and mortality were not related with the type of IBD or lymphoma, nor with thiopurines or biologic therapies. In conclusion, most IBD patients had been treated with thiopurines and/or anti-TNF agents before lymphoma diagnosis, and these patients were younger at diagnosis of lymphoma than those not treated with these drugs. Relapse and mortality of lymphoma were not related with these therapies

Aplicación práctica de los test cognitivos breves

Introducción.- Los test cognitivos breves (TCB) pueden ayudar a detectar el deterioro cognitivo (DC) en el ámbito asistencial. Se han desarrollado y/o validado varios TCB en nuestro país, pero no existen recomendaciones específicas para su uso. Desarrollo.- Revisión de estudios de rendimiento diagnóstico llevados a cabo en España con TCB que requieran menos de 20 minutos. Recomendaciones de uso consensuadas por expertos sobre la base de las características de los TCB y de los estudios disponibles. Conclusión.- El Fototest, el Memory Impairment Screen (MIS) y el Mini-Mental State Examination (MMSE) son las opciones más recomendables para el primer nivel asistencial, pudiendo añadirse otros test (Test del Reloj [TR], test de fluidez verbal [TFV]) en caso de resultado negativo y queja o sospecha persistente (aproximación escalonada). En el segundo nivel asistencial es conveniente una evaluación sistemática de las distintas áreas cognitivas, que puede llevarse a cabo con instrumentos como el Montreal Cognitive Assessment, MMSE, Rowland Universal Dementia Assessment o Addenbrooke's Cognitive Examination, o bien mediante el uso escalonado o combinado de herramientas más simples (TR, TFV, Fototest, MIS, Test de Alteración de la Memoria, Eurotest). El uso asociado de cuestionarios cumplimentados por un informador (CCI) aporta valor añadido a los TCB en la detección del DC. La elección de los instrumentos vendrá condicionada por las características del paciente, la experiencia del clínico y el tiempo disponible. Los TCB y CCI deben reforzar -pero nunca suplantar- el juicio clínico, la comunicación con el paciente y el diálogo interprofesional