Validation of the Argentine version of the memory binding test (MBT) for early detection of mild cognitive impairment

Background: “Forgetfulness” is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01). The MBT showed high sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (χ2=14,164, p<.001) was obtained when comparing the area under the curve (AUC) of the MBT (0.88) and the MMSE (0.70). Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI. © 2016, Academia Brasileira de Neurologia. All rights reserved

Clinical manifestations of geriatric depression in a memory clinic: Toward a proposed subtyping of geriatric depression

BACKGROUND: As the older population increases so does the number of older psychiatric patients. Elderly psychiatric patients manifest certain specific and unique characteristics. Different subtypes of depressive syndromes exist in late-life depression, and many of these are associated with cognitive impairment. MATERIALS AND METHODS: A total of 109 depressive patients and 30 normal subjects matched by age and educational level were evaluated using a neuropsychiatric interview and an extensive neuropsychological battery. Depressive patients were classified into four different groups by SCAN 2.1 (schedules for clinical assessment in Neuropsychiatry): major depression disorder (n: 34), dysthymia disorder (n: 29), subsyndromal depression (n: 28), and depression due to mild dementia of Alzheimer's type (n: 18). RESULTS: We found significant associations (p<.05) between depressive status and demographic or clinical factors that include marital status (OR: 3.4, CI: 1.2-9.6), level of daily activity (OR: 5.3, CI: 2-14), heart disease (OR: 12.5, CI: 1.6-96.3), and high blood cholesterol levels (p:.032). Neuropsychological differences were observed among the four depressive groups and also between depressive patients and controls. Significant differences were observed in daily life activities and caregivers' burden between depressive patients and normal subjects. CONCLUSION: Geriatric depression is associated with heart disease, high cholesterol blood levels, marital status, and daily inactivity. Different subtypes of geriatric depression have particular clinical features, such as cognitive profiles, daily life activities, and caregivers' burden, that can help to differentiate among them. LIMITATIONS: The cohort referred to a memory clinic with memory complaints is a biased sample, and the results cannot be generalized to other non-memory symptomatic cohorts.Fil: Dillon, Carol. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: MacHnicki, Gerardo. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Serrano, Cecilia M.. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Rojas, Galeno. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Vazquez, Gustavo. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Allegri, Ricardo Francisco. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Validação da versão argentina do memory binding test (mbt) para a detecção precoce do transtorno cognitivo leve

Background: “Forgetfulness” is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01). The MBT showed high sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (c2 =14,164, p<.001) was obtained when comparing the area under the curve (AUC) of the MBT (0.88) and the MMSE (0.70). Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI.“Esquecimento” é queixa frequente no envelhecimento normal e também ocorre nos primeiros estágios de síndromes demenciais. Testes de memória episódica são fundamentais para detectar comprometimento cognitivo amnéstico (CCL). O teste de Memória Associativa (Memory Binding Test-MBT) é um teste fácil e breve para detectar a fase inicial de perda de memória episódica. Objetivo: Validar a versão argentina do MBT e estimar a sua acurácia como instrumento diagnóstico para a detecção precoce do CCL. Métodos: 88 indivíduos (46 controles saudáveis e 42 pacientes com CCL amnéstico), emparelhados por idade e nível educacional, foram avaliados com extensa bateria neuropsicológica e o MBT. Resultados: Um desempenho significativamente melhor foi detectada no grupo controle; todas as escalas do MBT foram preditivas do diagnóstico de CCL (p<0,01). O MBT apresentou alta sensibilidade (69%) e alta especificidade (88%), com valor preditivo (VP) positivo de 93% e e VP negativo de 55% para a recordação dos itens associados (associative paired recall). Diferença estatisticamente significativa (c2 =14,164, p<0,001) foi obtida quando foram comparadas as áreas sob as curvas (AUC) do MBT (0,88) e o Mini-Exame do Estado Mental (MEEM) (0,70). Conclusão: A versão argentina do MBT correlacionou-se significativamente com o MEEM e com a bateria de memória e é uma ferramenta útil na detecção de CCL. As características operacionais do MBT são bem adequadas, superando outros testes usualmente utilizados para a detecção de CCL.Fil: Román, Fabián. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; Argentina. Universidad de la Costa.; ColombiaFil: Iturry, Mónica Liliana. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta". Servicio de Neurología. Laboratorio de Investigación de la Memoria; ArgentinaFil: Rojas, Zenón Galeno. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta". Servicio de Neurología. Laboratorio de Investigación de la Memoria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Barcelo, Ernesto. Universidad de la Costa.; ColombiaFil: Buschke, Herman. Albert Einstein College of Medicine; Estados UnidosFil: Allegri, Ricardo Francisco. Universidad de la Costa.; Colombia. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Clinical and economic characteristics associated with direct costs of Alzheimer's, frontotemporal and vascular dementia in Argentina

Background: The economic cost of dementia is high and can be predicted by cognitive and neuropsychiatric profiles. The differential costs of the various subtypes of dementia are unknown in Argentina, and this study therefore aimed to compare these costs. Methods: Patients with a diagnosis of dementia of Alzheimer-type (DAT), frontotemporal dementia (FTD) and vascular dementia (VaD), and their primary caregivers, were evaluated between 2002 and 2008. Results: 104 patients with dementia (DAT = 44, FTD = 34, VaD = 26) were screened and matched by age and educational level with 29 healthy subjects. Demographic variables showed no significant differences among dementia patients. The annual direct costs were US$4625 for DAT, US$4924 for FTD, and US$5112 for VaD (p > 0.05 between groups). In the post hoc analysis VaD showed higher hospitalization costs than DAT (p < 0.001). VaD exhibited lower medication costs than FTD (p < 0.001). DAT exhibited higher anti-dementia drug costs; FTD had higher psychotropic costs. In the multivariate analysis, depression, activities of daily living, and caregiver burden were correlated with direct costs (r2 = 0.76). Conclusions: The different dementia types have different costs. Overall, costs increased with the presence of behavioral symptoms, depression and functional impairment of activities of daily living.Fil: Rojas, Galeno. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Bartoloni, Leonardo Carlos. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Dillon, Carol. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Serrano, Cecilia Mariela. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Iturry, Mónica Liliana. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Allegri, Ricardo Francisco. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Efficacy of a cognitive intervention program in patients with mild cognitive impairment

Background: Mild cognitive impairment (MCI) is a transitional state between normal aging and dementia. Identifying this condition would allow early interventions that may reduce the rate of progression to Alzheimer's disease (AD). We examined the efficacy of a six-month cognitive intervention program (CIP) in patients with MCI and to assess patients' condition at one-year follow-up. Methods: Forty-six MCI participants assessed with neuropsychological, neurological, neuropsychiatry, and functional procedures were included in this study and followed up during a year. The sample was randomized into two subgroups: 24 participants (the trained group) underwent the CIP during six months while 22 (control group) received no treatment. Sixteen participants dropped out of the study. The intervention focused on teaching cognitive strategies, cognitive training, and use of external aids, in sessions of two hours, twice per week for six months. Cognitive and functional measures were used as primary outcome and all were followed up at one year. Results: The intervention effect (mean change from baseline) was significant (p < 0.05) on the Mini-Mental State Examination (1.74), the Clinical Dementia Rating Scale (0.14), the Boston Naming Test (2.92), block design (-13.66), matrix reasoning (-3.07), and semantic fluency (-3.071) tasks. Four patients (one trained and three controls) progressed to dementia after one year of follow-up. Conclusions: These results suggest that persons with MCI can improve their performance on cognitive and functional measures when provided with early cognitive training and it could persist in a long-term follow-up.Fil: Rojas, Galeno J.. Hospital Británico de Buenos Aires; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Villar, Veronica. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Iturry, Mónica Liliana. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Harris, Paula. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Serrano, Cecilia Mariela. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; ArgentinaFil: Herrera, Jorge A.. Neurobehavioral Institute of Miami; Estados UnidosFil: Allegri, Ricardo Francisco. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital "Dr. Abel Zubizarreta"; Argentin

Pharmacovigilance in Neuroscience

Background: Adverse drug reactions (ADRs) have a high impact on morbidity and mortality of the population, becoming a public health issue. Studying and publishing about these is referred as pharmacovigilance.Objective: To describe and compare the adverse reactions produced by drugs of nervous system action (CNS-D) and neurological ADRs produced by drugs of systemic action (Sys-D). To further develop the need of reporting adverse reactions. Methods: An observational, cross-sectional, retrospective study performed on a database of neurological consultations which took place at the Neurology department. Patients meeting the inclusion criteria were selected and divided into two groups: Sys-D and CNS-D. Demographic and neurological variables were analyzed. Parametric and non-parametric statistics were used according to distribution. The Naranjo Algorithm (NA) was used to define causality.Results: 71 ADRs were described, from which 63.38% (n=45) were produced by CNS-D, especially antiepileptics by 47% (n=21) and psycholeptics by 44%. Of the total, 36.62% (n=26) were caused by Sys-D, such as antineoplastics (n=9) and antibiotics (n=9), being Cefepime the most frequent. The diagnosis of ADRs caused by a Sys-D was delayed prolonging hospitalization (p 0.05) due to a lower NA score (p 0.003) compared to the CNS-D group.Conclusion: Multiple frequently used drugs of systemic action, such as antineoplastics and antibiotics, generate neurological adverse effects. From our analysis, it was presumed that the suspicion of a neurological ADR caused by these drugs was scarce, thus causing a higher morbidity for the patient

Practice recommendation for the detection and diagnosis of patients with alzheimer’s disease dementia at Buenos Aires City

La Enfermedad de Alzheimer es la causa más frecuente de trastornos cognitivos y demencia en adultos mayores, y es considerada una nueva epidemia. Por sus diferentes manifestaciones cognitivas, conductuales y funcionales, la detección, diagnóstico y tratamiento de los pacientes con Demencia debida a Enfermedad de Alzheimer puede representar un desafío. En las presentes recomendaciones se dan pautas de manejo con niveles de recomendación basados en la mejor evidencia científica disponible. Asimismo, se presentan indicaciones y sugerencias de estudio, o derivación a un nivel superior de asistencia según la complejidad de cada caso. De este modo, se brinda un conjunto de recomendaciones prácticas de apoyo para la toma de decisiones por parte de los profesionales de la salud en cada nivel sanitario, desde la asistencia primaria hasta los médicos especialistas. Mediante un enfoque operativo y dinámico, estas Recomendaciones proponen un enfoque global basado en la evidencia para los pacientes, familiares y agentes de Salud involucrados en esta patología, de enorme relevancia a nivel social.Alzheimer’s disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epidemic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer’s Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations proposes a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.Fil: Demey, Ignacio. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Hospital Británico de Buenos Aires; ArgentinaFil: Ollari, Juan A.. Hospital Británico de Buenos Aires; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital Municipal "José Tiburcio Borda"; ArgentinaFil: Rojas, Galeno. Hospital Británico de Buenos Aires; Argentina. Fundación Favaloro; Argentina. Ministerio de Salud. Administración Nacional de Medicamentos, Alimentos y Tecnología Médica; ArgentinaFil: Bagnati, Pablo. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Sarasola, Diego. No especifíca;Fil: Román, Fabián. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; Argentina. Universidad de la Costa.; ColombiaFil: Tarulla, Adriana. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; Argentina. Universidad de la Costa.; ColombiaFil: Blake, Andre. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; ArgentinaFil: Sevlever, Gustavo. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Caridi, Aldo. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; ArgentinaFil: Allegri, Ricardo Francisco. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud. Subsecretaria de Atencion Hospitalaria.; Argentina. Universidad de la Costa.; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Alzheimer's disease: Clinical practice guideline

El Grupo de Trabajo de Neurología de la Conducta y Neurociencias Cognitivas de la Sociedad Neurológica Argentina publicó en 2006 la primera Guía de práctica clínica sobre la enfermedad de Alzheimer para su aplicación en nuestro medio y, eventualmente, en el resto de los países hispanoparlantes del Cono Sur. La Guía que hoy publicamos, mediante la revisión y actualización del estado actual del conocimiento sobre la enfermedad de Alzheimer y su manejo clínico y neurológico, provee a los profesionales los estándares surgidos de la medicina basada en la evidencia para una adecuada implementación de las conductas diagnósticas y terapéuticas a su alcance en nuestro medio.In 2006, the Argentine Neurological Society Research Group on Behavioral Neurology and Cognitive Neurosciences published the first Clinical Practice Guideline on Alzheimer's Disease to be consulted in Argentina and eventually in other countries in Latin America. The present Guideline is a review of the state of the art concerning the 2010 knowledge on the management of this disease. It provides physicians with the usual standards provided by evidence based medicine in order to reach the most adequate diagnostic and therapeutic measures at hand in our countries.Fil: Allegri, Ricardo Francisco. Sociedad Neurológica Argentina; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia. Instituto de Neurociencias - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Neurociencias; ArgentinaFil: Arizaga, Raúl Luciano. Sociedad Neurológica Argentina; ArgentinaFil: Bavec, Claudia V.. Sociedad Neurológica Argentina; ArgentinaFil: Colli, Liliana P.. Sociedad Neurológica Argentina; ArgentinaFil: Demey, Ignacio. Sociedad Neurológica Argentina; ArgentinaFil: Fernández, María C.. Sociedad Neurológica Argentina; ArgentinaFil: Frontera, Silvina A.. Sociedad Neurológica Argentina; ArgentinaFil: Garau, María L.. Sociedad Neurológica Argentina; ArgentinaFil: Jiménez, Julio J.. Sociedad Neurológica Argentina; ArgentinaFil: Golimstok, Angel. Sociedad Neurológica Argentina; ArgentinaFil: Kremer, Janus. Sociedad Neurológica Argentina; ArgentinaFil: Labos, Edith. Sociedad Neurológica Argentina; ArgentinaFil: Mangone, Carlos Antonio. Sociedad Neurológica Argentina; ArgentinaFil: Ollari, Juan A.. Sociedad Neurológica Argentina; ArgentinaFil: Rojas, Zenón Galeno. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Sociedad Neurológica Argentina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Salmini, Omar. Sociedad Neurológica Argentina; ArgentinaFil: Ure, Jorge A.. Sociedad Neurológica Argentina; ArgentinaFil: Zuin, Daniel R.. Sociedad Neurológica Argentina; Argentin

Cognitive rehabilitation therapy after acquired brain injury in Argentina: Psychosocial outcomes in connection with the time elapsed before treatment initiation

Primary objective: To examine the effect of cognitive rehabilitation therapy (CRT) on psychosocial outcomes in Argentinean patients with acquired brain injury (ABI), in connection with the time elapsed between injury and treatment initiation.Fil: Saux, Gaston Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Demey, Ignacio. Instituto de Neurociencias Buenos Aires S. A.; ArgentinaFil: Rojas, Zenón Galeno. Instituto de Neurociencias Buenos Aires S. A.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Feldberg, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Manual de sanidad animal para profesores y técnicos rurales

120 páginas. Serie de Libros y Materiales Educativos (IICA) no. 95.El propósito del documento es brindar informaciones básicas sobre prácticas aprobadas de sanidad animal que facilitan y enriquezcan la labor docente y las acciones de extensión en el camp