Visuospatial Function in Early Alzheimer's Disease-The Use of the Visual Object and Space Perception (VOSP) Battery

Alzheimer's disease (AD) is the most frequent cause of dementia. the clinical symptoms of AD begin with impairment of memory and executive function followed by the gradual involvement of other functions, such as language, semantic knowledge, abstract thinking, attention, and visuospatial abilities. Visuospatial function involves the identification of a stimulus and its location and can be impaired at the beginning of AD. the Visual Object and Space Perception (VOSP) battery evaluates visuospatial function, while minimizing the interference of other cognitive functions.Objectives: To evaluate visuospatial function in early AD patients using the VOSP and determine cutoff scores to differentiate between cognitively healthy individuals and AD patients.Methods: Thirty-one patients with mild AD and forty-four healthy elderly were evaluated using a neuropsychological battery and the VOSP.Results: in the VOSP, the AD patients performed more poorly in all subtests examining object perception and in two subtests examining space perception (Number Location and Cube Analysis). the VOSP showed good accuracy and good correlation with tests measuring visuospatial function.Conclusion: Visuospatial function is impaired in the early stages of AD. the VOSP battery is a sensitive battery test for visuospatial deficits with minimal interference by other cognitive functions.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Associacao Fundo de Incentivo a Pesquisa (AFIP-Research Incentive Fund Association)Universidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilWeb of Scienc

Voxel-based morphometry findings in Alzheimer's disease: neuropsychiatric symptoms and disability correlations – preliminary results

INTRODUCTION: The role of structural brain changes and their correlations with neuropsychiatric symptoms and disability in Alzheimer's disease are still poorly understood. OBJECTIVE: To establish whether structural changes in grey matter volume in patients with mild Alzheimer's disease are associated with neuropsychiatric symptoms and disability METHODS: Nineteen Alzheimer's disease patients (9 females; total mean age =75.2 y old +4.7; total mean education level =8.5 y +4.9) underwent a magnetic resonance imaging (MRI) examination and voxel-based morphometry analysis. T1-weighted images were spatially normalized and segmented. Grey matter images were smoothed and analyzed using a multiple regression design. The results were corrected for multiple comparisons. The Neuropsychiatric Inventory was used to evaluate the neuropsychiatric symptoms, and the Functional Activities Questionnaire and Disability Assessment for Dementia were used for functional evaluation RESULTS: A significant negative correlation was found between the bilateral middle frontal gyri, left inferior temporal gyrus, right orbitofrontal gyrus, and Neuropsychiatric Inventory scores. A negative correlation was found between bilateral middle temporal gyri, left hippocampus, bilateral fusiform gyri, and the Functional Activities Questionnaire. There was a positive correlation between the right amygdala, bilateral fusiform gyri, right anterior insula, left inferior and middle temporal gyri, right superior temporal gyrus, and Disability Assessment for Dementia scores CONCLUSIONS: The results suggest that the neuropsychiatric symptoms observed in Alzheimer's disease patients could be mainly due to frontal structural abnormalities, whereas disability could be associated with reductions in temporal structures

Estudo longitudinal de um programa de reabilitação neuropsicológica dirigido a pacientes com doença de Alzheimer

Our aim was to study the duration of benefits derived from a neuropsychological rehabilitation program (NRP) for dementia patients. METHOD: The participants in this study were three patients diagnosed as probable Alzheimer's disease in the initial-to-moderate phase; the three were taking anticholinesterases. They were submitted to a neuropsychological evaluation (NE) before the NRP and then revaluated after 12 and 24 months of treatment. The aim of our intervention was to do practical work with implicit and explicit residual memory by training them in everyday life activities, and using compensatory strategies and their intact cognitive abilities. RESULTS: Analysis of quantitative NE data (descriptive measures) after the first year of NRP showed cognitive improvement, functional stabilization and fewer behavioral problems. However, this improvement did not continue in the second year, and the disease maintained its characteristic progression.OBJETIVO: Estudar a duração do beneficio de um programa de reabilitação neuropsicológica (PRN) dirigido a pacientes demenciados. MÉTODO: Participaram deste estudo, três pacientes com diagnóstico de provável doença de Alzheimer em fase inicial a moderada. Todos faziam uso de anti-colinesterásicos e passaram por uma avaliação neuropsicológica (AN) antes de começar o PRN e reavaliação após 12 e 24 meses do tratamento. O alvo de nossa intervenção foi trabalhar de forma prática a memória explicita residual e implícita, através do treino das atividades da vida diária, uso de estratégias compensatórias e habilidades cognitivas ainda preservadas. RESULTADOS: A análise dos dados quantitativos (medidas descritivas) da AN mostrou, que após o primeiro ano do PRN houve uma melhora cognitiva, estabilização funcional e redução dos problemas comportamentais nos pacientes. No entanto, observamos que essa melhora não se estendeu para o segundo ano, mostrando a doença sua característica progressiva.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Centro Paulista de NeuropsicologiaUNIFESP, EPM, Centro Paulista de NeuropsicologiaSciEL

Análise da competitividade da produção de soja nos sistemas de plantio direto e plantio convencional na região do cerrado brasileiro

The national agricultural section, in phase of reorganization and adaptation to the new production and sale standards, faces the challenge of growing in a competitive and sustainable way, to meet the internal demand and to conquer and to maintain foreign market space, supplying products and quality processes with sustainability and at competitive prices. To meet the new demands of a more ecologically and economically balanced agriculture, it requires the practice of a production consistent with the sustainable development.O setor agrícola nacional, em fase da reorganização e adequação aos novos padrões de produção e comercialização, enfrenta o desafio de crescer de modo competitivo e sustentável, para atender a demanda interna e conquistar e manter espaço de mercado externo, fornecendo produtos e processos de qualidade, com sustentabilidade e a preços competitivos. Para atender as novas demandas de uma agricultura mais equilibrada, ecológica e econômica, é necessário a prática de uma produção coerente com o desenvolvimento sustentável, o que o sistema de plantio direto desde a década de 60 vem demonstrando no País. Assim sendo, é objetivo deste trabalho analisar, utilizando a Matriz de Análise de Políticas, a lucratividade e competitividade da produção de soja no sistema de plantio direto, na região do cerrado de Mato Grosso do Sul que, como se pode observar pelos resultados obtidos, foi maior do que a do sistema de plantio convencional

The thickness of posterior cortical areas is related to executive dysfunction in Alzheimer's disease

OBJECTIVE: To establish whether alterations of brain structures in Alzheimer's disease are associated with executive dysfunction. METHODS: Nineteen patients with Alzheimer's disease and 22 older control subjects underwent a comprehensive evaluation. The clock drawing test, digit span test, executive motor function test, Behavioral Assessment of the Dysexecutive Syndrome battery (Rule Shift Cards test), and Stroop test were used to evaluate executive dysfunction. A multiparametric approach using the FreeSurfer image analysis suite provided a description of volumetric and geometric features of the gray matter structures. RESULTS: The cortical thickness maps showed a negative correlation between the Behavioral Assessment of the Dysexecutive Syndrome battery (Rule Shift Cards test) and the right middle frontal gyrus; a positive correlation between the executive motor function test and the left superior parietal gyrus, left middle temporal gyrus, bilateral supramarginal gyri, right middle frontal gyrus, and right precuneus; a negative correlation between the Stroop test (part III) and the right superior parietal gyrus; and a negative correlation between the Stroop test (part III) and the right middle temporal gyrus. CONCLUSION: Executive dysfunction in Alzheimer's disease is correlated with alterations not only in the frontal areas but also within many temporal and parietal regions.Associacao Fundo de Incentivo a Pesquisa (AFIP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico ( CNPq)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Universidade Federal de São Paulo (UNIFESP) Psychobiology DepartmentUniversidade Federal de São Paulo (UNIFESP) Laboratorio Interdisciplinar de Neurociencias Clinicas (LiNC) Psychiatry DepartmentFaculdade de Medicina da Universidade de São Paulo Hospital das Clinicas, Cognitive Neurology and Behavior GroupUNIFESP, Psychobiology DepartmentUNIFESP, Laboratorio Interdisciplinar de Neurociencias Clinicas (LiNC) Psychiatry Department2008/11282-9SciEL

The thickness of posterior cortical areas is related to executive dysfunction in Alzheimer's disease

OBJECTIVE: To establish whether alterations of brain structures in Alzheimer's disease are associated with executive dysfunction. METHODS: Nineteen patients with Alzheimer's disease and 22 older control subjects underwent a comprehensive evaluation. The clock drawing test, digit span test, executive motor function test, Behavioral Assessment of the Dysexecutive Syndrome battery (Rule Shift Cards test), and Stroop test were used to evaluate executive dysfunction. A multiparametric approach using the FreeSurfer image analysis suite provided a description of volumetric and geometric features of the gray matter structures. RESULTS: The cortical thickness maps showed a negative correlation between the Behavioral Assessment of the Dysexecutive Syndrome battery (Rule Shift Cards test) and the right middle frontal gyrus; a positive correlation between the executive motor function test and the left superior parietal gyrus, left middle temporal gyrus, bilateral supramarginal gyri, right middle frontal gyrus, and right precuneus; a negative correlation between the Stroop test (part III) and the right superior parietal gyrus; and a negative correlation between the Stroop test (part III) and the right middle temporal gyrus. CONCLUSION: Executive dysfunction in Alzheimer's disease is correlated with alterations not only in the frontal areas but also within many temporal and parietal regions

Estimation of HIV incidence in two Brazilian municipalities, 2013

OBJECTIVE To estimate HIV incidence in two Brazilian municipalities, Recife and Curitiba, in the year of 2013. METHODS The method for estimating incidence was based on primary information, resulting from the Lag-Avidity laboratory test for detection of recent HIV infections, applied in a sample of the cases diagnosed in the two cities in 2013. For the estimation of the HIV incidence for the total population of the cities, the recent infections detected in the research were annualized and weighted by the inverse of the probability of HIV testing in 2013 among the infected and not diagnosed cases. After estimating HIV incidence for the total population, the incidence rates were estimated by sex, age group, and exposure category. RESULTS In Recife, 902 individuals aged 13 years and older were diagnosed with HIV infection. From these, 528 were included in the study, and the estimated proportion of recent infections was 13.1%. In Curitiba, 1,013 people aged 13 years and older were diagnosed, 497 participated in the study, and the proportion of recent infections was 10.5%. In Recife, the estimated incidence rate was 53.1/100,000 inhabitants of 13 years and older, while in Curitiba, it was 41.1/100,000, with male-to-female ratio of 3.5 and 2.4, respectively. We observed high rates of HIV incidence among men who have sex with men, of 1.47% in Recife and 0.92% in Curitiba. CONCLUSIONS The results obtained in the two cities showed that the group of men who have sex with men are disproportionately subject to a greater risk of new infections, and indicate that strategies to control the spread of the epidemic in this population subgroup are essential and urgent.OBJETIVO Estimar a incidência de HIV em dois municípios brasileiros, Recife e Curitiba, no ano de 2013. MÉTODOS O método de estimação da incidência foi baseado em informações primárias, resultantes do ensaio laboratorial Lag-Avidity para detecção de infecções recentes do HIV, aplicado em uma amostra dos casos diagnosticados nas duas cidades em 2013. Para a estimação da incidência de HIV para a população total das cidades, as infecções recentes detectadas na pesquisa foram anualizadas e ponderadas pelo inverso da probabilidade de teste de HIV no ano de 2013 entre os casos infectados e não diagnosticados. Após a estimação da incidência de HIV para a população total, foram estimadas as taxas de incidência por sexo, faixa de idade e categoria de exposição. RESULTADOS Em Recife, foram diagnosticados 902 indivíduos de 13 anos e mais com infecção de HIV. Desses, 528 foram incluídos no estudo, e a proporção estimada de infecções recentes foi de 13,1%. Em Curitiba, foram diagnosticadas 1.013 pessoas de 13 anos e mais, 497 participaram do estudo, e a proporção de infecções recentes foi de 10,5%. Em Recife, a taxa de incidência estimada foi de 53,1 por 100 mil habitantes de 13 anos e mais, enquanto em Curitiba, de 41,1 por 100 mil, com razão do sexo masculino para o feminino de 3,5 e 2,4, respectivamente. Foram evidenciadas elevadas taxas de incidência de HIV entre homens que fazem sexo com homens, de 1,47% em Recife e 0,92% em Curitiba. CONCLUSÕES Os resultados obtidos nas duas cidades mostraram que o grupo dos homens que fazem sexo com homens está desproporcionalmente sujeito ao maior risco de novas infecções, e indicam que estratégias para controle da disseminação da epidemia nesse subgrupo populacional são essenciais e urgentes