Primer registro de procedimientos de intervencionismo cardiovascular pediátrico realizados en un laboratorio estatal de hemodinamia pediátrica en El Salvador / First record of pediatric cardiovascular interventional procedures performed in a state pediatric catheterization laboratory in El Salvador

Resumen Objetivo: Describir los tipos de cateterismo cardiaco que se realizan en el único laboratorio de hemodinamia pediátrica dentro de la red de salud pública de El Salvador, en colaboración con organizaciones sin fines de lucro. Material y método: Se realizó un estudio descriptivo retrospectivo de corte transversal en el periodo entre mayo de 2022 a enero de 2023, revisando los expedientes de todos los pacientes que pasaron a cateterismo cardiaco. Resultados: Se realizaron 54 procedimientos dentro de la sala de hemodinamia, 37 pacientes de sexo femenino. El peso fue de 20.6 ± 14.5 kg, de los procedimientos, 47 (87%) fueron terapéuticos y 7 (13%) diagnósticos. La oclusión del conducto arterioso se realizó en el 46% de los pacientes. No se reportaron complicaciones, los pacientes fueron dados de alta luego de 12 horas, todos los insumos fueron donados por fundaciones sin fines de lucro. Conclusiones: Nuestro laboratorio de hemodinamia realiza procedimientos de complejidad variada sin reportar hasta el momento complicaciones mayores. Nos vemos limitados debido al costo alto de algunos dispositivos, a la baja frecuencia de la utilización de estos y a la imposibilidad para adquirirlos en el mercado nacional.

Abstract Objective: To describe the types of cardiac catheterization that are performed in the only pediatric catheterization laboratory within the public health network of El Salvador, in collaboration with non-profit organizations. Material and method: A descriptive, retrospective, cross-sectional study was conducted in the period from May 2022 to January 2023, reviewing the records of all patients who underwent cardiac catheterization. Results: 54 procedures were performed in the catheterization room, 37 female patients. The weight was 20.6 ± 14.5 kg, of the procedures, 47 (87%) were therapeutic and 7 (13%) diagnostic. Occlusion of the ductus arteriosus was performed in 46% of the patients. No complications were reported, the patients were discharged after 12 hours, all supplies were donated by non-profit foundations. Conclusions: Our catheterization laboratory performs procedures of varied complexity without reporting any major complications to date. We are limited due to the high cost of some devices, the low frequency of their use and the impossibility of acquiring them in the national market.

First record of pediatric cardiovascular interventional procedures performed in a state pediatric catheterization laboratory in El Salvador.

OBJECTIVE: To describe the types of cardiac catheterization that are performed in the only pediatric catheterization laboratory within the public health network of El Salvador, in collaboration with non-profit organizations. MATERIAL AND METHOD: A descriptive, retrospective, cross-sectional study was conducted in the period from May 2022 to January 2023, reviewing the records of all patients who underwent cardiac catheterization. RESULTS: 54 procedures were performed in the catheterization room, 37 female patients. The weight was 20.6 ± 14.5 kg, of the procedures, 47 (87%) were therapeutic and 7 (13%) diagnostic. Occlusion of the ductus arteriosus was performed in 46% of the patients. No complications were reported, the patients were discharged after 12 hours, all supplies were donated by non-profit foundations. CONCLUSIONS: Our catheterization laboratory performs procedures of varied complexity without reporting any major complications to date. We are limited due to the high cost of some devices, the low frequency of their use and the impossibility of acquiring them in the national market.

OBJETIVO: Describir los tipos de cateterismo cardiaco que se realizan en el único laboratorio de hemodinamia pediátrica dentro de la red de salud pública de El Salvador, en colaboración con organizaciones sin fines de lucro. MATERIAL Y MÉTODO: Se realizó un estudio descriptivo retrospectivo de corte transversal en el periodo entre mayo de 2022 a enero de 2023, revisando los expedientes de todos los pacientes que pasaron a cateterismo cardiaco. RESULTADOS: Se realizaron 54 procedimientos dentro de la sala de hemodinamia, 37 pacientes de sexo femenino. El peso fue de 20.6 ± 14.5 kg, de los procedimientos, 47 (87%) fueron terapéuticos y 7 (13%) diagnósticos. La oclusión del conducto arterioso se realizó en el 46% de los pacientes. No se reportaron complicaciones, los pacientes fueron dados de alta luego de 12 horas, todos los insumos fueron donados por fundaciones sin fines de lucro. CONCLUSIONES: Nuestro laboratorio de hemodinamia realiza procedimientos de complejidad variada sin reportar hasta el momento complicaciones mayores. Nos vemos limitados debido al costo alto de algunos dispositivos, a la baja frecuencia de la utilización de estos y a la imposibilidad para adquirirlos en el mercado nacional.

Transition from mild cognitive impairment to normal cognition: Determining the predictors of reversion with multi-state Markov models.

INTRODUCTION: The theoretical framework of the Alzheimer's disease continuum considers transition between stages in a unidirectional manner. Here we examine the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) and explore a set of potential variables associated with this phenomenon. METHODS: A total of 985 Spanish community-dwelling individuals aged 70 years and over at baseline were monitored for 5 years. During this time, 173 MCI and 36 dementia cases were identified. Multi-state Markov models were performed to characterize transitions between states through the dementia continuum. RESULTS: The rate of reversion from MCI to NC was 11%. There were significant non-modifiable (age, socioeconomic status, or apolipoprotein E) and modifiable factors (cognitive training or absence of affective symptoms) associated with reversion. DISCUSSION: Overall, our results highlight that the likelihood of progression from MCI to dementia is very similar to that of reversion from MCI to NC.

Integrated rearing system proposal for Cantareus aspersus in experimental orchards: Growth models.

An integrated rearing system for Cantareus aspersus under environmental conditions in an experimental orchard is proposed. In this study, the natural behaviour, circadian rhythms and suitable rearing conditions of the edible snail were optimised to produce homogeneous growth and low variability. The growth was standardised, and growth pattern fit was assessed with various models. One thousand fry were cultured in the orchard, and a random sample of 100 snails were measured weekly for 23 weeks. The rearing system had the following characteristics: snails and earthworms were included in the experimental rearing orchard; a homogeneous group of juvenile snails of the same age and size and high rearing density (500 snails/m2) was used; snails were fed with layers mash ad libitum; and mixed and fringes vegetation was planted in the orchard. A commercial size of 60% of snails was achieved in 21 weeks and 95% in 23 weeks. The different models showed a good fit, and the quadratic model obtained the best fit. This experimental snail orchard proposal can be extended to other areas, although it must be corrected according to different environmental conditions and fit to other species of interest. This experimental model could constitute a viable alternative to traditional models of animal experimentation with mammals, and given its high adaptability, it could be applied in different fields of science.

Memory for future actions: the effect of prospective memory on an explicit and implicit memory task.

INTRODUCTION: In the field of retrospective memory, an explicit and implicit memory are known to exist. This study analyses the effect of the prospective memory on a recognition task and a lexical decision task. METHOD: In experiment 1 (n = 78, of which 39 belonged to the experimental group and 39 belonged to the control group), a recognition task was followed by an intentional task, as well as an incidental free recall task. In experiment 2 (n = 74, of which 37 belonged to the experimental group and 37 belonged to the control group), repetition priming was studied during a lexical decision task, followed by an intentional task. The data were analysed using a mixed ANOVA. RESULTS: Experiment 1 showed active monitoring of the prospective memory task accompanied by a recollective search process during the recognition task. The group which carried out the prospective task also showed better scores in the incidental free recall task. Experiment 2 showed active monitoring and repetition priming during the lexical decision task. CONCLUSION: While the prospective memory affects the performance in both concurrent tasks, it does not affect the recollective search process or repetition priming.

Estimation of Genetic Parameters for Peak Yield, Yield and Persistency Traits in Murciano-Granadina Goats Using Multi-Traits Models.

This paper studies parameters of a lactation curve such as peak yield (PY) and persistency (P), which do not conform to the usual selection criteria in the Murciano-Granadina (MG) breed, but are considered to be an alternative to benefit animal welfare without reducing production. Using 315,663 production records (of 122,883 animals) over a period of 24 years (1990-2014), genetic parameters were estimated with uni-, bi- and multivariate analysis using multiple trait derivative free restricted maximum likelihood (MTDFREML). The heritability (h2)/repeatability (re) of PY, yield (Y) and P was estimated as 0.13/0.19, 0.16/0.25 and 0.08/0.09 with the uni-trait and h2 of bi- and multi-traits analysis ranging from 0.16 to 0.17 of Y, while that of PY and Y remained constant. Genetic correlations were high between PY-Y (0.94 ± 0.011) but low between PY-P (-0.16 ± 0.054 to -0.17 ± 0.054) and between Y-P (-0.06 ± 0.058 to -0.05 ± 0.058). Estimates of h2/re were low to intermediate. The selection for Y-PY or both can be implemented given the genetic correlation between these traits. PY-P and Y-P showed low to negligible correlation values indicating that if these traits are implemented in the early stages of evaluation, they would not be to the detriment of PY-Y. The combination of estimated breeding values (EBVs) for all traits would be a good criterion for selection.

Vitrification induces critical subcellular damages in ram spermatozoa.

The aim of the present study was to analyse morphological variations in ovine spermatozoa subjected to different cryopreservation protocols using high resolution imaging techniques. Ejaculates were pooled and diluted in Tris-based extender. Aliquots containing 300 × 106 spz/ml were prepared and evaluated a) after the semen collection and pooling, b) after conventional freezing, c) after vitrification of samples maintained at room temperature (22 °C) prior to vitrification, and d) after vitrification of samples maintained at 5 °C prior to vitrification. Sperm motility, acrosome integrity, DNA fragmentation and morphology were assessed. Subcellular sperm changes were assessed and described by light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The maintenance of spermatozoa at 5 °C prior to vitrification and the use of 0.4 M sucrose pointed out lower dimensions of area, length and width than fresh, frozen and sperm maintained at 22 °C prior to vitrification. It was observed that the head width and length are significantly higher (P < 0.0001) in fresh spermatozoa than in the vitrified sperm samples. It could be hypothesized that greater intracellular fluid loss during vitrification could prevent damages in the spermatozoon throughout the reduced ice crystals formation, but mainly by the reduction of extracellular ice crystals due to the physical properties modification obtained when high concentrations of sugars are added. This is the first ultramicroscopic study carried out in ovine vitrified spermatozoa, which confirms the functional sperm alterations previously detected.

Loewenstein Occupational Therapy Cognitive Assessment to Evaluate People with Addictions.

BACKGROUND: The LOTCA (Loewenstein Occupational Therapy Cognitive Assessment) battery is a cognitive screening test which is widely used in occupational health. However, no work has been found that explores its use in addiction treatment. OBJECTIVES OF STUDY: To explore the convergent validity of LOTCA with neuropsychological tests that assess related cerebral functional areas. METHODS: The LOTCA, along with a battery of neuropsychological tests, was administered to a sample of 48 subjects who start a treatment by substance or gambling addictions. FINDINGS: A correlational pattern was observed of a considerable magnitude between the effects of the LOTCA scales and those of some neuropsychological tests, but not with others. There is barely any convergence in measures with memory and executive function tests. RELEVANCE TO CLINICAL PRACTICE: There is a lack of research applying test of occupational assessment to populations of patients treated by addictive behaviors. The LOTCA seems to be a reliable and valid test for preliminary screening of function in certain cognitive areas, easy, and quick to use (around 30 minutes). However, it must be supplemented with other tests for a full and ecological assessment of patients. LIMITATIONS: An incident, small-size sample. RECOMMENDATIONS FOR FURTHER RESEARCH: New studies are needed to explore the applicability, diagnostic validity, and whole psychometric quality of the test in addiction-related treatment.

Clinical Relevance of Specific Cognitive Complaints in Determining Mild Cognitive Impairment from Cognitively Normal States in a Study of Healthy Elderly Controls.

Introduction: Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI) by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ). Materials and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI). The EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis (EFA) and Item Response Theory (IRT) were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI. Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely Forgetfulness of Immediate Information (FII), Executive Functions (EF) and Prospective Memory (PM) proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10). Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to use the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints.

[Clinical utility and psychometric properties of Prefrontal Symptoms Inventory (PSI) in acquired brain injury and degenerative dementias]. / Utilidad clínica y propiedades psicométricas del inventario de síntomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas.

INTRODUCTION: The cognitive, emotional and behavioural alterations secondary to acquired brain injury and degenerative dementias can be quantitatively and quantitatively appraised by administering self-reports that ask both patients and reliable informants about the difficulties patients have in their everyday life. SUBJECTS AND METHODS: The Prefrontal Symptoms Inventory (PSI) and the Modified Memory Failures in Everyday Life Questionnaire (MFE-30) were administered to 174 paired participants: 87 patients with brain damage or degenerative dementias and their 87 reliable informants. In addition to the psychometric goodness of the tests, the study also explored the clinical usefulness of applying these questionnaires to patients and their informants in order to obtain a rate of discrepancy in the scores as a measure of anosognosia. RESULTS: The results show how applying the PSI-20 (20 items) or the PSI (46 items), whether administered together with the MFE-30 (30 items) or not, is a very useful procedure for assessing the symptoms in individuals with acquired brain injury or degenerative dementias, since it yields a great deal of information about patients' difficulties in their daily life. CONCLUSIONS: We recommend that, in addition to the compulsory neuropsychological assessment, questionnaires or inventories of symptoms like those proposed here should be carried out, due to the fact that they offer a number of advantages from the clinical point of view, as well as being efficacious and effective in economic terms.

TITLE: Utilidad clinica y propiedades psicometricas del inventario de sintomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas.Introduccion. Las alteraciones cognitivas, emocionales y comportamentales secundarias al daño cerebral adquirido y las demencias degenerativas pueden valorarse cuantitativa y cualitativamente mediante la administracion de autoinformes que interroguen ­a pacientes e informadores fiables­ sobre las dificultades de los pacientes en la vida cotidiana. Sujetos y metodos. Se administro el inventario de sintomas prefrontales (ISP) y el cuestionario de fallos de memoria en la vida cotidiana modificado (MFE-30) a 174 participantes emparejados: 87 pacientes con daño cerebral o demencias degenerativas y sus 87 informadores fiables. Se exploro, junto con la bondad psicometrica de las pruebas, la utilidad clinica de la aplicacion de estos cuestionarios a pacientes e informadores para obtener un indice de discrepancia de las puntuaciones como medida de la anosognosia. Resultados. Los resultados muestran como aplicar el ISP-20 (20 items) o el ISP (46 items), sean o no administrados conjuntamente con el MFE-30 (30 items), resulta un procedimiento muy util para la valoracion de la sintomatologia en los individuos con daño cerebral adquirido o demencias degenerativas, al proporcionar una gran cantidad de informacion sobre las dificultades de los pacientes en la vida cotidiana. Conclusiones. Se recomienda, junto con la obligada evaluacion neuropsicologica, la cumplimentacion de cuestionarios o inventarios de sintomas como los propuestos, dado que presentan ventajas desde el punto de vista clinico, ademas de resultar eficaces, efectivos y eficientes en terminos economicos.

High casein kinase 1 epsilon levels are correlated with better prognosis in subsets of patients with breast cancer.

Reliable biological markers that predict breast cancer (BC) outcomes after multidisciplinary therapy have not been fully elucidated. We investigated the association between casein kinase 1 epsilon (CK1ε) and the risk of recurrence in patients with BC. Using 168 available tumor samples from patients with BC treated with surgery +/- chemo(radio)therapy, we scored the CK1ε expression as high (≥ 1.5) or low (<1.5) using an immunohistochemical method. Kaplan-Meier analysis was performed to assess the risk of relapse, and Cox proportional hazards analyses were utilized to evaluate the effect of CK1ε expression on this risk. The median age at diagnosis was 60 years (range 35-96). A total of 58% of the patients underwent breast conservation surgery, while 42% underwent mastectomy. Adjuvant chemotherapy and radiation therapy were administered in 101 (60%) and 137 cases (82%), respectively. Relapse was observed in 24 patients (14%). Multivariate analysis found high expression of CK1ε to be associated with a statistically significant higher disease-free survival (DFS) in BC patients with wild-type p53 (Hazard ratio [HR] = 0.33; 95% CI, 0.12-0.91; P = 0.018) or poor histological differentiation ([HR] = 0.34; 95% CI, 0.12-0.94; P = 0.039) or in those without adjuvant chemotherapy ([HR] = 0.11; 95% CI, 0.01-0.97; P = 0.006). Our data indicate that CK1ε expression is associated with DFS in BC patients with wild-type p53 or poor histological differentiation or in those without adjuvant chemotherapy and thus may serve as a predictor of recurrence in these subsets of patients.

[Prefrontal clinical symptoms in daily living: screening assessment by means of the short Prefrontal Symptoms Inventory (PSI-20)]. / Sintomatologia prefrontal en la vida diaria: evaluacion de cribado mediante el inventario de sintomas prefrontales abreviado (ISP-20).

INTRODUCTION: Estimation of daily symptoms of frontal dysfunction is considered to be essential in order to endow neuro-psychological assessments with ecological validity. The questionnaires available today were constructed to estimate executive problems in daily life in populations with neurological damage. There is a need for instruments focused on measuring these behaviours in the general population or in clinical populations with mild or moderate impairment. AIM: To examine the factorial validity and to find evidence of concurrent validity of the short version of the Prefrontal Symptoms Inventory. SUBJECTS AND METHODS: Three samples were obtained: the first, from the Internet (n = 504); the second, in a non-clinical population by means of paper and pencil (n = 1,257); and the third, from patients being treated for substance addiction (n = 602). A factorial analysis without restraints was used on the first sample and the results were submitted to confirmatory factorial analysis on the other two samples. RESULTS: The three-factor structure that was found was confirmed with excellent indicators of fit in the other two samples. Evidence of concurrent validity was found with quality of life and mental health tests. CONCLUSIONS: We propose a short questionnaire for detecting failures of a prefrontal origin in daily living, which improves on the psychometric qualities of similar tests, but is oriented towards severe neurological pathologies. The structural stability of the test ensures it can be used in the general population, for the early detection of cognitive impairment, and in clinical populations with mild or moderate deterioration. A set of criteria are proposed for use in interpreting the results.

TITLE: Sintomatologia prefrontal en la vida diaria: evaluacion de cribado mediante el inventario de sintomas prefrontales abreviado (ISP-20).Introduccion. La estimacion de sintomas cotidianos de disfuncion frontal se considera imprescindible para aportar validez ecologica a las evaluaciones neuropsicologicas. Los cuestionarios disponibles se construyeron para estimar problemas ejecutivos en la vida diaria en poblaciones con daño neurologico. Se requieren instrumentos enfocados a medir estos comportamientos en la poblacion general o en poblaciones clinicas con fallos leves o moderados. Objetivo. Estudiar la validez factorial y encontrar indicios de validez concurrente de la version abreviada del inventario de sintomas prefrontales. Sujetos y metodos. Se obtuvieron tres muestras: la primera, a traves de Internet (n = 504); la segunda, en poblacion no clinica mediante lapiz y papel (n = 1.257), y la tercera, de pacientes en tratamiento por adiccion a sustancias (n = 602). Se utilizo un metodo de analisis factorial sin restricciones sobre la primera muestra y los resultados se sometieron a analisis factorial confirmatorio sobre las otras dos muestras. Resultados. La estructura de tres factores encontrada se confirmo con excelentes indicadores de ajuste en las otras dos muestras. Se hallaron indicios de validez concurrente con pruebas de calidad de vida y salud mental. Conclusiones. Se propone un cuestionario breve para la deteccion de fallos de origen prefrontal en la vida diaria, que mejora las cualidades psicometricas de tests similares, pero orientados a patologias neurologicas graves. La estabilidad estructural de la prueba garantiza la utilidad en la poblacion general, para la deteccion precoz del deterioro cognitivo, y en poblaciones clinicas con deterioro leve o moderado. Se proponen baremos para la interpretacion de resultados.

Dysexecutive Questionnaire (DEX): Unrestricted structural analysis in large clinical and non-clinical samples.

The factorial structure of the Dysexecutive Questionnaire (DEX) is an unresolved issue in scientific literature. One-to-five-factor solutions have been found in several studies by applying different research methods. Only a few of these studies used appropriate analysis procedures to suit a Likert scale-type of answer or investigated large enough samples to ensure the stability of factorial solutions. The present study examines a sample of 2151 subjects, 1482 from the general population and 669 from a clinical population. An unrestricted factorial analysis was carried out on both samples. The results unequivocally point to a single-factor solution in both samples. This means that only one latent variable is displayed in the DEX, which accounts for symptoms of oversight malfunction in activities of daily living. It is concluded that the diversity of results previously obtained in other studies may be due to using research methods that depict Likert-type scales on a continuum when they are actually ordinal categorical measures. In conclusion, the DEX should be considered a screening test that reports symptoms of prefrontal malfunction, although it is unable to specify what areas or functions have been affected, as previous studies have claimed.

[Cognitive reserve in substance addicts in treatment: relation to cognitive performance and activities of daily living]. / Reserva cognitiva en adictos a sustancias en tratamiento: relacion con el rendimiento cognitivo y las actividades cotidianas.

INTRODUCTION: The concept of cognitive reserve has gradually attracted more interest as a greater body of evidence has been collected on its relationship with the resistance of the brain to decline in its functioning when faced with neurological threats or disorders. Although a large amount of research has been conducted on (degenerative, traumatic, psychopathological) conditions, very few studies relate cognitive reserve with substance addiction, a multidimensional process with a clear neurological base. AIMS: To explore the cognitive reserve of patients undergoing treatment for addiction to drugs of abuse by relating it with their cognitive performance in neuropsychological tests and in activities of daily living. PATIENTS AND METHODS: The study involved a sample of 57 patients being treated for substance abuse at a centre set up for this specific purpose. The cognitive reserve questionnaire, the Montreal cognitive assessment and the prefrontal symptoms inventory were administered, and variables related with the addiction were collected. RESULTS: A positive relation was found between the cognitive reserve and the time of abstinence, and a negative one was seen with the severity of the addiction. Significant differences were observed according to the cognitive reserve in neuropsychological performance (especially in certain cognitive domains) and in daily activities. CONCLUSIONS: The cognitive reserve appears as a variable related to addiction and the cognitive deficits that accompany it. It is thus a potential target for rehabilitation activities and is linked to the environmental enrichment paradigm, as a strategy for enhancing resistance against the cognitive impairment that favours and maintains the addiction, and for lowering the reinforcing potential of the behaviour of consuming.

TITLE: Reserva cognitiva en adictos a sustancias en tratamiento: relacion con el rendimiento cognitivo y las actividades cotidianas.Introduccion. El concepto de reserva cognitiva ha ido ganando interes en la medida en que se ha acumulado evidencia sobre su relacion con la resistencia del cerebro a declinar en su funcionamiento ante amenazas o alteraciones neurologicas. Aunque se ha estudiado en un gran numero de alteraciones (degenerativas, traumaticas, psicopatologicas), pocos trabajos relacionan la reserva cognitiva con la adiccion a sustancias, un proceso multidimensional con clara base neurologica. Objetivo. Explorar la reserva cognitiva de pacientes en tratamiento por adiccion a drogas, relacionandolo con su rendimiento cognitivo en pruebas neuropsicologicas y en actividades de la vida diaria. Pacientes y metodos. Muestra de 57 pacientes en tratamiento por adiccion a sustancias en un centro especifico. Se administraron el cuestionario de reserva cognitiva, la evaluacion cognitiva de Montreal y el inventario de sintomas prefrontales, y se recogieron variables relacionadas con la adiccion. Resultados. Se encontro una relacion positiva entre la reserva cognitiva y el tiempo de abstinencia, y negativa con la gravedad de la adiccion. Aparecieron diferencias significativas segun la reserva cognitiva en rendimiento neuropsicologico (especialmente en ciertos dominios cognitivos) y en actividades cotidianas. Conclusiones. La reserva cognitiva aparece como una variable relacionada con la adiccion y los deficits cognitivos que la acompañan; resulta ser una potencial diana de las actividades rehabilitadoras, vinculada al paradigma de enriquecimiento ambiental, como estrategia para potenciar la resistencia frente al deterioro cognitivo que favorece y mantiene la adiccion y para disminuir el potencial reforzador de la conducta de consumo.

[Subjective memory complaints, personality and prefrontal symptomatology in young adults]. / Quejas subjetivas de memoria, personalidad y sintomatologia prefrontal en adultos jovenes.

INTRODUCTION: This work explores two issues related with the appearance of subjective memory complaints in young adults: on the one hand, the possibility of the complaints being a result of attentional and executive deficits and, on the other, whether certain characteristics of the personality favour and modulate the clinical expression of these complaints. SUBJECTS AND METHODS: The Memory Failures of Everyday questionnaire, Spanish version, the Prefrontal Syndromes Inventory and the Revised Temperament and Character Inventory were administered to a sample of 1132 participants (900 from the general population and 232 on treatment for drug addiction). The correlation among the variables of the memory complaints, of prefrontal functioning in daily life and of the dimensions of personality proposed by Cloninger was explored. The causal relationships among the variables were studied using structural methods. RESULTS: A strong correlation was observed between cognitive complaints and prefrontal symptoms, suggesting that the complaints are, in fact, a result of an inadequate management of the attentional and executive functions that favours daily errors. A relationship with a large effect size is also observed between the cognitive complaints and low self-management. This dimension of the personality offers an important predictive capacity regarding the appearance and the intensity of the complaints, either directly or modulated by other dimensions, especially harm avoidance. CONCLUSIONS: The data back the idea that memory complaints are the result of the self-perception of daily faults and errors that are produced at the attentional and executive level -although they are taken as instances of mnemonic oversight- and that the clinical expression of these complaints is modulated by a profile of the personality.

TITLE: Quejas subjetivas de memoria, personalidad y sintomatologia prefrontal en adultos jovenes.Introduccion. El presente trabajo explora dos cuestiones relacionadas con la aparicion de quejas subjetivas de memoria en adultos jovenes: la posibilidad de que dichas quejas sean resultado de deficits atencionales y ejecutivos, y, por otro lado, si determinadas caracteristicas de la personalidad propician y modulan la expresion clinica de las quejas. Sujetos y metodos. Se administro el Memory Everyday Failures, version española, el inventario de sintomas prefrontales y el inventario del temperamento y el caracter-revisado a una muestra de 1.132 participantes (900 de poblacion general y 232 en tratamiento por adiccion a drogas). Se exploro la correlacion entre variables de las quejas de memoria, del funcionamiento prefrontal en la vida diaria y de las dimensiones de la personalidad propuestas por Cloninger. Se estudiaron relaciones de causalidad entre las variables mediante metodos estructurales. Resultados. Se observa una fuerte correlacion entre las quejas cognitivas y la sintomatologia prefrontal, lo que sugiere que las quejas son, en realidad, resultado de una inadecuada gestion atencional y ejecutiva que propicia los errores cotidianos. Se aprecia tambien una relacion con gran tamaño del efecto entre las quejas cognitivas y la baja autodireccion. Esta dimension de la personalidad presenta una importante capacidad predictiva sobre la aparicion y la intensidad de las quejas, bien directamente, bien modulada por otras dimensiones, especialmente la evitacion del daño. Conclusiones. Los datos apoyan la idea de que las quejas de memoria son producto de la autopercepcion de fallos y errores cotidianos provocados a nivel atencional y ejecutivo ­aunque son tenidos por olvidos mnesicos­, y que la expresion clinica de dichas quejas esta modulada por un perfil de la personalidad.

[Prefrontal symptoms and personality disorders in substance abusers]. / Sintomatologia prefrontal y trastornos de la personalidad en adictos a sustancias.

INTRODUCTION: Neuroimaging findings associate personality traits and their disorders with an altered functioning of certain areas of the brain, especially in the frontal lobe. There is a need for instruments that can be applied in clinical practice to explore these relations based on their behavioural manifestations. PATIENTS AND METHODS: The sample was composed of 371 subjects with substance abuse/dependence. The Prefrontal Symptoms Inventory (PSI) and the Millon Clinical Multiaxial Inventory II (MCMI-II) were administered and diagnostic interviews were carried out to determine the existence of disorders affecting axis II (personality disorders). RESULTS: Criteria satisfying a diagnosis of some personality disorder were present in 43.9% of the sample. The results show a broad correlational pattern between the prefrontal symptoms scales and those of personality disorders. The variance in up to eight of the 13 scales of the MCMI-II is predicted in over 20%, based on the combination of scales from the PSI. The personality disorders diagnosed by means of a clinical interview present differential prefrontal symptomatological profiles that were consistent with what was expected. CONCLUSIONS: The results support the hypothesis of a relationship between the diagnosis of personality disorders and frontal malfunctioning, thus suggesting new lines for studying and approaching them in clinical practice. Such new paths could involve the use of cognitive rehabilitation to improve day-to-day functioning and modify the neurological substrates underlying personality disorders.

[Subtypes of cocaine addicts with and without associated problematic alcohol use: towards a neuropsychology of personality applied to clinical practice]. / Subtipos de adictos a la cocaína con y sin consumo problemático de alcohol asociado: hacia una neuropsicología de la personalidad aplicada a la clínica.

It is important to know which personality factors are associated with addiction so to distinguish addicts that require specialized treatment from those who do not, and to identify those addicts who achieve abstinence from those who continue their substance use despite the negative consequences. Cloninger's model includes biological and psychosocial variables that can be characterized in neuropsychological terms. Two samples were analyzed: individuals who had begun cocaine addiction treatment (n=183) and a non-clinical population sample (n = 183), matched for sex, age and educational level. Alcohol abuse/dependence was monitored as an independent variable. Significant differences and large effect size were found between addicts and non-clinical population in Novelty Seeking and Self-Directedness, and to a lesser extent, in Harm Avoidance. These differences increase when problematic use of alcohol is added. According to the profile of traits, clusters of addicts were established and differences were obtained in variables such as functional/dysfunctional impulsivity, dysexecutive symptoms and perceived stress. Six clusters were identified, some of minor severity, the most severely problematic clusters being characterized by higher levels of dysfunctional impulsivity, more dysexecutive symptoms and higher levels of perceived stress. Self-Directedness seems to reflect the deficit of prefrontal systems in the regulation of behavior, as well as in emotion and impulse control. It is proposed that evaluation of the personality is more useful than the mere assessment of symptoms for classifying addicts, determining their needs and designing a therapeutic itinerary.

[A new shortened version of the Boston Naming Test for those aged over 65: an approach from item response theory]. / Nueva versión reducida del test de denominación de Boston para mayores de 65 años: aproximación desde la teoría de respuesta al ítem.

INTRODUCTION: One of the tests that is mostly widely used to evaluate aphasia in clinical practice is the Boston Naming Test (BNT), a classic test in which 60 black and white pictures are presented to subjects in order to evaluate their capacity to put a name to such pictures. Despite its psychometric goodness, the number of items in the test has to be reduced in order to lower the time required to apply it. SUBJECTS AND METHODS: Researchers recruited a sample of 547 subjects over the age of 65, who were then administered a neuropsychological evaluation protocol, including the BNT, to determine their cognitive statuses. No relevant cognitive alterations were observed in 405 subjects versus 142 who were diagnosed with mild cognitive impairment. RESULTS: The number of items was reduced in accordance with the premises of the item response theory. Since both age and level of schooling were found to have a significant effect on performance in the test, the two variables were used to find the cut-off points of the shortened version. This new version presented an adequate degree of reliability (alpha = 0.765) and a high correlation with the original test (r = 0.876). CONCLUSIONS: The new shortened version consists of 15 items that are ordered according to the degree of difficulty. It is a task with a high level of discriminating power that is useful in day-to-day clinical practice for detecting alterations in the language of the elderly.