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Resumen Para poder cuantificar e investigar científicamente las quejas mnésicas de los pacientes, se hace necesario contar con un instrumento adaptado y que presente análisis psicométricos adecuados. El objetivo del presente trabajo fue estudiar propiedades psicométricas de una versión argentina del Cuestionario de Memoria Prospectiva y Retrospectiva. Para ello se administró el Cuestionario de Memoria Prospectiva y Retrospectiva de forma individual a 192 participantes sanos con más de 27 puntos en el Mini Mental State Examination. La media de edad fue de 39.67 años (DE = 12.3). La media de escolaridad fue de 14.5 años (DE = 2.72). A un subgrupo de participantes (n = 45) denominado Subgrupo A, también se les administraron pruebas de memoria prospectiva y retrospectiva. El Índice Global del Cuestionario presentó una distribución normal. Según el análisis factorial exploratorio se estableció la extracción de un factor que explicó el 35.19 % de la varianza. El coeficiente α de Cronbach fue de .87. La confiabilidad estimada por el método de la división por mitades fue de .73 y de .84 luego de la corrección con la fórmula de Spearman-Brown. No hubo correlación significativa entre las respuestas del cuestionario y los test de memoria retro y prospectiva en el subgrupo A. Estos resultados permiten concluir que el Cuestionario de Memoria Prospectiva y Retrospectiva presenta adecuados índices de confiabilidad y una estructura de un solo factor. Si bien no se asocia con el rendimiento objetivo en pruebas de memoria, muestra ser apropiado para el registro de las quejas subjetivas de los pacientes en la región de estudio.
Abstract Memory complaints are the reason for consultation in many cases of neurological injuries and in the majority of aged people who attend the neurological clinic. The presence of memory complaints is a diagnostic criterion for mild cognitive impairment, for which it is necessary to have an appropriate and specific instrument, which would allow us to quantify and scientifically investigate it. The aim of the present study is to analyze the psychometric properties of an Argentine version of the Prospective and Retrospective Memory Questionnaire: the factorial structure of the test; its internal consistency; correlations of the questionnaire with an objective measurement of retro and prospective memory; and correlations of the questionnaire with affective-emotional variables. The Mexican version of the Prospective and Retrospective Memory Questionnaire was administered individually to 192 healthy participants who achieved more than 27 point in the Mini Mental State Examination. A modification was made to the syntax of two sentences in order to increase the comprehensibility. A Global, Prospective and a Retrospective Index of the questionnaire was calculated for each participant. Anxiety (the State-Trait Anxiety Inventory: STAI) and depression (the Beck's Depression Inventory-II) scales were also administered. The mean age was 39.67 years (SD = 12.3). The average of schooling was 14.5 years (SD = 2.72). We also selected a subgroup of participants (n = 45) with a mean age of 37.58 years (SD = 11.4), and an average schooling in years of 14.36 (SD = 3). In addition to the memory questionnaire, this subgroup, called the A Subgroup, was administered prospective (El Cóndor test) and retrospective (The Selective Memory Test) objective memory tests. The mean in the Global Index was 32.25 (SD = 8.49), in the Prospective Index it was 17.3 (SD = 5.01) and in the Retrospective Index it was 14.95 (SD = 4.07). The test for normality of the distribution of the Global Index Kolmogorov-Smirnov (K-S) was Z = 1.031, p = .238. In the same way, the other two scores of the questionnaire show a normal curve, K-S of the Prospective Index Z = 1.109, p = .171; K-S of the Retrospective Index Z = 1.264, p = .082. According to the exploratory factor analysis through the Maximum Likelihood extraction method, a single factor explained 35.19 % of the variance. The Cronbach's α coefficient was .87. The reliability estimated by the split-half method was .73 and .84 after correction with the Spearman-Brown formula. There was a significant positive correlation of mild degree between the Global Questionnaire Index and the STAI Trait, r = .33, p = .013, and with the IDB-II, e = .23, p = .127. There was no significant correlation between the questionnaire responses and the retro and prospective memory objective tests in the A Subgroup. The Prospective and Retrospective Memory Questionnaire presents adequate reliability indexes and a single factor structure. The results indicate that the questionnaire associates with anxiety and depression in a positive way, but not with the objective measures of retro and prospective memory, in coincidence with the literature about the relationship between cognitive complaints and cognitive tests performance. In sum, this study shows that the questionnaire is an appropriate instrument to quantify patient's memory complaints and particularly for its use in the study region. This study is the first in the country to investigate the psychometric properties of the Prospective and Retrospective Memory Questionnaire, widely used in neuropsychological clinic and research around the world. Efforts should be made to obtain normative data and validation in the pathological population of interest.
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La discapacidad física y el curso de la enfermedad son fuertes predictores del estatus laboral en los pacientes con Esclerosis Múltiple (EM). Sin embargo, la cognición no tiene el mismo grado de evidencia. Este estudio plantea el objetivo de investigar la relación entre la situación laboral y el rendimiento cognitivo en la EM. Se recogieron los datos de 61 pacientes con EM de curso recurrente-remitente (EMRR) que fueron a atenderse en un hospital público entre abril de 2014 y abril de 2015. El 29.5% estaban desempleados, el 54.1% estaban empleados y el 10.4% eran estudiantes o amas de casa. Se implementaron como test neuropsicológicos la Batería Neuropsicológica Breve para Esclerosis Múltiple y el test Símbolo-Dígito. Además se administraron la Escala de Estatus de Discapacidad Expandida y el Inventario de Depresión de Beck II. La evaluación se realizó de forma individual en dos sesiones, una con el neurólogo y otra con el neuropsicólogo en un consultorio privado. Las diferencias no fueron significativas en edad y años de instrucción entre los pacientes con y sin empleo. En cambio, los pacientes desempleados tenían un puntaje más bajo en el Símbolo-Dígito, así como la Escala de Estatus de Discapacidad Expandida y un Inventario de Depresión de Beck más altos que aquellos con trabajos. Los pacientes con EMRR que estaban desempleados tenían un peor desempeño en la velocidad de procesamiento de la información, más depresión y discapacidad física que aquellos que conservan sus trabajos.
Employment is a very important aspect of a person's life, and that is why any health-related factor that can interfere in such activity must be identified. The reality of a Latin American country is different and should be approached as a separate object of study. Many factors that contribute to a patient losing the job can be identified in time in order to be reversed or compensated. Thus, identifying the vulnerability profile of the patients with multiple sclerosis (MS) who are at risk of losing their jobs is an important task for researchers. Physical disability and disease course are both strong predictors of work status in MS patients, however, cognition and affective variables do not have the same degree of evidence. This study raises the aim of investigating the relationship between employment status and cognitive performance in MS. With this knowledge, it would be possible to design a neuropsychological rehabilitation plan for patients, which focuses on compensating and recovering from cognitive impairment, as well as on serving as orientation for the person who is at risk of losing their job. A group difference design was used. The sample units were selected through a non-probability accidental sampling. We collected the data of 61 patients with relapsing-remitting MS (RRMS) who had attended consultation between April 2014 and April 2015, in a public hospital. 29.5% were unemployed; 54.1% were employed; and 10.4% were students or housewives. The Brief Repeatable Battery of Neuropsychology Tests adapted for Argentine population; Symbol Digit Modalities Test (SDMT), Expanded Disability Status Scale (EDSS) and Beck Depression Inventory-II (BDI-II), were administered individually in two sessions, one with a neurologist and one with the neuropsychologist in a private consulting room. Age and years of instruction differences between patients with and without employment were not significant. There were 60.8% of patients with cognitive impairment. Among them, 38.7% were unemployed. The relationship between cognitive deterioration and work status was not significant, X² = .404, df = 1, p = .371. When comparing the groups in the cognitive battery, a meaningful difference in cognitive performance was observed between the subjects who had a job with those who were unemployed in SDMT (t = -2.421, df = 49, p = .019); performance being higher among the former. No other cognitive score showed significant results. Unemployed patients had higher EDSS and depression, than those with jobs. The cognitive tests administered, together with the BDI-II and EDSS, were included in the binary logistic regression analysis. The second model retained the SDMT and the BDI-II; both tests were ableto correctly classify almost 80% of the cases. Also, both SDMT (ß = .080, p = .014) and BDI-II (ß = -.098, p = .022) shown significant effects on work status. This study is one of the first attempts in Argentina to analyze the possible determinants of unemployment, which is extremely important in the context of a lack of determining literature about the issue in Latin America. According to results, patients with RRMS who are unemployed have worse performance in speed of information processing, more depression and physical disability than those who retain their jobs. Results are in line with previous studies, although in the present research a cognitive variable showed a greater negative influence on employment status over motor difficulties or physical disability. Clinicians would be able to identify patients whose profile shows a higher tendency towards work life decline, so that they can receive early treatment and delay that progression. It is suggested the realization of a multicentric Latin American study, blind to the patients labor status, with the aim of broadening the results by improving the study methodology.
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BACKGROUND AND PURPOSE: Information processing speed is one of the most impaired cognitive functions in multiple sclerosis (MS). There are two tests widely used for evaluating information processing speed: the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). To analyze the relationship between processing speed and the clinical and social support variables of patients with MS. METHODS: A group of 47 patients with relapsing-remitting MS was studied, 31 were women and 16, men. Age: 39.04±13.17, years of schooling: 13.00±3.87, Expanded Disability Status Scale (EDSS): 2.78±1.81, and disease evolution: 8.07±6.26. Instruments of measure; processing speed: SDMT, PASAT, clinical variables: EDSS, Fatigue Severity Scale (FSS), Beck's Depression Inventory II (BDI-II), and social support: Medical Outcomes Study Social Support Survey (MOS). RESULTS: Significant correlations were found between information processing speed and psychiatric, motor disability and social support variables. The SDMT correlated significantly and negatively with BDI-II, FSS, EDSS, and MOS (p<0.05), whereas the PASAT correlated negatively with FSS and positively with MOS (p<0.05). Information processing speed appeared as the performance predictor of these variables. The SDMT produced significant changes in EDSS (R²=0.343, p=0.000); FSS (R²=0.109, p=0.031); BDI-II (R²=0.124, p=0.018), and MOS (R²=between 0.212 and 0.379, p<0.05). CONCLUSIONS: Information processing speed has influence on the clinical variables and the social support of patients with MS. These aspects are important to bear in mind for therapeutic approach.
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Oxytocin is used to induce and control parturition, nevertheless, the increase of uterine contractions decreases blood flow and gaseous exchange through the womb predisposing to intra-partum mortality. The objective of the present study was to evaluate the effect of oxytocin on myometrial activity, fetal intrauterine hypoxia and postnatal asphyxia in sows during farrowing. Hybrid (n = 120) sows approaching the time of farrowing were randomly assigned in two groups of 60 animals each. Group I (G(1): control) was treated IM with saline solution and Group II (G(2)) was injected IM with oxytocin (1IU/6kg LW) as a single dose at birth of the first piglet. Both average number of myometrial contractions and intensity in G(2) were greater (P < 0.01) as compared with G(1). The mean of intra-partum stillbirths (IPS's) and those where fetal cardiac frequency (FCF) or heart beats, could not be detected after birth, were greater (P < 0.01) in G(2) as compared with G(1). The average decelerations of FCF known as dips II, which indicate severe hypoxia, was greater in G(2) (P < 0.01) as compared with that of G(1). There was a greater (P < 0.01) number of intra-partum stillbirths, stained with severe meconium in G(2) when compared with G(1). Oxytocin treatment increased (P < 0.01) the number of pigs born alive with ruptured umbilical cords and those with different grades of meconium staining on their skin. It was concluded that administration of oxytocin at the onset of parturition increased the myometrial activity, decreased fetal cardiac frequency, predisposed the rupture of umbilical cords and the degree of meconium staining, and increased intra-partum mortality.