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.

[Cognition in dysthymia]. / Cognición en distimia.

UNLABELLED: Depression is named as one of the most prevalent Mental Health problem, affecting almost 10 % of the population. According to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) different subtypes are included. Dysthymic Disorder is characterized by a depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. The aim of this study was to investigate the neuropsychological profile of dysthymic disorder. Ninety three patients fulfilling criteria for dysthymia were examined on a variety of cognitive tasks, neurological exam and a semi-structured psychiatric interview. Forty one non-depressed individuals served as controls. Significant differences between groups were found in digit span; immediate and delayed recall of a story; and semantic and phonologic fluency. Logic memory was worse than serial learning task, and has a correlation with attention deficit and depressive features. CONCLUSIONS: This results indicate that the neuropsychological performance of patients with dysthymic disorder exhibit impairments in attention and memory. Attentional deficits appear to be the key of cognitive deficits in dysthymia.

[Psychic change in schizophrenic patients produced group therapy]. / Cambio psíquico en pacientes esquizofrénicos en tratamiento grupal.

The objective of this paper is to analyze the effectiveness of group therapy to produce psychic change in patients with schizophrenia and other related psychosis. The experience took place in a Public Psychiatric Hospital. It involved 96 patients with this condition who entered different groups from 1998 up to the present. During the year 2000, 66 of them were asked to answer a questionnaire especially designed to investigate the changes that they thought they had gone through during this treatment. On one hand, the results show the high valorization of the group appliance, while on the other hand the most valued operational categories were the facilitation of interpersonal links, the valorization of listening and being listened, the recognition of improvement and the recognition of one's own characteristics in the other person. On account of these discoveries, the mechanisms of these group appliances to produce such changes are postulated. In conclusion, group treatment for schizophrenic patients and related psychosis turns out to be useful for producing psychic changes different from those achieved with psychopharmacological agents.

Estereologia do miocárdio em fetos humanos: estudo quantitativo das modificaçöes estruturais nos dois últimos trimestres de gestaçäo / Stereology of the Myocardium in Human Fetuses: Quantitative Study of the Structural Changes in the Last Two Trimesters of Gestation

Objetivo - Quantificar o miocárdio humano comparando o 2§ e 3§ trimestres gestacionais. Métodos - Fragmentos de miocárdio de 8 coraçöes de fetos humanos (sendo 4 do 2§ e 4 do 3§ trimestre) foram coletados e processados histologicamente. Quinze campos miocárdicos aleatórios de cada coraçäo foram quantificados para miócitos, tecido conjuntivo e vasos contando pontos-teste e intersecçöes . Resultados - As diferenças esterológicas para os miócitos, vasos e tecido conjuntivo, näo foram significantes comparando os 2 trimestres (p > 0,05). A densidade volumétrica foi: miócitos (núcleos inclusive) = 75,6// no 2§ trimestre e 67,7// no 3§ trimestre; vasos = 3,7// no 2§ trimestre e 6,4// no 3§ trimestre; tecido conjuntivo (substância intersticial excluindo os vasos) de 20,6 a 25,9// do 2§ para o 3§ trimestres, respectivamente. Entretanto, a diferença das densidades volumétricas dos núcleos dos miócitos foi significante (p=0,004) e indicou reduçäo do 2§ para o 3§ trimestres, de 15,2 para 8,1// respectivamente. Conclusäo - Esses resultados sugerem que há reduçäo gradativa da síntese protéica nos 2 últimos trimestres gestacionais, sem alteraçäo quantitativa importante na composiçäo do tecido cardíaco, provavelmente relacionada à simultânea diminuiçäo da multiplicaçäo celular miocárdica

Purpose - Quantitative study of the human myocardial comparing the2nd and 3rd trimesters of gestation. Methods - Fragments of the myocardium were collected from 8 fetal human hearts (4 from 2nd and 4 from 3rd trimesters) and prepared by histological methods. Fifteen random fields from each region were analyzed considering independently myocytes, connective tissue and vessels. Stereological determinations were possible by counting test-points and intersections on a multipurpose test lattice (M42). Results - Stereological differences between last 2 trimesters of gestation were not significant (p>0,05). The volume density was myocyte (including nucleus)=75.6% in 2nd trimester and 67.7% in 3rd trimester; vessels=3.7% in 2nd trimester and 6.4% in 3rd trimester; connective tissue (interstitial substance without vessels) = 20.6 to 25.9% for 2nd and 3rd trimesters respectively. However, considering the nuclei of the myocytes differences between last 2 trimesters were significant (p=0.004). The volume density of the nuclei had a reduction from 2nd to 3rd trimesters (from 15.2 to 8.1% respectively). Conclusion - This result suggests decreasing synthesis of proteins from nucleus of myocyte in the last 2 gestational trimesters, but without quantitative important changes in the cardiac tissue, probably in relation to the reduction of the myocardial cellular multiplication