Aging and HIV/AIDS: neurocognitive implications for older HIV-positive Latina/o adults.

In recent years, HIV/AIDS populations have become older and increasingly more ethnically diverse. Concurrently, the prevalence of HIV-related neurocognitive (NC) impairment remains high. This study examined the effects of age and ethnicity on NC function in HIV-positive adults. The sample (N = 126; 84 Latina/o and 42 Non-Hispanic White) completed a comprehensive NC battery. Global NC and domain average demographically-corrected t-scores were generated. There were no significant differences between Younger (<50 years) Latina/os and non-Hispanic Whites on Global NC function or NC domains (all p's >.10), with generally small effect sizes. Older Latina/os (≥50 years) were significantly more impaired than Older Non-Hispanic Whites on processing speed and learning, with trends in Global NC function and memory. Further, effect sizes fell within the medium to large range (Cohen's d's = .49-1.15). This study suggests that older Latina/os are at potentially greater risk for NC impairment, particularly in processing speed and learning, when compared to similarly-aged non-Hispanic whites.

Neurocognitive, Sociocultural, and Psychological Factors Impacting Medication Beliefs Among HIV-Seropositive Latinx Adults.

Among Latinx people living with HIV (PLWH), neurocognitive (NC) function, culture, and mental health impact medication adherence. Similarly, health beliefs and attitudes play a role in health care barriers and health behaviors. Research has not examined the effect that compromised neurocognition, sociocultural factors, and mental health have on health beliefs and attitudes. This is especially relevant for Latinx PLWH who are disproportionately impacted by HIV, given that sociocultural factors may uniquely impact HIV-related NC and psychological sequelae. This study investigated the associations between neurocognition, sociocultural factors, mental health, health beliefs, and health attitudes among Latinx HIV-seropositive adults. Within a sample of 100 Latinx PLWH, better verbal learning and executive functioning abilities were associated with more positive attitudes about the benefits of medications and memory for medications. In terms of sociocultural factors, higher English language competence was related to better self-reported memory for medications, and overall, higher US acculturation was associated with more positive attitudes toward health professionals. Depressive symptomatology was negatively associated with attitudes toward medications and health professionals, as well as with self-reported memory for medications. These findings highlight the important interplay between NC, sociocultural, psychological factors, and health beliefs among Latinx PLWH. Adherence intervention strategies and suggestions for dispensing medical information are presented for clinicians and health care practitioners.

[Laryngeal function as node metastasis predictor in patients with cancer of the larynx]. / Funcionalidad laríngea como predictora de metástasis ganglionares en pacientes con cáncer de laringe.

INTRODUCTION: Although the possibility of developing cervical node metastases (CNM) in patients with squamous cell carcinoma of the larynx (SCCL) depends on the site of tumor origin, other factors may be associated, even in glottic tumors. The objective of this study was to determine factors associated with CNM. METHODS: We carried out a retrospective analysis of a series of patients with SCCL. We analyzed the following variables: T-staging, tumor site, and arytenoid-mobility/fixation. and correlated them with histopathological node status. Statistical significance was assessed using chi2 tests. RESULTS: 91 patients were included 82 were male and 9 female; median age was 66 years. The most frequently affected site was the glottic-subglottic region (38) followed by the glottis (22). The most frequent T stage was T3 (46%) followed by T4 (25%); 81% were NO and 19% N+. 76 (83%) had arytenoid fixation. Factors associated with CNM included glottic-supraglottic infiltration (65%) and arytenoid fixation (17% vs. 0, p = 0.048). None of the patients with arytenoid mobility had CNM. Tumor infiltration to thyroid gland was observed among 14% of patients studied The most important risk factor was subglottic extension (17%; p = 0.5). CONCLUSIONS: Lack of mobility of the arytenoid cartilage is a factor associated with CNM among SCCL patients. A subglottic tumor is a risk factor for thyroid infiltration

Neurocognitive intra-individual variability within HIV+ adults with and without current substance use.

OBJECTIVE: HIV infection and current substance use (SU) are linked to cognitive and functional deficits, yet findings on their combined effects are mixed. Neurocognitive intraindividual variability, measured as dispersion of scores across a neuropsychological battery, is associated with worse cognitive outcomes and functional deficits among HIV+ adults but has not been studied in the context of HIV+ adults with current SU. We hypothesized that, among HIV+ adults, current SU would be associated with greater dispersion, that greater dispersion would be associated with worse medication adherence, and that this relationship would be worse among substance users. METHOD: Forty HIV+ adults completed neuropsychological, psychiatric, SU, and medical evaluations and an electronic medication adherence measure. General linear models evaluated the main effect of SU status on neurocognitive dispersion, and models stratified by SU status evaluated the effect of dispersion on medication adherence, adjusting for relevant covariates. RESULTS: The SU+ group showed greater dispersion than did the SU- group, t(38) = 2.74, p = .049, d = 0.81, but this association did not survive multiple comparisons. Stratified analyses indicated a negative relationship between dispersion and medication adherence among the SU+ group but not in the SU- group; however, this effect was reduced after accounting for depressive symptoms. CONCLUSIONS: We found preliminary evidence that current SU is associated with greater neurocognitive dispersion among HIV+ adults. SU and neurocognitive dispersion may have a synergistic effect on medication adherence; however, this effect is largely accounted for by depressive symptoms. Future research should examine progression of dispersion in HIV and consequent neurocognitive and functional deficits in those with current SU. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Impact of racial-ethnic minority status and systemic vulnerabilities on time to acute TBI rehabilitation admission in an urban public hospital setting.

PURPOSE/OBJECTIVE: Racial/ethnic minorities and other vulnerable social groups experience health care disparities. There is a lack of research exploring how time to acute rehabilitation admission is impacted by race/ethnicity and other marginalizing systemic vulnerabilities. The purpose of this study is to investigate whether race/ethnicity and other sociodemographic vulnerabilities impact expediency of acute rehabilitation admission following traumatic brain injury (TBI). Research Method/Design: This study is a secondary analysis of an existing dataset of 111 patients admitted for acute TBI rehabilitation at an urban public hospital. Patient groups were defined by race/ethnicity (People of color or White) and vulnerable group status (high or low vulnerable group membership [VGM]). RESULTS: White patients are admitted to acute TBI rehabilitation significantly faster than people of color. After taking vulnerabilities into account, high VGM people of color experience the most severe injuries and take the longest to receive acute TBI rehabilitation. Despite small differences in injury severity, low VGM people of color take longer to be admitted to acute TBI rehabilitation than White patients. High VGM White patients have less severe injuries yet take longer to be admitted to acute rehabilitation than low VGM White patients. Finally, notable differences exist between White patients and patients of color on rater-based injury severity scales that are discordant with severity as measured by more objective markers. CONCLUSIONS/IMPLICATIONS: Overall, findings indicate that sociodemographic factors including race/ethnicity and systemic vulnerabilities impact injury severity and time to acute TBI rehabilitation admission. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Combined Roles of Nonsomatic Depressive Symptomatology, Neurocognitive Function, and Current Substance Use in Medication Adherence in Adults Living With HIV Infection.

Depression, global neurocognitive (GNC) function, and substance use disorders (SUDs) are each associated with medication adherence in persons living with HIV (PLWH). Because somatic symptoms can inflate depression scores in PLWH, the role of nonsomatic depressive symptomatology (NSDS) should be considered in adherence. However, the combined roles of NSDS, GNC function, and current SUDs in predicting combined antiretroviral therapy (cART) adherence remain poorly understood. Forty PLWH (70% Latina/o; 30% non-Hispanic White) completed psychiatric/SUD, neurocognitive, and self-report cART adherence evaluations. Higher NSDS was associated with suboptimal adherence (p < .01), but optimal and suboptimal adherers did not differ in GNC function or current SUDs. Only NSDS was associated with suboptimal adherence, after accounting for GNC function and SUDs (p = .01). NSDS uniquely predicted self-reported adherence, beyond GNC function and current SUDs among ethnically diverse PLWH. Methodological issues between present and prior studies should also be considered.

[Formula: see text]The Relative Utility of Three English Language Dominance Measures in Predicting the Neuropsychological Performance of HIV+ Bilingual Latino/a Adults.

OBJECTIVE: Given the disproportionate impact of neurologic disorders such as HIV on racial/ethnic minorities, neuropsychologists are increasingly evaluating individuals of diverse linguistic backgrounds. This study compares the utility of two brief and one comprehensive language measure to account for variation in English neuropsychological performance within a bilingual population. METHOD: Sixty-two HIV+ English/Spanish bilingual Latino adults completed three language measures in English and Spanish: Self-Reported Language Ability; Verbal Fluency (FAS/PMR); and the Woodcock Munoz Language Survey-Revised (WMLS-R). All participants also completed an English language neuropsychological (NP) battery. RESULTS: It was hypothesized that the comprehensive English/Spanish WMLS-R language dominance index (LDI) would be significantly correlated with NP performance, as well as the best predictor of NP performance over and above the two brief language measures. Contrary to our hypothesis, the WMLS-R LDI was not significantly correlated to NP performance, whereas the easily administered Verbal Fluency and Self-Report LDIs were each correlated with global NP performance and multiple NP domains. After accounting for Verbal Fluency and Self-Report LDI in a multivariate regression predicting NP performance, the WMLS-R LDI did not provide a unique contribution to the model. CONCLUSIONS: These findings suggest that the more comprehensive WMLS-R does not improve understanding of the effects of language on NP performance in an HIV+ bilingual Latino population.

Estrategia para la implantación del Sistema XAVIA HIS en instituciones hospitalarias / Strategy to Implant the System XAVIA HIS in Hospital Institutions

El Centro de Informática médica (CESIM) de la Universidad de las Ciencias Informáticas (UCI) desarrolla el Sistema de Información Hospitalaria XAVIA HIS. El éxito en la implantación es de gran importancia para el CESIM, no obstante, los proyectos de implantación se han visto incididos por un conjunto de insuficiencias. El objetivo de la investigación es desarrollar una estrategia que contribuya a aumentar el éxito en la definición del alcance de los proyectos de implantación del sistema XAVIA HIS, en instituciones de salud. Se realizó un estudio descriptivo, que incluyó como escenario de aplicación el Centro Nacional de Cirugía de Mínimo Acceso, entre 2015 y 2017. Como resultado se obtuvo una estrategia para la implantación del sistema XAVIA HIS en instituciones de salud, que impacta positivamente en la disminución del tiempo necesario para este fin(AU)

University of Computer Sciences (UCI) develops the XAVIA HIS Hospital Information System. The implement success of the system is of great importance for CESIM, however, this stage have been affected by a set of insufficiencies. The objective of the research is to develop a strategy that contributes to increasing success in defining the scope of projects to implement XAVIA HIS system in health institutions. A descriptive study was carried out, which included as an application scenario the National Center for Minimally Access Surgery, between 2015 and 2017. As a result, a strategy to implement XAVIA HIS system in health institutions was obtained, which positively impacts the decrease of time necessary for this purpose(AU)

Socioeconomic Status and Neuropsychological Functioning: Associations in an Ethnically Diverse HIV+ Cohort.

OBJECTIVE: There is limited research examining the relationship between socioeconomic status (SES) and neuropsychological functioning, particularly in racial/ethnic minority and HIV+ populations. However, there are complex associations between poverty, education, HIV disease, race/ethnicity, and health outcomes in the US. METHOD: We explored these relationships among an ethnically diverse sample of 134 HIV+ adults using a standardized SES measure (i.e., the Hollingshead scale), a comprehensive NP test battery, and a functional evaluation (i.e., Patient's Assessment of Own Functioning Inventory and Modified Instrumental Activities of Daily Living Scale). RESULTS: Bivariate analyses showed that adult SES was significantly, positively correlated with neuropsychological performance on specific tests within the domains of verbal fluency, attention/concentration, learning, memory, processing speed, and executive functioning, and childhood SES was significantly linked to measures of verbal fluency, processing speed, and executive functioning. In a series of linear regressions, controlling for SES significantly attenuated group differences in NP test scores between racial/ethnic minority individuals and non-Hispanic White individuals. Finally, SES scores significantly differed across HIV-Associated Neurocognitive Disorder (HAND) diagnoses. In a binary logistic regression, SES was the only independent predictor of HAND diagnosis. CONCLUSIONS: HIV+ individuals with lower SES may be more vulnerable to HIV-associated neuropsychological sequelae due to prominent health disparities, although the degree to which this is influenced by factors such as test bias remains unclear. Overall, our results suggest that SES is significantly linked to neuropsychological test performance in HIV+ individuals, and is an important factor to consider in clinical practice.

The role of decision-making ability in HIV/AIDS: impact on prospective memory.

BACKGROUND: Prospective memory (ProM), a form of episodic memory related to execution of future intentions, is important for everyday functioning. Among persons living with HIV (PLWH), executive dysfunction is implicated in ProM impairments. However, specific subcomponents of executive functioning involved in ProM deficits remain poorly understood. Unlike more "traditional" neurocognitive (NC) measures of executive functioning associated with dorsolateral prefrontal cortex (i.e., conceptual reasoning, abstraction), those associated with medial orbitofrontal/ventromedial prefrontal (mOF/vmP) cortex (i.e., decision making, inhibitory control, goal-oriented behavior) have yet to be examined in ProM. METHOD: This study characterized ProM ability in a sample of 89 HIV-seropositive adults and examined the unique role of decision-making ability in ProM. Participants completed a standard NC battery, the Iowa Gambling Task (IGT; a decision-making measure), and the Memory for Intentions Screening Test (MIST; a ProM measure). RESULTS: Correlational analyses revealed that both traditional executive functioning measures and the IGT were associated with ProM. Regression analyses revealed that the IGT significantly predicted ProM, even after accounting for NC measures. Among all NC measures, only executive functioning significantly contributed to ProM. DISCUSSION: Further examination of mOF/vmP-sensitive executive dysfunction within this population is needed as PLWH may require more tailored treatment recommendations due to specific decision-making difficulties that can impact medication management.

Multidimensional effects of acculturation on English-language neuropsychological test performance among HIV+ Caribbean Latinas/os.

Acculturation has been linked to neuropsychological performance in several ethnic groups. However, research among Latina/o samples has examined primarily Mexicans/Mexican Americans and has not examined Latina/o clinical populations of Caribbean descent. This study examined associations between a multidimensional acculturation measure and neuropsychological performance among 82 HIV+ Caribbean Latina/o adults. Multivariate results showed that US acculturation significantly predicted 11-14% of the variance in global neuropsychological functioning, verbal fluency, and processing speed, whereas Latina/o acculturation predicted 6-8% of the variance in motor and executive function (trend level associations). Both linguistic and nonlinguistic cultural factors had distinct effects on neuropsychological performance.

Exploring the internet's role in sexual compulsivity and out of control sexual thoughts/behaviour: a qualitative study of gay and bisexual men in New York City.

Sexual compulsivity and the internet have been investigated separately among gay and bisexual men for their connection to sexual risk behaviour, yet little research has addressed the intersection. This analysis explored qualitative interview data from 111 gay and bisexual men experiencing out of control sexual thoughts and/or behaviours, about the role of the internet in their lives. For some it facilitated their problematic sexual thoughts and behaviours and, to some extent, was a distraction from important facets of their lives. Equally, men identified strategies to limit their internet use and reduce these negative consequences. For some, the internet was attributed to being less discriminating about partners. In contrast, other men compared the internet to other venues for meeting sex partners (e.g. bars) and described the internet as a medium for reducing physical (cruising online versus cruising a dark alley) and sexual (multiple partners at bathhouses versus cyber-sex only) risk. Clinically, service providers should conduct more thorough assessments regarding the role of the internet in the lives of patients who experience sexual compulsivity, as many individual differences exist, and there may be positive benefits that stem from internet use.

Larga sobrevida en 5 pacientes con astrocitomas malignos / Long survival in 5 patients with malignant astrocytomas

Históricamente el tiempo de supervivencia promedio de los pacientes con glioblastoma multiforme y astrocitoma anaplásico ha sido de 6 a 12 meses y de 2 a 4 años respectivamente. Muy pocos pacientes alcanzan los 5 años de operados. El propósito fue identificar algún denominador común en los pacientes con larga sobrevida y diagnóstico histológico confirmado de astrocitoma anaplásico o glioblastoma multiforme. Se estableció comunicación con los familiares de 67 pacientes operados en el Instituto de Neurología y Neurocirugía entre los años 1983 a 1992. Se analizaron la edad de los pacientes al momento del diagnóstico, la localización del tumor, el estado neurológico en el comienzo de la enfermedad y el tiempo de evolución de esta, así como el tipo de tratamiento realizado. Se halló 5 pacientes con un tiempo de supervivencia mayor de 7 años. La edad menor de 35 años, la ubicación de la lesión en el lóbulo frontal derecho y el inicio clínico sin defecto neurológico focal, así como la exéresis quirúrgica total fue la norma en el 80 (por ciento) de estos casos. El Karnofsky inicial mayor de 70 puntos y el empleo de radioterapia y quimioterapia posquirúrgica fue común a todos. Los pacientes jóvenes con gliomas astrocíticos de alta malignidad ubicados en el lóbulo frontal derecho, que comienzan con un Karnofsky mayor de 70 puntos y son sometidos a exéresis quirúrgica total, radioterapia y quimioterapia posquirúrgica, tienen mayor probabilidad de prolongar su tiempo de sobrevivencia(AU)

Historically, the average time of survival of the patients with glioblastoma multiforme and anaplastic astrocytoma has ranged from 6 to 12 months and from 2 to 4 years, respectively. A few patients survive 5 years after surgery. The aim of this paper was to identify some common denominator in patients with long survival and confirmed histological diagnosis of anaplastic astrocytoma or multiform glioblastoma. Communication was established with the relatives of 67 patients operated on at the Institute of Neurology and Neurosurgery between 1983 and 1992. The age of the patients, the localization of the tumor, the neurological state at the onset of the disease, the time of evolution and the treatment used were analyzed. 5 patients had a time of survival over 7 years. The youngest patient was 35. The localization of the injury on the right frontal lobule, the clinical beginning without focal neurological defect, as well as the total exeresis was the norm in 80 percent of these cases. The initial scoring over 70 in Karnofsky scale (KS) and the use of radiotherapy and chemotherapy after surgery was common to all of them. Young patients with highly malignant astrocytic gliomas located in the right frontal lobule that begin with a KS over 70 points and undergo total exeresis, postsurgery radiotherapy and chemotherapy have greater probabilities of prolonging their time of survival(AU)

Evalución de tres métodos de sincronización del celo en un rebaño caprino mestizo / Evaluation of three methods for estrous synchronization in a crossbreed goat herd

Con la finalidad de evaluar el efecto de tres métodos de sincronización de celo sobre la proporción, aparición y duración del celo en cabras mestizas, se usaron 90 cabras con edades comprendidas entre uno a tres años y un peso promedio de 43 ± 4,8 kg. Las cabras fueron asignadas a los siguientes tratamientos: un grupo sometido al efecto macho o T1 (n = 30), durante un período de 30 días, luego de un aislamiento de dos meses del macho caprino; otro grupo tratado con PGF2alfa o T2 (n= 30), las cuales se sometieron a un protocolo de sincronización usando dos dosis (3,75 mg) de luprostiol, administrados a nivel de la submucosa vaginal a 11 días de intervalo y posteriormente se introdujo un recelador (vasectomizado), 36 horas después de la segunda dosis de lupostriol, para llevar a cabo la detección del celo; y un último grupo tratado con medroxiprogesterona (60 mg) o T3 (n = 30) usando esponjas intravaginales por 12 días y una dosis intramuscular de 400 UI de eCG al momento de retirar las esponjas. Seguidamente se detectó celo tal como se procedió en el T2. Todos los animales estuvieron bajo las mismas condiciones de manejo nutricional. Los resultados obtenidos, en cuanto a la exhibición del celo, fueron: 90, 80 y 73,3 por ciento para los grupos T1, T2 y T3, respectivamente, no encontrándose diferencias (P> 0,05) entre grupos; el intervalo tratamiento-aparición de celo fue de 289,8 ± 15,3; 53,7 ± 1,4 y 50,7 ± 0,9 horas, para los grupos T1, T2 y T3, respectivamente, observándose un mayor intervalo (P< 0,01), para T1; la duración del celo fue de 33,9 ± 1,9; 51,2 ± 4,3 y 44,8 ± 7,3 horas para los grupos T1, T2 y T3, respectivamente, presentándose diferencias (P< 0,01), entre los grupos T1 y T2. En las condiciones de este estudio se concluye que los tratamientos hormonales fueron más eficaces para concentrar y prolongar la duración de los celos en comparación al efecto macho.

Rotura de aneurisma intracraneal durante la angiografía cerebral: reporte de un caso / Rupture of intracranial aneurysm during cerebral angiography: report of a case

Se presenta el caso de una paciente con hemorragia subaracnoidea atendida en el Instituto de Neurología y Neurocirurgía, en la que el saco aneurismático se rompió durante la angiografía y falleció a las pocas horas. Se hace una breve revisión de la literatura y de los casos presentados en Cuba hasta 1982. Se afirma que el fallecimiento se debió a un hecho casual más que determinante. Se resalta la importancia del estudio angiográfico cerebral en la enfermedad aneurismática

Doble tumor cerebral: presentación de 2 casos / Double brain tumor: report of 2 cases

Se presentan 2 pacientes con doble tumor cerebral. En el primer caso ambos tumores estaban asociados, mientras que en el otro hubo una diferencia de 14 años en la presentación de éstos. La diferente histología en ambos casos, así como la larga evolución en la aparición del segundo tumor en el último de ellos, motivan su publicación