Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in individuals with multiple sclerosis from Mexico.

BACKGROUND: Cognitive impairment is observed in 43-70 % of Multiple sclerosis (MS) patients. One of the most widely used batteries for cognitive assessment in this population is the Brief International Cognitive Assessment for MS (BICAMS). The objective of this study was to validate and assess the reliability of the BICAMS in a Mexican population with MS and to obtain and provide regression-based norms. METHODS: One hundred healthy controls (HCs) and 100 patients with multiple sclerosis participated in the present study, and groups were matched for age, years of education and sex. Subjects completed all three tests of the BICAMS. Test-retest measures were obtained from 30 patients to test reliability. RESULTS: The sample´s average age was 43.39 ± 6.03 years old, and the average years of education was 12.55 ± 2.52 years. Approximately 63 % of the participants were female. The groups did not differ in age, years of education, or sex. The MS group performed significantly worse than the HCs group on all three neuropsychological tests. A significant difference was observed for the SDMT (t = 10.166; p=<0.001), CVLT-II (t = 10.949; p=<0.001), and BVMT-R (t = 2.636; p = 0.009). For all comparisons, the effect size (d) for each test was calculated as follows: SDMT= 0.58 and CVLT-II= 0.61. The test-retest coefficients for each test were as follows: SDMT: r = 0.95; CVLT-II: r = 0.84; and BVMT-R = 0.81. CONCLUSION: The BICAMS can provide information on cognitive impairment in MS patients, and this information can be used by neuropsychologists for cognitive rehabilitation in different domains.

[Cognitive assessment in children who presented gastroschisis: a case-control study]. / Evaluacion cognitiva en niños que presentaron gastrosquisis: estudio de casos y controles.

INTRODUCTION: Gastroschisis is a malformation of the abdominal wall that is corrected by surgery and requires special hospital care, such as immobilisation, dietary restriction and separation from the mother for a variable period of time, among others. To analyse the possible cognitive repercussions, the Bayley III test was administered to 14 children. SUBJECTS AND METHODS: The study was conducted with seven cases (born with gastroschisis) and seven controls, in civil hospitals in Guadalajara, over the period January-April 2013. RESULTS: No evidence of retardation was found in the cases in the cognition, language and motor conduct assessments, whereas in those associated with socio-emotional and adaptive behaviour the scores favoured the control group. This shows that the latter have better adaptation and interaction strategies with respect to the cases group. CONCLUSIONS: Gastroschisis will not affect later neurodevelopment, at least in this group which presented only this abnormality and deficits that can be explained by their perinatal circumstances. Nevertheless, this prognosis cannot be generalised to other cases with a more severe clinical picture, a longer stay in hospital and associated comorbidity. In any case, it is important to inform the parents as of the prenatal stage about the expected consequences of this pathology.

TITLE: Evaluacion cognitiva en niños que presentaron gastrosquisis: estudio de casos y controles.Introduccion. La gastrosquisis es una malformacion de la pared abdominal que se corrige mediante cirugia y requiere cuidados hospitalarios especiales, como inmovilizacion, restriccion alimenticia y separacion de la madre durante tiempo variable, entre otros; para analizar las posibles repercusiones cognitivas se aplico la prueba de Bayley III a 14 niños. Sujetos y metodos. Siete casos (nacidos con gastrosquisis) y siete controles, en los hospitales civiles de Guadalajara, en el periodo enero-abril de 2013. Resultados. Los casos no evidenciaron retraso en las evaluaciones relacionadas con la cognicion, el lenguaje y la conducta motora, en tanto que en las asociadas a la conducta socioemocional y adaptativa las puntuaciones favorecieron al grupo control, lo que refleja que poseen mejores estrategias de adaptacion e interaccion respecto al grupo de casos. Conclusiones. La gastrosquisis no afectara el neurodesarrollo ulterior, por lo menos en este grupo que presento esta unica anormalidad y deficits explicables por sus circunstancias perinatales, sin que este pronostico pueda generalizarse a otros casos con un cuadro clinico mas grave, mayor duracion de la estancia hospitalaria y comorbilidad asociada. De cualquier forma, es importante informar a los padres desde la etapa prenatal respecto a las consecuencias esperadas de esta patologia.

Examining the influence of three types of social support on the mental health of mexican caregivers of individuals with traumatic brain injury.

OBJECTIVE: The aim of this study was to examine the influence of three types of social support (appraisal, belonging, and tangible) on caregiver mental health (anxiety, burden, depression, and satisfaction with life) among Mexican caregivers of individuals with traumatic brain injury. DESIGN: This is a cross-sectional study of 90 family caregivers from Hospital Civil Fray Antonio Alcade in Guadalajara, Mexico. RESULTS: More months spent caregiving was associated with decreases in all three types of social support. Older age and fewer years of education were associated with lower appraisal social support. More hours per week spent caregiving was associated with lower caregiver state anxiety and greater satisfaction with life. Appraisal, belonging, and tangible social support were all significantly correlated with more salubrious caregiver mental health outcomes, except satisfaction with life. Appraisal social support independently predicted lower caregiver depression. CONCLUSIONS: Particularly in Latin America, strong social support networks and family connections seem closely tied to key mental health outcomes such as depression. Rehabilitation interventions aimed at strengthening perceptions of social support of caregivers of individuals with traumatic brain injury that specifically target availability of advice may improve mental health and contribute to more optimal informal care for individuals with traumatic brain injury.

[Dysthymia in the Clinical Context]. / La distimia en el contexto clínico.

Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. According to DSM IV-TR, Dysthymia is classified into two subtypes: early-onset, when it begins before 21 years-old, and late onset Dysthymia, when it starts after this age. Before age 21, symptoms of conduct disorder, attention deficit disorder and hyperactivity with a few vegetative symptoms are usually present. It is important to distinguish it from other types of depression, as earlier as possible. This would allow providing these patients with the appropriate treatment to attenuate the impact of symptoms, such as poor awareness of self-mood, negative thinking, low self-esteem, and low energy for social and family activities, which progressively deteriorate their life quality. The etiology of Dysthymia is complex and multifactorial, given the various biological, psychological and social factors involved. Several hypotheses attempt to explain the etiology of Dysthymia, highlighting the genetic hypothesis, which also includes environmental factors, and an aminergic hypothesis suggesting a deficiency in serotonin, norepinephrine and dopamine in the central nervous system. From our point of view, dysthymia cannot be conceived as a simple mild depressive disorder. It is a distinct entity, characterized by a chronic depressive disorder which could persist throughout life, with important repercussions on the life quality of both patients and families.