What a pooled data study tells us about the relationships between gender and knowledge of semantic categories.

Introduction: Both the neuropsychological study of patients with category-specific semantic disorders (CSSD) and the experimental research on categorical processing in healthy subjects (HSs) have shown that men are mainly impaired with fruits and vegetables and women with animals and artifacts. Since this difference is more striking in patients with CSSD than in HSs, we hypothesized that the lack of power of some investigations conducted with HSs and the different methods used in studies conducted with HSs and patients with CSSD could explain some of these inconsistencies and that a study conducted with a very large number of HSs using visual naming tasks should strongly confirm the role of gender in categorical tasks. Methods: Picture naming data gathered during the last ten years with our category-specificity paradigm from a large number (702) of HSs were reanalyzed. Results: As predicted, men named significantly more animals and artifacts, while women named more plant life items. Discussion: These data confirm that, if different domains of knowledge are studied in a very large sample of HSs using a picture naming task equivalent to the naming tasks used in most anatomo-clinical studies on CSSD, then the gender effects are highly significant.

QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infraction. / Duración y dispersión del QRS para predecir arritmias ventriculares en las fases iniciales del infarto agudo de miocardio.

OBJECTIVE: To determine the relationship between QRS duration and dispersion and the occurrence of ventricular arrhythmias in early stages of acute myocardial infarction (AMI). DESIGN: A retrospective, longitudinal descriptive study was carried out. SETTING: Hospital General Universitario "Camilo Cienfuegos", Sancti Spíritus, Cuba. Secondary health care. PATIENTS OR PARTICIPANTS: A total of 209 patients diagnosed with ST-segment elevation AMI from January 2012 to June 2014. MAIN VARIABLES OF INTEREST: The duration and dispersion of the QT interval, corrected QT interval, and QRS complex were measured in the first electrocardiogram performed at the hospital. The presence of ventricular tachycardia/fibrillation was assessed during follow-up (length of hospital stay). RESULTS: Arrhythmias were found in 46 patients (22%); in 25 of them (15.9%), arrhythmias originated in ventricles, and were more common in those subjects with extensive anterior wall AMI, which was responsible for 81.8% of the ventricular fibrillations and more than half (57.1%) of the ventricular tachycardias. The widest QRS complexes (77.3±13.3 vs. 71.5±6.4ms; P=.029) and their greatest dispersion (24.1±16.2 vs. 16.5±4.8ms; P=.019) were found on those leads that explore the regions affected by ischemia. The highest values of all measurements were found in extensive anterior wall AMI, with significant differences: QRS 92.3±18.8ms, QRS dispersion 37.9±23.9ms, corrected QT 518.5±72.2ms, and corrected QT interval dispersion 94.9±26.8ms. Patients with higher QRS dispersion values were more likely to have ventricular arrhythmias, with cutoff points at 23.5ms and 24.5ms for tachycardia and ventricular fibrillation, respectively. CONCLUSIONS: Increased QRS duration and dispersion implied a greater likelihood of ventricular arrhythmias in early stages of AMI than increased duration and dispersion of the corrected QT interval.

Why Almost Always Animals? Ranking Fluency Tasks for the Detection of Dementia Based on Receiver Operating Characteristic (ROC) and Quality ROC Analyses.

BACKGROUND/AIMS: Category fluency tasks have been widely used to assess cognitive functioning in both clinical and experimental environments as an index of cognitive and psycholinguistic dysfunctions in dementia. Typically, a reduced group of semantic categories has been selected for neuropsychological assessment (e.g., animals, fruits or vegetables), although empirical support for the prevalence of one category among others is absent in the literature. METHODS: We provide an empirical evaluation of the ability of 14 category fluency tasks to discriminate between subjects with dementia of the Alzheimer type and healthy elderly participants. As a novelty, we used both receiver operating characteristic (ROC) curves and quality ROC calibrated analyses to characterize the interplay of sensitivity and specificity of every category fluency task performance as a screening tool. The use of calibrated measures provided us with a useful tool for comparing the diagnostic ability of the different categories, as well as making rankings of categories based on the quality indices of efficiency, sensitivity, and specificity. RESULTS: The habitually used category of animals is far from being the most efficient one in terms of its diagnostic power to evaluate dementia. CONCLUSION: Our study might guide the selection of suitable category fluency tasks according to the diagnostic purposes in dementia.

On Colour, Category Effects, and Alzheimer's Disease: A Critical Review of Studies and Further Longitudinal Evidence.

The role of colour in object recognition is controversial; in this study, a critical review of previous studies, as well as a longitudinal study, was conducted. We examined whether colour benefits the ability of Alzheimer's disease (AD) patients and normal controls (NC) when naming items differing in colour diagnosticity: living things (LT) versus nonliving things (NLT). Eleven AD patients were evaluated twice with a temporal interval of 3 years; 26 NC were tested once. The participants performed a naming task (colour and greyscale photographs); the impact of nuisance variables (NVs) and potential ceiling effects were also controlled. Our results showed that (i) colour slightly favoured processing of items with higher colour diagnosticity (i.e., LT) in both groups; (ii) AD patients used colour information similarly to NC, retaining this ability over time; (iii) NVs played a significant role as naming predictors in all the participants, relegating domain to a minor plane; and (iv) category effects (better processing of NLT) were present in both groups. Finally, although patients underwent semantic longitudinal impairment, this was independent of colour deterioration. This finding provides better support to the view that colour is effective at the visual rather than at the semantic level of object processing.

The Nombela 2.0 semantic battery: an updated Spanish instrument for the study of semantic processing.

In this study, the Nombela 2.0 semantic battery is presented. This is a new version of its earlier precedent: the battery Nombela (I), in an attempt to improve it (dealing with ceiling effects) and reducing the application time by decreasing the number of tasks. The battery is constructed on a common set of 98 stimuli, including both living and nonliving semantic domains. It consists of five tasks designed to explore category specificity by tapping semantic production and comprehension, using both visual and verbal input. All of the items were rated according to Spanish norms, as stated in a previous study of our group, and all of the tasks were matched across domain on six nuisance variables. The present study has two goals: (i) to make available the updated version (2.0) of the Nombela semantic memory battery and (ii) to characterize and compare the neuropsychological profiles of two different patient groups: mild cognitive impairment and Alzheimer disease, with regard to normal controls.

Spanish norms for age of acquisition, concept familiarity, lexical frequency, manipulability, typicality, and other variables for 820 words from 14 living/nonliving concepts.

This article presents a new corpus of 820 words pertaining to 14 semantic categories, 7 natural (animals, body parts, insects, flowers, fruits, trees, and vegetables) and 7 man-made (buildings, clothing, furniture, kitchen utensils, musical instruments, tools, and vehicles); each word in the database was collected empirically in a previous exemplar generation study. In the present study, 152 Spanish speakers provided data for four psycholinguistic variables known to affect lexical-semantic processing in both neurologically intact and brain-damaged participants: age of acquisition, familiarity, manipulability, and typicality. Furthermore, we collected lexical frequency data derived from Internet search hits, plus three additional Spanish lexical frequency indexes. Word length, number of syllables, and the proportion of respondents citing the exemplar as a category member-which can be useful as an additional measure of typicality-are also provided. Reliability and validity indexes showed that our items display characteristics similar to those of other corpora. Overall, this new corpus of words provides a useful tool for scientists engaged in cognitive- and neuroscience-based research focused on examining language, memory, and object processing. The full set of norms can be downloaded from www.psychonomic.org/archive.

[Hypomagnesaemia severe in patients with high flow ileostomy]. / Hipomagnesemia severa en paciente con ileostomía de alto débito.

The need to create a stoma is frequent in the daily clinical practice. Usually ileostomies work well within the first 24 hours. However, many times they are associated with important morbidity up to 76%. Although the complications derived from this technique may be surgical, metabolic complications, which are preceded by large losses through the stoma, are the ones going undetected. It is not rare to see patients carrying an ileostomy that come repeatedly to the hospital with severe metabolic impairments and in whom the underlying cause remains untreated. The case reported herein is just one of a series published in this journal making us aware of the need for a multidisciplinary approach of the ileostomies and the prevention of major complications derived from their poor functioning.

Domain or not domain? That is the question: longitudinal semantic deterioration in Alzheimer's disease.

Category specific semantic impairment (e.g. living versus nonliving things) has been reported in association with various pathologies, including herpes simplex encephalitis and semantic dementia. However, evidence is inconsistent regarding whether this effect exists in diseases progressively impacting diverse cortical regions, such as Alzheimer's disease (AD). Ceiling effects producing non-Gaussian distributions and poor control for confounds such as nuisance variables (e.g. familiarity) may contribute to this discrepancy. Fourteen AD patients were longitudinally studied examining category effects on three semantic tasks (picture naming, naming to description and word to picture matching) matched across domain on all known nuisance variables (NV). To address non-Gaussian distributions, we run bootstrap analyses to determine whether NV, semantic domain or control performance best predicted AD patient performance. Multiple hierarchical regression analyses revealed that, whilst NV accounted for most of the explained variance in patients in the three tasks, the influence of semantic domain was substantially lower. Individual logistic regression demonstrated a significant category effect in only a few patients and healthy controls. No significant qualitative changes were observed in patients over time. Our results confirm the importance of NVs as predictors of AD patient performance, suggesting that the role of semantic domain is not a useful predictor of the progressive deterioration in AD.

Size matters: a study on naming and size knowledge in dementia of the Alzheimer type.

Category-specificity was longitudinally studied over a period of 12 months in seven Alzheimer disease patients, with two semantic tasks differing with respect to verbal processing demands: picture naming and a size ordering task. Items from each task were matched on all cognitive and psycholinguistic variables known to differ across domains (living-nonliving). Naming performance of patients was poorer than that of normal controls. Regarding category-specific effects, while naming performance of patients was parallel to that of normal controls, patients' performance with the size ordering task revealed a different scaling of living things while that of nonliving things mirrored performance of normal controls. This suggests that caution is needed when the picture naming task is exclusively used to document category-specific effects.

The impact of dementia, age and sex on category fluency: greater deficits in women with Alzheimer's disease.

A category specific effect in naming tasks has been reported in patients with Alzheimer's dementia. Nonetheless, naming tasks are frequently affected by methodological problems, e.g., ceiling effects for controls and "nuisance variables" that may confound results. Semantic fluency tasks could help to address some of these methodological difficulties, because they are not prone to producing ceiling effects and are less influenced by nuisance variables. One hundred and thirty-three participants (61 patients with probable AD; and 72 controls: 36 young and 36 elderly) were evaluated with semantic fluency tasks in 14 semantic categories. Category fluency was affected both by dementia and by age: while in nonliving-thing categories there were differences among the three groups, in living thing categories larger lexical categories produced bigger differences among groups. Sex differences in fluency emerged, but these were moderated both by age and by pathology. In particular, fluency was smaller in female than male Alzheimer patients for almost every subcategory.

No category specificity in Alzheimer's disease: a normal aging effect.

The authors examined category effects on tasks of picture naming, naming to definition, and word-picture matching in 38 patients with Alzheimer's disease (AD) and 30 elderly controls. Each task was matched across category on all "nuisance" variables known to differ across domains. Standard analyses revealed significant category disadvantages for classifying living things in AD patients but also for elderly controls on each task. To overcome the ceiling effect in controls, the authors conducted 1,000 bootstrap analyses of covariance, with control performance as a difficulty index covariate. These covariate analyses eliminated the category effect in AD patients on all 3 tasks. Indeed, the authors report that control performance accounted for 64% (picture naming), 49% (naming to description), and 42% (word-picture matching) of variance in AD performance. This suggests that, although category effects in AD patients do not reflect intrinsic variables, the size and direction of the category effect are not different from those in elderly controls.

[A theoretical review of category-specific impairment, its entity and the methodological problems associated with its study]. / Revisión teórica del deterioro categorial, su entidad y los problemas metodológicos asociados a su estudio.

INTRODUCTION: Studies on category-specific claim to provide insights on structure and organization of semantic information. This type of phenomenon consists of the selective impairment of the information on a domain, for instance, living things (animals) but the sparing of nonliving things (tools), or vice versa. Despite the large number of studies purportedly documenting double dissociations between both domains, the lack of theoretical debate on how to empirically define such dissociations is unclear, e.g. how they should be evaluated and reported. DEVELOPMENT: In this work, a review of literature on category-specific and the explanatory models is showed. A critical methodological is done, on the basis of three findings: 1) lack of normal control groups in the majority of case studies; 2) the questionable utilization of double dissociations; and 3) the presence of problems due to a 'ceiling effect' in most group studies of Alzheimer disease patients. CONCLUSIONS: It is claimed that while domain specificity may be a legitimate phenomenon, the critical review of literature do not provide a strong empirical foundation for the domain fractionations claimed in this literature.

A meta-analytic review of category naming in Alzheimer's disease.

Patients with Alzheimer's disease (AD) experience word-finding difficulties that become increasingly pronounced as pathological changes accrue in the brain. One question that has received increasing attention over the last two decades concerns whether the anomia in AD is category-specific, i.e. differentially affects the ability to name living things (LT) and non-living things (NLT). The current meta-analysis systematically reviewed the effect sizes for naming pictures of LT and NLT in comparisons of AD patients and healthy controls in 21 studies with over 1000 participants (557 patients and 509 healthy controls). A random effects model analysis revealed no significant difference in the large weighted effect sizes for naming pictures of LT and NLT (d=1.76 and 1.49, respectively). Moderator variable analyses revealed a significant impact of stimulus colour on the effect size for LT, indicating that using colour stimuli significantly increases the impairment of naming LT in AD patients. Additionally, we found that LT and the NLT effect sizes were larger for samples with proportionally more female patients; smaller samples produced larger LT effect sizes. In contrast, effect sizes were not significantly related to dementia severity, patient age, the number of stimuli, years of education, or the number of matching variables controlled.

[Alzheimer's disease, category-specific impairment and relevant variables in object naming]. / Enfermedad de Alzheimer, deterioro categorial y variables relevantes en la denominación de objetos.

INTRODUCTION: The study of the dissociations or category-specific effects between the domains of living beings and non-living beings in Alzheimer's disease (AD) is a controversial issue in the cognitive neurosciences. The lack of agreement among the different studies may be due to deficient control of certain cognitive and psycholinguistic variables that affect processing of the items. AIM: To determine whether the presence of category-specific effects in AD can be caused by inadequate control of variables, such as the typicality or familiarity of the items. Furthermore, since the groups may contain different types of patients with opposing impairments (which would mask this kind of effect in the group analysis), both group and individual analyses were conducted. SUBJECTS AND METHODS: A retrospective study was carried out to evaluate 66 participants (32 patients with AD) using a colour photo naming task with items controlled for seven disruptive variables. RESULTS: No evidence of living/non-living dissociation was found in the analyses by groups, although the individual-based analysis did show some cases of category-specific effects. CONCLUSIONS: Our data show that category-specific effects are not as widespread as they were believed to be and that the lack of control over the so-called disturbing variables may play an important role in studies on category-specific impairment. Our study also highlights the importance of conducting individual analyses in order to avoid overlooking certain effects that are masked in the group studies.

An attenuation of the 'normal' category effect in patients with Alzheimer's disease: a review and bootstrap analysis.

There is a consensus that Alzheimer's disease (AD) impairs semantic information, with one of the first markers being anomia i.e. an impaired ability to name items. Doubts remain, however, about whether this naming impairment differentially affects items from the living and nonliving knowledge domains. Most studies have reported an impairment for naming living things (e.g. animals or plants), a minority have found an impairment for nonliving things (e.g. tools or vehicles), and some have found no category-specific effect. A survey of the literature reveals that this lack of agreement may reflect a failure to control for intrinsic variables (such as familiarity) and the problems associated with ceiling effects in the control data. Investigating picture naming in 32 AD patients and 34 elderly controls, we used bootstrap techniques to deal with the abnormal distributions in both groups. Our analyses revealed the previously reported impairment for naming living things in AD patients and that this persisted even when intrinsic variables were covaried; however, covarying control performance eliminated the significant category effect. Indeed, the within-group comparison of living and nonliving naming revealed a larger effect size for controls than patients. We conclude that the category effect in Alzheimer's disease is no larger than is expected in the healthy brain and may even represent a small diminution of the normal profile.

[Giant atherosclerotic aneurysm. A case report]. / Aneurisma aterosclerótico gigante. Presentación de un caso.

INTRODUCTION: Intracraneal aneurysms are frequent in medical practice, most of them never produce symptoms, that is why occasionally, they are not diagnosed before death. Sacular is the most frequent aneurysm, and atherosclerotic aneurysm is rare. CASE REPORT: In this article we present the case of a 75 year old woman who has been suffering from high blood pressure and coronary artery disease since more than 20 years and in the last four months she had been complaining of dysphagia and dysartria. She was taken to the hospital because 24 hours ago mild headache started accompanied by vertigo, nausea and vomiting. On neurological exam we found sleepiness, dysartria, and right braguio crural hemiparesis, therefore we decided admitt her, but after 48 hours left braquio crural hemiparesis was added and later respiratory sepsis appeared. The patient died due to an acute respiratory failure. CONCLUSION: Necropsy revealed a huge atherosclerotic intracraneal aneurysm (31 mm) located on basilar artery. The case has been discussed and images were shown.