Effect of pistachio consumption on plasma lipoprotein subclasses in pre-diabetic subjects.

BACKGROUND AND AIMS: Nuts have been demonstrated to improve several cardiovascular risk factors and the lipid profile in diabetic and pre-diabetic subjects. However, analysis of conventional serum lipid profiles does not completely explain the atherogenic risk associated with pre-diabetes. We therefore investigated whether chronic consumption of pistachio modifies the lipoprotein subclasses to a healthier profile in pre-diabetic subjects. METHODS AND RESULTS: Randomized cross-over clinical trial in 54 subjects with pre-diabetes. Subjects consumed a pistachio-supplemented diet (PD, 50% carbohydrates, 33% fat, including 57 g/d of pistachios daily) and a control diet (CD, 55% carbohydrates, 30% fat) for 4 months each, separated by a 2-week wash-out. Diets were isocaloric and matched for protein, fiber and saturated fatty acids. Nuclear magnetic resonance (NMR) was performed to determine changes in plasma lipoprotein subclasses. Small low-density lipoprotein particles (sLDL-P) significantly decreased after pistachio consumption compared to the nut-free diet (P = 0.023). The non-high-density lipoprotein particles (non-HDL-P i.e. VLDL-P plus LDL-P) significantly decreased under the PD compared to CD (P = 0.041). The percentage of sHDL-P increased by 2.23% after the PD compared with a reduction of 0.08% after the CD (P = 0.014). Consequently, the overall size of HDL-P significantly decreased in the PD (P = 0.007). CONCLUSION: Chronic pistachio consumption could modify the lipoprotein particle size and subclass concentrations independently of changes in total plasma lipid profile, which may help to explain the decreased risk of cardiovascular disease and mortality associated with those individuals who frequently consumed nuts. REGISTRATION NUMBER: This study is registered at www.clinicaltrials.gov as NCT01441921.

[The cognitive rehabilitation process in a case of bithalamic infarction]. / Proceso de rehabilitación cognitiva en un caso de infarto bitalámico.

INTRODUCTION: One of the fundamental lines followed by Neuropsychology today focuses on rehabilitation processes and their effectiveness. Cognitive rehabilitation is an eclectic process that is dependent on a number of variables. This variability makes it necessary to establish a work plan that guides the intervention carried out by professionals and also makes it clear what objectives are to be achieved, as well as the strategies and tools that must be used to reach them. The purpose of this study is to offer a practical examination of the different points that must be developed in a cognitive rehabilitation process--exemplified here in a case of bithalamic infarction. CASE REPORT: From a single case and from the specific needs of the individual, a thorough work plan is drawn up. This plan includes a description of everything from the choice of a practical framework for intervention and its underlying principles up to the different training processes, learning techniques and tools that were used and finally proved to be effective. The efficacy and safety of the different strategies and tools used are demonstrated by the short and long term results of the different neuropsychological examinations carried out, which at the same time proved the effectiveness of the work plan that was selected for application. CONCLUSIONS: A clear understanding of the value of the cognitive rehabilitation processes chosen for use helps to improve the way clinical work is carried out, with the common purpose of restoring neuropsychological deficits and increasing the individual's independence and quality of life.

Proceso de rehabilitación cognitiva en un caso de infarto bitalámico / The cognitive rehabilitation process in a case of bithalamic infarction

Introducción. Actualmente, una de las direcciones fundamentales de la Neuropsicología se centra en los procesos de rehabilitación y en su eficacia. La rehabilitación cognitiva es un proceso ecléctico y dependiente de múltiples variables. Esta variabilidad hace necesario el establecimiento de un plan de trabajo que guíe la intervención de los profesionales, y clarifique los objetivos a conseguir, así como las estrategias y herramientas a utilizar. El objetivo del presente trabajo consiste en abordar de una forma práctica los distintos puntos a desarrollar en un proceso de rehabilitación cognitiva, ejemplificados en un caso de infarto bitalámico. Caso clínico. A partir de un caso único y de las necesidades particulares del individuo se desarrolla un plan de trabajo completo, en el cual se describen desde la elección de un marco práctico de intervención y sus principios subyacentes, hasta los distintos procesos de entrenamiento, técnicas de aprendizaje y herramientas que se utilizaron y que finalmente resultaron ser eficaces. La garantía de las distintas estrategias y herramientas utilizadas quedan patentes en los resultados a corto y largo plazo de las distintas exploraciones neuropsicológicas realizadas y que demostraban la eficacia del plan de trabajo elegido. Conclusión. El esclarecimiento de la utilidad de los procesos de rehabilitación cognitiva elegidos ayuda a un mejor desarrollo del trabajo clínico, con el propósito común de recuperar los déficit neuropsicológicos y aumentar la independencia del individuo y su calidad de vida (AU)

Introduction. One of the fundamental lines followed by Neuropsychology today focuses on rehabilitation processes and their effectiveness. Cognitive rehabilitation is an eclectic process that is dependent on a number of variables. This variability makes it necessary to establish a work plan that guides the intervention carried out by professionals and also makes it clear what objectives are to be achieved, as well as the strategies and tools that must be used to reach them. The purpose of this study is to offer a practical examination of the different points that must be developed in a cognitive rehabilitation process –exemplified here in a case of bithalamic infarction. Case report. From a single case and from the specific needs of the individual, a thorough work plan is drawn up. This plan includes a description of everything from the choice of a practical framework for intervention and its underlying principles up to the different training processes, learning techniques and tools that were used and finally proved to be effective. The efficacy and safety of the different strategies and tools used are demonstrated by the short and long term results of the different neuropsychological examinations carried out, which at the same time proved the effectiveness of the work plan that was selected for application. Conclusions. A clear understanding of the value of the cognitive rehabilitation processes chosen for use helps to improve the way clinical work is carried out, with the common purpose of restoring neuropsychological deficits and increasing the individual's independence and quality of life (AU)

[Memory evaluation using functional magnetic resonance: applications in preoperative patients and in Alzheimer s disease]. / Evaluacion de la memoria mediante resonancia magnetica funcional: aplicaciones en pacientes prequirurgicos y en la enfermedad de Alzheimer.

The assessment of memory functions related to medial temporal lobe has become one of the most important issues on current neuropsychology. On this communication, we review the results which our research group has achieved using two functional magnetic resonance Image procedures to assess memory function: Hometown walking task and an encoding/retrieval task using complex images. Nine patients with tumoural temporal lesions performed the hometown walking task. The results of these patients showed either a bilateral or contralesional representation of memory function. These results confirm those obtained by Jokeit, Okujava y Woermann (2001), and they seem to prove that this protocol is useful to determine the preservation of memory function in the non damaged hemisphere. On the other hand, the images encoding/retrieval task has been run by two groups of four patients diagnosed as Alzheimer disease and mild cognitive impairment, and another group of five patients who participated as a control group. According to our hypothesis, the results have shown a lower activation at the left parahippocampal gyrus in mild cognitive impairment and Alzheimer disease patients than controls, just as a lower bilateral activation in the same structure for the Alzheimer group than the control group. As a whole, our results show how important may become functional magnetic resonance image for neuropsychological assessment of memory, and as a diagnostic tool for CNS diseases.

Evaluación de la memoria mediante resonancia magnética funcional: aplicaciones en pacientes prequirúrgicos y en la enfermedad de Alzheimer / Memory evaluation using functional magnetic resonance: applications in preoperative patients and in alzheimer's disease

La evaluación de las funciones de memoria relacionadas con estructuras del lóbulo temporal medial se ha convertido en uno de los pilares más importantes en la Neuropsicología actual, dada su extrema relevancia en enfermedades como las demencias y las epilepsias temporales. En esta comunicación revisaremos los resultados que nuestro grupo de investigación ha obtenido con la utilización de sendos protocolos de evaluación de la memoria mediante resonancia magnética funcional (RMf): la tarea de `Paseo por tu Ciudad' (PPTC) y la tarea de `codificación/recuerdo' de imágenes complejas. La tarea de PPTC se ha aplicado a un grupo de nueve pacientes candidatos a neurocirugía por lesiones en el lóbulo temporal, y se obtuvo en todos ellos una representación bilateral o contralesional de la memoria. Los resultados coinciden con los obtenidos en el estudio original de Jokeit, Okujava y Woermann (2001) y parecen mostrar que este protocolo sirve para determinar la preservación o no de la función mnésica en el hemisferio lesionado. Por su parte, la tarea de codificación/recuerdo de imágenes se ha administrado a un grupo de cuatro pacientes con enfermedad de Alzheimer, cuatro con deterioro cognitivo leve y cinco participantes controles. De acuerdo con nuestras hipótesis, los resultados han mostrado una menor activación en la circunvolución parahipocampal izquierda en el grupo con deterioro cognitivo leve que en el grupo control, así como una menor activación bilateral en esas estructuras en el grupo con enfermedad de Alzheimer, si se compara con el grupo control. Nuestros resultados, en conjunto, muestran la importancia que en el futuro tendrá la RMf en la evaluación neuropsicológica de la memoria, y en el diagnóstico de las enfermedades del sistema nervioso central (AU)

he assessment of memory functions related to medial temporal lobe has become one of the most important issues on current neuropsychology. On this communication, we review the results which our research group has achieved using two functional magnetic resonance Image procedures to assess memory function: ‘Hometown walking’ task and an ‘encoding/retrieval’ task using complex images. Nine patients with tumoural temporal lesions performed the hometown walking task. The results of these patients showed either a bilateral or contralesional representation of memory function. These results confirm those obtained by Jokeit, Okujava y Woermann (2001), and they seem to prove that this protocol is useful to determine the preservation of memory function in the non-damaged hemisphere. On the other hand, the images encoding/retrieval task has been run by two groups of four patients diagnosed as Alzheimer disease and mild cognitive impairment, and another group of five patients who participated as a control group. According to our hypothesis, the results have shown a lower activation at the left parahippocampal gyrus in mild cognitive impairment and Alzheimer disease patients than controls, just as a lower bilateral activation in the same structure for the Alzheimer group than the control group. As a whole, our results show how important may become functional magnetic resonance image for neuropsychological assessment of memory, and as a diagnostic tool for CNS diseases (AU)

[Lymphatic malformation and chyluria: presentation of a treated case without relapse]. / Malformación linfática y quiluria: presentación de un caso intervenido sin recidiva.

Chyluria is a consequence of the aperture of one or more perirenal lymphatic vessels to the renal pelvis, and is characterized by milky urine, rich in protein, lipids, cholesterol and triglycerides. Where there is chyluria there is malformation of the chyliferous vessels of the small intestine associated to hypoplasia of Pecquet's cistern. A 22 year old patient who had had persistent chyluria since the age of 16 is presented with a test of induced hyperlipidemia typical of intestinal lymphatic malformation. Chyluria was demonstrated by lymphography by bilateral pedial approach and ascending pyelography. Following surgical ligation of the lymphatic vessels of the left kidney the chyluria remitted and the patient has had no further clinical manifestation up to the present, one year after surgery.

[Static gamma phlebography with Tc 99-marked blood erythrocytes]. / Gammaphlébographie statique moyennant marquage au Tc 99 des globules rouges du sang.

Our personal modification of the isotopic gammaphlebography technique involving red blood cells marked with (a 10 mCu dose of) Tc 99 is described. This process involves a further intravenous injection of the isotope, after a previous injection of 2 ml Cl2Sn, which allows re-injection of the radioactive bolus after its passage through the lung region, so that more accurate and complete images are obtained, without performing any other invasive examinations of the lower extremities. 80 patients are studied, and their study is completed by means of the Doppler effect and impedance rheopltethismography. The results are discussed: 87,5% and 88,6% of good correlations in Doppler are obtained for acute and chronic cases respectively. 77,75% and 92% with impedance rheoplethismography in the same cases. Six evidencing cases are shown.

[Static scintigraphy using technetium 99 labelled red blood cells]. / Gammaphlébographie statique par marquage au 99Tc des globules rouges du sang.

Our personal modification to the isotopic gammaphlebography technique involving red blood cells marked with (a 10 mCu dose of) Tc-99 is shown. This process involves further the injection of the isotope endovenously in the inner face of the elbow articulation, after having first injected 2 ml Cl2Sn, which allows re-injection of the radioactive bolus after its passage through the lung region, so that more accurate and complete images may be obtained, without having to perform any manipulations in the lower extremities. 80 patients are studied, and their study is completed by means of the Doppler Effect and impedance rheopletismography. The results are shown : 87,5% and 88,5% of good correlations in Doppler are obtained for acute and chronic cases respectively. 77,75% and 92% with impedance rheopletismography in the same cases. Six evidencing cases are shown.

[Study of arterial diseases of the lower limbs using an exercise test monitored by Doppler effect ultrasonometry]. / Etude des maladies artérielles des membres inférieurs au moyen d'un test d'effort controlé par ultrasonométrie a effet Doppler.

A study has been carried out using Doppler ultrasonometry on 223 cases, 191 of them suffering from occlusive or stenosing arterial illnesses and 12 with deep massive venous thrombosis, together with 68 control cases. Systolic tensions in the popliteal, dorsalis pedis and posterior tibialis arteries, both at rest and after a conveniently standardized effort, were studied every five minutes over periods of up to thirty minutes. The results are shown grouping these patients according to their clinical features and giving their different responses to the test. Special emphasis is given to cases of badly compensated recent intermittent claudication, diffused atheromatosis, asymtomatic arterial stenosis, thromboangiitis obliterans, Leriche's syndrome and hypertensive ulcers.

[Considerations on the role of the so-called non-invasive investigations: Doppler effect, rheography and labeled fibrinogen testi in acute arterial and venous leg]. / Considérations sur le rôle des explorations dites non invasives, effet Doppler, rhéographie et test au fibrinogéne margué. dans la jambe aiguë artérielle et veineuse.

The author outlines the first results obtained with Doppler investigation in arterial and venous emergencies. He analyzed thereafter the Kakkar test, through which he can detect acute venous more easily than with Doppler. He insists on the difficulty of detecting through either one of these methods, some cases of thrombosis located in the abdominal veins.