Amygdala structure and function and its associations with social-emotional outcomes in a low-risk preterm sample.

Amygdala atypical volume development and functional connectivity (FC) at small gestational ages (GA) have been found across childhood. This adult-oriented study assesses whether altered amygdala structure and function is present following low-risk preterm birth. T1-weighted and resting-state functional MRI images of 33 low-risk preterm (30-36 weeks' GA) and 29 full-term (37-42 weeks' GA) young adults of both sexes, aged between 20 and 32 years old, were analyzed using FreeSurfer (v6.0.0) and Coon Toolbox (v21.a). The social-emotional assessment included Happé's Strange Stories Test, the Moral Judgment Test, Delay-Discounting Test, Adult Self Report, and Emotion Regulation Questionnaire. No differences were found in social-emotional outcomes or amygdala volumes between the groups. Low-risk preterm young adults showed increased FC between the left amygdala, right amygdala and medial frontal cortex (MedFC) (F = 9.89, p-FWE = 0.009) at cluster level compared to their full-term peers. However, significant results at connection level were not observed between left and right amygdala. Lastly, increased FC at cluster level between the right amygdala and MedFC, and left amygdala and MedFC, was related to better social-emotional outcomes only in low-risk preterm young adults (F = 6.60, p-FWE = 0.036) at cluster level. At connection level, in contrast, only right amygdala-MedFC increased FC was significantly associated with better social-emotional outcomes. This study reveals that low-risk prematurity does not have an effect on social-emotional outcomes or structural amygdala volumes during young adulthood. However, individuals who were considered to be at a lower risk of exhibiting neurodevelopmental alterations following preterm birth demonstrated increased FC between the left and right amygdala and MedFC.

Test UD Interferencia: Creación y validación de un nuevo instrumento de resistencia a la interferencia. Normalización y estandarización en población española / UD Interference Test: Creation and validation of a new instrument of resistance to interference. Normalization and standardization for Spanish population

Introducción: El test UD Interferencia evalúa la velocidad de procesamiento y la atención, y está basado en el concepto de interferencia del test de Stroop. El objetivo principal de este estudio es proporcionar una versión alternativa del test de Stroop que evite algunas de las limitaciones de versiones anteriores, relacionadas con el daltonismo y las dificultades de lectura en personas mayores, y obtener datos normativos y estandarizados para este test, adaptados a población española. Métodos: El estudio se enmarca dentro del proyecto Normacog, para el cual se evaluó a 905 participantes (18-93 años). Se analizó la fiabilidad y la validez concurrente y de constructo del test. Se analizaron el efecto de la edad, nivel educativo y sexo sobre el rendimiento en UD Interferencia y se crearon percentiles y puntuaciones escalares ajustadas por edad y nivel educativo. Resultados: El test muestra buena fiabilidad (α = 0,875) y validez concurrente (r de 0,443 a 0,725; p < 0,001) y de constructo (r de 0,472 a 0,737; p < 0,001). Se observó un efecto significativo de la edad y el nivel educativo sobre el rendimiento en UD Interferencia, explicando del 12 al 40% de la varianza. El sexo únicamente presentó un efecto significativo en la variable índice de resistencia a la interferencia. Conclusiones: Se presenta una versión alternativa del test de Stroop que presenta algunas ventajas sobre anteriores versiones. Se aportan baremos estandarizados y normalizados para población española que permiten corregir el test teniendo en cuenta la edad y educación de la persona evaluada.(AU)

Introduction: The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Test. The main purpose of the study is to provide an alternative version of the Stroop Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. Methods: This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. Results: The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; p < .001) and construct validity (r = 0.472-0.737; p < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12-40% of variance. Sex only had a significant effect on the resistance to interference index. Conclusions: We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.(AU)

UD Interference Test: creation and validation of a new instrument of resistance to interference. Normalisation and standardisation for Spanish population.

INTRODUCTION: The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Color and Word Test. The main purpose of the study is to provide an alternative version of the Stroop Color and Word Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. METHODS: This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. RESULTS: The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; P < .001) and construct validity (r = 0.472-0.737; P < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12% to 40% of variance. Sex only had a significant effect on the resistance to interference index. CONCLUSIONS: We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.

Hippocampal volumes and cognitive performance in children born extremely preterm with and without low-grade intraventricular haemorrhage.

Children born extremely preterm, especially those with intraventricular haemorrhage (IVH), are at increased risk of adverse cognitive outcomes during childhood. The present study aimed to explore the effects of IVH (grades I-II) on hippocampal volumes, and their correlates with cognitive performance. The sample consisted of 94 participants, including 54 children born extremely preterm (19 with IVH, grades I-II), and 40 children born at term. All participants underwent a magnetic resonance imaging study at the age of 10 (Mage = 10.20 years; SDage = 0.78), and 74 of them (45 extremely preterm and 29 full-term) carried out a cognitive assessment at 12 years old. Children born extremely preterm had lower scores in cognitive performance compared to their full-term peers. Significant positive partial correlations were observed between global bilateral hippocampus, left CA-field, and left subiculum volumes with processing speed in the full-term group, while no significant correlations were found in the extremely preterm group. Moderation analyses in the extremely preterm sample revealed that low-grade IVH moderated the relationship between right hippocampal volume and full-IQ (F(4,40) = 5.42, p = 0.001, R2 = 0.35). Having greater right hippocampal volume had a protective effect on full-IQ in those children born extremely preterm with low-grade IVH.

High serum nitrates levels in non-survivor COVID-19 patients / Altas concentraciones séricas de nitratos en pacientes fallecidos por COVID-19

Objective: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. Design: A prospective observation study was carried out. Setting: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). Patients: COVID-19 patients admitted to the ICU. Interventions: Determination of serum nitrate levels at ICU admission. Main variable of interest: Mortality at 30 days. Results: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006–1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006–1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73–92%; p<0.001), APACHE II (AUC=85%; 95%CI=75–96%; p<0.001) and SOFA (AUC=78%; 95%CI=63–92%; p=0.005) based on the DeLong method. The Kaplan–Meier analysis found patients with serum nitrates levels>68.4μmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3–863.9; p<0.001). Conclusions: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation (AU)

Objetivo: Se han encontrado niveles más elevados de nitratos en la sangre de pacientes con enfermedad del coronavirus 2019 (COVID-19) que en sujetos sanos. Por lo tanto, el objetivo de estudio consistió en explorar la posible asociación entre los niveles séricos de nitratos y la mortalidad de pacientes por COVID-19. Diseño: Estudio observacional y prospectivo. Ámbito: Ocho unidades de cuidados intensivos (UCI) de 6 hospitales de las Islas Canarias (España). Pacientes: Pacientes COVID-19 ingresados en la UCI. Intervenciones: Se midieron los niveles séricos de nitratos al ingreso en la UCI. Variable de interés principal: Mortalidad a los 30 días. Resultados: Los pacientes fallecidos (n=11) comparados con los supervivientes (n=42) presentaron mayores APACHE-II (p<0,001), SOFA (p=0,004) y niveles séricos de nitratos (p=0,001). Los análisis de regresión logística mostraron una asociación entre los niveles séricos de nitratos al ingreso en la UCI y la mortalidad a los 30 días controlando por SOFA (OR:1.021; IC 95%:1.006-1.036; p=0,01) o APACHE-II (OR:1.023; IC 95%:1.006-1.041; p=0,01). No encontramos diferencias en el área bajo la curva (ABC) para la predicción de mortalidad entre los niveles séricos de nitratos (ABC:83%; IC 95%:73-92%; p<0,001), APACHE-II (ABC:85%; IC 95%:75-96%; p<0,001) y SOFA (ABC:78%; IC 95%:63-92%; p=0,005) con el método de DeLong. El análisis de Kaplan-Meier mostró que los pacientes que tenían niveles séricos de nitratos al ingreso en la UCI>68,4μmol/l presentaban mayor riesgo de fallecer (hazard ratio:138,8; IC 95%:22,3-863,9; p<0,001). Conclusiones: El principal nuevo hallazgo fue la asociación entre los niveles séricos de nitratos y la mortalidad de pacientes COVID-19 controlando por SOFA o APACHE-II; pero estudios de mayor tamaño muestral son necesarios para confirmar este resultado (AU)

High serum nitrates levels in non-survivor COVID-19 patients.

OBJECTIVE: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. DESIGN: A prospective observation study was carried out. SETTING: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). PATIENTS: COVID-19 patients admitted to the ICU. INTERVENTIONS: Determination of serum nitrate levels at ICU admission. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006-1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006-1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73-92%; p<0.001), APACHE II (AUC=85%; 95%CI=75-96%; p<0.001) and SOFA (AUC=78%; 95%CI=63-92%; p=0.005) based on the DeLong method. The Kaplan-Meier analysis found patients with serum nitrates levels>68.4µmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3-863.9; p<0.001). CONCLUSIONS: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

Test breve de memoria visuoespacial-revisado: normalización y estandarización de la prueba en población española / Brief visuospatial memory test-revised (BVMT-R): normalization and standardization for Spanish population

Introducción: El test breve de memoria visuoespacial-revisado (BVMT-R) evalúa el aprendizaje y la memoria visuoespacial en población adulta. Este test cuenta con versiones paralelas que permiten su readministración.Objetivo: Obtener datos normativos y estandarizados para el BVMT-R adecuados a las características sociodemográficas de la población española.Sujetos y métodos: El estudio se enmarca dentro del proyecto Normacog. Se evaluó a 903 participantes (rango de edad: 18-93 años) con el BVMT-R (versión 1). Se analizaron el efecto de la edad, el nivel educativo y el sexo sobre el BVMT-R, y se crearon los percentiles y las puntuaciones escalares ajustadas por edad y nivel educativo. Resultados: Se observó un efecto significativo de la edad y el nivel educativo sobre todas las variables analizadas (ensayo 1, recuerdo total, ensayo 4 e índice de discriminación), que explica entre el 12 y el 40% de la varianza. Los participantes más mayores y con menor nivel educativo obtuvieron un menor rendimiento en el BVMT-R. El sexo no presentó un efecto significativo en las variables analizadas. Conclusión: Este estudio aporta baremos estandarizados y normalizados para el BVMT-R, teniendo en cuenta las características sociodemográficas de la población española. Los resultados confirman la influencia de la edad y la educación en el rendimiento del test, por lo que aportamos datos que permiten corregir el BVMT-R teniendo en cuenta dichas características.(AU)

Introduction: The brief visuospatial memory test-revised (BVMT-R) assesses visuospatial learning and memory in adults. It has equivalent forms that allow reassessing patients. Aim: To obtain normative and standardized data for the BVMT-R taking into account the sociodemographic characteristics of the Spanish population.Subjects and methods: The present study is part of the Normacog Project. Nine hundred three participants (18 to 93 years old) were assessed using the BVMT-R (form 1). The effect of age, level of education and gender was analyzed on the BVMT-R, and percentiles and scalar scores adjusted by age and level of education were created.Results: A significant effect of age and educational level on the analyzed variables was observed (trial 1; total recall; trial 4; discrimination index), explaining from 12% to 40% of the variance. The older and less educated participants obtained lower performance in all the analyzed variables of the BVMT-R. Gender had not a significant effect in the analyzed variables.Conclusion: The study provides standardized and normalized data for the BVMT-R taking into account the Spanish sociodemographic characteristics. The results confirm the influence of age and level of education in the performance of the test, so normative data are provided to correct the BVMT-R taking into account these characteristics.(AU)

[Brief visuospatial memory test-revised (BVMT-R): normalization and standardization for Spanish population]. / Test breve de memoria visuoespacial-revisado: normalización y estandarización de la prueba en población española.

INTRODUCTION: The brief visuospatial memory test-revised (BVMT-R) assesses visuospatial learning and memory in adults. It has equivalent forms that allow reassessing patients. AIM: To obtain normative and standardized data for the BVMT-R taking into account the sociodemographic characteristics of the Spanish population. SUBJECTS AND METHODS: The present study is part of the Normacog Project. Nine hundred three participants (18 to 93 years old) were assessed using the BVMT-R (form 1). The effect of age, level of education and gender was analyzed on the BVMT-R, and percentiles and scalar scores adjusted by age and level of education were created. RESULTS: A significant effect of age and educational level on the analyzed variables was observed (trial 1; total recall; trial 4; discrimination index), explaining from 12% to 40% of the variance. The older and less educated participants obtained lower performance in all the analyzed variables of the BVMT-R. Gender had not a significant effect in the analyzed variables. CONCLUSION: The study provides standardized and normalized data for the BVMT-R taking into account the Spanish sociodemographic characteristics. The results confirm the in?uence of age and level of education in the performance of the test, so normative data are provided to correct the BVMT-R taking into account these characteristics.

TITLE: Test breve de memoria visuoespacial-revisado: normalización y estandarización de la prueba en población española.Introducción. El test breve de memoria visuoespacial-revisado (BVMT-R) evalúa el aprendizaje y la memoria visuoespacial en población adulta. Este test cuenta con versiones paralelas que permiten su readministración. Objetivo. Obtener datos normativos y estandarizados para el BVMT-R adecuados a las características sociodemográficas de la población española. Sujetos y métodos. El estudio se enmarca dentro del proyecto Normacog. Se evaluó a 903 participantes (rango de edad: 18-93 años) con el BVMT-R (versión 1). Se analizaron el efecto de la edad, el nivel educativo y el sexo sobre el BVMT-R, y se crearon los percentiles y las puntuaciones escalares ajustadas por edad y nivel educativo. Resultados. Se observó un efecto significativo de la edad y el nivel educativo sobre todas las variables analizadas (ensayo 1, recuerdo total, ensayo 4 e índice de discriminación), que explica entre el 12 y el 40% de la varianza. Los participantes más mayores y con menor nivel educativo obtuvieron un menor rendimiento en el BVMT-R. El sexo no presentó un efecto significativo en las variables analizadas. Conclusión. Este estudio aporta baremos estandarizados y normalizados para el BVMT-R, teniendo en cuenta las características sociodemográficas de la población española. Los resultados confirman la influencia de la edad y la educación en el rendimiento del test, por lo que aportamos datos que permiten corregir el BVMT-R teniendo en cuenta dichas características.

UD Interference Test: Creation and validation of a new instrument of resistance to interference. Normalization and standardization for Spanish population. / Test UD Interferencia: Creación y validación de un nuevo instrumento de resistencia a la interferencia. Normalización y estandarización en población española.

INTRODUCTION: The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Test. The main purpose of the study is to provide an alternative version of the Stroop Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. METHODS: This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. RESULTS: The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; p < .001) and construct validity (r = 0.472-0.737; p < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12-40% of variance. Sex only had a significant effect on the resistance to interference index. CONCLUSIONS: We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.

HLA genetic polymorphisms and prognosis of patients with COVID-19 / Polimorfismos genéticos de los HLA y pronóstico de pacientes con COVID-19

OBJECTIVE: Different genetic polymorphisms of human leukocyte antigen (HLA) have been associated with the risk and prognosis of autoimmune and infectious diseases. The objectives of this study were to determine whether there is an association between HLA genetic polymorphisms and the susceptibility to and mortality of coronavirus disease 2019 (COVID-19) patients. DESIGN: Observational and prospective study. SETTING: Eight Intensive Care Units (ICU) from 6 hospitals of Canary Islands (Spain). PATIENTS: COVID-19 patients admitted in ICU and healthy subjects. INTERVENTIONS: Determination of HLA genetic polymorphisms. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: A total of 3886 healthy controls and 72 COVID-19 patients (10 non-survivors and 62 survivor patients at 30 days) were included. We found a trend to a higher rate of the alleles HLA-A*32 (p = 0.004) in healthy controls than in COVID-19 patients, and of the alleles HLA-B*39 (p = 0.02) and HLA-C*16 (p = 0.02) in COVID-19 patients than in healthy controls; however, all these p-values were not significant after correction for multiple comparisons. Logistic regression analysis showed that the presence of certain alleles was associated with higher mortality, such as the allele HLA-A*11 after controlling for SOFA (OR = 7.693; 95% CI = 1.063-55.650; p = 0.04) or APACHE-II (OR = 11.858; 95% CI = 1.524-92.273; p = 0.02), the allele HLA-C*01 after controlling for SOFA (OR = 11.182; 95% CI = 1.053-118.700; p = 0.04) or APACHE-II (OR = 17.604; 95% CI = 1.629-190.211; p = 0.02), and the allele HLA-DQB1*04 after controlling for SOFA (OR = 9.963; 95% CI = 1.235-80.358; p = 0.03). CONCLUSIONS: The new finding from our preliminary study of small sample size was that HLA genetic polymorphisms could be associated with COVID-19 mortality; however, studies with a larger sample size before definitive conclusions can be drawn

OBJETIVO: Diferentes polimorfismos genéticos de los antígenos leucocitarios humanos (HLA) están asociados con el riesgo y el pronóstico de enfermedades autoinmunes e infecciosas. Los objetivos de estudio fueron determinar si existe una asociación entre polimorfismos genéticos de HLA y la susceptibilidad y mortalidad de pacientes con la enfermedad del coronavirus 2019 (COVID-19). DISEÑO: Estudio observacional y prospectivo. ÁMBITO: Ocho unidades de cuidados intensivos (UCI) de 6 hospitales de las Islas Canarias (España). PACIENTES: Pacientes COVID-19 ingresados en la UCI y sujetos sanos. INTERVENCIONES: Se determinaron los polimorfismos genéticos de los HLA. VARIABLE DE INTERÉS PRINCIPAL: Mortalidad a los 30 días. RESULTADOS: Se incluyeron 3.886 sujetos sanos y 72 pacientes COVID-19 (10 fallecidos y 62 supervivientes a 30 días). Encontramos una tendencia a una mayor frecuencia de los alelos HLA-A*32 (p = 0,004) en sujetos sanos que en pacientes COVID-19, y de los alelos HLA-B*39 (p = 0,02) y HLA-C*16 (p = 0,02) en pacientes COVID-19 que en sujetos sanos; sin embargo, no fueron significativos al corregir por comparaciones múltiples. En la regresión logística encontramos que la presencia de ciertos alelos estuvo asociada con mayor mortalidad, como el alelo HLA-A*11 controlando por SOFA (OR = 7.693; IC del 95% = 1.063-55.650; p = 0,04) o APACHE-II (OR = 11.858; IC del 95% = 1.524-92.273; p = 0,02), el alelo HLA-C*01 controlando por SOFA (OR = 11.182; IC del 95% = 1.053-118.700; p = 0,04) o APACHE-II (OR = 17.604; IC del 95% = 1.629-190.211; p = 0,02) y el alelo HLA-DQB1*04 controlando por SOFA (OR = 9.963; IC del 95% = 1.235-80.358; p = 0,03). CONCLUSIONES: Los nuevos hallazgos de nuestro preliminar estudio de pequeño tamaño muestral fueron que determinados polimorfismos genéticos de los HLA podrían estar asociados con la mortalidad de pacientes COVID-19; sin embargo, son necesarios estudios de mayor tamaño muestral para concluirlo definitivamente

[Hopkins Verbal Learning Test-revised: normalization and standardization for Spanish population]. / Test de aprendizaje verbal de Hopkins revisado: normalización y estandarización de la prueba en población española.

INTRODUCTION: The Hopkins Verbal Learning Test-revised (HVLT-R) was originally created with the objective of providing a short verbal memory and learning test with six alternative forms that allow the re-administration. AIM: To obtain normative and standardized data for the HVLT-R taking into account the sociodemographic characteristics of the current Spanish population. SUBJECTS AND METHODS: The study is part of the Normacog Project. Seven hundred participants (18 to 90 years old) were assessed. The effect of age, level of education and gender on the performance of HVLT-R were analyzed, and percentiles and scalar scores adjusted by age and level of education were created. RESULTS: A significant effect of age and educational level on the analyzed variables of the test was observed, explaining from 15% to 29% of the variance (trial 1, total recall, trial 4, discrimination index). As expected, the older and less educated obtained lower performance in all the analyzed variables of the HVLT-R. However, sex only had a significant effect on the variables trial 1, total recall and discrimination index. CONCLUSION: This study provides standardized and normalized data for the HVLT-R for the Spanish population, offering current norms to clinicians and researchers. The results confirm the influence of age and level of education on all the indicators of the test, so normative data are provided to correct the HVLT-R taking into account these characteristics.

TITLE: Test de aprendizaje verbal de Hopkins revisado: normalización y estandarización de la prueba en población española.Introducción. El test de aprendizaje verbal de Hopkins revisado (HVLT-R) se creó originalmente con el objetivo de proporcionar un test de aprendizaje y memoria verbal corto y con seis versiones paralelas que permitieran su readministración. Objetivo. Obtener datos normativos y estandarizados para el HVLT-R adaptado a las características sociodemográficas de la población española actual. Sujetos y métodos. El estudio se enmarca dentro del proyecto Normacog, para el cual se evaluó a 700 participantes (rango de edad: 18-90 años). Se analizó el efecto de la edad, el nivel educativo y el sexo sobre el rendimiento del HVLT-R, y se crearon los percentiles y las puntuaciones escalares ajustadas por edad y nivel educativo. Resultados. Se observó un efecto significativo de la edad y el nivel educativo sobre las variables analizadas del test, que explicaba entre el 15 y el 29% de la varianza (ensayo 1, recuerdo total, ensayo 4, índice de discriminación). Como era de esperar, a mayor edad y menor nivel educativo, el rendimiento en el HVLT-R fue menor en todas las variables analizadas. Sin embargo, el sexo presentó un efecto significativo únicamente en las variables ensayo 1, recuerdo total e índice de discriminación. Conclusión. Este estudio presenta baremos estandarizados y normalizados para el HVLT-R para población española, y ofrece normas actuales para los clínicos e investigadores. Los resultados confirman la influencia de la edad y la educación en todos los indicadores del test, por lo que se aportan datos que permiten corregir el HVLT-R teniendo en cuenta dichas características.

[HLA genetic polymorphisms and prognosis of patients with COVID-19]. / Polimorfismos genéticos de los HLA y pronóstico de pacientes con COVID-19.

OBJECTIVE: Different genetic polymorphisms of human leukocyte antigen (HLA) have been associated with the risk and prognosis of autoimmune and infectious diseases. The objectives of this study were to determine whether there is an association between HLA genetic polymorphisms and the susceptibility to and mortality of coronavirus disease 2019 (COVID-19) patients. DESIGN: Observational and prospective study. SETTING: Eight Intensive Care Units (ICU) from 6 hospitals of Canary Islands (Spain). PATIENTS: COVID-19 patients admitted in ICU and healthy subjects. INTERVENTIONS: Determination of HLA genetic polymorphisms. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: A total of 3886 healthy controls and 72 COVID-19 patients (10 non-survivors and 62 survivor patients at 30 days) were included. We found a trend to a higher rate of the alleles HLA-A*32 (p=0.004) in healthy controls than in COVID-19 patients, and of the alleles HLA-B*39 (p=0.02) and HLA-C*16 (p=0.02) in COVID-19 patients than in healthy controls; however, all these p-values were not significant after correction for multiple comparisons. Logistic regression analysis showed that the presence of certain alleles was associated with higher mortality, such as the allele HLA-A*11 after controlling for SOFA (OR=7.693; 95% CI=1.063-55.650; p=0.04) or APACHE-II (OR=11.858; 95% CI=1.524-92.273; p=0.02), the allele HLA-C*01 after controlling for SOFA (OR=11.182; 95% CI=1.053-118.700; p=0.04) or APACHE-II (OR=17.604; 95% CI=1.629-190.211; p=0.02), and the allele HLA-DQB1*04 after controlling for SOFA (OR=9.963; 95% CI=1.235-80.358; p=0.03). CONCLUSIONS: The new finding from our preliminary study of small sample size was that HLA genetic polymorphisms could be associated with COVID-19 mortality; however, studies with a larger sample size before definitive conclusions can be drawn.

HLA genetic polymorphisms and prognosis of patients with COVID-19.

Objective: Different genetic polymorphisms of human leukocyte antigen (HLA) have been associated with the risk and prognosis of autoimmune and infectious diseases. The objectives of this study were to determine whether there is an association between HLA genetic polymorphisms and the susceptibility to and mortality of coronavirus disease 2019 (COVID-19) patients. Design: Observational and prospective study. Setting: Eight Intensive Care Units (ICU) from 6 hospitals of Canary Islands (Spain). Patients: COVID-19 patients admitted in ICU and healthy subjects. Interventions: Determination of HLA genetic polymorphisms. Main variable of interest: Mortality at 30 days. Results: A total of 3886 healthy controls and 72 COVID-19 patients (10 non-survivors and 62 survivor patients at 30 days) were included. We found a trend to a higher rate of the alleles HLA-A*32 (p = 0.004) in healthy controls than in COVID-19 patients, and of the alleles HLA-B*39 (p = 0.02) and HLA-C*16 (p = 0.02) in COVID-19 patients than in healthy controls; however, all these p-values were not significant after correction for multiple comparisons. Logistic regression analysis showed that the presence of certain alleles was associated with higher mortality, such as the allele HLA-A*11 after controlling for SOFA (OR = 7.693; 95% CI = 1.063-55.650; p = 0.04) or APACHE-II (OR = 11.858; 95% CI = 1.524-92.273; p = 0.02), the allele HLA-C*01 after controlling for SOFA (OR = 11.182; 95% CI = 1.053-118.700; p = 0.04) or APACHE-II (OR = 17.604; 95% CI = 1.629-190.211; p = 0.02), and the allele HLA-DQB1*04 after controlling for SOFA (OR = 9.963; 95% CI = 1.235-80.358; p = 0.03). Conclusions: The new finding from our preliminary study of small sample size was that HLA genetic polymorphisms could be associated with COVID-19 mortality; however, studies with a larger sample size before definitive conclusions can be drawn.

Objetivo: Diferentes polimorfismos genéticos de los antígenos leucocitarios humanos (HLA) están asociados con el riesgo y el pronóstico de enfermedades autoinmunes e infecciosas. Los objetivos de estudio fueron determinar si existe una asociación entre polimorfismos genéticos de HLA y la susceptibilidad y mortalidad de pacientes con la enfermedad del coronavirus 2019 (COVID-19). Diseño: Estudio observacional y prospectivo. Ámbito: Ocho unidades de cuidados intensivos (UCI) de 6 hospitales de las Islas Canarias (España). Pacientes: Pacientes COVID-19 ingresados en la UCI y sujetos sanos. Intervenciones: Se determinaron los polimorfismos genéticos de los HLA. Variable de interés principal: Mortalidad a los 30 días. Resultados: Se incluyeron 3.886 sujetos sanos y 72 pacientes COVID-19 (10 fallecidos y 62 supervivientes a 30 días). Encontramos una tendencia a una mayor frecuencia de los alelos HLA-A*32 (p = 0,004) en sujetos sanos que en pacientes COVID-19, y de los alelos HLA-B*39 (p = 0,02) y HLA-C*16 (p = 0,02) en pacientes COVID-19 que en sujetos sanos; sin embargo, no fueron significativos al corregir por comparaciones múltiples. En la regresión logística encontramos que la presencia de ciertos alelos estuvo asociada con mayor mortalidad, como el alelo HLA-A*11 controlando por SOFA (OR= 7.693; IC del 95%= 1.063-55.650; p = 0,04) o APACHE-II (OR= 11.858; IC del 95%= 1.524-92.273; p = 0,02), el alelo HLA-C*01 controlando por SOFA (OR= 11.182; IC del 95%= 1.053-118.700; p = 0,04) o APACHE-II (OR= 17.604; IC del 95%= 1.629-190.211; p = 0,02) y el alelo HLA-DQB1*04 controlando por SOFA (OR= 9.963; IC del 95%= 1.235-80.358; p = 0,03). Conclusiones: Los nuevos hallazgos de nuestro preliminar estudio de pequeño tamaño muestral fueron que determinados polimorfismos genéticos de los HLA podrían estar asociados con la mortalidad de pacientes COVID-19; sin embargo, son necesarios estudios de mayor tamaño muestral para concluirlo definitivamente.

High serum nitrates levels in non-survivor COVID-19 patients.

OBJECTIVE: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. DESIGN: A prospective observation study was carried out. SETTING: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). PATIENTS: COVID-19 patients admitted to the ICU. INTERVENTIONS: Determination of serum nitrate levels at ICU admission. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006-1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006-1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73-92%; p<0.001), APACHE II (AUC=85%; 95%CI=75-96%; p<0.001) and SOFA (AUC=78%; 95%CI=63-92%; p=0.005) based on the DeLong method. The Kaplan-Meier analysis found patients with serum nitrates levels>68.4µmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3-863.9; p<0.001). CONCLUSIONS: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

El programa de tutorias: canal de acompañamiento a las trayectorias educativas en medicina veterinaria / Tutorship programs: a way of accompanying educational trajectories in Veterinary Medicine

Resumen El propósito del presente trabajo es socializar el impacto del Programa de Tutorías en la trayectoria educativa de los ingresantes a la carrera de medicina veterinaria de la Universidad Nacional del Litoral. El Programa de tutorías data del año 2010 cuando mediante el plan de mejoramiento de la carrera se instaura la necesidad de iniciar una labor de acompañamiento dirigida a los estudiantes ingresantes. Dicho programa se lleva a cabo mediante la labor profesional realizada desde la cátedra de Introducción a la Veterinaria, el Director de carrera y el Servicio de Orientación Educativa (S.O.E) de la Facultad de Ciencias Veterinarias siendo los co-responsables de dicha ejecución. El desafío constante del programa es responder a la construcción continua de alternativas que permitan a los estudiantes apropiarse de las habilidades necesarias para alcanzar el éxito académico. Teniendo en cuenta los resultados se observa que el Programa de Tutorías es recomendado por el 98% de los tutorados, debido a que el mismo es favorecedor de los procesos de afiliación universitaria. La novedad del programa es que se lleva a cabo por estudiantes avanzados, quienes luego de un proceso de selección y capacitación realizan la tarea orientativa.

Abstract The purpose of this work is to socialize the impact of the Mentoring Program in the educational path of the entrants to the veterinary medicine career at the National University of the Coast. The Mentoring Program dates back to 2010 when, through the career improvement plan, the need to start an accompaniment work aimed at incoming students was established. This program is carried out through the professional work carried out by the Chair of Introduction to Veterinary Medicine, the Career Director and the Educational Guidance Service (S.O.E) of the Faculty of Veterinary Sciences, being the co-responsible for said execution. The constant challenge of the program is to respond to the continuous construction of alternatives that allow students to appropriate the necessary skills to achieve academic success. Taking into account the results, it can be seen that the Tutoring Program is recommended by 98% of the tutors, because it is favorable to the university affiliation processes. The novelty of the program is that it is carried out by advanced students, who after a selection and training process carry out the orientation task.

Mechanisms of functional improvement through cognitive rehabilitation in schizophrenia.

Whereas the efficacy of cognitive rehabilitation in schizophrenia is widely known, studies examining mechanisms for functional improvement are still scarce. The aim of the study was to examine the mediational mechanisms through which cognitive rehabilitation improves functioning in schizophrenia. One hundred and eleven schizophrenia patients were randomly assigned to either a 4-month cognitive rehabilitation group or an active control group. Patients underwent a neurocognitive battery (including processing speed, verbal memory, working memory and executive functioning) and social cognition assessment (emotion perception, theory of mind and social perception). Functioning was assessed by the combined use of a performance-based instrument, the UCSD Performance-based Skills Assessment (UPSA) and an observer-rated instrument, the Global Assessment of Functioning (GAF). The trial was registered in clinicaltrials.gov (NCT02796417). Multiple mediational analyses revealed that the effect of cognitive rehabilitation on functional improvement was partially mediated by changes in processing speed and verbal memory, but not by the domains of social cognition and negative symptoms. More specifically, verbal memory partially mediated the treatment's effect on performance-based functioning (UPSA), whereas processing speed acted as a partial mediator for observer-rated functioning (GAF). The effect of rehabilitation on functioning did not take place through all the domains that showed significant improvement. Verbal memory and processing speed emerged as the most crucial factors. However, these complex interactions need further research.

Long-term effects of cognitive rehabilitation on brain, functional outcome and cognition in Parkinson's disease.

BACKGROUND AND PURPOSE: Cognitive rehabilitation has demonstrated efficacy in producing short-term cognitive and brain changes in patients with Parkinson's disease (PD). To date, no study has assessed the long-term effects of cognitive rehabilitation using neuroimaging techniques in PD. The aim was to assess the longitudinal effects of a 3-month cognitive rehabilitation programme evaluating the cognitive, behavioural and neuroimaging changes after 18 months. METHODS: Fifteen patients with PD underwent a cognitive, behavioural and neuroimaging assessment at pre-treatment (T0 ), post-treatment (T1 ) and after 18 months (T2 ). This study examined the long-term effects (from T0 to T2 ) and the maintenance of the changes (from T1 to T2 ). T1-weighted, diffusion-weighted, functional magnetic resonance imaging during both a resting-state and a memory paradigm were acquired. Voxel-based morphometry and tract-based spatial statistics were used for grey and white matter analyses. A region-of-interest-to-region-of-interest approach was used for resting-state functional connectivity (FC) and a model-based approach was used for brain activation during the memory paradigm. RESULTS: Patients with PD showed increased cognitive performance, decreased functional disability, increased brain FC and activation at T2 compared with T0 (P < 0.05, FDR). Moreover, patients showed maintenance of the improvements in cognition and functionality, and maintenance of the increased brain FC and activation at T2 compared with T1 . However, significant grey matter reduction and alterations of white matter integrity were found at T2 (P < 0.05, FWE). CONCLUSIONS: Findings suggest that the improved cognitive performance and increased brain FC and activation after cognitive rehabilitation were significantly maintained after 18 months in patients with PD, despite the structural brain changes, consistent with a progression of neurodegenerative processes.

Radiofrecuencia pulsada para el tratamiento de la neuralgia occipital: análisis de predictores y resultados / Occipital nerve pulsed radiofrequency treatment: analysis predictors and outcomes

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[Comparison of the Wechsler Memory Scale-III and the Spain-Complutense Verbal Learning Test in acquired brain injury: construct validity and ecological validity]. / Comparacion de la escala de memoria de Wechsler-III y el test de aprendizaje verbal España-Complutense en el daño cerebral adquirido: validez de constructo y validez ecologica.

AIMS: To perform an in-depth examination of the construct validity and the ecological validity of the Wechsler Memory Scale-III (WMS-III) and the Spain-Complutense Verbal Learning Test (TAVEC). PATIENTS AND METHODS: The sample consists of 106 adults with acquired brain injury who were treated in the Area of Neuropsychology and Neuropsychiatry of the Complejo Hospitalario de Navarra and displayed memory deficit as the main sequela, measured by means of specific memory tests. The construct validity is determined by examining the tasks required in each test over the basic theoretical models, comparing the performance according to the parameters offered by the tests, contrasting the severity indices of each test and analysing their convergence. The external validity is explored through the correlation between the tests and by using regression models. RESULTS: According to the results obtained, both the WMS-III and the TAVEC have construct validity. The TAVEC is more sensitive and captures not only the deficits in mnemonic consolidation, but also in the executive functions involved in memory. The working memory index of the WMS-III is useful for predicting the return to work at two years after the acquired brain injury, but none of the instruments anticipates the disability and dependence at least six months after the injury. CONCLUSION: We reflect upon the construct validity of the tests and their insufficient capacity to predict functionality when the sequelae become chronic.

TITLE: Comparacion de la escala de memoria de Wechsler-III y el test de aprendizaje verbal España-Complutense en el daño cerebral adquirido: validez de constructo y validez ecologica.Objetivo. Profundizar en la validez de constructo y en la validez ecologica de la escala de memoria de Wechsler-III (WMS-III) y el test de aprendizaje verbal España-Complutense (TAVEC). Pacientes y metodos. La muestra consta de 106 adultos con daño cerebral adquirido atendidos en el Area de Neuropsicologia y Neuropsiquiatria del Complejo Hospitalario de Navarra, con deficit de memoria como secuela principal, medido a traves de test especificos de memoria. Para determinar la validez de constructo se examinan las tareas requeridas en cada prueba sobre los modelos teoricos de base, comparando el rendimiento segun los parametros ofrecidos por los tests, contrastando los indices de gravedad de cada prueba y analizando su convergencia. La validez externa se explora a traves de la correlacion entre las pruebas y mediante modelos de regresion. Resultados. De acuerdo con los resultados obtenidos, la WMS-III y el TAVEC tienen validez de constructo. El TAVEC es mas sensible y capta no solo los deficits en la consolidacion mnesica, sino en las estrategias ejecutivas implicadas en la memoria. El indice de memoria de trabajo de la WMS-III es util para predecir la reincorporacion laboral a los dos años del daño cerebral adquirido, pero ningun instrumento anticipa la discapacidad y la dependencia al menos seis meses despues de la lesion. Conclusion. Se reflexiona sobre la validez de constructo de las pruebas y su capacidad insuficiente para predecir la funcionalidad cuando las secuelas se cronifican.

[Montreal Cognitive Assessment Test: normalization and standardization for Spanish population]. / Test de evaluacion cognitiva de Montreal: normalizacion y estandarizacion de la prueba en poblacion española.

INTRODUCTION: The Montreal Cognitive Assessment (MoCA) is a brief screening test that assesses the general cognitive state. It has become very popular and useful as an alternative resource for the traditional Mini-Mental State Examination. AIM: To normalize and to standardize the MoCA taking into account the sociodemographic characteristics of the Spanish population (INE data, 2012). SUBJECTS AND METHODS: The present study is part of the Normacog Project. Seven hundred participants were recruited (older than 18 years old). The effect of age, level of education and sex was analyzed on the performance of MoCA and percentiles and scalar score for nine ranges of age and scalar score adjusted by the level of education. RESULTS: Results showed a significant effect of age, level of education and sex on the cognitive performance of MoCA. However, sex was only significant in two domains (attention and delayed recall). Age, education and sex explained from 1.0% to 32.3% of the variance of the performance. The older participants with lower level of formal education obtained the worse performance shown in MoCA. Percentiles and scalar score for each range of age, and scalar score adjusted by the level of education were obtained. CONCLUSION: The normative data of the MoCA is provided taking into account the Spanish sociodemographic characteristics for adults in Spain and the cut-off to distinguish between normal cognitive performance and mild cognitive impairment according to different range of ages have been proposed.

TITLE: Test de evaluacion cognitiva de Montreal: normalizacion y estandarizacion de la prueba en poblacion española.Introduccion. La evaluacion cognitiva de Montreal (MoCA) es un test de cribado breve que evalua el estado cognitivo general, y resulta un recurso alternativo, muy util, al tradicional test minimental. Objetivo. Normalizar y estandarizar el test MoCA, teniendo en cuenta las caracteristicas sociodemograficas de la poblacion española (datos INE, 2012). Sujetos y metodos. El estudio se enmarca dentro del proyecto Normacog, en el que se evaluo a 700 participantes (18-86 años). Se analizaron el efecto de la edad, el nivel educativo y el sexo sobre el rendimiento del test MoCA, y se crearon los percentiles, las puntuaciones escalares para nueve rangos de edad y la puntuacion escalar normalizada ajustada por edad y nivel educativo. Resultados. Los resultados mostraron un efecto significativo de la edad, el nivel educativo y el sexo sobre el rendimiento cognitivo en el test MoCA. Sin embargo, el sexo solo presento un efecto significativo sobre dos dominios cognitivos: atencion y recuerdo diferido. La edad, la educacion y el sexo explicaron entre el 1% y el 32,3% de la varianza en las variables analizadas del test. Los participantes mas mayores con menor nivel de educacion formal obtuvieron peor rendimiento cognitivo. Se obtuvieron los percentiles y las puntuaciones escalares para cada rango de edad y la puntuacion escalar normalizada individual. Conclusion. Se presentan los datos normativos del test MoCA adecuados a las caracteristicas sociodemograficas de la sociedad española y los puntos de corte propuestos para discriminar entre rendimiento cognitivo normal y deterioro cognitivo leve segun los diferentes rangos de edad.