Influence of memory strategies on memory test performance: a study in healthy and pathological aging.

The ability to generate memory strategies is a key factor in the performance of episodic memory tasks. Whether the ability to generate memory strategies exerts an influence in the performance of memory tests in the elderly population is still a matter of debate. Here we present results from an experimental memory task (Test of Memory Strategies, TMS), comprised of five lists of words starting from an incidental learning task, and four more lists which progressively gain in their external organization of the material, reducing the necessity of mobilizing complex memory strategies. TMS has been applied to four groups of elderly patients (amnestic Mild Cognitive Impairment - aMCI, multidomain (mMCI), and Vascular Cognitive Impairment - VCI and Depression) and a healthy aging group. In conditions with low organization of the material, the mMCI and VCI groups (both showing a greater executive function impairment) have shown lower performance. However, as the material was progressively organized, they improved their performance. The aMCI group showed similar performance to the control group at the lower level of external organization but did not improve performance in conditions with a high level of external organization. The mMCI and VCI groups showed lower performance on all TMS conditions compared with controls. Discriminant analysis revealed 90% sensitivity and specificity to differentiate between groups based on TMS conditions. These results indicate how executive functions influence performance on memory tasks in elderly subjects with different neuropsychological profiles.

Reporte de un caso de anemia hemolítica autoinmune en paciente con enfermedad tipo influenza / A case report of autoinmune hemolytic anemia in patient with influenza-like illnes

Paciente varón con cuadro de 4 días de evolución de congestión nasal, rinirrea y cefalea intensa. Dos días después se agrega tos con expectoración hemoptoica, abundante, sensación febril con escalofríos. Ingresó a Unidad de Cuidados intensivos Adultos, lúcido con O2 por máscara facial, taquipneico, con presión arterial 110/40, pulso 117/minuto, 32 respiraciones/minuto, temperatura axilar 40º. Al segundo día, se conectó asistencia respiratoria mecánica por esfuerzo respiratorio intenso y desaturación progresiva, requiriendo altos parámetros ventilatorios. Se inició tratamiento con ceftriaxona, ciprofloxacina y oseltamivir. Ante el descenso de la hemoglobina se realizaron tres transfusiones de glóbulos rojos. Se administraron bolos de metilprednisona por tres días consecutivos. El paciente evolucionó febril, con glóbulos blancos en ascenso, por lo que al 7º día se cambiaron antibióticos a imipenem 2g/día más vancomicina 2 g/día, previo pancultivos. Se aisló otro germen en secresión traqueal: Stafilococus aureus meticilina resistente. En más del 95% de los pacientes con hemólisis inmune el test de Coombs es positivo, como en nuestro caso...(GG)