Evaluación de la versión española del Memory Impairment Screen / Evaluation of the spanish version of the memory impairment screen

Introducción. Los tests de cribado para detectar demenciassuelen ser largos, en ocasiones difíciles de aplicar, y precisancierto instrucción previa. El Memory Impairment Screen (MIS) esun test de cribado de fácil aplicación y rápido (3-4 minutos) queevalúa la memoria verbal a corto plazo. Objetivo. Evaluar la utilidaddel MIS para el cribado de demencia en nuestra población.Sujetos y métodos. Evaluamos a 101 sujetos, divididos en 49 sujetoscon demencia según los criterios DMS-IV y 52 sujetos sin deteriorocognitivo. Se estudiaron variables demográficas (edad, sexo,escolaridad) y los resultados de la escala de deterioro global, eltest minimental (MMSE) de Folstein, el MIS, la fluidez verbalsemántica (FVS) y el test del reloj a la orden (TRO). Análisis estadístico:se compararon variables demográficas y los resultados delos tests entre los grupos con y sin demencia, y se determinaron losparámetros de utilidad diagnóstica y áreas bajo la curva ROC(aROC). Resultados. No hubo diferencias significativas entre lasvariables sociodemográficas excepto una edad media mayor en elgrupo con demencia. El MIS mostró una sensibilidad del 83,7%(IC 95%: 71-97,9), mayor que la FVS y TRO, y una especificidaddel 94,2% (IC 95%: 84,4-98), mayor que el MMSE y la FVS. ElaROC del MIS fue de 0,935 (IC 95%: 0,954-1,006). Conclusión.Estos resultados demuestran que el MIS es un buen test de cribadode demencia, que podría emplearse por su sencillez y aplicaciónrápida en nuestra población

Introduction. Screening tests for detecting dementias are usually long, sometimes difficult to apply, and require acertain amount of instruction prior to using them. The Memory Impairment Screen (MIS) is a fast (3-4 minutes), easy-to-applyscreening test that evaluates short-term verbal memory. Aim. To evaluate the value of the MIS for screening for dementia inour population. Subjects and methods. We evaluated 101 subjects who were divided into two groups, one consisting of 49individuals with dementia according to DMS-IV criteria and the other made up of 52 subjects with no cognitive impairment.Demographic variables (sex, age, schooling) were studied together with the results from the Global Deterioration Scale, theFolstein Mini-Mental State Examination (MMSE), the MIS, the Semantic Verbal Fluency (SVF) and the Command-ConditionClock Test (CCCT). Statistical analysis: demographic variables and the results from the tests for the two groups (with andwithout dementia) were compared, and the parameters for diagnostic usefulness and the areas under the ROC (aROC) weredetermined. Results. No significant differences were found between the sociodemographic variables except for a higher meanage in the group with dementia. The MIS showed a sensitivity of 83.7% (95% CI: 71-97.9), which was higher than the SVF andthe CCCT, and a specificity of 94.2% (95% CI: 84.4-98), which was higher than the MMSE and the SVF. The aROC of the MISwas 0.935 (95% CI: 0.954-1.006). Conclusions. These findings show that the MIS is a good test for screening for dementia,and its simplicity and quick application could make it suitable for use in our population

[Evaluation of the Spanish version of the Memory Impairment Screen]. / Evaluación de la versión española del Memory Impairment Screen.

INTRODUCTION: Screening tests for detecting dementias are usually long, sometimes difficult to apply, and require a certain amount of instruction prior to using them. The Memory Impairment Screen (MIS) is a fast (3-4 minutes), easy-to-apply screening test that evaluates short-term verbal memory. AIM: To evaluate the value of the MIS for screening for dementia in our population. SUBJECTS AND METHODS: We evaluated 101 subjects who were divided into two groups, one consisting of 49 individuals with dementia according to DMS-IV criteria and the other made up of 52 subjects with no cognitive impairment. Demographic variables (sex, age, schooling) were studied together with the results from the Global Deterioration Scale, the Folstein Mini-Mental State Examination (MMSE), the MIS, the Semantic Verbal Fluency (SVF) and the Command-Condition Clock Test (CCCT). STATISTICAL ANALYSIS: demographic variables and the results from the tests for the two groups (with and without dementia) were compared, and the parameters for diagnostic usefulness and the areas under the ROC (aROC) were determined. RESULTS: No significant differences were found between the sociodemographic variables except for a higher mean age in the group with dementia. The MIS showed a sensitivity of 83.7% (95% CI: 71-97.9), which was higher than the SVF and the CCCT, and a specificity of 94.2% (95% CI: 84.4-98), which was higher than the MMSE and the SVF. The aROC of the MIS was 0.935 (95% CI: 0.954-1.006). CONCLUSIONS: These findings show that the MIS is a good test for screening for dementia, and its simplicity and quick application could make it suitable for use in our population.

[Recurrent meningitis as a manifestation of spinal dysraphism in a young adult]. / Meningitis recurrente como manifestación de un disrafismo espinal en un adulto joven.

INTRODUCTION: Dysraphias are a varied set of anomalies affecting neuroectodermic tissue caused by the alteration of the neural tube during embryogenesis. Neuroradiological classification is broad and clinical manifestations are numerous: they affect the skin, osteomuscular tissue and the vascular, urological and nervous systems. We describe the case of a young adult with infrequent spinal dysraphism, which appeared as recurrent meningitis, and we stress the importance of studies using neuroimaging to define dysraphias. CASE REPORT: Male aged 23 with a history of urinary sphincter dysfunction, spina bifida and meningitis in infancy. He was admitted for treatment for recurrent meningitis and neuroradiological exploration revealed a hidden spinal dysraphism associated with spina bifida, sacrococcygeal dermal sinus with a fistular duct and communication with the dural sac, epidural lipoma and anchored spinal cord. The patient was submitted to decompression laminectomy, the abovementioned sinus was cut and the lipoma was removed. CONCLUSIONS: When faced with a case of recurrent meningitis, one of the etiopathogenic mechanisms to be taken into account is the presence of different malformations that can act as a point of entry to the nervous system not only in the cranial area but also, as in our case, in the spinal region. Late diagnosis of the cases is infrequent, but the presence of spina bifida with skin and urological manifestations point to possible malformations of the neural tube. Early surgical treatment must be performed in order to prevent neurological complications, which are potentially serious and give rise to high morbidity and mortality rates.

Meningitis recurrente como manifestaciónde un disrafismo espinal en un adulto joven / Recurrent meningitis as a manifestation of spinal dysraphism in a young adult

Introducción. Las disrafias constituyen un conjunto de diferentes anomalías del tejido neuroectodérmico, causadas por la alteración en la disyunción del tubo neuronal durante la embriogénesis. La clasificación neurorradiológica es amplia, y las manifestaciones clínicas son numerosas; afectan a la piel, tejido osteomuscular, sistema vascular, urológico y nervioso. Mostramos a un adulto joven con disrafia espinal poco común, que se manifiesta por una meningitis recurrente. Se insiste en la importancia del estudio por neuroimagen para definir las disrafias. Caso clínico. Describimos el caso de un varón de 23 años de edad con antecedentes de disfunción del esfínter urinario, espina bífida y meningitis en la infancia. Ingresa por presentar meningitis recurrente, y tras realizar un estudio neurorradiológico se aprecia una disrafia espinal oculta que asocia: espina bífida, seno dérmico sacrocoxígeo con orificio fistuloso y comunicación al saco dural, lipoma epidural y médula anclada. Al paciente se le realiza una la miectomía descompresiva con una sección del mencionado seno y la extirpación del lipoma. Conclusiones. Ante la presencia de meningitis recurrente, uno de los mecanismos etiopatogénicos a valorar son las distintas malformaciones que puedan ser puerta de entrada al sistema nervioso central, no sólo en la zona craneal sino también como en nuestro caso en la espinal. Es poco frecuente el diagnóstico tardío de estos casos, pero la presencia de la espina bífida con manifestaciones cutáneas y urológicas hacen sospechar la posibilidad de que existan malformaciones del tubo neuronal. Se debe realizar un tratamiento quirúrgico precoz para evitar las complicaciones neurológicas que son potencialmente graves y que conllevan un alto índice de morbimortalidad (AU)