Search PubMed⌕ Search

Biomedical subjects

A Aleman

Publications and source records attributed to A Aleman.

At least 19 recordsLinked to original sources
PubMed2006

Cardiovascular disease and cognitive performance in middle-aged and elderly men.

BACKGROUND: Decline of cognitive function with age may be due, in part, to atherosclerotic changes. The aim of the present study was to determine the relative contribution of cardiovascular disease (CVD) to cognitive functioning in middle-aged and elderly men. METHODS: In a cross-sectional study, cognitive tests were administered to 400 independently living men aged 40-80 years. Compound scores were calculated for memory function, processing capacity/speed, and executive function. The MMSE was used as a measure of global cognitive function. Carotid intima-media thickness, pulse wave velocity and ankle brachial blood pressure index were assessed as measures of sub-clinical CVD. The adjusted association of sub-clinical and prevalent CVD with neuropsychological test scores in the total group and in subgroups was assessed by linear regression analysis. RESULTS: Increased IMT was associated with lower scores on memory performance, and increased PWV was associated with lower scores on processing capacity and executive functioning. Compared with subjects with no CVD, both sub-clinical and prevalent cardiovascular diseases were related to a lower memory performance, beta's (95% CI) were -0.45 (-0.83, -0.07) and -0.45 (-0.84, 0.01), respectively. These associations were present in both middle-aged and elderly men. Furthermore, we observed that for subjects who had sub-clinical or prevalent cardiovascular disease the distribution of MMSE-scores was shifted toward lower values; the distributions were statistically different (p=0.003). CONCLUSIONS: The results of this study support a relation of sub-clinical CVD with cognitive functioning in middle-aged and elderly men. These results suggest that actions to prevent cognitive decline by preventing atherosclerosis should be taken before middle age.

Adult↗
PubMed2005

Bed rest during pregnancy for preventing miscarriage.

BACKGROUND: Miscarriage is pregnancy loss before 23 weeks of gestational age and it happens in 10% to 15% of pregnancies depending on maternal age and parity. It is associated with chromosomal defects in about a half or two thirds of cases. Many interventions have been used to prevent miscarriage but bed rest is probably the most commonly prescribed especially in cases of threatened miscarriage and history of previous miscarriage. Since the etiology of miscarriage in most of the cases is not related to an excess of activity, it is unlikely that bed rest could be an effective strategy to reduce spontaneous miscarriage. OBJECTIVES: To evaluate the effect of prescription of bed rest during pregnancy to prevent miscarriage in women at high risk of miscarriage. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (July 2004). In addition, we searched The Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, POPLINE, LILACS and EMBASE. SELECTION CRITERIA: We included all published, unpublished and ongoing randomized trials with reported data which compare clinical outcomes in pregnant women who were prescribed bed rest in hospital or at home for preventing miscarriage compared with alternative care or no intervention. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the methodological quality of included trials using the methods described in the Cochrane Reviewers' Handbook. Studies were included irrespective of their methodological quality. MAIN RESULTS: Only two studies including 84 women were identified. There was no statistically significant difference in the risk of miscarriage in the bed rest group versus the no bed rest group (placebo or other treatment) (relative risk (RR) 1.54, 95% confidence interval (CI) 0.92 to 2.58). Neither bed rest in hospital nor bed rest at home showed a significant difference in the prevention of miscarriage. There was a higher risk of miscarriage in those women in the bed rest group than in those in the human chorionic gonadotrophin therapy group with no bed rest (RR 2.50, 95% CI 1.22 to 5.11). It seems that the small number of participants included in these studies is a main factor to make this analysis inconclusive. AUTHORS' CONCLUSIONS: There is insufficient evidence of high quality that supports a policy of bed rest in order to prevent miscarriage in women with confirmed fetal viability and vaginal bleeding in first half of pregnancy.

Abortion, Spontaneous↗
PubMed2005

Endogenous sex hormone levels and cognitive function in aging men: is there an optimal level?

OBJECTIVE: To determine whether endogenous sex hormone levels are associated with cognitive functioning in men. METHODS: Cognitive performance was assessed in 400 independently living men between ages 40 and 80 in a population-based cross-sectional study. Compound scores were calculated for memory function, processing capacity/speed, and executive function. The Mini-Mental State Examination was used as a measure of global cognitive function. The adjusted association of testosterone (T) and estradiol (E2) (total, bioavailable) with neuropsychological test scores in the total group and in subgroups was assessed by linear and logistic regression analysis. RESULTS: Curvilinear associations were observed between T and memory performance and processing capacity/speed, suggesting optimal sex hormone levels. No association between E2 and cognitive functioning was found. After the population was subdivided into four age decades, a linear association of T with cognitive functioning in the oldest age category remained. No association was found in the other age decades. Lower bioavailable T levels were associated with lower scores on processing capacity/speed and executive function; beta (95% CI) values were 0.36 (0.07 to 0.66) and 0.17 (-0.01 to 0.35). Similar results were observed for total T. CONCLUSIONS: Higher testosterone (T) levels are associated with better cognitive performance in the oldest age category. Apparent curvilinear associations between T and certain cognitive functions in men suggest an optimal hormone level for particular cognitive tasks and are explained by linear associations in the oldest age category.

Adult↗
PubMed2004

Outcomes of autologous stem cell transplantation in patients with multiple myeloma who received dexamethasone-based nonmyelosuppressive induction therapy.

High-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) improves survival in myeloma (MM). The role of induction therapy on outcomes of ASCT in MM has not been systematically studied. Nonmyelosuppressive (NMS) steroid-based induction can be used in MM, with the potential of reducing neutropenias and other toxic effects prior to ASCT. NMS induction however could be associated with poorer outcomes if disease control or stem cell collection were inadequate. We studied outcomes of 136 MM patients who underwent HDC and ASCT as part of their initial therapy between March 1998 and December 2000. Of these, 46 received HDC and ASCT without any exposure to myelosuppressive agents, 39 received myelosuppressive therapy for disease control and/or stem cell collection, and 51 received alkylating agent-based initial treatment. We compared OS and EFS rates, stem cell collectability, and contamination of the grafts with monoclonal plasma cells. After a median of 33 months, response rates, EFS and OS rates were comparable in the three groups of patients. Adequacy of stem cell collection and plasma cell contamination were similar. Our data support the hypothesis that NMS induction for patients with MM is safe and effective and does not compromise the results of HDC.

Dexamethasone↗
PubMed2004

Analysis of 96 patients with advanced ovarian carcinoma treated with high-dose chemotherapy and autologous stem cell transplantation.

The purpose of this study was to identify characteristics significant to survival and progression-free survival in patients with advanced ovarian cancer receiving high-dose chemotherapy. In all, 96 patients received autologous stem cell transplantation. Regimens included paclitaxel with carboplatin (PC), topotecan, melphalan, cyclophosphamide (TMC) and cyclophosphamide, BCNU, thiotepa (CBT). At the time of transplantation, 43% of patients were in clinical CR, 34% were in clinical PR, 18% had progressive disease and 5% had stable disease. There were no treatment-related deaths. The 6-year survival by Kaplan-Meier was 38%. For patients who received transplantation for remission consolidation, the 6-year survival was 53% with a PFS of 29%. On univariate analysis, the CBT regimen, clear cell histology and disease status other than CR prior to treatment were statistically significant adverse prognostic factors. This analysis has demonstrated that patients in clinical remission are most likely to benefit from autologous transplantation, with the exception of patients with clear cell histology. The TMC combination appeared to be superior to the PC and CBT combinations. Comparative studies of different consolidation approaches will be necessary to determine if autologous transplantation is the preferred treatment for this patient population.

Adult↗
PubMed2002

Fludarabine/melphalan conditioning for allogeneic transplantation in patients with multiple myeloma.

The purpose of the study was to determine the feasibility and efficacy of a reduced intensity conditioning regimen of fludarabine and melphalan for allogeneic transplantation in patients with multiple myeloma. From August 1996 to December 2000, 22 patients received a reduced intensity conditioning regimen with fludarabine and melphalan. Median age was 51 years (range, 45-64), median time from initial therapy to transplant was 36 months (range, 3-135 months). Disease phase prior to transplant was primary refractory in two patients, refractory relapse in 11 patients, sensitive relapse in eight patients and initial remission consolidation in one patient. The median number of prior therapies was five (range, 1-7), and median beta 2 microglobulin prior to transplant was 3.0 mg/l (range, 1.0-7.3). All patients received unmanipulated grafts from either HLA matched sibling donors (n = 13) or matched unrelated donors (n = 9). Eighteen patients received fludarabine 30 mg/m(2) for 4 days with melphalan 140 mg/m(2) as a single dose and four patients received fludarabine 25 mg/m(2) for 5 days with melphalan 90 mg/m(2) daily for 2 days. All 21 patients evaluable for engraftment achieved a neutrophil count of >0.5 x 10(9)/l after a median of 12 days (range, 9-24), 18 patients achieved platelet transfusion independence after a median of 14 days (range, 8-47). All engrafting patients had 100% donor cell engraftment. Seven patients achieved a complete remission. Six patients are currently alive with a median follow-up of 15 months (range, 10-47 months). The actuarial survival and progression-free survival is 30 +/- 11% and 19 +/- 9% at 2 years. Non-relapse mortality at 100 days was 19 +/- 10% and 40 +/- 10% at 1 year. Fludarabine/melphalan combinations are feasible and allow consistent engraftment of allogeneic progenitor cells from both related and unrelated donors in patients with multiple myeloma and should be explored in patients with less advanced disease.

Antineoplastic Agents↗
PubMed2001

Activation of striate cortex in the absence of visual stimulation: an fMRI study of synesthesia.

It has been suggested that internally generated visual perception involves the primary visual cortex V1. To test this hypothesis, a functional MRI study was conducted with a female subject with orthographic color-word synesthesia. This subject was selected as she reported clear involuntary visualization of auditorily presented verbal material. Hearing a word resulted in seeing the word in a particular color. fMRI scans were acquired while the subject performed two verbal tasks (passive listening to words and verbal fluency). Significant activity was detected in primary visual cortex, in the absence of external visual stimulation. This finding provides evidence for a role of modulatory feedback connections between associative and primary visual areas in visual experience without direct visual stimulation.

Acoustic Stimulation↗
PubMed2001

Visual imagery without visual experience: evidence from congenitally totally blind people.

We explored the ability of congenitally totally blind people (who were contrasted with age-, sex- and education matched blindfolded sighted subjects) to perform tasks which are mediated by visual mental imagery in sighted people. In the first (pictorial) task, subjects had to mentally compare the shape of the outline of three named objects and to indicate the odd-one-out. In the second (spatial) task the participants were asked to memorise the position of a target cube in two- and three-dimensional matrices, based on a sequence of spatially based imagery operations. In addition, during half of the trials of both imagery tasks subjects were required to perform a concurrent finger tapping task, to investigate whether the blind subjects would be more dependent on spatial processing. Although blind participants made significantly more errors than sighted participants, they were well able to perform the spatial imagery task as well as the pictorial imagery task. Interference from the concurrent tapping task affected both groups to the same extent. Our results shed new light on the question whether early visual experience is necessary for performance on visual imagery tasks, and strongly suggest that vision and haptics may share common representations.

Adult↗
PubMed2001

Effects of the atypical antipsychotic risperidone on hostility and aggression in schizophrenia: a meta-analysis of controlled trials.

Atypical antipsychotics have been hypothesized to be more effective than classical antipsychotics in the treatment of hostility and aggression, due to their characteristic pharmacological profile, involving serotonergic as well as dopaminergic systems. In the present quantitative review the published evidence regarding the effects of risperidone on hostility and aggression in schizophrenia is evaluated. Meta-analysis of seven controlled trials revealed significant differences between risperidone and classical antipsychotics and between risperidone and placebo, although the effect size was small. Additional analyses in which only methodological rigorous studies were included showed highly significant differences (risperidone versus classical antipsychotics) and the effect size approached the 'medium' range. We conclude that risperidone is superior to classical antipsychotics and placebo in the treatment of hostility and aggression in schizophrenia. Neuropharmacological mechanisms that might account for this effect are discussed, and directions for future research are outlined.

Aggression↗
PubMed2001

Thiotepa, busulfan, cyclophosphamide (TBC) and autologous hematopoietic transplantation: an intensive regimen for the treatment of multiple myeloma.

The study was designed to evaluate the efficacy and safety of an intensive, tri-alkylator conditioning regimen, consisting of thiotepa, busulfan and cyclophosphamide (TBC), prior to autologous hematopoietic cell transplantation in patients with multiple myeloma (MM) and to analyze factors associated with outcome. One hundred and twenty patients with MM received high-dose chemotherapy with TBC followed by autologous bone marrow (n = 24) or peripheral blood stem cell (PBSC) transplantation (n = 96). Fifty-four patients had chemosensitive disease and 66 had refractory disease at the time of transplantation. The overall response rate was 81% and the complete remission (CR) rate was 26%. Patients with chemosensitive disease had a CR rate of 52% vs 5% for patients with refractory disease. Multivariable analysis determined disease status at transplant as the factor most likely associated with long survival. Estimated median survival was 48, 35 and 9 months for patients with chemosensitive, primary refractory or disease in refractory relapse, respectively. Short interval from diagnosis to transplant among patients with primary refractory disease and younger age were also favorable prognostic factors for survival. Patients with refractory disease pre-transplant who achieved remission criteria rapidly after treatment had a worse outcome than the slow responders. Treatment-related mortality with the introduction of PBSC and better supportive care was 4.8%. In conclusion, TBC is an effective and relatively well-tolerated intensive conditioning regimen in patients with MM. A more favorable outcome was observed in patients with chemosensitive disease and with early treatment for primary refractory disease. TBC merits further study in these subgroups and comparison with alternative regimens in prospective studies is warranted.

Adult↗
PubMed2001

High-dose chemotherapy followed by stem cell transplantation in patients with resistant Waldenstrom's macroglobulinemia.

Preliminary evidence suggests that high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation may be effective in some patients with resistant Waldenstrom's macroglobulinemia. During the last 10 years, seven patients with Waldenstrom's macroglobulinemia have received transplants at the MD Anderson Cancer Center, four with autologous and three with allogeneic stem cells. Four patients achieved partial remission, and three patients have remained alive for at least 2 years. Our data confirm the feasibility of high-dose therapy in patients with macroglobulinemia and support the need for prospective studies of this modality in patients with chemosensitive disease.

Adult↗
PubMed2001

Handedness, language lateralisation and anatomical asymmetry in schizophrenia: meta-analysis.

BACKGROUND: Cerebral lateralisation appears to be decreased in schizophrenia. Results of studies investigating this, however, are equivocal. AIMS: To review quantitatively the literature on decreased lateralisation in schizophrenia. METHOD: Meta-analyses were conducted on 19 studies on handedness, 10 dichotic listening studies and 39 studies investigating anatomical asymmetry in schizophrenia. RESULTS: The prevalence of mixed- and left-handedness ('non-right-handedness') was significantly higher in patients with schizophrenia as compared to healthy controls, and also as compared to psychiatric controls. The analysis of dichotic listening studies revealed no significant difference in lateralisation in schizophrenia. However, when analysis was restricted to studies using consonant-vowel or fused word tasks, significantly decreased lateralisation in schizophrenia emerged. Asymmetry of the planum temporale and the Sylvian fissure was significantly decreased in schizophrenia, while asymmetry of the temporal horn of the lateral ventricle was not. CONCLUSION: Strong evidence is provided for decreased cerebral lateralisation in schizophrenia.

Brain↗
PubMed2001

Hallucinatory predisposition and vividness of auditory imagery: self-report and behavioral indices.

This study examined the relation between a subjective and a behavioral measure of the vividness of auditory imagery as well as the disposition towards hallucination in normal subjects. In addition to the Launay-Slade Hallucination Scale, subjects (57 university students) completed the Betts questionnaire in which they rated the vividness of their experienced mental images and performed a behavioral task aimed at measuring auditory imagery. The task consisted of a perception and an imagery condition in which subjects had to indicate the odd one of three everyday sounds. Performance on the behavioral task did not correlate with the auditory or scores on the Visual subscale of the Betts. In addition, neither scores on the behavioral measure nor the Auditory subscale of the Betts correlated significantly with hallucinatory predisposition as rated on the Launay-Slade Hallucination Scale. In contrast, the Visual subscale of the Betts did correlate with scores on the Launay-Slade Hallucination Scale, consistent with previous research. We conclude that there is no straightforward relationship between imagery vividness and hallucinatory experiences and that subjective and objective indices of imagery vividness measure different aspects of mental function.

Adult↗
PubMed2000

Music training and mental imagery ability.

Neuroimaging studies have suggested that the auditory cortex is involved in music processing as well as in auditory imagery. We hypothesized that music training may be associated with improved auditory imagery ability. In this study, performance of musically trained and musically naive subjects was compared on: (1) a musical mental imagery task (in which subjects had to mentally compare pitches of notes corresponding to lyrics taken from familiar songs); (2) a non-musical auditory imagery task (in which subjects had to mentally compare the acoustic characteristics of everyday sounds); and (3) a comparable measure of visual imagery (in which subjects had to mentally compare visual forms of objects). The musically trained group did not only perform better on the musical imagery task, but also outperformed musically naive subjects on the non-musical auditory imagery task. In contrast, the two groups did not differ on the visual imagery task. This finding is discussed in relation to theoretical proposals about music processing and brain activity.

Adult↗
PubMed2000

Growth hormone, insulin-like growth factor I and cognitive function in adults.

This review focuses on the possible contribution of the growth hormone (GH)-insulin-like growth factor I (IGF-I) axis to cognitive function. Binding sites for GH and IGF-I are found in various areas of the brain. Their distribution suggests that GH and IGF-I contribute to the function of the hippocampus, a brain structure important for the maintenance of cognitive functions such as learning and memory. Evidence for cognitive deficits in GH-deficient individuals has been found in various studies, some of which have shown that these deficits can be reversed by GH substitution therapy. In addition to examining conditions of GH deficiency, this article reviews studies evaluating the correlation between the cognitive deficits associated with ageing and age-related decreases in GH or IGF-I secretion. Based on the available data, one might hypothesize that relative GH or IGF-I deficiency could contribute to the deterioration of cognitive functions observed in the elderly.

Adult↗