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Biomedical subjects

R Gil

Publications and source records attributed to R Gil.

At least 19 recordsLinked to original sources
PubMed2006

Perceptual factors contribute to akinesia in Parkinson's disease.

Parkinson's disease (PD) patients have longer reaction time (RT) than age-matched control subjects. During the last decades, conflicting results have been reported regarding the source of this deficit. Here, we addressed the possibility that experimental inconsistencies originated in the composite nature of RT responses. To investigate this idea, we examined the effect of PD on different processes that compose RT responses. Three variables were manipulated: the signal quality, the stimulus-response compatibility and the foreperiod duration. These variables have been shown to affect, respectively, the ability to extract the relevant features of the stimulus (perceptual stage), the intentional selection of the motor response (cognitive stage) and the implementation of the muscle command (motor stage). Sixteen PD patients were tested on and off-medication and compared with an age and gender-matched control group. Results indicated that degrading the legibility of the response stimulus affected the latency of simple key-press movements more dramatically in the off-medication PD group than in the control population. The stimulus-response compatibility and the foreperiod duration had similar effects in the two groups. Interestingly, the response slowing associated with the degradation of the stimulus was the same whether the patients were on or off dopaminergic medication. This suggests that the high-level perceptual deficits observed in the present study do not have a dopaminergic origin.

Adult↗
PubMed2006

[Identification errors and delusions of false identification in Alzheimer's disease: a regional survey].

INTRODUCTION: Misidentification syndromes are the main symptoms in Alzheimer's disease. Underlain by complex cognitive, agnosic, and amnesic disturbances of degenerative etiology, they can be expressed by misidentification delusions, as in psychoses. To date, research has focused on identification disturbances of persons selected according to various definitions. OBJECTIVE: Our main objective was to evaluate the frequency of identification disturbances among patients suffering from Alzheimer's disease within the current conditions of diagnosis and treatment. The secondary objective aimed to establish a detailed analysis of symptoms and clinical correlations, and evaluate the effects of the troubles on the caregiver. METHODS: We conducted a regional survey using a questionnaire designed for the caregiver, proposed to the 60 geriatric doctors and neurologists in the Poitou-Charentes region of France, for all patients suffering from Alzheimer's disease (defined according to DSM IV criteria) seen between June 1st and August 31st of 2003. Statview software was used for statistical analysis. RESULTS: The survey was completed for 104 patients: 69.5 percent women and 30.5 percent men, with a mean age of 79 years. The majority of the patients were seen by a neurologist and presented an average cognitive deficiency (MMS ranging from 11 to 20). An identification disturbance, whether or not it was delusional, all domains included, was found in 81.6 percent of the patients and was related to a more severe cognitive deficiency and greater hardship on the part of the caregiver. DISCUSSION: We observed a high prevalence of identification disturbance, which can be explained by the systematic and exhaustive search for identification disturbance. The most frequent disturbance concerned the identification of places, whereas self-identification was less often affected; the authentic Capgras delusion was found less often. CONCLUSION: The study of identification disturbances in Alzheimer's disease can contribute to a better understanding of the cognitive, psychopathological, and physiopathological aspects of the disease as well as to a better knowledge and better care for the patient.

Aged↗
PubMed2006

[Automatic recall of didactic knowledge in semantic memory during normal aging and in Alzheimer's disease].

INTRODUCTION: The goal of our work is to study the most consolidated items of semantic memory in normal subjects and in patients with Alzheimer's disease (AD). PATIENTS AND METHOD: The first test is based on automatic recall of didactic knowledge. This test is made of 250 automatic verbal expressions exploring general knowledge. It as been validated according to age and cultural levels in 219 normal subjects (20-90 years old). Another simplified test called EVA including only 50 of the 250 previously chosen items was also used. The EVA scores found in a normal population have been classified by centilages according to age and cultural levels. The EVA was also tested in 20 patients with AD and the results compared with MMSE and "Pyramids and Palm Trees Test" (semantic memory testing). RESULTS: The results reveal that the scores observed with the first test in a normal population with comparable cultural levels are correlated with age. EVA test scores found in control subjects show that the median value, for a same age group, is positively correlated with cultural levels. In patients with AD, scores for EVA test and MMSE are associated, the low results being linked to the severity of dementia. In addition, scores for EVA test and "Pyramids and Palm Trees Test" are also significantly correlated. Seven patients with mild dementia (MMSE>20) have abnormal scores for the "Pyramids and Palm Trees Test". CONCLUSION: Our study confirms that changes linked to aging do not involve all aspects of cognition. The most consolidated items of semantic memory assessed by EVA test seem to resist at the beginning of AD but later decline similarly to the other items of semantic memory. Normal results for EVA tests do not imply that semantic memory is not affected in the early phases of AD. We propose this new test which assesses the semantic memory stock without involving an active process of recuperation. This test is not suitable for an early diagnosis of AD but could help to evaluate the severity of the disease during the evolution.

Adult↗
PubMed2006

[Neurological complications of Herpes zoster].

INTRODUCTION: Herpes zoster is a disease which occurs secondary to the reactivation of varicella-zoster virus (VZV). Its frequency is high in the general population. STATE OF ART: Herpes zoster leads to numerous complications, among which there were neurological peripheral or central lesions. Antiviral treatment must be instituted, particularly if neurological complications develop, as soon as possible. Corticosteroid therapy can be used, especially in Ramsay-Hunt syndrome or central nervous system involvement. CONCLUSION: Herpes-zoster is a frequent disease which can lead to serious neurological complications. Early treatment is necessary in order to improve functional outcome.

Acute Disease↗
PubMed2005

[Primitive neuroectodermal tumor/extraosseus Ewing sarcoma of the temporal bone].

The term primitive neuroectodermal tumor (PNET) should be included in the differential diagnosis of small round blue cell tumors, which come from the neural crest and explain their neuroectodermal character. This is one of the most indifferentiated histological types of malignant tumors. In the PNET family, we high light the Ewing's Sarcoma, that is frecuently located in bony sites and has a less frequent localization in soft tissues. We focus on one atypic case of PNET/Extraosseus Ewing's Sarcoma that involves the external auditory canal and infiltrates the temporal bone. Surgery followed by postoperative chemotherapy and radiation offers the best local control of the disease.

Adult↗
PubMed2005

[Statins and prevention of strokes].

Statins have become a leading prescription drug in France. Indications have been greatly extended over the last five years subsequent to publication of many multicentric prospective trials. Besides their preventive properties for coronary artery disease, their efficacy for the prevention of stroke also appears to be demonstrated in coronary patients (CARE and LIPID studies) and in subjects at risk (HPS and ASCOT-LLA studies) irrespective of the serum cholesterol level, the relative risk of stroke being decreased by 30 percent compared with placebo. This preventive capacity would involve pathways other than cholesterol and/or LDL-cholesterol lowering mechanisms, and would probably involve a direct effect on inflammation, coagulation, modulation of certain atherogenic processes, and endothelial function. There remains however certain questions concerning the exact role of statins on secondary prevention of stroke (SPARCL study), their real usefulness in the elderly subject (PROSPER study), and the relative superiority of individual statins.

Age Factors↗
PubMed2005

[Investigation of set-shifting ability in patients with Parkinson's disease: influence of task sequence type].

INTRODUCTION: The aim of the present study was to investigate the origin of set-shifting deficits observed in Parkinson's disease (PD). METHODS: Seventeen patients diagnosed as having idiopathic PD were compared with 15 control subjects. We used a task-switching paradigm, including two tasks (task A and task B) so that subjects were required to switch either immediately after a switch-trial (i.e. alternating switch or ABA task sequence) or following one or two non-switch trials (ABBA or ABBBA task sequences). RESULTS: In both groups, switch cost (SC) in ABA task sequence was larger than SC in ABBA task sequence (p<0.05) and SC was larger in ABBA than ABBBA task sequence (p<0.05). PD patients demonstrated an increased SC compared to controls for alternating switch trials (p<0.01). Alternatively, when required to switch to a task abandoned two or three trials earlier (i.e. ABBA and ABBBA tasks sequences), patients did not demonstrate increased SC compared to controls. DISCUSSION AND CONCLUSION: The fact that SC associated with alternating switch trials was exacerbated in PD patients may reflect difficulties for switching to a recently inhibited task-set. In conclusion, our results indicate that set-shifting deficits in PD patients may depend of the type of task sequence.

Cognition Disorders↗
PubMed2005

Chromosomal stasis versus plasmid plasticity in aphid endosymbiont Buchnera aphidicola.

The study of three genomes of the aphid endosymbiont Buchnera aphidicola has revealed an extraordinary stasis: conservation of gene order and genetic composition of the chromosome, while the chromosome size and number of genes has reduced. The reduction in genome size appears to be ongoing since some lineages we now know to have even smaller chromosomes than the first B. aphidicola analysed. The current sequencing by our group of one of these smaller genomes with an estimated size of 450 kb, and its comparison with the other three available genomes provide insights into the nature of processes involved in shrinkage. We discuss whether B. aphidicola might be driven to extinction and be replaced by secondary aphid endosymbionts. In some lineages, genes encoding key enzymes in the pathways leading to tryptophan and leucine biosynthesis (trpEG and leuABCD, respectively) are located on plasmids, rather than the main chromosome. In contrast to the stasis of the main chromosome, plasmid genes have frequently been transferred to the main chromosome and undergone other gene rearrangements. We propose a two-step scenario to explain these contrasting modes of evolution. Essential genes may have escaped regulation by moving to plasmids in a moving B. aphidicola ancestor. B. aphidicola became polyploidy at a given stage of its evolution and plasmid genes have been transferred to the main chromosome through several independent events.

Animals↗
PubMed2005

Host humoral immune response to Leishmania lipid-binding protein.

SUMMARY We report on the use of Leishmania donovani lipid-binding proteins (LBPs) as antigens capable of being recognized by serum from immunocompetent patients from southern Spain suffering from visceral leishmaniasis and from Peruvian patients with localized cutaneous leishmaniasis caused by Leishmania braziliensis. The absorbance found by immunoenzymatic techniques gave significantly different results for the serum samples from patients with and without leishmaniasis. Specificity by ELISA testing was 93.2% and sensibility 100%. Dot blots from human patient serum samples or naturally infected dogs from Spain gave similarly significant results. All the human serum samples from individuals with visceral leishmaniasis and the Leishmania-positive canine samples recognized two bands, with molecular weights of 8 and 57 kDa. The serum from individuals with cutaneous leishmaniasis caused by L. braziliensis recognized an additional band of 16 kDa. We discuss the role of Leishmania FABP and compare the immunological reactions found with serum samples from other protozoan infections such as toxoplasma and Chagas as well as bacterial infections such as tuberculosis and syphilis.

Adolescent↗
PubMed2004

Occupancy of dopamine D2 receptors by the atypical antipsychotic drugs risperidone and olanzapine: theoretical implications.

RATIONALE: To examine the D2 occupancy of two commonly used antipsychotic medications and relate this to the D2 occupancy by endogenous dopamine in schizophrenia. OBJECTIVES: The aim of this study is to compare the occupancy of striatal D2 receptors by the atypical antipsychotic medications risperidone and olanzapine at fixed dosages and to estimate the effect on D2 occupancy by dopamine as a result of these treatments. METHODS: Seven patients with schizophrenia taking risperidone 6 mg/day and nine patients with schizophrenia taking olanzapine 10 mg/day underwent an [123I]IBZM SPECT scan after 3 weeks of treatment. The specific to non-specific equilibrium partition coefficient (V3") after bolus plus constant infusion of the tracer was calculated as [(striatal activity)/(cerebellar activity)]-1. D2 receptor occupancy was calculated by comparing V3" measured in treated patients to an age-corrected V3" value derived from a group of untreated patients with schizophrenia, previously published, according to the following formula: OCC=1-(V3" treated/V3" drug free). RESULTS: V3" was significantly lower in risperidone treated patients compared with olanzapine treated patients (0.23+/-0.06 versus 0.34+/-0.08, P=-0.01), which translated to a significantly larger occupancy in schizophrenic patients treated with risperidone compared to olanzapine (69+/-8% versus 55 +/-11%, P=0.01). Data from our previous study were used to calculate the occupancy of striatal D2 receptors by antipsychotic medications required to reduce the occupancy of these receptors by endogenous dopamine to control values. In medication-free patients with schizophrenia, the occupancy of striatal D2 receptors by endogenous dopamine is estimated at 15.8%. In healthy controls, the occupancy of striatal D2 receptors by dopamine is estimated at 8.8%. In order to reduce the dopamine occupancy of striatal D2 receptors in patients with schizophrenia to control values, 48% receptor occupancy by antipsychotic medications is required. CONCLUSIONS: These data indicate that the dosage of these medications, found to be effective in the treatment of schizophrenia, reduces DA stimulation of D2 receptors to levels slightly lower than those found in unmedicated healthy subjects.

Adult↗
PubMed2004

Non-linear filtering of ultrasonic signals using neural networks.

Structure noise from inhomogeneous micro-structures makes the detection of flaws present in highly scattering materials difficult. Several techniques have been applied to improve the signal-to-noise ratio (SNR) in order to make flaw detection easier. Linear filtering does not provide good results because both structure noise and flaw signal concentrate energy in the same frequency band. Non-linear filtering can be used to reduce the structure noise of ultrasonic signals. Therefore, neural networks are applied in this work for this purpose. In order to use neural networks for non-linear filtering, dynamic structures must be applied. The easiest way to implement a neural network with the capability of processing temporal patterns is to consider them spatial ones, applying the signal into a tapped delay line of finite extension, that is the input of a static neural network (for example, a multi-layer perceptron). In this work, a dynamic neural network has been built to filter ultrasonic signals with structure noise, and has been trained with the real-time back-propagation algorithm, using as inputs 3000 synthetic ultrasonic signals of 896 samples each. Target signals for training are the same as the ones used as inputs but without noise. The neural network is trained in order to generate as output the target signal when the noisy input one is applied. For testing the performance of the non-linear filter, a new set of 500 noisy signals has been used. The SNR improvement is about 6 dB average. The results show that this non-linear filtering method is quite useful as pre-processing stage in flaw detection systems.

Algorithms↗
PubMed2004

[Communication disorders after decline in sub-cortical aphasia: the role of fronto-sub-cortical disconnection?].

INTRODUCTION: Pragmatic analysis of Language difficulties examines the pertinence and adaptation of the spoken Language which can be disturbed even when phonologic, syntactic and semantic functions, taken separately, appear normal. Disorders of pragmatic Language function remain poorly explored and the few published papers in adult neuropsychology have been devoted to patients with traumatic frontal lesions. METHODS: In the present study we report the case of a patient admitted for right hemiplegia with "dissident" aphasia related to a capsulo-lenticular hematoma. Aphasic disorders progressively improved but with the occurrence of speech disorders which were assessed by pragmatic indices. RESULTS: There was no difference between free and directed interview with the exception for the non-contingencies which were significantly more frequent in the directed interview. As compared with the spoken Language of a normal individual, highly significant differences were noted for incoherent lexical proximities, non-contingencies and markers of difficulty. DISCUSSION: and conclusion. For some Authors, the pragmatic speech disorders observed in this patient during the directed interview are linked to abnormal executive functions, also noted in the patient. The difficulties to adjust to speech constraints of the interview context could be related to a fronto-subcortical disconnection resulting in this patient to the left capsulo-lenticular lesion.

Aphasia, Broca↗
PubMed2003

[Internal carotid artery dissection after Heimlich maneuver].

We report a case of cervical artery dissection following a Heimlich maneuver. Cervical artery dissections are at the present time well known and are sometimes associated with trivial traumas. However, to our knowledge, this complication of such maneuver was never reported in the literature. Pathophysiological mechanisms are discussed.

Airway Obstruction↗
PubMed2003

[Arterial hypertension and intracerebral hemorrhage].

Intracerebral hemorrhage (ICH) is still a devastating stroke, with high mortality. Arterial hypertension (AHT) is the most common cause of primary ICH, causing changes in the wall of small vessels, leading to its rupture. Recent studies have attempted to understand the basic mechanisms of tissue damage around the hematoma. These days there is a debate regarding biochemical changes in this area, usually recognized as edema. Detection with the gradient-echo T2 weighted MRI of old and silent microhemorrhages in a patient with ICH as a radiological expression of a microangiopathy of small vessel poses questions regarding its predictive value of risk of bleeding recurrence. The object of our review is to analyze the present data that explains the interaction between chronic hypertension and primary ICH.

Cerebral Hemorrhage↗
PubMed2002

Relationship between sleep apnoea syndrome, snoring and headaches.

There is still a controversy regarding the relationship between sleep apnoea syndrome and headaches, especially morning headaches. Our objectives were: (i) to compare the prevalence and the clinical data of headaches in sleep apnoea syndrome (SAS) and control (snorers) groups defined by polysomnographic recording; (ii) to analyse the clinical improvement of headaches with appropriate treatment; and (iii) to correlate headaches with mood disorders, and nocturnal respiratory and architectural sleep parameters in order to understand the underlying pathophysiological mechanisms. This is a prospective study of 324 consecutive patients referred to our sleep centre for snoring. Of these, 312 patients who underwent sleep polysomnography were finally included. Patients and controls were interviewed about their medical past, headache history and clinical characteristics, their daytime sleepiness (Epworth's sleepiness scale) and their mood disorders (Zerssen's scale). Follow-up of patients with headaches (SAS and control groups), treated or not, was also assessed. According to our definition of SAS, patients were dissociated in SAS (n=164) and snorers (n=148). Fifty-three SAS patients had headaches, of whom 58.5% (n=30) suffered from morning headaches. However, there was no statistical difference between the two groups concerning the prevalence and the clinical characteristics of headaches. In addition, headaches and morning headaches were not correlated with nocturnal respiratory and architectural sleep parameters, nor with excessive daytime sleepiness, but were strongly correlated with mood disorders. In 36 SAS patients, headaches improved under treatment, but this was not statistically different from what was found among untreated snorers. Headaches and morning headaches are common in patients with SAS but may be considered as a non-specific symptom. The underlying mechanisms are not fully elucidated but depression could play an important role. Despite this absence of specificity, the treatment of SAS, especially nasal continuous positive airway pressure, leads to an improvement in headaches in several cases.

Antidepressive Agents↗