Abstract: INTRODUCTION: Few investigations have focused their attention on the study of neuropsychological deterioration associated to human inmunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection. This study has aimed to evaluate neuropsychological performance and neuropsychological impairment rates in HIV and HCV positive patients (HIV+/HCV+) of Spanish nationality of the region of Galicia. METHOD: Three groups of 122 subjects underwent neuropsychological evaluation: 55 HIV+, 29 HIV/HCV+ and 34 seronegative to both HIV/HCV. All subjects gave their written informed consent and underwent the same evaluation process. RESULTS: HIV+ and HIV/HCV+ patients showed significantly lower levels of neuropsychological performance in all neuropsychological domains evaluated in comparison with the control group. Nevertheless, only visual memory showed significantly differences between both groups. The rate of neuropsychological impairment of HIV+/HCV+ patients (62%) was significantly greater than that of HIV+ (38%). CONCLUSIONS: HIV and HIV/HCV infection are related to low levels of neuropsychological performance, HIV/HCV patients showing lower performance in visual memory tasks. HIV/HCV coinfection represents a neuropsychological impairment risk factor in HIV patients, because it influences the probability of having neuropsychological impairment. However, this may not only be related with HCV, but also with being in methadone-maintenance programs.
Abstract: The aim of this study was to evaluate the temporal stability and the situational specificity of the intra-anal EMG-activity, as well as the individual specificity of this response in dyssynergic defecation patients. With this purpose, 26 individuals (13 with dyssynergic defecation and 13 without anorectal pathology) participated in two sessions of psychophysiological assessment, with an inter-session period of 1 week. At each session, the EMG-activity of external anal sphincter was recorded under four different conditions (baseline, voluntary contraction, reflex contraction and simulated defecation). The findings provide empirical evidence about temporal stability of the intra-anal EMG-activity, situational specificity of this response and the existence of a specific profile of intra-anal EMG-activity characteristic of patients with dyssynergic defecation.
Abstract: A randomized controlled trial was carried out with the purpose to determine the effectiveness of EMG-biofeedback in the treatment of chronically constipated elderly patients with dyssynergic defecation as compared to a control condition characterized by information about the bowel functioning and counseling focused on the behavioural mechanisms involved in the defecation. With this purpose, after an initial assessment period (4 weeks), 30 chronically constipated elderly patients with dyssynergic defecation (11 males, 19 females) were randomly assigned to either EMG-biofeedback group (n = 15) or control group (n = 15). The results shown significant improvements in psychophysiological measures (EMG-activity during straining to defecate and anismus index), as well as in clinical variables (frequency of defecations per week, sensation of incomplete evacuation, difficulty evacuation level and perianal pain at defecation) only in the EMG-biofeedback group. The clinical benefits of this behavioural treatment were maintained at the follow-up period 2 months later.
Abstract: AIMS: Research into neuropsychological consequences of HIV has focused mainly on male subjects, and therefore very little is known about the disease in female subjects and, of course, about gender differences. The aim of the present research was therefore to investigate neuropsychological impairment rates and pattern in HIV male and female patients, with regard to the study of gender differences in tasks assessing attention, memory for texts, digits and words, psychomotor speed, verbal intelligence and abstract reasoning. METHODS: A clinical sample was recruited consisting of 122 subjects, divided into four groups: (i) 57 HIV+ men; (ii) 31 HIV+ women; (iii) 18 HIV- men and (iv) 16 HIV- women. All the subjects had more than 18 years, being the average of age of 34.08 for men and 33.35 for women. The evaluation of each subject consisted of a semistructured interview investigating sociodemographic, clinical and toxicological aspects and a neuropsychological assessment, with a battery of tests specifically selected for this study and chosen for their validity and because they have been shown to be sensitive to neuropsychological impairment in HIV-infected patients in other studies. RESULTS: None of HIV- male and female groups fulfilled impairment criteria. Regarding the HIV+ group, a rate of neuropsychological impairment of 51.9% was obtained for the men and 54.8% for the women, but there were no significant differences between groups. Nevertheless, were detected significant differences in neuropsychological impairment rates between HIV+ and HIV- women, and also between HIV+ and HIV- men. Although HIV+ women presented multiple factors that could increase their neuropsychological vulnerability to the effects of HIV, HIV+ men had the same probability of having neuropsychological impairment as HIV+ women. CONCLUSIONS: A different neuropsychological impairment pattern was detected between genders: while HIV+ men had greater impairment in visual memory, attention, psychomotor speed and abstract reasoning, HIV+ women had greater impairment on attention, psychomotor speed and verbal memory for texts.
Abstract: The authors set out to determine the rates and pattern of neuropsychological impairment shown by seropositive Spanish patients in different stages of HIV infection. A clinical sample was recruited consisting of 115 heterosexual subjects (30 seropositive asymptomatic; 17 seropositive in stage B; 41 seropositive with AIDS, and 27 seronegative). All subjects provided written informed consent and were submitted to the same process of evaluation. A rate of neuropsychological impairment of 33.3% was found in stage A (asymptomatic patients); of 41.2% in stage B (low symptomatology patients); and of 70.7% in stage C (AIDS patients). The pattern of neuropsychological impairment shown by the AIDS patients was qualitatively similar to that observed in the asymptomatic subjects, and consistent with fronto-subcortical-type alterations. Clinically asymptomatic HIV infection represents a risk factor for neuropsychological impairment, even though our results reinforce the idea that the impairment seen in the asymptomatic stages cannot be interpreted as a predictor of more severe cognitive deficits as the disease progresses.
Abstract: Given that studies about the differential efficacy of existing treatments in fibromyalgia syndrome are scarce, the aim of this study was to compare the differential efficacy of a cognitive-behavioral and a pharmacological therapy on fibromyalgia. Using a randomized controlled clinical trial, 28 fibromyalgic patients were assigned to one of following experimental conditions: (a) pharmacological treatment (i.e., cyclobenzaprine), (b) cognitive-behavioral intervention (i.e., stress inoculation training), (c) combined pharmacological and cognitive-behavioral treatment and (d) no treatment. The results show the superiority of cognitive-behavioral intervention to reduce the severity of fibromyalgia both at the end of the treatment and at follow-up. We conclude that cognitive-behavioral interventions must be considered a primary treatment of fibromyalgia syndrome.
