0000000000242049

AUTHOR

Carla Giménez-garzó

showing 9 related works from this author

A New Score Unveils a High Prevalence of Mild Cognitive Impairment in Patients with Nonalcoholic Fatty Liver Disease

2021

Patients with nonalcoholic fatty liver disease (NAFLD) may show mild cognitive impairment (MCI). The neurological functions affected remain unclear. The aims were to: (1) Characterize the neuropsychological alterations in NAFLD patients; (2) assess the prevalence of impairment of neurological functions evaluated; (3) develop a new score for sensitive and rapid MCI detection in NAFLD; (4) assess differences in MCI features between patients with nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH); and (5) compare neuropsychological alterations in NAFLD patients with cirrhotic patients with MCI. Fifty-nine NAFLD patients and 53 controls performed psychometric tests assessin…

medicine.medical_specialtyCirrhosisneurological impairmentpsychometric scoreGastroenterologybehavioral disciplines and activitiesdigestive systemArticle03 medical and health sciences0302 clinical medicineInternal medicineNAFLDNonalcoholic fatty liver diseasemedicineMemory spanHepatic encephalopathyPsychomotor learningbusiness.industryFatty liverRNeuropsychologyNASHnutritional and metabolic diseasesGeneral Medicinemedicine.diseasepsychometric score; NAFLD; NAFL; NASH; neurological impairmentdigestive system diseasesNAFLMedicine030211 gastroenterology & hepatologybusiness030217 neurology & neurosurgeryStroop effectJournal of Clinical Medicine
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The PHES battery does not detect all cirrhotic patients with early neurological deficits, which are different in different patients.

2017

Background and aims The psychometric hepatic encephalopathy score (PHES) is the “gold standard” for minimal hepatic encephalopathy (MHE) diagnosis. Some reports suggest that some cirrhotic patients “without” MHE according to PHES show neurological deficits and other reports that neurological alterations are not homogeneous in all cirrhotic patients. This work aimed to assess whether: 1) a relevant proportion of cirrhotic patients show neurological deficits not detected by PHES; 2) cirrhotic patients with mild neurological deficits are a homogeneous population or may be classified in sub-groups according to specific deficits. Methods Cirrhotic patients “without” (n = 56) or “with” MHE (n = 4…

Liver CirrhosisMalePathologyPediatricsCirrhosisPsychometricsSocial Scienceslcsh:MedicineNeuropsychological Tests0302 clinical medicineMedicine and Health SciencesPsychologyCluster AnalysisAttentionlcsh:ScienceHepatic encephalopathyCognitive Impairmenteducation.field_of_studyMultidisciplinaryCognitive NeurologyLiver DiseasesMiddle AgedNeurologyCirrhosisOncologyFemale030211 gastroenterology & hepatologyResearch Articlemedicine.medical_specialtyPsychometricsCognitive NeurosciencePopulationGastroenterology and HepatologyCarcinomas03 medical and health sciencesNeuropsychologyGastrointestinal TumorsmedicineHumanseducationNeuropsychological TestingAgedWorking memorybusiness.industryGold standardlcsh:RCognitive PsychologyCase-control studyBiology and Life SciencesCancers and NeoplasmsReproducibility of ResultsHepatocellular Carcinomamedicine.diseasePatient Outcome AssessmentCase-Control StudiesHepatic EncephalopathyStroop TestCognitive Sciencelcsh:QbusinessPsychomotor Performance030217 neurology & neurosurgeryNeuroscienceFollow-Up StudiesStroop effectPLoS ONE
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Klotho urinario determinado por ELISA como biomarcador precoz de fracaso renal agudo en pacientes sometidos a cirugía cardiaca o angiografía coronaria

2015

ResumenIntroducción y objetivos: El fracaso renal agudo (FRA) es una complicación frecuente tras la cirugía cardiaca y las intervenciones percutáneas coronarias cuya aparición empeora el pronóstico de manera marcada. En los últimos años se han identificado nuevos biomarcadores precoces de FRA, pero aún quedan muchos aspectos importantes por resolver. Klotho es una proteína pleiotrópica que actúa como un factor paracrino y endocrino en múltiples órganos. En diversos modelos animales de FRA se ha demostrado niveles disminuidos de Klotho renal. No se ha publicado ningún estudio en el que se haya probado Klotho como marcador precoz de FRA en humanos. El objetivo de este trabajo es investigar la…

Coronary angiographyGynecologymedicine.medical_specialtybusiness.industryCoronary angiographyCardiac surgerylcsh:Diseases of the genitourinary system. Urologylcsh:RC870-923urologic and male genital diseasesAngiografía coronariaAngiografia coronariafemale genital diseases and pregnancy complicationsKlothoAcute kidney injuryBiomarcadoresNephrologyFracaso Renal AgudoMedicineELISACirugía cardiacabusinessKlothoBiomarkersNefrología
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Cirrhotic patients with minimal hepatic encephalopathy have increased capacity to eliminate superoxide and peroxynitrite in lymphocytes, associated w…

2018

Patients with minimal hepatic encephalopathy (MHE) show increased oxidative stress in blood. We aimed to assess whether MHE patients show alterations in different types of blood cells in (a) basal reactive oxygen and nitrogen species levels; (b) capacity to metabolise these species. To assess the mechanisms involved in the altered capacity to metabolise these species we also analysed: (c) peroxynitrite formation and d) peroxynitrite reaction with biological molecules. Levels of reactive oxygen and nitrogen species were measured by flow cytometry in blood cell populations from cirrhotic patients with and without MHE and controls, under basal conditions and after adding generators of superoxi…

Liver CirrhosisMale0301 basic medicinemedicine.medical_specialtyFree radicalsmedicine.disease_causeBiochemistryNitric oxideBlood cell03 medical and health scienceschemistry.chemical_compound0302 clinical medicineSuperoxidesnitric oxidePeroxynitrous AcidInternal medicinemedicineHumansCognitive DysfunctionLymphocytesHepatic encephalopathycognitive impairmentnitrotyrosineSuperoxideNitrotyrosinePsychometric Hepatic Encephalopathy ScoreGeneral MedicinePlumbaginmedicine.disease030104 developmental biologymedicine.anatomical_structureEndocrinologychemistryHepatic EncephalopathyFemalehuman activities030217 neurology & neurosurgeryOxidative stressPeroxynitrite
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Serum nitrotyrosine and psychometric tests as indicators of impaired fitness to drive in cirrhotic patients with minimal hepatic encephalopathy

2013

BACKGROUND & AIMS: Cirrhotic patients with minimal hepatic encephalopathy (MHE) show impaired driving ability and increased vehicle accidents. The neurological deficits contributing to impair driving and the underlying mechanisms are poorly understood. Early detection of driving impairment would help to reduce traffic accidents in MHE patients. It would be therefore useful to have psychometric or biochemical parameters reflecting driving impairment. The aims of this work were as follows: (i) to shed light on the neurological deficits contributing to impair driving; (ii) to assess whether some psychometric test or biochemical parameter is a good indicator of driving impairment. METHODS: We a…

AdultLiver Cirrhosismedicine.medical_specialtyAutomobile DrivingCirrhosisPsychometricsEncephalopathyPoison controlminimal hepatic encephalopathyAudiologyNitric Oxidepsychometric testsFlicker FusionmedicineHumansHepatic encephalopathyCyclic GMPAgedPsychomotor learning3-nitrotyrosineAnalysis of VarianceHepatologybusiness.industryDriving simulatorMiddle Agedmedicine.diseaseAnticipationfitness to driveMotor coordinationHepatic EncephalopathyPhysical therapyTyrosineChemokinesbusinesshuman activitiesBiomarkers
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Non invasive blood flow measurement in cerebellum detects minimal hepatic encephalopathy earlier than psychometric tests

2013

AIM: To assess whether non invasive blood flow measurement by arterial spin labeling in several brain regions detects minimal hepatic encephalopathy. METHODS: Blood flow (BF) was analyzed by arterial spin labeling (ASL) in different brain areas of 14 controls, 24 cirrhotic patients without and 16 cirrhotic patients with minimal hepatic encephalopathy (MHE). Images were collected using a 3 Tesla MR scanner (Achieva 3T-TX, Philips, Netherlands). Pulsed ASL was performed. Patients showing MHE were detected using the battery Psychometric Hepatic Encephalopathy Score (PHES) consisting of five tests. Different cognitive and motor functions were also assessed: alterations in selective attention we…

Liver CirrhosisMaleCerebellumPathologyPerfusion scanningArterial spin labellingCognitionCerebellumAttentionHepatic encephalopathyCyclic GMPmedicine.diagnostic_testGastroenterologyGeneral MedicineBlood flowMiddle AgedMagnetic Resonance Imagingmedicine.anatomical_structurePredictive value of testsCerebrovascular CirculationFemaleInflammation MediatorsBlood Flow Velocitymedicine.medical_specialtyPsychometricsPerfusion ImagingMinimal hepatic encephalopathymacromolecular substancesMotor ActivityNitric OxideAmmoniaPredictive Value of TestsRetrospective StudymedicineHumansAgedRetrospective Studiesbusiness.industryNon invasiveMagnetic resonance imagingBlood flowmedicine.diseaseEarly DiagnosisRegional Blood FlowHepatic EncephalopathyStroop TestbusinessPsychometric testsBiomarkersNeurological impairment
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Patients with minimal hepatic encephalopathy show impaired mismatch negativity correlating with reduced performance in attention tests

2012

Attention deficit is an early event in the cognitive impairment of patients with minimal hepatic encephalopathy (MHE). The underlying mechanisms remain unclear. Mismatch negativity (MMN) is an auditory event-related potential that reflects an attentional trigger. Patients with schizophrenia show impaired attention and cognitive function, which are reflected in altered MMN. We hypothesized that patients with MHE, similarly to those with schizophrenia, should show MMN alterations related with attention deficits. The aims of this work were to assess whether (1) MMN is altered in cirrhotic patients with MHE, compared to those without MHE, (2) MMN changes in parallel with performance in attentio…

AdultMalemedicine.medical_specialtyPsychometricsPsychometricsMismatch negativityFlicker fusion thresholdAudiologybehavioral disciplines and activitiesmedicineHumansAttentionLongitudinal StudiesHepatic encephalopathyHepatologyReceiver operating characteristicbusiness.industryCognitionMiddle Agedmedicine.diseaseSchizophreniaCase-Control StudiesHepatic EncephalopathyStroop TestEvoked Potentials AuditoryFemalebusinesshuman activitiespsychological phenomena and processesStroop effect
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Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function

2021

Cirrhotic patients may experience alterations in the peripheral nervous system and in somatosensory perception. Impairment of the somatosensory system could contribute to cognitive and motor alterations characteristic of minimal hepatic encephalopathy (MHE), which affects up to 40% of cirrhotic patients. We assessed the relationship between MHE and alterations in thermal, vibration, and/or heat pain sensitivity in 58 cirrhotic patients (38 without and 20 with MHE according to Psychometric Hepatic Encephalopathy Score) and 39 controls. All participants underwent attention and coordination tests, a nerve conduction study, autonomic function testing, and evaluation of sensory thresholds (vibra…

medicine.medical_specialtylcsh:Medicineminimal hepatic encephalopathySural nerveSensory systemElectromyographythermal sensitivitySomatosensory systemArticle03 medical and health sciences0302 clinical medicineInternal medicineSensory thresholdmedicineHepatic encephalopathynerve conductionmedicine.diagnostic_testbusiness.industrylcsh:Rautonomic testingGeneral Medicinemedicine.diseaseAutonomic nervous systemNerve conduction studyCardiology030211 gastroenterology & hepatologybusinesshuman activities030217 neurology & neurosurgeryJournal of Clinical Medicine
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Altered postural control and stability in cirrhotic patients with minimal hepatic encephalopathy correlate with cognitive deficits

2017

Background & Aims: Cognitive dysfunction in cirrhotic patients with minimal hepatic encephalopathy (MHE) is associated with falls. Alterations in postural control and stability could contribute to increase falls risk in these patients. We aimed to assess whether postural control and direction-specific limits of stability are altered in cirrhotic patients with MHE compared to patients without MHE and controls. We also assessed if alterations in postural control correlate with neurological impairment and/or blood biomarkers. Methods: Posturography analysis, attention Stroop test and bimanual and visuo-motor coordination tests were performed in 18 controls, 19 patients with cirrhosis without M…

Liver CirrhosisMaleCirrhosisPsychometricslimits of stabilityminimal hepatic encephalopathypostural control03 medical and health sciencesCognition0302 clinical medicineAmmoniaPredictive Value of TestsRisk FactorsfallsOdds RatiomedicineHumansAttentionPhysical ExaminationPostural BalanceHepatic encephalopathyBalance (ability)Chi-Square DistributionHepatologyImpaired Balancebusiness.industryInterleukinsPosturographyCognitionMiddle Agedmedicine.diseaseMotor coordinationLogistic ModelsCase-Control StudiesHepatic EncephalopathyAnesthesiaMultivariate AnalysisSensation DisordersStroop TestAccidental FallsFemale030211 gastroenterology & hepatologyCognition Disordersbusinesshuman activitiesPsychomotor Performance030217 neurology & neurosurgeryStroop effect
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