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Chronic Kidney Disease II: Clinical Manifestations01:24

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Coronary Artery Disease III: Clinical Manifestations01:30

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

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Heart Failure III: Clinical Manifestations01:26

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Video Experimental Relacionado

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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Manifestaciones Clínicas

Michael J Kleiman1, Mirza Mohmmed Baig1, James E Galvin1

  • 1University of Miami Miller School of Medicine, Boca Raton, FL, USA.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 26, 2025
PubMed
Resumen
Este resumen es generado por máquina.

La narrativa "Puppy Escape" identifica eficazmente el deterioro cognitivo utilizando un retraso de 15 minutos, superando a los métodos tradicionales. Esta novedosa historia ayuda en la detección temprana del deterioro cognitivo leve (MCI) y la enfermedad de Alzheimer preclínica (pAD).

Palabras clave:
deterioro cognitivoenfermedad de Alzheimerpruebas neuropsicológicasnarrativaaprendizaje automáticoretraso cognitivo

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Área de la Ciencia:

  • Neurociencia; Psicología Cognitiva; Diagnóstico Clínico

Sus antecedentes:

  • Las pruebas de recuerdo narrativo son valiosas para diferenciar el deterioro cognitivo, pero a menudo requieren retrasos prolongados (30 minutos), lo que limita la utilidad clínica.
  • Las narrativas existentes pueden no ser lo suficientemente sensibles para detectar la declinación cognitiva en etapas muy tempranas.
  • La narrativa "Puppy Escape" se desarrolló para abordar la necesidad de medidas de recuerdo con retrasos más cortos.

Objetivo del estudio:

  • Desarrollar y validar una nueva tarea de recuerdo narrativo, "Puppy Escape", para evaluar el deterioro cognitivo con un retraso de 15 minutos.
  • Incorporar un sistema de puntuación ponderado que tenga en cuenta el recuerdo literal y parafraseado.
  • Evaluar la eficacia de la narrativa en la diferenciación de individuos cognitivamente normales de aquellos con enfermedad de Alzheimer preclínica (pAD) y deterioro cognitivo leve (MCI).

Principales métodos:

  • Se reclutaron 93 participantes (60 cognitivamente normales, 8 con AD preclínica, 25 con MCI).
  • La narrativa "Puppy Escape" se presentó a través de codificación multimodal (narración de audio con texto visual).
  • Los análisis incluyeron ANOVAs, regresiones logísticas y modelos de aprendizaje automático que utilizan datos léxicos y audiométricos con puntuación ponderada.

Principales resultados:

  • Se encontraron diferencias significativas en el recuerdo inmediato entre los grupos cognitivamente normales (CN) y MCI/pAD (p < .001).
  • El recuerdo diferido (15 minutos) también mostró diferencias significativas entre los grupos CN y MCI (p < .001).
  • Los modelos de aprendizaje automático lograron una alta precisión (72,7 % de sensibilidad, 94,0 % de especificidad, AUC 0,870) en la diferenciación de los grupos de diagnóstico.

Conclusiones:

  • La narrativa "Puppy Escape" es eficaz para la evaluación cognitiva con un breve retraso de 15 minutos.
  • Su longitud y presentación multimodal mejoran la detección de declinaciones cognitivas sutiles, particularmente en el deterioro cognitivo leve.
  • La narrativa de libre acceso muestra una promesa para la detección temprana del deterioro cognitivo en entornos clínicos.