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Estudio de clínica sensitiva leve durante la infección por SARS-CoV-2 en población sanitaria [医护人员在SARS-CoV-2感染期间的轻度感觉症状]。
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.06.008
D. Gayoso Cantero , E. Cantador Pavón , E. Pérez Fernández , M.E. Novillo López
{"title":"Estudio de clínica sensitiva leve durante la infección por SARS-CoV-2 en población sanitaria","authors":"D. Gayoso Cantero ,&nbsp;E. Cantador Pavón ,&nbsp;E. Pérez Fernández ,&nbsp;M.E. Novillo López","doi":"10.1016/j.nrl.2021.06.008","DOIUrl":"10.1016/j.nrl.2021.06.008","url":null,"abstract":"<div><h3>Introduction</h3><p>It is not yet possible to estimate the proportion of patients with COVID-19 who present distinguishable classical neurological symptoms and syndromes.</p><p>The objective of this study is to estimate the incidence of sensory symptoms (hypoaesthesia, paraesthesia, and hyperalgesia) in physicians who have presented the disease at Hospital Universitario Fundación Alcorcón (HUFA) in Madrid; to establish the relationship between sensory symptoms and the presence of other signs of infection; and to study their association with the severity of COVID-19.</p></div><div><h3>Methods</h3><p>We conducted a descriptive, cross-sectional, retrospective, observational study. HUFA physicians who presented SARS-CoV-2 infection between 1 March and 25 July 2020 were included in the study. A voluntary, anonymous survey was distributed via corporate email. Sociodemographic and clinical characteristics were collected from professionals with PCR- or serology-confirmed COVID-19.</p></div><div><h3>Results</h3><p>The survey was sent to 801 physicians and we received 89 responses. The mean age of respondents was 38.28 years. A total of 17.98% presented sensory symptoms. A significant relationship was found between the presence of paraesthesia and cough, fever, myalgia, asthaenia, and dyspnoea. A significant relationship was also found between paraesthesia and the need for treatment and admission due to COVID-19. Sensory symptoms were present from the fifth day of illness in 87.4% of cases.</p></div><div><h3>Conclusions</h3><p>SARS-CoV-2 infection can be associated with sensory symptoms, mostly in severe cases. Sensory symptoms often appear after a time interval, and may be caused by a parainfectious syndrome with an autoimmunity background.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 392-398"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39408923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Memory changes in patients with hippocampal sclerosis submitted to surgery to treat mesial temporal lobe epilepsy 海马硬化症患者接受手术治疗内侧颞叶癫痫的记忆改变
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.07.005
E. Leal-Conceição , M. Muxfeldt Bianchin , W. Vendramini Borelli , V. Spencer Escobar , L. Januário de Oliveira , M. Bernardes Wagner , A. Palmini , E. Paglioli , G. Radaelli , J. Costa da Costa , M. Wetters Portuguez
{"title":"Memory changes in patients with hippocampal sclerosis submitted to surgery to treat mesial temporal lobe epilepsy","authors":"E. Leal-Conceição ,&nbsp;M. Muxfeldt Bianchin ,&nbsp;W. Vendramini Borelli ,&nbsp;V. Spencer Escobar ,&nbsp;L. Januário de Oliveira ,&nbsp;M. Bernardes Wagner ,&nbsp;A. Palmini ,&nbsp;E. Paglioli ,&nbsp;G. Radaelli ,&nbsp;J. Costa da Costa ,&nbsp;M. Wetters Portuguez","doi":"10.1016/j.nrl.2021.07.005","DOIUrl":"10.1016/j.nrl.2021.07.005","url":null,"abstract":"<div><h3>Purpose</h3><p>This study was performed with the purpose of analysing the relationship between epileptological and surgical variables and post-operative memory performance, following surgery for refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS).</p></div><div><h3>Methods</h3><p>Logical memory (LM) and visual memory (VM) scores for immediate and late follow-up of 201 patients operated for MTLE/HS were reviewed. Scores were standardized with a control group of 54 healthy individuals matched for age and education. The Reliable Change Index (RCI) was calculated to verify individual memory changes for late LM and VM scores. A multiple linear regression analysis was carried out with the RCI, using LM and VM scores as well as the clinical variables.</p></div><div><h3>Results</h3><p>A total of 112 (56%) patients had right HS. The RCI of the right HS group demonstrated that 6 (7%) patients showed improvement while 5 (6%) patients showed decreased scores in late LM; for late VM, 7 (8%) patients presented improvement, and 2 (3%) patients showed poorer scores. RCI of the left HS group showed that 3 (3%) individuals showed improved scores, while scores of 5 (4%) patients worsened for late LM; for late VM, 3 (3%) patients presented higher scores and 6 (5%) showed lower scores. Left HS and advanced age at onset of the first epileptic seizure were predictors of late LM loss (<em>p</em> <!-->&lt;<!--> <!-->.05).</p></div><div><h3>Conclusion</h3><p>Left MTLE/HS and seizure onset at advanced ages were predictive factors for the worsening of late LM. We observed poorer baseline LM function in the left HS group and improvement of LM in some patients who had resection of the right MTL. Patients in the right HS group showed a higher percentage of reliable post-operative improvement for both VM and LM scores.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 399-407"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321001389/pdfft?md5=b06e6e13ab74507e67efcdbf341cc07d&pid=1-s2.0-S0213485321001389-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41931722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inicio temprano de alemtuzumab: cambio en el paradigma de tratamiento en esclerosis múltiple. Análisis intermedio del estudio LEMVIDA 阿莱姆图祖单抗的早期开始:多发性硬化症治疗范式的变化。莱姆维达研究的中期分析
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.06.007
J.E. Meca-Lallana , J.C. Álvarez-Cermeño , B. Casanova Estruch , G. Izquierdo Ayuso , R. Ortiz Castillo , A. Rodríguez-Antigüedad , C. Calles Hernández , en nombre del Grupo de Estudio LEMVIDA
{"title":"Inicio temprano de alemtuzumab: cambio en el paradigma de tratamiento en esclerosis múltiple. Análisis intermedio del estudio LEMVIDA","authors":"J.E. Meca-Lallana ,&nbsp;J.C. Álvarez-Cermeño ,&nbsp;B. Casanova Estruch ,&nbsp;G. Izquierdo Ayuso ,&nbsp;R. Ortiz Castillo ,&nbsp;A. Rodríguez-Antigüedad ,&nbsp;C. Calles Hernández ,&nbsp;en nombre del Grupo de Estudio LEMVIDA","doi":"10.1016/j.nrl.2021.06.007","DOIUrl":"10.1016/j.nrl.2021.06.007","url":null,"abstract":"<div><h3>Introduction</h3><p>LEMVIDA is a real-world prospective study of 3-year follow-up on quality of life of patients with multiple sclerosis (MS) receiving alemtuzumab in Spain.</p></div><div><h3>Methods</h3><p>This is an interim analysis evaluating the baseline characteristics of patients who started alemtuzumab between October 2016-September 2018. For 3 additional subanalysis patients were categorized by baseline EDSS score; time of alemtuzumab initiation during the recruitment period (cohort 1: October 2016-March 2017, cohort 2: April-September 2017, cohort 3: October 2017-March 2018 and cohort 4: April-September 2018); and the presence of highly active MS criteria.</p></div><div><h3>Results</h3><p>161 patients were analyzed: 67.1% female, age 38.7<!--> <!-->±<!--> <!-->9.4 years, MS duration 8.5<!--> <!-->±<!--> <!-->6.0 years, EDSS 3.3<!--> <!-->±<!--> <!-->1.7 and number of relapses in the previous 2 years 1.8<!--> <!-->±<!--> <!-->1.3. 48.3% of patients presented gadolinium-enhanced (Gd<!--> <!-->+) lesions (mean: 5.2<!--> <!-->±<!--> <!-->6.9) and 63.1% had received prior treatment with fingolimod or natalizumab. Baseline EDSS scores and number of Gd<!--> <!-->+<!--> <!-->lesions were higher in cohort 1 than in cohort 4 (4.1<!--> <!-->±<!--> <!-->1.8 <em>vs</em>. 3.2<!--> <!-->±<!--> <!-->1.7; p<!--> <!-->=<!--> <!-->0.040 and 10.9<!--> <!-->±<!--> <!-->11.9 <em>vs</em> 4.5<!--> <!-->±<!--> <!-->5.7; p<!--> <!-->=<!--> <!-->0.020). The frequency of prior treatment with fingolimod and natalizumab was lower in cohort 4 (60.6%) than in cohort 1 (70.6%) (comparison between groups not analyzed).</p></div><div><h3>Conclusions</h3><p>Unlike phase 3 studies of alemtuzumab, the patients included in LEMVIDA are older, have a longer duration of MS, higher disability and have received previous immunosuppressants. However, throughout the recruitment period, there is a tendency towards an early beginning of treatment with alemtuzumab, probably due to the evidence of higher effectiveness in the early stages of MS.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 383-391"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321001353/pdfft?md5=6345bf67a107486085b326baddcb0744&pid=1-s2.0-S0213485321001353-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48946971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factores predictivos de destino al alta tras una lesión medular 脊髓损伤后出院去向的预测因素
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.09.012
E. Bárbara-Bataller , J.L. Méndez-Suárez , C. Alemán-Sánchez , P. Peñaloza-Polo , J. Sánchez-Enríquez , P. Saavedra-Santana
{"title":"Factores predictivos de destino al alta tras una lesión medular","authors":"E. Bárbara-Bataller ,&nbsp;J.L. Méndez-Suárez ,&nbsp;C. Alemán-Sánchez ,&nbsp;P. Peñaloza-Polo ,&nbsp;J. Sánchez-Enríquez ,&nbsp;P. Saavedra-Santana","doi":"10.1016/j.nrl.2021.09.012","DOIUrl":"https://doi.org/10.1016/j.nrl.2021.09.012","url":null,"abstract":"<div><h3>Introduction</h3><p>One of the main goals of the rehabilitation of patients with spinal cord injury (SCI) is the reintegration of the individual to their family, social, and work setting. The objective of this study was to identify the factors that determine the discharge destination after a traumatic spinal cord injury.</p></div><div><h3>Material and methods</h3><p>We conducted a retrospective descriptive study of 305 patients with SCI who completed the rehabilitation treatment at the spinal injury unit of Hospital Insular de Gran Canaria between 2001 and 2018.</p></div><div><h3>Results</h3><p>During the study period, we observed an increase in the number of patients referred to long-term care centres, from 9.14% between 2001 and 2010 to 18.4% between 2011 and 2018 (p &lt; .01). Of 20 variables that presented a significant association with destination at discharge in the univariate study, 7 presented a significant association in the multivariate study: age (OR: 1.05; 95% CI, 1.02-1.08), living with a partner (OR: 0.26; 95% CI, 0.09-0.76), residing on another island (OR: 3.57; 95% CI, 1.32-9.63), smoking (OR: 3.44; 95% CI, 1.26-9.44), diabetes (OR: 6.51; 95% CI, 1.46-29.02), history of psychiatric disorders (OR: 3.79; 95% CI, 1.31-10.93), and scores on the Spinal Cord Independence Measure-III (SCIM-III) (OR: 0.48; 95% CI, 0.33-0.69).</p></div><div><h3>Conclusions</h3><p>Our findings identified advanced age, living on the island of Tenerife, not being married, smoking, type 2 diabetes mellitus, history of psychiatric disorders, and low SCIM-III scores as predictive factors of referral to a long-term care centre in patients with traumatic SCI in the Canary Islands.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 432-441"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002735/pdfft?md5=cf46e2bc6cb59f83b5e4c3781bb56d05&pid=1-s2.0-S0213485321002735-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141240440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3-Acetylpyridine-induced ataxic-like motor impairments are associated with plastic changes in the Purkinje cells of the rat cerebellum 3-乙酰吡啶诱导的共济失调样运动损伤与大鼠小脑浦肯野细胞的可塑性变化有关
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.09.005
D. González-Tapia , N. Vázquez-Hernández , F. Urmeneta-Ortiz , N. Navidad-Hernandez , M. Lazo-Yepez , A. Tejeda-Martínez , M. Flores-Soto , I. González-Burgos
{"title":"3-Acetylpyridine-induced ataxic-like motor impairments are associated with plastic changes in the Purkinje cells of the rat cerebellum","authors":"D. González-Tapia ,&nbsp;N. Vázquez-Hernández ,&nbsp;F. Urmeneta-Ortiz ,&nbsp;N. Navidad-Hernandez ,&nbsp;M. Lazo-Yepez ,&nbsp;A. Tejeda-Martínez ,&nbsp;M. Flores-Soto ,&nbsp;I. González-Burgos","doi":"10.1016/j.nrl.2021.09.005","DOIUrl":"10.1016/j.nrl.2021.09.005","url":null,"abstract":"<div><p>Ataxias are characterized by aberrant movement patterns closely related to cerebellar dysfunction. Purkinje cell axons are the sole outputs from the cerebellar cortex, and dysfunctional activity of Purkinje cells has been associated with ataxic movements. However, the synaptic characteristics of Purkinje cells in cases of ataxia are not yet well understood. The nicotinamide antagonist 3-acethylpyridine (3-AP) selectively destroys inferior olivary nucleus neurons so it is widely used to induce cerebellar ataxia. Five days after 3-AP treatment (65<!--> <!-->mg/kg) in adult male Sprague-Dawley rats, motor incoordination was revealed through BBB and Rotarod testing. In addition, in Purkinje cells from lobules V–VII of the cerebellar vermis studied by the Golgi method, the density of dendritic spines decreased, especially the thin and mushroom types. Western blot analysis showed a decrease in AMPA and PSD-95 content with an increase of the α-catenin protein, while GAD-67 and synaptophysin were unchanged. Findings suggest a limited capacity of Purkinje cells to acquire and consolidate afferent excitatory inputs and an aberrant, rigid profile in the movement-related output patterns of Purkinje neurons that likely contributes to the motor-related impairments characteristic of cerebellar ataxias.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 408-416"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002541/pdfft?md5=8a546b4cf34512dfbae2bfc8059aae75&pid=1-s2.0-S0213485321002541-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49577789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Status epilepticus—Therapeutic management at the pediatric emergency department 癫痫持续状态——儿科急诊科的治疗管理
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.09.009
I. Pais-Cunha , D. Valente , D.B. Abreu , J. Fonseca , C. Melo , M. Sampaio , L.A. Santos , R. Sousa
{"title":"Status epilepticus—Therapeutic management at the pediatric emergency department","authors":"I. Pais-Cunha ,&nbsp;D. Valente ,&nbsp;D.B. Abreu ,&nbsp;J. Fonseca ,&nbsp;C. Melo ,&nbsp;M. Sampaio ,&nbsp;L.A. Santos ,&nbsp;R. Sousa","doi":"10.1016/j.nrl.2021.09.009","DOIUrl":"10.1016/j.nrl.2021.09.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Status epilepticus is an important cause of pediatric neurological emergency. Immediate treatment is essential to prevent definitive neurological damage. Several antiepileptic drugs are available for the management of status epilepticus.</p></div><div><h3>Methods</h3><p>Retrospective study of patients admitted at the emergency department of a tertiary hospital for 5 years (2014–2019). We analyzed the compliance to the treatment guidelines for pediatric status epilepticus.</p></div><div><h3>Results</h3><p>One hundred and seventeen admissions were identified, 23.9% of these were febrile status epilepticus. Among the other cases, the most frequent cause was genetic (22.2%). The majority were convulsive status epilepticus (93.1%), 58.7% of which were generalized tonic–clonic seizures. Benzodiazepines were the most used first and second line drug (98.2% and 94.8%). The most frequent third drug used was diazepam (56.4%) followed by phenytoin (18.2%). An infra-therapeutic antiepileptic drug dose was given in 48.7% of cases. 49.6% presented with a prolonged status epilepticus and 6.8% needed intensive care. Incorrect sequence of drugs and infra-therapeutic doses were associated with prolonged status (<em>p</em> <!-->&lt;<!--> <!-->0.001 and <em>p</em> <!-->&lt;<!--> <!-->0.05) and an increased number of antiepileptic drugs used (<em>p</em> <!-->&lt;<!--> <!-->0.001 and <em>p</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>Benzodiazepines were the most frequently first and second line drugs used for status epilepticus management. Surprisingly, the most frequently third line drugs used were also benzodiazepines. These findings were partially explained by the misuse of infra-therapeutic doses of these drugs. Noncompliance with the implemented guidelines was associated with unfavorable outcomes.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 426-431"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002619/pdfft?md5=7dac88fa5c8cded46215a359e5ce7896&pid=1-s2.0-S0213485321002619-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47311927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Manejo de la atención paliativa de los pacientes con enfermedad de Parkinson y otros trastornos del movimiento en España. Encuesta Nacional a neurólogos 西班牙帕金森氏症和其他运动障碍患者的姑息治疗管理。全国神经学家调查
IF 3.9 4区 医学
Neurologia Pub Date : 2024-06-01 DOI: 10.1016/j.nrl.2021.09.008
M. Álvarez Saúco , R. García- Ramos , I. Legarda Ramírez , F. Carrillo García , J. Fernández Bueno , S. Martí Martínez , B. González García , A. Moya-Martínez , D. Santos-García
{"title":"Manejo de la atención paliativa de los pacientes con enfermedad de Parkinson y otros trastornos del movimiento en España. Encuesta Nacional a neurólogos","authors":"M. Álvarez Saúco ,&nbsp;R. García- Ramos ,&nbsp;I. Legarda Ramírez ,&nbsp;F. Carrillo García ,&nbsp;J. Fernández Bueno ,&nbsp;S. Martí Martínez ,&nbsp;B. González García ,&nbsp;A. Moya-Martínez ,&nbsp;D. Santos-García","doi":"10.1016/j.nrl.2021.09.008","DOIUrl":"10.1016/j.nrl.2021.09.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introducción&lt;/h3&gt;&lt;p&gt;La atención paliativa en enfermedades neurodegenerativas es útil pero infrautilizada. El objetivo de este estudio es conocer cómo se aplican en nuestro país los cuidados paliativos (CP) en los pacientes con trastornos del movimiento (TM) de cara a identificar posibles limitaciones y necesidades no cubiertas.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material y métodos&lt;/h3&gt;&lt;p&gt;Se trata de un estudio descriptivo, observacional, transversal, tipo encuesta anónima de 20 preguntas, dirigida y contestada por neurólogos dedicados a los TM en España.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Resultados&lt;/h3&gt;&lt;p&gt;Se obtuvieron 58 respuestas de neurólogos de 15 comunidades autónomas. El 69% contestó no disponer de enfermería especializada en TM pero sí de equipo de CP en su centro (81%). No se identificó ningún protocolo específico para CP en TM. Todos salvo un neurólogo afirmaron carecer de formación suficiente en CP, siendo la principal necesidad formativa la «explicación de voluntades anticipadas». Solo uno de cada 4 neurólogos contestó explicar rutinariamente la planificación anticipada de la asistencia sanitaria a sus pacientes, reconociendo hasta el 84,5% de los neurólogos desconocer cómo evaluar la competencia del paciente. El 60,3% de los encuestados respondió que entre el 10 y 30% de sus pacientes serían candidatos a CP, aunque 1 de cada 3 afirmó no tener claro en qué momento derivar al paciente a CP. El 100% de los neurólogos afirmó la necesidad prioritaria de implementar protocolos de CP en TM.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusiones&lt;/h3&gt;&lt;p&gt;Nuestro estudio evidencia un déficit formativo en CP en TM y en la asistencia al paciente con TM y su entorno, debiéndonos servir como punto de partida para elaborar protocolos de atención consensuados.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;p&gt;Palliative care in neurodegenerative diseases is useful but underused. The objective of this study is to know how palliative care (PC) is applied in our country in order to identify limitations and unmet needs.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;p&gt;It is a descriptive, observational, cross-sectional study, anonymous survey type of 20 questions, directed and answered by neurologists dedicated to TM in Spain.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;58 responses were obtained from neurologists from 15 autonomous communities. 69% answered that they did not have a specialized TM nursing facility but did have a PC team in their center (81%). No specific protocol for CP in TM was identified. All except one neurologist stated that they lacked sufficient training in PC, the main training need being the “advance directives explanation”. Only 1 in 4 neurologists answered routinely explaining advance healthcare planning to their patients, recognizing up to 84.5% of neurologists not knowing how to assess the patient's competence. 60.3% of those surveyed answered that between 10 and 30% of their patients would be candidates for PC, although 1 in 3 said they were not clear when to refer the patient to PC. 100% of neu","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 417-425"},"PeriodicalIF":3.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485321002577/pdfft?md5=5caec52e7119d4edcfac2221a8b2c282&pid=1-s2.0-S0213485321002577-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42446473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reliable change indices for 16 neuropsychological tests at six different time points 16 项神经心理测试在六个不同时间点的可靠变化指数
IF 2.9 4区 医学
Neurologia Pub Date : 2024-04-15 DOI: 10.1016/j.nrl.2023.06.004
O. Sáez-Atxukarro , J. Peña , R. del Pino , N. Ibarretxe-Bilbao , N. Ojeda
{"title":"Reliable change indices for 16 neuropsychological tests at six different time points","authors":"O. Sáez-Atxukarro ,&nbsp;J. Peña ,&nbsp;R. del Pino ,&nbsp;N. Ibarretxe-Bilbao ,&nbsp;N. Ojeda","doi":"10.1016/j.nrl.2023.06.004","DOIUrl":"10.1016/j.nrl.2023.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuropsychological assessment often involves repeated testing in order to assess a cognitive change or conduct a longitudinal follow-up study of a patient. To assess whether the change between assessments is relevant or not, longitudinal reference data are needed. The aim of this study is to provide reference data to enable interpretation of score changes between assessments for 16 commonly used tests, at six different time intervals between successive assessments, using five reliable change indices.</div></div><div><h3>Methods</h3><div>The study is part of the Normacog project, in which 388 healthy participants recruited in Spain (aged 18–84 years) were assessed on two occasions. A baseline assessment was carried out, and then followed up at 1 month (<em>n</em> <!-->=<!--> <!-->67), 3 months (<em>n</em> <!-->=<!--> <!-->64), 6 months (<em>n</em> <!-->=<!--> <!-->59), 9 months (<em>n</em> <!-->=<!--> <!-->60), 12 months (<em>n</em> <!-->=<!--> <!-->68), or 24 months (<em>n</em> <!-->=<!--> <!-->70). Longitudinal data were analyzed, and reliable change indices were calculated.</div></div><div><h3>Results</h3><div>A significant improvement was observed between assessment scores for all time points, especially in memory-related variables. Reference data are provided using the following indices: discrepancy scores expressed in percentiles, standard deviation index (SDI), reliable change index (RCI), RCI<!--> <!-->+<!--> <!-->practice effect (RCI<!--> <!-->+<!--> <!-->PE), and standardized regression-based formulae.</div></div><div><h3>Conclusions</h3><div>This study provides data to analyze whether or not a cognitive change can be considered reliable. The results support the use of these reliable change indices to avoid biases related to successive assessments. This study will lay the foundations for the implementation of these tools in clinical practice, and will be a reference for the creation of reliable change indices.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 256-278"},"PeriodicalIF":2.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Distonía lingual: respuesta al tratamiento con toxina botulínica 舌肌张力障碍:对肉毒杆菌毒素治疗的反应
IF 2.9 4区 医学
Neurologia Pub Date : 2024-02-06 DOI: 10.1016/j.nrl.2023.08.001
A. Fernández Revuelta, E. López Valdés, R. García-Ramos
{"title":"Distonía lingual: respuesta al tratamiento con toxina botulínica","authors":"A. Fernández Revuelta,&nbsp;E. López Valdés,&nbsp;R. García-Ramos","doi":"10.1016/j.nrl.2023.08.001","DOIUrl":"10.1016/j.nrl.2023.08.001","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 331-332"},"PeriodicalIF":2.9,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139812419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alemtuzumab y síndrome poliglandular autoinmune con diabetes mellitus tipo 1 阿来珠单抗与伴有1型糖尿病的自身免疫性多腺自身免疫综合征
IF 2.9 4区 医学
Neurologia Pub Date : 2024-02-03 DOI: 10.1016/j.nrl.2023.07.001
D.A. García Estévez , I. Pinal Osorio , A. Pato Pato
{"title":"Alemtuzumab y síndrome poliglandular autoinmune con diabetes mellitus tipo 1","authors":"D.A. García Estévez ,&nbsp;I. Pinal Osorio ,&nbsp;A. Pato Pato","doi":"10.1016/j.nrl.2023.07.001","DOIUrl":"10.1016/j.nrl.2023.07.001","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"40 3","pages":"Pages 329-330"},"PeriodicalIF":2.9,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139822435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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