墨西哥神经科学杂志新时代

IF 0.5 Q4 CLINICAL NEUROLOGY Revista Mexicana de Neurociencia Pub Date : 2022-07-08 DOI:10.24875/rmn.m22000090
A. Arauz, L. Dávila-Maldonado
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The overall median time of the diagnosis pathway was 14.5 (interquartile range [IQR] 31) months and the longest time in this pathway was between the first medical consultation and the definitive diagnosis of PD, a median of 9 (IQR 14) months. The main appraisal of the first symptom was being “not worried” (48.2%). The mains reasons for seeking medical attention were symptom worsening (42.1%). Patient’s perception on the diagnostic time was reported as very adequate/adequate in 52.7%. Barriers delaying the diagnosis identified included the belief of spontaneous symptoms relief and lack of trust in their doctor. Conclusion: Both the person with PD and the physician play a shared role in the diagnosis of PD. Improving the awareness of the disease, as well as improving medical education on PD, could result in a timely diagnosis. Abstract Background: Complications of COVID-19 can include neurological, psychiatric, psychological, and psychosocial sequelae. Little is known about the consequences of COVID-19 on the cognitive functions of patients in the subacute phase of the disease. Objective: The objective of the study was to determine if there is an incidence of cognitive impairment in patients with COVID-19 with mild to moderate symptoms in the remission phase. Method: This is a cross-sectional study conducted between April 2021 and August 2021 at the Eugenio Espejo Hospital in Quito, Ecuador. The Montreal Cognitive Assessment test was applied to COVID-19 patients with mild to moderate symptoms. Results: A total of 50 subjects were recruited, 88% (n = 44) presented cognitive deterioration and only 12% (n = 6) showed a normal score. Conclusions: In our cohort study, patients with COVID-19 with mild-moderate symptoms are at high risk of cognitive impairment. Abstract Objective: The objective of the study is to identify the risk and protective factors associated with Parkinson’s disease (PD) in inhabitants of Yucatan. Methods: Case control study. A questionnaire with the main risk and protective factors for PD described in the literature was applied to cases and controls. Results: The sample consisted of 85 cases and 124 controls. In the univariate logistic regression analyzes, it was found that the following factors were significantly associated with a higher risk of developing PD: family history of PD (OR = 5.28, p = 0.001), personal history of diabetes (OR = 2.35, p = 0.01), the number of head trauma (OR = 1.35, p = 0.02), number of general anesthesia received (OR = 1.27, p = 0.050), exposure to organic solvents (OR = 2.73, p = 0.02) and the years of exposure to organic solvents (OR = 1.05, p = 0.01): Conclusions: The findings of this research indicate that the inhabitants of the state of Yucatan are exposed to the following risk factors: having a relative with PD, personal history of diabetes, number of head traumas, exposure to organic solvents, years of exposure to organic solvents and number of general anesthesia received. Abstract This article proposes the term Somatodyspraxia to refer to the difficulties in body management and postural adjustments for performing actions, due to alterations in somatosensory and proprioceptive processing, as a consequence of acquired brain injury. In addition, we propose Somatoapraxia as a primary factor for apraxia and describe its applicability for a Neuropsychological Rehabilitation Model for apraxia. The explanatory models of apraxia, the somatosensory and proprioceptive alterations underlying various types of apraxia, and their manifestation in different neurological conditions, are taken into consideration. Recognizing Somatodyspraxia as a clinical component of patient’s life allows its integration for the improvement of current existing rehabilitation programs. Abstract Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. AF is associated with an increased risk of cardiovascular disease, heart failure, stroke, cognitive impairment and dementia, and mortality. Individuals with AF have a 5-fold risk of ischemic stroke, and AF-related strokes are associated with greater disability and mortality compared with strokes from other causes. Moreover, the burden of AF and AF-related stroke on patients, their caregivers, health-care systems, and society is significant and projected to increase in the coming decades due to the rapid growth of the ageing population. The care and management of patients with AF and AF-related stroke are challenging, often involving complex decision-making to weigh the risks and benefits of various treatment and prevention strategies. This topical review focuses on the latest science and advances in AF and AF-related stroke and identifies knowledge gaps and future directions of continued research. left hemispheric acute infarct, as well as evidence of hyperintensities in bilateral hemispheres suggestive of small vessel disease. Abstract Interatrial blocks (IABs) are a variety of abnormalities in the interatrial conduction. Bayes’ syndrome is a clinical entity based on the association between advanced IABs and supraventricular tachyarrhythmias, being atrial fibrillation (AF) the most frequent. Due to its negative effects on left atrial electromechanical function, both IABs and Bayes’ syndrome are associated with thromboembolic phenomena, causing cardiovascular and neurological complications. In regard to neurological involvement, patients with these conditions have an increased incidence of ischemic events, cognitive impairment, and dementia. 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引用次数: 0

摘要

目的:我们进行了一项横断面研究,以确定在诊断途径的每个阶段可能导致帕金森病(PD)患者诊断延迟的因素。材料与方法:纳入连续的PD患者。采用问卷调查的方法评估患者对初始症状的认识、寻求注意诊断的途径以及对诊断时间和识别障碍的认知。诊断延迟定义为从最初识别症状到最终诊断PD之间≥12个月。结果:共纳入114例PD患者,其中男性占57.9%。诊断途径的总中位时间为14.5(四分位间距[IQR] 31)个月,从首次就诊到最终诊断PD的时间最长,中位时间为9 (IQR] 14)个月。对第一症状的主要评价为“不担心”(48.2%)。就医的主要原因是症状加重(42.1%)。52.7%的患者对诊断时间的感知为非常充分/足够。延迟诊断的障碍包括相信症状会自发缓解和对医生缺乏信任。结论:PD患者和医生在PD的诊断中起着共同的作用。提高对疾病的认识,以及提高PD的医学教育,可以导致及时诊断。背景:COVID-19并发症可包括神经、精神、心理和社会心理后遗症。目前对COVID-19对亚急性期患者认知功能的影响知之甚少。目的:本研究的目的是确定在缓解期轻度至中度症状的COVID-19患者中是否存在认知功能障碍的发生率。方法:这是一项横断面研究,于2021年4月至2021年8月在厄瓜多尔基多的Eugenio Espejo医院进行。蒙特利尔认知评估测试适用于轻至中度症状的COVID-19患者。结果:共纳入50例受试者,88% (n = 44)出现认知功能减退,仅有12% (n = 6)得分正常。结论:在我们的队列研究中,轻-中度症状的COVID-19患者存在认知功能障碍的高风险。摘要目的:本研究的目的是确定与尤卡坦半岛居民帕金森病(PD)相关的危险因素和保护因素。方法:病例对照研究。在病例和对照组中应用了一份问卷,其中包含了文献中描述的PD的主要风险和保护因素。结果:本组病例85例,对照组124例。在单变量逻辑回归分析,发现下列因素与更高的患帕金森病的风险显著相关:PD家族史(或= 5.28,p = 0.001),个人历史的糖尿病(或= 2.35,p = 0.01),头部外伤的数量(或= 1.35,p = 0.02),收到的全身麻醉(或= 1.27,p = 0.050),接触有机溶剂(或= 2.73,p = 0.02)和多年的接触有机溶剂(或= 1.05,p = 0.01):结论:本研究结果表明,尤卡坦州的居民暴露于以下危险因素:有亲属患有PD,个人糖尿病史,头部创伤次数,接触有机溶剂的时间,接触有机溶剂的时间以及接受全身麻醉的次数。摘要:本文提出“躯体运动障碍”一词,指后天性脑损伤后由于躯体感觉和本体感觉加工的改变而导致的身体管理和姿势调整困难。此外,我们提出躯体失用症是失用症的主要因素,并描述了其在失用症神经心理康复模型中的适用性。本文考虑了失用症的解释模型、各种类型失用症背后的躯体感觉和本体感觉改变,以及它们在不同神经系统疾病中的表现。认识到躯体运动障碍是患者生活的临床组成部分,可以将其整合到当前现有的康复计划中。心房颤动(AF)是临床上最常见的持续性心律失常。房颤与心血管疾病、心力衰竭、中风、认知障碍和痴呆以及死亡率的风险增加有关。房颤患者发生缺血性卒中的风险是房颤患者的5倍,与其他原因引起的卒中相比,房颤相关卒中的致残率和死亡率更高。 此外,房颤和房颤相关卒中对患者、其护理人员、卫生保健系统和社会的负担是显著的,并且由于人口老龄化的快速增长,预计在未来几十年将会增加。房颤和房颤相关卒中患者的护理和管理具有挑战性,通常涉及复杂的决策,以权衡各种治疗和预防策略的风险和益处。这篇专题综述集中在房颤和房颤相关中风的最新科学和进展,并确定知识差距和未来继续研究的方向。左半球急性梗死,以及双侧半球高信号提示小血管疾病的证据。房间传导阻滞(IABs)是一种房间传导异常。贝叶斯综合征是一种基于晚期IABs与室上性心动过速之间关联的临床症状,其中以房颤(AF)最为常见。由于其对左心房机电功能的负面影响,IABs和贝叶斯综合征都与血栓栓塞现象有关,可引起心血管和神经系统并发症。在神经系统受累方面,患有这些疾病的患者缺血性事件、认知障碍和痴呆的发生率增加。这些观察结果引发了一个问题,即早期抗凝治疗(房颤记录之前)是否可以预防IABs诊断患者的血栓栓塞事件。本综述旨在总结描述IABs和贝叶斯综合征与神经系统事件相关的最新证据。我们还将讨论预防这些不良临床后果的潜在早期治疗方案。
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New era of the Revista Mexicana de Neurociencia
Objective: We carried out a cross-sectional study to identify the factors involved in each stage of the diagnosis pathway that may lead to a diagnostic delay in persons with Parkinson’s disease (PD). Materials and Methods: Consecutive patients with PD were included. A questionnaire assessing the recognition of the initial symptoms, pathway to seek attention diagnosis and perception on the diagnostic time and identified barriers was applied. Diagnosis delay was defined as ≥ 12 months between initial recognition of the symptom and the definitive diagnosis of PD. Results: A total of 114 patients (57.9% male) with PD were included in the study. The overall median time of the diagnosis pathway was 14.5 (interquartile range [IQR] 31) months and the longest time in this pathway was between the first medical consultation and the definitive diagnosis of PD, a median of 9 (IQR 14) months. The main appraisal of the first symptom was being “not worried” (48.2%). The mains reasons for seeking medical attention were symptom worsening (42.1%). Patient’s perception on the diagnostic time was reported as very adequate/adequate in 52.7%. Barriers delaying the diagnosis identified included the belief of spontaneous symptoms relief and lack of trust in their doctor. Conclusion: Both the person with PD and the physician play a shared role in the diagnosis of PD. Improving the awareness of the disease, as well as improving medical education on PD, could result in a timely diagnosis. Abstract Background: Complications of COVID-19 can include neurological, psychiatric, psychological, and psychosocial sequelae. Little is known about the consequences of COVID-19 on the cognitive functions of patients in the subacute phase of the disease. Objective: The objective of the study was to determine if there is an incidence of cognitive impairment in patients with COVID-19 with mild to moderate symptoms in the remission phase. Method: This is a cross-sectional study conducted between April 2021 and August 2021 at the Eugenio Espejo Hospital in Quito, Ecuador. The Montreal Cognitive Assessment test was applied to COVID-19 patients with mild to moderate symptoms. Results: A total of 50 subjects were recruited, 88% (n = 44) presented cognitive deterioration and only 12% (n = 6) showed a normal score. Conclusions: In our cohort study, patients with COVID-19 with mild-moderate symptoms are at high risk of cognitive impairment. Abstract Objective: The objective of the study is to identify the risk and protective factors associated with Parkinson’s disease (PD) in inhabitants of Yucatan. Methods: Case control study. A questionnaire with the main risk and protective factors for PD described in the literature was applied to cases and controls. Results: The sample consisted of 85 cases and 124 controls. In the univariate logistic regression analyzes, it was found that the following factors were significantly associated with a higher risk of developing PD: family history of PD (OR = 5.28, p = 0.001), personal history of diabetes (OR = 2.35, p = 0.01), the number of head trauma (OR = 1.35, p = 0.02), number of general anesthesia received (OR = 1.27, p = 0.050), exposure to organic solvents (OR = 2.73, p = 0.02) and the years of exposure to organic solvents (OR = 1.05, p = 0.01): Conclusions: The findings of this research indicate that the inhabitants of the state of Yucatan are exposed to the following risk factors: having a relative with PD, personal history of diabetes, number of head traumas, exposure to organic solvents, years of exposure to organic solvents and number of general anesthesia received. Abstract This article proposes the term Somatodyspraxia to refer to the difficulties in body management and postural adjustments for performing actions, due to alterations in somatosensory and proprioceptive processing, as a consequence of acquired brain injury. In addition, we propose Somatoapraxia as a primary factor for apraxia and describe its applicability for a Neuropsychological Rehabilitation Model for apraxia. The explanatory models of apraxia, the somatosensory and proprioceptive alterations underlying various types of apraxia, and their manifestation in different neurological conditions, are taken into consideration. Recognizing Somatodyspraxia as a clinical component of patient’s life allows its integration for the improvement of current existing rehabilitation programs. Abstract Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. AF is associated with an increased risk of cardiovascular disease, heart failure, stroke, cognitive impairment and dementia, and mortality. Individuals with AF have a 5-fold risk of ischemic stroke, and AF-related strokes are associated with greater disability and mortality compared with strokes from other causes. Moreover, the burden of AF and AF-related stroke on patients, their caregivers, health-care systems, and society is significant and projected to increase in the coming decades due to the rapid growth of the ageing population. The care and management of patients with AF and AF-related stroke are challenging, often involving complex decision-making to weigh the risks and benefits of various treatment and prevention strategies. This topical review focuses on the latest science and advances in AF and AF-related stroke and identifies knowledge gaps and future directions of continued research. left hemispheric acute infarct, as well as evidence of hyperintensities in bilateral hemispheres suggestive of small vessel disease. Abstract Interatrial blocks (IABs) are a variety of abnormalities in the interatrial conduction. Bayes’ syndrome is a clinical entity based on the association between advanced IABs and supraventricular tachyarrhythmias, being atrial fibrillation (AF) the most frequent. Due to its negative effects on left atrial electromechanical function, both IABs and Bayes’ syndrome are associated with thromboembolic phenomena, causing cardiovascular and neurological complications. In regard to neurological involvement, patients with these conditions have an increased incidence of ischemic events, cognitive impairment, and dementia. These observations triggered the question whether the use of early anticoagulation therapy (before the documentation of AF) could prevent thromboembolic events in patients with IABs diagnosis. This review aims to summarize the most recent evidence describing the association of IABs and Bayes’ syndrome with neurological events. Potential early therapeutic options to prevent these undesirable clinical consequences will be also discussed.
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Revista Mexicana de Neurociencia
Revista Mexicana de Neurociencia CLINICAL NEUROLOGY-
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