Introduction
Covid-19 was declared a global pandemic by the WHO on 11 March 2020. From the beginning, the pandemic posed a challenge to the different health systems around the world, which were ...forced to prioritise and distribute their resources as efficiently as possible. During the period between 11 March 2020 and 28 April 2021, the Regional ECT Unit of the Region of Murcia remained closed.
Objectives
- Determine the clinical status of patients on maintenance ECT in the Regional ECT Unit during the Covid-19 pandemic.
- Prioritise resumption of treatment in those who were clinically decompensated or at risk
- Understand the consequences of discontinuation of maintenance ECT for these patients.
Methods
A longitudinal descriptive study was conducted during the month of May 2020.
Results
Thirty-seven patients were contacted by telephone. On the first call, a total of 15 patients were unstable or at risk of decompensation.
Prior to the second call, CT was administered preferentially to a total of 8 patients and programmed to 2. On the second call, a total of 11 patients were at risk of decompensation.
Conclusions
The closure of the Regional ECT Unit had negative consequences for patients undergoing maintenance treatment. Electroconvulsive therapy is an essential part of the treatment of psychiatric patients both in acute episodes and in relapse prevention.
Disclosure
No significant relationships.
Objective
we aimed to evaluate the utility of transorbital ultrasonography (TOS) in optic nerve assessment and quantification of ON atrophy in MS patients, and to determine whether ON atrophy ...correlates with the disease duration and disability measured on the Kurtzke Expanded Disability Status Scale (EDSS).
Materials and methods
Prospective, multicentre, blinded cohort study of 59 patients diagnosed with relapsing‐remitting MS and 36 controls.
Results
When measured with TOS, the diameter of both the right (2.69 ± 0.30 mm in cases; 3.20 ± 0.19 mm in controls, P < .0001) and left (2.71 ± 0.26 mm in cases; 3.24 ± 0.15 mm controls, P < .0001) ON of study patients was smaller than controls. We observed a negative correlation between EDSS and both right (ρ = .524) and left (ρ = .469) ON diameter. We also observed a negative correlation between disease duration and both right (r = .602) and left (r = .538) ON diameter. No difference was observed in the diameter of both ON among patients with a history of optic neuritis (right OND 2.68 ± 0.29 mm; left OND 2.69 ± 0.25 mm) and patients with no history of optic neuritis (right OND 2.70 ± 0.30 mm; left OND 2.73 ± 0.27 mm) (P = .805; P = .651).
Conclusions
The thickness of ON measured with TOS is correlated with EDSS and the duration of the disease without being interfered by the previous history of optic neuritis. TOS could be a reliable technique for measuring ON atrophy in MS.
Seroma after breast cancer surgery is a frequent entity; therefore, different products have been described in literature with the aim to reduce it. The most studied ones have been the sealants ...products, being tested with aspirative drains. Symptomatic seroma represents the 19% after axillary lymphadenectomy without drains. The aim of this study is to analyze the effect of a sealant in the seroma control after axillary lymphadenectomy without drains and identify the risk factors related to symptomatic seroma.
This is a prospective, multicenter, international, and randomized clinical trial. Patients undergoing conservative surgery and axillary lymphadenectomy for breast cancer will be randomized to control group (lymphadenectomy without sealant) or interventional group (lymphadenectomy with sealant Glubran 2®). In any of the study groups, drains are placed. Patients who received neoadjuvant treatment are included. Measurements of the study outcomes will take place at baseline; at 7, 14, and 30 days post-surgery; and at 6-12 months. The primary outcome is symptomatic seroma. Secondary outcomes are seroma volume, morbidity, quality of life, and lymphedema.
Several studies compare the use of sealant products in axillary lymphadenectomy but generally with drains. We would like to demonstrate that patients who underwent axillary lymphadenectomy could benefit from an axillary sealant without drains and reduce axillary discomfort while maintaining a good quality of life. Assessing the relationship between axillary volume, symptoms, and related risk factors can be of great help in the control of seroma in patients who received breast cancer surgery.
ClinicalTrials.gov, NCT05280353. Registration date 02 August 2022.
The ANTARES dataset is a large collection of known and verified experimental bioconcentration factor data, involving 851 highly heterogeneous compounds from which 159 are pesticides. The BCF ANTARES ...data were used to derive a conformation-independent QSPR model. A large set of 27,017 molecular descriptors was explored, with the main intention of capturing the most relevant structural characteristics affecting the studied property. The structural descriptors were derived with different freeware tools, such as PaDEL, Epi Suite, CORAL, Mold
2
, RECON, and QuBiLs-MAS, and so it was interesting to find out the way that the different descriptor tools complemented each other in order to improve the statistical quality of the established QSPR. The best multivariable linear regression models were found with the Replacement Method variable sub-set selection technique. The proposed QSPR model improves previous reported models of the bioconcentration factor in the present dataset.
La Selva Baja Caducifolia (SBC) es de gran importancia por su biodiversidad. En el Istmo-Costa de Oaxaca, México, se encuentran áreas con SBC y distinta categoría de protección (legislación ...mexicana): (1) Área Natural Protegida (ANP), (2) Área Destinada Voluntariamente para la Conservación (ADVC) y (3) Área de Uso Común (ADUC). En cada una de ellas se analizó la estructura de vegetación leñosa, plantas con DAP mayor que o igual a 2.5 cm, muestreando 15 parcelas de 100 m.sup.2. La riqueza observada fue de 90 especies incluidas en 36 familias y corresponde al 80 % (Jackknife) y 85 % (ICE) de la esperada. El análisis de agrupamiento identificó dos grupos con 90 % de disimilitud: el primero (G1) incluyó a todas las parcelas muestreadas del ANP; y el segundo (G2) aglomeró las del ADVC y ADUC. Los índices de Shannon, dominancia de Simpson y diversidad verdadera de Jost para el G1 fueron H'= 2.43, D= 0.21 y sup.qD= 11 y para el G2, H'= 2.76, D= 0.28 y sup.qD= 15, sin diferencias entre grupos (P < 0.05). Las especies con Valor de Importancia Relativa más elevado, en ambos grupos, corresponden a vegetación secundaria. La densidad de especies del G1 fue de 1 829 ind/ha y en el G2 de 2 370 ind/ha. Los promedios de altura (6.8 m) y área basal (19.7 m.sup.2/ha) del G1 no variaron significativamente (P < 0.05) con los del G2 (7.9 m y 22.1 m.sup.2/ha). Las ADVC y ADUC, semejantes en composición y estructura, difieren del ANP. Se sugiere seguir monitoreando la SBC. Palabras clave: Área Natural Protegida, áreas de uso común, áreas destinadas voluntariamente a la conservación, bosque tropical seco, diversidad de especies, similitud florística. Tropical dry forest (TDF) is important due to its biodiversity. In the Isthmus- Coastal region of the state of Oaxaca, in Southeast Mexico, there are many areas of TDF with varying categories of legal protection (1) Protected Natural Areas (PNA), (2) Voluntarily Designated Conservation Areas (VDCA) and (3) Areas of Common Use (ACU). In each of these, tree vegetation structure was analysed, recording plants with a DBH greater than or equal to 2.5 cm and sampling 15 plots of 100 m.sup.2. Observed richness was 90 species, belonging to 36 families and corresponding to 80 % (Jackknife) and 85 % (ICE) of expected richness. A cluster analysis identified two groups with 90 % dissimilitude: the first (G1) included all the sampled plots in the PNA; and the second (G2), grouped together those from the VDCA and the ACU. The Shannon, Simpson dominance and Jost true diversity indices for G1 were H'= 2.43, D= 0.21 and sup.qD= 11 and for G2, H'= 2.76, D= 0.28 and sup.qD= 15 respectively, with no differences between groups (P < 0.05). The species that presented the highest relative importance value (RIV) in both groups, corresponded to secondary vegetation. Species density of G1 was 1 829 ind/ha and 2 370 ind/ha for G2. Mean height (6.8 m) and basal area (19.7 m.sup.2/ha) of G1 did not vary significantly (P < 0.05) when compared to G2 (7.9 m y 22.1 m.sup.2/ha). The VDCA and ACU presented similar composition and structure, differing from the PNA. Continual monitoring of the TDF is suggested. Rev. Biol. Trop. 66(2): 863-879. Epub 2018 June 01. Key words: Natural Protected Areas, areas of common use, voluntarily designated conservation areas, tropical dry forest, species diversity, floristic similitude.
Senescence is a mechanism that limits cellular lifespan and constitutes a barrier against cellular immortalization. To identify new senescence regulatory genes that might play a role in ...tumorigenesis, we have designed and performed a large-scale antisense-based genetic screen in primary mouse embryo fibroblasts (MEFs). Out of this screen, we have identified five different genes through which loss of function partially bypasses senescence. These genes belong to very different biochemical families: csn2 (component of the Cop9 signalosome), aldose reductase (a metabolic enzyme) and brf1 (subunit of the RNA polymerase II complex), S-adenosyl homocysteine hydrolase and Bub1. Inactivation, at least partial, of these genes confers resistance to both p53- and p16INK4a-induced proliferation arrest. Furthermore, such inactivation inhibits p53 but not E2F1 transcriptional activity and impairs DNA-damage-induced transcription of p21. Since the aim of the screen was to identify new regulators of tumorigenesis, we have tested their inactivation in human tumors. We have found, either by northern blot or quantitative reverse transcriptase-PCR analysis, that the expression of three genes, Csn2, Aldose reductase and Brf1, is lost at different ratios in tumors of different origins. These genes are located at common positions of loss of heterogeneity (15q21.2, 7q35 and 14q32.33); therefore,we have measured genomic losses of these specific genes in different tumors. We have found that Csn2 and Brf1 also show genomic losses of one allele in different tumors. Our data suggest that the three genes identified in the genome-wide loss-of-function genetic screen are putative tumor suppressors located at 15q21.2; 7q35 and 14q32.33.
El combustible principal en poblaciones rurales de diversas entidades de México es la leña. El objetivo de este trabajo fue analizar el efecto de la certificación de ADVC en la extracción de leña de ...las ADUC en tres núcleos agrarios de Oaxaca. Se realizaron entrevistas abiertas semiestructuradas y encuestas a ejidatarios y líderes comunitarios de manera aleatoria en San Pedro Huamelula, Unión Zapata y San Marcos Arteaga (regiones Istmo-Costa, Valles Centrales y Mixteca) de Oaxaca, así como a los directores regionales de la CONANP donde se ubican las ADVC. Además, se hicieron muestreos sistemáticos de las especies leñosas en las áreas (ADVC y ADUC), de los tres sitios y se estimó su Valor de Importancia Relativa (VIR). Entre 14 y 26 fue el número de especies utilizadas para leña en los núcleos agrarios (15% de las registradas en los muestreos); las preferidas para este fin corresponden mayoritariamente a vegetación secundaria. Si bien, en las ADVC se limita el acceso y uso de los recursos vegetales, lo que reduce la superficie de donde extraen la leña, no significó sobre explotar los recursos de las ADUC.
Depression is one of the most prevalent psychiatric conditions in adulthood, reaching figures of around 20%. The methodologies used to study depression are varied, and range from a self-administered ...test to structured psychiatric assessment. Several studies of patients with multiple sclerosis (MS) have been conducted in the last 20 years, and figures of around 35% have been found for depressive symptoms, while depressive disorders are less frequent, at approximately 21%.
The aim of this study is to evaluate the usefulness of patient self-reported scales such as the Beck depression inventory (BDI) for identifying depressive symptoms in patients with MS, and to analyse their correlation with the diagnosis of clinical depression or depressive disorder using the psychiatric clinical interview based on the criteria of the Diagnostic and statistical manual of mental disorders, fifth edition.
This is a multicentre descriptive cross-sectional study of patients with MS and depressive symptoms. The BDI and the Hamilton depression rating scale (HDRS) were used, and the patients with the highest scores underwent psychiatric assessment.
A total of 191 patients were included; 81 of these (40.5%) had depressive symptomatology in the pathological range according to the BDI (cut-off point of 14), and 20 had a severe score (above 28). Nineteen patients with severe depressive symptoms according to both scales were selected and finally evaluated by a psychiatrist, who also assessed five patients who according to the neurologist had severe depressive symptoms despite a BDI score of almost 28, but did not reach that level. The suspected major depressive disorder was confirmed in only four (21%) cases with BDI scores indicative of severe symptoms. There is no correlation between the severity score as evidenced by the BDI and the psychiatric assessment. A major depressive disorder was diagnosed in 16 (66.6%) of the 24 patients with BDI > 26 evaluated by psychiatry. A score above 26 on the BDI enables identification of 75% of cases of depressive disorder without subtyping. The correlation between the HDRS and the BDI was statistically significant (r = 0.8; p < 0).
The BDI is a useful screening test for identifying patients with depressive symptoms; in specific terms, a score above 26 is probably indicative of a depressive disorder that may benefit from psychiatric assessment.
The combination of antipsychotic drugs is a therapeutic resource in clinical practice. This study aimed to evaluate the efficacy and security of adding amisulpride in patients who at least partially ...responded to risperidone.
A 3-month, open, observational study was undertaken to evaluate the effectiveness of adding amisulpride in subjects who scored at least 25 on the brief psychiatric rating scale (BPRS) after risperidone monotherapy. Patients were evaluated with BPRS, the Clinical Global Impressions Severity of Illness scale (CGI-S) and the Udvalg for Kliniske Undersøgelser Side Effect Rating Scale (UKU) at baseline, 1 and 3 months.
Coadjuvant treatment with amisulpride achieves a statistically significant improvement in mental status over a period of 3 months when measured with BPRS, CGI and UKU scales. The response rate was 70 (45%) in the oral risperidone and 74 (28%) in the parenteral risperidone groups.
The addition of amisulpride could lead to an improvement in schizophrenia symptoms in patients that do not, or only partially, respond to risperidone. Further research is required into alternative therapies for poor responders.
A multicentre epilepsy registry in Mexico Reséndiz-Aparicio, J C; Ruiz-García, M; Castro-Martínez, E
Revista de neurologiá,
2024-Jan-01, 20240101, Letnik:
78, Številka:
1
Journal Article
Recenzirano
The National Epilepsy Registry in Mexico was carried out, from March 2021 to December 2022, in public hospitals of the Priority Epilepsy Program 'PPE', with the aim of describing the current ...situation in our pediatric and adult population.
Observational, cross-sectional, multicenter study. We used a database, according to classifications of the International League Against Epilepsy (ILAE) 2017. Patients of all ages were included, with a diagnosis of epilepsy according to the practical clinical definition ILAE 2014.
We registered 10,852 patients, 5,495 men (50.6%) and 5,357 women (49.4%). Family history of epilepsy in 1,714 patients (15.8%), febrile seizures in 987 (9.1%). Type of seizure: 5,542 (51.1%) presented focal onset, of which 1,889 (34.1%) evolved to bilateral tonic-clonic seizures; generalized onset 4,861 (44.8%), unknown 33 (3.1%) and unclassified 115 (1.1%). Almost half had unknown etiology and 40% were structural, of which hypoxic ischemic encephalopathy was the most frequent (21.6%) and neurocysticercosis was 1%. Comorbidities appeared in 6,326 patients (58.3%). Anti-seizure medications (ASM) were used in 96.4% patients, mainly valproate. Status epilepticus was found in 1,383 patients (12.7%) and drug-resistant epilepsy in 18.9%. Paraclinical studies: 79.3% with at least one electroencephalogram and 76.9% with a neuroimaging study. Epilepsy surgery occurred in 275 patients (2.5%).
Despite the efforts of the Pan American Health Organization in its Strategy and Action Plan on epilepsy, diagnostic technologies and ASM supply are still lagging behind.
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