Multiple sclerosis (MS)-related tremor is frequent and can often be refractory to medical treatment, which makes it a potential source of major disability. Functional neurosurgery approaches such as ...thalamic deep brain stimulation (DBS) or radiofrequency thalamotomy are proven to be effective, but the application of invasive techniques in MS tremor has so far been limited. Magnetic resonance (MR)-guided focused ultrasound thalamotomy, which has already been approved for treating essential and parkinsonian tremor, provides a minimally invasive approach that could be useful in the management of MS tremor. We report for the first time a patient with medically refractory MS-associated tremor successfully treated by focused ultrasound thalamotomy.
Theory of mind (ToM) is a social cognitive skill that involves the ability to attribute mental states to self and others (what they think (cognitive ToM) and feel (affective ToM)). We aim to provide ...an overview of previous knowledge of ToM in Parkinson’s disease (PD). In the last few years more attention has been paid to the study of this construct as a non-motor manifestation of PD. In advanced stages, both components of ToM (cognitive and affective) are commonly impaired, although in early PD results remain controversial. Executive dysfunction correlates with ToM deficits and other cognitive domains such as language and visuospatial function have also been related to ToM. Recent studies have demonstrated that PD patients with mild cognitive impairment show ToM deficits more frequently in comparison with cognitively normal PD patients. In addition to the heterogeneity of ToM tests administered in different studies, depression and dopaminergic medication may also be acting as confounding factors, but there are still insufficient data to support this. Neuroimaging studies conducted to understand the underlying networks of cognitive and affective ToM deficits in PD are lacking. The study of ToM deficit in PD continues to be important, as this may worsen quality of life and favor social stigma. Future studies should be considered, including assessment of the patients’ cognitive state, associated mood disorders, and the role of dopaminergic deficit.
Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to ...treatment are insufficiently studied in non-Japanese children.
This study aimed to investigate the epidemiology, clinical features and risk factors for resistance to treatment and coronary artery lesions (CAL) in KD in Spain.
Retrospective study (May 2011-June 2016) of all patients less than 16 years of age diagnosed with KD included in KAWA-RACE network (84 Spanish hospitals).
A total of 625 cases were analyzed, 63% were males, 79% under 5 year-olds and 16.8% younger than 12 months. On echocardiographic examination CAL were the most frequent findings (23%) being ectasia the most common (12%). Coronary aneurysms were diagnosed in 9.6%, reaching 20% in infants under 12 months (p<0.001). A total of 97% of the patients received intravenous immunoglobulin (IVIG) with a median number of days from fever onset to IVIG administration of 7.2. A second dose was given to 15.7% and steroids to 14.5% patients. Only 1.4% patients received infliximab. No deaths were reported. A multivariate analysis identified anemia, hypoalbuminemia, hyponatremia, higher creatinine and procalcitonin as independent risk factors for treatment failure and length under 103 cm, hemoglobin < 10.2 mg/dL, platelets > 900,000 cells/mm3, maximum temperature < 39.5°C, total duration of fever > 10 days and fever before treatment ≥ 8 days as independent risk factors for developing coronary aneurysms.
In our population, children under 12 months develop coronary aneurysms more frequently and children with KD with anemia and leukocytosis have high risk of cardiac involvement. Adding steroids early should be considered in those patients, especially if the treatment is not started before 8 days of fever. A score applicable to non-Japanese children able to predict the risk of aneurysm development and IVIG resistance is necessary.
En el año 2020, se cumplieron tres décadas de la entrada en vigor de la Convención de Naciones Unidas sobre los Derechos del Niño, el tratado internacional de Derechos humanos más universal de la ...historia, con 196 Estados Parte. Para la conmemoración de este aniversario, el Grupo de Derecho Europeo de la Universidad de Oviedo (EURODERUNIOVI) organizó, los días 5 y 6 de marzo del 2020, una Jornada en la Facultad de Derecho de Oviedo sobre el “30 Aniversario de la Convención sobre los Derechos del Niño: logros y retos desde una perspectiva multidisciplinar", con el objetivo de reflexionar y debatir sobre los logros conseguidos y los retos pendientes en la defensa y promoción de los derechos de la infancia. La presente obra colectiva recoge las ponencias y comunicaciones presentadas en las citadas Jornadas, tratando de dar una mayor difusión y visibilidad a la importancia que ha tenido la adhesión de España a esta Convención en nuestro sistema de protección a la infancia para garantizar que todos los niños gocen de sus derechos sin distinción alguna. El tratamiento se aborda desde cinco ejes específicos: la perspectiva histórica del tratamiento de la infancia; la perspectiva de la protección socio-laboral y educativa del niño; la perspectiva de la protección de la dimensión privada del niño; la perspectiva penal de la protección jurídica del niño y en último lugar, la perspectiva internacional y el balance de la protección internacional del niño.
Background
Cognitive reserve (CR) is the mismatch between preserved cognition and neuropathological damage. Amyloidopathy in Parkinson's disease (PD) could be associated with faster progression to ...dementia, but the putative protective effect of CR is unknown.
Objectives
To evaluate the effect of CR on β‐amyloid burden and brain metabolism in non‐demented PD subjects.
Methods
Participants with PD (n = 53) underwent a clinical evaluation, 18F‐fluorodeoxyglucose and 18F‐flutemetamol positron emission tomography magnetic resonances, and were classified according to CR. The metabolic pattern of 16 controls was compared to PD subjects.
Results
The PD subjects showed hypometabolism mainly in the bilateral posterior cortex. Superior‐CR subjects (n = 22) exhibited better cognitive performance, increased amyloid burden, and higher metabolism in several right hemisphere areas compared to low‐medium‐CR subjects (n = 31).
Conclusions
Higher CR in non‐demented PD is associated with better cognitive performance, which might reduce vulnerability to the effect of β‐amyloid. Whether superior CR leads to protection against metabolic deterioration, and predominantly right hemisphere involvement, deserves further exploration.
Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome. However, most manuscripts published to date only analyze the effects of ...post-COVID-19 in patients discharged from hospital, which may induce significant bias. Here, we propose a pioneering study to analyze the single and multiple associations between post-COVID-19 characteristics with up to 6-months of follow-up in hospitalized and non-hospitalized COVID-19 patients. The cohort study was conducted from May to October 2020 at the University Hospital Virgen de la Nieves, the leading hospital assigned for patients with COVID-19 in Granada, Spain. A total of 372 and 217 patients-with 217 and 207 included in the first and second follow-up visits-were referred 2 and 6 months after diagnosing COVID-19, respectively. We find out that post-COVID-19 clinical and mental health impairment symptoms are correlated with patient gender. Logistic adjustments showed strong statistically robust single and multiple associations of demographic, clinical, mental health, X-ray, laboratory indices, and pulmonary function variables. The functional lung tests are good predictors of chest CT imaging abnormalities in elderly patients. Bilateral lung involvement, subpleural reticulum, ground-glass opacity, peripheral lung lesions, and bronchiectasis were the most common findings of the high-resolution computed tomography images. Non-hospitalized patients suffer more severe thromboembolic events and fatigue than those hospitalized.
Mine driven trace elements' pollution entails environmental risks and causes soil infertility. In the last decades,
techniques such as phytostabilization have become increasingly important as ways to ...tackle these negative impacts. The aim of this study was to test the individual and combined effects of different aided phytostabilization techniques using substrate from barren tailings of a Cu mine, characterized by extreme infertility (high acidity and deficiency of organic matter and nutrients). The experiment analyzed the growth of
L. planted alone (P) or in co-cropping with
L. (PT), in pots containing mine soil amended with compost (1, 10, compost, soil, w/w) non inoculated (NI) or inoculated with plant growth promoting rhizobacteria (PGP), mycorrhizae (MYC) or a combination of bacterial and fungal inocula (PGPMYC). Non-amended, non-planted and non-inoculated reference ports were also prepared. Plants were harvested after 110 days of plant development and several biometric and phytopathological parameters (stem height, aerial biomass, root biomass, wilting, chlorosis, pest and death) and macro and micronutrient composition were determined. The growth substrate was analyzed for several physicochemical (pH, CEC
, and exchangeable cations, total C and N, P Olsen and availability of trace elements) and microbiological (community level physiological profiles: activity, richness and diversity) parameters. The use of the amendment,
plantation, and inoculation with rhizobacteria were the best techniques to reduce toxicity and improve soil fertility, as well as to increase the plant survival and growth. Soil bacterial functional diversity was markedly influenced by the presence of plants and the inoculation with bacteria, which suggests that the presence of plant regulated the configuration of a microbial community in which the inoculated bacteria thrive comparatively better. The results of this study support the use of organic amendments, tolerant plants, and plant growth promoting rhizobacteria to reduce environmental risk and improve fertility of soils impacted by mining.
Creativity has been engaged as a new way of developing tourism destinations, and this brings consequences for tourists and for the destinations themselves. Hence the need to measure the levels of ...creativity displayed by a specific tourist destination. To this end, an aggregate composite index is proposed, labelled Creacity, capable of evaluating spatial, environmental and institutional creativity in Spain's urban‐cultural destinations, taken as an example. The findings and methodology proposed pave the way to apply creativity as a key element in tourism competitiveness, in a clear bid to promote the Economics of Creativity, moving beyond the concept of Creative Economics.
Objective
To compare the prevalence of the main comorbidities in 2 large cohorts of patients with primary Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE), with a focus on ...cardiovascular (CV) diseases.
Methods
This was a cross‐sectional multicenter study where the prevalence of more relevant comorbidities in 2 cohorts was compared. Patients under followup from SJOGRENSER (Spanish Rheumatology Society Registry of Primary SS) and RELESSER (Spanish Rheumatology Society Registry of SLE), and who fulfilled the 2002 American–European Consensus Group and 1997 American College of Rheumatology classification criteria, respectively, were included. A binomial logistic regression analysis was carried out to explore potential differences, making general adjustments for age, sex, and disease duration and specific adjustments for each variable, including CV risk factors and treatments, when appropriate.
Results
A total of 437 primary SS patients (95% female) and 2,926 SLE patients (89% female) were included. The mean age was 58.6 years (interquartile range IQR 50.0–69.9 years) for primary SS patients and 45.1 years (IQR 36.4–56.3 years) for SLE patients (P < 0.001), and disease duration was 10.4 years (IQR 6.0–16.7 years) and 13.0 years (IQR 7.45–19.76 years), respectively (P < 0.001). Smoking, dyslipidemia, and arterial hypertension were associated less frequently with primary SS (odds ratio OR 0.36 95% confidence interval (95% CI) 0.28–0.48, 0.74 95% CI 0.58–0.94, and 0.50 95% CI 0.38–0.66, respectively) as were life‐threatening CV events (i.e., stroke or myocardial infarction; OR 0.57 95% CI 0.35–0.92). Conversely, lymphoma was associated more frequently with primary SS (OR 4.41 95% CI 1.35–14.43). The prevalence of severe infection was lower in primary SS than in SLE (10.1% versus 16.9%; OR 0.54 95% CI 0.39–0.76; P < 0.001).
Conclusion
Primary SS patients have a consistently less serious CV comorbidity burden and a lower prevalence of severe infection than those with SLE. In contrast, their risk of lymphoma is greater.
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