Alteraciones hemodinámicas y pulmonares en el síndrome del distress respiratorio águdo del adulto

A la veille de la Fête des Lumières, les retours sur cette journée ont été, en quelque sorte « lumineux ». Pour vous remettre un peu dans le contexte, le programme est toujours en ligne sur le site de la MOM. C’est avec grand plaisir que nous avons vu l’amphi Benveniste se remplir progressivement… puis quasi totalement. Nous estimons qu’environ 70 personnes, chercheurs, étudiants,  et autres professionnels des centres de recherche, bibliothèques et universités étaient présents. Certains d’ent..

Clinical presentation of burning mouth syndrome in patients with oral lichenoid disease

To analyze the presence of burning mouth syndrome (BMS) in a group of patients diagnosed with oral lichenoid disease (OLD). A retrospective study of 217 patients diagnosed with OLD; 158 (72,8%) women and 59 (27,2%) men, with an average age upon diagnosis of 56,4 years (SD 11,88). We carried out a detailed and complete characterization of symptoms, with special emphasis on BMS diagnostic data specified by the International Headache Society. Four patients (1.8%) presented with long-term clinical symptoms of burning mouth, indicative of BMS and they fulfilled the IHS 2018 criteria, except for criterion D, i.e.?Oral mucosa is of normal appearance?. The observed lichenoid mucosal lesions were not considered to be able to account for the reported intraoral pain in any of our patients. Thus neither diagnosis was considered to be exclusive. Patients diagnosed with OLD, and who simultaneously present clinical characteristics of BMS should be studied in detail, in order to evaluate the possibility of both diagnoses concurring

Alteraciones hemodinámicas y pulmonares en el síndrome del distress respiratorio águdo del adulto

Tesis Univ. Complutense. Madrid.Fac. de MedicinaTRUEProQuestpu

"Cheira-me que estou doente" : uma revisão sobre o nariz eletrónico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017O nariz eletrónico é uma tecnologia de ponta que se assemelha, em conceito, com o nariz humano biológico. Ele usa os padrões específicos de compostos orgânicos voláteis (COVs) emanados por várias substâncias para reconhecer as amostras. Atualmente já se desenvolveram dispositivos portáteis que permitem o seu potencial uso para fins médicos diagnósticos e de saúde pública. Desde o início do século que decorrem estudos com o nariz eletrónico, havendo ainda, no entanto, necessidade de otimização do sistema e da padronização do seu uso. Não obstante, o nariz eletrónico, como método complementar de diagnóstico (MCD) portátil e não invasivo, tem demonstrado capacidade para ser integrado numa abordagem abrangente de rastreio e diagnóstico de múltiplas doenças com custo reduzido. Este sistema vem ainda revolucionar o conceito da Medicina personalizada, com objetivação real de sintomas e monitorização clínica e terapêutica avançada.The electronic nose is a cutting-edge technology that resembles, in concept, the biological human nose. It uses the specific patterns of volatile organic compounds emanating from various substances to recognize the samples. Portable devices have now been developed so that the potential use of the electronic nose is achieved for medical diagnostic and public health purposes. Since the beginning of the century studies have been conducted with the electronic nose. Yet, there is still need for optimization of the system and the standardization of its use. Nonetheless, the electronic nose, as a portable and non-invasive complementary diagnostic method (MCD), has demonstrated potential to be integrated into a comprehensive approach to screening and diagnostic of multiple diseases at low cost. This system also revolutionizes the concept of personalized medicine, with real objectification of symptoms and advanced clinical monitoring and therapy

La tecnología y el medioambiente como estrategias competitivas de una empresa de transporte urbano

Con carácter general el objetivo prioritario de los transportistas es ampliar cuota de mercado optimizando costes y ofertando un servicio de altas prestaciones. En el presente el autobús ha dejado de ser el activo clave de diferenciación, adquiriendo preponderancia, en consecuencia con los nuevos requerimientos de los clientes, otras variables tales como la tecnología y el medioambiente. En lo que respecta a la tecnología, los sistemas ITS que engloban a actividades típicas relacionadas con hardware, software y comunicaciones permiten, una vez integradas en todo el proceso productivo, proporcionar el servicio que demanda el cliente directo basado en una información instantánea y personalizada en cualquier lugar y momento y con cualquier equipamiento electrónico fijo o móvil. Con referencia al medioambiente, no nos ceñimos tan solo al cliente directo sino también a los usuarios potenciales y, en general, a toda la ciudadanía. Teniendo en cuenta los problemas de contaminación en las grandes ciudades, los sistemas de propulsión alternativos al gasoil adquieren una relevancia significativa, sobresaliendo entre todos ellos el gas natural como alternativa viable técnica y económica. Por consiguiente tecnología y medioambiente son los factores que determinan hoy día, la calidad del producto ofertado por las empresas de transporte que tendrán que interiorizar estos aspectos si quieren sobrevivir en el mercado actual del transporte urbano.In general the main objective of the transport companies is to expand market share by optimizing costs and offering a high quality service. Currently the bus itself is not anymore the key asset of differentiation, gaining dominance, consistent with the new requirements of customers, other variables such as onboard technologies and the environment. With regard to technology, ITS systems encompassing typical activities related to hardware, software and communications make possible, once integrated into the entire production process, to provide the service that the customer demands, based on a direct and personalized instantaneous information any time and place and by means of any fixed or mobile electronic equipment. With reference to the environment, we won’t refer just to the direct customers but also to potential users, and in general to all citizens. Taking into account the pollution problems in large cities, propulsion systems alternative to diesel acquire a significant relevance, standing among them natural gas as a technically and economically viable alternative. Therefore technology and environment are factors that determine today, the quality level offered by transport companies that will have to internalize these issues if they are to survive in today's urban transport market

Comportamento alimentar em doentes bipolares do sexo feminino: estudo comparativo com grupo de controlo

Os doentes bipolares apresentam frequentemente perturbações do comportamento alimentar, que podem ser consideradas como comorbilidade da doença afectiva. O presente estudo teve como objectivo verificar se a existência de sintomas de perturbação do comportamento alimentar na doença bipolar é devida a factores específicos ou a factores inespecíficos relacionados com a doença bipolar.A trinta doentes do sexo feminino, com o diagnóstico clínico de doença bipolar (casos), e a dez doentes do sexo feminino com o diagnóstico de esclerose múltipla (controlos) foi aplicado o questionário EAT 26 e recolhidos dados demográficos e clínicos. Foram escolhidas para controlo doentes com esclerose múltipla devido a algumas semelhanças com a doença bipolar. Houve uma diferença estatisticamente significativa entre a pontuação do EAT das doentes bipolares e das doentes com esclerose múltipla, com as doentes bipolares a apresentarem uma média muito superior às doentes com EM. Não houve relação estatisticamente significativa entre a pontuação do EAT das doentes bipolares e variáveis demográficas e clínicas dessas mesmas doentes. O facto de a pontuação do EAT, que tem alta especificidade e sensibilidade para a presença de perturbação do comportamento alimentar, ser significativamente superior nas doentes bipolares pode significar que a perturbação do comportamento alimentar é devida a factores específicos de doença bipolar, e não a factores inespecíficos associados ao facto de se ter uma doença crónica

Cognitive impairment in multiple sclerosis: diagnosis and monitoring

Multiple sclerosis; Neurophysiological monitoring; Neuropsychological testsEsclerosi múltiple; Monitorització neurofisiològica; Proves neuropsicològiquesEsclerosis múltiple; Monitoreo neurofisiológico; Pruebas neuropsicológicasIntroduction Cognitive impairment (CI) has a prevalence of 45–70% in people with multiple sclerosis (MS), producing a negative impact on their quality of life, personal life, and work. Early detection of CI has become an important aspect to be considered for an adequate follow-up, to optimize social adaptation and to implement specific cognitive rehabilitation strategies. The aim of this work is to propose a suitable cognitive evaluation of patients with MS based on available and efficient tools for diagnosis and monitoring purposes well supported by literature review and clinical experience. Methods A multidisciplinary panel of professionals from the field of neurology, neuropsychology, and neuroimaging performed a literature review of the topic of cognitive impairment assessment. This was combined and completed with their clinical experience to produce a set of recommendations. Results Some limitations to cognitive evaluation are described: shortage of time and resources during the neurology consultation, scarceness or absence of specialized professionals’ availability, importance of tests adaptation, and doubts about its use to define therapeutic efficiency. We recommend a baseline and annual screening evaluation, and we suggest a baseline and periodic neuropsychological assessment. The latter ought to change to a recommendation with the presence of either positive screening test, or subjective to cognitive complaints, screening-test results and patient or family report mismatch, or in specific social/work situations. Conclusions Cognitive evaluation should be performed on all patients diagnosed with MS and throughout follow-up. It is necessary to support the creation of multidisciplinary MS teams to optimize the evaluation and follow-up of MS patients

XIII Reunión Post-ECTRIMS : revisión de las novedades presentadas en el Congreso ECTRIMS 2020 (I)

Introducción: Desde hace más de una década, tras el congreso ECTRIMS, se celebra en España la reunión Post-ECTRIMS, donde neurólogos expertos en esclerosis múltiple (EM) de toda España se reúnen para revisar las principales novedades presentadas en el ECTRIMS (en esta ocasión, celebrado junto con el ACTRIMS). Objetivo: En el presente artículo, publicado en dos partes, se resumen las ponencias que tuvieron lugar en la reunión Post-ECTRIMS, celebrada los días 16 y 17 de octubre de 2020 de forma virtual. Desarrollo. En esta primera parte se incluyen los últimos resultados acerca del impacto del ambiente y el estilo de vida sobre el riesgo de EM y su curso clínico, y el papel de la epigenética y los factores genéticos sobre estos procesos. Se discuten los hallazgos en investigación preclínica y clínica sobre los subtipos de linfocitos identificados, y la implicación de los folículos linfoides y la afectación meníngea en la enfermedad. Los cambios en la estructura cerebral se abordan a nivel microscópico y macroscópico, incluyendo resultados de técnicas de imagen de alta resolución. También se presentan los últimos avances sobre biomarcadores para el diagnóstico y el pronóstico de la EM, y sobre la afectación del microbioma en estos pacientes. Por último, se esbozan los resultados de registros de pacientes sobre el impacto de la COVID-19 en los pacientes con EM. Conclusiones: Ha habido nuevos datos sobre factores de riesgo de la EM, impacto de la EM a nivel celular y estructural, papel del microbioma en la enfermedad, biomarcadores y la relación entre COVID-19 y EM.Introduction. For more than a decade, following the ECTRIMS Congress, the Post-ECTRIMS Meeting has been held in Spain, where neurologists with expertise in multiple sclerosis (MS) from all over the country meet to review the most relevant latest developments presented at the ECTRIMS congress (on this occasion held together with ACTRIMS). Aim. This article, published in two parts, summarises the presentations that took place at the Post-ECTRIMS Meeting, held online on 16 and 17 October 2020. Development. This first part includes the latest results regarding the impact of the environment and lifestyle on risk of MS and its clinical course, and the role of epigenetics and genetic factors on these processes. Findings from preclinical and clinical research on the lymphocyte subtypes identified and the involvement of lymphoid follicles and meningeal involvement in the disease are discussed. Changes in brain structure are addressed at the microscopic and macroscopic levels, including results from high-resolution imaging techniques. The latest advances on biomarkers for the diagnosis and prognosis of MS, and on the involvement of the microbiome in these patients are also reported. Finally, results from patient registries on the impact of COVID-19 in MS patients are outlined. Conclusions. There have been new data on MS risk factors, the impact of MS at the cellular and structural level, the role of the microbiome in the disease, biomarkers, and the relationship between COVID-19 and MS