Epidemiología de la Esclerosis Múltiple en el área sanitaria de Ferrol

Programa Oficial de Doutoramento en Ciencias Sociosanitarias. 512V01[Resumen] Introducción: La epidemiología de la Esclerosis Múltiple (EM) es motivo de múltiples estudios debido a la posible influencia de factores ambientales y genéticos en su desarrollo. Objetivo: Conocer la incidencia y prevalencia de la EM en el Área Sanitaria de Ferrol (ASF). Metodología: Estudio retrospectivo de los pacientes con EM de la Sección de Neurología del ASF, estableciéndose el día 31 de diciembre de 2015 como “fecha de prevalencia” y analizando la incidencia de la enfermedad durante 2001-2015. Asimismo, se estudian los pacientes según su edad, sexo, agregación familiar, tiempo de evolución y fenotipo clínico. Resultados: Se estudian 214 pacientes. La prevalencia es de 109 casos/100.000 habitantes. La incidencia media durante 2001-2015 es de 5,5 casos/100.000 habitantes/año. La relación mujer/hombre es de 2,5/1. La forma clínica predominante es la remitente recurrente (RR). La edad media de comienzo de la enfermedad es de 34,5 años. Hay un 6,6% de formas familiares. Conclusiones: La prevalencia de la EM en el ASF es de las más altas notificadas en España. La incidencia, aunque elevada, es similar a las de otros estudios españoles recientes. Las características clínicas son similares a las de la mayoría de los pacientes de los estudios españoles contemporáneos.[Resumo] Introdución: A epidemioloxía da Esclerose Múltiple (EM) é motivo de múltiples estudos debido á posible influencia de factores ambientais e xenéticos no seu desenvolvemento. Obxectivo: Coñecer a incidencia e prevalencia da EM na Área Sanitaria de Ferrol (ASF). Metodoloxía: Estudo retrospectivo dos pacientes con EM da Sección de Neuroloxía da ASF, establecéndose o día 31 de decembro de 2015 como “data de prevalencia” e analizando a incidencia da enfermidade durante o período 2001-2015. Así mesmo, estúdanse os pacientes segundo a súa idade, sexo, agregación familiar, tempo de evolución e fenotipo clínico. Resultados: Estúdanse 214 pacientes. A prevalencia é de 109 casos/100.000 habitantes. A incidencia anual media durante 2001-2015 é de 5,5 casos/100.000 habitantes/ano. A relación muller/home é de 2,5/1. A forma clínica predominante é a remitente recorrente (RR). A idade media de comezo da enfermidade é de 34,5 anos. Hai un 6,6% de formas familiares. Conclusións: A prevalencia da EM na ASF é das máis altas notificadas en España. A incidencia, aínda que elevada, é similar á doutros estudos españois recentes. As características clínicas son similares ás da maioría dos pacientes dos estudos españois contemporáneos[Abstract] Introduction: The epidemiology of Multiple Sclerosis has motivated many studies due to the possible influence of certain environmental and genetic factors in its development. Aim: To research the incidence and prevalence of MS in the Ferrol Healthcare Area (FHA). Methodology: A retrospective study of MS patients at the Neurology Department of the FHA. A “prevalence date” of 31 December 2015 was established and the incidence of the disease was analysed for the period 2001 - 2015. Likewise, the distribution of patients according to age, sex, familial occurrence, evolution time and clinical phenotype. Results: We studied 214 patients. The prevalence is 109 cases / 100,000 inhabitants. The average annual incidence for the period 2001 - 2015 is 5.5 cases / 100,000 inhabitants / year. The ratio of women to men is 2.5:1. The predominant clinical form is relapsing remitting (RR). The average age at onset of the disease is 34.5 years. There are 6.6% of familial forms. Conclusions: The prevalence of MS in FHA is among the highest that have been reported in Spain. Incidence, although high, is similar to that found in other recent Spanish studies. The clinical characteristics of patients are similar to those in most contemporary Spanish studies

Predictive and criterion validity of the Cervantes-SF menopause quality of life questionnaire.

pre-print384 K

SARS-CoV-2 Infection in Multiple Sclerosis: Results of the Spanish Neurology Society Registry

Esclerosis múltiple; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoVEsclerosi múltiple; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoVMultiple sclerosis; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoVObjective To understand COVID-19 characteristics in people with multiple sclerosis (MS) and identify high-risk individuals due to their immunocompromised state resulting from the use of disease-modifying treatments. Methods Retrospective and multicenter registry in patients with MS with suspected or confirmed COVID-19 diagnosis and available disease course (mild = ambulatory; severe = hospitalization; and critical = intensive care unit/death). Cases were analyzed for associations between MS characteristics and COVID-19 course and for identifying risk factors for a fatal outcome. Results Of the 326 patients analyzed, 120 were cases confirmed by real-time PCR, 34 by a serologic test, and 205 were suspected. Sixty-nine patients (21.3%) developed severe infection, 10 (3%) critical, and 7 (2.1%) died. Ambulatory patients were higher in relapsing MS forms, treated with injectables and oral first-line agents, whereas more severe cases were observed in patients on pulsed immunosuppressors and critical cases among patients with no therapy. Severe and critical infections were more likely to affect older males with comorbidities, with progressive MS forms, a longer disease course, and higher disability. Fifteen of 33 patients treated with rituximab were hospitalized. Four deceased patients have progressive MS, 5 were not receiving MS therapy, and 2 were treated (natalizumab and rituximab). Multivariate analysis showed age (OR 1.09, 95% CI, 1.04–1.17) as the only independent risk factor for a fatal outcome. Conclusions This study has not demonstrated the presumed critical role of MS therapy in the course of COVID-19 but evidenced that people with MS with advanced age and disease, in progressive course, and those who are more disabled have a higher probability of severe and even fatal disease.This work was funded by the Spanish Society of Neurology for the writing, editorial assistance, statistical analysis and the Article Processing Charge. Other contributions related to financial support for writing, statistical analysis, and editorial assistance were supported by Biogen, Bristol-Myers Squibb, Merck, Roche, Sanofi, and Teva

Screening of CACNA1A and ATP1A2 genes in hemiplegic migraine: clinical, genetic and functional studies

Hemiplegic migraine (HM) is a rare and severe subtype of autosomal dominant migraine, characterized by a complex aura including some degree of motor weakness. Mutations in four genes (CACNA1A, ATP1A2, SCN1A and PRRT2) have been detected in familial and in sporadic cases. This genetically and clinically heterogeneous disorder is often accompanied by permanent ataxia, epileptic seizures, mental retardation, and chronic progressive cerebellar atrophy. Here we report a mutation screening in the CACNA1A and ATP1A2 genes in 18 patients with HM. Furthermore, intragenic copy number variant (CNV) analysis was performed in CACNA1A using quantitative approaches. We identified four previously described missense CACNA1A mutations (p.Ser218Leu, p.Thr501Met, p.Arg583Gln, and p.Thr666Met) and two missense changes in the ATP1A2 gene, the previously described p.Ala606Thr and the novel variant p.Glu825Lys. No structural variants were found. This genetic screening allowed the identification of more than 30% of the disease alleles, all present in a heterozygous state. Functional consequences of the CACNA1A-p.Thr501Met mutation, previously described only in association with episodic ataxia, and ATP1A2-p.Glu825Lys, were investigated by means of electrophysiological studies, cell viability assays or Western blot analysis. Our data suggest that both these variants are disease-causing

Diferencias territoriales en el reconocimiento de la discapacidad de niños y adolescentes con cáncer en España

El impacto del diagnóstico de cáncer en niños y adolescentes afecta a todas las áreas individuales y familiares desde el momento del diagnóstico colocándolos en situación de discapacidad. Existe un conocimiento empírico, no cuantificado, de que el reconocimiento de la discapacidad no es igual en todas las comunidades autónomas. Nos planteamos conocer el estado actual de concesión de la discapacidad de niños y adolescentes con cáncer y su variabilidad entre comunidades autónomas. Se utilizó una muestra de 1288 casos nuevos de niños y adolescentes diagnosticados de cáncer entre 0 y 18 años en el periodo 2014-2016. El 26,9 % solicitó valoración de discapacidad y se concedió en el 92,8 % con amplia variabilidad entre comunidades autónomas. El tiempo medio entre solicitud y diagnóstico es 6 meses, variando entre 1 y 11 meses entre comunidades autónomas. El tiempo medio entre solicitud y concesión es 3,4 meses, variando según comunidades autónomas entre 1 y 5 meses

Toothless wildlife protection laws

Granting legal protection to an endangered species has long been considered a major milestone for its conservation and recovery. A multitude of examples such as wolves in the contiguous USA (Boitani 2003) or many large carnivore populations in Europe (Chapron et al. 2014) have revealed how instrumental wildlife protection laws can be for species recovery. However, legal obligations to conserve endangered species may be useless if the rule of law is not properly enforced. Such situation is not exclusive to countries with political instability or weak institutional capacities but can also be relevant, for instance, to member states of the European Union and therefore bound to European legislation on nature conservation.Peer reviewe

II Jornadas de la Sociedad Española para la Conservación y Estudio de Los Mamíferos (SECEM) Soria 7-9 diciembre 1995

Seguimiento de una reintroducción de corzo (Capreolus capreolus) en ambiente mediterráneo. Dispersión y área de campeoModelos de distribución de los insectívoros ern la Península IbéricaDieta anual del zorro, Vulpes vulpes, en dos hábitats del Parque Nacional de DoñanaDesarrollo juvenil del cráneo en las poblaciones ibéricas de gato montés, Felis silvestris Schreber, 1777Presencia y expansión del visón americano (Mustela vison) en las provincias de Teruel y Castellón (Este de España).Preferencias de hábitat invernal de la musaraña común (Crocidura russula) en un encinar fragmentado de la submeseta norteUso de cámaras automáticas para la recogida de información faunística.Dieta del lobo en dos zonas de Asturias (España) que difieren en carga ganadera.Consumo de frutos y dispersión de semillas de serbal (Sorbus aucuparia L.) por zorros y martas en la cordillera Cantábrica occidentalEvaluación de espermatozoides obtenidos postmorten en el ciervo.Frecuencia de aparición de diferentes restos de conejo en excrementos de lince y zorroAtlas preliminar de los mamíferos de Soria (España)Censo y distribución de la marmota alpina (Marmota marmota) en Navarra.Trampeo fotográfico del género Martes en el Parque Nacional de Aigüestortes i Estany de Sant Maurici (Lleida)Peer reviewe

SARS-CoV-2 Infection in Multiple Sclerosis

To understand COVID-19 characteristics in people with multiple sclerosis (MS) and identify high-risk individuals due to their immunocompromised state resulting from the use of disease-modifying treatments. Retrospective and multicenter registry in patients with MS with suspected or confirmed COVID-19 diagnosis and available disease course (mild = ambulatory; severe = hospitalization; and critical = intensive care unit/death). Cases were analyzed for associations between MS characteristics and COVID-19 course and for identifying risk factors for a fatal outcome. Of the 326 patients analyzed, 120 were cases confirmed by real-time PCR, 34 by a serologic test, and 205 were suspected. Sixty-nine patients (21.3%) developed severe infection, 10 (3%) critical, and 7 (2.1%) died. Ambulatory patients were higher in relapsing MS forms, treated with injectables and oral first-line agents, whereas more severe cases were observed in patients on pulsed immunosuppressors and critical cases among patients with no therapy. Severe and critical infections were more likely to affect older males with comorbidities, with progressive MS forms, a longer disease course, and higher disability. Fifteen of 33 patients treated with rituximab were hospitalized. Four deceased patients have progressive MS, 5 were not receiving MS therapy, and 2 were treated (natalizumab and rituximab). Multivariate analysis showed age (OR 1.09, 95% CI, 1.04-1.17) as the only independent risk factor for a fatal outcome. This study has not demonstrated the presumed critical role of MS therapy in the course of COVID-19 but evidenced that people with MS with advanced age and disease, in progressive course, and those who are more disabled have a higher probability of severe and even fatal diseas

Role of educational level in the relationship between Body Mass Index (BMI) and health-related quality of life (HRQL) among rural Spanish women

BACKGROUND: The impact of obesity on health-related quality of life (HRQL) has been little explored in rural areas. The goal of this study is to ascertain the association between obesity and HRQL among Spanish women living in a rural area, and the influence of their educational level. METHODS: Cross-sectional study with personal interview of 1298 women (aged 18 to 60) randomly selected from the electoral rolls of 14 towns in Galicia, a region in the north-west of Spain. HRQL was assessed using the SF-36 questionnaire. The association between body mass index (BMI) and suboptimal scores in the different HRQL dimensions was summarised using odds ratios (ORs), obtained from multivariate logistic regression models. Separate analyses were conducted for women who had finished their education younger than 16 years old and women with secondary education to assess differences in the relationship between BMI and HRQL according to educational level. RESULTS: Among women with primary or lower education, obesity was associated with a higher prevalence of suboptimal values in the following dimensions: Physical functioning (OR: 1.97; 95%CI: 1.22-3.18); Role-physical (OR: 1.81; 95%CI: 1.04-3.14); General health (OR: 1.76; 95%CI: 1.10-2.81); and Role-emotional (OR: 2.52; 95%CI: 1.27-5.03). In women with higher education, physical functioning was the only dimension associated with obesity (OR: 2.02: 95%CI 0.83-4.97). CONCLUSION: The impact of obesity on women's HRQL is greater among those with a lower educational level. This group registered higher prevalence of obesity and poorer self-perceived health.This study was funded by the Instituto de Salud Carlos III (grant 001/05).S