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A mechanical thrombectomy was performed in an attempt to embolise the thrombus at a more distal level, but the patient died.
Mesenteric ischaemia can cause significant pneumatosis intestinalis, which, by a retrograde mechanism through the portal system, can cause air bubbles to reach the cerebral venous system, leading to acute stroke.
Mesenteric ischaemia can cause significant pneumatosis intestinalis, which, by a retrograde mechanism through the portal system, can cause air bubbles to reach the cerebral venous system, leading to acute stroke.
Apomorphine, a D1-D2 dopamine agonist, is the oldest drug with proven efficacy in the treatment of Parkinson's disease (PD), and the only with similar symptomatic power to levodopa. Its usefulness in the control of motor fluctuations, both as intermittent injections and in continuous subcutaneous infusion, has been demonstrated in open label and placebo controlled trials.
To analyse the role of apomorphine in the varied clinical symptoms and different clinical stages of PD through a narrative review of scientific literature (1951-2020).
Beyond on-time increase, off-time decrease, off dystonia and quality of life improvement in advanced PD, there is evidence to support a role of apomorphine in less known clinical areas of PD, such as non motor symptoms, a lower risk of impulse control disorders, potential to ameliorate visual hallucinations, improve neuropsychiatric symptoms and dyskinesia and even axial features. Nevertheless, the optimal timing of apomorphine treatment remains controversial, and its implementation of this valuable drug in clinical practice has been historically hindered by several factors.
Apomorphine is a unique drug in the PD treatment scenario, with a number of potential applications beyond motor fluctuations control. Acknowledging these properties, selecting the patient most likely to benefit from it and finding the right timing may be key in the symptomatic control of this complex disease.
Apomorphine is a unique drug in the PD treatment scenario, with a number of potential applications beyond motor fluctuations control. Acknowledging these properties, selecting the patient most likely to benefit from it and finding the right timing may be key in the symptomatic control of this complex disease.
Bladder neuromodulation has emerged as a new alternative in the management of adults with bladder dysfunctions from a neuropathic origin. Despite the fact that, numerous studies have proven the efficacy and safety of this therapy in adults' patients, there are however, still few studies that demonstrate its success in paediatric neuropathic bladder.
We perform a systematic review of the studies which analysed the impact of bladder electrostimulation in paediatric patients (0 to 18 years) with a neurogenic origin. The search identified 9716 potentially articles. Finally, 11 papers published between 1992 and 2019 fulfilled the necessary criteria to be part of our study and were selected for the systematic review.
We did not find a common trend among the results obtained from the studies included in the present review. Most of the studies demonstrated an optimal efficacy rate and high safety, but however the superiority of this therapy over anticholinergic drugs could not be established due the presented r, the therapeutic alternatives used in the management of this disease must have a proven efficacy. For this reason, and after the review, due the absence of evidence regarding bladder electrotherapy in this group of patients, its use should be limited and exceptional. Bladder neuromodulation has emerged as a new alternative in the management of adult patients with bladder dysfunctions of neuropathic origin. Despite the fact that numerous studies have proven the efficacy and safety of this therapy in this age group, there are still few studies that show its success in paediatric neuropathic bladder.
COVID-19 pandemic has disturbed many hospital activities, including medical education. We describe the switch from in-person didactic sessions to videoconferencing in a Neurology department. We analyse the opinions and satisfaction of participants.
Narrative description of the adopted measures; Online survey among participants.
One of the three weekly sessions was cancelled, and two switched to videoconferencing. There were more participants online than in the conference hall. 49 users answered the survey, 51% women, mean age 40.5 years (range 25-65). Satisfaction was higher for previous face-to-face meetings (8.68) than for videoconferencing (8.12) (p=0.006). There was a significant inverse correlation between age and satisfaction with virtual sessions (r=-0.37; p=0.01), that was not found for in-person attendance. Most users (75.5%) would prefer to continue with online sessions when the pandemic is over, and 87.8% support inter-hospital remote meetings, but the safety of web platforms is a concern (53.1%).
The change from in-person to virtual sessions is an easy measure to implement in a neurology department, with a good degree of satisfaction among users. There are some unsolved problems with the use of commercial web platforms and inter-hospital connection. Most users recommend leadership and support from educational and health authorities.
The change from in-person to virtual sessions is an easy measure to implement in a neurology department, with a good degree of satisfaction among users. There are some unsolved problems with the use of commercial web platforms and inter-hospital connection. Most users recommend leadership and support from educational and health authorities.
The brief visuospatial memory test-revised (BVMT-R) assesses visuospatial learning and memory in adults. It has equivalent forms that allow reassessing patients.
To obtain normative and standardized data for the BVMT-R taking into account the sociodemographic characteristics of the Spanish population.
The present study is part of the Normacog Project. Nine hundred three participants (18 to 93 years old) were assessed using the BVMT-R (form 1). The effect of age, level of education and gender was analyzed on the BVMT-R, and percentiles and scalar scores adjusted by age and level of education were created.
A significant effect of age and educational level on the analyzed variables was observed (trial 1; total recall; trial 4; discrimination index), explaining from 12% to 40% of the variance. The older and less educated participants obtained lower performance in all the analyzed variables of the BVMT-R. Gender had not a significant effect in the analyzed variables.
The study provides standardized and normalized data for the BVMT-R taking into account the Spanish sociodemographic characteristics. The results confirm the in?uence of age and level of education in the performance of the test, so normative data are provided to correct the BVMT-R taking into account these characteristics.
The study provides standardized and normalized data for the BVMT-R taking into account the Spanish sociodemographic characteristics. Ceralasertib cell line The results confirm the in?uence of age and level of education in the performance of the test, so normative data are provided to correct the BVMT-R taking into account these characteristics.
Postpartum hemorrhage (PPH) is an emergent obstetric complication and the leading cause of maternal mortality. Pelvic arterial embolization (PAE) is an effective treatment for intractable PPH. However, a unique protocol has not been accepted in obstetrical practice.
To evaluate its efficiency, safety, complications, and outcomes, we conducted a systematic review and meta-analysis of PAE for PPH in the literature.
The Medline, the database of abstract of reviews, the index to allied health literature, and the Chinese database Sino-Med were searched on March 31, 2020, for studies on PAE for PPH. The data for PAE indication, agents, arteries, success rate, complications, and outcomes were extracted and syncretized for meta-analysis.
From 1075 identified articles, 113 abstracts or full articles were retrieved and 43 studies were finally identified as meeting the including criteria. The results demonstrated that the indications for PAE were as follows uterine atony, placental abnormality, delivery tract indiameter have safe results. Pelvic arterial embolization may affect the recovery of menses and increase PPH in the subsequent pregnancy, but there was no noted correlation with fetal growth restriction.
Psychological reactions to perinatal loss, although often self-limited, may lead to significant psychological morbidities. Obstetrician-gynecologists and other maternal health providers play a key role in recognizing the range of psychological responses to perinatal loss and providing education, support, and treatment options to their patients.
This review aims to define psychological reactions associated with perinatal loss, examine psychotherapy and psychopharmacologic treatments for psychiatric morbidities, discuss interpregnancy interval following perinatal loss, and highlight brief, psychological interventions that can be implemented by maternal health providers.
Search terms "perinatal loss psychology," "reproductive loss grief," "perinatal psychopharmacology," "psychopharmacology grief," and "interpregnancy interval" were utilized to search PubMed, Google Scholar, and PsycINFO.
Grief is an expected, normal response to perinatal loss. Psychological morbidities, including major depressive disordeers acknowledging the psychological aspects of reproductive loss, inquiring about their emotional needs, and providing information regarding grief and mental health referrals.
Several predictive models and scoring systems have been developed to differentiate between benign and malignant ovarian masses, in order to guide effective management. These models use combinations of patient characteristics, ultrasound markers, and biochemical markers.
The aim of this study was to describe, compare, and prioritize, according to their strengths and qualities, all the adnexal prediction models.
This was a state-of-the-art review, synthesizing the findings of the current published literature on the available prediction models of adnexal masses.
The existing models include subjective assessment by expert sonographers, the International Ovarian Tumor Analysis models (logistic regression models 1 and 2, Simple Rules, 3-step strategy, and ADNEX [Assessment of Different NEoplasias in the adneXa] model), the Risk of Malignancy Index, the Risk of Malignancy Ovarian Algorithm, the Gynecologic Imaging Reporting and Data System, and the Ovarian-Adnexal Reporting and Data System. Overall, subjective assessment appears to be superior to all prediction models. link2 However, the International Ovarian Tumor Analysis models are probably the best available methods for nonexpert examiners. The Ovarian-Adnexal Reporting and Data System is an international approach that incorporates both the common European and North American approaches, but still needs to be validated.
Many prediction models exist for the assessment of adnexal masses. The adoption of a particular model is based on local guidelines, as well as sonographer's experience. link3 The safety of expectant management of adnexal masses with benign ultrasound morphology is still under investigation.
Many prediction models exist for the assessment of adnexal masses. The adoption of a particular model is based on local guidelines, as well as sonographer's experience. The safety of expectant management of adnexal masses with benign ultrasound morphology is still under investigation.
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