Functional Outcomes in Upper Limb Replantation-A Systematic Review.

Functionality after upper limb replantation is a decisive factor when considering the success of the intervention. Therefore, its evaluation is fundamental. The aim of this article was to conduct a systematic review of upper limb functions after replantation or reimplantation, seeking to identify reported functional outcomes as well as the level and mechanism of injury. To achieve this objective, a literature search was conducted in PubMed, ScienceDirect, Cochrane and Web of Science. Studies from the last 10 years which included patients with upper limb replantation and reported their functional outcomes were included. Out of 523 articles, 12 studies (n = 607) were finally included. DASH and CISS were the most commonly used assessments to report functional outcomes. In conclusion, functional outcomes after replantation are assessed using widely varying scales; therefore, due to this methodological variability, it is difficult to compare functional success between studies and further studies on functionality are needed to provide new data.

Retrospective Study of Lung Cancer: Evolution in 16 Years in the Burgos Region.

Background: This study investigates the evolution of lung cancer in the population of Burgos over more than a decade, focusing on key variables such as age, gender, histology, and stage of diagnosis. The aim is to understand how incidence rates and patterns have changed over time, especially in terms of early diagnosis. Methods: Retrospective data were collected from the Burgos University Hospital using histological or clinicoradiological methods. This data collection approach enabled a comprehensive examination of lung cancer trends in the province. Results: The results reveal an overall decrease in lung cancer incidence rates in men, offset by a steady increase in women. Histological analysis highlights a significant increase in adenocarcinoma, accounting for 43% of cases in the last year studied. Despite diagnostic advances, almost half of the diagnoses were made at stage IV, with no statistically significant change from previous years, highlighting persistent challenges in early diagnosis. Conclusions: The findings will not only inform resource management and prevention but could also have a significant impact on improved screening strategies and future lung cancer research.

Language-Independent Acoustic Biomarkers for Quantifying Speech Impairment in Huntington's Disease.

PURPOSE: Changes in voice and speech are characteristic symptoms of Huntington's disease (HD). Objective methods for quantifying speech impairment that can be used across languages could facilitate assessment of disease progression and intervention strategies. The aim of this study was to analyze acoustic features to identify language-independent features that could be used to quantify speech dysfunction in English-, Spanish-, and Polish-speaking participants with HD. METHOD: Ninety participants with HD and 83 control participants performed sustained vowel, syllable repetition, and reading passage tasks recorded with previously validated methods using mobile devices. Language-independent features that differed between HD and controls were identified. Principal component analysis (PCA) and unsupervised clustering were applied to the language-independent features of the HD data set to identify subgroups within the HD data. RESULTS: Forty-six language-independent acoustic features that were significantly different between control participants and participants with HD were identified. Following dimensionality reduction using PCA, four speech clusters were identified in the HD data set. Unified Huntington's Disease Rating Scale (UHDRS) total motor score, total functional capacity, and composite UHDRS were significantly different for pairwise comparisons of subgroups. The percentage of HD participants with higher dysarthria score and disease stage also increased across clusters. CONCLUSION: The results support the application of acoustic features to objectively quantify speech impairment and disease severity in HD in multilanguage studies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25447171.

Association Between Insulin-Like Growth Factor-1 and Social Cognition in Huntington's Disease.

Background: Insulin-like growth factor 1 (IGF-1) seems to be involved in the neural circuits associated with social cognition and brain structure. Objectives: To investigate the association of IGF-1 levels with social cognition and brain structure in Huntington's disease (HD). Methods: We evaluated social cognition using the Ekman test in 22 HD patients and 19 matched controls. Brain structure was assessed using standard volume-based voxel-based morphometry and surface-based cortical thickness pipeline. We analyzed the association of IGF-1 levels with social cognition and brain structure using adjusted regression analysis. Results: Social cognition was worse in HD patients (P < 0.001), on antidopaminergic drugs (P = 0.02), and with lower IGF-1 levels (P = 0.04). In neuroimaging analyses, lower IGF-1 levels were associated with social cognition impairment and atrophy mainly in frontotemporal regions (P < 0.05 corrected). Conclusions: In HD, abnormal IGF-1 function seems to be associated with brain atrophy leading to clinical deficits in social cognition.

Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington's Disease: A Cross-Sectional Multicentre Study.

Accelerometers can estimate the intensity, frequency, and duration of physical activity in healthy adults. Although thresholds to distinguish varying levels of activity intensity using the Actigraph wGT3X-B have been established for the general population, their accuracy for Huntington's disease (HD) is unknown. We aimed to define and cross-validate accelerometer cut-points for different walking speeds in adults with mild to moderate HD. A cross-sectional, multicentre, case-control, observational study was conducted with a convenience sample of 13 symptomatic ambulatory HD participants. The accelerometer was placed around the right hip, and a heart monitor was fitted around the chest to monitor heart rate variability. Participants walked on a treadmill at three speeds with light, moderate and vigorous intensities. Correlation and receiver operation curve analyses were performed between the accelerometer magnitude vector with relative oxygen and heart rate. Optimal cut-points for walking speeds of 3.2 km/h were ≤2852; 5.2 km/h: >2852 to ≤4117, and in increments until their maximum velocity: >4117. Our results support the application of the disease-specific cut-points for quantifying physical activity in patients with mild to moderate HD and promoting healthy lifestyle interventions.

The Impact of Dietary Intake and Physical Activity on Body Composition in Parkinson's Disease.

BACKGROUND: Skeletal muscle loss has been associated with declining physical performance and a negative prognostic effect on falls, disability, and mortality risk in Parkinson's disease. OBJECTIVES: We aimed to analyze the clinical correlates associated with skeletal muscle wasting in Parkinson's disease. METHODS: This was a cross-sectional, case-control, observational study. We collected information on dietary intake with a 24-hour recall questionnaire, body composition with bioelectrical impedance, motor severity with the Unified Parkinson's disease Rating Scale, and physical activity with the Global Physical Activity Questionnaire. We used multivariate linear regression analysis to analyze the sociodemographic and clinical correlates associated with skeletal muscle loss after adjusting for confounding variables. RESULTS: Forty-three patients with Parkinson's disease and 21 matched family members were included. Patients and family members had similar body composition, anthropometrics, and nutritional parameters. Advanced patients had similar nutrient intakes compared to patients with mild-to-moderate Parkinson's disease. In the multivariate linear regression analysis, female patients with low physical activity and low energy intake were more likely to have skeletal muscle loss. CONCLUSIONS: Skeletal muscle wasting is a complex multifactorial problem. Dietary strategies and physical exercise should be recommended, especially to females with Parkinson's disease, to prevent significant skeletal muscle wasting.

Tremor Control Devices for Essential Tremor: A Systematic Literature Review.

Background: There is a growing interest in nonpharmacological approaches for essential tremor (ET), including tremor cancelation devices. However, the true efficacy of such devices in ET remains unclear. Methods: A systematic literature review was conducted using standardized criteria regarding efficacy and comfortability. Devices focused on design or experimental testing in which tremor was simulated in a robot were excluded. Results: Out of 324 articles initially identified, 12 articles were included. Orthoses using biomechanical loading and neuromodulation with electrical stimulation, and external tremor cancelation devices, were the main interventions used to suppress tremor. All devices were designed to control tremor of the upper limbs at different anatomical locations. Overall, an average tremor attenuation of 50-98% was reported (level of evidence III). Interference with voluntary movements and portability was described as the main drawback. Discussion: In conclusion, this review highlights the growing interest in emerging tremor control devices and the importance of assessing comfort without affecting voluntary movements. However, the level of evidence regarding the efficacy of these tremor control devices remains low. An integrated multidisciplinary combination approach of engineering, robotics, physiology, physiotherapy, and clinical assessment is needed to improve the quality of non-pharmacological interventions for ET.

Is Restless Legs Syndrome Associated with an Increased Risk of Mortality? A Meta-Analysis of Cohort Studies.

Background: Restless legs syndrome (RLS) is a common sleep disorder,. although controversial, growing evidence relates the presence of RLS to an increased risk of mortality, mainly due to cardiovascular events. The aim of this article was to review the role of RLS as a risk factor of mortality according to independent cohort studies. Methods: We performed a literature review via PubMed database for articles relating RLS and mortality. We used the random-effects model to calculate the pooled effect estimates on mortality. Heterogeneity between studies was assessed using quantitative and qualitative analysis. Results: Out of 100 articles identified, 13 were finally included. Although studies were heterogeneous (p = 0.001), no significant publication bias was found. When all cohort studies were considered, the random-effects model yielded a significantly increased risk of mortality in RLS versus non-RLS patients (13 studies, hazard ratio [HR] = 1.52, 95% confidence interval [CI] 1.28-1.80). However, this association was not statistically significant when only cohort studies using the international RLS diagnostic criteria were considered (5 studies, HR = 1.63, 95% CI 0.94-2.81). Discussion: The results of this meta-analysis suggest that RLS seems to be a risk factor of mortality, although this association is conditioned by the diagnostic criteria used in the studies. Future long-term follow-up standardized mortality studies are needed to address this important question that carries potential impact on population global health.