Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study.

INTRODUCTION: In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. METHOD: Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. RESULTS: Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. CONCLUSIONS: The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.

Epilepsy and musical perception. A perspective involving 14 patients. / Epilepsia y percepción musical. Una visión a través de 14 pacientes.

INTRODUCTION: The relationship between epilepsy and music is poorly understood. Musicogenic epilepsy, which involves seizures triggered by music, and epilepsy that triggers or involves musical experiences are rare. Anti-seizure medications (ASMs) may affect cognition and possibly the musical sphere. The relationship between epilepsy, ASMs and music perception is insufficiently investigated in the literature. This study describes the clinical characteristics of patients with epilepsy with advanced musical knowledge, and aims to understand the disease's involvement in the musical sphere. PATIENTS AND METHODS: A qualitative study was conducted in epileptic patients with musical knowledge, investigating their musical perception before and after a diagnosis of epilepsy and after a change of ASM when this was possible. Questionnaires and recordings of music were used to assess musical perception. RESULTS: Fourteen patients had musical knowledge, and the majority of these (50%) had temporal lobe epilepsy. A total of 92.8% of the patients stated that epilepsy or its medications had affected them in the musical sphere. There was no clear relationship between the lateralisation of the epilepsy and musical involvement. 42.9% were professional musicians, and had to give up their profession. The patients prescribed with more than one ASM had greater musical involvement. CONCLUSIONS: Temporal lobe epilepsy appears to have the greatest effect on music perception, and more studies with ASM and music perception are needed to determine its effects.

TITLE: Epilepsia y percepción musical. Una visión a través de 14 pacientes.Introducción. La relación entre la epilepsia y la música es poco comprendida. La epilepsia musicógena, que involucra crisis desencadenadas por la música, y la epilepsia que produce o involucra experiencias musicales son poco comunes. Se sabe que los medicamentos anticrisis (MAC) pueden afectar a la cognición y posiblemente a la esfera musical. La relación entre la epilepsia, los MAC y la percepción musical está insuficientemente investigada en la bibliografía. El objetivo de este estudio es describir las características clínicas de pacientes con epilepsia con conocimientos musicales avanzados e intentar comprender la afectación de la enfermedad a la esfera musical. Pacientes y métodos. Se llevó a cabo un estudio cualitativo en pacientes epilépticos con conocimientos musicales, investigando su percepción musical antes y después del diagnóstico de epilepsia y, cuando fue posible, tras el cambio de MAC. Se utilizaron cuestionarios y grabaciones musicales para evaluar la percepción musical. Resultados. Catorce pacientes tenían conocimientos musicales, la mayoría (50%) con epilepsia del lóbulo temporal. Un 92,8% de los pacientes indicó que la epilepsia o sus medicamentos le habían afectado en la esfera musical. No había una clara relación entre lateralización de la epilepsia y afectación musical. Un 42,9% eran músicos profesionales y tuvieron que dejar la profesión. Los pacientes con más de un MAC pautado tenían mayor afectación musical. Conclusiones. La epilepsia del lóbulo temporal parece ser la que más afecta a la percepción musical, y hacen falta más estudios con MAC y percepción musical para dilucidar sus efectos.

Effects of non-stationary blur on texture biomarkers of bone using Ultra-High Resolution CT.

Purpose: To advance the development of radiomic models of bone quality using the recently introduced Ultra-High Resolution CT (UHR CT), we investigate inter-scan reproducibility of trabecular bone texture features to spatially-variant azimuthal and radial blurs associated with focal spot elongation and gantry rotation. Methods: The UHR CT system features 250×250 µm detector pixels and an x-ray source with a 0.4×0.5 mm focal spot. Visualization of details down to ~150 µm has been reported for this device. A cadaveric femur was imaged on UHR CT at three radial locations within the field-of-view: 0 cm (isocenter), 9 cm from the isocenter, and 18 cm from the isocenter; we expect the non-stationary blurs to worsen with increasing radial displacement. Gray level cooccurrence (GLCM) and gray level run length (GLRLM) texture features were extracted from 237 trabecular regions of interest (ROIs, 5 cm diameter) placed at corresponding locations in the femoral head in scans obtained at the different shifts. We evaluated concordance correlation coefficient (CCC) between texture features at 0 cm (reference) and at 9 cm and 18 cm. We also investigated whether the spatially-variant blurs affect K-means clustering of trabecular bone ROIs based on their texture features. Results: The average CCCs (against the 0 cm reference) for GLCM and GLRM features were ~0.7 at 9 cm. At 18 cm, the average CCCs were reduced to ~0.17 for GLCM and ~0.26 for GLRM. The non-stationary blurs are incorporated in radiomic features of cancellous bone, leading to inconsistencies in clustering of trabecular ROIs between different radial locations: an intersection-over-union overlap of corresponding (most similar) clusters between 0 cm and 9 cm shift was >70%, but dropped to <60% for the majority of corresponding clusters between 0 cm and 18 cm shift. Conclusion: Non-stationary CT system blurs reduce inter-scan reproducibility of texture features of trabecular bone in UHR CT, especially for locations >15 cm from the isocenter. Radiomic models of bone quality derived from UHR CT measurements at isocenter might need to be revised before application in peripheral body sites such as the hips.

Estudio clínico-genético molecular de la fibrosis quística en la V Región, Chile / Clinical and molecular genetic study of cystic fibrosis in the 5th Region of Chile

BACKGROUND: Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasian population. More than 900 mutations have been detected in the Cystic Fibrosis Transmembrane Regulator (CFTR) gene. The most common worldwide, is a deletion of phenylalanine 508 (delta F508). AIM: To analyze the presence of mutations delta F508, G542X, N1303K, G551D, R553X and S549N in patients from the 5th Region of Chile, with a clinical diagnosis of CF. PATIENTS AND METHODS: We studied 17 non-related patients, presenting frequent respiratory tract infections, malabsorption and positive sweat tests, or meconial ileum. Serum immunoglobulins (IgG, IgA, IgM), and total, CD3+ and B-lymphocytes, were determined to discard the presence of an immune deficiency. The molecular study of the gene was performed by Polymerase Chain Reaction amplification and restriction analysis. RESULTS: Immunological parameters were normal in all patients. The delta F508 mutation was detected in 11 chromosomes and the mutation G542X in 3 chromosomes. CONCLUSIONS: The mutation G542X was the second most frequent mutation found in this sample of Chilean CF patients. Since this mutation has a high frequency in Spanish CF patients, we suggest that this mutation might have had its origin in Spain.

Cirugia biliar y embarazo. / Biliary surgery and pregnancy

Se estudia "prospectivamente" un grupo de 20 pacientes embarazadas, intervenidas por patologia aguda de la via biliar, entre octubre de 1980 y septiembre de 1981 en el Hospital Doctor Sotero del Rio. Los datos obtenidos nos permiten concluir: 1. La indicacion mas frecuente de cirugia no obstetrica durante el embarazo, en nuestro medio, es de causa biliar. 2. El cuadro biliar agudo se presenta con las mismas caracteristicas clinicas que en la no gravida. 3. No se encontraron caracteristicas que definan un grupo de alto riesgo para desarrollar patologia biliar aguda durante la gestacion. 4. La cirugia en la segunda mitad del embarazo y aquella que comprende drenaje de la via biliar, se asocian con alta morbilidad obstetrica y perinatal pese a lo cual no determino mortalidad perinatal en la serie

Sensibilidad del canal anal de sujetos normales y pacientes tratados quirurgicamente de malformacion anorrectal: estudio mediante la tecnica de potenciales provocados. / Sensitivity of the anal canal in normal subjects and in patients surgically treated of anorectal malformation, study with evocked potentials technic

En condiciones fisioloficas la actividad motora que se lleva a cabo en el acto de defecacion depende de la informacion sensorial proveniente de la region del canal anal; sin embargo, en los estudios sobre el problema de incontinencia anal en pacientes con malformacion anorrectal tratados quirurgicamente, muy poco se ha tomado en cuenta el factor percepcion. Con el objetivo de determinar si existen diferencias en la actividad electrica de la via sensorial que se origina en los receptores del canal anal de sujetos normales y aquella de pacientes tratados quirurgicamente para correccion de malformacion anorrectal se estudiaron mediante la tecnica de potenciales, provocados 22 ninos aparentemente sanos y 11 pacientes. Nuestros resultados demuestran una actividad electrica de la via sensorial de los pacientes de menor intensidad y de conduccion ma lenta que la de los sujetos normales; inclusive en algunos pacientes no aparecio actividad Se sugiere que la alteracion sensorial podria ser en parte responsable de la incontiencia anal que pueda presentarse posteriormente en estos pacientes