Content and Quality of Information about Stroke in Wikipedia across Multiple Languages.

BACKGROUND: Given the high contribution of stroke to the global burden of disease, there is a need for good-quality information on Web platforms such as Wikipedia. AIMS: This study aimed to describe the quality of the Wikipedia articles on stroke written in different languages. METHODS: We studied the world's 30 most spoken languages. With the DISCERN score, we evaluated the quality of the information within the Wikipedia articles. Three investigators assessed each of the texts translated to English. We also registered the word count, the number of references, and if the text referred to the emergency status of stroke, cues to suspect a stroke, and allusions to endovascular treatment. RESULTS: There is a Wikipedia article for stroke in 23 out of the 30 languages. The mean DISCERN score was 35 29.9 ± 9.2. Overall quality ranged from 3/5 in 26.1% to 1/5 in 17.4%. Word count had a mean of 36 3,145.8 ± 3,048.9 words, and the texts included a mean of 43.1 ± 57.3 references; 69.6% of the articles referred to stroke as a medical emergency, 52.2% included awareness symptoms, and 34.8% included endovascular management among the stroke treatments. Three pages included steroids as part of the stroke treatment. The DISCERN score was not correlated with the number of speakers, but it was positively correlated with the number of references (r = 0.90, p < 0.001) and the number of words (r = 0.78, p < 0.001) in the articles. CONCLUSION: The analyzed Wikipedia articles do not contain relevant and up-to-date information to the general population. Further, the content varies widely across the different languages and is missing for some of them. The missing versions disproportionally affect millions of potential information seekers in undeveloped countries.

A Clinical Prognostic Scoring System for Neurocysticercosis.

Objectives In patients with neurocysticercosis (NCC), an accurate risk prediction would allow a better therapeutic approach; however, there are currently no tools that can enhance the accuracy of risk prediction. We designed a prognostic scoring system to be used by neurologists and other physicians managing patients with NCC. Materials and Methods Using data from clinical records of patients from a third-level national reference center for neurological diseases, we assessed demographic, clinical, and tomographic variables among 293 patients diagnosed with NCC. Multivariable logistic regression analyses were used to develop a clinical prognostic scoring instrument. Patients with NCC were assessed for neurological impairment at 3 months after diagnosis. Statistical Analysis Score accuracy was assessed by receiver operating characteristic (ROC) curve analysis. The primary outcome was the presence of neurological impairment, resulting in disability according to self-report or caregiver reports; this outcome was assessed during follow-up visits at 3 ± 1 months after discharge. Results The most common symptoms at presentation were headache (67%) and seizure (63%). A six-item (total score from -4 to + 2) prognostic instrument was constructed on the basis of the presence of seizures/headache at presentation, a leukocyte count above 12x 109/dL, the presence of six to ten parasites, subarachnoid localization, and the use of anthelmintic drugs. Among 113 patients with negative scores, 79.6% developed neurological deficits. Among patients with scores of 1 to 2, 64.6% recovered completely, with an overall accuracy of prediction of 74.7% and area under the ROC curve = 0.722 (95% CI, 0.664-0.780, p < 0.0001). Conclusions The clinical prognostic scoring system for NCC described in this study is a new instrument for use in daily clinical practice. It is simple to administer, and it has a prognostic accuracy of 75%. Its use has the potential to improve the quality of care by guiding appropriate decision-making and early management of patients with NCC.

[Guillain-Barré syndrome. Its association with alpha tumor necrosis factor]. / Síndrome de Guillain-Barré. Asociación con antagonista de FNT?

BACKGROUND: adalimumab, a human recombinant monoclonal antibody against tumoral necrosis factor alpha (TNFα), has been associated with central nervous system demyelinating diseases and peripheral neuropathic syndrome. The Guillain-Barré Syndrome (GBS) is one of them. CLINICAL CASE: we presented the case of a 65 year old woman, with diabetes mellitus and psoriasic arthritis, treated with adalimumab; after the fourth infusion, she developed paresthesia and mild weakness in lower limbs, these symptoms persisted three days after each infusion and each time remitted spontaneously; following the eight dose, presented a characteristic clinical picture of the GBS, confirmed with neurophysiological studies that showed an axonal motor-sensitive polyneuropathy. The treatment consisted in intravenous immunoglobulin, with good outcome. CONCLUSIONS: the synergy among cellular and humoral immune responses, against peripheral nerve antigens is responsible of immunopathogenesis related to GBS. The prolonged and intensified pathologic immune response induced by adalimumab, may be associated to the development of GBS.

[Acute bilateral thalamic infarcts in a young man with patent foramen ovale]. / Infarto agudo talámico bilateral en paciente joven con foramen oval permeable.

BACKGROUND: Patent foramen ovale (PFO) has been associated with cryptogenic stroke in young patients. CLINICAL CASE: A 27-year-old man presented with acute confusional syndrome, altered language, bradypsychia and somnolence. Brain MRI showed symmetrical bilateral thalamic infarctions probably due to occlusion of Percheron's artery type 2b. Echocardiography showed patent foramen ovale. CONCLUSIONS: Cerebrovascular disease is a frequent cause of disability and even death in young patients, and thus its medical approach should be emphasized.

Infarto agudo talámico bilateral en paciente joven con foramen oval permeable / Acute bilateral thalamic infarcts in a young man with patent foramen ovale

Antecedentes: La presencia de foramen oval permeable se asocia a infartos cerebrales criptogénicos en pacientes jóvenes. Caso clínico: Hombre de 27 años en quien se inició de forma súbita síndrome confusional agudo, bradipsiquia y somnolencia. La imagen de resonancia magnética cerebral mostró infarto talámico bilateral simétrico por probable oclusión de arteria de Percheron tipo 2b. El ecocardiograma identificó foramen oval permeable. Conclusiones: El evento cerebrovascular es causa frecuente de discapacidad e incluso muerte en población joven. Debe hacerse énfasis en el estudio integral de esta patología.

BACKGROUND: Patent foramen ovale (PFO) has been associated with cryptogenic stroke in young patients. CLINICAL CASE: A 27-year-old man presented with acute confusional syndrome, altered language, bradypsychia and somnolence. Brain MRI showed symmetrical bilateral thalamic infarctions probably due to occlusion of Percheron's artery type 2b. Echocardiography showed patent foramen ovale. CONCLUSIONS: Cerebrovascular disease is a frequent cause of disability and even death in young patients, and thus its medical approach should be emphasized.