Estimating bradykinesia severity in Parkinson's disease by analysing gait through a waist-worn sensor.

Bradykinesia is a cardinal symptom of Parkinson's disease (PD) and describes the slowness of movement revealed in patients. Current PD therapies are based on dopamine replacement, and given that bradykinesia is the symptom that best correlates with the dopaminergic deficiency, the knowledge of its fluctuations may be useful in the diagnosis, treatment and better understanding of the disease progression. This paper evaluates a machine learning method that analyses the signals provided by a triaxial accelerometer placed on the waist of PD patients in order to automatically assess bradykinetic gait unobtrusively. This method employs Support Vector Machines to determine those parts of the signals corresponding to gait. The frequency content of strides is then used to determine bradykinetic walking bouts and to estimate bradykinesia severity based on an epsilon-Support Vector Regression model. The method is validated in 12 PD patients, which leads to two main conclusions. Firstly, the frequency content of the strides allows for the dichotomic detection of bradykinesia with an accuracy higher than 90%. This process requires the use of a patient-dependant threshold that is estimated based on a leave-one-patient-out regression model. Secondly, bradykinesia severity measured through UPDRS scores is approximated by means of a regression model with errors below 10%. Although the method has to be further validated in more patients, results obtained suggest that the presented approach can be successfully used to rate bradykinesia in the daily life of PD patients unobtrusively.

[Takayasu arteritis and cerebral venous thrombosis: report of a case]. / Arteritis de Takayasu y trombosis venosa cerebral: a propósito de un caso.

Palpitations, paresthesias and anxiety are very common reasons of consultation in primary care. We report the case of a 40 year-old Caucasian woman who came to the clinic due to these symptoms, and was finally diagnosed with Takayasu arteritis. Later, she had an episode of headache, as the initial manifestation of cerebral venous thrombosis. Takayasu arteritis is a systemic vasculitis affecting medium and large arteries, mainly leacausing stenosis of the aorta and its branches. It most frequently affects Asian women, being much rarer in Europe. The primary care doctor plays a key role in the initial diagnosis and monitoring of patients with rare diseases, such as Takayasu arteritis, and must be a basic support for the patient and family, providing information and advice, and contributing with his work to reduce the vulnerability of this group.

["Dizziness" as the first manifestation of a chronic progressive multiple sclerosis]. / "Mareo" como primera manifestación de una esclerosis múltiple primariamente progresiva.

Dizziness is a common consultation in primary care. Most cases of dizziness can be managed in the first level of care. The family physician should be able to discriminate the cases that require referral to a second level, those potentially serious, and those requiring immediate care. We report the case of a patient with long-term dizziness and the diagnosis, clinical course, treatment and prognosis.

[Pulmonary Langerhans cell histiocytosis: report of a case]. / Histiocitosis pulmonar de células de Langerhans: a propósito de un caso.

Pulmonary Langerhans cell histiocytosis is a rare disease of young adults, usually smokers, which is associated with significant morbidity. The course of the disease is unpredictable, ranging from benign self-limiting types with spontaneous regression, to malignant forms with progression to respiratory failure and death. Its cause is unknown, but most authors believe that there is an alteration in immune system regulation in these patients. We report a case of a patient with the diagnosis of pulmonary Langerhans cell histiocytosis and review the clinical characteristics, diagnosis and treatment of this disease. We consider this case of interest due by the low frequency of this disease.

[Diagnostic-therapeutic approach to internal jugular thrombosis]. / Aproximación diagnóstico-terapéutica a la trombosis yugular interna.

The internal jugular vein thrombosis is a rare and critical disease. The infection of the head and neck deep spaces it is not the main cause since the antibiotic era. The ENT neoplasms and iatrogenic etiology are more frequent. Anodyne symptoms and vital complications are important to obtain an early diagnose and therapy, to improve the prognosis. The objective of this review is to obtain a certainly therapeutic criteria in the approach to this entity.