Síndrome de Guillain-Barré tras infección por SARS-CoV-2. Comentarios tras la publicación de 16 nuevos casos / Guillain-Barré syndrome associated with SARS-CoV-2 infection. Comments after 16 published cases

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Cumplimentación del certificado médico de defunción en Madrid: un estudio descriptivo trasversal / Completion of the medical certificate of cause of death in Madrid: a descriptive cross-sectional study

INTRODUCCIÓN: El certificado médico de defunción es un documento con una doble función: registro oficial del fallecimiento de una persona y análisis estadístico de las causas de muerte de la población. La cumplimentación de este documento en la práctica clínica genera grandes conflictos. OBJETIVOS: Analizar la cumplimentación y detectar los principales errores que existen al rellenar estos documentos. Se procedió a la comparación de las variables más importantes entre los diferentes tipos de documentos analizados. MATERIAL Y MÉTODOS: Estudio transversal descriptivo. Se analizaron 513 certificados del municipio de Madrid. El análisis incluía documentos oficiales, nuevos y antiguos, y de los hospitales. RESULTADOS: Como principal hallazgo destacó que 316 documentos empleaban el término «parada cardiorrespiratoria» como causa inmediata de muerte. En otros 98 casos se emplearon otras causas inmediatas mal definidas. También se pudo concluir que los documentos de los hospitales no siempre tienen los apartados requeridos para que el certificado haga su función legal. En los certificados de la Organización Médica Colegial existe una peor cumplimentación en el documento actual porque el propio documento dificulta que se rellene adecuadamente y precisa una mejor formación del médico para rellenarlo. CONCLUSIONES: Se proponen posibles mejoras en el propio documento oficial para que se consideren las exigencias legales, se facilite su cumplimentación y cumpla su función. También se proponen recomendaciones para los hospitales que tengan su propio documento y sugerencias de mejora de la cumplimentación

BACKGROUND: The medical certificate of cause of death is a dual-purpose document: an official registration of an individual's death and a statistical analysis of the populational causes of death. However, the completion of this document in clinical practice creates significant conflicts. OBJECTIVES: To analyse the completion and detect the main errors that occur when filling in these documents. We then compared the most important variables between the various types of documents analysed. MATERIAL AND METHODS: We conducted a descriptive cross-sectional study that analysed 513 certificates in the municipality of Madrid, Spain. The analysis included official documents (new and old versions) and hospital documents. RESULTS: The study's main finding was that 316 documents employed the term "cardiopulmonary arrest" as the immediate cause of death. In 98 other cases, other poorly defined immediate causes were listed. We were able to conclude that the hospital documents do not always have the required sections for the certificate to be legally functional. In the Professional Medical Association certificates, there is poorer completion of the current document because the document itself hinders its appropriate completion and requires better physician training to complete. CONCLUSIONS: We propose possible improvements to the official document so that it meets the legal requirements, facilitates its completion and fulfils its function. We also offer recommendations for hospitals that have their own document and suggestions for improving its completion

Completion of the medical certificate of cause of death in Madrid: A descriptive cross-sectional study. / Cumplimentación del certificado médico de defunción en Madrid: un estudio descriptivo trasversal.

BACKGROUND: The medical certificate of cause of death is a dual-purpose document: an official registration of an individual's death and a statistical analysis of the populational causes of death. However, the completion of this document in clinical practice creates significant conflicts. OBJECTIVES: To analyse the completion and detect the main errors that occur when filling in these documents. We then compared the most important variables between the various types of documents analysed. MATERIAL AND METHODS: We conducted a descriptive cross-sectional study that analysed 513 certificates in the municipality of Madrid, Spain. The analysis included official documents (new and old versions) and hospital documents. RESULTS: The study's main finding was that 316 documents employed the term "cardiopulmonary arrest" as the immediate cause of death. In 98 other cases, other poorly defined immediate causes were listed. We were able to conclude that the hospital documents do not always have the required sections for the certificate to be legally functional. In the Professional Medical Association certificates, there is poorer completion of the current document because the document itself hinders its appropriate completion and requires better physician training to complete. CONCLUSIONS: We propose possible improvements to the official document so that it meets the legal requirements, facilitates its completion and fulfils its function. We also offer recommendations for hospitals that have their own document and suggestions for improving its completion.

[Metronidazole-induced encephalopathy: description of a case with radiological and anatomopathological findings]. / Encefalopatia inducida por metronidazol: descripcion de un caso con hallazgos radiologicos y anatomopatologicos.

TITLE: Encefalopatia inducida por metronidazol: descripcion de un caso con hallazgos radiologicos y anatomopatologicos.

Encefalopatía inducida por metronidazol: descripción de un caso con hallazgos radiológicos y anatomopatológicos / Metronidazole-induced encephalopathy: description of a case with radiological and anatomopathological findings

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Comentarios a: "Temblor ortostático secundario al uso recreativo de disolventes" / Comments to "Orthostatic tremor secondary to recreational use of solvents"

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[Cervantes and Shakespeare, two Renaissance neurologists]. / Cervantes y Shakespeare, dos neurologos renacentistas.

TITLE: Cervantes y Shakespeare, dos neurologos renacentistas.

Face-to-Face or Telematic Cognitive Stimulation in Patients with Multiple Sclerosis and Cognitive Impairment: Why Not Both?

INTRODUCTION: Cognitive impairment (CI) affects 40-65% of patients with multiple sclerosis (MS). Few studies address telematic cognitive stimulation (TCS) in MS. The objective of this study is to evaluate the efficacy and impact of telestimulation or distance cognitive stimulation (TCS), with and without the support of face-to-face cognitive stimulation (FCS) in cognitive impairment in MS. METHODS: Multicentre, prospective, randomised, controlled study. We will include 98 MS patients with EDSS ≤ 6, symbol digit modality test (SDMT) ≤ Pc 25, and Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) > 26 points. Patients will be randomised into 3 groups, a TCS group, a mixed TCS/FCS group, and a control group. CS is performed 3 days a week for 3 months. Processing speed, memory, attention, and executive functions will be rehabilitated. FCS will include ecological exercises and strategies. EDSS and a cognitive evaluation (SDMT, CTMT, PASAT, and TAVEC), MSNQ, psychological impact scales (MSIS), and depression (BDI) will be carried out, baseline, postrehabilitation, and also 6 and 12 months later, to evaluate the effect of CS in the longer term. CONCLUSION: This study could help to establish the usefulness of TCS or, in its absence, TCS with face-to-face help for CI in MS. The interest lies in the clear benefits of remote rehabilitation in the daily life of patients.

Month of birth, HLA-DRB1*15 locus and risk of multiple sclerosis in offspring. / Mes de nacimiento, HLA-DRB1 y riesgo de esclerosis multiple en la descendencia.

INTRODUCTION: A relationship among April births, HLA-DRB1*15:01 genotype and risk of multiple sclerosis (MS) has been described. We aim to determine this association in our cohort of Spanish MS patients. SUBJECTS AND METHODS: We genotyped HLA-DRB1*15:01 allele in 326 MS patients and 226 controls (non-neurological disease patients) by SSP-PCR and compared month of birth with local births during the same period. RESULTS: MS patients carrying HLA-DRB1*15 allele were more frequently born in December (10.3% HLA-DRB1*15+ vs. 3.8% HLA-DRB1*15-; p = 0.019). Controls carrying HLA-DRB1*15 allele were less frequently born in December than non-carrier controls (0% HLA-DRB1*15+ vs. 10.3% HLA-DRB1*15-; p = 0.028). Thus, December was confirmed as the common month of birth for HLA-DRB1*15-non-carrier controls and MS HLA-DRB1*15-carrier patients. CONCLUSIONS: Month of birth, HLA-DRB1 genotype and risk of MS are associated. In Spain, this association was found in December, supporting the potential interaction of a seasonal risk factor in winter, inside/close to HLA-DRB1*15 locus, during pregnancy or after birth.

TITLE: Mes de nacimiento, HLA-DRB1 y riesgo de esclerosis multiple en la descendencia.Introduccion. El haplotipo HLA-DRB1*1501 es el marcador genetico que se ha asociado con un riesgo tres veces mayor de padecer esclerosis multiple (EM) en caucasicos occidentales. Recientemente se ha sabido que hay una asociacion entre el mes de nacimiento en abril, el genotipo HLA-DRB1 y el riesgo de EM en paises del norte de Europa y Canada. Esto apoya la teoria de que debe haber una interaccion entre un factor de riesgo estacional con un locus cercano al HLA-DRB1*15 durante la gestacion o cerca del posparto. Sujetos y metodos. Se realizo el genotipado de la presencia y subtipo de HLA-DRB1*1501 en 326 pacientes de dos centros espa˜oles y en 226 controles sin patologia neurologica. Se compararon los meses de nacimiento de la muestra de pacientes con los nacimientos mensuales locales en los mismos periodos. Resultados. Comparados los pacientes con EM que eran portadores del alelo HLA-DRB1*15 (10,3%) frente a los pacientes no portadores (3,8%), significativamente mas pacientes nacian en diciembre (p = 0,0185). Tambien se confirmaba el mismo mes de nacimiento de diciembre entre sanos portadores frente a no portadores de HLA-DRB1*15 y entre pacientes portadores de HLA-DRB1*15 frente a sanos. Conclusiones. El mes de nacimiento, el genotipo HLA-DRB1*15 y el riesgo de presentar EM estan asociados. A diferencia de los resultados obtenidos en paises del norte de Europa, donde esta asociacion se ha encontrado en el mes de abril, en Espa˜a es en diciembre. Se demuestra la interaccion de un factor de riesgo estacional en invierno en el locus HLA-DRB1*15 o cercano a este durante la gestacion o tras el nacimiento.

¿Fueron los aztecas quienes primero representaron la enfermedad de Parkinson? / Were the Aztecs the first to represent Parkinson's disease?

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[Internal carotid artery agenesis and multiple aneurysms in the posterior communicating artery]. / Agenesia de la carótida interna y múltiples dilataciones aneurismáticas de la arteria comunicante posterior.

Internal carotid artery agenesia is a rare anomaly of the embryonic development. We present a case with this anomaly and a vascular feeding of this territory out of the contralateral carotid system and the posterior vascular system. There were multiple aneurysms in the right posterior communicating artery, never described before in association with carotid agenesia, that are similar to the angiographic image of the fibromuscular dysplasia ("atypical" pattern). We review and discuss the embryonic development of this anomaly and its relationship with the hemodynamic stress and aneurysm formation.