A Possible Case of Centronuclear Myopathy: A Case Report.

Congenital myopathies (CMs) are a group of diseases that primarily affect the muscle fiber, especially the contractile apparatus and the different components that condition its normal functioning. They present as muscle weakness and hypotonia at birth or during the first year of life. Centronuclear CM is characterized by a high incidence of nuclei located centrally and internally in muscle fibers. Clinical case: a 22-year-old male patient with symptoms of muscle weakness since early childhood, with difficulty in performing physical activity according to his age, with the presence of a long face, a waddling gait, and a global decrease in muscle mass. Electromyography was performed, showing a neurogenic pattern and not the expected myopathic one, neuroconduction with reduced amplitude of the motor potential of the peroneal nerve and axonal and myelin damage of the posterior tibial nerves. The microscopic study of the studied striated muscle fragments stained with hematoxylin-eosin and Masson's trichrome showed the presence of fibers with central nuclei, diagnosing CM. The patient meets most of the description for CM, with involvement of all striated muscles, although it is important to note the neurogenic pattern present in this case, due to the denervation of damaged muscle fibers, which contain terminal axonal segments. Neuroconduction shows the involvement of motor nerves, but with normal sensory studies, axonal polyneuropathy is unlikely, due to normal sensory potentials. Different pathological findings have been described depending on the mutated gene in this disease, but all coincide with the presence of fibers with central nuclei for diagnosis by this means, which is so important in institutions where it is not possible to carry out genetic studies, and allowing early specific treatment, according to the stage through which the patient passes.

A Personal Health System for Self-Management of Congestive Heart Failure (HeartMan): Development, Technical Evaluation, and Proof-of-Concept Randomized Controlled Trial.

BACKGROUND: Congestive heart failure (CHF) is a disease that requires complex management involving multiple medications, exercise, and lifestyle changes. It mainly affects older patients with depression and anxiety, who commonly find management difficult. Existing mobile apps supporting the self-management of CHF have limited features and are inadequately validated. OBJECTIVE: The HeartMan project aims to develop a personal health system that would comprehensively address CHF self-management by using sensing devices and artificial intelligence methods. This paper presents the design of the system and reports on the accuracy of its patient-monitoring methods, overall effectiveness, and patient perceptions. METHODS: A mobile app was developed as the core of the HeartMan system, and the app was connected to a custom wristband and cloud services. The system features machine learning methods for patient monitoring: continuous blood pressure (BP) estimation, physical activity monitoring, and psychological profile recognition. These methods feed a decision support system that provides recommendations on physical health and psychological support. The system was designed using a human-centered methodology involving the patients throughout development. It was evaluated in a proof-of-concept trial with 56 patients. RESULTS: Fairly high accuracy of the patient-monitoring methods was observed. The mean absolute error of BP estimation was 9.0 mm Hg for systolic BP and 7.0 mm Hg for diastolic BP. The accuracy of psychological profile detection was 88.6%. The F-measure for physical activity recognition was 71%. The proof-of-concept clinical trial in 56 patients showed that the HeartMan system significantly improved self-care behavior (P=.02), whereas depression and anxiety rates were significantly reduced (P<.001), as were perceived sexual problems (P=.01). According to the Unified Theory of Acceptance and Use of Technology questionnaire, a positive attitude toward HeartMan was seen among end users, resulting in increased awareness, self-monitoring, and empowerment. CONCLUSIONS: The HeartMan project combined a range of advanced technologies with human-centered design to develop a complex system that was shown to help patients with CHF. More psychological than physical benefits were observed. TRIAL REGISTRATION: ClinicalTrials.gov NCT03497871; https://clinicaltrials.gov/ct2/history/NCT03497871. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12872-018-0921-2.

Producción cientifica cubana sobre Angiostrongylus cantonensis. 1981-2015 / Cuban scientific production of Angiostrongylus cantonensis.1981-2015

Introducción: En 1981 aparece por primera vez reportado en Cuba y en el hemisferio occidental el helminto Angiostrongylus cantonensis. Objetivo: caracterizar la producción científica cubana sobre Angiostrongylus cantonensis en el período 1981-2015. Material y Métodos: Se consultaron las bases de datos Google Académico, Medline (PubMed), ScieELO Regional, CUMED, IBECS, LILACS y se recuperaron todos los trabajos hechos o no con la colaboración de investigadores de otros países.Se relacionan las revistas, se hallan las redes de autoría por el programa UCINET y la frecuencia de publicaciones por año por GoPubMed. Para caracterizar a los autores más productivos en el tema se empleó Publish or perish y su familia de índices. Resultados: De este periodo se recuperaron 40 artículos de autores cubanos. El número de artículos por autores más productivos oscila entre 14 y 22 trabajos. Las revistas que más artículos de autores cubanos han publicado son la Revista Cubana de Medicina Tropical, la Revista de Neurología y la American Journal of Tropical Medicine and Higiene. Los idiomas utilizados han sido el español e inglés. El promedio de citas por artículo es de 9,92. La red de colaboración más fuerte encontrada fue la de los investigadores de LABCEL y se destaca la colaboración con Ecuador. Conclusiones: Existe un grupo de autores cubanos que han publicado sobre el tema y han establecido redes de colaboración que ganan en participación, en países del área, por la expansión del parásito y sus consecuencias en el hospedero(AU)

Introduction: In 1981, Angiostrongylus cantonensis was first reported in Cuba and in the Western Hemisphere. Objective: To characterize the scientific Cuban production during the years 1981-2015. Materials and Methods: Google Academic, Medline(PubMed), SciELO, CUMED, IBECS and LILACS databases were consulted, retrieving all the published papers from Cuban authors with or without the cooperation of foreign researchers. Journal and authors network were listed using UCINET and yearly frequency using GoPubMed software respectively. Most productive authors were characterized using Publish or perish and also its family index. Results: During the above mentioned period, 40 papers were collected from Cuban authors. The most productive authors published were between 14 and 22 papers. Revista Cubana de Medicina Tropical, Revista de Neurología and American Journal of Tropical Medicine and Hygiene were the journals where the Cuban authors have published more articles. Spanish and English languages were used. The average of Articles references was 9,92. The strongest collaboration network was LABCEL, collaboration with Ecuador stood out. Conclusions: There is a group of Cuban authors that have been publishing about this topic and a collaboration networks were established with a wider used among other regional countries due to the expansion of the parasite and its consequence on the host(AU)