Terapia con péptidos radiomarcados con [177Lu]Lu-DOTA-TATE / Peptide receptor radionuclide therapy with [177Lu]Lu-DOTA-TATE

Esta formación pretende presentar, de forma clara y de fácil comprensión, la biología de los tumores neuroendocrinos (TNE), las características de los receptores de somatostatina, cómo debe realizarse la selección de pacientes candidatos a terapia con péptidos radiomarcados (PRRT), si el paciente cumple los criterios para beneficiarse del tratamiento con los mínimos efectos adversos posibles, el protocolo de administración, seguimiento y evaluación de respuesta. También, se desarrollan los estudios de imagen funcional necesarios para explorar la biología del tumor e individualizar el tratamiento, que constituyen la piedra angular para el desarrollo de la teragnosis.Se están desarrollando ensayos clínicos para definir mejor la posición de PRRT dentro del amplio panorama terapéutico y, entre las perspectivas de futuro, hay varias líneas de investigación para mejorar la tasa de respuesta objetiva y la supervivencia con PRRT, centradas en el desarrollo de nuevos agonistas y antagonistas del receptor de somatostatina, nuevos radionúclidos y terapias combinadas radiosensibilizantes.En conclusión, la PRRT es un tratamiento bien tolerado, seguro y con efectos secundarios agudos, generalmente leves y autolimitados, que constituye una gran herramienta terapéutica que debe secuenciarse en el mejor momento de la evolución de la enfermedad de los pacientes con TNE. Los pacientes candidatos a la PRRT deben ser valorados siempre por un comité clínico multidisciplinar (AU)

This continuing education aims to present in a clear and easy-to-understand way, the biology of neuroendocrine tumors (NETs), the characteristics of somatostatin receptors, the selection of patients for radiolabelled peptide therapy (PRRT), the inclusion criteria to benefit from treatment with the minimum possible adverse effects, the administration protocol, follow-up and response evaluation. The functional imaging studies necessary to explore the biology of the tumor and to individualize the treatment are also carried out, and constitute the cornerstone for the development of teragnosis.Clinical trials are being developed to better define the position of PRRT within the broad therapeutic options, and among the future perspectives, there are several lines of research to improve the objective response rate and survival with PRRT, focused on the development of new agonists and somatostatin receptor antagonists, new radionuclides and radiosensitizing combination therapies.In conclusion, PRRT is a great therapeutic, well-tolerated and safe tool with generally mild and self-limited acute side effects, that must be sequenced at the best moment of the evolution of the disease of patients with NET. Candidate patients for PRRT should always be evaluated by an multidisciplinary clinical committee (AU)

Peptide receptor radionuclide therapy with [177Lu]Lu-DOTA-TATE.

This continuing education aims to present in a clear and easy-to-understand way, the biology of neuroendocrine tumors (NETs), the characteristics of somatostatin receptors, the selection of patients for radiolabelled peptide therapy (PRRT), the inclusion criteria to benefit from treatment with the minimum possible adverse effects, the administration protocol, follow-up and response evaluation. The functional imaging studies necessary to explore the biology of the tumor and to individualize the treatment are also carried out, and constitute the cornerstone for the development of teragnosis. Clinical trials are being developed to better define the position of PRRT within the broad therapeutic options, and among the future perspectives, there are several lines of research to improve the objective response rate and survival with PRRT, focused on the development of new agonists and somatostatin receptor antagonists, new radionuclides and radiosensitizing combination therapies. In conclusion, PRRT is a great therapeutic, well-tolerated and safe tool with generally mild and self-limited acute side effects, that must be sequenced at the best moment of the evolution of the disease of patients with NET. Candidate patients for PRRT should always be evaluated by a multidisciplinary clinical committee.

Validation of a free release measurement facility on a decommissioning site.

The paper summarizes measurements and the Monte Carlo simulations performed to adapt the high purity germanium (HPGe) detectors of the system to the particular tasks of the decommissioning site. The work carried out for the installation and adaptation in CIEMAT of the prototype 'SuperMum', developed in the framework of the European MetroDecom II project for segregation and declassification of materials is described. The activities related to the validation of the prototype for the specific needs of a real Waste Management Unit are presented. Monte Carlo models of the SuperMum have been developed at CIEMAT and CMI using different codes and adapted to the geometries used (big-bag containers with the material volume of up to 0.5 m3). Uncertainty budget reporting tailored for the possible deviations between Monte Carlo assumptions and real waste have been analyzed. Data for several filling levels and activity distributions have been measured with reference sources and a good agreement has been obtained with calculated values.

The morphometric acclimation to depth explains the long-term resilience of the seagrass Cymodocea nodosa in a shallow tidal lagoon.

Cadiz Bay is a shallow mesotidal lagoon with extensive populations of the seagrass Cymodocea nodosa at intertidal and shallow subtidal elevations. This work aims to understand the mechanisms behind the resilience of this species to gradual sea level rise by studying its acclimation capacity to depth along the shallow littoral, and therefore, to gradual variations in the light environment. To address this objective, these populations have been monitored seasonally over a 10 year period, representing the longest seasonal database available in the literature for this species. The monitoring included populations at 0.4, -0.08 and -0.5 m LAT. The results show that C. nodosa has a strong seasonality for demographic and shoot dynamic properties - with longer shoots and larger growth in summer (high temperature) than in winter (low temperature), but also some losses. Moreover, shoots have different leaf morphometry depending on depth, with small and dense shoots in the intertidal areas (0.4 m) and sparse large shoots in the subtidal ones (-0.08 and 0.5 m). These differences in morphometry and shoot dynamic properties, combined with the differences in shoot density, explain the lack of differences in meadow production balance (i.e. meadow growth - meadow losses) between the intertidal (0.4 m) and the deepest population (-0.5 m), supporting the long term resilience of Cymodocea nodosa in Cadiz Bay. This study contributes to the understanding of the mechanisms behind seagrass stability and resilience, which is particularly important towards predicting the effects of climate change on these key coastal ecosystems, and also highlights the value of continuous long-term monitoring efforts to evaluate seagrass trajectories.

Classical description of the parameter space geometry in the Dicke and Lipkin-Meshkov-Glick models.

We study the classical analog of the quantum metric tensor and its scalar curvature for two well-known quantum physics models. First, we analyze the geometry of the parameter space for the Dicke model with the aid of the classical and quantum metrics and find that, in the thermodynamic limit, they have the same divergent behavior near the quantum phase transition, as opposed to their corresponding scalar curvatures which are not divergent there. On the contrary, under resonance conditions, both scalar curvatures exhibit a divergence at the critical point. Second, we present the classical and quantum metrics for the Lipkin-Meshkov-Glick model in the thermodynamic limit and find a perfect agreement between them. We also show that the scalar curvature is only defined on one of the system's phases and that it approaches a negative constant value. Finally, we carry out a numerical analysis for the system's finite sizes, which clearly shows the precursors of the quantum phase transition in the metric and its scalar curvature and allows their characterization as functions of the parameters and of the system's size.

Versatile Target-Guided Screen for Discovering Bidirectional Transcription Inhibitors of a Trinucleotide Repeat Disease.

Myotonic dystrophy type 1 originates from d(CTG·CAG) repeats that undergo aberrant expansion during normal processing because the d(CTG) repeat forms stable hairpin structures. Bidirectional transcription of d(CTG·CAG) yields two RNA transcripts that undergo repeat-associated non-ATG (RAN) translation to form homopolymeric proteins. Thus, both the r(CUG) transcript and the r(CAG) transcript are known to be toxic. We report a pairwise fragment-based, target-guided approach to screen for proximity-induced click dimers formed on the nucleic acid template. This screen uses an azide/alkyne clickable fragment library of nucleic acid-binding ligands incubated in parallel, pairwise reactions as an alternative to our previously reported one-pot screening method. MALDI-TOF mass spectroscopy was used to detect template assisted click products. Hit compounds inhibited the in vitro transcription of d(CTG·CAG)90 bidirectionally with IC50 values in the low micromolar range. This approach may be broadly applicable to other trinucleotide repeat diseases and in targeting other disease-associated nucleic acid sequences.

Synthesis of Isoquinolones by Sequential Suzuki Coupling of 2-Halobenzonitriles with Vinyl Boronate Followed by Cyclization.

A novel, facile, and expeditious two-step synthesis of 3,4-unsubstituted isoquinolin-1(2H)-ones from a Suzuki cross-coupling between 2-halobenzonitriles and commercially available vinyl boronates followed by platinum-catalyzed nitrile hydrolysis and cyclization is described.

Expanded DNA and RNA Trinucleotide Repeats in Myotonic Dystrophy Type 1 Select Their Own Multitarget, Sequence-Selective Inhibitors.

There are few methods available for the rapid discovery of multitarget drugs. Herein, we describe the template-assisted, target-guided discovery of small molecules that recognize d(CTG) in the expanded d(CTG·CAG) sequence and its r(CUG) transcript that cause myotonic dystrophy type 1. A positive cross-selection was performed using a small library of 30 monomeric alkyne- and azide-containing ligands capable of producing >5000 possible di- and trimeric click products. The monomers were incubated with d(CTG)16 or r(CUG)16 under physiological conditions, and both sequences showed selectivity in the proximity-accelerated azide-alkyne [3+2] cycloaddition click reaction. The limited number of click products formed in both selections and the even smaller number of common products suggests that this method is a useful tool for the discovery of single-target and multitarget lead therapeutic agents.

Dermo-epidermal organotypic cultures for in vitro evaluation of skin irritation and corrosion.

In recent years, in-vitro skin models for chemical hazard identification have been developed. Most of them consist only of human keratinocytes, neglecting the contribution of other skin constituents. Cultures containing the dermal and epidermal component provide an attractive system to investigate, in a more realistic model, toxicological responses, which represents a distinct advantage over keratinocytes-based models that do not mimic faithfully the in vivo environment. This study aimed to validate dermo-epidermal organotypic cultures (ORGs) as a platform to perform irritation and corrosion tests. Skin models were constructed by seeding keratinocytes on fibroblast-containing fibrin gels. After 21 days, the ORGs were evaluated histologically, and the irritant and corrosion potential was determined by means of viability measurements (MTT assay) and cytokine release, according to 431 and 439 OECD tests guidelines. Skin models showed similar histological characteristics to native skin and were able to classify different substances with high accuracy, showing their applicability to skin irritation and corrosion tests. Although cytokines release seems to be chemical-dependent, a tendency was observed, leading to the improvement of the prediction capacity. Nevertheless, further studies should be done to reduce variability in order to increase prediction capacity.

Primary Multicentric Pulmonary Low-grade Fibromyxoid Sarcoma and Chelonid Alphaherpesvirus 5 Detection in a Leatherback Sea Turtle (Dermochelys coriacea).

We describe the gross, microscopical, histochemical and immunohistochemical features of a sclerosing pneumopathic disease process resembling primary multicentric pulmonary low-grade fibromyxoid sarcoma in a juvenile female leatherback sea turtle (Dermochelys coriacea). The animal was fresh, presented in good body condition and stranded dead in Aracaju, Sergipe state, Brazil, in September, 2017. Grossly, the lungs were enlarged bilaterally and the parenchyma was replaced by large, coalescing, white, firm masses that extended into the bronchi and bronchioles and to the pleura. Microscopically, these masses consisted of paucicellular populations of well-differentiated, spindle-shaped fibroblasts with low pleomorphism and low mitotic count, but tissue invasion. Abundant collagen in compact areas merged with peripheral fibromyxoid foci and inflamed stroma. Antibodies specific for cytokeratins AE1/AE3 and smooth muscle actin (SMA) labelled pneumocytes lining the remaining distorted alveoli and the hypertrophied and hyperplastic bronchial muscles, respectively. Tumour cells were negative for SMA; neither neoplastic nor normal tissues cross-reacted with antibodies specific for vimentin or Ki67. Chelonid alphaherpesvirus 5 (ChHV5) polymerase chain reaction analysis from formalin-fixed, paraffin wax-embedded lung tissue sections amplified a 450 base pair fragment of DNA-polymerase (UL30 region) that had 100% homology to sequences previously detected in green sea turtles (Chelonia mydas) on the Brazilian coast. Enterocolitis was a concomitant condition that likely caused morbidity in this case. These findings contribute to the body of knowledge on sea turtle health and expand the known geographical range for ChHV5 in the southern hemisphere.

Classical analog of the quantum metric tensor.

We present a classical analog of the quantum metric tensor, which is defined for classical integrable systems that undergo an adiabatic evolution governed by slowly varying parameters. This classical metric measures the distance, on the parameter space, between two infinitesimally different points in phase space, whereas the quantum metric tensor measures the distance between two infinitesimally different quantum states. We discuss the properties of this metric and calculate its components, exactly in the cases of the generalized harmonic oscillator, the generalized harmonic oscillator with a linear term, and perturbatively for the quartic anharmonic oscillator. Finally, we propose alternative expressions for the quantum metric tensor and Berry's connection in terms of quantum operators.

Utility of point-of-care vs reference laboratory testing for the evaluation of glucose levels.

AIMS: To assess the level of agreement between point-of-care and laboratory reference glucose values in defining glycaemic status. METHODS: We analysed 1292 overweight/obese, non-institutionalized participants, aged 40-65 years, in the San Juan Overweight Adults Longitudinal Study. Fasting venous blood glucose was determined using a point-of-care Bayer Contour Blood Glucose Meter and by Vitros System 250 instrument (laboratory). American Diabetes Association thresholds were used to classify participants into normoglycaemia (< 5.6 mmol/l), prediabetes (5.6 to 6.9 mmol/l), or diabetes groups (≥ 7 mmol/l). RESULTS: Bland-Altman plot analysis showed a slope of 0.04 (P=0.002) for the regression between the mean difference and the average of the two methods. The slopes were significantly different from zero among people with normoglycaemia (ß=-0.57, P<0.001), and prediabetes (ß=-0.75, P<0.001) but not among people with diabetes (ß=-0.02, P=0.68). When the prediabetes and diabetes groups were merged into one group, the slope was 0.01, and the glucose values remained similar using the two methods (P=0.76). CONCLUSION: Point-of-care blood glucose measurement may be useful to screen people with diabetes, and to assess glucose among individuals with diabetes where blood can be drawn, but laboratory tests are unavailable or untimely.

Interactive effect of temperature, acidification and ammonium enrichment on the seagrass Cymodocea nodosa.

Global (e.g. climate change) and local factors (e.g. nutrient enrichment) act together in nature strongly hammering coastal ecosystems, where seagrasses play a critical ecological role. This experiment explores the combined effects of warming, acidification and ammonium enrichment on the seagrass Cymodocea nodosa under a full factorial mesocosm design. Warming increased plant production but at the expense of reducing carbon reserves. Meanwhile, acidification had not effects on plant production but increased slightly carbon reserves, while a slight stimulation of net production and a slight decrease on carbon reserves under ammonium supply were recorded. When all the factors were combined together improved the production and carbon reserves of Cymodocea nodosa, indicating that acidification improved ammonium assimilation and buffered the enhanced respiration promoted by temperature. Therefore, it could indicate that this temperate species may benefit under the simulated future scenarios, but indirect effects (e.g. herbivory, mechanical stress, etc.) may counteract this balance.

Endemic caseous lymphadenitis in a wild Caprinae population.

Between 2010 and 2013, an outbreak of caseous lymphadenitis (CLA) occurred in a captive stock of Iberian ibexes (Capra pyrenaica, Schinz 1838) maintained for conservation purposes in the National Game Reserve 'Ports de Tortosa i Beseit' (PTB), northeastern Spain. The aim of this study was to assess the CLA status in the free-ranging donor population of ibexes. An ELISA test to detect antibodies to CLA was performed in 360 hunter-harvested ibexes between 2007 and 2013. A spatial analysis and recursive partitioning approaches with regression tree models were used to explore CLA-associated risk factors. Nineteen per cent of ibexes had antibodies to CLA. Significant differences in seroprevalence were observed among game management areas but no clear trends of CLA occurrence were observed over the study period. Ibexes from areas of higher population density and living close to aggregation points displayed a higher probability of testing positive to CLA. These results suggest that CLA is endemic in the Iberian ibex population inhabiting PTB and density-dependent risk factors. To the best of our knowledge, this is the first record of CLA maintenance in a free-ranging wild Caprinae population.

Evidence-based guides in tracheostomy use in critical patients

Objetivos: Proporcionar guías de traqueostomía para el paciente crítico, basadas en la evidencia científica disponible, y facilitar la identificación de áreas en las cuales se requieren mayores estudios. Métodos: Un grupo de trabajo formado con representantes de 10 países pertenecientes a la Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva y a la Latin American Critical Care Trial Investigators Network(LACCTIN) desarrollaron estas recomendaciones basadas en el sistema Grading of Recommendations Assessment, Development and Evaluation (GRADE). Resultados: El grupo identificó 23 preguntas relevantes entre las 87 preguntas planteadas inicialmente. En la búsqueda inicial de la literatura se identificaron 333 estudios, de los cuales se escogieron un total de 226. El equipo de trabajo generó un total de 19 recomendaciones: 10 positivas (1B = 3, 2C = 3, 2D = 4) y 9 negativas (1B = 8, 2C = 1). En 6 ocasiones no se pudieron establecer recomendaciones. Conclusión: La traqueostomía percutánea se asocia a menor riesgo de infecciones en comparación con la traqueostomía quirúrgica. La traqueostomía precoz solo parece reducir la duración de la ventilación mecánica pero no la incidencia de neumonía, la duración de la estancia hospitalaria o la mortalidad a largo plazo. La evidencia no apoya el uso de broncoscopia de forma rutinaria ni el uso de máscara laríngea durante el procedimiento. Finalmente, el entrenamiento adecuado previo es tanto o más importante que la técnica utilizada para disminuir las complicaciones.(AU)

OBJECTIVES: Provide evidence based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A task force composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: The group identified 23 relevant questions among 87 issues that were initially identified. In the initial search, 333 relevant publications were identified of which 226 publications were chosen. The task force generated a total of 19 recommendations: 10 positive (1B=3, 2C=3, 2D=4) and 9 negative (1B=8, 2C=1). A recommendation was not possible in six questions. CONCLUSION: Percutaneous techniques are associated with a lower risk of infections compared to surgical tracheostomy. Early tracheostomy only seems to reduce the duration of ventilator use but not the incidence of pneumonia, the length of stay, or the long-term mortality rate. The evidence does not support the use of routine bronchoscopy guidance or laryngeal masks during the procedure. Finally, proper prior training is as important or even a more significant factor in reducing complications than the technique used.(AU)

Guías basadas en la evidencia para el uso de traqueostomía en el paciente crítico / Evidence-based guides in tracheostomy use in critical patients

OBJETIVOS: Proporcionar guías de traqueostomía para el paciente crítico, basadas en la evidencia científica disponible, y facilitar la identificación de áreas en las cuales se requieren mayores estudios. MÉTODOS: Un grupo de trabajo formado con representantes de 10 países pertenecientes a la Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva y a la Latin American Critical Care Trial Investigators Network (LACCTIN) desarrollaron estas recomendaciones basadas en el sistema Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTADOS: El grupo identificó 23 preguntas relevantes entre las 87 preguntas planteadas inicialmente. En la búsqueda inicial de la literatura se identificaron 333 estudios, de los cuales se escogieron un total de 226. El equipo de trabajo generó un total de 19 recomendaciones: 10 positivas (1B=3, 2C=3, 2D=4) y 9 negativas (1B=8, 2C=1). En 6 ocasiones no se pudieron establecer recomendaciones. CONCLUSIÓN: La traqueostomía percutánea se asocia a menor riesgo de infecciones en comparación con la traqueostomía quirúrgica. La traqueostomía precoz solo parece reducir la duración de la ventilación mecánica pero no la incidencia de neumonía, la duración de la estancia hospitalaria o la mortalidad a largo plazo. La evidencia no apoya el uso de broncoscopia de forma rutinaria ni el uso de máscara laríngea durante el procedimiento. Finalmente, el entrenamiento adecuado previo es tanto o más importante que la técnica utilizada para disminuir las complicaciones

OBJECTIVES: Provide evidence based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A task force composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: The group identified 23 relevant questions among 87 issues that were initially identified. In the initial search, 333 relevant publications were identified of which 226 publications were chosen. The task force generated a total of 19 recommendations: 10 positive (1B=3, 2C=3, 2D=4) and 9 negative (1B=8, 2C=1). A recommendation was not possible in six questions. CONCLUSION: Percutaneous techniques are associated with a lower risk of infections compared to surgical tracheostomy. Early tracheostomy only seems to reduce the duration of ventilator use but not the incidence of pneumonia, the length of stay, or the long-term mortality rate. The evidence does not support the use of routine bronchoscopy guidance or laryngeal masks during the procedure. Finally, proper prior training is as important or even a more significant factor in reducing complications than the technique used

Evidence-based guides in tracheostomy use in critical patients. / Guías basadas en la evidencia para el uso de traqueostomía en el paciente crítico.

OBJECTIVES: Provide evidence based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A task force composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: The group identified 23 relevant questions among 87 issues that were initially identified. In the initial search, 333 relevant publications were identified of which 226 publications were chosen. The task force generated a total of 19 recommendations: 10 positive (1B=3, 2C=3, 2D=4) and 9 negative (1B=8, 2C=1). A recommendation was not possible in six questions. CONCLUSION: Percutaneous techniques are associated with a lower risk of infections compared to surgical tracheostomy. Early tracheostomy only seems to reduce the duration of ventilator use but not the incidence of pneumonia, the length of stay, or the long-term mortality rate. The evidence does not support the use of routine bronchoscopy guidance or laryngeal masks during the procedure. Finally, proper prior training is as important or even a more significant factor in reducing complications than the technique used.

Hybrid photoluminescent materials containing a benzobisthiazole core for liquid crystal and gel applications.

Tetra- and hexacatenar amide compounds containing a linear centrosymmetric benzobisthiazole core were synthesized with good yields. These compounds were characterized and their structures confirmed by elemental analysis, and FT-IR, Maldi mass and NMR spectroscopy. All compounds exhibited excellent thermal stability up to 330 °C. The tetracatenar series containing a double substitution in the meta positions did not show mesomorphic behaviour, whereas the hexacatenar and tetracatenar series having a double substitution in the meta and para positions showed liquid crystal properties with optical textures typical of columnar mesophases corroborated by POM analysis. The mesomorphic properties were dependent on the length, number and position of alkoxy chains attached at the end of the rigid core. XRD studies of the hexacatenar series showed the hexagonal columnar structure of the mesophases. Photoluminescence properties in solution were observed in the visible region, with good quantum yields. In the solid state, these compounds behave as blue emitters and they are able to change colour with acid or base addition. The hexacatenar benzobisthiazole compound with an alkoxy chain of 14 carbons presented properties of a supergelator in chloroform, leading to the formation of a fluorescent organogel material with fluorescence emission in the blue region.

Perfil demográfico y social de la epilepsia en una población vulnerable y de bajos recursos económicos en Bogotá, Colombia / Demographic and social profile of epilepsy in a vulnerable low-income population in Bogotá, Colombia

Introducción: Existen pocos estudios que demuestren el perfil demográfico y social de la epilepsia en poblaciones vulnerables y de bajos recursos económicos. Métodos: Estudio observacional, descriptivo, de corte transversal, en donde se registraron prospectivamente los datos de todos los pacientes con diagnóstico de epilepsia que asistieron a la consulta especializada de neurología durante el periodo comprendido entre enero y marzo del 2014. Se analizaron los datos utilizando herramientas de la epidemiología descriptiva. Resultados: Se valoraron un total de 107 pacientes, de los cuales el 24,2% son analfabetas, y solamente el 10,2% completó estudios de educación superior. El 86,8% de los pacientes viven en un estrato socioeconómico bajo y cerca del 73,8% son solteros. El 76,7% se encuentra desempleados. Los principales factores de riesgo para epilepsia documentados en esta población fueron: retraso en el desarrollo psicomotor (n = 24, 22,4%), trauma craneoencefálico (n = 16, 14,9%) e infección del sistema nervioso central (n = 13, 12,1%). La mayoría de los pacientes (70,1%) son respondedores a los fármacos anticonvulsivos (controlados) y el 15,4% (n = 15) son resistentes (refractarios). Conclusión: El perfil demográfico y clínico de los pacientes incluidos en este estudio es similar a los datos publicados en poblaciones de altos recursos económicos, la diferencia parece fundamentarse en la clasificación etiológica y los factores de riesgo. El perfil social de los pacientes evaluados en este estudio se caracteriza por desempleo, analfabetismo y soltería. Estos datos, en comparación con poblaciones de altos recursos económicos, parecen ser más frecuentes y prevalentes

Introduction: Very few studies describe the demographic and social profile of epilepsy in vulnerable low-income populations. Methods: Observational, descriptive, cross-sectional study prospectively recording data from all patients diagnosed with epilepsy who attended a specialist neurology consultation between January and March 2014. Data were analysed using descriptive epidemiology tools. Results: A total of 107 patients were evaluated, of whom 24.2% were illiterate and only 10.2% had completed a higher education programme. Most of the patients (86.8%) had a low socioeconomic status; 73.8% were single and 76.7% were unemployed. The main risk factors for epilepsy in this population were recorded as follows: delayed psychomotor development (n = 24, 22.4%), head trauma (n = 16, 14.9%), and central nervous system infection (n = 13, 12.1%). Most patients (70.1%) responded to antiepileptic drugs (controlled cases) and 15.4% (n = 15) had drug-resistant epilepsy (refractory cases). Conclusion: The demographic and clinical profiles of the patients included in this study resemble those published for high-income populations; differences are mostly limited to aetiological classification and risk factors. The social profile of the patients evaluated in this study shows high rates of unemployment, illiteracy, and single marital status. These findings seem to be more frequent and prevalent in this group than in high income populations