A systematic review and meta-analysis on the association between orthostatic hypotension and mild cognitive impairment and dementia in Parkinson's disease.

BACKGROUND: Cognitive impairment is a frequent disabling feature of Parkinson's disease (PD). Orthostatic hypotension (OH) is treatable and may be a risk factor for cognitive impairment. OBJECTIVE: We conducted a systematic review and meta-analysis to examine the relationship between OH with PD-associated minimal cognitive impairment (PD-MCI) and dementia (PDD) and assess the mitigating effects of potential confounding factors. METHODS: Observational studies published in English, Spanish, French, or Portuguese up to January 2022 were searched for in PubMed, EBSCO, and SciELO databases. The primary aim of this study was to revise the association between OH with PD-MCI and PDD. Alongside, we assessed OH as related to cognitive rating scales. Fixed and random models were fitted. Meta-regression was used to assess the mitigating effects of confounding variables. RESULTS: We identified 18 studies that reported OH association with PDD or PD-MCI, 15 of them reporting OH association with cognitive rating scales. OH was significantly associated with PDD/PD-MCI (OR, 95% CI: 3.31, 2.16-5.08; k = 18, n = 2251; p < 0.01). OH association with PDD (4.64, 2.68-8.02; k = 13, n = 1194; p < 0.01) was stronger than with PD-MCI (1.82, 0.92-3.58; k = 5, n = 1056; p = NS). The association between OH and PD-MCI/PDD was stronger in studies with a higher proportion of women and in those with a lower frequency of supine hypertension. Global cognition rating scale scores were lower in patients with OH (SMD, 95% CI: - 0.55, - 0.83/ - 0.26; k = 12, n = 1427; p < 0.01). CONCLUSIONS: Orthostatic hypotension shows as a significant risk factor for cognitive impairment in PD, especially in women and patients not suffering from hypertension.

Cinco claves preliminares para el estudio del psicoanálisis (lacaniano) en la España del segundo franquismo y la transición / Five preliminary keys to the study of psychoanalysis in Spain under the later Franco Regime and the Transition

El presente artículo identifica y propone cinco claves a tener en cuenta para analizar la recepción y desarrollo del psicoanálisis en la España del segundo franquismo y la Transición: 1) la ausencia -o muy escasa presencia- de referencias psicoanalíticas en la producción psiquiátrica de los años cincuenta y sesenta; 2) las conexiones entre psicoanálisis, antipsiquiatría y estructuralismo; 3) la importancia de la llegada a España de Oscar Masotta, y su psicoanálisis "laico", en la consolidación de un discurso y una práctica psicoanalítica al margen de la IPA; 4) el peso de los psicoanalistas argentinos llegados al estado español tras el golpe de estado en su país; y 5) la importancia de la Revista de la Asociación Española de Neuropsiquiatría en difusión y trasmisión del psicoanálisis. Estas cinco claves agrupan situaciones y procesos que han sido estudiados con desigual profundidad, pero cuya consideración en conjunto parece imprescindible para obtener una visión global del proceso. Se concluye que las relaciones psiquiatría-psicoanálisis, la circulación del conocimiento, el contexto socio-político y cultural, etc., explican, entre otras cosas, las características de la recepción y desarrollo de un psicoanálisis post-freudiano en el que la orientación lacaniana tuvo preponderancia sobre otros enfoques o escuelas

This article identifies and proposes five key elements to be taken into account in analysing the reception and development of psychoanalysis in Spain under the later Franco regime and during the Transition: 1) the absence - or very limited presence - of psychoanalytic points of reference in psychiatric production during the 1950s and 1960s; 2) the connections between psychoanalysis, anti-psychiatry and structuralism; 3) the importance of the arrival in Spain of Oscar Masotta, and his 'lay' psychoanalysis, in consolidating a psychoanalytic discourse and practice outside the IPA; 4) the influence of Argentinian psychoanalysts who came to Spain following the coup d'état in their country; and 5) the importance of the Revista de la Asociación Española de Neuropsiquiatría in disseminating and communicating psychoanalysis. These five keys group together situations and processes which have been studied to varying extents, but which it seems essential to consider as a whole in order to obtain an overall view of the process. We conclude that relations between psychiatry and psychoanalysis, the circulation of knowledge, and the socio-political and cultural context, etc. explain, among other things, the characteristics of the reception and development of a post-Freudian psychoanalysis in which the Lacanian position predominated over other approaches and schools

Combined avulsion fracture of the tibial tubercle and patellar tendon rupture in adolescents: a case report.

Simultaneous occurrence of tibial tubercle fracture and patellar tendon avulsion is an extremely rare condition. However, they have become more frequent due to increased participation in sports at a younger age. Diagnosis is not always straightforward, and treatment consists of open reduction and internal fixation. Only a few case reports of such injuries were reported in the literature with limited information according to diagnoses, treatment, and outcome in adolescents.