The effect of a cognitive training therapy based on stimulation of brain oscillations in patients with mild cognitive impairment in a Chilean sample: study protocol for a phase IIb, 2 × 3 mixed factorial, double-blind randomised controlled trial.

BACKGROUND: The ageing population has increased the prevalence of disabling and high-cost diseases, such as dementia and mild cognitive impairment (MCI). The latter can be considered a prodromal phase of some dementias and a critical stage for interventions to postpone the impairment of functionality. Working memory (WM) is a pivotal cognitive function, representing the fundamental element of executive functions. This project proposes an intervention protocol to enhance WM in these users, combining cognitive training with transcranial electrical stimulation of alternating current (tACS). This technique has been suggested to enhance the neuronal plasticity needed for cognitive processes involving oscillatory patterns. WM stands to benefit significantly from this approach, given its well-defined electrophysiological oscillations. Therefore, tACS could potentially boost WM in patients with neurodegenerative diseases. METHODS: This study is a phase IIb randomised, double-blind clinical trial with a 3-month follow-up period. The study participants will be 62 participants diagnosed with MCI, aged over 60, from Valparaíso, Chile. Participants will receive an intervention combining twelve cognitive training sessions with tACS. Participants will receive either tACS or placebo stimulation in eight out of twelve training sessions. Sessions will occur twice weekly over 6 weeks. The primary outcomes will be electroencephalographic measurements through the prefrontal theta oscillatory activity, while the secondary effects will be cognitive assessments of WM. The participants will be evaluated before, immediately after, and 3 months after the end of the intervention. DISCUSSION: The outcomes of this trial will add empirical evidence about the benefits and feasibility of an intervention that combines cognitive training with non-invasive brain stimulation. The objective is to contribute tools for optimal cognitive treatment in patients with MCI. To enhance WM capacity, postpone the impairment of functionality, and obtain a better quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05291208. Registered on 28 February 2022. ISRCTN87597719 retrospectively registered on 15 September 2023.

[Four corner fusion in patients with wrist arthritis]. / Artrodesis de cuatro esquinas en pacientes con artrosis de muñeca.

Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion. Both of these processes lead to abnormal joint kinematics, since the lunate is unrestrained by the distal scaphoid and, therefore, assumes an extended posture. Over time, this may result in Dorsal intercalated segment instability (DISI) deformity, which invariably progresses to degenerative arthritis of the radioescaphoid articulation, followed by carpal collapse and midcarpal arthritis. The purpose of this retrospective study is to evaluate the functional outcome and pain relief in SLAC/SNAC wrist, after four corner fusion. This study was made in 52 patients of the Hospital de Traumatología y Ortopedia Lomas Verdes, these patients undergone four corner fusion surgery, in a period january 2007 to december 2014. We used Quick Dash Questionary to evaluate functional outcome and pain relief in these patients.

El colapso avanzado de la muñeca secundario a pseudoartrosis del escafoides (scaphoid nonunion advanced collapse, SNAC) y el colapso avanzado escafosemilunar (scapholunate advanced collapse, SLAC) son dos de los patrones comunes de muñecas artrósicas postraumáticas. La muñeca SLAC se desarrolla después de una alteración, traumática o atraumática, del ligamento escafosemilunar. Entre las causas atraumáticas de muñeca SLAC se incluyen: enfermedad por depósito de pirofosfato de calcio, artritis reumatoide y enfermedad neuropática. Por otra parte, la muñeca SNAC se desarrolla por fractura del escafoides que ha progresado a no unión. Ambos procesos conllevan cinemática anormal de la articulación, desde que el semilunar no es contenido por el escafoides y, por lo tanto, asume una posición en extensión. Además, esto resulta en deformidad por inestabilidad dorsal del carpo (DISI), la cual invariablemente progresará a artritis degenerativa de la articulación radioescafoidal, seguida de colapso del carpo y artritis del medio-carpo. Este es un estudio retrospectivo, longitudinal, observacional realizado en 52 pacientes derechohabientes del IMSS, operados de artrodesis de cuatro esquinas del carpo en el Hospital de Traumatología y Ortopedia Lomas Verdes, de enero 2007 a diciembre 2014, evaluando resultados funcionales mediante cuestionario Quick Dash en los pacientes operados de artrodesis de cuatro esquinas en padecimientos de muñeca SLAC/SNAC.

The importance of right otitis media in childhood language disorders.

Studies relating chronic otitis media and language disorders in children have not reported consistent findings. We carried out the first selective study aimed at discerning the role of chronic right otitis media in children less than 3 years of age in language development. A total of 35 children were studied using a full linguistic protocol, auditory brainstem responses, and middle latency responses. Twelve children had a history of chronic exclusive right otitis media. Seventeen age-matched children were selected as controls. Also, three children having a history of chronic left otitis media were compared with three age-matched controls. Linguistic tests showed significant differences between patients and controls in phonetic, phonological, and syntax scores but not semantics. Correlation studies between linguistic scores and auditory evoked responses in the whole cohort showed a significant coefficient in phonetic and phonological domains. These results emphasize the causative effect of right ear chronic otitis media and indicate that it mainly impairs phonetic and phonological coding of sounds, which may have implications for prophylactic treatment of at-risk children.