[Neurology and Internet]. / La neurología en Internet.

The internet currently offers a powerful, but underused, substructure for fluid contact between neurologists all over the world. For improved exploitation of these resources, Thematic Virtual Communities are necessary to organize the information and to make available the tools which the necessary for the best use of it. The internet represents a great advantage for investigation and also for clinical practice, since it permits free, universal access to data bases and the interchange of texts, images and videos. Thus it facilitates multicentric trials, the circulation of scientific journals, long-distance education and telemedicine.

[Record of neurological emergencies at a tertiary care hospital]. / Registro de urgencias neurológicas en un hospital de tercer nivel.

INTRODUCTION AND OBJECTIVE: There is a progressive increase in the demand for multidisciplinary attention from the Emergency Medical Services. The objective of this study was to determine the proportion of neurological conditions in the total hospital emergency workload, their demographic composition and medical needs. PATIENTS AND METHODS: We present an observational study of a cohort of histories of neurological emergencies at a tertiary hospital during a period of one year. RESULTS: On analysis of all emergencies, 1,592 were neurological conditions. The duty neurologist was consulted in 87.9% of the cases. The average age was 59, and the majority were women (56.3%). Maximum demand was between 14.00 and 19.59 hours. Monday was the day of the week when most were seen. The commonest causes of consultation were change in strength or language, headache and epileptic crises. The complementary investigation done most frequently was a blood test. Cerebral CT scan were done in 31.9% of the patients. The diagnoses most often made, as a group, were cerebrovascular disease followed by epilepsy and headache. The majority of the patients were referred to Primary Care Centres or for neurological consultation. When the patients were grouped according to the specialties with doctors on duty, the second largest group were seen by the emergency neurologist at our hospital. CONCLUSION: In view of the above results, we consider the presence of a neurologist in the Emergency Department to be fully justified.

[The Internet application to neurology: electronic forums of Revista de Neurología. How The Internet, Medicine and Neurology Forum has been developed]. / Las aplicaciones de Internet al servicio de la neurología: los foros electrónicos de Revista de Neurología. Cómo se realizó el Foro 'Internet, Medicina y Neurología'.

The new communication techniques and, particularly, Internet, are changing our way of collaborating, relating to each other and searching for information, paving the way for telemedicine. Such initiatives are described in the Revista de Neurologia, as well as the methodology followed to prepare the first Electronic Forum of the Revista de Neurologia on 'Internet, Medicine and Neurology', using the web, IRC and E-mail tools.

[Electronic forum of Revista de neurología: 'Internet, Medicine and Neuroglia']. / Foro electrónico de revista de neurología: 'Internet, Medicina y Neurología'.

INTRODUCTION: In recent years Internet has drastically transformed the world of telecommunications. Questions about whether Internet and the global communication accessibility may be considered as a fundamental aspect in the medicine of today and tomorrow have been brought up. OBJECTIVE: Discuss current and future applications of Internet to the field of Medicine and Neurology. METHODS: Bibliographical review based on Medline and standard Web search engines. Forum sessions performed through Internet by means of Web-Chat. Forum coordination entirely performed by electronic mail. RESULTS: There are several opinions regarding the influence of Internet on Medicine and Neurology. Currently, the communication and collaboration between teams is improving. It allows scientific publications on-line, improves continuous remote training and facilitates information to patients. New applications like telemedicine need more development. CONCLUSIONS: Currently, Internet represents an efficient tool for collaboration, training and distribution of information in the field of Medicine and Neurology.

[Predictive mortality factors and the development of major complications in non-traumatic subarachnoid hemorrhage]. / Factores predictores de mortalidad y de desarrollo de complicaciones mayores en la hemorragia subaracnoidea no traumática.

Our aim was to analyze death prognostic factors in the first six months or the development of major neurological complications (delayed brain ischaemia and rebleeding) or general complications (cardiorespiratory, hydroelectrolytic or infectious) in non-traumatic subarachnoid haemorrhage. We carried out an observational study of a historical cohort of 111 patients admitted consecutively to our Centre between 1986 and 1992 and who were diagnosed as having subarachnoid haemorrhage based upon clinical data and confirmed in all cases by brain computerized tomography (CT) scan and/or lumbar puncture. Clinical variables upon admission were collected prospectively and radiological data were obtained retrospectively. We performed a logistic regression analysis which showed as significant predictive variables for death in the first six months a score on the Hunt-Hess scale greater than 2, a score on the Glassow scale of less than 9, female, aged over 50 and rebleeding. As predictive factors for delayed brain ischaemia we identified the female sex and the existence of earlier general complications. In the development of rebleeding a significant predictive factor was high blood pressure antecedents although this may have been controlled upon admission. For the appearance of general complications, significant predictive factors were more than 2 on the Hunt-Hess scale and hypertension antecedents. The use of these predictive parameters may help evaluate a prognosis in subarachnoid haemorrhage patients and also help make decisions in the management of this pathology.