Radiological insights into rheumatoid meningitis - a rare central nervous system manifestation of rheumatoid arthritis: a retrospective review of six cases.

BACKGROUND: The objective is to analyze and review the clinical, laboratory, and neuroimaging characteristics of rheumatoid meningitis (RM) in six patients with known rheumatoid arthritis (RA). METHODS: We performed a retrospective review of patients diagnosed with RM from August 2012 to June 2023. To identify the cases, we used medical term search engines and the hospital´s radiology case database. Clinical information and laboratory findings were gathered from the medical records. A neuroradiologist with five years of experience reviewed and analyzed the RM to determine the characteristics findings of RM. RESULTS: Six patients with RM are included. Seizures along with headaches were among the clinical signs that were documented. All the patients had high levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptides (ACPA) in the peripheral blood. Biopsy in two cases confirmed typical rheumatoid nodules. Leptomeningeal enhancement was found bilaterally in all cases and was predominantly found in the frontoparietal region. "Mismatch DWI/FLAIR" was found in five patients. Bilateral subdural collections could be found in two patients. Brain PET scan revealed increased metabolism in two cases. CONCLUSION: Rheumatoid meningitis is a rare complication of rheumatoid arthritis (RA) with challenging clinical diagnosis due to non-specific symptoms. This study highlights the importance of MR in detecting characteristic neuroimaging patterns, including "mismatch DWI/FLAIR", to aid in early diagnosis. Increased awareness of this condition may facilitate timely intervention and improve prognosis. These results still need to be verified by large studies.

Active Aging Program in Nursing Homes: Effects on Psychological Well-being and Life Satisfaction / El envejecimiento activo en residencias para personas mayores: su efecto en el bienestar psicológico y la satisfacción vital

A great number of intervention strategies that provide opportunities to maintain physical, psychological, and social wellbeing have been carried out in order to promote active aging. Most of these strategies are aimed at people without physicalor cognitive dependence, while institutionalized older people have not been considered as a target group. The main objectiveof this study was to analyze the effect of an active aging program on the psychological well-being and life satisfaction ofinstitutionalized older people. A total of 141 participants with adequate psychomotor skills were selected (Mage = 85.50 years,SD = 8.47), and a quasi-experimental pretest-posttest design with a control group and an experimental group was used. Thecontrol group participated in the traditional limited active aging program offered in long-term care facilities - cognitivestimulation and physical activity - while the experimental group participated in a comprehensive active aging program. Afterthe intervention, participants from the experimental group showed improvements in the mean values of psychological wellbeing and life satisfaction, while no change was found in the CONTROL GROUP: The improvements in psychological well-beingand life satisfaction were maintained 12 months later in the follow-up evaluation. This study suggests that the inclusionof a comprehensive active aging program in nursing homes, that comprises actions aimed at promoting empowerment,participation, and social openness, contributes to the maintenance of perceived well-being

Se ha implementado un gran número de estrategias de intervención para promover el envejecimiento activo basadasen el mantenimiento del bienestar físico, psicológico y social. Muchas de esas estrategias se han llevado a cabo conpersonas mayores sin dependencia física o cognitiva, mientras que las personas mayores institucionalizadas no hansido un grupo objetivo. El principal objetivo de este estudio fue analizar el efecto de un programa de envejecimientoactivo sobre el bienestar psicológico y la satisfacción vital de personas mayores institucionalizadas. Participó un grupo de141 personas mayores con adecuadas capacidades psicomotoras (Medad = 85.50 años, DT = 8.47), utilizándose un diseñocuasiexperimental pretest-postest con grupo control y grupo experimental. El grupo control participó en un programatradicional limitado de envejecimiento activo ofrecido en residencias (estimulación cognitiva y ejercicio físico) mientrasque el grupo experimental participó en un programa global de envejecimiento activo. Tras la intervención aumentó lapuntuación media de los participantes del grupo experimental en bienestar psicológico y satisfacción vital, mientras queno se observaron cambios en el grupo control, mejoras que se mantuvieron 12 meses después de la intervención. Esteestudio sugiere que la inclusión de un programa global de envejecimiento activo en residencias para personas mayores quecontemple medidas para impulsar el empoderamiento, la participación y la apertura social contribuye al mantenimientodel bienestar percibido

Remote cerebellar hemorrhage after lumbar spinal surgery.

Remote cerebellar hemorrhage (RCH) is a rare complication after supratentorial or spinal surgery. RCH is poorly known and hence probably underdiagnosed. Diminished consciousness and headache are the most common clinical features. Computed tomography and magnetic resonance reveal a characteristic pattern of linear bleeding between the cerebellar folia. The pathophysiological mechanism is disputed but is probably venous bleeding secondary to significant intraoperative or postoperative loss of cerebrospinal fluid. Multiple risk factors have been described, but postsurgical negative pressure drainage of cerebrospinal fluid is the only clearly predisposing factor. We present a case of RCH after spinal surgery with a literature review.