[High frequency of endoluminal thrombus in patients with ischaemic stroke following COVID-19]. / Alta Frecuencia de Trombo Endoluminal en pacientes con ictus isquémico tras la infección por Coronavirus 2019.

BACKGROUND: Ischaemic stroke may be a major complication of SARS-CoV-2 infection.Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment. METHODS: Data were collected retrospectively on consecutive patients with COVID-19 who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain). RESULTS: During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack).Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%).We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients). CONCLUSIONS: In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19-associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients.

Efectos locales del tratamiento transdérmico con rotigotina / Local effects of transdermal treatment with rotigotine

Introducción. La rotigotina es el primer agonista dopaminérgico transdérmico no ergótico utilizado en el tratamiento de la enfermedad de Parkinson. Presenta importantes ventajas, como una única administración diaria, ausencia de interacciones con alimentos, niveles plasmáticos estables y estimulación continua de receptores dopaminérgicos. Aunque sus efectos secundarios sistémicos son similares a los de otros agonistas dopaminérgicos, también produce diversos efectos locales derivados del sitio de aplicación, efectos que pretendemos analizar en este artículo. Pacientes y métodos. Se realizó un análisis retrospectivo de 165 pacientes tratados con rotigotina. Se descartaron aquéllos con lesiones intracraneales, patología psiquiátrica y demencia. Los pacientes fueron evaluados antes y tras dos, cuatro y seis meses de iniciar el tratamiento con rotigotina. Resultados. Se identificaron 94 varones y 71 mujeres, con una edad media de 65,2 años y una dosis media de rotigotina de 11,3 mg/día. Los efectos adversos locales afectaron a 21 pacientes y provocaron el abandono del tratamiento en dos casos por eritema y picor. Treinta pacientes se quejaron de problemas de adherencia del parche, sobre todo en los momentos de mayor calor, y 36 comunicaron la formación de arrugas. Ninguno de estos problemas se asoció a fluctuaciones motoras u otras complicaciones. Conclusiones. Las complicaciones locales de la rotigotina transdérmica son leves, pero frecuentes. Consideramos necesario tenerlas en cuenta para lograr un mejor tratamiento de los pacientes con enfermedad de Parkinson (AU)

Introduction. Rotigotine is the first transdermal non-ergolinic dopaminergic agonist used in the treatment of Parkinson’s disease. It has several important advantages such as once-daily administration, absence of interactions with food, steady levels in plasma and continuous dopaminergic stimulation. Although its systemic side effects are similar to those seen in other dopaminergic agonists, rotigotine also has local side effects derived from the site of application. The aim of this paper is to review those local problems. Patients and methods. A retrospective analysis was carried out in order to identify the first 165 patients treated with rotigotine. Patients with intracranial lesions, psychiatric pathology or dementia were excluded. Patients were evaluated before and at two, four and six months after beginning treatment with rotigotine. Results. In all, 94 males and 71 females were identified, with an average age of 65.2 and an average rotigotine daily dose of 11.3 mg. Local side effects were present in 21 patients and they were usually mild. Two patients abandoned the treatment because of these local adverse events, presenting erythema and prurigo. Thirty patients complained about lack of adherence of the patch, specially when it was hot, and 36 about the formation of wrinkles in the patch. None of these problems was associated to motor fluctuations or other complications. Conclusions. Local complications of transdermal rotigotine are mild but frequent. We consider it is necessarily to take them into account to get a better treatment of patients suffering from Parkinson’s disease (AU)

[Local effects of transdermal treatment with rotigotine]. / Efectos locales del tratamiento transdérmico con rotigotina.

INTRODUCTION: Rotigotine is the first transdermal non-ergolinic dopaminergic agonist used in the treatment of Parkinson's disease. It has several important advantages such as once-daily administration, absence of interactions with food, steady levels in plasma and continuous dopaminergic stimulation. Although its systemic side effects are similar to those seen in other dopaminergic agonists, rotigotine also has local side effects derived from the site of application. The aim of this paper is to review those local problems. PATIENTS AND METHODS: A retrospective analysis was carried out in order to identify the first 165 patients treated with rotigotine. Patients with intracranial lesions, psychiatric pathology or dementia were excluded. Patients were evaluated before and at two, four and six months after beginning treatment with rotigotine. RESULTS: In all, 94 males and 71 females were identified, with an average age of 65.2 and an average rotigotine daily dose of 11.3 mg. Local side effects were present in 21 patients and they were usually mild. Two patients abandoned the treatment because of these local adverse events, presenting erythema and prurigo. Thirty patients complained about lack of adherence of the patch, specially when it was hot, and 36 about the formation of wrinkles in the patch. None of these problems was associated to motor fluctuations or other complications. CONCLUSIONS: Local complications of transdermal rotigotine are mild but frequent. We consider it is necessarily to take them into account to get a better treatment of patients suffering from Parkinson's disease.

Eficacia de la lacosamida en el tratamiento del dolor neuropático / Efficacy of lacosamide in the treatment of neuropathic pain

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Eficacia de la lacosamida en el tratamiento del dolor neuropático / Efficacy of lacosamide in the treatment of neuropathic pain

No disponible