Comparison of the Material Quality of AlxIn1-xN (x-0-0.50) Films Deposited on Si(100) and Si(111) at Low Temperature by Reactive RF Sputtering.

AlxIn1-xN ternary semiconductors have attracted much interest for application in photovoltaic devices. Here, we compare the material quality of AlxIn1-xN layers deposited on Si with different crystallographic orientations, (100) and (111), via radio-frequency (RF) sputtering. To modulate their Al content, the Al RF power was varied from 0 to 225 W, whereas the In RF power and deposition temperature were fixed at 30 W and 300 °C, respectively. X-ray diffraction measurements reveal a c-axis-oriented wurtzite structure with no phase separation regardless of the Al content (x = 0-0.50), which increases with the Al power supply. The surface morphology of the AlxIn1-xN layers improves with increasing Al content (the root-mean-square roughness decreases from ≈12 to 2.5 nm), and it is similar for samples grown on both Si substrates. The amorphous layer (~2.5 nm thick) found at the interface with the substrates explains the weak influence of their orientation on the properties of the AlxIn1-xN films. Simultaneously grown AlxIn1-xN-on-sapphire samples point to a residual n-type carrier concentration in the 1020-1021 cm-3 range. The optical band gap energy of these layers evolves from 1.75 to 2.56 eV with the increase in the Al. PL measurements of AlxIn1-xN show a blue shift in the peak emission when adding the Al, as expected. We also observe an increase in the FWHM of the main peak and a decrease in the integrated emission with the Al content in room-temperature PL measurements. In general, the material quality of the AlxIn1-xN films on Si is similar for both crystallographic orientations.

Impacto de las tutorías en la formación integral de estudiantes universitarios / Impacto dos tutoriais na formação integral dos estudantes universitários / Impact of tutorials on the comprehensive training of university students

RESUMEN Los vertiginosos cambios producidos en la sociedad obligan a las instituciones de Educación Superior (IES) a formar ciudadanos con competencias profesionales y personales capaces de enfrentar los permanentes desafíos. En ese contexto, la labor del docente-tutor contribuye significativamente a este propósito y debe fortalecerse. Para ello, se realiza un diagnóstico cuyo objetivo consistió en conocer el estado de implementación de las tutorías y su impacto en la formación de los estudiantes. Se parte del análisis bibliográfico sobre la concepción y la práctica de la tutoría universitaria para, mediante un estudio cuantitativo, determinar el criterio de los educandos como actores principales. La muestra probabilística estuvo conformada por 180 estudiantes, de una población de 1557, de la Facultad de Ciencias de la Educación, Humanas y Tecnologías de la Universidad Nacional de Chimborazo, a quienes se les aplicó una encuesta validada científicamente, que determinó 97 % de fiabilidad y 95 % de confianza, lo que significa un alto porcentaje de correspondencia entre las variables de estudio y las escalas de medición. Estos estudiantes reciben diversas asignaturas, entre ellas algunas relacionadas con la actividad física y el deporte. Los resultados obtenidos se sometieron al análisis inferencial de multivariantes que permitió comprobar la tendencia de los estudiantes con respecto a la actividad tutorial que oferta la institución de Educación Superior.

RESUMO As vertiginosas mudanças na sociedade obrigam as Instituições de Ensino Superior (IES) a formar cidadãos com competências profissionais e pessoais capazes de enfrentar desafios permanentes. Neste contexto, o trabalho do professor-tutor contribui significativamente para este fim e deve ser reforçado. Para o efeito, foi realizado um diagnóstico com o objectivo de conhecer o estado de implementação dos tutoriais e o seu impacto na formação dos estudantes. O ponto de partida foi uma análise bibliográfica da concepção e prática da tutoria universitária a fim de determinar, por meio de um estudo quantitativo, os critérios dos estudantes como principais atores. A amostra probabilística consistiu em 180 estudantes, de uma população de 1557, da Faculdade de Ciências da Educação, Humanidades e Tecnologias da Universidade Nacional de Chimborazo, aos quais foi aplicado um inquérito cientificamente validado, que determinou 97% de fiabilidade e 95% de confiança, o que significa uma elevada percentagem de correspondência entre as variáveis de estudo e as escalas de medição. Estes estudantes recebem várias disciplinas, incluindo algumas relacionadas com atividade física e desporto. Os resultados obtidos foram submetidos a análises inferenciais multivariadas, o que nos permitiu verificar a tendência dos estudantes no que diz respeito à atividade tutorial oferecida pela instituição de ensino superior.

ABSTRACT The vertiginous changes produced in society force Higher Education Institutions (HEI) to train citizens with professional and personal skills capable of facing permanent challenges. In this context, the work of the teacher-tutor contributes significantly to this purpose and should be strengthened. For this, a diagnosis is made which objective was to know the state of implementation of the tutoring and its impact on the training of the students. It is started from the bibliographical analysis on the conception and practice of university tutoring to, through a quantitative study, determines the criteria of the students as main actors. The probabilistic sample consisted of 180 students, from a population of 1557, from the Faculty of Education, Human Sciences and Technology of the National University of Chimborazo, to whom a scientifically validated survey was applied, which determined 97% reliability and 95% confidence, which means a high percentage of correspondence between the study variables and the measurement scales. These students receive various subjects, including some related to physical activity and sports. The results obtained were submitted to the multivariate inferential analysis that allowed verifying the tendency of the students with respect to the tutorial activity offered by the Higher Education institution.

CHAOS: síndrome de obstrucción congénita de las vías aéreas superiores / CHAOS: congenital high airway obstruction syndrome

Resumen El síndrome de obstrucción congénita de vías áreas superiores (CHAOS) es una condición que se caracteriza por la existencia de una obstrucción en las vías áreas altas en el feto, la cual puede ser parcial o completa. Comúnmente es una situación incompatible con la vida, por lo que su diagnóstico prenatal es importante considerando el pronóstico y los diferentes manejos prenatales y posnatales que existen. Presentamos un caso de CHAOS diagnosticado en la semana 21, con una breve revisión de la literatura sobre su diagnóstico, pronóstico y alternativas terapéuticas.

Abstract Congenital high airway obstruction syndrome (CHAOS) is a condition characterized by the existence of an obstruction of the fetal upper airways, which may be partial or complete. It is commonly incompatible with life, so its prenatal diagnosis is important due to the prognosis and the recently described pre and postnatal management options. We present a case of CHAOS in a pregnancy of 21 weeks with a brief review of the current literature about its diagnosis, prognosis and therapeutic alternatives.

Structural Characterization of Al0.37In0.63N/AlN/p-Si (111) Heterojunctions Grown by RF Sputtering for Solar Cell Applications.

Compact Al0.37In0.63N layers were grown by radiofrequency sputtering on bare and 15 nm-thick AlN-buffered Si (111) substrates. The crystalline quality of the AlInN layers was studied by high-resolution X-ray diffraction measurements and transmission electron microscopy. Both techniques show an improvement of the structural properties when the AlInN layer is grown on a 15 nm-thick AlN buffer. The layer grown on bare silicon exhibits a thin amorphous interfacial layer between the substrate and the AlInN, which is not present in the layer grown on the AlN buffer layer. A reduction of the density of defects is also observed in the layer grown on the AlN buffer.

III-Nitrides Resonant Cavity Photodetector Devices.

III-nitride resonant cavity-enhanced Schottky barrier photodetectors were fabricated on 2 µm thick GaN templates by radio frequency plasma-assisted molecular beam epitaxy. The optical cavity was formed by a bottom distributed Bragg reflector based on 10 periods of Al0.3Ga0.7N/GaN, an Au-based Schottky contact as top mirror, and an active zone of 40 nm-thick GaN layer. The devices were fabricated with planar geometry. To evaluate the main benefits allowed by the optical cavity, conventional Schottky photodetectors were also processed. The results revealed a planar spectral response for the conventional photodetector, unlike the resonant devices that showed two raised peaks at 330 and 358 nm with responsivities of 0.34 and 0.39 mA/W, respectively. Both values were 80 times higher than the planar response of the conventional device. These results demonstrate the strong effect of the optical cavity to achieve the desired wavelength selectivity and to enhance the optical field thanks to the light resonance into the optical cavity. The research of such a combination of nitride-based Bragg mirror and thin active layer is the kernel of the present paper.

AlxIn1-xN on Si (100) Solar Cells (x = 0-0.56) Deposited by RF Sputtering.

We investigate the photovoltaic performance of solar cells based on n-AlxIn1-xN (x = 0-0.56) on p-Si (100) hetero-junctions deposited by radio frequency sputtering. The AlxIn1-xN layers own an optical bandgap absorption edge tuneable from 1.73 eV to 2.56 eV within the Al content range. This increase of Al content results in more resistive layers (≈10-4-1 Ω·cm) while the residual carrier concentration drops from ~1021 to ~1019 cm-3. As a result, the top n-contact resistance varies from ≈10-1 to 1 MΩ for InN to Al0.56In0.44N-based devices, respectively. Best results are obtained for devices with 28% Al that exhibit a broad external quantum efficiency covering the full solar spectrum with a maximum of 80% at 750 nm, an open-circuit voltage of 0.39 V, a short-circuit current density of 17.1 mA/cm2 and a conversion efficiency of 2.12% under air mass 1.5 global (AM1.5G) illumination (1 sun), rendering them promising for novel low-cost III-nitride on Si photovoltaic devices. For Al contents above 28%, the electrical performance of the structures lessens due to the high top-contact resistivity.

Determination of a cutoff value for medication regimen complexity index to predict polypharmacy in HIV+ older patient / Determinación del valor umbral del índice de complejidad de la farmacoterapia para predecir polifarmacia en pacientes VIH+

INTRODUCTION: HIV+ patients have increased their life expectancy with a parallel increase in age-associated co-morbidities and pharmacotherapeutic complexity. The aim of this study was to determine an optimal cutoff value for Medication regimen complexity index (MRCI) to predict polypharmacy in HIV+ older patients. PATIENTS AND METHODS: A transversal observational single cohort study was conducted at a tertiary Hospital in Spain, between January 1st up to December 31st, 2014. Patients included were HIV patients over 50 years of age on active antiretroviral treatment. Prevalence of polypharmacy and it pattern were analyzed. The pharmacotherapy complexity value was calculated through the MRCI. Receiver operating characteristic curve analyses were used to calculate the area under the curve (AUC) for the MRCI value medications to determine the best cutoff value for identifying outcomes including polypharmacy. Sensitivity and specificity were also calculated. RESULTS: A total of 223 patients were included. A 56.1% of patients had polypharmacy, being extreme polypharmacy in 9.4% of cases. Regarding the pattern of polypharmacy, 78.0% had a cardio-metabolic pattern, 12.0% depressive-psychogeriatric, 8.0% mixed and 2.0% mechanical-thyroidal. The ROC curve demonstrated that a value of medication complexity index of 11.25 point was the best cutoff for predict polypharmacy (AUC=0.931; sensitivity= 77.6%; specificity=91.8%). CONCLUSIONS: A cut-off value of 11.25 for MRCI is proposed to determine if a patient reaches the criterion of polypharmacy. In conclusion, the concept of polypharmacy should include not only the number of prescribed drugs but also the complexity of them

INTRODUCCIÓN: La esperanza de vida de los pacientes VIH+ se ha incrementado. De forma paralela han aumentado las comorbilidades asociadas a la edad y la complejidad farmacoterapéutica. El objetivo del estudio es estimar el valor umbral del índice de complejidad de la farmacoterapia (MRCI) para la determinación del criterio de polifarmacia en pacientes VIH+ mayores de 50 años. MÉTODOS: Estudio observacional, trasversal, unicéntrico. Se incluyeron todos los pacientes VIH+ mayores de 50 años, en tratamiento antirretroviral activo entre el 1 enero y 31 diciembre-2015. Se determinó la presencia de polifarmacia y los patrones asociados. La complejidad del tratamiento se calculó con la herramienta MRCI (Universidad de Colorado). Se analizó el índice de complejidad total como marcador cuantitativo de polifarmacia mediante la realización de una curva ROC y el cálculo de su área bajo la curva. Se calculó la sensibilidad y la especificidad de la misma. RESULTADOS: Se incluyeron 223 pacientes. El 56,1% presentó polifarmacia, siendo extrema en el 9,4% de los casos. En relación con el patrón de polifarmacia, el 78,0% presentaron un patrón cardio-metabólico, el 12,0% psico geriátrico-depresivo, el 8,0% mixto y el 2,0% mecánico tiroideo . Se determinó un valor de área bajo la curva ROC de 0,931 con límites entre (0,901-0,962) y p< 0,001. El valor 11,25 de índice de complejidad total de la farmacoterapia proporcionó un valor de especificidad del 92% y una sensibilidad del 78%. CONCLUSIÓN: El valor de 11,25 de índice de complejidad es un buen indicador para conocer los pacientes con polifarmacia. El concepto de polifarmacia no solo debe incluir el número de fármacos que toma el paciente sino incluir también la complejidad del tratamiento

Which Factors may reduce the Health-Related Quality of Life of Ecuadorian Patients with Diabetes?

OBJECTIVE: To quantify the health-related quality of life (HRQoL) of patients with type 2 diabetes mellitus (DM) in Ecuador and to determine its association, or lack thereof, with demographic and clinical variables, particularly with the comorbidities and complications of DM. METHODS: This was an analytical cross-sectional study with 325 patients attending regular care at a primary health care center in Quito, Ecuador. HRQoL was measured using the EuroQol 5-dimension 3-level (EQ-5D-3L) questionnaire. The patients were screened for diabetic nephropathy, retinopathy, and peripheral artery disease (PAD). Clinical files were reviewed to obtain data regarding gender, age, time since diagnosis, type of treatment, glycemic control, and history (if any) of hypertension and/or dyslipidemia. Associations were verified using the Mann-Whitney U or Kruskal-Wallis test, and the confounding effects of the variables "age" and "gender" were controlled for using logistic regression analysis. RESULTS: The mean HRQoL for the population was 0.844 (±0.215) on the EQ-5D-3L index (EQ-Index) and 80.6 (±18.8) on the EQ visual analogue scale (EQ-VAS). The prevalence of DM complications was 1.8% for nephropathy, 14.8% for retinopathy, and 14.5% for PAD. Of the participating patients, 66.8% presented hypertension and 91.4%, dyslipidemia. Significant associations were found between lower scores on the EQ-Index and age (≥65 years) (0.84 vs. 0.87; p = 0.016), time since diagnosis (≥10 years) (0.81 vs. 0.87; p = 0.005), presence of hypertension (0.83 vs. 0.88; p = 0.017), and, after controlling for age and gender, presence of nephropathy. For the EQ-VAS, only time since diagnosis (≥10 years) was associated with a lower score (77.99 vs. 82.97; p = 0.043). CONCLUSION: Older age, longer disease duration, hypertension, and nephropathy are associated with having a lower HRQoL, in patients with type 2 DM in Quito, Ecuador.

Manifestaciones neurooftalmológicas como forma de presentación de la neurosífilis / Neuro-ophthalmological manifestations presenting as neurosyphilis

No disponible

Hipertensión portal de causa no cirrótica por didanosina: una causa infrecuente de hemorragia digestiva / Non-cirrhotic portal hypertension associated with didanosine: An unusual cause of gastrointestinal bleeding

No disponible

[Pilot study about the effectivity of an intervention based on games in nutritional status and muscle strength on children]. / Estudio piloto de la efectividad de una intervención basada en juegos sobre el estado nutricional y la fuerza muscular en niños.

INTRODUCTION: The overnutrition is a constant on developing countries; Chile is not an exception because it has a marked tendency to overweight and obesity in schoolchildren. The muscular strength has been associated with cardiovascular and metabolic health status in scholars. Effective interventions using games are needed to improve the nutritional status and physical fitness in school children. OBJECTIVE: To assess the intervention effectiveness based on games played at school time to improve the nutritional status and physical fitness in schoolchildren. METHOD: 156 students aged between 7 to 15 years, attending to two public schools with full school day, to which a pilot program was applied. This pilot program was based on dynamic recreational games during 45 minutes from monday to friday for 3 months in the largest playtime of the school day. RESULTS: At the end of the intervention, we observed a significant modification on children nutritional status, which highlights an increase in the number of children that reached the normal nutritional status (p < 0.001). We also observed a significant number of obese children who reached overweight nutritional status (p < 0.001). We also observed a decrease of leg muscular strength at the end of the study. CONCLUSIONS: We found a positive effect of a program based on dynamic recreational games in the largest school playtime, improving nutritional status. However, we didn't observed modifications in the muscular strength.

INTRODUCCIÓN: La malnutrición por exceso es una constante en países en vías de desarrollo, Chile no es una excepción ya que existe una marcada tendencia hacia el sobrepeso y obesidad en la población escolar. La fuerza muscular ha sido asociada con un adecuado estado de salud cardiovascular y metabólica en la población escolar. Se necesitan intervenciones efectivas, que utilicen herramientas lúdicas y que permitan mejorar el estado nutricional y la capacidad física de los escolares. OBJETIVO: Valorar la efectividad de una intervención basada en juegos realizados dentro de la jornada escolar de los niños para mejorar el estado nutricional y la fuerza muscular. MÉTODO: 156 escolares de 7 a 15 años, pertenecientes a dos colegios municipalizados con jornada escolar completa, participaron de un programa piloto basado en juegos recreativos dinámico durante 45 minutos de lunes a viernes durante 3 meses, en el recreo más extenso de la jornada escolar. RESULTADOS: Al finalizar la intervención se observó una modificación estadísticamente significativa en el estado nutricional, donde destaca un aumento de niños que alcanza el estado nutricional normal. En aquellos que fueron clasificados previamente como obesos se logra modificar su estado nutricional hacia sobrepeso (p < 0,001). Se observó una disminución de la fuerza muscular del tren inferior al término del estudio (p < 0,001). CONCLUSIONES: Se demostró el impacto positivo de una intervención basada en juegos recreativos dinámicos durante los recreos escolares, con modificación positiva en el estado nutricional, pero sin mejoría de la fuerza muscular de los escolares.

Estudio piloto de la efectividad de una intervención basada en juegos sobre el estado nutricional y la fuerza muscular en niños / Pilot study about the effectivity of an intervention based on games in nutritional status and muscle strength on children

Introducción: La malnutrición por exceso es una constante en países en vías de desarrollo, Chile no es una excepción ya que existe una marcada tendencia hacia el sobrepeso y obesidad en la población escolar. La fuerza muscular ha sido asociada con un adecuado estado de salud cardiovascular y metabólica en la población escolar. Se necesitan intervenciones efectivas, que utilicen herramientas lúdicas y que permitan mejorar el estado nutricional y la capacidad física de los escolares. Objetivo: Valorar la efectividad de una intervención basada en juegos realizados dentro de la jornada escolar de los niños para mejorar el estado nutricional y la fuerza muscular. Método: 156 escolares de 7 a 15 años, pertenecientes a dos colegios municipalizados con jornada escolar completa, participaron de un programa piloto basado en juegos recreativos dinámico durante 45 minutos de lunes a viernes durante 3 meses, en el recreo más extenso de la jornada escolar. Resultados: Al finalizar la intervención se observó una modificación estadísticamente significativa en el estado nutricional, donde destaca un aumento de niños que alcanza el estado nutricional normal. En aquellos que fueron clasificados previamente como obesos se logra modificar su estado nutricional hacia sobrepeso (p < 0,001). Se observó una disminución de la fuerza muscular del tren inferior al término del estudio (p < 0,001). Conclusiones: Se demostró el impacto positivo de una intervención basada en juegos recreativos dinámicos durante los recreos escolares, con modificación positiva en el estado nutricional, pero sin mejoría de la fuerza muscular de los escolares (AU)

Introduction: The overnutrition is a constant on developing countries; Chile is not an exception because it has a marked tendency to overweight and obesity in schoolchildren. The muscular strength has been associated with cardiovascular and metabolic health status in scholars. Effective interventions using games are needed to improve the nutritional status and physical fitness in school children. Objective: To assess the intervention effectiveness based on games played at school time to improve the nutritional status and physical fitness in schoolchildren. Method: 156 students aged between 7 to 15 years, attending to two public schools with full school day, to which a pilot program was applied. This pilot program was based on dynamic recreational games during 45 minutes from monday to friday for 3 months in the largest playtime of the school day. Results: At the end of the intervention, we observed a significant modification on children nutritional status, which highlights an increase in the number of children that reached the normal nutritional status (p < 0.001). We also observed a significant number of obese children who reached overweight nutritional status (p < 0.001). We also observed a decrease of leg muscular strength at the end of the study. Conclusions: We found a positive effect of a program based on dynamic recreational games in the largest school playtime, improving nutritional status. However, we didn’t observed modifications in the muscular strength (AU)

[Consensus statement on the clinical management of human immunodeficiency virus-associated neurocognitive disorders]. / Documento de consenso sobre el manejo clínico de los trastornos neurocognitivos asociados a la infección por el virus de la inmunodeficiencia humana (enero 2013).

OBJECTIVE: To develop a consensus document containing clinical recommendations for the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND). METHODS: We assembled a panel of experts appointed by GeSIDA and the Secretariat of the National AIDS Plan (PNS), including internal medicine physicians with expertise in the field of HIV, neuropsychologists, neurologists and neuroradiologists. Scientific information was reviewed to October 2012 in publications and conference papers. In support of the recommendations using two levels of evidence: the strength of the recommendation in the opinion of the experts (A, B, C) and the level of empirical evidence (I, II, III), two levels based on the criteria of the Infectious Disease Society of America, already used in previous documents GeSIDA/SPNS. RESULTS: Multiple recommendations for the clinical management of these disorders are provided, including two graphics algorithms, considering both the diagnostic and possible therapeutic strategies. CONCLUSIONS: Neurocognitive disorders associated with HIV infection is currently highly prevalent, are associated with a decreased quality of life and daily activities, and given the possibility of occurrence of an increase in the coming years, there is a need to adequately manage these disorders, from a diagnostic as well as therapeutic point of view, and always from a multidisciplinary perspective.

Evolutionary vaccination dilemma in complex networks.

In this work we analyze the evolution of voluntary vaccination in networked populations by entangling the spreading dynamics of an influenza-like disease with an evolutionary framework taking place at the end of each influenza season so that individuals take or do not take the vaccine upon their previous experience. Our framework thus puts in competition two well-known dynamical properties of scale-free networks: the fast propagation of diseases and the promotion of cooperative behaviors. Our results show that when vaccine is perfect, scale-free networks enhance the vaccination behavior with respect to random graphs with homogeneous connectivity patterns. However, when imperfection appears we find a crossover effect so that the number of infected (vaccinated) individuals increases (decreases) with respect to homogeneous networks, thus showing the competition between the aforementioned properties of scale-free graphs.

Percepción de los neurólogos generales sobre la importancia e influencia del deterioro cognitivo y las alteraciones de conducta en la enfermedad de Parkinson / No disponible

Introducción. En los últimos años ha ido adquiriendo cada vez mayor importancia la influencia de los trastornos no motores en la enfermedad de Parkinson (TNMEP). Las alteraciones de conducta (AC) y el deterioro cognitivo (DC) forman parte del espectro de estos TNMEP. Actualmente, en nuestro entorno, un número considerable de pacientes con enfermedad de Parkinson (EP) es valorado inicialmente en las consultas de neurología general, por lo que resulta importante que los neurólogos no especialistas en trastornos del movimiento consideren los TNMEP en la evaluación inicial de sus pacientes con EP. El objetivo de este trabajo es conocer la percepción que el neurólogo general tiene sobre la importancia e influencia de las AC y el DC en los pacientes con EP. Material y métodos. Se diseñó una encuesta que fue enviada por correo electrónico a los neurólogos con ejercicio profesional en la Comunidad Autónoma de Canarias. Resultados. Se enviaron 73 encuestas, de las que se respondieron 40. Las AC y el DC fueron considerados relativamente frecuentes/muy frecuentes por un 78,6 % y un 86 % de los participantes, respectivamente; un 78,6 % y un 82,1 % consideró que las AC y el DC, respectivamente, tienen mucha influencia o tanta influencia como los trastornos motores en la percepción que los pacientes tienen de su enfermedad. Un 60,7 % y un 64,2 % de los encuestados consideró que las AC y el DC, respectivamente, aparecen cuando comienzan a surgir las complicaciones motoras de la enfermedad o en fases tardías de esta. Un 89,2% y un 82,1 % de los encuestados contestó que explora de forma específica siempre o prácticamente siempre las AC y el DC, respectivamente, en su valoración de los pacientes con EP. Un 78,5 % de los encuestados consideró que la levodopa y los agonistas dopaminérgicos no tienen ninguna eficacia o tienen una eficacia limitada en el tratamiento de las AC y el DC. Conclusión. La mayoría de los neurólogos generales en nuestra comunidad autónoma considera que las AC y el DC son problemas frecuentes e importantes en los pacientes con EP, e incluyen de forma específica la valoración de estas complicaciones en su práctica diaria, siendo, en general, consideradas complicaciones tardías(AU)

Introduction. The influence of non-motor disorders in Parkinson’s disease (NMDPD) has become increasingly more important in recent years. Behaviour changes (BC) and cognitive impairment (CI) are part of the spectrum of these NMDPD. Currently, a significant number of patients with Parkinson’s disease (PD) is initially evaluated by general neurologists in our sanitary area; it is therefore important that neurologists not specialized in movement disorders consider NMDPD in the initial assessment of patients with Parkinson's Disease. The aim of this study is to determine the perception that the general neurologist has about the importance and influence of the BC and CI in patients with PD. Materials and methods. We designed a survey that was e-mailed to neurologists with professional activity in the Canary Islands. Results. We sent by e-mail 73 surveys to general neurologists, and we received feedback from 40 of them. BC and CI were considered relatively frequent / very frequent for 78.6% and 86 % of participants, respectively; 78.6 % and 82.1 % considered that BC and CI, in this order, are more influent or are as influent as motor disturbances in the patient self-perception of their disease; 60.7 % and 64.2 % of general neurologists felt that BC and CI appear at the same time than motor complications of the disease, or in later stages of the disease; 89.2 % and 82.1 % answered that they always, or almost always, explore BC and CI in their assessment of patients with PD; 78.5 % thought that levodopa and dopamine agonists have no efficacy or have limited efficacy in the treatment of BC and CI. Conclusion. Most general neurologists in our region believe that BC and CI are frequent and important problems in PD patients, and they specifically include the evaluation of these complications in their daily practice. Both BC and CI are generally considered to appear at later stages of disease course(AU)

[Description of the follow-up protocol for idiopathic intracranial hypertension in the neuro-ophthalmological unit of a tertiary hospital]. / Descripcion del protocolo de seguimiento para la hipertension intracraneal idiopatica en una unidad de neurooftalmologia de un hospital terciario.

AIM: To review the results of implementing a protocol for following up patients with idiopathic intracranial hypertension (IICH) in a neuro-ophthalmological unit (NOU). PATIENTS AND METHODS: A review of the literature was conducted in order to determine the examinations that needed to be included in the follow-up protocol, as well as the optimum frequency of visits and the most adequate duration of the follow-up. Later, a prospective review was performed of the patients that have been included since the NOU was set up and they were compared with the patients included in the IICH register prior to the creation of the NOU. RESULTS: Since the protocol was implemented, visual acuity and the visual field have been evaluated in 100% of patients at three months, at six months and at one year after diagnosis. Moreover, the visual field was examined at three months, at six months and at one year after diagnosis in 91%, 72.8% and 100% of patients with IICH, respectively. Before our follow-up protocol was implemented, 190 had been carried out, which is roughly three per patient. Eleven lumbar punctures have been performed since the NOU was set up. CONCLUSIONS: The creation of a multidisciplinary NOU makes it possible to optimise resources and improve the care given to patients with IICH. This should result in an improvement in the functional prognosis of these patients.

TITLE: Descripcion del protocolo de seguimiento para la hipertension intracraneal idiopatica en una unidad de neurooftalmologia de un hospital terciario.Objetivo. Revisar los resultados de la implantacion de un protocolo de seguimiento de pacientes con hipertension intracraneal idiopatica (HICI) en una unidad de neurooftalmologia (UNO). Pacientes y metodos. Se realizo una revision bibliografica para determinar las exploraciones necesarias que debian incluirse en el protocolo de seguimiento, asi como la frecuencia optima de las visitas y la duracion adecuada del seguimiento. Posteriormente, se revisaron de forma prospectiva los pacientes incluidos desde la creacion de la UNO y se compararon con los pacientes incluidos en el registro de HICI previo a la creacion de la UNO. Resultados. Desde la implantacion del protocolo, en el 100% de los pacientes se ha valorado la agudeza visual y la campimetria visual a los tres meses, a los seis meses y al ano del diagnostico. Ademas, en un 91%, 72,8% y 100% de los pacientes con HICI se realizo una campimetria visual a los tres meses, a los seis meses y al ano del diagnostico, respectivamente. Antes de la implantacion de nuestro protocolo de seguimiento, se habian realizado 190, lo que corresponde a unas tres por paciente. El numero de punciones lumbares realizadas desde la creacion de la UNO es de 11. Conclusiones. La creacion de una UNO multidisciplinar permite optimizar los recursos y mejorar la asistencia a los pacientes con HICI. Esto deberia redundar en una mejoria del pronostico funcional de estos pacientes.

Descripción del protocolo de seguimiento para la hipertensión intracraneal idiopática en una unidad de neurooftalmología de un hospital terciario / Description of the follow-up protocol for idiopathic intracranial hypertension in the neuro-ophthalmological

Objetivo. Revisar los resultados de la implantación de un protocolo de seguimiento de pacientes con hipertensión intracraneal idiopática (HICI) en una unidad de neurooftalmología (UNO). Pacientes y métodos. Se realizó una revisión bibliográfica para determinar las exploraciones necesarias que debían incluirse en el protocolo de seguimiento, así como la frecuencia óptima de las visitas y la duración adecuada del seguimiento. Posteriormente, se revisaron de forma prospectiva los pacientes incluidos desde la creación de la UNO y se compararon con los pacientes incluidos en el registro de HICI previo a la creación de la UNO. Resultados. Desde la implantación del protocolo, en el 100% de los pacientes se ha valorado la agudeza visual y la campimetría visual a los tres meses, a los seis meses y al año del diagnóstico. Además, en un 91%, 72,8% y 100% de los pacientes con HICI se realizó una campimetría visual a los tres meses, a los seis meses y al año del diagnóstico, respectivamente. Antes de la implantación de nuestro protocolo de seguimiento, se habían realizado 190, lo que corresponde a unas tres por paciente. El número de punciones lumbares realizadas desde la creación de la UNO es de 11. Conclusiones. La creación de una UNO multidisciplinar permite optimizar los recursos y mejorar la asistencia a los pacientes con HICI. Esto debería redundar en una mejoría del pronóstico funcional de estos pacientes (AU)

Aim. To review the results of implementing a protocol for following up patients with idiopathic intracranial hypertension (IICH) in a neuro-ophthalmological unit (NOU). Patients and methods. A review of the literature was conducted in order to determine the examinations that needed to be included in the follow-up protocol, as well as the optimum frequency of visits and the most adequate duration of the follow-up. Later, a prospective review was performed of the patients that have been included since the NOU was set up and they were compared with the patients included in the IICH register prior to the creation of the NOU. Results. Since the protocol was implemented, visual acuity and the visual field have been evaluated in 100% of patients at three months, at six months and at one year after diagnosis. Moreover, the visual field was examined at three months, at six months and at one year after diagnosis in 91%, 72.8% and 100% of patients with IICH, respectively. Before our followup protocol was implemented, 190 had been carried out, which is roughly three per patient. Eleven lumbar punctures have been performed since the NOU was set up. Conclusions. The creation of a multidisciplinary NOU makes it possible to optimise resources and improve the care given to patients with IICH. This should result in an improvement in the functional prognosis of these patients (AU)

[Thrombosis of the cerebral venous sinuses in the differential diagnosis of idiopathic intracranial hypertension in young obese females: is it a real problem?]. / Trombosis de senos venosos cerebrales en el diagnostico diferencial de la hipertension intracraneal idiopatica en mujeres jovenes obesas: un problema real?

INTRODUCTION: Idiopathic intracranial hypertension (IICH) typically presents in young women with obesity or a recent weight increase. The differential diagnosis of IICH includes thrombosis of the cerebral venous sinuses (TCVS), which can also present as an isolated intracranial hypertension syndrome. We review the frequency with which patients with a typical IICH profile presented TCVS as their diagnosis. PATIENTS AND METHODS: The study consisted in a retrospective review of all the admissions due to intracranial hypertension syndromes in our centre between 2000 and 2011. The cases selected were those with a normal cerebrospinal fluid study and computerised axial tomography scan of the head that presented as an isolated intracranial hypertension syndrome; those who manifested a focal neurological picture, however, were excluded. From the patients that were included, a subgroup made up of females between 16 and 35 years of age with a body mass index of above 25 were selected. RESULTS: A total of 37 cases were obtained. Of these, 35 (94.6%) were cases of IICH and two (5.4%) were TCVS. The time elapsed between the onset of symptoms and diagnosis was less than seven days in both cases of TCVS (100%) and in two cases (5.4%) of IICH. CONCLUSIONS: Up to 5.4% of patients with a typical IICH profile that present with an intracranial hypertension syndrome can present TCVS. The presence of prothrombotic factors and a high D-dimer can suggest this possibility, although there is still a need for well-established parameters that allow decisions to be made in emergencies in the absence of any chance of performing an urgent MR phlebography scan.

Trombosis de senos venosos cerebrales en el diagnóstico diferencial de la hipertensión intracraneal idiopática en mujeres jóvenes obesas: ¿un problema real? / Thrombosis of the cerebral venous sinuses in the differential diagnosis of idiopathic intracranial hypertension in young obese females: is it a real problem?

Introducción. La hipertensión intracraneal idiopática (HICI) se presenta típicamente en mujeres jóvenes con obesidad o aumento de peso reciente. En el diagnóstico diferencial de la HICI se encuentra la trombosis de los senos venosos cerebrales (TSVC), que también puede presentarse como un síndrome de hipertensión intracraneal aislada. Revisamos la frecuencia con la que pacientes con un perfil típico de HICI presentaron como diagnóstico una TSVC. Pacientes y métodos. Se revisaron de forma retrospectiva todos los ingresos por síndromes de hipertensión intracraneal en nuestro centro entre 2000 y 2011. Se seleccionaron los casos con tomografía axial computarizada craneal y estudio de líquido cefalorraquídeo normal que se presentaron como un síndrome de hipertensión intracraneal aislado, excluyéndose los que manifestaron clínica neurológica focal. Entre los pacientes incluidos, se seleccionó el subgrupo de mujeres entre 16 y 35 años con un índice de masa corporal superior a 25. Resultados. Se obtuvieron 37 casos. De éstos, 35 (94,6%) fueron casos de HICI y dos (5,4%) de TSVC. El tiempo desde el inicio de los síntomas hasta el diagnóstico fue menor de siete días en los dos casos (100%) de TSVC y en dos (5,4%) de HICI. Conclusiones. Hasta un 5,4% de los pacientes con perfil típico de HICI que se presentan con un síndrome de hipertensión intracraneal pueden presentar una TSVC. La presencia de factores protrombóticos y un dímero D elevado pueden orientar hacia esta posibilidad, aunque se precisan todavía parámetros bien establecidos que permitan la toma de decisiones en urgencias en ausencia de la posibilidad de una fleborresonancia craneal urgente (AU)

Introduction. Idiopathic intracranial hypertension (IICH) typically presents in young women with obesity or a recent weight increase. The differential diagnosis of IICH includes thrombosis of the cerebral venous sinuses (TCVS), which can also present as an isolated intracranial hypertension syndrome. We review the frequency with which patients with a typical IICH profile presented TCVS as their diagnosis. Patients and methods. The study consisted in a retrospective review of all the admissions due to intracranial hypertension syndromes in our centre between 2000 and 2011. The cases selected were those with a normal cerebrospinal fluid study and computerised axial tomography scan of the head that presented as an isolated intracranial hypertension syndrome; those who manifested a focal neurological picture, however, were excluded. From the patients that were included, a subgroup made up of females between 16 and 35 years of age with a body mass index of above 25 were selected. Results. A total of 37 cases were obtained. Of these, 35 (94.6%) were cases of IICH and two (5.4%) were TCVS. The time elapsed between the onset of symptoms and diagnosis was less than seven days in both cases of TCVS (100%) and in two cases (5.4%) of IICH. Conclusions. Up to 5.4% of patients with a typical IICH profile that present with an intracranial hypertension syndrome can present TCVS. The presence of prothrombotic factors and a high D-dimer can suggest this possibility, although there is still a need for well-established parameters that allow decisions to be made in emergencies in the absence of any chance of performing an urgent MR phlebography scan (AU)