The contribution of executive functions to the process of return to work after brain injury: A systematic review.

Acquired brain injury (ABI) is a worldwide public health issue for its high prevalence rate and the disability it produces. The consequences of ABI, including cognitive deficits, may impact return to work. This review focuses on the association between executive functions (EFs) and return to work after ABI. A systematic review of the literature between 1998 and 2023 was conducted following PRISMA guidelines. The articles were retrieved from the Pubmed, Medline and Web of Science databases. A total of 49 studies were finally selected. Impairments of EF were consistently shown to have a negative impact on return to work after an ABI. There is evidence that specific executive functions and neurobehavioral variables may affect return to work Studies showed a significant theoretical and methodological heterogeneity, representing an important limitation to understand the relation between EFs and work. There is a robust association between EFs and return to work after brain injury. Findings in this systematic review raise the need for further research on the role of specific EF profiles in the process of returning to work after brain damage.

Detección y resolución de Problemas Relacionados con Medicamentos en un servicio de Atención Farmacéutica en Argentina / Detection and resolution of Drug Therapy Problems in a Pharmaceutical Care service in Argentina

Introducción: La Atención Farmacéutica consiste en un proceso asistencial sistemático para detec-tar, resolver y prevenir Problemas Relacionados con Medicamentos. El objetivo del presente trabajo es describir el número y perfil de problemas detecta-dos y resueltos en un conjunto de pacientes adul-tos atendidos en una Unidad de Optimización de la Farmacoterapia en Argentina, durante un segui-miento farmacoterapéutico promedio de un año.Método: Se realizó un estudio cuasi-experimental, abierto y prospectivo en 40 pacientes ambulatorios. Se registraron las características clínicas y medica-mentos, así como su adherencia o no al servicio. Se empleó la clasificación de Problemas Relacionados con Medicamentos de Minnesota, registrando su dimensión, categoría, causa, patología o condición clínica asociada, medicamento asociado, estado de riesgo, estado final y método de resolución.Resultados: Los grupos farmacoterapéuticos mayormente utilizados fueron beta-bloqueantes, estatinas, vitaminas y minerales, analgésicos, inhibidores de la bomba de protones y benzodiace-pinas. Los problemas de indicación, especialmente por necesidad de farmacoterapia adicional, prevale-cieron como los más frecuentes, incluyendo la falta de farmacoterapia preventiva con vacunas. Se lo-gró resolver el 73,6% de los problemas detectados, de los cuales el 60,3% se hizo a través de informes a los médicos tratantes. El resto se pudo abordar mediante la educación al paciente, especialmente los de adherencia.Conclusiones: La Atención Farmacéutica permitió una descripción sistemática del perfil de problemas farmacológicos detectados y resueltos en un con-junto de pacientes adultos mayores ambulatorios, principalmente de sexo femenino, en el contexto de una Unidad de Optimización de la Farmacoterapia montada en un hospital universitario de Argentina. (AU)

Introduction: Pharmaceutical Care is a systematic process to detect, solve, and prevent Drug Relat-ed Problems. The aim of this study is to describe the number and profile of problems detected and solved in a group of adult patients interviewed in a Pharmacotherapy Optimization Unit in Argentina, during an average pharmacotherapeutic follow-up of one year.Method: A quasi-experimental, open-label, pro-spective study was carried out in 40 outpatients. The Clinical characteristics and medications were revealed, as well as their adherence to the service. The Minnesota classification of Drug Therapy Problems was used, recording dimension, category, cause, associated clinical condition, associated medication, risk status, final status, and resolution method.Results: The most widely used pharmacotherapeu-tic groups were beta-blockers, statins, vitamins and minerals, analgesics, proton pump inhibitors, and benzodiazepines. Indication problems, especially due to the need for additional pharmacotherapy, prevailed as the most frequent, including the lack of preventive vaccines. It was possible to solve 73.6% of the detected problems, of which 60.3% was done through reports to the treating physicians. The rest could be addressed through patient education, especially those related to adherence.Conclusions: Pharmaceutical Care allowed a systematic pharmacotherapy work-up of Drug Related Problems detected and solved in a group of elderly outpatients, mainly female, in the context of a Pharmacotherapy Optimization Unit set up in a university hospital in Argentina. (AU)

Estudio radiológico simple de quiste óseo simple y aneurismático: diagnóstico diferencial / Plain radiologic assessment of unicameral and aneurysmal bone cyst: differential diagnosis

OBJETIVO Dar a conocer nuestra experiencia en el diagnóstico diferencial de los quistes óseos simple y aneurismático mediante estudio radiológico simple. MATERIALES Y METODOS Se incluyeron pacientes menores de 20 años con radiografía de quiste óseo simple o aneurismático histológicamente confirmado pertenecientes al Registro Nacional de Tumores Óseos. Las radiografías fueron analizadas por dos radiólogos experimentados. Se compararon las variables demográficas de los pacientes, y las variables clínicas y radiológicas de ambos quistes. RESULTADOS Un total de 97 pacientes cumplieron los criterios de inclusión (65% presentaba quistes óseos simples y 35%, aneurismáticos). No se observaron diferencias en cuanto a la edad, al hueso comprometido, al tamaño de la lesión, a la expansión ósea, ni al adelgazamiento cortical. El género, la forma de presentación, la presencia de interrupción de la cortical, y la localización de la lesión en los ejes longitudinal y transversal del hueso son parámetros que podrían ser útiles en el diagnóstico diferencial de ambos quistes. DISCUSIÓN Los quistes óseos simple y aneurismático son lesiones benignas frecuentes que, de acuerdo con la literatura, serían difíciles de diferenciar únicamente con radiografía simple. La resonancia magnética permite una mejor caracterización anatómica, y aporta sensibilidad y especificidad al diagnóstico. Sin embargo, debe ser precedida por la radiografía simple, y su disponibilidad es limitada. CONCLUSIÓN Aun en centros con disponibilidad de resonancia magnética, la radiografía simple sigue siendo el estudio inicial de elección en el diagnóstico de tumores óseos. Ciertas características demográficas y radiográficas permiten orientar el diagnóstico diferencial inicial entre el quiste óseo simple y el aneurismático

OBJETIVE To describe our experience in the differential diagnosis of unicameral and aneurysmal bone cysts using plain radiography. PATIENCES AND METHODS We included patients under 20 years of age with radiographs of histologically-confirmed unicameral or aneurysmal bone cysts found on the Chilean National Bone-Tumor Registry. The radiographs were evaluated by two experienced radiologists. We compared the demographic variables of the patients, and the clinical and radiological variables of both tumors.. RESULTADOS A total of 97 patients met the inclusion criteria, 65% of whom had simple bone cysts, and 35%, aneurysmal bone cysts. No differences were found regarding age, the bone affected, the size of the lesion, bone expansion, nor cortical thinning. Gender, clinical presentation, cortical interruption, and location of the lesion on the longitudinal and transverse bone axes are parameters that could be used in the differential diagnosis of both cysts. DISCUSSION According to the literature, unicameral and aneurysmal bone cysts are frequent benign lesions that are difficult to differentiate merely through plain radiographs. Magnetic resonance imaging enables a better anatomical characterization and provides sensitivity and specificity to the diagnosis. However, its availability is limited, and it should be preceded by plain radiography. CONCLUSION Plain radiography is still the initial imaging study of choice in patients with clinical suspicion of bone tumor, even in those centers where magnetic resonance imaging is available. Certain demographic and radiological characteristics guide physicians in the differential diagnosis of unicameral and aneurysmal bone cysts.

Pseudo-hemothorax at computed tomography due to residual contrast media.

Pleural effusion is a clinical problem that has many causes, with hemothorax being one of them. Computed tomography readily characterizes pleural fluid with determination of the attenuation value, helping to distinguish hemothorax from other types of effusion. Herein, we report the case of a 67-year-old man with end-stage renal disease in which a high-density pleural effusion due to residual contrast media was misinterpreted as hemothorax. Radiologists should consider the possibility of contrast media retention when interpreting a high-density pleural effusion in patients with end-stage renal disease. Recognition of this entity is crucial to avoid misdiagnosis, which might lead to unnecessary testing or procedures.

Apoplastic polyamine oxidation plays different roles in local responses of tobacco to infection by the necrotrophic fungus Sclerotinia sclerotiorum and the biotrophic bacterium Pseudomonas viridiflava.

The role of polyamine (PA) metabolism in tobacco (Nicotiana tabacum) defense against pathogens with contrasting pathogenic strategies was evaluated. Infection by the necrotrophic fungus Sclerotinia sclerotiorum resulted in increased arginine decarboxylase expression and activity in host tissues, as well as putrescine and spermine accumulation in leaf apoplast. Enhancement of leaf PA levels, either by using transgenic plants or infiltration with exogenous PAs, led to increased necrosis due to infection by S. sclerotiorum. Specific inhibition of diamine and PA oxidases attenuated the PA-induced enhancement of leaf necrosis during fungal infection. When tobacco responses to infection by the biotrophic bacterium Pseudomonas viridiflava were investigated, an increase of apoplastic spermine levels was detected. Enhancement of host PA levels by the above-described experimental approaches strongly decreased in planta bacterial growth, an effect that was blocked by a PA oxidase inhibitor. It can be concluded that accumulation and further oxidation of free PAs in the leaf apoplast of tobacco plants occurs in a similar, although not identical way during tobacco defense against infection by microorganisms with contrasting pathogenesis strategies. This response affects the pathogen's ability to colonize host tissues and results are detrimental for plant defense against necrotrophic pathogens that feed on necrotic tissue; on the contrary, this response plays a beneficial role in defense against biotrophic pathogens that depend on living tissue for successful host colonization. Thus, apoplastic PAs play important roles in plant-pathogen interactions, and modulation of host PA levels, particularly in the leaf apoplast, may lead to significant changes in host susceptibility to different kinds of pathogens.