Alto subdiagnóstico del síndrome de piernas inquietas en la consulta ambulatoria neurológica y psiquiátrica / Restless legs syndrome is highly underdiagnosed in a neurologic-psychiatric outpatient clinic

Background: Restless legs syndrome (RLS) is a neurological condition that is characterized by the irresistible urge to move the legs and is very common. In the last decade, much attention has been focused on RLS, given its high occurrence, underdiagnosis, and impact on quality of Ufe. Aim: To determine the frequency of RLS in a neurologic-psychiatric outpatient clinic. Patients and Methods: We interviewed patients attending a prívate neurological outpatient clinic, using a standardized validated questionnaire, and an additional phone interview to confirm diagnosis. Results: Of approximately 800 people attending the clinic, the questionnaire was answered by 238 subjects (168 females). Fifteen percent of respondents were affected by RLS and none had been diagnosed before. Most patients had a severe form that probably required treatment. Conclusions: A low awareness of RLS exists in Chile, even among specialized physicians.

Impacto de los trastornos del sueño en la salud de las personas: insomnio y síndrome de apnea del sueño / Impact of sleep disorders in the people's health: insomnia and sleep apnea syndrome

El sueño constituye un estado dinámico que busca ofrecemos descanso y reparación. El insomnio y las apneas del sueño, perturban el sueño generando importantes consecuencias. El insomnio conduce no sólo a disminución del alerta, la productividad laboral e incremento del riesgo de enfermar, sino también se relaciona con comorbilidades como depresión. El costo económico del ausentismo laboral, mayor tasa de enfermedades, menor rendimiento y accidentes es de billones de dólares al año en los Estados Unidos. En el caso de apneas del sueño, hay un mayor riesgo de enfermedad coronaria, insuficiencia cardiaca congestiva y accidente cerebrovascular. Los mecanismos intermediarios incluyen la, activación simpática. El tratamiento con CPAP reduce la presión arterial y mejora la función ventricular, lo que apoya la relación apnea y enfermedad cardiovascular. Son necesarios estudios sistemáticos para explicar otras relaciones complejas entre apnea del sueño y enfermedad vascular, las que pueden verse agravadas por el síndrome metabólico.

Sleep is a dynamic state aimed at offering rest and repair. insomnia and sleep apneas disrupt sleep generating significant consequences. Insomnia leads not only to decreased alertness, labor productivity, and increased risk of becoming ill, but is also related to comorbidities such as depression. The economic cost of absenteeism, ín addition to higher illness rate, accidents and reduced performance amaunts to billions of dallars a year in the United States. Individuals with severe sleep apnea are at increased risk far coronary disease, congestive heart failure, and stroke. Several intermediar y mechanisms might be in volved including sympathetic activation. Linkage between obstructive apnea and cardiovascular disease is corroborated by evidence that treatment with CPAP reduces systolic blood pressure and improves left ventricular systalic function. Several systematic studies are necessary to explicate complex assaciations between sleep apnea and vascular disease, which may be compounded by the metabolic syndrome.

Panencefalitis esclerosante subaguda de inicio en edad adulta: presentación atípica en 2 pacientes / Adult onset subacute sclerosing panencephalitis: atypical presentation in 2 cases

Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available

Fibrinolisis en el infarto cerebral / Fibrinolysis in brain infarction

Hasta hace poco años atrás no existía una terapia espececífica para el tratamiento del infarto cerebral (IC), sin embargo en los últimos treinta años la trombolisis constituyó un campo activo de la investigación terapéutica orientada a solucionar esta deficiencia en el tratamiento del IC. Actualmente la trombolisis es la única terapia específica disponible para casos seleccionados de IC. En este artículo presentamos una revisión de la literatura relacionada a la terapia fibronolítica como tratamiento IC y entregamos una pauta de criterios para el uso de fibronolítico con las prepaciones comerciales disponibles actualmente. Las recomendaciones dada en este trabajo están respaldadas por evidencia científica demostrada