Intervenciones de musicoterapia en pacientes adultos hospitalizados con esquizofrenia: una revisión crítica para la práctica enfermera / Music-therapy based interventions aimed to adults with schizophrenia during in-patient care setting: a critical review for nursing practice

La esquizofrenia es un trastorno neuropsiquiátrico complejo, cuyo tratamiento principal se centra en el abordaje farmacológico con antipsicóticos. Cada vez son más las intervenciones no farmacológicas, como la musicoterapia, las que se proponen como alternativa para complementar su abordaje y mejorar la calidad de vida de las personas afectadas.El objetivo de esta investigación es examinar las características y efectos de los estudios de intervención basados en la musicoterapia llevados a cabo por enfermeras y que estén dirigidos a personas adultas con esquizofrenia durante el proceso de hospitalización. Se llevó a cabo una búsqueda sistemática de la literatura que aportó 7 estudios de intervención basados en musicoterapia para personas con esquizofrenia en unidades de hospitalización y liderados por enfermería. Todas las intervenciones mostraron efectos beneficiosos de esta terapia en la mejora de la sintomatología psiquiátrica y un incremento de la calidad de vida. (AU)

Schizophrenia is a complex neuropsychiatric disorder, whose main treatment focuses on pharmacological treatment with antipsychotics. However, non-pharmacological interventions, as music therapy, are increasingly being proposed as an alternative to complement this approach and improve the quality of life of those affected.The objective of this research in to examine the characteristics and effects of intervention studies based on music therapy carried out by nursing professionals and aimed at adults with schizophrenia during the in-patient care setting. A systematic search of the literature was carried out returned seven intervention studies based on music therapy for people with schizophrenia in inpatient units and led by nurses were identified. All interventions showed beneficial effects of this therapy in the improvement of psychiatric symptomatology and an increase in the quality of life.

Síndrome de Brown-Séquard progresivo secundario a hernia medular idiopática: correlación clinicorradiológica y quirúrgica / Progressive Brown-Séquard syndrome secondary to idiopathic spinal cord herniation: clinico-radiological and surgical correlations

INTRODUCCIÓN: La hernia medular idiopática es una patología infrecuente que cursa clínicamente con una mielopatía progresiva, la mayoría de las ocasiones en forma de síndrome de Brown-Séquard. Su base anatómica es un defecto dural por el que se incarcera progresivamente una porción del cordón medular anterior. La resonancia magnética y la mielotomografía demuestran un acodamiento medular en «tienda de campaña» hacia la cara anterior del estuche dural, a nivel dorsal medio fundamentalmente. Caso clínico. Varón de 37 años, diagnosticado de hernia medular idiopática e intervenido quirúrgicamente mediante una técnica propia; se demuestra su correlación neurorradiológica, anatomoquirúrgica y evolutiva. CONCLUSIÓN: El tratamiento debe ser individualizado, pues no existe una técnica quirúrgica universalmente establecida

INTRODUCTION: Idiopathic medullary herniation is an infrequent disease, which shows up in clinical form as a progressive mielopathy, most commonly known as the Brown-Séquard syndrome. Its anatomical base is a dural defect where a portion of anterior spinal cord gets progressively incarcerated. The MRI and myelo-CT scan show a bending of the spinal cord in the form of a «bell tent» towards the anterior dural sheath at the mid-dorsal portion mainly. CASE REPORT: A 37 year old male, who was diagnosed of idiopathic medullary herniation and surgically treated by our own developed technique, reporting its neuroradiological, anatomo-surgical and clinical correlation. CONCLUSION. Treatment should be individualized, as no standard surgical technique has been established up to the present

High resistance to climatic variability in a dominant tundra shrub species.

Climate change is modifying temperature and precipitation regimes across all seasons in northern ecosystems. Summer temperatures are higher, growing seasons extend into spring and fall and snow cover conditions are more variable during winter. The resistance of dominant tundra species to these season-specific changes, with each season potentially having contrasting effects on their growth and survival, can determine the future of tundra plant communities under climate change. In our study, we evaluated the effects of several spring/summer and winter climatic variables (i.e., summer temperature, growing season length, growing degree days, and number of winter freezing days) on the resistance of the dwarf shrub Empetrum nigrum. We measured over six years the ability of E. nigrum to keep a stable shoot growth, berry production, and vegetative cover in five E. nigrum dominated tundra heathlands, in a total of 144 plots covering a 200-km gradient from oceanic to continental climate. Overall, E. nigrum displayed high resistance to climatic variation along the gradient, with positive growth and reproductive output during all years and sites. Climatic conditions varied sharply among sites, especially during the winter months, finding that exposure to freezing temperatures during winter was correlated with reduced shoot length and berry production. These negative effects however, could be compensated if the following growing season was warm and long. Our study demonstrates that E. nigrum is a species resistant to fluctuating climatic conditions during the growing season and winter months in both oceanic and continental areas. Overall, E. nigrum appeared frost hardy and its resistance was determined by interactions among different season-specific climatic conditions with contrasting effects.

Tratamiento del neurinoma acústico gigante / Treatment of giant acoustic neuromas

INTRODUCCIÓN Y OBJETIVOS: Analizar la modalidad de tratamiento y resultados en una serie clínica de pacientes con neurinomas acústicos gigantes, caracterizados por superar los 4 cm de diámetro extrameatal y por alta morbimortalidad. MATERIAL Y MÉTODO: Serie clínica retrospectiva y unicéntrica de schwannomas vestibulares tratados en un periodo de 12 años. En nuestra serie institucional de 108 neurinomas acústicos operados en ese periodo, fueron identificados 13 (12%) pacientes con tumores superiores a los 4 cm en su diámetro mayor extrameatal. En estos se analizó la forma de presentación y diversos parámetros clínicos y anatomoquirúrgicos. RESULTADOS: Todos los pacientes fueron operados mediante un abordaje suboccipital retrosigmoideo por el mismo neurocirujano (EU) y en 10 casos se consiguió extirpación completa. En un caso se planificó y practicó una extirpación subtotal, un caso fue tratado con derivación ventriculoperitoneal y otro no recibió tratamiento específico alguno. Un paciente falleció durante el postoperatorio inmediato. Cuatro pacientes tenían una parálisis facial mayor de III en la escala House-Brackman al año de la cirugía. CONCLUSIONES: Las 4 características pronósticas más importantes en los neurinomas acústicos gigantes son: tamaño, consistencia, adhesión a estructuras neurovasculares y vascularización. Solo la primera de ellas resulta evidente en los estudios de neuroimagen. Los neurinomas acústicos gigantes se caracterizan por alta morbilidad tanto en el momento de presentación clínica como tras el tratamiento. Sin embargo, el objetivo de extirpación completa con preservación de la función de los nervios craneales es alcanzable en algunos casos a través del abordaje suboccipital retrosigmoideo

INTRODUCTION AND OBJECTIVES: To analyze the treatment modality and outcome of a series of patients with giant acoustic neuromas, a particular type of tumour characterised by their size (extracanalicular diameter of 4 cm or more) and high morbidity and mortality Materials and methods: This was a retrospective unicentre study of patients with acousticneuromas treated in a period of 12 years. In our institutional series of 108 acoustic neuro mas operated on during that period, we found 13 (12%) cases of giant acoustic neuromas. We reviewed the available data of these cases, including presentation and several clinical, anatomical, and microsurgical aspects. RESULTS: All patients were operated on by the same neurosurgeon and senior author (EU)using the suboccipital retrosigmoid approach and complete microsurgical removal was achieved in 10 cases. In one case, near total removal was deliberately performed, in another case a CSF shunt was placed as the sole treatment measure, and in the remaining case no direct treatment was given. One patient died in the immediate postoperative period. One year after surgery, 4 patients showed facial nerve function of III or more in the House-Brackman scale. Conclusions: The 4 most important prognostic characteristics of giant acoustic neuromas are size, adhesion to surrounding structures, consistency and vascularity. Only the first of these is evident in neuroimaging. Giant acoustic neuromas are characterised by high morbidity at presentation as well as after treatment. Nevertheless, the objective of complete microsurgical removal with preservation of cranial nerve function is attainable in some cases through the suboccipital retrosigmoid approach

[Treatment of giant acoustic neuromas]. / Tratamiento del neurinoma acústico gigante.

INTRODUCTION AND OBJECTIVES: To analyze the treatment modality and outcome of a series of patients with giant acoustic neuromas, a particular type of tumour characterised by their size (extracanalicular diameter of 4cm or more) and high morbidity and mortality. MATERIALS AND METHODS: This was a retrospective unicentre study of patients with acoustic neuromas treated in a period of 12 years. In our institutional series of 108 acoustic neuromas operated on during that period, we found 13 (12%) cases of giant acoustic neuromas. We reviewed the available data of these cases, including presentation and several clinical, anatomical, and microsurgical aspects. RESULTS: All patients were operated on by the same neurosurgeon and senior author (EU) using the suboccipital retrosigmoid approach and complete microsurgical removal was achieved in 10 cases. In one case, near total removal was deliberately performed, in another case a CSF shunt was placed as the sole treatment measure, and in the remaining case no direct treatment was given. One patient died in the immediate postoperative period. One year after surgery, 4 patients showed facial nerve function of iii or more in the House-Brackman scale. CONCLUSIONS: The 4 most important prognostic characteristics of giant acoustic neuromas are size, adhesion to surrounding structures, consistency and vascularity. Only the first of these is evident in neuroimaging. Giant acoustic neuromas are characterised by high morbidity at presentation as well as after treatment. Nevertheless, the objective of complete microsurgical removal with preservation of cranial nerve function is attainable in some cases through the suboccipital retrosigmoid approach.