Exploring the perception of barriers to a dual career by student-athletes with/out disabilities.

In recent years, there has been an increase in knowledge about the barriers experienced by people with disabilities in the education system or sports. However, no studies have analyzed the barriers for those who try to succeed in both disciplines (dual career). The purpose of this study was to examine the barriers faced by student-athletes with/out disability to a dual career combining studies and sport. Two groups were involved in the study (n = 162): student-athletes with disabilities (n = 79) and student-athletes without disabilities (n = 83). Data collected included: (a) socio-demographic aspects; and (b) barriers towards achieving a good balance between sport and academics during the dual career, through the "Perceptions of dual career student-athletes" (ESTPORT) questionnaire. The results showed that student-athletes with disabilities were more likely to perceive in a greater extent the barriers, the university is far from my home (p = 0.007) and the university is far from my training site (p = 0.006), I find myself unable to balance study and training time (p = 0.030), I have to take care of my family (p<0.001), and my current job does not allow me to study enough (p<0.001). The MANOVA analysis showed that the factors gender, competitive level, and employment status had an influence on the perception of some barriers between groups. In conclusion, student-athletes with disabilities perceived barriers more strongly than those without disabilities, and measures are needed to ensure their inclusion in the education system.

Exploring dual career quality implementation at European higher education institutions: Insights from university experts.

INTRODUCTION: This paper examines the convergence of the opinions of European higher education institution (HEI) experts on possible implementation of dual career policies and provision areas at university level. METHODS: An online 32-item questionnaire encompassing 26 dual career aspects collected the opinion of European HEI experts as the last phase of a Delphi method preceded by i) focus groups with student-athletes who aimed to identify needs for dual careers and ii) a workshop with 21 dual career experts to generate the statements to be included in the survey. Seventy-one HEI experts from 12 EU member states participated in the survey, rating each dual career aspect identified in previous phases. RESULTS: The relative position of each aspect has been plotted based on relevance (x-axis) and feasibility (y-axis). The Quadrant IV of the resulting scatterplots identified the following nine aspects rated as highly relevant and highly feasible for implementation: tutorship/mentorship, psychological support, programmes based on integration of academic departments and sports services, and adaptable programmes to the needs of each student-athletes (assistance/tutorship area), individual study plans and distance learning (curricula requirements area), publicity for student-athletes and initiatives for increasing the awareness of student-athletes and knowledge of dual career issues (social support area), and access to educational facilities (logistic support area). DISCUSSION AND CONCLUSIONS: The HEI experts' views represent a coherent and useful starting point to develop a deep understanding of the considered 26 aspects founded on a phenomenological lifeworld-led approach and emphasizes the need for a minimum standard for dual career policies and provisions.

Spanish Pre-Olympic Athletes' Motivations and Barriers to Pursuing Dual Career as a Function of Sociodemographic, Sport and Academic Variables.

The dual career allows elite athletes to attain their maximum competitive and academic performance, but the COVID-19 pandemic hindered their development and changed their perception of the importance given to the sporting and educational environment. For this reason, the aim of the present study was to determine the differences in the motivations and perceived barriers, the importance given to academic qualifications, and the perception of the dual career from a multifactorial perspective, of elite athletes according to sex, type of sport practiced, job performance, time of sports career, type of athlete, and type of scholarship received. A total of 100 student-athletes participated in the research study by completing the "Perceptions of dual career student-athletes" questionnaire. The results showed that athletes from individual modalities (p = 0.012) and those who did not receive any scholarships described more barriers (p < 0.001). In addition, women studied more because they enjoyed it (p = 0.007); athletes from individual modalities studied to work later (p = 0.008); athletes who do not work perceived a greater influence between study and sports performance (p = 0.029); at the beginning and at the best stage of their sports career, a greater influence of academics on performance was perceived (p = 0.016); and athletes who considered themselves professionals, and athletes who did not receive any scholarships (p = 0.025), reported that the conciliation between sports and academic life was difficult (p = 0.034). The results obtained point to the importance of dual career scholarships for student-athletes, as well as the need for the programs implemented for these athletes to consider sex, sport modality or type of scholarship granted.

Understanding dual career views of European university athletes: The more than gold project focus groups.

Previous studies have found that student-athletes (S-As) have difficulties in achieving dual career (DC) success. However, no studies have analysed the opinion of the S-As on the functioning of DC with a qualitative methodology. The aim of the present work was to collect the opinions of elite university S-As in relation to DC policy adopted by their academic institutions in different European countries. In total, 77 athletes (F = 35, M = 42; age range: 20-25 years) participated in 15 national face-to-face focus groups in five different countries, to discuss aspects that higher education institutes should implement in relation to: 1) the athletes' needs; 2) assistance/tutorship: 2) curricula requirements; 3) financial support; 4) logistic support; 5) social support; and 6) dual career policies. Fifty of the athletes competed in individual sports and twenty-seven team sports. Of them, 57 was enrolled at undergraduate, 17 was enrolled in a master and 3 in a PhD. The athletes were presented with 13 open-ended questions one by one, and were ensured freedom to interact. All the discussions were recorded. After this, a general discussion took place in which the participants identified and agreed on a final list of statements from their focus group deemed to be relevant to DC athletes as university students. Then, at a consensus meeting, the findings were combined, repetitions were eliminated, and fragmented statements were condensed into broader ones. A final list of 31 statements, organized in six related content units, were identified in relation to the athletes' needs (n = 5), assistance/tutorship (n = 5), curricula requirements (n = 4), financial support (n = 4), logistic support (n = 4), social support (n = 6), and DC policies (n = 3), respectively. In conclusion, this cross-national qualitative research study synthesized the S-As views about their needs and the most relevant DC policies and provisions that higher education institutes should provide to ensure them with positive academic experiences towards the achievement of a degree.

Gender Stereotypes among Teachers and Trainers Working with Adolescents.

Previous scientific literature has not determined the influence exerted by trainers and teachers of adolescents on the development of gender stereotypes in sport. For this reason, the aims of the present research were to establish differences in gender stereotypes in sport among teachers and trainers as a function of profession and sex and to analyze the influence of age and years of experience of male and female trainers and teachers on the gender stereotypes in sport. For this purpose, 127 teachers and trainers completed the questionnaire "gender beliefs and stereotypes towards physical activity and sport". The results showed a significantly higher score of the teachers in "beliefs about physical activity and gender" (p = 0.048) and of the trainers in "physical education classes and gender" (p = 0.006). Concerning sex, women showed higher scores in "sport and gender" (p = 0.005), and men in "beliefs about physical activity and gender" (p = 0.045). Regarding covariates, age showed significant differences in "sport and gender" (p = 0.029), with female teachers showing higher values with respect to female trainers and male teachers, while years of experience showed differences in "beliefs about sport and gender" (p = 0.044), with male teachers showing higher values than male trainers and female teachers.

Effects of the COVID-19 Health Crisis on Sports Practice, Life Quality, and Emotional Status in Spanish High-Performance Athletes.

Spain is one of the many countries highly affected by the COVID-19 crisis, establishing very restrictive measures with a complete lockdown for more than 3 months. This situation forced the complete closure of sport practice and national or international competitions, leading to a negative impact on physical and psychological health of high-performance athletes. Therefore, the objectives of this study were (a) to determine the effects of the COVID-19 health crisis on Spanish high-performance athletes in terms of sports practice, life quality, and emotional state and (b) to identify the profile with the greatest difficulties during and after the lockdown. A sample of 130 high-performance athletes aged between 18 and 34 years (67 women and 63 men) participated in this study (83.1% achieved a medal in National-International elite competitions; 86.9% were considered student-athletes). Measures included socio-demographic data through a 5-dimension ad hoc survey: physical activity and exercise using an adapted version from the International Physical Activity Questionnaire (IPAQ); health status and limitations using an adapted version of SF-12 Health Questionnaire; Perceived stress (Short-PSS); and Mood States (29-item POMS). All participants have shown a significant decrease pre-post-lockdown in both health and performance perception, especially in women, individual athletes, medalists, and student-athletes. Strong limitations of training, attention, and motivation as well as a moderate negative emotional state during lockdown were reported, in women, individual athletes, medalists, and student-athletes. Even with an improved emotional state and energy level in the post-lockdown period, moderate-to-high stress scores were reported by women and medalists. Our findings highlight the importance of paying attention to the physical and psychological health of elite athletes on three profiles: team athletes (due to social distance), student-athletes (dual-career issues), and women athletes (prevalence of implicit gender inequalities in sport).

Performance of high-level Spanish athletes in the Olympic Games according to gender.

No studies have been found that analyzed the probabilities of high-level athletes according to gender for accessing programs that promote the professionalization of sports, and participation and success in the OG in Spain. This could explain the gender differences in these parameters and the trend towards more egalitarian data in recent years. The objective of this study was to analyze the probabilities of Spanish high-level athletes for participating and achieving sporting success in the 2008, 2012 and 2016 Olympic Games (OG). Data relating to a sample of 3757 high-level Spanish athletes (2398 men and 1359 women) between 2005 and 2016 were examined. The variables of gender, having obtained a scholarship from the Association of Olympic Athletes (ADO) program, training in a High Performance Center (CAR), participation and performance in the OG were analyzed. It was found that high-level female athletes were more likely than male athletes to belong to the ADO program (χ2 = 26,151; r* = 0.083; p = 0,000) and CAR (χ2 = 13,847; r* = 0.061; p = 0,000), and to qualify for an OG (χ2 = 22,838; r* = 0,078; p = 0,000), the same trend was found in the three Olympic cycles analyzed. With respect to the results in the OG, in general, no differences were found according to gender, although women were more likely to be finalists (χ2 = 4,406; r* = 0.071; p = 0,036), and more prominently in the 2016 OG (16.118; r* = 0.228; p = 0.000). The same applies to winning a medal (χ2 = 5.939; r* = 0.145; p = 0.015), more specifically bronze at the 2012 OG (χ2 = 6.215; r* = 0.149; p = 0.013). In conclusion, high-level female athletes in Spain have a higher percentage of access to high-level athlete support programs such as ADO and CAR, as well as participation in OG.

Dual Careers of Athletes During COVID-19 Lockdown.

This study aimed to investigate the student-athletes' capability to face the academic, sport, and social challenges during the coronavirus disease 2019 (COVID-19) lockdown and to disclose novel aspects of dual careers. A 32-item online survey encompassing demographic characteristics, sport and university engagement, support and dual-career benefits, physical activity, sitting time, and the time deemed necessary to recover the previous level of performance was developed. Four hundred sixty-seven student-athletes (males: 57%, females: 43%) from 11 countries, competing in 49 different sports (individual: 63.4%, team: 36.6%) at regional (17.5%), national (43.3%), and international (39.2%) levels, and enrolled at high school (21.9%) and university (78.1%) levels completed the survey. During the lockdown, the respondents decreased the time dedicated to sport and academics, although they maintained an active lifestyle. Student-athletes from countries under severe contagion were more likely to train at home, dedicate to academics, and receive support from the coach but less likely receive support from their teachers. With respect to their team sport counterparts, athletes competing in individual sports trained more and were more likely to receive support from their coaches. International athletes showed the highest training time and support from their coaches and as student-athletes. High school students received more support from their coaches and teachers, whereas university students were more likely considering dual careers useful to cope with the COVID-19 pandemic. This study substantiates the relevant role of competitive sports participation in the maintenance of active lifestyles, with student-athletes considering home training and e-learning valuable resources during the lockdown. Furthermore, their sport and academic commitments helped student-athletes cope with the emergency of the COVID-19 pandemic.

Influencia del género, nivel educativo y práctica deportiva de los progenitores sobre hábitos deportivos en escolares / Influência do gênero, nível educacional e prática desportiva dos pais nos hábitos esportivos das crianças em idade escolar / Influence of gender, educational level and parents' sports practice on sports habits of school children

Resumen La importancia de los padres en la actividad física de sus hijos durante la adolescencia ha sido constatada previamente, pero pocos estudios han establecido cuáles son las variables más determinantes. El objetivo del presente estudio fue analizar las diferencias en la práctica deportiva de los adolescentes según el nivel educativo, el nivel de práctica deportiva y los estereotipos de género de sus progenitores. La muestra estuvo compuesta por 965 adolescentes y 1599 progenitores de la Región de Murcia. Los resultados mostraron diferencias en la práctica deportiva de los adolescentes al considerar el nivel educativo de las madres, la actividad física realizada por los padres para los varones, la frecuencia de práctica de las madres para las mujeres y los estereotipos de género de las madres. Como conclusiones, señalar que los estereotipos de género y el nivel educativo de los progenitores influyeron en la práctica deportiva de los adolescentes.

Resumo A importância dos pais na atividade física dos seus filhos durante a adolescência foi previamente afirmada, mas poucos estudos determinaram quais são as variáveis mais determinantes. O objetivo do presente estudo foi analisar a influência dos estereótipos de gênero, o nível educacional e o nível de prática desportiva dos pais sobre a prática desportiva dos seus filhos. A amostra foi composta por 965 adolescentes e 1599 pais da Região de Múrcia. Os resultados mostraram diferenças na prática desportiva dos adolescentes ao considerar o nível educacional das mães, a atividade física realizada pelos pais para os homens, a frequência da prática das mães para as mulheres e os estereótipos de gênero das mães. Como conclusões, é de notar que os estereótipos de gênero e o nível de educação dos pais influenciaram a prática do desporto pelos adolescentes.

Abstract The importance of parents in the physical activity of their children during adolescence has been previously established, but few studies have determined which are the most important variables. This study analyzes the influence of gender stereotypes, educational level, and the level of parents' sports practice on their children's practice. The sample included 965 adolescents and 1,599 parents from the Region of Murcia. The results showed differences in the sports practice of the adolescents when considering the educational level of their mothers, the physical activity carried out by the fathers on male children, the frequency of practice of the mothers for female children and gender stereotypes of the mothers. It found that gender stereotypes and parents' educational level influenced adolescents' sports practice.

Effect of Coronavirus Disease 2019 (COVID-19) on Elite Spanish Student-Athletes' Perception of the Dual Career.

The aim of the present research was to assess elite student-athletes' perception of the dual career during the lockdown caused by the coronavirus disease 2019 (COVID-19) pandemic, compared with a group of elite student-athletes who could develop their dual career under normal conditions. A total of 150 elite athletes who were also undergraduate or postgraduate students self-completed the "Perceptions of dual career student-athletes (ESTPORT)" questionnaire. From them, 78 did it during the mandatory lockdown period due to the state of emergency caused by COVID-19 (COVID-19 group) and 72 completed it in the previous year to Rio 2016 Olympic Games (control group). The COVID-19 group was found to spend a significantly higher number of hours per week studying, while no significant differences were observed between groups in any training time variable. Student-athletes of the COVID-19 group showed better perception of whether their sport career could help them cope with their academic career and better general perception of remote learning and the use of tasks and videoconferencing as learning support tools. A lower percentage of athletes of the COVID-19 group than of the control group wished to continue with their sport career once they finished their studies. To conclude, student-athletes of the COVID-19 group show adaptations with regard to the organization of their studies and the importance they give to them and to the services provided by dual-career programs, compared with student-athletes from an ordinary pre-Olympic year. In general, student-athletes' perception of the dual career is very positive.

LACONORTE study: Efficacy and security of lacosamide as first add-on therapy for focal-onset epilepsy in real-life setting.

RATIONALE: Many patients with epilepsy need a second antiepileptic drug (AED), due either to inefficacy or side effects of the first tried one. We evaluated the efficacy and safety of lacosamide (LCM) as first add-on therapy in the real-life setting. METHODS: LACONORTE is a multicenter, retrospective, one-year study. Patients with focal epilepsy on monotherapy with another AED who were started on lacosamide as first add-on therapy were included. Clinical data was obtained at 3, 6 and 12 months and then analyzed. RESULTS: Seventy-three patients (48.6% men) with a mean age of 50.3 and a median duration of the epilepsy of 3.0 years (range 0-65) were included. At 1 year, 91.8% were responders (with at least 50% reduction in the number of seizures) and 64.4% of all patients and 75.8% of those with secondary generalization were seizure-free. Fifteen patients (20.5%) had adverse events (AE), most of them were transient and no severe AEs were reported. LCM was withdrawn in 2 patients due to intolerance and in 1 patient because of inefficacy. Neither side effects nor withdrawal seemed to be related to total dose or to escalating regimes. Seventy patients (95.9%) continued on LCM after the last visit (median dose 200 mg/day, ranging 100-400). Eighteen (24.7%) converted to monotherapy during the 12-month period, 83.3% of them remaining seizure-free. CONCLUSIONS: These results of real-life setting show LCM to be efficacious and safe when used as first add-on therapy for focal-onset epilepsy. Most adverse events were mild and/or transient.

Clinical response and tolerability of fampridine in clinical practice.

BACKGROUND: Gait disorder is very prevalent in multiple sclerosis. After 15 years of disease progression, 50% of patients need assistive devices for walking. MATERIALS & METHODS: We performed a multicenter observational study, including multiple sclerosis patients with an Expanded Disability Status Scale score between 4.0 and 7.0, normal kidney function and no previous history of seizures. RESULTS: The study sample comprised 138 patients with average age of 50.3 years median Expanded Disability Status Scale of 6.0. After treatment, a significant reduction was observed in both the Timed 25-Foot Walk test (baseline, 20.3 s; 14 days, 13.2 s; p < 0.001; 3 months, 12.1 s; p < 0.001) and the 12-Item Multiple Sclerosis Walking Scale score (baseline, 82.3; 14 days, 59.4; p < 0.001; 3 months, 57.2; p < 0.001). Adverse events were recorded in 39.9% of patients.

Fingolimod: efectividad y seguridad en la práctica clínica habitual. Estudio observacional, retrospectivo y multicéntrico en Galicia / Fingolimod: effectiveness and safety in routine clinical practice. An observational, retrospective, multi-centre study in Galicia

INTRODUCCIÓN: La efectividad y seguridad del fingolimod en pacientes con esclerosis múltiple remitente recurrente (EMRR) se demostró en ensayos clínicos. Sin embargo, por las limitaciones de éstos, es importante saber cómo se comporta en condiciones de práctica clínica habitual. Así, el objetivo de este estudio es evaluar la efectividad y seguridad del fingolimod después de 12 meses de uso en la práctica clínica en Galicia. PACIENTES Y MÉTODOS: Estudio retrospectivo y multicéntrico (n = 8) de pacientes con EMRR y tratados con una o más dosis de fingolimod, 0,5 mg/día. Se evaluó la efectividad -tasa anualizada de brotes (TAB), cambio en la puntuación de la escala expandida del estado de discapacidad (EDSS), porcentaje de pacientes libres de brotes, libres de progresión de discapacidad y libres de actividad en resonancia- para el total de pacientes y según tratamiento previo. Se evaluó la seguridad a partir del porcentaje de pacientes que discontinuaron y que presentaron efectos adversos. RESULTADOS: Después de 12 meses de uso, el fingolimod redujo un 87% la TAB (de 1,7 a 0,23; p < 0,0001) y, en consecuencia, un 81% de pacientes estuvo libre de brotes. La puntuación de la EDSS disminuyó un 9%. Un 91% de pacientes estuvo libre de progresión de discapacidad y un 72%, libre de actividad en resonancia. En el 43% de los pacientes no se evidenciaron signos de la actividad de la enfermedad. La mayoría de los beneficios del fingolimod difirieron según el tratamiento previo. Alrededor de un tercio de los pacientes comunicaron efectos adversos, pero sólo el 2% discontinuó debido a ellos. CONCLUSIONES: La mayoría de los resultados de efectividad de los ensayos clínicos del fingolimod se observa durante los 12 primeros meses de tratamiento en la práctica clínica. Se observó un mejor perfil de seguridad al comunicado en los ensayos clínicos

INTRODUCTION: The effectiveness and safety of fingolimod in patients with relapsing-remitting multiple sclerosis (RRMS) have been proven in clinical trials. Yet, due to their limitations, it is important to know how it behaves under everyday clinical practice conditions. Hence, the aim of this study is to evaluate the effectiveness and safety of fingolimod after 12 months' usage in clinical practice in Galicia. PATIENTS AND METHODS: We conducted a retrospective, multi-centre study (n = 8) of patients with RRMS who were treated with one or more doses of fingolimod, 0.5 mg/day. Effectiveness was assessed -annualised relapse rate (ARR), changes in the score on the Expanded Disability Status Scale (EDSS), percentage of patients free from relapses, free from progression of disability and free from activity in resonance- for the total number of patients and according to previous treatment. Safety was assessed based on the percentage of patients who withdrew and presented adverse side effects. RESULTS: After 12 months' use, fingolimod reduced the ARR by 87% (1.7 to 0.23; p < 0.0001) and, consequently, 81% of patients were free from relapses. The score was reduced by 9%. In all, 91% of patients were free from progression of disability and 72% were free from resonance activity. No signs of disease activity were found in 43% of the PATIENTS: Most of the benefits of fingolimod differed depending on previous treatment. About a third of the patients reported adverse side effects, but only 2% of them withdrew for this reason. CONCLUSIONS: In clinical practice, most of the results on the effectiveness of the clinical trials conducted with fingolimod were observed during the first 12 months of treatment. A better safety profile was observed than that reported in the clinical trials (AU)

[Clinical experience with lacosamide in Galicia: the GALACO study]. / Experiencia clinica con lacosamida en Galicia: estudio GALACO.

INTRODUCTION: Lacosamide is a sodium channel blocker antiepileptic drug authorized as an adjunctive therapy for focal seizures in adolescents and adults. AIM: To analyze the efficacy and safety of lacosamide in Galicia according to its use in daily clinical practice. PATIENTS AND METHODS: Retrospective observational study in patients who started treatment with lacosamide between January 2014 and June 2013 in 10 hospitals in Galicia, Spain. Its efficacy and safety at 3, 6 and 12 months after starting lacosamide was assessed. RESULTS: We included 184 patients with a mean age of 44.2 ± 17.4 years old; 56.5% (n = 104) were male; 173 patients constituted the efficacy population. Mean duration of epilepsy was 18.8 ± 15.5 years. Seizure frequency was 2.5 ± 1.6 episodes/month. After 12 months, 68.2% of patients (n = 118) had >= 50% improvement (responders) and among them, 54 (45.8% of responder patients) were seizure free. Twenty-three percent (n = 43) suffered from adverse events after 12 months, being dizziness (10.3%) and instability (3.3%) the most frequently reported. After the 12 month visit, 87.5% of patients (n = 161) continued treatment with lacosamide. CONCLUSIONS: Lacosamide provides a very good efficacy and safety profile for patients with focal refractory epilepsy. High percentage of responders may be related to a less refractory population compared to other daily clinical practice studies. It constitutes an attractive therapeutic option for the treatment of focal epilepsies.

TITLE: Experiencia clinica con lacosamida en Galicia: estudio GALACO.Introducción. La lacosamida es un fármaco antiepiléptico bloqueante de los canales de sodio, autorizado en adolescentes y adultos como tratamiento coadyuvante en crisis de inicio focal. Objetivo. Analizar los resultados de eficacia y seguridad de la lacosamida en Galicia en su uso de acuerdo con la práctica clínica habitual. Pacientes y métodos. Estudio retrospectivo observacional en pacientes que iniciaron tratamiento con lacosamida entre enero de 2013 y junio de 2014 en 10 hospitales de Galicia. Se evaluó su eficacia y seguridad a los 3, 6 y 12 meses del inicio del tratamiento. Resultados. Se incluyeron 184 pacientes con edad media de 44,2 ± 17,4 años; el 56,5% (n = 104) eran varones. Conforman la población de eficacia 173 pacientes. El tiempo medio de evolución de la epilepsia fue de 18,8 ± 15,5 años. La frecuencia de crisis era de 2,5 ± 1,6 episodios/mes. A los 12 meses, el 68,2% de los pacientes (n = 118) presentaba una mejoría igual o superior al 50% (pacientes respondedores) y, de ellos, 54 (el 45,8% de los respondedores) estaban libres de crisis. El 23,4% (n = 43) refirió efectos adversos a los 12 meses, principalmente mareos (10,3%) e inestabilidad (3,3%). Después de la visita de los 12 meses, continuaba con lacosamida el 87,5% de los pacientes (n = 161). Conclusiones. La lacosamida ofrece un perfil de eficacia y seguridad muy favorable para pacientes con epilepsia focal refractaria. El elevado porcentaje de respondedores podría atribuirse a una población de epilépticos menos refractarios que en otros estudios de práctica clínica. Constituye una opción terapéutica atractiva para el tratamiento de epilepsias de inicio focal.

Experiencia clínica con lacosamida en Galicia: estudio GALACO / Clinical experience with lacosamide in Galicia: the GALACO study

Introducción. La lacosamida es un fármaco antiepiléptico bloqueante de los canales de sodio, autorizado en adolescentes y adultos como tratamiento coadyuvante en crisis de inicio focal. Objetivo. Analizar los resultados de eficacia y seguridad de la lacosamida en Galicia en su uso de acuerdo con la práctica clínica habitual. Pacientes y métodos. Estudio retrospectivo observacional en pacientes que iniciaron tratamiento con lacosamida entre enero de 2013 y junio de 2014 en 10 hospitales de Galicia. Se evaluó su eficacia y seguridad a los 3, 6 y 12 meses del inicio del tratamiento. Resultados. Se incluyeron 184 pacientes con edad media de 44,2 ± 17,4 años; el 56,5% (n = 104) eran varones. Conforman la población de eficacia 173 pacientes. El tiempo medio de evolución de la epilepsia fue de 18,8 ± 15,5 años. La frecuencia de crisis era de 2,5 ± 1,6 episodios/mes. A los 12 meses, el 68,2% de los pacientes (n = 118) presentaba una mejoría igual o superior al 50% (pacientes respondedores) y, de ellos, 54 (el 45,8% de los respondedores) estaban libres de crisis. El 23,4% (n = 43) refirió efectos adversos a los 12 meses, principalmente mareos (10,3%) e inestabilidad (3,3%). Después de la visita de los 12 meses, continuaba con lacosamida el 87,5% de los pacientes (n = 161). Conclusiones. La lacosamida ofrece un perfil de eficacia y seguridad muy favorable para pacientes con epilepsia focal refractaria. El elevado porcentaje de respondedores podría atribuirse a una población de epilépticos menos refractarios que en otros estudios de práctica clínica. Constituye una opción terapéutica atractiva para el tratamiento de epilepsias de inicio focal (AU)

Introduction. Lacosamide is a sodium channel blocker antiepileptic drug authorized as an adjunctive therapy for focal seizures in adolescents and adults. Aim. To analyze the efficacy and safety of lacosamide in Galicia according to its use in daily clinical practice. Patients and methods. Retrospective observational study in patients who started treatment with lacosamide between January 2014 and June 2013 in 10 hospitals in Galicia, Spain. Its efficacy and safety at 3, 6 and 12 months after starting lacosamide was assessed. Results. We included 184 patients with a mean age of 44.2 ± 17.4 years old; 56.5% (n = 104) were male; 173 patients constituted the efficacy population. Mean duration of epilepsy was 18.8 ± 15.5 years. Seizure frequency was 2.5 ± 1.6 episodes/month. After 12 months, 68.2% of patients (n = 118) had ≥ 50% improvement (responders) and among them, 54 (45.8% of responder patients) were seizure free. Twenty-three percent (n = 43) suffered from adverse events after 12 months, being dizziness (10.3%) and instability (3.3%) the most frequently reported. After the 12 month visit, 87.5% of patients (n = 161) continued treatment with lacosamide. Conclusions. Lacosamide provides a very good efficacy and safety profile for patients with focal refractory epilepsy. High percentage of responders may be related to a less refractory population compared to other daily clinical practice studies. It constitutes an attractive therapeutic option for the treatment of focal epilepsies (AU)

Evaluación de eficacia y tolerabilidad de Sativex (R) en uso compasivo / Assessment of the effectiveness and safety of Sativex(R) in compassionate use

Introducción. Sativex (R) es un fármaco aprobado para el tratamiento de la espasticidad en la esclerosis múltiple. Hemos querido estudiar la tolerabilidad y eficacia de este fármaco en patologías fuera de indicación de ficha técnica, mediante su uso compasivo. Objetivo. Valorar la eficacia y tolerabilidad de Sativex en patologías no incluidas en la ficha técnica, mediante un protocolo de uso compasivo. Pacientes y métodos. Se realizó un estudio observacional, de seis meses de duración, para evaluar la eficacia y tolerabilidad de Sativex en el dolor neuropático y en la espasticidad de causa diferente a la esclerosis múltiple. Resultados. Se incluyó un total de 10 pacientes, seis mujeres y cuatro hombres. Sólo hubo efectos adversos en dos de ellos, y el fármaco se suspendió en un caso. Tras el inicio del tratamiento con Sativex mediante protocolo de uso compasivo, el consumo de fármacos concomitantes se redujo un 34,2% (p = 0,004), y se suspendió la administración de toxina botulínica en siete pacientes (70%). La mejoría de la escala de espasticidad de Ashworth fue del 65,6% (p = 0,004) y la escala visual analógica disminuyó su puntuación un 49,2% (p = 0,026). Conclusión. Sativex puede ser una alternativa terapéutica interesante en pacientes con espasticidad y dolor cuando sehan utilizado los tratamientos habituales disponibles, pero los pacientes continúan con afectación significativa de su calidad de vida (AU)

Introduction. Sativex (R) is a drug approved for use in the treatment of spasticity in multiple sclerosis. We sought to study the tolerability and effectiveness of this drug product in pathologies beyond the scope of the indications of the product data sheet, by means of its compassionate use. Aim. To evaluate the effectiveness and safety of Sativex in pathologies that are not included on the product data sheet, using a compassionate use protocol. Patients and methods. A six-month observational study was conducted to evaluate the effectiveness and safety of Sativex in neuropathic pain and in spasticity from causes other than multiple sclerosis. Results. A total of 10 patients were included: six females and four males. Side effects appeared in only two of them and the drug product was withdrawn in one case. After starting treatment with Sativex by means of a compassionate use protocol, the consumption of concomitant drugs was reduced by 34.2% (p = 0.004), and administration of botulinum toxin was suspended in seven patients (70%). The improvement on the Ashworth spasticity scale was 65.6% (p = 0.004) and the score on the analogical visual scale dropped by 49.2% (p = 0.026). Conclusions. Sativex may be an interesting therapeutic alternative in patients with spasticity and pain when the treatments that are usually available have been employed but patients’ quality of life continues to be significantly compromised (AU)

[Assessment of the effectiveness and safety of Sativex® in compassionate use]. / Evaluación de eficacia y tolerabilidad de Sativex® en uso compasivo.

INTRODUCTION: Sativex® is a drug approved for use in the treatment of spasticity in multiple sclerosis. We sought to study the tolerability and effectiveness of this drug product in pathologies beyond the scope of the indications of the product data sheet, by means of its compassionate use. AIM: To evaluate the effectiveness and safety of Sativex in pathologies that are not included on the product data sheet, using a compassionate use protocol. PATIENTS AND METHODS: A six-month observational study was conducted to evaluate the effectiveness and safety of Sativex in neuropathic pain and in spasticity from causes other than multiple sclerosis. RESULTS: A total of 10 patients were included: six females and four males. Side effects appeared in only two of them and the drug product was withdrawn in one case. After starting treatment with Sativex by means of a compassionate use protocol, the consumption of concomitant drugs was reduced by 34.2% (p=0.004), and administration of botulinum toxin was suspended in seven patients (70%). The improvement on the Ashworth spasticity scale was 65.6% (p=0.004) and the score on the analogical visual scale dropped by 49.2% (p=0.026). CONCLUSIONS: Sativex may be an interesting therapeutic alternative in patients with spasticity and pain when the treatments that are usually available have been employed but patients' quality of life continues to be significantly compromised.

TITLE: Evaluacion de eficacia y tolerabilidad de Sativex ® en uso compasivo.Introduccion. Sativex ® es un farmaco aprobado para el tratamiento de la espasticidad en la esclerosis multiple. Hemos querido estudiar la tolerabilidad y eficacia de este farmaco en patologias fuera de indicacion de ficha tecnica, mediante su uso compasivo. Objetivo. Valorar la eficacia y tolerabilidad de Sativex en patologias no incluidas en la ficha tecnica, mediante un protocolo de uso compasivo. Pacientes y metodos. Se realizo un estudio observacional, de seis meses de duracion, para evaluar la eficacia y tolerabilidad de Sativex en el dolor neuropatico y en la espasticidad de causa diferente a la esclerosis multiple. Resultados. Se incluyo un total de 10 pacientes, seis mujeres y cuatro hombres. Solo hubo efectos adversos en dos de ellos, y el farmaco se suspendio en un caso. Tras el inicio del tratamiento con Sativex mediante protocolo de uso compasivo, el consumo de farmacos concomitantes se redujo un 34,2% (p = 0,004), y se suspendio la administracion de toxina botulinica en siete pacientes (70%). La mejoria de la escala de espasticidad de Ashworth fue del 65,6% (p = 0,004) y la escala visual analogica disminuyo su puntuacion un 49,2% (p = 0,026). Conclusion. Sativex puede ser una alternativa terapeutica interesante en pacientes con espasticidad y dolor cuando se han utilizado los tratamientos habituales disponibles, pero los pacientes continuan con afectacion significativa de su calidad de vida.

[Tropical spastic paraparesis: a report of a new case in Spain]. / Paraparesia espastica tropical: presentacion de un nuevo caso en España.

TITLE: Paraparesia espastica tropical: presentacion de un nuevo caso en España.

Paraparesia espástica tropical: presentación de un nuevo caso en España / Tropical spastic paraparesis: a report of a new case in Spain

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[Leber's optic neuropathy, ten years on: Harding's syndrome]. / Neuropatía óptica de Leber, diez años después: síndrome de Harding.

TITLE: Neuropatia optica de Leber, diez años despues: sindrome de Harding.