Portable single-lead electrocardiogram device is accurate for QTc evaluation in hospitalized patients.

BACKGROUND: Many commonly used drugs can prolong the QTc interval (QTc), which can lead to potentially life-threatening arrhythmias. In the current era of the COVID-19 pandemic, it is worth mentioning that the disease itself and several drugs used for its treatment have been associated with QTc prolongation. OBJECTIVE: To evaluate the agreement and clinical precision of a portable single-lead electrocardiogram (ECG) device to measure the QTc interval compared to the standard 12-lead ECG. METHODS: In sequential tests, QTc of ECG recordings obtained with the KardiaMobile (KM-1L) device (AliveCor, San Francisco, CA) were compared to QTc obtained with conventional 12-lead ECG. Agreement was evaluated using Bland-Altman plots and Lin's concordance coefficient. Consistency between the 2 devices in determining QTc prolongation (QTc ≥470 ms in males or ≥480 ms in females) was evaluated with kappa statistics. RESULTS: A total of 128 patients with a presumed or confirmed diagnosis of COVID-19 admitted to a university hospital were included. QTc intervals measured with KM-1L were similar to QTc measured with conventional ECG (442.45 ± 40.5 vs 441.65 ± 40.3 ms, P = .15). Bland-Altman analysis showed no significant difference in QTc values (average difference of -0.797, 95% limits of agreement:-13.179; 11.585). Lin's concordance coefficient showed an excellent agreement (0.988, P < .001). Concordance between the 2 devices for determining QTc prolongation was excellent (kappa >0.90). CONCLUSION: ECG recordings obtained with KM-1L allow an accurate QTc interval assessment. Considering its simplicity of use, this approach has advantages over conventional ECG and can provide an alternative for the evaluation of QTc in hospitalized patients, during the current time of the COVID-19 pandemic and beyond.

Autoeficacia y embarazo adolescente / Self-Efficacy and Adolescent Pregnancy / Autoeficácia e gravidez na adolescência

Introducción: la autoeficacia es una habilidad social que parte de la disposición del individuo para enfrentar las situaciones\r\nestresantes del medio en el que se desenvuelve; se plantea como una herramienta que es necesario fortalecer en los programas\r\nde salud sexual y reproductiva para prevenir embarazos no planeados en la adolescencia. Objetivo: determinar la diferencia en\r\nla autoeficacia entre adolescentes gestantes y no gestantes de 15 a 19 años, a partir de la escala de autoeficacia general. Metodología:\r\ninvestigación cuantitativa comparativa de corte transversal, con una muestra de 60 adolescentes gestantes y 60 no\r\ngestantes, habitantes de una localidad del sur de Bogotá, Colombia. El análisis de datos se realizó con pruebas estadísticas no\r\nparamétricas. Resultados: se encontró que no existe una diferencia estadísticamente significativa en la autoeficacia entre los\r\ngrupos comparados y no se encontró relación entre la autoeficacia y el antecedente de haber sido hija de una madre adolescente.\r\nSin embargo, las adolescentes gestantes presentaron en mayor porcentaje el antecedente de haber sido hijas de madres adolescentes. Conclusiones: la investigación no mostró diferencia en la autoeficacia entre los dos grupos comparados, lo cual se relaciona con las características sociales y económicas similares de la población participante. Recomendaciones: investigar la relación del embarazo no planeado en la adolescencia con la autoeficacia y otras habilidades sociales, como la autoestima, en poblaciones con características socioeconómicas diferentes.

Introduction: Self-efficacy is a social skill that starts from the personal disposition to face the stressful situations of the environment in which the individual develops. It is considered a tool to be strengthened in sexual and reproductive health programs for the planned prevention of pregnancy in adolescence. Objective: To determine the difference in self-efficacy between pregnant and non-pregnant adolescents ages 15 to 19 using the scale of general self-efficacy. Methodology: A cross-sectional quantitative research was performed, in 60 pregnant adolescents and 60 non-pregnant adolescents, all residents of the south side of Bogotá, Colombia. The data analysis was performed with nonparametric statistical tests. Results: There was no significant statistical difference in the self-efficacy between the groups and the antecedent of having been the daughter of a teenage mother. However, the pregnant adolescents presented a higher percentage of having been daughters of adolescent mothers. Conclusions: The research showed no difference in self-efficacy between the two groups; this is related to the similar social and economic characteristics of the participating population. Recommendations: Investigate the relationship of unplanned pregnancy in adolescence with self-efficacy and other social skills such as self-esteem in populations with different socioeconomic characteristics.

Introdução: a autoeficácia é uma habilidade social que parte da vontade pessoal de enfrentar situações estressantes do meio em que se vive e, portanto, surge como uma ferramenta para fortalecer os programas de saúde sexual e reprodutiva para a prevenção da gravidez não planejada na adolescência. Objetivo: determinar a diferença na eficácia entre adolescentes grávidas e não grávidas com idades entre 15 a 19 anos usando como base a escala geral de autoeficácia. Metodologia: um estudo transversal quantitativo comparativo com uma amostra de 60 adolescentes grávidas e 60 adolescentes não grávidas, habitantes de uma cidade no sul de Bogotá, na Colômbia. A análise de dados foi realizada com testes estatísticos não paramétricos. Resultados: descobriu-se que não há diferença estatisticamente significativa na autoeficácia entre os dois grupos em comparação e entre a autoeficácia e ter como antecedente mãe que engravidou na adolescência. Porém, as adolescentes gestantes com mães adolescentes como antecedente apresentaram maior porcentagem. Conclusões: o estudo não apresentou diferença na autoeficácia entre os dois grupos comparados, adolescentes grávidas e adolescentes não grávidas, isso pode estar relacionado às características sociais e econômicas da população participante, portanto, podemos dizer que a autoeficácia nesta pesquisa não está relacionada com a decisão de gravidez na adolescência. Recomendações: investigar a relação de gravidez não planejada na adolescência com autoeficácia e outras habilidades sociais, como a autoestima em populações com diferentes características socioeconômicas.

A cross-sectional multicenter study of cognitive and behavioural features in multiple system atrophy patients of the parkinsonian and cerebellar type.

Imaging and neuropathology studies have demonstrated significant abnormalities not only in subcortical, but also in cortical regions of patients with multiple system atrophy (MSA). This raises the possibility that cognitive dysfunction may contribute to the clinical spectrum of this disorder to a greater extent than it is currently not widely appreciated. In this cross-sectional multicenter study from the European multiple system atrophy study group ( http://www.emsa-sg.org ), we applied an extensive neuropsychological test battery in a series of 61 clinically diagnosed probable MSA patients. The results demonstrated that general cognitive decline as assessed by MMSE was uncommon (2 out of 61 patients <24). In contrast, frontal lobe-related functions (as measured by FAB) were impaired in 41 % of patients, with abstract reasoning and sustained attention less compromised. This pattern was similar to our control group of 20 patients with Parkinson's disease (matched for disease duration and age at onset). There was no difference in cognitive performance between MSA patients with the parkinsonian versus the cerebellar variant. Behaviourally, MSA patients had greater depression than PD and in the case of MSA of the cerebellar variant significantly lower anxiety. Our data show that cognitive abnormalities are relatively frequent in multiple system atrophy and this involves primarily frontal-executive functions. Their contribution to clinical disability and disease progression needs to be addressed in larger prospective studies.

Permanent Genetic Resources added to Molecular Ecology Resources Database 1 June 2011-31 July 2011.

This article documents the addition of 112 microsatellite marker loci and 24 pairs of single nucleotide polymorphism (SNP) sequencing primers to the Molecular Ecology Resources Database. Loci were developed for the following species: Agelaius phoeniceus, Austrolittorina cincta, Circus cyaneus, Circus macrourus, Circus pygargus, Cryptocoryne × purpurea Ridl. nothovar. purpurea, Mya arenaria, Patagioenas squamosa, Prochilodus mariae, Scylla serrata and Scytalopus speluncae. These loci were cross-tested on the following species: Cryptocoryne × purpurea nothovar. purpurea, Cryptocoryne affinis, Cryptocoryne ciliata, Cryptocoryne cordata var. cordata, Cryptocoryne elliptica, Cryptocoryne griffithii, Cryptocoryne minima, Cryptocoryne nurii and Cryptocoryne schulzei. This article also documents the addition of 24 sequencing primer pairs and 24 allele-specific primers or probes for Aphis glycines.

A putative mesenchymal stem cells population isolated from adult human testes.

Mesenchymal stem cells (MSCs) isolated from several adult human tissues are reported to be a promising tool for regenerative medicine. In order to broaden the array of tools for therapeutic application, we isolated a new population of cells from adult human testis termed gonadal stem cells (GSCs). GSCs express CD105, CD166, CD73, CD90, STRO-1 and lack hematopoietic markers CD34, CD45, and HLA-DR which are characteristic identifiers of MSCs. In addition, GSCs express pluripotent markers Oct4, Nanog, and SSEA-4. GSCs propagated for at least 64 population doublings and exhibited clonogenic capability. GSCs have a broad plasticity and the potential to differentiate into adipogenic, osteogenic, and chondrogenic cells. These studies demonstrate that GSCs are easily obtainable stem cells, have growth kinetics and marker expression similar to MSCs, and differentiate into mesodermal lineage cells. Therefore, GSCs may be a valuable tool for therapeutic applications.

Administration of autologous bone marrow stem cells into spinal cord injury patients via multiple routes is safe and improves their quality of life: comprehensive case studies.

Presently, there is no cure or effective treatment for spinal cord injury (SCI). Studies in SCI patients have shown that for a treatment to be effective it must primarily improve their quality of life. Numerous studies have shown that stem cells represent an alternative treatment for various disorders and have shown promise in several disease/trauma states. For instance, the use of autologous CD34+ stem cells has been shown to ameliorate symptoms of several disorders such as leukemia, cardiomyopathy, diabetes, and several autoimmune diseases, including multiple sclerosis. For the first time, we report eight case studies of SCI (four acute, four chronic) with approximately 2 years of follow-up that were administered bone marrow stem cells (BMSCs) via multiple routes: directly into the spinal cord, directly into the spinal canal, and intravenous. Magnetic resonance imaging illustrated morphological changes in the spinal cord of some of the patients following BMSCs administration. Comprehensive evaluations demonstrate improvements in ASIA, Barthel (quality of life), Frankel, and Ashworth scoring. Moreover, in order to assess bladder function, we designed a simple numerical clinical scoring system that demonstrates significant changes in bladder function following BMSCs administration. To date, we have administration BMSCs into 52 patients with SCI and have had no tumor formations, no cases of infection or increased pain, and few instances of minor adverse events. These studies demonstrate that BMSCs administration via multiple routes is feasible, safe, and may improve the quality of life for patients living with SCI.

¿Es "irreversible" el término más apropiado para sustituir "terminal"? Una segunda opinión

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Rabdomiólisis, insuficiencia renal aguda (ira) y empleo combinado de cerivastatina con gemfibrozil. Una nueva evidencia

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Clinical validity of the 'mini-mental state' for Spanish speaking communities.

The Mini-Mental State (MMS) is a brief structured test of cognitive function. The purpose of this study was to adapt and normalise MMS for the Spanish population. The test was administered to 450 subjects (253 control volunteers, 86 mild memory/cognitive impairment without dementia subjects - CIWD and 111 Alzheimer's Disease patients - AD). A cross-sectional statistical study in a population stratified by age and education was conducted. A more accurate diagnosis is provided by scores that have been adjusted for age and level of education. The recommended cut-off in our study was 24/25 (non-demented above 24). The adaptation and normalisation of MMS provides the Spanish population with a highly valuable screening tool.

Unilateral thalamic stroke does not decrease ipsilateral sleep spindles.

STUDY OBJECTIVES: To measure the sleep spindle characteristics in patients with unilateral thalamic stroke. DESIGN: A prospective study of patients with thalamic stroke and age-matched healthy controls. SETTING: Department of Neurology of a University Hospital. PARTICIPANTS: Thirteen patients (mean age: 67 years, SD: 13,44) with an isolated, unilateral acute thalamic stroke and 18 healthy age-matched volunteers. INTERVENTIONS: A polysomnogram recording from 14 scalp EEG electrodes performed during 2 consecutive nights, the second or third week after the stroke. Only the sleep of the second night was analyzed. MEASUREMENTS AND RESULTS: Sleep spindles were counted during two separate 10-minute epochs of stage II. Spindles appearing synchronously in both sides with similar amplitude were called "bilateral." Spindles with twice the amplitude in one side than the other were "right" or "left-side predominant". There were 8 patients with posterolateral, 3 with global and 2 with anterior lesions. Eight were right and 5 left-sided. The number of spindles was similar in patients (39.8 +/- 23.4 in 20 minutes) than controls (26.07 +/- 29.07; p=0.173). Spindles with a centroparietal (34%) and centroparieto-occipital localization (22%) were the most frequent. In controls approximately 66% of the spindles had a bilateral and symmetric distribution over the scalp, 23% of the spindles were predominantly left-sided and 5% were predominantly right-sided. In patients, bilateral spindles decreased (p<0.0001) but asymmetric spindles did not change. CONCLUSION: Unilateral acute thalamic stroke does not decrease sleep spindles ipsilaterally; rather, it seems to produce a bilateral diminution in their number.

Caregiving in progressive supranuclear palsy.

BACKGROUND: Basic issues regarding factors influencing progressive supranuclear palsy (PSP) patient caregiver burden remain unresolved, including whether and how disease severity and duration influence caregiver burden. OBJECTIVE: To examine the relation between PSP patient caregiver burden and disease severity, describe the time course of caregiver burden in relation to disease progression, and identify the contribution of other factors (e.g., patient memory and behavioral problems, caregiver gender) to caregiver burden. METHODS: Mail survey of 180 caregivers of PSP patients (living at home and cared for by nonprofessionals) who were members of the Society for Progressive Supranuclear Palsy. The survey included the Burden Interview, an instrument measuring caregiver burden by inquiring how they feel about different aspects and demands of caregiving. RESULTS: Caregiver burden was related to both PSP disease severity (r = 0.40) and disability/need for assistance (r = 0.43). The relation between burden and disease duration was nonlinear, following the same time course as disease severity; the burden increased during the first 18 months postdiagnosis and leveled off thereafter. Women reported more burden than men (caregiver sex delta r2 = 0.05), even after controlling for disease severity and duration (delta r2 = 0.22) and patient gender (delta r2 < 0.01; NS), patient depression (delta r2 = 0.09), and aggressiveness (delta r2 = 0.02). CONCLUSION: Burden in PSP is related to disease severity, disease duration, and caregiver gender (even after controlling for patient's memory, patient depression, and aggression).

Progressive supranuclear palsy: a survey of the disease course.

BACKGROUND: The most accurate knowledge about progressive supranuclear palsy (PSP) comes from small sample studies that preclude precise estimation of the proportion of PSP patients affected with various symptoms and the examination of factors predicting survival time. OBJECTIVE: To describe the course of PSP in a large clinically diagnosed sample of PSP patients and to identify factors predicting survival time. METHODS: We surveyed the caregivers of 318 living and 119 deceased patients with progressive supranuclear palsy. The main outcome measures were a principal symptom severity questionnaire and a signs and symptoms questionnaire. RESULTS: The estimated age of PSP symptom onset depends critically on how symptom onset is defined, with estimates differing by as much as 1.5 years. Men and women were represented equally (51.6% versus 48.4%) in the living sample, but men formed 61.8% of the deceased sample. Men were diagnosed later than women following symptom onset (33.4 versus 24.1 months) and died earlier following the diagnosis (37.0 versus 47.6 months). Motor and visual symptoms appeared first, followed by emotional and personality problems, cognitive impairment, and sleep changes. Whereas motor symptoms eventually affected almost every patient, emotional/personality and cognitive symptoms did not. The early onset, presence of falls, slowness, and inability to move eyes downward early in the development of the disease predicted survival time. CONCLUSION: PSP is a rapidly progressive disease dominated by motor symptoms, and it affects men more frequently than women.

[Normalization of cognitive and functional assessment instruments for dementia (NORMACODEM) (I): objectives, content and population]. / Normalización de instrumentos cognitivos y funcionales para la evaluación de la demencia (NORMACODEM) (I): objectivos, contenidos y población.

UNLABELLED: To adequately evaluate patients with 4 neuropsychological deficits a project for norming cognitive and functional instruments that assess dementia (NORMACODEM) was designed. Four hundred fifty-one subjects in three groups: 254 controls, 86 patients with minor memory/cognitive deficits without dementia (DWD) and 111 patients with probable Alzheimer-type dementia (ATD) according to the NINCDS/ADRDA criteria. Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale (ADAS), Abbreviated Barcelona Test (ABT), Global Dementia Staging (GDS), Functional Assessment Staging (FAST), Clinical Dementia Rating (CDR), Rapid Disability Rating Scale-2 (RDRS-2), Blessed Dementia Rating Scale (BDRS), Interview for Deterioration in Daily life in Dementia (IDDD), Geriatric Evaluation by Relatives Rating Instrument (GERRI), Geriatric Depression Scale (GDS), Zung Self-Rating Anxiety Scale (ZSRAS). Descriptive statistics and analysis of variance. The characteristics of the sample were as follows. CONTROLS: 99 men, 155 women. Mean (SD) age: 64.6 (10.9) years. Mean (SD) educational level: 9.1 (4.9) years. DWD: 42 men, 44 women. Mean (SD) age: 65.8 (8.7) years. Men (SD) educational level: 8.4 (4.4) years. ATD: 48 mean, 63 women. Mean (SD) age: 68.3 (8.0) years. Mean (SD) educational level: 6.2 (4.3) years. The ATD patients were significantly older than the controls. Mean educational level was significantly lower in the ATD group than in the other two.