[Ulysses in the medical literature]. / Ulises en la literatura médica.

INTRODUCTION: Cultural manifestations are frequently used as a source of descriptors in the field of the health sciences. The story of Odysseus (Ulysses) is one of the oldest and most influential works of world literature and has given rise to many subsequent creations, with strong roots in popular culture. AIMS: To consider the use of the story of Odysseus in the medical literature, to describe the terms in which it is used, and to discuss its relevance. DEVELOPMENT: From a review performed in PubMed, 112 medical publications with references to the myth of Odysseus were found, out of a total of 343 results. Five different conditions named directly after Ulysses were found (three Ulysses syndromes, the Ulysses contract and the Ulysses conflict), together with two others that have been given the names of other characters who are part of the same cycle (Elpenor syndrome and Penelope syndrome), which we analyse in a critical manner referring to the original material from which they have been taken. CONCLUSIONS: The story of Odysseus constitutes one of the most frequent sources of inspiration in medicine, both for the creation of descriptors and for the use of similes, metaphors or other rhetorical figures, particularly in the area of neuroscience.

TITLE: Ulises en la literatura médica.Introducción. Es frecuente el empleo de manifestaciones culturales como origen de descriptores en el campo de las ciencias de la salud. La historia de Odiseo (Ulises) es una de las obras más antiguas e influyentes de la literatura universal y ha dado lugar a múltiples creaciones posteriores, con un fuerte arraigo en la cultura popular. Objetivo. Ponderar el uso del relato de Odiseo en la literatura médica, describir los términos en los que se emplea y discutir la pertinencia de estos. Desarrollo. Tras una revisión en PubMed, se hallaron 112 publicaciones de carácter médico con referencias al mito de Odiseo, de un total de 343 resultados. Se recogen hasta cinco entidades diferentes directamente nombradas a partir de Ulises (tres síndromes de Ulises, el contrato de Ulises y el conflicto de Ulises), y dos más sobre otros personajes que forman parte de su ciclo (síndrome de Elpenor y síndrome de Penélope), las cuales analizamos de forma crítica respecto al material original del que se parte. Conclusiones. La historia de Odiseo constituye una de las fuentes de inspiración más frecuentes en la medicina, tanto para la elaboración de descriptores como para el empleo de símiles, metáforas u otras figuras retóricas, particularmente en el área de las neurociencias.

Inter-rater variability in motor function assessment in Parkinson's disease between experts in movement disorders and nurses specialising in PD management. / Variabilidad en la exploración motora de la enfermedad de Parkinson entre el neurólogo experto en trastornos del movimiento y la enfermera especializada.

INTRODUCTION AND OBJECTIVE: In clinical practice, assessing patients with Parkinson's disease (PD) is a complex, time-consuming task. Our purpose is to provide a rigorous and objective evaluation of how motor function in PD patients is assessed by neurologists specialising in movement disorders, on the one hand, and by nurses specialising in PD management, on the other. METHODS: We conducted an observational, cross-sectional, single-centre study of 50 patients with PD (52% men; mean age: 64.7 ± 8.7 years) who were assessed between 5 January 2016 and 20 July 2016. A neurologist and a nurse evaluated motor function in the early morning hours using the Unified Parkinson's Disease Rating Scale (UPDRS) parts III and IV and Hoehn & Yahr (H&Y) scale. Tests were administered in the same PD periods (in 48 patients during the 'off' time and in 2 patients during the 'on' time). Inter-rater variability was estimated with the intraclass correlation coefficient (ICC). RESULTS: Forty-nine patients (98%) were classified in the same H&Y stage by both raters. Assessment times were similar for both raters. ICC for UPDRS-IV and UPDRS-III total scores were 0.955 (P<.0001) and 0.954 (P<.0001), respectively. The greatest variability was found for UPDRS-III item 29 (gait; ICC=0.746; P<.0001) and the lowest, for item 30 (postural stability; ICC=0.918; P<.0001). CONCLUSIONS: Motor function assessment of PD patients by a trained nurse is equivalent to that made by an expert neurologist and takes the same time to complete.

[Gastroparesis and other gastrointestinal symptoms in Parkinson's disease]. / Gastroparesia y otros sintomas gastrointestinales en la enfermedad de Parkinson.

Different gastrointestinal symptoms, such as excessive salivation, deterioration and other disorders affecting the teeth, dysphagia, gastroparesis, gastroesophageal reflux, constipation, difficult defecation or loss of weight are frequent events in all the stages of the development of Parkinson's disease and affect at least a third of the patients. These symptoms reflect the dysfunction of the enteric nervous system, and the stomach is one of the organs where alpha-synuclein is first deposited. Other factors, such as the dysfunction of structures in the central nervous system like the dorsal motor nucleus of the vagal nerve, hormonal factors or secondary effects deriving from the consumption of antiparkinsonian drugs, are involved in its origin. The present article offers a detailed review of the epidemiological, pathophysiological, clinical and therapeutic management aspects of the different gastrointestinal symptoms in Parkinson's disease.

TITLE: Gastroparesia y otros sintomas gastrointestinales en la enfermedad de Parkinson.Diferentes sintomas gastrointestinales, como salivacion excesiva, deterioro y otros trastornos de las piezas dentarias, disfagia, gastroparesia, reflujo gastroesofagico, estreñimiento, dificultades en la defecacion o perdida de peso, son frecuentes en todos los estadios evolutivos de la enfermedad de Parkinson y afectan al menos a un tercio de los pacientes. Estos sintomas reflejan la disfuncion del sistema nervioso enterico, siendo el estomago uno de los organos donde mas precozmente se deposita la alfa-sinucleina. Otros factores, como la disfuncion de estructuras del sistema nervioso central como el nucleo motor dorsal del nervio vago, factores hormonales o efectos secundarios derivados del consumo de farmacos antiparkinsonianos estan implicados en su origen. El presente articulo revisa en detalle aspectos epidemiologicos, fisiopatologicos, clinicos y de manejo terapeutico de los diferentes sintomas gastrointestinales en la enfermedad de Parkinson.

Estudios neurofisiológicos en los parkinsonismos / Neurophysiological studies in parkinsonism

Introducción. El estudio del sistema motor y de sus trastornos ha sido un tema importante para la neurofisiología, siendo uno de sus objetivos intentar comprender los mecanismos fisiopatológicos que subyacen a las disfunciones del mismo. Desarrollo: Se revisa lo más relevante acerca de: (1) Técnicas neurofisiológicas utilizadas en el diagnóstico de la EP y otros parkinsonismos; (2) Utilidad de la estimulación magnética transcraneal (EMT); (3) Estudios neurofisiológicos de los trastornos del sueño en la EP; (4) Aspectos neurofisiológicos de la estimulación cerebral profunda (ECP). Conclusiones: Las pruebas neurofisiológicas puede ayudar en el diagnóstico diferencial del parkinsonismo además de profundizar en la fisiopatología de los síntomas y signos parkinsonianos. Diferentes técnicas pueden emplearse en el estudio de los trastornos del sueño en la EP. La EMT resulta útil tanto desde el punto de vista diagnóstico como probablemente también terapéutico en la EP. Actualmente, los registros con microelectrodos constituyen la forma más precisa de poder identificar la diana seleccionada en la cirugía de la EP (AU)

Introduction. The study of motor system and its diseases has been an interesting topic for neurophysiology, being one of the objectives of this to know the physiopathology mechanisms. Development. We review the most relevant about: (1) Neurophysiological techniques used in the diagnosis of Parkinson's disease (PD) and other parkinsonisms; (2) Utility of transcranial magnetic stimulation (TMS); (3) Neurophysiological techniques used in the diagnosis of sleep disorders in PD patients; (4) Neurophysiological aspects of deep brain stimulation (DBS). Conclusions. Different neurophysiological techniques can be used for differential diagnosis of PD and others parkinsonisms besides to investigate in the physiopathology mechanisms. We can use different techniques for study sleep disorders in PD patients. TMS results to be utility for diagnosis and probably such as therapy in PD patients. Actually, microelectrode recording could be the best method for target identification in DBS surgery (AU)

[Sensory symptoms in Parkinson's disease]. / Síntomas sensoriales en la enfermedad de Parkinson.

INTRODUCTION: In addition to the motor disturbances experienced by the patients suffering from Parkinson's disease (PD), several non-motor symptoms also affect the PD patients: neurobehavior symptoms (dementia, depression, anxiety, psychosis), autonomic (postural hypotension, urinary symptoms, gastro intestinal symptoms, diaphoresis), sleep disorders (insomnia, somnolence, REM sleep behavior disorder, apnea), sensitive-motor (fatigue, diplopia, restless legs syndrome), and sensory symptoms. DEVELOPMENT: We review the most relevant about sensory symptoms in PD: visual dysfunction, olfactory dysfunction, taste, hearing loss, and pain and other sensitive associate symptoms. CONCLUSIONS: Pain is frequently observed in patients with PD, being its prevalence high and probably infra diagnosed. Its identification and classification is very important for a correct treatment. Hyposmia is a common symptom in PD and could be a predictor of future PD. Visual dysfunction and hearing dysfunction among others must be considered in patients with PD.

[Restless legs syndrome]. / Síndrome de las piernas inquietas.

INTRODUCTION: Restless legs syndrome (RLS) is a movement disorder with a neurological origin that manifests in the form of sensory-motor symptoms which are located mainly in the lower limbs. DEVELOPMENT: We review the epidemiological, pathophysiological, clinical and therapeutic characteristics of this disease, with special emphasis on the diagnostic criteria. CONCLUSIONS: Diagnosis of RLS is mainly clinical and is based on the criteria established by the National Institutes of Health consensus development conference in 2002. There are specific criteria for special groups (the elderly with cognitive impairment and children) in which it is not possible to determine whether RLS exists or not using the usual diagnostic criteria.

Síndrome de las piernas inquietas / Restless legs syndrome

Resumen. Introducción. El síndrome de piernas inquietas (SPI) es un trastorno del movimiento de origen neurológico, que se manifiesta por clínica sensitivomotora localizada principalmente en las extremidades inferiores. Desarrollo. Se revisan las características epidemiológicas, fisiopatológicas clínicas y terapéuticas de esta enfermedad, y se hace un especial énfasis en los criterios diagnósticos. Conclusiones. El diagnóstico del SPI es eminentemente clínico y se basa en los criterios de la conferencia de consenso de los National Institutes of Health de 2002. Existen criterios específicos para grupos especiales (ancianos con deterioro cognitivo y niños) en los cuales no es posible determinar si existe SPI mediante los criterios diagnósticos habituales (AU)

Summary. Introduction. Restless legs syndrome (RLS) is a movement disorder with a neurological origin that manifests in the form of sensory-motor symptoms which are located mainly in the lower limbs. Development. We review the epidemiological, pathophysiological, clinical and therapeutic characteristics of this disease, with special emphasis on the diagnostic criteria. Conclusions. Diagnosis of RLS is mainly clinical and is based on the criteria established by the National Institutes of Health consensus development conference in 2002. There are specific criteria for special groups (the elderly with cognitive impairment and children) in which it is not possible to determine whether RLS exists or not using the usual diagnostic criteria (AU)

Infección por HTLV-1 y demencia tipo Alzheimer / Htlv-1 infection and alzheimer-type dementia

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Parkinsonismo y convulsionessecundarias a hipoparatiroidismo primario / Parkisonism and convulsions secondary to primary hypoparathyroidism

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Mielitis postprimoinfección por virus varicela zoster (VVZ): presentacion de un caso / Myelitis following chickenpox: a case report

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