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Background Body composition is a strong indicator of nutritional and health status. Dual energy X-ray absorptiometry (DXA), multifrecuency bioelectrical impedance analysis (BIA), anthropometry and, skinfolds are non invasive methods to assess body composition with different levels of reliability. The validity of anthropometric and skinfolds to estimate body composition in HD is still controversial. Aims To determine and compare body composition according to DXA, BIA, anthropometry and, skinfolds estimates in HD. Methods Cross-sectional, multicenter and, national study. 20 genetically confirmed HD patients and, 10 gender gender-aged paired controls. Body composition was assessed under standardized conditions using the DXA (Prodigy of General Electric Healthcare), and BIA (Body Composition Analyzer Seca mBCA 525). Skinfold thicknesses were measured by Holtain skinfold caliper. Circumferences at waist, hip, calf, arm, wrist were measured using soft non stretchable tape Seca and, weight and heigth by Seca brand electronic scale with height rod. To analize the accuracy of BIA, anthropometrics, and skin folds against DXA, correlations and receiver operating curve analysis will be performed. Results Whereas DXA is a method where is necessary to have technical staff and qualified in the handling of X-rays equipment, rarely used in routine clinical practice. BIA has limitations due to the chemical composition of fat free mass because of considerable inter- and intraindividual variability. The accuracy of BIA measurements is high when specific predictive equations and standardized measurement protocols are utilized. Anthropometry and skinfolds are very-low cost, accesible to health personnel in routine clinical practice, with good sensitivity and specificity in the adult, healthy population. The results of this study will be presented. Conclusions The results will help to estimate body composition with low-cost methods easy to use to prevent malnutrition and sarcopenia in HD.

Background There is a need for accurate quantitative measures of speech in Huntington’s disease that can be used for home and in-clinic assessment. Mobile devices provide an easy-to-use, low-cost alternative to laboratory standard microphone-amplifier equipment but require validation prior to clinical use Aims To establish if mobile devices are suitable for monitoring speech in HD, and to examine how acoustic features from speech vary between HD and control participants. Acoustic features from speech tasks recorded using mobile devices from a HD and control group were then compared. Methods Voice was recorded using a mobile device in a control group (Xiaomi Mi 8 or Samsung Tab S6 Lite, N=11, 8 females, Ireland), and a HD group (Wales: Samsung Tab A, N=8, 2 females; Spain: Huawei Mate 10 Lite, N=19, 12 females). In the control group, voice was recorded simultaneously with a gold standard microphone-amplifier and mobile devices. Acoustic data were recorded during sustained vowel phonation (/a:/) and syllable repetition (/pa/). Features estimated are detailed in the supplementary material. Statistical analysis was performed using linear mixed models. Results In the control group, Bland-Altman analysis revealed good agreement between devices for all features. Linear mixed models showed no significant difference between devices during both tasks (p>0.05). When control and HD data were compared, no significant difference was observed in signal quality. Preliminary data suggests, similar to previous studies, an effect of gender1 and differences in acoustic features between HD and control groups.2 Conclusion Preliminary findings indicate the potential clinical use of mobile devices for objectively measuring speech in HD. Data collection is ongoing to allow comparison across clinical sites, with age and gender matched control participants. Supplementary Material: Features estimated were: signal-to-noise ratio (SNR), mean, standard deviation and perturbation of fundamental frequency (f0, stdf0), PPQ5, harmonics-to-noise ratio (HNR), jitter (j%), and shimmer (s%). Figure 1 presents mean and standard deviation for participants groups, data collection sites and Bland-Altman plots for fundamental frequency and jitter features across recording devices. Bland-Altman plots revealed low bias estimated from different devices. Analysis of preliminary data suggests a tendency of decreased f0 and HNR, and increased j%, s%, stdf0 in HD group, consistent with what has been reported previously in a French cohort of 24 controls and 61 HD participants.2 References Fitch James L, Anthony Holbrook. Modal vocal fundamental frequency of young adults. Archives of Otolaryngology 1970;92.4:379–382. Riad Rachid, et al. Vocal markers from sustained phonation in huntington’s disease. arXiv preprint arXiv:2006.05365 2020.

Background: A growing body of evidence relates restless legs syndrome (RLS) to an increased risk of mortality attributable to both cerebrovascular and cardiovascular events. The aim was to investigate survival in patients with RLS. Methods: This was an observational, retrospective longitudinal study of a cohort of patients followed up for 11 years. RLS was diagnosed by a physician using the International RLS Study Group criteria. Mortality was analyzed using age-standardized mortality ratios (SMR: observed/expected deaths) and Cox regression analysis. Results: Vital status was studied in a cohort of 232 patients: 181 women (78%), 96 with RLS (41.4%) with a mean age at baseline of 49.8 ± 15.0 years and a mean RLS duration of 14.1 ± 1.9 years, and 136 non-RLS (58.6%) with a mean age of 51.3 ± 14.9 years. This RLS cohort was followed up for a period of 10.4 ± 2.0 years. As of September 2019, 17 (7.3%) patients died (6 with RLS, 6.3%), and the most frequent cause was oncological (66.7%). A total of 944 person-years of observations were available for survival analysis. RLS was not associated with increased mortality in adjusted Cox regression analysis (HR = 1.12, 95% CI: 0.40–3.15), and survival was similar to that expected for the general population (SMR = 0.61, 95% CI: 0.27–1.36). Conclusions: RLS seems not to be associated with increased mortality compared to the general population. Still, studies with prospective data collection with large samples are needed to study the long-term mortality risk factors in RLS cohorts.

Objetivo: Analizar la influencia que los distintos factores de riesgo ejercen sobre la edad a la que se produce un ictus. Método: Estudio observacional transversal en el que se incluyeron a todos los pacientes con ictus ingresados de forma consecutiva en el Hospital Universitario de Burgos (España). Se recogieron parámetros sociodemográficos y clínicos, estudiándose su posible relación con la edad mediante análisis univariante y multivariante. Resultados: Se incluyeron 436 pacientes, siendo la edad media de 75,39 años (DE ±12,674). Los factores de riesgo más frecuentes fueron la hipertensión arterial y la enfermedad cardiovascular. Se observó que el tener antecedentes personales de hipertensión arterial (OR 2,49; IC95% 1,49-4,16) ó el no tener un estilo de vida sedentario (OR 3,24; 1,97-5,31) se relacionó con una mayor probabilidad de que el paciente tuviera una edad igual o superior a 75 años. Sin embargo, el tener sobrepeso/obesidad (OR 0,51; IC95% 0,30-0,88), el ser fumador activo (OR 0,47; 0,02-0,11) ó el consumir alcohol (OR 0,42; 0,26-0,69) aumentó la probabilidad de que el ictus ocurriera antes de 75 años. Conclusión: La edad de aparición de un ictus se relaciona con la ocurrencia de determinados factores de riesgo, los cuales deberían ser considerados en la planificación de futuras campañas educacionales.

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07, 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64, 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99, 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment.

Background Skeletal muscle loss has been associated with declining physical performance and a negative prognostic effect on falls, disability, and mortality risk in Parkinson's disease. Objectives We aimed to analyze the clinical correlates associated with skeletal muscle wasting in Parkinson's disease. Methods This was a cross-sectional, case-control, observational study. We collected information on dietary intake with a 24-hour recall questionnaire, body composition with bioelectrical impedance, motor severity with the Unified Parkinson's disease Rating Scale, and physical activity with the Global Physical Activity Questionnaire. We used multivariate linear regression analysis to analyze the sociodemographic and clinical correlates associated with skeletal muscle loss after adjusting for confounding variables. Results Forty-three patients with Parkinson's disease and 21 matched family members were included. Patients and family members had similar body composition, anthropometrics, and nutritional parameters. Advanced patients had similar nutrient intakes compared to patients with mild-to-moderate Parkinson's disease. In the multivariate linear regression analysis, female patients with low physical activity and low energy intake were more likely to have skeletal muscle loss. Conclusions Skeletal muscle wasting is a complex multifactorial problem. Dietary strategies and physical exercise should be recommended, especially to females with Parkinson's disease, to prevent significant skeletal muscle wasting.

IntroductionNeuroplasticity is defined as the capacity of the brain to reorganise new neuronal pathways. Mirror therapy (MT) and cognitive therapeutic exercise (CTE) are two neurorehabilitation techniques based on neuroplasticity and designed to improve the motor functions of the affected upper extremity in patients with severe hemiparesis after a stroke. Home-based interventions are an appropriate alternative to promote independence and autonomy. The objective of this study is to evaluate which of these techniques, MT and CTE, combined with task-oriented training, is more effective in functional recovery and movement patterns of the upper extremities in patients with severe hemiparesis after a stroke.Methods and analysisThis is a home-based, single-blind, controlled, randomised clinical trial with three parallel arms, including 154 patients who had a stroke aged above 18 years. The primary outcome will be the functionality of the affected upper extremity measured using the Fugl-Meyer Assessment. Secondary variables will include cognitive performance, emotional state, quality of life and activities of daily living. During 6 weeks, one of the intervention groups will receive a treatment based on MT and the other one on CTE, both combined with task-oriented training. No additional interventions will be provided to the control group. To assess the progress of patients who had a stroke in the subacute phase, all variables will be evaluated at different visits: initial (just before starting treatment and 4 weeks post-stroke), post-intervention (6 weeks after initial) and follow-up (6 months).Ethics and disseminationThis protocol has been approved by the Institutional Review Board (CEIm-2.134/2.019) and registered at ClinicalTrials.gov (NCT04163666). The results will be disseminated through open-access peer-reviewed journals, conference presentation, broadcast media and a presentation to stakeholders. These study results will provide relevant and novel information on effective neurorehabilitation strategies and improve the quality of intervention programmes aimed at patients after a stroke.Trial registration numberClinicalTrials.gov (NCT04163666).