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El síndrome del pronador redondo consiste en un atrapamiento del nervio mediano en su recorrido entre los vientres musculares del músculo pronador redondo. Es un cuadro poco común que habitualmente se confunde con otras neuropatías compresivas del miembro superior. Se presenta un caso infrecuente de síndrome del pronador redondo asociado a la compresión del nervio cubital en el codo y del nervio mediano en la muñeca. El estudio electrofisiológico detectó un atrapamiento del nervio mediano en la muñeca y una neuropatía cubital a nivel del codo. La ecografía dinámica del antebrazo constató una afectación morfológica del nervio mediano a su paso por el músculo pronador redondo. El paciente mejoró con la administración de corticoides y técnicas de rehabilitación y readaptación. Conclusiones: Se debe sospechar un síndrome del pronador redondo en pacientes que consultan por alteraciones sensitivas en el antebrazo y la muñeca. El diagnóstico diferencial con otras neuropatías compresivas es fundamental, porque la detección precoz permite indicar medidas terapéuticas conservadoras que eviten una progresión hacia la lesión estructural del nervio.

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Objetivos: Comparar la validez diagnóstica entre la escala Neuropathy Disability Score (NDS) sin Monofilamento (MF) y NDS modificada con MF frente a Electromiograma (EMG) de extremidades Inferiores. Concordancia entre neuropatía detectada y registrada en Historial Clínico Informatizado (HCI) Metodología: Estudio de concordancia. Duración: 12 meses. Ámbito: Dos centros de Atención Primaria (AP) del Institut Català de Salut. Población diana: Personas con EMG registrado en HCI por sospecha de neuropatía diabética y otras neuropatías de extremidad inferior. Muestreo: Para un coeficiente kappa de 0,8 y precisión de 0,2 necesitamos 104 personas. Criterios de inclusión por Grupos: A: DM con registros del pie de riesgo sin neuropatía. B: DM con diagnóstico de neuropatía. C: Sin neuropatía ni DM conocidas. Selección: Simple, mediante listado de candidatos por centros participantes. Captación: Telefónica y programados en agenda única. Intervenciones: Entrevista clínica (Cuestionario sintomático Neuropathy Symptoms Score) (NSS) (0-9 puntos), Examen clínico: (Valoración sensitivomotora mediante escala NDS modificada (0-5 puntos por pie). Neuropatía si NDS > 6 puntos). Exploraciones: Tres por Enfermería, dos consecutivas y una espaciada 2 semanas. Variables Independientes: Puntuación de NDS y NSS. Dependientes: Factores de Riesgo Cardiovascular. Complicaciones DM. Análisis estadístico: Si la muestra es homogénea, mediante t de Student y ANOVA. Se calculará la fiabilidad y validez inter observador. Concordancia mediante Kappa, sin descartar métodos no paramétricos si la distribución lo aconseja. STATA. Resultados esperados: Disponer de un procedimiento exploratorio que mejore la actual valoración del pie de riesgo en AP. Aplicabilidad: Mejorar el diagnóstico de neuropatía diabética en AP. ABSTRACT Objectives: Compare the diagnostic validity between the Neuropathy Disability Score (NDS) scale without Monofilament (MF) and NDS modified with the MF and Lower Extremity Electromyogram (EMG). Concordance between neuropathy detected and recorded in the Computerized Clinical History (HCI) Methodology: Concordance study. Duration: 12 months. Setting: Two Primary Care (PC) centers of the Institut Català de Salut. Target population: People with EMG recorded in HCI for suspected diabetic neuropathy and other lower extremity neuropathies. Sampling: For a kappa coefficient of 0.8 and precision of 0.2 we need 104 people. Inclusion criteria by Groups: A: DM with risk foot records without neuropathy. B: DM with diagnosis of neuropathy. C: No known neuropathy or DM. Selection: Simple, through a list of candidates by participating centers. Capture: Telephone and scheduled in a single agenda. Interventions: Clinical interview (Neuropathy Symptoms Score) (NSS) symptomatic questionnaire (0-9 points), Clinical examination: (Sensorimotor assessment using modified NDS scale) (0-5 points per foot). Neuropathy if NDS > 6 points. Examinations: Three per Nursing, two consecutive and one spaced 2 weeks apart.Variables Independent: NDS and NSS score. Dependents: Cardiovascular Risk Factors. DM complications. Statistical analysis: If the sample is homogeneous, using Student's t-test and ANOVA. Inter-observer reliability and validity will be calculated. Agreement using Kappa, without ruling out non-parametric methods if the distribution recommends it. STATA. Expected results: To have an exploratory procedure that improves the current assessment of the risk foot in PC. Applicability: Improve the diagnosis of diabetic neuropathy in PC.

Background Patients with anti-MAG neuropathy present with distal demyelinating polyneuropathy, IgM monoclonal gammopathy, and elevated titers of anti-MAG antibodies.

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Objectives: To determine the incidence of neuropathic pain after endodontic treatment with follow-up at 6 months. Materials and Methods: This was a prospective observational clinical study that was carried out on patients who underwent endodontic treatment or retreatment carried out in the Master of Endodontics at the International University of Catalonia (UIC) from January 2022 to December 2022. After the treatment, a six-month follow-up was carried out, determining the presence of persistent pain, and whether the cause was of non-odontogenic origin, through anamnesis and physical examination carried out in the Department of Craniomandibular Dysfunction and Orofacial Pain of the Faculty of Dentistry. Results: A total of 231 treatments were obtained, obtaining a 53% response via telephone call. A descriptive analysis of the results was done, there were 88 patients who did not present pain after 6 months of endodontic treatment (72%); while 35 patients reported pain (28%). 9% of the cases with pain were caused by endodontic failure, in 74% the cause was due to involvement of another tooth and 11% due to periodontal reasons. It was estimated that 1.5% of treated patients had failed endodontic treatments at 6 months of follow-up. The causes of persistent pain were periodontal problems, such as food packaging, dentin hypersensitivity or pulpal origin associated with another tooth. Conclusions: After 6 months of follow-up, no patient presented neuropathic origin pain. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 has caused many deaths on the planet. To date we do not know its long-term impact. Conversion of hospital centers and home reclusion impacted those with a disease. Currently, the presence of pain has been identified as a chronic complication of COVID-19. Objective: to document the impact of COVID-19 on patients with pain and its chronicity. Material and methods: literature search in the PubMed database for documents that contained the words «COVID», «SARS-CoV», «Pain» in the title. No metaanalyses were identified. We found systematized and documentary reviews on which we based our information. Conclusions: COVID-19 presents chronic pain as a long-term manifestation. It is advisable to generate lines of research aimed at documenting this phenomenon. [ABSTRACT FROM AUTHOR]

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E l síndrome de doble atrapamiento del nervio ulnar es una condición rara que involucra compresión en dos puntos distintos, con manifestaciones clínicas que varían según el grado de afectación nerviosa. El presente caso clínico aborda la complejidad del síndrome de doble atrapamiento del nervio ulnar, en el túnel cubital en el codo y en el canal de Guyon de la muñeca. La paciente presentó síntomas de debilidad y dificultad para la extensión activa del cuarto y quinto dedo izquierdo. Estos hallazgos clínicos, junto con los estudios complementarios, confirmaron la presencia de una neuropatía cubital grave. La identificación precisa y el tratamiento oportuno mejoran significativamente los resultados clínicos y la calidad de vida de los pacientes con este padecimiento.

Introdução: A prevalência da infeção pelo vírus da imunodeficiência humana (VIH) parece haver estabilizado nos 0,7%, enquanto em alguns países continua a aumentar. Durante muitos anos estava apenas associada ao continente africano e a populações específicas, mas atualmente constata-se um aumento de incidência nos países desenvolvidos. Esta infeção pode ser assintomática ou ter sintomas inespecíficos. Estes dependem do estádio da doença, da carga viral ou do estado imune do hospedeiro. Este caso mostra o desafio do diagnóstico de VIH, relatando uma forma de apresentação sintomática rara. Descrição do caso: Homem de 21 anos de idade, de nacionalidade angolana, que recorre à consulta aberta nos cuidados de saúde primários por quedas frequentes no último mês associadas a sensação de falta de força nos membros inferiores. À avaliação física constata-se uma discreta diminuição global da força nas quatro extremidades, com maior tradução no membro superior esquerdo. Nega práticas sexuais de risco ou consumo de drogas parenterais. Após realização de estudo analítico, estudo eletromiográfico e tomografia computorizada crânio-encefálica, da coluna cervical e lombar, constata-se um resultado positivo para a infeção por VIH como a causa desencadeante da sintomatologia apresentada. Comentário: O que inicialmente pareciam sintomas relacionados com uma doença neuromuscular incipiente veio a revelar-se o diagnóstico de uma infeção vírica. Pela inespecificidade dos seus sintomas é importante manter um elevado nível de suspeição para a infeção por VIH. No caso relatado, a neuropatia periférica era a única manifestação desta infeção. Ainda que tenha uma prevalência de até 60% entre os infetados, é rara como manifestação isolada. A sua etiopatologia não é ainda clara, sabe-se que é multifatorial e progressiva. Presentemente o doente encontra-se estável com o início da terapêutica antirretroviral, com melhoria da sintomatologia.

Introduction: The increasing incidence of diabetes mellitus, especially in low-income countries, poses challenges to healthcare systems. Diabetic foot, a serious and preventable complication, results in high healthcare costs. Patient and family education, along with a structured care approach, reduces rates of ulceration, infection, and amputation in individuals with diabetes. This study evaluates the impact of diabetic foot on patients with diabetes mellitus from a Health Benefit Plan Administrator and proposes an educational model for its prevention. Methodology: Retrospective observational study analyzing patients with diabetes mellitus registered in a specific software, excluding those with other chronic diseases. Computer tools were used to identify cases of diabetic neuropathy, hospitalizations, and amputations due to diabetic foot, collecting data from 2020 and 2021 to analyze prevalence and incidence rates. A validated survey was designed to assess foot care in patients with diabetes mellitus. Results: These indicate a significant prevalence and incidence of diabetic foot complications in the studied patient cohort, with only 1.4% affected by diabetic neuropathy. An increase in the amputation rate was observed between 2020 and 2021 due to diabetic foot and its complications, accounting for 90% of hospitalizations among DM patients. The survey revealed symptoms related to diabetic foot in 70% of patients, emphasizing the need for early detection. The use of social marketing strategies is suggested to implement educational programs that reduce complications and improve the quality of life of patients with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Defined as the unpleasant sensation that causes the desire to scratch, pruritus is the most common skin symptom associated with uremia and appears in almost half of patients with advanced chronic kidney disease (CKD). Beyond its direct impact on quality of life, CKD-associated pruritus (CKD-aP) is an independent predictor of mortality that also has a synergistic effect with other quality of life-related symptoms, such as insomnia, depression, and anxiety. Although different mechanisms have been proposed to explain the origin of Pa-ERC, its etiopathogenesis is still not fully understood. Since new therapeutic targets have been identified and several clinical trials have recently shown promising results, our current understanding of the interrelationships has expanded significantly and the pathophysiological mechanisms underlying CKD-aP are now considered to be multifactorial. The potential triggers of pruritus in patients with CKD are discussed in this review, including hypotheses about skin xerosis, accumulation of uremic toxins, dysregulation of the immune system and systemic inflammation, uremic neuropathy, and imbalances in the endogenous opioid system. Other non-uremic causes of pruritus are also discussed, with the aim of guiding the physicians to apply an adequate aetiopathogenic approach to CKD-aP in their day-to-day clinical practice. Resumen: Definido como la sensación desagradable que provoca el deseo de rascarse, el prurito es el síntoma cutáneo más frecuente asociado a la uremia, pudiendo aparecer en casi la mitad de los pacientes con enfermedad renal crónica (ERC) avanzada. Más allá de su repercusión directa sobre la calidad de vida, el prurito asociado a la ERC (Pa-ERC) es un predictor independiente de mortalidad que además ejerce un efecto sinérgico con otros síntomas también relacionados con la calidad de vida, como la depresión y el insomnio. Aunque se han propuesto diferentes mecanismos para explicar su origen, la etiopatogenia del Pa-ERC sigue sin conocerse por completo. Dado que se han identificado nuevas dianas terapéuticas y recientemente varios ensayos clínicos han mostrado resultados prometedores, nuestra comprensión actual de las interrelaciones se ha ampliado significativamente, considerando multifactoriales los mecanismos fisiopatológicos subyacentes al Pa-ERC. En la presente revisión se discuten los potenciales factores desencadenantes de prurito en el paciente con ERC, incluyendo las hipótesis sobre la xerosis cutánea, el acúmulo de toxinas urémicas, la desregulación del sistema inmune y la inflamación sistémica, la neuropatía urémica y los desequilibrios en el sistema opioide endógeno, así como otras causas no urémicas de prurito, con el objetivo de orientar al clínico para realizar un adecuado abordaje etiopatogénico del Pa-ERC en su día a día.

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El diagnóstico precoz de las complicaciones microvasculares de la diabetes mellitus (DM) nos permite realizar un tratamiento temprano y prevenir su progresión. Existen evidencia que la neuropatía diabética presenta un comienzo insidioso, que es previo al incremento de la glucemia, pero además concurren otros factores del síndrome metabólico como la dislipidemia, la obesidad y la hipertensión, las cuales impactan sobre el trofismo y la irrigación del nervio1,2. En relación a la nefropatía, sabemos la importancia de la hiperglucemia en el desarrollo de esta complicación, inclusive en la disglucemia considerándola a partir de 100 mg/dl3, todo esto sin dejar de tener en cuenta los factores genéticos, epigenéticos e inflamatorios que influyen en la progresión de la nefropatía. En conclusión, es imprescindible resaltar la importancia de la evaluación exhaustiva de nuestros pacientes con síndrome metabólico, con y sin disglucemia, para detectar precozmente las complicaciones microvasculares.

Las porfirias son un grupo heterogéneo de trastornos del metabolismo en el cual hay una deficiencia enzimática específica necesaria en la biosíntesis del grupo hemo. Dentro de estas se destaca la porfiria aguda intermitente como la forma más común, que se caracteriza por episodios de exacerbación o crisis neuroviscerales. Las manifestaciones clínicas son amplias, sin embargo, la presentación con síntomas del sistema nervioso central a diferencia de los síntomas disautonómicos o neuropáticos son poco frecuentes. Reportamos un caso que resalta la relación infrecuente entre la porfiria aguda intermitente y el síndrome de encefalopatía posterior reversible. Paciente femenina de 18 años con dolor abdominal persistente severo, hipertensión arterial, convulsiones, ceguera cortical y neuropatía axonal motora. Se le realizó una resonancia magnética nuclear (RMN) contrastada que evidenció lesiones hiperintensas corticales y cortico-subcorticales sugestivas de edema vasogénico, compatibles con síndrome de encefalopatía posterior reversible. Se hizo el diagnóstico de porfiria aguda intermitente por elevados niveles de resonancia magnética nuclear (PBG) y ácido 5-amino-levulínico (ALA) en orina y se inició tratamiento con hematina, terapia parenteral hiperglucida y el retiro de agentes porfirinogénicos. Los síntomas centrales así como los hallazgos imagenológicos se resolvieron de forma adecuada con el tratamiento. Este caso resalta la relación inusual entre la porfiria aguda intermitente y el síndrome de encefalopatía posterior reversible, en una paciente con crisis de dolor abdominal persistente, disautonomía, convulsiones, ceguera cortical y neuropatía axonal motora, síntomas que asociados nos deben sugerir estos diagnósticos.

Patient presents in ER with symptoms and history indicative of infectious disease, with muscle pain and double vison being the main complaints. After several consultations, it is decided to admit the patient to the internal medicine ward, where following clinical investigation focused on a differential diagnosis of eosinophilia and myopathy. Paciente acude al servicio de urgencias con un cuadro compatible con patología infecciosa, siendo dolor muscular y visión doble las principales quejas. Tras consultar con diferentes servicios, se decide ingreso en el servicio de medicina interna, donde la investigación clínica se focaliza en un diagnóstico diferencial de eosinofilia y miopatía.

Transthyretin-related hereditary amyloidosis (ATTR) is a systemic disease result of an autosomal dominant mutation in the transthyretin (TTR) gene. This mutation will cause the deposition of misfolded TTR protein in several organs, leading to its dysfunction. The disease has been described worldwide, although it is still considered rare. It has a region-dependent genotype- phenotype correlation. Cardiomyopathy and a symmetric length-dependent sensory-motor and autonomic polyneuropathy are the hallmark manifestations. However, in non-endemic areas, the diagnosis will challenge the neurologist because some systemic manifestations are usually attributed to more common disorders. Therefore, in the approach of a patient with polyneuropathy, the presence of family history, early autonomic dysfunction (cardiovascular, genitourinary, or gastrointestinal features), cardiac involvement, and inexplicable weight loss should be considered red flags that point toward ATTR. After diagnosis, the goal will always be to have a multidisciplinary approach, including a complete neurologic, autonomic, and cardiologic assessment, to establish a short- and long-term strategy for treatment, including symptomatic and disease-modifying medications that are now available. In that way, the increased awareness among specialists will positively impact the patient quality of life and survival by accomplishing an earlier diagnosis and treatment. [ABSTRACT FROM AUTHOR]

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Trench foot is considered the most common non-combat related military injury and we have known of its existance since Napoleon's time. However, this vasoneuropathy remains a poorly understood condition and, therefore, a diagnostic challenge. With the report of 2 clinical cases treated in our hospital during Filomena storm, which occurred in Spain in January 2021, with Madrid as one of the most affected areas, we intend to contribute a little more knowledge, in order to improve cases identification and the correct management that, surely will improve our patients prognosis, without forgetting preventive measures. In our experience, a rigorous diagnostic study (vascular and electroneurophysiological) and a vasodilatador treatment with sciatic popliteal block, 5-phosphodiesterase inhibitors and dihydropyridine calcium antagonists have been decisive. [ABSTRACT FROM AUTHOR]

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Many patients report persistent symptoms attributable to dysfunction of the peripheral nervous and muscular systems after acute COVID-19. These symptoms may constitute part of the so-called post–acute COVID-19 syndrome (PACS), or may result from neuromuscular complications of hospitalisation in intensive care units (ICUs). This article provides an updated review of symptoms of potential neuromuscular origin in patients with PACS, differentiating symptoms according to muscle, peripheral nerve, or autonomic nervous system involvement, and analyses the forms of neuromuscular involvement in patients who were admitted to the ICU due to severe COVID-19. Resumen: Los pacientes que han padecido COVID-19 frecuentemente refieren síntomas persistentes atribuibles a disfunción del sistema nervioso periférico y muscular. Estos síntomas pueden formar parte del denominado síndrome COVID-19 post-agudo (post-acute COVID-19 syndrome o PACS) o pueden surgir como consecuencia de las complicaciones neuromusculares del ingreso en unidades de cuidados intensivos (UCI). En este manuscrito se realiza una revisión actualizada de los síntomas de potencial origen neuromuscular en pacientes afectos de PACS, diferenciándolos en función de su posible origen a nivel de músculo, nervio periférico o sistema nervioso autónomo, así como las formas de afectación neuromuscular en pacientes que precisaron ingreso en UCI por COVID-19 grave.

Introduction: Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy characterized by flaccid, areflexic, ascending and symmetrical paralysis, which may have an infectious origin. It has recently been associated with COVID-19. Case presentation: Two pediatric patients with GBS and in whom COVID-19 was diagnosed by PCR are described. In both patients, the diagnosis of GBS was confirmed by neuroconduction studies. Both received treatment with immunoglobulin and had complete resolution of the neurological symptoms. Conclusions: Given that GBS can occur in pediatric patients with COVID-19, both conditions should be suspected in patients with clinical data similar to the cases reported here. [ABSTRACT FROM AUTHOR]

Introduction: Guillain-Barré syndrome is a set of neuropathies characterized by progressive motor weakness, decrease and absence of deep reflexes which is the leading cause of acute flaccid paralysis in first and second level care hospitals in Mexico. Case report: We present a 22-year-old male patient who began his condition with weakness of the lower limbs (0/5 Daniels) and upper limbs (2/5 Daniels), with a history of respiratory condition 2 weeks prior to the onset of symptoms. The cytochemistry CSF showed albuminocytologic dissociation and the electrophysiological test a demyelizing and motor polyradiculoneuropathy. Treatment with intravenous immunoglobulin was started showing good response continued with rehabilitation therapy until it was decided to discharge for presenting evident clinical improvement. Conclusion: multidisciplinary management and rapid care in patients with Guillain-Barré síndrome, it helps in a notorious way to his rapid recovery, avoiding sequelae of the disease in the long term. [ABSTRACT FROM AUTHOR]

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Resumo Objetivo: Verificar a presença das células-tronco mesenquimais (MSC) na área próxima ao nervo óptico de coelhos previamente lesado com álcool absoluto. Métodos: Os 12 coelhos da raça Nova Zelândia foram distribuídos em 2 lotes. Após sedação, cada olho do animal recebeu uma injeção retrobulbar de 1 ml de álcool absoluto em um dos olhos e de 1 ml de solução fisiológica 0,9% (SF) no olho contralateral. Após 15 dias deste procedimento inicial todos os olhos dos animais pertencentes ao lote A, receberam via retrobulbar, uma solução contendo MSC de tecido adiposo humano e previamente marcadas com Qdots,. Todos os olhos dos animais do lote B receberam solução PBS. Resultados: Após 15 dias desta última aplicação os animais foram sacrificados e as lâminas foram analisadas. A presença das MSC foi observada em 100% dos olhos dos animais do lote A. Conclusão: Os resultados sugerem que a marcação prévia das MSC com Qdots permitiu o acompanhamento das mesmas na região aplicada e em áreas mais internas do nervo óptico. A permanência de MSC após 15 dias de aplicação ao redor do nervo óptico sugere a viabilidade e possível participação das mesmas no processo de regeneração do tecido lesado. Nas condições deste estudo, a via de aplicação retrobulbar permitiu a mobilização das células tronco do local de aplicação até áreas centrais dos nervos ópticos nos animais do lote A, sugerindo que esta poderá ser uma via de acesso eficaz para as MSC no processo de regeneração de neuropatias ópticas.

Background: Guillain-Barré syndrome (GBS) patients who present very early (< 4 days) to health-care services generally have severe clinical forms due to rapid progression. Little information exists on the clinical and short-term functional prognosis in patients with very-early GBS (VEGBS). Methods: A prospective cohort study was conducted. We performed Kaplan-- Meier survival analysis to observe the recovery of independent gait between groups, where a log-rank value < 0.05 was considered significant. All statistical analyzes were performed using SPSS version 22. Results: Ninety-nine patients were included in the study. Mean age was 46.7 ± 16.7 years, 61.9% were male. Regarding nerve conduction studies, the most frequent electrophysiological variants in the very early-onset GBS group were axonal (38.7%). Twenty-three percent were classified as equivocal. In the GBS group > 4 days, the most frequent electrophysiological variant was acute inflammatory demyelinating polyneuropathy (52.1%). Conclusion: Patients with VEGBS do not present different clinical characteristics, nor severity or poor short-term outcome in our population compared to different GBS presentations. Only mechanical ventilation requirement and distal compound muscle action potential reduction are associated with poor outcome in this subset of patients. [ABSTRACT FROM AUTHOR]

Diabetic foot is a chronic complication of diabetes that consists of lesions in the deep tissues of the lower extremities, neurological disorders and peripheral vascular disease. It is one of the most frequent causes of hospitalization of people with diabetes and the main cause of non-traumatic amputations. Its main pathophysiological mechanisms are related to diabetic neuropathy and peripheral arterial disease that condition the deformity and higher risk of injury from trauma. The monofilament test as well as the brachial ankle index are useful tests for the early diagnosis of neuropathy and occlusive arterial disease. In addition, both infection and ischemia increase the risk of complications and amputation. [ABSTRACT FROM AUTHOR]

Diabetic neuropathy (DN) belongs to the microvascular complications with a major impact on quality of life and on life expectancy. It is a neurodegenerative disorder that compromises both the somatic and autonomic peripheral nervous systems in the context of Diabetes Mellitus. DN is a very prevalent complication that can be present even in non diabetic dysglycemia stages and Metabolic Syndrome. It requires a sustained intervention, and prevention of its appearance must be attempted. Regarding management, it is postulated that the optimization of glycemic control is effective as a therapeutic measure in people with T1Diabetes mainly, while the intervention must be multifactorial in patients with T2Diabetes. In this population, changes in lifestyle, with physical exercise and weight loss represent the bases of management for distal and symmetric diabetic polyneuropathy, which is the most frequent clinical form to observe in daily clinical practice. These changes should be implemented early in the course of the disease1.

Diabetic motor sensitive polyneuropathy (DSPN) is the most prevalent complication, affecting about a third of people with type 1 and 2 diabetes, the number increases if all the different types of diabetes neuropathies are considered, being in particular, that DSPN represents considerable morbidity, a higher risk of mortality, a reduced quality of life as a result of sensitive alterations, especially pain, motor, visceral and an increase in health care costs as a result, in particular, of neuropathic pain and foot ulcers. Painful DSPN is found in 13-26%, while up to 50% of patients with NPCD can be asymptomatic. Unfortunately, DSPN is still inadequately diagnosed, very late and treated incompletely. Currently, with the recommended diagnostic methodology to detect diabetic neuropathy and its possible phenotypes, it is already possible to establish in the daily clinic, the incipient dysfunctions of neuronal receptors (Paccini, Krausse, Libres, etc.), with their corresponding nerve fibers Beta (myelinized), Delta type I, type II (Neuropathic symptoms may be absent or present, typical ones include pain, paraesthesia and numbness, particularly in the feet and calves, bearing in mind that the predominant sign is the deficit of the alarm system "Nocceptual pain", they are usually accompanied by symptoms and / or signs of autonomic visceral dysfunctions.

RESUMEN El glaucoma, considerado el ladrón silencioso de la visión, es la segunda causa de ceguera irreversible en el mundo. A pesar de los avances científicos y tecnológicos no se ha encontrado una cura definitiva para esta enfermedad. Lo más evidente ha sido el control adecuado de los valores de presión intraocular para evitar la progresión del daño del nervio óptico y sus consecuencias en el campo visual, así como la ceguera irreversible. En muchas ocasiones logramos tener la presión intraocular en valores óptimos y aun así la enfermedad avanza, por lo que nos preguntamos qué falló y por qué sucede. No podemos olvidar que el nervio óptico no es lo único que se altera en esta patología; existe evidencia de que se extiende de las células ganglionares de la retina al cuerpo geniculado lateral y a la corteza visual en los hemisferios cerebrales. Ante fenómenos de espasmo, isquemia o bajo flujo, se desencadenan reacciones bioquímicas, estrés oxidativo y otras situaciones que contribuyen al desarrollo de esta neuropatía. Con el objetivo de evaluar con mayor profundidad a los pacientes glaucomatosos, se realizó una revisión sobre la influencia de las más frecuentes enfermedades sistémicas en la neuropatía óptica glaucomatosa.

A polirradiculoneurite idiopática aguda canina é de uma enfermidade imunomediada e a forma mais comum de polineuropatia aguda em cães. Os sinais clínicos normalmente associados a esta afecção estão relacionados à paralisia flácida dos membros, resultante da sensibilização nos ramos dos nervos espinhais, geralmente não apresentando perda de sensibilidade. Os tratamentos variam de cuidados clínicos e terapêuticos apresentando viabilidade na redução dos sinais clínicos e reabilitação do animal, em grande parte dos casos, de forma completa. O monitoramento do animal é de suma relevância para que a sintomatologia não retorne de forma agressiva, causando maiores prejuízos ao paciente. É necessário o diagnóstico diferencial de intoxicação, botulismo ou Miastenia gravis fulminante e anticorpos de memória para protozoários como Toxoplasma gondii e Neospora caninum. O objetivo do presente trabalho foi relatar a ocorrência de polirradiculoneurite idiopática aguda em canino encaminhado ao Hospital de Clínicas Veterinárias (HCV) na Universidade Federal de Pelotas (UFPel). Os resultados foram obtidos após diagnóstico clínico e terapêutico, tendo melhora no quadro em aproximadamente seis semanas, sendo este tratamento totalmente sintomático.

Introducción: El presente estudio evaluó la frecuencia de onicocriptosis recurrente en pacientes con diabetes mellitus (DM). Pacientes y métodos: Estudio transversal observacional de prevalencia. 146 individuos, diagnosticados de cualquier tipo de DM, excepto DM gestacional, del área básica de salud de los centros de atención primaria de Bufalà y Dr. Robert de Badalona, atendidos en un centro de podología a través del programa de pie diabético del sistema público de salud en Cataluña. Dos individuos se descartaron por presentar criterios de exclusión. Se valoró la incidencia de onicocriptosis y el tipo de curas de los pies realizadas habitualmente, a través de un cuestionario respondido por el paciente. Presencia de signos de neuropatía y o isquemia en extremidades inferiores a través de exploración clínica. Resultados: Se encontró una frecuencia de onicocriptosis del 33 %. No se encontró relación entre presencia de onicocriptosis con la edad, años evolución de la DM, presencia de signos de polineuropatía o de isquemia, o el tipo de curas. De los pacientes con onicocriptosis, un 29 % y un 33 % presentaban signos de isquemia y polineuropatía, respectivamente. Conclusiones: Un tercio de los pacientes con DM remitidos presentaba o ha presentado onicocriptosis. Cerca de un tercio de estos pacientes presentan además factores de riesgo de pie diabético: polineuropatía e isquemia. Dos tercios de los pacientes con onicocriptosis se realizan medidas de autocuidado en los pies sin control profesional sanitario.

Después de más de 40 años desde la descripción del Síndrome de Doble Compresión por Upton y McComas en el Lancet, sigue siendo un tema debatido que ha llevado a algunos cirujanos de mano a dudar de su existencia. La evidencia científica demuestra que la alteración del transporte axonal es el mecanismo más plausible en la fisiopatología de ese síndrome de compresión nerviosa. Se ha demostrado que una cuidadosa exploración clínica junto a un buen estudio neurofisiológico bien dirigido incrementa la eficiencia diagnóstica en términos de pacientes correctamente diagnosticados en el SDC. La liberación del Ligamento Transverso del Carpo está indicada en determinados pacientes que cumplen unos criterios de inclusión y exclusión específicos. Los resultados demuestran que la liberación del canal carpiano en esa población diana específica, es capaz de mejorar la gravedad de los síntomas de manera similar a la población afecta de Síndrome del Túnel Carpiano y de manera casi similar, a nivel de la Discapacidad de MMSS. Sólo instrumentos genéricos, como el SF-36, han sido capaces de detectar la diferencia a nivel de ciertas dimensiones de la Salud en relación a la Calidad de Vida entre los resultados del tratamiento en SDC y STC.

Objective: To describe the neurological symptoms and signs in SARS-CoV2 infection. Acquisition of evidence: A bibliographic search was carried out, in English, Spanish and Portuguese, in PubMed and LILACs databases. One hundred fourteen articles published from January 2020 to July 2, 2020 were selected, which addressed the clinical manifestations and neurological complications in SARSCoV2 infection. The search terms were COVID-19, SARS-CoV2, CoV-2, in combination with the terms nervous system, neurological manifestations, neurological symptoms, neuro-psychiatric symptoms, neurological damage, demyelination, neurological complications, encephalopathy, disease cerebrovascular, and encephalitis. Results: Neurological symptoms and signs are frequent in patients with COVID-19. The clinical manifestations of the central nervous system, musculoskeletal and peripheral nervous system are observed in both COVID-19, severe and non-severe forms. Headache, taste and smell alterations, and myalgias are referred to in the non-severe and severe forms of the disease. Disorders of consciousness, delirium, and pyramidal signs are characteristic of severe COVID-19. In the advanced phase of the disease, symptoms compatible with peripheral nerve involvement, dysautonomia, and myopathies are exhibited. Conclusions: The current epidemiological panorama requires that attending physicians be aware of the wide spectrum of neurological symptoms and signs of COVID19 for early diagnosis of the disease and complications. The inclusion of neurological practice in the diagnostic-therapeutic protocols allows optimizing the care of patients with COVID-19. [ABSTRACT FROM AUTHOR]

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Objective: The goal of this review is to explain the different therapeutic methods used to treat patients affected by NDP. Associated with this, the pathophysiology of Peripheral Diabetic Neuropathy is explained, in order to justify the treatments adopted. Methods: The PubMed, SciELO and Google Scholar databases were accessed. Descriptors related to the peripheral neuropathy and therapies were used in Portuguese and English. Results: The objectives and results were organized and presented in a table. Therefore, it is important to first treat the cause of NDP, diabetes mellitus, in order to prevent the appearance of this nervous disorder. Multidisciplinary treatments aim to reduce the consequences of pathology and promote better quality of life for patients, since they reduce the occurrence of serious consequences. [ABSTRACT FROM AUTHOR]

Copyright of Zdravotnicke listy is the property of Alexander Dubcek University in Trencin, Faculty of Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Oftalmologia is the property of Sociedade Brasileira de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The ulnar tunnel syndrome is the second compressive neuropathy, followed by the carpal tunnel, making it a frequent reference in hand surgery. There are few published studies about endoscopic technique. Material and methods: We studied 26 patients with ulnar tunnel syndrome diagnosis, were operated by endoscopic release of the ulnar tunnel. Nine women (35%) and 17 (65%) male patients. We used the modified McGowan, and the Wilson and Krout classification to analyze preoperative and postoperative variables. Results: After endoscopic decompression we obtained 18 patients (69%) with excellent evolution, 6 (24%) with good evolution, and 2 (7%) with acceptable outcome. We obtained a significant p of < 0.05. Conclusion: Endoscopic decompression of the ulnar tunnel is a safe technique, less invasive and with good outcome. [ABSTRACT FROM AUTHOR]

Introduction: Fibromyalgia suffers from pain frequently reported in women of reproductive age. A method to evaluate the sympathetic fibers in peripheral neuropathies, is the evaluation of the sympathetic response of the skin. Objective: Search association between small fiber neuropathy and fibromyalgia, in patients treated at the Hospital Central Militar. Material and methods: Pilot study, population-35 patients; A sympathetic skin response study was performed, reported as present-absent. Inferential statistical analysis using relative risk and moment ratio. Results: For analysis: two groups, control group-20 patients, group with fibromyalgia - 15 patients. Group with fibromyalgiawomen 100% (n = 15), control group 60% (n = 12) women and 40% (n = 8) men; distribution by age, control group between 29-38 years and fibromyalgia group between 39-48 years; noting that people with fibromyalgia lack sympathetic skin response 0.2 times more than people who do not have fibromyalgia, the possibility that patients with fibromyalgia have small fiber neuropathy in 3%. Conclusions: An association was found between small fiber neuropathy and fibromyalgia, as reported in the international literature. [ABSTRACT FROM AUTHOR]