Neurología : publicación oficial de la Sociedad Española de Neurología
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The professional activity of the Spanish neurologists require an analysis because their current situation and future perspectives need some transformations. ⋯ Ambulatory neurological assistance and neurological training (undergraduate and postgraduate and of the family physician) are the main professional aspects that require substantial improvement for the progress of the speciality.
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A combination of good clinical selection with reliable quantification of diverse parameters that characterize the dynamics of cerebrospinal fluid (CSF) flow from phase-contrast magnetic resonance imaging may identify patients with idiopathic normal pressure hydrocephalus (NPH). ⋯ Semiautomatic quantification of the dynamics of CSF by means of MRI differentiates patients with hyperdynamic state from the control subjects, with significant differences that can be used to classify idiopathic HNP.
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The Horner's syndrome in association with the anesthetic techniques is produced by a blockade of the stellate ganglion sympathetic fibers. This complication is produced by the local anesthetic non-expected migration when it is administered either in the epidural space while performing an epidural block or inside the aponeurosis vascular elements during the performance of a brachial plexus block. Its evolution is quick, with benign incident that disappears in a few hours, without leaving any sequels. It can occur in patients without any previous clinical condition. ⋯ Several etiopathologenic options were considered at the time, such as a possible subdural or paravertebral migration of the local anesthetic, the influence of the patient's position (decubitus) and the possible existence of fibrotic compartments in the epidurals space.
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The prognosis for patients with malignant brain tumors has always been poor and until recently chemotherapy had not shown to be very effective. Temozolomide is a novel second-generation alkylating agent that has shown efficacy for the treatment of high-grade gliomas. ⋯ The benefit of temozolomide is greatest in patients with tumors that have a methylated 06-methyl-guanine DNA methyl transferase gene promoter that results in decreased repair of temozolomide-induced DNA damage. This chapter will briefly review the diagnosis and treatment of patients with malignant brain tumors and then will focus on the role of temozolomide in glioma therapy.
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Most Spanish hospitals have no oncall neurologist (OCN) for emergency patients. This study was designed to highlight the benefits in patient management when an OCN system is implemented. ⋯ OCN improves the quality of attention to the neurological patient, reduces the number of unnecessary hospital admissions and increases the status of the neurological department. Implementation of on-call neurology physicians for 24 hours is necessary in all those sites that provide care to emergency patients and have neurology services.