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Objectives In patients with neurocysticercosis (NCC), an accurate risk prediction would allow a better therapeutic approach; however, there are currently no tools that can enhance the accuracy of risk prediction. We designed a prognostic scoring system to be used by neurologists and other physicians managing patients with NCC. Materials and Methods Using data from clinical records of patients from a third-level national reference center for neurological diseases, we assessed demographic, clinical, and tomographic variables among 293 patients diagnosed with NCC. Multivariable logistic regression analyses were used to develop a clinical prognostic scoring instrument. Patients with NCC were assessed for neurological impairment at 3 months after diagnosis. Statistical Analysis Score accuracy was assessed by receiver operating characteristic (ROC) curve analysis. The primary outcome was the presence of neurological impairment, resulting in disability according to self-report or caregiver reports; this outcome was assessed during follow-up visits at 3 ± 1 months after discharge. Results The most common symptoms at presentation were headache (67%) and seizure (63%). A six-item (total score from -4 to + 2) prognostic instrument was constructed on the basis of the presence of seizures/headache at presentation, a leukocyte count above 12x 109/dL, the presence of six to ten parasites, subarachnoid localization, and the use of anthelmintic drugs. Among 113 patients with negative scores, 79.6% developed neurological deficits. Among patients with scores of 1 to 2, 64.6% recovered completely, with an overall accuracy of prediction of 74.7% and area under the ROC curve = 0.722 (95% CI, 0.664-0.780, p < 0.0001). Conclusions The clinical prognostic scoring system for NCC described in this study is a new instrument for use in daily clinical practice. It is simple to administer, and it has a prognostic accuracy of 75%. Its use has the potential to improve the quality of care by guiding appropriate decision-making and early management of patients with NCC.
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The objective was to identify the sociodemographic and clinical characteristics of a large sample of patients with migraine in Mexico City. This cross-sectional study was performed in two tertiary centers in Mexico City and affiliated hospitals. We evaluated the presence of migraine through a standardised interview according to the criteria of the International Headache Society. We studied 1,147 patients. The mean age was 37.1+/-13.6 (6-77) years. Nine hundred and twenty one patients were female (80%). The age of onset of migraine was 19.4+/-10.3 (1-69) years. Six hundred and four patients had migraine with aura (53%) and 543 without aura (47%). The female/male ratio was 4:1. One hundred and forty-seven patients had cardiovascular problems (13%), 72 had neurological problems (6%), 233 had gastrointestinal problems (20%) and 323 had psychiatric problems (28%). In this study we described the clinical characteristics of a large sample of patients with migraine in Mexico City. Our sample has similar characteristics to other countries.
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Trastornos Migrañosos/epidemiología , Adulto , Factores de Edad , Edad de Inicio , Enfermedades Cardiovasculares/epidemiología , Comorbilidad/tendencias , Estudios Transversales , Femenino , Enfermedades Gastrointestinales/epidemiología , Humanos , Masculino , Trastornos Mentales/epidemiología , México/epidemiología , Persona de Mediana Edad , Trastornos Migrañosos/etiología , Trastornos Migrañosos/fisiopatología , Migraña con Aura/epidemiología , Migraña con Aura/genética , Migraña con Aura/fisiopatología , Enfermedades del Sistema Nervioso/epidemiología , Estudios Prospectivos , Factores SexualesRESUMEN
El síndrome de marinesco Sjögren (MS)esta caracterizado por cataratas, ataxia y retraso mental aunque puede acompañarse de muchos otros síntomas. Existen casos familiares y otros que aparecen sin estas características. Se presenta un caso de MS de aparición temprana en México sin historia. familiar. Un estudio completo se llevó a cabo.
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Humanos , Femenino , Adulto , Degeneraciones Espinocerebelosas , Ataxia , Catarata , Discapacidad IntelectualRESUMEN
Los carcinomas forman parte de las neoplasias epiteliales malignas. Ha sido descrito con distintos nombres. Es un tumor sólido que se presenta en las orbitas o fosas nasales. Se presenta en caso de cavernoma crónico.
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Humanos , Femenino , Anciano , Carcinoma Adenoide Quístico/diagnóstico , Seno Cavernoso , Sistema Nervioso Central , NeoplasiasRESUMEN
La cefalea tensional y la migraña representan un problema de salud que se reporta frecuentemente en la población, se ha descrito en la literatura médica mundial que muestran comorbilidad con la ansiedad y la depresión; sin embargo, en México no existen estadísticas actualizadas en relación a este fenómeno, por lo que, el objetivo de este estudio fue identificar la comorbilidad de la cefalea con la ansiedad y la depresión. El estudio fue realizado con 2 500, sujetos, 1 250 hombres y 1 250 mujeres con edades de 18 a 80 años. Para el diagnóstico se utilizó la Clasificación Internacional de Cefaleas se obtuvieron datos de migraña, probable migraña, cefalea tensional y probable cefalea tensional, los resultados mostraron que la migraña presenta mayor comorbilidad con la depresión y la ansiedad así como con insomnio que la cefalea tensional. Igualmente las mujeres presentan mayor frecuencia de alteraciones comorbidas en especial ansiedad.