Neurology Medicine

Archive for the ‘Neurologists’ Category

Chronic pain is more frequent, more intense and longer lasting in women than in men, as reported by experts in pain. Women are also more likely to experience multiple painful conditions simultaneously, which can lead to increased mental stress and increased risk of disability, according to Jennifer Kelly, Center for Behavioral Medicine in Atlanta.

Chronic pain, pain that lasts six months or more without experiencing any improvement with medical treatment, is associated with many conditions such as fibromyalgia, irritable bowel syndrome, rheumatoid arthritis and migraines, which are more common in women than in men, Kelly said, regarding the report on pain in women of the International Association for the Study of Pain 2007-2008.

“Chronic pain affects a higher proportion of women than men worldwide. We need to encourage women to take a more active role in their treatment and reduce the stigma and shame of having this problem,” said Kelly a statement from the American Psychological Association. Kelly was scheduled to discuss this topic at the annual meeting of the APA on Thursday in San Diego.
Hormones may be a factor in these gender differences, he said. For example, it is known that estrogen plays a role in migraines and that rates of conditions that cause pain among girls increases as they pass through puberty. Among adolescent boys, rates of diseases that cause pain are stable or not increase as dramatically.
Some research suggests that women and men may respond differently to medications for pain. “Genetic and hormonal differences may be the reason for any difference, but it is increasingly clear that social and psychological factors are also important,” said Kelly.
“Women tend to focus on the emotional aspects of pain,” he said. “While men focus on the physical sensations they experience. The women who focus on the emotional aspects of pain as a result may experience more pain, possibly because the emotions associated with pain are negative.”
Among other things, Kelly encourages doctors to allow patients, especially women, take an active role in their treatment, to offer psychological support and relaxation techniques and feedback.

Many older people suffer mild cognitive problems, but men are more likely to suffer momentary memory loss than women, says a U.S. study.

Researchers from the Alzheimer Research Center Mayo in Rochester, Minnesota, concluded that 19 percent of men between 70 and 89 years suffer the so-called “mild cognitive impairment,” compared with only 14 percent of women. People with disabilities have memory problems, but can perform daily activities and be aware that they are forgetful.

National Institutes of Health, United States notes that MCI is an intermediate point between forgetfulness and dementia. Dr. Ronald Petersen said the findings were surprising because Alzheimer’s disease, which usually is preceded by this type of mental decline, affects more women than men.

Even after analyzing the differences in education, age and diseases such as diabetes and hypertension, men had about 50 percent more likely than women to suffer mild cognitive impairment. “The gender differences were somewhat surprising to us, because most people believe that women have a higher risk than men” of getting this type of disease, Petersen told Reuters.

The researcher stated that not everyone with this disability develop dementia, but some people do, so it may be a risk factor for Alzheimer’s, which is the most common form of dementia.

About 15 percent of people with mild cognitive impairment dementia suffering ends, while the rest of the population, the percentage drops to 1 or 2 percent. The study, published in the journal Neurology, has made analysis of 2,000 people randomly selected in Olmsted County, Minnesota.

Investigators spent several hours observing each participant specifically to see if they had any symptoms of mild cognitive impairment or dementia. Around a quarter of the elderly had cognitive problems beyond the normal signs of aging, Alzheimer’s disease.

The mild impairment is more common in older people but also found that the more education a person had received the less likely it was that had this kind of cognitive disorders.

They often suffer from sleep disorders. Usually by disorders of the brain and nervous system: Insomnia, the parasonmias, hypersomnia.

According to Dr. Fernando Caballero Martinez., A specialist in Family Medicine and coordinator of the Family Medicine Teaching Unit, the dream is one of the facets of life that most influences mental health problems, almost all mental illnesses are associated with alterations dream.

Dyssomnias calls or the most common sleep disorders include:
Insomnia

Insomnia is one of the diseases most common sleep, is the inability to achieve normal sleep for the patient’s age. Frequency increases with age. The person suffering from insomnia, has the following features:

Daytime fatigue and moodiness.
Difficulty falling asleep and wake up easily.
Sleeping difficulty produces anxiety.
Lack of concentration and memory.
Ease of accidents because of fatigue.

For insomnia, before taking hypnotics to their risk of dependence, must exhaust the physics that are usually much more effective than pharmacological. This should observe the following rules:

Establish a regular bedtime.
Exercising during the day.
Sleep in a quiet place, dark and good room temperature.
Choosing a bed clothing as pajamas both very comfortable.
Use relaxation techniques for periods of particular tension.
Avoid stimulating or exciting beverages such as coffee or chocolate before going to bed.
Allow to digest before bedtime.
Do not go to bed hungry.

Rhythm disturbances

It is caused by an alteration of the schedule preset by the person at your usual pace. It is normal among the population with shift changes in their working lives. When their turn to change, and sleep during the day, symptoms usually appear this condition. On transoceanic flights (jet lag) and any other situation that disrupts the normal order, as students with exams or companions of patients. This alteration is transient once the cause, the person returns to its normal rhythm.

Parasomnias

The parasonmias are transient sleep disturbances that often occur without the person realizing it. As typical examples sleepwalking, bedwetting, nightmares or night terrors. There are changes that may be a malaise in individuals to meet their daily tasks, but can have serious consequences at times as in the case of sleepwalking may be at risk by the actions carried out during the disturbance as falls or accidents.

The enurosis or involuntary urination in bed during sleep off ages considered normal. It is more common among children, who feel bad about wetting the bed, sometimes they can create conditions such as shame and trouble sleeping away from home.

Hypersomnia

It is contrary to insomnia syndrome, but not exactly too much sleep, but about being sleepy during long hours with a restless sleep that does not reach deep stage and during the day has episodes of drowsiness and fatigue, altering the daily lifestyle.

The most common cause of this disorder is sleep apnea , which consist of a slip that the person is breathing during the night, forcing him to wake up to follow the rhythm of breathing. If these stops occur several times during the night, it is difficult to get restful sleep. It is usually more common among males aged 40 to 50 years and even more in those with problems of obesity, because excess fat in the neck can block the airway. About 2% of the population may suffer from this sleep disturbance.

A problem in the lining of blood vessels may have to do with developing Alzheimer’s disease, according to a recent study. The condition, known as endothelial dysfunction, leading to loss of nitric oxide in the endothelium, the layer of cells lining the blood vessels. Nitric oxide is essential for the widening of blood vessels (vasodilation), which improves blood flow and oxygen delivery and nutrients to tissues.

Previous research has linked endothelial dysfunction with cardiovascular disease. In the new study, researchers at the Mayo Clinic in Rochester, Minnesota, found that endothelial dysfunction increases the production of proteins that provide the raw material for the amyloid plaques observed in the brains of people with Alzheimer’s disease.

The findings are published online December 2 issue of Circulation Research. “As far as cardiovascular, have long known that the preservation of healthy endothelium is essential to prevent major cardiovascular events. Now it seems that this could have important implications for cognitive impairment,” he said in a news release from the American Heart Association Dr. Zvonimir S. Katusic, lead author and professor of anesthesiology and pharmacology at the Mayo Clinic.

Katusic said that the study could help explain how exercise benefits cardiovascular health and brain. Previous research has shown that exercise can delay or prevent cognitive decline.

“A lot of literature showing that every time you exercise, you stimulate the endothelium to produce more nitric oxide. What we have identified in this work may help explain the benefit (cognitive) reported the exercise,” Katusic said.

Increase antipsychotic treatment with biologically active natural product, L-theanine, relieves symptoms in patients with schizophrenia or schizoaffective disorder, a team of Israel published in the Journal of Clinical Psychiatry.

The team of Dr. Vladimir Lerner, Mental Health Center Be’er-Sheva, explains that neuroprotection became the center of the investigation of psychiatric disorders associated with progressive loss of brain tissue.

The L-theanine, experts say, is an amino acid present almost exclusively in the tea plant, Camellia sinensis, to 1 or 2 percent. You can cross the blood brain barrier and is neuroprotective, while improving mood and relaxing. The team tested benefits with a dose of 400 mg L-theanine daily for eight weeks, versus placebo, added to the therapy given antipsychotic treatment 60 patients with schizophrenia or schizoaffective disorder. Forty patients completed the study.

According to Positive Negative Syndrome Scale (PANSS, for its acronym in English), the positive subscale and general psychopathology score decreased significantly with L-theanine therapy than with placebo. The effect was modest for the positive subscale, but “significantly higher” for the general psychopathology. Furthermore, compared with placebo, L-theanine significantly reduced anxiety as Hamilton Rating Scale for Anxiety (HARS, for its acronym in English).

“The positive results encourage the hope that the L-theanine is neuroprotective in people with schizophrenia,” the researchers wrote, adding: “Further studies are needed to verify the clinical benefits of the use of L-theanine.”

Wetting the bed at night is a temporary discomfort, however, is a real problem when it occurs at least three times a week. This condition, known as enuresis, is resolved with age and spontaneously, but affects a large percentage of children. Experts insist to find its cause is critical because, in extreme cases, there is an underlying disorder. In addition, enuresis causes negative psychological and social impact, both for the individual and the family.

Between 3 and 4 years is achieved total control of the sphincters. However, 15% to 20% of children under 5 years wet the bed at night, according to recent data from the Spanish Association of Pediatrics (AEP). Although this disorder, called enuresis, is a common problem often is underdiagnosed. It affects twice as many boys as girls, in all probability a later maturing. It is a condition that resolves spontaneously, with a remission rate of 15% annually, and its prevalence decreased from 10 years.

Children who suffer from enuresis often develop anxiety and reduced self-esteem and emotional stability. Specific problems that hinder normal social activities and affect even the family are, among others, that the little boy refuses to go to camp or stay overnight away from home. Shame is another sign. The visit to the doctor becomes a nightmare, as the demand for those affected is not talk about it or ask about it. It seems reasonable to start treatment when the child is uncomfortable with their symptoms, either by age or by the intensity of the condition.

Recommendations

The first advice is to not throw the specialist press to children, reprimand or punish them for wetting the bed while sleeping, as it is counterproductive. You have to play down the problem and ensure that it is something fixable and that many other children suffer, not to worry too much. Some are useful reward systems such as star charts for dry nights, get up at night or giving a wake at a certain time to come to the toilet, training to control the retention and increase bladder capacity and sometimes, when fluid restriction is almost time for bed.

One of the most effective treatments to solve the problem is the alarm devices that are placed in the underwear and emit a signal to detect the first drops of urine. Although the method with higher cure rates (effective from 60% to 70% of cases with a relapse rate close to 50%) is the slowest (three months) and also requires the collaboration of the whole family. Its aim is to generate a conditioned reflex.

Alternatively, therapy with desmopressin, a drug that increases the reabsorption of fluid from the kidneys and therefore decreases the amount of urine. Although this treatment is often faster (one to two months), does not imply complete cure and relapses are very common. For this reason, the individualized prescription is vital to solve the problem permanently. Other drug treatments include tricyclic antidepressants, and anticholinergics.

Research in the U.S. states that HIV-infected patients are three times more likely to suffer a stroke than people not infected with the virus that causes AIDS. Scientists say they still do not know what could be the cause, but suspect it may be due to antiviral treatment taking these patients.

Another reason, they say, is because patients with HIV can now live longer thanks to these drugs and, therefore, older than the risk of stroke. “Although these therapies have greatly increased the expectations of life also could have stimulated the presence of risk factors associated with stroke, “he told BBC, Bruce Ovbiagele, a researcher who led the study.

This research, published in Neurology, the journal of the American Academy of Neurology, also found that HIV patients showed an increase in the number of spills of ischemic, but not in hemorrhagic.Un ischemic stroke is caused by a clot and is the most common type of stroke.

The human brain has been reduced in the past 30,000 years to the extent that during that time, has lost the size of a tennis ball. This trend baffles scientists. Are we becoming more stupid or, conversely, our brain is transformed to be more agile and efficient? The way in which we live, how we face the world and the demands of everyday life far from those that had, for example, a Neanderthal.

After taking measurements of skulls found in Europe, Middle East and Asia, scientists have concluded that the average size of the brain of modern humans, Homo sapiens has been reduced by 10%, and has grown from 1500-1359 cc. Women, whose brain is smaller than the male, have experienced an evolution equivalent.

Some anthropologists believe that this reduction is not as surprising as the bigger and stronger we are, more gray matter we need to control all that mass. Neanderthal man, a relative of modern man who disappeared about 30,000 years ago for unknown reasons, it was bigger and had larger brains. Cro-Magnon cave paintings left by animals in the monumental Lascaux cave 17,000 years ago, Homo sapiens was the biggest brain. They were also stronger than their modern descendants. Psychology professor David Geary, University of Missouri, believes that these features were necessary to survive in a hostile environment.

Geary complex social environment has studied the evolution of skull sizes from 1.9 million to 10,000 years old, while our ancestors lived in a social environment increasingly complex. Geary and colleagues used population density as a measure of social complexity, with the assumption that the closer humans live, the greater is the exchange between the group, the division of labor and rich and varied interactions between the people.

The scientists found that brain size decreased with increased population density. “As complex societies emerged, the brain became smaller because people do not have to be so smart to stay alive,” says Geary.

But the reduction does not mean that modern humans are dumber than their ancestors. Instead, simply evolved differently, even more sophisticated intelligence, says Brian Hare, an assistant professor of anthropology at Duke University.

The same phenomenon is observed in domestic animals compared to wild specimens. Thus, the Huskies pued
to have smaller brains than wolves, but they are more intelligent and sophisticated as they can understand the human communicative gestures, behaving like a small child. “Despite that a wolf has a much larger brains than dogs Dogs are much more intelligent and flexible, so that intelligence is not directly related to brain size, “Hare explained.

Insomnia is more common in women because of hormonal changes that occur prior to menopause and the responsibility of heads of households, revealed Isabel Tagle, head of the Sleep Laboratory of the National Institute of Neurological Sciences.

He explained that during the hours of sleep, the body not only recovers energy but help the learning process in children, increases the immune system and memory remains active. “A person who does not sleep well, ie if your sleep is interrupted, it is more likely to get the flu, infectious problems, is more irritable, non-profit to develop their daily tasks, even in chronic cases can cause forgetfulness”, said the specialist.

He added that the quality of sleep is related to the quality of life and longevity of people, and recommended to those suffering from sleep disorders, take a nap in the afternoon from 15 to 20 minutes. “The time off is related to age. A newborn should sleep between 14 and 16 hours, a child between 4 and 8 years old, ten hours, one between 8 and 12 years, eight hours for adults, seven hours, and the elderly, between four and five hours, “he said.

INCN The specialist recommended removing the equipment room as the TV, radio or computer, because they can cause insomnia. He also indicated that you should avoid the consumption of chocolates, coffee, tea or drinks that contain caffeine before bedtime. To relax you can drink milk with honey or warm water, and develop habits such as reading in bed.

Iberoamerican Academy of Pediatric Neurology (AINP) legally began in 1992 in Avila (Spain), founded by a group of Latin American pediatric neurologists who had completed three graduate courses in pediatric neurology at Miami, and Cancun Margarita. These courses were successful not only in establishing links of friendship, affection and respect, but in exchange knowledge in order to unify and improve treatment of children with central nervous system diseases. Objectives. It describes the origins and history legalization of the organization in its 10 years of work, highlighting the reason that led to its founding and its subsequent evolution. We must know our history and provenance is vital for developing countries and institutions to which we belong. Conclusions. The AINP has grown rapidly and plays an important role in the development of the Latin American Pediatric Neurology in several respects: first, continuing medical education, our annual conference, and secondly, to implement training of young physicians full graduate courses or partial updates of doctors who are studying in their home country training in pediatric neurology. In all Latin American countries should seek to pediatric neurology is recognized by the governments.