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The Participation of Ca2+ Channels in Epilepsy: A Bibliometric Analysis of the Scientific Literature in Latin America.

Bibliometric analysis allows us to quantify and evaluate scientific activity, and it has become increasingly important in all areas of scientific literature. Thanks to these analyses, we can infer where science should put greater efforts into elucidating the underlying mechanisms of diseases that have yet to be fully described or investigated. This paper delves into published articles related to the involvement of calcium (Ca2+) channels in epilepsy, which is a condition with a high prevalence in Latin America. We followed the scientific publication on SCOPUS and analyzed the impact of publications from Latin America in the field of epilepsy and the study of Ca2+ channels. We identified the countries with the largest number of publications and found that 68% of them were experimental (animal models), while 32% were clinical. We also identified the main journals, growth over time, and citation numbers. We found a total of 226 works produced by Latin American countries from 1976 to 2022. The countries that have contributed the most to the topic are Brazil, Mexico, and Argentina, with occasional collaborations between them to make contributions to the study of epilepsy and Ca2+ channels. Additionally, we found that the journal with the most citations is Nature Genetics. The number of authors per article ranges from 1 to 242, and neuroscience journals are the preferred target for researchers, with a predilection for publishing original articles, although 26% of the publications are review articles.

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Qualitative study exploring health professionals’ experiences concerning dementia in Mexico with a policy analysis perspective

Abstract Background Dementia has been declared a priority public health problem, however there still a need for policies to be put in place. Mexico, as a developing nation, has taken some policy actions but there still much to be done. In this paper, we analyze the experiences of service providers to people with dementia. This qualitative study identifies barriers and opportunities to promote policy change. Methods Data was collected through 30 in-depth interviews based on a semi-structured guide with health professionals - Geriatricians, Neurologists, Psychiatrists, Family Practitioners - who care for people with dementia, and researchers in health research institutions. For the analysis, the Policy Space framework was used. Results The care for dementia people is performed by medical specialists whose approach depends on their type of training. Some of the barriers identified are that care is provided in a fragmented manner depending on each institution, and people with dementia are arriving late to the health services. Opportunities found to be promoted in public agendas are early identification of cognitive impairment and leverage prevention of chronic diseases like hypertension and diabetes. Conclusions There is evidence for the need to take action, and various initiatives are available, but the challenge remains to put policies for the care of dementia syndromes on the public health agenda.

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Disrupting the epileptogenic network with stereoelectroencephalography-guided radiofrequency thermocoagulation.

Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RF-TC) is a treatment option for focal drug-resistant epilepsy. In previous studies, this technique has shown seizure reduction by ≥50% in 50% of patients at 1 year. However, the relationship between the location of the ablation within the epileptogenic network and clinical outcomes remains poorly understood. Seizure outcomes were analyzed for patients who underwent SEEG-guided RF-TC and across subgroups depending on the location of the ablation within the epileptogenic network, defined as SEEG sites involved in seizure generation and spread. Eighteen patients who had SEEG-guided RF-TC were included. SEEG-guided seizure-onset zone ablation (SEEG-guided SOZA) was performed in 12 patients, and SEEG-guided partial seizure-onset zone ablation (SEEG-guided P-SOZA) in 6 patients. The early spread was ablated in three SEEG-guided SOZA patients. Five patients had ablation of a lesion. The seizure freedom rate in the cohort ranged between 22% and 50%, and the responder rate between 67% and 85%. SEEG-guided SOZA demonstrated superior results for both outcomes compared to SEEG-guided P-SOZA at 6 months (seizure freedom p = .294, responder rate p = .014). Adding the early spread ablation to SEEG-guided SOZA did not increase seizure freedom rates but exhibited comparable effectiveness regarding responder rates, indicating a potential network disruption.

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Stem Cell Markers in Neoplasms and their Relationship with Progression-free and Overall Survival in Patients with Recurrence.

Gliomas account for 30% of primary brain tumors in adults, and despite the scientific progress in the field, recurrence is prevalent. Glioma Stem Cells (GSCs) can generate tumor cells in vivo and in vitro and they are associated with treatment resistance, tumor progression, and recurrence. Furthermore, the expression of SOX transcription factors (SOX1, SOX2, SOX9) in these cells is responsible for maintaining an oncogenic genotype and is associated with an aggressive tumor phenotype. The relationship between SOX transcription factors and their prognostic role in recurrent gliomas has not been described in detail. Therefore, we set out to describe the relationship between SOX expression and Progression-free Survival (PFS) and Overall Survival (OS) in patients with recurrent gliomas. In this observational study, we have retrospectively analyzed 69 patients, of which 20 met the inclusion criteria. The clinical, radiological, and histopathological findings have been described, and survival analysis has been performed according to SOX expression for PFS and OS. We found SOX1, SOX2, and SOX9 to show a non-statistically significant trend with increasing histopathological grade, co-expressed with Ki67, a cell proliferation factor. There has been found an inversely proportional correlation between the degree of immunopositivity of SOX1 and OS. A higher SOX1 immunopositivity could predict a worse clinical prognosis. There has also been found an interaction between a pluripotent genotype (GSC) and cell proliferation.

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Presymptomatic Testing for Huntington's Disease in Mexico: 28 Years of Experience

IntroductionHuntington's disease (HD) is a genetic neurodegenerative disorder with dominant inheritance. Our center in Mexico City has offered presymptomatic testing (PT) since 1995. ObjectiveTo describe the main clinical and demographic characteristics of at-risk HD individuals who applied to the PT program, the reasons for seeking it, and the molecular results. MethodsA cross-sectional study was conducted with sociodemographic and clinical data of all PT applicants from 1995–2023. Reasons for seeking PT were assessed using a modified questionnaire. In addition, anxiety, and depressive symptoms before and after PT were evaluated with Beck's instruments; cognitive impairment (CI) was assessed with the Mini-Mental State Examination (MMSE) and molecular results. Results214 people applied for PT (2.1% of the at-risk population identified in our center); 63% were women (mean age of 37.11 years). 204 (95.3%) were accepted and 190 received results. 70% indicated that the main reason for applying for PT was to inform their offspring about the risk of inheriting HD. Significant differences were observed in the reasons for seeking PT by age group. Although some subjects received treatment, Beck's instrument scores did not indicate special attention or pharmacological treatment. The MMSE showed probable CI in 20 subjects. Of those who received results, 37% were carriers of a full penetrance allele. ConclusionOur center has the only formal PT program for HD in Mexico. The reasons for seeking PT are varied and age-related. Although PT is offered to all subjects at risk for HD, uptake remains low.

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Surgical treatment of pituitary neuroendocrine tumors with coexisting intracranial lesions: A case series and review of the literature.

Pituitary neuroendocrine tumors (PitNETs) are a diverse group of benign neoplasms that account for a significant proportion of intracranial tumors (13%). The coexistence of PitNET with other intracranial lesions, such as meningiomas and intracranial aneurysms, has been constantly reported in the literature; yet, the pathophysiological mechanisms remain unknown, and the appropriate management is controversial. This study aims to describe the clinical characteristics, surgical treatment, and outcomes of patients with PitNET with coexisting intracranial lesions in a single healthcare center. A retrospective analysis was conducted on 12 patients who underwent surgical treatment for PitNET and another intracranial lesion at our single tertiary referral center over 15 years from January 2008 to May 2023. Among these coexisting lesions, aneurysms were the most commonly found (41.67%), followed by meningiomas (33.33%). Surgical intervention for both lesions was performed in a single-stage procedure for most cases (75%), employing transcranial, endoscopic endonasal, and combined approaches. We found low preoperative Karnofsky Performance Scale scores in three patients, with significant differences in functional outcomes. These findings contribute to the limited knowledge about PitNET coexisting with other intracranial lesions and emphasize the importance of patient-tailored, multidisciplinary management in these unusual scenarios.

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Reporting of participant race and ethnicity from COVID-19 randomized controlled drug and biologicals trials: a scoping review

Abstract Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials according to study-level characteristics of randomized controlled trials (RCT) that test effectiveness of COVID-19 drugs could be insightful for future researchers. The objective of this scoping review was to describe frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in Pubmed, ProQuest, WHO Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from 1/1/2020 to 5/4/2022. We included RCTs on emergency- or conditionally-approved COVID-19 drug interventions (remdesivir, barcitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. A total of 17 RCTs with 17935 participants was included. Most (n=13, 76%) reported at least one race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-flow oxygen/non-invasive ventilation. Time to recovery was assessed predominantly in Black and White participants, while hospitalization or death was mostly assessed in Asian, Latinx, and multi-race participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation. Registration: Open Science Framework: https://osf.io/3dx4f/?view_only=d1af00d952cc472b803df5297bce9a80

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Treatment strategies for saccular anterior inferior cerebellar artery aneurysms: a systematic review.

The anterior inferior cerebellar artery (AICA) plays a crucial role in cerebellar blood supply, and AICA aneurysms are relatively rare, comprising less than 1-1.5% of all brain aneurysms. Understanding their clinical scenarios, management approaches, and outcomes is essential. This systematic review analyzes data from 86 studies to comprehensively explore AICA aneurysms. The process of obtaining relevant research, which includes patients with AICA aneurysms, was carried out using the PubMed, Web of Science, and Scopus databases. This review exclusively included extensive papers written in English. The search included the MeSH phrases "Anterior inferior cerebellar artery aneurysm" and "AICA aneurysm." Microsurgical and endovascular treatments were compared using statistical analysis, exploring demographics, risk factors, treatment modalities, and clinical outcomes. The review includes 85 case reports and one retrospective study, totaling 140 patients. The study reveals a diverse patient profile with a slight female predominance (65%), a mean age of 50.7 years, and an 82.86% prevalence of no identified risk factors. Ruptured aneurysms accounted for 55%, with microsurgery and endovascular procedures accounting for 70.71% and 27.86%, respectively. The mortality rate was 2.86%, and no significant differences were found in rebleed, recurrence, or mortality rates between treatment groups. Microsurgical and endovascular interventions demonstrate comparable effectiveness, with microsurgery showing superiority in specific situations. Therefore, tailoring treatment is crucial to individual patient needs. Subgroup analyses highlight demographic-specific trends, guiding clinicians in managing this rare pathology.

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Combined endoscopic transorbital and transnasal approach for the management of a solitary plasmacytoma of the sphenoid bone: A case report and literature review.

Parasellar plasmacytomas are rare neurosurgical entities. Intrinsic characteristics of these tumors, such as adjacent bone erosion and symptoms resulting from invasion and mass effect, may lead to the possibility of a solitary extramedullary plasmacytoma (SEP) as a differential diagnosis. We present the case of a 39-year-old male with a 1-month history of bilateral decreased visual acuity, retroocular pulsating pain, and chromatic vision loss. A computed tomography scan of the head revealed a parasellar lesion causing chiasmatic compression, as well as clival, orbital, sphenoidal, and ethmoidal invasion. A combined transorbital and endonasal endoscopic approach was found suitable, and gross total resection was achieved. Histological analysis of the lesion established the diagnosis of a SEP. After radiotherapy, a new magnetic resonance imaging was performed, revealing a recurrence of the lesion with a high grade of invasion. The patient was treated with palliative radiotherapy, as surgical resection did not seem feasible. Surgical resection and radiotherapy may achieve remission of these lesions; however, recurrence rates remain high despite any treatment modality. Patients with this condition must be followed up with a multidisciplinary team due to the high risk of multiple myeloma progression.

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