Cu(II) binding to the λ6aJL2-R24G antibody light chain protein associated with light chain amyloidosis disease: The role of histidines.

Light chain amyloidosis is a conformational disease caused by the abnormal proliferation and deposition of antibody light chains as amyloid fibers in organs and tissues. The effect of Cu(II) binding to the model recombinant protein 6aJL2-R24G was previously characterized in our group, and we found an acceleration of the aggregation kinetics of the protein. In this study, in order to confirm the Cu(II) binding sites, histidine variants of 6aJL2-R24G were prepared and the effects of their interaction with Cu(II) were analyzed by circular dichroism, fluorescence spectroscopy, isothermal calorimetry titrations, and molecular dynamics simulations.

Humoral Response to SARS-COV-2 Vaccination in Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Real-World Study.

Introduction: The risk of SARS-CoV-2 infection or severe coronavirus disease 2019 (COVID-19) has been shown to increase in patients with multiple sclerosis (MS). Vaccination is recommended in this patient population, and the effect of disease-modifying treatments (DMTs) on response to vaccination should be considered.

Methods: This prospective, observational, cross-sectional study investigated humoral response after COVID-19 vaccination as well as possible predictors for response in patients with MS and other neuroinflammatory diseases who received DMTs in routine clinical practice in Spain.

Treatment with natalizumab during pregnancy in multiple sclerosis: The experience of implementing a clinical practice protocol (NAP-30).

Background: Pregnancy planning in women with highly active multiple sclerosis (HAMS) who need a high-efficacy disease-modifying therapy (heDMT) currently requires a careful risk-benefit evaluation. This includes minimizing fetal drug toxicity and preventing MS reactivation. We describe our experience with natalizumab in women with HAMS and unplanned pregnancy by implementing a clinical practice protocol (NAP-30) designed to maintain the effectiveness of natalizumab during pregnancy, reduce fetal exposure and prevent complications.

Trends in hospitalisation for ischaemic stroke in young adults in the region of Murcia (Spain) between 2006 and 2014.

Introduction: Recent studies conducted in Europe and the United States suggest upward trends in both incidence and hospitalisation rates for ischaemic stroke in young adults; however, data for Spain are scarce. This study analyses the trend in hospitalisation due to ischaemic stroke in adults aged under 50 years in the region of Murcia between 2006 and 2014.

Method: We performed a retrospective study of patients discharged after hospitalisation due to cerebrovascular disease (CVD); data were obtained from the regional registry of the Minimum Basic Data Set.

Prevention of rebound effect after natalizumab withdrawal in multiple sclerosis. Study of two high-dose methylprednisolone schedules.

Background: Natalizumab (NTZ) is a disease-modifying treatment (DMT) in multiple sclerosis (MS) whose discontinuation can produce a "rebound effect", consisting of severe clinical deterioration and/or evidence of disease reactivation on magnetic resonance imaging (MRI).

Objective: To analyze the efficacy of two treatment schedules with intravenous methylprednisolone (IVMP) administered during the washout period of natalizumab (i.e.

Pulse immunosuppressive therapy for multiple sclerosis during the SARS-CoV-2 lockdown de-escalation plan: Safety algorithm.

Introduction: The COVID-19 pandemic is changing approaches to diagnosis, treatment, and care provision in multiple sclerosis (MS). During both the initial and peak phases of the epidemic, the administration of disease-modifying drugs, typically immunosuppressants administered in pulses, was suspended due to the uncertainty about their impact on SARS-CoV-2 infection, mainly in contagious asymptomatic/presymptomatic patients. The purpose of this study is to present a safety algorithm enabling patients to resume pulse immunosuppressive therapy (PIT) during the easing of lockdown measures.

[Thymectomy in thymomatous and non-thymomatous myasthenia gravis: analysis of a cohort of 46 patients].

Introduction: Factors predicting remission after thymectomy for myasthenia gravis are not well known.

Aim: To analyze the clinical evolution of the patients after this intervention and discuss about predictors of response.

Patients And Methods: We retrospectively reviewed all clinical data of thymectomies in myasthenia gravis patients performed at our hospital between 2006 from 2016.

Trends in hospitalisation for ischaemic stroke in young adults in the region of Murcia (Spain) between 2006 and 2014.

Introduction: Recent studies conducted in Europe and the United States suggest upward trends in both incidence and hospitalisation rates for ischaemic stroke in young adults; however, data for Spain are scarce. This study analyses the trend in hospitalisation due to ischaemic stroke in adults aged under 50 years in the region of Murcia between 2006 and 2014.

Method: We performed a retrospective study of patients discharged after hospitalisation due to cerebrovascular disease (CVD); data were obtained from the regional registry of the Minimum Basic Data Set.

[Why is reperfusion therapy delayed in stroke code patients? A qualitative analysis].

Background: Efficacy and safety of reperfusion therapy in acute ischaemic stroke is time-dependent and has a limited therapeutic window, which is, in fact, the main exclusion criterion. Initiatives to evaluate the quality of care are essential to design future interventions and ensure the shortest management times and application of such treatments.

Objective: The aim of the study is to identify and classify potential causes of delay in the administration of reperfusion therapy in a tertiary hospital, a reference for the comprehensive treatment of acute ischaemic stroke.

[Identification of the factors conditioning times and indicators of quality in the intrahospital care of acute stroke].

Introduction: Stroke is a serious but potentially reversible entity. Reducing the time of care in the acute phase is essential to limit morbidity and mortality. The evaluation of the performances in stroke care is essential because it allows identify opportunities for improvement.

Neurophysiology training in the Neurology Specialist Education Program in Spain.

Introduction: The training period in neurophysiology is a substantial part of the Neurology Specialist Program in Spain. The National Neurology Committee (La Comisión Nacional de Neurología (CNN), which is the body reporting to the Ministries of Health and Education, must ensure compliance to the Program.

Material And Methods: During the first trimester of 2008, the CNN sent a questionnaire, in which there was a question asking about this training period, to each of the managers of the 69 teaching units accredited for neurology training in Spain, for them to answer.

[Specific neurology emergency training of medical residents in Spain].

Introduction: Training in emergency neurological illness is very important for the neurologist today. The Neurology National Commission has decided to obtain information on the work duties of neurologist residents in the different neurology units of the hospitals of our country and the supervision of the training in urgent pathology.

Method: A survey of adult neurology program directors to find out if their hospital fulfils the program criteria for the residents duty work.

[Quality of records in OMI-AP of the patients with stroke followed in primary care].

Objectives: 1) To determine the level of registration and control of cardiovascular risk factors in stroke patients treated in primary care in Murcia through electronic medical records. 2) To describe the registered drug treatment in patients with stroke.

Material And Methods: Observational descriptive, retrospective, evaluated through the records in OMI (electronic medical records) in all areas of Murcia Health Service.

[Analysis of the neurology teaching unit in Spain and compliance of accreditation criteria].

Introduction: Faced with the promulgation of the Health Care Professionals Ordinance Law and the publication of the new program of the Neurology training, the National Committee of neurology has considered it necessary to know the current situation of the Teaching Units (TU) accredited for the neurology training in regards to the existing accreditation criteria (AC). The purpose of this study is to know said situation.

Methods: A cross-sectional study performed by a voluntarily filled-out survey (ad hoc questionnaire) sent by regular mail in the year 2005 to all the TU accredited at that time.

[Use of extra-hospital emergency systems in the treatment of acute stroke in the region of Murcia. Possible repercussions on the urgent care of stroke patients].

Aim: To examine the use of extra-hospital emergency systems in the urgent care of stroke patients in our region and their influence on the time required to reach hospital, the time needed to perform an urgent computerised axial tomography (CAT) scan and the delay in receiving attention from the specialist.

Patients And Methods: Samples were collected from 232 stroke patients out of the total number admitted to our hospitals. Data about the stroke were collected prospectively, and included the arrival time, the time required to perform the CAT scan and the time the specialist devoted to attending the patient.

[Megadolicobasilar, ulcerative colitis and ischemic stroke].

Megadolichobasilar (MDB) is a rare arterial anomaly consisting of excessive elongation, widening and tortuosity of the basilar artery. It may be associated with different neurological disturbances, including cerebral ischemic stroke, compression of the cranial nerves, hydrocephalus, headache and vertigo. Ulcerative colitis (UC) is an inflammatory bowel disease of unknown aetiology which may be complicated by arterial or venous cerebral illness, among others neurological anomalies.

[Paraneoplastic cerebellar degeneration as initial presentation of a pancreatic small-cell carcinoma].

Introduction: Oat (small) cell carcinoma is the type of tumour most frequently associated to neurologic paraneoplastic syndromes. It is usually located in the lungs although it has been described in some other locations. Cerebellar symptoms may appear alone, associated to anti Yo antibodies ( Breast and gynaecologic carcinomas), or as manifestation of a more generalized paraneoplastic encephalopathy, associated to signs and symptoms of some other neurologic systems affected.

[Fever of central origin during stroke].

Introduction: Fever appears in a fourth of stroke, approximately. Its origins, (the most of them are infectious) are unknown in a minority of the cases. Some hypotheses indicate that central mechanisms like hypothalamic lesions or segregation of endogenous pyrogens may be implicated.

[Kinesigenic paroxysmal choreoathetosis: contribution of SPECT].

We report two unrelated patients affected of kinesigenic paroxysmal choreoathetosis (CPC), during a symptomatic period. Routine complementary exams were normal. The 99mTc-HMPAO cerebral SPECT showed hyperactivation in the basal ganglia opposite to the choreoathetosic symptoms and reduced untake in the near parietal and subcortical zones in one case.

Brainstem lesions decrease heart rate variability.

Objective: Brainstem is an essential region in the regulation of the autonomic cardiovascular functions. Some authors have reported that medulla oblongata is very important in this regulation, but probably is not the unique because the sympathetic cardiovascular centers are spread in the brainstem. Since some years ago, we are able to measure heart rate variability which is a useful tool for assessing quantitatively both sympathetic and parasympathetic autonomic effects on the heart.