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Background: Alzheimer's disease (AD) presents a significant global health challenge. Understanding the current and upcoming treatment landscape is crucial for effectively managing patients., Objective: The aim of this study was to assess the pattern of prescription and knowledge about new therapies by physicians who treat AD patients in Argentina., Methods: A cross- sectional and analytic study was conducted. A survey was elaborated about pharmacological treatment in AD. Statistical analysis of answers of specialists in cognitive disorders (SCD), non-specialists in cognitive disorders (NSCD), recommended treatment, non-recommended treatment (NRT), and off-label treatment was performed., Results: 155 physicians answered the survey. A 19.35%prescribed at least one NRT for dementia. 78.06%prescribed at least an off-label treatment or an NRT for mild cognitive impairment (MCI). 31%would prescribe monoclonal antibodies (MABs) against cerebral amyloid-β (Aβ) to AD patients, and 42.6%responded that they were not aware of any adverse effect of these. Quetiapine was the most frequent treatment for psychotic symptoms (88.4%) and escitalopram (32.3%) for apathy. A 70%of potential prescribers of MABs ( n  = 100) would request biomarkers of cerebral Aβ in the initial assessment. There were significant differences between the responses of SCD and NSCD regarding the prescription of MABs (52.17%versus 23.08, respectively) and knowledge about adverse events (76.09%versus 38.46%, respectively)., Conclusions: A considerable percentage of physicians indicated NRT and off-label medication in MCI and dementia. In Argentina, there are many physicians who would indicate a MABs for AD, but many are not completely aware of its safety profile., Competing Interests: The authors have no conflict of interest to report., (© 2024 – The authors. Published by IOS Press.)

Introduction: Restless legs syndrome (RLS) is a movement disorder characterized by an uncontrollable urge to move the legs in response to an unpleasant sensation. The coexistence of RLS and other sleep and mood disorders may require adjustment in the therapeutic strategy. The objective of this study was to determine the prevalence of RLS in adults studied with polysomnography and to evaluate its association with other sleep and mood disorders., Patients and Methods: Descriptive cross-sectional study. We included adults studied with polysomnography between 2015 and 2021. We collected information on their medical history, polysomnographic data and mood and sleep disorders using a self-administered written questionnaire which is part of the routine evaluation of all patients referred to this sleep unit. These variables were compared between patients with and without RLS., Results: We included 406 patients. The prevalence of RLS was 36.7% (n = 149). The presence of fatigue (45.3%), moderate to severe insomnia (38.9%) and depression (45.6%) was higher in subjects with RLS. We did not find differences regarding daytime sleepiness and anxiety symptoms. Periodic Limb Movements (PLM) was not associated with RLS (p = 0.26) and its prevalence was low., Conclusion: The prevalence of RLS in subjects studied with Polysomnography is high and it was associated with clinically significant fatigue, insomnia and depression. These symptoms should be identified in order to establish an adequate therapeutic strategy. The prevalence of periodic limb movements was low and was not linked with RLS. These findings contrast with previous publications. Therefore, it requires additional studies to clarify the cause of this variation.

Introduction: Triphasic waves (TW) constitute an electroencephalographic pattern associated with certain kinds of encephalopathy. Brain atrophy may be a predisposing factor linked with TW., Objective: To compare the degree of brain atrophy and white matter disease between patients with acute encephalopathy with and without TW., Methods: A retrospective observational study including adult patients with encephalopathy, with and without TW, hospitalized between 2016 and 2017. The degree of brain atrophy and white matter lesion were defined using the Global Cortical Atrophy and Age Related White Matter Changes (ARWMC) scales, respectively. Scores were compared between groups. Mortality rates were registered., Results: Sixteen patients with TW were identified matched by age and sex with 30 patients without TW. The mean age was 80 years in the TW group. Women represented 87.5%. Multifactorial encephalopathy was the most frequent diagnosis followed by metabolic encephalopathy. Patients with TW had more brain atrophy (10.43 vs 6.9, p = 0.03). Mean ARWMC was 9.43±6.5 and 8.5 ±7.89 in patients with and without TW respectively ( p = 0.5). Mortality rate was higher in the TW group (31.25 vs 6.66% p = 0.02)., Conclusions: Patients with acute encephalopathy and TW had higher degree of cerebral atrophy. It is possible that this structural alteration predisposes to the appearance of TW. There was no significant difference in white matter lesion degree. The mortality of the TW group was high, so future studies are necessary to determine their prognostic value., Competing Interests: Conflicts of interest: Authors declare that they have no conflicts of interest in regard to the content of the present study, (Copyright © 2022 Colombia Medica.)

Introduction . In clinical practice, it is difficult to define the prognosis of patients with acute encephalopathy; a syndrome characterized by cognitive dysfunction and altered sensorium. Discharges with triphasic morphology (DTM) are an electroencephalographic pattern that might be useful to establish the risk of death. The aim of this study was to define the prognostic value of DTM regarding mortality in patients with acute encephalopathy. Methods . We conducted an observational retrospective cohort study including patients with acute encephalopathy with and without DTM paired by age and gender in a 1:2 ratio. We calculated the odds ratio (OR) to determine the association between DTM and mortality. In addition, we calculated sensibility, specificity, and predictive values. Results . We included 72 patients, 24 with DTM and 48 without DTM. Mortality was higher in patients with DTM (41.6% vs 14.5%, P   =  .01). Factors associated with a higher risk of death were DTM (OR  =  4.1, 95% confidence interval [CI] 1.3-13, P   =  .01) and sequential organ failure assessment score (OR  =  1.3, 95% CI 1.04-1.67, P   =  .02). A higher Glasgow coma scale score was associated with a lower risk of death (OR  =  0.65, 95% CI 0.51-0.83, P   =  .001). The sensibility and specificity of DTM were 59% and 75%, respectively. Positive and negative likelihood ratios were 2.36 and 0.55. Discussion . Our results revealed high mortality in patients with acute encephalopathy and DTM. This electroencephalographic pattern was associated with 4 times higher risk of death. However, its usefulness for predicting death was limited.