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There are stressors arising in the workplace that influence emotional exhaustion, depersonalization and lack of personal fulfillment of workers; the most vulnerable populations are those who have contact with the public. The aim of this study was to assess the prevalence of depressive symptoms and burnout syndrome in staff of the National Institute of Neurology and Neurosurgery. The Burnout Inventory (MBI-HS) and the Beck Depression Inventory (BDI) were applied. Secretarial staff presented the higher rate of depressive symptoms. Concerning the MBI-HS differences were found regarding the lack of personal accomplishment and feelings towards patients according to the different categories of workers.

Background: Guillain-Barré syndrome (GBS) is an immune- mediated polyradiculoneuropathy, generally post-infectious, and is the leading cause of acute flaccid paralysis worldwide. Objective: To describe the epidemiological, clinical and behavioral characteristics of Guillain-Barré syndrome. Material and methods: An observational, cross-sectional and descriptive study was carried out. The records of all patients with GBS from 2012-2022 were reviewed, and information on epidemiological and clinical variables was obtained. The incidence was calculated for each of the study years and the trend for the study period using the Pearson correlation coefficient, considering p ≤ 0.05 statistically significant. Results: A total of 477 cases were obtained, 67% were men, among the comorbidities, drug addictions were present in 31% of the cases. Most cases were preceded by a gastrointestinal infectious condition. The most common phenotype was acute motor axonal neuropathy. 29% showed up in summer. A statistically significant tendency to increase was observed (p ≤ 0.05) and a mortality of 2.5% with predominance in the axonal variety. Conclusions: The results of this study cover a relatively long period compared to other reviews, the findings agree with previous studies. GBS showed a statistically significant tendency to increase. [ABSTRACT FROM AUTHOR]

Objective: To describe the behavior of neoplasms presentation of the central and intracranial nervous system, in a Mexican health institution specialized in neurosurgical sufferings. Methods: A descriptive study was carried out in a sample was made up of 7768 patients with histopathological diagnosis neoplasms of central and intracranial nervous system. They were assisted at the National Institute of Neurology and Neurosurgery, from Mexico City, from 2006 to 2017. The variables studied were the incidence and year of presentation of tumors, type of tumor, sex and age of presentation. Depending on the morphological and immunohistochemical diagnosis of tumors, these were categorized in accordance with the classification of tumors by 2007 WHO Central Nervous System. Simple frequencies were obtained; the incidence reason was calculated for each category. The trend over time was analyzed with the Pearson correlation coefficient; a p= 0.05 was considered statistically significant. Results: The general incident rate was 70.2 x 100 biopsies-year. The most frequent tumors were neurepithelial tissue (30.8%) and meninges (27.6%), with predominance in women (p <0.05). An increase in embryonic tumors (p <0.005) was evidenced. Conclusions: A tendency was not found in the increase of tumors of the central nervous system over the period studied. However, the incidence of this type of neoplasms is high. They cause high mortality and disability in those who have them. [ABSTRACT FROM AUTHOR]

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Hospital mortality during the weekends has been widely studied; however, it is still controversial. Aspects of medical care in health institutions and specific factors to which individuals are exposed during weekends have been considered as its origin. Material and methods: an observational, transversal and descriptive study was conducted. We analyzed all deaths occurred at National Institute of Neurology and Neurosurgery of Mexico City from 2007 to 2011, the frequency of occurrence with respect to t days of the week, various shifts of hospital care, and hospital services in which they occurred. Simple frequencies and measurements of central tendency were obtained; Chi2 was used to compare the proportions. Results: the mortality rate was 4 per each 100 discharges. There was no increment in mortality rate during the weekends; mortality rate was bigger on Mondays (17.7%). The largest number of deaths occurred during the night shift (p = 0.00006). [ABSTRACT FROM AUTHOR]

The sleep is defined as a state of unconsciousness from which one can take out the person with sensory or other types of stimuli. The sleep and wake cycle, as many other physiological activities, have a circadian periodicity of approximately 24 hours. Different hormones have been studied to know their relationship with sleep. There are some reports of experimental studies in humans to determine the relationship between the physiological prolactin levels and sleep. The experiments in animals reports the relationship but with abnormal levels of prolactin. There is still a controversy regarding the relationship between the abnormally elevated levels of prolactin and the sleep architecture. [ABSTRACT FROM AUTHOR]

Introduction: The new procedures and the radiological studies have reduced the uncertainty of physicians diagnosis. Imaging studies through Magnetic Resonance provide the information of some organs, about their functions and images in various levels. The introduction of imaging studies such as the Magnetic Resonance has increased the evaluation cost of patients. Sometimes, physicians use indiscriminately these studies. Material and methods: In this study we evaluate relevancy and prevalence of prescribing Magnetic Resonance studies in the National Institute of Neurology and Neurosurgery in Mexico City. The relevancy of the number of studies requested by doctors, according to the decease was 84%. Results: The 91% of the requested studies was for the area of External Consultation and the remaining for the area of hospitalization. Initial clinical diagnosis coincided with the result reported in the MRI study 79.5%. Conclusion: In general, this study didn't show an indiscriminate use of Magnetic Resonance studies on behalf of doctors, nevertheless, it is necessary to evaluate as a routine the clinical diagnosis and the definitive diagnosis agreement. [ABSTRACT FROM AUTHOR]

Introducción: dentro del grupo de las encefalopatías espongiformes transmisibles, se encuentra la enfermedad de Creutzfeldt Jacob (ECJ), cuyas primeras descripciones de la enfermedad se remontan al año de 1920. Este es un padecimiento poco frecuente, que afecta al sistema nervioso central, subagudo y con desenlace fatal. Se considera como agente infeccioso a los priones, al parecer se presenta de manera esporádica, como resultado de la exposición de productos contaminados y en otros casos es hereditaria. Es un padecimiento que ocasiona una disminución rápidamente progresiva de las funciones mentales y de los movimientos. Se presenta de manera esporádica y ataca a una de cada 1,000,000 de personas. Se presenta por Io general en personas de mediana edad, con una edad promedio de 50 años. Objetivo: describir las principales características epidemiológicas, clínicas e histopatológicas de los pacientes con ECJ, cuyo egreso hospitalario fue el de ECJ. Material y métodos: mediante un estudio observacional, transversal y descriptivo se recolectó la información de todos aquellos casos con el diagnóstico de la ECJ, atendidos en el INNN, durante del periodo comprendido del 01 de Enero del 2000 al 31 de Enero del 2005. La información sobre los resultados (interpretaciones) de laboratorio y gabinete se obtuvo de cada uno de los expedientes clínicos de los pacientes involucrados y la información sobre los resultados de histopatología y fotografías fueron proporcionadas por el Departamento de Patología del INNN. Resultados: se tienen registrados 14 casos, de los cuáles existen 2 confirmados mediante estudio de biopsia cerebral, un caso probable y 11 casos sospechosos. El año de mayor frecuencia de presentación fue el 2003, el rango de edad de los sujetos fue de 23 a 75 años. El sexo con mayor frecuencia fue el masculino, sin embargo, los casos confirmados fueron mujeres. Ninguno de los casos tenía antecedentes heredo-familiares ni patológicos de importancia. La mayoría de los estudios de electroencefalograma presentaron disfunción cortico-subcortical difusa; la resonancia magnética mostró imágenes compatibles con pérdida del volumen del parénquima cerebral. Los valores de la proteína 14-3-3, se pudo obtener en el 57% de los casos. Del 100% de los casos con resultados de ésta proteína, el 25% fueron negativos y del 75% restante la mitad fue positivo y la otra mitad (37.5%) indeterminado. Los resultados con la técnica de inmunohistoquímica mostraron la presencia de anticuerpo dirigido contra la proteína Prp cjd, así como gliosis y pérdida neuronal. Conclusiones: es necesario que se mejoren los sistemas de vigilancia de este tipo de padecimientos en nuestro país y que se disponga de un mayor acceso a laboratorios donde se puedan realizar análisis y determinaciones que apoyen este diagnóstico. Es importante, que se trabaje en concientizar a los familiares y pacientes con este tipo de padecimientos, así como con muchas otras enfermedades neurológicas, sobre la importancia y necesidad de permitir que se realicen estudios posmortem, para poder establecer diagnósticos más certeros y a su vez, profundizar en el conocimiento de las patologías. [ABSTRACT FROM AUTHOR]

Introducción: un trastorno mental es el resultado de un desequilibrio entre los aspectos biológicos y sociales del individuo que reflejan una alteración de las funciones cerebrales, como la atención, memoria, pensamiento, estado de ánimo, sensopercepción, aprendizaje y conducta entre otros; los cuales intervienen en la vida y productividad del individuo. En diversos países hay ciertos trastornos mentales que predominan en determinados grupos de edad. Actualmente en México existen trastornos neuropsiquiátricos que ocupan el quinto lugar como indicadores de muerte prematura y discapacidad. Se reporta que el índice de enfermos con padecimientos neuropsiquiátricos se incrementará debido a la pobreza, violencia, aumento en el consumo de drogas y envejecimiento de la población entre otros factores. Objetivo: conocer la prevalencia y tendencia de trastornos mentales que ameritaron hospitalización durante el período de 1995 al 2004 en el Instituto Nacional de Neurología y Neurocirugía (INNN). Material y métodos: se realizó un estudio transversal. Se identificaron de manera retrospectiva todos los expedientes de los pacientes hospitalizados cuyo diagnóstico de egreso fue algún tipo de trastorno mental de acuerdo a la Clasificación Internacional de enfermedades (CIE-10) durante el período de 10 años. Mediante un formato de recolección de datos se obtuvo la información. Para el análisis se calcularon frecuencias simples y para evaluar la tendencia de presentación durante el periodo de estudio se calculó el coeficiente de correlación de Spearman con el paquete estadístico SPSS. Se consideraron como valores estadísticamente significativos p<0.05. Resultados: se revisó un total de 3,342 expedientes, dentro de los 10 principales trastornos psiquiátricos figuran la esquizofrenia, el trastorno afectivo bipolar y el episodio depresivo, por mencionar algunos. En ambos sexos se observó una tendencia al incremento para el trastorno depresivo recurrente (r=0.826, p=0.146) y los trastornos esquizoafectivos (r=0.863, p=0.146), y una tendencia a la disminución de los trastornos de la personalidad (r=-0.641, p=0.146). Al analizar la tendencia de acuerdo al sexo se encontró que en los hombres de manera general los trastornos mentales tienden a disminuir (r=-0.713, p=0.146), al analizar en este mismo sexo cada uno de los padecimientos se observó una tendencia a la disminución de los trastornos de la personalidad y del comportamiento (-0.782, p=0.146), pero una tendencia al incremento en otros trastornos mentales (0.604, p=0.16), En las mujeres, de manera general no se observó ninguna tendencia, al analizar cada uno de los padecimientos en este género se observó una tendencia al incremento en otros trastornos mentales debidos a lesión y disfunción cerebral (r=0.600, p=0.146), así como en el trastorno depresivo recurrente (r=0.812, p=0.16). En este estudio también se analizaron las características epidemiológicas de la población de estudio, así como el comportamiento y la presencia de estos padecimientos en las diferentes épocas del año.… [ABSTRACT FROM AUTHOR]

Background: Neuropsychiatric disorders represent one of the first causes of disability worldwide. Recognizing the main causes for hospitalization may allow the implementation of interventions to prevent hospitalization and promote ambulatory care., Objective: To describe the trends of mental disorders requiring hospitalization in a neuropsychiatric referral center of a middle-income country., Material and Methods: Observational, cross-sectional, and analytic study. Information was obtained from dismissal letters and from the Department of Epidemiology database in a 16-year period at a neuropsychiatric referral center. Diagnoses and trends through this period were obtained using Spearman's correlation., Results: Schizophrenia represented most of the cases (19%), followed by bipolar disorder (13%). Psychotic disorders (PD) were found to contribute the most to the length of stay (43.76%), followed by mood disorders (MD) (39.07%). Schizophrenia-related dismissals diminished through the years ( r = -751; p = 0.001), whereas depression-related disorders increased ( r = 0.857; p < 0.001)., Conclusions: PD are the first cause of neuropsychiatric hospitalization. MD have an increasing frequency of hospitalization. Longer-stay disorders reflect global and economic burden of disease trends. These results might guide interventions that reduce hospital-based models of care, which represent a great burden in low and middle-income countries. Studies aiming to explain the trends reported are needed.

Background: Outpatient clinics for movement disorders provide specialized diagnosis and treatment services for the specific needs of this patient population., Objective: Describe the impact of implementing a Movement Disorder Clinic on the trends of consultations per year and hospitalizations of subjects with Parkinson's disease at a tertiary referral center., Methods: A retrospective study was carried out. We collected data from the Clinical File Archive and the Epidemiology Department at the National Institute of Neurology and Neurosurgery in Mexico. Data from January 1, 1999 through December 31, 2015 were included for analysis., Results: The number of total consultations had an increase of 632.1% between 1999 and 2015. Follow-up visits represented up to 95% of the consultations. Peaks found correlated with the inclusion of new specialists in the clinic. Regarding hospitalization, the number of patients discharged with a diagnosis of Parkinson's disease increased from a median of 17 (range 9-35) to 46 patients (range 31-53) per year., Conclusions: The implementation of a multidisciplinary Movement Disorders Outpatient Clinic in a tertiary referral center had a direct impact on the total number of consultations per year, mainly follow-up visits. The latter may reflect in an improvement in the quality of care.

Introduction: There is regulated study and mandatory reporting of epidemiological surveillance of diseases worldwide. However, it is difficult to observe the behavior of conditions especially over time, and especially when it comes to diseases that are addressed by their severity in tertiary care units., Objective: Describe and analyze the behavior of the major communicable neurological diseases subject to epidemiological surveillance for a period of seven years in the main National Institution of Health that takes in neurological, neurosurgical and psychiatric disorders in Mexico. The main conditions that are handled and reported were acute inflammatory polyneuropathy (Guillain Barre Syndrome) and viral encephalitis, 19.7 and 18.5%, respectively. The condition showing a tendency to decrease was neurocysticercosis, and conditions most strongly associated with mortality were diseases associated to the human immunodeficiency virus and unspecified viral encephalitis. The conditions were more frequent especially in men in the age group 25 to 44 years old. It is necessary to stress the importance of timely reporting of diseases under epidemiological surveillance in Mexico, since knowledge of the behavior of action allows decisions at all levels of care.

Unlabelled: Among the most prevalent psychiatric disorders, major depressive disorder is related with high incapacity levels, affecting also physical and mental health, and social, family, and work activities (burnout)., Objectives: This study assessed possible damage and emotional changes in a cohort of recently incoming medical residents to the postgraduate courses of the National Institute of Neurology and Neurosurgery of Mexico City., Materials and Methods: We collected information on sociodemographic data, and we applied two instruments: the scale of Maslach Burnout Inventory (MBI-HS) and the Beck Depression Inventory (BDI). Candidates were followed over time, at six and 12 months afterwards., Results: When the authors analyzed depressive symptoms, they found that the percentage of medical residents without depression at baseline was 97.7% and at the second application, this percentage decreased statistically (p = 0.008) and yet there was an increase in mild depressive symptoms (p = 0.017). With respect to MBI-HS, there was high emotional exhaustion with a significant increase at six months after arrival. The psychiatry residents were those more affected., Conclusions: Exploratory research is needed to be performed among residents to detect depressive symptoms and burnout syndrome, to act in a timely manner and prevent the progression of these diseases.

Background: Knowing the mortality of the population that goes to medical care, allows to the hospitals institutions and the government to make decisions on the services of health and the conditions of attention. Our objective was to describe the frequency and trend of the main causes of neurological hospital mortality for the period 2002-2007 in the National Institute of Neurology andNeurosurgery "Manuel Velasco Suárez"., Methods: The data was obtained from hospital discharge registers and medical records. Rates of hospital mortality and the tendency were calculated during the period of study., Results: The overall mortality rate was 4.9 per each 100 discharges. The leading causes of death were cerebrovascular diseases and brain tumors and there was a tendency for increased mortality in cases associated with human immunodeficiency virus (HIV) for men p = 0.004 and p = 0.05 for women with epilepsy, and with a status of epileptic condition., Conclusions: The cerebrovascular diseases and brain tumors tend to hold the first places. The mortality for neurological complications resulting from the diseases caused by the HIV is increasing. It is necessary to promote programs to prevent cardiovascular and HIV infection risk factors, to decrease the mortality rates from these diseases.

Unlabelled: To improve health policies directed toward ameliorating quality and also to characterize the profile of patients who attend medical centers, it is necessary to determine causes of mortality in any healthcare organization., Objective: To analyze time-trend hospital mortality at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (MVS-NINN) between 1995 and 2001., Methods: Data were taken from database of morbidity, and mortality of MVS-NINN. All cases were coded by the International Classification of Disease (10th edition). We calculated specific rates of mortality and time-trends during a 7-year-period., Results: When main causes of mortality were included in these analyzes, rates of hospital mortality at MVS-NINN showed a non-significant tendency to decrease during this period., Conclusions: Decline of mortality time-trend is generally in accordance with increasing life expectancy of Mexican population; this increase is due to progress in medical knowledge and to new technological and therapeutic advances, especially in the third level institutions such as this institute.

Unlabelled: Hospital statistics are very important as tools that help to define research objectives and design health programs., Objective: To determine the main causes of hospital morbility at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery (MVS-NINN) between 1995 and 2001., Material and Methods: Data were taken from the electronic database of morbidity and mortality of MVS-NINN. All outpatient records between 1995 and 2001 were considered. We calculated trends and specific rates of morbidity per 100 discharged patients., Results: The main causes of morbility were brain tumors, schizophrenic illness, neurocysticercosis, and stroke. We found a statistically significant declining time-trend of schizophrenic illness and in non-traumatic brain hemorrhage in males. In the case of females, we observed an increasing time-trend of benign meningeal tumors. The age groups more affected in both genders were those < 51 years of age., Conclusions: This study is not a population study, but it helps to increase knowledge of the main causes of hospitalization at one of the most important neurologic institutions in the world, which provides care for thinsured population throughout Mexico. These findings facilitate analysis and decision-making to undertake specifications to improve the quality of neurologic medical attention.