Dr, Jesús Porta-Etessam

Servicio de Neurología
Universidad Complutense
Hospital Clínico San Carlos de 

Instituto de Neurociencias Aplicadas

C/ La granja, 8. Madrid

Consulta 5.5

Citaciones: 91 299 12 99

Redes sociales :

Noticias destacadas


Desarrollo psicomotor y dificultades del aprendizaje en preescolares con probable trastorno por déficit de atención e hiperactividad. Estudio epidemiológico en Navarra y La Rioja
J.J. Marín-Méndez, M.C. Borra-Ruiz, M.J. Álvarez-Gómez, C. Soutullo Esperón Neurologia 2017;32:487-93 Resumen - Texto completo - PDF

Relación entre el trastorno de conducta del sueño REM y el trastorno de control de impulsos en pacientes con enfermedad de Parkinson
E. Bellosta Diago, L.J. Lopez del Val, S. Santos Lasaosa, E. López Garcia, A. Viloria Alebesque Neurologia 2017;32:494-9 Resumen - Texto completo - PDF

Amyloid PET scan: Staging beyond reading?
The advent of in vivo β-amyloid (Aβ) PET imaging has revolutionized the field of Alzheimer disease (AD). The opportunity to visualize, during life, one of the main neuropathologic hallmarks of the disease, i.e., Aβ deposition, has yielded considerable hope for diagnosis and treatment efficacy. From a clinical perspective, although the presence of Aβ deposition in the brain is not a sufficient criterion for AD dementia diagnosis, Aβ PET imaging is used to support or rule out the diagnosis, especially in patients with a complicated clinical course.1 Moreover, Aβ PET imaging is a powerful tool for clinical trials to enrich the sample for Aβ-positive participants, and to evaluate treatment effects on Aβ deposition. Finally, Aβ PET imaging has provided a unique opportunity to assess how Aβ deposition relates to cognitive and functional decline, brain atrophy, and hypometabolism, both cross-sectionally and longitudinally.
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Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine
Objective: To determine outcomes among patients with migraine in the emergency department (ED) who receive IV hydromorphone vs IV prochlorperazine + diphenhydramine. Methods: This study was conducted in 2 EDs in New York City. Patients who met international criteria for migraine were eligible for participation if they had not used an opioid within the previous month. Clinicians, participants, investigators, and research personnel were blinded to treatment. Patients were randomized in blocks of 4. Participants received hydromorphone 1 mg or prochlorperazine 10 mg + diphenhydramine 25 mg. Diphenhydramine was administered to prevent akathisia, a common side effect of IV prochlorperazine. The primary outcome was sustained headache relief, defined as achieving a headache level of mild or none within 2 hours of medication administration and maintaining that level for 48 hours without the requirement of rescue medication. A planned interim analysis was conducted once 48-hour data were available for 120 patients. Results: The trial was halted by the data monitoring committee after 127 patients had been enrolled. The primary outcome was achieved in the prochlorperazine arm by 37 of 62 (60%) participants and in the hydromorphone arm by 20 of 64 (31%) participants (difference 28%, 95% confidence interval 12–45, number needed to treat 4, 95% confidence interval 2–9). Conclusions: IV hydromorphone is substantially less effective than IV prochlorperazine for the treatment of acute migraine in the ED and should not be used as first-line therapy. ClinicalTrials.gov identifier: NCT02389829. Classification of evidence: This study provides Class I evidence that for patients in the ED with migraine, IV prochlorperazine + diphenhydramine is superior to IV hydromorphone.
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Dr Jesús Porta-Etessam. Madrid