Murie, M. (M.)

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    Tiempo es cerebro ¿solo en la fase aguda del ictus?
    (Elsevier España, 2012) Carmona-Abellán, M.M. (María del Mar); Ortega-Cubero, S. (Sara); Meyer, M. (M.); Murie, M. (M.); Teasell, R. (R.)
    Introduction and objective: In Spain, stroke is the leading cause of death in women as well as the leading cause of disability in adults. This translates into a huge human and economic cost. In recent years there have been significant advances both in the treatment of acute stroke and in the neuro-rehabilitation process; however, it is still unclear when the best time is to initiate neurorehabilitation and what the consequences of delaying treatment are. To test the effect of a single day delay in the onset of neurorehabilitation on functional improvement achieved, and the influence of that delay in the rate of institutionalisation at discharge. Methods: A retrospective study of patients admitted to Parkwood Hospital’s Stroke Neurorehabilitation Unit (UNRHI) (University of Western Ontario, Canada) between April 2005 and September 2008 was performed. We recorded age, Functional Independence Measurement (FIM) score at admission and discharge, the number of days between the onset of stroke and admission to the Neurorehabilitation Unit and discharge destination. Results: After adjustment for age and admission FIM, we found a significant association between patient functional improvement (FIM gain) and delay in starting rehabilitation. We also observed a significant correlation between delay in initiating therapy and the level of institutionalisation at discharge. Conclusions: A single day delay in starting neurorehabilitation affects the functional prognosis of patients at discharge. This delay is also associated with increased rates of institutionalisation at discharge.
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    Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis
    (SAGE, 2008) Toledo, S. (S.); Sepulcre, J. (Jorge); Villoslada, P. (Pablo); Garcia-Layana, A. (Alfredo); Murie, M. (M.); Salinas-Alaman, A. (Ángel); Bejarano, B. (B.)
    Studying axonal loss in the retina is a promising biomarker for multiple sclerosis (MS). Our aim was to compare optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT) techniques to measure the thickness of the retinal nerve fiber layer (RNFL) in patients with MS, and to explore the relationship between changes in the RNFL thickness with physical and cognitive disability. We studied 52 patients with MS and 18 proportionally matched controls by performing neurological examination, neuropsychological evaluation using the Brief Repetitive Battery-Neuropsychology and RNFL thickness measurement using OCT and HRT. RESULTS: We found that both OCT and HRT could define a reduction in the thickness of the RNFL in patients with MS compared with controls, although both measurements were weakly correlated, suggesting that they might measure different aspects of the tissue changes in MS. The degree of RNFL atrophy was correlated with cognitive disability, mainly with the symbol digit modality test (r=0.754, P<0.001). Moreover, temporal quadrant RNFL atrophy measured with OCT was associated with physical disability. CONCLUSION: In summary, both OCT and HRT are able to detect thinning of the RNFL, but OCT seems to be the most sensitive technique to identify changes associated with MS evolution.
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    Manejo de la primera crisis epiléptica y del status en urgencias
    (Gobierno de Navarra. Departamento de Salud, 2008) Murie, M. (M.); Urrestarazu, E. (Elena); Viteri, C. (César)
    First epileptic seizure is a common reason for attending the emergency department. Its management is focused on diagnosis of the episode and on identification and treatment of the underlying cause. Occasionally, anti-epileptic treatment will be required. However, when the seizure is prolonged - a condition known as status epilepticus - it becomes a life-threatening process and requires immediate treatment. In this article, general advice and guidelines for the management of seizures and of stat
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    Hombro doloroso hemipléjico en pacientes con ictus: causas y manejo
    (Elsevier España, 2012) Carmona-Iragui, M. (M.); Meyer, M. (M.); Murie, M. (M.); Gnanakumar, V. (V.); Foley, N. (N.); Teasell, R. (R.)
    The hemiplegic shoulder pain is common after a stroke. Its appearance brings pain and limits daily living activities as well as participation in specific Neuro-rehabilitation programs. All this leads to a worse functional outcome. Good management of patients can reduce both the frequency and intensity of shoulder pain, improving functional outcome. DEVELOPMENT: We conducted a literature search of various databases between 1980 and 2008. The articles were evaluated using the PEDro scoring system. Five evidence levels were established for the conclusions. CONCLUSIONS: Shoulder subluxation, occurs at an early stage after stroke and is associated with subluxation of the shoulder joint and spasticity (mainly subscapularis and pectoralis). Slings prevent subluxation of the shoulder. It is preferable to move within a lower range of motion and without aggression to prevent the occurrence of shoulder pain. The injection of corticosteroids does not improve pain and range of motion in hemiplegic patients, while botulinum toxin combined with physical therapy appears to reduce hemiplegic shoulder pain.