Cefepime is known to exert bactericidal activity against Pseudomonas aeruginosa. Cefepime-induced neurotoxicity, most likely caused by increased exposure, has recently become a major concern in clinical practice; therefore, appropriate dose reduction of cefepime should be applied with respect to patients with low cefepime clearance (mostly eliminated by the kidneys). Here, we report a case in which Bayesian prediction-based therapeutic drug monitoring (Bayes-TDM) was effectively used to reduce the dose of cefepime in a patient with pneumonia to prevent neurotoxic complications. A woman (age 59 years, body weight 32.5 kg, serum creatinine concentration 1.02 mg/dL) developed pneumonia caused by P. aeruginosa while receiving treatment for scleroderma and systemic lupus erythematosus. She started treatment with a dosing regimen of 1.0 g of cefepime every 8 h (day X). On day X+5, aphasia developed, and the serum cefepime concentration was 71.3 mg/L at trough. This concentration was twice or thrice higher than the reported safe concentration of cefepime (22 or 35 mg/L at trough). Therefore, we reduced the dose of cefepime to 0.5 g every 12 h using Bayes-TDM from day X+7. As a result, the severity of aphasia decreased by day X+10, and this dose was successfully continued up to day X+13 without further adjustment. In conclusion, individualizing doses by Bayes-TDM may be useful in preventing adverse effects associated with cefepime treatment. Central nervous system aspergillosis is relatively rare and difficult to diagnose. Here, we report a case of 90-year-old man with chronic lymphocytic leukemia who presented with a month-long gradually worsening headache followed by 3 days of low-grade fever associated with altered mental status. Aspergillus meningitis diagnosed using Aspergillus galactomannan antigen in the cerebrospinal fluid and treated with voriconazole. Delayed diagnosis and treatment of Aspergillus meningitis is typically associated with high mortality; therefore, it is imperative to include this disease in the differential diagnoses of subacute meningitis. Regularities in a sequence of sounds can be automatically encoded in a predictive model by the auditory system. When a sound deviates from the one predicted by the model, a mismatch negativity (MMN) is elicited, which is taken to reflect a prediction error at a particular level of the model hierarchy. Although there are many studies on deterministic regularities, only a few have investigated the brain's ability to encode non-deterministic regularities. We studied a simple stochastic regularity two tone pitches (standards, each occurring on 45% of trials); this regularity was occasionally violated by another tone pitch (deviant, occurring on 10% of trials). We found MMN when the deviant's pitch was outside those of the standards, but not when it was between them. Importantly, when we alternated the occurrence of the same two standards, making them deterministic, the deviant elicited MMN, even when its pitch was between those of the standards. https://www.selleckchem.com/products/mdl-28170.html Thus, although the MMN system is extremely powerful in establishing even quite complex deterministic regularities, it fails with a simple stochastic regularity. We argue that the MMN system does not know basic probability. BACKGROUND The Functional Gait Assessment (FGA) is a standardized instrument for assessing postural stability during various walking tasks. It was developed to increase the reliability and to decrease the potential ceiling effect observed with the Dynamic Gait Index (DGI). OBJECTIVE To translate and cross-culturally adapt the FGA into Portuguese-Brazilian, and to evaluate its reliability in community-dwelling Brazilian older adults. METHODS The process of translation and cross-cultural adaptation followed the recommendations of international guidelines. The pre-final version was applied to a sample of 55 older adults of both sexes living independently in the community. For the assessment of reliability (i.e. inter- and intra-rater reliability, standard error of measurement (SEM), and internal consistency), 70 older adults aged 60-87 years were evaluated. RESULTS There was a conceptual equivalence between the original and the translated versions. All FGA items that used measurements in inches and feet were modified to use matching values in centimeters to reflect the measurement unit used in Brazil. The FGA-Brazil showed excellent inter- and intra-rater reliability (ICC2,1 > 0.90), low SEM (ranging from 1.03 to 1.52), and good internal consistency (Cronbach's alpha = 0.858). CONCLUSION The FGA-Brazil is a semantically and linguistically valid and reliable instrument to assess walking balance among community-dwelling older adults. INTRODUCTION Parvovirus B19 (PVB19) infection has a high incidence and worldwide distribution. It has a broad clinical spectrum, with skin, joint and haematological manifestations being the most common. The objective of this study was to determine the epidemiology and clinical-analytical manifestations of acute PVB19 infection. PATIENTS AND METHODS A retrospective study of patients with a positive IgM serology for PVB19 (10 years). Forty-six patients were included and their demographic, clinical and analytical characteristics were analyzed. RESULTS Primary infection was most prevalent in women (ratio 2.21) aged 41 (mean age). Joint involvement was the most common manifestation (65%). Skin abnormalities were observed in more than half of patients (24 cases) rash (28%), megalerythema (9%), "gloves and socks" involvement (6.5%), periflexural rash (4%) and oedema (4%). Anaemia was the main haematological alteration (35%). The symptoms were self-limiting and resolved in 1-2 weeks in most patients. CONCLUSIONS Although there is a variable clinical spectrum, polyarthralgias and generalized maculopapular rash with fever and anaemia are the typical and most frequent manifestations of primary infection by PVB19 and are usually self-limiting. BACKGROUND AND OBJECTIVE The use of low-dose acetylsalicylic acid (LD-ASA) in primary prevention is a matter of controversy, but its magnitude is unknown in Spain. The aim of the study was to estimate the proportion of patients who are prescribed LD-ASA for primary prevention and to identify their characteristics. METHODS In a sample from the primary care database BIFAP we obtained the proportion of persons with prescriptions of LD-ASA over the period 2002-2015, excluding patients with any previous record of occlusive vascular disease, atrial fibrillation or cancer. The proportions were standardized to the Spanish population aged 40-99 years old. We identified the factors associated with the use of LD-ASA through a logistic regression and estimated its prevalence of use according to the presence of such factors. RESULTS The sample included 102,850 subjects; of which 6,198 were users of LD-ASA. The standardized prevalence of prescription was 2.21% at the start of the period and 3.57% at the end, and increased with age.