Craneosinostosis, una perspectiva pediátrica / Craniosynostosis, a pediatric perspective

La craneosinostosis se define como el cierre prematuro de una o más suturas del cráneo, que se manifiesta por una forma anormal de la cabeza. Es una condición infrecuente, pero requiere ser reconocida y derivada oportunamente a Neurocirugía para prevenir complicaciones. El objetivo de esta revisión es describir las características clínicas y genéticas más frecuentes de esta patología, su clasificación de acuerdo a la forma del cráneo y los signos más característicos para lograr reconocerla oportunamente. Se realizó una búsqueda de artículos científicos en bases de datos Pubmed, Scielo y EMBASE con las palabras craneosinostosis, plagio, escafo y braquicefalia. Se seleccionaron artículos en español e inglés que describieran las características de la patología y su manejo, optando por revisiones sistemáticas o recomendaciones de sociedades científicas cuando estuvieran disponibles. La craneosinostosis puede presentarse en forma aislada o asociada a otras deformidades. Su clasifi cación depende de la(s) sutura(s) afectada(s), lo que lleva a la forma característica del cráneo y de la presencia de otras malformaciones. Suele diagnosticarse y derivarse de forma tardía, lo que se asocia a complicaciones como hipertensión endocraneana y alteración del desarrollo encefálico. La cirugía precoz tiene menor comorbilidad y mejores resultados estético. En conclusión, la forma anormal del cráneo debe hacer sospechar la presencia de craneosinostosis, aunque se presente en forma aislada. El manejo quirúrgico antes del año de vida se asocia a mejor pronóstico.

Craniosynostosis is defined as the premature fusion of one or more skull sutures, characterized by an abnormal shape of the head. It is a rare condition but should be recognized and timely referred to Neurosurgery in order to prevent complications. The objective of this review is to describe the most frequent clinical and genetic characteristics of this pathology, its classification according to the shape of the skull, and the most characteristic signs to achieve timely recognition. A search for scientific articles in Pubmed, Scielo, and EMBASE databases was performed using the terms craniosynostosis, plagiocephaly, scaphocephaly, and brachycephaly. We selected articles in Spanish and English that described the characteristics of the pathology and about its management, choosing systematic reviews or recommendations from scientific societies when available. Craniosynostosis may occur in isola tion or associated with other deformities. Its classification depends on the affected suture(s), leading to the characteristic shape of the skull and the presence of other malformations. This condition is usually diagnosed and referred late, which is associated with complications such as intracranial hy pertension and impaired brain development. Early surgery has less comorbidity and better esthetic results. In conclusion, the abnormal shape of the skull must raise the suspicion of craniosynostosis, even if it occurs in isolation. Surgical management before one year of life is associated with a better prognosis.

Expression of Pax6 and Pax7 proteins during the central nervous system development in human embryos / Expresión de proteínas Pax6 y Pax7 durante el desarrollo del sistema central nervioso en embriones humanos

The family of paired box (Pax) genes encodes the transcription factors that have been emphasized for the particular importance to embryonic development of the CNS, with the evidence obtained from various animal models. Human embryos have rarely been available for the detection of the expression of Pax family members. In this study 32 human embryos of Carnegie (CS) stages 10-20 were investigated to find the differences in the expression of Pax6 and Pax7 proteins in different regions of the neural tube and the caudal spinal cord. The expression of Pax6 and Pax7, as determined by immunohistochemistry, showed a tendency to increase in the later stages of the development both in the spinal cord and the brain. Significantly weaker expression of Pax6 and Pax7 was observed at CS 10 as compared to the later stages. At CS 10-12 weak expression of Pax6 was noticed in both dorsal and ventral parts of the developing spinal cord, while the expression of Pax7 was restricted to the cells in the roof plate and the dorsal part of the spinal cord. At CS 14-20 in the developing spinal cord Pax6 and Pax7 were detected mostly in the neuroepithelial cells of the ventricular layer, while only weak expression characterized the mantle and the marginal layers. At the same stages in the developing brain Pax6 and Pax7 were expressed in the different regions of the forebrain, the midbrain and the hindbrain suggesting for their involvement in the differentiation of neurons in specific parts of the developing brain.

La familia de genes Pax del inglés (Paired box) codifica los factores de transcripción debido a la particular importancia en el desarrollo embrionario del SNC, con la evidencia obtenida de varios modelos animales. Rara vez han estado disponibles embriones humanos para la detección de la expresión de genes de la familia Pax. En este estudio, se investigaron 32 embriones humanos de Carnegie (CS) etapas 10-20 para encontrar las diferencias en la expresión de las proteínas Pax6 y Pax7 en diferentes regiones del tubo neural y la médula espinal caudal. La expresión de Pax6 y Pax7, según la inmunohistoquímica, se observó una tendencia a aumentar en las etapas posteriores del desarrollo, tanto en la médula espinal como en el cerebro. Se observó una expresión significativamente más débil de Pax6 y Pax7 en CS 10 en comparación con las etapas posteriores. En CS 10-12 se notó una expresión débil de Pax6 en las partes dorsal y ventral de la médula espinal en desarrollo, mientras que la expresión de Pax7 se limitó a células en la placa del techo y dorsal de la médula espinal. En CS 14-20 en la médula espinal en desarrollo, Pax6 y Pax7 se observó principalmente en las células neuroepiteliales de la capa ventricular, mientras que expresión débil se caracterizó en las capas marginales. En las mismas etapas en el cerebro en desarrollo, Pax6 y Pax7 se expresaron en las diferentes áreas del prosencéfalo, el mesencéfalo y el mesencéfalo, lo que sugiere su participación en la diferenciación de las neuronas en partes específicas del cerebro en desarrollo.

Vesicles stage of camel brain development / Etapas del desarrollo de las vesículas cerebrales del camello

A successive embryonic developmental study was conducted on the brain of twenty eight embryos and fetuses of one humped camel (Camelus Dromedarius), whose crown vertebral rump lengths (CVRL) ranged from 9 to 80 mm, collected from the El-Basateen (Cairo) and Belbees (ElSharqya) Slaughterhouse. The current investigation revealed that camel brain was found to consist of fore, mid and hind brains. The fore brain is divided into telencephalon and diencephalon while the rhombencephalon divided into metencephalon and myelencephalon. Flexures appeared between the vesicles are cervical flexure between the rhomencephalon and the spinal cord, cephalic flexure in the mesencephalon and pontine flexure between the metencephalon, and the myelencephalon of the hind brain (rhombencephalon). The cavity of the rhombencephalon is the fourth ventricle, while that of the diencephalon is the third ventricle, and those of the telencephalon are the lateral ventricles but that of mid brain is the cerebral aqueduct. myelencephalon becomes medulla oblongata and metencephalon developed to pons and cerebellum while mesencephalon gives rise to the cerebral crura and anterior and a posterior colliculus. Diencephalon gives the thalamus, hypothalamus, mamillary body, infundibulum and pineal body while telencephalon becomes the cerebral hemispheres and corpus striatum.

Se llevó a cabo un estudio del desarrollo embrionario cerebral de veintiocho embriones y fetos de camello jorobado (Camelus dromedarius). Las muestras fueron recolectadas en los mataderos de El-Basateen (El Cairo) y Belbees (ElSharqya). La investigación reveló que el cerebro de camello posee un cerebro anterior, medio y posterior. El cerebro anterior se divide en telencéfalo y diencéfalo, mientras que el rombencéfalo se divide en metencéfalo y mielencéfalo. Las flexiones encontradas entre las vesículas son la flexión cervical entre el rombencéfalo y la médula espinal; la flexión cefálica en el mesencéfalo; y la flexión pontina entre el metencéfalo y el mielencéfalo del cerebro posterior (rombencéfalo). La cavidad del rombencéfalo conforma el cuarto ventrículo, la del diencéfalo forma el tercer ventrículo, y las del telencéfalo a los ventrículos laterales. En el cerebro medio, la cavidad corresponde al acueducto cerebral. El mielencéfalo se convierte en médula oblonga y el metencéfalo deriva en puente y cerebelo, mientras que el mesencéfalo da lugar a la crura cerebral y a los colículos anterior y posterior. El diencéfalo origina el tálamo, el hipotálamo, el cuerpo mamilar, el infundíbulo y la hipófisis, mientras que del telencéfalo se originan los hemisferios cerebrales y el cuerpo estriado.

La maduración cerebral en el niño: el caso de la adquisición del concepto de muerte y su evolución / Brain development in childhood: acquisition and evolution of children's understanding of death

Se presenta la relación entre la maduración cerebral en el niño y la adquisición de los cinco subcom ponentes biológicos del concepto maduro de la muerte: Irreversibilidad, aplicabilidad, inevitabilidad, cese funcional y causalidad. Las teorías actuales plantean que el conocimiento (entre otros el de la muerte) se realiza en un proceso de oleadas confluentes, con avances y retrocesos y esto explica la diferencia muy importante que se puede encontrar en niños de la misma edad y buen coeficiente in telectual. Generalizando, niños menores de 4 años no tienen conciencia de la muerte. Posteriormente descubren, con dificultad, el concepto de irreversibilidad y hay mucha discusión sobre el orden de adquisición del resto de los subcomponentes- lo que está relacionado con la incorporación del pen samiento dualístico y cierto grado de conocimiento biológico. No hay acuerdo sobre la influencia cultural, socio económica y experiencias previas con la muerte de familiares. Alrededor de los 12 años se considera que se logra un concepto maduro. Se revisa la incorporación de elementos sobrenaturales en la literatura infantil clásica y actual, comprobándose que su presencia es más marcada en los cuentos para preescolares occidentales que orientales en el siglo XXI.

There is a relation between brain development in children and the acquisition of the five subcom ponents for a mature conceptualisation of biological death: Irreversibility, applicability, inevitability, functional cessation and casuality. Current theories propose that knowledge (among them about death) is acquired through a series of confluent waves with advances and setbacks, thus explaining the important differences encountered among children of the same age and good intellectual develop ment. Generally speaking children under four years of age do not have a consciousness of death. They later discover, albeit with difficulty, the concept of irreversibility and much discussion exists about the order in which the remaining concepts are acquired-which is related to incorporating dualistic thought and a degree of biological understanding. There is no agreement on the influence culture, socioeconomic background and previous experience of deaths in the family may have. The mature concept is thought to be acquired around the age of 12. We look at the inclusion of supernatural ele ments in classical and current chidren's literature, proving that is more prevalent in western literature in the 21st century.

Bovine central nervous system development / Desenvolvimento do sistema nervoso central de bovinos

Central nervous system (CNS) development researches are extremely important to the most common congenital disorders and organogenesis comprehension. However, few studies show the entire developmental process during the critical period. Present research can provide data to new researches related to normal development and abnormalities and changes that occur along the CNS organogenesis, especially nowadays with the need for preliminary studies in animal models, which could be used for experimental research on the influence of viruses, such as the influence of Zika virus on the development of the neural system and its correlation with microcephaly in human newborns. Then, present study describes CNS organogenesis in cattle according to microscopic and macroscopic aspects, identifying structures and correlating to gestational period. Fourteen embryos and nine bovine fetuses at different ages were collected and analyzed. All individuals were measured in order to detect the gestational period. Bovine embryo at 17 days age has its neural tube, cranial neuropore, caudal neuropore and somites developed. After 24 days of development, were observed in cranial part of neural tube five encephalic vesicles denominated: telencephalon, diencephalon, mesencephalon, metencephalon and myelencephalon. In addition, the caudal part of neural tube was identified with the primitive spinal cord. The primordial CNS differentiation occurred from 90 to 110 days. The five encephalic vesicles, primordial spinal cord and the cavities: third ventricule, mesencephalic aqueduct, fourth ventricle and central canal in spinal cord were observed. With 90 days, the main structures were identified: (1) cerebral hemispheres, corpus callosum and fornix, of the telencephalon; (2) interthalamic adhesion, thalamus, hypothalamus and epythalamus (glandula pinealis), of the diencephalon; (3) cerebral peduncles and quadruplets bodies, of the mesencephalon; (4) pons and cerebellum, of the metencephalon; (5) medulla oblongata or bulb, of the myelencephalon; and (6) spinal cord, of the primitive spinal cord. After 110 days of gestation, the five encephalic vesicles and its structures were completely developed. It was noted the presence of the spinal cord with the cervicothoracic and lumbossacral intumescences. In summary, the results describes the formation of the neural tube from the neural plate of the ectoderm, the encephalic vesicles derived from the neural tube and subsequent structural and cavities subdivisions, thus representing the complete embryology of the central nervous system.(AU)

Os estudos que descrevem o desenvolvimento do sistema nervoso central (SNC) são de suma importância para compreensão da organogênese e identificação dos prováveis eventos que resultam em malformações congênitas. Estes dados podem subsidiar novas pesquisas relacionadas ao desenvolvimento normal, e interpretação de malformações e alterações que ocorrem ao longo da organogênese do SNC, considerando neste momento a necessidade de estudos preliminares em modelos animais, os quais poderiam ser utilizados para pesquisas experimentais sobre a influência de agentes infecciosos como o Zika vírus, no desenvolvimento do sistema nervoso e suas relações com a microcefalia em humanos recém-nascidos. O presente estudo teve como objetivo descrever os aspectos morfológicos macro e microscópicos da organogênese do SNC de bovinos, buscando correlacionar os achados morfológicos com a idade gestacional. Todos os animais foram mensurados para detectar o período gestacional. Foram coletados e analisados 14 embriões e nove fetos de bovinos de diferentes idades gestacionais. No embrião bovino a partir do décimo sétimo dia de gestação, encontra-se a formação do tubo neural, o neuroporo cranial e neuroporo caudal, e formação dos somitos. Após 24 dias de desenvolvimento, são observadas na parte cranial do tubo neural cinco vesículas encefálicas denominadas: telencéfalo, diencéfalo, mesencéfalo, metencéfalo e mielencéfalo; e na parte caudal do tubo neural, encontra-se a medula espinhal primitiva. Entre 90 a 110 dias de gestação, observa-se a total diferenciação das cinco vesículas do SNC. Com 90 dias, são identificas as principais estruturas: (1) do telencéfalo, os hemisférios cerebrais, corpo caloso e fórnix; (2) do diencéfalo, a aderência intertalâmica, tálamo, hipotálamo e epitálamo (glândula pineal); (3) do mesencéfalo, os pedúnculos cerebrais e os corpos quadrigêmios; (4) do metencéfalo, a ponte e o cerebelo; (5) do mielencéfalo, a medula oblonga (ou bulbo); e (6) da medula espinhal primitiva, a medula espinhal. Após 110 dias, as cinco vesículas encefálicas e as suas subdivisões se encontram completamente desenvolvidas. Notou-se a presença da medula espinhal com as intumescências cervicotorácica e lombossacral. Em resumo, os resultados demonstram a formação do tubo neural a partir da placa neural do ectoderma, as vesículas encefálicas provenientes do tubo neural e posteriormente as subdivisões das estruturas e das cavidades, que representam a completa embriologia do sistema nervoso central.(AU)

Introducción a la neurobiología y neurofisiología del trastorno del espectro autista / Introduction to the neubiology and neurofisiology of the autism spectrum disorder

Cuando se altera el cerebro humano en desarrollo y se produce una disfunción cognitiva, neurológica o psiquiátrica, se originan los Trastornos del Neurodesarrollo, teniendo el Trastorno del Espectro Autista (TEA) un lugar destacado. La prevalencia del TEA es de 1 cada 68 niños, aunque se discuten las variaciones dependiendo la región y la forma de medición. Esta revisión comprende, en parte, las principales características y problemáticas alrededor del desarrollo biológico del cerebro desde el punto de vista genético. Sin embargo, es destacable el factor ambiental incidente de los genes, que tiene influencia pequeña a moderada, aunque a la hora de marcar un desencadenante genético o ambiental clave, existe una gran heterogeneidad etiológica del TEA. Por otra parte, en este trabajo se abarcarán cambios estructurales y funcionales en el sistema nervioso central, analizando las características neurofisiológicas y morfológicas que intervienen enel trastorno. Así mismo, se analizan los avances de los resultados actuales en investigación que tratan de dar luz sobre la etiología del TEA e identificar soluciones específicas a las deficiencias cognitivas que éste produce. En conclusión, esta revisión destaca cómo ciertas anormalidades no conocidas previamente, y que incluso cambian los paradigmas con respecto a lo que sabemos sobre la neurobiología de los TEA, son marcadas como punto de partida para profundizar nuestro conocimiento.

In the human brain, alterations occur during the neurodevelopmental stages that are associated to cognitive, neurologic and psychiatric dysfunctions, are known as neurodevelopmental disorders. The Autistic Spectrum Disorder (ASD) is listed prominently in this group, since 1 out 68 kids are affected, although this prevalence changes among regions and type of measurement. This review encompasses, in part, the main features and problems about the biological development of the brain from a genetic point of view. However, it is noteworthy that the environmental factor has little to moderate influence, although it is difficult to find a key genetic or environmental factor to trigger the etiological heterogeneity seen in ASD. Moreover, this study covers structural and functional changes in the central nervous system analyzing the neurophysiological and morphological characteristics that are taken over by the disorder. Recent updates in ASD research regarding both the etiological and specific solutions to the cognitive deficiencies of the disorder are also reviewed here. Here we present the highlights to how certain abnormalities, not previously associated to the neurobiology of ASD, represent a starting point to deepen our knowledge of this disorder.

Impacts of Preeclampsia on the Brain of the Offspring / Impactos da pré-eclâmpsia no cérebro de nascituros

Abstract Preeclampsia (PE) is a significant gestational disorder that causes complications in 3- 5% of all human pregnancies. Apart from the immediate risks and complications for mother and fetus, both additionally carry elevated lifelong risks for specific complications. Offspring of PE pregnancies (PE-F1) have higher risks for hypertension, stroke and cognitive impairment compared with well-matched offspring (F1) fromuncomplicated pregnancies. Prior to the clinical onset of PE, placental angiokines secreted into the maternal plasma are deviated. In many PE patients this includes deficits in placental growth factor (PGF). Our laboratory found that mice genetically-deleted for PGF (PGF - / -) have altered cerebrovascular and brain neurological development detectable from midgestation to adulthood. We hypothesized that the PGF deficits seen in human PE, deviate fetal cerebrovascular and neurological development in a manner that impairs cognitive functions and elevates stroke risk. Here we summarize the initial analytical outcomes from a pilot study of 8-10 year old male and female PE-F1s and matched controls. Our studies were the first to report magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and functional brain region assessment by eyemovement control and clinical psychometric testing in PE-F1s. Further studies in larger cohorts are essential to define whether there are image-based biomarkers that describe unique anatomical features in PE-F1 brains.

Resumo A pré-eclampsia (PE) é importante doença gravídica complicando 3-5% de todas as gestações humanas. Além dos riscos imediatos e complicações para a mãe e o feto, a PE associa-se a outros riscos materno-fetais elevados em longo prazo. Nascituros de gestações complicadas por PE (PE-F1) apresentam maiores riscos de desenvolver hipertensão, acidente vascular cerebral e disfunção cognitiva em comparação com prole (F1) de gestações sem complicações. Antes do aparecimento clínico da PE, angiocitocinas placentárias secretadas no plasma materno apresentam-se alteradas. Em muitos pacientes com PE, isso inclui valores plasmáticos reduzidos de Fator de Crescimento Placentário (PGF). Nosso laboratório identificou que camundongos geneticamente não produtores de PGF (PGF- / - ) apresentam alterações vasculares e de desenvolvimento cerebral detectáveis do período gestacional à idade adulta. Nossa hipótese é que os déficits de PGF identificados em mulheres que desenvolveram PE podem desviar o desenvolvimento neurológico e vascular cerebral fetal, de maneira a prejudicar funções cognitivas, elevando o risco de AVC. Aqui resumimos os resultados analíticos iniciais de um estudo piloto comcrianças do sexomasculino e feminino de 8- 10 anos de idade nascidas de mães que tiveram PE (PE-F1s) comparadas com crianças controle pareadas por idade e sexo. Nossos estudos são os primeiros a relatar a ressonância magnética (RNM), a angiorressonância e a avaliação funcional do cérebro pelo controle de movimento dos olhos e pelo teste clínico psicotécnico em PE-F1s. Estudos adicionais em coortes maiores são essenciais para definir se há biomarcadores com base em imagens que possam descrever características anatômicas únicas em cérebros de crianças PE-F1.

Mortalidad infantil por malformaciones congénitas en Chile: análisis temporal y espacial, 1997-2011 / Infant mortality from congenital malformations in Chile: temporal and spatial analysis, 1997-2011

OBJETIVO:Analizar la distribución espacial y temporal (1997-2011) de la mortalidad infantil por malformaciones congénitas (MC) en Chile. MÉTODOS: Los datos de nacimientos y muertes en menores de 1 año de edad codificados con la CIE-10 se obtuvieron del Instituto Nacional de Estadísticas. Para las regiones administrativas y las naturales (Norte Grande, Norte Chico, Central, Austral y Sur), sistemas (nervioso, cardiovascular, digestivo, genitourinario, musculo esquelético, anomalías cromosómicas) y 28 malformaciones específicas, se estimaron el porcentaje de muertes por MC (PM-MC) y la tasa de mortalidad infantil por MC (TMI-MC) en 3 períodos (1997-2001, 2002-2009, 2007-2011). La tendencia secular y la variación del riesgo de muerte se estimaron con un modelo de regresión de Poisson. RESULTADOS: Para todo Chile, la tendencia secular de la TMI-MC y el PM-MC fueron negativa y positiva, respectivamente (P < 0,01). La TMI-MC y el PM-MC exhibieron una heterogeneidad espacial discreta en las regiones administrativas y naturales. La región natural que más se acercó al patrón nacional fue la Central. La tendencia secular de la TMI-MC de los sistemas nervioso y cardíaco y de algunas MC específicas (anencefalia, espina bífida, y comunicaciones interauricular e interventricular) fue negativa. El patrón de mortalidad infantil por MC para todo Chile se caracteriza por presentar en el período 1997-2011 un descenso de la TMI-MC y un aumento del PM-MC. CONCLUSIONES: Los resultados indican que Chile se encuentra en un estadio avanzado de la transición epidemiológica de las causas de mortalidad infantil. Sin embargo, se observan disparidades interregionales de estos indicadores, más notorias en el sur del país.

OBJECTIVE: To analyze the spatial and temporal distribution (1997-2011) of infant mortality resulting from congenital malformations (CM) in Chile. METHODS: Data on births and deaths among infants aged less than one year using ICD-10 coding were obtained from the National Statistics Institute. The percentage of deaths from CM (PD-CM) and the infant mortality rate from CM (IMR-CM) during three different periods (1997-2001, 2002-2009, 2007-2011) were estimated for Chile's administrative and natural regions (Norte Grande, Norte Chico, Central, Austral, and Sur), broken down by systems (nervous, cardiovascular, digestive, genitourinary, musculoskeletal, and chromosomal abnormalities) and by 28 specific malformations. The secular trend and the variation in the risk of death were estimated using a Poisson regression model. RESULTS: For the whole of Chile, the secular trend for the IMR-CM was negative, and the secular trend for the PD-CM was positive (P < 0,01). The IMR-CM and the PD-CM both showed mild spatial heterogeneity in all administrative and natural regions. The Central region was the natural region that came closest to showing the pattern observed nationwide. The IMR-CM involving the nervous and cardiovascular systems and specific types of CM (anencephaly, spina bifida, and atrial and ventricular septal defects) showed a negative secular trend. For Chile as a whole, the pattern of infant mortality from CM is marked by a drop in the IMR-CM and by an increase in the PD-CM over the period from 1997 to 2011. CONCLUSION: The findings suggest that Chile is in the latter stages of the epidemiological transition with respect to the causes of infant mortality. However, these indicators show disparities between regions, more pronounced in the south of the country.

Differential expression of immunologic proteins in gingiva after socket preservation in mini pigs

During healing following tooth extraction, inflammation and the immune response within the extraction socket are related to bone resorption. Objective : We sought to identify how the alloplastic material used for socket preservation affects the immune responses and osteoclastic activity within extraction sockets. Material and Methods : Using a porcine model, we extracted teeth and grafted biphasic calcium phosphate into the extraction sockets. We then performed a peptide analysis with samples of gingival tissue from adjacent to the sockets and compared the extraction only (EO) and extraction with socket preservation (SP) groups. We also used real-time polymerase chain reaction (PCR) to evaluate the expression level of immunoglobulins, chemokines and other factors related to osteoclastogenesis. Differences between the groups were analyzed for statistical significance using paired t tests. Results : Levels of IgM, IgG and IGL expression were higher in the EO group than in the SP group 1 week post-extraction, as were the levels of CCL3, CCL5, CXCL2, IFN-γ and TNF-α expression (p<0.05). In addition, receptor activator of nuclear factor kappa-B ligand (RANKL) was also significantly upregulated in the EO group (p<0.05), as were IL-1β, IL-6 and IL-8 (p<0.05). Conclusions : These results suggest that the beneficial effect of socket preservation can be explained by suppression of immune responses and inflammation. .

Determination of lateral ventricle and brain volume in children with stereological method using MRI / Determinación del volumen del ventrículo lateral y del cerebro en niños utilizando el método estereológico mediante RNM

Although brain development is most active during the intrauterina period of life, the processes of myelination and arborization affect the structure of the brain throughout childhood and adolescence. Brain development is also very active in the early years of a child's life, and continues to be so for approximately 15 years after gestation. Volumetric changes in the brain are effected by sex. Understanding the variability of human brain volume during development is important for the interpretation of childhood neuroimaging studies. Hence the aim of this study is to determine the effects of sex difference on brain volume (BV), lateral ventricle volume (LV) and the ratio of brain volume and lateral ventricle volumes as a percentage (RLBV%) of 90 healthy children between the ages of 6-17 according to their sex with MRI. These children were divided into three age groups of 6-9, 10-13 and 14-17 also BV, LV were calculated using the Cavalieri principle, which is classified as a stereological method and than RLBV% were calculated. Results: The BV of age group 6-9 was significantly smaller than the other two age groups (P < 0.05). General average BV of the age group 10-13 was higher than the other two age groups but this difference is insignificant. When the groups were compared according to sex, there was no important difference between girls and boys (P > 0.05). General average LV of the age group 6-9 was higher than the other two age groups but this difference insignificant. Moreover there was no sex difference. This study was presented that BV was continued to increase until the ages 10-13 for both of the genders. While LV was increased until the ages 10-13 for boys, it was had a negative relationship with changes of BV for girls.

Aunque el desarrollo del cerebro es más activo durante el período de la vida intrauterina, los procesos de mielinización y arborización afectan a la estructura del cerebro durante la infancia y la adolescencia. El desarrollo del cerebro es activo en los primeros años de la vida, y sigue siendo así durante unos 15 años después de la gestación. Cambios volumétricos en el cerebro son afectados según el sexo. La comprensión de la variabilidad del volumen del cerebro humano durante el desarrollo es importante para la interpretación de los estudios de neuroimagen en la infancia. Por lo tanto, el objetivo de este estudio fue determinar, a través de resonancia nuclear magnética, los efectos de las diferencias de sexo en el volumen cerebral (VC), en el volumen del ventrículo lateral (VL) y la relación porcentual de los volúmenes del cerebro y del ventrículo lateral (% VLVC) de 90 niños sanos entre 6-17 años de edad, en ambos sexos. Los niños fueron divididos en tres grupos de edad: 6-9, 10-13 y 14-17. El VC y el VL se calcularon utilizando el principio de Cavalieri, además de la relación porcentual RLBV. El VC del grupo 6-9 años fue significativamente menor que el de los otros dos grupos (p <0,05). El promedio del BC del grupo 10-13 años fue superior a los otros dos grupos de edad, pero esta diferencia fue mínima. Cuando se compararon los grupos en cuanto al sexo, no hubo diferencia entre niños y niñas (P> 0,05). El promedio general del grupo VL de 6-9 años fue mayor que los otros dos, sin diferencia significativa entre ambos sexos. El VC siguió aumentando hasta los 10-13 años en ambos sexos. Mientras LV aumentó hasta los 10-13 años de edad en los niños, se observó en las niñas una relación negativa con cambios de BV.

The role of antioxidants in cerebellar development: a review of literature / Rol de los antioxidantes en el desarrollo del cerebelo: una revisión de la literatura

Developmental pathologies may result from endogenous or xenobiotic-enhanced formation of reacting oxygen species (ROS), which oxidatively damage cellular macromolecules and/or alter signal transduction, and that the embryonic processes regulating the balance of ROS formation, oxidative DNA damage and repair, and ROS-mediated signal transduction may be important determinants of teratological risk. ROS can oxidize molecular targets such as DNA, protein, lipid in a process called oxidative stress resulting in cellular dysfunction and in utero death or teratogenicity. This review, consisting of literature search of journals and chapters in books aims at highlighting the importance of the cerebellum in controlling various motor activities in the body, as well as substances affecting cerebellar development with a view of providing an insight to the role antioxidants play in cerebellar development. It is interesting to note that the developing brain (especially the cerebellum, cerebrum and hippocampus) is highly vulnerable to the deleterious effects of ROS. Studies have shown that exposure to oxidants in the first trimester is associated with an increased risk of major congenital anomalies, as most vital organs in the body develop and some become functional within this period in offspring. Antioxidants may prevent oxidative damage in degenerative diseases including ageing, cardiovascular diseases, cancer, Alzheimer's disease, stroke and Parkinson's disease as such play a critical role in wellness and health maintenance.

Las patologías del desarrollo pueden resultar de la formación endógena o xenobiótica de especies reactivas de oxígeno (ROS), que dañan oxidativamente macromoléculas celulares y/o alteran la transducción de señales, y los procesos embrionarios que regulan el equilibrio de la formación de ROS, daño oxidativo y reparación del ADN; la transducción de señales mediada por ROS pueden ser determinantes e importantes del riesgo teratológico. Las ROS pueden oxidar blancos moleculares como el ADN, proteínas y lípidos en un proceso llamado estrés oxidativo que resulta en disfunción celular y muerte intrauterina o teratogenicidad. Esta revisión consiste en la búsqueda bibliográfica de artículos y capítulos de libros con el objetivo de destacar la importancia del cerebelo en el control de diversas actividades motoras del cuerpo, así como las sustancias que afectan el desarrollo de él con el fin de proporcionar una visión del rol que juegan los antioxidantes en el desarrollo del cerebelo. Es interesante observar que el encéfalo en desarrollo (especialmente el cerebelo, cerebro e hipocampo) son altamente vulnerables a los efectos deletéreos de las ROS. Se ha demostrado que la exposición a oxidantes en el primer trimestre de embarazo se asocia con un mayor riesgo de anomalías congénitas graves, como la mayoría de los órganos vitales del cuerpo en desarrollo y algunos se vuelven funcionales dentro de este período en la descendencia. Los antioxidantes pueden prevenir el daño oxidativo en enfermedades degenerativas incluyendo envejecimiento, enfermedades cardiovasculares, cáncer, enfermedad de Alzheimer, accidente cerebrovascular y enfermedad de Parkinson, y desempeñan un rol crítico en el mantenimiento de la salud y el bienestar.

Survival and long-term neurodevelopmental outcome of the extremely preterm infant. a systematic review

Survival rates among live births in North American tertiary perinatal centers since 1990 were 28% at 23 weeks, 52% at 24, 70% at 25 and 83% at 26 weeks. However, there is wide variation among centers. Survival rates in 2010 among tertiary centers in the United States participating in the Vermont-Oxford Network were 34% at 23 weeks, 61% at 24, 79% at 25, and 87% at 26. All reports of neurodevelopmental outcome of extremely preterm infants in the English literature were reviewed. This literature is very heterogeneous and prevalence highly variable. Major limitations are astonishing variation in criteria for major disability and that, even with the same disability criteria, children with major disabilities are functionally very heterogeneous. Mean prevalence of disability in the literature is 36%, but ranges from 10-61%. This literature could be improved if survivors were followed until early school age, there were more uniform reporting by week of gestation, and outcomes of term control groups were included

Evolutionary difference of brain of male and female.

The difference between male and female brain is age old mystery. Recently CT,MRI and especially PET and fMRI and other brain mapping studies, it was found that the gender differences in brain were far from just expected. As the major difference between male and female is reproductive system,there is expected differences reproductive system in representation in brain.especially in hypothalamus and limbic system. The reviews the differences are beyond that due evolutionary functional role the gender play. The most signifying differences are in language and communication area i.e. Wernick’ and Braca’ areas of brain, Prefrontal lobe, inferior parietal lobules, Straight gyrus,amygdale, pain perception and oxytocin mediated stress responses. Though certain facts generate controversy more research will give better high light understanding the gender differences of brain structure and function.

Comparison of the cranial capacity and brain weight of Arak (Central Iran) with other subgroups of Iranian population / Comparación de la capacidad craneana y el peso del cerebro de Arak (Irán Central) con otros subgrupos de la población iraní

Newborn's body dimensions such as brain weight and cranial capacity can be basis for all changes in anthropometric indices and later problems. This study is undertaken on 978 term-born normal and native newborns in Thaleghany Hospital, Arak, Iran. The measurements of the heads were done according classic cephalometry. The cranial capacity and brain weight of males and female statistically evaluated by using c²- and t test and significance was set up at p<0.05. Means and SD of the cranial capacity were 606.2 +/- 26 and 440.82 +/- 28 for males and females. Means and SD of the brain weight were 627.41 +/-30 for males and 456.24 +/-32 for females. The data showed that cranial capacity and brain weight of males were greater for males than that for females. This data in accompany with other studies proves that, the manner of distribution of cranial capacity and brain weight neither is depend on the age nor the ethnicity of correspondents in Iranian population. The differences in the data of this study with other studies in Iran confirm the effect of ethnicity and environmental condition on cranial capacity and brain weight of Iranian population.

Las dimensiones corporales del recién nacido tales como el peso del cerebro y la capacidad craneal puede ser la base para todos los cambios en los índices antropométricos y problemas futuros. Este estudio se llevó a cabo en 978 recién nacidos normales en el Hospital Thaleghany, recién nacidos nativos de Arak, Irán. Las medidas de las cabezas se realizaron de acuerdo a la cefalometría clásica. La capacidad craneal y el peso del cerebro de hombres y mujeres fueron evaluados estadísticamente mediante el uso de c2 y prueba T, con un nivel de significancia de p<0,05. La media y DS de la capacidad craneal fueron 606,2 +/-26 y 440,82 +/-28 para los hombres y mujeres, respectivamente. La media y DS del peso del cerebro fueron 627,41 +/-30 g para los hombres y 456,24 +/-32 g para las mujeres. Los datos mostraron que la capacidad craneana y el peso del cerebro fue mayor en los hombres que en las mujeress. Estos datos junto con otros estudios, demuestran que la forma de distribución de la capacidad craneana y el peso del cerebro no dependen de la edad ni el origen étnico de la correspondiente población Iraní. Las diferencias en los datos de este estudio con otros estudios en Irán confirman el efecto de la etnicidad y la condición del medio ambiente en la capacidad craneana y el peso del cerebro de la población Iraní.

Risk factor profiles of adverse neuromotor outcome in infants

Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in term and near-term infants. This case-control study was a representative sample of infants from different health-care centers of north and east of Tehran. The association between risk factors and delayed motor development [developmental quotient below 70 indicating a significant delay] was analyzed using correlating risk factors; including the perinatal and neonatal data to the developmental status. The case group consisted of 143 infants whose DQ score was less than 70 and the control group consisted of 140 infants who had a DQ score of more than 70. Neonatal seizures, Apgar score less than 3 after 5 minutes of birth [OR = 2.87 [95% CI; 1.68, 4.92]], low birth weight [OR= 5.86[95% CI; 3.07, 11.18]], preterm delivery [OR =6.17 [95% CI; 3.04, 12.52]], Premature rupture of membranes [PROM]>24 hours [OR = 6.18[95% CI; 2.07, 18.51]] and hyperbilirubinemia leading to phototherapy or exchange transfusion [OR=3.75 [95%CI; 2.12, 6.65]] were associated with an increased risk for neuromotor delay on developmental examination at 1 year. This study identified distinct risk factors for an adverse outcome in infants. In this environment, perinatal risk predictors are most important

Vitamin-C protect ethanol induced apoptotic neurodegeneration in postnatal rat brain

To evaluate ethanol effects to induced activation of caspsae-3, and to observe the protective effects of Vitamin C [vit-C] on ethanol-induced apoptotic neurodegeneration in rat cortical area of brain. Administration of a single dose of ethanol in 7-d postnatal [P7] rats triggers activation of caspase-3 and widespread apoptotic neuronal death. Western blot analysis, cells counting and Nissl staining were used to elucidate possible protective effect of vit-C against ethanol-induced apoptotic neurodegeneration in brain. The results showed that ethanol significantly increased caspase-3 expression and neuronal apoptosis. Furthermore, the co-treatment of vit-C along with ethanol showed significantly decreased expression of caspase-3 as compare to control group. Our findings indicate that vit-C can prevent some of the deleterious effect of ethanol on developing rat brain when given after ethanol exposure and can be used as an effective protective agent for Fetal Alcohol Syndrome [FAS]

The effect of acute and chronic exposure to ethanol on the developing encephalon: a review / Os efeitos da exposição aguda e crônica ao etanol sobre o desenvolvimento do encéfalo: uma revisão

OBJECTIVES: to compare the acute and chronic effects of ethanol on the neural development, by analysis of the ontogenetic neural structure of mammals. METHODS: searches were performed in the following electronic databases: MEDLINE, SciElo, PubMed, LILACS, CAPES periodical, and the Open Journal System. The descriptors used were: "chronic ethanol toxicity", "chronic alcohol toxicity", "acute ethanol toxicity", "acute alcohol", "neural ontogenic development", "neuronal migration disturbances", "neural structure". The following inclusion criteria were used: articles published between 2003 and 2007, some classic articles in the field and an important neuropsychology textbook. RESULTS: the analysis of papers revealed that, although several studies of the chronic effects of ethanol exposure on the mammalian nervous system have been conducted, only a few have investigated the acute effects of ethanol on specific days of gestation, and these studies have revealed important disorders relating to the cerebral tissue. CONCLUSIONS: it should be recommended that women refrain from the consumption of ethanol during gestational phase to protect the fetus' health. Furthermore, the acute consumption of ethanol by women nearing the eighth or ninth week of gestation has been shown to be potentially harmful to the nervous tissue of the fetus.

OBJETIVOS: comparar os efeitos agudo e crônico do etanol sobre o desenvolvimento do sistema nervoso através da análise da estrutura ontogênica neural dos mamíferos. MÉTODOS: pesquisas foram feitas nas bases eletrônicas: MEDLINE, SciElo, PubMed, LILACS, CAPES periodical, Open Journal System. Os descritores usados foram: "toxidade crônica ao etanol", "toxidade crônica ao álcool", "toxicidade aguda ao etanol", "toxicidade aguda ao álcool", "desenvolvimento ontogênico neural", "distúrbios da migração neuronal", "estrutura neural".Foram considerados critérios de inclusão: artigos publicados no periódo de 2003 e 2007, alguns artigos clássicos da área, e um livro básico em neuropsicologia. RESULTADOS constatou-se que muitos estudos sobre os efeitos crônicos do etanol sobre o sistema neural de mamíferos foram feitos, mas poucos estudos foram realizados sobre os efeitos agudos do etanol em dias específicos da gestação, e esses revelaram importantes desordens sobre o tecido neural. CONCLUSÕES: o consumo de etanol não é recomendado para mulheres na fase gestacional para preservar a saúde do feto, e o consumo agudo de etanol entre mulheres próxima à oitava e nona semanas de gestação têm demonstrado ser potencialmente perigoso para o tecido neural do feto.

Psychobiology of childhood maltreatment: effects of allostatic load?

OBJECTIVE: Facing an adverse physical or psychosocial situation, an individual is forced to adapt in order to survive. Allostasis is the term used to refer to adapting processes used to maintain the stability of an organism through active processes. When allostatic response is excessive or inefficient, the organism develops an allostatic load. The cascade of molecular and neurobiological effects associated with childhood abuse and neglect could be an example of allostatic response that could precipitate allostatic load in organism still vulnerable during its development. This article reviews the psychobiological consequences related to childhood abuse and neglect. METHOD: A selective review with a systematic procedure was performed to investigate studies showing explicit association between childhood maltreatment and psychobiological/neurobiological consequences. We searched electronic database MedLine-PubMed to identify English-language articles from 1990 to 2007. RESULTS: From 115 articles we selected 55 studies from MedLine and 30 from their reference lists, in a total of 85 articles (JCR IF range: 1-31.4; median: 5.88). Only 29 studies showed direct and explicit association between them. CONCLUSION: Structural consequences of childhood maltreatment include disruptive development of corpus callosum, left neocortex, hippocampus, and amygdale; functional consequences include increased electrical irritability in limbic areas, frontal lobe dysfunctions and reduced functional activity of the cerebellar vermis; and neurohumoral consequences include the reprogramming activity of hypothalamo-pituitary-adrenal (HPA) axis and subsequently the stress response.

OBJETIVO: Frente a uma situação psicossocial ou física adversa, o indivíduo é forçado a se adaptar de maneira que possa sobreviver. Alostase é o termo utilizado para descrever os processos adaptativos usados para manter a estabilidade de um organismo por meio de processos ativos. Quando a resposta alostática é excessiva ou ineficiente, o organismo desenvolve um peso alostático. A cascata de efeitos moleculares e neurobiológicos associados ao abuso e negligência na infância poderia ser um exemplo de respostas alostáticas e, dessa forma, poderia precipitar peso alostático em um organismo ainda vulnerável no seu desenvolvimento. Este artigo revisa as conseqüências psicobiológicas relacionadas com os maus-tratos na infância. MÉTODO: Uma revisão seletiva com base sistemática foi realizada na base de dados MedLine, procurando artigos em inglês que investigassem uma associação direta e explícita entre maus-tratos na infância e conseqüências psicobiológicas em humanos durante o período de 1990-2007. RESULTADOS: De 115 artigos, foram selecionados 55 estudos do MedLine e 30 de suas listas de referências, num total de 85 artigos (JCR IF: 1-31,4; mediana: 5,88). Especificamente apenas 29 estudos investigaram uma associação direta e explícita entre eles. CONCLUSÃO: Em resumo, as conseqüências estruturais dos maus-tratos na infância incluem anormalidades no desenvolvimento do corpo caloso, neocórtex esquerdo, hipocampo e amígdala; as conseqüências funcionais incluem um aumento da irritabilidade nas áreas límbicas, disfunções do lobo frontal e redução da atividade funcional do vermis cerebelar; e as conseqüências neuro-humorais englobam a reprogramação do eixo HPA e subsequentemente à resposta ao estresse.