Entre la clínica exagerada y la clínica exasperada. Puentes, diferencias y rupturas en Salud Mental Infantojuvenil / [Between the exaggerated and the exasperated clinic. Bridges, differences and rupture in child and youth mental care].

This article intends to approach a series of contrasting concepts regarding different relevant issues for the Child and Youth Mental Health. Diagnosis as a temporary and unstable assessment method. Early detection and treatment as opposed to the possibility of premature diagnoses. The possible or impossible dialogues between psychoanalysis, neuroscience and cognitive sciences. The problems associated with autism and its different theoretical approach models. The development of each of these complex aspects of the practice considers the risk of treating the child as a mere "pathological entity" and dehumanizing him and his condition from the different perspectives, disciplines and discourses, which intend to address the child and his condition. Finally this proposal aims at building bridges of dialogue, overcoming differences in order to avoid rupture.

Morphological abnormalities in mitochondria of the skin of patients with sporadic amyotrophic lateral sclerosis / Alteraciones morfológicas en las mitocondrias en la piel de enfermos con esclerosis lateral amiotrófica esporádica

OBJECTIVES: Mitochondrial dysfunction has been reported in the central nervous system, hepatocytes and peripheral blood lymphocytes from patients with sporadic amyotrophic lateral sclerosis (SALS). However, the status of skin mitochondria has not been reported, in spite of the fact that SALS patients present skin abnormalities. The objective of the present study was to compare mitochondrial ultrastructural parameters in keratinocytes from patients with SALS and healthy controls. METHODS: Our study was based on the analysis of 112 skin mitochondria from 5 SALS patients and 99 organelles from 4 control subjects by electron microscopy. RESULTS: Computerized image analysis showed that mitochondrial major axis length, area and perimeter of the organelle were significantly smaller in SALS respect of healthy control subjects. Morphologically, SALS mitochondria presented cristolysis and breakage of the outer membrane. CONCLUSIONS: Mitochondrial dysfunction in the skin may possibly reflect changes occurring in mitochondria of the central nervous system. The analysis of mitochondrial morphology in this tissue may be of value to follow disease progression and, eventually, the effectiveness of current therapies for SALS.

OBJETIVOS: Existen alteraciones en la función mitocondrial en el sistema nervioso central, en hepatocitos y en linfocitos de sangre periférica en SALS. Aunque, no se ha estudiado si existen cambios estructurales en las mitocondrias de la piel. Nuestro objetivo fue comparar la ultraestructura de mitocondrias en queratinocitos de enfermos con SALS con la de controles sanos. MÉTODO: Fueron analizadas en el microscopio electrónico 112 mitocondrias dérmicas de 5 pacientes y 99 provenientes de 4 controles. RESULTADOS: EL análisis computarizado mostró que el eje mayor mitocondrial, el área y el perímetro de las organelas fueran significativamente menor que en controles. Morfológicamente, las mitocondrias de SALS presentaron cristólisis y ruptura de la membrana externa. CONCLUSIÓN: La alteración mitocondrial en la piel posiblemente refleje cambios que también ocurran en las mitocondrias neuronales. Este análisis morfológico de las mitocondrias podría tener valor en el seguimiento de la enfermedad y eventualmente en la evaluación de la efectividad de futuras terapias.

Distribution of NADPH-diaphorase in rat mesencephalon: a light and electron microscopical study

NADPH-diaphorase is a useful technique to reveal NO producing neurons at light microscopic level (LM). A modification of the technique using the tetrazolium salt BSPT as substrate, is useful to study the ultrastructure of NO neurons. The aim of this work was to perform a detailed analysis of NADPH-diaphorase reactive neurons in rat mesencephalon both at light and electron microscopic levels. NADPH-diaphorase reactive neurons were observed in superior colliculus, in central gray matter, in dorsal and medial raphe and in the pedunculopontine tegmental nucleus using two histochemical techniques at LM. Electron microscopy showed deposits on membranes of the endoplasmic reticulum, Golgi apparatus and nuclear envelope of dorsal raphe neurons. Presynaptic and postsynaptic terminals showed deposits on membranous elements but postsynaptic terminals also showed deposits on the inner surface of their membranes. Further physiological studies are needed to clarify the meaning of the ultrastructural findings such as the putative interaction of NOS with postsynaptic proteins, receptors or membranous channels.

Striatal cytomegalic neurons containing nitric oxide are associated with experimental perinatal asphyxia: implication of cold treatment

Neuropathological mechanisms triggered by excitatory aminoacids are Known to involve nitric oxide (NO). Neurons containing NO are histochemically reactive to nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d), which labels NO synthase in CNS, Sprague-Dawley male rats subjected to perinatal asphyxia (PA) at 37 degreese Celsius, and PA plus 15 degreese Celsius hypothermia were evaluted when 6 months old by NADPH-d histochemical reaction. Computarized image analysis was used for quantification of stained sections. NADPH-d neurons in striatum from subsevere and severe PA showed a significant increment in soma size and dendritic process length versus control and hypothermic treated rats. Post-ischemic damage reurons are therefore involved in NO changes induced by PA that may be prevented by hypothermia treatment.

Factores causantes del temor en la atención estomatológica / Fear-inducing factors in dental care

El presente trabajo tiene como antecedente un estudio preliminar realizado por los autores en 1981. El actual se ha llevado a cabo con una muestra de 200 personas en varias instituciones de salud del municipio Cotorro, en un periodo de 4 meses (julio-septiembre de 1985), los cuales manifestaron temor o miedo a la atención estomatológica. En la muestra estudiada encontramos las causas fundamentales que lo generan, así como los hábitos, patrones de comportamiento, estados de ánimo y datos generales de los entrevistados y su relación con dichas causas. Los resultados obtenidos se presentan en tablas y porcentajes para un mejor análisis y comprensión. Se brindan conclusiones y recomendaciones