[Bilateral amputation in diabetic patient with blindness, the use of inadequate prosthesis. Case report]. / Amputación bilateral en paciente diabética con ceguera, el uso de prótesis inadecuadas. Reporte de caso.

The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal¼ or «rustic¼ systems that hamper their adaptation process. We present herein the case of a 47 year-old female patient, housewife, with bilateral paresthesias and phantom limb sensation associated with amputation neuromas resulting from type II diabetes mellitus that had affected the patient for eight years. This patient of a low socioeconomic stratum underwent a post-amputation assessment and was diagnosed as being heavily dependent when performing activities of daily living and required assisted wheelchair for ambulation. This is a frequent variant resulting from bilateral loss of lower limbs together with complete loss of vision. We describe the rehabilitation therapy during the pre- and post-prosthetic stages, together with the results of the assessments to show the effectiveness of the treatment process, without forgetting the participation of the caregiver as a fundamental co-therapeutic element in this process.

Las complicaciones más frecuentes asociadas con la diabetes incluyen al pie diabético y al glaucoma, que suelen llevar a la amputación y a la pérdida de la visión, respectivamente. El desarrollo científico y tecnológico actual ha permitido el diseño e implementación de sistemas protésicos óptimos para estos pacientes, asegurando una reincorporación a las actividades de la vida diaria, así como una correcta adaptación al uso de las mismas. La falta de recursos económicos compromete la adquisición de las prótesis ideales, recurriendo al uso de sistemas «artesanales¼ o «rústicos¼ que afectan la adaptación. Se presenta el caso de un paciente femenino de 47 años de edad, ama de casa, quien presenta parestesias bilaterales y sensación de miembro fantasma asociado a neuromas de amputación por diabetes mellitus tipo II de ocho años de evolución. La paciente, con bajos recursos económicos, es evaluada postamputación con diagnóstico de dependencia grave en la ejecución de las actividades de la vida diaria, con desplazamiento en silla de ruedas asistido; esta presentación es una variante frecuente como consecuencia de la pérdida bilateral de miembros inferiores, concomitante a la ausencia total de la visión. Se presenta el tratamiento de rehabilitación en etapa preprotésica y protésica, acompañados por los resultados de las evaluaciones para mostrar la efectividad del proceso terapéutico, sin olvidar la participación del cuidador como ente coterapéutico fundamental en el proceso.

Chorionic gonadotropin hormone receptors on Taenia solium and Taenia crassiceps cysticerci in culture.

Hormones play a significant role in murine Taenia crassiceps cysticercosis, and they may also participate in the susceptibility to Taenia solium cysticercosis. In the present study, in vitro effects are reported for human chorionic gonadotropin (hCG) on the larval stages of T. crassiceps (WFU strain) and T. solium. Our results reveal the presence of receptors for hCG in different developmental phases of both cultured parasites. On day 30, both taeniid species had the highest percentage of receptors in the neck, strobila, and suckers, but these receptors decreased by day 60, delimiting the segments and the exterior of the developing proglottids in T. solium. At the same time, there was a large number of hCG receptors in the area of the presumptive cirrus organ and in calcareous corpuscles within the parenchyma. This is the first report detecting receptors for hCG on different larval stages of T. crassiceps and T. solium. A direct effect of hCG could be recognized by the cysticerci as a factor contributing to the growth and development of T. crassiceps and T. solium cysticerci, respectively.

Different effects of chorionic gonadotropin on Taenia crassiceps and Taenia solium cysticerci cultured in vitro.

Hormones play a significant role in murine Taenia crassiceps cysticercosis, and they may also participate in the susceptibility to Taenia solium cysticercosis. In the present study, in vitro effects are reported for human chorionic gonadotropin (hCG) on the larval stages of T. crassiceps (WFU strain) and T. solium. hCG effectively promotes parasite reproduction, i.e., it increases the number of buds on T. crassiceps cysticerci and the percentage of evagination and parasite length in T. solium. This is the first report in which a direct effect of hCG is reported for a parasite. hCG or mouse luteinizing hormone could be recognized by the cysticerci as mitogenic factors and contribute to the female and pregnancy bias toward susceptibility to T. crassiceps and T. solium cysticercosis, respectively.