Sistema penitenciario y vejez: aportes de la evaluación neuropsicológica forense / Penitentiary System and old age: contributions of the forensic neuropsychological evaluation

Resumen Introducción: El envejecimiento poblacional ha impulsado a que su abordaje se convierta en un tema prioritario a nivel mundial, sobre la cual aún existen mitos y discriminación, siendo las personas adultas mayores en privación de libertad en un sistema penitenciario, una población con mayores riesgos de exclusión y que cuentan con características neuropsicológicas que ameritan su atención. Por lo tanto, se realizó en Costa Rica un primer abordaje en el Centro de Atención Institucional Adulto Mayor desde la neuropsicología forense, para mejorar los protocolos disponibles de evaluación de la población adulta mayor. Procedimiento: Se llevó a cabo un trabajo final de graduación en formato de práctica dirigida durante 858 horas tanto de forma presencial como a distancia, en el período de abril del 2017 a abril del 2018, participando de los procesos de evaluación neuropsicológica forense, elaboración de un protocolo de evaluación neuropsicológica forense y participación en procesos psicoeducativos sobre consumo de sustancias y violencia sexual. Resultados: En total se atendieron 40 personas hombres, entre 58 y 85 años de edad. Con variables sociodemográficas y de salud como una baja escolaridad (45%), con antecedentes de trauma craneoencefálico (67%) y en su mayoría cometieron abuso sexual (55%). Se elaboró un protocolo de evaluación neuropsicológica que incluye un módulo de entrevista y observación, evaluación del estado de ánimo y evaluación del funcionamiento cognitivo.

Abstract Introduction: Population ageing has become a priority between the attention and care systems but still deals with myths and discrimination, being the older adults incarcerated in the prison system a population with a greater risk of exclusion and that have neuropsychological characteristics that need attention. Therefore, a first approach was carried out in Costa Rica in the Institutional Adult Care Center from the forensic neuropsychology, to improve the available protocols for the evaluation of the older adult population. Method: A final graduation work was carried out in a guided practice format for 858 hours both in person and remotely, in the period from April 2017 to April 2018, participating in the processes of forensic neuropsychological evaluation, preparation of a protocol of forensic neuropsychological evaluation and participation in psychoeducational processes on substance use and sexual violence. Results: In total 40 male people, between 58 and 85 years of age, were attended. With sociodemographic and health variables such as low schooling (45%), with a history of cranioencephalic trauma (67%) and most of them committed sexual abuse (55%). A neuropsychological evaluation protocol was elaborated that includes an interview and observation module, evaluation of mood and evaluation of cognitive functioning module.

Milk fat components with potential anticancer activity-a review.

During many years, the milk fat has been unfairly undervalued due to its association with higher levels of cardiovascular diseases, dyslipidaemia or obesity, among others. However, currently, this relationship is being re-evaluated because some of the dairy lipid components have been attributed potential health benefits. Due to this, and based on the increasing incidence of cancer in our society, this review work aims to discuss the state of the art concerning scientific evidence of milk lipid components and reported anticancer properties. Results from the in vitro and in vivo experiments suggest that specific fatty acids (FA) (as butyric acid and conjugated linoleic acid (CLA), among others), phospholipids and sphingolipids from milk globule membrane are potential anticarcinogenic agents. However, their mechanism of action remains still unclear due to limited and inconsistent findings in human studies.

Necrosis retiniana aguda bilateral en el anciano por varicela zóster / Bilateral acute retinal necrosis due to varicella zóster virus in an elderly patient

CASO CLÍNICO: Presentamos a un paciente de 77 años, con un cuadro de necrosis retiniana aguda con afectación bilateral; la reacción en cadena de la polimerasa (PCR) de la muestra de humor acuoso fue positiva al virus de varicela zóster. En su evolución desarrolla vasculitis de Kyrieleis al mes de inicio del tratamiento y con el análisis por PCR negativo. DISCUSIÓN: La PCR es un método rápido, con una sensibilidad y especificidad del 97%. La actuación debe ser urgente por la rapidez de la progresión. El famciclovir oral es buena alternativa por su mejor biodisponibilidad

CASE REPORT: The case is reported of acute retinal necrosis with bilateral involvement due to Varicella Zoster virus in a 77 year-old man. Polymerase chain reaction (PCR) of aqueous humor was positive for Varicella Zoster virus (VZV). He developed a Kyrieleis’ vasculitis a month after the starting treatment, when the PCR analysis was negative. DISCUSSION: PCR is a quick and safe technique, with a high sensitivity and specificity of 97%, useful to diagnose and monitor the viral activity. The intervention must be urgent, due to the dramatically rapid evolution. Oral famciclovir oral is good alternative owing to its bioavailability

Bilateral acute retinal necrosis due to varicella zóster virus in an elderly patient.

CASE REPORT: The case is reported of acute retinal necrosis with bilateral involvement due to Varicella Zoster virus in a 77 year-old man. Polymerase chain reaction (PCR) of aqueous humor was positive for Varicella Zoster virus (VZV). He developed a Kyrieleis' vasculitis a month after the starting treatment, when the PCR analysis was negative. DISCUSSION: PCR is a quick and safe technique, with a high sensitivity and specificity of 97%, useful to diagnose and monitor the viral activity. The intervention must be urgent, due to the dramatically rapid evolution. Oral famciclovir oral is good alternative owing to its bioavailability.

Total milk fat extraction and quantification of polar and neutral lipids of cow, goat, and ewe milk by using a pressurized liquid system and chromatographic techniques.

Although milk polar lipids such as phospholipids and sphingolipids located in the milk fat globule membrane constitute 0.1 to 1% of the total milk fat, those lipid fractions are gaining increasing interest because of their potential beneficial effects on human health and technological properties. In this context, the accurate quantification of the milk polar lipids is crucial for comparison of different milk species, products, or dairy treatments. Although the official International Organization for Standardization-International Dairy Federation method for milk lipid extraction gives satisfactory results for neutral lipids, it has important disadvantages in terms of polar lipid losses. Other methods using mixtures of solvents such as chloroform:methanol are highly efficient for extracting polar lipids but are also associated with low sample throughput, long time, and large solvent consumption. As an alternative, we have optimized the milk fat extraction yield by using a pressurized liquid extraction (PLE) method at different temperatures and times in comparison with those traditional lipid extraction procedures using 2:1 chloroform:methanol as a mixture of solvents. Comparison of classical extraction methods with the developed PLE procedure were carried out using raw whole milk from different species (cows, ewes, and goats) and considering fat yield, fatty acid methyl ester composition, triacylglyceride species, cholesterol content, and lipid class compositions, with special attention to polar lipids such as phospholipids and sphingolipids. The developed PLE procedure was validated for milk fat extraction and the results show that this method performs a complete or close to complete extraction of all lipid classes and in less time than the official and Folch methods. In conclusion, the PLE method optimized in this study could be an alternative to carry out milk fat extraction as a routine method.

Xantogranuloma juvenil en limbo corneoescleral en el adulto / Juvenile xanthogranuloma of the corneoscleral limbus in adults

Caso clínico: Mujer de 25 años de edad que refería una tumoración no dolorosa amarillenta en el ojo derecho. Su agudeza visual era de la unidad. En la exploración en lámpara de hendidura se observa una masa amarilla-anaranjada localizada en el limbo superior del ojo derecho. No se observaron otras anormalidades. Discusión: Se realizó una escisión quirúrgica de la lesión y se remitió a anatomía patológica para su examen. La lesión granulomatosa mostraba células de Touton. Este hecho sugiere de forma importante el diagnóstico de xantogranuloma juvenil (JXG). La afectación ocular ocurre en el 10% de los casos de JXG (AU)

Case report: A 25-year-old woman noticed a painless yellow-orange mass on her right eye. Her visual acuity was 20/20 in both eyes, and a slit-lamp examination showed a yellow-orange mass located at the superior limbus of the right eye. No other ocular abnormalities were observed. Discussion: Surgical excision was carried out and the lesion was sent for histological examination. This showed a granulomatous lesion, rich in Touton-type giant cells, features that are strongly suggestive of juvenile xanthogranuloma (JXG). Ocular involvement occurs in 10% of cases of JXG (AU)

Tirotoxicosis facticia y trastorno de la conducta alimentaria / Thyrotoxicosis factitia and eating disorders

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[Juvenile xanthogranuloma of the corneoscleral limbus in adults]. / Xantogranuloma juvenil en limbo corneoescleral en el adulto.

CASE REPORT: A 25-year-old woman noticed a painless yellow-orange mass on her right eye. Her visual acuity was 20/20 in both eyes, and a slit-lamp examination showed a yellow-orange mass located at the superior limbus of the right eye. No other ocular abnormalities were observed. DISCUSSION: Surgical excision was carried out and the lesion was sent for histological examination. This showed a granulomatous lesion, rich in Touton-type giant cells, features that are strongly suggestive of juvenile xanthogranuloma (JXG). Ocular involvement occurs in 10% of cases of JXG.