Coagulation factors, anticoagulant proteins, and plasminogen in Mexican older adults.

INTRODUCTION: Hemostasis protects upon the occurrence of vascular endothelial damage, with involving of different factors. The interaction of these factors in older adults is poorly known, and has been associated with different disorders. Therefore, we determined the activity of coagulation factors (CF), anticoagulant proteins (AP), and plasminogen (Plg), as well as the frequency of deficiencies of these proteins in a population of healthy Mexican older adults (OA). METHODS: CF (I, II, V, VII, VIII, IX, X, and XI y XII), AP [protein C (PC), protein S (PS), and antithrombin (AT)], and Plg were determined from 244 plasma samples of OA using commercial kits in a coagulometer ACL Elite Pro. RESULTS: A total of 139 women and 105 men were under study. They were divided into age range groups (50-59, 60-69, 70-79, and ˃80 years). Activity of CF, AP, and Plg was determined. Frequencies of CF, AP, and Plg activity values were obtained for each age group according to gender. Differences were found between both frequencies for each protein. CONCLUSION: Significant differences were found, so it is recommended to establish reference values (RV) for the activity of fibrinogen and FX by decade and gender, FVII and FXII by gender, FII, FV, FVIII, PC, PS, and Plg by decade, whereas for FIX, FXI, and AT, they are not modified by age or gender, so the RV described for adult Mexican population can be used. It is important to integrate these results into established diagnostic algorithms, which can be taken into account to provide an accurate diagnosis and treatment for patients with suspected hemorrhagic or thrombotic processes, as well as suggest those habits that improve their quality of life, to maintain optimal health and prevent thrombotic and hemorrhagic events.

[Hypernephroma associated motor neuron disease. Presentation of a case]. / Enfermedad de la motoneurona asociada a hipernefroma. Presentación de un caso.

INTRODUCTION: Paraneoplastic motor neuron disease are rare among patients with renal cell carcinoma. OBJECTIVE: Present the clinical and electrophysiological evolution of a patient with a motor neuron disease and hypernephrome. CASE REPORT: A 60 years old woman, affected only by high level pressure since 10 years ago. She noticed sudden palsy of the left leg and 10 months later an abdominal ultrasound showed a renal cell carcinoma, discovered without other symptoms than neurologic. After radical nephrectnomy, the patient was treated with recombinant interferon alpha 2b. The neurologic damage advanced and she has a flaccid weakness and muscle atrophy in the legs and brisk reflexes, also in wasted limbs. There is Babinski, fasciculations, light flaccid dysarthria and laryngospasm. Peripheral nerve conduction studies are within normal limits. The electromyogram show positive sharp waves in both legs and left hand. Recruitment patterns are decreased and there are fasciculations in the tongue, upper and lower limbs. The magnetic resonance of the brain and spinal cord is normal. There are not evidence of metastasis. The question of whether or not this is a paraneoplastic form of motor neuron disease remain unclear. CONCLUSION: This case suggest the need to consider a renal cell carcinoma in the course of a motor neuron disease.

Enfermedad de la motoneurona asociada a hipernefroma. Presentación de un caso / Hypernefroma-associated motor neuron disease. Presentation of a case

Introducción. Las enfermedades de motoneurona como síndromes paraneoplásicos, en especial el daño de motoneurona inferior, se encuentran asociadas a síndromes linfoproliferativos y evolucionan de diversas maneras. Objetivo. Presentar la evolución clínica y electrofisiológica de una paciente en la que se asociaron una enfermedad de motoneurona (EMN) y un hipernefroma. Caso clínico. Mujer de 60 años, con antecedentes de más de una década de hipertensión arterial, que comenzó a presentar paresia brusca e intermitente del miembro inferior izquierdo. Pasados 10 meses del inicio neurológico, se diagnosticó un hipernefroma en un ultrasonido abdominal, sin antecedentes de síntomas y signos renales. Se realizó nefrectomía y se impuso tratamiento con interferón alfa 2b recombinante. De modo progresivo, se instaló una parálisis flácida de ambos miembros inferiores, con hiperreflexia. El daño neurológico se ha extendido a miembros superiores y existen signos ligeros de disfunción bulbar. Predominan los signos de afectación de la motoneurona inferior y también existen manifestaciones de daño de la motoneurona superior. Los estudios de neuroconducción motora y sensitiva fueron normales; la electromiografía mostró abundantes signos de denervación parcial en los músculos afectados; la resonancia magnética nuclear de raquis y cráneo fue normal. Después de 24 meses, no se han detectado metástasis. Conclusiones. El hipernefroma debe descartarse siempre que se sospeche una EMN (AU)

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[Primary diffuse leptomeningeal gliomatosis. Presentation of one case]. / Gliomatosis leptomeníngea difusa primaria: presentación de un caso.

A twenty-four-year-old woman presented with asthenia, anorexia and weight los associated with headache, neck ache, lumbo-sacral pain, flaccid quadriparous, bilaterally diminished vision and sphincter disorders. On computerized axial tomography of the skull, only slight signs of ventricular dilatation were seen. Cytochemical study of the cerebro-spinal fluid showed a marked increase in protein and there was a raised erythrocyte sedimentation rate. The patient was treated with steroids in view of the possibility of vasculitis or a demyelinating disorder. However the disease worsened and she died four months after onset of the disorder. Neuro-pathological study showed tumour infiltration of the leptomeninges of the base of both cerebral hemispheres, cerebellum and spinal medulla. The optic nerves, chiasma and spinal nerve roots were also infiltrated with neoplastic cells. No intraparenchymatous tumour was found. The neuropathological findings were compatible with primary diffuse leptomeningeal gliomatosis.

[Treatment of acute attack of migraine with sumatriptan]. / Tratamiento del ataque agudo de la cefalea migrañosa con sumatriptán.

INTRODUCTION AND MATERIAL: In the Hospital Clínico Quirúrgico Hermanos Almeijeiras a randomized double blind clinical trial was carried out involving 52 patients who presented with painful migraine crises with or without prodromes. A group of 27 patients were given 6 mg of sumatriptan subcutaneously. Another group of 25 patients were given 1 mg of dihydroergotamine intramuscularly. It was seen that both drugs relieved the migrainous pain. However, sumatriptan did so in a greater percentage of patients. RESULTS AND CONCLUSIONS: There was earlier, and also more complete, relief of pain in those patients receiving sumatriptan. With regard to side-effects of sumatriptan were pain at the back of the site of injection, sensation of pressure at the back of the neck, facial flushing and asthenia.