Does Distance Among Colonies and Resource Availability Explain the Intercolonial Aggressiveness in Nasutitermes aff. coxipoensis?

Aggressive behaviour can ensure animal access to local resources. To reduce constant costs in the defence of territories, species could save energy with conflicts avoiding aggression with neighbour or in situations with abundance of resources. In the present study, we analysed the effect of distance among colonies and resource availability on the aggression level and responses to chemical cues of Nasutitermes aff. coxipoensis (Holmgren) (Termitidae: Nasutitermitinae). Manipulation of resource offer was conducted in the field, where nests with different distances were kept without addition of baits (control), with addition of three or 16 sugarcane baits/nest. After 3 months, aggressiveness, linear and Y-shaped trail-following bioassays were carried out with all pairwise combinations of colonies in each treatment. Our results showed that aggressive index of N. aff. coxipoensis was affected by the resource availability. However, individuals from colonies with 0 and 3 baits/nest showed a higher number of fighting with neighbours than those from non-neighbours colonies. Termite workers from colonies without baits (control) followed shorter distance in the linear trails compared to those from colonies with addition of baits. In all treatments, there was no preference of workers in relation to the choice of chemical cues from own or other colonies. The response of intercolonial aggressiveness in N. aff. coxipoensis seems to be resource-dependent. These results may contribute to the comprehension of the use of space by N. aff. coxipoensis and could be useful to explain patterns of termite co-occurrence at different spatial scales, from local (inside the nest-e.g. cohabitation of nests by inquilines) to regional (e.g. around the nest).

Ants Associated with Turnera subulata (Turneraceae): Elaiosome Attraction, Seed Dispersion and Germination.

Symbiosis between plants and ants include examples in which the plant provides shelter and/or food for ants that, in turn, act in the defense or in the dispersion of seeds from the host plant. Although traditionally referred as mutualistic, the results of these interactions may vary with the ecological context in which patterns are involved. A range of species have facultative association with Turnera subulata (Turneraceae). Here, using behavioral bioassays, we investigated the effects of the most frequent ant species associated with T. subulata (Brachymyrmex sp.1, Camponotus blandus (Smith), Dorymyrmex sp.1, Crematogaster obscurata Emery, and Solenopsis invicta Buren) in the dispersion of plant host seeds and in the number of seedlings around the associated ant nests. We also evaluated the effects of these ant species in the germination of T. subulata seeds, in the consumption of elaiosome, and in the attractiveness to elaiosome odor. Our results showed that the ant species associated with T. subulata presented variation in the attraction by the odor and in the rate of consumption of the elaiosomes. However, none of the ant species studied contributed significantly to the increase of seed germination and seedling growth. Our results suggest that the consumption of the elaiosome by ant species is not a determinant factor to the success of germination of T. subulata. However, such species could contribute indirectly to seed germination by carrying seeds to sites more fertile to germination. In general, our results help to elucidate the results of ecological interactions involving ants and plants.

Efficacy of narrow-band imaging for detecting intestinal metaplasia in adult patients with symptoms of dyspepsia. / La eficacia de la imagen de banda estrecha para la detección de metaplasia intestinal en pacientes adultos con síntomas de dispepsia.

INTRODUCTION AND OBJECTIVE: Atrophy and intestinal metaplasia are early phenotypic markers in gastric carcinogenesis. White light endoscopy does not allow direct biopsy of intestinal metaplasia due to a lack of contrast of the mucosa. Narrow-band imaging is known to enhance the visibility of intestinal metaplasia, to reduce sampling error, and to increase the diagnostic yield of endoscopy for intestinal metaplasia in Asian patients. The aim of our study was to validate the diagnostic performance of narrow-band imaging using 1.5× electronic zoom endoscopy (with no high magnification) to diagnose intestinal metaplasia in Mexican patients. MATERIALS AND METHODS: A retrospective cohort study was conducted on consecutive patients with dyspeptic symptoms at a private endoscopy center within the time frame of January 2015 to December 2016. RESULTS: A total of 338 patients (63±8.4 years of age, 40% women) were enrolled. The prevalence of H. pylori infection was 10.9% and the incidence of intestinal metaplasia in the gastric antrum and corpus was 23.9 and 5.9%, respectively. Among the patients with intestinal metaplasia, 65.3% had the incomplete type, 42.7% had multifocal disease, and one third had extension to the gastric corpus. Two patients had low-grade dysplasia. The sensitivity of white light endoscopy was 71.2%, with a false negative rate of 9.9%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of narrow-band imaging (with a positive light blue crest) were 85, 98, 86.8, 97.7, and 87.2%, respectively. CONCLUSION: The prevalence of H. pylori infection and intestinal metaplasia in dyspeptic Mexican patients was not high. Through the assessment of the microsurface structure and light blue crest sign, non-optical zoom narrow-band imaging had high predictive values for detecting intestinal metaplasia in patients from a general Western setting.

The Role of Resource Density on Energy Allocation in the Neotropical Termite Nasutitermes aff. coxipoensis (Termitidae: Nasutitermitinae).

Organisms acquire energy from environment and must allocate it among different life traits (growth, maintenance and reproduction). Social insects must manage the energy allocation to various levels such as colony growth and caste functions. Here, we addressed the question of whether resource density affects the energy allocation to the number of individuals and caste functions as well as nest's growth rate in the Neotropical termite Nasutitermes aff. coxipoensis (Homgren) (Termitidae: Nasutitermitinae). In a manipulative field experiment, colonies of N. aff. coxipoensis, with known volume, were maintained in plots with three different resource's density (0.32, 0.64 and 1.92 baits/m2) over 3 months. After this period, the number of individuals as well as the caste identity and nest volume were measured. Surprisingly, our results showed that colonies reared in the extremes of resource's density (0.32 and 1.92 baits/m2) produced a higher number of individuals compared with colonies reared with intermediate resource density (0. 64 baits/m2). The mean number of workers increased linearly with resource density; however, the average number of immature was higher in colonies reared with 0.32 baits/m2 compared with colonies reared with 0.64 and 1.92 baits/m2. No significant differences of resource density were observed in the mean number of soldiers, worker/soldier ratio as well as in the nest's growth rate. In conclusion, the resource's density seems to play an important role in determining the investment of energy in the number of individuals and caste in N. aff. coxipoensis colonies.

Undernutrition during early life alters neuropeptide Y distribution along the arcuate/paraventricular pathway.

Perinatal nutrient restriction exerts profound influences on brain development. Animals that suffer undernutrition during lactation also display impaired weight gain. Feeding behavior is mainly modulated by neural and hormonal inputs to the hypothalamus. The arcuate-paraventricular neuropeptidergic Y pathway has a prominent role in appetite regulation. The aim of this work was to study the effects of protein undernutrition during lactation on this hypothalamic pathway. We used rats from 5 to 60 postnatal (P) days whose dams were fed a 0% protein diet (PFG) or a normoprotein diet (CG) from P1 to P10. To reproduce the same amount of calorie ingested by the PFG we used an underfed group (UFG). Immunohistochemistry was performed to assess neuropeptide Y (NPY) distribution in the arcuate, periventricular and paraventricular nuclei. Our results showed a NPY immunostaining peak at P10 in all nuclei in CG animals. In UFG animals this peak was observed by P15, while, in the PFG animals only by P20. Our results suggest that the neuropeptidergic arcuate-paraventricular pathway suffered a delay in NPY distribution in undernourished animals, particularly those fed a 0% protein diet, reflecting an effect on this pathway maturation that could explain previously reported alterations on feeding behavior in these animals.

Necrotizing sialometaplasia in an HIV positive cocaine user: a case report.

The aim of this paper was to present a case report of a male patient attending a Semiology and Stomatology Clinic with an erythematous ulcerated lesion on his palate. The patient reported that he was HIV positive as well as being addicted to cocaine. After a biopsy and a histopathological exam, he was diagnosed as having necrotizing sialometaplasia. The lesion diminished spontaneously in thirty days after the exam. Correct diagnosis as well as physical and complementary exams are paramount to avoid any incorrect therapy. As drug addiction and HIV infection have both been associated to necrotizing sialometaplasia, as in the present case, it is difficult to establish if the aetiological factor was drug usage or the HIV infection or even, the combination of these two factors. Although considering the influence of HIV infection on the oral health, we may assume that, at least, it favored the onset of this oral lesion.

Antinociceptive properties in mice of a lectin isolated from the marine alga Amansia multifida Lamouroux.

The antinociceptive effects of a lectin (LEC) isolated from the marine alga Amansia multifida were determined in Swiss mice. The LEC (1, 5, and 10 mg/kg) inhibited acetic acid-induced abdominal writhings in a dose-dependent manner after intraperitoneal or oral administration. A partial but significant inhibition of writhings was observed after the combination of LEC (10 mg/kg) with avidin (1 mg/kg), a potent inhibitor of the hemmaglutinant activity of the lectin. However, total writhing inhibition was demonstrable in the group of mice treated with LEC plus mannose (1 mg/kg), as compared to LEC alone or to control groups. Furthermore, avidin and mainly mannose also play a role in antinociception, somehow facilitating the interaction of LEC with its active cell sites. In the formalin test, although both phases of the response were significantly inhibited, the effect of LEC was predominant during phase 2, causing inhibition of licking time that ranged from 48 to 88% after oral (5 and 10 mg/kg) and intraperitoneal (1 to 5 mg/kg) administration. As is the case with morphine, the effect of LEC (2 mg/kg) was reversed by naloxone (2 mg/kg), indicating the involvement of the opioid system. LEC was also effective in the hot-plate test, producing inhibitory responses to the thermal stimulus, and its effects were blocked by naloxone. In the pentobarbital-induced sleeping time, although LEC did not alter the onset of sleep significantly, it increased the time of sleep within the same dose range compared to control. These results show that LEC presents antinociceptive effects of both central and peripheral origin, possibly involving the participation of the opioid system.

Antinociceptive properties in mice of a lectin isolated from the marine alga Amansia multifida Lamouroux

The antinociceptive effects of a lectin (LEC) isolated from the marine alga Amansia multifida were determined in Swiss mice. The LEC (1, 5, and 10 mg/kg) inhibited acetic acid-induced abdominal writhings in a dose-dependent manner after intraperitoneal or oral administration. A partial but significant inhibition of writhings was observed after the combination of LEC (10 mg/kg) with avidin (1 mg/kg), a potent inhibitor of the hemmaglutinant activity of the lectin. However, total writhing inhibition was demonstrable in the group of mice treated with LEC plus mannose (1 mg/kg), as compared to LEC alone or to control groups. Furthermore, avidin and mainly mannose also play a role in antinociception, somehow facilitating the interaction of LEC with its active cell sites. In the formalin test, although both phases of the response were significantly inhibited, the effect of LEC was predominant during phase 2, causing inhibition of licking time that ranged from 48 to 88 percent after oral (5 and 10 mg/kg) and intraperitoneal (1 to 5 mg/kg) administration. As is the case with morphine, the effect of LEC (2 mg/kg) was reversed by naloxone (2 mg/kg), indicating the involvement of the opioid system. LEC was also effective in the hot-plate test, producing inhibitory responses to the thermal stimulus, and its effects were blocked by naloxone. In the pentobarbital-induced sleeping time, although LEC did not alter the onset of sleep significantly, it increased the time of sleep within the same dose range compared to control. These results show that LEC presents antinociceptive effects of both central and peripheral origin, possibly involving the participation of the opioid system.

Valores del protocolo neuropsicológico GERMCIDE en una muestra de sujetos normales / Values of GERMCIDE neuropsychological protocol in a sample of normal subjects

Introducción. El diagnóstico de los pacientes con deterioro cognitivo o demencia exige un enfoque global en el que la exploración neuropsicológica es una pieza clave. Como parte del estudio GERMCIDE (Grupo para el Estudio y Registro Multicéntrico de Casos Incidentes de Demencia en España) se diseñó un protocolo que incluye una valoración de las diferentes funciones cognitivas que con mayor frecuencia se alteran en las demencias (memoria, orientación, lenguaje, praxias, capacidad de abstracción y función ejecutiva). Métodos. Con el objetivo de obtener datos en sujetos normales este protocolo neuropsicológico se aplicó a un grupo de personas mayores de 50 años sin deterioro cognitivo ni demencia. Resultados. Se estudiaron 103 sujetos con edades comprendidas entre 50 y 95 años (media: 73,5; desviación estándar [DE]: '9,3 años); 39 (37,90J0) hombres y 64 (62,1 %) mujeres. La puntuación media en el Mini-Mental State Examination (MMSE) fue de 27/30 (DE: 2,0). En las pruebas de lenguaje y praxias el 900J0 de los sujetos obtuvieron el valor máximo, mientras que en memoria, razonamiento y programación los rendimientos fueron más dispares. Se presenta la puntuación media, DE y distribución en percentiles para cada subtest. Conclusiones. Los valores obtenidos en esta muestra de sujetos normales y su distribución en percentiles pueden ser de gran ayuda para facilitar la interpretación de los hallazgos de la exploración neuropsicológica con el protocolo GERMCIDE en las consultas de neurología general y también en las consultas especializadas en demencia

Introduction. The diagnosis of patients with cognitive deterioration or dementia requires a global approach in which the neuropsychological examination is a key piece. As part of the GERMCIDE study (Group for the Study and Multicenter Registry of Incident Cases of Dementia in Spain), a protocol was designed that included an assessment of the different cognitive functions that are most frequently altered in dementias (memory, orientation, speech, praxis, abstraction capacity and executive function). Methods. In order to obtain data in normal subjects, this neuropsychological protocol was applied to a group of persons over 50 years without cognitive deterioration or dementia. Results. A total of 103 subjects whose ages ranged from 50 to 95 years (mean: 73.5; SD: 9.3 years); 39 (37.9%) men and 64 (62.1%) women were studied. The mean score on the Mini-Mental State Examination (MMSE) was 27/30 (SD: 2.0). In the speech and praxis tests, 90% of the subjects obtained the maximum value, while performances were more unequal in memory, reasoning and programming. Mean score, standard deviation and distribution in percentages for each subtest are presented. Conclusions. The values obtained in this sample of normal subjects and their distribution in percentages may be very helpful to facilitate the interpretation of the findings of the neuropsychological examination with the GERMCIDE protocol in the general neurology clinic visits and also in the specialized visits in dementia

Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease.

OBJECTIVE: To evaluate the efficacy of a cognitive-motor program in patients with early Alzheimer disease (AD) who are treated with a cholinesterase inhibitor (ChEI). METHODS: Patients with mild cognitive impairment (MCI) (12), mild AD (48), and moderate AD (24) (Global Deterioration Scale stages 3, 4, and 5) were randomized to receive psychosocial support plus cognitive-motor intervention (experimental group) or psychosocial support alone (control group). Cognitive-motor intervention (CMI) consisted of a 1-year structured program of 103 sessions of cognitive exercises, plus social and psychomotor activities. The primary efficacy measure was the cognitive subscale of the AD Assessment Scale (ADAS-cog). Secondary efficacy measures were the Mini-Mental State Examination, the Functional Activities Questionnaire, and the Geriatric Depression Scale. Evaluations were conducted at 1, 3, 6, and 12 months by blinded evaluators. RESULTS: Patients in the CMI group maintained cognitive status at month 6, whereas patients in the control group had significantly declined at that time. Cognitive response was higher in the patients with fewer years of formal education. In addition, more patients in the experimental group maintained or improved their affective status at month 12 (experimental group, 75%; control group, 47%; p = 0.017). CONCLUSIONS: A long-term CMI in ChEI-treated early Alzheimer disease patients produced additional mood and cognitive benefits.

Programa de rehabilitación de las capacidades atencionales en pacientes con demencia tipo Alzheimer y enfermedades cerebrovasculares / Program for the rehabilitation of attentional processes in patients with Alzheimer's disease and stroke

En los últimos años, el incremento de la esperanza de vida y el aumento del número de personas que padecen algún tipo de demencia o enfermedad cerebrovascular han hecho patente la necesidad de desarrollar métodos de intervención neuropsicológica. El objetivo principal de esta investigación es la búsqueda de un método de rehabilitación de las capacidades atencionales que se muestre efectivo en pacientes con enfermedad de Alzheimer en estadios iniciales así como en personas que hayan sufrido un accidente cerebrovascular. Para ello se ha diseñado un programa de rehabilitación neuropsicológica que ha sido aplicado a dos muestras: una formada por veintidós personas diagnosticadas de demencia tipo Alzheimer y otra constituida por diez sujetos que habían sufrido un accidente cerebrovascular en los últimos seis meses (AU)

[Oral hairy leukoplakia: histopathologic features of subclinical stage]. / Leucoplasia pilosa oral: aspectos histopatológicos da fase subclínica.

Oral hairy leukoplakia (OHL) is one of the most common oral manifestations of AIDS, with diagnostic and prognostic value. OHL is associated to the Epstein-Barr virus and presents clinical and histological defined characteristics. There have already been reports about a subclinical stage of OHL, although they lacked histopathologic characterization. The present study had the aim to describe the histopathological characteristics of subclinical hairy leukoplakia, as well as to carry out a comparative analysis between clinical and subclinical OHL. For that, 11 cases were analyzed--5 biopsies from patients who presented with the lesion and 6 samples from the borders of tongues obtained in necropsies. The histopathological findings in subclinical OHL were: absence of parakeratosis and papillomatosis, mild acanthosis, ballooning cells and nuclear alterations. In situ hybridization and immunostaining were positive for EBV in the nuclear alterations identified in the histopathological analysis. Based on the identification of EBV in the nuclear alterations, it was possible to conclude that subclinical OHL, similarly to the clinical lesion, presents histopathological features that are specific and sufficient to establish the definitive diagnosis, regardless of the identification of the virus.

[Antoniana Margarita: Gómez Pereira, Francisco Lobato and the antecedents of cerebral mechanicism during the Spanish renaissance]. / Antoniana Margarita: Gómez Pereira, Francisco Lobato y los antecedentes del mecanicismo cerebral en el Renacimiento español.

The year 2000 is the fifth century of the birth, in Medina del Campo (Vallodolid, Spain) of licenciado Perea (Gomez Perea or Pereira). A man of the Renaissance, he was an outstanding doctor, humanist, theologist, nominalist philosopher, naturalist and practical engineer. He developed the first modern theory of behavior, based purely on mechanicistic principles, describing his ideas in a text known by the curious title of Antoniana Margarita. The objective of this paper is to pay him homage on the fifth centenary of his birth, making a historiographic study of Gomez Perea and his works, with particular emphasis on the ideological basis and its relationship with Renaissance hydraulic engineering, collaborating with his colleague Francisco Lobato, author of one of the only two pretechnological codices of sixteenth century Spain. The book Antoniana Margarita is written in Renaissance Latin and was published in Medina del Campo in 1554. It represents the first truly modern approach to brain function which excludes the providencialist concepts of Galen involving the soul and the spirit, in vogue until then, transmitted through the Arab and Scholastic tradition. Analyzing his theory of the automatism of animals Perea made the first description ever of the reflex arc and the conditioned reflex. He also established a topographical model of the brain in which he sketched the functioning of the prefrontal cortex and neurophysiology of memory. Perea was the immediate forerunner of Neuropsychology and of the methodology and organicist thought which predominates in modern Neurobiology. He was also a visionary of the Evolution of Darwin and of modern aetiology.

[Pancreatoduodenectomy in digestive tract hemorrhage. A case report]. / Pancreatoduodenectomía en hemorragia de tubo digestivo. Reporte de un caso.

OBJECTIVE: To describe the clinical presentation and treatment of one patient with a neuroendocrine pancreatic neoplasm and gastrointestinal hemorrhage. BACKGROUND: Neuroendocrine pancreatic tumors are relatively rare neoplasms. When the tumor does not have endocrine function, clinical manifestations are non-specific and show symptoms when the tumor is quite large. Massive upper gastrointestinal hemorrhage is an infrequent clinical manifestation of these tumors. METHOD: A case of gastrointestinal hemorrhage, which required a pancreaticoduodenectomy to control bleeding of an ulcerated pancreatic head neoplasm, is presented. CONCLUSION: Pancreaticoduodenectomy is the procedure of choice to control duodenal massive bleeding secondary to an ulcerated neuroendocrine tumor of the pancreas.

Oral hairy leukoplakia. Histopathologic and cytopathologic features of a subclinical phase.

Accurate diagnosis of oral hairy leukoplakia (OHL) is important because it may be an early indicator of undiagnosed HIV infection; moreover, it may be a prognostic indicator. Our purpose was to investigate the histopathologic features of subclinical OHL and to evaluate and support the rationale of detecting subclinical OHL with cytopathology. The Epstein-Barr virus (EBV) was detected by immunohistochemistry and in situ hybridization in 4 cases of macroscopically normal lateral borders of tongue mucosa from 8 AIDS necropsies and in none of 8 controls. The histopathologic features were specific when based on nuclear changes: Cowdry type A inclusion, ground glass, and nuclear beading. Smears were obtained from 50 patients with AIDS, without OHL, from the scraping of lateral borders of the tongue. Numerous clusters of the cells were associated with Candida organisms (30% of cases). Nuclear changes were observed in 12 patients (24%) on both sides of the tongue. We describe the histopathologic features of subclinical OHL, and our observations suggest that cytopathology can detect OHL in the subclinical phase.

[Cerebral ischemia in Rendu-Osler-Weber disease]. / Isquemia cerebral en la enfermedad de Rendu-Osler-Weber.

Neurologic manifestations occur in 8-12% of the patients with Rendu-Osler-Weber disease or hereditary hemorrhagic telangiectasia (HHT), principally infectious and hemorrhagic and, less frequently, ischemic ones. More than a half of these neurologic complications are associated with pulmonary arterio-venous malformations (PAVM). The diagnosis of HHT is based on the presence of telangiectases, hemorrhagic events and a family history with an autosomal dominant pattern. We report a case of a patient diagnosed as having HHT with transient ischemic attacks and a PAVM, which was occluded by the use of embolotherapy. Cerebral ischemia in HHT is related to the existence of a PAVM and results from three mechanisms: 1) secondary poliglobulia and hyperviscosity because of the hypoxemia due to a right-left shunt; 2) communication between the airway and the pulmonary circulation during cough access, which produces gas embolism and hemoptysis; 3) and, finally, paradoxical embolism trough the PAVM, the same mechanism proposed to the infectious neurologic manifestations of the disease. When the diagnosis of HHT is suspected, early search and treatment of PAVM, with embolotherapy or surgery, are necessary in order to avoid respiratory problems (hemoptysis, exertional dyspnea, cianosis, clubbing) and neurologic complications.

Isquemia cerebral en la enfermedad de Rendu-Osler-Weber / Cerebral ischemia in Rendu-Osler-Weber disease

Un 8-12 por ciento de los pacientes con enfermedad de Rendu-Osler-Weber o telangiectasia hemorrágica hereditaria presenta manifestaciones neurológicas, sobre todo, hemorrágicas e infecciosas y, de forma menos frecuente, isquémicas. De ellos, más de la mitad asocian la presencia de malformaciones arteriovenosas pulmonares. El diagnóstico de la enfermedad se basa en la existencia de telangiectasias, fenómenos hemorrágicos y un patrón hereditario autosómico dominante. Se describe el caso clínico de un paciente, diagnosticado previamente de telangiectasia hemorrágica hereditaria, con accidentes isquémicos transitorios y una malformación arteriovenosa pulmonar que fue tratada mediante embolización. La isquemia cerebral en la telangiectasia hemorrágica hereditaria está relacionada con la presencia de una malformación arteriovenosa pulmonar y puede deberse a tres mecanismos: a) hiperviscosidad por poliglobulia secundaria a la hipoxemia provocada por la formación de un cortocircuito derecha-izquierda; b) comunicación de la vía aérea y la circulación pulmonar durante accesos de tos, lo que ocasiona una embolia gaseosa habitualmente acompañada de hemoptisis, y, por último, c) embolia paradójica a través de la malformación arteriovenosa pulmonar, que es, asimismo, el origen de las complicaciones neurológicas infecciosas de la enfermedad. En los pacientes con telangiectasia hemorrágica hereditaria debe investigarse la presencia de malformaciones arteriovenosas pulmonares y llevar a cabo de forma precoz su tratamiento, ya sea intravascular o quirúrgico, con el fin de evitar tanto problemas respiratorios (hemoptisis, disnea de esfuerzo, cianosis o acropaquías) como las posibles manifestaciones neurológicas. (AU)

[ISO 9002 at the Center of Pediatric Intensive Care at the Albert Einstein Israeli Hospital]. / ISO 9002 No Centro de Terapia Intensiva Pediátrico do Hospital Israelita Albert Einstein.

This study shows the process of implementation of a quality program in Pediatric Intensive Therapy Center of "Hospital Israelita Albert Einstein" which resulted in the certification of this service for the Standards ISO 9002/94. It points out the nurse's role as a leader in this process.

[Segmental arteriographic anomalies in migranous cerebral infarct]. / Anomalías arteriográficas segmentarias en el infarto cerebral migrañoso.

A migranous cerebral infarct (ICM) has the appearance of an ischaemic cerebral lesion which occurs during a migraine crisis and is shown by neuroimaging techniques to be in the corresponding vascular area. Four young patients are described. They fulfilled the clinical and neuroimaging criteria for compatibility with ICM and the protocol for the aetiological study of stroke was normal. Angiography ruled out other causes of ischaemia (dissection, fibromuscular dysplasia, etc.) and showed segmental images of 'vasculitis appearance' similar to these described in Call's syndrome, in 'benign intracranial angiopathy' and in other intracranial vasculopathies or criteria of 'reversible segmental cerebral vasoconstriction'. The pathogenic significance, as with migraine, is still unknown.