Bilateral Motor Cortex tDCS Effects on Post-Stroke Pain and Spasticity: A Three Cases Study.

Stroke patients frequently suffer from chronic limb pain, but well-suited treatment approaches have been not established so far. Transcranial direct current stimulation (tDCS) is a safe and non-invasive brain stimulation technique that alters cortical excitability, and it has been shown that motor cortex tDCS can reduce pain. Some data also suggest that spasticity may be improved by tDCS in post-stroke patients. Moreover, multiple sessions of tDCS have shown to induce neuroplastic changes with lasting beneficial effects in different neurological conditions. The aim of this pilot study was to explore the effect of multiple anodal tDCS (atDCS) sessions on upper limb pain and spasticity of stroke patients, using a within-subject, crossover, sham-controlled design. Brain damage was of similar extent in the three patients evaluated, although located in different hemispheres. The results showed a significant effect of 5 consecutive sessions of atDCS, compared to sham stimulation, on pain evaluated by the Adaptive Visual Analog Scales -AVAS-, and spasticity evaluated by the Fugl-Meyer scale. In two of the patients, pain was completely relieved and markedly reduced, respectively, only after verum tDCS. The pain improvement effect of atDCS in the third patient was considerably lower compared to the other two patients. Spasticity was significantly improved in one of the patients. The treatment was well-tolerated, and no serious adverse effects were reported. These findings suggest that multiple sessions of atDCS are a safe intervention for improving upper limb pain and spasticity in stroke patients, although the inter-individual variability is a limitation of the results. Further studies including longer follow-up periods, more representative patient samples and individualized stimulation protocols are required to demonstrate the efficacy and safety of tDCS for improving limb symptoms in these patients.

Anodal tDCS over Wernicke's area improves verbal memory and prevents the interference effect during words learning.

BACKGROUND: Wernicke's area is a key component of the cortical language network, and it is functionally related to the comprehension of oral and written language. In addition to its main role in the perception of language, some other functions related to verbal learning also seem to involve the activity of this cortical region. It is unknown whether different degrees of neuromodulation on this area determine its effect on word learning. OBJECTIVE: We aimed to analyze the influence of the application of anodal transcranial DC stimulation (tDCS) over Wernicke's area at two different intensities on word learning. METHOD: We compared the effect of anodal tDCS at an intensity of 0.5 mA and 1.5 mA with sham tDCS, separately in different groups, on performance in a word learning and recall task. RESULTS: The results show that 1.5 mA anodal tDCS improved performance. The number of words learned in this condition was higher compared with stimulation at 0.5 mA current strength and sham stimulation. Furthermore, stimulation with 1.5 mA specifically prevented the interference effect over word learning, compared to the other two tDCS conditions. CONCLUSIONS: These results show an intensity-dependent effect of anodal tDCS on verbal memory formation. These findings are discussed in the context of the various functions of Wernicke's area and the ability of tDCS to modulate the activity and functionality of this cortical area at different intensities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Effects of temporal contexts and contextual habituation on latent inhibition / Efectos de contextos temporales y habituación contextual sobre inhibición latente

Background: Latent inhibition of conditioned taste aversion (CTA) is sensitive to external and internal cues. Time of day can serve as an internal cue, and latent inhibition may be reduced if the pre-exposure and conditioning stages occur at different times of day. This contextual cue attributed to a change in the time of day may reveal a temporal specificity of latent inhibition. Although the habituation period to spatial contexts is a determinant variable for the spatial specificity of latent inhibition of CTA, the influence of contextual-temporal familiarity (time of day) on latent inhibition of CTA has not been explored through direct comparisons between different periods of habituation to the temporal context. Method: Two different periods of contextual habituation (short vs. long) previous to taste pre-exposures were compared in Wistar rats to analyze the influence of these periods on the temporal specificity of latent inhibition of CTA. Results: A long period of habituation, in relation to a short period, facilitated the effect of a change of the time of day between pre-exposure and conditioning on the magnitude of taste aversion. Conclusions: A long habituation to temporal contexts facilitates the temporal specificity of latent inhibition of CTA (AU)

Antecedentes: la inhibición latente del aprendizaje aversivo gustativo (AAG) es sensible a claves externas e internas. La hora del día puede actuar como una clave interna, y la inhibición latente puede ser reducida si pre-exposición y condicionamiento ocurren a diferentes horas del día. Esta clave contextual atribuida a un cambio en la hora del día puede revelar una especificidad temporal de la inhibición latente. Aunque el período de habituación a contextos espaciales es determinante para la especificidad espacial de la inhibición latente del AAG, la influencia de la familiaridad contextual-temporal (hora del día) sobre la inhibición latente del AAG no ha sido explorada mediante comparaciones directas entre diferentes períodos de habituación al contexto temporal. Método: en ratas Wistar se compararon dos diferentes períodos de habituación contextual (corto versus largo) previos a pre-exposiciones gustativas para analizar la influencia de éstos sobre la especificidad temporal de la inhibición latente del AAG. Resultados: un largo período de habituación, en relación con uno corto, facilitó el efecto de un cambio de la hora del día entre pre-exposición y condicionamiento sobre la magnitud de la aversión gustativa. Conclusiones: una larga habituación a contextos temporales facilita la especificidad temporal de la inhibición latente del AAG (AU)

Effects of temporal contexts and contextual habituation on latent inhibition.

BACKGROUND: Latent inhibition of conditioned taste aversion (CTA) is sensitive to external and internal cues. Time of day can serve as an internal cue, and latent inhibition may be reduced if the pre-exposure and conditioning stages occur at different times of day. This contextual cue attributed to a change in the time of day may reveal a temporal specificity of latent inhibition. Although the habituation period to spatial contexts is a determinant variable for the spatial specificity of latent inhibition of CTA, the influence of contextual-temporal familiarity (time of day) on latent inhibition of CTA has not been explored through direct comparisons between different periods of habituation to the temporal context. METHOD: Two different periods of contextual habituation (short vs. long) previous to taste pre-exposures were compared in Wistar rats to analyze the influence of these periods on the temporal specificity of latent inhibition of CTA. RESULTS: A long period of habituation, in relation to a short period, facilitated the effect of a change of the time of day between pre-exposure and conditioning on the magnitude of taste aversion. CONCLUSIONS: A long habituation to temporal contexts facilitates the temporal specificity of latent inhibition of CTA.

Excretion product of shigella dysenteriae (sdyep) induced cell death in early larval stage of zebrafish (danio rerio): acridine orange and ethidium bromide (AO/EB) in vivo staining / Producto de excreción de shigella dysenteriae (pesdy) induce muerte celular en larvas de pez cebra (danio rerio): marcaje in vivo con naranja de acridina y bromuro de etidio (NA/BE)

In the field of studies of acute toxicity induced by bacterial agents, Shiga toxins have been relevant due to the severity of the extra-intestinal diseases they cause. Numerous studies have shown that Shiga toxin induced apoptosis in different cell types; however, this important process has been little studied in vivo experimental models. In this study, the effects of excretion products of Shigella dysenteriae, in which Shiga toxin is present, were investigated on early larval stages of Zebrafish, an animal model with many advantages over other in vivo experimental models traditionally used. Both the collection of eggs and larvae of Zebrafish, and the product from excretion from Shigella dysenteriae (SdyEP) were performed according to laboratory standards. Also, toxicity bioassay, larvae treatment with pure and diluted solution, 10-1, 10-2, 10-3 , 10-4 and 10-5, v/v SdyEP and cell death in vivo using Acridine Orange (AO) and Ethidium Bromide (EB) were applied. The excretion product of Shigella dysenteriae (SdyEP) effect was expressed in terms of larval mortality and dependent dilution rather than incubation time. The larval population surviving treatment with Shigella excretion product presents severe morphological effects. The larval population generally presents notable severe morphological damage, the necrosis state is represented by the opacity of the larvae after being treated for 24 h (b) compared to control. Other changes associated with larval anatomy were also observed; particularly the caudal end curvature was significant into 10%. The use of AO/EB revealed a distribution pattern from fluorescence into green and orange in surviving larvae SdyEP poisoning, there was a large population of dead cells around the anal and caudal region as evidenced by the presence of orange nuclei in greater numbers as controls in the larvae. The results support the application of coloring AO/EB in Zebrafish experimental models for the evaluation of the toxic action of new molecules and new products with therapeutic potential.

En el campo de los estudios de toxicidad aguda inducida por agentes bacterianos, las toxinas Shiga resultan relevantes debido a la severidad de las enfermedades extra-intestinales que causan. Numerosos estudios han demostrado que la toxina Shiga induce la apoptosis en diferentes tipos de células, sin embargo, este importante proceso ha sido poco estudiado en modelos experimentales in vivo. En este estudio, fueron evaluados los efectos del productos de excreción de Shigella dysenteriae (PESdy), sobre estadios larvarios de pez cebra (Danio rerio), un modelo animal con muchas ventajas sobre otros modelos experimentales in vivo utilizados tradicionalmente. Tanto la recolección de los huevos y larvas de pez cebra, así como la obtención del producto de la excreción, se realizaron de acuerdo a los estándares de laboratorio. Poblaciones larvarias, fueron tratadas con distintas soluciones; pura y diluidas, 101, 10-2, 10-3, 10-4 y 10-5, v/v de PESdy. La muerte celular in vivo, usando naranja de acridina (NA) y bromuro de etidio (BE) fue evaluada. El efecto del SdyEP, se expresó como dependiente de la concentracion y del tiempo de exposición. La población de larvas sobrevivientes, presentaron curvatura troncal en un 10%, en relación a los controles. La necrosis se puso en evidencia a través de la opacidad de las larvas después de 24 h. El uso de NA/BE reveló un patrón de distribución de la fluorescencia en verde y naranja en larvas sobrevivientes al tratamiento. Una granpoblación de células muertas, alrededor de la región anal y caudal, se ponen en evidencia por la presencia de núcleos de naranja en mayor número que en los controles. Los resultados apoyan la aplicación de la coloración NA/BE en modelo experimental de pez cebra, para la evaluación de la acción tóxica de nuevas moléculas y nuevos productos de excreción bacterial con potencial terapéutico.

Excretion product of shigella dysenteriae (sdyep) induced cell death in early larval stage of zebrafish (danio rerio): acridine orange and ethidium bromide (ao/eb) in vivo staining / El producto de excreción de la shigella dysenteriae (pesdy) Induce muerte celular en larvas de pez cebra (danio rerio): marcaje in vivo con naranja de acridina y bromuro de etidio (na/be)

In the field of studies of acute toxicity induced by bacterial agents, Shiga toxins have been relevant due to the severity of the extra-intestinal diseases they cause. Numerous studies have shown that Shiga toxin induced apoptosis in different cell types; however, this important process has been little studied in vivo experimental models. In this study, the effects of excretion products of Shigella dysenteriae, in which Shiga toxin is present, we investigated on early larval stages of Zebrafish, an animal model with many advantages over other in vivo experimental models traditionally used. Both the collection of eggs and larvae of Zebrafish, and the product from excretion from Shigella dysenteriae (SdyEP) were performed according to laboratory standards. Also, toxicity bioassay, larvae treatment with pure and diluted solution, 10-1, 10-2, 10-3 , 10-4 and 10-5 v/v SdyEP and cell death in vivo using Acridine Orange (AO) and Ethidium Bromide (EB) were applied. The excretion product of Shigella dysenteriae (SdyEP) effect was expressed in terms of larval mortality and dependent dilution rather than incubation time. The larval population surviving treatment with Shigella excretion product presents severe morphological effects. The larval population generally presents notable severe morphological damage, the necrosis state is represented by the opacity of the larvae after being treated for 24 h (b) compared to control. Other changes associated with larval anatomy were also observed; particularly the caudal end curvature was significant into 10%. The use of AO/EB revealed a distribution pattern from fluorescence into green and orange in surviving larvae SdyEP poisoning, there was a large population of dead cells around the anal and caudal region as evidenced by the presence of orange nuclei in greater numbers as controls in the larvae. The results support the application of coloring AO/EB in Zebrafish experimental...

En el campo de los estudios de toxicidad aguda inducida por agentes bacterianos, las toxinas Shiga resultan relevantes debido a la severidad de las enfermedades extra-intestinales que causan. Numerosos estudios han demostrado que la toxina Shiga induce la apoptosis en diferentes tipos de células, sin embargo, este importante proceso ha sido poco estudiado en modelos experimentales in vivo. En este estudio, fueron evaluados los efectos del productos de excreción de Shigella dysenteriae (PESdy), sobre estadios larvarios de pez cebra (Danio rerio), un modelo animal con muchas ventajas sobre otros modelos experimentales in vivo utilizados tradicionalmente. Tanto la recolección de los huevos y larvas de pez cebra, así como la obtención del producto de la excreción, se realizaron de acuerdo a los estándares de laboratorio. Poblaciones larvarias, fueron tratadas con distintas soluciones; pura y diluidas, 10-1, 10-2, 10-3 , 10-4 and 10-5 v/v de PESdy. La muerte celular in vivo, usando naranja de acridina (NA) y bromuro de etidio (BE) fue evaluada. El efecto del PESdy, se expresó como dependiente de la concentración y del tiempo de exposición. La población de larvas sobrevivientes, presentaron curvatura troncal en un 10 por ciento, en relación a los controles. La necrosis se puso en evidencia a través de la opacidad de las larvas después de 24 h. El uso de NA/BE reveló un patrón de distribución de la fluorescencia en verde y naranja en larvas sobrevivientes al tratamiento. Una gran población de células muertas, alrededor de la región anal y caudal, se ponen en evidencia por la presencia de núcleos de naranja en mayor número que en los controles. Los resultados apoyan la aplicación de la coloración NA/BE en modelo experimental...

Queratosis liquenoide / Lichenoid keratosis

La queratosis liquenoide se presenta como una lesión solitaria, en forma de una mácula o pápula de color rojo, violáceo o marrón, que aparece predominantemente en mujeres y se localiza en el tronco. Su histología es semejante a la del liquen plano. Su origen es desconocido, aunque se presume que corresponde al resultado final de un proceso inflamatorio de una lesión preexistente, principalmente léntigo solar, queratosis actínica yqueratosis seborreica.

Lichenoid keratosis occurs as a solitary lesion in form of a red, purple or brown, macule or papule which appears predominantly in women, and in the trunk. Its histology is similar to lichen plannus. Its origin is unknown, although it is presumed that it corresponds to the final result of an inflammatory process of a preexistinglesion, mainly solar lentigo, actinic keratosis and seborrheic keratosis.

Ausencia de afectación axilar en dos casos de pitiriasis versicolor / Absolutely sparing axillae in two cases of versicolor pityriasis

La pitiriasis versicolor (PV) es una infección micótica superficial común de la piel producida por diferentes especies del género Malassezia. Las lesiones se localizan principalmente en la parte superior del tronco, pudiendo diseminarse a cuello y brazos. En los últimos años dos publicaciones han llamado la atención acerca de la ausencia de afectación axilar en la PV, lo que contrasta con la creencia de que la humedad y sudoración excesiva son factores que predisponen a su desarrollo. Se describen dos nuevos casos en varones jóvenes sanos, con lesiones extensas típicas de PV en el tronco, pero con absoluta ausencia de lesiones a nivel axilar. Los factores responsables de esta situación son desconocidos, aunque se ha sugerido que diferencias en el pH, temperatura y flora microbiana especial en las axilas podrían inhibir el crecimiento de la Malassezia en estas áreas. Otro hecho a considerar es la posible acción germicida o fungostática de diversos componentes presentes en desodorantes y antisudorales de uso común.

Pityriasis versicolor (PV) is a common superficial fungal infection of the skin caused by diverse species of the genus Malassezia. The lesions are mainly located on the upper trunk but they can spread to the neck and arms. On the last years, two reports have called attention about the sparing of axillary areas in PV, which contrasts with the view that humidity and excessive sweating are predisposing factors for its development. In this report, another two cases are described, being both young healthy males with extensive typical lesions of PV affecting the trunk, but absolutely sparing the axillae. The responsible factors involved in this situation are unknown, but it has been suggested that differences in pH, temperature and the special microbial flora of the axillae could inhibit the growth of Malassezia on these areas. Another fact to be considered is the possible germicide or fungistatic action of diverse components in deodorants or antiperspirants of common use.

Linfangioma circunscrito adquirido: a propósito de un caso / Acquired lymphangioma circumscriptum: a case report

Los linfagiomas adquiridos son dilataciones de los vasos linfáticos que pueden resultar como complicación de cirugía o radioterapia. Comparten características clínicas e histológicas con aquellos de las lesiones congénitas. El diagnóstico y tratamiento de estas lesiones vesiculobulosas son importantes, ya que se pueden asociar con dolor y celulitis. Presentamos el caso de una paciente que presentó estas lesiones tras tratamiento de un cáncer de mama.

Acquired lymphangiomas are dilatations of lymphatic vessels that can result as a complication of surgical or radiation therapy. They share clinical and histological features with those of congenital lesions. Diagnosis and treatment of this vesiculobullous lesion are important because it may be associated with pain and cellulitis. We describe a patient who presented these lesions after treatment of mammary cancer.

Notalgia parestésica / Notalgia paresthetica

La notalgia parestésica es una neuropatía sensorial caracterizada clínicamente por una mancha hiperpigmentada bien circunscrita localizada en la espalda, que afecta las áreas correspondientes a los dermatomos D2 a D6. El prurito es el síntoma más común, aunque algunos pacientes describen otras sensaciones, incluyendo ardor, parestesia, hiperestesia o dolor. Los hallazgos histopatológicos son inespecíficos. Su etiología no ha sido claramente demostrada, pero en algunos casos existe una llamativa correlación con patología de la columna vertebral, incluyendo cambios degenerativos y/o hernias del núcleo pulposo. El diagnóstico diferencial incluye la neurodermitis y la amiloidosis macular. No existe un tratamiento definitivo para la enfermedad. Se han empleado diversas terapias incluyendo capsaicina tópica, bloqueo anestésico para vertebral, oxcarbazepina, gabapentina y toxina botulínica.

Notalgia paresthetica is a sensory neuropathy characterizd clinically by a well-circumscribed hyperpigmented patch located on the back, affecting the areas corresponding to dermatomes D2-D6. Pruritus is its most common symptom, but some patients describe other sensations including burning, paresthesia, hypeesthesia or pain. Histopathological findings are not specific. The etiology of this condition has not be en clearly demonstrated but in some cases there exists a striking correlation with spinal pathology, including degenerative changes or a herniated nucleous pulposus. Differential diagnoses include neurodermitis and maclular amyloidosis There is no definitive treatment for the disease diverse therapies have been employed including topical capsaicin paravertebral local anesthetic block, oxcarbazepine, gabapentir and botulinum toxin type A.

Nódulo de la Hermana María José / Sister Mary Joseph's nodule

La metástasis de una neoplasia hacia el ombligo se conoce con el epónimo de “Nódulo de la Hermana María José”, en honor a la enfermera jefe de cirugía quien devotamente trabajó por décadas en la Clínica Mayo y que fue la primera que llamó la atención sobre esta ominosa manifestación metástasica cutánea. La lesión se presenta clínicamente como un nódulo p placa granulomatosa y exudativa, correspondiendo a la localización metastásica de un adenocarcinoma intraabdominal, principalmente derivado del estomago, intestino grueso, ovario o páncreas, entre otros. Describimos dos casos de Nódulos de la Hermana María José en relación con adenocarcinomas gástricos.