RESUMEN
La afasia es una alteración adquirida del lenguaje debida a una lesión cerebral, que se caracteriza por errores en la producción, la denominación o la comprensión del lenguaje. Aunque la mayoría de las afasias suelen ser mixtas, desde un punto de vista práctico se clasifican en diferentes tipos según sus rasgos clínicos principales: afasia de Broca, afasia de Wernicke, afasia de conducción, afasia transcortical y alexia con o sin agrafia. Presentamos los hallazgos clínicos de los principales subtipos representándolos con casos radiológicos, y proporcionamos una revisión actualizada de la red del lenguaje con imágenes de resonancia funcional y de tractografía
Aphasia is an acquired language disorder due to a cerebral lesion; it is characterized by errors in production, denomination, or comprehension of language. Although most aphasias are mixed, from a practical point of view they are classified into different types according to their main clinical features: Broca's aphasia, Wernicke's aphasia, conduction aphasia, transcortical aphasia, and alexia with or without agraphia. We present the clinical findings for the main subtypes of aphasia, illustrating them with imaging cases, and we provide an up-to-date review of the language network with images from functional magnetic resonance imaging and tractography
Asunto(s)
Humanos , Afasia/diagnóstico por imagen , Trastornos del Lenguaje/diagnóstico por imagen , Neuroimagen/métodos , Afasia/clasificación , Alexia Pura/diagnóstico por imagen , Dislexia/diagnóstico por imagen , Imagen de Difusión Tensora/métodos , Afasia de Wernicke/diagnóstico por imagen , Afasia de Broca/diagnóstico por imagen , Accidente Cerebrovascular/complicaciones , Corteza Cerebral/diagnóstico por imagenRESUMEN
Aphasia is an acquired language disorder due to a cerebral lesion; it is characterized by errors in production, denomination, or comprehension of language. Although most aphasias are mixed, from a practical point of view they are classified into different types according to their main clinical features: Broca's aphasia, Wernicke's aphasia, conduction aphasia, transcortical aphasia, and alexia with or without agraphia. We present the clinical findings for the main subtypes of aphasia, illustrating them with imaging cases, and we provide an up-to-date review of the language network with images from functional magnetic resonance imaging and tractography.
Asunto(s)
Afasia/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Imagen de Difusión Tensora , Imagen por Resonancia Magnética , Neuroimagen , HumanosRESUMEN
BACKGROUND: Scleroderma can present with esophageal involvement causing important morbidity. AIMS: To describe the manometric findings and clinical characteristics of patients with scleroderma and esophageal symptoms. MATERIALS AND METHODS: Patients with scleroderma and esophageal symptoms were evaluated through esophageal manometry within the time frame of one year. Descriptive statistics were carried out and the continuous variables were expressed as means and standard deviation. Frequencies were expressed as percentages. RESULTS: The study included 24 female patients with a mean age of 53.5 years and mean disease progression of 7.84 years. The most frequent findings were short and hypotonic lower esophageal sphincter (mean length 1.58cm and mean tone 9.49mmHg) and ineffective esophageal motility (mean non-transmitted waves 92.91%, mean effective primary peristalsis 40.05%, and mean amplitude 13.11mmHg). The most frequent symptom was dysphagia. CONCLUSIONS: Scleroderma is associated with lower esophageal sphincter alterations and symptomatic ineffective esophageal motility.
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Trastornos de la Motilidad Esofágica/complicaciones , Esclerodermia Sistémica/complicaciones , Adolescente , Adulto , Anciano , Progresión de la Enfermedad , Trastornos de la Motilidad Esofágica/diagnóstico , Trastornos de la Motilidad Esofágica/fisiopatología , Esfínter Esofágico Inferior/fisiopatología , Femenino , Humanos , Masculino , Manometría , Persona de Mediana Edad , Esclerodermia Sistémica/diagnóstico , Esclerodermia Sistémica/fisiopatología , Adulto JovenRESUMEN
El carcinoma escamocelular (CEC) representa la entidad patológica maligna de mayor prevalencia en la cavidad bucal. Aunque múltiples estudios respaldan que la aparición de esta enfermedad es de carácter idiopático, factores de riesgo como el alcohol y la exposición al tabaco son elementos directamente desencadenantes de la aparición de esta entidad oncológica, sin dejar a un lado la predisposición a padecer cáncer oral (CO) por parte de la codificación genética entre otros aspectos hereditarios. En la actualidad, se ha evidenciado que la infección por virus del papiloma humano (VPH) y las lesiones que lo relacionan, están profundamente asociados como etiología potencial del CO y suelen tener relación con hábitos sexuales modificados. La profundización de conceptos, efectos y medios de diagnóstico eficaces para establecer relaciones existentes del VPH con el CO, biología del virus y comportamiento cancerígeno, fueron los objetivos de la presente publicación así mismo determinar factores de riesgo predisponentes a la malignización de las lesiones propias del VPH, su incidencia y prevalencia en la comunidad. La identificación clínica oportuna de las lesiones originadas por el VPH, permiten establecer de manera certera el comportamiento, evolución de la lesión y a su vez determinar la presencia de actividad displásica y/o anaplásica propiamente dicha. Cabe resaltar la importancia del empleo de exámenes auxiliares a la clínica, como lo es la citología exfoliativa, la biopsia, los análisis moleculares y genéticos, para establecer mancomunadamente y de manera certera el comportamiento, evolución y pronóstico de una afección por VPH (AU)
Introduction: Squamous cell carcinoma (SCC) represents the malignant disease entity most prevalent in the oral cavity. Although multiple studies support that the appearance of this disease is idiopathic nature, risk factors such as alcohol and exposure to snuff are directly triggers the onset of this cancer entity, leaving aside the predisposition to oral cancer (CO) by the hereditary genetic coding among other aspects. Today it has been demonstrated that infection with human papillomavirus (HPV) and related injuries that are deeply associated CO as a potential etiology and are usually related to changed sexual habits. Objectives: The deepening of concepts, effects and effective means of diagnosis to establish relationships with the CO HPV, the virus biology and carcinogenic behavior, were the objectives of this publication likewise determine predisposing risk factors for malignant lesions own HPV incidence and prevalence in the community. Methods: A search of scientific papers was conducted in Spanish and English in the last 15 years in the database PubMed to do relationship, oral cancer, HPV and SCC. Conclusions: Timely clinical lesions caused by HPV, accurate identification can be established from the behavior, evolution of the injury and in turn the presence of dysplastic activity and/or anaplastic itself. It should highlight the importance of using auxiliary to clinical examinations, such as the exfoliative cytology, biopsy, genetic and molecular analyzes to establish jointly and accurate way the behavior, evolution and prognosis of a condition HPV (AU)
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Humanos , Papillomaviridae/patogenicidad , Neoplasias de la Boca/virología , Carcinoma de Células Escamosas/virología , Infecciones por Papillomavirus/complicacionesRESUMEN
STAT4 has been consistently associated with several autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The aim of this study was to determine whether the STAT4 rs7574865G/T polymorphism confers susceptibility for RA and SLE in a sample of Mexican patients. This study included 869 individuals: 415 patients with RA, 128 patients with SLE, and 326 controls. Genotyping using TaqMan probes showed an association between the STAT4 rs7574865G/T polymorphism and RA (GG vs. TT: OR 1.99, p=0.0009; G vs. T: OR 1.42, p=0.0009) and SLE (GG vs. TT: OR 2.98, 0.0003; G vs. T: OR 1.74, p=0.0002). Gender stratification showed an association with RA (GG vs. TT: OR 1.99, 95% CI 1.3-3.1, p=0.002; G vs. T: OR 1.42, 95% CI 1.1-1.8, p=0.002) and SLE (GG vs. TT: OR 3.3, 95% CI 1.7-6.2, p=0.0002; G vs. T: OR 1.8, 95% CI 1.3-2.4, p=0.0002) in women. Thus, the STAT4 rs7574865G/T polymorphism confers risk for RA and SLE in the Mexican population.
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Artritis Reumatoide/genética , Lupus Eritematoso Sistémico/genética , Factor de Transcripción STAT4/genética , Adulto , Artritis Reumatoide/epidemiología , Análisis Mutacional de ADN , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Lupus Eritematoso Sistémico/epidemiología , Masculino , México/epidemiología , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Riesgo , Factores SexualesRESUMEN
Rheumatoid arthritis (RA) is a complex genetic disease. Human leukocyte antigen (HLA) and non-HLA genes are reportedly associated with an increased risk of RA. The protein tyrosine phosphatase non-receptor 22 gene (PTPN22), which encodes the lymphoid tyrosine phosphatase (LYP) protein, is one of the best examples of a non-HLA gene associated with a risk for RA in several populations. The functional PTPN22 C1858T (R620W) non-synonymous polymorphism is widely associated with an increased risk for RA in Europeans and non-Europeans. The aim of this study was to determine if the PTPN22 C1858T polymorphism confers susceptibility to RA in a sample of patients from Mexico. This study included 364 RA patients and 387 non-related controls from Central Mexico. Genotyping of the PTPN22 C1858T (rs2476601) polymorphism was performed using allelic discrimination assays with TaqMan probes. The functional PTPN22 C1858T polymorphism was associated with an increased risk for RA in our study population. The CC vs CT genotype in RA patients versus healthy controls had an odds ratio (OR) of 4.17 (95 % CI 1.79-9.74, p = 0.00036), while T allele had an OR of 4.06 (95 % CI 1.75-9.41, p = 0.00043). PTPN22 is a genetic risk factor for developing RA in the Mexican population.
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Artritis Reumatoide/epidemiología , Artritis Reumatoide/genética , Polimorfismo de Nucleótido Simple , Proteína Tirosina Fosfatasa no Receptora Tipo 22/genética , Adulto , Anciano , Alelos , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Masculino , México , Persona de Mediana Edad , Oportunidad Relativa , Factores de RiesgoRESUMEN
Rheumatoid arthritis (RA) is a multifactorial disease. A combination of genetic and environmental risk factors contributes to its etiology. Several genes have been reported to be associated with susceptibility to the development of RA. The MHC2TA and FCRL3 genes have been associated previously with RA in Swedish and Japanese populations, respectively. In two recent reports, we show an association between FCRL3 and juvenile rheumatoid arthritis (JRA), and MHC2TA and acute coronary syndrome (ACS) in Mexican population. We assessed the association between three single nucleotide polymorphisms (SNPs) of the MHC2TA (-168G/A; rs3087456, and +16G/C; rs4774) and FCRL3 (-169T/C; rs7528684) genes and rheumatoid arthritis in Mexican population through a genotyping method using allelic discrimination assays with TaqMan probes. Our case-control study included 249 patients with RA and 314 controls. We found no evidence of an association between the MHC2TA -168G/A and +1614G/C or FCRL3 -169T/C polymorphisms and RA in this Mexican population. In this cohort of Mexican patients with RA, we observed no association between the MHC2TA or FCRL3 genes and this autoimmune disease.
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Artritis Reumatoide/genética , Proteínas Nucleares/genética , Polimorfismo de Nucleótido Simple , Receptores Inmunológicos/genética , Transactivadores/genética , Adulto , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Haplotipos , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Fenotipo , Factores de RiesgoRESUMEN
The development of cardiovascular diseases (CVD) has been associated to alterations on lipid profile as well found during postprandial period, phenomenon known as postprandial lipaemia (PL). Physical exercise is currently the major non-pharmacological intervention used to prevention and reduction of risk factors to developing of CVD. For this reason, there is growing interest under the effects of physical exercise, especially strength training, on regulation and balance of lipid metabolism, particularly of risk groups such as post-menopausal women that have more prone to CVD than men and lose much of the cardioprotective effect of estradiol during and after menopause period. In this review, we seek to compare the results of articles that addressed the beneficial effects of strength training on PL. We used articles selected in databases PubMed, Scopus and EBSCO dating from the year 1975-2012, with many quotes from leading researchers in subject and published in international journals. All studies were obtained to report at least three variables of interest. The authors of this review concluded that strength training proves to be effective in reducing PL concentrations by inducing an improvement of basal energy demand, can be seen as an important strategy to treatment of chronic diseases such as atherosclerosis.
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Hiperlipidemias/terapia , Periodo Posprandial , Entrenamiento de Fuerza , Enfermedades Cardiovasculares/prevención & control , HumanosRESUMEN
BACKGROUND: Neurobehçet disease (NBD) is a rare complication of Behçet disease (BD) but with important burdens of morbidity and mortality. Little is known about this complication because there are no validated diagnostic criteria, and all the studies have small number of patients. The prevalence reported normally ranges between 5% and 15% and it is more frequent amongst men between 20 and 40 years old. The typical presentations include focal parenchymal lesions, vascular thrombosis, arterial vasculitis, and aseptic meningo-encephalitis. METHODS: We retrospectively studied medical histories of all patients admitted to the hospital and discharged from it with diagnosis of BD from January 1996 to September 2009. NBD was defined as having neurological and/or psychiatric symptoms with compatible abnormalities in MRI and/or cerebrospinal fluid and without another possible explanation for their symptoms. RESULTS: Behcet disease was diagnosed in 25 patients and seven from these patients fulfilled our criteria of Neurobehcet disease (28%). Patients with NBD were significantly younger at the onset of their symptoms and had a significantly longer evolution until diagnosis and treatment compared to patients with non-Neuobehçet disease. Six presented a relapsing-remitting pattern, with a good outcome with corticosteroids. CONCLUSIONS: As reported in previous studies, progressive course was less frequent, with only one case, and had a more aggressive disease. Brainstem involvement bears a poorer prognosis because it is linked with a progressive evolution. In our series, NBD complication was not that infrequent. It is very important to be highly suspicious of this possibility to start early a correct treatment.
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Síndrome de Behçet , Enfermedades del Sistema Nervioso , Adulto , Síndrome de Behçet/complicaciones , Síndrome de Behçet/fisiopatología , Síndrome de Behçet/terapia , Femenino , Humanos , Inmunosupresores/uso terapéutico , Masculino , Trastornos Mentales/etiología , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/etiología , Enfermedades del Sistema Nervioso/fisiopatología , Enfermedades del Sistema Nervioso/terapia , Estudios RetrospectivosRESUMEN
Introducción: La frecuencia de los síntomas neurootológicos son frecuentes en los pacientes con migraña, habiéndose descrito la asociación de diversas entidades. Pacientes y métodos: Seleccionamos de la unidad de cefaleas a 70 pacientes con diagnóstico de migraña episódica con o sin aura y valoramos específicamente el diagnóstico de inestabilidad, mareo psicofisiológico, síntomas presincopales, vértigo posicional paroxístico benigno (VPPB), vértigo recurrente asociado a la migraña (VRAM) y la enfermedad de Meniere.Resultados: Un 44,3% presentó ortostatismo o síncopes, un 15,7% inestabilidad posiblemente por hipofunción vestibular bilateral, un 14,2% VRAM y un 8,6% VPPB. La presencia de VPPB la hemos observado en pacientes de mayor edad (40 años), mientras que el VRAM es una entidad de más jóvenes (35 años). Estos hallazgos nos llaman la atención y nos recuerdan cómo el vértigo benigno paroxístico es una entidad de la infancia y para el VPPB la edad es un factor de riesgo. Conclusiones: Los migrañosos presentan con frecuencia síntomas neurootológicos que podemos clasificar en síntomas interepisódicos y episódicos, y síntomas específicos e inespecíficos de la migraña. Esta aproximación tiene un evidente interés fisiopatológico dado que tanto el VRAM como la posible hipofunción vestibular de los migrañosos son síntomas que comparten aspectos fisiopatológicos con la migraña, mientras que los síntomas de ortostatismo y el VPPB son inespecíficos y se observan asociados a otras entidades (AU)
Introduction: Neurootological symptoms are common in patients with migraine, and have been reported to be associated with diverse conditions. Patients and methods: A total of 70 patients with a diagnosis of episodic migraine, with or without aura, attending our Migraine Unit were selected. The specific variables studied were the diagnosis of instability, psycho-physiological dizziness, presyncopal symptoms, benign paroxysmal positional vertigo (BPPV), migraine associated recurrent vertigo (MARV), and Meniere's disease. Results: A total of 44.3% of cases had orthostatism or syncope, 15.7% with instability (possibly due to bilateral vestibular hypofunction), 14.2% with MARV and 8.6% with BPPV. The presence of BPPV was observed in older patients (40 years), whilst MARV was a condition seen in younger ones (35 years). These findings are of interest and remind us that benign paroxysmal vertigo is a childhood condition and age is a risk for BPPV.Conclusions: Migraine patients often present with neuro-otological symptoms that can be classified as inter-episodic and episodic symptoms, and specific and non-specific migraine symptoms. This approach is of obvious pathophysiological interest, given that MARV and the possible vestibular hypofunction of migraine patients are symptoms that share physiological aspects with migraine, while the orthostatism symptoms and BPPV are non-specific and are seen to be associated with other conditions (AU)
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Humanos , Trastornos Migrañosos/complicaciones , Vértigo/epidemiología , Mareo/epidemiología , Enfermedades Vestibulares/epidemiología , Intolerancia Ortostática/epidemiología , Factores de RiesgoRESUMEN
INTRODUCTION: Neurootological symptoms are common in patients with migraine, and have been reported to be associated with diverse conditions. PATIENTS AND METHODS: A total of 70 patients with a diagnosis of episodic migraine, with or without aura, attending our Migraine Unit were selected. The specific variables studied were the diagnosis of instability, psycho-physiological dizziness, presyncopal symptoms, benign paroxysmal positional vertigo (BPPV), migraine associated recurrent vertigo (MARV), and Meniere's disease. RESULTS: A total of 44.3% of cases had orthostatism or syncope, 15.7% with instability (possibly due to bilateral vestibular hypofunction), 14.2% with MARV and 8.6% with BPPV. The presence of BPPV was observed in older patients (40 years), whilst MARV was a condition seen in younger ones (35 years). These findings are of interest and remind us that benign paroxysmal vertigo is a childhood condition and age is a risk for BPPV. CONCLUSIONS: Migraine patients often present with neuro-otological symptoms that can be classified as inter-episodic and episodic symptoms, and specific and non-specific migraine symptoms. This approach is of obvious pathophysiological interest, given that MARV and the possible vestibular hypofunction of migraine patients are symptoms that share physiological aspects with migraine, while the orthostatism symptoms and BPPV are non-specific and are seen to be associated with other conditions.
Asunto(s)
Enfermedades del Oído/etiología , Trastornos Migrañosos/complicaciones , Enfermedades del Sistema Nervioso/etiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/diagnóstico , Adulto JovenRESUMEN
SETTING: Tuberculous rheumatism (Poncet's disease) is a reactive polyarthropathy associated with extra-pulmonary and pulmonary tuberculosis (TB) without evidence of mycobacterial infection of the involved joints. As all patients with TB do not present with this peculiar clinical feature, a genetic susceptibility is suspected. OBJECTIVE: To determine the major histocompatibility complex (MHC) class I and II alleles in Mexican mestizo patients with Poncet's disease. DESIGN: In this case-control study of 16 Mexican mestizo patients diagnosed with Poncet's disease and 99 ethnically matched healthy controls, high resolution human leukocyte antigen (HLA) typing was performed for HLA-A, B, DR and DQ by polymerase chain reaction. HLA-DRB1 and HLA-DQB1 subtypes were performed by sequence-specific oligonucleotide probe hybridization. RESULTS: A significantly increased frequency of HLA-B27 (corrected P = 0.01) and DQB1*0301 (corrected P = 0.0009) alleles and decreased frequency of HLA-DQB1*0302 (corrected P = 0.00001) were identified in patients compared to healthy controls. CONCLUSION: These data suggest that genes located within the MHC may play a role in the susceptibility to Poncet's disease in patients diagnosed with TB.
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Predisposición Genética a la Enfermedad , Antígenos HLA/genética , Tuberculosis Osteoarticular/genética , Adulto , Alelos , Estudios de Casos y Controles , Femenino , Genes MHC Clase I/genética , Genes MHC Clase II/genética , Antígeno HLA-B27/genética , Antígenos HLA-DQ/genética , Cadenas beta de HLA-DQ , Humanos , Masculino , México , Persona de Mediana Edad , Sondas de Oligonucleótidos , Reacción en Cadena de la Polimerasa , Adulto JovenRESUMEN
INTRODUCTION: Osmophobia is often reported by migraine patients. This study evaluates osmophobia in connection with the diagnosis of episodic migraine with or without aura, chronic migraine and episodic and chronic tension-type headache. METHODS: We recruited from our Headache Unit 68 patients (59 female, 9 male; age 37+/-14.7 years), of whom 24 were migraine without aura (MoA), 11 migraine with aura (MA), 10 chronic migraine (CM) and 23 TTH (episodic-TTH). Patients with two or more forms of primary headache were excluded. RESULTS: Among migraine patients, 54% with MoA and 0% with MA, 40 %CM reported osmophobia during the attacks; none of the 23 TTH patients suffered this symptom. The crisis frequency was MoA and osmophobia 2.15 crisis per month; MoA without osmophobia 3,14. MC with osmophobia 22; MC without osmophobia 21.7. CONCLUSIONS: Osmophobia and taste abnormalities were demonstrated to be very specific in diagnosing migraine, but very insensitive. Osmophobia frequency does not depend on migraine frequency. Osmophobia seems to be more frequent in females than in males. The lack of osmophobia in MA patients could be explained by a different pathophysiological mechanism between MA and MoA.
Asunto(s)
Trastornos Migrañosos , Trastornos del Olfato/diagnóstico , Trastornos Fóbicos/diagnóstico , Cefalea de Tipo Tensional , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/fisiopatología , Trastornos del Olfato/epidemiología , Trastornos Fóbicos/epidemiología , Olfato/fisiología , Cefalea de Tipo Tensional/diagnóstico , Cefalea de Tipo Tensional/fisiopatología , Adulto JovenRESUMEN
Introducción. La osmofobia es un síntoma que aparece en lospacientes con migraña; aunque su frecuencia no es alta, parece bastanteespecífico, siendo bastante infrecuente en otros tipos de cefaleas.Presentamos una serie de pacientes con migraña episódica, crónicay cefalea tipo tensión, analizando la presencia de osmofobia ysu relación con otros síntomas.Material y métodos. Se seleccionan 68 pacientes (59 mujeres y9 varones) remitidos a la unidad de cefaleas, 24 con migraña sin aura(MSA), 11 con migraña con aura (MA), 10 con migraña crónica (MC),23 con cefalea tipo tensión (CTT) (5 episódica y 18 crónica), segúncriterios de la IHS-II (tabla 1). Se analiza la presencia de osmo, foto,fonofobia, náuseas y vómitos y frecuencia de crisis.Resultados. La edad media de la serie es de 37 ± 14,7 años(MSA: 35,5, MA: 33,1, MC: 44,4, CTT: 36,4). La edad promedio de lospacientes con osmofobia es de 41,6 años, y sin osmofobia, 34,4. OsmofobiaMSA: 54%, MA: 0%, MC: 40%, CTT: 0%. Todos los pacientescon osmofobia presentan foto y fonofobia. El promediocrisis/mes para MSA con osmofobia: 2,15; MSA sin osmofobia: 3,14;MC con osmofobia: 22; MC sin osmofobia: 21,7. Ningún varón presentóosmofobia.Conclusiones. La osmofobia es un síntomas específico de la migrañafrente a la cefalea tipo tensión. La frecuencia de las crisis demigraña es independiente de la presencia o no de osmofobia. Ennuestra serie tampoco es frecuente en la MA, lo que puede ser la expresiónde una fisiopatología diferente (AU)
Introduction. Osmophobia is often reported by migraine patients.This study evaluates osmophobia in connection with thediagnosis of episodic migraine with or without aura, chronic migraineand episodic and chronic tension-type headache.Methods. We recruited from our Headache Unit 68 patients(59 female, 9 male; age 37 ± 14.7 years), of whom 24 were migrainewithout aura (MoA), 11 migraine with aura (MA), 10 chronicmigraine (CM) and 23 TTH (episodic-TTH). Patients with twoor more forms of primary headache were excluded.Results. Among migraine patients, 54 % with MoA and 0%with MA, 40 % CM reported osmophobia during the attacks; noneof the 23 TTH patients suffered this symptom. The crisis frequencywas MoA and osmophobia 2.15 crisis per month; MoAwithout osmophobia 3,14. MC with osmophobia 22; MC withoutosmophobia 21,7.Conclusions. Osmophobia and taste abnormalities were demonstratedto be very specific in diagnosing migraine, but veryinsensitive. Osmophobia frequency does not depend on migrainefrequency. Osmophobia seems to be more frequent in femalesthan in males. The lack of osmophobia in MA patients couldbe explained by a different pathophysiological mechanism betweenMA and MoA (AU)
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Trastornos Migrañosos/fisiopatología , Trastornos del Olfato/fisiopatología , Trastornos Fóbicos/fisiopatología , Cefalea/fisiopatología , Olfato/fisiologíaRESUMEN
Symptoms of grapevine decline were surveyed. Samples from mature vines exhibiting external symptoms of Eutypa dieback and Esca were collected, as were young plants with and without external symptoms, and fungal isolations were performed. In 2007, 3-year-old grapevines (cv. Tempranillo grafted onto 110R rootstock) with low vigor, reduced foliage, and vascular streaking in the wood were observed. Small pieces of discolored wood were placed onto malt extract agar supplemented with 0.25 g/liter of chloramphenicol, incubated at 25°C, and resulting colonies were transferred to potato dextrose agar (PDA). Isolates were characterized by abundant aerial and fast-growing mycelium covering the plate surface after 3 days, mycelium became dark green. Pycnidia contained thick-walled, aseptate conidia 15 to 35 × 10 to 15 µm. Lasidiplodia theobromae was identified based on morphological characteristics (3) and confirmed by banding patterns obtained after the digestion of the 1,200-bp amplicon generated with ITS1 and NL4 primers (2) using restriction endonucleases (2). Single-spore cultures were generated and DNA sequences of the rDNA internal transcribed spacer region, partial sequence of the 5' end of the ß-tubulin gene, and a fragment of the elongation factor further confirmed the identification and revealed genetic similarity with other isolates of L. theobromae. A sequence of each fragment was deposited in GenBank with Accession Nos. EU600925, EU597297, and EU597298, respectively. Pathogenicity tests were conducted on four replicate rootstocks (110R) and 15 canes of current-season growth (cv. Tempranillo). Plants were inoculated with an agar plug containing L. theobromae; controls were treated with agar only. Grapevines were maintained in a greenhouse at 20 to 25°C. After 3 months, L. theobromae was reisolated from internal vascular lesions in 100 and 66% of inoculated rootstocks and canes, respectively. Control plants were asymptomatic and L. theobromae was not recovered. Using the same methodology, a fungus identified based on morphological characteristics in culture as Cryptovalsa ampelina (1) was isolated from grapevines (cv. Tempranillo) planted in 1987. Cultures in PDA were white to creamy white and cottony with diffuse margins. Colonies covered the 90-mm-diameter petri dish surface in 5 days. Conidia were 20 to 23 × 1 to 1.5 µm, unicellular, hyaline, and filiform. PCR amplifications of the DNA extracts of C. ampelina with Camp-1 and Camp-2R primers gave a characteristic DNA fragment of 300 bp (3) and DNA sequences of the ITS4-ITS5 amplicons (GenBank Accession No. EU597296) confirmed the identification. For the first time, the 5' end of the ß-tubulin gene was sequenced and deposited in GenBank (Accession No. EU600926). Pathogenicity tests were conducted as described above for L. theobromae. Both pathogens were examined in the same experiment. C. ampelina was reisolated from internal brown streaking lesions in 25% of the rootstocks and 33% of the canes. Control plants exhibited no symptoms. L. theobromae appeared to be a more aggressive pathogen than C. ampelina on grapevine with more internal brown streaking and greater recovery of pathogen from inoculated samples. To our knowledge, this is the first report of L. theobromae and C. ampelina causing grapevine decline in Castilla y León. References: (1) J. Luque et al. Phytopathol. Mediterr. 45:S101, 2006. (2) M. T. Martin and R. Cobos. Phytopathol. Mediterr. 46:18, 2007. (3) D. Pavlic et al. Stud. Mycol. 50:313, 2004.
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Asunto(s)
Masculino , Adulto , Humanos , Miositis/virología , Enfermedad AgudaRESUMEN
OBJECTIVE: To estimate the aptitude for the critical reading of papers of clinic research of psychiatry residents of the Mexican Institute of the Social Security in Mexico City. METHODS: A total of 34 residents from two hospitals (A and B) participated. Measuring instrument with abstracts of published research papers and 96 items was constructed to explore their abilities of interpretation, discernment and critical reading. Its reliability was of 0.88. RESULTS: The median of Hospital A was 11 and Hospital B was 9 and the global of 9.5 (p NS). There were no differences of results according to the year of residency (I, II and III) nor in the indicators. Most of the participants (n = 26, 76%) had a score below 18 which would be the score if answered in a random fashion. CONCLUSIONS: Critical reading of the participants was very low. Our results suggest that the bibliography sessions of the psychiatry residents were oriented to consumption of information and that critical reading of research papers was absent or very poor.
Asunto(s)
Pruebas de Aptitud , Internado y Residencia , Médicos/psicología , Psiquiatría , Investigación , Adulto , Cognición , Escolaridad , Femenino , Humanos , Periodismo Médico , Juicio , Masculino , México , Psiquiatría/educación , LecturaRESUMEN
OBJECTIVE: To investigate in first year pediatric residents whether they increase their knowledge by questioning, debate and discussion. METHODS: The participants were 53 residents from 6 hospitals of the Mexican Social Security system. A Differential Scale of Group Interaction (DSGI) was constructed and validated. It had subscales A and B to assess group interactions (A) and individual construction of knowledge (B). Scoring with the DSGI was done in the 6 hospitals by two observers on different occasions. RESULTS: Sub-scale A showed a significant interhospitals differences with a Kruskal-Wallis ANOVA (p < .001) whereas the 6 hospitals showed the minimum score in Subscale B with obviously no interhospital differences. Two items in Subscale A (Individual work and Trainee participation) showed a high concordance between observers (weighted kappas of 0.66 and 0.59) but it was negative (kw = -0.20) in "Time participation". CONCLUSIONS: Our results showed that there were differences in group interactions of the hospitals but without any apparent reflection on the construction of knowledge in the trainees. These observations suggest to us that there was an orientation toward a passive consuming of information by these participants.