Encefalitis vírica y convulsiones refractarias por gripe A en época no estacional / Influenza A viral encephalitis and refractory seizures out of season

El virus H1N1 se caracteriza por producir sobretodo sintomatología respiratoria y presentarse en época invernal o epidemiológica. Presentamos el caso de una paciente que debutó con cuadros convulsivos en mayo, fuera de la poca invernal y requirió cuidados intensivos (AU)

The H1N1 virus is characterized by producing respiratory symptoms mostly in winter or epidemiological time. We report the case of a patient that started with seizures in May, out of the winter, and required intensive care (AU)

Impact of exercise training on neuroplasticity-related growth factors in adolescents.

OBJECTIVES: We aimed to determine the effect of exercise training on plasma levels of brain-derived neurotrophic factor (BDNF), and serum insulin-like growth factor-1 (IGF-1) as well as cAMP response element-binding (CREB) activation in peripheral blood mononuclear cells (PBMCs) in adolescents. METHODS: Nine trained and seven sedentary male adolescents, matched in age (14.0±2.2 years), were recruited for the study. Trained boys performed higher physical activity levels (expressed both as total energy expenditure and as physical activity energy expenditure) and showed significant bradycardia when compared with sedentary ones. RESULTS: We found that BDNF and IGF-1 levels were significantly higher in trained adolescents than in sedentary ones. However, no effect of training was found in the activation of CREB in PBMCs. CONCLUSIONS: We demonstrated the increase of neuroplasticity-related proteins due to exercise training in adolescents. Our results emphasize the significance and impact of exercise in this developmental period.

Conducción en la tercera edad / Driving patterns in the elderly

Introducción. El objetivo del presente estudio es describir los patrones de conducción en varones ancianos, accidentalidad vial y factores que pueden influir en la misma. En exconductores, motivos del abandono de la conducción y repercusiones en su vida. Material y métodos. Estudio descriptivo transversal, en un centro de salud urbano. Muestra aleatoria, estratificada por grupos de edad, de 216 varones conductores/exconductores mayores de 64 años. Mediante revisión de historias clínicas y entrevista clínica, se recogieron variables médicas, sociodemográficas, características de conducción, accidentalidad, razones del cese de conducir y repercusión emocional. Resultados. Edad media 75 (IC95%:74–75,9) años. Un 65% (140) eran conductores: el 96% (136) padecía alguna enfermedad crónica y el 78,5% (110) consumía fármacos que podían alterar la capacidad de conducción, el 29,2% (41) conducía diariamente, el 70% (98) evitaba circular de noche y el 58,6% (82) situaciones de tráfico denso. La media de edad en abandonar la conducción era de 73 (IC95%:71,2–74,5) años, por razones médicas un 34,2% (26). El 36,6% (79) había sufrido algún accidente durante los 5 años previos y en el último hubieron lesionados en un 10,1% (8); un accidente influyó en dejar de conducir en 10 casos. Un 19,7% (15) de exconductores consideraba que había empeorado su calidad de vida por este hecho y un 25% (19) refería efectos negativos en su estado anímico. Conclusiones. Los conductores mayores padecen enfermedades crónicas y consumen fármacos que pueden alterar los reflejos pero modifican su patrón de conducción para compensar sus déficits. La accidentalidad es considerable, aunque de consecuencias poco graves. Renunciar a conducir genera emociones negativas en un número respetable de ancianos (AU)

Introduction. The aim of the study was to describe driving patterns and traffic injuries in the elderly. To describe self-reported reasons for stopping driving and its impact in quality of life. Material and methods. Cross-sectional study in a primary health care centre. An age stratified random sample was taken of 216 males (drivers/ex-drivers) aged 65 years and older. The main measurements were obtained by clinical record audit and personal interviews, collecting medical and sociodemographic data, driving patterns, traffic injuries history, reasons for stopping driving, and psychological impact. Results. Mean age 75 (95%CI:74–75.9) years. Overall, 64.8% (140) used to drive: 29.2% (41) drove daily, 70% (98) avoided night driving, and 58.6% (82) crowded roads; 97.1% (136) suffered from a chronic disease and 78.5% (110) had taken drugs that might interfere with driving abilities. Mean age for giving up driving was 73 (95%CI:71.2–74.5), 34.2% (26) for medical reasons. Overall, 36.6% (79) reported a traffic accident during the previous five years and 10.1% (8) with injured persons in the last one. Of those suffering a traffic accident, 10 gave up driving definitively. Furthermore, 19.7% (15) of those giving up driving reported a decrease in quality of life and 25% (19) had a negative psychological emotional status. Conclusions. Elderly drivers suffer chronic diseases and take prescriptions that modify ability to drive safety, but they adopt driving behaviours to compensate for their deficiencies. The number of traffic accidents is also high, but without serious injuries. Giving up driving had a negative emotional impact in a sizeable number of elderly persons (AU)

Surgical treatment for neuroblastoma: complications during 15 years' experience.

BACKGROUND/PURPOSE: Surgery plays an important role in neuroblastoma treatment. Although influence of resectability in survival has been studied deeply, reports about surgical complications are scant. The authors analyze retrospectively their experience in neuroblastomas (NB) diagnosed from 1980 to 1995. METHODS: Clinical variables such as age, stage, location, presurgical chemotherapy, type, and extent of surgery were studied. Complications were classified according to the following criteria: time, type of surgery, and extent of resection. RESULTS: Seventy-eight NB patients had surgery performed in our hospital. Mean age at diagnosis was 2.4 years (range, 0 to 11 years); 33 patients were under 1 year of age. Sixty-eight percent of the patients had advanced disease. Abdominal tumors were predominant. Sixty-three percent of the patients had chemotherapy before surgery, with shrinkage of the tumor in most of the cases (88%). Eighty-six surgical procedures were performed, 29 initially and 57 delayed. Complete resection was reached in 52 patients, partial in 19 patients, and seven patients underwent biopsy only. There were 42 surgical complications. Three of them were considered extremely serious (one death caused by cardiac arrest, one tumoral rupture, and one great vessel injury). Nephrectomies (n = 12) were the most frequent intraoperatory complications. Bernard-Horner syndrome (n = 5) and pleural effusions (n = 5) predominated in the postoperative period. CONCLUSIONS: (1) Surgery in NB can be performed safely. (2) Nephrectomies can be necessary to achieve complete resection in some abdominal tumors. (3) Nephrectomies, Bernard-Horner syndrome, and pleural effusions were the most frequent complications in our patients. (4) Presurgical chemotherapy can lead to a wider and safer removal of locally advanced tumors.