Encefalitis autoinmunitaria secundaria a teratoma ovárico: un nuevo síndrome neuropsiquiátrico. Reporte de caso / Autoimmune encephalitis secondary to ovarian teratoma: a new neuropsychiatric syndrome. Report of one case

Resumen ANTECEDENTES: los síndromes neurológicos paraneoplásicos son trastornos asociados con neoplasias, casi siempre por autoanticuerpos producidos por el propio tumor, que causan autoinmunidad cruzada con antígenos en el sistema nervioso central. Hace poco se describió una nueva enfermedad neuropsiquiátrica en mujeres jóvenes con teratoma ovárico, que producen anticuerpos en contra del receptor de N-metil-D-aspartato, que es parte de los diferentes tipos de encefalitis límbicas. CASO CLÍNICO: paciente de 20 años de edad, con un cuadro neuropsiquiátrico prominente con diagnóstico final de encefalitis límbica por anticuerpos anti rNMDA secundaria a teratoma ovárico, con remisión total del cuadro neurológico después del tratamiento multimodal. CONCLUSIÓN: en nuestro conocimiento es el primer caso reportado de encefalitis límbica anti rNMDA debida a teratoma ovárico, con remisión completa del cuadro después del tratamiento multimodal con cirugía, inmunosupresión e inmunomodulación.

Abstract BACKGROUND: paraneoplastic neurological syndromes are disorders associated with neoplasias, generally from autoantibodies produced by the tumor itself that cause crossed immunity with antigens in the central nervous system. A new neuropsychiatric disease was described recently in young women with ovarian teratoma that produce antibodies against the N-methyl-D-aspartate receptor that is part of the spectrum of limbic encephalitis. CLINICAL CASE: 20 year old patient with a significant neuropsychiatric picture with a final diagnosis of limbic encephalitis from anti rNMDA antibodies secondary to ovarian teratoma, and total remission of the neurological picture after multimodal treatment. CONCLUSION: to our knowledge it is the first case of anti rNMDA limbic encephalitis due to ovarian teratoma reported with complete remission of the picture after multimodal treatment with surgery, immunosuppression and immunomodulation.

[Environment, health and urban poverty. A perspective for the study of human settlements]. / Ambinete, salud y pobreza urbanas. Una perspectiva para el estudio de los asentamientos populares.

PIP: Urbanization in Mexico has given rise to creation of unauthorized squatter settlements on the peripheries of large cities. Such settlements are estimated to house about 1/2 of the urban population of Mexico. These settlers share a low standard of housing resulting from lack of employment and low income. Very often large households are crowded into poor quality structures with no running water or sewage disposal. Health consequences are serious. Although precise data are lacking in Mexico, residents of squatter settlements generally fall below the rest of the urban population in health indicators. Settlers in these makeshift communities all tend to be disadvantaged, but there are significant differences in the health and living conditions of different low income zones on the urban periphery. The relationship between the physical and social environments of squatter settlements and the health of the residents should be analyzed by urban administrators and public health officials as well as by demographers and social scientists, in order that solutions be found to existing problems. An integrated focus on the problem will be necessary. A working hypothesis to guide research is that habitat is a principal factor influencing the health o the population, and it affects health through a series of processes that can be analytically decomposed. In this multicausal approach, health status is the final result of a complex process in which many different factors intervene. A fundamental determinant is that of factors in the general social context, including public policy regarding low income housing, basic services, and health. A 2nd level of determinants is that of underlying factors in the physical and social environment. In squatter settlements, housing and services are central elements of the physical environment in which the life of the inhabitants unfolds. The current cholera epidemic in Latin American demonstrates the importance of housing and related variables for health. Social variables affecting health include demographic and socioeconomic characteristics of families. It must also be remembered that conditions of the physical and social habitat are mediated by social practices such as hygienic habits, diet, use of medications, and reproductive patterns.^ieng

Malformaciones abdominales en gemelos dobles toracopagos / Abdominal malformations in double thoracopagus twins

Hemos estudiado las malformaciones abdominales encontradas en cinco fetos dobles toracópagos. Estas alteraciones comprometen a parte de la pared supraumbilical sólo el tubo digestivo y glándulas anexas; son especialmente importantes y frecuentes en el hígado, vía biliar, duodeno, páncreas, intestino delgado y colon. Los órganos retroperitoneales y pelvianos no mostraron anomalías. Se comentan las posibilidades de sobrevida mediante cirugía y microcirugía de acuerdo a la viabilidad determinada por el tipo, grado y asociación de malformaciones, destacando que para las técnicas correctoras se puede disponer de la mejor fuente de órganos de implante, representada por el gemelo no viable