Collateral circulation on perfusion-computed tomography-source images predicts the response to stroke intravenous thrombolysis.

BACKGROUND AND PURPOSE: Perfusion-computed tomography-source images (PCT-SI) may allow a dynamic assessment of leptomeningeal collateral arteries (LMC) filling and emptying in middle cerebral artery (MCA) ischaemic stroke. We described a regional LMC scale on PCT-SI and hypothesized that a higher collateral score would predict a better response to intravenous (iv) thrombolysis. METHODS: We studied consecutive ischaemic stroke patients with an acute MCA occlusion documented by transcranial Doppler/transcranial color-coded duplex, treated with iv thrombolysis who underwent PCT prior to treatment. Readers evaluated PCT-SI in a blinded fashion to assess LMC within the hypoperfused MCA territory. LMC scored as follows: 0, absence of vessels; 1, collateral supply filling ≤ 50%; 2, between> 50% and < 100%; 3, equal or more prominent when compared with the unaffected hemisphere. The scale was divided into good (scores 2-3) vs. poor (scores 0-1) collaterals. The predetermined primary end-point was a good 3-month functional outcome, while early neurological recovery, transcranial duplex-assessed 24-h MCA recanalization, 24-h hypodensity volume and hemorrhagic transformation were considered secondary end-points. RESULTS: Fifty-four patients were included (55.5% women, median NIHSS 10), and 4-13-23-14 patients had LMC score (LMCs) of 0-1-2-3, respectively. The probability of a good long-term outcome augmented gradually with increasing LMCs: (0) 0%; (1) 15.4%; (2) 65.2%; (3) 64.3%, P = 0.004. Good-LMCs was independently associated with a good outcome [OR 21.02 (95% CI 2.23-197.75), P = 0.008]. Patients with good LMCs had better early neurological recovery (P = 0.001), smaller hypodensity volumes (P < 0.001) and a clear trend towards a higher recanalization rate. CONCLUSIONS: A higher degree of LMC assessed by PCT-SI predicts good response to iv thrombolysis in MCA ischaemic stroke patients.

[Validity and reliability of the CERAD-Col neuropsychological battery]. / Validez y fiabilidad de la batería neuropsicológica CERAD-Col.

INTRODUCTION: Alzheimer's disease (AD) is an important public health problem due to its disabling character and high individual, familial and social costs. The CERAD neuropsychological battery has been widely used for evaluation and diagnosis of the cognitive deficit associated with AD. This instrument has been adapted to the Colombian culture (CERAD-Col) for the Neurosciences Group. SUBJECTS AND METHODS: A study was carried out to establish the validity and reliability of the CERAD-Col in Colombian, Spanish-speaking individuals aged 50 years or more. It included 151 controls and 151 AD patients. Controls were selected from a convenience sample of 848 adults aged 50 years or more. The construct validity was determined in three ways: 1) factorial analysis; 2) correlation with the functional scales FAST and GDS (convergent-type validity) and, 3) comparison between the two groups. Internal consistency was determined by means of Cronbach's alpha coefficient. RESULTS: Three factors -memory, language and praxis- explained 88% of the total variance. Moderate but statistically significant correlations were found between neuropsychological tests and functional scales. Internal consistency and test-retest reproducibility were high. The AD group exhibited significantly lower scores (p < 0.05) than the control one. CONCLUSION: CERAD-Col is valid and reliable for the diagnosis of AD in Colombian Spanish-speaking population aged 50 years or more.

Universal scaling of ballistic magnetoresistance in magnetic nanocontacts.

We show that ballistic magnetoresistance exhibits universal scaling in atomic or nanometer scale contacts. Plotting the data as conductance, we find that, if the maximum magnetoconductance is normalized to unity and the conductance is scaled with the conductivity of the bulk material, the data fall in a narrow region, independent of the nanocontact materials, for our four data sets and four from the literature. The results agree with a theory that takes into account spin-scattering within a magnetic-domain wall.

Famotidina en úlcera duodenal aguda

Se trataron con Famotidina (MK-208=Pepcidine M.S.D.), 40 mg nocturnos, 37 pacientes con diagnóstico endoscópico de úlcera doudenal, de los cuales el 82.4 por ciento mostraron una respuesta excelente, siendo buena en el resto. Desde el punto de vista endoscópico, las úlceras que cicatrizaron lo hicieron entre la cuarta y sexta semana de tratamiento. En ninguno de los pacientes se observaron efectos colaterales mayores y los exámenes de laboratorio fueron normales antes y después del tratamiento

[Risk factors for infection among the patrons of an HIV Control Program, Antioquia, Colombia]. / Factores de riesgo de infección en usuarios de un programa de control del VIH, Antioquia, Colombia.

A review is presented of the characteristics of 432 users of the Human Immunodeficiency Virus (HIV) Control Program sponsored by the Public Health Departmental Laboratory of Antioquia, Colombia, who were seen between July 1988 and June 1989. The prevalence of seropositivity to HIV was 29.4%, while that of AIDS was 6.7%. Eight of the seropositive subjects were women. The average age on entrance into the Program was 28.7 +/- 7.9, and it was significantly higher among the seropositive subjects. The study sample was divided into four subgroups: women, bisexual men, homosexual men, and heterosexual men. In all the subgroups the prevalence of high-risk sexual practices was high and the percentage of condom utilization was low. Frequency of exposure to different risk factors, such as injections, transfusions of blood or other fluids, surgical interventions, tattoos, consumption of alcohol and other psychoactive substances, acupuncture, and sexual preference and practices, was determined. HIV seropositivity for the group as a whole was associated with sexual relations with infected persons (OR = 3.96), active anal coitus (OR = 3.81), sexual relations with men (OR = 3.69), passive anal coitus (OR = 3.35), and sexual relations abroad (OR = 2.24). In men, HIV seropositivity was associated with anal coitus (OR = 4.0), homosexual relations (OR = 3.96), sexual relations with infected persons (OR = 3.75), and sexual relations abroad (OR = 1.88); in women there was an association with intravenous drug use (chi 2 = 10.72) and with sexual relations abroad (OR = 12.67).

Frecuencia de marcadores serológicos del virus B en maternas

Se estudiaron 175 madres y sus hijos determinando los marcadores del virus de Hepatitis B, para establecer la frecuencia de portadores de esta infección, que fue del 8.5 por ciento. Se determinó la ausencia de relación entre la seropositividad y los factores de riesgo de ser portador. No se encontraron marcadores en la sangre del cordon umbilical de los neonatos. Se hacen recomendaciones tanto en el control prenatal como sobre las medidas terapéuticas a ser tomadas

Carcinoma primario de la vesícula biliar

Se revisan los casos de carcinoma primario de la vesícula biliar diagnosticados en el Hospital San Juan de Dios de Bogotá, durante 10 años (1977-1986). Se informan 59 casos, todos con confirmación histológica. Esta entidad es más frecuente en mujeres, los síntomas son poco específicos y de corta duración. El diagnóstico con frecuencia es hecho tardíamente y el pronóstico es pésimo. La laparoscopia es el método diagnóstico más fidedigno y se recomienda practicar a todos los pacientes sospechosos de padecer esta neoplasia