[Idiopathic intracranial hypertension. Review of our experience in the last eight years (2016-2023)]. / Hipertensión intracraneal idiopática. Revisión de nuestra experiencia en los últimos ocho años (2016-2023).

INTRODUCTION: Idiopathic intracranial hypertension (IIH) or benign intracranial hypertension is a rare disease in childhood. The clinical presentation in pediatric patients can be very variable, being more unespecific in younger patients. PATIENTS AND METHODS: A retrospective descriptive study was carried out on patients diagnosed of IIH in the last eight years (2016-2023) in the neuropediatrics unit of a tertiary hospital. In the present study, the clinical-epidemiological characteristics and the diagnostic-therapeutic procedure carried out in each case were analyzed. RESULTS: We studied 14 patients, 57% were women. The average age at diagnosis was 9 years, headache was the most common reason for consultation. In all patients, papilledema was found in the fundus and neuroimaging didn´t find alterations. Optical coherence tomography has been carried out in 78.5% of the sample, > 80% of patients showed thickening of the retinal nerve fiber layer. All patients had a high cerebrospinal fluid opening pressure (>25 cmH2O). 57% of patients required treatment with acetazolamide, a carbonic anhydrase inhibito. In all patients the resolution was complete, however almost 30% of them have presented recurrences during follow-up. CONCLUSIONS: In recent years there has been an increase in the incidence of this entity, making early diagnosis and treatment essential to avoid possible irreversible damage.

TITLE: Hipertensión intracraneal idiopática. Revisión de nuestra experiencia en los últimos ocho años (2016-2023).Introducción. La hipertensión intracraneal idiopática (HII), o hipertensión intracraneal benigna, es una enfermedad poco frecuente en la infancia. La presentación clínica en pacientes pediátricos puede ser muy variable, y es más inespecífica a menor edad. Pacientes y métodos. Se ha realizado un estudio descriptivo retrospectivo de los pacientes diagnosticados de HII en los últimos ocho años (2016-2023) en la consulta de neuropediatría de un hospital de tercer nivel. En el presente estudio se analizaron las características clinicoepidemiológicas y el procedimiento diagnosticoterapéutico llevado a cabo en cada caso. Resultados. Se estudió a 14 pacientes, de los cuales el 57% eran mujeres. La edad media en el momento del diagnóstico fue de 9 años, y la cefalea fue el motivo de consulta más habitual. En todos los pacientes se constató papiledema en el fondo de ojo y una prueba de neuroimagen sin alteraciones. Se llevó a cabo una tomografía de coherencia óptica en el 78,5% de la muestra, y >80% de los pacientes presentaba engrosamiento de la capa de fibras nerviosas retiniana. La totalidad de los pacientes presentaba una presión de apertura de líquido cefalorraquídeo elevada (> 25 cmH2O). El 57% de los pacientes precisó como tratamiento acetazolamida, un inhibidor de la anhidrasa carbónica. En todos los pacientes la resolución fue completa; sin embargo, casi el 30% de ellos presentó recurrencias durante el seguimiento. Conclusiones. En los últimos años se ha mostrado un aumento en la incidencia de esta entidad, y es fundamental un diagnóstico y un tratamiento precoces para evitar posibles secuelas irreversibles.

Molecular identification of Borrelia and SFG Rickettsia spp. in hard ticks parasitizing domestic and wild animals in southeastern Spain.

Lyme disease and the spotted fever group rickettsiosis, involve bacteria belonging to the genus Borrelia and Rickettsia, respectively. These infections are the most important tick-borne zoonotic diseases involving ticks as vectors. Descriptive and epidemiological studies are essential to determine the animal hosts involved in the maintenance of these diseases. In the present study, 94 tick pool samples from 15 different host species located in the Region of Murcia (southeastern, Spain) were analysed. Ticks were morphologically identified as: Dermacentor marginatus, Hyalomma lusitanicum, Ixodes Ricinus, and Rhipicephalus sanguineus. Our results showed that 5.3% of the tick pool samples carried Borrelia spp. DNA, and 20.2% carried SFG Rickettsia DNA. In every hard tick pool Spot Fever Group (SFG) Rickettsia spp. DNA were detected, except for H. lusitanicum. Likewise, D. marginatum was the only species in which Borrelia spp. DNA was not detected. Barbary sheep and wild boar were the host species in which tick pools showed DNA presence of both pathogens. This study increases the knowledge about the presence of Borrelia spp. DNA and SFG Rickettsia spp. DNA in different hard tick species from this geographical area.

Morbility, clinical data and proteomic analysis of IUGR and AGA newborns at different gestational ages.

The data are related to the proteomic analysis of 43 newborns with intrauterine growth retardation (IUGR) and 45 newborns with appropriate weight for gestational age (AGA) carried out by separation via 2DE and analyzed by MS-TOF/TOF. All newborns were separated into three gestational age groups, "Very Preterm" 29-32 weeks, "Moderate Preterm" 33-36 weeks, and, "Term" ≥37weeks. From each newborn, blood was drawn three times from birth to 1 month life. High-abundant serum proteins were depleted, and the minority ones were separated by 2DE and analyzed for significant expression differences. The data reflect analytic and clinic variables analyzed globally and categorized by gestational age in relation to IUGR and the optimization of conditions for 2-DE separation. The data from this study are related to the research article entitled "Alterations of Protein Expression in Serum of Infants with Intrauterine Growth Restriction and Different Gestational Ages" (M.D. Ruis-González, M.D. Cañete, J.L. Gómez-Chaparro, N. Abril, R. Cañete, J. López-Barea, 2015) [1]. The present dataset of serum IUGR newborn proteome can be used as a reference for any study involving intrauterine growth restriction during the first month of life.

Breastfeeding during the first 6 months of life, adiposity rebound and overweight/obesity at 8 years of age.

BACKGROUND: The question of whether breastfeeding protects the child from obesity is a still debated issue; however, the relationship between early adiposity rebound and higher risk of obesity is well known. This study was aimed at evaluating whether breastfeeding (without formula supplement) during the first 6 months of life delays the time of adiposity rebound and consequently reduces the rates of obesity at the age of 8. METHODS: This retrospective cohort study included 1812 children born in Gran Canaria in 2004, with follow-up until they were 8 years of age. Anthropometrical data had been taken during routine visits to the doctor and were extracted from medical record databases. Only children with breastfeeding for the first 6 months of life (173 children) and children without breastfeeding (192 children) were included. Children with mixed feeding and children whose data were not available were excluded. RESULTS: No body mass index (BMI) differences were found between children with breastfeeding (17.7) or without breastfeeding (17.3) during the first 6 months of life. The percentages of children with normal weight, overweight and obesity were similar in both groups, as well as the age of adiposity rebound breastfeeding 3.61 years; formula 3.64 years). Early adiposity rebound was associated with increased BMI at the age of 8, both in male and female children. CONCLUSIONS: Breastfeeding during the first 6 months of life was not demonstrated to delay the age of the adiposity rebound, in our study.

Afalia: diagnóstico inesperado en un recién nacido con retraso de crecimiento intrauterino / Aphallia: striking diagnosis in intrauterine growth retardation

La afalia es una es una anomalía extremadamente rara, cuya incidencia es de 1 por cada 30 millones de recién nacidos vivos. Hasta la actualidad se han descrito menos de 100 casos en la literatura médica. Se describe un caso de afalia asociado a cardiopatía congénita de diagnóstico posnatal en un recién nacido con retraso del crecimiento intrauterino, sin otro hallazgo prenatal. Se decidió una reasignación de sexo masculino. En el estudio cromosómico se determinó un cariotipo 46XY. No se describieron otras anomalías asociadas (AU)

Aphallia is a really uncommon anomaly occurring in 1 per 30 million births. At this time, less than 100 cases have been reported worldwide. Herein, we describe a case of aphallia associated with congenital heart disease in a fetus with intrauterine growth retardation. No other congenital anomalies were detected. Karyotype was 46XY. Gender assignment has been to male (AU)

Secular changes in Paget's disease: contrasting changes in the number of new referrals and in disease severity in two neighboring regions of Spain.

SUMMARY: We studied the changes in the number of new referrals with Paget's disease of bone (PDB) and severity of PDB in a high prevalence focus and its neighboring region. Referral of patients changed only in the high prevalence focus. The severity of PDB decreased in both regions. These results could suggest the effects of an environmental influence on disease activity. INTRODUCTION: The prevalence and severity of PDB have decreased in several countries over recent years. We previously reported a high radiological prevalence of PDB in Vitigudino. Here we sought to determine if secular changes in the number of new referrals and severity of PDB had occurred over recent years. METHODS: We studied 280 patients with clinically diagnosed PDB who were evaluated at a regional referral center for metabolic bone disease between 1986 and 2009. Changes in the number of new referrals were calculated by relating these data to the number of subjects at risk as determined by population registers. Trends in disease severity were analyzed with alkaline phosphatase (ALP) activity and disease extent on scan. RESULTS: Referrals from the Vitigudino region increased substantially between 1986 and 2003 but fell markedly between 2004 and 2009, although by this time there had been depopulation of the region due to emigration. No significant changes in the rates of referral occurred in the remainder of Salamanca. ALP activity and disease extent decreased in Salamanca, but only ALP activity decreased in Vitigudino. Referrals rate and severity of PDB in Vitigudino were greater than in the remainder of Salamanca. CONCLUSIONS: Referral of patients with clinically diagnosed PDB has remained stable for most of Salamanca during the past 24 years, but substantial changes have been observed in Vitigudino. In agreement with other reports, the severity of PDB has decreased in both regions consistent with the effects of an environmental influence on disease activity.

[Thymic uptake of 18FFDG following radioiodine ablation therapy]. / Captación de 18F-FDG en timo tras terapia ablativa de restos tiroideos con 131I.

We report the case of a 47 year-old woman with a history of non-Hodgkin's lymphoma. During the course of her disease, we performed various (18F)FDG PET/CT that identified several significant incidental findings. First, we incidentally identified a hypermetabolic nodule in the left thyroid lobe, whose final diagnosis was differentiated thyroid carcinoma. Second, metabolic activity was visualized in the thymus secondary to ablative treatment with radioiodine. This uptake disappeared in subsequent studies. Several papers have reported thymic rebound following chemotherapy but we have found only one case report of (18F)FDG uptake after radioiodine treatment. On the other hand, this case is of interest because it supports the benefit of studying the hypermetabolic thyroid nodules incidentally detected on the PET/CT performed for other reasons.

Change in psychiatrists' attitudes towards the physical health care of patients with schizophrenia coinciding with the dissemination of the consensus on physical health in patients with schizophrenia.

PURPOSE: To evaluate the impact of the "Spanish Consensus on Physical Health in Patients with Schizophrenia" on psychiatrists' evaluations of the physical health of patients with schizophrenia. METHOD: Epidemiological, non-interventional, national, multicentre study, with two retrospective, cross-sectional data collection stages in which 229 psychiatrists evaluated 1193 clinical records of patients with schizophrenia (ICD-10) seen in January and September of 2007. RESULTS: Mean age of the patients was 39.7±11.6 years, 65.5% were men, diagnosed for schizophrenia 14.0±10.3 years ago. Forty percent of the patients suffer from a concomitant disease, the most prevalent being hypercholesterolemia (46.3%), hypertriglyceridaemia (33.5%) and arterial hypertension (26.0%). The difference in the number of patients who had all the physical measurements taken between the two cross-sectional evaluations was 13.8% (CI: 11.8%, 15.7%). The differences for each parameter were: weight 13.7% (CI: 11.7%, 15.6%), BMI 13.58% (CI: 11.6%, 15.5%), waist circumference 14.0% (CI: 12.0%, 15.39%), lipid profile 2.9% (CI: 1.9%, 3.9%) and glycaemia 2.6% (CI: 1.7%, 3.5%). CONCLUSIONS: These results imply that the dissemination of the "Consensus on Physical Health in Schizophrenia Patients", and possibly other actions, has made psychiatrists more aware of an integral approach to patients with schizophrenia, promoting increased monitoring of the physical health of these patients.

[Risk factors involved in the need for blood transfusion in very low birth weight newborns treated with erythropoietin]. / Factores de riesgo implicados en la necesidad de transfusión sanguínea en recién nacidos de muy bajo peso tratados con eritropoyetina.

OBJECTIVE: To identify and quantify risk factors related to red blood cell transfusion in premature babies weighing<1,500g who received erythropoietin (EPO). Secondly, to assess the relationship between retinopathy of prematurity and rh-EPO. MATERIAL AND METHODS: Prospective descriptive study of infants admitted to the Reina Sofía University Hospital between January 2006 and March 2009. Infants reviewed had a birth weight<1,500g and gestational age<32 weeks. Infants were administered rh-EPO 750IU/kg/week subcutaneously 3 days/week/ 6 weeks. We used univariate and multivariate logistic regressions with PASW Statistics 18 for Windows. RESULTS: Data were obtained from 110 infants, with a mean birth weight of 1154grs and mean gestational age of 29.3 weeks. Risk factors (OR; 95% CI) for being transfused were: male sex (4.41; 1.24-15.66), GA (1.64; 1.14-2.36, 1 week), Hb level on admission (1.45; 1.04-2.04; 1g/dl), late onset sepsis (7.75; 2.21-21.11), late onset treatment with rh-EPO (6.27; 1.22-32.35). All surgically treated infants with patent ductus arteriosus ligation or necrotizing enterocolitis needed transfusion. There is no relationship between rh-EPO administration and retinopathy of prematurity (ROP), but there was a relationship with transfusion. CONCLUSIONS: Premature infants with the lower gestational age, being male, a lower Hb level on admission and late onset sepsis are those with the greatest risk for blood transfusion.

[A program to protocolize nursing care]. / Sistemática para la protocolización de los cuidados de enfermería.

OBJECTIVE: To decrease variability in clinical practice and to standardise and develop a systematic care programusing nursing care protocols. MATERIALS AND METHODS: The Directorate of Nursing of the Gregorio Marañón Hospital decided to develop a systematic program to produce nursing care protocols in 2004. It followed 5 phases: preparation, processing, dissemination, evaluation and updating. The program was based on the methodology for continuous improvement cycle (PDCA). Particular attention was paid to the evaluation phase, and to the three types of tools used: evaluation of the process and performance indicators and a survey on the perception of professionals. RESULTS: A total of 30 protocols and 80 procedures were developed. They were evidence based, accessible, available for updating and with evaluation indicators. DISCUSSION: Nursing care protocols decrease the variability of clinical practice. They homogenize care and increase the involvement of professionals. The evaluation of the process, outcomes and adherence of professionals is imperative for continuous improvement.

Estudio de necesidades de orientación académicas y profesionales, Plan de Acción Tutorial: BIOrienta2 / Study needs of academic and professional guidance, Tutorial Action Plan BIOrienta2

Farmacia es la Licenciatura que ofrece una mejor formación curricular para aquellos profesionalesque quieren desarrollarse en el campo de la Biomedicina. No existe ninguna otra Licenciatura queaúne conocimientos tan amplios en Ciencias de la Salud, Química, Microbiología, Parasitología,Biología Molecular y Biotecnología, y que aborde la enseñanza de los aspectos relacionados con elmedicamento y las alteraciones fisio/patológicas a un nivel molecular como es la Licenciatura deFarmacia. Para valorar el conocimiento de los alumnos de esta Licenciatura en las diversassalidas profesionales en el área de Biomedicina, hemos realizado un estudio de las necesidades de losmismos basado en encuestas de opinión. Este trabajo ha puesto de manifiesto la necesidad de crear unPlan de Orientación Tutorial (PAT) enfocado a orientarlos sobre salidas profesionales en el área deBiomedicina, de tal manera que se cubran las principales carencias puestas de manifiesto:Motivación: si comprenden la utilidad de la Licenciatura en su futuro profesional se animaránmás a trabajar.Orientación: Fundamentalmente en la elección de asignaturas e itinerarios profesionales relacionadoscon la Biomedicina.Información: Mediante charlas y conferencias en las que profesionales del área de la Biomedicina deentes públicos y privados los orienten sobre las carreras de investigador en ambos ámbitos.Nuestra experiencia como profesores e investigadores nos indica que aquellos alumnos que durantesus estudios de Licenciatura se vinculan a un Departamento como alumnos internos o al menosmuestran algún interés por la investigación, no sólo se orientan profesionalmente mejor sino queaumentan su rendimiento académico significativamente. Este hecho justifica por sí solo la puesta enmarcha del PAT(AU)

The Degree of Pharmacy offers the best instruction for those professionals that want to specialise inthe field of Biomedicine. It doesn't exist any other Degree offering to the students so wide knowledgein Health Sciences, Chemistry, Microbiology, Parasitology, Molecular Biology and Biotechnologythat deals with all the aspects related with drugs and physio/phatological alterations at a molecular level.We have carried out a study of the students’ requirements based on opinion surveys at the GranadaUniversity. This work has shown the necessity to create a PAT focused on the orientation of thestudents in their professional development in the area of Biomedicine, in such a way that the followingneeds are covered:Motivation: The understanding of the usefulness of the Degree in their professional future willencourage them to work more intensively.Orientation: Mainly in the election of subjects and professional itineraries related with theBiomedicine.Information: Professionals of Biomedicine from both public institutions and private companies willshow them the different aspects of the research in both type institutions by means of chats andconferences.Our experience as professors and researchers shows that those students that are linked to a Departmentduring their Degree or that show some interest for the research, significantly increase both theiracademic and professional performance. This fact justifies the initiation of the PAT(AU)

Severity of personality disorders and suicide attempt.

OBJECTIVE: Severity of personality disorders (PDs) may be more useful in estimating suicide risk than the diagnosis of specific PDs. We hypothesized that suicide attempters with severe PD would present more attempts and attempts of greater severity/lethality. METHOD: Four hundred and forty-six suicide attempters were assessed. PD diagnosis was made using the International Personality Disorder Questionnaire--Screening Questionnaire. PDs were classified using Tyrer and Johnson's classification of severity (no PD, simple PD, diffuse PD). Severity/lethality of attempts was measured with the Suicide Intent Scale, Risk-Rescue Rating Scale and Lethality Rating Scale. RESULTS: Attempters with severe (diffuse) PD had more attempts than the other groups. After controlling for age and gender, this difference remained significant only for the younger age group and women. There was no relationship between severity of PDs and severity/lethality of attempts. CONCLUSION: Younger female attempters with severe PD are prone to repeated attempts. However, the severity of PD was not related to the severity/lethality of suicide attempts.

[The role of bone scintigraphy in two cases of hereditary multiple exostoses]. / Papel de la gammagrafía ósea en dos casos de exóstosis múltiple hereditaria.

We present the cases of two patients aged 18 and 40 years, with no previous personal history of interest. The only symptoms reported by the first patient in the previous year were episodes of pain and stiffness without inflammation in the right knee and third finger of the right hand. These episodes lasted two to three weeks. Our second patient presented numbness in the lower left limb over the previous year. The analytical study was normal. The patients were diagnosed with hereditary multiple exostoses, based on the clinical, radiological and scintigraphic findings. The bone scintigraphy enabled whole body images to be obtained in a single examination and may be used for the differential diagnosis of other osteoarticular conditions, as well as for the follow-up and assessment of the response to treatment.

Papel de la gammagrafía ósea en dos casos de exóstosis múltiple hereditaria / The role of bone scintigraphy in two cases of hereditary multiple exostoses

Se presentan los casos de dos pacientes de 18 y 40 años sin antecedentes personales de interés. Como única sintomatología, el primer paciente refería en el último año episodios de dolor y sensación de rigidez sin inflamación en la rodilla derecha y el tercer dedo de la mano derecha. Dichos episodios fueron de dos y tres semanas de evolución. Nuestro segundo paciente presentaba sensación de adormecimiento del miembro inferior izquierdo de 1 año de evolución. El estudio analítico fue normal. Se llegó al diagnóstico de exóstosis múltiple hereditaria basándose en los hallazgos clínicos, radiológicos y gammagráficos. La gammagrafía ósea permite obtener en una sola exploración imágenes de cuerpo entero y puede emplearse para el diagnóstico diferencial de otros procesos osteoarticulares, así como para el control evolutivo y la valoración de la respuesta al tratamiento

We present the cases of two patients aged 18 and 40 years, with no previous personal history of interest. The only symptoms reported by the first patient in the previous year were episodes of pain and stiffness without inflammation in the right knee and third finger of the right hand. These episodes lasted two to three weeks. Our second patient presented numbness in the lower left limb over the previous year. The analytical study was normal. The patients were diagnosed with hereditary multiple exostoses, based on the clinical, radiological and scintigraphic findings. The bone scintigraphy enabled whole body images to be obtained in a single examination and may be used for the differential diagnosis of other osteoarticular conditions, as well as for the follow-up and assessment of the response to treatment

[Application of the motor unit number estimation (MUNE-Poisson) statistical technique in patients with neurogenic processes]. / Aplicación en pacientes con procesos neurogénicos de la técnica estadística de estimación del número de unidades motoras (MUNE-Poisson).

INTRODUCTION: Little research has been conducted on applying the statistical estimation of the number of motor units (the MUNE statistic) in the diagnosis of neurogenic processes. AIMS: To determine the sensitivity of this test in patients with different neurogenic processes and to disseminate and clarify its basic methodological aspects. SUBJECTS AND METHODS: Both the conventional calculation and the modified version of the MUNE-Poisson put forward by Shefner et al (MUNEm) were used to carry out unilateral studies of the extensor digitorum brevis muscle in 82 patients who had previously been clinically and electromyographically diagnosed with sensory-motor axonal polyneuropathy (36 cases), unilateral L5 radiculopathy (26 patients) and second motor neuron disease (20 cases). RESULTS: Overall sensitivity of the two methods was 81.7% and 82.9%, respectively, with no significant differences between them. Similarly, the sensitivity of the MUNE studies does not differ statistically according to the diagnosis. Patients who had a compound muscle action potential (CMAP) with a reduced amplitude displayed significantly higher sensitivity in MUNE studies (94.8%) than those who exhibited a normal CMAP (69.7%) (p < 0.001). CONCLUSIONS: Although routine use of the MUNE statistical method is unnecessary in daily practice, it should be considered for use in processes in which conventional muscle electromyography, especially involving distal ones, offers doubtful results or the aim is to follow the progression of certain neurogenic processes.

Aplicación en pacientes con procesos neurogénicos de la técnica estadística de estimación del número de unidades motoras (MUNE-Poisson) / Application of the motor unit number estimation (mune-poisson) statistical technique in patients with neurogenic processes

Introducción. Existe poca experiencia sobre la aplicación de la estimación estadística del número de unidades motoras (MUNE estadístico) en el diagnóstico de procesos neurogénicos. Objetivos. Determinar la sensibilidad de dicho test en pacientes con distintos procesos neurogénicos y difundir y aclarar los aspectos metodológicos fundamentales de aquél. Sujetos y métodos. Se ha estudiado mediante MUNE-Poisson, utilizando el calculo convencional y el modificado propuesto por Shefner et al (MUNEm), unilateralmente el músculo extensor digitorum brevis de 82 pacientes previamente diagnosticados clínica y electromiográficamente de polineuropatía axonal sensitivomotora (36 casos), radiculopatía L5 unilateral (26 pacientes) y enfermedad de la segunda motoneurona (20 casos). Resultados. La sensibilidad global de ambos métodos ha sido de 81,7 y 82,9%, respectivamente, sin diferencias significativas entre ellos. La sensibilidad de los estudios MUNE tampoco es estadísticamente diferente según el diagnóstico. Los pacientes que presentaron amplitud del potencial muscular compuesto (CMAP) reducida en amplitud mostraron significativamente mayor sensibilidad en los estudios MUNE (94,8%) que los que exhibieron un CMAP normal (69,7%) (p < 0,001). Conclusión. Aunque es innecesario utilizar rutinariamente en la práctica diaria el método MUNE estadístico, sí se debe considerar su empleo en procesos en los que la electromiografía convencional de músculos, sobre todo distales, presenta resultados dudosos, o se pretende seguir la evolución de ciertos procesos neurogénicos

Introduction. Little research has been conducted on applying the statistical estimation of the number of motor units (the MUNE statistic) in the diagnosis of neurogenic processes. Aims. To determine the sensitivity of this test in patients with different neurogenic processes and to disseminate and clarify its basic methodological aspects. Subjects and methods. Both the conventional calculation and the modified version of the MUNE-Poisson put forward by Shefner et al (MUNEm) were used to carry out unilateral studies of the extensor digitorum brevis muscle in 82 patients who had previously been clinically and electromyographically diagnosed with sensory-motor axonal polyneuropathy (36 cases), unilateral L5 radiculopathy (26 patients) and second motor neuron disease (20 cases). Results. Overall sensitivity of the two methods was 81.7% and 82.9%, respectively, with no significant differences between them. Similarly, the sensitivity of the MUNE studies does not differ statistically according to the diagnosis. Patients who had a compound muscle action potential (CMAP) with a reduced amplitude displayed significantly higher sensitivity in MUNE studies (94.8%) than those who exhibited a normal CMAP (69.7%) (p < 0.001). Conclusions. Although routine use of the MUNE statistical method is unnecessary in daily practice, it should be considered for use in processes in which conventional muscle electromyography, especially involving distal ones, offers doubtful results or the aim is to follow the progression of certain neurogenic processes

[Utility of diuretic renography in the detection of an enteroureteral fistula]. / Utilidad del renograma diurético en la detección de una fístula enteroureteral.

After a 2-year-old male with left impairment underwent surgery for a left vesicoureteral stenosis, his renal function was followed up by means of dynamic renal scintigraphy with 99mTc-DTPA. Incidental radiotracer accumulation was observed in left hemiabdomen tracing the descending and sigmoid colon. A vesico-colonic fistula was suspected. However, ultrasonography and cystography studies showed no presence of a vesico-enteric fistula. Because the patient persisted without symptoms, an expectant approach was adopted. One year later, he began to suffer watery diarrhoea episodes. 99mTc-DTPA renography was again performed to re-evaluated renal function and explore presence of urinary-enteric fistula. Diuretic renography demonstrated the presence of a vesical leak to sigmoid gut, which was confirmed by recovery of fecal matter from the patient. Both isotopic renograms evidenced the presence of uretero-sigmoid fistula, an uncommon postsurgical that was not detected by cystography, ultrasonography or RMN. The patient subsequently underwent surgery for fistula repair.