Erythropoietin improves object placement recognition memory in a time dependent manner in both, uninjured animals and fimbria-fornix-lesioned male rats.

An increasing number of reports sustain a possible role of erythropoietin (EPO) as neuroprotective agent. In two previous articles we have evaluated EPO as plasticity promoting agent, and to contribute the restoration of brain function affected by acquired damage. We have shown that EPO is able to induce an increased synaptic efficacy in vivo along with a plasticity promoting effect. In the Morris water maze EPO administration to fimbria-fornix lesioned male rats induces a significant improvement of their spatial memory, affected by the lesion. Singularly, EPO was only effective when administered shortly after training (10 min) but not after several hours (5 h), suggesting a specific EPO effect on time dependent plasticity process. In the present paper we have expanded this line of evidence using a low stress paradigm of object placement recognition in lesioned and healthy male rats. The memory trace in this model is short-lasting; animals could recognize the change in object position when tested 24 h after, but not 48 or 72 h after the acquisition session. EPO administration 10 min after acquisition significantly prolongs retention to, at least, 72 h in healthy rats. No effect was seen if EPO was administered 5 h after training, suggesting a specific EPO modulatory effect on the consolidation process. Remarkably, early EPO treatment to fimbria fornix lesioned animals reverts the memory deficit caused by the lesion. An increased expression of the plasticity related gene arc, was also confirmed in the hippocampus and the prefrontal cortex, that is likely to be involved in the behavioral improvement observed.

Is the cleft lift procedure for non-acute sacrococcygeal pilonidal disease a definitive treatment? Long-term outcomes in 74 patients.

PURPOSE: No definitive surgical treatment for non-acute pilonidal disease has been established thus far. We herein report the short-term and long-term outcomes of 74 consecutive patients who underwent the cleft lift procedure for non-acute pilonidal disease. METHODS: A total of 74 consecutive patients who underwent the cleft lift procedure for the treatment of non-acute pilonidal disease were evaluated. RESULTS: Complete healing was achieved in 54 patients (73%). Wound seroma was observed in 12 patients (15%) in the first week, and this persisted until the second week in 10 patients (13%). Partial dehiscence was found in eight patients (11%). One patient presented with complete wound dehiscence (1%), and another experienced early postoperative bleeding (1%). Wound infection was observed in one patient (1%). The median follow-up period was 51.5 months (range 15-88 months). Three cases of recurrences were observed, which occurred after 51, 42 and 12 months of follow-up. CONCLUSIONS: If longer-term follow-up is achieved, definitive conclusions may be obtained. However, the present results suggest that the cleft lift procedure may become the gold standard technique for the surgical management of non-acute pilonidal disease.

Prevalence of Pneumocystis jirovecii and Mycoplasma pneumoniae in Patients Presenting with Pneumonia at Hospitals in Port Elizabeth

The study was conducted to determine the prevalence of Pneumocystis jirovecii and Mycoplasma pneumoniae in patients presenting with community-acquired pneumonia; in order to improve treatment management programmes. Sputum specimens from 45 patients presenting with pneumonia/symptoms of pneumonia admitted to hospitals in the Port Elizabeth region were assessed. Details of patient's gender; age; HIV and Mycobacterium tuberculosis status were provided by the hospitals. PCRs were performed employing primers directed at the following genes: P. jirovecii for detection of mitochondrial large subunit ribosomal RNA (mtLSUrRNA) and for cotrimoxazole resistance mutation analysis dihrdropteroate synthase (DHPS) and dihydrofolate reductase (DHFR); M. pneumoniae for detection of P1 adhesin and 16SrRNA. Women were seen to be at high risk for community-acquired P. jirovecii colonisation. Overall; prevalence of P. jirovecii was 73(33/45 patients). P. jirovecii was mainly associated with HIV (28/30 P. jirovecii-positive patients for which clinical data were available) and co-colonisation with M. tuberculosis was observed in 10 HIV cases and one HIV-negative patient. DHPS and DHFR primers seriously lacked sensitivity and on six and four PCR products obtained; respectively; no resistanceassociated mutations were found. M. pneumoniae was detected in one patient. The high prevalence of P. jirovecii and presence of M. pneumoniae in cases of pneumonia investigated emphasises that in the absence of definitive diagnoses; it is crucial to monitor treatment responses carefully; especially when first line antibiotic preferences are a-lactams or cephalosporins

Gangrena gaseosa espontánea del páncreas y neumoperitoneo sin perforación visceral por Clostridium perfringens / Spontaneous gaseous gangreneof the pancreas and pneumoperitoneumwithout visceral perforation dueto Clostridium perfringens

No disponible

No disponible

Mucinosis papulosa acral persistente / Acral persistent papular mucinosis

Presentamos un caso de mucinosis papulosa acral persistente (MPAP). Se trata de una mujer de 69 años que presenta pápulas del mismo color de la piel de 2-4mm en el dorso de las manos y las muñecas. En el estudio histopatológico aparece un depósito de mucina focal en la dermis papilar y reticular superior. La MPAP es un tipo de mucinosis que presenta un curso benigno y persistente, sin asociación a alteraciones sistémicas. Existe controversia sobre si se trata de una nueva entidad o un subtipo de la forma discreta papular de liquen mixedematoso

We present a case of acral papular persistent mucinosis(APPM). A 69 years old woman had 2-4mm flesh-colored papules on the back of her hands and extensor wrist. Examination of biopsy specimen showed focal mucin deposition in papillary and upper reticular dermis. APPM is a mucinosis subtype which has a benign and persistent course, without systemic involvement. Controversy exist as to wether this subtype should be considered a new entity o as a variant of the discrete papular form of lichen myxedematosus

Epidemiology of cancer in children under one year of age in Mexico City.

In this work, the epidemiology of cancer in children under one year of age in Mexico City is described. A survey (observational, descriptive and prolective study) from 1 January 1996 to 31 December 1999 was conducted at two paediatric hospitals of the Instituto Mexicano de Seguro Social in Mexico City (IMSS-MC). To calculate both the general and the by sex incidence (rates are given per 10) all new cases recorded for children under one year of age (numerator) and Mexico City population served by the IMSS (denominator) were used. When the total of 34 cases that fulfilled the requirements was analysed, an incidence of 194.5 was obtained. Leukaemia occupied first place with a rate of 68.6 and hepatic and germinal cells tumours occupied second place with an incidence of 28.6, whereas peripheral nervous system tumours (neuroblastoma) showed a very low rate (11.4). Overall, the male/female ratio for tumours was 1.4:1, with the ratio varying with different types of tumours. Cancer incidence in this population was shown to be close to that in developed countries, but differed in the distribution of the type of tumour: leukaemia had a very high incidence and that for neuroblastoma was very low.

[Factors that influence non-donation of blood in relatives of patients at a pediatric hospital]. / Factores que influyen en la no-donación de sangre en los familiares de pacientes de un hospital pediátrico.

OBJECTIVE: To identify factors that influence refusing to donating blood. MATERIAL AND METHODS: Prospective case and control study. Hospitalized patients' relatives were interviewed with a questionnaire to evaluate their knowledge of blood and personal attitudes toward blood donation. Cases were all relatives who did not donate blood and controls who did. RESULTS: A total of 121 individuals was studied, 30 cases and 91 controls. Age of the cases was 32.3 +/- 8.1 years and controls was 28.8 +/- 7.9 years (p = 0.04). Risk factors were female sex (OR = 6.3; 95%CI 2.4 to 17.1), being married (OR = 3.7 95%CI 1.3 to 10.5). No differences were present between the two groups in level of knowledge concerning blood. The average of positive attitudes toward blood donation was greater among relatives who donated blood (cases 5.9 +/- 1.6; controls 6.4 +/- 1.2; P = 0.049). Among the attitudes that influence refusing to donate blood were fear of getting dizzy at the sight of blood (OR = 5.2, 95%CI 1.3-21.4), fear of donating blood (OR = 2.2, 95%C, 0.8-6.0), and getting nervous at the sight of blood (OR = 4.1, 95%CI% 1.5-10.9). CONCLUSIONS: Among patient's relatives who donate blood positive personal attitudes toward blood donation have more weight than knowledge on the subject.

[The trend in pregnancies terminated by a cesarean operation in Mexico during 1991-1995]. / Tendencia de los embarazos terminados por operación cesárea en México durante el periodo 1991-1995.

In the last decades has been a worldwide trend to increase the number of cesarean sections as an alternative of obstetric resolution, phenomenon for which it was proposed a variety of explanation, this fact remains practically unknown in the institutions of the National Health System (NHS) in Mexico. To identify the trend of the pregnancy to end for cesarean sections during the years of 1991-1995 in the 32 states of de country, as well as of all the institutions of the National Health System. Descriptive, cross sectional and retrospective. We use the data of the Bureau of Statistics and Informatics of de Health Ministry of each one of the 32 states of the country, of the years 1991 to 1995, and of the number of cesarean sections made in the hospitals of the different institutions of the NHS. We started off with a data-base, to calculate frequency tables, and the specific rate of the cesarean section for each year, for each one of the states and institutions of the NHS. We calculate the secular trends using the annual rates of cesarean section, for each one of the states and institutions of the NHS. We also made bivariate analysis and estimated the odds ratio (OR) and 95% Confidence Interval (95% IC); and the statistic X2 for trend, setting the two tailed statistic significance level of 0.05. During the study period, there was 7,503,817 births in all hospitals of the NHS, of these births 1,929,865 (25.72%) was resolved by cesarean section. For the whole period it there was a clear trend to increment of the cesarean section, the rate for 1991 was 20.44%, and by 1995 was 28.58%, the raise for the period was 39.82%, with values of the OR for trend of 1.56; 95% IC (1.55-1.57). "P" < 0.05. The rate for institutions attending open population had an increment of 35.08% [OR trend 1.45; 95% IC (1.43-1.46), "p" < 0.05], of them the highest rate was for the State System of Health in 1995 with 29.78%, the rates for the remaining institutions varied from 16.57% for the IMSS/SOLIDARIDAD and 21.7% for the Health Ministry, all trends were statistically significant. In relation to the institutes attending closed population the raise was of 53.27% [OR trend 1.82; 95% IC (1.81-1.83), "p" < 0.05], with the highest rate for the National Defense Ministry which had a rate of 51-15%, the rates for the remaining institutions varied from 33.52% for the Mexican Institute of Social Security (IMSS) to 43.89% for the Institute of Safety and Social Services for the State Workers (ISSSTE), with exception of the Management of the Medical Services of the Mexican Oils (PEMEX) and the Marine Ministry (SECMAR), all trends were statistically significant. When the analysis of the cesarean section rates for the 32 states of the Mexican Republic was carried out, we found that in 1995, the national average rate was 28.58%, the lowest rate corresponded to the state of Zacatecas with 19.82% and the highest to the state of Nuevo León with 42.14%. There was a tendency to increment for all states which varied from 23.55% for the state Chiapas and 67.97% for the states of Querétaro, all increments were statistically significant. We conclude, that rates of cesarean section for both, institutions of NHS and states of the Mexican Republic, are of the highest in the world, no matter what big the interinstitutional and interstate variation are. The highest rates occurred in institutions attending closed population, and the states with a higher degree of socioeconomic development.

Valores gasométricos en población geriátrica. Análisis en dos diferentes altitudes / Blood gas levels in the geriatric population: Analysis at two different altitudes. (Initial results of a national project)

Introducción: Al no contar con valores de referencia de los gases en sangre en la población geriátrica, se afectuó un estudio observacional, prolectivo, transversal, descriptivo y de causa efecto en 204 sujetos voluntarios sanos mayores de 60 años, en ambos sexos. material y métodos: Se dividieron en dos grupos: El grupo A con 102 sujetos sanos que vivían a una altura de 2,238 metros sobre el nivel del mar (Cd. de México); y el grupo B, con 102 pacientes que residían a nivel del mar. Ambos grupos fueron divididos a su vez en tres: mayores de 60 y menores de 69, mayores de 70 y menores de 79 y mayores de 80. A todos ellos se les tomó gasometría en reposo con un gasómetro IL modelo 4002 y, el análisis estadístico se efectuó mediante frecuencias simples y medidas de dispersión. Resultados: Se demuestra una relación inversa entre la altura y la concentración de oxígeno y una relación decreciente y proporcional conforme transcurre la edad