Pre-and post-surgical non-functional pituitary adenomas and their relationship with high levels of serum glucose.

OBJECTIVES: This clinical, analytical, retro-prospective, auto-controlled, not randomized, and not blinded study, aimed to investigate the association of changes in the serum glucose levels with the pre-and-post changes in the size tumor in mm3 in the Non-Functional pituitary adenomas. METHODS: Pre-and post-surgical MRI, as well as the measurements in the serum glucose levels and immunohistochemical techniques were performed in all the patients in the study, with a mean followed-up until 208.57 days. A comparison was made between the reductions in tumor size of hormonally active pituitary adenomas (HSPAs) vs NFPAs. RESULTS: Seventy-four patients were included in this study, of whom, 46 were NFPAs. The decrease in the NFPAs tumor size after surgery was statistically significant (P ≤ 0.0001). The Mean of the differences of both type of tumors in mm3 were -9552 ± 10287. Pre-surgery, the mean of the HSPAs were 8.923 ± 2.078; and the NFPAs were 14.161 ± 1.912. The differences in the tumor size were statistically significant (p = 0.039). Post-surgical, the mean of the HSPAs were 2.079 ± 971, with a (p = 0.14): and the NFPAs were 4.609 ± 1.205. After surgery of the NFPAs, most of the patients-maintained serum levels ≤ 100 mg/dL, with a statistical significance (P ≤ 0.0003). CONCLUSION: This study demonstrates for the first time the correlation between the presence of pre-and post- surgical changes in the NFPAs, with modifications in the levels of serum glucose, and the comparison, pre- and post-surgical between the tumor size of HSPAs and NFPAs.

Improvement of metabolic syndrome and its components in patients who underwent transsphenoidal resection for pituitary adenoma.

BACKGROUND: Pituitary adenomas (PA) are neoplasms of pituitary adenohypophyseal cell lineage, which are the third most common cause of brain tumors among adults. Due to hormone secretion, PAs are closely related to metabolic syndrome (MetS). However, the relationship between these two entities has been scarcely studied to date. PURPOSE: This paper aims to evaluate changes in the metabolic status of patients with PA before and after surgical treatment and to look for differences in metabolic outcomes among patients according to the adenoma type and the surgery success rate. METHODS: We assessed patients with PA who went through transsphenoidal surgery for its treatment, documenting metabolic parameters before and after surgery, analyzed whole sample changes, and then stratified them according to adenoma type (nonfunctioning, somatotroph, lactotroph, and corticotroph), and surgery success (total resection, near-total resection, partial resection, subtotal resection). RESULTS: A total of 214 patients were enrolled for this study. The prevalence of MetS with AACE criteria went from 51.52% before surgery to 28.99% after surgery (P < 0.001). Hyperglycemia (HG) was the most beneficial component; it went from 56% pre-surgery to 40.51% post-surgery (P = 0.03). The total resection group had the best improvement, with a significant decrease of prevalence in MetS from 83 to 16% (P < 0.001), and every component, except hypoalphalipoproteinemia (HA): obesity went from 96 to 67% (P < 0.001), arterial hypertension (AH) 59 to 24% (P < 0.001), HG 74 to 23% (P < 0.001), and hypertriglyceridemia (HTG) from 81 to 54% (P < 0.001). According to MetS prevalence, there was no difference in the improvement according to PA type. CONCLUSION: Surgical treatment in patients with PA is associated with MetS improvement.

Peripheral neurotrophin levels during controlled crack/cocaine abstinence: a systematic review and meta-analysis.

Cocaine/crack abstinence periods have higher risk of relapse. Abstinence as initial part of the recovery process is affected by learning and memory changes that could preserve the addictive cycle. To further understand how the interruption of cocaine/crack consumption affects neurotrophin level we performed the present systematic review and meta-analysis following the PRISMA statement (number CRD42019121643). The search formula was conducted in PubMed, Web of Science, Embase, ScienceDirect, and Google Scholar databases. The inclusion criterion was cocaine use disorder in 18 to 60-year-old people, measuring at least one neurotrophin in blood before and after a controlled abstinence period. Studies without pre-post design were excluded. Five investigations had nine different reports, four of them were subjected to a meta-analysis (n = 146). GRADE risk of bias method was followed. Individual studies reported increased peripheral brain derived neurotrophic factor (BDNF) after abstinence, evidence pooled by Hedge's g showed no significant change in BDNF after abstinence. Relevant heterogeneity in the length of the abstinence period (12-32 days), last cocaine/crack consumption monitoring and blood processing were detected that could help to explain non-significant results. Further improved methods are suggested, and a potential BDNF augmentation hypothesis is proposed that, if true, would help to understand initial abstinence as a re-adaptation period influenced by neurotrophins such as the BDNF.

Pre- and post-clinical-radiological and surgical evaluation of patients with pituitary adenoma and metabolic syndrome.

BACKGROUND: Pituitary adenomas are benign tumors located in the anterior hypophysis. Its appearance is associated with the development of parameters related to metabolic syndrome; therefore, surgical treatment could reduce associated morbimortality. METHODS: Pre- and post-surgical MRI, using the Hardy-Wilson and Knosp classification, and clinical data according to the American Association of Clinical Endocrinology (AACE) criteria for metabolic syndrome: all the patients were followed-up until 208.57 days were reviewed on 217 consecutive patients with pituitary surgery. RESULTS: Seventy-four patients were included in this study. There was a significant reduction in tumor size in mm3 [average pre- and post-surgery respectively: 12,362 mm3 (±12,397); 3,910 mm3 (±7,160)], (p < 0.0001). This was confirmed by the Hardy-Wilson and Knosp classification, where most patients went from grade IV C (33.7%) to grade 0 (12.1%), IA (20.2%), IIB (21.36%), and IIC (16.2%); as well as from grade 4 (24.3%) to grade 0 (45.9%), respectively. After surgery, there were statistically significant reductions in total serum levels of glucose [average pre- and post-surgery, respectively: 116 mg/dL (±26.9); 90 mg/dL (±10.2)], (p < 0.001), triglycerides [average pre- and post-surgery, 240 mg/dL (±102); 171 mg/dL (±60.5)], (p = 0.001); and HDL-c [average pre- and post-surgery, respectively: 39 mg/dL (±11.8); 44.6 mg/dL (±8.4)], (p = 0.029). The other parameters remained unchanged. CONCLUSION: This is the first study to demonstrate the relationship between the presence of pituitary adenoma and significative changes in serum glucose, triglycerides and c-HDL related to metabolic syndrome.

Using integrated wildlife monitoring to prevent future pandemics through one health approach.

In the One Health context, Integrated Wildlife Monitoring (IWM) merges wildlife health monitoring (WHM) and host community monitoring to early detect emerging infections, record changes in disease dynamics, and assess the impact of interventions in complex multi-host and multi-pathogen networks. This study reports the deployment and results obtained from a nationwide IWM pilot test in eleven sites representing the habitat diversity of mainland Spain. In each study site, camera-trap networks and sampling of indicator species for antibody and biomarker analysis were used to generate information. The results allowed identifying differences in biodiversity and host community characteristics among the study sites, with a range of 8 to 19 relevant host species per point. The Eurasian wild boar (Sus scrofa) was the most connected and central species of the host communities, becoming a key target indicator species for IWM. A negative relationship between biodiversity and disease risk was detected, with a lower number and prevalence of circulating pathogens in the sites with more species in the community and larger network size. However, this overall trend was modified by specific host-community and environmental factors, such as the relative index of wild boar - red deer interactions or the proximity to urban habitats, suggesting that human-driven imbalances may favour pathogen circulation. The effort of incorporating wildlife population monitoring into the currently applied WHM programs to achieve effective IWM was also evaluated, allowing to identify population monitoring as the most time-consuming component, which should be improved in the future. This first nationwide application of IWM allowed to detect drivers and hotspots for disease transmission risk among wildlife, domestic animals, and humans, as well as identifying key target indicator species for monitoring. Moreover, anthropogenic effects such as artificially high wildlife densities and urbanisation were identified as risk factors for disease prevalence and interspecific transmission.

Clinical outcomes report in different brachial plexus injury surgeries: a systematic review.

Brachial plexus injury is a lesion that results in loss of function of the arm, and there are multiple ways of surgically approaching its treatment. Controlled trials that compare all surgical repair strategies and their clinical outcomes have not been performed. A systematic review was conducted to identify all articles that reported clinical outcomes in different surgeries (nerve transfer, nerve graft, neurolysis, end-to-end, multiple interventions, and others). Advanced search in PubMed was performed using the Mesh terms "brachial plexus injury" as the main topic and "surgery" as a subtopic, obtaining a total of 2153 articles. The clinical data for eligibility extraction was focused on collecting motor, sensory, pain, and functional recovery. A statistical analysis was performed to find the superior surgical techniques in terms of motor recovery, through the assessment of heterogeneity between groups, and of relationships between surgery and motor recovery. The frequency and the manner in which clinical outcomes are recording were described. The differences that correspond to the demographics and procedural factors were not statistically significant among groups (p > 0.05). Neurolysis showed the highest proportion of motor recovery (85.18%), with significant results between preoperative and post-operative motor assessment (p = 0.028). The proportion of motor recovery in each group according to the surgical approach differed significantly (X2 = 82.495, p = 0.0001). The motor outcome was the most reported clinical outcome (97.56%), whereas the other clinical outcomes were reported in less than 15% of the included articles. Unexpectedly, neurolysis, a technique displaced by new surgical alternatives such as nerve transfer/graft, demonstrated the highest proportion of motor recovery. Clinical outcomes such as pain, sensory, and functional recovery were infrequently reported. These results introduce the need to re-evaluate neurolysis through comparative clinical trials, as well as to standardize the way in which clinical outcomes are reported.

Experiencias docentes en el cambio curricular vivido en la carrera de enfermería de la FES, Iztacala / Teaching experiences in the curricular change experienced in the nursing career of the FES Iztacala

Introducción: la calidad educativa en las IES (Instituciones de Educación Superior) ha sido avalada por procesos de evaluación y acreditación a nivel institucional y curricular, llevando a cabo un proceso de mejora continua, mediante recomendaciones sugeridas por los evaluadores, lo anterior garantizará la calidad institucional ante la formación de futuros profesionales. Objetivo: analizar las experiencias del profesorado de la carrera de enfermería de la Facultad de Estudios Superiores Iztacala, sobre el cambio curricular vivido. Material y métodos: estudio cualitativo con enfoque fenomenológico, mediante entrevista a profundidad a doce profesores de enfermería. Muestreo por conveniencia de acuerdo a la saturación de datos. En aspectos éticos y legales, se realizó carta de consentimiento informado. El análisis de datos fue basado en Miles y Huberman, con abordaje teórico según Van Manen. Resultados: surgieron dos categorías: 1. Sentimientos y afectaciones emocionales respecto al cambio curricular y laborales; 2. impacto del cambio curricular en los aprendizajes de los estudiantes, las cuales evidenciaron cómo el profesorado ha vivido los cambios curriculares en los 17 años desde que fue implementada la licenciatura. Conclusiones: los informantes narraron que en cada cambio curricular surgen emociones diferentes, entre incertidumbre, compromiso, responsabilidad y asumir empoderamiento para implementar la curricula, con ello, lograr los objetivos esperados por la misma, considerando perfil de egreso y rendimiento académico de los estudiantes.

Introduction: the educational quality at the higher level in schools and faculties has been endorsed by evaluation and accreditation processes at the institutional and curricular level, carrying out an improvement process, through the recommendations suggested by the evaluators, thus covering them in a certain time. The foregoing will guarantee the institutional quality before the training of future professionals. Objective: to analyze experiences of the teaching staff of the nursing career of the Iztacala Faculty of Higher Studies, on the curricular change experienced. Material and methods: Qualitative study with a phenomenological approach, through an in-depth interview with twelve nursing professors. Convenience sampling according to data saturation. In ethical and legal aspects, an informed consent letter was drawn up. The data analysis was through Miles and Huberman, with a theoretical approach based on Van Manen. Results: two categories emerged: 1. Feelings and emotional affectations regarding the curricular and work change; 2. impact of curricular change on student learning, which showed how teachers have experienced curricular changes in the 17 years since the degree was implemented. Conclusions: the informants narrated that in each curricular change different emotions arise, between uncertainty, commitment, responsibility and assuming empowerment to implement the curriculum, thereby achieving the objectives expected by it, considering the graduation profile and the academic performance of the students.

Cognitive functions of subjects with cocaine and crack dependency disorder during early abstinence. / Funcionamiento cognitivo en sujetos con trastorno de dependencia a cocaina y crack durante la abstinencia temprana.

INTRODUCTION: Cognitive effects caused by cocaine and crack consumption, especially deficits in executive functions may increase the likelihood of drug-seeking behaviour and interfere with the ability of users to assimilate and participate in rehabilitation programs. AIM: To determine in early abstinence the state of executive functions, the impulsiveness and craving in cocaine and crack consumers. SUBJECTS AND METHODS: This cross-sectional study functions, with a sample of 60 male aged between 31.38 ± 7.26 years old, distributed in three groups: inhaled cocaine users (CDP-I; n = 15), with 23.13 ± 7.2 age of onset of consumption; crack cocaine users (CDP-C; n = 26), with 20.81 ± 4.21 age of onset of consumption, and a control groups of no-addiction individuals (n = 19). Sociodemographic, clinical and cognitive assessments were applied. RESULTS: The data showed that significant differences in socioeconomic level score and impulsiveness. Consumer groups have with lower scores with respect the control group. CDP-C group showed poor performances compared to the CDP-I and control groups, in the Berg Test, Tower of London, numbers in the direct order and subtraction. CDP-I group showed less score in planning compare with the other two groups. CONCLUSIONS: In early abstinence crack users manifest a greater number of deficits, mainly in working memory, planning and cognitive flexibility.

TITLE: Funcionamiento cognitivo en sujetos con trastorno de dependencia a cocaina y crack durante la abstinencia temprana.Introduccion. Los efectos cognitivos causados por el consumo de cocaina y crack, especialmente los deficits de las funciones ejecutivas, aumentan la probabilidad de un comportamiento de busqueda de drogas e interfieren en la capacidad de los usuarios de asimilar y participar en los programas de rehabilitacion. Objetivo. Determinar en la abstinencia temprana el estado de las funciones ejecutivas, la impulsividad y la ansiedad (craving) en consumidores de cocaina y crack. Sujetos y metodos. Este estudio transversal tuvo una muestra de 60 hombres, con una edad media de 31,38 ± 7,26 años, distribuidos en tres grupos: usuarios que inhalan cocaina (CDP-I; n = 15), con una edad de inicio de consumo de 23,13 ± 7,2 años; consumidores de cocaina en crack (CDP-C; n = 26), con una edad de inicio de consumo de 20,81 ± 4,21 años, y un grupo control de sujetos sin adiccion (n = 19). Se aplicaron evaluaciones sociodemograficas, clinicas y cognitivas. Resultados. Los datos mostraron diferencias significativas en las puntuaciones del nivel socioeconomico e impulsividad. Los grupos de consumidores tienen puntuaciones mas bajas con respecto al grupo control. El grupo CDP-C mostro rendimientos pobres en comparacion con el grupo CDP-I y el grupo control en las pruebas de Berg, torre de Londres, numeros en orden y sustraccion directos. El grupo CDP-I mostro una menor puntuacion en la planificacion comparada con los otros dos grupos. Conclusiones. En la abstinencia temprana, los consumidores de crack manifiestan mayor numero de deficits, principalmente en la memoria de trabajo, la planificacion y la flexibilidad cognitiva.

Similar clinical improvement and maintenance after rTMS at 5 Hz using a simple vs. complex protocol in Alzheimer's disease.

BRACKGROUND: Current treatments for Alzheimer's disease (AD) have a limited clinical response and methods, such as repetitive transcranial magnetic stimulation (rTMS), are being studied as possible treatments for the clinical symptoms with positive results. However, there is still seldom information on the type of rTMS protocols that deliver the best clinical improvement in AD. Objetive: To compare the clinical response between a simple stimulation protocol on the left dorsolateral prefrontal cortex (lDLPFC) against a complex protocol using six regions of interest. METHODS: 19 participants were randomized to receive any of the protocols. The analysis of repeated measures evaluated the change. RESULTS: Both protocols were equally proficient at improving cognitive function, behavior and functionality after 3 weeks of treatment, and the effects were maintained for 4 weeks more without treatment. CONCLUSION: We suggest rTMS on the lDLPFC could be enough to provide a clinical response, and the underlying mechanisms should be studied.

The effect of crack cocaine addiction and age on the microstructure and morphology of the human striatum and thalamus using shape analysis and fast diffusion kurtosis imaging.

The striatum and thalamus are subcortical structures intimately involved in addiction. The morphology and microstructure of these have been studied in murine models of cocaine addiction (CA), showing an effect of drug use, but also chronological age in morphology. Human studies using non-invasive magnetic resonance imaging (MRI) have shown inconsistencies in volume changes, and have also shown an age effect. In this exploratory study, we used MRI-based volumetric and novel shape analysis, as well as a novel fast diffusion kurtosis imaging sequence to study the morphology and microstructure of striatum and thalamus in crack CA compared to matched healthy controls (HCs), while investigating the effect of age and years of cocaine consumption. We did not find significant differences in volume and mean kurtosis (MKT) between groups. However, we found significant contraction of nucleus accumbens in CA compared to HCs. We also found significant age-related changes in volume and MKT of CA in striatum and thalamus that are different to those seen in normal aging. Interestingly, we found different effects and contributions of age and years of consumption in volume, displacement and MKT changes, suggesting that each measure provides different but complementing information about morphological brain changes, and that not all changes are related to the toxicity or the addiction to the drug. Our findings suggest that the use of finer methods and sequences provides complementing information about morphological and microstructural changes in CA, and that brain alterations in CA are related cocaine use and age differently.

Environmental enrichment prevents anxiety-like behavior induced by progesterone withdrawal in two strains of rats.

Stress vulnerability could influence the treatment response to anxiety associated with abrupt hormonal suppression. The present study explored the effects of different treatments on experimental anxiety induced by progesterone withdrawal (PW) in a stress-sensitive rat strain, Wistar Kyoto (WKY), in the burying behavior test (BBT). The following experimental series was conducted using independent groups of Wistar (control strain) and WKY ovariectomized rats: Experiment 1: Rats were treated for 5days with oil, a constant dose of progesterone (0.5mg/rat, s.c) or a combination of progesterone (0.5mg/rat, s.c) plus fluoxetine (10 mg/kg, i.p); on day 6, all rats were subjected to BBT. Experiment 2: Rats received corn oil or decreasing doses of progesterone (0.84, 0.67, 0.5, 0.33 and 0.17mg/rat; one dose daily); on day 6, the rats were subjected to BBT. Experiment 3: Rats were divided into two groups that were subjected to 30days of standard conditions or environmental enrichment (EE); from days 25 to 30, all rats received a fixed dose of progesterone (0.5mg/rat, s.c.) or vehicle. On day 31, the rats were tested with BBT. Results showed that PW increased anxiety in both strains, and fluoxetine prevented anxiety in WKY rats. In contrast, a gradual reduction of progesterone prevents the anxiety in Wistar but not in WKY. EE was preventive against the anxiety induced by PW in both strains of rats. Thus, the results suggest that anxiety induced by PW is prevented by EE while the anxiolytic effect of pharmacological treatments depends on stress vulnerability.

Pestivirus in alpine wild ruminants and sympatric livestock from the Cantabrian Mountains, Spain.

Bovine viral diarrhoea virus (BVDV) and Border disease virus (BDV) were investigated at the wildlife-livestock interface in the distribution area of chamois in the Cantabrian Mountains, North-Western Spain. From 2010 to 2014, sera from sympatric wild (n=167) and domestic (n=272) ruminants were analysed for pestivirus antibodies by cELISA, virus neutralisation test (VNT) and for the presence of pestiviral RNA using a reverse transcription (RT)-PCR. Results showed a higher seroprevalence in cattle (59.4 per cent, 13/13 of herds) than in domestic small ruminants (5.9 per cent sheep, 2/8 of flocks; 0 per cent goats of 4 flocks) and wildlife (10.8 per cent in red deer, 0 per cent in roe deer and 0 per cent in Cantabrian chamois). High VNT titres were detected in two cattle herds, suggesting the circulation of BVDV-1 and BVDV-2 strains. BVDV-1 RNA was detected in one cattle calf by RT-PCR and sequencing. Conversely to other similar grazing systems, sheep flocks did not play a relevant role in the pestivirus epidemiology in this region. Pestivirus infections in wild ruminants were sporadic and most probably dependent on a domestic source.

Electropyroelectric technique: A methodology free of fitting procedures for thermal effusivity determination in liquids.

This paper describes an alternative methodology to determine the thermal effusivity of a liquid sample using the recently proposed electropyroelectric technique, without fitting the experimental data with a theoretical model and without having to know the pyroelectric sensor related parameters, as in most previous reported approaches. The method is not absolute, because a reference liquid with known thermal properties is needed. Experiments have been performed that demonstrate the high reliability and accuracy of the method with measurement uncertainties smaller than 3%.

Perfil de ingreso de los alumnos de Enfermería, Facultades de Estudios Superiores Iztacala y Zaragoza, UNAM / Nursing student's enrollment profile, Iztacala and Zaragoza Superior Studies Faculties, UNAM

Introducción: La Universidad tiene como una de sus tareas conocer a los estudiantes, ya que en la medida que nuestro sistema de educación logre tener mayor información sobre el perfil de éstos y sus trayectorias escolares, se podrán diseñar e implementar políticas novedosas y funcionales que atiendan las necesidades específicas de su población. Objetivo: Analizar el perfil de los estudiantes que ingresan a la Licenciatura en Enfermería de México. Las Facultades de Estudios Superiores (FES) Iztacala y Zaragoza. Método: Estudio descriptivo-transversal, con estudiantes de primer ingreso de la generación 2011-I de la FES Zaragoza e Iztacala. La población de estudio fueron 600 alumnos. La recolección de la información fue a través de un cuestionario. La confiabilidad del instrumento fue de 0.875 con la prueba de Alfa de Cronbach. Para el manejo de la información se elaboró una base de datos con el programa SPSS® y se utilizó estadística descriptiva. Resultados: El 49% de alumnos proviene de pase reglamentado, el promedio de ingreso es de 8.1 a 9.0; en el 61% Enfermería fue primera elección; el nivel socioeconómico de los alumnos es bajo; en el 74% el promedio durante el primer año fue de 8.0 a 10.0. Discusión: A diferencia de otras Carreras de la Universidad Nacional Autónoma de México (UNAM), la de Enfermería da cabida a casi el 50% de los aspirantes de escuelas externas a ella. Los alumnos aún cuando son de nivel socioeconómico bajo, reúnen características favorables para su trayectoria escolar, entre ellas, un buen promedio y que fueron admitidos en la Carrera que seleccionaron.

Introduction: The University has as one of its tasks to better know the profiles and trajectories of students, so that supporting innovative and functional policies can be designed and implemented. Objective: To analyze the profile of students enrolling into the Nursing Undergraduate System at the Iztacala and Zaragoza Superior Studies Faculty. Method: Basic-descriptive study with freshmen students of the 2011-I generation of the Nursing Bachelors Degree program at the FES Zaragoza and Iztacala. the population was 600 alumni. A questionnaire was used to gather data. the instrument reliability was equivalent to a 0.875 Cronbach Alpha score. A SPSS® database was created and data were analyzed through descriptive statistics. Results: The 49% of the students came from the "automatic pass" format. The enrollment grade point average went from 8.1 to 9.0. For the 61% of the students, nursing was their first choice of major. The socioeconomic level of the students was low. The 76% of the students obtained a grade point average between 8.0 and 10.0 during all their freshman year. Discussion: Unlike other careers at the Universidad Nacional Autónoma de México (UNAM), Nursing accepts almost 50% of the prospects from external schools, situation which does not occur in other careers. Although the majority of students who entered have a low social-economical level, they have other favorable characteristics for their school trajectory such as a good grade point average and that they were accepted in the career that they chose.

Exencefalia, malformación severa y mortal, diagnóstico prenatal y autopsia fetal / Exencephaly, a severe and lethal malformation: prenatal diagnosis and fetal autopsy

Las malformaciones congénitas constituyen un problema de salud en nuestro país, la tasa de malformaciones es del orden del 2 al 6% de los recién nacidos. Las malformaciones del sistema nervioso central ocupan el segundo lugar en población de México. l igual que la mayoría de las malformaciones congénitas, las del sistema nervioso central son un grupo de afecciones de etiología multifactorial, producto de una interacción de factores genéticos, infecciosos, ambientales, raciales, agentes físicos y químicos, y la deficiencia o alteración en el metabolismo del ácido fólico. Se presenta un caso de excenfalia con análisis post mórtem, así como una revisión de la embriología de esta entidad, con énfasis en los aspectos ecográficos para establecer criterios diagnósticos y la importancia del uso del ácido fólico en la etapa de embriogénesis del sistema nervioso central

Congenital malformations constitute a public health problem in Mexico, affecting approximately 2-6% of new-borns. Central nervous system malformations are the second most frequent malformations in the population of Mexico. As with most congenital malformations, the etiology of central nervous system anomaliesis multifactorial, resulting from interactions among genetic, infectious, environmental, racial, physical and chemical factors, and deficiency or alteration of folic acid metabolism. We report a case of exencephaly with postmortem analysis. We also review the embryology of this entity, with emphasis on the use of ultrasound to establish diagnostic criteria and the importance of folic acid intake at the stage of central nervous system embryogenesis

Síndrome de Forestier: Reporte de un caso y revisión de la literatura / Forestier syndrome: Case report and literature review

Introducción: El síndrome de Forestier, también conocido como hiperostosis esquelética idiopática difusa, es una enfermedad de etiología desconocida, caracterizada por aumento en la masa ósea de diferentes partes del cuerpo, responsable de cervicalgia y dorsalgia crónicas. Métodos: Se presenta el caso de un paciente masculino de 40 años con diagnóstico mediante estudios de imagen de síndrome de Forestier desde el 2006. Inició su cuadro clínico con lumbalgia de intensidad progresiva irradiada a miembro pélvico derecho asociado a rigidez matutina de espalda. Se le realizó cirugía de columna lumbar en Junio de 2005 (laminotomía y disquectomía L4-L5, espaciadores intersomáticos rellenos de hueso y colocación de espaciador interespinoso dinámico L4-L5) con poca mejoría postquirúrgica, nosotros iniciamos tratamiento médico antiinflamatorio como se describe en la literatura presentando una evolución satisfactoria. Discusión: Este padecimiento se reporta como una entidad poco frecuente, por lo cual el médico no lo tiene presente dentro de sus diagnósticos diferenciales; se presenta con disfagia como síntoma principal además de condicionar cervicalgia o lumbalgia debido a hipertrofia y osificación ligamentaria, aumento de la masa ósea con la consiguiente formación de puentes óseos. El dolor lumbar o cervical es una causa frecuente de consulta médica neuroquirúrgica. Conclusiones: La finalidad de este trabajo es presentar un caso poco habitual de dolor lumbar aumentando la sensibilidad diagnóstica de este padecimiento y evitar así una posible cirugía innecesaria; se complementó además con una revisión de la literatura.

Introduction: Forestier syndrome, also known as diffuse idiopathic skeletal hyperostosis, is a disease of unknown etiology, characterized by an increase in the bone mass in different parts of the body, which results in chronic cervical and back pain. Methods: We report the case of a male 40 year-old patient with a diagnosis of Forestier syndrome in 2006 based on imaging studies. The clinical picture began with lumbar pain of progressive intensity irradiating to the right pelvic limb and associated with morning spine stiffness. Lumbar spine surgery was performed in June 2005 (laminotomy and L4-L5 diskectomy, interbody spaces filled with bone, and a dynamic interspinous spacer in L4-L5), but there was little postoperative improvement. We instituted antiinflammatory medical treatment as described in the literature and the patient did fine. Discussion: This condition is reported as an infrequent entity leading to physicians not considering it within their initial differential diagnoses. It presents with dysphagia as the main symptom, together with neck or lumbar pain due to ligament hypertrophy and ossification, and increased bone mass leading to the formation of bone bridges. Lumbar or cervical pain is a frequent cause for visiting the neurosurgeon. Conclusions: The purpose of this paper is to present an unusual case of lumbar pain, which increases the diagnostic sensitivity of this disease, and may contribute to avoid unnecessary surgery. This was complemented with literature review.

[Forestier syndrome: case report and literature review]. / Síndrome de Forestier: reporte de un caso y revisión de la literature.

INTRODUCTION: Forestier syndrome, also known as diffuse idiopathic skeletal hyperostosis, is a disease of unknown etiology, characterized by an increase in the bone mass in different parts of the body, which results in chronic cervical and back pain. METHODS: We report the case of a male 40-year-old patient with a diagnosis of Forestier syndrome in 2006 based on imaging studies. The clinical picture began with lumbar pain of progressive intensity irradiating to the right pelvic limb and associated with morning spine stiffness. Lumbar spine surgery was performed in June 2005 (laminotomy and L4-L5 diskectomy, interbody spaces filled with bone, and a dynamic interspinous spacer in L4-L5), but there was little postoperative improvement. We instituted antiinflammatory medical treatment as described in the literature and the patient did fine. DISCUSSION: This condition is reported as an infrequent entity leading to physicians not considering it within their initial differential diagnoses. It presents with dysphagia as the main symptom, together with neck or lumbar pain due to ligament hypertrophy and ossification, and increased bone mass leading to the formation of bone bridges. Lumbar or cervical pain is a frequent cause for visiting the neurosurgeon. CONCLUSIONS: The purpose of this paper is to present an unusual case of lumbar pain, which increases the diagnostic sensitivity of this disease, and may contribute to avoid unnecessary surgery. This was complemented with literature review.

Sex-related differences in body condition and serum biochemical parameters in red deer (Cervus elaphus) naturally infected with Mycobacterium bovis.

Although Mycobacterium bovis infection is commonly reported in red deer (Cervus elaphus), potential differences in the effects of infection on male and female animals in terms of body condition and clinical biochemistry have not been reported. Between November 2000 and January 2006, serum and biometrical data were collected post-mortem from 88 red deer. M. bovis-infected deer, particularly males, were typically older, heavier and in poorer body condition than uninfected animals. Serum triglyceride, cholesterol (both particularly in males) and total protein concentrations were lower, whereas serum creatinine (more evident in females), and immunoglobulin G and M concentrations were higher in the infected deer. These sex-related differences in the response to M. bovis infection in red deer should be considered when undertaking epidemiological assessments and designing disease control strategies as they may reflect differing roles of male and female animals as potential reservoirs or disseminators of disease.

Haematology and serum chemistry of Pyrenean chamois (Rupicapra pyrenaica) naturally infected with a border disease virus.

In 2005 and 2006 an outbreak of disease associated with border disease virus (BDV) infection caused high mortality in the Pyrenean chamois (Rupicapra pyrenaica) in the Catalan Pyrenees (NE Spain). The aim of this study was to determine values for different haematological and serum biochemical analytes in 32 free-ranging Pyrenean chamois affected by the disease and to compare them with those obtained from healthy chamois. In the affected chamois red blood cell counts, haemoglobin concentrations, packed cell volumes, mean corpuscular volumes and lymphocyte counts were all lower, while the neutrophil and platelet counts were higher. Glucose, lactate, triglycerides, creatinine, total protein concentrations and alkaline phosphatase activity were also lower, in contrast to the concentrations of total bilirubin, urea and aspartate aminotransferase activity, which were higher. Most of the observed changes could be associated with cachexia and inflammation in the affected chamois. Lymphopenia could be directly related to the BDV, which would lead to immunosuppression and explain the high rate of secondary infection observed in these animals.

Haloperidol and azaperone in drive-net captured Southern chamois (Rupicapra pyrenaica).

We investigated the effect of haloperidol and azaperone in drive-net captured Southern chamois (Rupicapra pyrenaica). Both tranquilizers have been successfully used in a wide range of wild species for reducing postcapture stress response. During 2005, 39 free-ranging chamois were captured, randomly injected intramuscularly with haloperidol (0.29 +/- 0.12 mg/kg; n=24), azaperone (1.1 +/- 0.82 mg/kg; n=6), or saline (0.5 ml; n=9), and restrained for 3 hr. Heart rate was higher in the treated chamois; erythrocyte parameters and total protein concentration decreased over time owing to splenic sequestration, hemodilution, vasodilation, and reflex tachycardia. Creatinine, sodium, and chloride remained stable only in the haloperidol-treated group, suggesting an improvement in renal perfusion. Nevertheless, the azaperone-treated chamois displayed higher body temperature, and both treated groups had higher serum muscular enzymes than the control group, suggesting higher muscle stress. These results lead us not to recommend the use of these tranquilizers-especially azaperone-as first-choice neuroleptics in chamois.