Morfología de los aneurismas aislados de la aorta descendente. Estudio morfométrico / Morphology of isolated aneurysms of the descending aorta. Morpometric study

Se presenta un trabajo descriptivo y retrospectivo de la valoración de los aneurismas de aorta descendente, con criterio de indicación terapéutica quirúrgica, con el fin de evaluar diferentes datos demográficos, como la edad, el sexo, factores de riesgo, morfologíade los aneurismas y los datos del principal objetivo del estudio en lo que respecta a la morfometría tanto la longitud del aneurisma,su diámetro, el grosor del trombo y diámetro del cuello y longitud proximal y distal. Estos datos no son aportados en la bibliografíapor lo que consideramos que disponer de los mismos desde el punto de vista estadístico supone una aportación en lo que se refierea la planificación operatoria de los aneurismas de aorta torácica descendente, zona del vaso donde se ha centrado el estudio, ala vez que puede indicar las medidas más frecuentes de endoprótesis que se van a requerir más frecuentemente en el tratamientoendovascular de este tipo de patología. (AU)

A descriptive and retrospective study of the evaluation of aneurysms of the descending aorta is presented, with surgical therapeuticindication criteria, in order to evaluate different demographic data, such as age, sex, risk factors, morphology of the aneurysms andthe data from the main objective of the study with regard to morphometry, both the length of the aneurysm, its diameter, the thickness of the thrombus and diameter of the neck and proximal and distal length. These data are not provided in the literature, so weconsider that having them from a statistical point of view represents a contribution in terms of surgical planning of aneurysms of thedescending thoracic aorta, the area of the vessel where the focus has been the study, at the same time that it can indicate the mostfrequent measures of endoprosthesis that will be required more frequently in the endovascular treatment of this type of pathology. (AU)

[Conduct disorders in autism spectrum disorders]. / Alteraciones de conducta en los trastornos del espectro autista.

INTRODUCTION: Autism spectrum disorders (ASD) are neurodevelopmental disorders that affect social communication and present stereotypic behaviours. Comorbidity associated to conduct disorders is frequent, starts in infancy and, in general, continues into adulthood. It is sometimes associated with aggressiveness, negativism, self-harm and breaking social norms. It causes a high degree of dysfunctionality in persons with ASD, their family, professionals and those around them, and is the main cause of pharmacological treatment, hospitalisation and special education. Factors related to the symptoms of ASD, comorbidity and social factors are associated with an increased risk of conduct disorders. In many cases it would be necessary to perform a detailed examination that includes a functional analysis and a combination of psychoeducational, social and pharmacological interventions. AIM: To review the precipitating factors, causes, evaluation and treatment of the conduct disorders associated with ASD. DEVELOPMENT: The study outlines what is understood by conduct disorders in ASD, the different clinical and cognitive mechanisms associated with it, and the most effective strategies for intervention. CONCLUSIONS: Comorbid ASD with conduct disorders is frequent, begins in early infancy and continues throughout life. A detailed evaluation that includes a functional analysis of the behaviour to be eliminated and treatment with different psychological, social educational and pharmacological strategies are essential.

TITLE: Alteraciones de conducta en los trastornos del espectro autista.Introduccion. Los trastornos del espectro autista (TEA) son trastornos del neurodesarrollo que afectan la comunicacion social y presentan conductas estereotipadas. La comorbilidad asociada a trastornos de conducta es frecuente, comienza en la infancia y, en general, continua hasta la edad adulta. En ocasiones se asocia a agresividad, negativismo, autolesiones y ruptura de normas sociales. Origina gran disfuncionalidad a la persona con TEA, a la familia, a los profesionales y al entorno, y es causa principal de tratamiento farmacologico, hospitalizacion y educacion especial. Factores relacionados con los sintomas de TEA, comorbilidad y factores sociales se asocian a un incremento de riesgo de problemas conductuales. Sera necesaria una exploracion detallada que incluya un analisis funcional y una combinacion de intervenciones psicoeducativas, sociales y farmacologicas en muchos casos. Objetivo. Revisar los factores desencadenantes, causas, evaluacion y tratamiento de los problemas de conducta asociados a TEA. Desarrollo. Se expone que se entiende por problemas de conducta en TEA, los diferentes mecanismos clinicos y cognitivos asociados, y las estrategias mas efectivas para la intervencion. Conclusiones. El TEA comorbido con problemas de conducta es frecuente, comienza en la primera infancia y continua a lo largo de la vida. Una detallada evaluacion, que incluya un analisis funcional de la conducta a extinguir, y un tratamiento con diferentes estrategias psicologicas, educativas sociales y farmacologicas resultan esenciales.

Encefalitis de Bickerstaff: a propósito de un caso / Bickerstaff encephalitis: a case report

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Handedness and gender influence blood pressure in young healthy men and women: A pilot study.

OBJECTIVE: The type and level of sex steroids influence blood pressure (BP). It has been suggested that functional brain asymmetries may be influenced by sex hormones. In addition, there are inter-arm differences in BP not yet related with handedness. In this study, we hypothesize a possible association between sex hormones, handedness, and inter-arm differences in blood pressure. METHODS: To analyze this hypothesis, we measured BP in the left and right arm of the left and right handed adult young men and women in menstrual and ovulatory phase and calculated their mean arterial pressure (MAP). RESULTS: Significant differences depending on sex, arm, handedness or phase of the cycle were observed. MAP was mostly higher in men than in women. Remarkably, in women, the highest levels were observed in the left handed in menstrual phase. Interestingly, the level of handedness correlated negatively with MAP measured in the left arm of right-handed women in the ovulatory phase but positively with the MAP measured in the right arm of right-handed women in the menstrual phase. CONCLUSIONS: These results may reflect an asymmetrical modulatory influence of sex hormones in BP control.

Specific Antigens by Federal Entity in Patients at the Transplant Unit of Specialities Hospital, National Medical Center Twenty-First Century, Mexico.

BACKGROUND: The study of the kidney transplant involves understanding the immunologic basis, such as histocompatibility and the genetic basis of a population. In Mexico, the study of the genetic basis has led to a genetic map by federal entities. METHODS: We performed an HLA study with 1,276 kidney transplant patients (recipients and donors) in the Hospital of the National Medical Center Twenty-First Century, determining HLA class I (A, B, and Cw) and class II (DRß1 and DQß1) antigens with the use of SSOP-PCR. A descriptive analysis was conducted with measures of central tendency (mean, SD). RESULTS: Of 1,276 HLA patients studied, we obtained 2,552 results for each class by the composition of the 2 haplotypes, and for HLA-Cw we processed 796 patients, for a total of 1,592 antigens for this class. We found antigens specific to each federal entity, and it was found that the Federal District had the highest number of specific antigens (10) followed by Morelos (7), Querétaro and Mexico State (3 each), and Tamaulipas, Aguascalientes, Michoacán, Guerrero, Puebla, and Oaxaca (1 each). CONCLUSIONS: The genetic map allows us to know proportions of antigens in every state in the center and south of Mexico owing to the diversity and area of influence of the National Medical Center XXIst Century, as well as the wide number of patients. Furthermore, there are still preserved proportionally distinct genetic roots in every entity.

Nueva mutación como causa de enfermedad de jarabe de arce: c.1128-1130delCinsTT / Maple syrup urine disease caused by a new mutation: C.1128-1130delCinsTT

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Neuropatía pudenda: a propósito de un caso / No disponible

La neuropatía pudenda o atrapamiento del nervio pudendo fue descrito por primera vez en 1987. Se presenta con un dolor neuropático perineal y/o pelviano, que se agrava al sentarse y disminuye o desaparece al estar de pie, habitualmente no suele presentarse al acostarse (pueden dormir) y que puede asociarse a disfunción urinaria, anal e incluso sexual. El nervio pudendo tiene tres ramas terminales en diferente proporción de fibras motoras, sensitivas y autonómicas. Por ello, su atrapamiento puede causar signos y síntomas tanto a nivel sensitivo, como motor o autonómico (en total se estima que el 30% es autonómico, y el 70% es somático,50% sensitivo y 20% motor). Su diagnóstico es básicamente clínico y se confirma con la compresión del nervio pudendo en la electromiografía. El tratamiento consiste en el autocuidado, infiltraciones perineurales y cirugía de descompresión del nervio (AU)

Pudendal neuropathy or pudendal nerve entrapment wasfirst described in 1987. It presents with a perineal neuropathicand/or pelvic pain, which worsens when the subject is sitting and decreases or disappears when the subject is standing, It is usually absent at bedtime (the individual can sleep) and may be associated with urinary, anal and even sexual dysfunction. The pudendal nerve has three terminal branches in different proportions of motor, sensitive and autonomic fibers. Hence, its entrapment can cause sensitive, motor or autonomic signs and symptoms (as a whole, it is estimated that 30% is autonomic, 70% somatic, the latter divided into 50% sensitive and 20% motor). Its diagnosis is essential clinical and it is confirmed with the compression of the pudendal nerve in the electromyography. Treatment consists in self-care, perineural infiltrations and decompression nerve surgery (AU)

[Hyperalphalipoproteinemias and medical advise in primary care. Changes of the lipid pattern]. / Las hiperalfalipoproteinemias y el consejo médico en atención primaria. Modificaciones del patrón lipídico.

OBJECTIVE: To analyse the modifications in the lipid pattern experienced in the observance of patients with Hyperalpha-lipoproteinaemia (HAL). DESIGN: A prospective follow-up study. SETTING: La Orden Primary Care Centre, Huelva. PATIENTS: 120 diagnosed with HAL (cHDL higher than the 90 percentile of their same age and sex group from a reference population with cLDL and Triglycerides less than 150 and 200 mg/dl, respectively) and observed for 2.5 +/- 1.5 years. MEASUREMENTS AND RESULTS: Blood pressure, weight, size, cholesterol, cHDL, cLDL, Triglycerides, Glucaemia and Uric acid were determined. The modifications in the diagnosis of HAL, and changes in averages and percentages of several variables, were calculated. Out of 95 people (79.1%) (Age: 42.6 +/- 16), HAL was confirmed in 42.1% (CI, 24.8-59.4) and Hypercholesterolaemia 11a in 20%. There was no lipid disorder in 37.9%. CONCLUSIONS: HAL at a high rate was not confirmed. After HAL is diagnosed, we must be cautious in our advice on cardiovascular protection, as it could be secondary or be modified over time.

[Trousseau's syndrome in lung adenocarcinoma. The rare appearance of venous gangrene]. / Síndrome de Trousseau en adenocarcinoma de pulmón. La infrecuente aparición de la gangrena venosa.

Trousseau's syndrome includes a wide range of coagulation disorders, migratory thrombotic phenomena being the main associated entities. Treatment is difficult and venous gangrene constitutes a rare but deadly final stage that is particularly painful for the patient. The outlook after treatment is poor.