Experiencia en trasplante pulmonar pediátrico en Chile / Experience with pediatric lung transplantation in Chile

El trasplante de pulmón (TP) es una opción para pacientes pediátricos con enfermedades pulmonares terminales. OBJETIVO: Evaluar resultados y sobrevida de pacientes pediátricos trasplantados de pulmón. MÉTODOS: Análisis retrospectivo de registros clínicos de pacientes TP ≤ 15 años de Clínica Las Condes. Se analizaron datos demográficos, tipo de trasplante, función pulmonar basal y post trasplante, complicaciones precoces y tardías y sobrevida. RESULTADOS: Nueve pacientes < 15 años de edad se han trasplantado. La edad promedio fue 12,7 años. La principal indicación fue fibrosis quística (7 pacientes). El IMC promedio fue de 17,6 y todos estaban con oxígeno domiciliario. El 77% utilizó soporte extracorpóreo intraoperatorio. Las principales complicaciones precoces fueron hemorragia y la disfunción primaria de injerto mientras que las tardías fueron principalmente las infecciones y la disfunción crónica de injerto. Cuatro pacientes han fallecido y la sobrevida a dos años fue de 85%. El trasplante les permitió una reinserción escolar y 3 lograron completar estudios universitarios. CONCLUSIÓN: El trasplante pulmonar es una alternativa para niños con enfermedades pulmonares avanzadas mejorando su sobrevida y calidad de vida.

Lung transplantation (TP) is a treatment option in children with terminal lung diseases. OBJECTIVE: To evaluate the results and survival of pediatrics lung transplant patients. METHODS: Retrospective analysis of clinical records of lung transplantation of patients ≤ 15 years from Clínica Las Condes, Santiago, Chile. Demographic data, type of transplant, baseline and post transplant lung function, early and late complications and survival rate were analyzed. RESULTS: Nine patients ≤ 15 years-old were transplanted. The average age at transplant was 12.7 years. The main indication was cystic fibrosis (7 patients). The average BMI was 17.6 and all the patients were with home oxygen therapy. 77% used extracorporeal intraoperative support. Average baseline FEV1 was 25.2% with progressive improvement in FEV1 of 77% in the first year. The main early complications were hemorrhage and primary graft dysfunction, while late complications were infections and chronic graft dysfunction. Four patients have died and the estimated 2 years survival was 85%. They achieved school reinsertion and three managed to complete university studies. CONCLUSION: Lung transplantation is an alternative for children with advanced lung diseases improving their survival and quality of life.

[Plasmatic concentracion of piperacillin/tazobactam in pediatric patients on ECMO support. Preliminary analysis]. / Concentraciones plasmáticas de piperacilina/tazobactam en pacientes pediátricos críticos sometidos a ECMO. Análisis preliminar.

BACKGROUND: Pharmacokinetics and optimal dosing of piperacillin tazobactam (PT) have not been well studied in pediatric patients undergoing extracorporeal oxygenation membrane (ECMO). AIM: To describe piperacillin plasmatic concentration and evaluate achievement of pharmaccokinetic/pharmacodinamic objective in patients on ECMO support. METHOD: We report three pediatric patients admitted to the Pediatric Intensive Care Unit, treated with PT undergoing ECMO. Plasmatic concentrations of piperacillin were obtained in the middle of the dosing interval using high performance liquid chromatography. RESULTS: Plasmatic concentrations were 51,7-14,1 and 6,5 µg/mL for patient A, B and C respectively. Only one patient reached adequate concentrations. CONCLUSION: These preliminary results suggest that availability of plasmatic concentrations of piperacillin could optimize the achievement of pharmacokinetic/pharmacodynamic objectives in pediatric patients on ECMO support.

Concentraciones plasmáticas de piperacilina/tazobactam en pacientes pediátricos críticos sometidos a ECMO: análisis preliminar / Plasmatic concentracion of piperacillin/tazobactam in pediatric patients on ECMO support: preliminary analysis

Resumen Introducción: Se desconocen las alteraciones farmacocinéticas de piperacilina/tazobactam (PT) en pacientes pediátricos que requieren de membrana de oxigenación extracorpórea (ECMO) y cómo dosificar adecuadamente dicho antimicrobiano. Objetivo: Describir las concentraciones plasmáticas (CP)y evaluar el cumplimiento del objetivo farmacocinético/famacodinámico de piperacilina en pacientes pediátricos en soporte con ECMO. Métodos: Presentamos tres pacientes pediátricos en tratamiento con PT que requirieran de ECMO en los que se midieron CP de piperacilina en la mitad del intervalo de dosificación mediante cromatografía liquida de alta resolución. Resultados: Las CP fueron 51,7-14,1 y 6,5 μg/mL para los pacientes A, B y C, respectivamente. Sólo se alcanzaron CP adecuadas en un paciente. Conclusión: Estos resultados preliminares sugieren que la disponibilidad de CP de piperacilina podría optimizar el cumplimiento de los objetivos farmacocinéticos/farmacodinámicos en pacientes pediátricos en soporte con ECMO.

Abstract Background: Pharmacokinetics and optimal dosing of piperacillin tazobactam (PT) have not been well studied in pediatric patients undergoing extracorporeal oxygenation membrane (ECMO). Aim: To describe piperacillin plasmatic concentration and evaluate achievement of pharmaccokinetic/pharmacodinamic objective in patients on ECMO support. Method: We report three pediatric patients admitted to the Pediatric Intensive Care Unit, treated with PT undergoing ECMO. Plasmatic concentrations of piperacillin were obtained in the middle of the dosing interval using high performance liquid chromatography. Results: Plasmatic concentrations were 51,7-14,1 and 6,5 μg/mL for patient A, B and C respectively. Only one patient reached adequate concentrations. Conclusion: These preliminary results suggest that availability of plasmatic concentrations of piperacillin could optimize the achievement of pharmacokinetic/pharmacodynamic objectives in pediatric patients on ECMO support.

Identification of gender differences in the factors influencing shoulders, neck and upper limb MSD by means of multivariate adaptive regression splines (MARS).

In the present research, models based on multivariate adaptive regression splines (MARS) are proposed to study the influence of gender in the factors affecting the development of shoulders, neck and upper limb MSD. Two different MARS models, corresponding to men and women, are constructed to identify variables with the strongest effect on the target MSD. Both models are capable to predict successfully the occurrence of the studied disorders. Men seem to be more vulnerable to physical risk factors and some other working conditions, whereas women appear to be more affected by psychosocial risk factors and activities carried out outside their working hours. According to the results, gender needs to be considered to ensure the success and effectiveness of ergonomic interventions on the whole working population.

Ocular manifestations in patient with congenital erythropoietic porphyria.

We present the case of a 52-year-old woman referred to our service because of extreme ocular surface dryness. The patient showed corneal, conjunctival, and eyelid manifestations of ocular congenital erythropoietic porphyria (CEP). We started treatment with autologous serum, topical steroids, and cyclosporine twice a day, topical retinoids, and intense corneal lubrication. The patient referred significant improvement of ocular bothering and less discomfort since treatment was initiated. We describe the management of the herewith presented case of ocular CEP.

Hipertensión venosa epiescleral idiopática como causa de glaucoma de ánguala abierto unilateral (HVEI) / Idiopathic episcleral venous hypertension as a cuase of unilateral open-angle glauca

Caso clínico. Presentamos el caso de vasos epiesclerales dilatados y glaucoma de ángulo abierto. Mujer de 40 años que acude a consulta por ojo derecho (OD) rojo de 7 años de evolución. En la exploración destaca marcada dilatación de los vasos epiesclerales e hiperemia conjuntival, una presión intraocular (PIO) de 30mmHg, con un escotoma arciforme superior en el campo visual (C.V.) y una pérdida de fibras nerviosas en los sectores superior e inferior en la OCT. La gonioscopia mostró un ángulo abierto y sangre en el trabeculum y en la fundoscopia se observa una excavación papilar de 0.4. Se consigue control de la PIO con tratamiento hipotensor. Al persistir la dilatación epiescleral venosa solicitamos estudio tiroideo y resonancia magnética nuclear craneal, que resultaron normales. Se realizó una angiografía cerebral también normal. Por exclusión se diagnosticó de HVEI unilateral como causa de glaucoma de ángulo abierto. Discusión. Debemos resaltar que la HVEI es una causa de glaucoma rara que cursa con dilatación de los vasos epiesclerales y PIO alta y que su diagnóstico se hace tras haber descartado patologías intracraneales e intraorbitarias (AU)

Case report. We report a case of dilated episcleral vein with unilateral secondary open angle glaucoma. A 40-year-old female presented with redness of right eye without any prior systemic history. Her ocular examination revealed dilated episcleral veins and a high intraocular pressure (IOP) of 30 mmHg in the right eye, with a superior arciform scotom in the visual field and a decrease of retinal nerve fiber layer (RNFL) in superior and inferior sectors. Gonioscopy showed open angle with blood in Schlemm’s. Dilated fundus examination showed cup to disc ratio (CDR) to be 0.4. We achieved a control of IOP with hypotensive treatment. Systemic examination was negative for carotid cavernous fistula, low-grade dural arteriovenous fistula and dysthyroid ophthalmopathy. She was diagnosed by exclusion of idiopathic venous episcleral hypertension. Discussion. We want to highlight that this is a rare condition of glaucoma , presented by dilated episcleral veins and high IOP and its diagnosis is a diagnosis of exclusion (AU)

Paresia del vi par como primera manifestación de la DM Tipo 2 / VI cranial nerve palsy as a debut of DM type 2

Caso Clínico. Varón de 56 años sin antecedentes personales de interés, que acude a urgencias por diplopia brusca en la mirada horizontal. A la exploración oftalmológica sólo destaca una restricción a la levoversión en el ojo izquierdo (OI), sin alteraciones en la visión biomicroscopía o fundoscopia. La exploración neurológica y el TAC eran normales. No refería otros síntomas, pero en la analítica observamos una glucemia esporádica de 298 mg/dl y una HbA1c 11,7%, criterio diagnóstico de diabetes (DM) tipo 2, de la que fue tratado. Discusión. La DM es una enfermedad metabólica con alto riesgo cardiovascular, en especial para aquellos enfermos con factores de riesgo asociados. Mientras que la DM tipo 1 presenta sintomatología desde su comienzo diagnóstico, la tipo 2 puede pasar desapercibida. Las complicaciones agudas a destacar para estos enfermos son la cetoacidosis y el estado hiperglucémico hiperosmolar. Sin embargo la neuropatía periférica se trata de un infrecuente síntoma debut (AU)

Case Report. 56 year old male with no relevant past medical history. He came to the emergency department with sudden horizontal dyplopia. Ophthalmological examination only revealed a levoversion restriction in his left eye (OS), with no changes in his vision acuity, slit lamp examination or funduscopy. Neurological examination and CT scan were normal. He had no other symptoms, but the analytical observed glucose levels of 298 mg / dl and HbA1c 11.7%, which is a diagnostic criteria for diabetes (DM) type 2, and so he was treated. Discussion. DM is a metabolic disease with high cardiovascular risk, especially for those patients with associated risk factors. While diabetes type 1 has symptoms just after diagnosis, onset type 2 may go unnoticed. Acute complications are ketoacidosis and hyperosmolar hyperglycemic state, however peripheral neuropathy is an uncommon symptom debut (AU)

Loiasis ocular. Valoración de nuestra actuación / Ocular loiasis. An assessment o our management

Caso Clínico: varón de 24 años procedente de Guinea Ecuatorial que durante su ingreso por una tuberculosis pulmonar resistente al tratamiento refiere molestias oculares. Las analíticas de control revelaron una gran eosinofilia. Fue remitido a consulta al referir gran sensación de cuerpo extraño en el ojo izquierdo sobre todo por las noches. A la exploración evidenciamos hiperemia conjuntival y epiescleral y la presencia de un gusano adulto a nivel subconjuntival que fue retirado en quirófano. Ante la gran sospecha de loiasis se toman muestras de hemocultivo confirmando la presencia de microfilarias. Tras la recuperación de la enfermedad pulmonar se procede al tratamiento sistémico contra el Loa-loa. Discusión: debemos resaltar que la loiasis ocular es una parasitosis bastante frecuente en las zonas endémicas del centro de África, sin embargo en España se está convirtiendo una patología emergente debido al aumento de la población inmigrante (AU)

Case Report: 24-year-old male from Equatorial Guinea income for treatment- resistant pulmonary tuberculosis. He referred eye discomfort. Ancillary tests revealed strong eosinophilia. He was sent for consultation because of large strange body sensation in the left eye, especially at night. Ophthalmic examination showed episcleral and conjunctival hyperemia and the presence of an adult worm under the conjunctiva, which was removed in surgery. Due to the high suspicion of loiasis we took blood samples for cultivation which confirmed the presence of microfilariae. After he recovered of his lung disease we scheduled systemic therapy against Loa-loa. Discussion: we must emphasize that ocular loiasis is a fairly common parasite infection in endemic areas of central Africa, but in Spain is becoming an emerging pathology due to the increase in the immigrant population (AU)

Farmacogénetica y degeneración macular asociada a la edad, hacia un tratamiento individualizado de la enfermedad / Pharmacogenetics and Age-related Macular Degeneration, towards an individualized treatment of the disease

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Manejo de las complicaciones oculares de la radioterapia / Management for ocular side effects in radiotherapy

Desde el descubrimiento de los rayos X por Roetgen en 1895, su utilización para el diagnóstico y, sobre todo, para el tratamiento de diferentes patologías ha ido en aumento. A pesar de que en los últimos años la tasa de efectos adversos ha disminuido, no debemos olvidar que pueden presentarse en los tejidos circundantes al área tratada. En este artículo hemos querido realizar una revisión de los efectos oculares más frecuentes y presentar el caso de una paciente con alteraciones corneales por la radiación (AU)

Since X-ray discoverment made by Roetgen in 1895, indications for the diagnosis and especially for the treatment of multiple pathologies have increased enormously. Despite during the last years the rate of side effects has decreased, we should not forget they may appear at the tissues around the treated area. In this article we have tried to make a review of ocular side effects, and to present the case of a patient with corneal affectation because of radiation (AU)

Coroidopatía serosa central crónica. Tratamiento combinado con Ranibizumab y terapia fotodinámica / Chronic central serous chorioretinopathy. Combined treatment with Ranibizumab and photodynamic therapy

Caso Clínico. Varón de 72 años que acude a consulta refiriendo visión borrosa en ojo derecho (OD) de más de dos años de evolución y que presentaba un desprendimiento neurosensorial (DNS) macular en la tomografía de coherencia óptica (OCT). Habiendo sido diagnosticado previamente de coroidopatía serosa central (CSC) crónica en otro centro y habiendo sido tratado con ranibizumab intravítreo y fotocoagulación láser. Decidimos combinar el tratamiento con ranibizumab intravítreo y terapia fotodinámica para evitar nuevas reactivaciones. Discusión. Tras dos sesiones de terapia fotodinámica junto con tres dosis de Ranibizumab el cuadro se controló estabilizándose la agudeza visual del paciente. Ambas estrategias combinadas dieron buen resultado, disminuyendo el número de brotes en los últimos meses; no obstante debemos continuar con el seguimiento para observar posibles efectos adversos a medio o largo plazo (AU)

Case Report. 72 years-old male who came to our service because of blurred vision in his right eye (OD), and who presented a neurosensorial detachment (NSD) in optical coherence tomography (OCT). Having already been diagnosed in other center of chronic central serous chorioretinopathy and having already been treated with intravitreous Ranibizumab and photocoagulation laser. We decided to combine intravitreous Ranibizumab treatment and photodynamic therapy in order to avoid new reactivations. Discussion. After two photodynamic therapy sessions and three intravitreous Ranibizumab inyections the patient´s visual acuity got stable. We got good results combining both therapeutical strategies, and the number of outbreaks has decreased during the last months; however we should carry on checking our patient to detect any possible half or long term side effects (AU)

Reliability of reduced-thickness and thinly veneered lithium disilicate crowns.

The present investigation hypothesized that the reliability of reduced-thickness monolithic lithium disilicate crowns is high relative to that of veneered zirconia (Y-TZP) and comparable with that of metal ceramic (MCR) systems. CAD/CAM first mandibular molar full-crown preparations were produced with uniform thicknesses of either 1.0-mm or 2.0-mm occlusal and axial reduction, then replicated in composite for standard crown dies. Monolithic 1.0-mm (MON) and 2.0-mm CAD/CAM lithium disilicate crowns, the latter with a buccal thin veneer (BTV) of 0.5 mm, were fabricated and then sliding-contact-fatigued (step-stress method) until failure or suspension (n = 18/group). Crack evolution was followed, and fractography of post mortem specimens was performed and compared with that of clinical specimens. Use level probability Weibull calculation (use load = 1,200 N) showed interval overlaps between MON and BTV. There was no significant difference between the Weibull characteristic failure loads of MON and BTV (1,535 N [90% CI 1,354-1,740] and 1,609 N [90% CI 1,512-1,712], respectively), which were significantly higher than that of Y-TZP (370 N [90% CI 322-427]) and comparable with that of MCR (1,304 N [90% CI 1,203-1,414]), validating the study hypothesis.

Pericarditis lúpica: a propósito de un caso / No disponible

El derrame pericárdico (DP) es una entidad que se diagnostica con poca frecuencia en Urgencias. Presentamos este caso, en el que gracias a la adquisición de nuevas técnicas innovadoras por parte de los médicos especialistas en urgencias, la ecocardiografía, se consigue llegar al diagnóstico de DP y cuantificarlo como grave, sin compromiso hemodinámico, en el mismo Servicio de Urgencias. Posteriormente, en planta, se establece el diagnóstico etiológico, al cumplir la paciente 4 criterios diagnósticos de lupus eritematoso sistémico (LES). El LES es una enfermedad autoinmune, inflamatoria, crónica y con afectación multisistémica, de causa desconocida, siendo la pericarditis la afectación cardiaca más frecuente, aunque es raro que se llegue a una situación de taponamiento cardiaco. El curso clínico de esta enfermedad es variable, dependiendo el pronóstico de la gravedad y del tipo de órganos implicados. El tratamiento se basa en el uso de antiinflamatorios no esteroideos(AINE), corticoides, antipalúdicos e inmunosupresores (AU)

Pericardial effusion (Pericardial effusion (PE) is a condition that is rarely diagnosedin the Emergency Department. We present this case inwhich thanks to the new technologies developed by theEmergency Department medical personnel, it was possible toreach the diagnosis of PE using the echocardiography and todetermine its severity, without compromising the hemodynamicswithin the Emergency Department itself.Once the patient had been transferred out of the EmergencyDepartment, the etiological diagnosis was established asthe patient had 4 Systemic Lupus Erythematosus criteria(SLE). SLE is an autoimmune, inflammatory, chronic illnesswith multisystemic effect, of unknown origin. Pericarditis isthe most frequent heart condition (although it is unusual fora cardiac tamponade to develop). The clinical course for thisillness varies, depending on the severity and type of organsinvolved. Treatment is based on the use of NSAIDs, corticoids,antimalarial and immunosuppressive medications (AU)

[Dorsal osseous hemangiopericytoma: a primary or metastatic tumour?]. / Hemangiopericitoma óseo dorsal: tumor primario o metastásico?

INTRODUCTION: Hemangiopericytomas are potentially malignant vascular tumours. They are usually located in the thighs, the buttocks and the retroperitoneum. Recurrence is very common and they produce metastases that are not usually intracranial within a period of not less than 24 months. Treatment involves surgery, accompanied by radiotherapy. CASE REPORT: A 32-year-old female who had been suffering from back pain for two months. The clinical examination was normal; however, the neuroimaging studies showed a lumbar tumour that involved the L1, and the patient was therefore submitted to a surgical intervention. The histopathological analysis showed the tumour to be a hemangiopericytoma. The patient received radiotherapy, and two months later presented recurrent vomiting and headaches. Computerised tomography and magnetic resonance imaging of the head enabled us to diagnose an intracranial tumour and she underwent a new operation. A new histopathological analysis of the lesion confirmed that it was a meningeal hemangiopericytoma. CONCLUSIONS: After reviewing the literature, this is the first case of a hemangiopericytoma in which the initial symptoms were caused by metastasis and not by the primary tumour.

Hemangiopericitoma óseo dorsal: ¿tumor primario o metastásico? / Dorsal osseous hemangiopericytoma: A primari of metastatic tumour?

Introducción. Los hemangiopericitomas son tumores vasculares potencialmente malignos. Se localizan preferentemente en los muslos, los glúteos y el retroperitoneo. Recidivan con mucha frecuencia y producen metástasis que no suelen ser intracraneales en un período no menor a los 24 meses. El tratamiento es quirúrgico y acompañado de radioterapia. Caso clínico. Mujer de 32 años de edad que refería dolor dorsolumbar de dos meses de evolución. Su exploración clínica fue normal; sin embargo, los estudios neurorradiológicos le detectaron un tumor lumbar que afectaba a L1, por el que fue sometida a intervención quirúrgica. La histología demostró que se trataba de un hemangiopericitoma. La paciente recibió radioterapia, y presentó dos meses después cefalea y vómitos de repetición. Mediante tomografía computarizada y resonancia magnética de cráneo se le diagnosticó un tumor intracraneal del que fue operada. El estudio histológico de la lesión confirmó que se trataba de un hemangiopericitoma meníngeo. Conclusión. Una vez revisada la bibliografía, éste es el primer caso de un hemangiopericitoma en que los síntomas iniciales han sido ocasionados por la metástasis y no por el tumor primario (AU)

Introduction. Hemangiopericytomas are potentially malignant vascular tumours. They are usually located in the thighs, the buttocks and the retroperitoneum. Recurrence is very common and they produce metastases that are not usually intracranial within a period of not less than 24 months. Treatment involves surgery, accompanied by radiotherapy. Case report. A 32-year-old female who had been suffering from back pain for two months. The clinical examination was normal; however, the neuroimaging studies showed a lumbar tumour that involved the L1, and the patient was therefore submitted to a surgical intervention. The histopathological analysis showed the tumour to be a hemangiopericytoma. The patient received radiotherapy, and two months later presented recurrent vomiting and headaches. Computerised tomography and magnetic resonance imaging of the head enabled us to diagnose an intracranial tumour and she underwent a new operation. A new histopathological analysis of the lesion confirmed that it was a meningeal hemangiopericytoma. Conclusions. After reviewing the literature, this is the first case of a hemangiopericytoma in which the initial symptoms were caused by metastasis and not by the primary tumour (AU)

Cytoprotective effect of Valeriana officinalis extract on an in vitro experimental model of Parkinson disease.

Parkinson's disease (PD) is one of the most important neurodegenerative worldwide disorders. The potential cytoprotective effects of aqueous extract of Valeriana officinalis on rotenone-induced apoptosis in human neuroblastoma SH-SY5Y cells were demonstrated. The cytotoxicity, cell viability and analysis of cellular morphology were performed by MTT-tetrazole (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and phase contrast microscopy, respectively. Significant changes in the cellular morphology, and condensation of the cell body could be observed when cells were treated with 300 nM rotenone for 48 h. Three different concentrations of Valeriana officinalis extract were used (0.049, 0.098 and 0.195 mg/mL). These extracts brought about an increase of 7.0 +/- 1.3%, 14.5 +/- 1.3% and 14.5 +/- 3.2% in cell viability. Our results indicated that neuroprotector action of the Valeriana officinalis extract provides support for later studies as they help understanding this drug for the development of cytoprotective various therapies in PD.

Effects of the extract of Anemopaegma mirandum (Catuaba) on Rotenone-induced apoptosis in human neuroblastomas SH-SY5Y cells.

Parkinson's disease (PD) is one of the most important neurodegenerative worldwide disorders. It is characterized by a selective and progressive degeneration of dopaminergic neurons, causing a series of symptoms which might ultimately induce programmed cell death. The potential cytoprotective effects of one of the commercial extracts of Anemopaegma mirandum (Catuaba), a Brazilian tree, on Rotenone-induced apoptosis in human neuroblastomas SH-SY5Y cells was demonstrated. The cell viability, analysis of cellular morphology, nuclei morphology and ultra structural research were done by MTT-tetrazole (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, phase contrast microscopy, stained with Hoechst 33258 and electron microscopy transmission, respectively. Three different concentrations of Catuaba extract were used (0.312, 0.625 and 1.250 mg/mL). These extracts promoted an increase of 22.3+/-3.6%, 22.0+/-2.1% and 15.8+/-0.7% on the cell viability. Notable changes in the cellular morphology, condensation of the cell body, nuclear fragmentation and condensation into discrete dense chromatin clumps were observed when the cells were treated with 300 nM Rotenone for 48 h. These effects were partially altered when the extract of A. mirandum was added to the Rotenone treatment. Ultra structural analysis by electron microscopy demonstrated that citoplasmatic membranes and mitochondria membrane were also clearly preserved in the group treated with the extract. Therefore, in this study, our findings indicated that extracts of A. mirandum have cytoprotective effects on Rotenone-induced apoptosis in human neuroblastomas SH-SY5Y cells.

[Spontaneous resolution of the syrinx. A case report and survey of the literature]. / Resolucion espontanea de la siringomielia. A proposito de un caso y revision de la bibliografia.

INTRODUCTION: Syringomyelia is characterized by the presence of single or multiple intramedullary cavities. Since Abbe and Coley performed the first syringotomy, a number of surgical techniques have been used in an attempt to collapse the cavities. Spontaneous resolution of the syrinx, however, is an unusual event that has been reported on very few occasions. CASE REPORT: A two year old male with chronic neck pain and normal results from the neurological exploration. A craniocervical magnetic resonance scan revealed a Chiari type I malformation associated to a cervical syringomyelia, which disappeared spontaneously three years after it was diagnosed. CONCLUSION: After reviewing the literature, we found that the case reported here is the first to describe a child in whom, despite the persistence of a Chiari malformation, there was complete spontaneous resolution of the syrinx.

Resolución espontánea de la siringomielia. A propósito de un caso y revisión de la bibliografía / Spontaneous resolution of the syrinx. A case report and survey of the literature

Introducción. La siringomielia se caracteriza por la presencia de cavidades intramedulares únicas o múltiples. Desde que Abbe y Coley realizaran por primera vez una siringotomía, se han empleado varias técnicas quirúrgicas con el objeto de colapsar las cavidades; sin embargo, la resolución espontánea de la siringomiegalia es un hecho insólito pocas veces descrito. Caso clínico. Niño de 2 años de edad, con un cuadro de dolor cervical crónico y una exploración neurológica normal. Se le detectó en la resonancia magnética craneocervical una malformación de Chiari tipo I asociada a una siringomielia cervical, la cual, tres años después del diagnóstico, desapareció espontáneamente. Conclusión. Tras revisar la bibliografía, hemos comprobado que el caso presentado es el único descrito en niños en el que, persistiendo la malformación de Chiari, la siringomielia se resolvió completamente de forma espontánea (AU)

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