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Introduction: Sepsis is a clinical condition that seriously threatens the body’s balance and is still a significant cause of death. Therefore, clinical management is aimed at a timely classification and implementation of emergency measures based on systems of scales for detection that helps reduce complications in patients. That is the importance of using SOFA (Sequential Organ Failure Assessment) and qSOFA (quick SOFA) in the different services for hospitalized patients. Objective: To evaluate the usefulness of SOFA and qSOFA scale as a predictor of mortality in patients with sepsis hospitalized in the intensive care unit (ICU) of the Good Hope Clinic from January to December 2015. Materials and methods: Retrospective study of adult patients hospitalized in ICU/NICU with sepsis diagnoses. Epidemiological, clinical, and laboratory data were collected to apply the SOFA and qSOFA scales. We performed a description of the variables studied, an analysis of the variables, and the scoring systems compared in the ROC curve. Results: The main infectious focus was respiratory (41.5%). The patients died was 28.3%. The variables serum creatinine and lactate were statistically significant with OR = 11.67 (95% CI 2.58-52.85, p

Allergic diseases are increasing around the world with unprecedented complexity and severity. One of the reasons is that genetically modified crops produce new potentially allergenic proteins. From this starting point, many researchers have paid attention to the development of tools to predict the allergenicity of new proteins. In this study, a novel approach is introduced for the prediction of food allergens based on Artificial Intelligence techniques: a pairwise sequence alignment with the FASTA program for feature extraction and the use of the Deep Learning technique known as Restricted Boltzmann Machines in combination with the Decision Tree method for the prediction process. The developed tool, called ALLERDET (publicly available at http://allerdet.frangam.com), overcomes the state-of-the-art methods. The performance of our method is: 98.46% sensitivity, 94.37% specificity and 97.26% accuracy), on a data set built from several publicly available sources.

ObjectivesTo synthesise evidence on the effectiveness, cost-effectiveness and barriers to responding to violence against women (VAW) in sexual and reproductive health (SRH) services in low/middle-income countries (LMICs).DesignMixed-methods systematic review.Data sourcesMedline, Embase, Psycinfo, Cochrane, Cinahl, IMEMR, Web of Science, Popline, Lilacs, WHO RHL, ClinicalTrials.gov, Google, Google Scholar, websites of key organisations through December 2019.Eligibility criteriaStudies of any design that evaluated VAW interventions in SRH services in LMICs.Data extraction and synthesisConcurrent narrative quantitative and thematic qualitative syntheses, integration through line of argument and mapping onto a logic model. Two reviewers extracted data and appraised quality.Results26 studies of varied interventions using heterogeneous outcomes. Of ten interventions that strengthened health systems capacity to respond to VAW during routine SRH consultation, three reported no harm and reduction in some types of violence. Of nine interventions that strengthened health systems and communities’ capacity to respond to VAW, three reported conflicting effects on re-exposure to some types of VAW and mixed effect on SRH. The interventions increased identification of VAW but had no effect on the provision (75%–100%) and uptake (0.6%–53%) of referrals to VAW services. Of seven psychosocial interventions in addition to SRH consultation that strengthened women’s readiness to address VAW, four reduced re-exposure to some types of VAW and improved health. Factors that disrupted the pathway to better outcomes included accepting attitudes towards VAW, fear of consequences and limited readiness of the society, health systems and individuals. No study evaluated cost-effectiveness.ConclusionsSome VAW interventions in SRH services reduced re-exposure to some types of VAW and improved some health outcomes in single studies. Future interventions should strengthen capacity to address VAW across health systems, communities and individual women. First-line support should be better tailored to women’s needs and expectations.PROSPERO registration numberCRD42019137167.

El propósito del presente artículo es analizar la gestión ambiental como estrategia para la innovación y competitividad de las organizaciones prestadoras de servicios ecoturísticos en áreas protegidas, como es el caso del Parque Nacional Natural Tayrona. Se planteó el enfoque cualitativo y técnicas como el análisis documental, la observación cualitativa, la entrevista no estructurada. Los resultados ofrecen una percepción de estas organizaciones sobre la gestión ambiental y el desarrollo de su actividad productiva; las estrategias y herramientas ambientales utilizadas en el sector ecoturístico. La investigación se realiza en áreas de interés ecológico y ambiental aprovechada por organizaciones que desarrollan actividades productivas generadas por el consumo de turistas extranjeros y nacionales; así como las implicaciones en procesos de innovación y competitividad para este tipo de organizaciones que operan en los sectores de Cañaveral y Arrecifes del Parque Nacional Natural Tayrona. Se concluye acerca de la aplicación continua de estrategias ambientales preventivas e integradas a los procesos productivos, los productos y los servicios con el fin de incrementar la eficiencia, competitividad y rentabilidad de las organizaciones.

Introduction 15-year-old female referred to outpatient unit after COVID lockdown for binge eating and purging with depressive symptoms and anxiety. Objectives To show the importance of a correct diagnosis in an impulsive patient with eating disorder Methods case report and literature review Results The patient presents emotional instability with interpersonal difficulties with high fear of rejection. She suffered from fear of gaining weight and desires to lose weight with rejection of her body image. Fluoxetine and lorazepam are started together with low doses of olanzapine. During the follow up she presented a worsening of mood, onset of self-injuries and an episode of suicidal attempt. A biographical examination was performed, expressing a feeling of academic failure with difficulty concentrating and performing simple tasks. As a child she is described as impulsive, with frequent arguments with classmates. CPT III was performed with a high probability of ADHD. Treatment was started with lisdexamfetamine up to 50 mg with good tolerance. From the beginning of the treatment the patient expressed a feeling of improvement in the control of emotions as well as in the management of her impulsivity. There was an improvement in her academic performance with a decrease in self-injury episodes. The patient was able to express improvement in the sense of incapacity she felt. Conclusions This case shows how marked emotional dysregulation and impulsive symptoms improves after diagnosis and subsequent treatment of ADHD, also improving eating symptoms. ADHD is present in eating disorders, especially in those with impulse dyscontrol such as binge eating disorder or bulimia nervosa. Disclosure No significant relationships.

Introduction We present the case of a patient who after a year of psychotic symptoms is diagnosed with thyroid cancer with hyperthyroidism. Objectives A brief review is made of the psychotic symptoms in a patient with hyperthyroidism secondary to cancer of the gland. Methods We present the case of a 52-year-old patient, a former injecting drug addict, who after a year with psychotic symptoms, is diagnosed with thyroid cancer with hyperthyroidism. The patient reported that a year ago, he suddenly had a painless and indurated lump in his neck, associated with weight loss and confusional symptoms. One month after the appearance of the tumor, the patient began to present visual, kinesthetic and haptic hallucinations, with the sensation that supernatural beings were passing through and possessing him. Likewise, he referred to being able to see and feel the atoms of matter, being able to communicate with a superior being whom he called “creator”. Results The patient is admitted for psychotic symptoms. During it, the necessary complementary tests are carried out, objectifying a clinical situation of hyperthyroidism. The study is extended, observing a hyperfunctioning nodule, which corresponded to thyroid cancer. Conclusions Neuropsychiatric symptoms in hyperthyroidism are relatively common. In most cases, the most frequent are cognitive alterations, attention problems and working memory problems. It can also lead to depressive episodes, and more rarely, psychotic symptoms. Disclosure No significant relationships.

Introduction A 9-year-old girl under pediatric follow-up since the age of 4 years after diagnosis of neurofibromatosis type 1 Objectives To present a case of neurofibromatosis and ADHD comorbidity to raise awareness of the importance of screening for neurodevelopmental disorders. Methods Case report and literature review Results The patient had an adequate control and follow-up of the disorder with periodic check-ups and magnetic resonance imaging during her follow-up. She was referred due to symptoms of inattention with failure to perform exams and impulsivity in interpersonal relationships, affecting her social functioning. In addition, the patient presented simple motor tics of eye contraction and shoulder elevation. The patient was diagnosed with attention deficit hyperactivity disorder together with tic disorder. She was treated with stimulant medication with worsening of tics and marked hyporexia. Therefore, medication with guanfacine was started up to 4 mg per day, adjusted by weight. With this dose there was a control of the tics, with improvement of the symptoms of inattention and impulsivity. In different spheres an improvement in their functionality was observed, with improvement in mood, self-esteem and academic performance. Conclusions Neurofibromatosis type 1 is a rare monogenic disorder with a varied presentation (ophthalmologic, dermatologic and predisposition to tumor development). Patientshave been shown to present with symptoms of inattention and executive function impairment, along with other neurodevelopmental disorders such as autism spectrum disorders, learning disabilities or intellectual disability. The literature shows that up to 60% of them has ADHD criteria. Disclosure No significant relationships.

Introduction 16-year-old female who starts psychiatric follow-up due to episodes of anxiety crises with dizziness and tremors. Objectives To expose a case in which it is essential to rule out organic pathology in cases where there is anxiety and physical symptoms. Methods Case report and literature review Results The patient explains that she was in a situation of conflict with her ex-partner, commenting that he did not accept the breakup. Sertraline was prescribed in ascending doses up to 100 mg per day with complete remission of anxiety. 8 months later, she went to the emergency room for loss of consciousness and tremor of the lower limbs. She was diagnosed with conversive disorder and was prescribed lorazepam up to 3 mg per day. Since then, there has been a worsening in the frequency of syncope occurring up to 10 times a day, limiting her academic and social life. She was evaluated by a cardiologist who diagnosed Pots Syndrome (postural orthostatic tachycardia syndrome) and started treatment with ivabradine and mineralocorticoids. With this treatment, the episodes were drastically reduced and spaced out to 1-2 per week. The dose of lorazepam is decreased until its withdrawal without worsening of the anxious symptomatology. Conclusions This disorder consists of an involvement of the autonomic nervous system in which there is a sudden drop in blood pressure together with an abrupt increase in heart rate. Its treatment is based on increasing blood volume with drugs such as corticosteroids as well as postural measures with adequate water intake. Disclosure No significant relationships.

The research conducted in this publication was funded by the Spanish Ministry of Economy and Competitiveness (Agencia Estatal de Investigacion) under grant number: PID2019-109644RB-I00/AEI/10.13039/501100011033. Funding for open access charge: Uni-versidad de Granada/CBUA., Background and Objective: The assessment of dependence in older adults currently requires a manual collection of data taken from questionnaires. This process is time consuming for the clinicians and intrudes the daily life of the elderly. This paper aims to semi-automate the acquisition and analysis of health data to assess and predict the dependence in older adults while executing one instrumental activity of daily living (IADL). Methods: In a mobile-health (m-health) scenario, we analyze whether the acquisition of data through wearables during the performance of IADLs, and with the help of machine learning techniques could replace the traditional questionnaires to evaluate dependence. To that end, we collected data from wearables, while older adults do the shopping activity. A trial supervisor (TS) labelled the different shopping stages (SS) in the collected data. We performed data pre-processing techniques over those SS and analyzed them with three machine learning algorithms: k-Nearest Neighbors (k-NN), Random Forest (RF) and Support Vector Machines (SVM). Results: Our results confirm that it is possible to replace the traditional questionnaires with wearable data. In particular, the best learning algorithm we tried reported an accuracy of 97% in the assessment of dependence. We tuned the hyperparameters of this algorithm and used embedded feature selection technique to get the best performance with a subset of only 10 features out of the initial 85. This model considers only features extracted from four sensors of a single wearable: accelerometer, heart rate, electrodermal activity and temperature. Although these features are not observational, our current proposal is semi-automatic, because it needs a TS labelling the SS (with a smartphone application). In the future, this labelling process could be automatic as well. Conclusions: Our method can semi-automatically assess the dependence, without disturbing daily activities of elderly people. This method can save clinicians’ time in the evaluation of dependence in older adults and reduce healthcare costs., Spanish Ministry of Economy and Competitiveness (Agencia Estatal de Investigacion) PID2019-109644RB-I00/AEI/10.13039/501100011033

Large clinical trials testing hydrocortisone therapy in septic shock have produced conflicting results. Subgroups may benefit of hydrocortisone treatment depending on their individual immune response. We performed an exploratory analysis of the database from the international randomized controlled clinical trial Corticosteroid Therapy of Septic Shock (CORTICUS) employing machine learning to a panel of 137 variables collected from the Berlin subcohort comprising 83 patients including demographic and clinical measures, organ failure scores, leukocyte counts and levels of circulating cytokines. The identified theranostic marker was validated against data from a cohort of the Hellenic Sepsis Study Group (HSSG) (n = 246), patients enrolled in the clinical trial of Sodium Selenite and Procalcitonin Guided Antimicrobial Therapy in Severe Sepsis (SISPCT, n = 118), and another, smaller clinical trial (Crossover study, n = 20). In addition, in vitro blood culture experiments and in vivo experiments in mouse models were performed to assess biological plausibility. A low serum IFNγ/IL10 ratio predicted increased survival in the hydrocortisone group whereas a high ratio predicted better survival in the placebo group. Using this marker for a decision rule, we applied it to three validation sets and observed the same trend. Experimental studies in vitro revealed that IFNγ/IL10 was negatively associated with the load of (heat inactivated) pathogens in spiked human blood and in septic mouse models. Accordingly, an in silico analysis of published IFNγ and IL10 values in bacteremic and non-bacteremic patients with the Systemic Inflammatory Response Syndrome supported this association between the ratio and pathogen burden. We propose IFNγ/IL10 as a molecular marker supporting the decision to administer hydrocortisone to patients in septic shock. Prospective clinical studies are necessary and standard operating procedures need to be implemented, particularly to define a generic threshold. If confirmed, IFNγ/IL10 may become a suitable theranostic marker for an urging clinical need. © Copyright © 2021 König, Kolte, Ahlers, Oswald, Krauss, Roell, Sommerfeld, Dimopoulos, Tsangaris, Antoniadou, Jaishankar, Bogatsch, Löffler, Rödel, Garcia-Moreno, Tuchscherr, Sprung, Singer, Brunkhorst, Oppert, Gerlach, Claus, Coldewey, Briegel, Giamarellos-Bourboulis, Keh and Bauer.

Brain Computer Interfaces (BCI) can be used not only to monitor users, recognizing their mental state and the activities they perform, but also to make decisions or control their environment. Hence, BCI could improve the health and the independence of users, for example those with low mobility disabilities. In this work, we use a low-cost and low-invasive BCI headband to detect Electroencephalography (EEG) motor imagery. In particular, we propose a deep learning classifier based on Convolutional Neural Networks (CNN) and Long Short-Term Memory (LSTM) in order to detect EEG motor imagery for left and right hands. Our results report a 96.5% validation accuracy in the correct classification. Additionally, we discuss the influence of using raw data over using the data split in frequency bands in the model proposed. We also discuss the influence of certain frequency bands activity over other frequency bands in the task proposed. These results represent a promising discovery in order to democratize users’ independence by the adoption of low-cost and low-invasive technologies in combination with deep learning.

The population in developed countries is aging and this fact results in high elderly health costs, as well as a decrease in the number of active working members to support these costs. This could lead to a collapse of the current systems. One of the first insights of the decline in elderly people is frailty, which could be decelerated if it is detected at an early stage. Nowadays, health professionals measure frailty manually through questionnaires and tests of strength or gait focused on the physical dimension. Sensors are increasingly used to measure and monitor different e-health indicators while the user is performing Basic Activities of Daily Life (BADL). In this paper, we present a system based on microservices architecture, which collects sensory data while the older adults perform Instrumental ADLs (IADLs) in combination with BADLs. IADLs involve physical dimension, but also cognitive and social dimensions. With the sensory data we built a machine learning model to assess frailty status which outperforms the previous works that only used BADLs. Our model is accurate, ecological, non-intrusive, flexible and can help health professionals to automatically detect frailty., Ministry of Economy and Competitiveness from Spain MINECO/FEDER MAT2017-85999P, European Union (EU) MINECO/FEDER MAT2017-85999P, Regional Government of Andalusia Research Fund from Spain A-BIO-157-UGR-18

Electroencephalography (EEG) signals to detect motor imagery have been used to help patients with low mobility. However, the regular brain computer interfaces (BCI) capturing the EEG signals usually require intrusive devices and cables linked to machines. Recently, some commercial low-intrusive BCI headbands have appeared, but with less electrodes than the regular BCIs. Some works have proved the ability of the headbands to detect basic motor imagery. However, all of these works have focused on the accuracy of the detection, using session sizes larger than 10 s, in order to improve the accuracy. These session sizes prevent actuators using the headbands to interact with the user within an adequate response time. In this work, we explore the reduction of time-response in a low-intrusive device with only 4 electrodes using deep learning to detect right/left hand motion imagery. The obtained model is able to lower the detection time while maintaining an acceptable accuracy in the detection. Our findings report an accuracy above 83.8% for response time of 2 s overcoming the related works with both low- and high-intrusive devices. Hence, our low-intrusive and low-cost solution could be used in an interactive system with a reduced response time of 2 s., Spanish Ministry of Economy and Competitiveness (Agencia Estatal de Investigacion-AEI) TIN2016-79484-R, European Union (EU) TIN2016-79484-R, Spanish Government PID2019-109644RB-I00/AEI/10.13039/501100011033 FPU18/00287

The increasing adoption of mobile computing technology in the health and social domains offers new possibilities, for instance, promoting active aging. Health deterioration in elderly people could be successfully assessed by monitoring activities of daily living (ADLs) through mobile technology. In particular, frailty affects several dimensions (physical, psychological, and social) of human functioning, which are required to perform instrumental ADLs (IADLs). Starting from the definition of a model, this paper proposes the design of an intelligent mobile health system to assess frailty in an ecological way: to automatize the frailty assessment through wearable sensors, unobtrusively in free-living environments, and using machine learning in order to reduce the traditional efforts of clinicians assessing frailty. It supports automatic data collection from sensors and artificial intelligence analysis during the performance of real IADLs by elderly. The proposed system uses mobile/wearable devices, follows a microservices software architecture, and implements machine learning algorithms. A technical validation of the proposal is shown.

New solutions in the e-Health domain are been applied to address problems such as monitoring, user adaptation and context influence, particularly if the patients are older people. The social and economic burdens associated with age decline can be decreased by providing more holistic technological solutions. Our aim is to contribute to the integration of different aspects in the active ageing process (cognitive, physical and social) to achieve more complete evaluations and by performing more effective interventions in the elderly. To this end, in this research work we propose a technological solution based on microservices architectures, which has been validated in two different projects: cognitive training and frailty prevention. The solution involves a system of systems engineering, thus improving reusability, extensibility, and performance in the e-Health domain.

Amphiphilic glycomimetics encompassing a rigid, undistortable nortropane skeleton based on 1,6anhydro-L-idonojirimycin and a polyfluorinated antenna, when formulated as the corresponding inclusion complexes with beta-cydodextrin (beta CD), have been shown to behave as pharmacological chaperones (PCs) that efficiently rescue lysosomal beta-glucocerebrosidase mutants associated with the neuronopathic variants of Gaucher disease (GD), including.the highly refractory L444P/L444P and L444P/P415R single nucleotide polymorphs, in patient fibroblasts. The body of work here presented includes the design criteria for the PC prototype, the synthesis of a series of candidates, the characterization of the PC:beta CD complexes, the determination of the selectivity profiles toward a panel of commercial human lysosomal glycosidases, the evaluation of the chaperoning activity in type 1 (non-neuronopathic), type 2 (acute neuronopathic), and type 3 (adult neuronopathic) GD fibroblasts, the confirmation of the rescuing mechanism by immunolabeling, and the analysis of the PC:GCase binding mode by docking experiments.

Background. Peripheral cytokines are related to cognitive impairment in delirium and dementia. During alcohol detoxification, elevation of pro- and anti-inflammatory cytokines is reported. However, the relationship between peripheral cytokines and cognitive function in alcohol dependence has not been examined. We characterised the serum cytokine profile during alcohol detoxification, hypothesising that cytokines changing during detoxification would relate to cognitive performance. Methods. We recruited 54 patients undergoing in-patient detoxification (M = 33, aged 47 ± 13), took blood for serum cytokine analysis early (day 1-3), mid (day 4-6) and late (day 7 -10) in detoxification. At the last time point, verbal memory (Weschler Memory Scale), and Trail Making Tests A and B (Halstead-Reitan battery) were administered. Cytokines were measured using a Luminex 25-plex system. Ten cytokines undetectable in >10% samples were excluded from further analysis. We performed repeated-measures analyses of variance to examine cytokine changes during detoxification, and correlations controlling for age, previous alcohol intake, previous detoxifications and gamma glutamyl transferase, to examine the relationship between cytokines and cognition. Results. Few cytokines changed during detoxification: IL-6 (F = 7.210; p = 0.0038), MCP-1 (F = 10.25; p = 0.0002) and IL-8 (F = 11.46; p = 0.0002) decreased while IL-12 increased (F = 12.32; p = 0.0003). MCP-1 (-0.508, p = 0.004) correlated inversely with time taken to complete Trails A (-0.508, p = 0.004), and directly with performance on both immediate (0.371; p = 0.044), and delayed verbal memory (0.412; p = 0.024). Conclusions. Our initial analysis suggests an association between MCP-1 and cognitive function. Further exploration is required to understand its nature, and whether it can be exploited to protect cognition in alcohol dependence.

Microbial growth on medical and technical devices is a big health issue, particularly when microorganisms aggregate to form biofilms. Moreover, the occurrence of antibiotic-resistant bacteria in the clinical environment is dramatically growing, making treatment of bacterial infections very challenging. In search of an alternative, we studied a novel antimicrobial surface coating based on micro galvanic elements formed by silver and ruthenium with surface catalytic properties. The antimicrobial coating efficiently inhibited the growth of the nosocomial pathogens Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and Enterococcus faecium as demonstrated by the growth inhibition on agar surface and in biofilms of antibiotic resistant clinical E. faecalis, E. faecium, and S. aureus isolates. It also strongly reduced the growth of Legionella in a drinking water pipeline and of Escherichia coli in urine. We postulate a mode of action of the antimicrobial material, which is independent of the release of silver ions. Thus, the novel antimicrobial coating could represent an alternative to combat microbial growth avoiding the toxic side effects of high levels of silver ions on eukaryotic cells.

To review some of the lesser known aspects of sneezing, which is a universal phenomenon suffered the world over but which has received little attention in the medical literature and especially by that dealing with neurology.Here we consider the causation, neurophysiology, pathophysiology, diagnosis and treatment of this reflex action, which sometimes goes beyond being just a simple ailment of little importance and becomes a sign associated to a series of different medical conditions.Despite its being such a commonplace occurrence, little is known about sneezing and few studies have been conducted to further our knowledge on the subject. Today there are still reports of cases of pathological sneezers, who often respond poorly to different treatments and for whom this reflex paroxysm becomes both a social and a health problem. Moreover, sneezing is sometimes associated with severe secondary medical sequelae. In contrast, there have also been reports of conditions in which the first symptom was an inability to sneeze. A thorough knowledge of this reflex, its causes and associated phenomena can be a valuable aid in the diagnosis of other concomitant diseases.

Multifocal motor neuropathy with conduction blocks (MMNCB) is a peripheral demyelinating neuropathy. The etiology of this disease is unknown, but an autoimmune origin is postulated. Prurigo nodularis (PN), a chronic dermatosis also having an unknown etiology and many peripheral neuropathies of different nature are associated to hematological tumors. We have found no cases in the literature in which MMNCB was presented as a paraneoplastic syndrome of a non-Hodgkin B-cell type lymphoma (NHL-B). We present the case of a 67 year old man who simultaneously developed PN and MMNCB in upper limbs and who was diagnosed of a NHL-B 19 months later. We raise the hypothesis that both prurigo and neuropathy are a paraneoplastic syndrome for lymphoma with a possible common autoimmune pathogenic mechanism.

We study the power of IgG synthesis value as a marker of disease activity in multiple sclerosis (MS).Link index was calculated in 202 MS patients. Time between first, second and third attack and progression index (PI) were compared in patient with normal (NLI) high (HL) or very high Link index (VHLI).Secondary progressive (SP) patients had a higher LI than relapsing-remitting (RR) and primary progressive (PP) courses (1.10 +/- 0.5 for SP vs 0.86 +/- 0.5 for RR and 0.81 +/- 0.5 for PP, P=0.01 and 0.03, respectively). Having a HLI in MS RR and SP patients has no time effect in the development of the second and third attack. PI was higher in patients with VHIL (0.67 +/- 0.7) vs patients with NLI (0.42 +/- 0.4, P=0.008) and with HLI (0.39 +/- 0.3, P=0.001).This study confirmed that LI is a good marker of subsequent progression of MS.

Cerebral cavernous malformations are vascular malformations mostly located in the CNS. Their frequency is estimated close to 0.5% in the general population.1 Cerebral cavernous malformations occur as a sporadic or hereditary condition. From the Hispano-American population, familial forms were reported with a high frequency.2 CCM1 , a hitherto unidentified gene mapping on chromosome 7 was shown to be involved in all families with cerebral cavernous malformations of Hispano-American descent with a strong founder effect.2 3 Around 50% of non-Hispano-American families showed linkage to CCM1 but no common haplotype was found.4 5 A recent study showed linkage of cerebral cavernous malformations to two additional loci.5 No Spanish family with cerebral cavernous malformations has been analysed so far. (A) Pedigrees of the nine families with cerebral cavernous malformations. Black symbols=symptomatic patients with cavernous angiomas on MRI; half filled symbols=asymptomatic members with cavernous angiomas on MRI; empty symbols=asymptomatic members with normal MRI; question mark=members with unknown status. (B) Comparison of the Hispano-American CCM1 haplotype and the haplotypes segregating with the disease phenotype within Spanish families. Polymorphic markers are shown on the left. Numbers indicate the sizes in base pairs. Primers used to amplify D7S2409 were …

We present a case of cerebral vasculitis secondary to infection with Varicella Zoster Virus which appeared in a 27 year old patient after a latency period of eight weeks. We emphasize the usefulness of angioresonance as a fitting means of evolutive follow up without the need to carry out control cerebral angiography. We likewise point out the usefulness of acyclovir as the sole treatment necessary in non-complicated cases.