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Introduction: The use of functional magnetic resonance imaging (fMRI) has represented an important step forward for the neurosciences. Nevertheless, it has also been subject to rather a lot of criticism., Aim: To study the most widespread criticism against fMRI, so that researchers who are starting to use it may know the different elements that must be taken into account to be able to take a suitable approach to this technique., Development: The fact that fMRI allows brain activity to be observed makes it a very attractive and useful tool, and its use has grown exponentially since the last decade of the 20th century. At the same time, criticism against its use has become especially fierce. Most of this scepticism can be classified into aspects related with the technique and physiology, the analysis of data and their theoretical interpretation. In this study we will review the main arguments defended in each of these three areas, as well as looking at whether they are well-founded or not. Additionally, this work is also intended as a reference for novel researchers when it comes to identifying elements that must be taken into account as they approach fMRI., Conclusions: Despite the fact that fMRI is one of the most interesting options for observing the brain available today, its correct utilisation requires a great deal of control and knowledge. Even so, today most of the criticism it receives no longer has any solid foundation on which to stand.

Graft-versus-host disease (GVHD) remains the greatest source of morbidity-mortality in allogenic transplant patients. Although in most cases the more easily obtainable clinical and laboratory test parameters suffice to confirm the diagnosis and establish the stage of the disease biopsies of the affected organ are sometimes needed. At present there is great Interest in the study of factors allowing a prognosis of the course and type of response to treatment in patients with CVHD. In this sense, It would be necessary to objectively Identify and validate biomarkers capable of predicting biological or pathological processes in patients with cVHD. To this effect we have performed serial analyses of skin tissue using peripheral blood and tissue biomarkers in a prospective observational study conducted in three transplant centers. The still preliminary results Indicate that certain histopathological findings classically attributed to CVHD ore also seen in patients not clinically affected by the disease--this probably being related to other physiopathological phenomena occurring during transplantation. The study of these findings, combined with biomarker analysis, will allow improved understanding of the underlying etiopathogenesis, as well as the definition of new diagnostic, prognostic and response-evaluating criteria.

Malignant or noduloulcerative syphilis is an infrequent variant of secondary syphilis which appears in HIV+ patients. It is associated with fever, general malaise and skin lesions in the form of pustules or ulcerative scabs. Histology studies on the lesions show a perivascular infiltration of plasma cells and a formation of granuloma of giant and epitheloid cells. Most patients test positive for syphilis. We discuss the case of a 37-yar-old man who attended our service complaining of fever and scabby nodular lesions all over his skin. Blood testing confirmed that he had syphilis and HIV. The patient responded rapidly to penicillin treatment, with remittance of his fever. The skin lesions disappeared after 8 weeks. The rareness of malignant syphilis and its unusual clinical manifestation is a challenge to medical personnel. This diagnosis ought to be considered in HIV+ patients with fever and ulcerative skin lesions. Penicillin is the treatment of choice.

Gefitinib (Iressa) is a new antineoplastic agent that acts by selectively inhibiting epidermal growth factor receptor tyrosine kinase (EGFR-TK). It has shown activity against several solid tumors. Because of their action mechanism, gefitinib and other tyrosine kinase inhibitors have been associated with multiple cutaneous effects, most of which are mild and well tolerated. We present a case of perforating dermatosis after treatment with gefitinib.

Aims: To review the role played by the mitochondrial permeability transition pore (MPTP) in different physiological and pathological processes., Method: Both genetic and functional alterations in mitochondria can lead to errors that trigger programmed cell death, which in turn give rise to a number of diseases that affect the nervous system. Over the last few years the mitochondrion has been seen as the link between the different signalling pathways involved in some degenerative processes. The mitochondrion seems to play an important part in the cellular decision making that leads, irreversibly, toward the execution phase in cellular death processes. This being the case, the action would be mediated by the permeability of its membranes, through the formation of the mitochondrial permeability transition pore, and would involve phenomena such as the dissipation of the mitochondrial electrochemical potential and the release of substances from within it. These substances include apoptosis inducing factor (AIF), apoptosis protease activating factor 1 (apaf 1), cytochrome c and members of the protease family: the caspases. These alterations have been described in neurodegenerative pathologies such as Alzheimer s and Parkinson s disease, amyotrophic lateral sclerosis and transmissible spongiform encephalopaties., Conclusions: Designing pharmaceutical products capable of interfering with the functions of MPTP would allow a better therapeutic approach in neurological pathologies.

Objective: This is a review of the part played by the cysteine proteases in different physiological and pathological processes., Development: Apoptotic processes have a crucial function in control of the number of cells in multicellular organisms, both during development and throughout life. Alterations in these are closely related to different pathological processes, from cancer (with fewer apoptotic processes) to the degenerative disorders in which apoptosis is increased. Although the stimuli which may induce apoptosis are very varied, the apoptotic phenotypes are similar. Different metabolic routes are involved in apoptosis and in these changes, both in transcription and postranscription. The latter form the basis of this paper. We review the role of the cysteine protease family, in which the caspases and calpains are the best representatives, which have been related to different degenerative models. In this review we describe the stimuli and cascades of intracellular signalling which occur on activation., Conclusion: These proteases are involved in many situations involving the development and maintenance of the number of cells in the tissues, both physiological and pathological. They may be considered to be possible therapeutic targets in neurodegenerative diseases such as Alzheimer's disease, amyotrophic lateral sclerosis, Parkinson's disease and Huntington's chorea.

Philadelphia chromosome-positive chronic myeloid leukaemia (CML) developed three years after the diagnosis of Waldenström macroglobulinemia (WM) in a patient who had received chlorambucil and prednisone during this time. Treatment with busulphan was started and two and a half years later the died in blastic crisis. Six months before the blastic transformation of the leukaemia the amount of IgM, which remains stable (above normal values) along the chronic phase, initiates a decrease, reaching normal values in the phase of acute transformation. CML is a very rare second neoplasia in patients receiving anticancer drugs. The correlation between the decrease of IgM and the blastic crisis is very interesting. We do not find an explanation for this finding although similar observations have been described heralding the appearance of second neoplasias in WM, and one might speculate with a possible role of IgM in the control of chronic phase of the myeloid leukaemia or if the overgrowth of blastic cells could overwhelm the development of lymphoplasmacytoid cells.

Three cases of postpartum acquired factor VIII inhibitors were seen in our hospital between 1981 and 1989. The clinical picture, which was mild in one patient and severe in two, began several months after delivery (four to nine). After treatment with methylprednisolone, good clinical response was obtained in the three cases. However, normal values of factor VIII:C were obtained more easily with the higher doses of steroids. A new pregnancy and delivery in one of our patients did not induce the reappearance of the inhibitor after several years of follow-up.

Our study group consisted of 43 healthy preadolescence and adolescence of which 17 were boys and 13 premenarcheal and 13 postmenarcheal girls. Haematocrit, haemoglobin, serum iron, transferrin saturation, total iron-binding capacity, latent iron-binding capacity and serum ferritin were analyzed. Authors found that post-menarcheal girls are at lower levels than boys and that menstrual blood loss is a significant factor in determining iron status.