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Background: POEMS syndrome is a debilitating paraneoplastic disorder associated with plasma cell neoplasia. Clinically, it is characterized by predominantly demyelinating peripheral neuropathy that often starts in the pelvic limbs, organomegaly, endocrinopathy, skin changes, and elevated serum M protein. Diagnosis requires meeting a set of clinical criteria in which polyradiculoneuropathy and plasma cell disorder are the two mandatory criteria. The aim of this article is to describe 3 clinical cases, their diagnostic approach, and therapeutic management. Clinical cases: In this study, three clinical cases with features compatible with POEMS syndrome are presented. Nerve conduction studies revealed demyelinating involvement with sensory-motor impairment, and evidence of a monoclonal spike was found. Treatment was successful in two cases and partially effective in one, although the latter was associated with delayed diagnosis. Conclusion: Despite significant advancements in understanding the pathophysiology and treatment of this disease, diagnosis remains challenging, especially in locations lacking the necessary resources for accurate diagnosis. It is essential to emphasize that it requires a multidisciplinary approach. The prognosis of this disease is closely linked to early diagnosis. Here, we describe three cases from a reference center in Mexico to increase awareness of the disease›s diagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Kranion is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acute intermittent porphyria (AIP) is an uncommon metabolic disease, being the most common of the acute porphyrias. The most frequent symptom is acute abdominal pain, although can be accompanied by seizures, neuro-psychiatric alterations or symmetrical motor neuropathies, which in some patients can progress to respiratory musculature paralysis. Objective: Describe an atypical presentation of acute porphyria to be considered as differential diagnoses in abdominal pain. Clinical case: We present a case of a patient with AIP, presenting acute abdomen, seizures, later developed neuropsychiatric compromise and symmetrical motor neuropathy, and was admitted to mechanical ventilation. Due to the severity of the neurological involvement, he received hemin arginate, presenting with transient hypertransaminemia, an adverse event not previously reported. The evolution was favorable, with mechanical ventilation and hospital discharge withdrawn. Conclusions: The diagnosis of AIP should be considered in cases of acute abdominal pain associated with neurological and/or psychiatric symptoms, particularly young women. The administration of hemin is considered the standard of treatment, and even late could have beneficial effects. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Late-onset Systemic Lupus Erythematosus (SLE) is rare and affects older adults. Case report: A 71-year-old woman is reported with generalized weakness and muscle strength loss, which increased suddenly after a hemorrhagic stroke. The patient presented a torpid evolution for six months. The diagnosis of late-onset SLE was confirmed with antinuclear antibodies (+) and compliance with criteria for SLE and neurolupus, with significant improvement after two weeks of treatment. We made a rapid systematic review and found few similar cases with peripheral neuropathy. Conclusion: It is necessary to consider late-onset SLE with peripheral neuropathy in older adults with muscle weakness, as an atypical clinical presentation and the need for confirmatory tests. [ABSTRACT FROM AUTHOR]

The diabetes mellitus is a chronic disease that can cause multiorganic complications as the diabetic polyneuropathy, with the consequent invalidant disorder to whom suffer from it. For such a reason, an exhaustive literature review was carried out with the objective of upgrading some important aspects on this affection, such as concept, risk factors, pathogenic mechanisms, classification, diagnosis and treatment, among others. It was concluded that this disease is associated with several risk factors, its diagnosis is fundamentally clinical and the glycemic control, the care of feet and the use of medicines are considered as treatment. [ABSTRACT FROM AUTHOR]

Background: Diabetic neuropathy represents a polyneuropathy with electrophiosiological alterations. Electroneuromyography (NMD) plays an important role in the evaluation of patient with diabetes mellitus type 2 (DM2) and doubtful neuropathy. Objective: To determine clinical manifestations in patients with distal symmetrical sensory polyneuropathy (DSSP) and to correlate them with electromyographic alterations. Material and methods: Transversal, analytical study. 138 patients over 18 years old, with DM2 and PSSD were selected. They underwent physical examination, laboratory studies and electromyography (EM) with 4-channel Nicolet electromyograph. Measures of central tendency and their dispersion were analyzed; data normality with Kolmogorov-Smirnov; Student's t test and Spearman's correlation. Results: Thalar hyperkeratosis was the most frequent clinical finding in 103 (74%) patients. The most frequent symptoms were paresthesia in 132 (95.7%) patients and tingling in 93 (67.4%) patients. Exploration of superficial sensitivity determined neuropathy in 42 (30.4%) patients finding greater insensitivity in the medial plantar nerve territory. In the EM, the nerve with the greatest absent response was the left lateral plantar nerve in 51 (59%) patients. A significant correlation (p < 0.05) was found between the variables of EM with age, years of evolution and levels of glycated hemoglobin A1c. Conclusions: The higher the lack of glycemic control, the chronobiology of the patient and the time of illness, the greater the electromyographic affection. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The porphyrias come from the Greek porphyra. These are a heterogeneous group of metabolic disorders caused by enzymatic deficiency for the biosynthesis of the Hem group. Acute intermittent porphyria is caused by a deficiency of the porphobilinogen deaminase enzyme. A 40-year-old woman with 10 days of abdominal pain evolution (required laparotomy without finding surgical pathology), severe hydroelectrolytic disorder due to hyponatremia and resistant hypokalemia, maintained tachycardia and hypertension. 7 days later, acute flabby quadriparesis development and presented a single generalized tonic-clonic convulsive crisis. Neurophysiological studies supported mixed axonal polyneuropathy and urine results of porphobilinogen and porphyrins were elevated. After Acute Intermittent Porphyria was diagnosed, hemin was administered, which stabilized the patient's clinic and showed normalization of the porphobilinogen. The prevalence of this entity is 1/2000 people. An autosomal dominant disease, which manifests mainly in women between the ages of 20 and 40 years. This entity manifests with neurological and visceral symptoms. Management is given with hematin and dextrose, avoiding hypotonic solutions because of the risk of exacerbating hyponatremia. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cuarzo (REC) is the property of Fundacion Universitaria Juan N. Corpas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Polyneuropathy in the critically ill patient was defined as a generalized weakness, acquired during Intensive Care Unit (ICU) admittance and attributed to lesion of the peripheral nerve. Research in this field progressed over time, revealing the crucial role of muscle injury in this disease, to the point of re-naming the disorder as ICU adquired weakness (ICUAW). Muscle damage is common in severe illness, and may be classified in qualitative (weakness) or quantitative (decrease in mass) muscle loss. The most frequent scenario in these patients, is simultaneous change in quality and quantity of muscle; resulting in a challenging and delayed recovery during hospital admittance and after discharge. Multiple causes have been identified in the pathogenesis of this disorder, such as: prolonged bed rest, inadequate intake of nutrients and exposure to drugs that affect muscle structure and contraction. The assessment of muscle mass using images provided by ultrasound or computerized tomography may guide follow up. The prevention and treatment of ICUAW requires a multimodal approach: early mobilization and exercise, appropriate nutritional prescription and, occasionally, muscle protein synthesis stimulants. Further studies will clarify more aspects regarding critically ill patients suffering from muscle injury, in order to better address prevention and treatment of ICUAW. [ABSTRACT FROM AUTHOR]

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Currently, type 2 diabetes mellitus is considered a global epidemic. It is one of the most transcending problems due to its high prevalence and huge social and economic repercussion; for this reason, the purpose of this study was to comprehensively evaluate foot sensitivity in people with type 2 diabetes mellitus in Villahermosa, Tabasco, Mexico. Materials and Methods: The study design was descriptive correlational; the sample was comprised of 198 participants. The Michigan Neuropathy Screening test was used with Semme-Weinstein monofilament testing, diapason, cold/hot temperature testing, and Achilles reflex. Results and Discussion: Females prevailed with 70.2% and 29.8% for men; mean age was 56.44 years and an average of 12.34 years with the disease. Moderate neuropathic symptoms were registered in 46%, 26.3% severe; 65.7% showed risk of positive neuropathy (40.9% women and 24.8% men), 41.1% with moderate loss of sensitivity and 29.3% normal sensitivity; 74.7% have deficient glycemic control. The risk factors detected with greater prevalence were helomas, hyperkeratosis, and deformities. Conclusions: Significant correlation exists between sensitivity loss with years with the disease and hyperglycemia and neuropathy symptoms; sensitivity loss in women is from moderate to severe and in men it is moderate. [ABSTRACT FROM AUTHOR]

Introduction: Multiple myeloma is a B-cell malignant and progressive tumor, associated with osteolytic lesions, immunodeficiency and renal dysfunction, that has been treated since 2008 with Bortezomib, which achieved an increase in patients survival, however its use was limited due to dose dependent adverse effects, especially painful peripheral neuropathy, it has recently come into use Carfilzomib (a second generation proteasome inhibitor agent) approved by the FDA in 2012 as the only agent for treatment of refractory disease and relapsing of multiple myeloma. Objective: To conduct a literature review and determine the Colombian experience with the drug Carfilzomib, considering national statistics contained in the individual records of health service delivery, plus the status of a case is described. Methodology: for the review was considered literature indexed in PubMed, as an inclusion criterion was considered clinical studies Phase 2 and 3 that reviewed Carfilzomib in handling multiple myeloma. Regarding the Colombian experience, taking information provided by Biotoscana, 37 multiple myeloma Colombian patients diagnosed between 2003 and 2012 and who had been prescribed Carfilzomib were identified. Results: A total of eight randomized trials shown on hematologic adverse effects such as fatigue (367 of 678 patients, 54%), and nausea (323 patients, 48%). For the RIPS of 37 patients, 22 patients received 1 to 8 cycles Carfilzomib (3.0 average, median 3). Clinical response in 9 of them, 4 patients (22%) very good partial response, 4 patients (22%) partial response, 1 patient (6%) with stable disease was assessed. Conclusions: We found difference between the side effects reported in Colombia from the ones who have been reported globally, fatigue prevails in our patients, also experience with new drugs has not been sufficiently documented. [Castañeda C, Pantoja MC, Montaño L, Rosselli D. Carfilzomib for the Treatment of Multiple Myeloma: Systematic Review of the Literature and Colombian Experience Based on RIPS. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Serum free fatty acids alterations have been associated to polyneuropathy and macro or micro vascular disease in patients with diabetes. Objective: to compare the composition of serum free fatty acids in diabetic patients type 2 with healthy subjects. Methods: 40 diabetic patients and 40 non diabetic patients were included previous informed consent. We assayed glucose and free fatty acids composition (through gas chromatography) in non diabetic and diabetic patients, additionally in the diabetic group we assayed glycosylated hemoglobin. An oral glucose tolerance test was performed in the control group. Results: saturated fatty acids were found higher in both groups, C16:0 showed the highest increase, as was found increased C18:2t in both experimental groups. Conclusions: the composition of free fatty acid reflects inappropriate dietary habits; in the studied population conducting to biochemical changes such as metabolic syndrome, diabetes mellitus and hypertension or acute cardiovascular events. We emphasize the medical importance of healthy dietary habits. [ABSTRACT FROM AUTHOR]

Introduction: Guillain-Barré syndrome (GBS) is an autoimmune polyradiculoneuropathy subdivided in demyelinating and axonal types. There is no established frequency about the electrophysiological subtypes in Mexico. Objective: to determine the frequency of electrophysiological subtypes of GBS in Mexican patients. Material and methods: The study design was descriptive and retrospective. Patients with GBS older than 15 years without coexisting major diseases were selected retrospectively from a three-year period. These patients should have met the clinical and electrophysiological criteria of GBS. Motor nerve conduction studies were made of the median, ulnar, tibial and peroneal nerves, and antidromic sensory conduction studies were performed in the median, ulnar and sural nerves. Descriptive statistics, analysis of variance and ?2 test were used. Results: The study included fifty-one patients with median age of 45.5 years (range 16-79); 37 men and 14 women, with a ratio man-woman 2.6:1; 37% were observed in winter (p = 0.56). The electrophysiological subtypes were acute motor axonal neuropathy (AMAN) 39 %; acute inflammatory demyelinating polyneuropathy (AIDP) 23.5 %; mixed neuropathy (MN) 20%; and acute motor sensory axonal neuropathy (AMSAN) 17.5 %. Conclusions: the most frequent electrophysiological subtype in Mexican patients was AMAN. Other frequent subtypes were MN and AMSAN. Axonal variants were the predominant types. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: Miller Fisher syndrome is the most common variant of Guillain Barré syndrome, reaching a prevalence of 5% among all its variants. It was described by Charles Miller Fisher in 1956, who exposed him as an unusual variant of acute inflammatory demyelinating polyneuropathy. It is characterized by acute onset of polyneuropathy, associated with the triad of ophthalmoplegia, ataxia and areflexia, and may progress to life-threatening respiratory compromise. CASE REPORT: The following article presents a case of a patient researched in a retrospective review of the hospital discharges of the department of neurology of Hospital Clínico Herminda Martin, who was diagnosed as Miller Fisher syndrome. This is the case of a 77 years old male patient with a history of unspecified coronary heart disease, and hypercholesterolemia, who was presented in the emergency unit with dysarthria, ataxia, paraparesis and ophthalmoplegia. DISCUSSION: We will make an analysis contrast between the presentation, treatment and data collected made during his stay, in relation to the handling and features found in the literature. [ABSTRACT FROM AUTHOR]

We present the case of a 59 years-old male with clinical features of acute demyelinating polyneuropathy with distal sensitive alterations, weight loss, axillary adenopathies, painful hepatosplenomegaly and widen mediastinum demonstrated by CT scan. Axillary lymph node biopsy showed follicular lymphoma grade II (no Hodgkin). Guillain-Barre syndrome is an acquired inflammatory disease produced by an immunological mechanism associated to Campylobacter jejunii and some viruses. Peripheral neuropathies associated to non-Hodgkin malignant lymphomas are commonly due to drug toxicity or infiltration to nervous system or both, but the paraneoplastic association is less than 3%, reason to present this case. [ABSTRACT FROM AUTHOR]