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objetivo: El presente trabajo busca describir el cambio en las características imagenológicas en resonancia magnética cerebral en estudios pre y post-embolización de meningiomas en plan de ser llevados a resección quirúrgica. Justificación: La embolización pre-quirúrgica de los meningiomas intracraneales ha mostrado beneficios relacionados principalmente a un menor sangrado intra-operatorio y duración de estancia hospitalaria, así como mayor facilidad técnica en su resección debido a los cambios por necrosis licuefactiva que sufre el tumor. Métodos: Se presenta un caso representativo con estudios imagenológicos pre y post-embolización realizados a un paciente que posteriormente fue llevado a resección quirúrgica de un meningioma del tercio posterior de la hoz, en el que se aprecia una marcada disminución en la intensidad de la señal en estudio de resonancia magnética cerebral, especialmente en las imágenes con información en T1 y secuencia con medio de contraste, posiblemente relacionado a la obstrucción vascular y microvascular que se logra posterior a la embolización de las arterias aferentes del tumor. Conclusión: La perdida de realce posterior a la administración de medio de contraste (Gadolinio) en las imágenes por resonancia magnética cerebral con información en T1 post-embolización, ponen en evidencia la lesión vascular y microvascular posterior a la administración de material de embolización, lo cual se convierte en un signo imagenológico de embolización exitosa o satisfactoria previa a la resección quirúrgica. Palabras clave: Embolización, resonancia magnética cerebral, medio de contraste, meningiomas, resección quirúrgica, sangrado Intraoperatorio objective: The present work seeks to describe the change in imaging characteristics in brain magnetic resonance in pre and post-embolization studies in meningiomas in the plan of being taken to surgical resection. Justification: The pre-surgical embolization of intracranial meningiomas has shown benefits related mainly to less intra-operative bleeding and length of hospital stay, as well as greater technical ease in resection due to changes due to liquefactive necrosis suffered by the tumor. Methods: A representative case is presented with pre and post-embolization imaging studies performed on a patient who was subsequently taken to surgical resection of a meningioma of the posterior third of the sickle, in which there is a marked decrease in signal intensity in MRI study, especially in images with information in T1, sequence with contrast medium, possibly related to vascular and microvascular obstruction that is achieved after embolization of the arteries afferent to the lesion. Conclusion: The loss of enhancement after the administration of contrast medium (Gadolinium) in the images by cerebral magnetic resonance with information in post-embolization T1, evidences the vascular and microvascular lesion that is sought with the administration of embolization material, which serves as an imaging sign of successful or satisfactory embolization prior to being taken to surgery. Key words: Embolization, brain magnetic resonance, contrast medium, meningiomas, surgical resection, intraoperative bleeding., Introducción Los meningiomas son los tumores intracraneales más frecuentes en la población general, según sus características histológicas se pueden dividir en tres grupos: típicos, atípicos y anaplásicos según la cuarta [...]

Background: Glomus jugulare tumors (GJTs) are rare and mainly affect women between the 5th and 6th decades of life. Its localization and anatomic relationships make conventional surgical treatment difficult and with a considerable risk of complications. This manuscript aims to describe the results of Gamma Knife radiosurgery (GKR) in patients with GJT treated in a single center in Latin America, as well as to systematically review the literature to determine the clinical and radiological effectiveness of this technique. Methods: A search of information from January 1995 to June 2023 was performed. Twenty-two articles reporting 721 GJT patients treated with GKR were included in the study. Variables such as symptomatic control, control of tumor size, and complications were evaluated. These variables were described using measures of central tendency and proportions. For the institutional experience, 77 patients with GJT tumors were included in the study. Pretreatment clinical variables and follow-up data were collected from medical charts and phone interviews. The Short Form-36 scale was applied to assess the quality of life. The data were analyzed using the statistical program STATA17.0. Results: A total of 721 patients were considered. The median of patients included in these studies was 18.5. The mean age was 58.4 years. The median of symptom control was 89%, and the median of imaging control was 95.7%. In our institution, 77 patients were included in the study. The mean age was 53.2 years. The median hospital stay was 4.92 hours. For the clinical follow-up, information on 47 patients was obtained. An improvement in pretreatment symptoms was described in 58%, with general symptomatic control of 97%. The tumor-control rate was 95%, and there were statistically significant differences in six of the nine Short Form-36 scale domains. Conclusion: GKR is an effective, safe, and cost-effective technique that offers a high degree of symptomatic and tumor size control in patients with GJT. [ABSTRACT FROM AUTHOR]

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Introducción: La reconstrucción del defecto óseo de la bóveda craneal en pacientes craniectomizados sobrevivientes de un traumatismo craneoencefálico grave se ha convertido en un procedimiento frecuente en el funcionamiento neuroquirúrgico de nuestro servicio. Objetivos: Relacionar el tiempo promedio de realización de la craneoplastia con la aparición de manifestaciones clínicas y complicaciones. Métodos: Se realizó un estudio correlacional prospectivo con un grupo de pacientes que sobrevivieron luego de un traumatismo craneoencefálico grave y que mostraron defectos óseos de la bóveda craneal como consecuencia de una craniectomía descompresiva uni o bilateral, los que fueron sometidos a procedimientos reconstructivos para corregir la deformidad, en el período comprendido entre enero de 2003 y diciembre de 2011, en el servicio de neurocirugía del hospital universitario 'Roberto Rodríguez', de la ciudad de Morón, Ciego de Ávila, Cuba. Resultados: Se evaluaron 33 casos (47,14%), 23 (69,7%) del sexo masculino y 10 (30,3%) del femenino. Se realizaron 29 (87,88%) procedimientos fronto-temporo- parietooccipitales (FTPO) unilaterales, dos FTPO bilaterales (6,06%) y dos (6,06%) bifrontales. Entre uno y tres meses fueron reconstruidos seis cráneos (18,18%) y con más de tres meses de evolución 27 (81,82%), 22 de ellos (66,67%) entre cuatro y seis meses y con más de seis meses de evolución se operaron cinco casos (15,15%). Cinco casos mostraron complicaciones relacionadas con la craneoplastia (15,15%) y seis (18,18%) tenían diagnóstico de síndrome post craniectomía en el momento de la craneoplastia, todos con más de tres meses de evolución. Conclusiones: Con el presente estudio no fue posible demostrar la existencia de correlación entre el tiempo de realización de la craneoplastia en pacientes craniectomizados con los resultados. Palabras clave: Craniectomía descompresiva, craneoplastia, traumatismo craneoencefálico grave. Introduction: Craneoplasty in patients with decompressive craniectomy after severe head trauma is one of the most common surgical procedures in our hospital. Objetives: The aim of the investigation was to know the timing of craneoplasty and its relation with the complications. Method: We have conducted a prospectively study from January 2003 to december 2011 with 33 cranioplasty procedures in patients who previously underwent decompressive craniectomy after severe head trauma. Patients were stratified into two groups according to the time from DC to cranioplasty (1-3 months, and more than 3 months). Results: Overall craneoplasty was performed between 1-3 months in 18.18% (early cranioplasty), and more than 3 months in 81,82% (Late cranioplasty). Five patients (15.15 %) shows complications after cranioplasty, 2 (6.06%) with early and 3 (9.09%) with late cranioplasty. Conclusions: In this study we can't correlate the timing of cranioplasty after decomresive craniectomy with complications. Key words: Decompressive craniectomy, cranioplasty, severe head trauma., Introducción El traumatismo craneoencefálico grave (TCEG) es una de las principales causas de morbilidad y mortalidad en el mundo, alrededor del 50% de aquellos que sufren un accidente, presentarán un [...]

Copyright of Religación: Revista de Ciencias Sociales y Humanidades is the property of Religacion: Revista de Ciencias Sociales y Humanidades 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.)

Objective: To describe the clinical characteristics and outcomes in patients with refractory myasthenia gravis (MG) and to determine the effectiveness and side effects of the drugs used for their treatment. Methods: This observational retrospective cross‐sectional multicenter study was based on data from the Spanish MG Registry (NMD‐ES). Patients were considered refractory when their MG Foundation of America post‐interventional status (MGFA‐PIS) was unchanged or worse after corticosteroids and two or more other immunosuppressive agents. Clinical and immunologic characteristics of drug‐refractory patients, efficiency and toxicity of drugs used, and outcome (MGFA‐PIS) at end of follow‐up were studied. Results: We included 990 patients from 15 hospitals. Eighty‐four patients (68 of 842 anti‐acetylcholine receptor [AChR], 5 of 26 anti‐muscle‐specific tyrosine kinase [MusK], 10 of 120 seronegative, and 1 of 2 double‐seropositive patients) were drug refractory. Drug‐refractory patients were more frequently women (p < 0.0001), younger at onset (p < 0.0001), and anti‐MuSK positive (p = 0.037). Moreover, they more frequently presented a generalized form of the disease, bulbar symptoms, and life‐threatening events (p < 0.0001; p = 0.018; and p = 0.002, respectively) than non‐drug‐refractory patients. Mean follow‐up was 9.8 years (SD 4.5). Twenty‐four (50%) refractory patients had side effects to one or more of the drugs. At the end of follow‐up, 42.9% of drug‐refractory patients (42.6% of anti‐AChR, 100% of anti‐MuSK, and 10% of seronegative patients) and 79.8% of non‐drug‐refractory patients (p < 0.0001) achieved remission or had minimal manifestations. Eighty percent of drug‐refractory‐seronegative patients did not respond to any drug tested. Interpretation: In this study, 8.5% of MG patients were drug‐refractory. New more specific drugs are needed to treat drug‐refractory MG patients. [ABSTRACT FROM AUTHOR]

Background: Gamma Knife radiosurgery (GKR) is a technique that consists of the release of a high dose of ionizing radiation onto a therapeutic target, which has been previously delimited. This technique was described by Lars Leksell and Borje Larsson in 1951. In Colombia, there is only one GKR unit functioning machine nowadays. The objective of this study is to describe the institutional experience of a single institution with Gamma Knife Perfexion over 12 years. Methods: We conducted a retrospective observational study. A total of 1906 medical records, taken from the period between May 4, 2010, and May 4, 2022, were included in the study. Descriptive analysis was performed through STATA 17 as statistic tool. Measures of central tendency were calculated depending on the distribution of the continuous data and proportions were taken into account in the case of qualitative variables. Results: A total of 1906 procedures were performed. Patients from 1 year to 99 years old were treated, with a median age of 51 years. The most frequent diagnoses were meningioma (20.8%), arteriovenous malformation (AVM) (17%), vestibular schwannoma (15.6%), metastases (9.81%), and trigeminal neuralgia (9.12%). At 3-year posttreatment, in meningiomas, tumor size stability was observed in 57.3%, size decrease in 36%, and disappearance in 1.3%. In AVM, complete obliteration of the lesion was described in 36.8% and a decrease in size in 52.6%. Intracranial hemorrhage occurred in 5.2% during the follow-up period and 3.5% of all treated patients required a new procedure due to residual malformation. In vestibular schwannomas, tumor size remained stable in 62.2% and decreased in 28.8%. No new cases of facial paralysis after the procedure were described. At 1-year posttreatment, in metastasis, the size of the lesions remained stable in 40% of the patients, decreased in 47.5%, and disappeared in 2.5%. In trigeminal neuralgia, 88.4% of patients had pain relief and recurrences occurred in 16.6%. Acute complications were generally uncommon, the main ones being headache, pain at frame fixation points, and nausea. Conclusion: Our experience suggests that GKR is a noninvasive procedure with a broad spectrum of clinical applications, low frequency of complications, feasible, with good enough control size of tumor and vascular lesions in images, and good clinical results in the medium and long term. [ABSTRACT FROM AUTHOR]

The pineal gland is an endocrine organ located in the cranial vault. Its endocrine function has been extensively studied and has been found to be the cause of important regulatory functions in the physiology of the human body. Although the initial approaches to the suggestive action of this organ on the organism were of a philosophical and spiritual nature, in the last century technological advances have made it possible to clearly elucidate its effector function as an endocrine gland. In this order of ideas, the objective of this review is to address basic and recent descriptions of the physiology of the pineal gland. [ABSTRACT FROM AUTHOR]

The "Talk and Die" Syndrome is described as the clinical deterioration following a mild to moderate traumatic brain injury. In the face of this event, individuals are able to articulate recognizable words and then deteriorate within 48 hours of the injury. This syndrome represents a major public health challenge due to its high morbidity and mortality rate; it develops from an intracranial haemorrhage causing an increase in intracranial pressure and leading the person to a neurological crisis with focal signs, coma and later death. [ABSTRACT FROM AUTHOR]

Background and purpose: Prognosis of myasthenia gravis (MG) in patients with thymoma is not well established. Moreover, it is not clear whether thymoma recurrence or unresectable lesions entail a worse prognosis of MG. Methods: This multicenter study was based on data from a Spanish neurologist‐driven MG registry. All patients were aged >18 years at onset and had anti‐acetylcholine receptor antibodies. We compared the clinical data of thymomatous and nonthymomatous patients. Prognosis of patients with recurrent or nonresectable thymomas was assessed. Results: We included 964 patients from 15 hospitals; 148 (15.4%) had thymoma‐associated MG. Median follow‐up time was 4.6 years. At onset, thymoma‐associated MG patients were younger (52.0 vs. 60.4 years, p < 0.001), had more generalized symptoms (odds ratio [OR]: 3.02, 95% confidence interval [CI]: 1.95–4.68, p < 0.001) and more severe clinical forms according to the Myasthenia Gravis Foundation of America (MGFA) scale (OR: 1.6, 95% CI: 1.15–2.21, p = 0.005). Disease severity based on MGFA postintervention status (MGFA‐PIS) was higher in thymomatous patients at 1 year, 5 years, and the end of follow‐up. Treatment refractoriness and mortality were also higher (OR: 2.28, 95% CI: 1.43–3.63, p = 0.001; hazard ratio: 2.46, 95% CI: 1.47–4.14, p = 0.001). Myasthenic symptoms worsened in 13 of 27 patients with recurrences, but differences in long‐term severity were not significant. Fifteen thymomatous patients had nonresectable thymomas with worse MGFA‐PIS and higher mortality at the end of follow‐up. Conclusions: Thymoma‐associated MG patients had more severe myasthenic symptoms and worse prognosis. Thymoma recurrence was frequently associated with transient worsening of MG, but long‐term prognosis did not differ from nonrecurrent thymoma. Patients with nonresectable thymoma tended to present severe forms of MG. [ABSTRACT FROM AUTHOR]

Abstract Background We previously reported risk haplotypes for two genes related with serotonin and dopamine metabolism: MAOA in migraine without aura and DDC in migraine with aura. Herein we investigate the contribution to migraine susceptibility of eight additional genes involved in dopamine neurotransmission. Methods We performed a two-stage case-control association study of 50 tag single nucleotide polymorphisms (SNPs), selected according to genetic coverage parameters. The first analysis consisted of 263 patients and 274 controls and the replication study was composed by 259 cases and 287 controls. All cases were diagnosed according to ICHD-II criteria, were Spanish Caucasian, and were sex-matched with control subjects. Results Single-marker analysis of the first population identified nominal associations of five genes with migraine. After applying a false discovery rate correction of 10%, the differences remained significant only for DRD2 (rs2283265) and TH (rs2070762). Multiple-marker analysis identified a five-marker T-C-G-C-G (rs12363125-rs2283265-rs2242592-rs1554929-rs2234689) risk haplotype in DRD2 and a two-marker A-C (rs6356-rs2070762) risk haplotype in TH that remained significant after correction by permutations. These results, however, were not replicated in the second independent cohort. Conclusion The present study does not support the involvement of the DRD1, DRD2, DRD3, DRD5, DBH, COMT, SLC6A3 and TH genes in the genetic predisposition to migraine in the Spanish population.

The evaluation of the ocean energy balance is crucial for improving the fundamental understanding of the mechanisms sustaining ocean circulation. Based on the outputs of the ROMS ocean model, the energy cycle, eddy-mean flow interactions, and energy pathways of the deep Gulf of Mexico (GoM) have been investigated in this study. The theoretical framework for the analysis is based on the energy equations for the time-mean and time-varying flow, where some of the terms were split into their horizontal and vertical components to monitor the energy pathways. Of the energy maintaining deep kinetic energy (KE), approximately 75% is transferred from the upper layer to the deep layer by vertical pressure work (PW), about6%by the horizontal PW through the Yucatan and Florida straits, and ;19% is generated through the processes related to baroclinic instabilities. The mean circulation generates eddies in the upper layer, while eddies drive mean circulation in the deep layer. Energy is transferred downward in the eastern and western part of the Gulf, upward in the deep western-central part, and a strong westward energy transport can be observed below 2000-m depth. [ABSTRACT FROM AUTHOR]

Continental shelves are the most productive areas in the seas with the strongest implications for global nitrogen cycling. The Yucatán shelf (YS) is the largest shelf in the Gulf of Mexico (GoM); however, its nitrogen budget has not been quantified. This is largely due to the lack of significant spatio-temporal in situ measurements and the complexity of the shelf dynamics, including coastal upwelling, coastal-trapped waves (CTWs), and influence of the Yucatán Current (YC) via bottom Ekman transport and dynamic uplift. In this paper, we investigate and quantify the nitrogen budget of dissolved inorganic nitrogen (DIN) and particulate organic nitrogen (PON) in the YS using a 9-year output from a coupled physical–biogeochemical model of the GoM. The sum of DIN and PON is here referred to as total nitrogen (TN). Results indicate that the main entrance of DIN is through its southern (continental) and eastern margins. The TN is then advected to the deep oligotrophic Bay of Campeche and central GoM. It is also shown that the inner shelf (bounded by the 50 m isobath) is "efficient" in terms of TN, since all DIN imported into this shelf is consumed by the phytoplankton. Submarine groundwater discharges (SGDs) contribute 20 % of the TN, while denitrification removes up to 53 % of TN that enters into the inner shelf. The high-frequency variability of the TN fluxes in the southern margin is modulated by fluxes from the YC due to enhanced bottom Ekman transport when the YC leans against the shelf break (250 m isobath) on the eastern margin. This current–topography interaction can help to maintain the upwelling of Cape Catoche, uplifting nutrient-rich water into the euphotic layer. The export of TN at both western and northwestern margins is modulated by CTWs with a mean period of about 10 d in agreement with recent observational and modelling studies. [ABSTRACT FROM AUTHOR]

Continental shelves are the most productive areas in the seas with strongest implications for global Total Nitrogen (TN) cycling. The Yucatan shelf is the largest shelf in the Gulf of Mexico (GoM), however, its general TN budget has not been quantified. This is largely due to the lack of significant spatio-temporal in situ measurements and the complexity of the shelf dynamics, including the Yucatan Current, coastal upwelling, Coastal Trapped Waves (CTWs) and bottom Ekman transport. Through a nine years output of a coupled physical-biogeochemical model of the GoM, the TN budget in the Yucatan shelf is quantified. Results indicate that the main entrance of inorganic nitrogen is through its southern and eastern margins. The TN is then advected to the oligotrophic deep GoM and to the deep Campeche bay. The analysis also shows that the inner shelf (50m isobath) is efficient in terms of TN, since all the DIN imported into the shelf is consumed by the phytoplankton. Rivers contribute 20% of the TN, while denitrification removes up to 53% of TN that enters into the inner shelf. The high-frequency variability of the TN fluxes are modulated by the Yucatan Current in the south and by bottom Ekman transport produced by this current against the shelf-break (250m isobath) in the east. This current-topography interaction can help to maintain the upwelling of Cape Catoche, uplifting nutrient-rich water into the euphotic layer. The export of TN at both western and northwestern margins is modulated by CTWs with a mean period of 10 days in agreement with recent observational and modelling studies. [ABSTRACT FROM AUTHOR]

Background Mutations in the metalloendopeptidase (MME) gene were initially identified as a cause of autosomal recessive charcot-Marie-tooth disease type 2 (CMT2). Subsequently, variants in MME were linked to other late-onset autosomal dominant polyneuropathies. thus, our goal was to define the phenotype and mode of inheritance of patients carrying changes in MME. Methods We screened 197 index cases with a hereditary neuropathy of the CMT type or distal hereditary motor neuropathy (DHMN) and 10 probands with familial amyotrophic lateral sclerosis (FALS) using a custom panel of 119 genes. in addition to the index case subjects, we also studied other clinically and/or genetically affected and unaffected family members. results We found 17 variants in MME in a total of 20 index cases, with biallelic MME mutations detected in 13 cases from nine families (three in homozygosis and six in compound heterozygosis) and heterozygous variants found in 11 families. all patients with biallelic variants had a similar phenotype, consistent with lateonset axonal neuropathy. conversely, the phenotype of patients carrying heterozygous mutations was highly variable [CMT type 1 (CMT1), CMT2, dHMN and FALS] and mutations did not segregate with the disease. Conclusion MME mutations that segregate in an autosomal recessive pattern are associated with a lateonset CMT2 phenotype, yet we could not demonstrate that MME variants in heterozygosis cause neuropathy. Our data highlight the importance of establishing an accurate genetic diagnosis in patients carrying MME mutations, especially with a view to genetic counselling. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate whether the clinical benefit and relapse rates in anti‐muscle‐specific kinase (MuSK) myasthenia gravis (MG) differ depending on the protocol of rituximab followed. Methods: This retrospective multicentre study in patients with MuSK MG compared three rituximab protocols in terms of clinical status, relapse, changes in treatment, and adverse side effects. The primary effectiveness endpoint was clinical relapse requiring a further infusion of rituximab. Survival curves were estimated using Kaplan–Meier methods and survival analyses were undertaken using Cox proportional‐hazards models. Results: Twenty‐five patients were included: 11 treated with protocol 4 + 2 (375 mg/m2/4 weeks, then monthly for 2 months), five treated with protocol 1 + 1 (two 1 g doses 2 weeks apart), and nine treated with protocol 4 (375 mg/m2/4 weeks). Mean follow‐up was 5.0 years (SD 3.3). Relapse occurred in 18.2%, 80%, and 33.3%, and mean time to relapse was 3.5 (SD 1.5), 1.1 (SD 0.4), and 2.5 (SD 1.4) years, respectively. Based on Kaplan–Meier estimates, patients treated with protocol 4 + 2 had fewer and later relapses than patients treated with the other two protocols (log‐rank test P = 0.0001). Patients treated with protocol 1 + 1 had a higher risk of relapse than patients treated with protocol 4 + 2 (HR 112.8, 95% CI, 5.7–2250.4, P = 0.002). Patients treated with protocol 4 showed a trend to a higher risk of relapse than those treated with protocol 4 + 2 (HR 9.2, 95% CI 0.9–91.8, P = 0.059). Interpretation: This study provides class IV evidence that the 4 + 2 rituximab protocol has a lower clinical relapse rate and produces a more durable response than the 1 + 1 and 4 protocols in patients with MuSK MG. [ABSTRACT FROM AUTHOR]

Background: The aim of the research is to study the human leukocyte antigen (HLA) class II allele frequencies in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with anti-neurofascin 155 (NF155) antibodies.Methods: Thirteen anti-NF155+ and 35 anti-NF155 negative (anti-NF155neg) CIDP patients were included in a case-control study. The frequencies of the DRB1 HLA allele were analyzed in all patients while DQ frequencies were only studied in patients sharing the DRB1*15 allele. In silico HLA-peptide binding and NF155 antigenicity, predictions were performed to analyze overlap between presented peptides and antigenic regions.Results: DRB1*15 alleles (DRB1*15:01 and DRB1*15:02) were present in 10 out of 13 anti-NF155+ CIDP patients and in only 5 out of 35 anti-NF155neg CIDP patients (77 vs 14%; OR = 20, CI = 4.035 to 99.13). DRB1*15 alleles appeared also in significantly higher proportions in anti-NF155+ CIDP than in normal population (77 vs 17%; OR = 16.9, CI = 4.434 to 57.30). Seven anti-NF155+ CIDP patients (53%) and 5 anti-NF155neg CIDP patients had the DRB1*15:01 allele (OR = 7, p = 0.009), while 3 anti-NF155+ CIDP patients and none of the anti-NF155neg CIDP patients had the DRB1*15:02 allele (OR = 23.6, p = 0.016). In silico analysis of the NF155 peptides binding to DRB1*15 alleles showed significant overlap in the peptides presented by the 15:01 and 15:02 alleles, suggesting functional homology.Conclusions: DRB1*15 alleles are the first strong risk factor associated to a CIDP subset, providing additional evidence that anti-NF155+ CIDP patients constitute a differentiated disease within the CIDP syndrome. [ABSTRACT FROM AUTHOR]

Background: Studies have shown a slight excess risk in Guillain-Barré syndrome (GBS) incidence associated with A(H1N1)pdm09 vaccination campaign and seasonal trivalent influenza vaccine immunisations in 2009-2010. We aimed to assess the incidence of GBS as a potential adverse effect of A(H1N1)pdm09 vaccination. Methods: A neurologist-led network, active at the neurology departments of ten general hospitals serving an adult population of 4.68 million, conducted GBS surveillance in Spain in 2009-2011. The network, established in 1996, carried out a retrospective and a prospective study to estimate monthly alarm thresholds in GBS incidence and tested them in 1998-1999 in a pilot study. Such incidence thresholds additionally to observation of GBS cases with immunisation antecedent in the 42 days prior to clinical onset were taken as alarm signals for 2009-2011, since November 2009 onwards. For purpose of surveillance, in 2009 we updated both the available centres and the populations served by the network. We also did a retrospective countrywide review of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis from January 2009 to December 2011. Results: Among 141 confirmed of 148 notified cases of GBS or Miller-Fisher syndrome, Brighton 1-2 criteria in 96 %, not a single patient was identified with clinical onset during the 42-day time interval following A(H1N1)pdm09 vaccination. In contrast, seven cases were seen during a similar period after seasonal campaigns. Monthly incidence figures did not, however, exceed the upper 95 % CI limit of expected incidence. A retrospective countrywide review of the registry of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis did not suggest higher admission rates in critical months across the period December 2009-February 2010. Conclusions: Despite limited power and underlying reporting bias in 2010-2011, an increase in GBS incidence over background GBS, associated with A(H1N1)pdm09 monovalent or trivalent influenza immunisations, appears unlikely. [ABSTRACT FROM AUTHOR]

Introduction: Carotid-cavernous fistulae is an abnormal communication between the carotid artery and the cavernous sinus, it can be of spontaneous or traumatic origin and it can be classified in direct or indirect fistulae. Clinical case: Male patient, 62 years old, treated in neurosurgery service of University Hospital in Morón (Ciego de Ávila) with a diagnosis of direct traumatic carotid-cavernous fistulae. The treatment applied includes the intracavernous carotid trapping and vascular sacrifice technique. The results were satisfactory. Exophthalmos fully disappeared, but right amaurosis persist and a slight clinical recovery in left hemiparesis. Conclusions: The trapping and vascular sacrifice technique is a surgical option for selected patients with direct carotid-cavernous fistulae in hospital without endovascular treatment. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cubana de Neurología y Neurocirugía is the property of Sociedad Cubana de Neurologia y Neurocirugia 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 Cubana de Neurología y Neurocirugía is the property of Sociedad Cubana de Neurologia y Neurocirugia 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.)

ABSTRACT A hexanucleotide repeat expansion in chromosome 9 open reading frame 72 ( C 9orf72) can cause amyotrophic lateral sclerosis ( ALS) and/or frontotemporal dementia ( FTD). We assessed its frequency in 781 sporadic ALS (s ALS) and 155 familial ALS (f ALS) cases, and in 248 Spanish controls. We tested the presence of the reported founder haplotype among mutation carriers and in 171 Ceph Europeans from Utah ( CEU), 170 Yoruba Africans, 81 Han Chinese, and 85 Japanese subjects. The C 9orf72 expansion was present in 27.1% of f ALS and 3.2% of s ALS. Mutation carriers showed lower age at onset ( P = 0.04), shorter survival ( P = 0.02), greater co-occurrence of FTD ( P = 8.2 × 10−5), and more family history of ALS ( P = 1.4 × 10−20), than noncarriers. No association between alleles within the normal range and the risk of ALS was found ( P = 0.12). All 61 of the mutation carriers were tested and a patient carrying 28 hexanucleotide repeats presented with the founder haplotype. This haplotype was found in 5.6% Yoruba Africans, 8.9% CEU, 3.9% Japanese, and 1.6% Han Chinese chromosomes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cubana de Neurología y Neurocirugía is the property of Sociedad Cubana de Neurologia y Neurocirugia 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 Cubana de Neurología y Neurocirugía is the property of Sociedad Cubana de Neurologia y Neurocirugia 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.)

This article, based on research, shows the technological- based companies' intellectual capital (NEBTs) and its impact on knowledge assets management. These new companies share common features related with techno- scientific knowledge value as a critical asset. The community of Madrid has developed a research line based on intellectual capital reports as a strategic diagnosis for NEBTs. This qualitative study was made having a sample of 35 companies that are experiencing a consolidation period in this economic sector: information technology, natural feeding, environment, biotechnology and engineering. These companies are located in the so- called Madrid Scientific Park and Leganes Technological Park. The results of this study describe the importance of managing intangible assets as a way to approach scientific research and development (R & D) as a business deal, and to recognize the complexity and depth of the necessary innovation knowledge [ABSTRACT FROM AUTHOR]

The inference problem we consider is that of model choice from a nested sequence of binomial regression models. The approach we take is to test successively, from most general to most specific, the corresponding sequence of composite hypotheses. This approach is based on the very general class of divergence measures, the φ-divergence. An approximation to the power function of the new family of test statistics proposed is obtained. An extensive simulation study is carried out by obtaining new test statistics that are a good alternative to the traditional loglikelihood test statistic. [ABSTRACT FROM AUTHOR]

Abstract: Desminopathies represent a subtype of myofibrillar myopathy caused by mutations in the DES gene, which cause myofibril disruption and intracellular inclusions containing desmin and other protein components. Desminopathy mainly involves skeletal and cardiac muscle, separately or together. Both autosomal dominant and autosomal recessive inheritance have been reported. Here, we describe the second family identified to date with an L370P desmin mutation. The disease in this family shows autosomal dominant inheritance with a particular phenotype, where males suffer from sudden death of cardiac origin while females exhibit a more benign myopathy of distal onset and slower progression. Because the only family previously identified with this mutation was limited to one studied patient, the present kindred represents the largest clinical investigation of the phenotype associated with the L370P mutation. [Copyright &y& Elsevier]