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Producción Científica, Particularly evCerebrospinal fluid has shown itself to be an essential brain component during development. This is parident at the earliest stages of development where a lot of research, performed mainly in chick embryos, supports the evidence that cerebrospinal fluid is involved in different mechanisms controlling brain growth and morphogenesis, by exerting a trophic effect on neuroepithelial precursor cells (NPC) involved in controlling the behaviour of these cells. Despite it being known that cerebrospinal fluid in mammals is directly involved in corticogenesis at fetal stages, the influence of cerebrospinal fluid on the activity of NPC at the earliest stages of brain development has not been demonstrated. Here, using ‘‘in vitro’’ organotypic cultures of rat embryo brain neuroepithelium in order to expose NPC to or deprive them of cerebrospinal fluid, we show that the neuroepithelium needs the trophic influence of cerebrospinal fluid to undergo normal rates of cell survival, replication and neurogenesis, suggesting that NPC are not self-sufficient to induce their normal activity. This data shows that cerebrospinal fluid is an essential component in chick and rat early brain development, suggesting that its influence could be constant in higher vertebrates.

Presentamos el caso de un recién nacido femenino, con encefalocele occipital, diagnosticado en el período perinatal a las 29 semanas de gestación; atendido en los Servicios de Obstetricia y Neurocirugía del Hospital Universitario de Caracas. Se realizó una revisión la literatura dada la poca frecuencia de esta patología. We presente a case of female newborn child with occipital encephalocele diagnosed at 29 weeks of pregnancy; being attended in the Service of Obstetrics and Neurosurgery of the Hospital Universitario de Caracas. A literature review was done by infrecuent pathology.

Objetivo: Evaluar las características que determinan el grado de desarrollo de la vellosidad placentaria en los casos de las malformaciones del tubo neural. Ambiente: Laboratorio de microscopia electrónica del CIADANA, Maracay. Métodos: Se utilizó un protocolo de observación, usando la microscopía de luz, basado en los tipos de vellosidades y de membranas vásculosincitiales; incremento de citotrofoblastos, calcificación y puentes sincitiales en los casos de acraneo-excencefalia; cráneo-raquisquisis con trisomía 18, mielomeningocele con hidrocefalia asociada con otras malformaciones congénitas, mielomeningocele lumbar, anencefalia y malformación de Chiari tipo II apareando con controles a la misma edad gestacional sin malformaciones. Resultados: Las cifras en porcentaje de vellosidades maduras e inmaduras y de membranas vásculosincitiales periféricas o centrales exhiben variaciones según la malformación con predominio de inmaduras. Se encontró daño hipóxico velloso extenso. Conclusión: Estos resultados revelaron inmadurez vellosa persistente correspondiéndose con mala perfusión placentaria y disfunción de la capacidad de transferencia. Estos hallazgos son de interés cuando otros test como la determinación de alfafetoproteínas y estudios ultrasonográficos son empleados al brindar información adicional útil en el diagnóstico complementario. Objective: To evaluate the characteristics which determine the level of development of placental villi in the cases of defects of the neural tube. Setting: Laboratory of electron microscopy, CIADANA, Maracay. Methods: An observational protocol was performed with the use of light microscopy, based on the types of villi and vasculosyncytial membranes; increase of cytotrophoblast cells, calcification and syncytial bridges in the cases of acranium-excencephaly, cranium rachischisis-trisomy 18, mielomeningocelehydrocephaly with inherited malformations, mielomeningocele lumbar, anencephaly and Chiari II´s malformation. Controls without malformations and at the same gestational age were employed. Results: The percent of mature or immature villi and of peripheral or central vasculosyncytial membranes exhibited variability according to the malformation type with a predominance of immature villi. Extensive hypoxic villous damage was revealed. Conclusion: Lessen placental perfusion and dysfunction of the transfer capacity is correlated with persistent villous immaturity. These results are of interest when tests such as the determination of alphafetoproteins and ultrasonographic studies are employed in the complementary additional diagnostic.

Editorial. Reflexiones sobre el fraude científico en el ambiente universitario. Reflections on the scientific fraud in the academic environment. Salinas, Pedro José Rol del odontólogo en el diagnóstico precoz del Pénfigo vulgar. Reporte de un caso. Role of the dentist in early diagnosis of Phemphigus vulgaris. Case report. Burguera G., Liliana Ruiz A., Melina Arteaga A., Susana Trastornos cognoscitivos en pacientes con Diabetes mellitus tipo 2. Cognitive impairment in patients with Diabetes mellitus type 2. Urban national health clinics and I.V.S.S. Mérida 2004. Vielma, Marly Salinas, Pedro José Paredes, Gustavo Nava, Lisbeth Ramírez, Isabel El médico ante los derechos del paciente pediátrico. The physician and the pediatric patient rights. Flores, María Gabriela Guerrero, María del Valle Salinas, Perla R. González, Maury Comentarios acerca del artículo: "El médico ante los derechos del paciente pediátrico". Comments on the paper: "The physician and the pediatric patient rights". Pérez Manzaneda, David Enfalocele. Reporte de un caso. Encephalocele. A case report. Moncada, Carlos Colina, Adán. Misoprostol oral u oxitoxina para la expulsión del feto muerto intrauterino en el segundo trimestre. Oral misoprostol or oxytocin for the expusion of the intrauterine dead foetus, in the second trimester. Reyna Villasmil, Eduardo Guerra Velásquez, Mery Torres Montilla, Marielys Reyna VIllasmil, Nadia Mejia Montilla, Jorly Pentalogia de Cantrell. Reporte de un caso. Pentalogy of Cantrel. Case report. Moncada Rodríguez, Ivonelia Ortiz Díaz, Alliskair Velásquez, Olga Moncada Rodríguez, Carlos Tocoferol durante el primer trimestre en pacientes con riesgo de desarrollar preeclampsia. Tocoferol during first trimester of pregnacy in women at risk of developing preeclampsia. Reyna Villasmil, Eduardo Guerra Velásquez, Mery Torres Montilla, Marielys Reyna VIllasmil, Nadia Mejia Montilla, Jorly Fraude científico en el ambiente universitario. Scientific fraud in the academic environment. Salinas, Pedro José 25 - 28 moncadaro_carlos@hotmail.com adan.colina@gmail.com semestral Nivel analítico

Promocionar el consumo de ácido fólico en las mujeres de edad fértil para prevenir la ocurrencia de DTN.

CONTEXT AND OBJECTIVE: Anencephaly is considered to be the most common type of neural tube defect. Our aim was to assess the clinical and gestational features of a cohort of fetuses with suspected anencephaly. DESIGN AND SETTING: Population-based retrospective cohort study in a referral hospital in southern Brazil. METHODS: The sample consisted of fetuses referred due to suspected anencephaly, to the Fetal Medicine Service of Hospital Materno Infantil Presidente Vargas, between January 2005 and September 2013. Clinical, radiological, pathological and survival data were gathered. RESULTS: Our sample was composed of 29 fetuses. The diagnosis of suspected anencephaly was made on average at 21.3 weeks of gestation. Seven fetuses had malformations that affected other organs, and these included oral clefts (n = 4) and congenital heart defects (n = 2). In 16 cases, there was termination of pregnancy (n = 12) or intrauterine death (n = 4). Regarding those who were born alive (n = 13), all of them died in the first week of life. After postnatal evaluation, the diagnosis of anencephaly was confirmed in 22 cases (75.9%). Other conditions included amniotic band disruption complex (6.9%), microhydranencephaly (6.9%), merocrania (3.4%) and holoprosencephaly (3.4%). CONCLUSIONS: Different conditions involving the cranial vault may be confused with anencephaly, as seen in our sample. However, these conditions also seem to have a poor prognosis. It seems that folic acid supplementation is not being properly performed. CONTEXTO E OBJETIVO: A anencefalia é considerada o tipo mais comum de defeito de fechamento do tubo neural. Nosso objetivo foi avaliar as características clínicas e gestacionais de uma coorte de fetos com suspeita de anencefalia. TIPO DE ESTUDO E LOCAL: Estudo de coorte retrospectivo de base populacional em um hospital de referência no sul do Brasil. MÉTODOS: A amostra foi composta por fetos encaminhados por suspeita de anencefalia ao Serviço de Medicina Fetal do Hospital Materno Infantil Presidente Vargas, no período de janeiro de 2005 a setembro de 2013. Foi realizada coleta de dados clínicos, radiológicos, patológicos e de sobrevida. RESULTADOS: Nossa amostra foi composta por 29 fetos. A suspeita do diagnóstico de anencefalia foi realizada em média com 21,3 semanas de gestação. Sete fetos apresentavam malformações que afetavam outros órgãos, e incluíram fendas orais (n = 4) e defeitos cardíacos congênitos (n = 2). Em 16 casos houve interrupção da gravidez (n = 12) ou morte intrauterina (n = 4). Daqueles que nasceram vivos (n = 13), todos morreram na primeira semana de vida. Após a avaliação pós-natal, o diagnóstico de anencefalia foi confirmado em 22 casos (75,9%). Outras condições incluíram o complexo disruptivo de banda amniótica (6,9%), microhidranencefalia (6,9%), merocrania (3,4%) e holoprosencefalia (3,4%). CONCLUSÕES: Diferentes condições que envolvem a calota craniana podem ser confundidas com a anencefalia, como verificado em nossa amostra. No entanto, estas também parecem ter um prognóstico pobre. A suplementação com ácido fólico parece não estar sendo realizada de forma adequada.

Este artículo describe de forma comprehensiva parte del devenir histórico que han tenido, el conocimiento médico de los defectos del tubo neural (DTN) y el descubrimiento de la vitamina B9 o ácido fólico, así como algunos de los acontecimientos investigativos relevantes que a través de varios siglos definieron las relaciones entre la comprensión de la embriología del sistema nervioso central, el descubrimiento de la vitamina, la correlación del ácido fólico con la proliferación celular y finalmente el desarrollo de medidas preventivas de este tipo de defectos. Se pretende, a través de esta narrativa, exponer los conceptos históricamente relevantes que sustentan las acciones de índole clínico y de impacto poblacional que previenen los DTN a través del consumo preconcepcional de ácido fólico. This article gives a broad overview of part of the historical evolution of medical knowledge about neural tube defects (NTD) and the discovery of vitamin B9 or folic acid, as well as some relevant research events that, over the course of several centuries, defined the relationships between the understanding of central nervous system embryology, the discovery of the vitamin, the correlation between folic acid and cell proliferation and lastly the development of preventive measures for this type of defects. This narrative allows us to examine historically relevant concepts underlying clinical actions with a populational impact that prevent NTDs via folic acid consumption prior to conception.