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Background: The HLA complex involved is a factor in the pathogenesis of leukemia., Objectives: The presence of class II HLA alleles DRB1 *, DQB1 *, DPA1 *, and DPB1 * was evaluated in 47 patients with acute lymphoblastic leukemia (ALL) and 48 with chronic myeloid leukemia (CML) for comparison with 48 healthy volunteers in Zulia, Venezuela, and to evaluate potential associations of HLA with leukemia., Methods: Low- and high-resolution PCR-SSP was used for class II HLA regions DRB1 *, DQB1 *, DPA1 *, and DPB1 * following the instructions of KIT Olerup SSP Genovision., Results: Alleles HLA-DRB1*14, especially DRB1*14:21, -DPA1*1:06, -DPA1*01:03,-DPA1*02:01, and the haplotypes HLA-DPA1*01:03-DPB1*04:01, DPA1*01:03-DPB1*02:01, DPA1*01:03-DPB1*99:01, -DRB1*14-DPA1*01:03, -DRB1*15-DPA1*01:03 were associated with CML (RR > 3); alleles HLA-DRB1*13, -DQB1*02, -DPA1*01:05, -DPA1*01:09 and the haplotypes HLA-DPA1*01:09-DPB1*02:01, DPA1*01:09-DPB1*04:01 were protective (RR < 1). Alleles HLA-DQB1*04, -DQB1*05, -DPA1*1:06, -DPA1*01:07, -DPA1*1:08 had a positive association with ALL. Alleles HLA-DPA1*01:09, -DPA1*02:01, -DPB1*02:01, -DPB1*03:01 and the haplotypes HLA-DPA1*01:03-DPB1*04:02, -DPA1*01:09-DPB1*02:01, -DPA1*01:09-DPB1*04:01, -DPA1*02:01-DPB1*04:02 were negatively associated., Conclusions: The other association patterns identified suggest marked differences in the pathogenesis of leukemia, which suggests possible deficiencies in antigen presentation for ALL or potential effects of molecular mimicry in CML.

Background: A possible interaction between a specific HLA type and Adenovirus has been postulated as a promoter in leukemia clonal evolution. The HLA-DRB1*14, specifically DRB1*14:21, 14:22, 14:45, 14:26, 14:33, 14:51, 14:35 subtypes was the most frequent in CML Venezuelan patients., Objectives: It is interesting to evaluate the molecular mimicry between the Adenovirus and the DRB1*14 subtypes which exhibit the same change in the amino acid position of the DR53 epitope. This mimicked segment has been identified as a LLERRRA polypeptide., Material and Method: Experimental research conducted in the IHO Venezuela, in peripheral blood samples of patients with ALL, CML and healthy controls. Mixed culture, serology, lymphocyte proliferation and cytofluorometry were performed., Results: DRB1*14 patient's lymphocytes reacted in 48 hours mixed culture against DRB1*14 promoters lymphocytes exhibiting increased CD8+T lymphocytes. CML patients show a different serological profile against Adenovirus. Only CML patients reacted to LLERRRA peptide, increasing CD8+ T cells., Conclusion: It is established that the relationship CML, HLADRB1* 14, autoreactive CD8+ T memory cell and CD8+T specific response from Adenovirus could be at the origin of the CML in Venezuelan patients.

We describe a 43-year-old patient who experienced visual loss 4 years after beginning antiepileptic therapy with topiramate. Ophthalmological and neurological examinations led to a preliminary diagnosis of bilateral toxic optic neuritis. Mitochondrial genome sequence analysis detected a Leber hereditary optic neuropathy 11778G>A mutation. The possibility that topiramate might favor a conversion disease, alerts physicians to seek a history of blindness in patients undergoing chronic antiepileptic therapy.

Objectives: In this study we investigated the effect of polarity-related differences in short-duration very low-intensity galvanic vestibular stimulation (GVS), not perceived by the subject, by evaluating the minimal postural sway responses in healthy people. We also verified its possible usefulness as a differential diagnostic tool in patients with postural instability disturbances related to polyneuropathy or peripheral vertigo., Methods: We applied bimastoid opposite polarity direct current GVS (0.7 mA for 1 s) and recorded the induced postural response with an electromagnetic head position tracker. Latency, amplitude, velocity and an asymmetry index were measured between two reverse polarity sessions., Results: The postural response was easily recorded and was statistically wider in amplitude and velocity in the polyneuropathy group than in the other groups. Postural responses were asymmetric only in the group with mild peripheral vertigo., Conclusion: These findings suggest that even weak GVS affects vestibular excitability: cathodal polarization increases whereas anodal GVS decreases excitability. Symmetry and amplitude or velocity of the postural responses, particularly in the eyes closed condition, can differentiate the three groups of subjects tested., (Copyright © 2010 The Authors. Journal compilation © 2010 Blackwell Munksgaard.)

Botulinum toxin type A (BoNT/A) has been proposed as an alternative treatment for sialorrhoea in patients with amyotrophic lateral sclerosis (ALS). In an open-label prospective study, BoNT/A was injected into the parotid glands bilaterally using anatomic landmarks in 26 ALS patients with bulbar symptoms. Two weeks after injection the severity of sialorrhoea and the related disability were evaluated subjectively and objectively. A group of healthy subjects acted as controls for saliva production. Patients also underwent electrophysiological tests to evaluate possible toxin effects in the nearby non-injected muscles by comparing the amplitude of compound motor action potentials (cMAPs) elicited by electrical stimulation and recorded from the orbicularis oculi and masseter muscles. After BoNT/A injections, of the 26 patients treated, 23 reported that the severity of sialorrhoea improved and the disabling symptoms diminished. Cotton roll weight also decreased after BoNT/A injection, suggesting a reduction in saliva production. Two patients complained of dry mouth. BoNT/A injection left the cMAP amplitude unchanged, suggesting that botulinum toxin does not significantly affect the non-injected facial and masticatory muscles. In conclusion, intraparotid anatomically-guided BoNT/A injection is an effective, easy, and safe treatment for sialorrhoea in patients with bulbar symptoms related to ALS.

Repetitive transcranial magnetic stimulation (rTMS) delivered in short trains at 5Hz frequency and suprathreshold intensity over the primary motor cortex (M1) in healthy subjects facilitates the motor-evoked potential (MEP) amplitude by increasing cortical excitability through mechanisms resembling short-term synaptic plasticity. In this study, to investigate whether rTES acts through similar mechanisms we compared the effects of rTMS and repetitive transcranial electrical stimulation (rTES) (10 stimuli-trains, 5Hz frequency, suprathreshold intensity) delivered over the M1 on the MEP amplitude. Four healthy subjects were studied in two separate sessions in a relaxed condition. rTMS and anodal rTES were delivered in trains to the left M1 over the motor area for evoking a MEP in the right first dorsal interosseous muscle. Changes in MEP size and latency during the course of the rTMS and rTES trains were compared. The possible effects of muscle activation on MEP amplitude were evaluated, and the possible effects of cutaneous trigeminal fibre activation on corticospinal excitability were excluded in a control experiment testing the MEP amplitude before and after supraorbital nerve repetitive electrical stimulation. Repeated measures analysis of variance (ANOVA) showed that rTES and rTMS trains elicited similar amplitude first MEPs and a similar magnitude MEP amplitude facilitation during the trains. rTES elicited a first MEP with a shorter latency than rTMS, without significant changes during the course of the train of stimuli. The MEP elicited by single-pulse TES delivered during muscle contraction had a smaller amplitude than the last MEP in the rTES trains. Repetitive supraorbital nerve stimulation left the conditioned MEP unchanged. Our results suggest that 5 Hz-rTES delivered in short trains increases cortical excitability and does so by acting on the excitatory interneurones probably through mechanisms similar to those underlying the rTMS-induced MEP facilitation.

The deep changes in values, beliefs and behaviour, both individual and group, have been examined, referred to the sexuality, by various methods and prospects. Sexual differentiation, typical of the plast, has been rediscussed and modified. As a result of these changes we can talk about old myths, concerning the conception of sexuality in the past, and new myths that concern the present. In this work we have reviewed the different aspects of male and female roles: masturbation, the obsession abort performance, the orgasm and, not last, the sexuality in old age condition.

The aim of the epidemiological psychiatric survey carried out among the users of the Mental Hygiene Centre of Avezzano local health district was to study the socio-demographic and clinical characteristics of participants. Data for patients for the years 1979 and 1989 were collected and analysed by studying all clinical records registered during those periods. This choice reflected the need compare user characteristics and methods of using the service following the introduction of the reform decree no. 180/1978. The aim of this retrospective epidemiological survey was to obtain data and information which would serve to formulate answers which responded to the needs expressed by users. The results revealed a heterogenous territorial distribution of psychiatric cases and this provided some indication for the realisation of a complex network of psychiatric network in the Avezzano health district.

The extradural lumbosacral localization represents for ependymomas an exceptional event full of interest both from an etiopathogenetic point of view and from a clinical one. Extradural ependymomas develop in two characteristic sites: with an anterior or presacral expression in the retro-rectal pelvic area; posterior in the intergluteal space below the lumbo-sacral fascia. The possibilities of a correct diagnosis are based essentially on radiographical examinations and CAT which supply useful factors, but not peculiar to the lesion. The Authors describe a case of posterior "extradural lumbo-sacral ependymomas" which is added to the 36 already reported.