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Introduction: Given the increasing prevalence of mental health problems in the general population, it is indispensable to use assessment tools aimed to assess the outcome of therapeutic interventions in order to refine the process of psychological rehabilitation., Method: We describe the process of adaptation into Spanish and a first psychometric study of the Young Person's- Clinical Outcomes in Routine Evaluation (YP-CORE), an instrument designed to measure the outcome in terms of general distress of therapeutic interventions in young people (11-16 years). 104 adolescents participated in the clinical and 131 in the non-clinical samples., Results: Analyses showed good levels of acceptability, adequate internal consistency and acceptable test-retest stability, with moderately high correlations between administrations. In addition, the instrument yielded significant correlations with all dimensions of the Youth Self Report, the highest being between both total scores. Crucially, discriminated between clinical and non-clinical samples and showed a small effect of age but a larger effect of gender, with higher scores for females. The Principal Component Analysis replicates the original structure. Cut-off scores to calculate the reliable and clinically significant change are provided., Conclusions: These results support initial use of the instrument though there are certain limitations that indicate the need for more research with larger and more representative samples, in which the psychometric properties of the instrument should be verified.

Objective: Determinate the frequency and the risk factors for Metabolic Syndrome in adults with diabetes mellitus, Hypertension and without Diabetes- Hypertension., Materials and Methods: We realized a cross-sectional study in patients of both sexes and older than 20 years of the "Hospital General de Zona 1 IMSS" in Colima, Mexico. The variables studied were: age, BMI, waist circumference, cigarette smoking, and family history of diabetes and hypertension, and biochemical parameters, such as glucose, HDL cholesterol and triglycerides., Results: A total of 417 persons were enrolled (170 men and 247 women), with an age average of 53.2 ± 13.4 years (age range, 20 to 86 years). The global frequency of the metabolic syndrome was 52.3 % (56 % in women and 46.4 % in men). While the MS frequency was 50 % in DM2, 42 % in hypertension, 80 % in DM2+hypertension and 28.2 % without DM2 and hypertension. The cigarette smoking frequency was 27.8 %, and it was an important risk factor for the totally of patients with MS, in DM2 and in DM2+hypertension., Conclusions: The frequency of MS in adults was 52.3 %, women were the most affected, and cigarette smoking was the most important risk factor.

Background: Solid plastic replicas of anatomical structures obtained by stereolithography from computed tomographic images and magnetic resonance imaging are being used as complementary tools for diagnostic purposes and therapy planning for diverse pathologies., Case Descriptions: Case 1--The spine mold of a 62-year-old man with neurologic compromise secondary to degenerative cervical disease was used to study the pathologic features of his spine and to plan and simulate the approach to remove osteophytes before surgery. Also, by examining the replica of his spine, the unconvinced patient was able to understand the nature of his pathology and realize that his neurologic symptoms would disappear only through surgery, as they did. Case 2--A 27-year-old woman had uncontrolled back and leg pain possibly related to anxiety and depression. She had undergone one unsuccessful lumbo-sacral surgery and was now obsessed with the thought that her second surgery, performed by us, likewise had failed, even though her magnetic resonance images proved otherwise. It was not until she held a replica of her repaired spine in her hands that she was able to understand that her pain was unfounded. Once she was able to relax, her chronic pain and anxiety disappeared within a month, using the same antidepressive treatment that formerly had been ineffective., Conclusions: Spine replicas are useful devices for diagnosis, planning, and simulating surgery, and they enable patients to understand the nature of their pathologies and the surgical procedures at hand.

Management of hemifacial spasm can actually be done medically, surgically and with Botulinum-A Toxin. The Botulinum-A Toxin treatment locally injected into the involved facial muscles offers a useful alternative to medical and surgical therapy. The objective of this study was to evaluate the efficacy of Botulinum-A Toxin for the treatment of hemifacial spasm in those subjects for whom the presently available medical therapy is inadequate. A total of 28 individuals were enrolled in the clinical study. Patients were evaluated using the Fahn's blepharospasm rating and disability scales. Efficacy was assessed by evaluating changes from the baseline in eyelid spasm intensity, brow spasm intensity, eyelid force and facial spasm intensity. All 28 subjects with hemifacial spasm showed clinical improvement in relation to this baseline, which was statistically significant. The mean decrease from baseline at their follow-up examination was statistically significant for all subjects and for all measurements: eyelid spasm changed from 2.3 to 0.3 (p = 0.0001); brow spasm from 1.9 to 0.1 (p = 0.0001); facial spasm from 2.3 to 0.1 (p = 0.0001) and eyelid force from 0.9 to -0.1 (p = 0.0020). We concluded that Botulinum-A Toxin provides a significant therapeutic benefit to patients with hemifacial spasm, without the risk of disabling side effects.

The possibility of altering the course of Parkinson's disease by brain grafting is slowly becoming a reality through the efforts of many research groups worldwide. It has been shown that this procedure, as performed in high-level medical research centers, usually produces no permanent adverse effects and can effectively ameliorate parkinsonian signs in certain patients. This progress has served to reinforce our commitment to develop neural transplantation into an effective therapy to treat such a devastating neurodegenerative disease. We have summarized the most important events that have shaped the initial phase of this research. In the course of the last 4 years, considerable knowledge has been gained in the clinical neurosciences regarding the real potential of various brain grafting procedures in treating Parkinson's disease, their shortcomings, and their usefulness in carefully selected patients. There is still no consensus regarding the various fundamental aspects of human brain grafting in Parkinson's disease. Questions concerning surgical technique, candidate selection, the optimal brain regions for implantation, the optimal tissue for implantation, and the real usefulness of brain grafting must be addressed. The importance of the quality of adrenal medulla fragments for grafting, the requirement for immunosuppressors in fetal brain grafting, and the optimal fetal age and the amount of donor tissue for effective grafting are additional areas of concern. The potential of xenografting, preserved tissues, and genetically engineered cells for human brain grafting remain unanswered. The development of human neural transplantation is the responsibility and privilege of neurosurgery.