Renogram in kidney transplant. Utility of delayed images with SPECT/CT in the diagnosis of urinary leak. / Renograma en trasplante renal. Utilidad de imágenes tardías con SPECT/TC para el diagnóstico de fuga urinaria.

Urinary leakage in patients with kidney transplantation is a relatively common surgical complication that requires early diagnosis and intervention. The isotopic renogram is a non-invasive and effective method to evaluate the perfusion and function of kidney transplantation, and allows us to diagnose urological complications such as urinary leakage. In these cases, it is useful to complete the study with planar images and delayed SPECT/CT to specify the diagnosis and locate the leak. We expose two cases diagnosed with urinary leak after performing a renogram with early and delayed planar images and delayed SPECT/CT a week after transplantation. In both cases, a percutaneous nephrostomy catheter was placed, as well as a double J catheter, resolving the surgical complication.

A computer-aided diagnosis of multiple sclerosis based on mfVEP recordings.

INTRODUCTION: The aim of this study is to develop a computer-aided diagnosis system to identify subjects at differing stages of development of multiple sclerosis (MS) using multifocal visual-evoked potentials (mfVEPs). Using an automatic classifier, diagnosis is performed first on the eyes and then on the subjects. PATIENTS: MfVEP signals were obtained from patients with Radiologically Isolated Syndrome (RIS) (n = 30 eyes), patients with Clinically Isolated Syndrome (CIS) (n = 62 eyes), patients with definite MS (n = 56 eyes) and 22 control subjects (n = 44 eyes). The CIS and MS groups were divided into two subgroups: those with eyes affected by optic neuritis (ON) and those without (non-ON). METHODS: For individual eye diagnosis, a feature vector was formed with information about the intensity, latency and singular values of the mfVEP signals. A flat multiclass classifier (FMC) and a hierarchical classifier (HC) were tested and both were implemented using the k-Nearest Neighbour (k-NN) algorithm. The output of the best eye classifier was used to classify the subjects. In the event of divergence, the eye with the best mfVEP recording was selected. RESULTS: In the eye classifier, the HC performed better than the FMC (accuracy = 0.74 and extended Matthew Correlation Coefficient (MCC) = 0.68). In the subject classification, accuracy = 0.95 and MCC = 0.93, confirming that it may be a promising tool for MS diagnosis. CONCLUSION: In addition to amplitude (axonal loss) and latency (demyelination), it has shown that the singular values of the mfVEP signals provide discriminatory information that may be used to identify subjects with differing degrees of the disease.

Diagnostic ability of multifocal electroretinogram in early multiple sclerosis using a new signal analysis method.

PURPOSE: To determine if a novel analysis method will increase the diagnostic value of the multifocal electroretinogram (mfERG) in diagnosing early-stage multiple sclerosis (MS). METHODS: We studied the mfERG signals of OD (Oculus Dexter) eyes of fifteen patients diagnosed with early-stage MS (in all cases < 12 months) and without a history of optic neuritis (ON) (F:M = 11:4), and those of six controls (F:M = 3:3). We obtained values of amplitude and latency of N1 and P1 waves, and a method to assess normalized root-mean-square error (FNRMSE) between model signals and mfERG recordings was used. Responses of each eye were analysed at a global level, and by rings, quadrants and hemispheres. AUC (area under the ROC curve) is used as discriminant factor. RESULTS: The standard method of analysis obtains further discrimination between controls and MS in ring R3 (AUC = 0.82), analysing N1 waves amplitudes. In all of the retina analysis regions, FNRMSE value shows a greater discriminating power than the standard method. The highest AUC value (AUC = 0.91) was in the superior temporal quadrant. CONCLUSION: By analysing mfERG recordings and contrasting them with those of healthy controls it is possible to detect early-stage MS in patients without a previous history of ON.

The asymmetry of dermatoglyphic finger ridge counts and the geographic altitude of the Jujenean population in northwest Argentina.

Asymmetry is omnipresent in the living world and therefore is a measure of developmental noise and instability. The main stressing agent in high-altitude ecosystems is hypobaric hypoxia. The variation in bilateral dermatoglyphic symmetry in populations from the Province of Jujuy in northwest Argentina is analyzed, and these results are compared to those for other populations with different ethnic and environmental backgrounds. Fingerprints were collected from 310 healthy students (140 males and 170 females) aged 18-20 years from three localities in Jujuy Province-Abra Pampa (3484 m above sea level), Humahuaca (2939 m above sea level), and San Salvador de Jujuy (1260 m above sea level). Asymmetry by sex was assessed based on radial and ulnar ridge counts to determine its pattern of variability (directional asymmetry [DA], fluctuating asymmetry [FA] and antisymmetry), and asymmetry and diversity indices were calculated. A bivariate plot and principal component analysis (PCA) were used to compare these indices with those for other populations. Homogeneity was found between populations and sexes when radial and ulnar ridges were counted. FA values did not show significant differences by locality or side (ulnar and radial), but significant differences were found by finger and sex, with males showing significantly greater FA values. The asymmetry and diversity indices clearly group the Andean populations and separate them from populations of different ethnic and geographic origin. Only the diversity index showed significant differences by locality in males, which suggests a substantially different genetic component in Abra Pampa male samples.

[Angina pectoris in the heart transplant recipient: evidence of reinnervation]. / Angina de pecho en el paciente con trasplante cardíaco: una evidencia de reinervación.

Heart transplantation involves the removal of a sick heart together with its innervation and replacement with a donor heart isolated from the control of the autonomous nervous system of the recipient, therefore being, functionally dennervated. Dennervation conditions several alterations in cardiac physiology, such as the inability to experience pain during myocardial ischemia, so that theoretically these patients cannot present angina pectoris. However, several reports have shown evidence of reinnervation with isolated cases of transplanted patients with angina pectoris having been reported. We describe the case of a transplanted patient who showed typical effort angina, vascular disease of the graft and data of sympathetic reinnervation demonstrated by cardiac gammagraphy with metayodo-benzilguanidina-I-123.

[Eight year history of neuroblastoma in an adult patient. Value of 123I-MIBG and 111In-DTPA-D-Phe-octreotide scintigraphy]. / Neuroblastoma de 8 años de evolución en paciente adulto: valor de la gammagrafía con 123I-MIBG y con 111In-DTPA-D-Phe-octreótido.

A case of a 30 year old male with an eight year history of neuroblastoma and whose general health was good is presented. After his last check-up, which included a CT scan and 99mTc-MDP bone scintigraphy, a 123I-MIBG and 111In-DTPA-D-Pheoctreotide scintigraphy was performed and provided us with complementary data that contributed to a more precise diagnosis of the location and extension of the neuroblastoma and to the biological features of the tumor. Thus, this report deals with an adult neuroblastoma patient whose general health is good in whom the exact extension of the lesion was determined by a combination of diagnostic imaging techniques.

[Neuropsychological assessment of memory in attention deficit hyperactivity disorder: the role of executive functions]. / Evaluación neuropsicológica de la memoria en el trastorno pordéficit de atención/hiperactividad: papel de las funciones ejecutivas.

INTRODUCTION: There is an important agreement on the consideration of attention deficit hyperactivity disorder (ADHD) as a condition characterized by neurodevelopmental dysfunction of fronto-striatal dopaminergic and noradrenergic circuits with resultant executive deficits in cognitive functioning. AIM: To assess the existence of memory deficits in children with ADHD associated with a poor performance executive. SUBJECTS AND METHODS: We assess 14 children diagnosed with ADHD combined type and 14 controls matched on intellectual coefficient, age and level of schooling, in a neuropsychological evaluation protocol designed to assess executive functions and memory skills using Auditory Verbal Learning Test, Memory for Stories Test -Test of Memory and Learning (TOMAL)-, Complex Figure Text, Visual Selective Reminding Test (TOMAL), Tower of Hanoi, Memory Phrases Test (Siegel and Ryan), Digit Span (Wechsler Intelligence Scale for Children-Revised) and Tapping Test (Wechsler Memory Scale III). RESULTS: The ADHD group showed deficits in the learning and free recall of verbal material, in procedural and working memory. No group differences were observed in the visual memory tasks. CONCLUSIONS: The results are analyzed in terms of difficulty in coding strategies, storage and search of information previously stored in the group with ADHD, at least for the kind of verbal information. These difficulties are associated with deficits in executive functioning.