Relevance of sampling and DNA extraction techniques for the analysis of salivary evidence from bite marks: a case report.

Bite mark evidence has been repeatedly found in criminal cases. Physical comparison of a bite mark to the teeth of available suspects may not always be possible. Experimental studies have shown that the analysis of DNA present in the saliva recovered from bite marks might help in the identification of individuals. However, the application of this approach to an actual criminal case has been reported only once before in forensic literature. Therefore, there is very limited scientific and technical information available on this subject. The current study focuses on a woman found dead in her home; the autopsy ruled the death to be a result of manual strangulation. A bite mark was found on each breast. The single swab technique was used to collect evidence from these bite marks, and an organic extraction method was employed for DNA isolation. Short tandem repeat (STR) sequence typing was performed using a commercially available kit, and the result was compared to the STR profile of a suspect. A full single-source STR profile was obtained from both bite marks, which matched the STR profile of the suspect. To the best of our knowledge, this is the second report on the analysis of DNA isolated from bite marks on the victim used to identify the crime perpetrator. Our results indicated that, contrary to most theoretical indications, a single swab technique for evidence collection and an organic method for DNA isolation could be very useful in solving this class of criminal cases.

Polymorphisms in GSTM1, GSTT1, GSTP1, and GSTM3 genes and breast cancer risk in northeastern Mexico.

Glutathione S-transferases (GSTs) are a family of phase II metabolizing enzymes involved in carcinogen detoxification and the metabolism of various bioactive compounds. Several genes that code for these enzymes are polymorphic in an ethnicity-dependent manner, with particular genotypes previously associated with an increased risk of breast cancer. The purpose of this study was to determine the frequencies of polymorphisms in the genes GSTM1, GSTT1, GSTP1, and GSTM3 and to investigate whether an association exists between these genes and breast cancer risk in subjects from northeastern Mexico. Genotypes were determined for 243 women with histologically confirmed breast cancer and 118 control subjects. Gene polymorphisms were analyzed using a DNA microarray. We found an increased breast cancer risk associated with the GSTM1 gene deletion polymorphism (OR = 2.19; 95%CI = 1.50-3.21; P = 0.001). No associations between the GSTT1, GSTP1, and GSTM3 genotypes and neoplasia risk were observed. In conclusion, we determined the genotype distribution of GST polymorphisms in control subjects and breast cancer patients from northeastern Mexico. The GSTM1 null genotype was associated with breast cancer risk. Our findings may be used to individualize breast cancer screening and therapeutic intervention in our population, which displays ethnic characteristics that differentiate it from other populations in Mexico.

[Fluorescence-guided resection with 5-aminolevulinic acid of an intramedullary tumor]. / Resección de tumor intramedular guiada por fluorescencia con ácido aminolevulínico.

Fluorescence-guided resection with 5-aminolevulinic acid (5-ALA) has demonstrated its usefulness in the resection of malignant cerebral gliomas. It also seems useful for the treatment of other types of cerebral and intramedullary neoplasms. We present the case of a patient with an intramedullary tumor in who fluorescence- guided resection was useful for intraoperative localization, definition of small tumor nodules and in order to achieve a complete resection of the tumor.

[Intramedullary schwannomas. Report of two cases]. / Neurinomas intramedulares. Presentación de dos casos de un tumor infrecuente.

Intramedullary schwannomas are benign tumors that arise from clusters of Schwann cells embedded in the medullary parenchyma. They are very rare and account for 0.3 to 1.5 % of all spinal schwannomas. It is not known for certain why this happens, and several theories have been put forward. They do not exhibit any characteristic clinical picture, being pain the most frequent symptom. Imaging is also not specific and the correct diagnosis is attained most of the times after pathological examination. The goal of treatment must be complete removal, which is curative. We are presenting two patients in whom an intramedullary tumor was removed. The true nature of the lesions was suspected during the operation, but only after pathological examination was confirmed. A review of the literature has been undertaken, with special attention to the theories about the origin of these uncommon tumors.

[Isolated mesencephalic stroke related to a ruptured intracranial dermoid cyst]. / Ictus isquémico mesencefálico aislado secundario a ruptura de quiste dermoide.

Dermoids cysts are embrionary benign lesions that comprise approximately 0.04-0.25% of all intracranial tumors. Occasionally they break and spread their content into subarachnoid space and/or lateral ventricles causing several acute or delayed symptoms. Debut of this type of tumor as acute stroke is poorly reflected in literature. We present a 26-year-old woman with a isolated mesencephalic infarct secondary to spontaneous rupture of a dermoid cyst. We discuss the possible pathophysiological mechanisms for this condition and review the literature.

[Remote cerebellar hemorrhage after lumbar spinal fluid drainage. Report of two cases and literature review]. / Hematomas de cerebelo como complicación de drenaje lumbar. Presentación de dos casos y revisión de la literatura.

Remote cerebellar hematoma, a cerebellar hematoma occurring after performing a surgical procedure in an anatomical distant area from the cerebellum, is a rare complication. It has been reported after supratentorial surgery and, less often, after spinal surgery with dural opening with important loss of cerebrospinal fluid. We report the occurrence of remote cerebellar hemorrhage after lumbar spinal fluid drainage in two patients with suspected normal pressure hydrocephalus. They were managed conservatively with good outcome. We review the pathologic mechanism, diagnostic procedures, management and prognosis of remote cerebellar hemorrhage.

[The effect of age on the prognosis of patients with traumatic brain injury who undergo a craniotomy: analysis of a surgical series]. / Efecto de la edad en el pronostico de pacientes con traumatismo craneoencefalico sometidos a craneotomia: analisis de una serie quirurgica.

INTRODUCTION: In our setting, the ageing of the population has led to management of traumatic brain injury (TBI) in the later stages of life becoming an increasingly frequent problem. AIM: To evaluate the association between age and the functional and survival prognosis of patients who have undergone surgery due to TBI. PATIENTS AND METHODS: We performed a retrospective analysis of a series of 404 patients submitted to surgery between the years 2000 and 2015: 144 youngsters (12-44 years), 77 adults (45-64 years), 148 geriatric patients (65-79 years) and 26 'super geriatric' patients (> 80 years). We reviewed the demographic and nosological characteristics of the population, the survival and functional prognosis (Glasgow Outcome Scale, GOS) on discharge and at six months. RESULTS: Age presents a positive linear association with both intra-hospital mortality and the proportion of patients with an unfavourable prognosis (GOS 1-3) on hospital discharge and at six months (p < 0.001). Taking the population of youngsters as a reference, the relative risk for an unfavourable prognosis at six months was 1.5 (95% CI: 1.04-2.19) for adults; 2.37 (95% CI: 1.77-3.17) for the geriatric patients; and 3.5 (95% CI: 2.63-4.7) for the 'super geriatric' patients. These latter present a mortality rate while in hospital of 77.78% and a percentage of poor functional prognosis at six months of 94.44%. CONCLUSION: Increased age is a major negative determining factor in the prognosis of patients who undergo a craniotomy due to TBI. More precise knowledge of these outcomes and an adequate pre-operative discussion with the family will be an invaluable aid in the decision-making process.

TITLE: Efecto de la edad en el pronostico de pacientes con traumatismo craneoencefalico sometidos a craneotomia: analisis de una serie quirurgica.Introduccion. En nuestro entorno, el envejecimiento poblacional ha convertido el manejo del traumatismo craneoencefalico (TCE) en etapas avanzadas de la vida en un problema de frecuencia creciente. Objetivo. Valorar la asociacion entre la edad y el pronostico vital y funcional de pacientes intervenidos por TCE. Pacientes y metodos. Analizamos retrospectivamente una serie de 404 pacientes intervenidos en nuestro centro entre los años 2000 y 2015: 144 jovenes (12-44 años), 77 adultos (45-64 años), 148 pacientes geriatricos (65-79 años) y 26 supergeriatricos (> 80 años). Revisamos las caracteristicas demograficas y nosologicas de la poblacion, y el pronostico vital y funcional (escala pronostica de Glasgow, GOS) en el momento del alta y a los seis meses. Resultados. La edad presenta asociacion lineal positiva tanto con la mortalidad intrahospitalaria como con la proporcion de pacientes con pronostico desfavorable (GOS 1-3) en el alta y a los seis meses (p < 0,001). Tomando como referencia la poblacion de jovenes, el riesgo relativo para pronostico desfavorable a los seis meses fue de 1,5 (IC 95%: 1,04-2,19) para los adultos, 2,37 (IC 95%: 1,77-3,17) para los geriatricos y 3,5 (IC 95%: 2,63-4,70) para los supergeriatricos. Estos ultimos presentan una mortalidad durante el ingreso del 77,78% y un porcentaje de mal pronostico funcional a los seis meses del 94,44%. Conclusion. El aumento de la edad es un factor determinante negativo mayor en el pronostico de pacientes sometidos a craneotomia por TCE. Un conocimiento preciso de estos resultados y una adecuada discusion preoperatoria con la familia resultaran de gran ayuda en el proceso de toma de decisiones.

Diffuse leptomeningeal seeding from benign choroid plexus papilloma.

Choroid plexus papillomas (CPP) are rare intracranial tumours with a favourable long-term outcome after surgical excision. Although they are histologically benign, local recurrences may occasionally occur, but leptomeningeal dissemination is exceptional. We report an unusual example of a fourth ventricle choroid plexus papilloma with diffuse leptomeningeal seeding. Neither the initial tumour nor the recurrence showed malignant histological features. Treatment with systemic and intrathecal chemotherapy was ineffective in this patient. We review the literature concerning leptomeningeal dissemination of benign choroid plexus papillomas.

[Chordoid glioma of the III ventricle. Case report and revision of the literature]. / Glioma cordoide del III ventrículo. Nuevo caso y revisión de la literatura.

Chordoid glioma of the third ventricle is an infrequent brain tumour that was described for the first time by Brat et al. in 1998; since then, only 39 cases have been reported. We present a new case of chordoid glioma of the third ventricle in a 51-year-old-man that was treated with total surgical removal, with a good initial postoperative evolution. Sudden death, most likely due to a massive pulmonary embolism, occurred in the third postoperative day. We present the histological characteristics of the tumour and review the literature regarding this entity.

[Calcified disc herniation in childhood]. / Hernias discales calcificadas en la infancia.

Calcification of intervertebral discs is a rare occurrence in children. Although the etiology of the calcification remains uncertain, it is no related with degenerative diseases. The clinical picture is non specific with neck pain, muscle contractures and, sometimes, low-grade fever. These symptoms generally disappear spontaneously, and surgery rarely becomes necessary. In our review of the literature, we have found only seventeen cases requiring surgical management. Two of these children had been previously diagnosed with calcified intervertebral discs, but at the time no herniation had been ruled out with magnetic resonance imaging (MRI). We report the case of a girl who was diagnosed, when she was ten years old, with intervertebral idiopatic calcifications. Four years later she presented with radiculopathy caused by the posterolateral displacement of a calcified cervical disc, which required operative management. We think that this case supports the theory of Heinrich et al. that considers that the calcified hernia is a complication of a previous pathology, namely intervertebral calcification. Clinical and therapeutic aspects of this entity are discussed.