Illusory Body Ownership Affects the Cortical Response to Vicarious Somatosensation.

Fundamental human feelings such as body ownership ("this" body is "my" body) and vicariousness (first-person-like experience of events occurring to others) are based on multisensory integration. Behavioral links between body ownership and vicariousness have been shown, but the neural underpinnings remain largely unexplored. To fill this gap, we investigated the neural effects of altered body ownership on vicarious somatosensation. While recording functional brain imaging data, first, we altered participants' body ownership by robotically delivering tactile stimulations ("tactile" stroking) in synchrony or not with videos of a virtual hand being brushed ("visual" stroking). Then, we manipulated vicarious somatosensation by showing videos of the virtual hand being touched by a syringe's plunger (touch) or needle (pain). Only after the alteration of body ownership (synchronous visuo-tactile stroking) and specifically during late epochs of vicarious somatosensation, vicarious pain was associated with lower activation in premotor and anterior cingulate cortices with respect to vicarious touch. At the methodological level, the present study highlights the importance of the neural response's temporal evolution. At the theoretical level, it shows that the higher-level (cognitive) impact of a lower-level (sensory) body-related processing (visuo-tactile) is not limited to body ownership but also extends to other psychological body-related domains, such as vicarious somatosensation.

Seroprevalence and Vaginal Shedding of Herpes Simplex Virus Type 2 in Pregnant Adolescents and Young Women from Morelos, Mexico.

Adolescents and young people are particularly vulnerable to contracting STIs, including HSV-2; furthermore, vaginal shedding of HSV-2 during pregnancy can cause vertical transmission and neonatal herpes. To evaluate the seroprevalence of HSV-2 and vaginal HSV-2 shedding in adolescent and young pregnant women, a cross-sectional study was carried out in 496 pregnant women-adolescents and young women. Venous blood and vaginal exudate samples were taken. The seroprevalence of HSV-2 was determined by ELISA and Western blot. Vaginal HSV-2 shedding was assessed by qPCR of the HSV-2 UL30 gene. The seroprevalence of HSV-2 in the study population was 8.5% (95% CI 6-11), of which 38.1% had vaginal HSV-2 shedding (95% CI 22-53). Young women presented a higher seroprevalence of HSV-2 (12.1%) than adolescents (4.3%), OR = 3.4, 95% CI 1.59-7.23. Frequent alcohol consumption was significantly associated with HSV-2 seroprevalence, OR = 2.9, 95% CI 1.27-6.99. Vaginal HSV-2 shedding is highest in the third trimester of pregnancy, but this difference is not significant. The seroprevalence of HSV-2 in adolescents and young women is similar to that previously reported in other studies. However, the proportion of women with vaginal shedding of HSV-2 is higher during the third trimester of pregnancy, increasing the risk of vertical transmission.

Clinical heterogeneity in autoimmune acute liver failure.

AIM: To describe the outcome and prognosis in a cohort of patients with acute liver failure due to autoimmune hepatitis without liver transplantation. METHODS: A retrospective trial was conducted in 11 patients with acute liver failure due to autoimmune hepatitis who attended the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran. Demographic, biochemical and severity indexes, and treatment and outcome were assessed. RESULTS: Among the 11 patients, with a median age of 31 years, 72% had inflammatory response syndrome, and six patients received corticosteroids. The mortality rate within four weeks was 56%, and the one-year survival was 27%. In the survivors, severity indexes were lower and 83% received corticosteroids. CONCLUSION: We observed a relatively high survival rate in patients with acute liver failure due to autoimmune hepatitis. This survival rate could be influenced by severity of the disease and/or use of corticosteroids.

Pathophysiology of ascites and dilutional hyponatremia: contemporary use of aquaretic agents.

Ascites, the most common complication of cirrhosis, is associated with a poor quality of life, an increased risk of infection, and renal failure. Twenty percent of cirrhotic patients have ascites at the time of diagnosis, while 30% and 50% will develop ascites by 5 and 10 years, respectively. There are several factors that contribute to ascites formation in cirrhotic patients, these include splanchnic vasodilatation, arterial hypotension, high cardiac output, and decreased vascular resistance. These factors lead to ineffective intravascular volume (hyperdynamic state), impairment of renal function, and subsequent water and sodium retention, all of which lead to dilutional hyponatremia (serum sodium <130 mEq/L), one of the most important prognostic factors in these patients. In conclusion, the therapeutic objective is to improve sodium balance and circulatory function through non-pharmacological measures, such as dietary sodium and water restriction as well as bed rest. Spironolactone (100-400 mg/day) is the initial drug of choice, while loop diuretics (like furosemide, 40-60 mg/day) are frequently used as adjuvants. Recently, agent that interfere with the renal effects of vasopressin by inhibiting water reabsorption in collecting ducts and producing free water diuresis have been used. These agents are called aquaretics and can be useful in the treatment o ascites unresponsive to conventional therapy.

[Asymmetric pulmonary perfusion causing unilateral pulmonary edema as a complication of acute myocardial infarction]. / Perfusión pulmonar asimétrica como causa de edema agudo de pulmón unilateral complicando un infarto agudo de miocardio.

Acute unilateral pulmonary edema is an unusual clinical condition occasionally associated with severe mitral valve insufficiency. We describe a patient diagnosed as having unilateral pulmonary edema after an acute anterior myocardial infarction. Echocardiograms performed in the acute phase ruled out mitral insufficiency. A perfusion lung scan showed left-sided pulmonary hypoperfusion. The diagnosis of acquired hypoplasia of the left pulmonary artery tree was made by chest computed tomography. The pathogenesis and differential diagnosis are discussed.

Microscopic colitides: a single center experience in Mexico.

BACKGROUND/AIM: Microscopic colitis is characterized by chronic diarrhea and specific microscopic changes in a macroscopically normal colonic mucosa. In this paper, we report the clinical and histological features of a group of Mexican patients with microscopic colitis. MATERIALS AND METHODS: Patients were identified from 10 years of data in the pathology database of our institution. A pathologist reassessed all biopsy material. We included only patients who met strict histopathological criteria. Clinical data were obtained from medical records. RESULTS: Microscopic colitis was diagnosed in 26 cases. The female/male ratio was 1.8:1. The median age at diagnosis was 56.5 +/- 15.7 (range, 26-85) years. The most frequent symptoms were diarrhea in all, weight loss in 22 (84%), and abdominal pain in 18 (69%) patients. Sixteen (61%) patients reported associated diseases; autoimmune thyroid disorders were the most common. Drug-induced microscopic colitis was suspected in 12 (46%) patients. More than 80% of the treated patients improved or had clinical remission. CONCLUSION: Microscopic colitis is an uncommon colonic disease at our institution, representing less than 1% of the final diagnoses in mucosal colonic biopsies. It is the largest case series of microscopic colitis in the Mexican population.

Conducta conservadora ante el traumatismo esplénico / Conservative behavior in case of splenic traumatism

INTRODUCCIÓN. El bazo es el órgano que más frecuentemente se lesiona en los traumatismos abdominales. Fueron objetivos de este trabajo describir la conducta conservadora ante el traumatismo esplénico y determinar su frecuencia en el Hospital Pediátrico Juan Manuel Márquez, centro provincial de atencion al niño politraumatizado, donde se preconiza esta conducta por los beneficios que ofrece la preservación del bazo a la función inmunolópgica. MÉTODOS. Se realizó un estudio prospectivo con 36 pacientes con traumatismo esplénico que fueron tratados de forma conservadora teniendo como criterio principal la estabilidad hemodinámica del paciente. Se analizó edad, sexo, causa de lesión esplénica, lesiones asociadas, tratamiento conservador realizado, complicaciones y estadía hospitalaria. RESULTADOS. El traumatismo esplénico estuvo presente en el 66,6 por ciento de los traumatismos abdominales. Las causas más frecuentes fueron los accidentes de tránsito (50 por ciento), seguidos de las caídas desde alturas (33 por ciento). En el 89 por ciento de los pacientes se siguió una conducta conservadora: en el 88 por ciento de los casos se aplicó tratamiento médico conservador y en el 11 por ciento, métodos quirúrgicos de conservación esplénica. CONCLUSIONES. Todas las lesiones ocurrieron por traumatismos contusos. Las técnicas quirúrgicas utilizadas fueron dos esplenorrafias y una esplenectomía parcial. No hubo fallecidos y las complicaciones fueron mínimas, por lo que consideramos que la conducta conservadora del traumatismo esplénico es una modalidad de tratamiento segura en la infancia

INTRODUCTION. The spleen is the more frequent involved organ in the abdominal traumata. The aims of present paper were to describe the conservative behavior in case of splenic traumatism and to determine its frequency in the Juan Manuel Márquez Children University Hospital, provincial children center of care for poli-traumatism child, where this type of behavior is emphasized due to benefits offered by spleen preservation to the immunologic function. METHODS. A retrospective study was conducted in 36 patients presenting with splenic traumatism treated in a conservative way taking into account as main criterion the hemodynamic patient's stability. The age, sex, cause of splenic lesion, associated lesions, and conservative treatment, applied complications and hospital stay. RESULTS. Splenic traumatism was present in the 66,6 percent of abdominal traumata. The more frequent causes were the road accidents (50 percent), followed by falls from heights (33 percent). In the 89 percent of patients there was a conservative behavior: in the 88 percent a conservative medical treatment was applied and in the 11 percent surgical methods of splenic conservation were used. CONCLUSIONS. Total of lesions occurred due to bruise traumatisms. Surgical techniques used were two splenorrhaphies and a partial splenectomy. There were not deceased and complications were minimal, thus, we considered that conservative behavior of splenic traumatism is a safe treatment modality in childhood

[Peptic stricture of the esophagus: long term outcome of conservative treatment]. / Estenosis péptica del esófago: resultados alejados del tratamiento conservador.

BACKGROUND: Endoscopic dilatation of esophageal strictures is a simple and safe procedure. AIM: To analyze the long term outcome of conservative treatment for esophageal peptic stricture in patients with high surgical risk. PATIENTS AND METHODS: Twenty consecutive patients, 13 male, whose mean age was 75.2 years, with a peptic stricture of the esophagus and high surgical risk were prospectively studied. All were subjected to endoscopic esophageal dilatation and treated with continuous medical antireflux therapy thereafter. RESULTS: Only five patients complied with antireflux treatment on a regular basis. The remaining 15 were non compliant or abandoned it. A total of 56 dilatations were done (mean 2.8 per patient, range 1-6). No complications were observed after the procedure. With a mean follow up period of 49 months, the outcome of the conservative treatment was classified as excellent or good in all the cases. Eight patients (40%) died of causes unrelated to the treatment. Two patients had an organic foreing body impactation. This situation was solved endoscopically in both. CONCLUSION: In high risk patients, endoscopic dilatation, with or without regular antireflux medical treatment is a simple, safe and effective therapy in the management of peptic oesophagel stenosis.