Multiple sclerosis prevalence in Malaga, Southern Spain estimated by the capture-recapture method.

BACKGROUND: Although not definitively proven, there is commonly accepted to be a latitudinal gradient in the distribution of multiple sclerosis (MS), which is more frequent in temperate zones. The European Mediterranean countries are situated in a zone of median frequency, although ever increasing figures have been noted in the last decades. OBJECTIVE: The objective of this study was to assess the current prevalence rate of MS in the province of Malaga, Southern Spain. METHODS: The capture-recapture method (CRM) uses independent sources of data and permits the number of non-registered cases of a given disease to be estimated, and by doing so, to avoid ascertainment bias. RESULTS: Use of this method showed the estimated prevalence rate of MS in the province of Malaga, Southern Spain, to be 125/10(5) (95% confidence interval: 102/10(5)-169/10(5)), higher than the figures published previously. CONCLUSIONS: Although we recognize that these data need to be confirmed in further studies and in other areas of the country using a similar method, we believe this study is the first to find such high figure of prevalence, being very similar to the figures reported in recent years in other southern European countries.

Structural characterization and stability of dimethylaminoethanol and dimethylaminoethanol bitartrate for possible use in cosmetic firming.

2-Dimethylaminoethanol (DMAE) (also known as deanol) has been used as an ingredient in skin care, and in cognitive function- and mood-enhancing products. It is marketed as a free base or salt, and in theory, the two forms should be equally effective and able to substitute for each other in pharmaceutical formulations. Detecting possible alterations in the active principle is a basic part of preformulation studies. Accordingly, this study compared DMAE and DMAE bitartrate to identify potential alterations or differences between the free base and the salt that might compromise the long-term stability of cosmetic preparations at different temperatures, and also compared the behavior of the base substance and derivative alone and in solution. Samples were analyzed with different physicochemical methods such as differential scanning calorimetry, ultraviolet and infrared spectroscopy, and nuclear magnetic resonance spectroscopy.

[Frontal dementia-motor neuron disease: a case report and literature review]. / Demencia frontal-enfermedad de motoneurona. Presentación de un caso y revisión de la literatura.

The association between frontal dementia and motor neurone disease has been known for years now although its existence as a nosologic entity in its own right is still subject to debate. Lack of strict histological criteria and inspecificity in complementary tests which might otherwise lend weight to such a diagnosis prevent our considering it as much more than a mere clinical syndrome. We present here the case of a 56 year old female patient who developed a type of dementia with frontal characteristics associated with motor neurone disease. We discuss the clinical picture and review the relevant literature.

[Membranous glomerulonephritis. Experience at the Instituto Nacional de la Nutrición Salvador Zubirán]. / Glomerulonefritis membranosa. Experiencia en el Instituto Nacional de la Nutrición Salvador Zubirán.

The purpose of this retrospective study was to study the incidence of idiopathic and secondary forms of membranous nephropathy in our institution, its clinical course and progression to chronic renal failure, and the risk factors associated with it. Two hundred fourteen (16%) of the 1,287 renal biopsies obtained between 1962 and 1988 were primary glomerular diseases and 28 of this 214 (13%) were idiopathic membranous nephropathy. On the other hand 59 of 1,287 biopsies were membranous nephropathy of whom 28 were idiopathic, 27 secondary to systemic lupus erythematosus, 2 due to drugs, one associated with rheumatoid arthritis, and one more with breast cancer. The clinical picture was: nephrotic syndrome in 84%, hypertension in 15%, non-nephrotic proteinuria in 14%, chronic renal failure in 8.4%, and renal vein thrombosis in 6.3%. In the idiopathic group 75% of the patients were male while in the lupus group 85% were female. For the analysis of progression to chronic renal failure we excluded 5 patients with renal failure when the biopsy was taken, 2 because the nephropathy was due to drugs, one associated with breast cancer, and nine were within the first year of follow-up. Thus, for this analysis the group consisted of 22 patients with idiopathic form and 20 with systemic lupus erythematosus. The idiopathic and lupus groups were similar except for a lower serum albumin in the former. The progression to renal failure was seen in 9 patients: six in the idiopathic group and the other 3 in the lupus group; this difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnosis, prevention and treatment of renal and urinary tract lithiasis]. / Diagnóstico, prevención y tratamiento de la litiasis renal y de vías urinarias.

Kidney and urinary stone disease is a major public health problem which requires a systemic clinical and biochemical evaluation to establish a precise diagnosis and well oriented therapy. This study reviews the results of a protocol designed to establish the metabolic abnormalities that occurred in 626 consecutive renal stone patients studied in two periods; group I (1979-1987) 441 cases and group II (1987-1989) 185 cases. The group I included the following determinations before and after a five day oral calcium load: serum and 24 hr urine electrolytes, divalent cations, phosphate, uric acid, cystine, glomerular filtration rate, parathyroid function evaluation with PTH and Tm Phosphate and since 1982 also (Ia) cAMP. In group II we also determined inhibitors of crystallization (magnesium and citrate) and promoters of nucleation (oxalate). In 185 cases of group I, we monitored months of follow up after metabolic evaluation and the number of stones formed per patient/year before and after treatment was begun. In group I we detected some variety of metabolic abnormality in 88.2 percent of our patients and in group II increased to 96.2 percent. A two year follow up was recorded in 55 percent and four year follow up in 39 percent of our cases. The stone/patient/year formation rate before treatment was 2.8 and significantly decreased to 0.8 after treatment. The highly diagnostic efficiency, the long term follow up and the adequacy of treatment significantly decreased stone activity in this group of patients. We concluded that this protocol should be included in the systematic evaluation of kidney stone patients.

[Prolonged therapeutic hypothermia after pericardial effusion drain surgery]. / Hipotermia terapéutica prolongada tras cirugía de drenaje de derrame pericárdico.

Therapeutic hypothermia is an effective treatment for neurological protection after out-of-hospital cardiac arrest, and may also be beneficial for in-hospital cardiac arrest. Its use is limited in post-surgical patients due to the risk of specific complications, particularly bleeding. There are significant differences among previous publications regarding the time to reach the target temperature and the duration of therapy, so the optimal strategy is not yet established. We present the case of a patient who suffered a perioperative cardiac arrest related to a pericardial tamponade, and who underwent therapeutic hypothermia for 48h.

Dental arch size, biting force, bizygomatic width and face height in three Colombian ethnic groups / Tamaño del arco dental, fuerza de mordida, anchura bizigomatica y altura facial en tres grupos étnicos colombianos

The objective of this study was to describe transversal dimensions of the dental arches, bite force and facial index in three ethnic groups representative of Colombia. The sample size included 197 adolescents, 12 to 14 year old, 33% mestizo, 35% of African ancestry and 32% Amazon Indian; 50.3% male and 49.7% female. The comparative analysis to determine differences between ethnic groups was made by the Kruskal Wallis test and then the Principal Component Analysis was used to establish the pattern of measurements identifying ethnic characteristics. All measurements showed statistically significant differences among ethnic groups except facial height (p=0.157). It was evidenced that Amazon indian have a higher bite force (p <0.05) than the other twoethnic groups. Regarding dental arch transversal dimensions, Amazon Indian have a higher arch transversal width with a length average of 44.1 mm. This length was greater than mestizo adolescents (M=36.7 mm) and Afroamerican (M=38.3 mm). In conclusion, the amazon Ticuna Indian ethnia has a significantly higher bite force, higher dental arch transversal width and higher bizygomatic width than the other two ethnic groups considered.

El objetivo fue describir las dimensiones transversales de los arcos dentales, la fuerza de mordida y el índice facial en tres grupos étnicos de Colombia. El tamaño de la muestra fue de 197 adolescentes, de 12 a 14 años; 33% mestizos, 35% de ascendencia africana y 32% indio amazónico; 50,3% hombres y 49,7% mujeres. El análisis comparativo para determinar las diferencias entre los grupos étnicos se hizo mediante la prueba de Kruskal Wallis y luego el Componente Principal de Análisis se utilizó para establecer el patrón de las mediciones para identificar las características étnicas. Todas las mediciones mostraron diferencias estadísticamente significativas entre los grupos étnicos, excepto la altura facial (p=0,157). Se evidencia que el indio amazónico tiene una mayor fuerza de mordida (p<0,05) que los otros dos grupos étnicos. En cuanto a las dimensiones transversales del arco dental, el indio amazónico se caracterizó por tener un mayor ancho, con una longitud media de 44,1 mm. Esta longitud es mayor que en los adolescentes mestizos (M=36,7 mm) y afroamericanos (M=38,3 mm). En conclusión, la etnia india amazónica Ticuna tiene una fuerza de mordida significativamente mayor, así como mayor ancho del arco dental transversal y ancho bicigomático que los otros dos grupos étnicos considerados.

Biotipo morfológico facial en tres grupos étnicos colombianos: una nueva clasificación por medio del índice facial / Facial biotype in three Colombian ethnic groups: a new classification by facial index

El objetivo de este estudio es evaluar el índice facial de tres poblaciones colombianas y proponer un nuevo método para identificar los biotipos morfológicos faciales teniendo en cuenta el tipo de ascendencia. Para esto, se tomaron las medidas de Nasion a Gnation y la distancia Bicigomática con un calibrador digital en tres grupos étnicos diferentes: 63 niños de la población Ticuna (Amazonas), 68 niños del municipio de Puerto Tejada (Cauca) y 65 niños del municipio de Santiago de Cali (Valle). Por medio de la prueba post hoc T2 de Tamhane se determinó que las poblaciones son distintas y que el índice morfológico facial tradicional no discriminaba esas diferencias. Por tal razón se utilizó el método estadístico de conglomerados difusos con el fin de determinar el número de grupos o biotipos para cada tipo de ascendencia. Se concluyó, que las poblaciones mestizas y afro-descendientes tienen similitudes por lo cual se agruparon juntas y el algoritmo c-medias generó cuatro biotipos característicos, mientras que para la población indígena Ticuna (Amazonas) solo se generaron tres biotipos.

The aim of this study is evaluate the facial index of three Colombian populations and propose a new method to identifythe facial morphological biotypes taking into account the type of ascendancy. For this, measures were taken of Nasion to Gnation and bizygomatic distance with a digital caliper in three ethnic groups: 63 children from Ticuna population (Amazonas), 68 children from municipality of Puerto Tejada (Cauca) and 65 children from municipality Santiago de Cali (Valle). Through the post hoc Tamhane's T2 was determined that the populations are different and the facial morphological index did not discriminate these differences. We used the statistical method of fuzzy clusters to determine the number of groups or biotypes for each type of ascendancy. We concluded that mixed populations and African descent have similarities, therefore they were grouped together and the c-means algorithm generated four biotypes characteristic, while the indigenous population Ticuna (Amazon) only generated three biotypes.

OAS1 gene haplotype confers susceptibility to multiple sclerosis.

Multiple sclerosis (MS) is associated with genetic susceptibility and unknown environmental triggers, possible viral infections, but the specific etiological mechanism that subsequently develops into an inflammatory/autoimmune cascade of events is poorly understood. Recently, genetic variants of 2',5'- oligoadenylate synthetase 1 (OAS1) gene, a critical enzyme involved in innate antivirus response, have been associated with differential enzyme activity and type 1 diabetes in both case-control and family studies. We hypothesized that polymorphisms in the OAS1 gene could influence the susceptibility to MS. To test this hypothesis, we conducted a case-control study of 333 patients with MS and 424 healthy controls and genotyped two OAS1 single nucleotide polymorphisms (SNPs) by restriction fragment length polymorphism method: rs 10774671, A/G SNP altering the splicing site at the seventh exon, and rs 3741981, a nonsynonymous (Ser162Gly) A/G SNP in the third exon. Haplotype but not single-marker analysis revealed an association of the haplotype created by the G allele at rs 10774671 and the A allele at rs 3741981 with the susceptibility to MS (P value = 8.8 x 10(-5)). Subjects carrying this haplotype had an increased risk of MS comparing with those not carrying it (odds ratio = 4.7, 95% confidence interval 2.1-10.9). Our findings indicate that the OAS1 gene polymorphisms may confer susceptibility to MS or serve as markers of functional variants and suggest that OAS1 activity is involved in the etiology of the disease. Future studies in a larger sample and association analysis with functional variants will clarify the role of the OAS1 gene in the susceptibility to MS.

HLA class II and response to interferon-beta in multiple sclerosis.

OBJECTIVE: To study the relationship between human leucocyte antigen (HLA) genotype and clinical response to interferon-beta (IFN-beta). METHODS: We analysed the HLA class II genotypes of 96 multiple sclerosis (MS) patients treated with IFN-beta. The patients were classified as responders or non-responders according to clinical criteria: one or more relapses or a sustained increase after 1 year treatment compared with the year prior to IFN-beta therapy of > or = 0.5 points on the Expanded Disability Status Scale (EDSS). RESULTS: There were 66 (69%) responders and 30 (31%) non-responders. Baseline clinical characteristics were similar. We found no association between HLA class II alleles and clinical response to IFN-beta. CONCLUSIONS: HLA genotype does not appear to influence the clinical response to IFN-beta in MS patients.

[SUNCT type headache. A report of a new case. Short-lasting, unilateral, neuralgiform, headache attacks with conjuctival injection and tearing]. / Cefalea tipo SUNCT. Aportación de un nuevo caso. Short-lasting, Unilateral, Neuralgiform, headache attacks with Conjuctival injection and Tearing.

We report a new case of short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). This rare headache, described in 1978, shares clinical traits with trigeminal neuralgia and cluster headache and its diagnostic classification as a unilateral headache with autonomic involvement has been the subject of considerable debate. The etiology of SUNCT is unknown, although it is considered a highly difficult pain to treat. We discuss our patient's symptoms and response to treatment with carbamazepine.

[Carotid artery dissection at the cervical level presenting as unilateral paresis of lower cranial nerves]. / Paresia de pares bajos unilateral como forma de presentación de disección carotídea cervical.

Internal carotid artery dissection at the cervical level is a known cause of stroke in young patients. The usual clinical presentation is strong ipsilateral cephalea and oculosympathetic paresis or ischemic symptoms in the affected artery. Paresis of the lower cranial nerves due to local compression in the space behind the parotid is rarely found and may complicate the diagnosis by leading physicians to look for anomalies in the vertebro-basilar territory. We present a patient with internal carotid artery dissection at the cervical level diagnosed by angiography. Symptoms at presentation were hemicranial cephalea accompanied by Villaret's syndrome. We point out the importance of keeping this diagnostic possibility in mind when looking for the etiology of subacute paresis of the lower cranial nerves.

[Partial Currarino syndrome in a non-pediatric patient. A rare cause of bacterial meningitis]. / Síndrome de Currarino incompleto en paciente no pediátrico. Una causa infrecuente de meningitis bacteriana.

Enterogenic meningitis is an infrequent cause of central nervous system infection. Among these causes the Currarino syndrome may be found presenting sacral agenesis, presacral mass and anorectal stenosis. This syndrome normally causes enterogenic meningitis in the early years of life. The case reported corresponds to a 24-year-old male presenting polymicrobial meningitis with fecal flora germs (anerobic enterococci, Bacteroides fragilis and Escherichia coli). These clinical findings led to radiologic lumbar study with the diagnosis of Currarino syndrome. The existence of neuroenteric fistulas justifies the development of fecal flora meningitis. The nosology of the syndrome as well as the therapeutic strategy are reviewed.