A Computational Model for the Simulation of Prepulse Inhibition and Its Modulation by Cortical and Subcortical Units.

The sensorimotor gating is a nervous system function that modulates the acoustic startle response (ASR). Prepulse inhibition (PPI) phenomenon is an operational measure of sensorimotor gating, defined as the reduction of ASR when a high intensity sound (pulse) is preceded in milliseconds by a weaker stimulus (prepulse). Brainstem nuclei are associated with the mediation of ASR and PPI, whereas cortical and subcortical regions are associated with their modulation. However, it is still unclear how the modulatory units can influence PPI. In the present work, we developed a computational model of a neural circuit involved in the mediation (brainstem units) and modulation (cortical and subcortical units) of ASR and PPI. The activities of all units were modeled by the leaky-integrator formalism for neural population. The model reproduces basic features of PPI observed in experiments, such as the effects of changes in interstimulus interval, prepulse intensity, and habituation of ASR. The simulation of GABAergic and dopaminergic drugs impaired PPI by their effects over subcortical units activity. The results show that subcortical units constitute a central hub for PPI modulation. The presented computational model offers a valuable tool to investigate the neurobiology associated with disorder-related impairments in PPI.

The Impact of Motor, Non-Motor, and Social Aspects on the Sexual Health of Men Living with Parkinson's Disease.

Background: Sexual health (SH) is influenced by several biological, mental, and social factors that may be negatively impacted by Parkinson's disease (PD). Despite its prevalence and relevance for quality of life, the factors that affect SH in men with PD (MwPD) are still poorly understood. Objectives: To investigate the impact of motor, non-motor, and social aspects on the SH in MwPD. Methods: We conducted a cross-sectional study of 80 men (mean-age 53.55±10.8) in stages 1-3 of Hoehn and Yahr classification (H&Y), who reported having an active sex life in the last six months. The following data were collected for each person: 1) Demographic and clinical features; 2) global cognitive capacity (T-MoCA); 3) Non-Motor Aspects of Experiences of Daily Living (MDS-UPDRS, part I); 4) Motor Aspects of Experiences of Daily Living (MDS-UPDRS, part II); 5) Fatigue (FSS); 6) Self-esteem (RSES); 7) Sleep disorder (PDSS); 8) Couple relationship quality (DAS); 9) Depressive signals (BDI); 10) Short-term sexual health by International Index of Erectile Function (IIFE); and 11) Long-term sexual health by Sexual Quotient-Male (SQ-M). Results: Our results showed that although several motor, non-motor, and social factors were correlated with SH, only motor disability levels in daily living predicted short-term SH and erectile dysfunction, while only depression predicted long-term SH in MwPD. Age, disease onset, and medication daily dosage were not correlated with SH. Conclusions: Our findings confirm that multidimensional factors can affect the SH of MwPD and emphasize that only a multi-professional team can offer proper care to improve SH in MwPD.

A non-expensive bidimensional kinematic balance assessment can detect early postural instability in people with Parkinson's disease.

Background: Postural instability is a debilitating cardinal symptom of Parkinson's disease (PD). Its onset marks a pivotal milestone in PD when balance impairment results in disability in many activities of daily living. Early detection of postural instability by non-expensive tools that can be widely used in clinical practice is a key factor in the prevention of falls in widespread population and their negative consequences. Objective: This study aimed to investigate the effectiveness of a two-dimensional balance assessment to identify the decline in postural control associated with PD progression. Methods: This study recruited 55 people with PD, of which 37 were men. Eleven participants were in stage I, twenty-three in stage II, and twenty-one in stage III. According to the Hoehn and Yahr (H&Y) rating scale, three clinical balance tests (Timed Up and Go test, Balance Evaluation Systems Test, and Push and Release test) were carried out in addition to a static stance test recorded by a two-dimensional movement analysis software. Based on kinematic variables generated by the software, a Postural Instability Index (PII) was created, allowing a comparison between its results and those obtained by clinical tests. Results: There were differences between sociodemographic variables directly related to PD evolution. Although all tests were correlated with H&Y stages, only the PII was able to differentiate the first three stages of disease evolution (H&Y I and II: p = 0.03; H&Y I and III: p = 0.00001; H&Y II and III: p = 0.02). Other clinical tests were able to differentiate only people in the moderate PD stage (H&Y III). Conclusion: Based on the PII index, it was possible to differentiate the postural control decline among the first three stages of PD evolution. This study offers a promising possibility of a low-cost, early identification of subtle changes in postural control in people with PD in clinical practice.

Comparison of disability level between Early and Late Onset Parkinson's Disease using WHODAS 2.

Background: Parkinson's disease (PD) is a degenerative neurological disorder that usually affects people over the age of 60. However, 10%-20% of patients have an early onset of PD (EOPD). Objectives: To compare disability levels according to the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2) between people with EOPD and those with late-onset PD (LOPD). Methods: We conducted a cross-sectional study with 95 EOPD patients (mean-age 44.51 ± 4.63, H&Y 1.93 ± 0.93) and 255 LOPD patients (mean-age 63.01 ± 7.99, H&Y 2.02 ± 0.95). Demographic information, clinical characteristics, cognitive evaluation by Telephone-Montreal-Cognitive-Assessment (T-MoCA), functionality self-evaluation by WHODAS-2 and the Unified-Parkinson's-Disease-Rating-Scale (MDS-UPDRS), parts I and II, were documented for each patient by an individual remote interview. Results: Analysis showed a statistically significant difference between EOPD and LOPD in two domains of WHODAS-2 only: cognition (Z-adjusted = 2.60; p-value adjusted <0.009) and activities of daily living related to work/school (Z-adjusted = 2.34; p-value adjusted <0.01). T-MoCA scores confirmed more impaired cognition capacity in LOPD (Z-adjusted = 2.42; p-value adjusted <0.01). The two groups had no significant differences in levodopa daily dosage, Hoehn and Yahr (H&Y) stages, disease time duration, and MDS-UPDRS I and II scores. Conclusion: People living with EOPD face similar disability levels as those with LOPD, except for cognition, where LOPD patients exhibited higher levels of disability than EOPD and for work activities where the EOPD exhibited higher levels of disability than LODP. These results highlight the challenges faced by people with EOPD in interacting with society and living with the disease for a longer time. The WHODAS-2 can be a useful tool to assess disability and tailor interventions for people with PD of different age groups.

A non-expensive bidimensional assessment can detect subtle alterations in gait performance in people in the early stages of Parkinson's disease.

Background: Gait is one of the activities most affected by the symptoms of Parkinson's disease and may show a linear decline as the disease progresses. Early assessment of its performance through clinically relevant tests is a key factor in designing efficient therapeutic plans and procedures, which can be enhanced using simple and low-cost technological instruments. Objective: To investigate the effectiveness of a two-dimensional gait assessment to identify the decline in gait performance associated with Parkinson's disease progression. Methods: One hundred and seventeen people with Parkinson's disease, classified between early and intermediate stages, performed three clinical gait tests (Timed Up and Go, Dynamic Gait Index, and item 29 of the Unified Parkinson's Disease Rating Scale), in addition to a six-meter gait test recorded by a two-dimensional movement analysis software. Based on variables generated by the software, a gait performance index was created, allowing a comparison between its results with the results obtained by clinical tests. Results: There were differences between sociodemographic variables directly related to the evolution of Parkinson's disease. Compared to clinical tests, the index proposed to analyze gait showed greater sensitivity and was able to differentiate the first three stages of disease evolution (Hoehn and Yahr I and II: p = 0.03; Hoehn and Yahr I and III: p = 0.00001; Hoehn and Yahr II and III: p = 0.02). Conclusion: Based on the index provided by a two-dimensional movement analysis software that uses kinematic gait variables, it was possible to differentiate the gait performance decline among the three first stages of Parkinson's disease evolution. This study offers a promising possibility of early identification of subtle changes in an essential function of people with Parkinson's disease.

Prevalence of Obesity and Metabolic Syndrome in the High Cardiovascular Risk Setting of Rural Western Honduras.

Objective: To determine the prevalence of obesity and metabolic syndrome (MS) in the population older than 45 years in rural Western Honduras and contribute to the limited literature on MS in Central America. Methods: Descriptive cross-sectional study conducted in the District of Copan. The study includes 382 men and women aged 45 to 75 years. With proper consent, anthropometric parameters, blood pressure, blood sugar, and lipid profile were evaluated. MS was diagnosed by using the National Cholesterol Education Program Criteria - Adult Panel Treatment III (NCEP-ATP III). Data were stored in REDCap (Research Electronic Data Capture) and analyzed with STATA14. Results: Data were collected on 382 patients; of these, 38% were male and 62% female. The prevalence of obesity was 24.1% for both sexes. The prevalence of MS was 64.9%. Prevalence in males and females was 54% and 71%, respectively. Notable parameters were elevated triglycerides (71%), low High-density lipoprotein cholesterol (HDL-C) (63.4%), and abdominal obesity (56.8%). In men, the distribution of MS was more homogeneous, with a mean result of 80% amongst all ages. Conclusions: The overall prevalence of obesity and MS is severely underestimated in rural Honduras. The most remarkable parameter for MS was high triglycerides (71%). Sixty-nine percent of the population has above-normal Body Mass Index (BMI). Public health efforts to control comorbidities and tackle risk factors in this population should take utmost priority.

Recycling of crushed concrete and steel slag in drainage structures of geotechnical works and road pavements.

A crushed concrete aggregate, processed from construction and demolition waste and a siderurgical aggregate, processed from electric arc furnace steel slag, were selected based on their very high availability worldwide and known technical feasibility to be used in construction works. Given the association of their presence to the possibility of reducing the drainage capacity of unbound granular layers of road pavements and drainage structures which they may be associated with, there are studies and regulations that do not recommend their use. The causes that are at the origin of restrictions are mainly the possibility of formation of tufa and recementation phenomena. This behaviour has also hampered their recycling in drainage structures of geotechnical works. Therefore, it was considered that it would be relevant to investigate the drainage capacity of those recycled aggregates, using a leachate produced in a municipal solid waste landfill and tap water. To reference their behaviour, two natural aggregates, a basalt and a limestone, were also studied under identical test conditions. The results obtained showed no reduction in the drainage capacity of the recycled aggregates, similarly to what was observed with the natural aggregates. The possibility of building drainage structures with the tested aggregates is verified.

Effects of Altered Excitation-Inhibition Balance on Decision Making in a Cortical Circuit Model.

The synaptic balance between excitation and inhibition (E/I balance) is a fundamental principle of cortical circuits, and disruptions in E/I balance are commonly linked to cognitive deficits such as impaired decision-making. Explanatory gaps remain in a mechanistic understanding of how E/I balance contributes to cognitive computations, and how E/I disruptions at the synaptic level can propagate to induce behavioral deficits. Here, we studied how E/I perturbations may impair perceptual decision-making in a biophysically-based association cortical circuit model. We found that both elevating and lowering E/I ratio, via NMDA receptor (NMDAR) hypofunction at inhibitory interneurons and excitatory pyramidal neurons, respectively, can similarly impair psychometric performance, following an inverted-U dependence. Nonetheless, these E/I perturbations differentially alter the process of evidence accumulation across time. Under elevated E/I ratio, decision-making is impulsive, overweighting early evidence and underweighting late evidence. Under lowered E/I ratio, decision-making is indecisive, with both evidence integration and winner-take-all competition weakened. The distinct time courses of evidence accumulation at the circuit level can be measured at the behavioral level, using multiple psychophysical task paradigms which provide dissociable predictions. These results are well captured by a generalized drift-diffusion model (DDM) with self-coupling, implementing leaky or unstable integration, which thereby links biophysical circuit modeling to algorithmic process modeling and facilitates model fitting to behavioral choice data. In general, our findings characterize critical roles of cortical E/I balance in cognitive function, bridging from biophysical to behavioral levels of analysis.SIGNIFICANCE STATEMENT Cognitive deficits in multiple neuropsychiatric disorders, including schizophrenia, have been associated with alterations in the balance of synaptic excitation and inhibition (E/I) in cerebral cortical circuits. However, the circuit mechanisms by which E/I imbalance leads to cognitive deficits in decision-making have remained unclear. We used a computational model of decision-making in cortical circuits to study the neural and behavioral effects of E/I imbalance. We found that elevating and lowering E/I ratio produce distinct modes of dysfunction in decision-making processes, which can be dissociated in behavior through psychophysical task paradigms. The biophysical circuit model can be mapped onto a psychological model of decision-making which can facilitate experimental tests of model predictions.

NetPyNE Implementation and Scaling of the Potjans-Diesmann Cortical Microcircuit Model.

The Potjans-Diesmann cortical microcircuit model is a widely used model originally implemented in NEST. Here, we reimplemented the model using NetPyNE, a high-level Python interface to the NEURON simulator, and reproduced the findings of the original publication. We also implemented a method for scaling the network size that preserves first- and second-order statistics, building on existing work on network theory. Our new implementation enabled the use of more detailed neuron models with multicompartmental morphologies and multiple biophysically realistic ion channels. This opens the model to new research, including the study of dendritic processing, the influence of individual channel parameters, the relation to local field potentials, and other multiscale interactions. The scaling method we used provides flexibility to increase or decrease the network size as needed when running these CPU-intensive detailed simulations. Finally, NetPyNE facilitates modifying or extending the model using its declarative language; optimizing model parameters; running efficient, large-scale parallelized simulations; and analyzing the model through built-in methods, including local field potential calculation and information flow measures.

Conductance-based models and the fragmentation problem: A case study based on hippocampal CA1 pyramidal cell models and epilepsy.

Epilepsy has been a central topic in computational neuroscience, and in silico models have shown to be excellent tools to integrate and evaluate findings from animal and clinical settings. Among the different languages and tools for computational modeling development, NEURON stands out as one of the most used and mature neurosimulators. However, despite the vast quantity of models developed with NEURON, a fragmentation problem is evident in the great majority of models related to the same type of cell or cell properties. This fragmentation causes a lack of interoperability between the models because of differences in parameters. The problem is not related to the neurosimulator, which is prepared to reuse elements of other models, but related to decisions made during the model development, when it is not uncommon to adjust parameter values according to the necessities of the study. Here, this problem is presented by studying computational models related to temporal lobe epilepsy and the definitions of hippocampal CA1 pyramidal cells. The current assessment aims to highlight the implications of fragmentation for reliable modeling and the need to adopt a framework that allows a better interoperability between different models. This article is part of the Special Issue "NEWroscience 2018".

Binding of Filamentous Actin to CaMKII as Potential Regulation Mechanism of Bidirectional Synaptic Plasticity by ß CaMKII in Cerebellar Purkinje Cells.

Calcium-calmodulin dependent protein kinase II (CaMKII) regulates many forms of synaptic plasticity, but little is known about its functional role during plasticity induction in the cerebellum. Experiments have indicated that the ß isoform of CaMKII controls the bidirectional inversion of plasticity at parallel fibre (PF)-Purkinje cell (PC) synapses in cerebellar cortex. Because the cellular events that underlie these experimental findings are still poorly understood, we developed a simple computational model to investigate how ß CaMKII regulates the direction of plasticity in cerebellar PCs. We present the first model of AMPA receptor phosphorylation that simulates the induction of long-term depression (LTD) and potentiation (LTP) at the PF-PC synapse. Our simulation results suggest that the balance of CaMKII-mediated phosphorylation and protein phosphatase 2B (PP2B)-mediated dephosphorylation of AMPA receptors can determine whether LTD or LTP occurs in cerebellar PCs. The model replicates experimental observations that indicate that ß CaMKII controls the direction of plasticity at PF-PC synapses, and demonstrates that the binding of filamentous actin to CaMKII can enable the ß isoform of the kinase to regulate bidirectional plasticity at these synapses.

Optimal Interplay between Synaptic Strengths and Network Structure Enhances Activity Fluctuations and Information Propagation in Hierarchical Modular Networks.

In network models of spiking neurons, the joint impact of network structure and synaptic parameters on activity propagation is still an open problem. Here, we use an information-theoretical approach to investigate activity propagation in spiking networks with a hierarchical modular topology. We observe that optimized pairwise information propagation emerges due to the increase of either (i) the global synaptic strength parameter or (ii) the number of modules in the network, while the network size remains constant. At the population level, information propagation of activity among adjacent modules is enhanced as the number of modules increases until a maximum value is reached and then decreases, showing that there is an optimal interplay between synaptic strength and modularity for population information flow. This is in contrast to information propagation evaluated among pairs of neurons, which attains maximum value at the maximum values of these two parameter ranges. By examining the network behavior under the increase of synaptic strength and the number of modules, we find that these increases are associated with two different effects: (i) the increase of autocorrelations among individual neurons and (ii) the increase of cross-correlations among pairs of neurons. The second effect is associated with better information propagation in the network. Our results suggest roles that link topological features and synaptic strength levels to the transmission of information in cortical networks.

Modeling Hippocampal CA1 Gabaergic Synapses of Audiogenic Rats.

Wistar Audiogenic Rats (WARs) are genetically susceptible to sound-induced seizures that start in the brainstem and, in response to repetitive stimulation, spread to limbic areas, such as hippocampus. Analysis of the distribution of interevent intervals of GABAergic inhibitory postsynaptic currents (IPSCs) in CA1 pyramidal cells showed a monoexponential trend in Wistar rats, suggestive of a homogeneous population of synapses, but a biexponential trend in WARs. Based on this, we hypothesize that there are two populations of GABAergic synaptic release sites in CA1 pyramidal neurons from WARs. To address this hypothesis, we used a well-established neuronal computational model of a CA1 pyramidal neuron previously developed to replicate physiological properties of these cells. Our simulations replicated the biexponential trend only when we decreased the release frequency of synaptic currents by a factor of six in at least 40% of distal synapses. Our results suggest that almost half of the GABAergic synapses of WARs have a drastically reduced spontaneous release frequency. The computational model was able to reproduce the temporal dynamics of GABAergic inhibition that could underlie susceptibility to the spread of seizures.

Goalkeeper Game: A New Assessment Tool for Prediction of Gait Performance Under Complex Condition in People With Parkinson's Disease.

Background: People with Parkinson's disease (PD) display poorer gait performance when walking under complex conditions than under simple conditions. Screening tests that evaluate gait performance changes under complex walking conditions may be valuable tools for early intervention, especially if allowing for massive data collection. Objectives: To investigate the use of the Goalkeeper Game (GG) to predict impairment in gait performance under complex conditions in people with Parkinson's disease (PPD) and compare its predictive power with the one of the Montreal Cognitive Assessment (MoCA) test. Methods: 74 PPD (HY stages: 23 in stage 1; 31 in stage 2; 20 in stage 3), without dementia (MoCA cut-off 21), tested in ON period with dopaminergic medication were submitted to single individual cognitive/motor evaluation sessions. MoCA and GG were used to assess cognition, and the dynamic gait index (DGI) test was used to assess gait performance under complex condition. GG test resulted in 9 measures extracted via a statistical model. The predictive power of the GG measures and the MoCA score with respect to gait performance, as assessed by DGI, were compared. Results: The predictive models based on GG obtained a better score of prediction (65%) then MoCA (56%) for DGI scores (at a 50% specificity). Conclusion: GG is a novel tool for noninvasive screening that showed a superior predictive power in assessing gait performance under complex condition in people with PD than the well-established MoCa test.

Autochthonous Outbreak of Cutaneous Leishmaniasis due to Leishmania infantum in Corrientes Province, Argentina.

Endemic cutaneous leishmaniasis (CL) in northern Argentina has traditionally been caused by Leishmania braziliensis. This study aims to describe an outbreak of Leishmania infantum-caused human CL in the Department Capital of Corrientes Province, Argentina. We retrospectively analyzed the reported cases of CL in this area from May 2015 to December 2016. Eighty cases of CL were clinically and analytically diagnosed, and there was one case of visceral leishmaniasis in a boy who also had CL. Patients' median age was 33.6 years (range 1-89 years), and 18.5% were younger than 15 years; the male:female ratio was 3.5:1. Cases lived mostly in the municipality of Corrientes (72.8%), whereas 27.2% resided in Riachuelo. Although 67.9% had a single lesion, 32.1% had several. Molecular analyses showed that L. infantum was the causative species in all cases. Our results show that for the first time, there was an outbreak of CL by L. infantum in an urban area of Argentina.

Firing properties of ventral medullary respiratory neurons in sino-aortic denervated rats.

NEW FINDINGS: What is the central question of this study? After sino-aortic denervation (SAD), rats present normal levels of mean arterial pressure (MAP), high MAP variability and changes in breathing. However, mechanisms involved in SAD-induced respiratory changes and their impact on the modulation of sympathetic activity remain unclear. Herein, we characterized the firing frequency of medullary respiratory neurons after SAD. What is the main finding and its importance? Sino-aortic denervation-induced prolonged inspiration was associated with a reduced interburst frequency of pre-inspiratory/inspiratory neurons and an increased long-term variability of late inspiratory neurons, but no changes were observed in the ramp-inspiratory and post-inspiratory neurons. This imbalance in the respiratory network might contribute to the modulation of sympathetic activity after SAD. ABSTRACT: In previous studies, we documented that after sino-aortic denervation (SAD) in rats there are significant changes in the breathing pattern, but no significant changes in sympathetic activity and mean arterial pressure compared with sham-operated rats. However, the neural mechanisms involved in the respiratory changes after SAD and the extent to which they might contribute to the observed normal sympathetic activity and mean arterial pressure remain unclear. Here, we hypothesized that after SAD, rats present with changes in the firing frequency of the ventral medullary inspiratory and post-inspiratory neurons. To test this hypothesis, male Wistar rats underwent SAD or sham surgery and 3 days later were surgically prepared for an in situ experiment. The duration of inspiration significantly increased in SAD rats. During inspiration, the total firing frequency of ramp-inspiratory, pre-inspiratory/inspiratory and late-inspiratory neurons was not different between groups. During post-inspiration, the total firing frequency of post-inspiratory neurons was also not different between groups. Furthermore, the data demonstrate a reduced interburst frequency of pre-inspiratory/inspiratory neurons and an increased long-term variability of late-inspiratory neurons in SAD compared with sham-operated rats. These findings indicate that the SAD-induced prolongation of inspiration was not accompanied by alterations in the total firing frequency of the ventral medullary respiratory neurons, but it was associated with changes in the long-term variability of late-inspiratory neurons. We suggest that the timing imbalance in the respiratory network in SAD rats might contribute to the modulation of presympathetic neurons after removal of baroreceptor afferents.

Fracturas inusuales de la diáfisis del fémur por bifosfonatos. Reporte de caso clínico / Unusual fractures of the femoral shaft produced by bisphosphonates use. Case report

Existe una tendencia actual de presentación de fracturas de fémur atípicas en la población adulta. El tratamiento con bifosfonatos durante más de 5años puede poner a los pacientes en mayor riesgo. El objetivo del reporte es mostrar como con un dispositivo intramedular rígido puede mantenerse la posición y la longitud del fémur y a su vez mejorar la inestabilidad y el dolor en fracturas no desplazadas secundarias al uso de bifosfonatos. Se revisó el caso clínico de una paciente de 77años con cuadro clínico de 2meses de evolución de dolor moderado presente con la deambulación y que mejora en reposo. Se realizaron exámenes imagenológicos y se planificó la colocación del dispositivo intramedular rígido. Posteriormente se realizó una valoración clínica mediante la escala funcional de miembro inferior y se realizaron radiografías de control para determinar el grado de consolidación durante el tratamiento y la supresión del alendronato. Se realizó fijación con clavo intramedular gamma de segunda generación citando a control periódicamente a la paciente y suprimiendo la terapia con alendronato. A los 6meses de postoperatorio se aplicó la escala funcional de miembro inferior, obteniendo un resultado del 100%.

There is a growing trend of atypical femur fractures in the current adult population. Treatment with bisphosphonates for more than 5years may put patients at greater risk. The aim of this report is to demonstrate how surgical treatment with a rigid intramedullary device can maintain the position and length of the femur by improving stability and pain in non-displaced fractures secondary to the use of bisphosphonates. A review is presented on the clinical case of a 77year-old patient with moderate pain on walking of 2-months onset that improved with rest. After imaging tests were performed, it was decided to insert a rigid intramedullary device. The subsequent follow-up included a clinical assessment using the Lower Extremity Functional Scale (LEFS). Control X-rays were performed to determine the degree of consolidation during treatment, as well as the suspending of alendronate. Fixation was made with a second-generation gamma intramedullary nail, after which there was periodic monitoring and suspension of alendronate therapy. At 6months post-operatively, the LEFS was applied, obtaining a 100% result.

Uso de tornillos arponados de titanio en traumatología y ortopedia. Reporte de casos / Use of titanium harpoon screws in traumatology and orthopaedic surgery. Case report

Para determinar la eficacia en el uso de arpones de titanio en diferentes regiones de la anatomía humana se presenta una serie de casos de lesiones postraumáticas que afectan los miembros superiores e inferiores. La lesiones fueron identificadas mediante el uso de imágenes poder diagnosticar lesiones osteotendinosas o ligamentarias. Se utilizaron las escalas de DASH y AOFAS para evaluar los resultados del tratamiento. Posterior a la reinserción tendinosa al hueso y la recuperación anatómica en la zona afectada, los pacientes presentaron resultados excelentes y buenos con retorno a las actividades diarias con poca o ninguna modificación de las mismas. El uso de arpones de titanio en traumatología actualmente constituye un tratamiento con excelentes resultados postquirúrgicos dependiendo de la habilidad del especialista y su curva de aprendizaje.

In order to determine the effectiveness of the use of titanium harpoons in different regions of the human anatomy, a case report is presented of post-traumatic injuries affecting the upper and lower limbs. The injuries were identified through the use of images to diagnose osteotendinous or ligamentous lesions. The DASH and AOFAS scales were used to evaluate the results of the treatment. After the reinsertion of tendon to the bone and the anatomical recovery in the affected area, the patients showed excellent and good results with return to daily activities with little or no modification of them. The use of titanium harpoons in traumatology is currently a treatment with excellent post-surgical results, depending on the skill of the specialist and its learning curve.

Artroplastia total de rodilla con defecto angular extraarticular. Reporte de caso / Total knee arthroplasty with extra-articular angular deformity. Case report

Establecer cuales deformidades angulares en el fémur deben ser tratadas con resección ósea intraarticular inusual más artroplastia total de rodilla en artrosis tricompartimental de rodilla es uno de los retos mayores que se enfrenta en cirugía ortopédica. Presentamos el caso de un paciente masculino de 67 años de edad, con antecedente de fractura diafisaria de fémur hace 30 años tratada en forma conservadora con dolor en la rodilla izquierda de 2 años de evolución con un diagnóstico de artrosis tricompartimental de la rodilla asociada a genu valgum de 20° y consolidación viciosa en diáfisis femoral izquierda con valgo femoral de 10°. El tratamiento quirúrgico realizado fue utilizando cortes intraarticulares inusuales y artroplastia total de rodilla. De acuerdo a la escala propuesta por la Knee Society Score el paciente obtuvo 89 al año de la cirugía. Ante deformidades femorales de hasta 20°, suele ser suficiente realizar la corrección con los cortes óseos intraarticulares (inusuales) evitando afectar las inserciones ligamentarias femorales.

To establish the angular deformities in the femur that should be treated with unusual intra-articular bone resection plus total knee arthroplasty in tricompartmental arthrosis of the knee is one of the major challenges faced in orthopaedic surgery. The case is presented of a 67 year-old male patient with a history of diaphyseal fracture of the left femur (30 years ago) treated conservatively with malunion in left femoral diaphysis with 10° femoral valgus and left knee pain of 2 years onset. He was diagnosed with tricompartmental osteoarthritis of the knee associated with genu valgum of 20°. Surgical treatment was performed using intra articular «unusual¼ bone cuts and total knee arthroplasty. According to the scale proposed by the Knee Society Score, the patient obtained a score of 89 one year after surgery. In femoral deformities of up to 20°, it is usually sufficient to perform the correction with intra articular «unusual¼ bone cuts, and avoiding affecting the femoral ligament insertions.

Intrinsic and synaptic properties of hippocampal CA1 pyramidal neurons of the Wistar Audiogenic Rat (WAR) strain, a genetic model of epilepsy.

Despite the many studies focusing on epilepsy, a lot of the basic mechanisms underlying seizure susceptibility are mainly unclear. Here, we studied cellular electrical excitability, as well as excitatory and inhibitory synaptic neurotransmission of CA1 pyramidal neurons from the dorsal hippocampus of a genetic model of epilepsy, the Wistar Audiogenic Rat (WARs) in which limbic seizures appear after repeated audiogenic stimulation. We examined intrinsic properties of neurons, as well as EPSCs evoked by Schaffer-collateral stimulation in slices from WARs and Wistar parental strain. We also analyzed spontaneous IPSCs and quantal miniature inhibitory events. Our data show that even in the absence of previous seizures, GABAergic neurotransmission is reduced in the dorsal hippocampus of WARs. We observed a decrease in the frequency of IPSCs and mIPSCs. Moreover, mIPSCs of WARs had faster rise times, indicating that they probably arise from more proximal synapses. Finally, intrinsic membrane properties, firing and excitatory neurotransmission mediated by both NMDA and non-NMDA receptors are similar to the parental strain. Since GABAergic inhibition towards CA1 pyramidal neurons is reduced in WARs, the inhibitory network could be ineffective to prevent the seizure-dependent spread of hyperexcitation. These functional changes could make these animals more susceptible to the limbic seizures observed during the audiogenic kindling.