Evaluación de las afasias: consideraciones dialectales y culturales en neurología / Assessment of aphasia: dialectal and cultural considerations in neurology

Introducción: La evaluación del lenguaje en el contexto de las alteraciones neurológicas se fundamenta, tradicionalmente, en el uso de la lengua estándar de la comunidad en la que tiene lugar. Las variables dialectales constituyen un tema «olvidado». El objetivo de esta revisión es aportar recursos y guías de trabajo para superar esta limitación. Desarrollo: (1) Revisión de conceptos propios de la dialectología (lengua, dialecto, líneas isoglosas, idiolecto, registro, «variante estándar», bilingüismo). (2) Caracterización fundamental de las dialectologías española y catalana y búsqueda de recursos online para el desarrollo de instrumentos en neurología. (3) Búsqueda ad hoc en PubMed (palabras clave: dialect, aphasia, multilingual). Conclusiones: (1) Se aportan recursos online para promover un adecuado desarrollo de instrumentos de evaluación en lenguas castellana y catalana, considerando aspectos dialectales. (2) Se aportan unas guías de trabajo orientadas a la introducción de variables dialectales en los test de lenguaje para asegurar su objetivo último: evaluar el uso real de la lengua, y no el conocimiento cultural de la lengua estándar. (AU)

Introduction: In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectal variables constitute a ‘forgotten’ topic. This review aims to provide resources and working guidelines to overcome this limitation. Development: The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, ‘standard variant’, bilingualism); 2)characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords ‘dialect’, ‘aphasia’ and ‘multilingual’). Conclusions: We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for Dialectal considerations. We propose a set of working guidelines for the introduction of Dialectal variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language. (AU)

Assessment of aphasia: dialectal and cultural considerations in neurology.

INTRODUCTION: In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectal variables constitute a "forgotten" topic. This review aims to provide resources and working guidelines to overcome this limitation. DEVELOPMENT: The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, "standard variant," bilingualism); 2) characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords: "dialect," "aphasia," and "multilingual"). CONCLUSIONS: We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for dialectal considerations. We propose a set of working guidelines for the introduction of dialectal variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language.

Intervention protocol to improve scabies control in enclosed communities: a case report.

OBJECTIVES: To describe patients with scabies in a prison setting. Document what type of treatment was carried out. Prepare an intervention protocol to improve scabies control in the Penitentiary Center. MATERIAL AND METHOD: All cases of scabies diagnosed in the Youth Detention Centre (La Roca del Vallès, Barcelona) between November 2018 and November 2019 were recorded. The treatment used was recorded. Bibliographical research on the protocols and treatment guidelines was carried out for community-acquired scabies. RESULTS: The study was performed with 762 inmates, of whom 61 patients were diagnosed with scabies. 39 patients' pathologies were detected at the time of admission to the center, 11 cases were diagnosed in the first 6 weeks after entering the prison, coinciding with the incubation period of the disease. Finally, 11 more were diagnosed when they had already been in prison for more than 6 weeks and therefore could be infected cases within the center. This parasitosis was detected mainly in inmates of North African origin, 14.7% of Algerian inmates and 14.2% of Moroccan inmates presented this pathology, compared to 1.6% among Spanish prisoners. All 61 patients were treated with permethrin and 8 cases had to repeat the treatment cycle due to apparent therapeutic failure. Research literature indicates that oral ivermectin should be the drug of first choice for the treatment of scabies in prison. DISCUSSION: The high incidence of scabies cases detected in prison led us to carry out a bibliographic review that brought about changes in the treatment protocol that may be of interest for the control of the disease in closed communities.

Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia.

BACKGROUND: In low transmission settings early diagnosis is the main strategy to reduce adverse outcomes of malaria in pregnancy; however, microscopy and rapid diagnostic tests (RDTs) are inadequate for detecting low-density infections. We studied the performance of the highly sensitive-RDT (hsRDT) and the loop mediated isothermal DNA amplification (LAMP) for the detection of P. falciparum in pregnant women. METHODS: A cross-sectional study was conducted in two malaria-endemic municipalities in Colombia. We screened pregnant women in the context of an antenatal care program in health facilities and evaluated five tests (microscopy, conventional RDT, hsRDT, LAMP and nested polymerase chain reaction-PCR) for the detection of P. falciparum in peripheral blood, using a quantitative reverse transcription PCR (qRT-PCR) as the reference standard. Diagnostic performance of hsRDT and LAMP were compared with routine testing. RESULTS: The prevalence of P. falciparum was 4.5% by qRT-PCR, half of those infections were subpatent. The sensitivity of the hsRDT (64.1%) was slightly better compared to microscopy and cRDT (59 and 53.8% respectively). LAMP had the highest sensitivity (89.7%) for detecting P. falciparum and the ability to detect very low-density infections (minimum parasite density detected 0.08 p/µL). CONCLUSIONS: There is an underestimation of Plasmodium spp. infections by tests routinely used in pregnant women attending antenatal care visits. LAMP methodology can be successfully implemented at local hospitals in malaria-endemic areas. The relevance of detecting and treating this sub-patent P. falciparum infections in pregnant women should be evaluated. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT03172221 , Date of registration: May 29, 2017.

Assessment of aphasia: dialectical and cultural considerations in neurology. / Evaluación de las afasias: consideraciones dialectales y culturales en neurología.

INTRODUCTION: In the context of neurological disorders, language assessment is traditionally based on the use of the standard language of the community in which the assessment is performed. Dialectical variables constitute a 'forgotten' topic. This review aims to provide resources and working guidelines to overcome this limitation. DEVELOPMENT: The study was conducted as follows: 1) review of basic concepts of dialectology (language, dialect, isogloss line, idiolect, register, 'standard variant', bilingualism); 2) characterisation of Spanish and Catalan dialectologies and search for online resources for the development of neurological assessment tools; 3) ad hoc search on the PubMed database (keywords 'dialect', 'aphasia' and 'multilingual'). CONCLUSIONS: We provide online resources to promote adequate development of assessment tools in Spanish and Catalan, accounting for dialectical considerations. We propose a set of working guidelines for the introduction of dialectical variables in language tests to ensure their ultimate objective: to evaluate the real use of the language, and not cultural knowledge of the standard language.

Inmate carrier of cutis verticis gyrata

The cutis verticis gyrata (CVG) is a clinical stigma considered to be very rare that mostly affects males. It consists of characteristic folds in the scalp, similar to cerebral convolutions, which tend to affect the parietal and occipital areas. It is considered a pachyderma of the cranial skin, and can appear at different ages for different reasons. Images are shown of the first clinical case described in prisons, as well as the initial diagnostic and therapeutic approach.

Recluso portador de cutis verticis gyrata / Inmate carrier of cutis verticis gyrate

El cutis verticis gyrata (CVG) es un estigma clínico considerado muy raro, que afecta fundamentalmente a varones. Consiste en un plegamiento característico del cuero cabelludo, a modo de circunvoluciones cerebrales, que suele afectar las áreas parietales y occipital. Se considera una paquidermia de la piel del cráneo, que puede aparecer a diferentes edades por diferentes causas. Se muestran imágenes del primer caso clínico descrito en prisiones y el abordaje diagnóstico y terapéutico inicial

The cutis verticis gyrata (CVG) is a clinical stigma considered to be very rare that mostly affects males. It consists of characteristic folds in the scalp, similar to cerebral convolutions, which tend to affect the parietal and occipital areas. It is considered a pachyderma of the cranial skin, and can appear at different ages for different reasons. Images are shown of the first clinical case described in prisons, as well as the initial diagnostic and therapeutic approach

Colitis eosinofílica primaria en paciente con enfermedad celíaca / Primary eosinophilic colitis in a celiac patient

Los trastornos eosinofílicos primarios del tracto gastrointestinal abarcan una serie de enfermedades crónicas que cursan con un infiltrado eosinofílico a nivel intestinal en ausencia de otras causas de eosinofilia. Pueden afectar a cualquier área del tubo digestivo, siendo excepcional la afectación exclusiva del colon. Dada su baja prevalencia no suelen tenerse en cuenta en el diagnóstico diferencial de los pacientes con diarrea crónica, por lo que en muchos casos la demora diagnóstica puede ser de años. Describimos el caso de una paciente con enfermedad celíaca bien controlada y diarrea crónica de origen indeterminado que fue finalmente diagnosticada de una colitis eosinofílica. Recibió tratamiento con budesonida oral con muy buena respuesta clínica y en la actualidad se mantiene asintomática

Primary eosinophilic gastrointestinal disorders include a spectrum of inflammatory chronic diseases in which eosinophils infiltrate the gut in the absence of known causes of such tissue eosinophilia. They may affect any area of the gastrointestinal tract although exclusive colonic disease is exceptional. Due to their low prevalence these disorders are not usually taken into account when making a differential diagnosis in a patient with chronic diarrhea, which is the reason why in many cases the diagnosis can take many years. We describe the case of a patient with well-controlled celiac disease and chronic diarrhea of indeterminate origin. The final diagnosis was eosinophilic colitis. A complete response was obtained when she was treated with oral budesonide. Nowadays she remains asymptomatic

[Primary eosinophilic colitis in a celiac patient]. / Colitis eosinofílica primaria en paciente con enfermedad celíaca.

Primary eosinophilic gastrointestinal disorders include a spectrum of inflammatory chronic diseases in which eosinophils infiltrate the gut in the absence of known causes of such tissue eosinophilia. They may affect any area of the gastrointestinal tract although exclusive colonic disease is exceptional. Due to their low prevalence these disorders are not usually taken into account when making a differential diagnosis in a patient with chronic diarrhea, which is the reason why in many cases the diagnosis can take many years. We describe the case of a patient with well-controlled celiac disease and chronic diarrhea of indeterminate origin. The final diagnosis was eosinophilic colitis. A complete response was obtained when she was treated with oral budesonide. Nowadays she remains asymptomatic.

¿De qué enfermamos en Afganistán? / What sick in Afghanistan?

INTRODUCCIÓN: Existe mucha información sobre la asistencia a bajas en combate en Afganistán en escalones avanzados, pero poca sobre la prestada al personal desplegado en misión que demanda consultas médicas más cotidianas. OBJETIVO: Conocer dichas demandas analizando las consultas registradas en el libro de botiquín durante una rotación sanitaria en el ROLE-1 de Qala-e-Naw en los meses de mayo, junio y julio. MATERIAL Y MÉTODOS: Se ha llevado a cabo una revisión, con un estudio observacional transversal, de 900 consultas registradas, analizando sólo aquellas que cumplían con las variables a estudio correctamente registradas. VARIABLES: sexo, unidad, fecha, síntomas, tratamiento, hospitalización. Análisis estadístico: SPSS 17.0. RESULTADOS: 876 (97'3%) consultas, de las cuales 91,5% (802) fueron varones, y 8'5% (74) mujeres. Por escalas, la más voluminosa, corresponde a la tropa 68'2% (614). Por empleos, encabezando la lista, los soldados 44'2% (398), y último puesto, el empleo de comandante con 0'2% (2), civiles españoles: 4'4% (39), civiles afganos: 8'4% (75). Mayor patología registrada; digestiva: 31'9% (287 consultas), seguida por trastornos músculo-esqueléticos 17'1% (154), destacan las escasas consultas por picaduras de insectos: 5'3% (48), y lesiones oculares: 2'2% (20). Media de consultas diarias: 16, Moda: 43. Rebaje puntual: 15% (132). Ingreso: 1'4% (12). Evacuaciones: 0'7% (6). Traslado a territorio nacional: 3 personas. DISCUSIÓN: Clara demanda de patología digestiva y traumatológica (de personal civil y militar) siendo característica la escasa demanda asistencial por picaduras de insectos, quemaduras solares o lesiones oftalmológicas. CONCLUSIÓN: Patologías cotidianas que, no por ser banales, dejan de suponer ciertas limitaciones al personal para llevar a cabo su misión

INTRODUCTION: Despite the amount of information known about the assistance to combat casualties in advanced medical structures in Afghanistan, there is a lack of information related to the assistance given to military and civilian staff stationed abroad who demands medical consultations ondaily. Objetive: Increase this knowledge by the present work analyzing 900 consultations during a sanitary rotation in Qala-e-Naw Spanish ROLE-1 in a summer-round. MATERIALS AND METHOD: A review using a transversal and observational study taking only into account those consultations which completely fulfilled the general requirements. VARIABLES: sex, unit, date, symptoms, treatment, hospitalization, evacuation. Statistical analysis: SPSS 17.0. RESULTS: 876 (97'3 %) consultations, of which 91.5 % (802) were male, and 8.5 % (74) women. For scales, the most voluminous, it is for the troop's 68'2 % (614). For jobs, topping the list, the soldiers 44.2 % (398), and last place, the commander with 0.2 % (2), Spanish civilians 4.4% (39), Afghan civilians, 8'4% (75). Increased registered pathology; digestive: 31.9 % (287 visits), followed by musculoskeletal disorders 17'1 % (154), include consultations for insect stings: 5.3% (48) and eye damage: 2'2 % (20). Average daily consultations: 16, Fashion 43. Recess point: 15% (132). Income: 1.4 % (12). Evacuations: 0.7 % (6). Transfer to Spain: 3 people. DISCUSSION: Clearly point to a high demand of digestive and trauma pathology, being surprisingly underneath the demand for work accidents, sunburns or ocular injuries. CONCLUSION: Daily basis ailments are not banal and they may bring certain limitations when it comes to accomplish a mission

Trombosis portal como causa de trombopenia persistente en la neutropenia aloinmune neonatal con anticuerpos HNA-2a / Portal vein thrombosis as a cause of thrombocytopenia persistent in neonatal alloimmune neutropenia HNA-2a

La neutropenia aloinmune neonatal (NAN) es una patología poco frecuente, que se debe a la producción materna de anticuerpos IgG frente a antígenos específicos de los neutrófilos fetales (HNA), de herencia paterna y no presentes en los neutrófilos de la madre. Estos anticuerpos maternos pasan al feto a través de la placenta, provocando la eliminación de los neutrófilos fetales e incrementando el riesgo de infección durante el periodo neonatal. Existen siete subtipos de HNA, pero los que más a menudo se relacionan con la NAN son el HNA-1a, el HNA-1b y el HNA-2a. El tratamiento de elección es el factor estimulante de colonias granulocíticas (G-CSF) y, en casos refractarios, otras opciones terapéuticas son la gammaglobulina intravenosa o los corticoides. La sepsis neonatal y la trombopenia persistente son dos complicaciones frecuentemente asociadas a la NAN. La trombopenia en la NAN se produce comúnmente por tres mecanismos: la propia sepsis, el efecto yatrogénico del G-CSF, y por reacción cruzada entre los anticuerpos anti-HNA y las plaquetas. En este caso clínico presentamos un cuarto mecanismo que, de forma multifactorial y asociado a los tres mecanismos previos, explica la trombopenia persistente en nuestro caso de NAN (AU)

The alloimmune neonatal neutropenia (NAN) is a rare condition that affects newborn maternal IgG antibody production against specific antigens of neutrophils (HNA) of paternal inheritance and not present on neutrophils from the mother and in antigens present in the fetus. These maternal antibodies pass the fetus through the placenta causing the elimination of the fetal neutrophils, increasing the risk of infection during the neonatal period. There are seven subtypes of HNA, but the most often related to NAN are the HNA-1a, HNA-1b and HNA-2a. The treatment of choice is G-CSF and refractory cases, intravenous immunoglobulin or corticosteroids, are other treatment options. Neonatal sepsis and persistent thrombocytopenia are two complications frequently associated with NAN. Thrombocytopenia in NAN, commonly occurs by three mechanisms: sepsis own, iatrogenic effect of G-CSF and cross-reactivity between antibodies and platelets anti-HNA. In our case report we present a fourth mechanism, so multifactorial and associated with the previous three mechanisms explains the persistent thrombocytopenia in our case NAN (AU)

Yala-Yala: ¿cómo fue la gastroenteritis en Badghis (Afganistán)? / Yala-Yala: how was gastroenteritis like in Badghis (Afghanistan)?

INTRODUCCIÓN: La gastroenteritis es un compañero habitual de los contingentes militares desplegados en el exterior. Sin embargo, sus características han sido poco estudiadas. Describimos las particularidades de las observadas en un contingente militar español en la provincia afgana de Badghis. No hemos encontrado estudios similares al presentado en este trabajo. OBJETIVO: describir características de cuadros de gastroenteritis observados durante una rotación de Sanidad Militar en Afganistán. Material y MÉTODOS: Estudio descriptivo transversal. Se revisaron las consultas del ROLE-1 de la base de Qala-e-Naw durante una rotación de Sanidad (mayo a julio de 2013) que cumplían criterios de gastroenteritis (aumento 2-3 veces número habitual de deposiciones diarias / 2 vómitos diarios / 1 vómito con fiebre u otros síntomas digestivos). VARIABLES: sexo, unidad, fecha inicial, síntomas (fiebre, diarrea, vómitos, localización del dolor, productos patológicos), tratamiento, hospitalización. Análisis estadístico: SPSS 17.0. RESULTADOS: 892 militares censados (94,46% varones), 135 consultan por gastroenteritis (89,4% varones), prevalencia de 15,34%. Prevalencia según sexos: 14,35% entre hombres, 28,57% entre mujeres (RR=1,99, OR=2,3867, IC95% 1,88-3,01, p = 0,007). Dolor: 54,1% (34,24% de éstos, focalizado), náuseas 53,3%, vómitos 37,8%, diarrea 93,3%, productos patológicos 1,5% y fiebre 11,1% (febrícula 15,6%). Antibioticoterapia 8,1%, hospitalización 8,9%. Distribución normal según fecha inicial, mostrando pico máximo la cuarta semana del despliegue. DISCUSIÓN: Prevalencia de gastroenteritis observada inferior a descrita en otras publicaciones. Distribución de síntomas atribuible al tipo de población, zona geográfica, medidas preventivas o pérdida de casos que no buscaron atención. Pico máximo de aparición y mayor riesgo en mujeres coincide con otros estudios. CONCLUSIÓN: Nuevos estudios más potentes deberían diseñarse para identificar las características de esta patología en otras zonas de despliegue español

INTRODUCTION: Gastroenteritis is a common companion to troops deployed overseas since forever. However, its features are not fully known and there were no similar studies during the Spanish presence in Badghis. OBJECTIVE: To describe qualities of gastroenteritis observed during one rotation of Military Health in Afghanistan. MATERIAL AND METHODS: Descriptive study reviewing all medical consultations in ROLE-1 of Qala-e-Naw during one rotation of Military Health (from May to July 2013) who met criteria for gastroenteritis (increased 2-3 times usual number of stools / 2 vomiting daily / 1 vomiting with fever or other gastrointestinal symptoms). VARIABLES: gender, unit, start date, symptoms (fever, diarrhea, vomiting, pain location, pathological products), treatment, hospitalization. Statistical analysis: SPSS 17.0. Outcomes: 892 troops registered (94.46% male), 135 consulting for gastroenteritis (89.4% male), prevalence of 15.34%. Prevalence by sex: men 14.35%, 28.57% among women (RR = 1.99, OR = 2.3867, 95% CI 1.88-3.01, p = 0.007). Pain: 54.1% (34.24% of them, focused), 53.3% nausea, vomiting 37.8%, diarrhea 93.3%, 1.5% pathological products and fever 11.1% (low fever 15.6%). Antibiotic therapy 8.1% and ROLE-1 income 8.9%. Normal distribution as start date, showing the fourth week peak deployment. DISCUSSION: Observed prevalence of gastroenteritis is less than that reported in other publications. Distribution of symptoms attributable to the type of population, geographical area, preventive measures or loss cases not sought care. Peak at the onset of the disease and increased risk in women is consistent with other studies. CONCLUSION: New, more powerful studies should be designed to identify the characteristics of this disease in other parts of Spanish deployment

Apendicitis aguda atípica diagnosticada durante una colonoscopia / Colonoscopic diagnosis of acute appendicitis with atypical presentation

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Lumbalgia mecánica crónica en pacientes con vértebras limbus anterior: revisión de la literatura y presentación de tres casos clínicos / Chronic mechanical low back pain in patients with anterior limbus vertebra: a review of the literature and a study of three cases

La vertebra limbus es un hallazgo radiológico de prevalencia desconocida y significado incierto. Se trata de un defecto óseo que afecta al margen de los cuerpos vertebrados, con un fragmento desprendido de morfología triangular y bordes escleróticos. Se produce como consecuencia de una herniación intraósea del núcleo pulposo a través del anillo apofisario vertebral, antes de la fusión completa del cuerpo vertebral. En este artículo se describe tres casos clínicos de pacientes jóvenes (de 19, 20 y 22 años), reclusos en el Centro Penitenciario de Jóvenes (Barcelona, España), diagnosticados de lumbalgía mecánica crónica, y portadores de vértebras limbus lumbar. Nuestros hallazgos, y la revisión sistemática de la escasa literatura disponible, ponen en duda algunas convicciones actuales sobre la vértebra limbus.(AU)

The limbus vertebra is a radiological finding of unknown prevalence and uncertain significance. This is a bone defect which affects themargin of the vertebral bodies, with a triangular-shaped detached fragment and sclerotic margins. This occurs as a result of an intraosseus herniation of the nucleus pulposus through the vertebral apophyseal ring before the complete fusion of the vertebral body. In this paper we describe the clinical cases of three young patients(aged 19, 20 and 22), in mates of the Young Offenders Institute of Barcelona, Spain, who were diagnosed with chronic mechanical lowback pain and suffered from lumbar limbus vertebrae. Our findings, and the systematic review of the limited literature available, question some of the current beliefs about limbus vertebrae.(AU)

Lumbalgia mecánica crónica en pacientes con vértebras limbus anterior: revisión de la literatura y presentación de tres casos clínicos / Chronic mechanical low back pain in patients with anterior limbus vertebra: a review of the literature and a study of three cases

La vertebra limbus es un hallazgo radiológico de prevalencia desconocida y significado incierto. Se trata de un defecto óseo que afecta al margen de los cuerpos vertebrados, con un fragmento desprendido de morfología triangular y bordes escleróticos. Se produce como consecuencia de una herniación intraósea del núcleo pulposo a través del anillo apofisario vertebral, antes de la fusión completa del cuerpo vertebral. En este artículo se describe tres casos clínicos de pacientes jóvenes (de 19, 20 y 22 años), reclusos en el Centro Penitenciario de Jóvenes (Barcelona, España), diagnosticados de lumbalgía mecánica crónica, y portadores de vértebras limbus lumbar. Nuestros hallazgos, y la revisión sistemática de la escasa literatura disponible, ponen en duda algunas convicciones actuales sobre la vértebra limbus.

The limbus vertebra is a radiological finding of unknown prevalence and uncertain significance. This is a bone defect which affects themargin of the vertebral bodies, with a triangular-shaped detached fragment and sclerotic margins. This occurs as a result of an intraosseus herniation of the nucleus pulposus through the vertebral apophyseal ring before the complete fusion of the vertebral body. In this paper we describe the clinical cases of three young patients(aged 19, 20 and 22), in mates of the Young Offenders Institute of Barcelona, Spain, who were diagnosed with chronic mechanical lowback pain and suffered from lumbar limbus vertebrae. Our findings, and the systematic review of the limited literature available, question some of the current beliefs about limbus vertebrae.

[Diagnosis and treatment of bladder schistosomiasis from penitentiary primary care: case report]. / Diagnóstico y tratamiento de la esquistosomiasis vesical desde la atención primaria penitenciaria: a propósito de un caso.

We describe a case of a patient from Senegal with voiding symptoms and microscopic hematuria diagnosed and treated for bladder schistosomiasis in the medical services of the Youth Prison in Barcelona. According to our information in the Medline database no bladder schistosomiasis cases have been seen in primary care outside endemic areas. Patients can be diagnosed and treated before referral to specialized care for further study of possible complications.

Effects of surgery and/or remifentanil administration on the expression of pERK1/2, c-Fos and dynorphin in the dorsal root ganglia in mice.

Tissue injury and/or opioids induce plastic changes in the spinal cord resulting in pain hypersensitivity; the contribution of the dorsal root ganglia (DRG) is poorly understood. We evaluated DRG phenotypic changes induced by surgery and/or remifentanil in a mice model of postoperative pain using as neuronal markers ERK1/2 and c-Fos; prodynorphin mRNA and dynorphin levels were also determined. We hypothesized that a correlation between nociception and DRG reactivity would occur. Surgery and/or remifentanil induced mechanical hypersensitivity, correlated with ERK1/2 phosphorylation and c-Fos expression in the DRG; changes were greater in the remifentanil + incision group and still present on day 14 (p < 0.01 vs. control). Intrathecal PD98059 (ERK1/2 inhibitor) partially reversed the mechanical hypersensitivity (44%, p < 0.05) observed in the remifentanil + incision group. In this group, significant increases in prodynorphin mRNA (at 2, 7, and 14 days, p < 0.01) roughly coincided with increases in dynorphin (days 2 and 14, p < 0.001) in the DRG. Remifentanil or incision (alone) also induced an up-regulation in prodynorphin mRNA expression on days 7 and 14 (p < 0.01, p < 0.05, respectively), partially correlating with dynorphin levels. On day 21, all molecular changes returned to control levels in all experimental conditions, concurring with the complete recovery of nociceptive thresholds. Surgery and/or remifentanil induce up-regulation of c-Fos and pERK in the DRG, approximately correlating with nociceptive behavior, also associated with an increased expression of prodynorphin/dynorphin. These changes support the role of the DRG in the development and maintenance of pain hypersensitivity after surgery. The findings could contribute to the development of new therapeutic agents focused on peripheral targets.

Diagnóstico y tratamiento de la esquistosomiasis vesical desde la atención primaria penitenciaria: a propósito de un caso / Diagnosis and treatment of bladder schistosomiasis from penitentiary primary care: case report

Se describe un caso clínico de un paciente procedente de Senegal con síndrome miccional y hematuria microscópica que fue diagnosticado y tratado de esquistosomiasis vesical en los servicios médicos del Centro Penitenciario de Jóvenes de Barcelona. Según nuestra información en la base de datos Medline no existen casos de esquistosomiasis vesical abordados en atención primaria fuera de áreas endémicas. Los pacientes pueden diagnosticarse y tratarse antes de ser derivados a la asistencia especializada para continuar estudio de posibles complicaciones(AU)

We describe a case of a patient from Senegal with voiding symptoms and microscopic hematuria diagnosed and treated for bladder schistosomiasis in the medical services of the Youth Prison in Barcelona. According to our information in the Medline database no bladder schistosomiasis cases have been seen in primary care outside endemic areas. Patients can be diagnosed and treated before referral to specialized care for further study of possible complications(AU)