Análisis cuantitativo del COVID-19 y sus impactos psicológicos y educativos en estudiantes universitarios y de secundaria en Córdoba, España / Quantitative analysis of COVID-19 and its psychological and educational impacts on university and secondary students in Córdoba, Spain

Introducción La pandemia COVID-19, que empezó en Wuhan, China, a finales del 2019, y, que hoy amenaza a todos los habitantes del planeta, configura el tema de investigación prioritaria en la actualidad. En este contexto, este artículo enfoca la manera en que este problema de salud afecta directamente al estado psicológico y educativo de 344 estudiantes universitarios y de secundaria, en Córdoba, España. Material y métodos Para el análisis se ha empleado el modelo de ecuaciones estructurales (SEM), a través de la cuantificación de un conjunto de relaciones entre una o más variables independientes, intentando condensar el escenario de pandemia y sus implicaciones sanitarias, psicológicas y educativas. Resultados La primera variable latente «Salud», es causal de la variable latente «Psicología», y de las variables endógenas «efectos relaciones sociales», «efectos tristeza» y «efectos sexualidad», lo cual confirma que la COVID-19 afectó seriamente al comportamiento psicológico de los estudiantes de universidad y de secundaria de Córdoba (AU)

Introduccion The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. Material and methods For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. Results The first latent variable “Health” is causal of the latent variable “Psychology”, and, of the endogenous variables, “social relations effects”, “sadness effects” and “sexuality effects”, which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba (AU)

Outcome without any adjuvant systemic treatment in stage I ER+/HER2- breast cancer patients included in the MINDACT trial.

BACKGROUND: Adjuvant systemic treatments (AST) reduce mortality, but have associated short- and long-term toxicities. Careful selection of patients likely to benefit from AST is needed. We evaluated outcome of low-risk breast cancer patients of the EORTC 10041/BIG 3-04 MINDACT trial who received no AST. PATIENTS AND METHODS: Patients with estrogen receptor-positive, HER2-negative, lymph node-negative tumors ≤2 cm who received no AST were matched 1 : 1 to patients with similar tumor characteristics treated with adjuvant endocrine therapy (ET), using propensity score matching and exact matching on age, genomic risk (70-gene signature) and grade. In a post hoc analysis, distant metastasis-free interval (DMFI) and overall survival (OS) were assessed by Kaplan-Meier analysis and hazard ratios (HR) by Cox regression. Cumulative incidences of locoregional recurrence (LRR) and contralateral breast cancer (CBC) were assessed with competing risk analyses. RESULTS: At 8 years, DMFI rates were 94.8% [95% confidence interval (CI) 92.7% to 96.9%] in 509 patients receiving no AST, and 97.3% (95% CI 95.8% to 98.8%) in 509 matched patients who received only ET [absolute difference: 2.5%, HR 0.56 (95% CI 0.30-1.03)]. No statistically significant difference was seen in 8-year OS rates, 95.4% (95% CI 93.5% to 97.4%) in patients receiving no AST and 95.6% (95% CI 93.8% to 97.5%) in patients receiving only ET [absolute difference: 0.2%, HR 0.86 (95% CI 0.53-1.41)]. Cumulative incidence rates of LRR and CBC were 4.7% (95% CI 3.0% to 7.0%) and 4.6% (95% CI 2.9% to 6.9%) in patients receiving no AST versus 1.4% (95% CI 0.6% to 2.9%) and 1.5% (95% CI 0.6% to 3.1%) in patients receiving only ET. CONCLUSIONS: In patients with stage I low-risk breast cancer, the effect of ET on DMFI was limited, but overall significantly fewer breast cancer events were observed in patients who received ET, after the relatively short follow-up of 8 years. These benefits and side-effects of ET should be discussed with all patients, even those at a very low risk of distant metastasis.

Combining method of detection and 70-gene signature for enhanced prognostication of breast cancer.

PURPOSE: Studies have shown that screen detection by national screening programs is independently associated with better prognosis of breast cancer. The aim of this study is to evaluate the association between tumor biology according to the 70-gene signature (70-GS) and survival of patients with screen-detected and interval breast cancers. METHODS: All Dutch breast cancer patients enrolled in the MINDACT trial (EORTC-10041/BIG3-04) accrued 2007-2011, who participated in the national screening program (biennial screening, ages 50-75) were included (n = 1102). Distant Metastasis-Free Interval (DMFI) was evaluated according to the 70-GS for patients with screen-detected (n = 754) and interval cancers (n = 348). RESULTS: Patients with screen-detected cancers had 8-year DMFI rates of 98.2% for 70-GS ultralow-, 94.6% for low-, and 93.8% for high-risk tumors (p = 0.4). For interval cancers, there was a significantly lower 8-year DMFI rate for patients with 70-GS high-risk tumors (85.2%) compared to low- (92.2%) and ultralow-risk tumors (97.4%, p = 0.0023). Among patients with 70-GS high-risk tumors, a significant difference in 8-year DMFI rate was observed between interval (85.2%, n = 166) versus screen-detected cancers (93.8%, n = 238; p = 0.002) with a HR of 2.3 (95%CI 1.2-4.4, p = 0.010) adjusted for clinical-pathological characteristics and adjuvant systemic treatment. CONCLUSION: Among patients with 70-GS high-risk tumors, a significant difference in DMFI was observed between screen-detected and interval cancers, suggesting that method of detection is an additional prognostic factor in this subgroup and should be taken into account when deciding on adjuvant treatment strategies.

Analysis of health habits, vices and interpersonal relationships of Spanish adolescents, using SEM statistical model.

The objective of this article is to know the state of health of a sample of adolescents and how it relates to toxic habits and personal relationships. Likewise, it is presented how can influence eating habits, sports practice and interpersonal relationships in their general health status. The research has carried out through a survey of 56 questions to 470 adolescents, between 13 and 18 years old, of both sexes, of different schools in the province of Cordoba, Spain. These results have been subjected to a statistical model widely used in health and social sciences in general, called Structural Equations Model (SEM), through the SPSS program, v. 23 and AMOS. SEM is widely used in the social sciences to estimate regression models (usually multi-equational). The estimated model shows a significant global acceptability based on the usual statistical tests and goodness-of-fit measures. In this regard, these results are: CMIN = 17.554 with 33 degrees of freedom (DF) and a probability level, p = 0.987, which is higher than any reasonable level of significance (α = 0.05, 0.10, even 0.20). Likewise, FMIN = 0.038, CFI = 1.000 and RMSEA = 0.000. The main recommendation of this research aimed at improving good eating and healthy habits, and to avoid toxic habits of adolescents, is to begin the education in the family, in coordination with their school and high school.

Surface of Half-Neutralized Diamine Triflate Ionic Liquids. A Molecular Dynamics Study of Structure, Thermodynamics, and Kinetics of Water Absorption and Evaporation.

Surface properties of room temperature ionic liquids (RTILs) consisting of half neutralized diamine cations (H2N-(CH2)n-NH3+, n = 2, 4) and triflate anions have been investigated by molecular dynamics simulations, based on an empirical atomistic force field. Planar slabs periodically repeated in 2D have been considered, and the temperature range 260 ≤ T ≤ 360 K has been covered, extending from below the melting and glass point to the equilibrium liquid range of the diamine compounds under investigation. Addition of water at 1% weight concentration allowed us to investigate the kinetics of water absorption through the RTIL surface, and to characterize the structural and dynamical properties of subsurface water. Animations of the simulation trajectory highlight the quick absorption of water molecules, progressing downhill in free energy and taking place without apparent intermediate kinetic stages. To verify and quantify these observations, a variant of the umbrella sampling algorithm has been applied to compute the variation of excess free energy upon displacing a water molecule along the normal to the surface, from the center of the slab to the vapor phase. The results provide a comprehensive picture of the thermodynamic properties underlying the kinetics of water absorption and evaporation through the surface, and they also provide the ratio of the equilibrium density of water in the vapor and liquid phase at the average concentration considered by simulations. A variety of properties such as the surface energy, the 90-10% width of the profile, the layering of different species at the interface, and the electrostatic double layer at the surface are computed and discussed, focusing on the effect of water contamination on all of them.

Identification of RSVP14 and RSVP20 components by two-dimensional electrophoresis and Western-blotting.

We have already shown that RSVP14 and RSVP20, two ram seminal plasma (SP) proteins postulated to be involved in sperm capacitation and gamete interaction can protect spermatozoa against cold-shock. In this study, we use two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) for the analysis of SP proteins of Rasa Aragonesa rams, using enhanced protein solubilization in the presence of tributyl phosphine (TBP) and a polyacrylamide linear gradient gel with a narrow pH range (4-7). The image analysis of the 2D map detected 195 protein spots, with isoelectric points (pIs) ranging from 4.5 to 6.6, and molecular weight (M(r)) from 11.7 to 90.4. Staining of 2D gels with Pro-Q Emerald 300 Glycoprotein Stain revealed that most significant proteins in ram SP are glycosylated. The removing of protein N-linked oligosaccharides improved the gel resolution. 2D-PAGE analysis of the whole fraction 6 (F6) separated from ram SP by exclusion chromatography showed six main protein spots, four (a, b, c, d) in the 14 kDa and two (e, f) in the 20 kDa region. Western-blot analyses indicated that the anti-P14 antibody recognized four spots on the SP map, 4, 5, 6 and 7, that matched with spots a, b, c, d of F6 map. The anti-P20 antibody recognized spots 13 and 14 of SP map that corresponded to spots e, f of F6 map. The deduced sequences by de novo sequencing evidenced that protein spots 7 and 13 have significant similarities to BSP family, while protein spots 4 and 14 did not appear to be homologous with any reported protein in the current mammalian Proteinbank databases.

Primary cerebral fibrosarcoma in a child.

OBJECTIVE: To describe the case of a primary cerebral fibrosarcoma in a child. CLINICAL CASE: A 6-year-old boy presented with a history of headache, drowsiness, vomiting and seizures. He was referred to our institution and died shortly upon arrival to the ER. The autopsy revealed a large left frontoparietal mass with histopathologic features characteristic of fibrosarcoma. Immunohistochemical and ultrastructural studies allowed the exclusion of other mimickers such as meningiomas, and neoplasms of glial or neuronal origin. No other growths were found in the CNS or in other parts of the body. CONCLUSIONS: Brain fibrosarcoma is an exceedingly uncommon tumor. Only 41 cases have been reported to date. The diagnosis of fibrosarcoma must be based on the identification of a predominant herringbone architectural pattern, and immunohistochemical features, although the latter are of limited diagnostic value, its importance being that they facilitate the exclusion of other entities considered in the differential diagnosis.

Penile cancer associated with so-called low-risk human papilloma virus. Report of five cases from rural Venezuela.

Penile cancer is uncommon in western countries. It has been related to human papilloma virus (HPV) types 16 and 18. We describe five cases of carcinoma of the penis in men from a rural Venezuelan town that were related to HPV types 6, 11, 53, which represent a rather low risk for cancer.

Monthly variations in ovine seminal plasma proteins analyzed by two-dimensional polyacrylamide gel electrophoresis.

This study was conducted to evaluate monthly changes in the ram seminal plasma protein profile using two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) with a polyacrylamide linear gradient gel. Likewise, comparative analyses of the protein composition of ovine seminal plasma (SP) from ejaculates obtained along the year, and its relationship with sperm motility, viability and concentration of ejaculate were carried out. Western-blot analysis was performed to specifically detect P14, a ram SP protein postulated to be involved in sperm capacitation and gamete interaction [Barrios B, Fernández-Juan M, Muiño-Blanco T, Cebrián-Pérez JA. Immunocytochemical localization and biochemical characterization of two seminal plasma proteins which protect ram spermatozoa against cold-shock. J Androl 2005;26:539-49], and its variations along the year have also been established. The experiment was carried out from May 2003 to April 2004, with nine Rasa Aragonesa rams. Ejaculates obtained every 2 days were pooled and used for each assay, to avoid individual differences, and three two-dimensional SDS-PAGE gels were run for each month. The high resolution of the gradient gel allowed the image analysis software to detect around 252 protein spots, with pIs ranging from 4.2 to 7.6, and molecular weight (M(r)) from 12.5 to 83.9 kDa. Four protein spots (1, 2, 3 and 4) of low M(r) (15.1, 15.7, 15.9 and 21.0 kDa) and acidic pI (5.9, 5.3, 5.7 and 6.6), respectively, had the highest relative intensity in the SP map (11.2, 9.3, 4.7 and 7.7%, respectively). Spot 3 was more abundant (P<0.05) from May to December, and negatively correlated (P<0.05, r=-0.34) with sperm viability and concentration (P<0.05, r=0.36). Another 12 protein spots also had significant quantitative differences (P<0.05) along the year, and 17 protein spots, which correlated with some seminal quality parameter, did not show quantitative monthly changes. Western-blot analysis indicated that spots 1 and 2 reacted with the anti-P14 antibody, raised against the P14 band (approximate M(r) 14 kDa) of ram SP. This indicates that spots 1 and 2 are similar to RSP15 [Bergeron A, Villemure M, Lazure C, Manjunath P. Isolation and characterization of the major proteins of ram seminal plasma. Mol Reprod Dev 2005;71:461-70], bovine PDC-109 [Esch FS, Ling NC, Bohlen P, Ying S, Guillemin R. Primary structure of PDC-109, a major protein constituent of bovine seminal plasma. Biochem Biophys Res Commun 1983;113:861-7] (also called BSP A1/A2 [Manjunath P, Sairam MR. Purification and biochemical characterization of three major acidic proteins (BSP-A1, BSP-A2 and BSP-A3) from bovine seminal plasma. Biochem J 1987;241:685-92]) and goat GSP-14/15 kDa [Villemure M, Lazure C, Manjunath P. Isolation and characterization of gelatine-binding proteins from goat seminal plasma. Reprod Biol Endocrinol 2003;1:39], based on our previous results on the P14 amino acid sequence [Barrios B, Fernández-Juan M, Muiño-Blanco T, Cebrián-Pérez JA. Immunocytochemical localization and biochemical characterization of two seminal plasma proteins which protect ram spermatozoa against cold-shock. J Androl 2005;26:539-49].

[Idiopathic hypertrophic pachymeningitis: a diagnostic dilemma]. / Paquimeningitis hipertrófica idiopática: un dilema diagnóstico.

INTRODUCTION: Idiopathic hypertrophic pachymeningitis (IHP) is a rare fibrosing inflammatory process of unknown pathogenesis that causes diffuse thickening of the duramater. In spite of the fact that this pathological entity has been linked to specific etiological agents such as syphilis, tuberculosis, mycosis and sarcoidosis, In recent years there has been an increase in the number of patients with IHP of undetermined cause. CASE REPORT: 58 year-old female with a long date history of oppressive headaches, frontally located at first, and later generalized, accompanied by weakness and asthenia; urinary incontinence, dizziness, vomiting, and gait ataxia. Physical examination revealed bilateral cerebellar signs, and optic atrophy. Magnetic resonance displayed a diffuse thickening of the falx cerebrii, and cerebellar tentorium, hypointense in T1 and T2- weighted images, and markedly enhanced following administration of intravenous Gd-DTPA. A biopsy obtained from the falx revealed conspicuous fibrosis, and focal chronic inflammatory mononuclear infiltrate. Complementary exams carried out in order to reveal a specific etiologic agent were negative. CONCLUSION: Due to the variable clinical presentation, and the difficulty to establish the etiology of the pathological process, to make the diagnosis of IHP usually represents a true dilemma. This diagnosis is often made by exclusion.

[Cerebrovascular disease: its relationship with cardiovascular and renal pathology in 134 clinical autopsies]. / Enfermedad cerebrovascular: su relación con cardiovasculopatías y nefropatías en 134 necropsias clínicas.

OBJECTIVE: To establish the relationship between cardiopathy and chronic nephropathy, and cerebral vascular pathology in clinical necropsies performed in adult patients. MATERIAL AND METHODS: The protocols of 861 clinical autopsies done during the lapse 1990-2000 were reviewed, of these, 134 cases with diagnosis of cerebrovascular disease (CVD) were selected. Analyzed features included: neuropathological study of CVD, renal and cardiovascular pathology, and cause of death. RESULTS: CVD represented 15.5% of all autopsies done during the study period. Ischemic CVD constituted 56.7% of the cases, whereas cases of hemorrhagic CVD accounted for 43.3% of the total. Causes included arterial hypertension (33%), atherosclerosis (19%), emboli and vascular malformations (13% each, respectively), coagulopathies (8%), angeiitis (4%), tumors (1%), and unknown origin (11%). Ischemic CVD was caused by atherosclerosis in 34.2% of the cases, lacunar infarcts in 32.8%, of embolic cause in 14.4% of the cases, angeiitis in 1.3%, and of unknown origin in 17.1% of the cases. Hemorrhagic CVD presented as intraparenchymal hematoma in 50% of the cases, as sub-arachnoid hemorrhage in 28%, as disseminated petechial hemorrhages in 19%, and intraventricular in 3% of the cases. Ischemic CVD was associated with hypertensive cardiopathy in 86.5% of the cases, and with nephrosclerosis in 51.3%, whereas hemorrhagic CVD was seen associated with the same pathological entities in 86.2% and 29.3% of the cases, respectively. Cerebral herniation was the cause of death in 2.6% of the patients with ischemic CVD, and in 74.1% of the patients with hemorrhagic CVD. CONCLUSIONS: CVD was associated with a high frequency of intercurrent pathological processes, namely hypertensive cardiopathy, atherosclerosis, nephroscleroisis, and other chronic nephropathies, that eventually interact, and constitute well known predisposing and/or concomitant factors to the cerebrovascular event

[Non neoplastic space occupying lesions mimicking central nervous system tumors]. / Lesiones ocupantes de espacio no neoplasicas que simulan tumores del sistema nervioso central.

OBJECTIVE: To establish the frequency and nature of space occupying lesions of the central nervous system (CNS) that mimic neoplastic growths. PATIENTS AND METHODS: We reviewed the clinical records, imaging and neuropathological studies of patients operated in different hospitals of Maracaibo, Venezuela during the period January 1 1996 July 31 2002. These patients had a pre operative diagnosis of CNS tumor, and their definitive diagnosis was non neoplastic disease. RESULTS: The 33 cases of expansive, non neoplastic growths represented 8% of 408 CNS lesions diagnosed during the study period. Approximately two thirds of the cases (63,36%) consisted of either inflammatory or vascular lesions, whereas the rest of the cases grouped miscellaneous conditions. CONCLUSIONS: Even though it is not frequent that non neoplastic lesions of the CNS mimic expansive growths of neoplastic nature, on occasions the clinical and neuroimaging features of both groups of entities are remarkably similar.

[Characterization of neuronal ceroid lipofuscinosis in Venezuelan children]. / Caracterización de la ceroidolipofuscinosis en niños venezolanos.

INTRODUCTION: Neuronal ceroid lipofuscinosis (NCL), represents a group of inherited neurodegenerative disorders. Based on the age of the patient at onset, clinical course and ultrastructural morphology it has been identified three clinical types for the pediatric group: 1) Infantile NCL (INCL); 2) Late infantile NCL (LINCL); and 3) Juvenile NCL (JNCL). Other variants or atypical forms represent around 20% of the NCL in different populations. Genetic advances have made possible a better characterization, diagnostic and classification of these disorders. CASE REPORTS: We present the clinical, neurophysiological, neuroradiological, and morphological data from 6 patients with NCL, who were assessed at the pediatric neurology department of the Hospital Universitario de Maracaibo during a ten years period (1993 2003). All 6 cases corresponded with the late infantile form. Age of onset ranged form 2 to 5 years. For most of the patients initial symptoms included seizures, psychomotor delay, accompanied by macular degeneration and optic atrophy. The EEG was characterized by high voltage spikes elicited by low frequency photic stimulation, in 5 cases. Neuroimaging findings were characteristic of the late infantile form of the NCL. In three patients a decreased intensity of signal was seen in the thalami and putamen on T2-weighted images. The ultrastructural examination of the samples obtained through a biopsy showed curvilinear bodies in all patients. CONCLUSION: There is not epidemiological data of the NCL in Venezuela; it is presumed the presence of clinical forms and variants in the pediatric group. This first study could contribute to the knowledge and a better research of this group of disorders in our population.

[Estimations of the prevalence of attention deficit hyperactivity disorder in Marabino children]. / Estimaciones de la prevalencia del trastorno por déficit de atención-hiperactividad en niños marabinos.

AIMS: This study reports the findings of research aimed at determining the rate of prevalence of attention deficit hyperactivity disorder (ADHD) in children of school age. SUBJECTS AND METHOD: The epidemiological study was conducted using a community sample extracted by means of multi stage stratified sampling according to socio economic level and schooling and consisted in 1,141 children of both sexes of school age from the city of Maracaibo. The revised Conners scales were used to collect data. RESULTS: The estimated prevalence of ADHD was 7.19% and we also obtained 0.35% for the hyperactive type, 1.14% for the disattentional subtype, and 5.70% for the combined type. Contrary to what was expected, prevalence was higher for females. It was found that 7.45% of the general sample scored higher on the academic problems scales, whereas for the sample identified as having ADHD, academic problems were 50% and the comorbidity between ADHD and academic problems was confirmed. CONCLUSIONS: The estimates for prevalence found in this study are consistent with those reported in the literature, which suggests that ADHD is a valid diagnosis for Marabino children.

[Disseminated acute encephalomyelitis in children]. / Encefalomielitis aguda diseminada en niños.

INTRODUCTION: Disseminated acute encephalomyelitis (DAE) is an autoimmune inflammatory condition, usually monophasic with gradual resolution, polysymptomatic, usually in relation to a virus, bacteria or immunizations but may also occur in the absence of any obvious infection. OBJECTIVE: To describe DAE, its aetiology, clinical features, diagnosis and treatment. Also to analyze these aspects with regard to a series of 13 children with DAE. RESULTS: The clinical condition started with fever in 61% of the patients. The commonest neurological findings were sensory deterioration, convulsions and motor disorders (paresias). The cerebrospinal fluid was abnormal in four patients. MR showed hyperintense lesions of multifocal distribution, predominantly in the subcortical white matter. All patients were treated with intravenous methylprednisolone at a dose of 20 30 mg/kg. Clinical follow up showed complete recovery in 11/13 patients and mild sequelae in two cases. CONCLUSIONS: Diagnosis of DAE is based on suggestive clinical data and MR findings. MR is very sensitive in detecting demyelinating lesions and is the method of choice for confirmation of the diagnosis. DAE is characterized by a satisfactory clinical course with simultaneous resolution of the demyelinating lesions.

Comparison of the genomes of two Xanthomonas pathogens with differing host specificities.

The genus Xanthomonas is a diverse and economically important group of bacterial phytopathogens, belonging to the gamma-subdivision of the Proteobacteria. Xanthomonas axonopodis pv. citri (Xac) causes citrus canker, which affects most commercial citrus cultivars, resulting in significant losses worldwide. Symptoms include canker lesions, leading to abscission of fruit and leaves and general tree decline. Xanthomonas campestris pv. campestris (Xcc) causes black rot, which affects crucifers such as Brassica and Arabidopsis. Symptoms include marginal leaf chlorosis and darkening of vascular tissue, accompanied by extensive wilting and necrosis. Xanthomonas campestris pv. campestris is grown commercially to produce the exopolysaccharide xanthan gum, which is used as a viscosifying and stabilizing agent in many industries. Here we report and compare the complete genome sequences of Xac and Xcc. Their distinct disease phenotypes and host ranges belie a high degree of similarity at the genomic level. More than 80% of genes are shared, and gene order is conserved along most of their respective chromosomes. We identified several groups of strain-specific genes, and on the basis of these groups we propose mechanisms that may explain the differing host specificities and pathogenic processes.

[Epidemiologic studies of cerebellopontine angle tumors surgically treated in Maracaibo, Venezuela, in 1985-1999]. / Estudio epidemiológico de los tumores del ángulo pontocerebeloso operados en Maracaibo, Venezuela, durante el lapso 1985-1999.

OBJECTIVE: To analyze the epidemiological, clinical and neuropathological data of cases of cerebellopontine angle (CPA) tumors. MATERIAL AND METHODS: The clinical records, neuroimaging and neuropathological studies of 50 patients with diagnosis of CPA tumor operated in different hospitals of Maracaibo, Venezuela, during the lapse January 1st, 1985-December 31, 1999 were reviewed. The variables age, gender, side of the lesion and neuropathological diagnosis were analyzed. RESULTS: A 2:1 female to male ratio was observed. Median age was 48 +/- 12.7 years. Acoustic neuromas (AN) represented 48% of the cases, whereas nonacoustic neuroma tumors (NANT) made up for the rest (52%). Meningiomas were the second more commonly diagnosed lesions, they constituted 32% of the cases. Meningiomas and AN were more frequent in women, their ratios being 7:1 and 1.6:1, respectively. In 60% of the cases the signs and symptoms became eloquent in patients of the fourth and fifth decades of life. CONCLUSIONS: The difference between our results and the ones previously reported in the medical literature are due in part to the predominance of female patients in our series. Endocrinologic, genetic and biochemical factors could also be responsible; nevertheless, this does not constitute the objective of the present study.

Encefalomielitis aguda diseminada en niños / Disseminated acute encephalomyelitis in children

Introducción. La encefalomielitis aguda diseminada (EAD) representa un trastorno inflamatorio autoinmune, habitualmente monofásico con resolución gradual, polisintomático, habitualmente relacionado con virus, bacterias o inmunizaciones, el cual también puede ocurrir en ausencia de un fenómeno infeccioso precedente aparente. Objetivo. Describir la EAD, su etiología, manifestaciones clínicas, proceso diagnóstico y tratamiento. Asimismo analizar estos aspectos a través de la presentación de una serie de 13 niños con EAD. Resultados. El cuadro clínico se inició con fiebre en el 61 por ciento de los pacientes. Las manifestaciones neurológicas más frecuentes fueron el deterioro del sensorio, convulsiones y trastornos motores (paresias). El líquido cefalorraquídeo fue patológico en cuatro pacientes. La RM inicial mostró lesiones hiperintensas de distribución multifocal con predominio en la sustancia blanca subcortical. Todos los pacientes fueron tratados con metilprednisolona en dosis de 2030 mg/kg por vía endovenosa. El seguimiento clínico ha evidenciado una recuperación completa en 11/13 pacientes con secuelas leves en dos casos. Conclusiones. El diagnóstico de EAD se basa en los datos clínicos sugestivos y hallazgos en la RM, la cual es altamente sensible para detectar las lesiones desmielinizantes y constituye el método de elección para confirmar el diagnóstico. La evolución clínica favorable de los pacientes con resolución simultánea de las lesiones desmielinizantes caracterizan la EAD (AU)

Estudio epidemiológico de los tumores del ángulo pontocerebeloso operados en Maracaibo, Venezuela, durante el lapso 1985-1999 / Epidemiological study of the cerebellopontine angle tumors operated in Maracaibo, Venezuela, during the lapse 1985-1999

Objetivo: Analizar los datos epidemiológicos, clínicos y neuropatológicos relacionados con los tumores del ángulo pontocerebeloso (APC).Material y métodos: Se revisaron las historias clínicas, estudios por imágenes y estudios neuropatológicos correspondientes a 50 pacientes con diagnóstico de tumor de APC intervenidos en diferentes hospitales de Maracaibo, Venezuela, entre el 1° de enero de 1985 y el 31 de diciembre de 1999. Se recabaron los datos correspondientes a las variables edad, género, lado de la lesión y diagnóstico neuropatológico. Resultados: Se observó una razón de 2:1 entre el género femenino y el masculino. La media de edad fue de 48+/-12.7 años. Los neuromas acústicos (NA) representaron el 48 por ciento de los casos y los tumores no neuromas acústicos (TNNA) el 52 por ciento. Los meningiomas fueron segundos en frecuencia, constituyendo el 32 por ciento del total. Los Meningiomas y los NA fueron mas frecuentes en mujeres a razón de 7:1 y 1.6:1, respectivamente. El 60 por ciento de los casos se presentaron en pacientes correspondientes a las décadas cuarta y quinta. Conclusiones: La diferencia entre los resultados de nuestra serie y los comunicados previamente a la literatura médica mundial en relación con la incidencia de NA y TNNA en el APC obedece en parte al predominio de pacientes del género femenino en la presente muestra y probablemente al concurso de factores endocrinos, genéticos y bioquímicos, entre otros; sin embargo ello no formó parte de los objetivos del presente estudio (AU)