Characterization of autism spectrum disorder inside prison.

INTRODUCTION: Autism is a neurodevelopmental disorder characterized by intolerance of change, empathy deficits, misunders- tandings, and emotional dysregulation. Core symptoms can determine criminal behaviour and subsequent interactions with the penal system. A significant presence of such symptoms is detected in forensic settings. The objective of this study is to analyze the characteristics of autism within the prison context, summarizing and updating the knowledge in this field. MATERIAL AND METHOD: Systematic review through databases on studies that analyze the socio-demographic, clinical, and judi- cial characteristics of prisoners diagnosed with autism spectrum disorder. RESULTS: Autistic traits constitute an independent risk factor for incarceration. Those inmates with autism spectrum disorder frequently present a psychiatric comorbidity, especially substance use disorder, psychotic disorders, and other neuro-develop- mental disorders. They are associated with a greater probability of self-harming thoughts and disruptive behaviours, which are not predicted by the usual evaluation tools. DISCUSSION: Prisoners with autism spectrum disorder have a differential socio-demographic, clinical, and criminal profile. A specific approach that is different from the one provided for neurotypical prisoners should be offered to these inmates. In- frastructures should be adapted to reduce fragility, make the environment more flexible and specific methods for evaluation and treatment should be developed.

Caracterización del trastorno del espectro autista dentro de prisión / Characterisation of autistic spectrum disorder within in prison

Introducción: El autismo es un trastorno del neurodesarrollo caracterizado por intolerancia al cambio, déficit en empatía,falsas interpretaciones y desregulación emocional. La sintomatología nuclear determina la comisión de delitos y la posteriorinteracción con el sistema penal, detectándose una presencia significativa en entornos forenses. El objetivo del trabajo esanalizar las características del autismo dentro del contexto penitenciario, resumiendo y actualizando el conocimiento endicho ámbito.Material y método: Revisión sistemática a través de bases de datos sobre aquellos estudios que analizan las características sociodemográficas, clínicas y judiciales, en reclusos con diagnóstico de trastorno del espectro autista.Resultados: Los rasgos autistas constituyen un factor de riesgo independiente para el encarcelamiento. Aquellos internos contrastorno del espectro autista presentan con mayor frecuencia una comorbilidad psiquiátrica, especialmente trastornos por usode sustancias, trastornos psicóticos y otros trastornos del neurodesarrollo. Asocian mayor probabilidad de pensamientos autolesivos y conductas disruptivas, que no son prevenidas por las herramientas de evaluación de uso frecuente.Discusión: Los reclusos con trastorno del espectro autista (TEA) presentan un perfil diferencial a nivel sociodemográfico,clínico y delictivo. Debe ofrecerse un abordaje específico para esos internos, diferente respecto al dispuesto para los internosneurotípicos. Hay que adaptar infraestructuras para reducir su fragilidad, flexibilizando el entorno y desarrollando métodosespecíficos para la evaluación y tratamiento. (AU)

Introduction: Autism is a neurodevelopmental disorder characterized by intolerance of change, empathy deficits, misunderstandings, and emotional dysregulation. Core symptoms can determine criminal behaviour and subsequent interactions with thepenal system. A significant presence of such symptoms is detected in forensic settings. The objective of this study is to analyzethe characteristics of autism within the prison context, summarizing and updating the knowledge in this field.Material and method: Systematic review through databases on studies that analyze the socio-demographic, clinical, and judicial characteristics of prisoners diagnosed with autism spectrum disorder.Results: Autistic traits constitute an independent risk factor for incarceration. Those inmates with autism spectrum disorderfrequently present a psychiatric comorbidity, especially substance use disorder, psychotic disorders, and other neuro-developmental disorders. They are associated with a greater probability of self-harming thoughts and disruptive behaviours, which arenot predicted by the usual evaluation tools. Discussion: Prisoners with autism spectrum disorder have a differential socio-demographic, clinical, and criminal profile. Aspecific approach that is different from the one provided for neurotypical prisoners should be offered to these inmates. Infrastructures should be adapted to reduce fragility, make the environment more flexible and specific methods for evaluationand treatment should be developed. (AU)

Escuchar con los ojos: evaluación por tomografía axial computarizada de la pérdida auditiva / Listening with your eyes: computed tomography assessment of hearing loss

Múltiples patologías pueden afectar el funcionamiento del aparato auditivo. El conocimiento anatómico de los compartimentos del hueso temporal en la tomografía axial computarizada (TAC) conduce a una mejor comprensión de estas entidades y mejora el enfoque clínico hacia la pérdida auditiva conductiva o neurosensorial. Un diagnóstico preciso significa un inicio rápido del tratamiento, lo cual puede modificar el pronóstico del paciente

Multiple pathologies can affect the function of the auditory apparatus. Anatomical knowledge of the temporal bone compartments on computed tomography leads to a better understanding of these entities and improves the clinical approach toward conductive or sensorineural hearing loss. An accurate diagnosis means a rapid initiation of treatment, which can change the patient's prognosis.

Comparación de Panc3 con Apache II como escalas predictoras de severidad en pancreatitis aguda en Hospital de Especialidades Carlos Andrade Marín / Comparison between Panc3 score and Apache II score to predict severity in acute pancreatitis in Carlos Andrade Marin Speciality Hospital

INTRODUCCIÓN. La pancreatitis aguda es una patología que conlleva importante morbilidad, la adecuada estratificación de su severidad determina su manejo oportu-no. OBJETIVO. Comparar la escala Panc3 con el Apache II como predictora de seve-ridad en pacientes con pancreatitis aguda. MATERIALES Y MÉTODOS. Se realizó un estudio analítico observacional, con universo y muestra conocida de 148 pacientes con pancreatitis aguda atendidos en el Hospital de Especialidades Carlos Andrade Marín entre agosto 2018 a junio 2019. Los criterios de inclusión fueron: pacientes adultos jóvenes, mayores de 18 años con pancreatitis aguda, como criterios de ex-clusión: pacientes con antecedente de pancreatitis crónica. Se obtuvo los datos con medidas de asociación y análisis bivariado con pruebas de hipótesis de Chi cuadra-do, un nivel de confianza de 95,0% y con una p menor de 0,05, y con error de 5,0%. RESULTADOS. Las escalas Apache II y Panc3 mostraron resultados estadísticamen-te significativos para predecir severidad de pancreatitis aguda, no existió asociación significativa entre la severidad y los factores de riesgo o antecedentes estudiados DISCUSIÓN. La asociación de las escalas con la severidad fue similar a estudios disponibles. CONCLUSIONES. La escala Panc3 fue tan eficaz como la escala Apa-che II para predecir la severidad en los pacientes con pancreatitis aguda, no existió asociación entre los factores de riesgo, los antecedentes estudiados y la severidad, además la escala Apache II fue útil para predecir severidad.

INTRODUCTION. Acute pancreatitis is a pathology that carries important morbidity, the adequate stratification determines its timely management. OBJECTIVE. Com-pare the Panc3 scale with Apache II as a predictor of severity in patients with acute pancreatitis. MATERIALS AND METHODS. An observational analytical study was conducted, with universe and known sample of 148 patients with acute pancreati-tis treated at the Carlos Andrade Marín Specialities Hospital between august 2018 and june 2019. The inclusion criteria were: young adult patients, over 18 years old with acute pancreatitis, as exclusion criteria: patients with chronic pancreatitis history. Data was obtained with bivariate association measures and analysis with Chi square hypothesis tests, a confidence level of 95,0% and with a p less than 0,05, and with error of 5,0%. RESULTS. The Apache II and Panc3 scales showed statistically signifi-cant results in predicting severity of acute pancreatitis, there was no significant asso-ciation between severity and risk factors or background studied. DISCUSSION. The association of scales with severity was similar to available studies. CONCLUSIONS. The Panc3 scale was as effective as the Apache II scale in predicting severity in pa-tients with acute pancreatitis, there was no association between risk factors, the back-ground studied and severity, and the Apache II scale was useful in predicting severity.

Association of a characteristic membrane pattern of annexin A2 with high invasiveness and nodal status in colon adenocarcinoma.

The identification of tumor cells in lymph nodes is essential for the correct classification of patients with colorectal cancer who may benefit from adjuvant treatments. Proper classification of tumor stage becomes entangled by variables such as an insufficient number of lymph nodes examined, which can result in erroneous or missed diagnosis. The determination of pathologic factors in the primary tumor associated with positive lymph nodes is an area of research that has attempted to provide variables to solve this problem. In the present study, we observed that the localization of annexin A2 (AnxA2) in a cell membrane is the characteristic that distinguishes tumor cells with high invasiveness. Localization of AnxA2 expression was also studied in tissue specimens from 58 patients with invasive colorectal carcinoma (T3-T4), who had undergone colectomy with radical lymph node dissection. Interestingly, the membrane pattern observed in tumor cell lines was also identified in patient's tissue samples and allowed us to distinguish among different cell populations with the tumor. Univariate analysis showed that tumor deposits in pericolic fat, extramural vascular invasion, and amount of cells with AnxA2 membrane pattern in the tumor invasive edge had a significant influence on lymph node metastasis. On the contrary, multivariate analysis revealed that the number of cells with AnxA2 membrane pattern (P < 0.05) and tumor deposits (P < 0.05) was significantly associated with lymph node metastasis. Furthermore, AnxA2 cellular localization was observed in cell clusters that define tumor budding, and a significant association between both variables was detected.

Role of corticotropin-releasing factor (CRF) receptor-1 on the catecholaminergic response to morphine withdrawal in the nucleus accumbens (NAc).

Stress induces the release of the peptide corticotropin-releasing factor (CRF) into the ventral tegmental area (VTA), and also increases dopamine (DA) levels in brain regions receiving dense VTA input. Since the role of stress in drug addiction is well established, the present study examined the possible involvement of CRF1 receptor in the interaction between morphine withdrawal and catecholaminergic pathways in the reward system. The effects of naloxone-precipitated morphine withdrawal on signs of withdrawal, hypothalamo-pituitary-adrenocortical (HPA) axis activity, dopamine (DA) and noradrenaline (NA) turnover in the nucleus accumbens (NAc) and activation of VTA dopaminergic neurons, were investigated in rats pretreated with vehicle or CP-154,526 (selective CRF1R antagonist). CP-154,526 attenuated the increases in body weight loss and suppressed some of withdrawal signs. Pretreatment with CRF1 receptor antagonist resulted in no significant modification of the increased NA turnover at NAc or plasma corticosterone levels that were seen during morphine withdrawal. However, blockade of CRF1 receptor significantly reduced morphine withdrawal-induced increases in plasma adrenocorticotropin (ACTH) levels, DA turnover and TH phosphorylation at Ser40 in the NAc. In addition, CP-154,526 reduced the number of TH containing neurons expressing c-Fos in the VTA after naloxone-precipitated morphine withdrawal. Altogether, these results support the idea that VTA dopaminergic neurons are activated in response to naloxone-precipitated morphine withdrawal and suggest that CRF1 receptors are involved in the activation of dopaminergic pathways which project to NAc.