[Classification of continuous multilevel vertebral fractures]. / Clasificación de las fracturas vertebrales multinivel continuas.

Currently there is still little information about multilevel vertebral fractures (MVF), in addition to the fact that there are no classifications that help us group them in a simpler way, and guide us on their prognosis. The objective of this work is to propose a new classification of continuous type MVF, based on the number of end plates injured of the vertebral bodies and their severity, where we form four groups. A review of continuous MVF cases that we found in our hospital over a 6-year period was carried out, managing to designate 100% of the fractures, by their characteristics, to the corresponding group. In addition, we observed a better neurological prognosis in group 1. This classification is a proposal that will help us to group these injuries, that can be very varied, in only four groups; with the aim of later creating a more standardized management proposal, and knowing its neurological prognosis.

Actualmente aún existe poca información acerca de las fracturas vertebrales multinivel (MVF), además de que no hay clasificaciones que nos ayuden a agruparlas de una manera más sencilla y nos orienten sobre su pronóstico. El objetivo del presente trabajo es proponer una nueva clasificación de MVF del tipo continuas, basada en el número de plataformas lesionadas de los cuerpos vertebrales y su gravedad, donde formamos cuatro grupos. Se realizó la revisión de casos de MVF continuas que encontramos en nuestro hospital en un período de seis años; logrando designar cada fractura, debido a sus características, al grupo correspondiente en 100% de los casos. Además, se observó un mejor pronóstico neurológico en el grupo 1. Esta clasificación es una propuesta que nos ayudará a agrupar estas lesiones, que pueden ser muy variadas, en sólo cuatro grupos; con el objetivo de posteriormente crear una propuesta de manejo más estandarizado y conocer su pronóstico neurológico.

Analysis of Retinal Layers in Fibromyalgia Patients with Premium Protocol in Optical Tomography Coherence and Quality of Life.

PURPOSE: To evaluate the inner retinal layers in fibromyalgia (FM) patients compared to control subjects using posterior pole protocol (PPole) analysis in optical coherence tomography (OCT) and to correlate structural retinal changes with subjective quality of life. METHODS: Seventy-four eyes of healthy subjects and 55 eyes of those with FM were analyzed. All subjects underwent retinal evaluation using the PPole protocol for Spectralis OCT (Heidelberg Engineering) to obtain measurements of the retinal nerve fiber layer (RNFL) and the ganglion cell layer (GCL) in the macular area. The EuroQol (EQ-5D) questionnaire and Fibromyalgia Impact Questionnaire (FIQ) were performed to analyze health-related quality of life. Additionally, the FM group was divided into three groups depending on the disease phenotype (atypical, depressive, and biological). RESULTS: Patients with FM presented with a reduction of the RNFL thickness compared to controls in 17/64 cells of the PPole area, and a reduction of the GCL thickness in 47/64 cells. Depressive FM phenotype showed the greatest number of cells with significant reduction compared with the control group in both RNFL and GCL layers. A correlation between temporal-inferior cells of the GCL and the EuroQol 5D questionnaire results was observed. CONCLUSIONS: Patients with FM present with a reduction of the inner retinal layers in the macular area. This degeneration correlates with disease severity/reduced quality of life in these patients. The PPole protocol for OCT is a non-invasive and fast tool that might help clinicians diagnose and monitor neurodegeneration in FM patients.

[Mental retardation as a risk factor to develop a psychotic disease]. / Retraso mental como factor de riesgo para el desarrollo de un trastorno psicótico.

INTRODUCTION: One of the main aims of research on schizophrenia has been to pinpoint the early symptoms and signals of the disease before its appearance. OBJECTIVES: We have examined the diagnoses previously given to patients before they were diagnosed of schizophrenia. METHOD: This is a case-control study in which we used a data register including the fields of minimum basic data set (MBDS) whose time period included 1999 to 2005. RESULTS: In our study, there was a 3.6% frequency of mental retardation and 2.1% one of behavioral and emotional disorders with onset usually occurring in childhood and adolescence, both diagnosed previously. The estimated odds ratio for a mentally retarded patient to suffer adult onset psychosis is 4.6 (95%CI [3.43-6.26]), schizophrenia 5.8 (95% CI [4.20-7.88]), paranoid schizophrenia 4.8 (95% CI [3.39 -6.93]), residual schizophrenia 7.0 (95% CI [4.81 -10.09]) and persistent delusional disorder 2.7 (95% CI [1.57 -4.73]). CONCLUSIONS: It can be concluded from our study that there is an increased frequency of mental retardation among the pathological records of subjects who will be diagnosed with paranoid schizophrenia and residual schizophrenia in the future. This fact supports the etiological thesis of schizophrenia involving neurodevelopment disorders.

Phenotypical differences among B. cinerea isolates from ornamental plants.

B. cinerea is a common pathogenic fungus which causes Botrytis blight (Grey mould) in most ornamental plants. It may be responsible for serious preharvest diseases and postharvest losses in fruits, vegetables and flowers. In this work, several B. cinerea isolates from ornamental plants (Chamelaucium uncinatum, Pelargonium x hortorum, Euphorbia pulcherrima, Lantana camara, Lonicera japonica, Hydrangea macrophylla, and Cyclamen persicum) affected by Botrytis blight in the south of Spain were studied. All the isolates were confirmed as B. cinerea by PCR using a specific 750-bp molecular marker, which is present in all strains of this species but absent from other species of Botrytis. The isolates were evaluated by reference to mature conidia length, sclerotia production, and growth rate. Conidia, conidiophores and hyphae were described by light microscopy and some by cryogenic scanning electron microscopy (Cryo-SEM). Conidium length was measured by using an eyepiece micrometer at 400x power, whereas the growth rate was assessed from differences in colony diameter between the third and fourth day of growth in potato-dextrose agar culture medium at 26 degrees C. B. cinerea showed a high degree of phenotypical variability among isolates, not only as regards visual aspects of the colonies but also in some morphological structures such as conidium length, conidiophores, sclerotia production, and hyphae. Differences were also observed in the growth rates. Conidiation was insignificant in the isolates from H. macrophylla, and P. x hortorum, where the overall appearance was white in all the growing stages, whereas isolates from L. camara, C. persicum and C. uncinatum were mainly grey or brown in mature stages. The longest conidia were obtained in isolates from H. macrophylla and C. persicum (17-18 microm) and the lowest in C. uncinatum (9 microm). All the isolates, except L. camara, developed mature sclerotia after approximately 16 days in the conditions used. H. macrophylla had around 72 sclerotia per colony, whereas C. persicum had only nine after 28 days. The growth rate of isolates from L. camara was the highest (1.64 cm/day). Such phenotypical variability may result in a differential response to plant growth regulators if plants are infected by Botrytis in the early stages of growth. In this way, we confirm, as we have done in other published studies, that isolates show different responses to some plant hormones and inhibitors.

Meckel's diverticulum adenocarcinoma: a rare malignant degeneration.

The case of a 40 year old male that, after the etiological study performed due to rectorrhages that was the only symptom he presented, was referred to an exploratory laparotomy. A disseminated adenocarcinoma arising in Meckels diverticulum was detected and palliative segmentary resection of the small bowel was performed. The lack of previous symptoms lead to the dissemination of the disease and to the impossibility of curative surgical resection of the tumor.

[Diagnostic utility of carcinoembryonic antigen, neuron-specific enolase and squamous cell carcinoma antigen in malignant pleural effusion]. / Utilidad del antígeno carcinoembrionario, enolasa neuroespecífica y antígeno de células escamosas (en líquido pleural y suero) en el diagnóstico del derrame pleural maligno.

We evaluated the diagnostic utility of the carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC Ag.) in malignant pleural effusion (MPE). CEA, NSE and SCC Ag, blood and pleural levels were quantified by enzyme immunoassay (EIA) in 85 patients with pleural effusions: 35 non malignant pleural effusions, and 50 MPE; 42 with lung carcinoma (LC), and 8 with extrapulmonary carcinoma. The sensitivity and specificity was compared to cytological results of the pleural fluid. The sensitivities of CEA7 NSE and SCC Ag. (in pleural fluid) were 59.5%, 48.7% and 16.7% respectively in patients with LC (specificity higher than 90%). Using a combination with CEA and NSE, the sensitivity reached 80.9% (specificity, 91.4%). The cytology of pleural fluid was positive in 45.2%. The pleural/blood ratios did not improve the diagnostic performance. In patients with extrapulmonary carcinoma, the sensitivity of these tumor markers was lower. The combination of CEA and NSE pleural levels is useful in the diagnostic approach to the patient with pleural effusion. A high level of NSE is suggestive of small cell lung cancer (SCLC).

[The CREST syndrome associated with the sicca syndrome]. / Síndrome de CREST asociado a síndrome seco.

A case of CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal hypomotility, sclerodactyly, and telangiectasia) that initially showed Raynaud's phenomenon, sclerodactyly and polyarthralgias, 3 years later completing the process, associated to sicca syndrome, is presented. The esophageal affectation showed a loss of peristalsis of the inferior 2/3, as well as hypotonia of the gastroesophageal sphincter. We comment the prognostic relationship between CREST syndrome and the centromeric region antibodies.