Fatty acid metabolism and brain mitochondrial performance of juvenile Nile tilapia (Oreochromis niloticus) exposed to the water-accommodated fraction of Maya crude oil.

Crude oil and its derivatives are still the primary source of energy for humankind. However, during its transportation and treatment, spills of this resource can occur in aquatic environments. Nile tilapia is one of the most globally widespread fish species. This species is even found in brackish water due to its tolerance to salinity and pollution. In this study, the performance of brain cells (mitochondrial membrane potential [ΔΨm], calcium [Ca2+] and O2 and H2O2 levels) exposed to crude oil was assessed. In addition, fatty acid metabolism (cholesterol concentration and fatty acid synthase [FAS], acyl CoA-oxidase [AOX] and catalase [CAT] activities) in the brain, heart, liver and intestine of Nile tilapia exposed to the water-accommodated fraction (WAF) of 0.01, 0.1 or 1 g/L Maya crude oil (MCO) for 96 h were evaluated. After exposure, in brain cells, there were only increases in ROS and slight reductions in ΔΨm. Exposure to WAF of MCO induced and increased the levels of cholesterol and altered FAS and AOX activities in all examined tissues. The brain is the most susceptible organ to alterations in the activity of fatty acid metabolic enzymes and cholesterol levels relative to the heart, liver and intestine. The correlation between inhibition of the activity of CAT and AOX suggests a possible reduction in the proliferation and size of peroxisomes. Most biomarkers were significantly altered in the brains of Nile tilapia exposed to the WAF containing 1 g/L MCO in comparison to the control.

Associated Inosine to interferon: results of a clinical trial in multiple sclerosis.

BACKGROUND: Uric acid (UA) could act as a natural peroxynitrite scavenger with antioxidant properties. It has been proposed that hyperuricemia might protect against multiple sclerosis (MS). METHODS: Patients with relapsing-remitting MS starting treatment with interferon beta-1a 44 µg sc 3/week were randomly assigned to receive either inosine 3 g/day or placebo in a double-blind manner. Follow-up was 12 months. Outcome measures were adverse events and UA laboratory results. Secondary end point was clinical and radiological activity of MS. Relapse rates, percentage of patients without relapses, and progression to secondary MS (SPMS) were assessed. RESULTS: Thirty six patients were included. Two patients in the inosine group showed UA serum level above 10 mg/ml, and symptoms derived from renal colic not leading to hospital admission. Ten additional patients had asymptomatic hyperuricemia (>7 mg). Efficacy parameters (clinical and radiological) were similar between groups. No patient progressed to SPMS CONCLUSIONS: Inosine administration was associated with hyperuricemia and renal colic with no additional effect on MS. We cannot conclude inosine is a safe and well-tolerated drug. Doses of around 2 g/day may be more appropriate for future trials.

Hemorragia intracerebral lobular: análisis de una serie y características en pacientes antiagregados y anticoagulados / Lobar intracerebral haemorrhage: analysis of a series and characteristics of patients receiving anti-platelet or anticoagulation treatment

Introducción: La hemorragia intracerebral lobular (HIL) es una causa poco frecuente de ictus y representan cerca del 20% de las hemorragias intracerebrales primarias. La causa más frecuente son la angiopatía amiloidea cerebral (AAC), la hipertensión arterial (HTA) y otras como el tratamiento antiagregante o anticoagulante. Analizar una serie de pacientes con HIL y compararla con subgrupos de pacientes con HIL antiagregados o anticoagulados previamente. Determinar el volumen de la hemorragia y su valor predictivo de mortalidad.Pacientes y métodos: Se incluyó de forma consecutiva y retrospectiva a 162 pacientes diagnosticados de HIL y atendidos en el servicio de neurología del Hospital Meixoeiro de Vigo entre los años 1991 y 2009. Se recogieron características demográficas, factores de riesgo, etiologías y clínica, y se realizó un análisis comparativo entre la serie general y los subgrupos de paciente antiagregados y anticoagulados.Resultados: En la serie general la causa más frecuente fue la AAC posible o probable seguida de la HTA. En los subgrupos de pacientes antiagregados o anticoagulados no había diferencias en las variables estudiadas excepto en la frecuencia de cardiopatía. Sí existían diferencias en cuanto a la edad, la cardiopatía y la volumen de la hemorragia entre la serie general (sin los pacientes antiagregados o anticoagulados) cuando se compararon con los subgrupos de antiagregados y anticoagulados.Conclusiones: Aportamos algunas novedades respecto al comportamiento clínico de la HIL y sus diferencias en los pacientes antiagregados o anticoagulados. La mortalidad es superior en las HIL anticoaguladas. Son variables predictivas de defunción el sexo femenino y el volumen de la hemorragia (AU)

Introduction: Lobar intracerebral haemorrhage (LIH), is a rare cause of stroke which accounts for about 20% of primary intracerebral haemorrhages. The most common causes are cerebral amyloid angiopathy (CAA), high blood pressure and others, such as using anti-platelet or anticoagulation agents. We analysed a series of patients with LIH and compared it with subgroups of patients with LIH who were previously receiving anti-platelet or anticoagulation agents. We determined the volume of the bleeding and its predictive value for mortality. Patients and methods: We consecutively and retrospectively included 162 patients diagnosed with LIH and cared for in the Neurology Department of Hospital Meixoeiro in Vigo between 1991 and 2009. We collected demographic characteristics, risk factors, aetiologies and symptoms, and conducted a comparative analysis between the general series and the subgroups of patients receiving anticoagulation and anti-platelet agents. Results: In the general series, the most common cause was possible or probable CAA followed by hypertension. In the subgroup of patients receiving anti-platelet or anticoagulation agents there were no differences in the variables studied, except for the frequency of heart disease. Nonetheless, there were differences with respect to age, heart disease and bleeding volume between the general series (patients not treated with anti-platelet or anticoagulation agents) when compared with the subgroups of patients receiving anti-platelet and anticoagulation agents. Conclusions: We provide new information regarding the clinical behaviour of LIH and its differences in patients receiving anti-platelet or anticoagulation agents. Mortality is higher in cases of LIH on anticoagulants. LIH. Female sex and the volume of bleeding are predictors of mortality (AU)

Lobar intracerebral haemorrhage: analysis of a series and characteristics of patients receiving antiplatelet or anticoagulation treatment.

INTRODUCTION: Lobar intracerebral haemorrhage (LIH), is a rare cause of stroke which accounts for about 20% of primary intracerebral haemorrhages. The most common causes are cerebral amyloid angiopathy (CAA), high blood pressure and others, such as using anti-platelet or anticoagulation agents. We analysed a series of patients with LIH and compared it with subgroups of patients with LIH who were previously receiving anti-platelet or anticoagulation agents. We determined the volume of the bleeding and its predictive value for mortality. PATIENTS AND METHODS: We consecutively and retrospectively included 162 patients diagnosed with LIH and cared for in the Neurology Department of Hospital Meixoeiro in Vigo between 1991 and 2009. We collected demographic characteristics, risk factors, aetiologies and symptoms, and conducted a comparative analysis between the general series and the subgroups of patients receiving anticoagulation and anti-platelet agents. RESULTS: In the general series, the most common cause was possible or probable CAA followed by hypertension. In the subgroup of patients receiving anti-platelet or anticoagulation agents there were no differences in the variables studied, except for the frequency of heart disease. Nonetheless, there were differences with respect to age, heart disease and bleeding volume between the general series (patients not treated with anti-platelet or anticoagulation agents) when compared with the subgroups of patients receiving anti-platelet and anticoagulation agents. CONCLUSIONS: We provide new information regarding the clinical behaviour of LIH and its differences in patients receiving anti-platelet or anticoagulation agents. Mortality is higher in cases of LIH on anticoagulants. LIH. Female sex and the volume of bleeding are predictors of mortality.

Hemorragia intracerebral lobular y angiopatía amiloidea cerebral: análisis de una serie de 106 pacientes / Lobar intracerebral haemorrhage and cerebral amyloid: analysis of a series of 106 patients

Introducción. La hemorragia intracerebral lobular (HL) es una causa infrecuente de ictus. Muchas HL están causadas por angiopatía amiloidea cerebral (AAC). El objetivo del presente estudio es analizar la clínica, factores de riesgo, volumen de la lesión y evolución, de una serie consecutiva de pacientes con HL y comparar las distintas características entre las hemorragias que cumplían los criterios de Boston para AAC y aquellas que no reunían los criterios. Métodos. Se describe una serie consecutiva de 106 pacientes con HL ingresados en el Servicio de Neurología del Hospital Meixoeiro de Vigo entre los años 1991 y 2005. Se aplicaron a todos los pacientes los criterios de Boston para HL relacionadas con AAC posible, probable y definitiva. Se comparan las características clínicas, factores de riesgo, tamaño de la hemorragia, evolución y complicaciones del grupo de pacientes que reunían los criterios de AAC, con aquellos que no los cumplían. Resultados. Los 106 pacientes de la serie representan el 14,4% de las hemorragias intracerebrales y el 3,7% de todos los ictus estudiados en nuestro servicio. El 54% de los pacientes fueron mujeres y la hipertensión arterial fue el factor de riesgo más importante. Un 20,8% de los pacientes ingresaron en coma y el 60% con hemiparesia, falleciendo el 28,3% de las HL. El volumen de la hemorragia y el sexo femenino fueron los únicos factores predictivos de exitus. En el análisis comparativo de los subgrupos de pacientes con criterios de AAC y los no AAC, no se encontraron variables significativas que diferencien un grupo de otro. Conclusión. La serie estudiada presenta unos factores de riesgo y características clínicas similares a otras series publicadas. No encontramos variables clínicas predictivas que diferencien entre las HL que reúnen criterios de AAC, con las HL que no los cumplen (AU)

Introduction. Lobar intracerebral haemorrhage (LH) is an uncommon cause of stroke. Many LH are caused by cerebral amyloid angiopathy (CAA). The aim of the present study is to analyse the clinical signs, risk factors, lesion volume and development, of a consecutive series of patients suffering from LH and to compare the various characteristics between haemorrhages which comply with the Boston criteria for CAA and those which do not comply with these inclusion criteria. Methods. A consecutive series of 106 patients suffering from LH and admitted to the neurological service in the Meixoeiro Hospital of Vigo between 1991 and 2005 is described. The Boston criteria were applied to all patients suffering from LH associated with possible, probable and confirmed CAA. The clinical signs, risk factors, haemorrhage sizes, evolution and complications of the patients complying with the CAA inclusion criteria were compared to those who did not comply with the inclusion criteria. Results. The 106 patients from the series, represent 14.4% of intracerebral haemorrhages and 3.7% of all strokes. Fifty-four percent (54 %) of the patients were female and arterial hypertension was an important risk factor. Twenty point eight percent (20.8%) of the patients were admitted in coma and 60% with hemiparesis. Of these LH patients 28.3% died. The haemorrhage volume and the female gender were the only predictive factors for death. No significant variables were observed to differentiate the groups in the comparative analysis of the subgroups of patients with CAA inclusion criteria and those without. Conclusions. The series studied showed similar risk factors and clinical characteristics to other published series. No predictive clinical variables were found to differentiate between LH which complied with CAA inclusion criteria and those that did not comply (AU)

[Rapid-onset dystonia-parkinsonism: sporadic form]. / Distonía-parkinsonismo de inicio rápido: forma esporádica.

INTRODUCTION: The rapid-onset dystonia-parkinsonism is a movement disorder which associates dystonic symptoms, especially those affecting orofacial muscles, and parkinsonian symptoms. All these symptoms start suddenly and then they stabilize along the process. This disorder usually occurs to young adults and is an autosomal dominant trait with a reduced penetrance, although some sporadic cases have been reported. The genetic alteration is found on the chromosome 19q13, where the mutated gene ATP1A3 has been identified. This gene is linked to the regulation of the sodium-potassium pump. CASE REPORT: A 16-year-old woman developed a sudden onset of dystonic symptoms which affected her higher and lower limbs, bulbar muscles, together with severe dysarthria and dysphagia. The onset occurred over hours, but her symptoms have been stabilized for years. No movement or other neurological disorders are reported in her family history. CONCLUSIONS: This is probably a sporadic case of rapid-onset dystonia-parkinsonism, and it is the second one reported in Spain. Diagnostic criteria, differential diagnosis, etiopahogenesis and genetic alterations are also discussed.

Distonía-parkinsonismo de inicio rápido: forma esporádica / Rapid-onset dystonia-parkinsonism: sporadic form

Introducción. La distonía-parkinsonismo de inicio rápido es un trastorno del movimiento que asocia distonía, conespecial afectación de la musculatura orofacial, y síntomas parkinsonianos. Esta sintomatología se instaura de forma brusca y posteriormente permanece estable a lo largo de la enfermedad. Afecta sobre todo a personas jóvenes y tiene carácter hereditario autosómico dominante con escasa penetrancia, aunque se han descrito casos esporádicos. La alteración genética selocaliza en el cromosoma 19q13, donde se ha encontrado una mutación del gen ATP1A3 relacionado con la regulación de la bomba de sodio-potasio. Caso clínico. Mujer de 16 años con un cuadro brusco de distonía que afecta a los miembros superiores e inferiores y a la musculatura bulbar, con importante disartria y disfagia. El cuadro clínico se instauró en unas horas yha permanecido estable a lo largo de los años. No existen antecedentes familiares de trastornos del movimiento ni de otras enfermedades neurológicas. Conclusiones. La distonía-parkinsonismo de inicio rápido constituye una forma rara de parkinsonismo que puede aparecer de forma esporádica o familiar. Este caso representa probablemente una forma esporádica y es elsegundo caso de esta rara entidad comunicado en España. El diagnóstico diferencial es complejo y debe realizarse principalmente con el parkinsonismo juvenil, la distonía que responde a la levodopa y la distonía-parkinsonismo unido al cromosoma X. Se discuten los criterios diagnósticos, el diagnóstico diferencial, la etiopatogenia y las alteraciones genéticas

Introduction. The rapid-onset dystonia-parkinsonism is a movement disorder which associates dystonic symptoms,especially those affecting orofacial muscles, and parkinsonian symptoms. All these symptoms start suddenly and then they stabilize along the process. This disorder usually occurs to young adults and is an autosomal dominant trait with a reduced penetrance, although some sporadic cases have been reported. The genetic alteration is found on the chromosome 19q13,where the mutated geneATP1A3 has been identified. This gene is linked to the regulation of the sodium-potassium pump. Case report. A 16-year-old woman developed a sudden onset of dystonic symptoms which affected her higher and lower limbs, bulbar muscles, together with severe dysarthria and dysphagia. The onset occurred over hours, but her symptoms have been stabilized for years. No movement or other neurological disorders are reported in her family history. Conclusions. This isprobably a sporadic case of rapid-onset dystonia-parkinsonism, and it is the second one reported in Spain. Diagnostic criteria, differential diagnosis, etiopahogenesis and genetic alterations are also discussed

Angiopatía amiloidea cerebral, hemorragias cerebrales de repetición y síndrome de Down / Cerebral amyloid angiopathy, recurrent intracerebral haemorrhages and Down's syndrome

Los pacientes con síndrome de Down en la edad media de la vida desarrollan demencia con cambios anatomopatológicos propios de la enfermedad de Alzheimer. La angiopatía amiloidea cerebral (AAC) puede manifestarse por hemorragias intracerebrales de localización lobular, únicas o múltiples, simultáneas o de repetición. La AAC se asocia frecuentemente con la enfermedad de Alzheimer. Sin embargo, la relación entre AAC y síndrome de Down es poco conocida. Aunque existen unos criterios diagnósticos de AAC relacionada con hemorragia intracerebral lobular, en la actualidad el diagnóstico definitivo de esta entidad es anatomopatológico. Aportamos el caso de un varón con síndrome de Down y hemorragias intracerebrales lobulares de repetición que en el estudio post mortem mostró alteraciones en los vasos leptomeníngeos y corticales características de AAC, así como cambios anatomopatológicos compatibles con enfermedad de Alzheimer que afectaban especialmente a la corteza entorrinal e hipocampo. Se discute la relación patogénica entre la proteína ²-amiloide, los alelos de la APOE, la AAC, la enfermedad de Alzheimer y el síndrome de Down (AU)

Middle-age Down's syndrome patients develop dementia with antomicopathological changes that are characteristic for Alzheimer's disease. Cerebral amyolid angiopathy (CAA) most commonly manifests itself as a lobar intracerebral haemorrhage that tends to recur. Multiple haemorrhages may occur simultaneously. CAA is frequently associated with Alzheimer's disease, however the relationship between CCA and Down's syndrome is poorly know. Although there are established clinical criteria for the diagnosis of CAA related to lobar intracerebral haemorrhage, definitive CAA needs anatomicopathologial confirmation. This paper presents the case of a male with Down's syndrome and recurrent lobar intracerebral haemorrhage. An autopsy showed lesions in leptomeningeal and cortical arteries which are characteristic of CAA in addition to anatomicopathological changes of Alzheimer s disease that were mostly seen in entorhinal cortex and hippocampus. The paper also discusses the pathological association between beta-amyloid protein, apolipoprotein alleles, CAA, Alzheimer's disease and Down's syndrome (AU)

[Cerebral amyloid angiopathy, recurrent intracerebral haemorrhages and Down's syndrome]. / Angiopatía amiloidea cerebral, hemorragias cerebrales de repetición y síndrome de Down.

Middle-age Down's syndrome patients develop dementia with antomicopathological changes that are characteristic for Alzheimer's disease. Cerebral amyolid angiopathy (CAA) most commonly manifests itself as a lobar intracerebral haemorrhage that tends to recur. Multiple haemorrhages may occur simultaneously. CAA is frequently associated with Alzheimer's disease, however the relationship between CCA and Down's syndrome is poorly know. Although there are established clinical criteria for the diagnosis of CAA related to lobar intracerebral haemorrhage, definitive CAA needs anatomicopathologial confirmation. This paper presents the case of a male with Down's syndrome and recurrent lobar intracerebral haemorrhage. An autopsy showed lesions in leptomeningeal and cortical arteries which are characteristic of CAA in addition to anatomicopathological changes of Alzheimer s disease that were mostly seen in entorhinal cortex and hippocampus. The paper also discusses the pathological association between beta-amyloid protein, apolipoprotein alleles, CAA, Alzheimer's disease and Down's syndrome.

SPECT de perfusión cerebral con 99mTc-HMPAO en un caso de encefalitis por VHS / 99mTc-HMPAO brain SPECT in a case of HSV encephalitis

Presentamos un caso de encefalitis aguda herpética en una mujer de 57 años con cuadro agudo sugestivo de infección vírica sin clínica neurológica asociada. Ante la aparición posterior de focalidad neurológica, se realizó análisis de líquido cefalorraquídeo (LCR) que mostró pleocitosis y linfocitosis, datos de proceso inflamatorio, y test serológico con positividad para Virus del Herpes Simple (VHS) subtipos I y II. Durante el ingreso, se practicaron otras pruebas complementarias: EEG, TC, RM, SPECT de perfusión cerebral; esta última aportó datos significativos con respecto a la neuroimagen anatómica (TC, RM) en cuanto a extensión bihemisférica del proceso encefalítico. Además, tras el alta clínica, demostró persistencia de la alteración metabólica en cortex temporal responsable de un cuadro de afasia mixta concomitante

We present a case of encephalitis caused by Herpes Simplex Virus in a 57 year old woman. The acute picture was suggestive of viral infection without associated neurological symptoms. Due to the posterior appearance of neurological focality, cerebral spinal fluid (CSF) was analyzed. It showed pleocytosis and lymphocytosis, inflammatory process data, and serological test with positivity for Simple Herpes Virus (SHV) subtypes I and II. During admission, other complementary tests were performed: EEG, CT, MRI, cerebral perfusion SPECT; the later supplied significant data regarding anatomical neuroimaging (CT, MRI) in regards to bihemispheral extension of the encephalic condition. Furthermore, after clinical discharge, persistent metabolic abnormality was demonstrated in temporal cortex, responsible for concomitant mixed aphasia

[99mTc-HMPAO brain SPECT in a case of HSV encephalitis]. / SPECT de perfusión cerebral con 99mTc-HMPAO en un caso de encefalitis por VHS.

We present a case of encephalitis caused by Herpes Simplex Virus in a 57 year old woman. The acute picture was suggestive of viral infection without associated neurological symptoms. Due to the posterior appearance of neurological focality, cerebral spinal fluid (CSF) was analyzed. It showed pleocytosis and lymphocytosis, inflammatory process data, and serological test with positivity for Simple Herpes Virus (SHV) subtypes I and II. During admission, other complementary tests were performed: EEG, CT, MRI, cerebral perfusion SPECT; the later supplied significant data regarding anatomical neuroimaging (CT, MRI) in regards to bihemispheral extension of the encephalic condition. Furthermore, after clinical discharge, persistent metabolic abnormality was demonstrated in temporal cortex, responsible for concomitant mixed aphasia.

[Experience in the treatment of multiple sclerosis with interferon beta in Galicia]. / Experiencia del tratamiento con interferón beta en la esclerosis múltiple en Galicia.

OBJECTIVE: To analyze the experience in daily clinical practice of interferon-beta (IFN-beta) treatment in relapsing-remitting (RR) and secondary progressive (SP) multiple sclerosis (MS) in Galicia (Spain). PATIENTS AND METHODS: Patients with RR-MS and SP-MS treated with IFN-beta1a and 1b between 1995 and December/2000, analyzing demographic and clinical data. RESULTS: 313 patients were included, with a mean age of 38.2 years. A total of 296 patients (94.6%) were clinically defined MS and 17 (5.4%) were laboratory supported (Poser criteria); 84.6% of the patients were RR and 15.4% were SP. The mean duration of the disease prior to treatment was 7.06 years. Betaferon was used in 52.4% patients (115 RR-MS and 47 SP-MS), Avonex in 26% and Rebif in 21.6%. Relapse rate was reduced in 68.8% for the RR-MS for Betaferon-treated patients, 73.3% for Avonex treated and 35.7% for Rebif-treated patients. Betaferon reduced relapse rate in 50% for SP-MS. The global EDSS remained stable during IFN-beta treatment. During treatment, 33% of Betaferon, 60.5% of Avonex and 54.5% of Rebif-treated patients remained relapse-free. Treatment was suspended in 12.9% of Betaferon, 6.2% of Avonex, and 3% Rebif-treated patients. The most frequent causes of treatment suspension were increase in disability and in relapse count. CONCLUSIONS: The present study supports the benefits of IFN-beta treatment in RR MS and SP MS in daily clinical practice, with reduction in relapses count and incapacity, good over-all tolerance and low incidence of serious adverse side-effects.

Experiencia del tratamiento con interferón B en la esclerosis múltiple en Galicia / Experience in the treatment of multiple of multiple sclerosis with interferón beta in Galicia

Objetivo. Analizar la experiencia en la práctica clínica diaria del tratamiento con interferón b (IFN b) en la esclerosis múltiple (EM) remitenterecidivante (RR) y secundaria progresiva (SP) en Galicia. Pacientes y métodos. Se analizaron los datos clínicos y demográficos de pacientes con EM RR y EM SP tratados con IFN b 1a y 1b entre 1995 y diciembre de 2000. Resultados. Se incluyeron 313 pacientes, con una media de edad de 38,2 años. Un total de 296 caso (94,6%) fueron EM clínicamente definidos y 17 (5,4%) fueron EM apoyados por laboratorio (criterios Poser); el 84,6% de los pacientes padecían EM RR y el 15,4%, EM SP. La duración media de la enfermedad antes del tratamiento fue 7,06 años. Se empleó Betaferón â en el 52,4% de los pacientes (115 EM RR y 47 EM SP), Avonex â en el 26% y Rebif â en el 21,6%. La tasa de brotes se redujo en un 68,8% para la EM RR en los pacientes tratados con Betaferón, en un 73,3% en los tratados con Avonex y en un 35,7% en los tratados con Rebif. El Betaferón redujo la tasa de brotes en un 50% para la EM SP. Durante el tratamiento, el EDSS global permaneció estable, y el 33% de los pacientes tratados con Betaferón, el 60,5% de los tratados con Avonex y el 54,5% de los tratados con Rebif permanecieron libres de brotes. El tratamiento se suspendió en el 12,9% de los pacientes tratados con Betaferón, el 6,2% de los tratados con Avonex, y el 3% de los tratados con Rebif, y las causas más frecuentes fueron el incremento de la discapacidad y el aumento de brotes. Conclusiones. Este estudio apoya el beneficio del tratamiento con IFN b en la EM RR y la EM SP en la práctica clínica diaria, pues promueve la reducción de los brotes, la tasa de brotes y la discapacidad, con una buena tolerancia global y una baja incidencia de efectos secundarios graves (AU)

Objective. To analyze the experience in daily clinical practice of interferonbeta (IFN b) treatment in relapsing remitting (RR) and secondary progressive (SP) multiple sclerosis (MS) in Galicia (Spain). Patients and methods. Patients with RRMS and SPMS treated with IFN b 1a and 1b between 1995 and December/2000, analyzing demographic and clinical data. Results. 313 patients were included, with a mean age of 38,2 years. A total of 296 patients (94,6%) were clinically defined MS and 17 (5,4%) were laboratory supported (Poser criteria); 84,6% of the patients were RR and 15,4% were SP. The mean duration of the disease prior to treatment was 7,06 years. Betaferon â was used in 52,4% patients (115 RRMS and 47 SPMS), Avonex â in 26% and Rebif â in 21,6%. Relapse rate was reduced in 68,8% for the RRMS for Betaferontreated patients, 73,3% for Avonex treated and 35,7% for ebiftreated patients. Betaferon reduced relapse rate in 50% for SPMS. The global EDSS remained stable during IFN b treatment. During treatment, 33% of Betaferon, 60,5% of Avonex and 54,5% of Rebiftreated patients remained relapsefree. Treatment was suspended in 12,9% of Betaferon, 6,2% of Avonex, and 3% Rebiftreated patients. The most frequent causes of treatment suspension were increase in disability and in relapse count. Conclusions. The present study supports the benefits of IFN b treatment in RR MS and SP MS in daily clinical practice, with reduction in relapses count and discapacity, good overall tolerance and low incidence of serious adverse sideeffects (AU)

[The association of Marchiafava-Bignami disease, cerebral pellagra and cerebellar degeneration in an alcoholic patient]. / Asociación de enfermedad de Marchiafava-Bignami, pelagra cerebral y degeneración cerebelosa en un paciente alcohólico.

INTRODUCTION: Marchiafava-Bignami disease, cerebral pellagra and alcoholic cerebellar degeneration are a group of diseases included in the alcoholic encephalopathies, although they may also be caused by metabolic or nutritional disorders. The isolated appearance of these diseases usually permits diagnosis during the life of the patient, based on the neuro-radiological findings. However, their combination leads to complex form, with variable neurological expression, which means that precise diagnosis may often be post mortem. CLINICAL CASE: We present a malnourished alcoholic patient with neurological features compatible with alcoholic encephalopathy. The post mortem findings showed lesions typical of alcoholic cerebellar degeneration, cerebral pellagra and Marchiafava-Bignami disease.

[Normotensive hydrocephalus as a manifestation of meningovascular syphilis]. / Hidrocefalia normotensiva como manifestación de sífilis meningovascular.

Progressive general paralysis, tabes dorsalis and meningovascular syphilis are different manifestations of tertiary syphilis. The clinical picture of meningovascular syphilis is of a subacute or chronic meningeal syndrome. It may be associated with focal neurological signs of cerebral arteritis. Inflammation of the leptomeninges may impede circulation of the cerebrovascular fluid at different levels, giving rise to noncommunicating, or exceptionally to communicating hydrocephalus. Diagnosis of this depends on the clinical signs and neuro-imaging changes. We present the case of a man with meningovascular syphilis who developed clinical signs of normotensive hydrocephalus.

[Neurological presentation of systemic lupus erythematosus]. / Presentación neurológica del lupus eritematoso sistémico.

We describe the case of a 61 years-old-woman with lupus erythematosus who presented with neurological symptoms, namely dementia, focality and crisis. The neurological presentation of lupus is evaluated clinically, being similar to the central manifestations of patients with systemic onset. The marked cognitive affectation with relation to other cases of lupus with a neurological onset is emphasized. MR has been shown to be a sensitive means of detection of corticosubcortical lesions of neurolupus, not specific to this condition, as well as to their response to immunosuppressors. The aetiopathogenesis of some of the manifestations of cerebral lupus and the clinical response to corticosteroids and cyclophosphamide is reviewed.

[Preeclampsia in pregnancy. Importance of reclassification]. / Preeclampsia en el embarazo. Importancia de la reclasificación.

It is difficult to determine the etiology of hypertension during pregnancy on the basis of clinical criteria alone. The purpose of the present study is to emphasize the impact of the postpartum reclassification of the hypertensive disorders in gestation. One hundred and fifty eight patients with an initial diagnosis of preeclampsia were prospectively studied. The follow-up included a reclassification of their hypertensive disorder at 4, 8 and 12 weeks postpartum. Such reclassification was based on renal function test and values of blood pressure. Among 158 patients, 118 had an initial diagnosis of preeclampsia during pregnancy, and only in 39 cases (33%) such diagnosis was confirmed postpartum. At the time of reclassification the rest of the patients belonged to the following conditions: gestational hypertension without proteinuria 35%, chronic hypertension 16%, nephropathy (7 with renal biopsy) 11%, and 4% with chronic hypertension and superimposed preeclampsia. There was no significative difference in perinatal morbidity between patients with chronic and gestational hypertension. A total of 10% of perinatal mortality rate was found. We concluded that the reclassification postpartum of the hypertensive disorders in pregnancy is essential to avoid errors in diagnosis and to establish adequate maternal and perinatal outcomes in future pregnancies.

[Granulomatous angiitis of the basilar artery related to herpes zoster of the 7th cranial nerve]. / Angeítis granulomatosa de la arteria basilar en relación con herpes zoster del VII par.

Granulomatous angiitis of the central nervous system is an uncommon condition characterized by vascular wall necrosis, inflammatory exudate and development of giant cells in medium and small size vessels. The pathogenesis of this disease remains unknown, but it has been associated with immune complexes, mechanical factors and infection by the varicella-zoster virus. We report a young patient who presented with herpes zoster involving the VII cranial nerve and contralateral hemiplegia. Subsequently, pontine infarct and fatal subarachnoid hemorrhage developed. The pathological study showed granulomatous angiitis of basilar artery.