Simpatectomía toracoscópica: una revisión de la literatura

INTRODUCTION: Since its first description by Kux in 1954, the thoracic endoscopic (thoracoscopic) sympathectomy has rendered the open techniques obsolete in the treatment of the hyperhidrosis and other sympathetic-related diseases. AIM. The goal of this article is to present a critical review of the current indications, results and complications of the endoscopic thoracic sympathectomy. MATERIAL AND METHODS: An extensive search and review of published papers on the thoracoscopic sympathectomy was undertaken. RESULTS: The thoracoscopic sympathectomy has evolved as a therapeutic choice in patients with focal hyperhidrosis, pain syndromes and peripheral vascular disorders, particularly. The results, recurrences and complications are similar to the previously established open procedures; nevertheless, the morbidity, the hospital stay and the time to return to activities of daily living are substantially reduced. The highest success and satisfaction rates (over 95%) were observed among patients treated for focal hyperhidrosis. CONCLUSIONS: The success and complication rates of thoracoscopic sympathectomy are comparable to those of open techniques, with an easier postoperative period and an earlier return to labor and daily living

Vestibular impairment in hemifacial spasm syndrome: A case report

A 52-year-old man presented with left hemifacial spasm (HFS). A magnetic resonance imaging scan showed compression of the left facial nerve at the cerebellopontine angle by a dolichoectatic basilar artery. The neurotological evaluation showed an otolithic deficit, with canalicular preservation and normal hearing. The deficit improved after surgical decompression. No previous report has described the impairment of vestibular function in patients presenting with HFS

Memory decline evolves independently of disease activity in MS

The natural history of cognitive impairment in multiple sclerosis (MS) and its relationship with disease activity is not well known. In this study, we evaluate a prospective cohort of 44 MS patients who were followed every 3 months for 2 years. Cognitive evaluation was done at baseline and by the end of the study using the Brief Repeatable Battery-Neuropsychology. Clinical evaluation included assessment of new relapses and changes in disability (Extended Disability Status Scale (EDSS)) confirmed at 6 months. RESULTS: We found that verbal memory performance deteriorates after 2 years in patients with MS. These changes were observed in stable and active patients both in terms of relapses and disability progression, even at the beginning of the disease, and in patients with or without cognitive impairment at study entry. Attention and executive functions measured with the symbol digit modality test (SDMT) declined after 2 years in patients with confirmed disability progression. Furthermore, SDMT performance correlated with the EDSS change. CONCLUSIONS: Our findings indicate that verbal memory steadily declines in patients with MS from the beginning of the disease and independently of other parameters of disease activity

Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis

Studying axonal loss in the retina is a promising biomarker for multiple sclerosis (MS). Our aim was to compare optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT) techniques to measure the thickness of the retinal nerve fiber layer (RNFL) in patients with MS, and to explore the relationship between changes in the RNFL thickness with physical and cognitive disability. We studied 52 patients with MS and 18 proportionally matched controls by performing neurological examination, neuropsychological evaluation using the Brief Repetitive Battery-Neuropsychology and RNFL thickness measurement using OCT and HRT. RESULTS: We found that both OCT and HRT could define a reduction in the thickness of the RNFL in patients with MS compared with controls, although both measurements were weakly correlated, suggesting that they might measure different aspects of the tissue changes in MS. The degree of RNFL atrophy was correlated with cognitive disability, mainly with the symbol digit modality test (r=0.754, P<0.001). Moreover, temporal quadrant RNFL atrophy measured with OCT was associated with physical disability. CONCLUSION: In summary, both OCT and HRT are able to detect thinning of the RNFL, but OCT seems to be the most sensitive technique to identify changes associated with MS evolution

Apoptosis Is a Demanding Selective Tool During the Development of Fetal Male Germ Cells

Apoptosis is widely known to play a major role on diseases related to male infertility. Diseases of the male genital tract as defective spermatogenesis, decreased sperm motility, sperm DNA fragmentation, testicular torsion, varicocele and immunological infertility are strongly related to apoptotic cell death. Apoptosis must not be considered only as a fail on germ cell physiology or a secondary effect of certain pathologies and exogenous hazardous agents. Apoptosis orchestrates correct function and development of the male germ cell from the early embryonic stages of gonadal differentiation to the fertilization. In this review we have tried to address a reading frame of the main knowledge about apoptosis in male germ cell development. Focussing on mechanisms concerning cellular apoptosis, which are independent of exogenous stimuli, we aimed to highlight that apoptosis is a selective instrument that guarantees the delivery of genetic message to offspring

Fractal dimension analysis of grey matter in multiple sclerosis

The fractal dimension (FD) is a quantitative parameter that characterizes the morphometric variability of a complex object. Among other applications, FD has been used to identify abnormalities of the human brain in conventional magnetic resonance imaging (MRI), including white matter abnormalities in patients with Multiple Sclerosis (MS). Extensive grey matter (GM) pathology has been recently identified in MS and it appears to be a key factor in long-term disability. The aim of the present work was to assess whether FD measurement of GM in T1 MRI sequences can identify GM abnormalities in patients with MS in the early phase of the disease. A voxel-based morphometry approach optimized for MS was used to obtain the segmented brain, where we later calculated the three-dimensional FD of the GM in MS patients and healthy controls.We found that patients with MS had a significant increase in the FD of the GM compared to controls. Such differences were present even in patients with short disease durations, including patients with first attacks of MS. In addition, the FD of the GM correlated with T1 and T2 lesion load, but not with GM atrophy or disability. The FD abnormalities of the GM here detected differed from the previously published FD of the white matter in MS, suggesting that different pathological processes were taking place in each structure. These results indicate that GM morphology is abnormal in patients with MS and that this alteration appears early in the course of the disease

Nueva información sobre la coloración e historia natural del Cutín de Papallacta Pristimantis acerus (Lynch & Duellman, 1980) (Anura: Craugastoridae)

The Papallacta Robber Frog Pristimantis acerus (Lynch &amp; Duellman) was described in 1980 and remains restricted to the Upper Napo River, Ecuador, lacking subsequent records after its original description. During herpetological surveys at Guango Lodge, several individuals of P. acerus were collected. We present herein new information on the individual and ontogenic colour variation and natural history of P. acerus.El Cutín de Papallacta Pristimantis acerus (Lynch &amp; Duellman) fue descrito en 1980 y está restringido a la cuenca alta del río Napo, Ecuador, careciendo de registros posteriores a su descripción original. Durante evaluaciones herpetológicas en Guango Lodge, varios individuos de P. acerus fueron colectados. Presentamos aquí nueva información sobre la variación de color individual y ontogénica y la historia natural de P. acerus