Reversible cerebral vasoconstriction syndrome induced by adrenaline

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute severe thunderclap headaches and evidence of multifocal, segmental, reversible vasoconstrictions of the cerebral arteries. Several precipitating factors have been identified and reported, including the use of recreational substances or sympathomimetic drugs and the postpartum state. Case description: Here we present the case of a woman who developed RCVS after the administration of adrenaline (epinephrine) in the setting of an anaphylactic reaction during antibiotic allergy testing. Discussion: To our knowledge, this is the first reported case of RCVS following the administration of exogenous adrenaline. This case contributes to the understanding of the physiopathological mechanisms underlying reversible cerebral vasoconstrictio

RM en el diagnóstico y control evolutivo de la degeneración combinada subaguda. A propósito de un caso

A deficit of vitamin B12, generally resulting from pernicious anaemia, can give rise to disorders of the spinal cord, brain, optic and peripheral nerves. The principal neurological syndrome is subacute combined degeneration of the spinal cord (SCD), which can cause progressive motor and/or sensitive alterations, instability and incontinency, due to the demyelination of the posterior horn of the spinal cord. The identification by magnetic resonance (MR) of signal hyperintensity in T2 weighted sequences at the level of the posterior horns of the spinal and/or cervical cord can be of great use in diagnosising the patient with SCD, above all when the symptoms are mild or nonspecific, and the patient does not have haematological or gastrointestinal alterations. Besides, the evolution of the altered signal of the posterior horns in MR can be of use in evaluating the efficacy of treatment, since their normalization is related to clinical improvemen

Ion-Transfer Voltammetric Behavior of Propranolol at Nanoscale Liquid-Liquid Interface Arrays

In this work, the ion-transfer voltammetric detection of the protonated β-blocker propranolol was explored at arrays of nanoscale interfaces between two immiscible electrolyte solutions (ITIES). Silicon nitride nanoporous membranes with 400 pores in a hexagonal arrangement, with either 50 or 17 nm radius pores, were used to form regular arrays of nanoITIES. It was found that the aqueous-to-organic ion-transfer current continuously increased steadily rather than reaching a limiting current plateau after the ion-transfer wave; the slope of this limiting current region was concentration dependent and associated with the high ion flux at the nanointerfaces. Electrochemical data were examined in terms of an independent nanointerface approach and an equivalent microdisc approach, supported by finite element simulation. In comparison to the larger interface configuration (50 nm radius), the array of 17 nm radius nanoITIES exhibited a 6.5-times higher current density for propranolol detection due to the enhanced ion flux arising from the convergent diffusion to smaller electrochemical interfaces. Both nanoITIES arrays achieved the equivalent limits of detection, 0.8 μM, using cyclic voltammetry. Additionally, the effect of scan rate on the charging and faradaic currents at these nanoITIES arrays, as well as their stability over time, was investigated. The results demonstrate that arrays of nanoscale liquid–liquid interfaces can be applied to study electrochemical drug transfer, and provide the basis for the development of miniaturized and integrated detection platforms for drug analysis

Evidence of Erroneous Deductions and their Possible Effects on the Initial Learning of the Concept of Cell in Primary School

En este trabajo se han obtenido evidencias sobre dificultades para procesar información referida al concepto de célula en estudiantes de escuela primaria. Se identificaron posibles deducciones erróneas que podrían establecer estudiantes de 5to grado (10-11 años) que intentaran procesar cognitivamente, y por primera vez, la información de libros de texto escolares y del discurso docente sobre el tema y se diseñó un cuestionario con el objetivo de hallar evidencia de estas deducciones. Fue posible detectar algunas evidencias de construcción de modelos explicativos incipientes siendo destacable la aparición de modelos consistentes, pero científicamente incorrectos. Luego, se aplicó el mismo cuestionario a estudiantes de 6to y 7mo grado (11-13 años) y se observó que algunos patrones de respuesta se mantenían e, incluso, se afianzaban. Estos modelos podrían dar cuenta del origen de errores o dificultades en la comprensión del concepto célula en estudiantes de niveles educativos subsiguientes.In this paper we have obtained some evidence on difficulties in processing information about the cell among primary school students. We identified possible misleading deductions that 5th grade students (10-11 years) could establish when trying, for the first time, to cognitively process information on the subject from school textbooks and teacher discourse, and we designed a questionnaire to find evidence of these deductions. It was possible to detect some evidence of incipient explanatory models. It is important to highlight the emergence of consistent but scientifically incorrect models. Then, the same questionnaire was applied to 6th and 7th grade students (11-13 years), and it was found that some response patterns prevailed and were even reinforced. These models could account for the origin of errors or difficulties in understanding the concept of cell among students of subsequent educational levels.Fil: Edelsztein, Valeria Carolina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Formación e Investigación en Enseñanza de las Ciencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Galagovsky, Lydia Raquel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Formación e Investigación en Enseñanza de las Ciencias; Argentin

Role of the repeat expansion size in predicting age of onset and severity in RFC1 disease

RFC1 disease, caused by biallelic repeat expansion in RFC1, is clinically heterogeneous in terms of age of onset, disease progression and phenotype. We investigated the role of the repeat size in influencing clinical variables in RFC1 disease. We also assessed the presence and role of meiotic and somatic instability of the repeat. In this study, we identified 553 patients carrying biallelic RFC1 expansions and measured the repeat expansion size in 392 cases. Pearson’s coefficient was calculated to assess the correlation between the repeat size and age at disease onset. A Cox model with robust cluster standard errors was adopted to describe the effect of repeat size on age at disease onset, on age at onset of each individual symptoms, and on disease progression. A quasi-Poisson regression model was used to analyse the relationship between phenotype and repeat size. We performed multivariate linear regression to assess the association of the repeat size with the degree of cerebellar atrophy. Meiotic stability was assessed by Southern blotting on first-degree relatives of 27 probands. Finally, somatic instability was investigated by optical genome mapping on cerebellar and frontal cortex and unaffected peripheral tissue from four post-mortem cases. A larger repeat size of both smaller and larger allele was associated with an earlier age at neurological onset [smaller allele hazard ratio (HR) = 2.06, P < 0.001; larger allele HR = 1.53, P < 0.001] and with a higher hazard of developing disabling symptoms, such as dysarthria or dysphagia (smaller allele HR = 3.40, P < 0.001; larger allele HR = 1.71, P = 0.002) or loss of independent walking (smaller allele HR = 2.78, P < 0.001; larger allele HR = 1.60; P < 0.001) earlier in disease course. Patients with more complex phenotypes carried larger expansions [smaller allele: complex neuropathy rate ratio (RR) = 1.30, P = 0.003; cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) RR = 1.34, P < 0.001; larger allele: complex neuropathy RR = 1.33, P = 0.008; CANVAS RR = 1.31, P = 0.009]. Furthermore, larger repeat expansions in the smaller allele were associated with more pronounced cerebellar vermis atrophy (lobules I–V β = −1.06, P < 0.001; lobules VI–VII β = −0.34, P = 0.005). The repeat did not show significant instability during vertical transmission and across different tissues and brain regions. RFC1 repeat size, particularly of the smaller allele, is one of the determinants of variability in RFC1 disease and represents a key prognostic factor to predict disease onset, phenotype and severity. Assessing the repeat size is warranted as part of the diagnostic test for RFC1 expansion

RM en el diagnóstico y control evolutivo de la degeneración combinada subaguda. A propósito de un caso

A deficit of vitamin B12, generally resulting from pernicious anaemia, can give rise to disorders of the spinal cord, brain, optic and peripheral nerves. The principal neurological syndrome is subacute combined degeneration of the spinal cord (SCD), which can cause progressive motor and/or sensitive alterations, instability and incontinency, due to the demyelination of the posterior horn of the spinal cord. The identification by magnetic resonance (MR) of signal hyperintensity in T2 weighted sequences at the level of the posterior horns of the spinal and/or cervical cord can be of great use in diagnosising the patient with SCD, above all when the symptoms are mild or nonspecific, and the patient does not have haematological or gastrointestinal alterations. Besides, the evolution of the altered signal of the posterior horns in MR can be of use in evaluating the efficacy of treatment, since their normalization is related to clinical improvemen

Undertreatment of human immunodeficiency virus in psychiatric inpatients: a cross-sectional study of seroprevalence and associated factors

Miguel Angel Gonzalez-Torres,1,2 Miguel Angel Salazar,3 Manuel Imaz,4 Luc&iacute;a Inchausti,1,2 Berta Iba&ntilde;ez,5 Aranzazu Fernandez-Rivas,1,2 Javier Pastor,3 Bosco Anguiano,3 Pedro Mu&ntilde;oz,3 Eduardo Ruiz,1,2 Rodrigo Oraa,3 Sonia Bustamante,1,2 Sofia Alvarez de Eulate,2 Ram&oacute;n Cisterna4,61Department of Neuroscience, University of the Basque Country, 2Psychiatry Service, Basurto University Hospital, Bilbao, 3Mental Health Network of Biscay, Basque Health Service, Biscay, 4Microbiology Service, Basurto University Hospital, Bilbao, 5Navarra Biomed-Miguel Servet Foundation, Red de Investigaci&oacute;n en Servicios Sanitarios y Enfermedades Cr&oacute;nicas (REDISSEC), Pamplona, 6Department of Microbiology, University of the Basque Country, Bilbao, SpainBackground: The aims of this study were to evaluate the prevalence of HIV and its associated demographic and clinical factors among psychiatric inpatients of a general hospital.Methods: This was a single-center, observational, cross-sectional study that included patients consecutively admitted to our unit aged 16 years or older and with no relevant cognitive problems. The patients were evaluated using a semistructured interview and an appropriate test for HIV infection.Results: Of the 637 patients who were screened, 546 (86%) who consented to participate were included in the analyses. Twenty-five (4.6%, 95% confidence interval [CI] 3.0&ndash;6.8) patients were HIV-positive. The prevalence was higher among patients with substance misuse (17.4%, 95% CI 9.7&ndash;28.8). All except one of the 25 patients knew of their seropositive condition prior to participation in the study. Only 14 (56%) of the 25 seropositive patients had previously received pharmacological treatment for their infection. According to the multiple logistic regression analysis, the likelihood of HIV infection was lower in patients with higher levels of education and higher among patients who were single, had history of intravenous drug use, and had an HIV-positive partner, particularly if they did not use condoms. Among the patients with HIV infection, 18 (72%) had a history of suicide attempts compared with 181 (34.7%) of the patients without HIV infection (relative risk 2.1, 95% CI 1.6&ndash;2.7; P&lt;0.001).Conclusion: HIV infection is highly prevalent in patients admitted to a psychiatric unit, especially those with a diagnosis of substance misuse. Seropositive patients show very poor treatment adherence. The risk of suicide seems to be very high in this population. Implementing interventions to reduce the suicide risk and improve adherence to antiretroviral therapy and psychotropic medications seems crucial.Keywords: severe mental illness, human immunodeficiency virus, adherence, epidemiolog