Mortalidad de la enfermedad de Parkinson y otros parkinsonismos: datos del estudio poblacional nedices

Tesis doctoral inédita realizada en la Universidad Autónoma de Madrid, Facultad de Medicina. Departamento de Anatomía, Histología y Neurociencia. Fecha de lectura: 10 de Mayo de 2010

Recursos asistenciales y de investigación en enfermedades raras ubicados en la Comunidad de Madrid

El principal objetivo de este trabajo es desarrollar y poner al servicios de las administraciones sanitarias y también de los ciudadanos, un informe sobre los centros y unidades asistenciales y de investigación existentes en la Comunidad de Madrid (CM), que pudieran ser de utilidad para la planifi cación de los recursos orientados al control y seguimiento de las personas con enfermedades raras en el ámbito de esta comunidad

Análisis de Derecho comparado relativo a la regulación y protección animal en Costa Rica y Colombia entre 1990 a la actualidad

Gracias a las habilidades que ha desarrollado el ser humano con el transcurso de su evolución, ha tomado el control de la sociedad, del cual es conllevado a su provecho; que encamina a una mal de decisión en cuanto al maltrato animal. No es un tema que surgió el siglo pasado, es una discusión moral que ha separado al ser humano es distintas ocasiones. El vínculo que ha generado con el transcurso de los años entre el hombre y el animal ha generado el nacimiento de los derechos, se ha demostrado que son seres que nos brindan compañía. Es cierto que cuando leemos el concepto de que son los derechos es asimilado con la palabra “humanidad”, creyendo que las personas son las únicas que necesitan ser protegidas. Hoy en día vemos como los animalistas han sido fieles protectores de los derechos de aquellos que no lo pueden hacer. Los animales, quienes son conocidos como personas que velan por los derechos de quien no tienen voz ante la violación de sus derechos se han encargado de generar movimientos sociales. El resultado de estos grupos ha generado que, con el transcurso del paso del tiempo, que existen casos donde los animales quienes viven bajo el poder de personas que no entienden que son seres con sentimientos, hagan que estos seres vivan en condiciones de crueldad, que su bienestar sea en las peores condiciones. En una conexión de los animales y la vida jurídica, ha con llevado que sean reconocidos como sujetos de derechos, tiempos atrás eran conocidos como cosas.Thanks to the skills that human beings have developed in the course of their evolution, they have taken control of society, which is brought to their advantage, leading to a bad decision regarding animal abuse. It is not an issue that arose in the last century, it is a moral discussion that has separated the human being in different occasions. The bond that has generated over the years between man and animal has generated the birth of rights, it has been shown that they are beings that give us company. It is true that when we read the concept of what rights are, it is assimilated with the word "humanity", believing that people are the only ones who need to be protected. Today we see how animalists have been faithful protectors of the rights of those who cannot. Animals, who are known as people who watch over the rights of those who have no voice in the violation of their rights, have been in charge of generating social movements. The result of these groups has generated that, with the passage of time, that there are cases where animals who live under the power of people who do not understand that they are beings with feelings, make these beings live in conditions of cruelty, that their welfare is in the worst conditions. In a connection of the animals and the juridical life, it has led them to be recognized as subjects of rights, times before they were known as things.Abogadohttp://www.ustavillavicencio.edu.co/home/index.php/unidades/extension-y-proyeccion/investigacionPregrad

Tremor severity in Parkinson’s disease and cortical changes of areas controlling movement sequencing: a preliminary study.

. There remains much to learn about the changes in cortical anatomy that are associated with tremor severity in Parkinson’s disease (PD). For this reason, we used a combination of structural neuroimaging to measure cortical thickness and neurophysiological studies to analyze whether PD tremor was associated with cortex integrity. Magnetic resonance imaging and neurophysiological assessment were performed in 13 nondemented PD patients (9 women, 69.2%) with a clearly tremor-dominant phenotype. Cortical reconstruction and volumetric segmentation was performed with the Freesurfer image analysis software. Assessment of tremor was performed by means of high-density surface electromyography (hdEMG) and inertial measurement units (IMUs). Individual motor unit discharge patterns were identified from surface hdEMG and tremor metrics quantifying motor unit synchronization from IMUs were defined. Increased motor unit synchronization (i.e., more severe tremor) was associated with cortical changes (i.e., atrophy) in dorsal premotor cortices, left posterior parietal cortex, left lateral orbitofrontal cortex, cingulate cortex bilaterally, left posterior and transverse temporal cortex, and left occipital lobe, as well as reduced left middle temporal volume. Given that the majority of these areas are involved in controlling movement sequencing, our results support Albert’s classic hypothesis that PD tremor may be the result of an involuntary activation of a program of motor behavior used in the genesis of rapid voluntary alternating movements.pre-print670 K

Cardiac abnormalities in the toxic oil syndrome, with comparative observations on the eosinophilia-myalgia syndrome

AbstractEarly in the course of studies of the Spanish toxic oil syndrome it was recognized that vascular lesions were a major problem, most logically attributable to endothelial damage by the toxic oil. However, most clinical attention has been directed to the pulmonary complications and the evolution into a scleroderma-like illness later. p]In this study of 11 victims of the toxic oil syndrome careful postmortem studies of the coronary arteries and conduction system and neural structures of the heart demonstrated major injury to all those components of the heart. Obliterative fibrosis of the sinus node in four cases resembled findings in fatal scleroderma heart disease, and in eight the cardiac lesions resembled those of lupus erythematosus.The more impressive pathologic features involved the coronary arteries and neural structures, which were abnormal in every heart. The arterial disease included widespread focal fibromuscular dysplasia, but there was also an unusual myointimal proliferative degeneration of both small and large coronary arteries in five patients, four of whom were young women. In two hearts, portions of the inner wall of the sinus node artery had actually detached and embolized downstream. Coronary arteritis was rarely found. Inflammatory and noninflammatory degeneration of cardiac nerves was widespread. Fatty infiltration, fibrosis and degeneration were present in the coronary chemoreceptor.In most respects these cardiac abnormalities resemble those described in the eosinophilia-myalgia syndrome caused by an altered form of l-tryptophan. In both diseases there is good reason to anticipate more clinical cardiac difficulties than have so far been reported, and even more basis for future concern, especially relative to coronary disease and cardiac electrical instability

Essential tremor severity and anatomical changes in brain areas controlling movement sequencing.

Objective: Although the cerebello-thalamo-cortical network has often been suggested to be of importance in the pathogenesis of essential tremor (ET), the origins of tremorgenic activity in this disease are not fully understood. We used a combination of cortical thickness imaging and neurophysiological studies to analyze whether the severity of tremor was associated with anatomical changes in the brain in ET patients. Methods: Magnetic resonance imaging (MRI) and a neurophysiological assessment were performed in 13 nondemented ET patients. High field structural brain MRI images acquired in a 3T scanner and analyses of cortical thickness and surface were carried out. Cortical reconstruction and volumetric segmentation was performed with the FreeSurfer image analysis software. We used high-density surface electromyography (hdEMG) and inertial measurement units (IMUs) to quantify the tremor severity in upper extrimities of patients. In particular, advanced computer tool was used to reliably identify discharge patterns of individual motor units from surface hdEMG and quantify motor unit synchronization. Results: We found significant association between increased motor unit synchronization (i.e., more severe tremor) and cortical changes (i.e., atrophy) in widespread cerebral cortical areas, including the left medial orbitofrontal cortex, left isthmus of the cingulate gyrus, right paracentral lobule, right lingual gyrus, as well as reduced left supramarginal gyrus (inferior parietal cortex), right isthmus of the cingulate gyrus, left thalamus, and left amygdala volumes. Interpretation: Given that most of these brain areas are involved in controlling movement sequencing, ET tremor could be the result of an involuntary activation of a program of motor behavior used in the genesis of voluntary repetitive movements.Methods Magnetic resonance imaging (MRI) and a neurophysiological assessment were performed in 13 nondemented ET patients. High field structural brain MRI images acquired in a 3T scanner and analyses of cortical thickness and surface were carried out. Cortical reconstruction and volumetric segmentation was performed with the FreeSurfer image analysis software. We used high‐density surface electromyography (hdEMG) and inertial measurement units (IMUs) to quantify the tremor severity in upper extrimities of patients. In particular, advanced computer tool was used to reliably identify discharge patterns of individual motor units from surface hdEMG and quantify motor unit synchronization. Results We found significant association between increased motor unit synchronization (i.e., more severe tremor) and cortical changes (i.e., atrophy) in widespread cerebral cortical areas, including the left medial orbitofrontal cortex, left isthmus of the cingulate gyrus, right paracentral lobule, right lingual gyrus, as well as reduced left supramarginal gyrus (inferior parietal cortex), right isthmus of the cingulate gyrus, left thalamus, and left amygdala volumes. Interpretation Given that most of these brain areas are involved in controlling movement sequencing, ET tremor could be the result of an involuntary activation of a program of motor behavior used in the genesis of voluntary repetitive movements.post-print432 K

Adult height in girls with idiopathic premature adrenarche: A cohort study and design of a predictive model

Idiopathic premature adrenarche (IPA) is considered a normal variant of puberty, presenting more commonly in female patients. There are concerns as to whether IPA alters the final height of these girls. Our main objectives were to (a) compare the adult height of girls with IPA against their target height and (b) design a mathematical model to predict adult height at diagnosis in female patients with IPA. Materials and Methods: A cohort study of girls with IPA was conducted from the time of IPA diagnosis until adult height. The following data were collected: target height, perinatal history, anthropometric and biochemical variables and bone age at diagnosis, age at Tanner stage 2 and menarcheal age, and adult height. First, we performed a univariate statistical analysis after which we carried out a multiple linear regression analysis using adult height as the dependent variable. Results: We obtained data from 79 female patients diagnosed with IPA with a mean adult height of 164.6 cm (95% CI: 163.36–165.85 cm). The mean follow-up time was 6.60 years. Average age at Tanner stage 2 was 9.71 years. Mean menarcheal age was 11.64 years. There were no significant differences between target height and adult height. Of the several predictive models designed for these patients, one of them, which included bone age, obtained an R2 value of 71%. Conclusions: Although slightly advanced puberty was observed among the girls with IPA, their adult height was preserved. The use of predictive models of adult height on diagnosis of IPA could facilitate closer follow-up of girls at risk of reduced adult heigh