Enteric duplication cysts in children: varied presentations, varied imaging findings

Abstract Enteric duplication cysts (EDCs) are rare congenital malformations formed during the embryonic development of the digestive tract. They are usually detected prenatally or in the first years of life. The size, location, type, mucosal pattern and presence of complications produce a varied clinical presentation and different imaging findings. Ultrasonography (US) is the most used imaging method for diagnosis. Magnetic resonance (MR) and computed tomography (CT) are less frequently used, but can be helpful in cases of difficult surgical approach. Conservative surgery is the treatment of choice. Pathology confirms the intestinal origin of the cyst, showing a layer of smooth muscle in the wall and an epithelial lining inside, resembling some part of the gastrointestinal tract (GT). We review the different forms of presentation of the EDCs, showing both the typical and atypical imaging findings with the different imaging techniques. We correlate the imaging findings with the surgical results and the final pathological features. Teaching Points • EDCs are rare congenital anomalies from the digestive tract with uncertain pathogenesis. • More frequently, diagnosis is antenatal, with most EDCs occurring in the distal ileum. • Ultrasonography is the method of choice for diagnosis of EDCs. • Complicated EDCs can show atypical imaging findings. • Surgery is necessary to avoid complications

Eficacia de un sistema virtual multiusuario para la rehabilitación de las habilidades metacognitivas y de cognición social de pacientes con daño cerebral adquirido

Además de los reconocidos problemas que las lesiones cerebrales adquiridas generan en las funciones cognitivas básicas, frecuentemente estos pacientes presentan dificultades de reconocimiento de sus propios déficits (metacognicion) y alteraciones en las relaciones interpersonales (cognición social). Los avances tecnológicos permiten trabajar estos problemas salvando el obstáculo del entorno hospitalario.Navarro Pérez, MD.; Llorens Rodríguez, R.; Garcia Blázquez, MC.; Renau Hernández, O.; Caballero Coulon, MDC.; Mesa Gresa, P.; Alcañiz Raya, ML.... (2012). Eficacia de un sistema virtual multiusuario para la rehabilitación de las habilidades metacognitivas y de cognición social de pacientes con daño cerebral adquirido. Revista de Neurologia. 55(1):50-51. http://hdl.handle.net/10251/79129S505155

Metabolic Phenotypes of Hypoxic-Ischemic Encephalopathy with Normal vs. Pathologic Magnetic Resonance Imaging Outcomes

Hypoxic-Ischemic Encephalopathy (HIE) is one of the most relevant contributors to neurological disability in term infants. We hypothesized that clinical outcomes of newborns with (HIE) can be associated with changes at plasma metabolic level enabling the detection of brain injury. Plasma samples of a cohort of 55 asphyxiated infants who evolved to moderate/severe HIE were collected between birth and completion of therapeutic hypothermia (TH). Samples were analyzed employing a quantitative gas chromatography–mass spectrometry method for the determination of lactate and pyruvate and an untargeted liquid chromatography–time-of-flight mass spectrometry method for metabolic fingerprinting. Brain injury was assessed employing magnetic resonance imaging (MRI). A critical assessment of the usefulness of lactate, pyruvate, and pyruvate/lactate for outcome prediction was carried out. Besides, metabolic fingerprinting identified a dynamic perturbation of eleven metabolic pathways, including amino acid and purine metabolism, and the steroid hormone biosynthesis, in newborns with pathologic MRI outcomes. Although data suggest the usefulness of lactate and pyruvate monitoring during 72 h for discerning outcomes, only the steroid hormone biosynthesis pathway was significantly altered in early plasma samples (i.e., before the initiation of TH). This study highlights pathways that might potentially be targeted for biomarker discovery or adjuvant therapies to be combined with TH