Síndrome de Ramsay Hunt asociado a SIADH

Ramsay Hunt syndrome (RHS) consists of peripheral facial palsy associated with a vesicular erythematous rash in the ear (auricular zoster) or in the mouth. Syndrome of inappropriate secretion of antidiuretic hormone(SIADH) is the most frequent cause of hyponatremia with normovolaemia and has occasionally been described in association with RHS. We present the case of a 59-year-old woman diagnosed with RHS associated with SIADH. This association can be serious, so it requires early diagnosis and treatment.El síndrome de Ramsay Hunt (RHS) consiste en una parálisis facial periférica asociada a un rash eritematoso vesicular en el oído (zóster auricular) o en la boca. El síndrome de secreción inadecuada de hormona antidiurética (SIADH) es la causa más frecuente de hiponatremia con normovolemia y ocasionalmente se ha descrito asociado al RHS. Se presenta el caso de una mujer de 59 años a la que diagnosticamos de RHS asociado a SIADH. Esta asociación puede ser grave por lo que requiere un diagnóstico y tratamiento tempranos

Hemorragia digestiva e insuficiencia cardiaca como forma de presentación de mieloma múltiple

AL cardiac amyloidosis is caused by extracellular deposition of immunoglobulin light chains in the heart. It is a multisystemic disease that can affect multiple organs, and around 10% of the cases are associated with multiple myeloma. The presence of AL amyloidosis is an independent factor of poor prognosis, not only for symptomatic multiple myeloma but also for latent multiple myeloma. We present below an unusual case of IgA-lambda multiple myeloma that manifested with recurrent gastrointestinal bleeding and heart failure.La amiloidosis cardiaca AL está causada por el depósito extracelular de cadenas ligeras de inmunoglobulinas en el corazón. Se trata de una enfermedad multisistémica que puede afectar a múltiples órganos y alrededor del 10% de los casos se asocia a mieloma múltiple. La presencia de amiloidosis AL es un factor independiente de mal pronóstico, no solo para el mieloma múltiple sintomático sino también para el mieloma múltiple latente. A continuación, presentamos un caso inusual de mieloma múltiple IgA-lambda que debutó con hemorragias digestivas de repetición e insuficiencia cardiaca

Caso atípico de enfermedad de Kimura en varón de 66 años

Kimura disease should be suspected when there are lymphoid masses or nodules in the head and neck, with subcutaneous cellular tissue involvement and regional lymphadenopathy, with minor inflammation and few systemic symptoms. It is usually associated with blood eosinophilia and elevated serum IgE. Even without treatment, it has a good prognosis, although recurrence is common. We present the case of a 66-year-old Caucasian male with a rapidly appearing laterocervical mass whose final diagnosis was made by biopsy. Biopsy showed mixed findings of Kimura disease and angiolymphoid hyperplasia with eosinophilia (ALHE), once thought to be the same disorder.La enfermedad de Kimura se debe sospechar ante masas o nódulos linfoides en cabeza y cuello, con afectación del tejido celular subcutáneo y linfadenopatías regionales, con poca inflamación y pocos síntomas sistémicos, habitualmente acompañadas de eosinofilia periférica y elevación de IgE sérica. Presenta buen pronóstico incluso sin tratamiento, aunque con tendencia a la recidiva. Se presenta el caso de un varón caucásico de 66 años con una masa laterocervical de rápida aparición cuyo diagnóstico final se realizó con la biopsia, en la que se encontraron hallazgos mixtos con hiperplasia angiolinfoide con eosinofilia (HALE), que antes se pensaba que era la misma entidad

Interaction between maternal immune activation and peripubertal stress in rats: impact on cocaine addiction-like behaviour, morphofunctional brain parameters and striatal transcriptome.

Substance use disorders are more prevalent in schizophrenia, but the causal links between both conditions remain unclear. Maternal immune activation (MIA) is associated with schizophrenia which may be triggered by stressful experiences during adolescence. Therefore, we used a double-hit rat model, combining MIA and peripubertal stress (PUS), to study cocaine addiction and the underlying neurobehavioural alterations. We injected lipopolysaccharide or saline on gestational days 15 and 16 to Sprague-Dawley dams. Their male offspring underwent five episodes of unpredictable stress every other day from postnatal day 28 to 38. When animals reached adulthood, we studied cocaine addiction-like behaviour, impulsivity, Pavlovian and instrumental conditioning, and several aspects of brain structure and function by MRI, PET and RNAseq. MIA facilitated the acquisition of cocaine self-administration and increased the motivation for the drug; however, PUS reduced cocaine intake, an effect that was reversed in MIA + PUS rats. We found concomitant brain alterations: MIA + PUS altered the structure and function of the dorsal striatum, increasing its volume and interfering with glutamatergic dynamics (PUS decreased the levels of NAA + NAAG but only in LPS animals) and modulated specific genes that could account for the restoration of cocaine intake such as the pentraxin family. On its own, PUS reduced hippocampal volume and hyperactivated the dorsal subiculum, also having a profound effect on the dorsal striatal transcriptome. However, these effects were obliterated when PUS occurred in animals with MIA experience. Our results describe an unprecedented interplay between MIA and stress on neurodevelopment and the susceptibility to cocaine addiction.This work has been funded by the Spanish Ministry of Economy and Competitiveness (Project no.: PSI2016-80541-P to EA and AH-M); Ministry of Science (PID2019- 104523RB-I00 to A-HM and PID2019-111594RB-100 to EA), Spanish Ministry of Health, Social Services and Equality (Network of Addictive Disorders - Project no.: RTA-RD16/ 020/0022 of the Institute of Health Carlos III and National Plan on Drugs, Project no.: 2016I073 to EA and 2017I042 to A H-M); The BBVA Foundation (Leonardo Grants) to AH-M; The European Union (Project no.: JUST- 2017- AG- DRUG-806996-JUSTSO) to EA; and the UNED (Plan for the Promotion of Research) to EA and AH-M. MLS-M was supported by the Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III (project PI17/01766), co-financed by the European Regional Development Fund (ERDF), ‘A way to make Europe’; project PID2021-128862OB-I00 funded by MCIN/AEI/ 10.13039/501100011033/FEDER, UE, CIBER de Salud Mental - Instituto de Salud Carlos III (project number CB07/09/0031); Delegación del Gobierno para el Plan Nacional sobre Drogas (project number 2017/085, 2022/008917); and Fundación Alicia Koplowitz. Fundación Tatiana Pérez de Guzmán el Bueno supported MC-V. MD’s work was supported by Ministerio de Ciencia e Innovación (MCIN) and Instituto de Salud Carlos III (PT20/00044). The CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovación (MCIN) and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (SEV-2015-0505).S

What risk do Brucella vaccines pose to humans? A systematic review of the scientific literature on occupational exposure.

BackgroundCurrently, vaccination of livestock with attenuated strains of Brucella remains an essential measure for controlling brucellosis, although these vaccines may be dangerous to humans. The aim of this study was to review the risk posed to humans by occupational exposure to vaccine strains and the measures that should be implemented to minimize this risk.MethodsThis article reviewed the scientific literature indexed in PubMed up to September 30, 2023, following "the PRISMA guidelines". Special emphasis was placed on the vaccine strain used and the route of exposure. Non-occupational exposure to vaccine strains, intentional human inoculation, publications on exposure to wild strains, and secondary scientific sources were excluded from the study.ResultsNineteen primary reports were found and classified in three subgroups: safety accidents in vaccine factories that led to an outbreak (n = 2), survellaince studies on vaccine manufacturing workers with a serologic diagnosis of Brucella infection (n = 3), and publications of infection by vaccine strains during their administration, including case reports, records of occupational accidents and investigations of outbreaks in vaccination campaigns (n = 14). Although accidental exposure during vaccine manufacturing were uncommon, they could provoke large outbreaks through airborne spread with risk of spread to the neighboring population. Besides, despite strict protection measures, a percentage of vaccine manufacturing workers developed positive Brucella serology without clinical infection. The most frequent type of exposure with symptomatic infection was needle injury during vaccine administration. Prolonged contact with the pathogen, lack of information and a low adherence to personal protective equipment (PPE) use in the work environment were commonly associated with infection.ConclusionsBrucella vaccines pose occupational risk of contagion to humans from their production to their administration to livestock, although morbidity is low and deaths were not reported. Recommended protective measures and active surveillance of exposed workers appeared to reduce this risk. It would be advisable to carry out observational studies and/or systematic registries using solid diagnostic criteria

Publications of brucellosis cases acquired through exposure to vaccine strains.

Publications of brucellosis cases acquired through exposure to vaccine strains.</p

PRISMA flow diagram.

BackgroundCurrently, vaccination of livestock with attenuated strains of Brucella remains an essential measure for controlling brucellosis, although these vaccines may be dangerous to humans. The aim of this study was to review the risk posed to humans by occupational exposure to vaccine strains and the measures that should be implemented to minimize this risk.MethodsThis article reviewed the scientific literature indexed in PubMed up to September 30, 2023, following "the PRISMA guidelines". Special emphasis was placed on the vaccine strain used and the route of exposure. Non-occupational exposure to vaccine strains, intentional human inoculation, publications on exposure to wild strains, and secondary scientific sources were excluded from the study.ResultsNineteen primary reports were found and classified in three subgroups: safety accidents in vaccine factories that led to an outbreak (n = 2), survellaince studies on vaccine manufacturing workers with a serologic diagnosis of Brucella infection (n = 3), and publications of infection by vaccine strains during their administration, including case reports, records of occupational accidents and investigations of outbreaks in vaccination campaigns (n = 14). Although accidental exposure during vaccine manufacturing were uncommon, they could provoke large outbreaks through airborne spread with risk of spread to the neighboring population. Besides, despite strict protection measures, a percentage of vaccine manufacturing workers developed positive Brucella serology without clinical infection. The most frequent type of exposure with symptomatic infection was needle injury during vaccine administration. Prolonged contact with the pathogen, lack of information and a low adherence to personal protective equipment (PPE) use in the work environment were commonly associated with infection.ConclusionsBrucella vaccines pose occupational risk of contagion to humans from their production to their administration to livestock, although morbidity is low and deaths were not reported. Recommended protective measures and active surveillance of exposed workers appeared to reduce this risk. It would be advisable to carry out observational studies and/or systematic registries using solid diagnostic criteria.</div

The long-term effects of adolescent Δ9-tetrahydrocannabinol on brain structure and function assessed through neuroimaging techniques in male and female rats.

Several studies performed on human subjects have examined the effects of adolescent cannabis consumption on brain structure or function using brain imaging techniques. However, the evidence from these studies is usually heterogenous and affected by several confounding variables. Animal models of adolescent cannabinoid exposure may help to overcome these difficulties. In this exploratory study, we aim to increase our understanding of the protracted effects of adolescent Δ9-tetrahydrocannabinol (THC) in rats of both sexes using magnetic resonance (MR) to obtain volumetric data, assess grey and white matter microstructure with diffusion tensor imaging (DTI) and measure brain metabolites with 1H-MR spectroscopy (MRS); in addition, we studied brain function using positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-d-glucose as the tracer. THC-exposed rats exhibited volumetric and microstructural alterations in the striatum, globus pallidus, lateral ventricles, thalamus, and septal nuclei in a sex-specific manner. THC administration also reduced fractional anisotropy in several white matter tracts, prominently in rostral sections, while in vivo MRS identified lower levels of cortical choline compounds. THC-treated males had increased metabolism in the cerebellum and olfactory bulb and decreased metabolism in the cingulate cortex. By contrast, THC-treated females showed hypermetabolism in a cluster of voxels comprising the entorhinal piriform cortices and in the cingulate cortex. These results indicate that mild THC exposure during adolescence leaves a lingering mark on brain structure and function in a sex-dependant manner. Some of the changes found here resemble those observed in human studies and highlight the importance of studying sex-specific effects in cannabinoid research.This work has been funded by the Spanish Ministry of Economy and Competitiveness (Project n°: PSI2016–80,541-P to EA and A H-M); Ministry of Science (PID2019–104523RB-I00 to A-HM and PID2019–111594RB-100 to EA), Spanish Ministry of Health, Social Services and Equality (Network of Addictive Disorders - Project n°: RTA-RD16/020/0022 of the Institute of Health Carlos III and National Plan on Drugs, Project n°: 2016I073 to EA and 2017I042, 2012I039 to A H-M); The BBVA Foundation (Leonardo Grants) to AH-M; The European Union (Project n°: JUST- 2017- AG- DRUG-806,996-JUSTSO) to EA; and the UNED (Plan for the Promotion of Research) to EA and AH-M. MLS was supported by the Ministerio de Ciencia e Innovación (PID2021-128862OB-100 funded/AEI /10.13039/501100011033/FEDER, UE), Instituto de Salud Carlos III (project PI17/01,766), co-financed by European Regional Development Fund (ERDF), “A way of making Europe”, CIBERSAM, Delegación del Gobierno para el Plan Nacional sobre Drogas (2017/085 and 2022/008917) and Fundación Alicia Koplowitz. Fundación Tatiana Pérez de Guzmán el Bueno supported MCV. The CNIC was supported by the Spanish Ministerio de Ciencia, Innovación y Universidades (MCIU) and the Pro-CNIC Foundation and is a Severo Ochoa center of Excellence. These funding agencies had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.S