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Sotelo J.,National Institute of Neurology and Neurosurgery
Surgical Neurology International | Year: 2012

Long-term treatment of hydrocephalus continues to be dismal. Shunting is the neurosurgical procedure more frequently associated with complications, which are mostly related with dysfunctions of the shunting device, rather than to mishaps of the rather simple surgical procedure. Overdrainage and underdrainage are the most common dysfunctions; of them, overdrainage is a conspicuous companion of most devices. Even when literally hundreds of different models have been proposed, developed, and tested, overdrainage has plagued all shunts for the last 60 years. Several investigations have demonstrated that changes in the posture of the subject induce unavoidable and drastic differences of intraventricular hydrokinetic pressure and cerebrospinal fluid (CSF) drainage through the shunt. Of all the parameters that participate in the pathophysiology of hydrocephalus, the only invariable one is cerebrospinal fluid production at a constant rate of approximately 0.35 ml/min. However, this feature has not been considered in the design of currently available shunts. Our experimental and clinical studies have shown that a simple shunt, whose drainage capacity complies with this unique parameter, would prevent most complications of shunting for hydrocephalus. Copyright © 2012 Sotelo J.

Roldan-Valadez E.,MRI Unit | Favila R.,General Electric | Martinez-Lopez M.,MRI Unit | Uribe M.,Gastroenterology and Liver Unit | And 2 more authors.
Journal of Hepatology | Year: 2010

Background & Aims: The clinical application of liver fat quantification has increased in recent years, paralleling the epidemic increase in nonalcoholic fatty liver disease. The aim of this study was to perform a diagnostic evaluation of spectroscopy by comparing its measurement of total lipid content with that from liver biopsies and morphometry in normal subjects and patients with nonalcoholic fatty liver disease. Methods: Patients with symptomatic cholelithiasis underwent 3T MR cholangiography with spectroscopic quantification of TLC. A laparoscopic cholecystectomy was performed on the day of admission, with liver samples taken during surgery. Microcolorimetric assessment quantified lipid content in liver samples and morphometric evaluation in stained slides. Statistical analysis included bivariate correlation, regression, and ROC analysis. Results: The study was conducted in 18 patients, 5 men (mean age, 35.2 ± 11.03 years; range, 27-54 years) and 13 women (mean age, 46.77 ± 11.77 years; range, 21-61 years). Using a cut-off value >5% for fat content, 8 patients presented with steatosis and 10 patients presented with normal liver fat content. A significant correlation was observed between fat spectroscopy and lipid content (r = 0.876, p <0.001). A lower and non-significant correlation was observed between lipid content and morphometry (r = 0.190, p >0.05). Conclusions: The accuracy of spectroscopy in assessing fat concentration with a cut-off level of 7.48% was 100%. Spectroscopy showed a strong and significant correlation with lipid content. It may reliably replace liver biopsy for the assessment of liver fat content. © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Roldan-Valadez E.,Coordination of Research and Innovation | Rios C.,National Institute of Neurology and Neurosurgery
European Journal of Gastroenterology and Hepatology | Year: 2015

INTRODUCTION: A deeper understanding of supplementary bibliometrics beyond the impact factor might provide researchers with a better understanding of the citation process. This study presents a multivariate analysis of gastroenterology and hepatology journals to evaluate the predictive ability of seven bibliometrics in the Web of Science to calculate total cites over a 2-year period. METHODS: Coincidentally, bibliometrics appearing during 2008, 2009, and 2010, with their corresponding cites in 2010, 2011, and 2012, were recorded from the Journal Citation Reports Science Edition. A linear mixed-effects design using random slopes and intercepts was performed on 51 out of 74 journals in the Gastroenterology and Hepatology category. RESULT: There was a significant global effect size (R=0.992; P<0.001), which yielded a total variance of 99.2%. The strongest predictors in the model were the Eigenfactor Score and Cited Half-life (P<0.001), followed by the Number of Articles (P=0.011) and the Immediacy Index (P=0.021). The impact factor was not a significant predictor. CONCLUSION: The Eigenfactor Score and Cited Half-life predictors might be the new standards to assess the influence and importance of scientific journals; this approach may help researchers select journals in which to publish their work. © 2015 Wolters Kluwer Health, Inc.

Arauz A.,National Institute of Neurology and Neurosurgery | Berge E.,University of Oslo | Sandercock P.,University of Edinburgh
Current Opinion in Neurology | Year: 2014

PURPOSE OF REVIEW: The third International Stroke Trial (IST-3) was a randomized controlled trial of thrombolysis with intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke within 6h of onset. It sought to determine whether a wider variety of patients might benefit from treatment than were eligible under the prevailing European Union approval for the drug, especially among those aged over 80 years. RECENT FINDINGS: The entry criteria were broad, and there was no upper age limit for inclusion; over half the 3035 patients were aged over 80 years. For the types of patient recruited in IST-3, despite the early hazards (chiefly of fatal intracerebral hemorrhage), thrombolysis within 6h did not affect longer-term survival and improved functional outcome. Benefit was greatest among patients treated within 3h, and benefit did not appear to be diminished among elderly patients or those with severe stroke. SUMMARY: These results should, therefore, encourage clinicians to: consider thrombolytic treatment for a wider variety of patients (particularly those aged over 80 years); treat those with more severe strokes; reinforce their efforts to increase the proportion of ischemic strokes treated within 3h; and, have greater confidence that mortality is not increased by treatment. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.

Rojas P.,National Institute of Neurology and Neurosurgery | Montes P.,National Institute of Neurology and Neurosurgery | Rojas C.,National Autonomous University of Mexico | Serrano-Garcia N.,National Institute of Neurology and Neurosurgery | Rojas-Castaneda J.C.,National Institute of Pediatrics
Nutrition | Year: 2012

Ginkgo Biloba extract 761 (EGb 761) is a patented and well-defined mixture of active compounds extracted from Ginkgo biloba leaves. This extract contains two main groups of active compounds, flavonoids (24%) and terpenoids (6%). EGb 761 is used clinically to treat dementia and vaso-occlusive and cochleovestibular disorders. This extract has neuroprotective effects, exerted probably by means of its antioxidant function. Parkinson's disease (PD) is a neurodegenerative disorder that affects 2% of the population older than 60 y. It produces a progressive loss of dopaminergic neurons and depletion of dopamine (DA), leading to movement impairment. The production of reactive oxygen species, which act as mediators of oxidative damage, is linked to PD. This disease is routinely treated with the DA precursor, L-3,4-dihydroxyphenylalanine. However, this produces severe side effects, and its neurotoxic properties can be due to a free radical production. Thus, administration of antioxidant drugs might be used to prevent neuronal death produced by oxidative mechanisms. The use of synthetic antioxidants has decreased because of their suspected activity as carcinogenic promoters. We describe the studies related to the antioxidant effect of EGb 761 in an animal model of PD. It has been shown that EGb761 can provide a neuroprotective/neurorecovery effect against the damage to midbrain DA neurons in an animal model of PD. EGb 761 also has been found to lessen the impairment of locomotion, correlating with an increase of DA and other morphologic and biochemical parameters related to its antioxidant effect in an animal model of PD. These studies suggest it as an alternative in the future treatment of PD. © 2012 Elsevier Inc.

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