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Navarro-Zarza J.E.,Hospital General Of Chilpancingo Dr Raymundo Abarca Alarcon | Hernandez-Diaz C.,National Institute of Rehabilitation | Saavedra M.A.,National Autonomous University of Mexico | Alvarez-Nemegyei J.,Mayab University | And 3 more authors.
Arthritis Care and Research | Year: 2014

Objective To report the baseline knowledge of clinical anatomy of rheumatology fellows and rheumatologists from Argentina, Chile, Ecuador, El Salvador, Mexico, the US, and Uruguay. Methods The invitation to attend a workshop in clinical anatomy was an open call by national rheumatology societies in 4 countries or by invitation from teaching program directors in 3 countries. Prior to the workshop, a practical test of anatomic structures commonly involved in rheumatic diseases was administered. The test consisted of the demonstration of these structures or their function in the participant's or instructor's body. At one site, a postworkshop practical test was administered immediately after the workshop. Results There were 170 participants (84 rheumatology fellows, 61 rheumatologists, and 25 nonrheumatologists). The overall mean ± SD number of correct answers was 46.6% ± 19.9% and ranged from 32.5-67.0% by country. Rheumatology fellows scored significantly higher than nonrheumatologists. Questions related to anatomy of the hand scored the lowest of the regions surveyed. Conclusion Rheumatology fellows and rheumatologists showed a deficit in knowledge of musculoskeletal anatomy that is of central importance in rheumatologic assessment and diagnosis. This gap may hinder accurate and cost-effective rheumatologic diagnosis, particularly in the area of regional pain syndromes. Presently, widespread use of musculoskeletal ultrasound (MSUS) by rheumatologists may be premature, since a key component of expert-level MSUS is the integration of an accurate knowledge of anatomy with the views obtained with the ultrasound probe. Copyright © 2014 by the American College of Rheumatology.


Terslev L.,Copenhagen University | Naredo E.,Hospital General Universitario Gregorio Maranon | Iagnocco A.,University of Rome La Sapienza | Balint P.V.,National Institute of Rheumatology and Physiotherapy | And 12 more authors.
Arthritis Care and Research | Year: 2014

Objective To standardize ultrasound (US) in enthesitis. Methods An initial Delphi exercise was undertaken to define US-detected enthesitis and its core components. These definitions were subsequently tested on static images taken from spondyloarthritis patients in order to evaluate their reliability. Results Excellent agreement (>80%) was obtained for including hypoechogenicity, increased thickness of the tendon insertion, calcifications, enthesophytes, erosions, and Doppler activity as core elementary lesions of US-detected enthesitis. US definitions were subsequently obtained for each elementary component. On static images, the intraobserver reliability showed a high degree of variability for the detection of elementary lesions, with kappa coefficients ranging from 0.13-1. The interobserver kappa values were variable, with the lowest kappa coefficient for enthesophytes (0.24) and the highest coefficient for Doppler activity at the enthesis (0.63). Conclusion This is the first consensus-based US definition of enthesitis and its elementary components and the first step performed to ensure a higher degree of homogeneity and comparability of results between studies and in daily clinical work. © 2014, American College of Rheumatology.


Navarrete M.G.,General Hospital of Guadalajara | Hernandez A.D.,National Institute of Rehabilitation | Collado-Ortiz M.A.,American British Cowdray Hospital | Salinas-Lara C.,National Institute of Neurology and Neurosurgery | Tena-Suck M.L.,National Institute of Neurology and Neurosurgery
Annals of Diagnostic Pathology | Year: 2014

Brain vascular malformations are relatively common lesions that cause serious neurologic disability or death in a significant proportion of individuals bearing them. The purpose of this study was to analyze the clinicopathologic and immunohistochemistry these lesions, looking for common antibodies expressed such as CD31, CD34, CD15, factor VIII, nestin, vimentin, vascular endothelial grow factor (VEGF), vascular endothelial grow factor receptor-2 (VEGF-R2), glial fibrillar acidic protien (GFAP), and fibroblastic grow factor β (β-FGF) and ultrastructure in endothelial cells as well as in vessel walls. Fifty cases of vascular lesions were included in this study: 29 (58%) of them were arteriovenous malformations and 21 (52%) were brain cavernomas. Twenty-six (52%) patients were women and 24 (48%) men. The age range was from 13 to 68 years (mean age, 35.86 ± 15.19 years). The size of the lesions ranged between 1 and 8 cm (3 ± 1.65 cm), and parieto-occipital lesions had a bigger size. Evolution time varied from 1 month to 1 year (mean, 7.5 months). There was a significant statistical correlation between age and sex (P = -035), rupture of lesion (P =.015), brain hemorrhage (P =.033), necrosis (P =.011), hemosiderin deposit (P =.042), VEGF (P =.015), and VEGFR (P =.037), as well as localization of rupture (P =.017), loss of consciousness (P =.000), visual deficit (P =.026), hyaline vessels (P =.000), and CD31 (.009). Interactions between endothelial cells and mural cells (pericytes and vascular smooth muscle cells) in blood vessel walls have recently come into focus as central processes in the regulation of vascular formation, stabilization, remodeling, and function in brain vascular lesions. However, the molecular mechanisms that underlie the formation and growth of brain arteriovenous malformations are still poorly understood. © 2014 Elsevier Inc.


Uribe-Escamilla R.,National Institute of Rehabilitation | Poblano A.,National Institute of Rehabilitation | Alfaro-Rodriguez A.,National Institute of Rehabilitation
Egyptian Journal of Ear, Nose, Throat and Allied Sciences | Year: 2013

Amplitude measurement and reproducibility of Transient-otoacoustic emissions (T-EOAE) depend on synchronicity and functional integrity of cochlear outer hair cells, thus, the main objective of this study was to determine the usefulness of amplitude measurement and reproducibility in five selective frequencies of T-EOAE in patients with Sensorineural hearing loss (SNHL). We studied 44 subjects with SNHL by means of T-EOAE and Brainstem auditory evoked potentials (BAEP), and compared the results with those of a six control-normal-hearing subject group. We observed significant differences in the reproducibility of T-EOAE and in amplitudes of 0.7, 1.5, 2.2, 3.0 and 3.7. kHz. In addition, we observed negative significant correlations between BAEP threshold and T-EOAE reproducibility and with all specific amplitude measurement frequency values. These results confirm the clinical usefulness of reproducibility and selective amplitude measurement of frequency of T-EOAE for SNHL identification. © 2013 .


Rogojan R.,National Institute of Rehabilitation | Andronescu E.,Polytechnic University of Bucharest | Ghitulica C.,Polytechnic University of Bucharest | Stefan Vasile B.,Polytechnic University of Bucharest
UPB Scientific Bulletin, Series B: Chemistry and Materials Science | Year: 2011

It is known that sol-gel method is an alternative method to produce ceramic powders. The present study deals with the synthesis and characterization of Al2O3 nanopowders which can be a potentially utilized material for biocompatible implants.[1,2,3,4] Based on sol-gel method, the synthesis started from different chemical nature precursors - inorganic (aluminum chloride, AlCl3) and organic (aluminum triisopropylate, (C3H7O) 2)Al). The powders obtained after drying the gel were heat treated at 1000°C and 1200°C for 2 hours. X-ray diffraction was used in order to characterize the powders in terms of their crystallinity degree and crystallite size. Microstructural and morphological characterization was performed using electron-microscopic techniques - scanning electron microscopy (SEM) and transmission electron microscopy (TEM).


Zambrano-Sanchez E.,National Institute of Rehabilitation | Martinez-Cortes J.A.,National Institute of Rehabilitation | del Rio-Carlos Y.,National Institute of Rehabilitation | Martinez-Wbaldo M.D.C.,National Institute of Rehabilitation | Poblano A.,National Institute of Rehabilitation
Psychiatry Research | Year: 2011

The objective was weighing the usefulness of a Spanish-language Scale for the evaluation of deficit of attention and hyperactivity (EDAH) to identify children with attention deficit-hyperactivity disorder (AD-HD) and conduct disorder (CD) in a sample of school-aged children. We studied 132 children from a government-run public elementary school previously selected by teachers as having learning and attention disorders. We screened children of the sample with parents' and teachers' EDAH and Diagnostic and Statistical Manual of Mental Disorders-IV edition Text Revision (DSM-IV-TR) questionnaires, and performed an interdisciplinary clinical examination for the final diagnosis. We found 81 children with AD-HD and 51 children without AD-HD. AD-HD was classified as follows: AD-HD-combined (-C), n= 32; AD-HD-inattentive (-I), n= 17 and AD-HD-hyperactive (-H), n= 32. Cronbach's alpha calculation for the EDAH parents' questionnaire was 0.76, and for teachers, 0.80. Sensitivity of the teachers' EDAH questionnaire was 0.94, and specificity, 0.91. Sensitivity of the parents' EDAH questionnaire was 0.91, while specificity was 0.87. The data of EDAH parents' and teachers' questionnaires have a concordance of 93.1% and 80%, respectively. The correlation of scores among parents' and teachers' EDAH scales was significant. The correlation between results from parents' and teachers' DSM-IV-TR and EDAH questionnaires was also significant. Our results partially support the use of EDAH questionnaires for AD-HD and CD screening in Spanish-speaking populations. © 2010.


Poblano A.,National Institute of Rehabilitation | Luna B.,National Institute of Rehabilitation | Reynoso C.,National Institute of Rehabilitation
Arquivos de Neuro-Psiquiatria | Year: 2014

Objective: To determine frequency of motor alterations in children with attention deficit hyperactivity disorder (ADHD). Method: We evaluated 19 children aged 7-12 years with ADHD classified in three sub-types: Combined (ADHD-C), with Inattention (ADHD-I), and with Hyperactivity (ADHD-H). Controls were age- and gender matched healthy children. We utilized Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for measuring motor skills. Results: We observed differences between children with ADHD and controls in BOTMP general score and in static coordination, dynamic general- and hand- coordination, and in synkinetic movements. We also found differences in dynamic hand coordination between controls and children with ADHD-C; in dynamic general coordination between controls and children with ADHD-H; and in frequency of synkinetic movements between controls and children with ADHD-H. Conclusion: Children with ADHD with a major degree of hyperactivity showed greater frequency of motor alterations. © 2014, Arquivos de Neuro-Psiquiatria. All rights reserved.


Zambrano-Sanchez E.,National Institute of Rehabilitation | Martinez-Cortes J.A.,Neurologist | del Rio-Carlos Y.,Psychiatrist | Dehesa-Moreno M.,Psychiatrist | Poblano A.,National Institute of Rehabilitation
Arquivos de Neuro-Psiquiatria | Year: 2012

Objective: Attention deficit hyperactivity disorder (ADHD) is an alteration that begins early in infancy and whose cardinal symptoms are inattention, hyperactivity and impulsivity. There are few studies for specific tests to measure Quality of Life (QoL) in children with ADHD. Methods: We evaluated QoL of 120 children from 7-12 years of age with ADHD and of a group of 98 healthy control children. To measure QoL, we utilized the Questionnaire of Quality of Life for Children in Pictures (AutoQuestionnaire Qualité de Vie Enfant Imagé, AUQUEI). We evaluated anxiety in children by the Childreńs Manifest Anxiety Scale-Revisited (CMAS-R). We compared results among groups and employed the calculation of correlation between the AUQUEI questionnaire and the CMAS-R scale. Results: The total average of the AUQUEI questionnaire in children with ADHD was 45.2, while in the control group it was 54.3 (p<0.05). We also observed significant differences between the control group and groups of children with ADHD in the CMAS-R scale. We found significant correlations between AUQUEI questionnaire and CMAS-R scale. Conclusion: The main result was to the disclosure that low QoL scores in ADHD children was anxiety-related.


Konstantinidis C.,National Institute of Rehabilitation | Samarinas M.,General Hospital Koutlibanio of Larisa | Andreadakis S.,General Clinic | Xanthis S.,General Hospital Koutlibanio of Larisa | Skriapas K.,General Hospital Koutlibanio of Larisa
Urologia Internationalis | Year: 2013

Objective: To evaluate the efficacy and safety of fesoterodine extended-release (ER) plus tamsulosin in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Patients and Methods: Men aged ≥50 years, with LUTS, prostate volume ≤60 ml and International Prostate Symptom Score (IPSS) ≥13 were enrolled in this study. 173 consecutive patients were treated initially with tamsulosin (0.4 mg) for 1 week. At the second visit, 47 patients out of the sample of 173 who were still experiencing inconvenient LUTS were randomized into two groups. The first group received a therapy with tamsulosin and fesoterodine combination (group 1, n = 24) while the second continued the therapy with the single administration of tamsulosin (group 2, n = 23) for an additional 4-week period. Results: There was no statistically significant difference in age, prostate volume, Q max, and postvoid residual urine between the two groups. A statistical significance appeared in the combination group regarding the storage and the total IPSS values among the second and third visits (10.5 ± 1.4 to 8.5 ± 1.3 and 16.1 ± 1.8 to 13.7 ± 1.5 respectively). Conclusion: Regarding bothersome LUTS and storage symptoms, fesoterodine ER and tamsulosin combination was significantly more effective than the single administration of tamsulosin. Copyright © 2012 S. Karger AG, Basel.


Cardenas-Rodriguez N.,National Institute of Pediatrics | Huerta-Gertrudis B.,National Institute of Pediatrics | Rivera-Espinosa L.,National Institute of Pediatrics | Montesinos-Correa H.,National Institute of Pediatrics | And 3 more authors.
International Journal of Molecular Sciences | Year: 2013

Oxidative stress, a state of imbalance in the production of reactive oxygen species and nitrogen, is induced by a wide variety of factors. This biochemical state is associated with systemic diseases, and diseases affecting the central nervous system. Epilepsy is a chronic neurological disorder with refractoriness to drug therapy at about 30%. Currently, experimental evidence supports the involvement of oxidative stress in seizures, in the process of their generation, and in the mechanisms associated with refractoriness to drug therapy. Hence, the aim of this review is to present information in order to facilitate the handling of this evidence and determine the therapeutic impact of the biochemical status for this pathology. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

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