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Background: Posttraumatic stress disorder (PTSD) is prevalent in people with acquired brain injury (ABI). Despite the established efficacy of eye movement desensitization and reprocessing (EMDR) for PTSD in general, evaluation studies on EMDR in ABI patients with PTSD are limited.Objective: The aim of this study is to explore clinical features, treatment characteristics, feasibility and first indications of efficacy of EMDR in adult ABI patients with PTSD.Method: This retrospective consecutive case series included ABI patients, who received at least one session of EMDR for PTSD between January 2013 and September 2020. PTSD symptoms were measured using the Impact of Event Scale (IES) pre- and post-treatment. Affective distress was measured using the Subjective Units of Distress (SUD) pre- and post-treatment of the first target.Results: Sixteen ABI patients (median age 46 years, 50% males), with predominantly moderate or severe TBI (50%) or stroke (25%) were included. Treatment duration was a median of seven sessions. Post-treatment IES scores were significantly lower than pre-treatment scores (p < .001). In 81% of the cases there was an individual statistically and clinically relevant change in IES score. Mean SUD scores of the first target were significantly lower at the end of treatment compared to scores at the start of treatment (p < .001). In 88% of the patients full desensitization to a SUD of 0-1 of the first target was accomplished. Only few adjustments to the standard EMDR protocol were necessary.Conclusions: Findings suggest that EMDR is a feasible, well tolerated and potentially effective treatment for PTSD in ABI patients. For clinical practice in working with ABI patients, it is advised to consider EMDR as a treatment option.

This retrospective consecutive case series (N = 16) explores clinical features, treatment characteristics, feasibility and first indications of efficacy of eye movement desensitization and reprocessing (EMDR) in adult patients with acquired brain injury (ABI) and Posttraumatic stress disorder (PTSD).The results suggest that EMDR is a feasible and potentially efficacious treatment for PTSD in ABI patients, as patients demonstrated statistically and clinically significant large sized reductions in PTSD-symptoms after EMDR treatment.For clinical practice in working with ABI patients, we advise to consider EMDR as a treatment option.

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Resumen OBJETIVO: Describir las características clínicas e imagenológicas de pacientes con encefalopatía posterior reversible atendidas en una unidad de cuidados intensivos. MATERIALES Y MÉTODOS: Estudio retrospectivo, descriptivo y transversal de serie de casos efectuado en pacientes con diagnóstico de encefalopatía posterior reversible secundaria a trastornos hipertensivos atendidas en la unidad de cuidados intensivos del Hospital Universitario de la Samaritana, Bogotá, Colombia, entre el 1 de enero de 2013 y el 31 de diciembre de 2020. RESULTADOS: Se encontraron 12 pacientes con encefalopatía posterior reversible; 8 de ellas con inicio durante el puerperio inmediato y 4 en el puerperio mediato. Se diagnosticó eclampsia en 6 pacientes durante el embarazo y en 5 durante el posparto. Los síntomas más comunes fueron: cefalea y convulsiones. Los hallazgos imagenológicos mostraron edema con mayor frecuencia en los lóbulos posteriores del cerebro; sobre todo en el occipital bilateral y parietooccipital. Todas las pacientes fueron dadas de alta del hospital sin lesiones neurológicas irreversibles. CONCLUSIONES: La encefalopatía posterior reversible es poco común pero debe considerarse en las pacientes con síntomas neurológicos concomitantes con los trastornos hipertensivos del embarazo. Si bien la muestra es de pocos casos, sí puede mencionarse que el diagnóstico radiológico con resonancia magnética cerebral, el tratamiento oportuno y las intervenciones multidisciplinarias disminuyen el riesgo de lesiones neurológicas irreversibles y el desenlace fatal.

Abstract OBJECTIVE: To describe the clinical and imaging characteristics of patients with posterior reversible encephalopathy seen in an intensive care unit. MATERIALS AND METHODS: Retrospective, descriptive, cross-sectional case series study performed in patients with a diagnosis of reversible posterior encephalopathy secondary to hypertensive disorders attended in the intensive care unit of the Hospital Universitario de la Samaritana, Bogotá, Colombia, between January 1, 2013 and December 31, 2020. RESULTS: We found 12 patients with reversible posterior encephalopathy; 8 of them with onset during the immediate puerperium and 4 in the mediate puerperium. Eclampsia was diagnosed in 6 patients during pregnancy and in 5 during the postpartum period. The most common symptoms were headache and convulsions. Imaging findings showed edema most frequently in the posterior lobes of the brain, especially in the bilateral occipital and parietooccipital lobes. All patients were discharged from the hospital without irreversible neurological lesions. CONCLUSIONS: Reversible posterior encephalopathy is uncommon but should be considered in patients with neurologic symptoms concomitant with hypertensive disorders of pregnancy. Although the sample is small, it can be mentioned that radiological diagnosis with brain magnetic resonance imaging, timely treatment and multidisciplinary interventions decrease the risk of irreversible neurological lesions and fatal outcome.

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Resumen En las últimas décadas la investigación neurocientífica soporta el hecho de que las adicciones son enfermedades del cerebro, como la epilepsia o la enfermedad de Parkinson. El enfoque de manejar las adicciones de manera punitiva no ha arrojado resultados satisfactorios; por eso la investigación básica y clínica cada vez aporta más evidencia que la adicción podría ser mejor considerada y tratada como una enfermedad adquirida del cerebro, lo que constituye el "modelo de enfermedad cerebral de las adicciones". Con el desarrollo de este modelo se ha conseguido un avance significativo en la implementación de estrategias de prevención y tratamiento más efectivo, así como políticas de salud pública mejor fundamentadas. No obstante, el concepto de la adicción como una enfermedad del cerebro sigue siendo cuestionado. En este artículo se exponen argumentos para considerar los trastornos por uso de sustancias como enfermedades producidas por alteraciones en la estructura y funcionamiento de áreas específicas del cerebro, así como visualizar las implicaciones clínicas y en la política pública de éste modelo de enfermedad.

Abstract In the last decades, neuroscientific research has supported the fact that addictions are diseases of the brain such as epilepsy or Parkinson's disease. The punitive approach to manage addictions has not yielded satisfactory results, therefore the basic and clinical research provides growing evidence that addiction could be better considered and treated as an acquired brain disease which constitute the brain disease model of addictions. With the development of this model, significant progress has been achieved in the implementation of prevention and more effective treatment strategies and also better informed public health policies. However, the concept of addiction as a brain disease is still being questioned. This article presents arguments to consider substance use disorder as a disease caused by alterations in the structure and functioning of specific areas of the brain, as well as to visualize the clinical implications and the public policies of this disease model.

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Erdheim-Chester disease is a non-Langerhans histiocytosis. Until 2014 at least 550 cases have been reported. According to European Rare Disease Organization and National Organization for Rare Disorders it is a rare disease. The most common symptom is bone pain in the lower extremities and it usually appears between the 5th and 7th decades of life. The diagnostic is based on immunohistochemical results: S100(+/-), CD68(+), and CD1a(-), the latter 2 are mandatory. The best treatment nowadays is alpha-interferon or pegylated alpha-2. The overall survival is 96% at one year and 68% at 5 years. Central nervous system involvement is associated with a worse outcome. Two cases are presentedwith central nervous system lesions in the absence of lesions in other organs on their onset. Very few cases have been reported with this kind of presentation. We also noted that these patients had recurrences or new lesions at 8 months. A follow-up is proposed with brain MRI and thoraco-abdominal PET every 3-4 months.

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Introducción: La calbindina (CB) es una proteína reguladora del metabolismo del calcio intracelular. Previamente se demostró que la infección con virus fijo de la rabia induce pérdida de la expresión de CB, en el cerebro de ratones en estado terminal de la enfermedad, a los 7-8 días de post-inoculación (p.i.) intramuscular. Objetivo: Determinar si la pérdida de expresión de CB se presenta también en etapas tempranas de la infección y si es una consecuencia inmediata a la aparición de antígenos virales en el cerebro. Materiales y métodos: Se inocularon ratones con virus fijo de la rabia, por vía intramuscular, en su extremidad posterior izquierda. Diariamente se tomaron entre 4 y 6 animales infectados y sus respectivos controles, se fijaron por perfusión intracardíaca con paraformaldehído, se extrajeron sus cerebros y se obtuvieron cortes coronales en un vibratomo. Estos se sometieron a reacciones inmunohistoquímicas para evaluar la presencia de antígenos virales y la expresión de CB. Esta última fue cuantificada mediante densitometría óptica en un microscopio con anßlisis de imßgenes. Resultados: La inmunorreactividad a la rabia fue positiva en el cerebro a partir del día 3 p.i.; se observó primero en neuronas piramidales de la corteza frontal. La inmunotinción para CB no sufrió ninguna alteración cualitativa ni cuantitativa en la corteza cerebral y el estriado hasta el día 6 p.i. Conclusiones: Estos resultados coinciden con los de otros estudios sobre la rabia en los que se han encontrado alteraciones moleculares, metabólicas o fisiopatológicas en el sistema nervioso sólo en la fase terminal de la enfermedad.

Introduction: The calcium-binding protein calbindin (CB) plays a critical role in intracellular calcium metabolism. In a previous study we demonstrated that the infection with fixed rabies virus caused loss of CB expression in mouse brain during terminal state of the disease, 7-8 days after intramuscular inoculation. Objectives: To determine loss of CB expression also appears in early stages of the infection and if it is a consequence immediate to the appearance of viral antigens in the brain. Materials and methods: Mice were inoculated with fixed rabies virus, by intramuscular route, in the left hind limbs. Daily, to sixth day, 4-6 animals and their respective controls were killed and fixed by intracardiac perfusion with paraformaldehyde and their brains were extracted to obtain coronal sections using a vibratome. Free-floating sections were treated by immunohistochemical procedures to evaluate the presence of rabies viral antigens and the expression of CB. The last one was quantified by optical densitometry in a microscope with a system of image analysis. Results: Rabies immunoreactivity was observed in the brain three days after virus inoculation, beginning in pyramidal neurons of the frontal cortex whereas the immunostaining for CB did not undergo any qualitative nor quantitative changes neither in the cerebral cortex or striatum during the six days post-inoculation. Conclusions: These results agree with other studies in which it has been settled down that the rabies molecular or metabolic effects on the nervous system are well-known only in the final stage of the disease.

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Introducción: existen dos maneras de defi nir la neuropsiquiatría: la visión estadounidense, que entiende esta práctica como neurología de la conducta, y la europea, que la propone como una subespecialidad psiquiátrica relacionada con el enfoque diagnóstico y el tratamiento de los pacientes con enfermedades neurológicas establecidas que tienen manifestaciones psicopatológicas en su conducta. Objetivo: plantear esta práctica clínica como un neuroenlace, que pone al profesional de la salud mental en la necesidad de un trabajo interdisciplinario que se adapte a las particularidades del individuo afectado. Conclusión: aunque existe un cuerpo teórico neuropsiquiátrico importante, en Colombia aún son necesarias reformas curriculares profundas en los posgrados de Psiquiatría, para poder responder a las necesidades de formación de nuevos profesionales en este campo de trabajo, por eso en este artículo se plantean algunos precedentes necesarios para la discusión.

Introduction: There are two broad ways of defi ning neuropsychiatry: the North American view understands this discipline as behavioral neurology and European view argues that it constitutes a subspeciality within psychiatry dealing with diagnosis and treatment of patients with established neurological diseases that have disturbances in their behavior. Objectives: To understand the clinical practice of neuropsychiatry as a sort of neuro-liasion creates the need of an interdisciplinary work for the neuropsychiatrist adapted to the different needs of the affected individual. From this perspective treatment and rehabilitation teams in neuropsychiatry accept the relationships existing between structural brain damage, behavior and environment and relational contexts. Additionally, psychiatric interview and case formulation are helped by techniques coming from neuropsychology and neuroimaging. Conclusion: Although there are several groups interested in neuropsychiatry in Colombia, important curricular changes are needed in order to make possible the creation of training programs in this area. In this paper some key aspects for discussing this matter are enounced.

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Con el objetivo de conocer los factores de riesgos de ictus cerebral en profesionales de la salud del hospital 14 de Junio fueron estudiados 102 profesionales. Predominó el grupo etareo de 25 35 años, el sexo femenino y la raza blanca. El sedentarismo, los antecedentes familiares de ictus y el hábito de fumar los factores de riesgos más relevantes, la hipertensión arterial y el asma bronquial fueron las enfermedades crónicas más frecuentes. El 87 por ciento de los profesionales con enfermedades crónicas llevan tratamiento médico irregular(AU)

With the objective of knowing the factors of risks of [ictus cerebral] in professionals of the health of the hospital 14 of June 102 professionals were studied. it prevailed the group of 25- 35 years, the feminine sex and the white race. The [sedentarismo], the family antecedents of [ictus] and the habit of smoking the factors of more excellent risks, the arterial hypertension and the asthma [bronquial] they were the illness more frequent chronicles. The 87 per cent they of the professionals with chronic illness carry medical irregular treatment(AU)

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