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ABSTRACT Amaranth flour is of high nutritional value, which makes it a potential food. Grinding of the grains is a necessary operation to obtain products with physical properties that provide the food products with adequate characteristics. To analyze the effect of grinding velocity and time on the particle diameters and physical properties of Amaranth flour by ball mill, a Doehlert design with triplicate at the central point was used. The tests were carried out with the mass ratio (balls/samples) (R1:5). Granulometry curve of each design system was fitted to the Rosin-Ramler-Bennet and Holmes-Hukki equations. A found a very significant effect of the velocity on the particle diameters (D50, D63 and D80). The flour obtained were modeled satisfactorily (r2>0.99) by using the Rosin-Ramler-Bennet equation, where the homogeneity index of (n1) was obtained, which was directly influenced by the milling energy. By using the Holmes-Hukki model, were able to model the characteristic diameters with the grinding energy; a critical region was observed between 100μm and 200μm, where lost efficiency in the size reduction. The excess energy, released in the critical region, caused the decrease in starch crystallinity and structural changes in the protein, which affect the functional properties of the flour. The planetary mill is emerging as an effective mean of modifying the functional properties in the development of new food products.

RESUMEN La harina de amaranto es de alto valor nutricional, convirtiéndola en un alimento potencial. La molienda de los granos es una operación necesaria, para brindarle a los productos alimenticios unas adecuadas propiedades físicas. Para analizar el efecto de la velocidad y el tiempo de molienda sobre el diámetro de particular y las propiedades físicas de la harina obtenida por molienda de bolas, se usó un diseño experimental Doehlert, con réplica en el punto central. En las pruebas de molinería se tuvo en cuenta la relación masa de bolas/masa de muestra (R1:5). Las curvas de granulometría de cada punto del diseño experimental fueron modeladas por las ecuaciones de Rosin-Ramler-Bennet y Holmes-Hukki. Se encontró un efecto muy significativo de la velocidad de molienda sobre los diámetros característicos (D50, D63 y D80). El modelo de Rosin-Ramler-Bennet ajustó satisfactoriamente (r2>0.99), además, se obtuvo el índice de homogeneidad (n1), el cual, fue afectado directamente por la energía de molienda. El uso del modelo de Holmes-Hukki permitió relacionar el diámetro de partícula con la energía de molienda y se logró observar una región crítica entre 100μm y 200μm, donde hay una reducción en la eficiencia de la reducción de tamaño de partícula. El exceso de energía liberada en la región crítica causó el descenso en la cristalinidad del almidón y provocó cambios en la estructura de las proteínas, lo cual, modificó las propiedades físicas de la harina. El Molino planetario es una técnica emergente y efectiva para modificar las propiedades funcionales en el desarrollo de nuevo productos alimenticios.

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Despite the criticism and reservations made about him still nowadays, Louis Pasteur may be considered one of the most important scientists of the last two centuries in public health, even if the work of the numerous scientists who preceded him have largely contributed to the successes he obtained without following too much to the rules of deontology and ethics currently in force in the world of research and medicine. He has definitively put down, by his experiments, the "theory of spontaneous generation" in force since antiquity, validated that of "germs or microbes", enacted the first rules of asepsis, while inspiring those of the antisepsis applied by Joseph Lister, and developed a certain number of vaccinations in veterinary and human medicine, including the anti-rabies, the one which made him famous all over the world. All this was not done without difficulty and Pasteur encountered for a large part of his life the misunderstanding of his contemporaries and the hostility of the medical world to which he did not belong. The authors comment in this text the movie The Story of Louis Pasteur by William Dieterle, filmed in 1936, based on the knowledge acquired since that date and doing the part of the real and the fiction.

Malgré les critiques et les réserves dont il est l'objet aujourd'hui, Louis Pasteur peut être considéré comme l'un des scientifiques les plus importants de ces deux derniers siècles en matière de santé publique, même si les apports des nombreux hommes de science qui l'ont précédé ont largement contribué aux succès qu'il obtint sans trop se soucier des règles de déontologie et d'éthique actuellement en vigueur dans le monde de la recherche et de la médecine. Il a mis définitivement à bas, par ses expériences, la « théorie de la génération spontanée ¼ en vigueur depuis l'Antiquité, validé celle « des germes ou microbes ¼, édicté les premières règles de l'asepsie tout en inspirant celles de l'antisepsie appliquée par Joseph Lister et mit au point un certain nombre de vaccinations en médecine vétérinaire puis humaine, notamment celle contre la rage, ce qui le rendit célèbre dans le monde entier. Tout cela ne s'est pas fait sans difficulté, et Pasteur s'est heurté pendant une grande partie de sa vie à l'incompréhension de ses contemporains et à l'hostilité du monde médical auquel il n'appartenait pas. Les auteurs commentent dans ce texte le film L'Histoire de Louis Pasteur de William Dieterle, tourné en 1936, en s'appuyant sur les connaissances acquises depuis cette date et en faisant la part du réel et de l'imaginé.

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Resumen El temblor de Holmes o rúbrico es infrecuente de ver como manifestación única o predominante de un accidente vascular encefálico cerebeloso. "Grosso modo" el temblor es un trastorno del movimiento habitual en la practica medica, siendo el fisiológico exacerbado el más frecuentemente visto; y el temblor esencial el más común de los movimientos involuntarios patológicos. Los estudios de neuroimágenes han concluido la importancia del cerebelo y de toda la vía cerebelotalámo-cortical en la patogénesis del temblor en general; sin dilucidar aun todas las estructuras involucradas entre las que se menciona a nivel molecular, las células de Purkinje. El temblor de Holmes es una manifestación extrapiramidal frecuente en lesiones cerebelosas de origen vascular; asociándose habitualmente a otra sintomatología de circulación posterior. Presentamos dos casos de temblor rúbrico o de Holmes como manifestación predominante de accidente vascular encefálico. Los autores concluyen que es posible este tipo de presentación, especialmente en pacientes con temblor de acción de inicio ictal, o en aquellos casos de temblor de reposo no parkinsoniano con mala respuesta a la L-Dopa; y en dichos casos, con lesión no mescencefálica, los pacientes podrían beneficiarse del uso de anticolinérgicos.

Holmes's tremor; or rubric tremor is infrequent as predominantly or unique manifestation of cerebellum stroke. Grosso modo tremor is a movement's disorder common in medical practice, being the physiological exacerbated type the most frequently seen, and the essential tremor the most frequently seen in pathological involuntary movements. Neuroimaging studies have concluded the importance of the cerebellum and of the entire cortical-cerebellar- thalamic pathway in the pathogenesis of tremor in general; without specifically of all the structures involved; but among which is mentioned at the molecular level the Purkinje cells. Holmes's tremor, is one of the frequently extrapyramidal manifestations of cerebellar lesions of vascular origin; and it is common to be associated with another symptomatology of posterior circulation. We present two cases of rubric Holmes tremor, as a predominant manifestation of stroke. The authors conclude that this type of presentation is possible, especially in patients with Holmes tremor with ictal onset, or in those cases of non-parkinsonian resting tremor that responds poorly to L-Dopa; and suggest that in such cases, with non-mesencephalic injury, patients could benefit from the use of anticholinergics.

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Background: Holmes tremor is a rare symptomatic movement disorder, characterized by a combination of resting, postural, and intention tremor. It is usually caused by lesions in the brainstem, thalamus, and cerebellum. Despite pharmacological advances, its treatment remains a challenge; many medications have been used with various degrees of effectiveness. Stereotactic thalamotomy and deep brain stimulation in the ventralis intermedius nucleus have been effective surgical procedures in cases refractory to medical treatment. Case Report: Here we report a young woman with topiramate-responsive Holmes tremor secondary to a brainstem cavernoma. Discussion: Herein we report a Holmes tremor responsive to Topiramate.

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Autosomal recessive cerebellar ataxias (ARCAs) represent a heterogeneous group of inherited disorders. The association of early-onset cerebellar ataxia with hypogonadotropic hypogonadism is related to two syndromes, known as Gordon Holmes syndrome (GHS-ataxia and pyramidal signs with hypogonadotropic hypogonadism) and Boucher-Neuhäuser syndrome (BNS-ataxia with chorioretinal dystrophy). Mutations in the PNPLA6 gene have been identified as the cause of hereditary spastic paraplegia and complex forms of ataxia associated with retinal and endocrine manifestations. We reported two Brazilian patients with sporadic, progressive cerebellar ataxia, associated with hypogonadotropic hypogonadism, in whom the GHS and BNS were confirmed by the demonstration of compound heterozygote mutations in the PNPLA6 gene. Genetic analysis of the patient 1 revealed compound heterozygous mutations, one allele in exon 34 and the other allele in exon 29. Genetic exam of the patient 2 also demonstrated compound heterozygous mutations. Three were novel mutations. The missense mutation c.3373G> A, found in the BNS patient, was previously related to Oliver-McFarlane syndrome. These different mutations in this gene suggest a complex phenotype associated disease spectrum.

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BACKGROUND: Lesions in the Guillain-Mollaret triangle or dentate-rubro-olivary pathway may lead to hypertrophic olivary degeneration (HOD), a secondary trans-synaptic degeneration of the inferior olivary nucleus. HOD is usually associated with palatal tremor and rarely with Holmes tremor. Bilateral HOD is a very unusual condition and very few cases are reported. CASE REPORT: We report here two cases of bilateral HOD after two different vascular lesions located at the decussation of superior cerebellar peduncles, thus impairing both central tegmental tracts and interrupting bilaterally the dentate-rubral-olivary pathway. Interestingly, both developed bilateral Holmes tremor but not palatal tremor. DISCUSSION: Lesions in some of the components in the Guillain-Mollaret triangle may develop Holmes tremor with HOD and without palatal tremor. Magnetic resonance imaging is an invaluable tool in these cases. Better understanding of the pathways in this loop is needed.

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We report a 37-year-old woman with uveitic phase of Vogt Koyanagi Harada disease and tonic pupil, the tonic pupil persisted after other clinical features of this syndrome had disappeared; neurological evaluation shows absent knee and arm tendon reflexes and positive cholinergic supersensitivity test with Pilocarpine 0.125% confirming the diagnosis of Holmes Adie Syndrome.

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El método holmesiano o sherlockiano según se le quiera designar, se advierte en la obra de Pifano y se sostiene en los siguientes enunciados: 1 Ciudadosa observación mediante el empleo combinado de los sentidos, asociada a un conocimiento intiutivo y razonamiento deductivo. 2 Prestar atención a los detalles y mantener alerta a las discrepancias. 3 Considerar las diversas opciones presentes en un caso. 4 Aprender a diferenciar y conocer lo que es importante de lo que no lo es. El Maestro Pifano dio a conocer a sus alumnos lo que consideraba importante al fusionar el método clínico condicente a formular un diagnóstico (historia clínica y anamnesis cuidadosa, examen físico integral e integrado, e investigaciones complementarias) con el método epidemiológico que situaba al paciente en un espacio geográfico, en un tiempo determinado e insertado en una comunidad donde concurrían los diferentes elementos que determinaban su condición de enfermo. En suma, en su concepción, el estudio integral del enfermo era indisoluble de su ambiente, del biotopo donde se desarrollaban los fenómenos de la ecología asociada al grupo a la cual pertenecía-soma, psiquis y mundo externo

The Holmesian or Skerlockian methodology considered four important steps, 1 Careful observation by use of the senses combined with intuitive knowledge and deductive reasoning. 2 Attention to details and alertness to discrepancies. 3 Considering the many options present in a case 4 Knowing what is important and what is not. Through the discussion we will show how these elements were present in the work of Félix Pifano, M.D. Master Pifano unveiled their students what was considered important to merge the leading clinical method to make a diagnosis (medical history and careful anamnesis, physical examination, integral and integrated and complementary procedures) with the epidemiological method that placed the patient in a geographic area, at a time determined and inserted in a community where the various elements that determined their condition of ill person. In short, in its conception, the comprehensive study of the patient was indissoluble of its environment, the biotope where unfolded the phenomena of ecology associated to the group to which he belonged-soma, psyche and world external

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El síndrome de Ross fue descrito en 1958 como una afección degenerativa del sistema nervioso autónomo definido por la tríada de anhidrosis generalizada, disminución de los reflejos tendinosos y pupila tónica. Desde su descripción inicial se han descrito cerca de cuarenta casos. Comunicamos tres pacientes con variantes de interés que incluyen la presencia de espasmos cíclicos espontáneos del esfínter de iris, el desarrollo conjunto de síndrome de Holmes-Adie en un lado y síndrome Horner posganglionar en el otro, trastornos del desarrollo piloso en el lado de la anhidrosis, alteraciones de la motilidad intestinal, lengua sin papilas gustativas y disfunción sexual.

Ross Syndrome was described in 1958 as a degenerative condition of the autonomic nervous system defined by a triad of generalized anhidrosis, reduction of tendon reflexes and tonic pupil. Since its initial description about 40 cases have been described. We communicate three cases with variants of interest involving the presence of the simultaneous development of syndrome of Holmes-Adie on one side and Horner syndrome in the other, disorders of pilous follicle development on the side of anhidrosis, spontaneous disturbances of intestinal motility, tonque without papillae and sexual dysfunction.

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Sir Arthur Conan Doyle, además de ameno escritor de best sellers, era médico y escribió excelentes cuentos sobre el ejercicio de su profesión en Inglaterra. Sin embargo, a pesar de mencionar The British Medical Journal y The Lancet en sus historias de Sherlock Holmes, al introducir enfermedades infecciosas en sus tramas, ignora descubrimientos importantes ya realizados en su época en el campo del tétanos. En todo caso, las apariciones de las enfermedades infecciosas en las historias del detective son escasas: una mención del tétanos, otra de la lepra y -la más analizada en la literatura médica- un caso de asesinato realizado mediante la inoculación de una bacteria, probablemente del agente de la melioidosis. También hizo a su héroe descubrir las acciones tóxicas de una medusa y de un trasplante de órganos. Poco para un médico y poco para un autor que también escribía ciencia ficción: pareciera que la historia de los grandes descubrimientos médicos de fines del siglo XX y comienzos del XXI pasó por su lado... y no la vio.

Besides a pleasant author of best sellers, Sir Arthur Conan Doyle was a medical doctor, writing excellent short stories about the exercise of his profession in England. However, even he mentions The British Medical Journal and The Lancet in the Sherlock Holmes’s stories, when in the plot introduces infectious diseases, Conan Doyle ignores important discoveries in the field of tetanus. Anyway, the appearing of infectious diseases in the adventures of the detective are rare: one mention of tetanus, another of leprosy and- the most analyzed in medical literature -a case of murder by inoculation of bacteria, probably the agent of melioidosis. Also he makes his hero discovers the toxic actions of a medusa and a transplant of solid organ. Little for a physician and less for an author who also wrote science fiction: it seems that the history of the great medical discoveries at the end of nineteenth century and beginning of the twentieth has passed by his side… and he just couldn’t see it.

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