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INTRODUCTION: Recombinant human erythropoietin is used primarily to treat anemia. There is evidence of its neuroprotective capacity from preclinical studies in Parkinson's disease and other neurodegenerative diseases. Recombinant human erythropoietin produced in Cuba (ior-EPOCIM) is registered and approved for use in humans in Cuba and in a number of other countries. OBJECTIVE: Assess safety and possible neuroprotective effect of ior-EPOCIM in a group of Parkinson's disease patients. METHODS: A three-phase exploratory study (proof of concept) was conducted from August 2008 to April 2009: preliminary assessment, treatment (weeks 1-5), and post-treatment (weeks 6-35). Participants were 10 Parkinson's disease patients (8 men, 2 women) from the outpatient clinic at the International Neurological Restoration Center, all at least one year post onset, aged 47-65 years. The ior-EPOCIM was administered subcutaneously in a once-weekly dose (60 IU/kg body weight) for five weeks. Therapy with patients' antiparkinsonian drugs was maintained throughout the study, except during motor examination, conducted following a 12-hour withdrawal (OFF condition). Safety was evaluated primarily by recording adverse events (by intensity and causality) from start of treatment until the study's completion. Hematological parameters and blood pressure were also measured because of their direct relationship to the medication's action. To evaluate possible neuroprotective activity, variables were included related to patients' motor function and cognitive and affective status, measured using internationally recognized scales. All variables were evaluated before, during and after treatment. Data were processed using a fixed-effects linear model, with a repeated-measures design (significance level p ≤ 0.05). RESULTS: Three patients experienced mild adverse events (precordial discomfort and hypertension in one; leg fatigue in another; renal colic in a third), with a possible causal relationship in the first two that was neither life threatening nor required hospitalization. Hemoglobin was the only hematological parameter that showed a growing and significant increase (p < 0.001), but without reaching pathological levels. The other variables presented clinically positive and statistically significant changes compared to pretreatment assessment: motor function (p < 0.001), cognitive status (p < 0.001) and mood (p = 0.013). CONCLUSIONS At the dosage used, ior-EPOCIM was safe and well tolerated in these Parkinson's disease patients. Further studies are needed to corroborate these results and evaluate the medication's possible neuroprotective effect. KEYWORDS Parkinson disease, erythropoietin, recombinant proteins, neuroprotective agents, clinical trial, safety, ior-EPOCIM, Cuba.

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The authors report a case of a 55-year-old Caucasian woman who received autologous bone marrow stem cell transplantation 3 years after a subcortical stroke. She exhibited positive cognitive changes 6 months and 1 year after the surgery without rehabilitation. The blood flow changes, measured with SPECT, were statistical significant in prefrontal areas. During the presurgical neuropsychological assessment, the patient presented a critical speech reduction, reflected in impaired performance in verbal fluency, vocabulary and in each task which required overt verbal response. One year later, she showed improvement in mental flexibility, receptive language, phonological fluency, verbal memory and auditory verbal memory. Positive cognitive changes in verbal and executive functions seem to be contingent on increased blood flow in prefrontal areas. Posterior neuropsychological evaluation 3 and 5 years after transplantation did not show deterioration of the cognitive improvement.

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Nearly one quarter of the global burden of disease stems from neurological, psychiatric and neurodevelopmental disorders due to malformations or dysfunctions of the central nervous system.[1] Such neuropsychiatric conditions influence quality of life worldwide, causing one third of years lost due to disability (YDL).[2] Ranging from congenital conditions to dementias of the elderly, these disorders appear throughout the life cycle and also account for a substantial proportion of mortality. Recent advances in neuroimaging and neuroinformatics have opened the way for early identification of dysfunctional brain networks, providing essential information for the early detection, proper diagnosis, treatment selection, and follow-up of people with disabilities due to brain disorders.

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La familia es la institución básica de la sociedad; constituye la unidad de reproducción y mantenimiento de la especie humana y en ese sentido, es el elemento que sintetiza la producción de la salud a escala microsocial. Cumple funciones importantes en el desarrollo biológico, psicológico y social del individuo y ha asegurado, junto con otros grupos sociales, la socialización y educación de este para su inserción en la vida social y la transmisión generacional de valores culturales. Podemos decir que la familia es en sí misma una tríada ecológica, aún hoy en parte desconocida, y por lo tanto, con problemas de manejo por parte del estomatólogo. Esto motivó a realizar una revisión bibliográfica con el objetivo de profundizar en la importancia de la familia en la promoción y prevención de salud general y bucal, así como actualizar estos conocimientos sobre esta situación en nuestro país, concluyendo con la necesidad de perfeccionar la actividad de la familia, formando en ella una determinada cultura de salud que abarque todos los aspectos de la vida, incluyendo la salud bucal, para mejorar los resultados en la prevención de enfermedades y promoción de salud(AU)

The family is the basic institution of the society, the reproductive unit that keeps the human species, and thus, it constitutes the element that centered health production at microsocial scale. The family has important functions in the biological, psychological and social development of the individual and has assured, together with other social groups, the socialization and education of the human being for its integration into the social life and the transfer of cultural values from one generation to the other. We may say that the family is an ecological triade, still partly unknown, difficult to be managed by the dentist. The above-mentioned prompted us to make a literature review on the importance of family in the promotion and prevention of general and oral health status and to update knowledge on our country´s situation. It was concluded that the role of the family should be improved in this regard by creating certain health culture that embraces all aspects of life including oral health, in order to better the results in the prevention of diseases and health promotion(AU)

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This paper focuses on the application of quantitative electric tomography (qEEGT) to map changes in EEG generators for detection of early signs of ischemia in patients with acute middle cerebral artery stroke. Thirty-two patients were studied with the diagnosis of acute ischemic stroke of the left middle cerebral artery territory, within the first 24 hours of their clinical evolution. Variable Resolution Electrical Tomography was used for estimating EEG source generators. High resolution source Z-spectra and 3- dimensional images of Z values for all the sources at each frequency were obtained for all cases. To estimate statistically significant increments and decrements of brain electric activity within the frequency spectra, the t-Student vs. Zero test was performed. A significant increment of delta activity was observed on the affected vascular territory, and a more extensive increment of theta activity was detected. A significant alpha decrement was found in the parieto-occipital region of the affected cerebral hemisphere (left), and in the medial and posterior region of the right hemisphere. These findings suggest that qEEGT Z delta images are probably related to the main ischemic core within the affected arterial territory; penumbra, diaschisis, edema, might explain those observed theta and alpha abnormalities. It was concluded that qEEGT is useful for the detection of early signs of ischemia in acute ischemic stroke.

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UNLABELLED: Fecal incontinence (FI) is a devastating condition that affects quality of life. Age and gender are related with the prevalence of FI. In adults, prevalence varies from 2% to 7%. It is more frequent in women than in men (3:1) and is more prevalent in elderly patients. There are no studies in Mexico that evaluate the frequency of FI in adults older than 60 years. AIM: To investigate the FI frequency, severity and associated factors in patients > or = 60 years. PATIENTS AND METHODS: Three groups of patients were included: a) Group I: consecutive outpatients patients from the Gastroenterology and Geriatrics Clinics of the INCMNSZ; b) Group II: INCMNSZ inpatients admitted due to a non-related condition with FI; c) Group III: Reyna Sofia nursing home residents (NHR) in Mexico City. A structured questionnaire was used to obtain demographic data, comorbidity and associated factors with FI. Grade of FI was assessed with the Wexner scale. RESULTS: 159 patients were included, 89 (56%) were women. Mean age was 75 years (range 59-98). There were 54 patients in group I, 50 in group II and 55 in group III. Overall frequency of FI was 33% (n = 53). Frequency of FI was 26% in group 1, 20% in group II and 53% in group III. Sixty six percent (n = 35) of the FI cases were female. Neuropsychiatric disorders were associated to FI in 29 patients (54%) and diabetes mellitus in 17 (32%). Eighty percent of patients wore disposable pads for FI. Urinary incontinence was associated to FI in 31 (58%). Thirteen (24%) patients had mild FI, 20 (38%) moderate, and 20 (38%) severe FI. The severity score for FI was lower in groups I and II (8.1 y 9.7) than in group III (18, p = 0.001). Age in patients with mild FI was significantly lower (73 years) than in patients with severe FI (83y, p = 0.01). CONCLUSIONS: FI in patients older than 60 years old is a very common condition. FI was more frequent and severe in women, in NHR and in those with neuropsychiatric disorders. Urinary incontinence was associated in half of patients with FI.

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A method for the exploratory analysis of electroencephalographic (EEG) data for neurophysiological experiments is presented. It is based on a time-frequency decomposition of the EEG time series, which is measured by several electrodes in the scalp surface, and includes the computation of a statistic that measures the deviations of the log-power with respect to the pre-stimulus average; the computation of a significance index for these deviations; a new type of display (the time-frequency-topography plot) for the visualization of these indices, and the segmentation of the time-frequency plane into regions with uniform activation patterns. As a particular example, an experiment to study EEG changes during figure and word categorization is analyzed in detail.

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Fecal incontinence (FI) is a devastating condition that affects quality of life. Age and gender are related with the prevalence of FI. In adults, prevalence varies from 2% to 7%. It is more frequent in women than in men (3:1) and is more prevalent in elderly patients. There are no studies in Mexico that evaluate the frequency of FI in adults older than 60 years. Aim. To investigate the FI frequency, severity and associated factors in patients ≥ 60 years. Patients and methods. Three groups of patients were included: a) Group I: consecutive outpatients patients from the Gastroenterology and Geriatrics Clinics of the INCMNSZ; b) Group II: INCMNSZ inpatients admitted due to a non-related condition with FI; c) Group III: Reyna Sofia nursing home residents (NHR) in Mexico City. A structured questionnaire was used to obtain demographic data, comorbidity and associated factors with FI. Grade of FI was assessed with the Wexner scale. Results. 159 patients were included, 89 (56%) were women. Mean age was 75 years (range 59-98). There were 54 patients in group I, 50 in group II and 55 in group III. Overall frequency of FI was 33% (n = 53). Frequency of FI was 26% in group I, 20% in group II and 53% in group III. Sixty six percent (n = 35) of the FI cases were female. Neuropsychiatric disorders were associated to FI in 29 patients (54%) and diabetes mellitus in 17 (32%). Eighty percent of patients wore disposable pads for FI. Urinary incontinence was associated to FI in 31 (58%). Thirteen (24%) patients had mild FI, 20 (38%) moderate, and 20 (38%) severe FI. The severity score for FI was lower in groups I and II (8.1 y 9.7) than in group III (18, p = 0.001). Age in patients with mild FI was significantly lower (73 years) than in patients with severe FI (83y, p = 0.01). Conclusions. FI in patients older than 60 years old is a very common condition. FI was more frequent and severe in women, in NHR and in those with neuropsychiatric disorders. Urinary incontinence was associated in half of patients with FI.

La incontinencia fecal (IF) es una condición que afecta la calidad de vida del enfermo. La prevalencia está relacionada con la edad y el género. Afecta de 2 a 7% de los adultos y es tres veces más frecuente en mujeres que hombres. En personas mayores de 65 años la frecuencia de IF se incrementa y varía según la población estudiada. En México no existen estudios que evalúen la frecuencia de IF en los adultos mayores. Objetivo. Investigar la frecuencia, gravedad y factores asociados a la IF en tres poblaciones de pacientes adultos mayores de 60 años. Pacientes y métodos. Se realizó un estudio descriptivo en el cual se evaluaron tres poblaciones de pacientes adultos > de 60 años: a) Grupo I, pacientes consecutivos que acudieron a la consulta externa de Gastroenterología y Geriatría del INCMNSZ; b) Grupo II, pacientes hospitalizados en el INCMNSZ por motivos diferentes a la IF; y c) Grupo III, pacientes residentes del asilo Reina Sofía de la Ciudad de México. Mediante un cuestionario estructurado se investigaron datos demográficos, tiempo de evolución, comorbilidad y factores asociados a la IF. El grado de IF se evaluó mediante la escala de Wexner modificada por Kamm. Resultados. Se evaluaron 159 pacientes, 89 (56%) mujeres. La edad promedio fue de 75 años (rango 59-98). Hubo 54 pacientes en el grupo I, 50 en el grupo II y 55 en el grupo III. Cincuenta y tres pacientes (33%) presentaron IF. La frecuencia de IF fue de 26% en el grupo I, de 20% en el grupo II y de 53% en el grupo III. De los casos con IF, 66% (n = 35) fueron mujeres. Veintinueve pacientes (54%) tuvieron trastornos neuropsiquiátricos asociados y 17 (32%) diabetes mellitus. De los pacientes, 80% utilizaron pañal. La incontinencia urinaria estuvo presente en 31 (58%) pacientes. De acuerdo con la escala de gravedad, 13 (24%) pacientes tuvieron IF leve, 20 (38%) moderada y 20 (38%) tuvieron IF grave. Los pacientes de los grupos I y II tuvieron puntuaciones menores en la escala de gravedad (8.1 y 9.7) que los pacientes del grupo III (18, p = 0.001). Los pacientes con IF leve tuvieron un promedio de edad menor (73 años) que los pacientes con IF grave (83 años, p = 0.01). Conclusiones. La frecuencia de IF en pacientes adultos mayores es elevada y afecta a la mitad de los pacientes residentes de un asilo. El grado de IF es más grave en las mujeres, en los pacientes residentes de un asilo y con trastornos neuropsiquiátricos. La incontinencia urinaria se asoció a IF en más de la mitad de los pacientes.

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Se realizó un estudio transversal sobre la presencia de anticuerpos antiislotes pancreáticos por el método de inmunofluorescencia indirecta con incubación prolongada en familiares de primer grado de niños diabéticos insulino dependientes, de reciente diagnóstico atendidos en el Policlínico de Especialidades Pediátricas de Camagüey, y a un grupo control sin antecedentes de diabetes mellitus realizándole a todos una encuesta previa. Se encontró una alta frecuencia de anticuerpos antiislotes pancreáticos en los diabéticos tipo 1 de reciente diagnóstico (p<0, 001), en relación con los familiares de diabéticos insulino dependientes (FPG) y controles (80 % vs 5, 7 % y 0, 0 %, respectivamente). Esta frecuencia fue también superior en los FPG en comparación con los controles (p = 0, 045). No se encontró diferencias al relacionar los ICA con el parentesco, historia familiar de diabetes tipo 1 y 2, la edad y el sexo de los FPG. Nuestros resultados indican que los anticuerpos antiislotes pancreáticos (ICA) son un buen marcador del proceso de destrucción de las células b pancreáticas en la diabetes tipo 1 de reciente diagnóstico y que la presencia de estos en los FPG pudiera identificar a los familiares con una mayor probabilidad a desarrollar una diabetes tipo 1.

A crosssectional study about the presence of antibodies anti-islets pancreatic by the indirect inmunofluorescent method with prolonged incubation in families of first grade of diabetic children type 1, of diabetic of recent prognosis assisted at pediatric Specialties Polyclinic of Camagüey, and to a control group withoud antecedentes of diabetes mellitus was performed. They all were carried out aq previous survey. A high frequency of pancreatic antiislets antibodies in diabetics type ! of recent prognosis (p< 0, 001), in relation with parents of diabetics type 1 (FPG) and contol (80 % vs 5, 7 % and 0, 0 % respectively) was found. This frequency was also superior in FPG in comparison to control ( p= 0, 045) there were not differences when relating ICA with the Kindred, family history of diabetes, type 1 and 2, age and sex of FPG. Our results indicate that pacreatic antiislet antibodies (ICA) is a good marker of the destruction process of pancreatic B cells in diabetes type ! of recent diagnosis, and the presence of them in FPG may identify families with a higher probabilty for developing diabetes type 1.