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Fundamentos: El objetivo principal del estudio es analizar la relación entre el apoyo social y la mortalidad en una cohorte de población de 60 años o más, residente en Barcelona y no institucionalizada, observada durante el período de seguimiento de 1996 a 1999, con el objetivo de analizar la relación entre el apoyo social y la mortalidad en las personas que constituyen la cohorte. Métodos: En 1996 se realizó una entrevista telefónica a 755 personas (316 hombres y 439 mujeres) que habían sido entrevistadas en la encuesta de salud de Barcelona de 1992, y que en ese año tenían 60 años o más. En el cuestionario se recogían variables socio-demográficas, de morbilidad y estado de salud, de apoyo social y de red social. Se han registrado los fallecimientos ocurridos entre 1996 y 1999. Se ha utilizado la regresión logística para analizar la asociación del apoyo social con la mortalidad. Resultados: El número de defunciones durante este período fue de 55 (5,9% de las mujeres y 9,2% de los hombres). Entre las variables que reflejan el apoyo social para los hombres, únicamente la situación de convivencia mostró en el análisis bivariado una asociación significativa con la mortalidad, que fue superior para los hombres que vivían con otros familiares pero no si vivían con su esposa o compañera (OR=3,7; IC 95% 1,4-9,6). Entre las mujeres, la existencia de apoyo vecinal, el tamaño de la red familiar, el número de contactos con la red comunitaria y la situación de convivencia se asociaron a la mortalidad en el análisis bivariado, aunque en la regresión logística multivariada, únicamente el apoyo vecinal (OR=3,6; IC:1,1-11,1) mantuvo una asociación significativa. Conclusiones: Los resultados muestran una asociación de las variables de apoyo social con la mortalidad. La relación entre las diversas variables de apoyo social, y los posibles mecanismos de prevención deberían ser abordados en futuros estudios.

Objective: The main purpose of this study is to determine the agreement between two radiological tests, ultrasonography and magnetic resonance, in the diagnosis of distal brachial biceps tendon injury., Material and Method: A retrospective study was made of patients over 3 years who underwent distal brachial biceps tendon reattachment open surgery, and whose preoperative diagnosis was complemented either by ultrasonography, by magnetic resonance or both. The agreement was calculated by Cohen's kappa coefficient (k)., Results: Information of 79 patients was analyzed. The concordance was excellent between resonance and surgical findings (k=.950), and a good Cohen's kappa coefficient was also achieved between both ultrasonography and surgery (k=.706) and between information of sonography and magnetic resonance (k=.667)., Conclusions: Resonance and ultrasonography could be considered reliable diagnostic tests to determine the acute rupture of the distal brachial biceps tendon in patients with consistent aetiology and physical examination., (Copyright © 2019 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

MRI is a powerful diagnostic imaging tool and its use has increased significantly in hospitals all over the world. Due to the technical particularities of MRI, all staff members dealing with the scanner need to have adequate knowledge of how it works and of aspects related to safety. The European parliament and council's directive on minimum health and safety requirements for workers dealing with electromagnetic fields (EMF) 2004/40/CE represents a threat to the clinical development and healthcare use of MRI. The efforts of the Alliance for MRI led to a postponement of the European parliament's decision, first until April 2012 and finally until October 2013. The purpose of this article is to define and propose a set of practical rules to ensure the protection of workers involved with MRI scanners. It also aims to define our position with respect to UE directive (2004/40/CE)., (Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.)

Neuroimaging using both functional and structural examinations like positron emission tomography (PET), single photon emission tomography (SPECT), computed tomography (CT) and magnetic nuclear imaging (MRI) provide supportive information of great importance for the diagnosis and treatment of patients with central nervous system disorders. Therefore, they have become commonplace in clinical practice and basic biomedical research. In recent years we have seen the development of multimodality equipment that enables PET or SPECT to be combined with a CT structural image. Moreover, experimental equipment combining PET and MRI has now been developed. Additionally, methodological features that provide a higher image quality, and analysis tools for objective quantification and interpretation have been refined. This article reviews the technical aspects of those imaging methods, highlighting the most significant and recent advances in the development of neuroimaging., (Copyright © 2010 Elsevier España, S.L. y SEMNIM. All rights reserved.)

Carotid-cavernous fistulas are uncommon anomalous communications between the venous cavernous sinus and the carotid arterial system. We present two cases studied at our center. We show the characteristic CT, MRI, and orbital ultrasound findings and review the relevant literature.

The type I Chiari malformation consists of an caudal descent of the cerebellar tonsils through the foramen magno towards the spinal cervical channel. The usual clinical presentation are occipital headaches and cervical pain, as well as some otoneurological symptoms. Among them are common dizziness and crisis of central positional vertigo in which down beating nystagmus can be observed. We present our experience with three cases presenting with neurotological manifestations in which MRI showed a type I Chiari malformation. Case 1: a patient of 24 years that had frequent instability, and common crisis ofpositional vertigo. It was possible to see the presence of positional down-beating nystagmus, of central characteristics, that improved after neurosurgical treatment. Case 2: patient of 11 years who suffered from occasional headaches, dizziness and positional vertigo, without severe handicap, and did not need surgery. Case 3: lady of 63 years who had common episodes of vertigo with head tilt, and unsteadiness during walks. Due to the coexistence of hydrocephalus and syringomyelia, surgery was indicated. A revision is done on otoneurological presentation of type I Chiari malformation, especially as differential diagnosis on central positional vertigo.

Unlabelled: Bronchoscopy is the diagnostic gold standard in patients with airway malformations. Helical CT scan has produced studies such as virtual bronchoscopy or 3-D reconstruction of the airway. The purpose of this study is to analyze the correlation between fiberoptic bronchoscopy, virtual bronchoscopy and 3-D reconstruction of the airway in patients with airway malformations., Methods: From January 2001 to March 2002 we evaluated the airway of 17 patients with airway malformations by means of a diagnostic protocol consisting on fiberoptic bronchoscopy, and Helical CT scan with 3-D reconstruction of the airway and virtual bronchoscopy. The radiologist had no access to bronchoscopic information. Age at study, associated cardiovascular anomalies, indications, localization, degree of diagnostic concordance, etiology and influence in treatment were analyzed., Results: 20 studies were done to 17 patients whose mean age was 1.64 +/- 0.48 years (7 days-7 years). Twelve patients had associated anomalies of the aorta, pulmonary arteries or supraortic vessels. Excellent concordance was obtained in 13 cases (65%), good in 6 (30%) and poor in one (5%). 3-D reconstruction of the airway and adjacent vascular structures provided additional information in 14 cases (70%): in 3 exact length of the tracheal lesion and in 11 defined the cause of the compression. In all the cases, absolute concordance in localization was obtained. CT scan information modified treatment in 6 patients (35%). In 7 patients with associated vascular anomalies, no further image studies were done, confirming the anatomy concordance during surgery., Conclusions: 3-D reconstruction of the airway and virtual bronchoscopy are excellent diagnostic tools in patients with airway malformations, and contribute to define the etiology, length and diameter of the lesion. Excellent diagnostic correlation was obtained between analogic and virtual bronchoscopies, although further multicentric studies should be conducted.

Platelet-Rich Plasma (PRP) concentrates have been widely used in the past decade as a complement to tissue regeneration procedures. The authors who have clinically used PRP refer no risk of infection, disease transmission, or undesirable effects. Nevertheless, there have been reports on the over-expression of growth factors (GFs) and their receptors related to tumour and dysplastic tissues. This has led to evaluation of the possible coincidences between carcinogenesis and the mitogenic pathways employed by GFs. The present study provides a review of the literature on the possible effects of the therapeutic uses of GFs (including PRP) in relation to carcinogenesis, their influence upon tissues with epithelial dysplasia or oral carcinoma, and their relation to tumour growth and infiltration.

Although newborn screening of congenital hearing loss through otoacustic emissions allow prompt recognition, imaging techniques, such as CT and MRI are needed to get a morphological diagnosis. Furthermore they can be very useful in unilateral cases, whose clinical presentation is belated and more insidious. Our aim is to show the utility of MRI in the study of inner ear congenital anomalies, whose presentation is belated. Thus from a series of 88 consecutive patients in which a MRI was performed as screening of assymetric sensorineural hearing loss, we selected 6 cases aged between 6 and 20. Four of them showed an inner ear anomaly on MRI. We present these anomalies commenting the findings on CT and MRI. Imaging techniques are required to start hearing rehabilitation programs early on patients with bilateral inner ear anomalies. But also they are very useful in the evaluation of unilateral assymetric sensorineural hearing loss, in young patients, even if only some frequencies are damned, to determine the nature of hearing loss.

The case of an 9-year-old girl with precocious puberty and a non-functioning pituitary adenoma is described. A review of the literature on the incidence, evolution and therapeutic options of pituitary incidentalomas in children and adults is performed.

Although internal auditory canal (IAC) and cerebellopontine angle (CPA) tumors are rare, their clinical suspicion is quite common in the otolaryngology office. MRI is the imaging modality of choice in diagnosing these tumors. Perceived high costs may prevent clinicians from using it as a screening tool. A protocol designed to improve cost-effectiveness in such diagnosis results in a more rationale clinical practice. Our aim was to evaluate the usefulness of MRI as screening tool in diagnosis of IAC and CPA tumors in our population. Between March 1998 and March 2000, a prospective series of 200 cases had a MRI screening requested. MRI were performed following Fast Spin Echo technique, providing T2-weighted images. Gadolinium enhanced MRI was reserved for selected cases. We report on 190 MRI done. We found 7 neuromas (3.5%), one CPA metastasis, one epidermoid cyst and 9 IAC vascular anomalies. Only 138 cases (69%) had normal MRI images. When used following a designed protocol, MRI is our procedure of choice while screening IAC and CPA tumors because it is a cost-effective tool.

Vascular anomalies of the internal auditory canal (IAC) are relatively common, being found in 20-25% of magnetic resonance imaging (MRI) studies performed in patients with unilateral sensorineural hearing loss. They are usually asymptomatic and their diagnosis is almost always based on MRI, as they are generally undetected by routine clinical examination. Recently, the clinical relevance of these IAC anomalies and the effectiveness of vascular decompression have been debated. We present a series of 7 vascular anomalies of the IAC found in a series of 83 consecutive MRI scans performed in a screening program for IAC and cerebellopontine angle pathology. We reviewed their clinical and radiological presentation to evaluate their clinical relevance. In this series, we found no correlation between the presence of such vascular anomalies and the clinical symptoms that motivated MRI, so we conclude that most of these anomalies were accidental findings.

Introduction: The homeostasis of tissues depends on a strict control of cell growth, differentiation and death. Several proteins, which are involved on the regulation of the cell cycle, can suffer diverse alterations and produce an uncontrolled cell proliferation and the genesis of a neoplastic process. The assessment of cell proliferation is an useful method applied to Neuro-oncology in order to know the behavior of gliomas., Development: This work is focussed on the analysis of different methods, all of them employed to study the cell proliferation: immunostaining of proliferating cell nuclear antigen (PCNA) and Ki-67, DNA content and ploidy by flow cytometry, in vitro incorporation of bromodeoxyuridine (BrdU) and the identification of apoptotic cells. The study of the DNA by flow cytometry establishes a relationship between ploidy and the prognostic of gliomas. The assessment of PCNA provides us with objective data about the proliferative activity of gliomas. Both Ki-67 expression and BrdU incorporation are also useful methods in the study of gliomas., Conclusions: In short, the most malignant gliomas are characterized by a high frequency of aneuploidies and high PCNA, Ki-67 and BrdU labelling indexes. All of these described methods can be used as prognostic markers complementary to the classic criteria employed nowadays.

Presentation of the results obtained by our team in the treatment of 22 cases of penial incurvation (11 congenital and 11 secondary to Peyronie's Disease) using the albuginea plication technique. Evaluation of post-operative results taking into account both subjective (extent of satisfaction, comfort during the post-operative etc.) and objective (post-operative complications, degree of correction, reincurvation or failure etc.) factors was done by a follow-up programme through the out-patients practices using a Questionnaire-Survey system. Presentation of results obtained and detailed discussion of each case. The conclusions were as follows: Albuginea plication is a safe technique that achieves total penis redressment, with no post-operative complications. The extent of satisfaction and success obtained exceed 85%, and can be increased by improving the pre-operative selection and providing correct and precise information on what can be resolved with this technique.

Introduction: In traumatic brain injury the secondary damage is responsible for the majority of the clinical and pathological sequels. This circumstance together with the difficulties of acquiring well preserved brain material for specialized neuropathological study impair the understanding of processes implied in their pathophysiology., Development and Conclusions: The development of experimental models has played an outstanding role for the better knowledge of these processes. For the development of standardized experimental models the biophysical and anatomical characteristics of brain and skull of the various utilized species have to be considered, but the physiological, neurochemical and molecular peculiarities must also be taken into account. Various in vivo models have been developed, inducing direct impact to the skull or to the brain, or mimicking lesions subsequent to craniocerebral trauma, such as subarachnoid hemorrhage, hematoma or necrosis. To analyze the molecular mechanisms of cellular response in vitro models have been developed. A great amount of cells in the contusional area die immediately following traumatic brain injury, but a still higher number of cells will undergo in the following hours. This second wave of neuronal death is induced by phenomena such as secondary axotomy and brain edema. In the pathogenesis of both the damage of cytoplasmic membrane is involved.

Objective: To describe a case of vasitis nodosum causing spontaneous recanalization of the vas deferens., Methods: Herein we describe a patient who had undergone vasectomy 9 years earlier. A nodule in the vas deferens arising from granulomatous reaction had progressed to vasitis nodosum, causing spontaneous recanalization of the vas deferens., Results: Vasitis nodosum may be more frequent than it is considered to be although clinical problems rarely arise., Conclusion: Confusion may arise in distinguishing the histological features of vasitis nodosum from those of adenocarcinomatous neoplasia. Although rarely, its growth may cause recanalization of the vas deferens in vasectomized patients.

Finding tumor cells in the fluid of hydrocele secondary to testicular tumor is rare and may be due to the fact that hydrocele fluid cytology has not been studied systematically. The presence of malignant cells in the hydrocele fluid may be ascribed to two mechanisms: retrograde lymphatic flow from the infiltrated retroperitoneal lymph nodes or from tumor directly invading the tunica albuginea and vaginalis testis, with cells passing into the cavity of the vaginalis. Only two cases of hydrocele secondary to testicular seminoma with vaginalis fluid cytology positive for malignant seminomatous cells have been previously reported in the literature. To our knowledge, the case reported herein is the third. These three cases are briefly discussed.

We reviewed the results achieved by ligation of the deep dorsal vein of the penis in 14 males with erectile dysfunction secondary to venous leakage. Prostaglandin E1 injection, echo Doppler and cavernosometry were utilized for the diagnosis. Surgical correction was performed when the cavernosometric flow required for erection was more than 200 cc/minute. The patients had a follow-up evaluation at 3, 6 and 12 months postoperatively. At one year, 4 (28.5%) patients showed good results and 10 (71.4%) poor. The factors that may influence the short, medium and long-term results are briefly described.

Presentation of the case of a 42-year old male patient with Type I Multiple Endocrine Neoplasia, known as the Wermer Syndrome, who developed Leydig's cells tumour. No association was found between both processes and therefore a fortuitus, though worthwhile mentioning given the characteristics and hormonal implications of both pathologies, can be presumed.

Pharmacologically-induced erection is commonly utilized as a diagnostic test in the work up of erectile disorders. Our experience using prostaglandin E1 (PGE1) to induce erection for diagnostic testing is described. The present study, which had been carried out in 24 patients with different etiologies (9 neurologic, 7 arterial, 1 hormonal and 7 with no known disorder), showed PGE1 to be a good inductor of erection, well-tolerated and with no adverse effects. Because this drug can induce erection with a high degree of safety and patient tolerance, it is considered to be useful as a diagnostic procedure in erectile dysfunction.

An Eco-Duplex study of the penile arterial system in 19 patients which consulted their physician for impotence is presented and a two-group classification is made: Group 1, arterial cause (7 patients) and, Group 2, non-arterial cause (12 patients). Diameter and blood flow of the cavernous artery pre-and post intracavernous injection of papaverine was evaluated. A significant difference was found in the increase of arterial diameter in both groups as well as in the quantification of arterial flow pre- and post-application of papaverine, these being larger than 32 cm/sec in all non-arterial impotent patients (group 2).

Sarcomatoid renal carcinoma is an uncommon but not rare histologic variant of renal carcinoma that accounts for 1-1.5% of all renal masses. It may originate from metaplasia of carcinomatous epithelial cells. Clinically, it generally presents as a large renal mass. The survival rate after diagnosis is approximately 6 months. We report on a 71-year-old male patient with general clinical features of paraneoplasia and a mass in the left kidney. Histological work up revealed a sarcomatoid renal carcinoma and the patient survived 4 months after the diagnosis was made.

On a review of 500 spina bifidas, the authors presents 44 lypomeningoceles (8.8%). During de first two years of age a clinical follow-up with a T.A.C. and myelography is performed. Depending on the symptoms the surgical intervention is performed after two years of age. The authors described the surgical technique. Urological, gastroenterological and orthopedics sequelae are presented and reviewed.