Abstract Objective: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. Diagnosis is based on the Mc-Donalds criteria, magnetic resonance imaging (MRI) studies, and the expanded disability status scale (EDSS) which assesses disease progression. These criteria do not include the recently described cortical lesions. The aim of the study was to describe the most frequent location and morphology of cortical lesions in patients with MS in Puebla, Mexico. Methods: A descriptive, retrospective, cross-sectional, and analytical study was conducted on patients with MS at a tertiary care hospital. Patients diagnosed with relapsing-remitting, secondary-progressive, and progressive-relapsing MS variants with cranial magnetic resonance imaging were included in the study. Age, sex, MS variant, EDSS score, cognitive impairment, annual relapse rate, morphology, location, and number of cortical lesions were evaluated. Descriptive statistics were used. To compare features between groups, the χ2 test was used, and for correlations, the Spearman's Correlation Coefficient was used. A p ≤ 0.05 was considered significant. Results: Twenty-five patients met the selection criteria. The most frequent location of cortical lesions was the parietal region 84%, and the second was the temporal region 16%. The most common morphology was juxtacortical at 64% and mixed at 36%. The most frequent variant of MS was relapsing-remitting, present in 92%, and 8% had the secondary progressive variant. In the EDSS scale, the scores most frequently observed were 0.0 and 3.5. Conclusions: The most frequent location of cortical lesions was in the parietal region, and the most common morphology was juxtacortical.

Resumen Objetivo: La esclerosis múltiple es una enfermedad desmielinizante inflamatoria crónica del sistema nervioso central. El diagnóstico se basa en los criterios de Mc-Donalds, los estudios de Resonancia Magnética y la Escala Expandida del Estado de Discapacidad (EDSS) que evalúa la progresión de la enfermedad. Estos criterios no incluyen las lesiones corticales descritas recientemente. Describir la localización y morfología más frecuente de lesiones corticales en pacientes con esclerosis múltiple en Puebla, México. Métodos: Se realizó un estudio descriptivo, retrospectivo, transversal y analítico en pacientes con esclerosis múltiple en un hospital de tercer nivel de atención. Se incluyeron pacientes con diagnóstico de Esclerosis Múltiple con variantes Remitente-Recurrente, Secundaria-Progresiva y Progresiva-Recurrente con resonancia magnética de cráneo. Se evaluó edad, sexo, variante de esclerosis múltiple, puntaje de EDSS, deterioro cognitivo, tasa de recaída anual, morfología, ubicación y numero de lesiones corticales. Se utilizó estadística descriptiva. Para comparar características entre grupos se utilizó χ2, para correlaciones se utilizó Coeficiente de Correlación de Spearman. Una p ≤ 0.05 se consideró significativa. Resultados: 25 pacientes cumplieron con criterios de selección. La localización más frecuente de lesiones corticales fue la región parietal 84% y la segunda temporal 16%. La morfología más frecuente fue la yuxtacortical en un 64%, y la mixta en 36%. La variante más frecuente de esclerosis múltiple fue Remitente-Recurrente presente en 92%, y 8% la variante Secundaria Progresiva. En la escala de EDDS la puntuación con mayor frecuencia fue 0.0 y 3.5. Conclusiones: La localización más frecuente de las lesiones corticales fue en región parietal y la morfología más frecuente la yuxtacortical.

Resumen Introducción: El Trastorno por Déficit de Atención e Hiperactividad es el desorden pediátrico del neurodesarrollo más frecuente. Los estudios en México que evalúan Calidad de vida y características cognitivas son escasos. Objetivo: Describir la relación entre las características cognitivas y la calidad de vida en niños con trastorno por déficit de atención e hiperactividad en Puebla, México. Método: Se realizó un estudio transversal, analítico en un Hospital de 2º nivel de atención en Puebla, México. Se incluyeron pacientes con Trastorno por Déficit de Atención e Hiperactividad de 6 a 12 años. Se excluyeron aquellos con discapacidad visual/auditiva y retraso severo del lenguaje. Se eliminaron quienes no completaron la información. Se les aplicó WISC-IV, Neuropsi y BMSLSS (como indicador de Calidad de Vida). Se utilizó Coeficiente de Spearman; p ≤ 0.05 se consideró significativa. Resultados: 104 niños reclutados, 71 hombres (68.26%), edad media 8.94 años (DE 1.83, mín. 6, máx. 12). Los dominios más afectados fueron Memoria de trabajo, Velocidad de procesamiento (WISC-IV), y Atención y memoria (Neuropsi). La Calidad de Vida fue mayoritariamente baja (60%). Coeficiente intelectual (WISC-IV) (r = 0.3962, p = 0.000) y Atención y memoria (Neuropsi) (r = 0.451, p = 0.018) reportaron correlación moderada significativa con Calidad de vida. Conclusión: Atención, Memoria y Velocidad de procesamiento son las características cognitivas más afectadas en niños con Trastorno por Déficit de Atención e Hiperactividad. La Calidad de vida es baja. Coeficiente intelectual y Atención y memoria reportaron correlación moderada significativa con Calidad de Vida.

Abstract Background: Attention deficit hyperactivity disorder (ADHD) is the most frequent pediatric neurodevelopmental disorder. Studies in Mexico about health-related quality of life (QOL) and cognitive characteristics in these patients are scarce. Objectives: The objective of this study is to describe the relationship between cognitive characteristics and health-related QOL in children with ADHD in Puebla, Mexico. Method: A cross-sectional, analytical study was carried out in a second-level care hospital in Puebla, Mexico. Both genders, from 6 to 12 years old patients with ADHD were included. Those with visual/hearing disabilities and/or severe language delays were excluded. Patients who did not complete the information were eliminated. The Wechsler Intelligence Scale for Children IV (WISC-IV), The Neuropsi and Brief Multidimensional Life Satisfaction Scale for Students (as health-related QOL indicator) scales were applied. Spearman test was used; p ≤ 0.05 was considered significant. Results: 104 children were recruited, 71 male (68.26%), medium age was 8.94 years old (SD = 1.83, min = 6, max = 12). Work memory and processing speed (WISC-IV), and memory and attention (Neuropsi) were the most affected domains. Health-related QOL was low at 60%. WISC-IVs intellectual quotient (r = 0.3962, p = 0.000), and Neuropsi's memory and attention (r = 0.451, p = 0.018) reported a significant moderated correlation with health-related QOL. Conclusion: Attention, memory, and processing speed were the most affected cognitive characteristics in children with attention deficit/hyperactivity disorder. Health-related QOL resulted low. Intellectual coefficient, as well as memory and attention, reported a significant moderated correlation with health-related QOL.

ABSTRACT Introduction: Xanthogranulomatous inflammation is a chronic inflammatory process, rarely located in the appendix. A case of xanthogranulomatous appendicitis is presented. Clinical case: A 77-year-old male presents with intermittent pain in the right hemiabdomen and hyperthermia of one month's evolution. Physical examination showed a tumor in the iliac fossa and right abdomen. He underwent surgery for a probable incarcerated right inguinal hernia, acute perforated appendicitis was found, with inflammation and adhesions, purulent fluid in the right hemiabdomen, and abdominal wall dissection. The histopathological result was xanthogranulomatous appendicitis. The evolution of the patient was favorable. Conclusion: Xanthogranulomatous appendicitis simulates a typical picture of acute appendicitis. Histopathologically, pathologies such as Crohn's disease, malacoplakia, and tuberculous appendicitis were ruled out.

RESUMEN Introducción: La inflamación xantogranulomatosa es un proceso inflamatorio crónico, rara vez se localiza en apéndice. Se presenta un caso de apendicitis xantogranulomatosa. Caso clínico: Masculino de 77 años, presenta con dolor intermitente en hemiabdomen derecho e hipertermia de un mes de evolución. La exploración física mostró tumoración en fosa iliaca y abdomen derecho. Se sometió a cirugía por probable hernia inguinal derecha incarcerada, se encontró apendicitis aguda perforada, con inflamación y adherencias, líquido purulento en hemiabdomen derecho y disección en pared abdominal. El resultado histopatológico fue apendicitis xantogranulomatosa. La evolución del paciente fue favorable. Conclusión: La apendicitis xantogranulomatosa simula un cuadro típico de apendicitis aguda. Histopatológicamente se descartan patologías como enfermedad de Crohn, malacoplaquia y apendicitis tuberculosa.

A variabilidade cardiovascular (VCV) tem sido avaliada em doentes parkinsonianos em vários países e apresenta diferenças étnicas. Objetivo Investigar a variabilidade da frequência cardíaca (VFC) e a variabilidade da pressão arterial (VPA) em doentes parkinsonianos mexicanos. Método Comparamos VFC e VPA entre o grupo de estudo e controles jovens (CJ), a fim de estimar a magnitude da diferença. CVV foi estudada no domínio do tempo e da frequência durante repouso supino (RS), ortostase ativa (OA) e respiração controlada. Estas medições foram comparadas com aquelas de 20 CJ. Resultados Nosso estudo mostrou diminuição em quase todos os parâmetros da VFC em doentes parkinsonianos. A diminuição dos parâmetros da VPA foi encontrada com menos frequência. Conclusão Nossos resultados indicam que a VFC é prejudicada na doença de Parkinson. Alguns parâmetros do VPA também são reduzidos.

Cardiovascular variability (CVV) has been evaluated in patients with Parkinson's disease (PD) in other countries and exhibit ethnic differences. Objective We investigated heart rate variability (HRV) and blood pressure variability (BPV) in Mexican patients with PD. Method We further compared HRV and BPV between this group and young healthy controls (YHC) in order to estimate, for the first time in our country, the magnitude of the difference. Twenty patients were examined. Time- and frequency-domain CVV parameters were studied during supine rest (SR), active standing (AS) and controlled breathing. These measurements were compared to those of 20 YHC. Results In the three conditions tested, our study showed a decrease in almost all HRV parameters in PD patients; on the contrary, decreased BPV parameters were found less frequently and only during SR and AS. Conclusion Our results indicate that HRV is impaired in PD. Some BPV parameters are also diminished.