Repositorio Institucional Fleni
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Tumor-to-tumor: un lobo disfrazado de cordero
No full textTumor-to-tumor es un fenómeno infrecuente, asociado a altas tasas de mortalidad, cuyo mecanismo fisiopatológico no está del todo aclarado. Se caracteriza por la siguiente dinámica: un tumor receptor que presenta en su interior metástasis de otra estirpe celular . El objetivo de este trabajo es comunicar el caso de una paciente con un meningioma meningoteliomatoso bifrontal (tumor receptor) con focos metastásicos de un tumor pulmonar de células pequeñas (tumor donante).Fil: Ries Centeno, Tomás. Fleni. Departamento de Neurología; Argentina.Fil: Villalonga, Juan Francisco.Fleni. Departamento de Neurología; Argentina.Fil: Giovannini, Sebastián Juan María. Fleni. Departamento de Neurología; Argentina.Fil: Cervio, Andrés Eduardo. Fleni. Departamento de Neurología; Argentina
Author Correction: Retrieval of retrained and reconsolidated memories are associated with a distinct neural network
Get PDFA correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
Erratum for
Retrieval of retrained and reconsolidated memories are associated with a distinct neural network. [Sci Rep. 2019]Fil: Bavassi, Luz. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina.Fil: Forcato, Cecilia. Universidad Nacional "Arturo Jauretche". Hospital de Alta Complejidad en Red El Cruce "Néstor Kirchner". Unidad Ejecutora de Estudios de Neurociencias y Sistemas Complejos; Argentina.Fil: Fernández, Rodrigo Sebastian. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina.Fil: De Pino, Gabriela. Fleni. Departamento de Diagnóstico por Imágenes. Laboratorio de Neuroimágenes; Argentina. Universidad Nacional de San Martín. Escuela de Ciencia y Tecnología. Centro Universitario de Imágenes Médicas; Argentina. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina.Fil: Pedreira, María Eugenia. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; Argentina.Fil: Villarreal, Mirta Fabiana. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina
An Attypical Choroid Plexus Papilloma of IV Ventricle with Dissemination to a Sacral Tarlov Cyst: A Case Report
Get PDFChoroid Plexus Papillomas (CPP) is uncommon tumors of the CNS. Atypical CPPs represent an
intermediate-grade subtype (Grade II) introduced in the update 2007 of the WHO classification.
Distal spread of atypical CPPs through the subarachnoid space is very rare. We present a 53 yearold female with history of macroscopic surgical excision of an atypical CPP in the IV ventricle, with
multiple local relapses and who ten years after diagnoses, presented tumor metastasis in a Tarlov
cyst in the sacrum.
Atypical CPPs are uncommon tumors, and to the best of our knowledge, no cases linking atypical
CPP tumor dissemination to a Tarlov cyst have been reported in English or Spanish language
medical literatureFil: Gentile, Aixa. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Diez, Blanca. Fleni. Departamento de Neurología. Servicio de Neurooncología; Argentina.Fil: Cervio, Andrés Eduardo. Fleni. Departemento de Neurocirugía; Argentina.Fil: Arakaki, Naomi. Fleni. Departamento de Neuropatología y Biología Molecular. Sector Biobancos; Argentina.Fil: Cejas, Claudia. Fleni. Departamento de Diagnóstico por Imágenes; Argentina
Neuropatías, plexopatías y radiculopatías en pediatría
No full textCapítulo relativo a parálisis braquial neonatal, polineuropatías hereditarias y enfermedad de Charcot Marie Tooth, mononeuropatías craneales y periféricas, Síndrome de Guillain-Barré, Polineuropatía desmielinizante inflamatoria crónica y Bulbomielitis/mielitis fláccida aguda por enterovirus D68.Fil: Vázquez, Gabriel. Fundación Favaloro. Instituto de Neurociencias; Argentina.Fil: Cavassa, Eliana. CEMIC; Argentina
Frequency of diagnoses in a specialized headache clinic in Buenos Aires
Get PDFObjective: Headache is one of the most frequent reason for consultations in
neurology. The global prevalence among adults with migraine is approximately
10% with migraine, 40% for tension-type headache (TTH) and 3% for chronic daily
headache. The purpose of this study is to analyze the prevalence of the diagnoses
of headache and craniofacial pain among patients evaluated in a specialized
headache clinic of Buenos Aires during 2017. Methods: Retrospective, descriptive
study. We reviewed the electronic medical records of patients who consulted
for headaches or craniofacial pain from January 1st to December 31st, 2017.
Diagnoses were made according to the criteria of the International Classification
of Headache Disorders (ICHD-3). Results: We reviewed 3254 electronic medical
records and documented 3941 diagnoses: headache (93.03%), craniofacial pain
(3.62%) and unclassifiable (3.35%). The average age was 43.14 years. 80.7% were
women. Primary headaches were the most frequent diagnoses (78.54%). Migraine
represented the main diagnosis (87.42%). Episodic migraine without aura was the
most prevalent diagnosis (48%). Tension- type headache (TTH) was found in 8.74%
of cases of primary headaches and Trigeminal autonomic cephalalgias (TACs) in
2.89%. Medication-overuse headache (MOH) represented 77.93% of the secondary
headaches, and most of them also met chronic migraine criteria fulfilled criteria of
chronic migraine. Primary trigeminal neuralgia represented 50% of craniofacial pain
and 27% were secondary trigeminal neuralgia, mostly postherpetic or posterior to
dental procedures. Regardin to the frecuency, 33.58% of the patients had chronic
headache. Conclusion: In our section, migraine is the most frequent diagnosis
followed by medication-overuse headache. The percentage of chronic headache
is higher than the prevalence in the general population, probably because it is a
tertiary centerFil: Nagel, Vanesa. Fleni. Departamento de Neurología. Clínica del Dolor; Argentina..Fil: Cavanagh, Sol. Fleni. Departamento de Neurología; Argentina.Fil: Olivier, Marina. Fleni. Departamento de Neurología; Argentina.Fil: Larripa, Natalia. Fleni. Departamento de Neurología. Clínica del Dolor; Argentina..Fil: Gutierrez, María T. Fleni. Departamento de Neurología. Clínica del Dolor; Argentina..Fil: Grandinetti, Mariela. Fleni. Departamento de Neurología; Argentina.Fil: Calvo, Daniela. Fleni. Departamento de Neurología. Clínica del Dolor; Argentina..Fil: Salvat, Fernando. Fleni. Departamento de Neurología. Clínica del Dolor; Argentina.Fil: Bonamico, Lucas. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Goicochea, María Teresa. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina
Volumetric Analysis and Densitiy of Extraocular Muscles in patients with Myasthenia Gravis (P5.4-036)
No full textObjective: To analyze the volumetric and density characteristics of the extraocular muscles (EOM) in patients with Myasthenia Gravis (MG).
Background: MG is an autoimmune disease that mainly involves EOM. Myopathies affecting extraocular muscles (MEOM) are a common differential diagnosis. Frequently, complementary methods are required to differentiate between them. There are no published data from the volumetric and density characteristics of the EOM in these pathologies.
Design/Methods: Case-control study in adult patients, evaluated in FLENI between 2017/2018, with diagnosis of MG and MEOM, compared with healthy controls adjusted for age and sex.
Orbit CT scan was obtained in primary position of the gaze. Manual segmentation of the EOMs of both eyes was done using the ITK.SNAP Software.
Volume (mm3) and average density (Hounsfield Unit) of each EOM were evaluated. References of tendon density of the superior oblique muscle (SO) and intraorbital fat were taken.
Results: We included 18 patients with MG, 7 with MEOM and 18 controls.
No differences were observed in the individual and total muscle volume between patients with MG and controls. Patients with MEOM showed lower volume in all the EOM compared to MG and controls (p<0.0001).
The muscle density of patients with MG was significantly lower (p<0.001) regarding the controls; muscle density in the MEOM was lower than the MG group and controls (p<0.001 respectively).
No differences were observed in SO tendon density and intraorbital fat among the 3 groups.
Conclusions: Volumetric and density analysis of the EOM by CT has been shown to be a feasible procedure and an interesting approach towards neuromuscular diagnosis in cases of MG and MEOM. In our experience, it allows to demonstrate differences in the muscular density of patients with MG with respect to MEOM and controls. In the same way, MEOM present differences in volume and muscle density with respect to MG and healthy controls.Fil: Köhler, Alejandro Alfredo. Fleni. Departamento de Neurología; Argentina.Fil: Farez, Mauricio Franco. Fleni. Centro para la Investigación de Enfermedades Neuroinmunológicas; Argentina.Fil: Rivero, Alberto Daniel. Fleni. Departamento de Neurología. Servicio de Neurofisiología Clínica; Argentina
Mechanisms of Neurodegeneration and Axonal Dysfunction in Progressive Multiple Sclerosis
Get PDFMultiple Sclerosis (MS) is a major cause of neurological disability, which increases predominantly during disease progression as a result of cortical and grey matter structures involvement. The gradual accumulation of disability characteristic of the disease seems to also result from a different set of mechanisms, including in particular immune reactions confined to the Central Nervous System such as: (a) B-cell dysregulation, (b) CD8⁺ T cells causing demyelination or axonal/neuronal damage, and (c) microglial cell activation associated with neuritic transection found in cortical demyelinating lesions. Other potential drivers of neurodegeneration are generation of oxygen and nitrogen reactive species, and mitochondrial damage, inducing impaired energy production, and intra-axonal accumulation of Ca2+, which in turn activates a variety of catabolic enzymes ultimately leading to progressive proteolytic degradation of cytoskeleton proteins. Loss of axon energy provided by oligodendrocytes determines further axonal degeneration and neuronal loss. Clearly, these different mechanisms are not mutually exclusive and could act in combination. Given the multifactorial pathophysiology of progressive MS, many potential therapeutic targets could be investigated in the future. This remains however, an objective that has yet to be undertaken.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Marrodán, Mariano. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Ysrraelit, María Célica. Fleni. Departamento de Neurología; Argentina
Human MAIT Cell Response Shows Subset Diversity in Multiple Sclerosis (P2.2-089)
No full textObjective: To investigate cytotoxic activity heterogeneity in MAIT cell populations from MS patients
Background: MAIT cells are a subset of innate T lymphocytes characterized by expression of an invariant TCR α-chain (Vα7.2-Jα33) paired with a limited number of Vβ chains. They recognize riboflavin metabolites from a range of microbes presented by MR1, a MHC-class 1-related molecule. We recently demonstrated how MAIT cell presence correlated with MS disease activity. The association recently described between MS development and the microbiome, also make MAIT cells a potentially interesting therapeutic target.
Design/Methods: Forty peripheral blood MAIT cell clones isolated from 12 relapsing remitting MS patients were studied. TCRα and β-chains were characterized using high-throughput RNA sequencing. TCCs were stimulated with 5-OE-RU, 5-OP-RU (both riboflavin derivatives), as well as with E. Coli, or Candida albicans. Cytotoxicity was measured by fatal assay, and granzyme B and perforin by ELISA. Flow cytometry was used to detect activation markers CD25 and CD69 and the degranulation marker, CD107a.
Results: MR1-restricted MAIT cells with particular TCRβ-chains reacted specifically with different types of riboflavin metabolite-derived antigens. Higher cytotoxicity magnitude and sensitivity were found for non-pathogenic E. Coli, compared to the opportunistic fungal pathogen C. albicans. MAIT cells expressing Vβ8 and Vβ13.6 were hyporesponsive to E. Coli, expressing fewer activation markers and showing less cytotoxic effect compared to MAIT cell clusters expressing different Vβ chains. Interestingly, MAIT cell response to C. albicans presented a Vβ bias, in which Vβ 13.2 MAIT cells displayed higher cytotoxic activity.
Conclusions: 1) MAIT cells display microbe-specific cytotoxic responses, indicating functional heterogeneity, despite the highly conserved nature of MR1; 2) MAIT cell TCR Vβ-chain activity influences response to specific MR1-presented antigens; 3) MAIT cell repertoire may expand depending on their response to microbial challenge, ultimately influencing the course of MS.
Disclosure: Dr. Correale has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen Argentina, Teva Argentina, Novartis Argentina and MERCK Argentina, and Merck/Serono Argentina and Novartis Argentina. Dr. Carnero Contentti has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen-Idec, Genzyme, Merck-Serono, Novartis, Teva, Roche and Bayer. Dr. Farez has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with TEVA, Merck-Serono, Biogen-Idec, and Novartis.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina. Fleni. Centro para la Investigación de Enfermedades Neuroinmunológicas; Argentina.Fil: Carnero Contentti, Edgar. Hospital Alemán. Departamento de Neurociencias; Argentina.Fil: Farez, Mauricio Franco. Fleni. Centro para la Investigación de Enfermedades Neuroinmunológicas; Argentina
MON-432 Symptomatic Pituitary Metastases: A Report of 16 Cases
No full textIntroduction: Pituitary Metastases (MTS) are infrequently seen in clinical practice. The incidence ranges from 0.14 to 28%. Breast and lung cancer are the primary sites that most frequently metastasize to sellar region, between the sixth and seventh decades of life. Most cases are diagnosed in patients with advanced malignant disease, however, in 20-30%, symptoms of pituitary involvement can precede the diagnosis of the primary tumor. Objectives: To evaluate symptoms at presentation, hormonal, radiological and histological findings, management and outcome of a series of patients with pituitary MTS. Patients and methods: medical records of 16 patients from eight Endocrine Centers were reviewed. Ten patients had histological confirmation of the pituitary MTS, 6 were not operated, being the diagnostic criteria the presence of sellar mass associated with diabetes insipidus (DI) and / or sudden-onset of neuro-ophthalmological symptoms in patients with confirmed primary neoplasia. Results: The median age was 54 years (range 35-70), 9 women (56.2%). The sites of the primary tumor were: 7 lung (44%), 5 breast (32%), 1 follicular thyroid carcinoma (6%), 1 Hodgkin lymphoma (6%), 1 poorly differentiated carcinoma (6%), and 1 clear cell renal carcinoma (6%). The median time between the diagnosis of the primary neoplasm and the occurrence of the pituitary MTS was 12 months (range: 3-120). In 9 patients (56.2%), the diagnosis of the primary neoplasm was made after the finding of the symptomatic sellar mass. DI was found in 14 patients (87.5%), adenohypophyseal deficit in 12 (75%), visual disorders in 10 (62.5 %), headache in 6 (37.5%) and cranial nerve deficits in 6 (37.5%). In 68.7% (11 patients), other MTS were detected. Fifteen patients were evaluated by MRI and one by CT: 13 (81.3%) harbored supra / parasellar masses, and the remaining 3 had lesions limited to the pituitary gland, with stalk thickening and lack of spontaneous neurohypophysis hyperintensity in 2 of them. In all cases diffuse gadolinium uptake was present. Fourteen patients died (87.5%), with a median survival time of 6,5 months (range: 1-36); the remaining 2 are still alive with a follow-up period of 4 and 12 months respectively. Conclusions: In this series of 16 patients with pituitary MTS, the most frequent primary neoplasms were lung and breast. Median age was lower than in published series. DI was the most common condition at presentation, followed by hypopituitarism and visual disorders. The short survival was related to the extent of the disease at the time of diagnosis. In more than half of the cases the diagnosis of primary neoplasia was made through the symptomatic pituitary mass. In the presence of a pituitary lesion with diffuse gadolinium uptake, associated with DI and / or acute visual deficit, pituitary MTS should be suspected even in patients without a history of oncological disease.Fil: Loto, Monica. Hospital Británico; Argentina.Fil: Tkatch, Julieta. Hospital Durand; Argentina.Fil: Katz, Debora. Fleni. Departamento de Neurología. Servicio de Neuroendocrinología; Argentina. Sociedad Argentina de Endocrinologia y Metabolismo; Argentina.Fil: Slavinsky, Patricia. Fleni. Departamento de Neurología. Servicio de Neuroendocrinología; Argentina. Sociedad Argentina de Endocrinologia y Metabolismo; Argentina.Fil: Alfieri, Analia. Hospital Posadas; Argentina.Fil: Chervin, Alberto B. Hospital Santa Lucia; Argentina.Fil: Rogozinski, Amelia. Hospital Ramos Mejía; Argentina.Fil: Mallea-Gil, María Susana. Hospital Militar Central; Argentina.Fil: Ballarino, Maria Carolina. Hospital Militar Central; Argentina.Fil: Furioso, Alejandra. Hospital Ramos Mejía; Argentina.Fil: Miragaya, Karina. Sanatorio Guemes; Argentina.Fil: Battistone, Maria. Hospital Austral; Argentina.Fil: Sabate, Maria. Hospital Austral; Argentina.Fil: Szuman, Gabriela. Sanatorio Méndez; Argentina.Fil: Glerean, Mariela. Hospital Italiano; Argentina.Fil: Fainstein Day, Patricia. Hospital Italiano; Argentina.Fil: Vitale, Nicolas Marcelo. Hospital Santa Lucía; Argentina.Fil: González Pernas, Mariana Soledad. Fleni. Departamento de Neurología. Servicio de Neuroendocrinología; Argentina.Fil: Sosa, Soledad. Hospital de Clínicas José de San Martín; Argentina.Fil: Danilowicz, Karina. Hospital de Clínicas José de San Martín; Argentina
MRI features of medulloblastomas histologic and molecular subtypes
No full textReview the epidemiologic, clinical and MRI features of medulloblastomas histologic and molecular subtypes. Describe the most frequent Magnetic Resonance Imaging (MRI) findings from a series of 13 patients with pathologically proven medulloblastomas from our institution.Fil: Paday Formenti, María Emilia. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Stefanoff, Nadia Ivanna. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Serra, Mercedes. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Hernandez Pinzón, Jairo. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Chaves, Hernán. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Arakaki, Naomi. Fleni. Departamento de Neuropatología y Biología Molecular; Argentina.Fil: Diez, Blanca. Fleni. Departamento de Neurología. Servicio de Neurooncología; Argentina.Fil: Yáñez, Paulina. Fleni. Departamento de Diagnóstico por Imágenes; Argentina