Diencephalic-mesencephalic Junction Dysplasia: A Case Report and Overview of What is Known so far

Background: Diencephalic-mesencephalic junction dysplasia (DMJD) is a rare and recently newly described forebrain-midbrain malformation involving the upper aspect of the brainstem and resulting in an abnormal regionalization of the diencephalon and mesencephalon level. The fingerprint of DMJD is the pathognomonic butterfly-like appearance of the midbrain seen on the axial plane of brain magnetic resonance imaging (MRI). Initially, only two types of diencephalon-mesencephalon continuity were defined: type A describes the continuity of the hypothalamus with the mesencephalon, and type B a parenchymal band between the thalamus and the superior surface of the midbrain. However, DMJD classification continues to expand, and recently, type C was described as showing a complete continuity of the thalamus and midbrain. In this paper, we refer to mesencephalon and midbrain as the anatomical marker of the topmost part of the brainstem, and those terms are used interchangeably in the text. Methodology: PubMed database search for the exact words “diencephalic-mesencephalic junction dysplasia” and “DMJD” yielded 12 relevant publications. A showcase of an original rare type C DMJD was performed. Objective: The purpose of this article is to present a brief comprehensive illustration /elucidation of the physiopathology of neural tube regionalization to facilitate the understanding of DMJD malformation; to present an updated overview of recent publications involving imaging findings, genetics, and clinical concerns; and to show an original fetal case of type C DJMD. The aim is to increase awareness of DMJD and strengthen clinical suspicion, especially since early diagnosis is primarily based on imaging

Um debate historiográfico sobre a conquista da Nova Espanha: do “bom selvagem” ao protagonismo indígena

Este trabalho apresenta a evolução do pensamento historiográfico sobre as razões que possibilitaram a Conquista da Nova Espanha. A partir de trabalhos de pesquisadores renomados e bastante discutidos no meio acadêmico, analiso a crescente abordagem que visa priorizar a participação e o protagonismo indígenas no processo de Conquista e Colonização da Nova Espanha. Com base nesta discussão historiográfica, as perspectivas europeias e ameríndias sobre este acontecimento serão apresentadas a partir da análise de fontes

MABLESim: A Tool for Simulating Indoor Accessibility

Challenges arise for people with disabilities when built environments do not accommodate their needs, resulting in significant accessibility issues. Regulations and initiatives often struggle to effectively address the diverse requirements of these populations. MABLESim (Mapping for Accessible Built Environments Simulator) is a framework designed to tackle these challenges by providing a solution for evaluating the accessibility of indoor environments. By converting floor plans into digital models, MABLESim facilitates thorough testing and analysis of various scenarios for people with disabilities. This section will demonstrate how MABLESim operates, showcasingits ability to replicate real-world conditions and user experiences. This makes it a tool for architects, urban planners, and accessibility researchers. These users can interact with the simulation to explore how different mobility needs impact navigation, allowing them to observe potential barriers andinefficiencies. Ultimately, MABLESim offers insights that inform the design of more inclusive and user-friendly spaces, fostering environments that better accommodate the diverse needs of all individuals

Prevalence and correlates of neck injection among people who inject drugs in Tijuana, Mexico

© 2015 Australasian Professional Society on Alcohol and other Drugs. Introduction and Aims: Injecting drugs in the neck has been related to adverse health conditions such as jugular vein thrombosis, deep neck infections, aneurysm, haematomas, airway obstruction, vocal cord paralysis and wound botulism, among others. We identified prevalence and correlates of neck injection among people who inject drugs (PWID) in Tijuana, Mexico. Design and Methods: Beginning in 2011, PWID aged ≥18 years who injected drugs within the last month were recruited into a prospective cohort. At baseline and semi-annually, PWID completed interviewer-administered surveys soliciting data on drug-injecting practices. Logistic regression was used to identify predictors of injecting in the neck as the most frequent injection site at a single visit. Results: Of 380 PWID, 35.3% injected in the neck at least once in the past 6 months, among whom 71.6% reported it as their most common injection site, the most common injecting site after the arms (47%). Controlling for age, years injecting and injecting frequency, injecting heroin and methamphetamine two or more times per day and having sought injection assistance were associated with injecting in the neck [adjusted odds ratios (AOR): 2.12; 95% confidence intervals (CI): 1.27-3.53 and AOR: 2.65; 95% CI: 1.52-4.53 respectively]. Discussion and Conclusions: Injecting in the neck was very common among PWID in Tijuana and was associated with polydrug use and seeking injection assistance. Tailoring harm reduction education interventions for individuals who provide injection assistance ('hit doctors') may allow for the dissemination of safe injecting knowledge to reduce injection-related morbidity and mortality. [Rafful C, Wagner KD, Werb D, González-Zúñiga PE, Verdugo S, Rangel G, Strathdee SA. Prevalence and correlates of neck injection among people who inject drugs in Tijuana, Mexico

“Another Person Was Going to Do It”: The Provision of Injection Drug Use Initiation Assistance in a High-Risk U.S.–Mexico Border Region

Background: Persons who inject drugs (PWID) play a key role in assisting others' initiation into injection drug use (IDU). We aimed to explore the pathways and socio-structural contexts for this phenomenon in Tijuana, Mexico, a border setting marked by a large PWID population with limited access to health and social services. Methods: Preventing Injecting by Modifying Existing Responses (PRIMER) is a multi-cohort study assessing socio-structural factors associated with PWID assisting others into initiating IDU. Semi-structured qualitative interviews in Tijuana included participants ≥18 years old, who reported IDU within the month prior to cohort enrollment and ever initiating others into IDU. Purposive sampling ensured a range of drug use experiences and behaviors related to injection initiation assistance. Thematic analysis was used to develop recurring and significant data categories. Results: Twenty-one participants were interviewed (8 women, 13 men). Broadly, participants considered public injection to increase curiosity about IDU. Many considered transitioning into IDU as inevitable. Emergent themes included providing assistance to mitigate overdose risk and to protect initiates from being taken advantage of by others. Participants described reluctance in engaging in this process. For some, access to resources (e.g., shared drugs or a monetary fee) was a motivator to initiate others. Conclusion: In Tijuana, public injection and a lack of harm reduction services are perceived to fuel the incidence of IDU initiation and to incentivize PWID to assist in injection initiation. IDU prevention efforts should address structural factors driving PWID participation in IDU initiation while including PWID in their development and implementation

POSSÍVEL ASSOCIAÇÃO ENTRE DOENÇA DESMIELINIZANTE E NEOPLASIAS OLIGODENDROGLIAIS: RELATO DE CASO

Desde o primeiro relato de doença desmielinizante associada a tumores cerebrais por Scherer em 1938, inúmeros outros relatos de casos foram publicados fazendo associação desta doença com diferentes tumores primários do sistema nervoso central. Nosso trabalho descreve o caso de uma paciente de 23 anos com duas lesões encefálicas biopsiadas, mostrando inicialmente processo inflamatório desmielinizante que no seguimento desenvolve um oligodendroglioma anaplásico. A partir deste caso, realizamos uma revisão da literatura dessa as- sociação específica, primeiramente publicada por Barnard e Jellinek em 1967, e ressaltamos a importância da diferenciação entre a forma desmielinizante tumefativa de uma neoplasia cerebral verdadeira.

“I would rather do it myself”: injection initiation and current injection patterns among women who inject drugs in Tijuana, Mexico

Background Women who inject drugs (WWID) experience unique risks and adverse health outcomes related to injection initiation and patterns of injection drug use. However, there is limited information on injection initiation experiences and injection patterns among women and the protective strategies employed to limit injection-related harms, especially in low- and middle-income settings. Therefore, this study sought to explore injection initiation and current injection patterns (e.g., relying on someone else to inject) among women who inject drugs and engage in sex work in Tijuana, Mexico. Methods Semistructured in-depth interviews were conducted with 30 WWID on the following topics: injection initiation, current injection patterns, places where women inject, and protective strategies (i.e., risk reduction). All interviews were audio-recorded, transcribed, and de-identified. An inductive thematic analysis was conducted to identify and compare common themes and patterns across participants. Results The interviews revealed that the vast majority of study participants were first initiated by another person who injects drugs (PWID), often a male sexual partner. However, the majority of the women transitioned to become self-injectors in order to avoid risks associated with relying on others for injection, including overdose, interpersonal violence, sexual abuse, and wounds. Those who relied on others indicated that they would prefer to inject themselves without assistance from others if they were able to. Conclusions The narratives uncovered in this study reveal the importance of multiple risk environments in shaping perceived risks associated with injection drug use among women in Tijuana, Mexico. Specifically, the interviews elucidate the connection between interpersonal relationships with other PWID and protective strategies used to minimize risk and harm. These findings highlight the need for women-centered harm reduction programs to facilitate the development of safer drug use environments among WWID in Tijuana, Mexico

Diferencias sociodemográficas entre usuarios de inhalables, usuarios de otras drogas y adolescentes no consumidores en una muestra mexicana de estudiantes

Introducción: los inhalables como el pegamento, el thinner y otros derivados del petróleo son uno de los grupos de sustancias más utilizados entre la población adolescente mexicana. Estudios recientes han mostrado que, junto con la mariguana, los inhalables son el tipo de droga de preferencia de la población joven. Objetivo: el propósito de este estudio es determinar los factores que diferencian a los usuarios de inhalables de los usuarios de otras drogas, así como de quienes no las consumen. Método: se utilizaron datos de la Encuesta de Estudiantes 2009 del Distrito Federal, la cual contó con la participación de 22 mil 980 estudiantes de secundaria y preparatoria. Resultados: los usuarios de inhalables son más jóvenes, provienen de niveles con menos recursos y sus padres y madres tienen menor nivel de escolaridad que los padres de los no usuarios; encontramos además que los usuarios de inhalables provienen de lugares en los que se tolera más el consumo de drogas, incluyendo el entorno familiar y social; son importantes también la disponibilidad y la oportunidad de consumo. En comparación con quienes consumen otras drogas, los usuarios de inhalables son más impulsivos, tienen más amigos con problemas antisociales y, con más frecuencia, reportan algún familiar usuario de drogas. Discusión y conclusiones: nuestros resultados reafirman la necesidad de diseñar programas de prevención que no se enfoquen únicamente en el consumo de drogas, sino en los factores familiares y socialesrelacionados con un mayor riesgo de consumo. </jats:p

The effect of public health-oriented drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico:an epidemic modelling study

BACKGROUND: As countries embark on public health-oriented drug law reform, health impact evaluations are needed. In 2012, Mexico mandated the narcomenudeo reform, which depenalised the possession of small amounts of drugs and instituted drug treatment instead of incarceration. We investigated the past and future effect of this drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico.METHODS: In this epidemic modelling study, we used data from the El Cuete IV cohort study to develop a deterministic model of injecting and sexual HIV transmission in people who inject drugs in Tijuana between 2012 and 2030. The population was stratified by sex, incarceration status, syringe confiscation by the police, HIV stage, and exposure to drug treatment or rehabilitation (either opioid agonist treatment or compulsory drug abstinence programmes). We modelled the effect of these exposures on HIV risk in people who inject drugs, estimating the effect of observed and potential future reform enforcement levels.FINDINGS: In 2011, prior to the narcomenudeo reform, 547 (75%) of 733 people who inject drugs in the El Cuete cohort reported having ever been incarcerated, on average five times since starting injecting. Modelling estimated the limited reform implementation averted 2% (95% CI 0·2-3·0) of new HIV infections in people who inject drugs between 2012 and 2017. If implementation reduced incarceration in people who inject drugs by 80% from 2018 onward, 9% (95% CI 4-16) of new HIV infections between 2018 and 2030 could be averted, with 21% (10-33) averted if people who inject drugs were referred to opioid agonist treatment instead of being incarcerated. Referral to compulsory drug abstinence programmes instead of prison could have a lower or potentially negative impact with -2% (95% CI -23 to 9) infections averted.INTERPRETATION: Mexican drug law reform has had a negligible effect on the HIV epidemic among people who inject drugs in Tijuana. However, appropriate implementation could markedly reduce HIV incidence if linked to opioid agonist treatment. Unfortunately, compulsory drug abstinence programmes are the main type of drug rehabilitation available and their expansion could potentially increase HIV transmission.FUNDING: National Institute on Drug Abuse, UC San Diego Center for AIDS Research.</p