9/15/2010

El Bicentenario


MÉXICO ES MI MUSEO / LISTA POR ESTADOS
http://www.bicentenario.gob.mx/index.php?option=com_content&view=section&id=19&Itemid=210


86.- AGUSTÍN DE ITURBIDE
87.- GUADALUPE VICTORIA
88.- VICENTE GUERRERO
89.- JOSÉ MARÍA BOCANEGRA
90.- ANASTASIO BUSTAMANTE
91.- MELCHOR MÚZQUIZ
92.- MANUEL GÓMEZ PEDRAZA
93.- VALENTÍN GÓMEZ FARÍAS
94.- MIGUEL BARRAGÁN
95.- JOSÉ JUSTO CORRO
96.- NICOLÁS BRAVO
97.- FRANCISCO JAVIER ECHEVERRÍA
98.- VALENTÍN CANALIZO
99.- MARIANO PAREDES Y ARRILLAGA
100.- JOSÉ MARIANO SALAS
101.- PEDRO MARÍA ANAYA
102.- MANUEL DE LA PEÑA Y PEÑA
103.- JOSÉ JOAQUÍN DE HERRERA
104.- MARIANO ARISTA
105.- JUAN BAUTISTA CEBALLOS
106.- MANUEL MARÍA LOMBARDINI
107.- ANTONIO LÓPEZ DE SANTA ANNA
108.- MARTÍN CARRERA
109.- RÓMULO DÍAZ DE LA VEGA
110.- JUAN ÁLVAREZ
111.- IGNACIO COMONFORT
112.- BENITO JUÁREZ
113.- FÉLIX MARÍA ZULOAGA
114.- MANUEL ROBLES PEZUELA
115.- JOSÉ IGNACIO PAVÓN
116.- MIGUEL MIRAMÓN
117.- JUAN NEPOMUCENO ALMONTE
118.- MAXIMILIANO DE HABSBURGO
119.- SEBASTIÁN LERDO DE TEJADA
120.- JOSÉ MARÍA IGLESIAS
121.- JUAN N. MÉNDEZ
122.- MANUEL GONZÁLEZ
123.- PORFIRIO DÍAZ
124.- FRANCISCO LEÓN DE LA BARRA
125.- FRANCISCO I. MADERO
126.- PEDRO LASCURÁIN
127.- VICTORIANO HUERTA
128.- FRANCISCO S. CARVAJAL
129.- EULALIO GUTIÉRREZ
130.- ROQUE GONZÁLEZ GARZA
131.- FRANCISCO LAGOS CHÁZARO
132.- VENUSTIANO CARRANZA
133.- ADOLFO DE LA HUERTA
134.- ÁLVARO OBREGÓN
135.- PLUTARCO ELÍAS CALLES
136.- EMILIO PORTES GIL
137.- PASCUAL ORTIZ RUBIO
138.- ABELARDO L. RODRÍGUEZ
139.- LÁZARO CÁRDENAS
140.- MANUEL ÁVILA CAMACHO
141.- MIGUEL ALEMÁN VALDÉS
142.- ADOLFO RUIZ CORTINES
143.- ADOLFO LÓPEZ MATEOS
144.- GUSTAVO DÍAZ ORDAZ
145.- LUIS ECHEVERRÍA ÁLVAREZ
146.- JOSÉ LÓPEZ PORTILLO
147.- MIGUEL DE LA MADRID HURTADO
148.- CARLOS SALINAS DE GORTARI
149.- ERNESTO ZEDILLO PONCE DE LEÓN
150.- VICENTE FOX QUESADA
151.- FELIPE CALDERÓN HINOJOSA


                                                 DOLORES HIDALGO

                                               CAMPANA DE LA INDEPENDENCIA


                           CASA DE DON MIGUEL HIDALGO Y COSTILLA
                                                   ASI DE BELLO ES DOLORES

                                                         GRITO DE LIBERTAD





Para esto sí hay dinero, ¿pero para los programas de las personas con Discapacidad?

México a la vanguardia en el Síndrome de Post Polio

The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

video

movie

movie2

A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

    Link here