Exosomes, nanovesicles secreted by all cells, carry out intercellular communication by transmitting biologically active cargo comprising DNA, RNA, and proteins. These biomolecules reflect the status of their parent cells and can be altered by pathological conditions. Therefore, the researchers have been investigating differential sequences and quantities of DNA associated with exosomes as valuable biomarkers of diseases. Exosomes carry different types of DNA molecules, including genomic, cytoplasmic, and mitochondrial (mtDNA). The mtDNA aberrations are reported to be a hallmark of diseases involving oxidative stress, such as cancer and neurodegenerative diseases. Establishing robust in vitro models comprising appropriate cell lineages is the first step towards investigating disease-specific anomalies and testing therapeutics. Induced pluripotent stem (iPS) cells from patients with diseases have been used for this purpose since they can differentiate into various cells. The current study investigated mtDNA aberrations in exosomes secreted by primary cancer cells and neural stem cells (NSCs) differentiated from iPS cells. The primary cancer cells were isolated from surgically removed glioblastoma multiforme (GBM) tissue, and the iPS cells were produced from control and Alzheimer’s disease (AD) subjects’ B lymphocytes. We detected aberrations in mtDNA associated with exosomes secreted from GBM cells but not from the NSCs. This result indicates that the cells may not secrete exosomes carrying mtDNA aberration without exposure to a pathological condition. Thus, we may need to consider this fact when we use iPS cell-derived cells as an in vitro disease model.

Background: Sexual dysfunction (SD) is a common comorbidity in people with multiple sclerosis (pwMS). It affects the quality of life and remains an overlooked condition. We will describe how Colombian neurologists assess and treat SD in pwMS.Methods: In this observational cross-sectional study we developed a questionnaire for neurologists with 4 sections ( demographic data, evaluation and treatment of SD, and possible reasons for not discussing sexual dysfunction.) It was sent via email to 326 Colombian neurologists. We grouped the answers according to the type of consultation (neurologists from a MS program or no MS program). We described through absolute frequencies and proportions. Results: 50 neurologists answered the survey, 5 have never attend pwMS; the section 2-4 was not answered by them. 29% work in a MS program, all of them asked their patients about sexual function, but 18.75% of physicians working outside an MS program have never asked about it. Reasons for not talking about sexual dysfunction were lack of knowledge (65.1%), presence of a companion (65.1%) and lack of time (55.8%). 91% of the neurologists reported that their patients usually and frequently ask about sexual function. Neurologists use informal questions to assess sexual function (80%), although 64.4% said that they are aware of SD questionnaires. When sexual dysfunction is detected, 91% of neurologists refer patients to another specialist and 87% do not start any treatmentConclusions: Colombian neurologists are concerned about sexual function. There is still a gap in the treatment and evaluation of sexual dysfunction.

El tratamiento con activador tisular del plasminógeno intravenoso es probablemente recomendado para pacientes con infarto cerebral agudo que tienen una neoplasia intracraneal extraaxial, pero en aquéllos con historia de hemorragia intracraneal es potencialmente nocivo. No ha sido reportada en la literatura la administración de trombólisis intravenosa durante un infarto cerebral agudo en pacientes con historia de macroadenoma de hipófisis con apoplejía pituitaria y sangrado intratumoral. Presentamos el caso de una paciente joven con un evento isquémico cerebral agudo en el territorio de la arteria cerebral media izquierda, porción M3, con puntaje de 14 de la National Institutes of Health Stroke Scale y 0 en la escala de Rankin modificada al ingreso, con historia de macroadenoma hipofisiario con apoplejía pituitaria y escaso sangrado intratumoral que exitosamente fue llevada a trombólisis intravenosa. La toma de decisiones sobre la administración intravenosa del activador tisular del plasminógeno para el manejo del infarto cerebral agudo debe estar basada en la evaluación de los potenciales riesgos y beneficios esperados caso por caso, teniendo en cuenta como marco de referencia las guías escritas sobre el tema.Palabras clave: Infarto cerebral isquémico, macroadenoma hipofisiario, apoplejía pituitaria, trombólisis intravenosa, activador tisular del plasminógeno.