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Management of Parkinson’s disease and other movement disorders in women of childbearing age: Part 1. NEUROLOGÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.nrleng.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1. Neurologia 2021; 36:149-158. [DOI: 10.1016/j.nrl.2020.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023] Open
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Directional versus omnidirectional Deep Brain Stimulation: Results of a multi-cente prospective blinded crossover study. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Management of Parkinson's disease and other movement disorders in women of childbearing age: Part 2. Neurologia 2020; 36:159-168. [PMID: 32980194 DOI: 10.1016/j.nrl.2020.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Many diseases associated with hyperkinetic movement disorders manifest in women of childbearing age. It is important to understand the risks of these diseases during pregnancy, and the potential risks of treatment for the fetus. OBJECTIVES This study aims to define the clinical characteristics and the factors affecting the lives of women of childbearing age with dystonia, chorea, Tourette syndrome, tremor, and restless legs syndrome, and to establish guidelines for management of pregnancy and breastfeeding in these patients. RESULTS This consensus document was developed through an exhaustive literature search and a discussion of the content by a group of movement disorder experts from the Spanish Society of Neurology. CONCLUSIONS We must evaluate the risks and benefits of treatment in all women with hyperkinetic movement disorders, whether pre-existing or with onset during pregnancy, and aim to reduce effective doses as much as possible or to administer drugs only when necessary. In hereditary diseases, families should be offered genetic counselling. It is important to recognise movement disorders triggered during pregnancy, such as certain types of chorea and restless legs syndrome.
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COPPADIS
‐2015 (
CO
hort of Patients with PArkinson's
DI
sease in Spain, 2015): an ongoing global Parkinson's disease project about disease progression with more than 1000 subjects included. Results from the baseline evaluation. Eur J Neurol 2019; 26:1399-1407. [DOI: 10.1111/ene.14008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/23/2019] [Indexed: 01/03/2023]
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Correction of whistle deformity using the myomucosal vertical Z-plasty technique. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
In presenting the case of a 61-year-old man with a primary squamous carcinoma in a bladder diverticulum, the authors stress the usefulness of applying all the available modalities of imaging, since it has been found that a bladder diverticulum may harbor a neoplasm more often than a normal bladder.
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Elaboration of the SPM template for the standardization of SPECT images with 123I-Ioflupane. Rev Esp Med Nucl Imagen Mol 2013. [DOI: 10.1016/j.remnie.2013.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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[Advanced Parkinson's disease: clinical characteristics and treatment (part 1)]. Neurologia 2013; 28:503-21. [PMID: 23856182 DOI: 10.1016/j.nrl.2013.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 04/16/2013] [Accepted: 05/02/2013] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION A large percentage of patients with Parkinson's disease (PD) develop motor fluctuations, dyskinesias, and severe non-motor symptoms within 3 to 5 years of starting dopaminergic therapy, and these motor complications are refractory to treatment. Several authors refer to this stage of the disease as advanced Parkinson's disease. OBJECTIVE To define the clinical manifestations of advanced PD and the risk factors for reaching this stage of the disease. DEVELOPMENT This consensus document has been prepared by using an exhaustive literature search and by discussion of the contents by an expert group on movement disorders of the Sociedad Española de Neurología (Spanish Neurology Society), coordinated by two of the authors (JK and MRL). CONCLUSIONS Severe motor fluctuations and dyskinesias, axial motor symptoms resistant to levodopa, and cognitive decline are the main signs in the clinical phenotype of advanced PD.
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[Elaboration of the SPM template for the standardization of SPECT images with 123I-Ioflupane]. Rev Esp Med Nucl Imagen Mol 2013; 32:350-6. [PMID: 23570700 DOI: 10.1016/j.remn.2013.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 02/05/2013] [Accepted: 02/23/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE Statistical parametric mapping (SPM) is a widely used produced for normalization of functional images. This study has aimed to develop a normalization template of (123)I-Ioflupane SPECT-imaging DaTSCAN(®), GE Healthcare), not available in SPM5, and to validate it compared to other quantification methods. MATERIAL AND METHODS In order to write the template we retrospectively selected 26 subjects who had no evidence of nigrostriatal degeneration and whose age distribution was similar to that of the patients in the usual practice of our Department: 2 subjects (7.6%) were < 35 years, 9 between 35-65 years (34.6%) and 15 > 65 years (57.7%). All the studies were normalized with the T1-template available in SPM5 and an average image of the value was obtained for each voxel. For validation we analyzed 60 patients: 30 with idiopathic Parkinson's disease patients (iPD) with right involvement (66.83±12.20 years) and 30 with essential tremor patients (ET) (67.27±8.33 years). Specific uptake rates (SUR) of different striatal regions were compared after image normalization with our template and the application of a semiautomated VOIs-map created with Analyze v9.0 ((©)BIR, Mayo Clinic), against two quantification methods: a) manual adjustment of a ROIs-map drawn in Analyze, and b) semi-automated method (HERMES-BRASS) with normalization and implementation of VOIs-map. RESULTS No statistically significant differences in the iPD/ET discriminatory capacity between the three methods analyzed were observed (p<0,001). The correlation of SUR after normalization with our «template» was higher than that obtained by method b) (R>0,871, p<0,001). This difference was greater in patients with PD. CONCLUSIONS Our study demonstrates the efficacy of our SPM «template» for (123)I-Ioflupane SPECT-imaging, obtained from normalization with «T1-template».
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Low serum uric acid concentration in Parkinson's disease in southern Spain. Eur J Neurol 2012; 20:208-10. [DOI: 10.1111/j.1468-1331.2012.03745.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 03/26/2012] [Indexed: 11/29/2022]
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[Relationship between fibrinolytic system and neurological diseases]. Rev Neurol 2010; 51:295-301. [PMID: 20669129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The fibrinolytic system, also named plasminogen system is formed by a group of molecules that transforms plasminogen in its active form plasmine, which is able to participate in a number of pathophysiological processes. AIM To carry out a review of the literature and an analysis of the relationship between fibrinolytic system and neurological diseases and its potential therapeutic implications. DEVELOPMENT The fibrinolytic system has been involved in many different pathologies. Although its role in neurological diseases has always been thought to be scarce, many relations have been recently established. This way, fibrinolytic system seems to be involved not only in cerebrovascular diseases but also in epilepsy, inflammatory diseases such as multiple sclerosis, alterations of the dopaminergic system, learning disorders and several lesions of the peripheral nervous system. Different genotypes of several components of this system have been related as risk or protector factors to the development of these neurological diseases and information to this respect is rapidly increasing. CONCLUSIONS A better knowledge about the relations between the fibrinolytic system and neurological diseases could clarify several aspects about their pathophysiology and it could suppose future prevention and treatment lines.
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Abstract
OBJECTIVES Parkinson's disease (PD) is characterized by the dopaminergic neuronal death in substantia nigra, and genetic factors appear to be involved in the pathophysiology of this disease. Brain-derived neurotrophic factor (BDNF) is widely expressed in the central nervous system and is necessary for the survival of dopaminergic neurons in substantia nigra. G196A, a common polymorphism of the BDNF gene, not only affects cognitive and motor processes, but also is associated with various psychiatric disorders. We evaluated whether G196A polymorphism is associated with PD and/or modifies clinical manifestations in PD patients. METHODS We included 193 PD patients and 300 control subjects. G196A polymorphism was screened by restriction fragment length polymorphism analysis. Clinical features of each patient were examined in detail. The possible association between genotype and clinical characteristics were determined by bivariate and multivariate analyses. RESULTS The distribution of G196A allele and genotype frequency was similar between PD and control subjects. Clinical characteristics, including Hoehn-Yahr stage, motor symptoms, non-motor symptoms (depression, cognitive dysfunction, psychiatric dysfunctions, and sleep behavior disorder), and dyskinesias, were not associated with this polymorphism. CONCLUSIONS G196A polymorphism is not a risk factor for PD and does not seem to modify clinical features in PD patients studied here.
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[Symptomatic causes of restless legs syndrome.]. Neurologia 2009; 24:841-844. [PMID: 20340060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Restless legs syndrome (RLS) is characterized by discomfort and paresthesias in the legs with urge to move the legs, worsening of the symptoms with the rest or inactivity, present or exacerbation in the evening or night and partial or total relief with movement. The diagnosis is primarily clinical. RLS is idiopathic, with family history in 40-60% of the cases, or symptomatic associated conditions such as iron deficiency, uremia, pregnancy, Parkinson's disease, neuropathy or myelopathy. Although the pathophysiology of RLS remains unknown, it has been implicated a central dopaminergic dysfunction. In the last years it has increased the interest and has been published several papers about RLS, that make significant contributions to the current understanding of the syndrome. The aim of this paper is to review the cur-rent advances in the field of RLS, with special emphasis on symptomatic causes of the syndrome, from both epidemiological and pathophysiological points of view.
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Cerebellar magnetic stimulation decreases levodopa-induced dyskinesias in Parkinson disease. Neurology 2009; 73:113-9. [PMID: 19597133 DOI: 10.1212/wnl.0b013e3181ad5387] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The neural mechanisms and the circuitry involved in levodopa-induced dyskinesia (LID) are still partially obscure. LID can be considered the consequence of an abnormal pattern or code of activity that originates and is conveyed from the basal ganglia to the thalamus and the cortical motor areas. However, not only striatothalamocortical motor circuits but also other interconnected pathways could be implicated in its pathogenesis. METHODS In a series of experiments, we applied repetitive transcranial magnetic stimulation (rTMS) over the lateral cerebellum in a group of patients with advanced Parkinson disease, to investigate whether modulation of cerebellothalamocortical circuits by means of rTMS may result in a modification of a dyskinetic state induced by levodopa ingestion. RESULTS We found that a single session of cerebellar continuous theta burst stimulation (cTBS) was capable of transiently reducing LID. In the same patients, we observed that cerebellar cTBS changed the profile of activation of intracortical circuits in the contralateral primary motor cortex. Cerebellar cTBS reduced short intracortical inhibition and increased long intracortical inhibition, inducing a cortical reorganization that is associated with a reduction of LID. Furthermore, in another experiment, we observed that a 2-week course of bilateral cerebellar cTBS induced persistent clinical beneficial effects, reducing peak-dose LID for up to 4 weeks after the end of the daily stimulation period. CONCLUSIONS Our study demonstrates that cerebellar continuous theta burst stimulation has an antidyskinetic effect in Parkinson disease patients with levodopa-induced dyskinesia, possibly due to modulation of cerebellothalamocortical pathways.
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Prevalence and clinical features ofLRRK2mutations in patients with Parkinson’s disease in southern Spain. Eur J Neurol 2009; 16:957-60. [DOI: 10.1111/j.1468-1331.2009.02620.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Olfaction in patients with suspected parkinsonism and scans without evidence of dopaminergic deficit (SWEDDs). J Neurol Neurosurg Psychiatry 2009; 80:744-8. [PMID: 19276101 DOI: 10.1136/jnnp.2009.172825] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Positron emission tomography and single photon emission computed tomography scanning have 87-94% sensitivity and 80-100% specificity to differentiate patients with Parkinson's disease (PD) from control subjects and patients with essential (ET) or atypical tremor. More than 10% of patients diagnosed as early PD can have scans without evidence of dopaminergic deficiency (SWEDDs). This study investigated whether smell tests can help identify possible cases with SWEDDs. METHODS The 40 item University of Pennsylvania Smell Test (UPSIT) was used to evaluate the sense of smell in 21 SWEDDs patients. Twenty-six ET patients, 16 patients with a diagnosis of idiopathic adult onset dystonia (D), 191 non-demented PD patients and 136 control subjects were also tested. Multiple regression analyses were used to compare the mean UPSIT score in the SWEDDs group with the other four groups (ET, D, PD and controls) after adjusting for the effects of relevant covariates. RESULTS The mean UPSIT score for the SWEDDs group was greater than in the PD group (p<0.001) and not different from the mean UPSIT in the control (p = 0.7), ET (p = 0.4) or D (p = 0.9) groups. Smell tests indicated a high probability of PD in only 23.8% of SWEDDs as opposed to 85.3% of PD patients. CONCLUSIONS In a patient with suspected PD, a high PD probability on smell testing favours the diagnosis of PD, and a low PD probability strengthens the indication for dopamine transporter imaging.
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Effect of the particle size and acid pretreatments on compatibility and properties of recycled HDPE plastic bottles filled with ground tyre powder. J Appl Polym Sci 2009. [DOI: 10.1002/app.29611] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Highly skewed inactivation of the wild-type X-chromosome in asymptomatic female carriers of spinal and bulbar muscular atrophy (Kennedy’s disease). J Neurol 2008; 255:853-7. [DOI: 10.1007/s00415-008-0766-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 05/23/2007] [Accepted: 10/05/2007] [Indexed: 10/22/2022]
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Alternative methods for the wool wax extraction from wool scouring wastes. GRASAS Y ACEITES 2007. [DOI: 10.3989/gya.2007.v58.i4.453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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A single dose of bovine somatotropin 5 days before the end of progestin-based estrous synchronization increases prolificacy in sheep. Anim Reprod Sci 2007; 102:31-7. [PMID: 17064860 DOI: 10.1016/j.anireprosci.2006.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 09/21/2006] [Indexed: 10/24/2022]
Abstract
Bovine somatotropin (bST) enhances ovarian follicular and embryonic development in sheep and cattle. In the present study, the objective was to assess whether bST given 5 days before the end of progestin-based estrous synchronization improves prolificacy and lambing rate in sheep. Pelibuey ewes (n=92) exhibiting estrous cycles at regular intervals received an intravaginal sponge containing 45mg of FGA for 12 days. Five days before sponge withdrawal, ewes were treated with either 125mg of bST sc (bST group; n=47) or saline solution (control; n=45). After the sponge was removed, ewes were observed for estrus and subsequently mated twice. Lambing rate and prolificacy was determined at birth. Blood samples were taken from the time of treatment until day 15 after estrus in eight ewes from the bST group and nine from the control group. Concentrations of IGF-I were determined by immunoradiometric assay and progesterone by RIA. Treatment with bST increased (P<0.01) the proportion of ewes with more than one lamb (bST, 56% compared with control, 26%) and prolificacy (bST, 1.6 compared with control, 1.3). Treatment with bST increased (P<0.05) the lambing rate of multiparous (bST, 92% compared with control, 67%) but not in ewes at the first time they were mated (bST, 71% compared with control, 87%; P>0.05). IGF-I concentrations were greater (P<0.01) in ewes treated with bST than in control ewes from 2 days after treatment. Progesterone concentrations did not vary (P>0.05) between groups. It is concluded that a single dose of bST 5 days before progestin withdrawal increases lambing rate and prolificacy in sheep. These effects are associated with an increase in circulating concentrations of IGF-I.
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Supercritical fluid extraction as a clean-up method for the extraction of pesticides from wool wax. A preliminary approach. GRASAS Y ACEITES 2007. [DOI: 10.3989/gya.2007.v58.i2.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Multislice CT with single-phase technique in patients with suspected pancreatic cancer. Radiol Med 2006; 111:159-66. [PMID: 16671374 DOI: 10.1007/s11547-006-0017-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the role of multislice computed tomography (MSCT) with a single-phase technique in patients with suspected pancreatic cancer (PC). MATERIALS AND METHODS Seventy-eight patients underwent MSCT with the following technical parameters: collimation: 4x1 mm; pitch 1; 120 kVp; 260 mAs. The pre-contrast scan was followed by a single acquisition phase in the caudocranial direction from the inferior hepatic margin to the diaphragm with a 60-s delay after IV administration of 150 ml of iodinated contrast material at a rate of 3 ml/s. Two radiologists assessed the single images independently. Receiver operating characteristics (ROC) curves were obtained for each of the two observers. RESULTS The final diagnosis was pancreatic cancer in 46 cases and chronic pancreatitis in 32 cases. Areas under the curve (AZ) for diagnosis and evaluation of disease resectability were 0.97 and 0.93 for the first observer (p=ns), and 0.97 and 0.90 for the second observer (p=ns). The mean difference in tissue attenuation values between the cancer and normal pancreas was 72 +/- 3 Hounsfield units (HU). No statistically significant differences were observed in the degree of opacification between the peripancreatic arteries and veins. CONCLUSIONS MSCT with a single-phase technique is an accurate and reproducible method for diagnosis and evaluation of disease resectability in patients with suspected PC, ensuring optimal tumour-to-pancreas contrast and maximal opacification of the main peripancreatic arterial and venous structures.
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MESH Headings
- Biopsy, Fine-Needle
- Carcinoma, Pancreatic Ductal/diagnostic imaging
- Carcinoma, Pancreatic Ductal/pathology
- Contrast Media/administration & dosage
- Cystadenocarcinoma, Mucinous/diagnostic imaging
- Cystadenocarcinoma, Mucinous/pathology
- Diagnosis, Differential
- Female
- Follow-Up Studies
- Humans
- Image Processing, Computer-Assisted/methods
- Injections, Intravenous
- Iodides/administration & dosage
- Male
- Mesenteric Artery, Superior/diagnostic imaging
- Mesenteric Veins/diagnostic imaging
- Middle Aged
- Observer Variation
- Pancreas/blood supply
- Pancreas/diagnostic imaging
- Pancreatic Neoplasms/diagnostic imaging
- Pancreatic Neoplasms/pathology
- Pancreatitis/diagnostic imaging
- Pancreatitis/pathology
- ROC Curve
- Radiographic Image Enhancement
- Time Factors
- Tomography, X-Ray Computed/methods
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Abstract
The yield of fiberoptic bronchoscopy (FB) in the diagnosis of pulmonary metastases has not been conveniently analyzed. With the advances in the surgery of pulmonary metastases, there is a need to evaluate the diagnostic yield and the usefulness of FB to exclude other diseases with similar radiological patterns. To determine the value of FB in the diagnosis of pulmonary metastases we have retrospectively analyzed our experience in 113 patients with proven pulmonary metastases. An endobronchial lesion was identified in 57/113 (50.4%). The most frequent tumors with endobronchial lesions were thyroid (100%), head-neck (67%) and breast carcinomas (59%). The highest diagnostic yield was obtained combining techniques of brushing, washing and biopsy (72.6%); in cases with endobronchial lesions (84.2%) and with certain histological types (head-neck 100%; breast 90.9% and colon 84.6%). The most frequent radiological findings were single or multiple nodules (77.9%). Atelectasis were associated with endobronchial lesions. In conclusion, bronchoscopy is a valuable diagnostic procedure in selected patients with metastatic lung disease.
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Dihydroxyprogesterone acetophenide 150 mg + estradiol enantate 10 mg as monthly injectable contraceptives. ADVANCES IN CONTRACEPTION : THE OFFICIAL JOURNAL OF THE SOCIETY FOR THE ADVANCEMENT OF CONTRACEPTION 1996; 12:213-25. [PMID: 8910663 DOI: 10.1007/bf01849664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A survey among users and health personnel participating in the Salvadorian Social Security Institute (ISSS) Family Planning Program revealed interest in including a monthly preparation for injection as a contraceptive method offered by this Institution. The formulation containing dihydroxyprogesterone acetophenide (DHPA) 150 mg + estradiol enantate (E2EN) 10 mg was chosen for conducting an open and prospective study of efficacy and tolerability. Between January 1992 and March 1994, 7054 women were treated with this product for a total of 60010 months. A sample composed of 4505 women treated at this Institution confirmed that average users are young, have one or two children, do not show a particular geographical distribution and choose the monthly injection instead of oral contraceptives as the first contraceptive method or for the puerperium. The study formulation showed a high efficacy (Pearl Index: 0.018) and tolerability (general withdrawal rate throughout the study: 27.09%). The most frequent adverse events included bleeding disorders, headache and mastalgia; their incidence decreased spontaneously from the sixth month (3.9%), reaching 0% after two years. Treatment was discontinued due to adverse events in 3.47% of women. No significant bodyweight or systolic and diastolic blood pressure alterations were observed. Based on these results, the monthly injectable contraceptive was included in the basic product list at ISSS.
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[Acute paraparesis associated with dorsal diastematomyelia in an adult]. Rev Neurol 1996; 24:290-2. [PMID: 8742392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Diastematomelia presenting in adult life has long been considered a rare occurrence. With the development of modern imagining techniques, cases of adult are being discovered with increasing frequency, but their exact number remains unclear. It occurs most often in the lumbar region, is rarely located above the level of T3 and it present clinical features such as deformity of the food, peculiar posture, or gait disturbance. The symptoms and signs of diastematomelia usually are recognized in children. We are reporting the case of an adult patient who had a forme frustre of Sjögren's syndrome and thoracic diastematomelia presenting as a acute myelopathy. Although in most of patients, the pathogenesis of the neurological deficits could be attributed to lesions such as spondylosis, herniation of a disc, traction injury or the tethering effect derived from an osseous septum or a fibrous band, in our patients was absent. We suggested as contributory cause to damage of the spinal cord a vascular ischemic mechanism during flexion and extension of the spine, and we postulated the role that anti-Ro (SS-A) antibodies play in the immunopathogenesis (mediating or potentiating) vascular injury by altering vascular endothelial function or proliferation.
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[Recurrence of meningoencephalitis induced by cotrimoxazole]. Rev Neurol 1995; 23:142-4. [PMID: 8548610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Although infrequent, one of the etiological causes of aseptic meningoencephalitis is drug-induced. In our patient, two cases of meningocephalitis took place over a period of six years, together with a meningismus following consumption of trimetroprim-sulphametoxazol (cotrimoxazol). Features of the cases were mental confusion, fever, alterations in the CSF and a benign clinical course, with a high degree of doubt regarding diagnosis, given the similarity of anomalies in the CSF to those present in partially treated bacterian meningitis.
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[Parathyroid scintigraphy with 99mTc-MIBI in hyperparathyroidism. A comparison between diagnostic imaging technics in the location and characterization of glandular hyperfunction and in the evaluation of skeletal changes]. LA RADIOLOGIA MEDICA 1994; 88:331-7. [PMID: 7938749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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[Morphofunctional evaluation of the kidney in retroperitoneal fibrosis. Correlations of computerized tomography, magnetic resonance and radionuclide renography]. LA RADIOLOGIA MEDICA 1994; 88:146-9. [PMID: 8066244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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[Effects on the newborn infant of thiopental and propofol used in anesthetic induction in cesarean section]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 1994; 41:20-2. [PMID: 8016425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To compare the effects of an anesthetic induction dose of thiopental to that of propofol on the vitality of the neonate, as measured by Apgar score and the interval between extraction of the newborn and unassisted respiration. PATIENTS AND METHODS One hundred ASA I-II women undergoing cesarean section were randomly assigned to two groups of 50. Anesthesia was induced with thiopental 4 mg/kg in one group; in the other group, propofol 2 mg/kg was used. Time intervals recorded were induction-to-extraction, uterine incision-to-extraction and extraction-to-unassisted respiration. An Apgar score was recorded 1, 5 and 10 min after birth. For statistical analysis, each group was divided into three subgroups, in accordance with the reason for performing the cesarean section: subgroup 1, elective cesarean; subgroup 2, emergency cesarean due to dystocia or failure; subgroup 3, emergency cesarean section due to acute fetal distress. RESULTS Means of intervals for induction-extraction and uterine incision-extraction showed no significant differences. All induction-extraction intervals were under 10 min (4.94 +/- 1.55 min) and all uterine incision-extraction intervals were under 180 sec, with most staying under 90 sec (43.13 +/- 25.76 sec). No statistically significant differences were found for vitality between the two groups of neonates. CONCLUSIONS If the induction-extraction interval is 10 min or less, both thiopental (4 mg/kg) and propofol (2 mg/kg) given in a single dose for induction of general anesthesia in all types of cesarean section are equally safe for the newborn infant.
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[Adenovirus in infantile diarrheas]. Med Clin (Barc) 1993; 100:637-8. [PMID: 8497164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
Fifty-two knees were examined using real-time high-definition ultrasonography with a 7.5 MHz probe. The extra-articular structures were easily visualized and diagnosis of patellar tendon lesions and Baker's cysts formulated. While the meniscal cartilages were shown as a homogeneous triangular structure between the femoral condyle and the tibial plateau, no lesions were detected. Deeper intra-articular structures, such as the cruciate ligaments, were not shown by the scan, thus their evaluation was not possible. Given its low cost, wide availability, non-invasiveness and patients' acceptability of the technique, ultrasonography may play an important role in the diagnosis of soft tissue lesions in and around the knee joint.
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[Arterio-portal intrahepatic pseudoaneurysm secondary to fetal trauma. Diagnostic and therapeutic considerations]. LA RADIOLOGIA MEDICA 1991; 82:536-8. [PMID: 1767067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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41
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[Detection of enteric adenoviruses]. Enferm Infecc Microbiol Clin 1991; 9:313-4. [PMID: 1659458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
The findings of ultrasound examination at and around the lateral humeral epicondyle in 41 tennis players suffering from so called tennis elbow are reported. Ultrasound examinations were performed with a real time ultrasound machine. The tenderness and functional impairment of tennis elbow may be caused by several different lesions, at times appearing in association. Six ultrasonographic characteristics could be identified: Enthesiopathy The proximal part of the tendon was enlarged and there were echogenicity alterations. Tendonitis The tendon of the extensor carpi radialis brevis was enlarged and areas of dyshomogeneous hypoechogenicity were evident with loss of the normal microscopic waveform structure of the tendon collagen. Peritendonitis A thickening of the peritendonous lining was present. Bursitis A bursa was located on the inferior surface of the tendon of the extensor carpi radialis brevis. Intramuscular haematoma Some circular or ovoid hypoechogenic areas within the muscular substance of the extensor carpi radialis brevis were evident. Mixed lesions These were not correlated with the intensity and the duration of the symptoms. Ultrasonographic examination gives a detailed ++image of the structures involved in the tennis elbow syndrome, confirms the diagnosis, and may be useful in monitoring treatment.
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Abstract
As in cystic fibrosis (CF), gallbladder (GB) hypokinesia might play a role in the high incidence of either cholelithiasis or atrophic and hypoplastic GBs. We studied the contractility of the GB by ultrasonography (US) in 57 CF patients and in 25 age- and sex-matched healthy controls. We evaluated the status of the GB, the GB volume after an overnight fasting and 30 min after the ingestion of a standardized milk meal, the GB contractility (the percentage of reduction, (%R) of the GB volume after a meal), the presence of gallstones, and finally, the span of the liver. In addition, liver function test results were evaluated in the CF group. We concluded that the mean values of GB contractility in CF patients do not differ from those of healthy controls, the most hypokinetic GBs (%R less than 40%) being observed, however, only in the CF group. Gallstones occur in CF patients with a greater frequency than seen in the normal population, even in early childhood. The CF patients' GB mean volumes in fasting conditions are significantly greater than in healthy controls (13.5 +/- 2 versus 8.5 +/- 1.5 cc, p less than 0.0001).
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[Pulmonary tuberculosis and Schoenlein-Henoch purpura]. Rev Clin Esp 1987; 180:515. [PMID: 3616043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Determination of mercury in biological samples by a sensitized cold vapor atomic absorption technique. Microchem J 1986. [DOI: 10.1016/0026-265x(86)90071-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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[Abdominal echography in childhood]. Minerva Pediatr 1983; 35:341-8. [PMID: 6865878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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[Lymphatic nodular hyperplasia of the colon in childhood]. Minerva Pediatr 1983; 35:111-7. [PMID: 6843526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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[Diagnostic problems in thyroid cancer]. MINERVA CHIR 1982; 37:485-6. [PMID: 7088355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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[Comparative evaluation of echotomography and HIDA in the diagnosis of obstructive jaundice]. MINERVA CHIR 1982; 37:409-14. [PMID: 7088339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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50
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[Echotomography in the diagnosis of obstructive jaundice. Personal experience]. MINERVA CHIR 1982; 37:421-3. [PMID: 7088341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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