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A Primavera

Publications and source records attributed to A Primavera.

At least 19 recordsLinked to original sources
PubMed2001

Epilepsy.

Explore the source record for details and available documents.

Adult↗
PubMed2001

Reversible posterior leucoencephalopathy syndrome in systemic lupus and vasculitis.

OBJECTIVES: Reversible posterior leucoencephalopathy syndrome (RPLS) may develop in patients with renal insufficiency, hypertension, and immunosuppression, and is managed by prompt antihypertensive and anticonvulsant treatment. Four patients with renal insufficiency and fluid overload associated with Wegener's granulomatosis (one patient) and systemic lupus erythematosus (SLE) (three patients) are described, whose clinical picture and neuroimaging indicated RPLS. CASE REPORTS: All patients had headache, seizures, visual abnormalities, and transient motor deficit, and were hypertensive at the onset of the symptoms. Head computed tomography (CT) scan and magnetic resonance imaging showed predominantly posterior signal abnormalities, which were more conspicuous on T(2) weighted spin echo images than on CT scan. All patients had some form of cytotoxic treatment shortly before the syndrome developed, and dramatically responded to blood pressure control and anticonvulsant treatment. In two patients with SLE, dialysis was required for renal insufficiency. DISCUSSION: Follow up neuroimaging studies showed almost complete resolution of signal abnormalities, and suggested that RPLS was associated with cerebral oedema without concomitant infarction. The treatment of hypertension and neurotoxic condition such as uraemia appears of primary importance, while immunosuppressive treatment may cause further damage of the blood-brain barrier.

Acute Disease↗
PubMed2000

360 degrees laparoscopic fundoplication with tension-free hiatoplasty in the treatment of symptomatic gastroesophageal reflux disease.

BACKGROUND: Since laparoscopic Nissen fundoplication was first described by Cuschieri in 1989 and later by Dallemagne in 1991, this procedure has been widely employed for the treatment of symptomatic gastroesophageal reflux disease (GERD) and/or hiatal hernia. However, a relatively high incidence (7-11%) of intrathoracic Nissen valve migration/paraesophageal hernia following laparoscopic fundoplication has recently been reported. METHODS: Between November 1992 and August 1995, 65 consecutive patients with severe GERD and/or hiatal hernia underwent laparoscopic 360 degrees fundoplication. In nine of these 65 (13.8%) patients, an intrathoracic Nissen valve migration had occurred within 4 months. Six of these patients were symptomatic and were again submitted to the laparoscopic intervention. Videotapes of both the first and second operation were reviewed. In all cases, it was apparent that, at the first operation, closure by stitches of the hiatus was under tension, and at the second operation, the muscle fibers of the right crus were disrupted, probably due to the tension between the suture margins during the inspiratory movements of the diaphragm. These findings prompted us to perform an effective tension-free closure of the hiatus. A polypropylene mesh (3 x 4 cm) was placed on the hiatus behind the esophagus and fixed with eight metallic agraphes (2 + 2 on the superior edge and 2 + 2 on the lateral sides of the right and left cruses). RESULTS: Between August 1995 and February 1998, the technique, complete with 360 degrees fundoplication, was used for 67 patients with GERD. At mean follow-up of 22.5 months (range, 1-30), there was no evidence of postoperative paraesophageal hernia or complications related to the use of the mesh. CONCLUSIONS: This tension-free hiatoplasty seems to be an effective solution to prevent postoperative paraesophageal hernia in patients undergoing antireflux laparoscopic surgery. However, longer follow-up is still needed.

Adolescent↗
PubMed2000

An Italian family with Ala-47 transthyretin mutation associated with cardiomyopathy and polyneuropathy.

We describe two Italian first cousins with familial amyloidotic polyneuropathy associated with transthyretin variant consisting of the substitution of alanine for glycine at codon 47 (TTR Ala-47), from a family with a history of cardiac failure. The 40-year-old patient presented with autonomic dysfunction and the 44-year-old cousin with congestive heart failure. Both developed sensorimotor and autonomic polyneuropathy. Since a similar clinical picture has been described in another Italian family, the cardiac involvement must be regarded as a salient and early feature of the TTR Ala-47 mutation.

Adult↗
PubMed1999

Frontotemporal dementia and corticobasal degeneration in a family with a P301S mutation in tau.

The tau gene has been found to be the locus of dementia with rigidity linked to chromosome 17. Exonic and intronic mutations have been described in a number of families. Here we describe a P301S mutation in exon 10 of the tau gene in a new family. Two members of this family were affected. One individual presented with frontotemporal dementia, whereas his son has corticobasal degeneration, demonstrating that the same primary gene defect in tau can lead to 2 distinct clinical phenotypes. Both individuals developed rapidly progressive disease in the third decade. Neuropathologically, the father presented with an extensive filamentous pathology made of hyperphosphorylated tau protein. Biochemically, recombinant tau protein with the P301S mutation showed a greatly reduced ability to promote microtubule assembly.

Adult↗
PubMed1999

Multiple sclerosis and non-communicating syringomyelia: a casual association or linked diseases?

Non-communicating syringomyelia (NCS) can be associated with different disease processes such as arachnoidytis, trauma or tumor. Approximately 12 cases, documented radiographically, of the association of non-communicating syringomyelia and multiple sclerosis (MS) have been described but their relationship remains obscure. In 3 patients with laboratory supported MS spinal magnetic resonance imaging (MRI) revealed a central cystic cavity. In 2 patients lesions on the spinal cord above the cavity were demonstrated. At 3-year follow-up in 1 patient, no change in the cavity was detected. Although 3 cases are insufficient for providing a definitive conclusion on the relationship between these two diseases, we suggest that demyelinating lesions have to be regarded as possible causes of spinal, asymptomatic cavities.

Adolescent↗
PubMed1998

Selective induction of cell-associated interleukin-1alpha in murine keratinocytes by chemical allergens.

Cytokines may be useful tools to discriminate between irritant and allergic contact dermatitis. In the mouse only, it has been demonstrated by other, that contact sensitizers up-regulated keratinocytes-derived interleukin-1alpha (IL-1), macrophage inflammatory protein-2 and interferon induced protein 10 mRNAs. The purpose of this study was to investigate the possibility to use in vitro IL-1 production by a murine keratinocyte cell line for preliminary screening of chemicals for their irritant and/or allergic potential. We investigated the effects of five relevant skin allergens (dinitrochlorobenzene, oxazolone, nickel sulfate, penicillin G and eugenol), two skin irritants (benzalkonium chloride, and methylsalicilate) and two compounds with no sensitizing activity (glycerol and ethanol) on IL-1 production in HEL30 cells. Twenty four hours following treatment, both IL-1 release in conditioned media and cell-associated IL-1 were measured by a specific sandwich ELISA. Under our experimental conditions, only contact sensitizers were able to increase in a dose dependent fashion cell-associated IL-1, confirming the in vivo findings. Both skin irritants and allergens induced the release of IL-1, because of the irritative properties of both chemicals, while ethanol and glycerol failed to induce changes in IL-1 production, confirming the specificity of the proposed test. Taken together, these data indicate that it may be realistic to consider potential skin allergens those chemicals which are able to increase cell-associated IL-1, to consider skin irritants those chemicals which induce only IL-1 release, and to exclude as potential allergens or irritants those chemicals which fail to induce changes in IL-1 production.

Allergens↗
PubMed1998

De novo status epilepticus as the presenting sign of neurosyphilis.

Although the incidence of seizures in neurosyphilis ranges from 14 to 60%, status epilepticus (SE) as a presenting complaint of neurosyphilis is definitely rare. A 44-year-old human immunodeficiency virus (HIV)-negative man with no history of epilepsy suddenly presented with acute mental confusion and was diagnosed as having a de novo complex partial nonconvulsive SE. Cerebrospinal fluid (CSF) findings, neuroimaging, and clinical course indicated that SE was the presenting symptom of an undiagnosed syphilitic meningovasculitis. The case is presented with a review of previous reports to emphasize the differential features and to underscore the importance of considering neurosyphilis among the possible causes of de novo SE.

Adult↗