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Biomedical subjects

A Vidaller

Publications and source records attributed to A Vidaller.

At least 19 recordsLinked to original sources

[Endovascular treatment of carotid and pulmonary aneurysms in Behçet's disease].

Arterial aneurysm formation is a rare manifestation in Behçet's disease (BD). Aneurysm rupture is the main cause of death among BD patients. In recent years, endovascular treatment has been proposed as an effective and less invasive procedure compared with classical surgical treatment. We report the case of a 29-year-old man with BD who had two syncopes precipitated by pressure on a left cervical mass and hemoptysis. Cerebral magnetic resonance imaging (MRI) showed acute infarction of left basal ganglia. Other examinations demonstrated carotid and pulmonary aneurysms that were treated by endovascular methods. The patient received treatment with corticosteroids and immunosuppressive therapy. First of all, the pulmonary aneurysm was treated by means of coil embolization. After anticoagulant therapy was initiated, a covered stent was placed to exclude the carotid aneurysm at the level of extracranial internal carotid artery (ICA), with no immediate complications. After twenty-seven months of follow-up the patient remains asymptomatic. Endovascular treatment may be a definite therapeutic option for extracranial carotid aneurysms in BD, although longer term follow-up studies are needed.

Adult↗

[Geriatric information in the hospital discharge reports of patients over 65 years of age admitted to an Internal Medicine Department].

CONTEXT: The hospital discharge report (HDR) is a document that serves as a link between the hospital clinician and the primary care team. Our objective has been to evaluate the level of geriatric information in the HDR developed in the Internal Medicine Department of an tertiary care university hospital. Besides, the possible changes along the last 5 years were also evaluated. METHODS: HDRs of 1,000 patients over 65 years (500 in 1996 and 500 in 2001) and cared in the Bellvitge University Hospital were evaluated. Data relative to social, functional (qualitative and quantitative), and cognitive (qualitative and quantitative) assessment were collected. RESULTS: In 269 patients (27%) there was some kind of geriatric information in the HDRs. In the 2001 HDRs a significant increase in the percentage of social, qualitative functional and qualitative cognitive information was observed compared to 1996 HDRs. There were no significant differences upon comparing the subgroup of 269 patients with geriatric data in their HDRs with the subgroup of 731 remaining patients. CONCLUSIONS: The level of geriatric information in the HDRs is low. Care of elderly patients admitted to the Internal Medicine Department requires an additional evaluation on the part of all the professionals involved in their assistance, carrying out a global assessment that let a better knowledge of the patient. These evaluations should be part of the HDR.

Aged↗

Prognostic factors in leukocytoclastic vasculitis: a clinicopathologic study of 160 patients.

OBJECTIVE: To analyze risk factors for systemic involvement and long-term course in leukocytoclastic vasculitis. DESIGN: A clinicopathological study of 160 patients with leukocytoclastic vasculitis followed up for at least 3 years. Univariate and multivariate analysis were conducted by logistic regression methods. SETTING: The Bellvitge Hospital, a referral center in Barcelona, Spain. PATIENTS: One hundred sixty patients with cutaneous leukocytoclastic vasculitis. Patients in the categories cutaneous/systemic vasculitis and acute/chronic cutaneous vasculitis were selected for comparative analysis. MAIN OUTCOME MEASURES: Clinical, laboratory, and histopathological findings. RESULTS: Of 89 females and 71 males, aged 14 to 89 years, systemic involvement was documented in 20% of cases. Perinuclear-staining antineutrophil cytoplasmic autoantibodies were found in 21% of patients and cryoglobulins in 25.4%. Of the patients, 1.9% died of systemic vasculitis. The average duration of cutaneous lesions was 27.9 months. In 67.2%, a cause or associated condition was identified. Of the skin specimens, 59.6% showed vasculitis limited to superficial dermal vessels. Direct immunofluorescence was positive in 84.3% of cases. In the multivariate analysis, paresthesia, fever, and absence of painful lesions were found to be risk factors for systemic involvement. Cryoglobulins, arthralgia, and normal temperature were risk factors for chronic cutaneous disease. CONCLUSION: Our results identify prognostic factors in leukocytoclastic vasculitis and may provide some aid in the management of this heterogeneous group of patients.

Adolescent↗

[The involvement of the parenchyma of the central nervous system in Behçet disease].

INTRODUCTION: Behçet disease is a systemic form of vasculitis which presents with neurological symptoms with a frequency varying between 16 and 40%. Involvement of the parenchyma has been found to worsen the prognosis in patients with neuroBehçet (NB). OBJECTIVE: To review the clinical features and course of patients with NB involving the parenchyma of the central nervous system (CNS). CLINICAL CASES: Seven patients with Behçet disease and neurological localizing signs were seen in our hospital between 1989 and 1996. The initial diagnosis was of ischemic ictus in five of the seven patients. Both neuroimaging studies and investigation of the cerebrospinal fluid were always pathological in all cases. Vascular studies (arteriography and echo-Doppler of the supra-aortic trunks) were normal. One patient died. Four patients had serious sequelae following treatment. CONCLUSION: NB should be included in the different diagnosis of ictus. Involvement of the parenchyma of the CNS was accompanied by lymphocytic meningitis, perhaps also leading to a worse functional prognosis.

Adult↗

Autoantibody production in healthy elderly people is not promoted by interleukin-10 although this cytokine is expressed in them by a peculiar CD8+CD3+ large granular cell subpopulation.

Healthy elderly people tend to have autoantibodies in their sera. These antibodies, not being associated with any clinical manifestation, have been considered as natural autoantibodies. In systemic lupus erythematosus, as well as in rheumatoid arthritis, the presence of autoantibodies characteristic of these disease (anti-dsDNA and rheumatoid factor, respectively) depends on the endogeneous production of IL-10. The same could hold true for autoantibodies found in healthy elderly individuals. In the present work, the authors analysed whether an increased production of IL-10 contributed to the production of autoantibodies in elderly people. The authors found that there is neither increased in vivo gene expression nor augmented production of IL-10 by peripheral blood mononuclear cells from elderly women even if they do produce autoantibodies. The authors further sought to determine if the production of autoantibodies is inhibited in vitro by adding an anti-IL-10 MoAb to cell cultures and found that it is not. Despite these negative findings of a role for IL-10 in the production of autoantibodies in elderly people, the authors investigated which cells produce IL-10. In so doing they found that intracellular IL-10 expression occurred exclusively in monocytes in young female controls, but in elderly females it involved also CD8+CD3+ large granular cells. These results indicate that autoantibody production in healthy aged individuals is IL-10 independent.

Adult↗