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Biomedical subjects

F Bermejo

Publications and source records attributed to F Bermejo.

At least 55 records · Page 3Linked to original sources
PubMed1998

Primary progressive aphasia with glial cytoplasmic inclusions.

We report a 80-year-old woman who suffered from primary progressive aphasia for 3 years. Cranial CT and MRI studies showed moderate cerebral atrophy, more marked in the left frontal and temporal lobes, and SPECT brain scans revealed marked hypometabolism in the left frontal and temporal lobes. Neuropathologic examination of a temporal lobe biopsy demonstrated Gallyas-positive intracytoplasmic inclusions looking like fibrillary tangles and of Gallyas-positive cell processes, probably from glial cells. Glial intracytoplasmic inclusions were immunolabelled with antibodies to ubiquitin and with phosphorylion-dependent antitau antibodies, indicating the presence of hyperphosphorylated tau in the inclusions. There was only mild pathology of cortical neurons consisting in rare perikarya diffusely stained with antitau antibodies. There were no senile plaques, neurofibrillary tangles, 'achromatic' neurons, ballooned cells, Pick or Lewy bodies, nor microvacuoles or spongiform changes of the neuropil. The glial intracytoplasmic inclusions found in this case were similar to those found in multiple system atrophy, and differ from the cortical changes hitherto reported in primary progressive aphasia.

Aged↗
PubMed1998

[Diagnostic criteria of Parkinson's disease and their influence on the prevalence of this disease in population studies].

Parkinson's disease is one of the most frequent chronic diseases. Prevalence varies widely across geographic areas and studies. Although geographic variation could be produced by environmental factors, most of the studies have different methodology, and the diagnostic criteria which have been used are not homogeneous. Population-based door-to-door studies are an accurate method for determining disease frequency in a community. This paper analyses diagnostic criteria in Parkinson's disease and its influence on the prevalence estimated by this type of studies.

Adult↗
PubMed1998

[Paraneoplastic cerebellar degeneration with asymmetrical pan-cerebellar syndrome].

INTRODUCTION: Paraneoplasic cerebellar degeneration is seen clinically as a pancerebellar condition which is usually symmetrical. Different families of tumours are associated with this, particularly (in view of its frequency) oat cell pulmonary carcinoma, gynecological tumours and Hodgkin's lymphoma. CLINICAL CASE: Signs of cerebellar atrophy were seen on MR and cortical hypoperfusion was seen on Single Photon Emission Computerized Tomography (SPECT). We present the case of a 76 year old woman who presented with an asymmetrical pancerebellar disorder of gradual onset, with positive anti-self antibodies and undifferentiated carcinoma of the breast. CONCLUSIONS: Paraneoplasic cerebellar degeneration should be suspected in a patient with symmetrical, progressive cerebellar disease. The syndrome characteristically starts with a slightly uncoordinated gait. This progresses over a period of weeks or months to an ataxic gait with incoordination of the limbs, dysarthria and frequently nystagmus with oscilloscopy. No satisfactory treatment has been found for DCP in spite of trials with vitamins, corticosteroids, plasmapheresis and immunoglobulin infusion. Slight improvement may be seen after treatment of the primary tumour.

Adenocarcinoma↗
PubMed1998

[Omeprazole plus 2 antibiotics for the eradication of H. pylori, are 5 days of treatment sufficient?].

OBJECTIVE: Combinations of omeprazole plus two antibiotics for seven days have repeatedly been studied and high Helicobacter pylori eradication rates have been obtained, ranging from 80% and 90% in our country. Our objective was to verify whether length of such therapies (with omeprazole, metronidazole and clarithromycin or amoxicillin) can be shortened to five days with no loss of efficacy. METHODS DESIGN: randomized clinical trial. PATIENTS: forty-eight consecutive patients with duodenal ulcer were prospectively studied. The exclusion criteria were previous administration of antibiotics, bismuth or gastroerosive drugs, and associated diseases. During the initial endoscopy biopsy specimens from antrum and corpus were obtained (haematoxylin-eosin). Two therapies were administered for five days: omeprazole (20 mg/12 h) and clarithromycin (500 mg/12 h) plus metronidazole (500 mg/12 h) (n = 24) or amoxicillin (1 g/12 h) (n = 24). One month after therapy was completed a new endoscopy was performed, biopsy specimens were obtained, and the 13C-urea breath test was performed. Compliance of therapy was assessed by questioning the patient and counting the residual medication. DATA ANALYSIS: multiple logistic regression and "intention-to-treat" analysis. OUTCOME VARIABLE: eradication was defined as the absence of H. pylori by all diagnostic methods. RESULTS: Mean age +/- SD was 48 +/- 10 years, 73% were males. Twenty-three patients in each group completed the protocol and the distribution of investigated parameters was similar in both groups. Eradication was obtained in 91.7% (95% CI = 74%-98%) in the metronidazole group and 70.8% (51%-85%) in the amoxicillin group (chi 2 = 2.19; p = 0.13). In the multivariate analysis, OR for the effect of type of therapy on eradication was 4.5 (CI = 0.83-24.7; p = 0.077). No relevant secondary effects were reported. The most common secondary effect was a metallic taste of medication, which was perceived by half of patients in each group. CONCLUSION: The combination of omeprazole, clarithromycin, and metronidazole for only five days has a high eradicating efficacy (approximately 90%), similar to that obtained in previous studies with seven days of therapy. Nevertheless, the association of omeprazole, clarithromycin, and amoxicillin should probably be administered at least for one week to reach an optimal eradicating efficacy.

Amoxicillin↗
PubMed1998

[Central pontine myelinolysis associated with cyclosporin in liver transplantation].

Liver transplant is the only effective treatment in the terminal liver disease. However, the complexity of the surgical technique and immunosuppression cause many neurologic complications. Three liver transplant recipients treated with cyclosporine developed a reversible neurologic syndrome characterized by early dysarthria, which evolved to anarthria, and tetraparesis. Brain MRI disclosed hyperintense lesions, on T2, and proton density-weighted images, in basis pontis. The substitution of the cyclosporine for FK 506, or its reduction, led to the clinical improvement of the patients. Therefore, cyclosporine may cause central pontine myelinolysis, being dysarthria the first manifestation of neurotoxicity. The early recognition of speech disorders in liver transplant recipients that receive cyclosporine should prompt withdrawal of the drug to avoid possible neurological sequelae. Furthermore, the strict control of natremias before and after the transplant may help to reduce the incidence of this type of complications, since a synergyc osmotic mechanism cannot be ruled out.

Adult↗
PubMed1997

Decreased cerebrospinal fluid levels of neutral and basic amino acids in patients with Parkinson's disease.

We measured the CSF levels of 21, and the plasma levels of 26, amino acids in 31 patients with Parkinson's disease (PD) and in 45 matched controls. We used an ion-exchange chromatography method. When compared to controls, PD patients had lower CSF levels of taurine, alanine, valine, leucine, isoleucine, ethanolamine, citrulline, ornithine, lysine, histidine, arginine, and alpha-aminobutyric acid. PD patients not treated with levodopa or with dopamine agonists had higher CSF tyrosine and phenylalanine levels than those not treated with these drugs and also than controls. PD patients had higher plasma levels of phosphoserine, threonine, methionine, tyrosine, sarcosine and alpha-aminoadipic acid, and lower plasma levels of valine, leucine, and tryptophan, than controls. The CSF/plasma ratio of many of these amino acids was significantly lower in PD patients than those of controls, suggesting that PD patients might have a dysfunction in the transport of neutral and basic amino acids across the blood-brain barrier.

Adult↗
PubMed1997

Estimation of premorbid intelligence in Spanish people with the Word Accentuation Test and its application to the diagnosis of dementia.

The Word Accentuation Test assesses the accentuation of 30 infrequent Spanish words written without the accentuation mark and is an easy-to-use tool for estimating premorbid intelligence of Spanish-speaking people. Its intraobserver (0.97) and interobserver (0.93) reliabilities and its correlation with the Wechsler Adult Intelligence Scale (.837) and Raven's Progressive Matrices (.655) are high, offering a good prediction of general intelligence. It is resistant to mental deterioration; 20 demented and 40 controls matched by sex, age, and education obtained similar scores. The discrepancies between current and predicted scores in Raven's scale can diagnose mild-moderate dementia with 0.79 accuracy (sensitivity, 0.78; specificity, 0.82).

Aged↗
PubMed1997

Application of a Spanish version of the "Informant Questionnaire on Cognitive Decline in the Elderly" in the clinical assessment of dementia.

We studied the validity of a complete (S-IQCODE) and a shortened (SS- IQCODE) Spanish version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the diagnosis of dementia in a clinical setting. Fifty-three consecutive outpatients were assessed with an extensive workup and followed up for 6 months in a specialized clinic for the diagnosis and management of dementia. Thirty eight (71%) were finally diagnosed as demented. The Mini-Mental State Examination (MMSE) had a slightly greater diagnostic power than did the S-IQCODE and the SS-IQCODE (sensitivity 89% vs. 84% and 79%; specificity 80% vs. 73% for both; positive predictive value 92% vs. 89% and 88%; negative predictive value 75% vs. 65% and 58%), but without statistical significance. Both the S-IQCODE and SS-IQCODE were independent of previous education of the patients. The best diagnostic results were obtained when the cognitive scores of the patient in the MMSE and the report of the relative in the S-IQCODE were simultaneously considered. We conclude that the IQCODE, in a complete as well as in a shortened form, is a good diagnostic instrument in the clinical setting that can enhance the validity of other cognitive tests.

Adult↗
PubMed1997

Erosive duodenitis: prevalence of Helicobacter pylori infection and response to eradication therapy with omeprazole plus two antibiotics.

OBJECTIVES: To study the prevalence of Helicobacter pylori infection in patients with erosive duodenitis (ED), the associated gastric histological lesions and their response to eradication therapy with omeprazole plus two antibiotics. METHODS: A prospective study was made of 57 patients with ED (mean age 46 +/- 16 years, 72% males). At endoscopy, biopsies from gastric antrum and body were obtained for histological study (haematoxylin and eosin). A 13C-urea breath test was also performed. Omeprazole 20 mg twice daily plus two antibiotics (amoxycillin 1 g twice daily, clarithromycin 500 mg twice daily, metronidazole 500 mg twice daily) were administered for 1 week. Endoscopy and breath test were repeated 1 month after completing therapy, and the breath test was performed again at 6 months. RESULTS: All patients were H. pylori positive. Overall eradication was achieved in 86% (95% CI 75-93%). Duodenal erosion healing was obtained in 45 patients (79%). Healing was achieved in 86% (CI 73-93%) of cases with successful eradication therapy, but only in 3/8 (37%; CI 8.5-75%) patients with therapy failure (P < 0.01). In the multivariate analysis, H. pylori eradication was the only variable which correlated with erosion healing (odds ratio 10; CI 2-51; P < 0.01). Histological improvement, in both the gastric antrum and body, was demonstrated when eradication was achieved (P < 0.001). Six months after diagnosis H. pylori absence was confirmed in all patients with initial therapy success (all of them asymptomatic), and infection was confirmed in the eight patients who were H. pylori positive after therapy (six of them symptomatic). At 6-month follow-up, endoscopy was normal in 6/7 H. pylori-negative patients with previously persistent ED, while erosions were still present in 4/5 H. pylori-positive patients with previously persistent ED. CONCLUSION: A high prevalence (100%) of H. pylori infection in patients with ED was observed. A 1-week twice daily therapy with omeprazole plus two antibiotics (clarithromycin plus amoxycillin or metronidazole) was very effective in H. pylori eradication, duodenal erosion healing, symptomatic improvement, and in disappearance of associated histological gastritis. These observations suggest that ED should be considered a variant form of duodenal ulcer disease and treated accordingly; that is, with H. pylori eradication therapy.

Adult↗
PubMed1997

Respiratory chain enzyme activities in isolated mitochondria of lymphocytes from patients with Alzheimer's disease.

We studied respiratory chain enzyme activities in lymphocyte mitochondria from 33 patients with Alzheimer's disease (AD) and from 30 age- and sex-matched healthy controls. The respiratory chain enzyme activities did not differ significantly between patients and controls. No patient showed any value for respiratory chain enzyme levels below normal range. Values for activities of complexes in the AD group did not correlate with age at onset or duration of the disease. Our finding of normal mitochondrial function in lymphocyte mitochondria suggests that this tissue cannot be used to demonstrate the involvement of oxidative phosphorylation in AD and, thus, to develop a diagnostic test for AD.

Aged↗
PubMed1997

Prevalence of stroke in two samples (rural and urban) of old people in Spain. A pilot door-to-door study carried out by health professionals.

The aim of this study was to present the prevalence of stroke from a pilot study in old people. The urban site sample (Madrid) was made up of 397 subjects and the rural site sample (Arévalo, Avila) of 862 subjects. The study was performed with a door-to-door methodology. In the urban sample, the prevalence of stroke was 8.5% (CI 95% = 5.5-11.5%) and that of TIA was 2.1% (CI 95% = 0.6-3.6%). In the rural location the prevalence of stroke was 7.1% (CI 95% = 5.4-8.8%). This prevalence of stroke is higher than in other Spanish studies. These results need to be confirmed in a wider investigation.

Aged↗