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Biomedical subjects

F Coret-Ferrer

Publications and source records attributed to F Coret-Ferrer.

5 recordsLinked to original sources

[Axonal involvement in multiple sclerosis. Current concepts].

INTRODUCTION: Axon pathology in multiple sclerosis is an emerging concept, not because it is unknown but because it has been forgotten. However, clinical, functional and pathological aspects have clearly shown that it is damaged at a very early stage in development of the plaque of demyelination. There is sufficient clinical, radiological and pathological evidence to permit definition of axonal damage as the central element of the pathology and clinical features of multiple sclerosis. DEVELOPMENT AND CONCLUSIONS: Throughout this article we will see how the axon is affected in multiple sclerosis, how this affects the inflammatory response and which parameters allow us to measure axonal damage and its relation to disability. Finally we will see how a new physiopathogenic concept of multiple sclerosis appears, based on the axonal lesion, and how this fits current clinico-pathological concepts better.

Axons↗

[Differences in the spectroscopy of the lesions of the remitting relapsing form of multiple sclerosis shown by magnetic resonance].

INTRODUCTION: Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system, characterized by the presence of inflammatory lesions. OBJECTIVE: To analyze the biochemical profile of the demyelinating lesions of the initial forms of MS (remitting relapsing) by analyzing the proton magnetic resonance spectra (1H MRS) to characterize the process of demyelination and relate it to the metabolites and clinical variables analyzed. PATIENTS AND METHODS: We analyzed the largest demyelinating lesions in eight patients with remitting relapsing MS (RRMS) using the technique of single volume 1H MRS (VOI) with short echo time. The spectra of the white matter of two healthy control were used as reference. RESULTS: NAA/Cr and NAA/Cho value ratios decrease and mI/Cr one increase in all spectra lesions as compared to healthy controls. In four of the eight patients, the Cho/Cr was higher than in the controls. Qualitative and quantitative differences in the resonances of macromolecules were observed, related to the biochemistry of the process of demyelination. These differences in NAA/Cr, Cho/Cr, mI/Cr and macromolecules probably represent different stages in the evolution of the plaques. CONCLUSIONS: MRS is a non invasive technique able to observe biochemical variations related to the evolution process of demyelination. Activity of the lesion is shown by the increment of resonances around 0.9 1.3 ppm. An increase in mI seems to occur at an early stage of demyelination and later the NAA is reduced. The initial forms of MS show metabolic alterations in the plaques which are similar to the most advanced forms of MS.

Adult↗

[Pseudopolyneuritic symptoms with a medullary origin as the presenting symptom of multiple sclerosis].

INTRODUCTION: Myelopathy is, frequently, the first manifestation of a multiple sclerosis (MS), being the acute transverse mielitis, partial or incomplete, the habitual clinical syndrome. Other sensitive symptoms with an origin in the spinal cord as 'steroanesthesia', 'pseudo-athetosis' or 'pseudo-radiculopathy' have been described as unusual form of presentation in MS, but not the 'pseudo-polyneuropathy', perhaps in relation with its rapid progression in an acute transverse mielitis or other sensory pattern. CASE REPORTS: We presented two patients with a 'pseudo-polyneuropathy' pattern as the first manifestation of MS. In the two cases magnetic resonance imaging showed a cervical lesion of spinal cord with a probably inflammatory origin and other similar lesions in the brain. Neurophysiological studies were normal. We think that the 'pseudo-polyneuropathy' could be caused by an antero-lateral demyelinating process in the cervical spinal cord, with affectation of the anterior comissure and the ventral portion of lateral spinothalamic pathway. CONCLUSION: The 'pseudo-polyneuropathic' syndrome is uncommon form of presentation of MS in young people. We may be capable of recognize the 'pseudo-polyneuropathy' with spinal origin and early choose the appropriate complementary examinations for a correct diagnosis and therapy.

Adult↗

[Subacute uveomeningoencephalitis as the presenting symptom of acute infection by the human immunodeficiency virus].

INTRODUCTION: The uveo-meningitic syndrome, or the combination of chronic or recurrent meningitis and acute uveitis, has a specific differential diagnosis. This syndrome can be the clinical debut of systemic disorders, vasculophathies, connective tissue disorders and inmuno-mediated diseases. In patients with AIDS, the syndrome often appears in relation with an opportunist concomitant infection of the central nervous system (CNS). CASE REPORT: We present one case of subacute uveo-meningitic syndrome as symptomatic presentation of a early infection of HIV. The patient was a man, 37 years-old. He was inmunocompetent and did not know his seropositivity for HIV type 1. We relate the results of the neurologic examination and complementary tests. Only serologic test for HIV type 1 and detection of IgG anti-HIV in cerebrospinal fluid were positives. CONCLUSIONS: In patients HIV-positive the ocular infection, usually a posterior uveitis, appears together with systemic disorders or central nervous infections. In other hand, the cause of meningitic infection depends on grade of immunocompromise. Aseptic meningitis, for early stages of the disease, is usually no symptomatic. After, opportunist infections or neoplasic infiltration of CNS can be cause of meningoencephalitis. In this patient, the early infection of HIV causes an subacute uveomeningoencephalitis. Early infection of HIV increases the possibilities of aetiological diagnosis of uveomeningitic syndrome.

AIDS-Related Opportunistic Infections↗