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Biomedical subjects

F Regli

Publications and source records attributed to F Regli.

At least 307 records · Page 17Linked to original sources
PubMed1981

[Adult Listeria monocytogenes infections. Study of 10 cases and review of the literature].

Ten cases of adult L. monocytogenes infections were observed at the University Medical Center in Lausanne (Switzerland) during a 6 year observation period. There were 2 septicemias and 8 infections of the central nervous system. All the 4 patients with active neoplastic underlying disease died, against only one of those without neoplastic disease (76 years of age). In 5 cases the diagnosis of L. monocytogenes infection of the central nervous system was delayed because of the subacute evolution of meningeal signs or, in the absence of meningeal signs, because of the subacute evolution of neurologic deficits. Furthermore, examination of the cerebrospinal fluid often did not suggest bacterial infection, and the Gram stain showed Gram-positive rods in only one of 8 cases with documented L. monocytogenes central nervous system infection. The only sign common to all patients was fever of less than 39 degrees C. This suggests that L. monocytogenes infection should be carefully considered in every patient with neurological symptoms and fever.

Adult↗
PubMed1981

[Crural and lumbar plexus neuropathies under anticoagulant treatment].

Thirteen cases of crural or, less often, lumbar plexus neuropathies are reported which were secondary to hematomas in patients under anticoagulant therapy. They are the most frequent peripheral neurological complications of anticoagulant therapy. The clinical symptoms, which often point directly to the diagnosis, are discussed and several additional investigations (conventional X-ray, transverse tomography, EMG, etc.) are presented. The criteria for prognosis and therapeutic problems, in particular the indication for surgical drainage of the hematoma or for neurolysis, are discussed. Finally, the pathogenic mechanisms of these neuropathies are outlined.

Abdomen, Acute↗
PubMed1981

[Neurovegetative function tests: clinical importance and physiological aspects].

Evaluation of autonomic defects in polyneuropathies or diseases of the central nervous system is assuming increasing importance. Five simple non-invasive cardiovascular tests are described: an orthostatic test taking account of changes in arterial blood pressure, the orthostatic test of Ewing, the Valsalva maneuver, sustained handgrip, and heart beat to beat variation. The physiological mechanisms involved in each test, the need to bear in mind failure of the effector organs (cardiovascular system) and also the effect of medication are discussed. Finally, the beat to beat variation expressed as the coefficient of variation and as the meansquare successive difference, measured in 32 healthy subjects, are suggested as reference values.

Adult↗
PubMed1981

[Changes in autonomic functions in diabetic neuropathy: cardiovascular reflexes and sweating].

Failure of autonomic functions in diabetes has been investigated. Cardiovascular reflexes, and thermoregulation during heat exposure, were studied in 11 diabetic patients. Five had clinical signs of sensorimotor neuropathy and 6 served as age- and sex-matched controls. The subjects were studied by the following tests: orthostatic test, Valsalva, beat-to-beat variation during normal and forced respiration, and analysis of urinary catecholamines. Thermoregulation was measured for 80 minutes, at an ambient temperature of 37 degrees C, in a gradient layer direct calorimeter measuring evaporative heat losses with a precision of +/- 1 watt. The cardiovascular tests showed a relationship between the sensorimotor defects and the autonomic dysfunctions. The beat-to-beat variation was found to be the most sensitive test, the Valsalva and orthostatic test being respectively less so. However, the diabetic patients' autonomic disorders were not associated with a significant decrease in evaporative heat losses. The internal temperature (esophageal) at which sweating began (set point) was higher in some of the neuropathic diabetics than in the controls. Once the set point had been reached, however, the increase in evaporative heat losses was greater in diabetics than in controls. These findings can be accounted for by zones of compensatory hypersweating in patients with polyneuropathy. The changes in evaporative heat loss pattern may represent an early alteration in autonomic diabetic neuropathy.

Adult↗
PubMed1981

Postanoxic myoclonus. Treatment of a case with 5-hydroxytryptophane and a decarboxylase inhibitor.

Postanoxic myoclonus was first accepted as being related to a dysfunction of the ventrolateral thalamic nucleus. Several stereotaxic studies have invalidated this hypothesis. The neurochemical approach, in particular the measure of 5-hydroxyindolacetic acid in the cerebrospinal fluid, has opened new theoretical and therapeutic possibilities involving serotoninergic pathways. A typical case is presented who improved markedly under a combined therapy with 5-hydroxytryptophan and a decarboxylase inhibitor. A review of the pathogenesis and therapeutic approach to postanoxic myoclonus is presented.

5-Hydroxytryptophan↗
PubMed1981

Immersion and venous occlusion plethysmography in patients with idiopathic orthostatic hypotension.

In 3 patients suffering from idiopathic orthostatic hypotension (Shy-Drager's syndrome) venous distensibility was measured by occlusion plethysmography in supine and upright position. In this latter position, venoconstriction was absent, contrasting with the marked venoconstriction observed in normal volunteers studied under identical conditions. Venous occlusion plethysmography therefore seems to be useful to detect the autonomic defect leading to venous pooling. These patients were also immersed in water to the mid-abdomen while standing. This maneuver fully abolished orthostatic hypotension. Immersion is useful in motivating these patients to accept treatment by counterpressure garments, and makes early active physiotherapy possible.

Aged↗
PubMed1981

[Cerebral amyloid angiopathy. A clinicopathological study (author's transl)].

A case with repeated cerebral hemorrhages associated with severe cerebral amyloid angiopathy (CAA) is reported. CAA may be considered a rare but important cause of cerebral hemorrhages and of local cerebrovascular lesions in the aged. The morphological and ultrastructural characteristics of CAA are discussed. The etiology is still unknown; probably more than one mechanism may be involved.

Aged↗
PubMed1980

[On the etiology of syndromes of dementia (author's transl)].

Some new aspects of dementia are discussed. It is emphasized that the idea of dementia as a primary entity is obsolete. The following classification is proposed: dementia as a sign of a (still) unknown illness; dementia is a sign of a known, but not yet treatable illness and dementia as a sign of a known and also treatable illness. The differential diagnosis of the last group is described. Finally, some tests are proposed for the examination of demented patients to diagnose early treatable illnesses.

Alcoholism↗
PubMed1980

[The Creutzfeldt-Jakob disease. Clinical, epidemiological, pathogenetic and aetiological aspects (author's transl)].

Creutzfield-Jakob Disease is a kind of fatal progressive dementia in adults with cerebellar, extrapyramidal and corticospinal signs leading via decerebration to death within an average period of 7 months. EEG and biopsy of the brain are the only diagnostic means of significant importance. Neuropathologically, there are spongiform changes with loss of neurons and gliosis. The epidemiological conditions are complicated and indicate that certain families and population groups are preferred. Together with kuru and two veterinary diseases, namely, scrapie and transmissible mink encephalopathy, Creutzfeld-Jakob disease forms a group of subacute spongiform encephalopathies. The diseases in this group are infectious diseases without inflammatory reaction, which are caused by a "slow virus" with unconventional properties. The successful transmission of this disease to laboratory animals has contributed towards an understanding of these aetiological and pathogenetic correlations and has also opened up new diagnostic perspectives. However, the natural mode of transmission of Creutzfeld-Jakob disease remains largely unknown. Since it has been established that some cases were definitely iatrogenic, importance is attached to measures which must be taken when treating suspicious demented patients.

Biopsy↗
PubMed1980

Oligodendrocyte-binding antibodies in multiple sclerosis: 125I-protein A studies.

Sera from patients with multiple sclerosis (MS), patients with neurologic diseases other than MS, controls (adult and newborn), and rabbits immunized with bovine oligodendrocytes were assayed for antioligodendrocyte antibodies by a binding test with 125I-protein A. The mean binding of 125I-protein A to oligodendrocytes was similar in MS and non-MS sera, but both were significantly higher than binding in controls. A hundredfold increase of 125I-protein A binding over the preimmune value was obtained with a rabbit antioligodendrocyte antiserum. Oligodendrocyte-binding antibodies measured with 125I-protein A do not appear to be a distinctive feature of MS.

Adult↗
PubMed1980

[Positron emission computed tomography and cerebrovascular disorders: significance and principles of the technic, first applications in cerebrovascular diseases].

Positron emission computed tomography is a new technic allowing to map the functional state (metabolism and circulation) of a given human organ. By using the coincidence detection of annihilation radiation emitted by positron emitting radionuclides and applying the three-dimensional reconstruction technic to the regional radionuclide distribution in the tissue, it yields an image of the distribution of a previously administered radionuclide in any desired transverse section of the body and allows through already developed mathematical models the precise measurement of local values of metabolism and circulation. This approach appears to be especially promising for the study of the nomal and diseased brain. It circumvents many of the problems of conventional radionuclides and detection systems. Principles, interest and first results of the technic in relation to cerebrovascular problems are presented.

Blood Volume Determination↗
PubMed1980

[A syndrome of visuo-verbal and visuo-gestural disconnexion. Optic aphasia and optic apraxia (author's transl)].

A 71 year-old female patient was investigated during several months after a double left hemispheric lesion of vascular origin. The larger lesion was temporo-occipital, the second one parietal. The main neurological disorder was a right homonymous hemianopia. Clinical and neuroradiological data confirmed the integrity of the right hemisphere. There was neither a global deterioration of intellectual capacities nor aphasia. In particular, visual agnosia was excluded by a series of matching and functional classification tests. Nevertheless the objects and their pictures, which the patient could recognize, could not be named. The lack of words was limited to the visual modality. No apraxia neither ideomotor nor ideational was present on verbal commands, but the evocation of movements for the use of objects was deficient if the stimulation was visual. This disorder is considered in the frame of the visual-gestural disconnection and thus represents what we propose to call visual apraxia. Further we discuss the disorders of constructive apraxia which are characterized by the poor reproduction of models when executed by the right hand whereas the reproduction by the left hand is incorrect.

Aged↗