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Biomedical subjects

J M Prieto

Publications and source records attributed to J M Prieto.

At least 37 records · Page 2Linked to original sources

[3 year survival in patients hospitalized for acute cerebrovascular disorders].

For three years we studied the mortality and functional situation of all patients admitted in 1991 to the Neurology Service suffering from acute stroke with the exception of subarachnoid haemorrhage cases. We analyzed the cause of death whether directly related to the initial illness or not. Out of 134 patients admitted for acute stroke, 48 (41.02% of the 117 patients examined after excluding 17 whom we did not obtain complete information from) had died after three years. The main causes of death were directly related to acute stroke (37.5%) and pneumonia (37.5%). Death occurred mainly in the first month (79.16% of deaths). Predictive variables for mortality directly related to acute stroke during the first month include severe weakness, brain haemorrhage, dysphasia and earlier incidence of acute stroke. Variables related to higher mortality rate due to other causes in the first month were dysphasia, age and angina antecedents, whereas earlier incidence of acute stroke was associated with a lesser mortality rate for these causes, as distinct from acute stroke itself. Greater levels of weakness and sphincteral incontinence are the best predictive signs of dependency functional situation at the end of the first month and, along with diabetes, after one and three years.

Acute Disease↗

Physical and psychosocial functioning of 117 survivors of bone marrow transplantation.

All surviving patients receiving a BMT at our center since 1976 were surveyed. Among 163 eligible patients, 145 were contacted and 117 (81%) responded. Their median follow-up was 55 months (range 6-154). The research instruments consisted of a demographic questionnaire, a current medical status form, a quality of life questionnaire (Nottingham Health Profile), and a screening instrument for psychiatric morbidity (the 28-item version of the General Health Questionnaire). Current functioning varied considerably across patients. They reported a high use of medical services (37%) and varied ongoing medical problems within the last 6 months. Most of them (93%) received Karnofsky ratings of 80 or above. Eight percent had current chronic GVHD. Comparing our patients' quality of life with a British reference population, most important differences were found for physical mobility, work, and sex life. Psychiatric morbidity in BMT survivors was higher than in a Spanish general population. Multivariate analyses revealed that a higher systemic symptomatology score, a lower educational level, an older age at BMT, a shorter time post-BMT, a female gender, and impotence were significant predictors of an impaired overall quality of life. Similarly, a higher systemic symptomatology score, a shorter time post-BMT, a higher number of major infections, and a lower educational level were predictive factors of a higher psychosocial distress. No differences in quality of life or psychosocial status between allogeneic and autologous transplants were found. Quality of life and psychosocial distress improved with the passage of time, specially within the first 3 years.

Adolescent↗

[Changes in neuroexcitatory amino acids during and between migraine attacks].

We studied changes in plasma levels of neuroexcitatory amino acids during and between migraine attacks in 16 patients with migraine without aura, 11 with aura and 21 controls. Glutamic acid levels between attacks were 1.027 +/- 0.60 and 0.890 +/- 0.41 mg/dl in migraine patients without and with aura, respectively; during attacks the levels were 0.535 +/- 0.23 and 0.601 +/- 0.20 for the same patients. The concentration of glutamic acid in the control group was 0.980 +/- 0.64 mg/dl. Aspartic acid levels between attacks in patients without and with aura were 0.179 +/- 0.04 and 0.167 +/- 0.03 mg/dl. Concentrations during attacks were 0.129 +/- 0.02 and 0.119 +/- 0.02 mg/dl for the same patients. Plasma levels of aspartic acid for controls were 0.146 +/- 0.03 mg/dl. We found no significant variations in neuroexcitatory amino acids between migraine attacks in patients with an without aura; changes took place only during attacks, possibly related to the mechanisms of the spreading depression process.

Adult↗

Magnetic resonance imaging of muscles in myotonic dystrophy.

The MR findings in 27 patients with myotonic dystrophy were compared with those observed in 11 patients with other muscular dystrophies: six with limb-girdle dystrophy, three with facioscapulohumeral muscular dystrophy and two with Becker-type muscular dystrophy. Clinical status was graded into 10 stages. The MR study was performed at the medium third of the thigh, with a slice thickness of 7.5 mm (TR: 750/TE: 25 for T1; TR: 2200/TE: 30/90 for DP/T2). Muscle signal intensity was evaluated with a four-point grading scale using subcutaneous fat as a reference. Statistical analysis was done using the Mann-Whitney-Wilcoxon's test and simple linear regression. In the myotonic dystrophy group, 81.4% of the patients showed an abnormal signal at the crural muscle level, adopting a semilunar shape around the anteroexternal side of the femur. The presence and intensity of this hyperintense signal correlated positively with the duration of disease (r = 0.54) and the clinical stage (r = 0.69). Of the 11 patients with other muscular dystrophies, only three (27.2%) showed hyperintense signal at the crural muscle level. MR imaging of patients with muscle disease may contribute to the in vivo study of muscular dystrophy, its differential diagnosis and the detection of asymptomatic patients.

Adolescent↗

Platelet-rich plasma serotonin levels in tension-type headache and depression.

We measured platelet-rich plasma (PRP) serotonin in patients suffering from tension-type headache, before and after treatment with amitriptyline, comparing them with a healthy control group and patients with untreated depression. We evaluated the severity of headache and depression in each group. PRP serotonin levels were higher in patients with headache than in controls and depressed patients. We observed a fall of PRP serotonin in patients with tension-type headache to similar levels after treatment as the depressed group. This fall was correlated with the improvement of headache but not with depression scales. Our data suggest that the rise of platelet serotonin levels in tension-type headache is related to pain and not depression.

Adult↗

Taurine levels in plasma and cerebrospinal fluid in migraine patients.

Taurine is the amino acid with the highest concentration in the human body. Its physiologic functions are not yet well understood. As a neurotransmitter or neuromodulator it may display inhibitory functions. We have measured taurine levels in plasma and cerebrospinal fluid of migraine patients during attacks, comparing them with controls. Patients with migraine had significantly higher concentrations than controls. No sex or age influence over the amino acid levels were observed. Plasma taurine levels in patients with classic migraine correlated negatively with severity of headache. Central taurine liberation during migraine crisis may be due to spontaneous depolarization or a defensive reaction in the context of cerebral homeostatic processes.

Adolescent↗

[Magnetic resonance of the brain and Achilles tendon in cerebrotendinous xanthomatosis].

We report a 31 year old patient with cerebrotendinous xanthomatosis who presented with dementia, tendinous xanthomas, cataracts, pyramidal involvement, cerebellar ataxia and peripheral neuropathy. Cerebral CT scan demonstrated diffuse hypodensity in the white matter in both cerebellar hemispheres while MR detected additional focal alterations in both frontal lobes. MR study of the Achilles tendon showed a diffuse enlargement of the tendon with multiple areas of hypersignals in T1 and T2 demonstrative of the lipid deposits, interpossed between the isosignal zones that may correspond to the inflammatory reaction secondary to the accumulation of cholesterol and cholestanol.

Achilles Tendon↗

[Rhombencephalitis caused by Listeria monocytogenes].

The observation of an abscess in the brain stem and cerebellum due to Listeria monocytogenes is presented. The patient was a 55 year old diabetic, alcoholic, gastrectomized male in whom a febrile and meningeal syndrome developed. Three days later he had a progressive unilateral dysfunction of the cranial nerves. The cerebrospinal fluid showed pleocytosis of the polymorphonuclear cells, an increase in proteins and low glucose in relation with the glycemia. No parenchymatous lesion was observed upon emergency computerized tomography. Magnetic resonance imaging showed a hyper-signal lesion in the brain stem and cerebellum with a contrast enhancement in ring. Following antibiotic treatment the clinical evolution of the patient was favorable with slight focal sequelae persistent at discharge. A review of the epidemiology, clinical manifestations and treatment of this infection is carried out.

Encephalitis↗

[Biologic markers in multiple sclerosis (I). Clinical correlations].

Seven biological markers were studied in a population of 236 patients (144 females, 92 males) with multiple sclerosis as was the relation with the different degrees of diagnostic certainty (Rose and Poser scales), the time of evolution and number of bouts of the disease. The IgG concentrations, IgG ratio and the quantification of the intrathecal IgG synthesis by the Tourtellotte formula isolatedly constituted the most sensitive biological markers for the diagnosis of multiple sclerosis. Altogether, the determination of the number of cells, IgG and the IgG ratio achieved diagnostic sensitivity of 94% for defined multiple sclerosis. The IgG ratio was the most closely related biological marker related with the number of bouts and the time of evolution of the disease.

Adult↗

[Magnetic resonance in the evaluation of neurologic complications of cervical spondylosis].

The evaluation of the neurological complications of cervical spondylosis frequently requires contrast myelography. Magnetic resonance (MR) scan would appear as a good alternative approach. We report the MR findings in 12 patients with symptoms and/or signs of spinal cord and radicular disease associated with cervical spondylosis, and we compare them with the conventional studies, including CT and CT assisted myelography. The MR image, weighted in T1, permitted to visualize the compressed spinal cord in the sagittal planes in 4 cases, with enhanced spinal cord signal in 2 of them. In a patient with herniated C5-C6 disk, the sagittal sections directly demonstrated the herniated material in the spinal canal, displacing and compressing the spinal cord. The sequences weighted in T2 demonstrated the degree of stenosis of the cervical canal caused by extradural compression. In these images, the diminished signal of the nucleus pulposus was correlated with degeneration of intervertebral disks. MR was more sensitive than the other studies to detect discal degeneration and herniation, stenosis of the spinal canal, compression of the subarachnoidal space and spinal cord injury.

Aged↗

Isoelectric focusing patterns of some mammalian keratins.

An isoelectric focusing method followed by silver staining has been used for the study of keratins from a total of 97 individuals belonging to 17 families and 39 species. The method distinguishes perfectly between two different animal species. In addition, there are often considerable differences between breeds and even occasionally slight individual differences which in no way impede the identification of a particular species as such.

Animals↗

Topical anti-inflammatory lignans from Haplophyllum hispanicum.

The present paper reports the results of the methanol extract of Haplophyllum hispanicum Spach on single or repeated local 12-O-tetradecanoylphorbol acetate (TPA) administration and in the oxazolone-induced contact-delayed hypersensitivity mouse ear edemas. Two topical anti-inflammatory aryl naphthalide lignans were isolated from the active fractions of the methanol extract. They were identified by spectroscopic methods, including 13C NMR and heteronuclear multiple bond correlation (HMBC), as diphyllin acetyl apioside and tuberculation. The former was the most active on acute TPA edema with a ID50 of 0.27 mumol/ear.

Administration, Topical↗

[Headache secondary to carbon monoxide poisoning].

INTRODUCTION: Chronic intoxication due to carbon monoxide (CO) is a condition in which the frequency is underestimated since the clinical features are nonspecific. It is important since serious neurological sequelae may result: an extrapyramidal syndrome, dementia or a vegetative state. The diagnosis is established when there are venous blood levels of carboxyhemoglobin greater than 10%. Early treatment with hyperbaric O2 rapidly improves the symptoms and avoids the development of neurological sequelae. CLINICAL CASE: We report the case of a 30 year old woman who was admitted to hospital for investigation into two episodes of loss of consciousness with vomiting and subsequent somnolence not accompanied by other neurological sequelae. For the previous eight months she had had daily pulsatile biparietal headaches, sometimes accompanied by a fainting feeling, nausea and vomiting. During her admission she remained asymptomatic and all neurophysiological, cardiological and neuroimaging studies were normal. The day after medical discharge she returned with the same clinical condition. A woman who lived with her and accompanied her also complained of similar symptoms. Venous gasometry showed raised levels of carboxyhemoglobin in both the patient (30.4%) and her companion (31.2%). Treatment with hyperbaric 100% O2 reverted the symptoms within a few hours. Later studies showed that the domestic gas burner was faulty. CONCLUSIONS: Occult CO intoxication causes headache which often requires differential diagnosis from psychiatric disorders and episodes of migraine. In patients with refractory nonspecific headache, irregular course and systemic symptoms, usually in winter, CO intoxication should be considered to be a possible cause. Diagnosis is based on finding venous blood levels of carboxyhemoglobin of over 10%. Early treatment avoids lesion of the globus pallidus and irreversible extrapyramidal sequelae.

Adult↗