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J Montalbán

Publications and source records attributed to J Montalbán.

At least 19 recordsLinked to original sources
PubMed1995

Asterixis associated with anatomic cerebral lesions: a study of 45 cases.

INTRODUCTION: Asterixis is an uncommon sign in structural central nervous system disorders. When asterixis is present, one cannot rule out the possibility of a focal lesion, but it is almost always due to a metabolic encephalopathy. PATIENTS AND METHODS: In the last five years all patients with uni- or bilateral neurologic asterixis attended in our hospital have been studied. Cerebral computed tomogram or magnetic resonance imaging was performed in all patients with uni or bilateral asterixis. RESULTS: We describe 45 patients with different forms of structural cerebral pathology who presented unilateral (37 patients) or bilateral (8 patients) asterixis not associated to either toxic or metabolic disorder. Central nervous system ischemic or hemorrhagic disorders were found to be the most frequent causes of asterixis (95.5%) and the thalamus the most frequent localization for unilateral asterixis to result (54%). CONCLUSIONS: Bilateral asterixis is not always associated with toxic or metabolic disorders and it may be a sign of some structural neurologic alterations. A good correlation was found between the presence of unilateral asterixis and structural intracranial disease.

Adult↗
PubMed1994

Value of immunologic testing in stroke patients. A prospective multicenter study.

BACKGROUND AND PURPOSE: The aims of this prospective and multicenter study were to determine the frequency of anticardiolipin and antinuclear antibodies in an unselected ischemic and hemorrhagic stroke population and to evaluate the clinical significance of these autoantibodies. METHODS: Over a 1-year period, we collected plasma from 481 consecutive patients with ischemic or hemorrhagic stroke attending four different hospitals. Blood (10 mL) was drawn from each subject into a citrated glass tube. Plasma was obtained immediately by centrifugation and was stored at -70 degrees C until use. Concentrations of IgM and IgG anticardiolipin antibodies were measured at room temperature in normal (not heat-treated) plasma by standardized enzyme-linked immunosorbent assay. All sera were treated by indirect immunofluorescence on mouse liver and kidney sections for antinuclear antibodies. RESULTS: A total of 481 patients (325 men, 156 women) 16 to 90 years in age (mean age, 61 years) were studied. Anticardiolipin antibodies were present in 5 of 481 (1.04%) patients. One patient was IgG positive and four patients were IgM positive. Of 481 patients, 35 (7.2%) were positive for antinuclear antibodies. Anti-DNA antibodies were not demonstrable in any patient. CONCLUSIONS: The frequency of anticardiolipin antibodies in a heterogeneous stroke population is possibly lower than reported. The routine screening of anticardiolipin and antinuclear antibodies in a stroke population is of questionable value.

Adolescent↗
PubMed1994

[Neuro-Behçet].

Explore the source record for details and available documents.

Behcet Syndrome↗
PubMed1993

[Retinal periphlebitis in multiple sclerosis. A prospective study].

Twenty-four patients with clinically defined multiple sclerosis were prospectively studied with the aim of establishing the frequency of retinal periphlebitis. In three cases (12.5%) retinal periphlebitis was observed. None of the patients with multiple sclerosis and retinal periphlebitis presented a severe form or progressive course of the disease; however, in one patient it caused complete unilateral amaurosis. Aggressive immunosuppressive treatment was effective in one case. Given the absence of myelin in the retina, the presence of retinal periphlebitis suggests the existence of a vascular mechanism in the pathogenesis of multiple sclerosis.

Adult↗
PubMed1992

Lack of association between anticardiolipin antibodies and migraine in systemic lupus erythematosus.

We carried out a prospective study of the prevalence and characteristics of anticardiolipin antibodies (aCL) and migraine on 103 consecutive patients with systemic lupus erythematosus (SLE) derived from three European referral university centers. We also included a control group of 58 patients with migraine not associated with SLE. We interviewed all patients using a data collection form designed to provide a complete record of the clinical characteristics of headache. Fifty-four (52%) patients with SLE suffered recurrent headache. We diagnosed migraine in 32 patients, tension headache in 21, and cluster headache in one. Thirty (29%) patients with SLE had aCL. Migraine was present in five patients with aCL and in 27 patients without aCL (17% versus 37%, p = 0.07). No migraine control patient had aCL. Our study highlights the frequency of headache in SLE, but does not support an association between the presence of aCL and migraine in this disease.

Adolescent↗
PubMed1992

Neurokinin concentrations in cerebrospinal fluid. A preliminary study in Parkinson's disease.

Immunoreactive neurokinin A was measured in the cerebrospinal fluid of twelve patients with Parkinson's disease and eleven normal subjects, using a sensitive and precise extraction/concentration radioimmunoassay method. The mean value obtained in Parkinson's disease patients (13.2 +/- 4.6 pmol/l) was lower than that of the controls (17.4 +/- 5.9). The tendency toward a significant decrease (p = 0.085) found in this preliminary study could indicate that neurokinin A containing neurons are involved in the pathophysiology of Parkinson's disease. In addition, the establishment of reference values for neurokinin A in cerebrospinal fluid may provide a basis for further studies of this neuropeptide in neurological disorders.

Aged↗
PubMed1992

Antibodies against gangliosides in patients with SLE and neurological manifestations.

Pathogenesis of neuropsychiatric manifestations of systemic lupus erythematosus (SLE) has not been clearly defined, and the search for pathogenic mechanisms has focused on the importance of several autoantibodies. There is increasing evidence that antibodies against gangliosides may have a pathogenic role in some neurological disorders. The aim of the present study was to examine the association between antibodies against gangliosides and neuropsychiatric SLE. We found anti-type II ganglioside antibodies in two out of 32 patients with multiple sclerosis (6.25%) and in 10 out of 60 patients with SLE (16.6%); five of 17 patients with neurological abnormalities also had high levels of these antibodies (29.4%). Five of the 10 patients with SLE and positive antiganglioside antibody had only IgM antibodies, three had IgG antibodies and two had both isotypes. By chi-square analysis, the incidence of anti-type II ganglioside antibodies was not significantly higher in patients with symptoms related to the nervous system than in SLE patients without neurological involvement (P > 0.2). No clear correlation was found between antibodies against gangliosides and cardiolipin.

Adolescent↗
PubMed1991

[Pituitary apoplexy and empty sella].

Pituitary apoplexy (PA) is currently considered as one of the causes of empty sella (ES). However, in most reported cases the diagnosis of PA was based on anamnesis. A prospective study of three patients diagnosed during the PA episode was carried out. Periodical evaluations of hormone concentrations and cerebral computed tomography images were carried out. Initially, the three patients had a global anterior pituitary developed ES within 6 and 18 months. Surgical therapy was not undertaken in any case. Owing to the rarity of the disease definitive conclusions are difficult to obtain; however, the present study suggests that after an episode of PA global anterior pituitary failure develops, with subsequent ES. Early medical therapy with glucocorticoids can avoid surgical therapy.

Aged↗
PubMed1991

Antiphospholipid antibodies in cerebral ischemia.

In a 2-year prospective study of 146 patients with cerebral ischemia, we compared vascular risk factors for stroke with clinical and laboratory findings, particularly antiphospholipid antibodies. Ten patients (6.8%) were positive for at least one antiphospholipid antibody; one patient had systemic lupus erythematosus, one had rheumatoid arthritis, and the remaining eight fulfilled criteria for the diagnosis of primary antiphospholipid syndrome. These patients were predominantly male, not necessarily young, and 50% of them did not have any other vascular risk factors; there were no significant clinical or paraclinical differences between these patients and those without antiphospholipid antibodies. Outcome in the 10 patients was good, and platelet antiaggregating drugs proved to be useful in preventing further cerebrovascular ischemic events in our patients.

Arthritis, Rheumatoid↗
PubMed1991

Antiendothelial cell antibodies in patients with the antiphospholipid syndrome.

Antiendothelial cell antibodies (AECA) have been detected in 20 out of 30 patients (67%) with thrombosis associated with antiphospholipid antibodies. Seven patients had systemic lupus erythematosus and 13 had the "primary" antiphospholipid syndrome. Seven patients had both IgG and IgM AECA, 9 had IgG AECA only, and 4 had only IgM AECA. None of 30 control patients with thrombotic events not related to antiphospholipid antibodies had a positive titre of AECA (P less than 0.001). No correlation between AECA, antinuclear antibodies, anti-dsDNA antibodies, anti-neutrophil cytoplasm antibodies, precipitating antibodies to soluble nuclear and cytoplasmic antigens or complement components was found. The possible role of these AECA in the pathogenesis of thrombotic events is discussed.

Adult↗
PubMed1991

[Polymyositis as the first manifestation of acquired immunodeficiency syndrome].

We present a case of polymyositis (PM) in a patient with no previous relevant medical history, who had received blood transfusion four years ago during surgery. It could be demonstrated that the patient was HIV infected inspite the fact that he did not belong to any other high risk groups. PM was the clinical presentation form of HIV infection, the patient dying five months later due to a Pneumocystis carinii. The main clinical and histologic characteristics of PM in HIV infected patients are described as well as the main myopathies that these patients present.

Acquired Immunodeficiency Syndrome↗