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M Alves

Publications and source records attributed to M Alves.

At least 37 records · Page 2Linked to original sources

Somatosensory evoked potentials in the differential diagnosis between spinal cord compression and amyotrophic lateral sclerosis.

Spinal cord compression (SCC) often presents a similar clinical picture to amyotrophic lateral sclerosis (ALS). An early differential diagnosis is important because SCC is a potentially treatable clinical disorder. We carried out a longitudinal study of 43 patients with an initial diagnosis of ALS, in order to ascertain the percentage of patients with SCC, and to evaluate the usefulness of somatosensory evoked potentials (SEPs) in early diagnosis. Thirty-three patients had a final diagnosis of ALS and 8 of SCC. SEPs central conduction was abnormal in 3 ALS and 7 SCC patients, respectively (Fisher exact test, p < 0.05). We concluded that SEPs investigation is useful in the differential diagnosis between ALS and SCC patients with pure motor signs.

Adult↗

[Prejudices and traditions in nursing].

The authors try to identify the prejudices and traditions in nursing, thinking about the maintenance of the myths, stigmas and stereotypes throughout its history, facing the GADAMER's ideas.

Female↗

[Lumbar spinal stenosis. Significance of neurophysiologic tests].

The authors review Lumbar Spinal Stenosis discussing the diagnostic criteria, the etiopathogenesis, and clinical manifestations. Imaging and neurophysiological investigations are also discussed. EMG, Sensory Evoked Potencials and Motor Stimulation are described stressing their role in differential diagnosis. The therapeutic approach is briefly commented.

Diagnosis, Differential↗

[Neurophysiological methods for the diagnosis of genitourinary dysfunctions].

Genito-urinary function is a watershed field interesting several areas of medical concern. Neurophysiological studies allow objective assessment of central, peripheral and autonomic pathways in the nervous system contributing to topographical localisation of lesions. The authors describe different methods used, namely somatosensory evoked potentials by pudendal nerve stimulation, bulbo-cavernous reflex, cutaneous sympathetic reflex, transcranial cortical or spinal magnetic stimulation and single fiber EMG. Abnormalities in neurological diseases are presented.

Anal Canal↗

[Carbon monoxide poisoning].

The authors present a case of acute carbon monoxide (CO) poisoning, with associated cerebral, spinal and peripheral nerve lesions. The spinal lesion observed in our patient is a rare condition and, the association between cerebral ischemic lesions and spinal and peripheral nerve lesions has not been previously described. In this case the spinal cord lesion is of hemorrhagic type as shown by MRI. The authors discuss the possible mechanisms implied in each type of lesion.

Adolescent↗

Neurologic involvement in patients with rheumatoid arthritis with atlantoaxial subluxation--a clinical and neurophysiological study.

Anterior subluxation of the atlantoaxial joint (AAS) is a frequent and potentially serious complication of rheumatoid arthritis (RA). The results of neurological evaluation, obtained in 30 patients with RA with AAS, and of somatosensory evoked potentials (SEP) studies, accomplished in 25 of these patients, were compared with the findings observed in 20 patients with RA without AAS, all of whom underwent neurological evaluation and SEP studies. Abnormal plantar responses were found only in patients with RA with AAS. There were more frequent SEP abnormalities in patients with RA with AAS than in patients without AAS, namely increased latencies of the N13 potentials evoked by stimulation of the median and radial nerves, which correspond to conduction delays at the cervical spinal cord level. A sensitivity of 56% and a specificity of 90% for SEP studies in the diagnosis of AAS in patients with RA were found. On the other hand, the observation that the mean values for the latencies of the N11 and N13 potentials evoked by stimulation of the radial nerves were significantly higher in patients with RA with AAS compared to patients with RA without AAS may suggest the existence of a frequent subclinical involvement of the cervical spinal cord caused by AAS.

Adult↗

[Familial amyloidotic polyneuropathy --Portuguese type-- clinical and neurophysiologic course].

Sixteen (16) patients with Familial Amyloidotic Polyneuropathy-Portuguese Type (FAP) were evaluated longitudinally, using the EMG and Clinical protocols with the aim of establishing the clinical and neurophysiological evolution rate of FAP. We conclude that spontaneous evolution of FAP patients shows a linear progression. Clinical and neurophysiological evolution times are parallel, with the EMG scores being higher than Clinical ones. We propose that Clinical and EMG scores should be used in the evaluation of future therapeutic trials, namely immunodepuration and liver transplantation.

Adult↗

Plasma catecholamines and postural hypotension in familial amyloidotic polyneuropathy of the Portuguese type.

Plasma adrenaline and noradrenaline levels were measured while supine and following head-up tilt to 45 degrees, in both normal controls and in patients with familial amyloidotic polyneuropathy of the Portuguese type. In nine patients systolic blood pressure fell by less than 15 mmHg, while in seven patients it fell by more than 15 mmHg. Plasma noradrenaline rose during tilt in the majority of patients, as in the controls. There was no correlation between levels of catecholamines and fall in blood pressure on head-up tilt. The data excludes widespread sympatho-neural failure as a cause for postural hypotension in familial amyloidotic polyneuropathy of the Portuguese type. The results are compatible with either segmental/patchy sympathetic denervation or dysfunction of the receptor/effector mechanisms in target organs such as the heart and blood vessels.

Adult↗

[Myocardiopathy caused by Portuguese-type familial amyloidotic polyneuropathy. Sequential morphologic and functional study of 60 patients].

AIM OF THE STUDY: To assess the cardiac involvement of familial amyloidotic polyneuropathy--Portuguese type (FAP) in a prospective study. INTRODUCTION: FAP is a sensitive, motor and autonomic familial polyneuropathy, due to amyloid deposits on nerve and vascular structures, related to abnormal transthyretin synthesis. FAP is a progressive systemic disease. The associated cardiomyopathy is well characterized in the Japanese form, but studies on FAP--Portuguese type cardiomyopathy remains controversial, regarding its occurrence and clinical and morphofunctional aspects. POPULATION: The Authors studied 60 Portuguese caucasoid patients, belonging to 55 different families: 23 women from 27 to 67 years old (m = 40.78 +/- 18.4) and 37 men, from 31 to 60 years old (m = 40.8 +/- 12.8). The diagnosis was established by characteristic clinical aspects, electromyograms and nerve or gut biopsies, positive for amyloid. Patients were classified in phases from I to VI according to the severity of neurological involvement and disability. METHODS: All the patients carried out clinical evaluation, thorax X-Ray, conventional EKG, Holter EKG (20-24 hours), M + 2D echocardiography and phonocardiography. Morphological and functional data were obtained from 85 echocardiographic recordings; special attention was paid to the evidence of structural abnormalities, evaluation of internal chamber dimension, left ventricular mass and systolic function indexes (left ventricular fractional shortening, left ventricular ejection fraction, left ventricular end-systolic stress index and Vcf). CONCLUSIONS: Suggestive aspects of pericardial and myocardial amyloid infiltration were found even in the earliest phases of the disease; all the records of patients in advanced phases (III to VI) were abnormal. The most frequent abnormalities founded were: a bright sparkling pericardial and myocardial echo pattern and increased ventricular wall thickness, with increased left ventricular mass index in 85% of patients in phases III to VI. Vcf was abnormally increased when plotted together with left ventricular end-systolic stress index, which was normal or decreased, probably reflecting "excessive" inotropism, in 1/3 of patients in phases III to VI. Systolic function was never depressed; no cardiac chamber enlarged. So, this study points out the presence of an infiltrative and/or hypertrophic cardiomyopathy in FAP--Portuguese type; suggestive aspects of diastolic dysfunction and decrease in systolic function were recorded. However, in the clinical setting of FAP, symptoms and signs like dyspnea, fatigue, oedema, may not be diagnosis of congestive heart disease.

Adult↗

Gastric infarction: a complication of selective vasopressin infusion.

This report describes a case of massive gastric hemorrhage, initially controlled by selective arterial vasopressin infusion. Infusion was followed by extensive necrosis of the gastric wall which necessitated subtotal gastrectomy. Gastric necrosis following arterial infusion is rare and in this case appears to be due to migration of the infusion catheter into a peripheral branch of the left gastric artery in a patient whose gastric circulation had been compromised by prior surgery. The complications related to the use of arterial infusion for the control of gastric hemorrhage are discussed and the literature is reviewed.

Angiography↗

[Not Available].

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Brazil↗