Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report.
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Biomedical subjects
Publications and source records attributed to V Gallai.
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The authors describe the clinical and electrophysiological features in 2 cases of ponto-bulbar palsy with deafness, and the clinical course and post-mortem findings in a sibling of one of these, who died in infancy, and who appears to have suffered from the same disease. The cases are compared with 17 previously published cases, and the disease is discussed in relation to other progressive neurological diseases of childhood.
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We have clinically and genetically evaluated 24 affected patients belonging to 22 Italian Friedreich ataxia (FA) families, 52 patients from 32 kindreds with proven autosomal dominant cerebellar ataxia (ADCA), 9 patients belonging to 5 families with autosomal recessive hereditary ataxia (ARCA) and 103 sporadic cases, 89 of which affected by idiopathic late onset cerebellar ataxia (ILOCA). Genotype-phenotype correlation analyses in FA patients have evidenced an inverse relationship between GAA repeat expansion length and age of onset, disease duration, and presence of cardiomyopathy. Among autosomal dominant types, spinocerebellar ataxia 2 (SCA2) genotype has been found in 31% of our ADCA families, resulting the most frequent form of ataxia. Phenotypic analysis of the various SCA subtypes evidenced a marked heterogeneity of symptoms with a substantial overlap between different syndromes.
A multicenter 3-year follow-up study was carried out on young patients with headache referred to tertiary headache centers or pediatric clinics. Three years after the first examination in 1993, 442 (of an original sample of 719) young outpatients with headache (226 females and 216 males) were re-examined. The diagnostic criteria of the International Headache Society (IHS) and those modified for migraine without aura by Winner et al were applied at both the baseline evaluation and the 3-year re-examination. At the follow-up, 290 children still had headache, 101 were in clinical remission, and 51 had dropped out. Using the current diagnostic criteria, only 46.2% of patients having migraine without aura, 50% of those having migraine with aura, and 35.3% of those suffering from migraine disorders which do not fulfill IHS criteria for migraine received the same diagnosis at the time of follow-up. The percentage of patients receiving a diagnosis of migraine without aura rose significantly when new modified criteria were used (60.5%), whereas a drop in the frequency of migraine disorders not fulfilling IHS criteria was observed at follow-up, both in patients with the diagnosis of migraine without aura at the first examination (4.6%) and in patients with migraine not always fulfilling IHS criteria at the first examination (6.2%). Among all patients who received this latter diagnosis at the first examination, it was possible to make a diagnosis of migraine with aura at the follow-up in 8.8% of cases and that of migraine without aura in 26.5%. No significant variations in the frequency of either episodic tension-type headache or chronic tension-type headache were found, with the exception of a slight decrease in the percentage of tension-type headache which did not fulfill IHS criteria, but the difference between the first examination and the follow-up values does not reach the level of statistical significance (5% versus 12%). As far as the evolution of migraine is concerned, 17.4% of patients with migraine were headache-free at the 3-year follow-up. In tension-type headache, the percentage of patients who were headache-free was particularly high in those with the episodic form (32.9%) and in those suffering from tension-type headache not fulfilling IHS criteria (29.1%). The majority of patients who had been diagnosed as having unclassifiable headache at the first examination received a correct diagnosis at the follow-up with the exception of one patient. As observed in adult patients, variations in the headache characteristics were also observed in children and adolescents (that is, migraine with aura can change to migraine without aura, or the latter can transform into episodic tension-type headache or chronic tension-type headache can change into the episodic form). This follow-up study was aimed at reaching a better understanding of headache disturbances in children and adolescents, examining, in particular, variations of headache with time in this stage of life.
A study was conducted in 120 normal male subjects (age range 15-20 years) by testing the bulbo-cavernosus reflex (BCR). The mean latency +/- SD of the reflex was 32.9 +/- 0.7 ms. BCR latency values reported in subjects grouped according to age (15-20, 21-30, 31-40, 41-50, 51-60, 61-70) did not vary significantly for individuals between the ages of 15 and 50; whereas, the latency values for the older age groups (5th and 6th groups), were statistically significant. In conclusion, the authors attribute the increased latency associated with age to changes which occur in the fibres of the nerve pathways and emphasize the importance of collecting normative data according to age groups.
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The influence of dietary lipid components on fatty acids content of the sciatic nerve was studied in rats. Rats of both sexes were divided into three groups according to diet: 1. standard diet; 2. standard diet enriched with various seed oils; 3. colza oil-enriched diet. Six animals from each group (3 males and 3 females) were killed after 15, 30, 60 and 90 days, respectively, of controlled feedings. Their sciatic nerves were immediately removed and freeze-dried. Lipid extracts were prepared from each sample gas chromatography tests were made on the esterified fats. The results obtained show that there is a change in the fatty acids of the sciatic nerve lipids in rats on low fat diets, while the amount of phospholipids remains the same.
Motor conduction velocity of the median and posterior tibial nerves and sensory conduction velocity of the radial and sural nerves were examined in 45 uremic patients: 15 treated by hemodialysis (HD), 15 treated by combined peritoneal dialysis (CPD) and 15 treated as outpatients with peritoneal dialysis (CAPD). Motor and sensory conduction velocity were reduced in uremic patients treated by HD more than in those treated by CPD and CAPD; there were no significant differences between the last two groups.
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