Peripheral artery occlusive disease in chronic phase chronic myeloid leukemia patients treated with nilotinib or imatinib.

Several retrospective studies have described the clinical manifestation of peripheral artery occlusive disease (PAOD) in patients receiving nilotinib. We thus prospectively screened for PAOD in patients with chronic phase chronic myeloid leukemia (CP CML) being treated with tyrosine kinase inhibitors (TKI), including imatinib and nilotinib. One hundred and fifty-nine consecutive patients were evaluated for clinical and biochemical risk factors for cardiovascular disease. Non-invasive assessment for PAOD included determination of the ankle-brachial index (ABI) and duplex ultrasonography. A second cohort consisted of patients with clinically manifest PAOD recruited from additional collaborating centers. Pathological ABI were significantly more frequent in patients on first-line nilotinib (7 of 27; 26%) and in patients on second-line nilotinib (10 of 28; 35.7%) as compared with patients on first-line imatinib (3 of 48; 6.3%). Clinically manifest PAOD was identified in five patients, all with current or previous nilotinib exposure only. Relative risk for PAOD determined by a pathological ABI in first-line nilotinib-treated patients as compared with first-line imatinib-treated patients was 10.3. PAOD is more frequently observed in patients receiving nilotinib as compared with imatinib. Owing to the severe nature of clinically manifest PAOD, longitudinal non-invasive monitoring and careful assessment of risk factors is warranted.

[Effects of dexmedetomidine on intracranial hemodynamics in severe head injured patients]. / Efectos de la dexmedetomidina sobre la hemodinámica intracraneal en pacientes con lesión encefálica traumatica grave.

Dexmedetomidine, an alpha 2 adrenergic agonist, with distinctive characteristics when compared to traditional plans, namely: conscious sedation, sympatholysis and lack of respiratory depression, represents an attempt to improve the sedoanalgesia of critically ill patients. OBJECTIVE. To study dexmedetomidine's effect on intracranial hemodynamic and hemometabolic parameters in severe head injured patients. MATERIAL AND METHODS. Prospective study on the effect of Dexmedetomidine on twelve severe head injured patients (Glasgow Coma Scale score

[Spinomedullary compression caused by neurinomas and meningiomas]. / Compresión radiculomedular por neurinomas y meningiomas.

A series of 30 spinal neurinomas and meningiomas studied in the Instituto de Neurología of Montevideo from 1958 to 1973 is analyzed. Seventeen neurinomas and 13 meningiomas are included. The following conclusions, in accordance with previous studies, were obtained from the clinical study and operative observations. Meningiomas were more commonly observed in females, in the sixth decade of life and were localized most frequently in the dorsal region. Neurinomas showed no preference for sex or site of the spine, and although they were more common in the sixth decade, they showed a greater dispersion in age. Clinical manifestations were similar in both groups but parasthesias were a more common initial symptom in meningiomas. Protein content of CSF was clearly greater in neurinomas. Radiological alterations of vertebrae were more frequently seen in neurinomas, but inespecific nature. Positive contrast mielography was in all cases useful for precise topographic diagnosis. Surgical results were satisfactory even in cases with severe preoperatory motor deficit.