RESUMEN
AIDS-related polyradiculopathy is a syndrome associated with cytomegalovirus infection. We report two cases of AIDS-related polyradiculopathy in which spinal T1-weighted MRI with gadolinium-DTPA showed enhancement of the pial lining of the conus medullaris, cauda equina, and lumbar nerve roots. Both patients clinically improved with ganciclovir treatment.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Citomegalovirus/complicaciones , Polirradiculoneuropatía/patología , Adulto , Medios de Contraste , Gadolinio , Gadolinio DTPA , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Compuestos Organometálicos , Ácido Pentético , Polirradiculoneuropatía/etiologíaRESUMEN
Skeletal muscle biopsies from five patients with severe myalgias, peripheral eosinophilia, and a recent history of L-tryptophan ingestion were analyzed. Perimysial inflammation, predominantly mononuclear with variable numbers of eosinophils was seen (in five of five patients), which was perineurial (in three of five) and perivascular (in five of five) in location. Grouping of the myofiber types was identified by enzyme histochemistry in two of four patients; fresh muscle for histochemical studies was unavailable from one patient. An occasional degenerating myofiber was seen in only one patient, who was still ingesting L-tryptophan at the time of biopsy. No vasculitis was seen. The focus of muscle injury in this syndrome appeared to be the perimysium and, in particular, the perineurial and perivascular connective tissue.
Asunto(s)
Eosinofilia/inducido químicamente , Músculos/enzimología , Enfermedades Musculares/inducido químicamente , Miositis/inducido químicamente , Neuritis/inducido químicamente , Triptófano/efectos adversos , Adulto , Anciano , Biopsia , Eosinofilia/enzimología , Eosinofilia/patología , Femenino , Histocitoquímica , Humanos , Masculino , Persona de Mediana Edad , Músculos/patología , Enfermedades Musculares/enzimología , Enfermedades Musculares/patología , SíndromeRESUMEN
Enactment of the federal Health Maintenance Act in 1973 set the stage for broad consumer protection and participation in health plan governance. HMO boards today are concerned with a much broader range of issues than in past years, such as the strategic direction of the company; its fiscal soundness; the morale and satisfaction of employees, members, and providers; the composition of its provider network; the methods of reimbursement to its providers; and issues related to cost, access, service and quality.