RESUMEN
In the period between 18 October and 4 December 1994, 12 indigenous cases of cholera were registered in the southern Italian region of Puglia, 10 of them were diagnosed in our Departments of Infectious Diseases. All patients were infected by consumption of raw fish or mussels. The patients had an elevated mean age and most were affected with systemic pathologies. The clinical course was mild and rarely complicated, although frequently the characteristic riziform diarrhoea was absent. In all patients V. cholerae serotype Ogawa biotype El Tor, was isolated; one patient was co-infected by Salmonella typhi. All strains showed resistance to cotrimoxazole and tetracycline. Nine of ten patients were treated with oral ciprofloxacin at 1 g/day for 10 days resulting in disappearance of the symptoms within a median of 36 hours and negative fecal cultures within a median of 24 hours. Our data suggest that Italy is at high risk of infection imported from nearby nations. The resistance to commonly used antibiotics for treatment of cholera and the good response to ciprofloxacin suggest including fluoroquinolones among the drugs of first choice geographical areas involved in the circulation of resistant strains of V. cholerae O1.
Asunto(s)
Cólera/epidemiología , Adulto , Anciano , Antiinfecciosos/uso terapéutico , Cólera/tratamiento farmacológico , Cólera/etiología , Cólera/fisiopatología , Ciprofloxacina/uso terapéutico , Brotes de Enfermedades , Farmacorresistencia Microbiana , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Alimentos Marinos/envenenamiento , Vibrio cholerae/efectos de los fármacosRESUMEN
Alterations in sleep organization were longitudinally studied in 6 new cases of fatal familial insomnia (FFI) by 24 h polygraphic recording. All patients showed an early reduction in sleep spindles and K complexes, and a drastic reduction in total sleep time and disruption of the cyclic sleep organization. Complete abolition of NREM sleep and persistence of only brief residual periods of REM sleep without atonia were features characteristic of the 3 patients with a short (less than 1 year) clinical course, and lacking in the 3 cases with a longer (more than 2 years) disease course. In the latter, sudden transitions from waking to NREM or REM sleep occurred, sometimes recurring periodically. Our findings confirm that impairment of sleep-wake regulation is a consistent distinctive feature of FFI.
Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño/fisiopatología , Sueño/fisiología , Tálamo/fisiopatología , Vigilia/fisiología , Adulto , Electroencefalografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Trastornos del Inicio y del Mantenimiento del Sueño/genética , Factores de TiempoRESUMEN
We used a chronobiological inferential statistical method to investigate circadian rhythms of hypophyseal hormones, cortisol, melatonin and catecholamines in two females of the same family affected by fatal familial insomnia. Case 1 (confirmed at autopsy) presented an absent or progressive loss of circadian rhythms of all hormones. In case 2 there was a loss of GH circadian rhythm and a less significant rhythm for melatonin, catecholamines and gonadotropins. These results confirm the role of the thalamus in regulating hormonal circadian rhythm.
Asunto(s)
Aberraciones Cromosómicas/genética , Ritmo Circadiano/genética , Disautonomía Familiar/genética , Genes Dominantes/genética , Hormonas/sangre , Trastornos del Inicio y del Mantenimiento del Sueño/genética , Adulto , Trastornos de los Cromosomas , Ritmo Circadiano/fisiología , Disautonomía Familiar/sangre , Femenino , Humanos , Persona de Mediana Edad , Trastornos del Inicio y del Mantenimiento del Sueño/sangre , Tálamo/fisiopatologíaRESUMEN
This report describes the polysomnographic findings and the respiratory alterations during sleep in a 20-year-old patient with the Prader-Willi syndrome. Nocturnal recordings and a variant of the multiple sleep latency test showed excessive daytime sleepiness, sleep onset rapid eye movement episodes, snoring and sleep apnea. Treatment with nasal continuous positive airway pressure normalized the respiratory pattern and the sleep structure, except for rapid eye movement sleep onset. Whereas upper airway obstruction and obesity may explain the respiratory disorders, as shown by their resolution with continuous positive airway pressure treatment, hypothalamic dysfunction could play a role in the disruption of the normal nonrapid eye movement/rapid eye movement sleep periodicity.
Asunto(s)
Respiración con Presión Positiva , Síndrome de Prader-Willi/complicaciones , Síndromes de la Apnea del Sueño/etiología , Trastornos del Sueño-Vigilia/etiología , Ronquido/etiología , Adulto , Obstrucción de las Vías Aéreas/complicaciones , Obstrucción de las Vías Aéreas/terapia , Frecuencia Cardíaca , Humanos , Hipotálamo/fisiopatología , Masculino , Nariz , Respiración con Presión Positiva/métodos , Síndrome de Prader-Willi/fisiopatología , Síndromes de la Apnea del Sueño/terapia , Trastornos del Sueño-Vigilia/terapia , Sueño REM/fisiología , Ronquido/terapiaRESUMEN
The relationship between hypothalamic temperature and deep interscapular temperature measured just below the brown fat lobes has been studied during desynchronized sleep at two ambient temperatures (24 degrees C and 4 degrees C) before and after adaptation (9 days) to cold (4 degrees C). The results show that the increase in hypothalamic temperature during this stage of sleep occurs independently of a transfer of heat from interscapular brown fat.