Asunto(s)
Proteínas de Transporte de Catión/genética , Terapia por Quelación/métodos , Enfermedades Metabólicas/genética , Mutación/genética , Trastornos Parkinsonianos/tratamiento farmacológico , Trastornos Parkinsonianos/genética , Femenino , Humanos , Estudios Longitudinales , Enfermedades Metabólicas/complicaciones , Persona de Mediana Edad , Trastornos Parkinsonianos/complicaciones , Transportador 8 de ZincRESUMEN
Headache is a common Emergency Department (ED) problem accounting for 1.7%-4.5% of patients every year. The main aim in the ED is to differentiate between primary and secondary headache. Although secondary headache represents the lowest percentage (20%) of ED patients presenting with headache, it can be life threatening. Patients with primary headache require a follow-up programme on discharge from the ED with a specialist headache clinic taking responsibility for these patients. This procedure was applied at Ravenna Hospital ED for 2 years and recorded (unpublished data) a reduction in the number of repeat visits to the ED for headache and the number of inappropriate admissions for headache (DRG 25).
Asunto(s)
Atención a la Salud/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Cefalea/terapia , Clínicas de Dolor , HumanosRESUMEN
We report the effects of treatment with plasma-exchange (PE) and intravenous immune globulins (IVIg) in 36 out of 50 patients with Guillain-Barré syndrome (GBS) recruited by an incidence study in the Emilia-Romagna region of Italy. Comparison of the patients treated with PE and IVIg showed no significant differences in terms of effectiveness in improving the clinical course of GBS: at one month, respectively 11.1% and 25% had recovered, and 55.5% and 58.3% had improved by at least one grade. These results are in agreement with those of the Dutch GBS trial. No relapses were observed in either group. Moreover, our results showed no difference in clinical outcome at 1 and 3 months between the patients receiving only one therapy and those receiving two; a second cycle of therapy did not seem to improve the clinical course of the disease significantly. We conclude that PE and IVIg are both safe and effective therapies for GBS.
Asunto(s)
Inmunoglobulinas Intravenosas/uso terapéutico , Intercambio Plasmático , Polirradiculoneuropatía/terapia , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
The relationship between polyneuropathies and monoclonal gammopathies is well known even though the pathogenetic hypotheses are controversial. The role of autoantibodies against neural antigens has been recently underlined. 45 patients (29 M and 16 F), affected by multiple myeloma (MM) non-Hodgkin lymphoma (NHL) with paraproteinemia and monoclonal gammopathies of undetermined significance (MGUS)4, underwent an EMG study including SCV, MCV and late responses of several nerves, and a search for serum antibodies against neural antigens by immunoblotting assay. 19 out of 45 pts. tested positive to EMG and 15 out of 45 (10 MM and 5 NHL) showed a serological positivity. Among them 11 were positive to EMG too. The results confirm the hypothesis of a possible pathogenetic role of high-titer autoantibodies against neural antigens in cases of polyneuropathy.
Asunto(s)
Enfermedades Autoinmunes/etiología , Linfoma no Hodgkin/complicaciones , Mieloma Múltiple/complicaciones , Enfermedades del Sistema Nervioso/etiología , Paraproteinemias/inmunología , Adulto , Anciano , Anciano de 80 o más Años , Autoanticuerpos/sangre , Electromiografía , Femenino , Reflejo H , Humanos , Linfoma no Hodgkin/inmunología , Masculino , Persona de Mediana Edad , Mieloma Múltiple/inmunología , Proteínas del Tejido Nervioso/inmunología , Enfermedades del Sistema Nervioso/inmunología , Conducción Nerviosa , Paraproteinemias/complicacionesAsunto(s)
Magnoliopsida , Intoxicación por Plantas/etiología , Enfermedad Aguda , Adulto , Salud de la Familia , Femenino , Humanos , MasculinoRESUMEN
The relationship between monoclonal gammapathies and peripheral nerve involvement is well known. The pathogenesis of neuropathy has been ascribed to infiltrative, compressive, ischemic or haemorrhagic phenomena, to an amyloid storage or to antibody autoaggression toward neural antigens. Forty-five patients suffering from monoclonal gammapathy of uncertain significance (MGUS), multiple myeloma (MM), MG IgM, were submitted to a neurophysiological examination. 10 pts. were excluded because of neurotoxic drugs, diabetes or alcohol abuse. The investigation included SCV of median, ulnar, and sural n., MCV and F wave of peroneal n., H reflex, and computerized analysis of recruitment pattern. A subclinical neuropathy was found in 11 of 35 pts. (30%) without any neurological symptom. A CTS was found in 4 patients. The high rate of subclinical neuropathy in asymptomatic pts. is underlined by the Authors, while the presence of subclinical neuropathy in cases of MGUS needs further studies.
Asunto(s)
Paraproteinemias/complicaciones , Enfermedades del Sistema Nervioso Periférico/etiología , Anciano , Electrofisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/complicaciones , Paraproteinemias/fisiopatología , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Macroglobulinemia de Waldenström/complicacionesRESUMEN
Three familial cases of idiopathic hypertrophy of the masticatory muscles are reported. The muscular enlargement was noted in late childhood or early adult life, was bilateral, insidious, painless and non-progressive. Electrophysiological and laboratory findings were normal in one case. CT examination, performed in two cases, showed homogeneous bilateral enlargement of masseter muscle bulk consistent with true hypertrophy. Two patients also showed congenital malformations. A review of the literature showed that this disorder is very rare.
Asunto(s)
Músculo Masetero/patología , Músculos Masticadores/patología , Adolescente , Adulto , Humanos , Hipertrofia , Masculino , Músculo Masetero/diagnóstico por imagen , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
In four patients, calf muscular hypertrophy developed after the onset of sciatica. Hypertrophic muscles were weak and showed electromyographic signs of denervation. In all cases, calf muscle biopsy showed striking hypertrophy of type 1 and, especially, type 2 muscle fibers. This hypertrophy was associated with other signs indicating a neurogenic lesion. Muscle hypertrophy is a rare finding in neurogenic lesions. Stretch and exercise of muscle are probably the causative factors.
Asunto(s)
Enfermedades Musculares/patología , Ciática/patología , Adulto , Anciano , Enfermedad Crónica , Femenino , Humanos , Hipertrofia , Pierna , Masculino , Persona de Mediana Edad , Enfermedades Musculares/etiología , Ciática/complicacionesRESUMEN
Five cases of Shy-Drager Syndrome (SDS) are reported. All patients showed marked muscular wasting often with fasciculation and without sensory loss. Clinical, electromyographic and in one case, pathological findings in the spinal cord indicated a lesion at the level of the anterior born cell. An extensive review of the literature disclosed a significant number of cases of SDS displaying amyotrophy referable to a spinal lesions.