[Guillain-Bare syndrome in a patient with tuberculous]. / Sindrom Giiena­Barre u bol'noi tuberkulezom.

The article reports on the rarest case of Guillain-Barré syndrome in the form of acute motor-sensory polyneuropathy in a female patient with tuberculous meningitis, disseminated pulmonary tuberculosis, and tuberculous pleurisy. In the neurological status at the exit from the coma, the patient was diagnosed with tetraplegia, bulbar syndrome, and respiratory disorders. Further, within a week, pronounced muscle atrophy appeared. Active etiotropic, pathogenetic therapy, including plasmapheresis, gave a dramatic effect with a significant improvement in the condition and a gradual regression of neurological disorders. The differential diagnosis was carried out primarily with critical illness polyneuropathy. The authors emphasize the rarity of the presented case: to date, such a combination of pathologies has never been described in the literature.

[A case report of central pontine and extrapontine myelinolysis in the combination with spinal cord damage in a patient with tuberculosis in the lung]. / Sluchai tsentral'nogo pontinnogo i ekstrapontinnogo mielinoliza v sochetanii s porazheniem spinnogo mozga u bol'nogo tuberkulezom legkikh.

A case report of central pontine and extrapontine myelinolysis in the combination with spinal cord damage is presented. The authors analyze literature data on this problem and discuss the pathogenesis and diagnostic issues of myelinolysis.

[Photomatrix LED therapy in patients with post-stroke arthropathy of the shoulder joint]. / Primenenie svetodiodnoi fotomatrichnoi terapii pri postinsul'tnykh artropatiyakh plechevogo sustava.

AIM: To assess the impact of quasi-monochromatic partially coherent infra-red radiation on the dynamics of recovery of the affected joint and the hemostatic system in patients with post-stroke arthropathy of the shoulder joint. MATERIAL AND METHODS: Fifty-five patients in the early, late and residual period of ischemic stroke were studied. Group I consisted of 27 patients who underwent 10 sessions of photomatrix therapy (wavelength 600 nm) on the affected joint, lasting for 10 minutes. In patients of group II (n=28), the duration of photomatrix therapy was 20 minutes. Patients of the comparison group (n=20) did not receive photomatrix therapy. RESULTS AND CONCLUSION: The results pointed to a significant reduction in the severity of pain, increase in the range of motion in the shoulder joint. All this was combined with a decrease in the severity of anxiety and depression, followed by a mild hypocoagulation effect and improvement of blood circulation in the paretic limb. The authors point out to the prospect of using this method for the prevention and treatment of post-stroke arthropathy.

Germline BAP1 mutations predispose also to multiple basal cell carcinomas.

The BRCA1-associated protein 1 (BAP1) gene encodes a nuclear deubiquitin enzyme which acts as a tumour suppressor. Loss of function germline mutations of BAP1 have been associated with an enhanced risk of uveal and cutaneous melanomas, mesothelioma, clear cell renal cancer and atypical cutaneous melanocytic proliferations. In two independent BAP1 families, we noticed an unusual frequency of basal cell carcinomas (BCCs). Indeed, 19 BCCs were diagnosed in four patients, either of superficial (13/19) or nodular (6/19) subtype; they were all located in chronic sun-exposed areas (limbs, head or neck). Immunohistochemistry (IHC) identified in the 19 tumours, complete or partial loss of BAP1 protein nuclear expression, restricted to the BCC nests. A control study was conducted in 22 sporadic BCCs in 22 subjects under 65 without known associated BAP1 tumours: no loss of BAP1 expression was found. Overall, our observations suggest that BCCs are part of the BAP1 cancer syndrome, perhaps in relation with chronic sun exposure and melanocortin 1 receptor (MC1R) variants. In conclusion, cutaneous follow-up of BAP1 carriers should not only aim to detect melanocytic neoplasms but also BCCs.

[The tuberculous meningoencephalitis in patients with later stages of HIV infection].

Based on the examination and treatment of 120 patients with tuberculous meningoencephalitis (TM) in the later stages of HIV infection, the differences between these patients and patients without HIV infection were found. HIV-infected patients with TM had a more acute disease onset, more clinical symptoms of encephalitis confirmed by magnetic resonance imaging of the brain, more frequent presence of mycobacterium tuberculosis in the cerebrospinal fluid and higher level of resistance to tuberculosis drugs. The morphologic study demonstrated the domination of necrotic and exudative reactions over productive inflammation with destructive abscess-type lesions in the brain matter. The mortality was more than 2 times higher than that in the control group.

[Cutaneous metastatic Crohn's disease]. / Manifestations métastatiques cutanées de la maladie de Crohn.

INTRODUCTION: Cutaneous metastatic Crohn's disease is a granulomatous inflammation of the skin that is noncontiguous to the gastrointestinal tract. CASE REPORT: A 42-year-old man with Crohn's disease is admitted for antibiotic resistant erysipela-like dermo-hypodermitis. The presence of granulomatous lesions on skin biopsy, the absence of any infectious agent identified despite extensive investigations and the dramatic improvement observed with corticosteroid eventually lead to the diagnosis of cutaneous metastatic Crohn's disease. CONCLUSION: During Crohn's disease, biopsy should be considered for every undiagnosed skin lesion as the characteristics of cutaneous metastatic Crohn's disease are not specific. The presence of a non caseous granulomatous dermal infiltration suggests the diagnosis and should make consider the initiation of corticosteroid and the discontinuation of others inappropriate therapeutics (i.e. surgical treatment, antibiotics).

[The distribution of tuberculin allergy among students in their 5th and 6th years at the University of Medicine and Pharmacy Iasi]. / Distributia alergiei tuberculinice la studentii din anul V si VI ai U.M.F. Iasi.

The authors studied the distribution of tuberculin allergy in a group of high TB risk, the students in last years of study of the Iasi University of Medicine. They are already BCG vaccinated. An infection prevalence of 18.6% was found--reactions over 18 mm, also a reaction of 10-17 mm was found at 62.2% of the students having 2-3 BCG scars. In the time of the present national BCG vaccination program there is need for new criteria for separating the two types of allergy: post BCG and post infection.

[A microepidemic of severe tuberculosis in a hospital for chronic neuropsychiatric patients]. / Consideratii asupra unei microepidemii de tuberculoza grava, într-un spital de neuropsihici cronici.

Details and considerations on a microepidemic of severe tuberculosis occurring in a hospital for chronic neuro-psychic patients are presented. This episode presents a practical interest by the knowledge of the circumstances of occurrence and progression, clinical-epidemiological features, associated favouring factors (immunodeficiency, absence of a sustained program for tuberculosis investigation) and biologic prophylaxis by BCG vaccinations and revaccinations. Several measures for avoiding such epidemics and, in prospect, of AIDS in the institutions at high risk are discussed.

[The risk of tuberculous infection on the territory of Iasi County in a 5-year period]. / Riscul de infectie tuberculoasa într-un teritoriu judetean pe o perioda de 5 ani.

The authors study the infection risk (IR) in the Iasi County, between 1983 and 1987, at the age of 6-7 years old, in relation to the evolution of tuberculosis incidence in children and to the bacillary incidence and prevalence. TR was maintained, in the period of study, at about 0.90%, thus corresponding to the bacillary incidence on the territory, on average of 39% inhabitants. Calculation of the contagiousness parameter of the contaminating sources showed that a source is infectious for about 13 children at 100,000 inhabitants. The findings above plead for the necessity of improving the county fighting program against tuberculosis.