RESUMO
To examine the impact of the plasma homocysteine level on the anti-atherosclerotic effects of pitavastatin treatment, we retrospectively examined 59 patients who had a history of stroke and had been prescribed pitavastatin for the treatment of dyslipidemia at the Neurology department of Toho University Ohashi Medical Center Hospital. The patients were classified into two groups according to their homocysteine levels. Carotid artery plaque progression was determined before and after pitavastatin treatment. Plasma levels of high-sensitivity C-reactive protein, platelet molecular markers, and von Willebrand factor were measured. Pitavastatin treatment had beneficial effects on the lipid profiles of these patients and slowed atherosclerosis progression. These effects were observed in both the high and low homocysteine groups. Proactive lipid intervention using pitavastatin may inhibit the progression of atherosclerosis and contribute to secondary prevention of stroke in high-risk patients. We conclude that this statin could inhibit progression at any stage of disease and should therefore be proactively administered to these patient groups, regardless of disease severity.
Assuntos
Homocisteína/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Quinolinas/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/tratamento farmacológico , Aterosclerose/patologia , Biomarcadores/sangue , Proteína C-Reativa/análise , Artérias Carótidas/diagnóstico por imagem , Demografia , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Ativação Plaquetária/efeitos dos fármacos , Quinolinas/farmacologia , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/patologia , Ultrassonografia , Fator de von Willebrand/análiseRESUMO
A 69-year-old woman presented with generalized myasthenia gravis and a left orbital cavernous hemangioma (OCH), which elevated the optic nerve and displaced the external eye muscles. Cyclosporine treatment induced a gradual size reduction in the OCH, and consequently contributed to improved external ocular symptoms in combination with immunosuppressant effects.
RESUMO
We report a 71-year-old man with legionellosis, who presented with abducens nerve palsy, singultus, confusion, memory impairment, ataxia, and hyporeflexia. Legionella pneumonia was diagnosed on the basis of detection of Legionella pneumophila antigen in the urine. The cerebrospinal fluid was negative for the antigen and antibody, but an oligoclonal band was detected, and the IgG index was elevated. It was speculated that an undetermined immune-mediated mechanism had contributed to the development of the neurological manifestations.
Assuntos
Legionelose/complicações , Legionelose/diagnóstico , Oftalmoplegia/complicações , Oftalmoplegia/diagnóstico , Idoso , Diagnóstico Diferencial , Humanos , Pneumopatias/complicações , Pneumopatias/diagnóstico , MasculinoRESUMO
Limb-girdle muscular dystrophy 2B and Miyoshi myopathy are characterized by muscle fiber necrosis caused by a defect in dysferlin and inflammatory changes. SJL/J mice are deficient in dysferlin and display severe inflammatory changes, most notably the presence of cytokines, which may be related to destruction of the sarcolemma. We tested the hypothesis that tumor necrosis factor (TNF) contributes to myofibril necrosis. Administration of etanercept, an agent that blocks TNF, resulted in dose-dependent reductions in inflammatory change, necrosis, and fatty/fibrous change. These findings indicate that TNF does indeed play a role in the damage to muscle in SJL/J mice and that etanercept has the potential to reduce such damage.
Assuntos
Imunoglobulina G/uso terapêutico , Inflamação/tratamento farmacológico , Proteínas de Membrana/fisiologia , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/imunologia , Distrofia Muscular do Cíngulo dos Membros/tratamento farmacológico , Receptores do Fator de Necrose Tumoral/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Modelos Animais de Doenças , Disferlina , Etanercepte , Inflamação/imunologia , Inflamação/patologia , Camundongos , Camundongos Knockout , Músculo Esquelético/patologia , Distrofia Muscular do Cíngulo dos Membros/imunologia , Distrofia Muscular do Cíngulo dos Membros/patologia , Taxa de SobrevidaRESUMO
We report on the case of a 32-year-old woman with tuberculous meningitis (TBM) with electroencephalogram (EEG) output displaying triphasic waves (TWs). The EEG on day 8 revealed generalized slowing, frontal bilateral TWs, a background of 2Hz delta waves, and no epileptiform activity. The patient's condition improved slowly with antituberculosis chemotherapy treatment. A follow-up EEG on day 34 showed marked improvement, with no TWs, background activity improved to a 12Hz symmetric alpha wave pattern, and no epileptiform activity, as before. To our knowledge, this is the first report of TWs observed in a TBM case.