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1.
Eur Spine J ; 21 Suppl 1: S123-7, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22411038

RESUMEN

PURPOSE: To assess the usefulness of magnetic resonance imaging (MRI) with spin-echo echo-planar diffusion-weighted imaging (SE-EPI-DWI) in differentiation between vertebral osteoporotic fractures and pathological neoplastic fractures. MATERIALS AND METHODS: Thirty-three patients with both osteoporotic or neoplastic vertebral fractures diagnosed with X-ray or TC were studied with MRI exam, (1.5 T unit) with DWI sequences. DWI sequences were qualitatively analyzed. Apparent diffusion coefficient (ADC) values were also determined and compared to the definitive histologic diagnosis. RESULTS: DWI of neoplastic lesions showed hyperintensity signal in 22 out of 23 cases. Mean ADC value of neoplastic fractures was 1.241 ± 0.4 × 10(-3) mm(2)/s; mean ADC value of osteoporotic fractures was 0.646 ± 0.368 × 10(-3) mm(2)/s. Neoplastic fractures showed ADC values significantly higher than osteoporotic ones (p < 0.001). DWI imaging and histology showed a significant correlation. CONCLUSION: DWI provides reliable information to support MRI diagnosis of neoplastic versus osteoporotic fractures. ADC value appears as a useful adjunctive parameter.


Asunto(s)
Imagen de Difusión por Resonancia Magnética/métodos , Fracturas Osteoporóticas/diagnóstico , Fracturas de la Columna Vertebral/diagnóstico , Fracturas de la Columna Vertebral/etiología , Neoplasias de la Columna Vertebral/complicaciones , Vértebras Torácicas/lesiones , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fracturas Osteoporóticas/patología , Estudios Retrospectivos , Sensibilidad y Especificidad , Fracturas de la Columna Vertebral/patología , Vértebras Torácicas/patología
2.
Panminerva Med ; 40(4): 345-6, 1998 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9973835

RESUMEN

Mefloquine represents a promising antimalarial drug against Plasmodium falciparum. It has been related to an increase in seizure frequency in epileptic patients and should not be administered to patients with a history of convulsions, epilepsy in first degree relatives, or serious psychiatric disorders. We report a case of a man from the Ivory Coast complaining of fever, headache and anemia treated with chloroquine and subsequently with mefloquine in the suspicion of malaria, even in the absence of laboratory confirmation. When the patient came to our division, malaria was excluded, but the patient developed two convulsive episodes, respectively 4 and 7 days after the ingestion of the second therapeutic dose of mefloquine. Further investigation was performed; particularly an EEG showed abnormalities compatible with tendency for seizures, diffuse waves and spikes. CSF culture was positive for M. tuberculosis as well as urine, sputum and blood cultures. Anti-HIV antibodies were positive, so the final diagnosis was tuberculosis in HIV infection. As seizures are common signs of cerebral tuberculomas, but not of meningitis it is possible that tubercular meningitis might have enhanced severe neuropsychiatric side effects of mefloquine. Physicians should be aware that treatment with mefloquine with concomitant meningitis could have a risk of development of grand mal seizure.


Asunto(s)
Antimaláricos/efectos adversos , Epilepsia Tónico-Clónica/inducido químicamente , Mefloquina/efectos adversos , Tuberculosis Meníngea/fisiopatología , Adulto , Antimaláricos/uso terapéutico , Humanos , Malaria Falciparum/tratamiento farmacológico , Masculino , Mefloquina/uso terapéutico
3.
Panminerva Med ; 42(3): 197-9, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11218625

RESUMEN

BACKGROUND: Treatment of malaria represents a problem as antimalarial drugs are relatively few, and because of the increasing widespread resistance of Plasmodium falciparum to most of these drugs. A partial efficacy of azithromycin against Pl. falciparum hepatic stage and against trophozoytes in the erythrocytic stages of the disease has been demonstrated. No data concerning the activity against gametocytes are available, and primaquine stands as the only therapy against Pl. falciparum gametocytes. Primaquine causes haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, so primaquine therapy is usually avoided. A better tolerated therapy against gametocytes would be useful to reduce malaria transmission. We present the results of a study concerning the efficacy of azithromycin in the treatment of P. falciparum gametocytes. METHODS: A prospective study was performed: 4 patients with Pl. falciparum gametocytes (3 children, 1 adult) were treated with azithromycin for concomitant bacterial infections; in the meantime two children with gametocytes were taken as control. Azithromycin was administered as recommended. RESULTS: Gametocytes were detectable in children thick blood smears after 8, 5 and 6 days respectively after the beginning of azithromycin therapy, while they were undetectable in the adult thick blood smear 5 days after the beginning of the therapy. The gametocytes spontaneously disappeared in the two controls 4 to 6 days after the beginning of observation. CONCLUSIONS: These data suggest that azithromycin seems ineffective against Pl. falciparum gametocytes. Further studies are needed in order to determine whether azithromycin treated gametocytes are infective to mosquitoes or not, and to confirm this first observation.


Asunto(s)
Azitromicina/farmacología , Malaria Falciparum/tratamiento farmacológico , Malaria Falciparum/parasitología , Plasmodium falciparum/efectos de los fármacos , Animales , Antibacterianos/farmacología , Estudios de Casos y Controles , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Plasmodium falciparum/crecimiento & desarrollo , Plasmodium falciparum/aislamiento & purificación , Estudios Prospectivos
4.
Circulation ; 99(12): 1555-9, 1999 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-10096930

RESUMEN

BACKGROUND: Chronic Chlamydia pneumoniae and Helicobacter pylori infections could be a risk factor for ischemic heart disease (IHD), possibly by increasing fibrinogen levels. The aim of our study was to evaluate changes in fibrinogen level in patients with IHD and H pylori and/or C pneumoniae positivity randomly assigned to antibiotic treatment. METHODS AND RESULTS: Eighty-four patients with chronic IHD, H pylori and/or C pneumoniae antibodies, and normal acute-phase reactants were randomly assigned to treatment or no treatment. Treatment consisted of omeprazole, clarithromycin, and tinidazole in H pylori-positive patients and clarithromycin alone in C pneumoniae-positive patients. The effect of treatment and other baseline variables on fibrinogen levels, determined at 6 months, was evaluated by multivariate analysis. Treatment significantly reduced fibrinogen level at 6 months in the overall study population and in the groups of patients divided according to H pylori or C pneumoniae positivity. In the 43 treated patients, mean (+/-SD) basal fibrinogen was 3.65+/-0.58 g/L, and mean final fibrinogen was 3. 09+/-0.52 g/dL (P<0.001), whereas in the 41 untreated patients, mean basal and final fibrinogen levels were 3.45+/-0.70 and 3.61+/-0.71 g/L, respectively. The largest decrease was observed in patients with both infections. Fibrinogen changes were also significantly and negatively correlated with age. CONCLUSIONS: Our data suggest that a short, safe, and effective course of antibiotic therapy might be suggested as a means of interacting with an "emerging" risk factor.


Asunto(s)
Infecciones por Chlamydia/tratamiento farmacológico , Chlamydophila pneumoniae , Fibrinógeno/análisis , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Isquemia Miocárdica/sangre , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Antiulcerosos/administración & dosificación , Antiulcerosos/uso terapéutico , Infecciones por Chlamydia/complicaciones , Enfermedad Crónica , Claritromicina/administración & dosificación , Claritromicina/uso terapéutico , Quimioterapia Combinada , Femenino , Infecciones por Helicobacter/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Isquemia Miocárdica/etiología , Omeprazol/administración & dosificación , Omeprazol/uso terapéutico , Factores de Riesgo , Tinidazol/administración & dosificación , Tinidazol/uso terapéutico
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