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Querol L, Rojas-Garcia R, Casasnovas C, Sedano MJ, Muñoz-Blanco JL, Alberti MA, Paradas C, Sevilla T, Pardo J, Capablo JL, Sivera R, Guerrero A, Gutierrez-Rivas E, Illa I. Long-term outcome in chronic inflammatory demyelinating polyneuropathy patients treated with intravenous immunoglobulin: A retrospective study. Muscle Nerve 2013; 48:870-6. [DOI: 10.1002/mus.23843] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Luis Querol
- Neuromuscular Diseases Department; Hospital de la Santa Creu i Sant Pau; Mas Casanovas 90 08041 Barcelona Spain
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Ricard Rojas-Garcia
- Neuromuscular Diseases Department; Hospital de la Santa Creu i Sant Pau; Mas Casanovas 90 08041 Barcelona Spain
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Carlos Casasnovas
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
- Neuromuscular Diseases Unit; Hospital Universitari de Bellvitge; Barcelona Spain
| | - Maria Jose Sedano
- Neurology Department; Hospital Universitario “Marques de Valdecilla”; Santander Spain
| | - Jose Luis Muñoz-Blanco
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
- Neuromuscular Diseases and ALS Unit; Hospital Universitario Gregorio Marañón; Madrid Spain
| | | | - Carmen Paradas
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
- Neuromuscular Diseases Unit; Hospital Universitario Virgen del Rocío; Sevilla Spain
| | - Teresa Sevilla
- Neurology Department; Hospital Universitari I Politècnic La Fe; Valencia Spain
| | - Julio Pardo
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
- Neurology Department; Hospital Universitario de Santiago; Santiago de Compostela Spain
| | - Jose Luis Capablo
- Neurology Department; Hospital Universitario “Miguel Servet”; Zaragoza Spain
| | - Rafael Sivera
- Neurology Department; Hospital Universitari I Politècnic La Fe; Valencia Spain
| | - Antonio Guerrero
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
- Neuromuscular Diseases and ALS Unit; Hospital Clinico “San Carlos”; Madrid Spain
| | | | - Isabel Illa
- Neuromuscular Diseases Department; Hospital de la Santa Creu i Sant Pau; Mas Casanovas 90 08041 Barcelona Spain
- Centro Investigacion Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
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Giraldo P, Capablo JL, Alfonso P, Garcia-Rodriguez B, Latre P, Irun P, de Cabezon AS, Pocovi M. Neurological manifestations in patients with Gaucher disease and their relatives, it is just a coincidence? J Inherit Metab Dis 2011; 34:781-7. [PMID: 21384230 DOI: 10.1007/s10545-011-9298-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 01/21/2011] [Accepted: 02/07/2011] [Indexed: 12/23/2022]
Abstract
Gaucher disease (GD) is an autosomal recessive disorder characterized by defective function of glucocerebrosidase. GD presents a wide spectrum of manifestations, and patients and their relatives may develop neurological abnormalities more frequently than the general population. This study aims to determine the presence of neurological symptoms (NS) and Parkinson's disease (PD) in Spanish GD patients and their relatives. We surveyed 87 GD Spanish families and validated the information obtained on the neurological involvement through their physicians, as well as the historical data included in the Spanish Gaucher Disease Registry. Neurological abnormalities were correlated with the genetic characteristics. Statistical analyses included descriptive parameters, ANOVA, t-test, correlation study and Pearson coefficient. Information was obtained from 118 patients and 324 relatives. Out of 110 patients with type 1 GD, 32 (29.1%) reported NS and 7 (6.4%) had PD. In relatives, a total of 39 (13.1%) subjects had NS, including 16 with PD (5.3%). The prevalence of NS in genetic carriers (15.9%) was greater than that in non-carriers (5.9%; p < 0.01). Patients with PD carried the following GBA mutations: S364R, D409H, L444P, R257Q, IVS4-2A > G, c.500insT, and L336P. Relatives with PD exhibited a wide spectrum of mutations: L444P, N370S, V398I, R257Q, G202R, c.1439-1445del7, [E326K; N188S], and c.953delT. We observed a high incidence of PD in type 1 GD and relative's carriers. PD was more frequent in carriers of L444P and other rare GBA mutations. Therefore, it is important to perform a systematic neurological exam in patients with type 1 GD and carriers with high risk mutations.
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Affiliation(s)
- Pilar Giraldo
- Hematology Department, Miguel Servet University Hospital, Pº Isabel La Católica 1-3, 50009 Zaragoza, Spain.
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Ara JR, García-Mata JR, Capablo JL, Martín J, López-Gastón JI, Bertol V, Alarcia R, Marta J. [Quality as management tool. Actions to improve efficiency in neurological care]. Neurologia 2009; 24:292-296. [PMID: 19642030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Quality of care involves meeting the needs and expectations of patients with the lowest consumption of resources and in accordance with scientific knowledge. In this context it is important to know if the changes in medical care procedures based on scientific and technical aspects of the quality positively impacts both efficiency measures and perceived quality. METHODS Prospective study carried out during the 2000-2006 period at the neurology department of a public hospital with has 1303 beds. Changes in medical care introduced: adequacy of a high resolution hospitalization zone, setting up of three care pathways (transient ischemic attach [TIA], multiple sclerosis exacerbation and first epileptic seizure) and practice guidelines for stroke, and implementation of neurological care at the emergency department. RESULTS There has been an increase in the number of patients treated in the emergency department of the hospital (17%), although the number of admissions has stabilized. In the neurology department, the number of admissions has decreased by 20%, especially those arising from TIA (decrease by 47%), the average stay has been reduced by 30% (especially in demyelinating and vascular disease, which has fallen by 50%). Adjusted average length of stay has remained below 1 and the complexity index above 1. Satisfaction with the information and health care has undergone little change. CONCLUSIONS The changes in clinical practice to improve the quality of care have been associated with improvements in the efficiency indicators but not in patient satisfaction. The improvement in the perceived quality probably requires specific actions.
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Affiliation(s)
- J R Ara
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza.
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Capablo JL, Saenz de Cabezón A, Fraile J, Alfonso P, Pocovi M, Giraldo P. Neurological evaluation of patients with Gaucher disease diagnosed as type 1. J Neurol Neurosurg Psychiatry 2008; 79:219-22. [PMID: 17682016 DOI: 10.1136/jnnp.2006.111518] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Type 1 Gaucher disease (GD1) is characterised by lack of central nervous system involvement; however, there are several reports of associated neurological manifestations. The aim of this study was to systematically evaluate neurological manifestations in 31 patients with GD1 (12 males and 19 females; mean age 39.4 (range 5-77) years). Participants underwent a complete neurological examination and cognitive tests. Investigation of symptoms and medication intake, and motor and sensory electroneurograms were obtained. 30.7% of adult patients had neurological deficits, including psychomotor delay, parkinsonism, dementia, impaired saccadic ocular movements and peripheral nerve dysfunction. Three patients were redefined as type 3 GD. Electrodiagnosis was performed on 15 patients; 26.7% had reduced amplitude and/or abnormal waveforms in at least three nerves, 33.3% had a mild reduction in amplitude of two nerves and 40% had amplitude reduction in one nerve. Patients with three or more affected nerves had additional neurological symptoms. Our results demonstrate that neurological alterations occur in patients diagnosed with GD1, and subclinical peripheral neuropathy is a frequent finding.
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Affiliation(s)
- J L Capablo
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
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Guallar JP, Vilà MR, López-Gallardo E, Solano A, Domingo JC, Gámez J, Pineda M, Capablo JL, Domingo P, Andreu AL, Montoya J, Giralt M, Villarroya F. Altered expression of master regulatory genes of adipogenesis in lipomas from patients bearing tRNA(Lys) point mutations in mitochondrial DNA. Mol Genet Metab 2006; 89:283-5. [PMID: 16603396 DOI: 10.1016/j.ymgme.2006.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Revised: 02/28/2006] [Accepted: 03/02/2006] [Indexed: 11/24/2022]
Abstract
The mechanisms underlying the appearance of lipomas in patients bearing mutations in the tRNA(Lys) gene of mitochondrial DNA are unknown. We investigated changes in gene expression patterns in lipomas from three patients bearing A8344G or G8363A tRNA(Lys) gene mutations. Uncoupling protein-1 mRNA was detected in the lipomas, in contrast with undetectable expression in normal adipose tissue. However, expression of other markers of brown fat, such as PGC-1alpha, was unaltered. PPARgamma and retinoblastoma gene expression was down regulated in the lipomas, but C/EBPalpha mRNA was not affected. The expression of Pref-1 was dramatically down regulated. Thus, lipomatosis due to tRNA(Lys) mutations is associated with a pattern of altered expression of master regulators of adipogenesis consistent with enhanced proliferation but maintenance of adipocyte features, and with a distorted pattern of brown versus white adipocyte differentiation.
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Affiliation(s)
- Jordi P Guallar
- Departament de Bioquímica i Biologia Molecular, Universitat de Barcelona, Spain
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Alarcia R, Ara JR, Marta E, Barrena MR, Giménez-Más JA, Capablo JL, Serrano M. [Demyelinating pseudotumoral lesion prior to a primary cerebral lymphoma]. Rev Neurol 2000; 31:955-8. [PMID: 11244691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
INTRODUCTION Some case of demyelinating pseudotumoral lesions preceding the appearance of primary cerebral lymphoma have been reported. The relation between the two conditions is not known. We report the case of a woman in whom a demyelinating pseudotumoral lesion had been diagnosed on biopsy and who developed a primary cerebral lymphoma 13 months later. CLINICAL CASE In October 1997 a 38 year old woman presented with a secondarily generalized focal motor seizure. Neuroimaging showed a left frontal tumour with marked oedema and uptake of contrast medium. Based on the clinicoradiological suspicion of a primary cerebral tumour or metastasis, treatment was started with dexamethasone. Approximately two weeks later a stereotaxic biopsy was done, in which there was demyelination with conservation of the axons and perivascular inflammatory infiltration with polyclonal T and B lymphocytes. The diagnosis was 'a pseudotumoral form of a demyelinating disease'. Thirteen months later the patient had episodes of falling to the floor, followed by subsequent slight confusion and difficulty in speaking. On neuroimaging studies (cerebral CAT and MR) there was a tumour of the left basal ganglia, considerable oedema and homogeneous marking following the injection of contrast. Anatomopathological study of the lesion showed a B cell lymphoma. CONCLUSION In cases of pseudotumoral demyelinating lesions the possibility of a primary cerebral lymphoma of the central nervous system must be remembered.
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Affiliation(s)
- R Alarcia
- Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España
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Pina MA, Ara JR, Modrego PJ, Morales F, Capablo JL. Prevalence of multiple sclerosis in the sanitary district of Calatayud, Northern Spain: is Spain a zone of high risk for this disease? Neuroepidemiology 2000; 17:258-64. [PMID: 9705585 DOI: 10.1159/000026178] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED We undertook an epidemiologic study to ascertain the prevalence of multiple sclerosis (MS) in the Sanitary District of Calatayud, in the north-east of Spain. METHODS The study was performed from October 1990 to July 1996. The total number of residents in the area was 58,591. An extensive search was carried out to identify all cases of known or suspected MS through general practitioners and specialists, sanitary authorities in the area, the reference hospital, the Spanish Multiple Sclerosis Society, the newspaper and radio. RESULTS April 1, 1995 was chosen as prevalence day. The crude prevalence rate for the area was 58 per 100,000 (95% CI: 39-78). The approximate annual incidence rate was 2.6/100,000 (1980-1989). CONCLUSIONS This study and others conducted recently in Spain show that MS is more prevalent than was previously thought and afflicts at least 53-65 per 100,000 population.
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Affiliation(s)
- M A Pina
- Department of Neurology, Obispo Polanco Hospital, Teruel, Spain
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Alarcia R, Ara JR, Serrano M, García M, Latorre AM, Capablo JL. [Severe polyneuropathy after using nitrous oxide as an anesthetic. A preventable disease?]. Rev Neurol 1999; 29:36-8. [PMID: 10528308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Nitrous oxide is a commonly used anaesthetic agent. One complication of this is due to its capacity to inactivate cobalamin. Therefore, in patients with poor reserves of vitamin B12, neurological and hematological alterations may be induced after a short period of exposure to nitrous oxide. CLINICAL CASE A 69 year old man was anesthetized for three hours with 50% nitrous oxide during a surgical operation. Two weeks later he complained of severe mixed, mainly sensory polyneuropathy and was unable to walk. On diagnostic studies, vitamin B12 levels were found to be 18 pg/ml. The Shilling test confirmed that there was lack of intrinsic factor. In the preoperative studies a striking increase in motor conduction velocity was observed. Neurophysiological studies showed that there was mixed polyneuropathy, predominantly axonal. After starting treatment with hydroxycobalamin there was marked improvement and the patient became able to walk unaided. CONCLUSION Since nitrous oxide may cause serious neurological alterations in patients with subclinical deficits of cobalamin, which may not always be accompanied by hematological changes, we consider the need for determination of plasma levels of vitamin B12 and if possible, of methylmalonic acid and homocysteine in elderly patients who are to have general anesthetics involving nitrous oxide.
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Affiliation(s)
- R Alarcia
- Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España
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Almárcegui C, Lorente S, Romero MF, Capablo JL, Serrano M, Oliveros A, Valdizán JR. Blink reflex in trigeminal hypoesthesia caused by a pontine demyelinating lesion. J Neurol 1999; 246:140-1. [PMID: 10195411 DOI: 10.1007/s004150050322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Spinal epidural abscesses account for approximately one of every 10, 000 admissions to tertiary hospitals. The midthoracic vertebrae are the most frequently affected, whilst the cervical spine is involved in fewer patients. Staphylococcus aureus is identified as the cause in most cases of epidural abscess; other bacteria responsible include Gram-negative bacteria, Streptococcus species and Brucella species. We report the case of a patient with cervical spondylodiscitis at level C4-C5 and an epidural abscess which was compressing the spinal cord and the retropharyngeal space. The previous symptoms of brucellosis were atypical. We discuss the clinical manifestations, diagnosis, treatment and prognosis of the case.
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Affiliation(s)
- M A Pina
- Department of Neurology, Obispo Polanco Hospital, Teruel, Spain
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Serrano-González C, Capablo JL, Cay E, Ara-Callizo JR, Velilla I, López-Gastón JI, Pérez López-Fraile I. [Ischemic stroke and auricular septal aneurysm: six cases]. Rev Neurol 1998; 27:658-62. [PMID: 9803518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Aneurysms of the atrial septum (AAS) are uncommon. They have been considered to be related to embolic phenomena. They are usually associated with other cardiac anomalies, especially persistence of the formen ovale. PATIENTS AND METHODS We studied six patients diagnosed during a period of 24 months as having ischemic ictus and AAS. They were investigated for vascular risk factors and possible causes of cardiac embolism by means of ECG, transthoracic and transoesophagic echography (ETE). Cases with the clinical characteristics of embolism were anticoagulated. RESULTS Five patients were men with an average age of 47.6 years. Three had the clinical features of established ictus, one of RIND and two of AIT. Three patients had vascular risk factors. The TSA study showed pathology of the carotid arteries to be present in three patients. In all six cases the AAS was identified on ETE. There were no thrombi in the atria in any case, and in two there was left-right communication. In four patients the condition was considered to have a cardio-embolic origin. No patient has had further episodes of cerebral ischaemia. DISCUSSION It seems there is a certain risk of cerebral embolus associated with AAS. The simultaneous presence of alterations in cardiac rhythm together with other structural cardiac pathology seems to have a synergic effect on this. Paradoxical embolism, arrhythmias and intra-aneurysmal thrombi appear to be the mechanisms involved in the appearance of emboli. The best therapeutic approach is still unknown. New studies are therefore necessary to establish whether or not it is necessary to anticoagulate these patients.
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Marzo ME, Pérez López-Fraile I, Capablo JL, Ara JR, Usón M. [Ocular myasthenia: clinical course and strategies for treatment]. Rev Neurol 1998; 26:398-400. [PMID: 9585951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Ocular myasthenia gravis is a localized form of myasthenia in which only the extra-ocular muscles are clinically affected, namely the levator palpebrae superioris and orbicularis oculi. Two years after onset of the ocular condition, it became generalized in 44-53% of the patients. OBJECTIVE 1. To describe the clinical features, diagnostic characteristics and clinical course of seven patients who fulfilled the criteria for diagnosis of ocular myasthenia and in whom the condition did not become generalized: 2. Review recent papers on this. Material and methods. We studied seven patients (two men and two women) diagnosed as having ocular myasthenia gravis, and followed them up for at least three years. RESULTS The average age was 56.5. The clinical findings were of ptosis of the eyelids and diplopia. All seven patients were treated with pyridostigmine. In six cases prednisone was also given and in one patient thymectomy was done. There was a satisfactory result in all cases. CONCLUSIONS The basic treatment of ocular myasthenia is with anticholinesterases and corticosteroids. Occasionally other immunosuppressives may be required. Prednisone seems to reduce the number of patients who go on to develop the generalized form.
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Affiliation(s)
- M E Marzo
- Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España
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Ara JR, Martín J, Bestué M, Brieva L, Iturriaga C, Capablo JL. [Determining factors in decisions regarding cardio-pulmonary resuscitation in patients with cerebral hemorrhage]. Rev Neurol 1997; 25:1518-20. [PMID: 9462970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND OBJECTIVE Some medical factors related with cardiopulmonary resuscitation (CPR) outcome are known. Moreover, there are other factors, not strictly medical ones, as age, gender, race and socioeconomic status, that influence on decisions of CPR. The aim of this study was to analyse the influence of all this factors on in-hospital CPR of the patients with intracerebral hemorrhage. MATERIAL AND METHODS This retrospective study comprised all the consecutive patients hospitalized with spontaneous intracerebral hemorrhage who died within 30 days of hospital admission in a public hospital during the period 1987-1994. We used stepwise logistic regression to identify variables that had a significant independent relation with decision of CPR. RESULTS We identified 73 patients, 50 men and 23 women. Their mean age was 61 years. RCP was performed in 25 patients (34%). A logistic regression revealed that age (OR 0.8), Glasgow score on admission (OR 0.67) and time of death (OR 1.2) were significantly associated with CPR decision. CONCLUSIONS CPR was less probable in aged even though they had better level of consciousness on admission. Moreover, CPR was less probable early in the morning.
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Affiliation(s)
- J R Ara
- Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España
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Pina MA, Ara JR, Capablo JL, Omeñaca M. [Myelitis and optic neuritis caused by varicella]. Rev Neurol 1997; 25:1575-6. [PMID: 9462984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Varicella mainly affects children between 1 and 14 years old. It is the initial infection caused by the Varicella-Zoster virus. It is characterized by a vesicular cutaneous eruption, fever and generally good prognosis. The neurological complications caused by the Varicella-Zoster virus are infrequent and include: meningitis, encephalitis, cerebellar ataxia, Reye's syndrome, myelitis, optic neuritis, mononeuropathy, polyneuropathy, necrosis of the retina and cerebral arteritis. CLINICAL CASE We present the unusual case of a woman patient aged 18 who presented with myelitis 15 days after having a varicella rash. Analysis of the cerebrospinal fluid showed intrathecal production of antibodies against the Varicella-Zoster virus. Fourteen days after resolution of the myelitis, she presented with unilateral optic neuritis which remitted without sequelae, (as did the myelitis). Cerebral and medullary MR showed no alterations. CONCLUSIONS The pathogenesis leading to involvement of the nervous system is still not well defined. Direct invasion by the virus has been postulated, particularly in Herpes-Zoster (reinfection by Varicella-Zoster), as immunological phenomena which may be more frequent with Varicella (initial infection by Varicella-Zoster virus). In our case there were two short episodes of neurological involvement: optic neuritis and myelitis, with a satisfactory clinical course after giving corticosteroids. This makes one think of immunological mechanisms rather than direct invasion of the central nervous system by the Varicella-Zoster virus.
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Affiliation(s)
- M A Pina
- Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España
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Ara JR, Marzo ME, Brieva L, Usón M, Capablo JL. ["Locked-in" syndrome due to hyperglycemia]. Rev Neurol 1997; 25:1091-2. [PMID: 9280643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Hypoglycemia can cause a diffuse brain malfunction and sometimes a focal neurological deficiency, that could lead to a mistaken diagnosis of cerebrovascular disease. CLINICAL CASE We describe the case of a 67 year old man, with diabetes mellitus type II treated with glibenclamide, that was referred to our hospital due to worsening of his chronic obstructive pulmonary disease. On the fifth day following admission he developed acute weakness in the right extremities and experienced difficulty in talking: six hours later he was conscious, with normal eye movements, but there was an absence of spontaneous facial motility and to pain; he showed complete cuadraplegia and bilateral Babinski. A determination of glycemia was made with the result of 24 mg/dl; after immediate treatment with glucose solution intravenously the patient recovered in a few minutes. CONCLUSION This clinical observation reminds us of the importance of determining blood glucose in the assessment of any acute neurological dysfunction.
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Affiliation(s)
- J R Ara
- Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España
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Carod J, Guelbenzu S, Capablo JL, Marzo E. [Neuroimaging, CT and MR brain findings in a case of McCune-Albright syndrome]. Rev Neurol 1996; 24:979-81. [PMID: 8755361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
McCune-Albright syndrome is characterized by the triad of polyostotic fibrous dysplasia, precocious puberty, cutaneous pigmentation and cafe-au-lait spots. A 23-year-old woman with McCune-Albright is reported. Findings on CT scan and magnetic resonance imaging of the skull in an affected girl with McCune-Albright syndrome are shown, and also the histopathological study of the right temporal bone biopsy.
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Affiliation(s)
- J Carod
- Servicio de Neurologia, Hospital Miguel Servet, Zaragoza
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Delgado Beltrán P, Rubio-Félix D, García Zueco JC, Capablo JL, Alvarez R. [Chronic neutrophilic leukemia (CNL) and meningeal tuberculosis (TBC): chance or cause?]. Sangre (Barc) 1995; 40:235-7. [PMID: 7570287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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García-Zueco JC, Gimeno JJ, Tapia M, Capablo JL. [Paraparesis caused by epidural granulocytic sarcoma in a non-leukemic patient]. Sangre (Barc) 1995; 40:166-167. [PMID: 7784949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Capablo JL, Tordesillas C, Elcano J, Aguirre M. [Hypoglycemia simulating acute cerebrovascular disease]. Rev Clin Esp 1990; 187:314. [PMID: 2091105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Giménez-Mas JA, Ara JR, Valer J, Almajano C, Alvarez Alegret R, Capablo JL. [Encephalopathy caused by nicotinic acid deficiency (pellagra) in a chronic alcoholic patient: necropsy study]. Rev Clin Esp 1986; 179:142-3. [PMID: 3763994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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