ABSTRACT
El síndrome de Sneddon, es una vasculitis que afecta principalmente a la piel y al sistema nervioso central. Se caracteriza por la presencia de unalivedo reticularis idiopática junto a accidentes cerebrovasculares isquémicos. De forma menos frecuente puede presentar afectación cardiaca, renalo retiniana. Presentamos el caso de un varón con livedo racemosa desde la tercera década de vida, que a los 44 años de edad sufrió un infartocerebral y tres años después un infarto de miocardio, con normalidad en todas las pruebas realizadas (AU)
Sneddon´s syndrome is a skin and cerebral vasculitis. It is characterize by idiopathic livedo reticularis and ischemic cerebrovascular strokes. Less common,heart, kidneys and retina can be affected. We report a man, with livedo racemosa since third decade of life , who at the age of 44 years, hesuffered a cerebral stroke and three years later a heart stroke, all the tests realised were normal (AU)
Subject(s)
Humans , Male , Middle Aged , Sneddon Syndrome/diagnosis , Livedo Reticularis/diagnosis , Skin Diseases, Vascular/diagnosis , Cerebral Infarction/complications , Myocardial Infarction/complicationsABSTRACT
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Subject(s)
Humans , Male , Aged , Fibrosarcoma/complications , Fibrosarcoma/diagnosis , Epidermolysis Bullosa/complications , Epidermolysis Bullosa/diagnosis , Histiocytoma, Benign Fibrous/complications , Histiocytoma, Benign Fibrous/diagnosis , Varicose Ulcer/diagnosis , Venous Insufficiency/surgery , Tomography, Emission-Computed/methods , Mastocytosis, Cutaneous/complications , Varicose Ulcer/surgery , Venous Insufficiency/complications , Venous Insufficiency/diagnosis , Histiocytoma, Benign Fibrous/physiopathology , Histiocytoma, Benign Fibrous/therapy , Giant Cells/pathology , Dermatitis/complicationsSubject(s)
Blister/pathology , Fibrosarcoma/pathology , Skin Neoplasms/pathology , Aged , Diagnosis, Differential , Humans , MaleABSTRACT
INTRODUCCIÓN. Recientemente se ha hecho evidente el potencial terapéutico de las células madre adultas en el tratamiento de arteriopatías periféricas, pues la implantación en los miembros isquémicos de células mononucleares procedentes de la médula ósea (CMN-MO) o de la sangre periférica (CMN-SP) puede mejorar la vascularization del tejido. MATERIAL Y MÉTODO. Se trataron 30 pacientes con isquemia critica de un miembro inferior, en los que no existía ninguna posibilidad de revascularización por métodos tradicionales. En 13 se implantaron CMN-MO autólogas en el miembro isquémico y en 17 se utilizaron CMN-SP. Los pacientes se monitorearon durante 24 semanas con el índice de presiones tobillo-brazo (ITB) en reposo, la distancia de marcha sin claudicación y la evaluación de la escala del dolor de reposo. RESULTADOS. Veintiún pacientes tenían indicación de amputación mayor del miembro afectado y en catorce (67%) de ellos se logró evitar. Tanto en los pacientes en que se emplearon CMN-MO como en los que recibieron CMN-SP hubo mejoría significativa del ITB en el miembro en que se hizo la implantación celular. El dolor de reposo mejoró significativamente en ambos grupos a las 4 semanas y a las 24 semanas había desaparecido. La distancia de marcha sin claudicación mejoró progresivamente en los dos grupos. En ningún caso se observaron efectos adversos secundarios al tratamiento. CONCLUSIONES. Los métodos de implantación de CMN-MO y de CMN-SP autólogas en pacientes con isquemia crítica de miembros inferiores resultaron procedimientos eficaces y sin complicaciones, lo que estimula a la continuación de los estudios clínicos en este campo (AU)
INTRODUCTION. Recently the therapeutic potential of adult stem cells in the treatment of peripheral arterial diseases has become increasingly evident, since implantation of bone marrow mononuclear cells (BM-MNC) or peripheral blood mononuclear cells (PB-MNC) into ischemic limbs can improve tissue vascularization. PATIENTS AND METHODS. Thirty patients with severe unilateral lower limb ischemia, with no option for standard revascularization therapies, were treated. Autologous BM-MNC were implanted into the ischemic limb in 13 cases and 17 received PBMNC. The patients were monitored during 24 weeks with resting ankle-brachial pressure index (ABI), pain-free walking distance and rest pain scale evaluation. RESULTS. Twenty one patients had been specifically advised to undergo major limb amputation that was avoided in 14 (67%). ABI significantly improved in the treated limb in both groups. Rest pain significantly improved in both groups at week 4 and at 24 weeks patients were completely pain-free. Pain free walking distance progressively improved in both groups. No related adverse effects were observed in any patient throughout the therapeutic procedure. CONCLUSIONS. The methods of autologous BM-MNC and PB-MNC implantation in patients with critical lower limb ischemia showed to be effective procedures without related complications. These results encourage to continue clinical studies in this field (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Transplantation, Autologous/methods , Peripheral Blood Stem Cell Transplantation/methods , Ischemia/surgery , Peripheral Vascular Diseases/surgery , Arteriosclerosis Obliterans/complications , Angiography , Risk Factors , Amputation, SurgicalABSTRACT
A program called "An Epidemiological Approach to Computerized Medical Diagnosis" (AEDMI) is presented. Using an interactive questionnaire, physician-patient interviews are conducted and a summary of the relevant clinical data is provided. Standard items, obtained on a multi-centre basis, form a large-scale data base. Simultaneously, the reasoning of clinical experts in each real case is analyzed to obtain a knowledge-rules data base. The methodology of the program combines Bayesian systems, expert systems, and other new lines of research such as neural networks or case-based reasoning. The general concepts of clinical decision making aid systems are reviewed. This publication is aimed at obtaining international cooperation.
Subject(s)
Diagnosis, Computer-Assisted , Medical History Taking , Software , Artificial Intelligence , Bayes Theorem , Expert Systems , Humans , Sensitivity and Specificity , Surveys and Questionnaires , User-Computer InterfaceABSTRACT
The effect of norepinephrine (NE) stimulation of near-term pregnant rabbit myometrium was studied by comparing cumulative dose-response curves for NE and NE with prazosin or indomethacin. Prazosin blocked the stimulatory effects of NE. Indomethacin pretreatment resulted in attenuation, but not suppression of contractile activity. Myometrial activity was associated with a progressive increase in the synthesis of prostaglandin (PG) F2 alpha. Our observations suggest that alpha-adrenergic agonists have some myometrial stimulating effect independent of PG production.
Subject(s)
Indomethacin/pharmacology , Norepinephrine/pharmacology , Prazosin/pharmacology , Pregnancy, Animal/physiology , Uterine Contraction/drug effects , Animals , Dinoprost , Female , In Vitro Techniques , Pregnancy , Prostaglandins F/biosynthesis , RabbitsABSTRACT
This study evaluated in vitro binding of dopamine ligands to myometrial alpha adrenoceptors. With cell membranes from pregnant rabbits, receptor radioligand binding studies utilizing [3H] dihydroergocryptine +/- dopamine demonstrated receptor affinity (KD) = 0.75 +/- 0.10 nM (+/- SEM) and density (Bmax) = 533.2 +/- 45.2 fM/mg protein. Similar studies utilizing phentolamine or apomorphine gave essentially identical results. Competition binding studies demonstrated steriospecific butaclamol binding, along with significant binding of haloperidol, spiperone, apomorphine, and bromoergocryptine. These observations provide a mechanism for the observed uterotonic effects of dopamine.
