ABSTRACT
OBJECTIVE: To determine the regional effects of age and sex on the metabolic ratios obtained in the medial temporal lobe, the posteromedial region, and the frontal lobe at 1.5 T single-voxel magnetic resonance spectroscopy. MATERIAL AND METHODS: We used single-voxel magnetic resonance spectroscopy to study the areas of the brain most affected in neurodegenerative disease (the left frontal lobe, the left medial temporal lobe, and the posteromedial region) in 31 healthy subjects older than 55 years of age (group 1) and in 20 healthy subjects under 30 years of age (group 2). We calculated the following ratios for each voxel: N-acetyl-aspartate/creatine-phosphocreatine (NAA/Cr), N-acetyl-aspartate/choline (NAA/Cho), N-acetyl-aspartate /myoinositol (NAA/mI), choline/creatine-phosphocreatine (Cho/Cr), and myoinositol (mI/Cr). We compared the metabolic ratios in each region in each group and the correlation between age and the ratios within age ranges. Finally, we analyzed the differences in the metabolic ratios between groups and between sexes. RESULTS: In group 1, we found negative correlations between age and Cho/Cr in the frontal region and NAA/mI in the temporal region. In group 2, we found negative correlations between age and mI/Cr and NAA/Cho in the temporal region as well as a positive correlation between age and NAA/mI in the temporal region. In the frontal lobe and the posteromedial region, NAA/Cr, NAA/Cho, and NAA/mI were lower in group 1 (P≤0.003). No differences between groups were seen in Cho/Cr or mI/Cr. The values of the ratios differed regionally in all cases (P<0.001). In the temporal lobe, NAA/Cr and Cho/Cr were higher in women (P≤0.034). CONCLUSIONS: When using single-voxel magnetic resonance spectroscopy, especially in patients with neurodegenerative disease, variations due to region, age, and sex should always be taken into account.
Subject(s)
Brain Diseases/diagnosis , Magnetic Resonance Spectroscopy , Adult , Age Factors , Aged , Female , Humans , Male , Middle Aged , Sex Factors , Young AdultABSTRACT
We performed a study to evaluate the variability and adequacy of prescribing antibiotics in community-acquired pneumonia (CAP) in 10 Spanish hospitals. We studied 452 patients with CAP. Initial empirical administration of antibiotics was prescribed in 90.7% of the cases, 82.5% as monotherapy. Macrolides and third and second generation cephalosporins were the most widely used groups of antibiotics. Penicillin and amoxicillin were only prescribed in 1. 7% of the patients. A significant variability between hospitals was observed. Reference patterns for the use of antibiotics in CAP were devised by a panel of experts. According to the recommendations of this panel, 29% of the total prescriptions were not adequate, with this percentage reaching 65% in outpatients older than 65 years or with comorbidity. This was mainly due to the fact that monotherapy with erythromycin, which was considered inadequate, was the most widely prescribed treatment.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Pneumonia, Bacterial/drug therapy , Adult , Aged , Community-Acquired Infections/drug therapy , Cross-Sectional Studies , Drug Prescriptions/standards , Female , Humans , Male , Middle AgedSubject(s)
Fish Products/adverse effects , Food Hypersensitivity/diagnosis , Foodborne Diseases/diagnosis , Adult , Animals , Chymases , Disease Outbreaks , Female , Food Contamination , Food Hypersensitivity/epidemiology , Foodborne Diseases/immunology , Histamine/adverse effects , Humans , Male , Middle Aged , Serine Endopeptidases/analysis , Tryptases , TunaABSTRACT
We report the case of a patient with Henoch-Schönlein Purpura related to a treatment with cefuroxime and diclofenac who presented important systemic manifestations including a glomerulonephritis with IgA mesangial deposits. Skin testing with beta lactam antibiotics and diclofenac were negative in immediate and late reaction as well as RAST test to penicillins G and V. No cautious administration of drugs was done because of the illness severity. Although a reaction to diclofenac could not be excluded we thought that the more probably implicated drug was cefuroxime because the patient referred a purpuric rash after the intake of cephradine for a mastitis, ten years ago.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cefuroxime/adverse effects , Cephalosporins/adverse effects , Diclofenac/adverse effects , IgA Vasculitis/chemically induced , Adult , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Cefuroxime/administration & dosage , Cephalosporins/administration & dosage , Diclofenac/administration & dosage , Drug Therapy, Combination , Female , Hematuria/chemically induced , Humans , Mastitis/drug therapy , Proteinuria/chemically inducedABSTRACT
We present a non-controlled prospective study of 10 hypertensive patients with systemic erythematous lupus and nephropathy, treated with captopril exclusively or combined with other drugs, in order to assess its effectivity and potential side effects. Four of these 10 patients had mild hypertension; 3, moderate hypertension and 3, severe hypertension. In 5 of them, arterial pressures was controlled with just captopril; in other 3, we added furosemide and in one patient, we added furosemide and nifedipine. In one case, hypertension was not controlled. Renal function remained stable and proteinuria improved in six patients. Three patients presented reversible agranulocytosis, during or immediately after treatment. One of them was treated two years after with enalapril, without observing hematologic recurrence. We conclude that captopril is useful in treating arterial hypertension associated to lupous nephropathy, but frequent leukocyte counting controls must be done during the first months.
