[Systemic inflammatory response syndrome and primary of spontaneous intracerebral haemorrhage]. / Síndrome de respuesta inflamatoria sistémica y hemorragia intracerebral espontánea.

OBJECTIVE: Systemic inflammatory response syndrome (SIRS) without infection is a well known phenomenon that accompanies various acute cerebral insults. We in tented to determine whether SIRS was associated with outcome in patients with spontaneous intracerebral hemorrhage. PATIENTS AND METHODS: In patients with intracerebral hemorrhage, the occurrence of SIRS was assessed according to the guidelines of the 1992 Consensus Conference. SIRS criteria and other prognostic parameters were evaluated as predictors of final outcome. RESULTS: SIRS was highly related to poor clinical grade (Glasgow coma scale), hemorrhage volume on CT scan and intraventricular extension of hemorrhage. By univariate analysis,the occurrence of SIRS was associated with higher mortality and morbidity rates than was the nonoccurrence (p<0.005). CONCLUSIONS: In patients with intracerebral hemorrhage, SIRS reflected the extent of tissue damage and predicted a poor outcome.

Síndrome de respuesta inflamatoria sistémica y hemorragiaintracerebral primaria o espontánea / Systemic inflammatory response syndrome and primary or spontaneous intracerebral haemorrhage

Objetivo. El síndrome de respuesta inflamatoria sistémica (SRIS) sin infección se conoce bien por acompañar a una variedad de lesiones cerebrales agudas. Por ello, en el presente trabajo tratamos de determinar si la presencia del SRIS se correlaciona con el resultado final en pacientes portadores de hemorragia intracerebral espontánea (HICE). Pacientes y métodos. En pacientes portadores de HICE, se valoró la ocurrencia del SRIS, su relación con parámetros pronósticos validados y el resultado final. Resultados. La presencia de SRIS se correlaciona estrechamente con el estado clínico en el momento del ingreso (escala de Glasgow), volumen de la hemorragia en la TAC y presencia de volcado ventricular. Por análisis univariado, el SRIS se asocia a altas tasas de mortalidad y morbilidad con relación a su no ocurrencia (p< 0,005). Conclusión. En pacientes con HICE, el SRIS refleja la extensión del daño tisular y predice malos resultados (AU)

Trombosis venosa cerebral secundaria a síndrome antifosfolípido y déficit de antitrombina III / Cerebral venous thrombosis secondary to antiphospholipid syndrome and dificit of antithrombin III

La trombosis venosa cerebral es menos frecuente que la arterial como causa de stroke, sin embargo aún continua subdiagnosticada. Fisiopatológicamente se caracteriza por un desequilibrio entre factores trombogénicos y fibrinolíticos. Los desórdenes hematológicos tienen un rol protagónico importante, destacándose entre ellos el sindrome antifosfolipídico, el cual debe particularmente sospecharse cuando el accidente cerebrovascular ocurre en individuos jóvenes

Trombosis venosa cerebral secundaria a síndrome antifosfolípido y déficit de antitrombina III / Cerebral venous thrombosis secondary to antiphospholipid syndrome and dificit of antithrombin III

La trombosis venosa cerebral es menos frecuente que la arterial como causa de stroke, sin embargo aún continua subdiagnosticada. Fisiopatológicamente se caracteriza por un desequilibrio entre factores trombogénicos y fibrinolíticos. Los desórdenes hematológicos tienen un rol protagónico importante, destacándose entre ellos el sindrome antifosfolipídico, el cual debe particularmente sospecharse cuando el accidente cerebrovascular ocurre en individuos jóvenes (AU)

C to T nucleotide substitution in codon 713 of amyloid precursor protein gene not found in 86 unrelated schizophrenics from multiplex families.

Jones et al. Nature Genet 1:306-309, [1992] recently detected a C to T nucleotide transition (codon 713) in a highly conserved region of the beta-amyloid precursor gene in a single case of schizophrenia. Although the sequence variant may be a natural polymorphism, it is crucial to determine whether the mutation might be present in a small subset of schizophrenics. We isolated DNA from 86 unrelated chronic schizophrenics who had a first degree relative with chronic schizophrenia or chronic schizoaffective disorder. After PCR amplification of exon 17, we were unable to detect the presence of the codon 713 variant in these schizophrenic cases, as well as in 156 controls. Unless additional cases are found with the codon 713 mutation, it is unlikely that the sequence variant is pathogenic for schizophrenia.

The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome.

The present study is an examination of ventricular and temporal lobe size in 50 DSM-III-R first-episode schizophreniform or schizoaffective patients who were ill for less than 6 months. Two-year clinical follow-up and magnetic resonance imaging (MRI) scan analyses are also reported from data collected on an initial group of 30 first-episode schizophrenic patients and controls. Left ventricular enlargement, which was present in our previously published report of first-episode cases of schizophrenia, is not present to the same extent in this larger group of schizophreniform patients closer to the onset of their illness, and no temporal lobe volume reduction was detected. However, lateral ventricular size at the time of the first-episode was generally correlated with outcome--the larger the ventricles, the poorer the outcome. No mean change in ventricular or temporal lobe size was found at rescanning 2 years later, but the degree of ventricular change was inversely correlated with the number of hospitalizations and the amount of time spent in hospital; it did not correlate with temporal lobe size. When rescanned, some patients showed change greater than 20% in ventricular size and 10% in temporal lobe size. Thus, these findings need further evaluation by serial scans over a longer time period before it can be determined that no progression of brain structural abnormalities is occurring as part of the pathology of schizophrenia, even in a subgroup of patients.

Anomalous lateral sulcus asymmetry and cognitive function in first-episode schizophrenia.

This study examines the cognitive functioning of first-episode schizophreniform patients within several weeks of hospitalization and at 2 years into the illness. Differences between patients and controls are also reported for measurements of the length of the lateral sulcus, which borders the planum temporal, an area of the brain integral to language function. Neuropsychological test results are also correlated to magnetic resonance imaging structural variables at the time of first hospitalization. Findings on neuropsychological summary scales reveal a diffuse pattern of cognitive impairment in schizophreniform patients compared to controls, which appears to improve over time. An atypical pattern of anatomic lateral symmetry is found in female schizophreniform patients, with female appearing to have a reduction in the normally occurring left greater than right length of the lateral sulcus. Such atypical asymmetry of the lateral sulcus is also associated with better cognitive function, particularly in schizophreniform patients. These findings suggest that atypical lateralization in an area critical to language function may be related to cognitive function in schizophreniform illness.

Familial thyroid disease and delayed language development in first admission patients with schizophrenia.

One hundred consecutive first admission patients with a DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder were compared with 100 randomly selected community controls. Childhood histories of physical, medical, and perinatal trauma, as well as physical and cognitive development, were examined by structured interviews with all available mothers of patients and controls. The prevalence of specific psychiatric disorders and several medical illnesses among first degree and more distant relatives was determined by family history questionnaires. The patient group did not have an excess of childhood head injuries, serious infections, or perinatal/birth complications compared with controls. With social class level taken into account, it was found that the acquisition of reading skills occurred significantly later in patients than controls. Family histories of schizophrenia and thyroid disorders were significantly more frequent among patients than controls. These data fail to indicate any childhood physical or medical environmental trauma that could lead to an increased risk for schizophrenia, although patients were substance abusers to a greater extent than controls. This study also confirms the already known contribution of familial factors and suggests an association of the inheritance of thyroid disorders with schizophrenia. Delayed development of reading skills suggests that precursers of illness may appear early in life before psychosis is evident.

Evidence for a pseudo-autosomal locus for schizophrenia using the method of affected sibling pairs.

A susceptibility locus for schizophrenia in the 'pseudo-autosomal' region has been proposed on the basis of the reported excess of sex-chromosome aneuploidies (e.g. XXY and XXX) among patients with schizophrenia and the finding that schizophrenic sib-pairs are more often of the same than of the opposite sex. This hypothesis has been tested in 83 sibships with two or more siblings fulfilling Research Diagnostic Criteria for schizophrenia or schizoaffective disorder. Alleles at the pseudo-autosomal telomeric locus DXYS14, which is unlinked with sex, were analysed using the method of affected sib-pairs. Affected sibs shared alleles at DXYS14 more frequently than expected by random Mendelian assortment, supporting genetic linkage between DXYS14 and schizophrenia.

No genetic linkage detected for schizophrenia to Xq27-q28.

The hypothesis that at least a subgroup of familial cases of schizophrenia could be due to a genetic defect on the X chromosome is supported by the observation of an excess of X-chromosome aneuploidies (XXX and XXY) among populations of patients with psychosis. The distal long arm, Xq27-q28, is a candidate region where linkage has been claimed to manic-depressive disorder and a fragile site has been associated with schizophrenia spectrum disorders. The present study excluded linkage to a large part of this region using four polymorphic probes and multipoint lod-score analysis in 10 families with multiple members with schizophrenia.

Intestinal uptake of fluorescent microspheres in young and aged mice.

Rhodamine B-labeled synthetic latex particles (microspheres), 1.8 micron in diameter, were administered by gavage 5 days per week to young (24 days) and aged (18 months) mice. After 25 days (19 gavages), the particles were assayed in solubilized tissues by depositing them on filters and counting under fluorescence microscopy. Aged mice exhibited significantly more fluorescent particle accumulation in Peyer's patches but significantly less in lungs than young mice. Mesenteric lymph nodes and Peyer's patch-free intestinal segments contained measurable latex, but differences between young and aged animals were not significant. Liver contained only trace amounts of latex, and spleen and kidney were latex free in both young and aged animals. Nonquantitative observations on KOH-glycerol-cleared whole Peyer's patches and slices of liver, lung, and mesenteric lymph node were similar.