Metástasis intramedulares como manifestación inicial de carcinoma pulmonar / Spinal cord metastasis as initial manifestation of pulmonary carcinoma

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Síndrome SUNCT secundario a dolicomegabasilar / SUNCT syndrome secondary to megadolichobasilar anomaly

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Oxcarbacepina en el tratamiento de la coreoatetosis paroxística cinesigénica / Oxcarbacepine in the treatment of kinesigenic paroxysmal choreoathetosis

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[Seasonal variations in the outbreaks in patients with multiple sclerosis]. / Variaciones estacionales de los brotes en pacientes con esclerosis múltiple.

INTRODUCTION: It has been suggested that there is an environmental factor at play in the aetiology and pathogenesis of multiple sclerosis (MS) that acts as an essential component of the disease process, and a number of studies also point to a relationship between the seasons of the year and the appearance of outbreaks. AIMS: Our aim was to study the possible relation between seasonal variations and the appearance of outbreaks in patients with relapsing-remitting forms of MS. PATIENTS AND METHODS: We studied 31 patients over the period between 1997 and 2002 and calculated the monthly and quarterly rate of incidence of outbreaks. The statistical evaluation of the results was performed by applying the Chi-squared test. RESULTS: We observed a higher incidence of outbreaks in the summer months (more in June) and a lower incidence in winter (less in December), with statistically significant differences. CONCLUSIONS: In our patients, outbreaks of MS are related to seasonal variations, with a higher number in the warmer months and fewer in the colder months.

Variaciones estacionales de los brotes en pacientes con esclerosis múltiple / Seasonal variations in the outbreaks in patients with multiple sclerosis

Introducción. En la etiología y la patogenia de la esclerosis múltiple (EM) se ha sugerido un factor ambiental como componente esencial del proceso de la enfermedad, y diversos estudios sugieren además una relación entre las estaciones del año y la aparición de brotes. Objetivo. Estudiar la posible relación entre las variaciones estacionales y la aparición de brotes en pacientes con formas remitentes-recurrentes de EM. Pacientes y métodos. Estudiamos 31 pacientes durante el período comprendido entre 1997 y 2002 y calculamos la tasa de incidencia mensual y trimestral de los brotes. La evaluación estadística de los resultados se realizó aplicando el test de Chi-cuadrado . Resultados. Observamos una mayor incidencia de brotes en los meses de verano (más en junio) y una menor incidencia en invierno (menos en diciembre), con diferencias estadísticamente significativas. Conclusiones. En nuestros pacientes existe una relación estacional de los brotes de la EM, con un número mayor en los meses cálidos y menor en los meses fríos

Introduction. It has been suggested that there is an environmental factor at play in the aetiology and pathogenesis of multiple sclerosis (MS) that acts as an essential component of the disease process, and a number of studies also point to a relationship between the seasons of the year and the appearance of outbreaks. Aims. Our aim was to study the possible relation between seasonal variations and the appearance of outbreaks in patients with relapsing-remitting forms of MS. Patients and methods. We studied 31 patients over the period between 1997 and 2002 and calculated the monthly and quarterly rate of incidence of outbreaks. The statistical evaluation of the results was performed by applying the Chi-squared test. Results. We observed a higher incidence of outbreaks in the summer months (more in June) and a lower incidence in winter (less in December), with statistically significant differences. Conclusions. In our patients, outbreaks of MS are related to seasonal variations, with a higher number in the warmer months and fewer in the colder months

Evolución temporal de TNF-a, VCAM-1, IL-4, IL-10, neopterina y CD-30 en pacientes tratados con interferón / Time evolution of TNF-alpha, VCAM-1, IL-4, IL-10, neopterin and CD-30 in patients treated with interferon

Introducción. El interferón (IFN) disminuye los brotes de la esclerosis múltiple (EM) y enlentece su evolución. El seguimiento de los enfermos se realiza empleando parámetros clínicos y de resonancia, al no disponer de marcadores biológicos que permitan conocer su eficacia. Objetivos. 1. Conocer el efecto del IFN sobre la concentración sérica de TNF-a, IL-4, IL-10, VCAM-1, neopterina y CD-30 en pacientes con EM; 2. Conocer la evolución temporal de esas modificaciones, y 3. Conocer la utilidad clínica de su determinación aislada. Pacientes y métodos. Estudiamos 19 pacientes con EM clínicamente estables y en tratamiento con IFN. Las muestras se obtuvieron cada tres meses durante dos años y medio, siempre inmediatamente antes de inyectar el fármaco. Las interleucinas se determinaron mediante el método ELISA. Resultados. Las concentraciones séricas de neopterina, CD-30 y VCAM-1 no se modificaron, el TNF-a sufrió oscilaciones independientes del estado clínico del enfermo y la IL-4 y la IL-10 tuvieron un pico sérico significativo a los 9-12 meses del tratamiento. Conclusiones. La existencia de un pico significativo de IL-4 e IL-10 entre los 6 y los 12 meses del tratamiento indica que el IFN consigue su posible efecto inmunomodulador después de varios meses, por lo que una mala respuesta clínica inicial no debe ser motivo de suspensión del fármaco. La determinación puntual de las concentraciones séricas de IL no es útil en el seguimiento de los pacientes tratados con IFN (AU)

Introduction. Interferon (IFN) diminishes the outbreaks of multiple sclerosis (MS) and slows down its progression. Follow-up of patients is performed using clinical and resonance imaging parameters, and no biological markers are available that allow us to determine its efficiency. Aims. 1. To discover the effects of IFN on the serum levels of TNF-alpha, IL-4, IL-10, VCAM-1, neopterin and CD-30 in patients with MS; 2. To determine how these modifications evolve over time; 3. To find out the clinical value of its determination in isolation. Patients and methods. We studied 19 patients with MS who were clinically stable and undergoing IFN therapy. Samples were obtained every 3 months over a 2.5 year period and always immediately before injecting the drug. The ELISA method was used to determine interleukins. Results. Serum levels of neopterin, CD-30 and VCAM-1 were not modified, TNF-alpha levels oscillated regardless of the clinical status of the patient and IL-4 and IL-10 had a significant serum peak at 9-12 months after beginning treatment. Conclusions. The existence of a significant IL-4 and IL-10 peak between 6 and 12 months of therapy indicates that IFN reaches its possible immunomodulatory effect after several months and, therefore, a poor initial clinical response must not be a reason for discontinuing medication. The specific determination of the serum levels of IL is not useful in following up patients treated with IFN (AU)

[Time evolution of TNF-alpha, VCAM-1, IL-4, IL-10, neopterin and CD-30 in patients treated with interferon]. / Evolución temporal de TNF-a, VCAM-1, IL-4, IL-10, neopterina y CD-30 en pacientes tratados con interferón.

INTRODUCTION: Interferon (IFN) diminishes the outbreaks of multiple sclerosis (MS) and slows down its progression. Follow-up of patients is performed using clinical and resonance imaging parameters, and no biological markers are available that allow us to determine its efficiency. AIMS: 1. To discover the effects of IFN on the serum levels of TNF-alpha, IL-4, IL-10, VCAM-1, neopterin and CD-30 in patients with MS; 2. To determine how these modifications evolve over time; 3. To find out the clinical value of its determination in isolation. PATIENTS AND METHODS: We studied 19 patients with MS who were clinically stable and undergoing IFN therapy. Samples were obtained every 3 months over a 2.5 year period and always immediately before injecting the drug. The ELISA method was used to determine interleukins. RESULTS: Serum levels of neopterin, CD-30 and VCAM-1 were not modified, TNF-alpha levels oscillated regardless of the clinical status of the patient and IL-4 and IL-10 had a significant serum peak at 9-12 months after beginning treatment. CONCLUSIONS: The existence of a significant IL-4 and IL-10 peak between 6 and 12 months of therapy indicates that IFN reaches its possible immunomodulatory effect after several months and, therefore, a poor initial clinical response must not be a reason for discontinuing medication. The specific determination of the serum levels of IL is not useful in following up patients treated with IFN.