Early electrophysiological study variants and their relationship with clinical presentation and outcomes of patients with Guillain-Barré syndrome.

This study compared the clinical outcomes of the two main neurophysiological types of Guillain-Barré Syndrome (GBS). Sixty-two GBS patients were examined clinically at onset using Medical Research Council (MRC), Hughes disability scales (HDS), and nerve conduction studies were evaluated in four limbs. The Modified Erasmus GBS outcome score (MEGOS) was assessed 2 weeks after onset. Outcomes were measured after 3 months using MRC and HDS scores. According to electrophysiological data two main groups identified acute inflammatory demyelinating polyneuropathy (AIDP = 31 cases) or acute axonal GBS including inexcitable forms (26 cases). The number of days between onset of weakness and admission was significantly shorter, and gastrointestinal symptoms were significantly higher among the axonal type than AIDP. MRC sum scores at onset and at nadir were significantly worse in the axonal type than in AIDP. Neck muscle weakness, impaired cough reflex, the need for mechanical ventilation, hypoalbuminemia, and hypernatremia were more common in the axonal type. At outcome, 74% of the AIDP were healthy/minor symptoms versus 38.46% of the axonal type. There was a high prevalence of the axonal variant (41.9%) compared with European and North American populations. The axonal type had a significantly worse outcome than AIDP type.

Radial artery ultrasound predicts the success of transradial coronary angiography.

BACKGROUND: The transradial approach has become the preferred vascular access during conventional coronary angiography (CCA). Hereby, we evaluated the impact of pre-procedural radial artery diameter (RAD), the cross-sectional area (CSA), and the perimeter on vascular complications (VACs). METHODS: We conducted a single-center prospective analysis of 513 patients who underwent CCA. Radial artery ultrasonography was performed before and after CCA to measure the RAD, CSA, and perimeter. RESULTS: The average RAD, CSA, and perimeter were 2.60 ± 0.48 mm, 6.2 ± 3.0 mm2, and 8.9 ± 1.7 mm, respectively. Vascular complications were reported in 56 (11%) patients. The RAD, CSA, and perimeter were significantly smaller in patients in whom procedure-related VACs were observed than in those with no complications: 2.3 ± 0.5 vs. 2.70 ± 0.54 mm (p = 0.0001), 4.9 ± 2.1 vs. 6.4 ± 3 mm2 (p = 0.001), and 7.6 ± 2.1 vs. 9.2 ± 1.6 mm (p = 0.0001), respectively. Univariate logistic regression showed that RAD, CSA and perimeter can independently predict VACs (OR 0.833, 95% CI 0.777-0.894, p < 0.0001; OR 0.647, 95% CI 0.541-0.773, p < 0.0001; OR 0.545, 95% CI 0.446-0.665, p < 0.0001, respectively). CONCLUSIONS: Ultrasonographic study of the radial artery before CCA can provide valuable information regarding vascular access.

[Bladder schistosomiasis. Etiologic diagnosis of detrusor contraction insufficiency]. / Esquistosomiasis vesical. Diagnóstico etiológico de la insuficiencia de contracción del detrusor.

This paper reports a case of bladder bilharziasis with histopathological exam and different patterns of urodynamic evaluation. The need for urodynamics is emphasized in order to avoid diagnostic and therapeutic mistakes.

Fístula vésico-acetabular tras migración protésica / Vesico-acetabular fistula following prosthesis displacement

Se describe el caso excepcional de una fístula vésico-acetabular tras la migración del acetábulo de una prótesis de cadera hasta el interior vesical, catorce años después del implante de dicha prótesis y que cursó con osteomielitis, linfedema, infección urinaria recurrente, hematuria y fiebre. A propósito de nuestra paciente se realiza una revisión de los casos recogidos en la literatura (AU)

Esquistosomiasis vesical. Diagnóstico etiológico de la insuficiencia de contracción del detrusor / Bladder bilharziasis. Etiologic diagnosis of impaired bladder muscle contractility

Presentamos un caso de esquistosomiasis vesical con análisis histopatológico y estudio urodinámico completo, describiendo los diferentes patrones de afectación de la vejiga urinaria. Se insiste en la necesidad de la evaluación mediante urodinámica de estos pacientes para evitar posibles errores diagnósticos y terapéuticos (AU)

[Vesico-acetabular fistula following prosthesis migration]. / Fístula vésico-acetabular tras migración protésica.

A rare case is described of vesico-acetabular fistula following acetabulum displacement of a hip replacement towards the inner bladder, fourteen years after the original insertion of the prosthesis. In all the reviewed literature of we have not found a single described case of vesico-acetabular fistula associated with displacement towards the bladder interior of a hip prosthesis, which leads us to consider this complication an exceptional one.