RESUMEN
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.
Asunto(s)
Síndrome de Guillain-Barré , Humanos , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/epidemiología , Síndrome de Guillain-Barré/terapia , Axones , Electrofisiología Cardíaca , Extremidades , Estado de SaludRESUMEN
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.
Asunto(s)
Cateterismo Periférico/métodos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico , Arteria Radial/diagnóstico por imagen , Ultrasonografía Doppler/métodos , Enfermedad de la Arteria Coronaria/cirugía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea , Periodo Preoperatorio , Estudios Prospectivos , Reproducibilidad de los ResultadosRESUMEN
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.
Asunto(s)
Esquistosomiasis Urinaria/diagnóstico , Enfermedades de la Vejiga Urinaria/diagnóstico , Enfermedades de la Vejiga Urinaria/parasitología , Adulto , Humanos , Masculino , Contracción Muscular , Músculo Liso/fisiopatología , Esquistosomiasis Urinaria/fisiopatología , Enfermedades de la Vejiga Urinaria/fisiopatología , UrodinámicaRESUMEN
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)
Asunto(s)
Anciano , Femenino , Humanos , Anciano de 80 o más Años , Acetábulo , Prótesis de Cadera , Falla de Prótesis , Acetábulo , Fístula , Migración de Cuerpo Extraño , Fístula de la Vejiga Urinaria , Enfermedades ÓseasRESUMEN
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)
Asunto(s)
Adulto , Masculino , Humanos , Esquistosomiasis Urinaria , Urodinámica , Contracción Muscular , Músculo Liso , Enfermedades de la Vejiga UrinariaRESUMEN
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.