Asunto(s)
Cardiología/educación , Competencia Clínica , Curriculum , Especialización , Humanos , Sociedades MédicasRESUMEN
We set out to investigate the possible beneficial effects on cognitive function of demented patients with cobalamin deficiency after cobalamin replacement. A total of 181 consecutive, demented (DSM-III or DSM-III-R criteria and score below 24 on the Mini-Mental State Examination [MMSE]) outpatients (mean age 77.5 years) were prospectively evaluated and had their vitamin B12 level measured by radioimmunoassay. The frequency of vitamin B12 deficiency (less than 200 pg/mliter) was 25% (46 patients). Treatment outcome was obtained in 19 patients (19 of 46). Despite cobalamin replacement, 16 of 19 patients persisted in showing progressive decline during follow-up visits (3 to 24 months). The nonresponse to vitamin B12 replacement in most cases seems to reflect the presence of associated irreversible dementia or a follow-up of shorter duration in a few patients. All of the patients who showed some improvement (MMSE returned to normal values) had mild dementia with a history of less than 2 years. Thus, screening for B12 deficiency should be considered in patients with recent onset of mild mental status changes.
Asunto(s)
Demencia/diagnóstico , Deficiencia de Vitamina B 12/diagnóstico , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/sangre , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/tratamiento farmacológico , Enfermedad de Alzheimer/psicología , Demencia/sangre , Demencia/tratamiento farmacológico , Demencia/psicología , Demencia por Múltiples Infartos/sangre , Demencia por Múltiples Infartos/diagnóstico , Demencia por Múltiples Infartos/tratamiento farmacológico , Demencia por Múltiples Infartos/psicología , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intramusculares , Masculino , Escala del Estado Mental , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Vitamina B 12/administración & dosificación , Vitamina B 12/sangre , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/tratamiento farmacológico , Deficiencia de Vitamina B 12/psicologíaRESUMEN
This study was undertaken to characterize the different phases of the allergic pleurisy induced by ovalbumin in actively sensitized rats. The reaction was triggered by the intrathoracic injection of ovalbumin (12 micrograms/cavity) into animals sensitized 14 days before. The challenge caused, at 30 min, a drastic mast cell degranulation and exudation which peaked within 4 h. At this time, an intense pleural leucocyte recruitment also occurred, accounted for by an increase in the mononuclear cell counts and by a predominant influx of neutrophils. After 24 h, the mast cell counts started to recover, accompanied by a long-lasting (96 h) accumulation of pleural eosinophils. Forty-eight hours later, the exudation and neutrophils were at basal levels, whereas mast cell counts increased progressively to reach control values at 120 h. This study describes the time course of the exudative and cellular alterations observed during pleural inflammation induced by low antigen concentrations.
Asunto(s)
Leucocitos/patología , Mastocitos/patología , Derrame Pleural/patología , Pleuresia/inmunología , Enfermedad Aguda , Hidróxido de Aluminio , Animales , Femenino , Cinética , Masculino , Ovalbúmina , Derrame Pleural/inducido químicamente , Pleuresia/inducido químicamente , Ratas , Ratas EndogámicasRESUMEN
This study was undertaken to characteize the different phases of the allergic pleurisy induced by ovalbumin in actively sinsitized rats. The reaction was triggered by the intrathoracic injection of ovalbumin (12 microng/cavity) into animals sensitized 14 days before. The challenge caused, at 30 mjin, a drastic mast cell degranulation and exudation which peaked within 4h. At this time, an intense pleural leucocyte recruitment also occurred, accounted for by an increase in the mononuclear cell counts and by a predominant influyx of neutrophils. After 24h, the mast cell counts stated to reover, accompanied by a long-lasting (96 h) accumaltion of pleural eosinophils. Forty-eight hour later, the exudation and neutrophils were at basal levels, whereas mast cell counts increased progressively to reach control values at 120 h. This study describes the time course of the exudatory and cellular alterations observed during pleural inflammation induced by low antigen concentrations