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B Estañol

Publications and source records attributed to B Estañol.

At least 19 recordsLinked to original sources
PubMed2004

Response of thymectomy: clinical and pathological characteristics among seronegative and seropositive myasthenia gravis patients.

OBJECTIVE: To identify the response to thymectomy in patients with seronegative and seropositive myasthenia gravis (SPMG). We analyzed the associated diseases, thymus histology, and the severity of symptoms between the two groups. MATERIAL AND METHODS - DESIGN: Descriptive, comparative. STUDY UNITS: Fourteen patients with seronegative myasthenia gravis (SNMG) and 57 patients with SPMG who had a thymectomy between 1987 and 1997, with at least 3 years of follow-up. The patients were divided into four groups; (1) Remission, (2) Improvement, (3) No change and (4) Deterioration. RESULTS: Fourteen patients (20%) were seronegative and 57 were seropositive (80%). In the group of patients with SNMG, three patients were in remission (21%), five with improvement (36%), five with no change (36%) and one with worsening (7%). In the group of patients with SPMG, 12 were in remission (21%), 17 with improvement (30%), 25 with no change (44%) and three (5%) with worsening. The patients with SNMG were older, with less associated diseases and with a lower frequency of thymomas. CONCLUSIONS: The response to thymectomy was similar between the two groups. It has been suggested that seronegative patients have a better prognosis, but our results show no differences.

Adult↗
PubMed2004

Associated conditions in myasthenia gravis: response to thymectomy.

To compare the response of thymectomy in patients with associated conditions (PWAC) and without associated conditions (PWOAC). Comparative, retrospective. 198 patients with the established diagnosis of myasthenia gravis who had a thymectomy between 1987 and 2000, and who were folowed up for at least 3 years. We formed two groups, one with associated conditions and the second without associated conditions. The patients were divided into four groups: (i) patients in remission, (ii) patients with improvement, (iii) patients without changes, and (iv) patients whose condition worsened. Associated conditions (AC) were found in 49 patients (26%). The main associated conditions were hyperthyroidism in 16 patients (33%) hypothyroidism in seven (14%), rheumatoid arthritis in five (10%) and hypothyroidism and Sjogren syndrome in three (6%). Concerning the response of thymectomy, 13 patients WAC showed remission (27%), vs. 54 patients WOAC (39%). Twenty patients WAC showed improvement (41%) vs. 46 WOAC (33%). Thirteen patients WAC had no changes (27%) vs. 37 WOAC (26%). Finally, in three patients WAC their condition worsened (6%) vs. three WOAC (2%). The response to thymectomy was high (69%) in both groups. We did not identify significant differences.

Adult↗
PubMed2003

HLA class II genotypes in Mexican Mestizo patients with myasthenia gravis.

Myasthenia gravis is an autoimmune, heterogeneous disorder, characterized by the presence of antibodies against acetylcholine receptors at the neuromuscular junction. There is a strong evidence that an individual's genetic composition is an important predisposing factor for the development of the disease. To correlate HLA class II genotypes with thymic pathology in Mexican Mestizo patients who had been subjected to thymectomy. HLA class II genes were analyzed in 60 patients and in 99 healthy ethnically matched controls. Thymic hyperplasia, atrophy, thymoma, and normal histology were encountered in 56, 33, 8 and 2% of patients, respectively. HLA-DR11 was significantly increased in patients with thymoma compared with healthy controls (pC = 0.001, OR = 13.35, 95% CI 3.5-51.3), compared with the subgroup of hyperplasia patients (pC = 0.005, OR = 15.5, 95% CI 2.78-95.58) and with the atrophy subgroup (pC = 0.04, OR = 10.5, 95% CI 1.75-70.95). This study provides the evidence of an association between HLA class II alleles with clinical and genetic heterogeneity in myasthenia gravis, particularly in those with thymoma (HLA-DR11).

Adolescent↗
PubMed2003

The association of myasthenia gravis and connective tissue diseases. Effects of thymectomy in six cases with rheumatoid arthritis and one case with systemic lupus erythematosus.

OBJECTIVES: To describe the effects of thymectomy in a group of patients with myasthenia gravis (MG) with associated connective tissue diseases (CTD). PATIENTS AND METHODS: We analyzed six patients with CTD and myasthenia. They were followed-up for at least 3 years. RESULTS: Records of a cohort of 132 patients with established diagnosis of MG undergoing thymectomy in our institution between 1987-1999 were reviewed. The percentage of patients with CTD was 5 % (6/132). Five patients had rheumatoid arthritis (RA) and one patient systemic lupus erythematosus (SLE). All patients were women, and the mean age was 38.5 years old (SD 13.7). Mean time of MG diagnosis to operation was 16 months (range from 1 to 144 months). Preoperative Osserman classification was the following: stage IIb, four patients; stage III, one patient; and stage IV, one patient. Before surgery all patients were on anticholinesterase agent (pyridostigmine), and four patients were on corticosteroids. An extended transsternal thymectomy was practiced on five patients and a transcervical thymectomy was performed in the remaining patient. Pathologic findings were as follows: thymic hyperplasia in four patients and thymic atrophy in the other two. Good response (remission or improvement) was present in three patients (50 %) and poor response (no change or worse) in the other three (50 %). CONCLUSIONS: A low response to the thymectomy is observed in patients with MG and associated CTD (RA and an SLE).

Adult↗
PubMed2001

Prognostic factors of thymectomy in patients with myasthenia gravis: a cohort of 132 patients.

OBJECTIVE: To identify the response to thymectomy and the factors associated with a poor response, a nested case-control study was performed on 132 patients with an established diagnosis of myasthenia gravis who had had a thymectomy between 1987 and 1997 and had been followed up for at least 3 years. METHODS: In order to assess the response to thymectomy, the following two points were taken into account: (a) the dose of pyridostigmine and other drugs (steroids, azathioprine) that the patient took before and after thymectomy, and (b) the Osserman classification before and after thymectomy. The patients were divided into 4 groups: (1) patients in remission; (2) patients with improvement; (3) patients with no change, and (4) patients who were worse. RESULTS: 91 patients had a good response (69%) and 41 patients had a poor response (31%). The response by groups was as follows: 50 patients were found to be in remission; 41 patients had improved; 34 patients had no changes, and 7 got worse. Being more than 60 years old was associated with a poor prognosis (odds ratio 4.6, CI 1.11-20.32, p 0.01). The patients who had the disease for more than 3 years (odds ratio 2.97, CI 0.79-5.39, p 0.09) had a tendency towards a bad prognosis even though there was no statistical significance, and for those who had it for more than 4 years (odds ratio 2.58, CI 0.89-0.96, p 0.02) the bad prognosis was statistically significant. The patients who had the disease for more than 3 years between diagnosis and thymectomy (odds ratio 2.02, CI 0.69-5.90, p 0.15) and those with it for more than 4 years (odds ratio 2.53, CI 0.83-7.7, p 0.06) had a tendency towards a poor prognosis even though there was no statistical significance. In addition, having Osserman I was associated with a bad prognosis. Referring to the pathological findings, patients with thymoma (odds ratio 3.51, CI 0.43-31.5, p 0.15) and those with thymic atrophy (odds ratio 2.19, CI 0.93-5.16, p 0.04) had a poor prognosis. Finally, the use of steroids before thymectomy (odds ratio 2.26, CI 0.99-5.18, p 0.03) was associated with a worse prognosis. CONCLUSIONS: The response to thymectomy was high (69%). The variables that had the most prognostic importance were age and the Osserman stage. Other variables of poor prognosis were: high doses of pyridostigmine and use of steroids before surgery; the total duration of the disease and the duration of the disease between diagnosis and the surgical procedure; history of previous thymectomy; use of plasmapheresis after surgery, and the discovery of thymic atrophy and thymoma in the histopathological result.

Adrenal Cortex Hormones↗
PubMed2000

HLA class II genotypes in Mexican Mestizos with familial and nonfamilial multiple sclerosis.

Predisposition to MS is associated with the HLA-DR2 antigen in white patients. The authors investigated the genetic factors behind the increasing frequency of MS in the Mexican population. HLA-DR and DQ were analyzed in 17 patients with MS, 15 of their first-degree relatives, and 99 healthy ethnically matched controls. DR2 or DR3 was found in 15 of 17 patients. In controls, both alleles had frequencies less than 0.05. MS in Mexican patients was associated with HLA-DR2 and DR3.

Adult↗
PubMed1998

[A case of cortical amusia in a patient with musical ability].

CLINICAL CASE: A women who had previously had musical ability presented with bilateral embolic damage to both superior temporal convolutions. For the first few days, she had complete cortical deafness with reception aphasia. This evolved to a slight Wernicke's aphasia and reception amusia. The amusia was characterized by inability to understand lyrics and tunes, and in this patient has persisted a year and a half later. CONCLUSIONS: It is postulated that the inability to understand the words of songs is due to damage to the first left temporal convolution, whilst the amusia of tunes is due to damage to the first right temporal convolution.

Female↗
PubMed1989

Humoral immune response in patients with cerebral parenchymal cysticercosis treated with praziquantel.

The humoral immune response to treatment with praziquantel (PZQ) was studied in eight patients with parenchymal cerebral cysticercosis (CC). In the serum and in the cerebrospinal fluid (CSF) before, during and after the administration of the drug, the following were quantitated (a) levels of specific anticysticercous antibodies measured in optical densities by the ELISA method; (b) levels of IgG, IgM, IgA and IgE; (c) levels of complement fraction C3, C4; (d) presence of immune complexes; (e) total number of white blood cells in the CSF. It was found that after treatment with PZQ, the level of specific anticysticercous antibodies and the level of IgG rose significantly in the CSF but not in the blood. The levels of the fractions of the complement and the immunoglobulins IgM, IgA and IgE did not change significantly either in the serum or in the CSF. The blood-brain barrier was found ruptured in three patients before therapy and in five patients after the therapy as measured by the albumin index. Nevertheless, the IgG index showed that there was local production of IgG in five patients before treatment and in seven after the end of it. The relative specific antibody index was greater than 1.0 in five patients before therapy and in seven after therapy. This data strongly supports the idea that the specific antibodies are produced intrathecally and are not derived from the serum pool through a ruptured blood-brain barrier. It was concluded that patients with parenchymal CC have an elevation of specific anticysticercous probably due to a combination of a ruptured blood-brain barrier and intrathecal synthesis. The relatively small rupture of the blood-brain barrier and the high IgG and relative specific antibody index suggest that intrathecal synthesis is the most important mechanism. The humoral immune response may be of importance not only in the elimination of the parasite but also in the genesis of the illness.

Adult↗
PubMed1986

A prognostic classification of cerebral cysticercosis: therapeutic implications.

Cerebral cysticercosis is a parasitic infestation with a highly variable prognosis and diverse clinical manifestations. Over the period of two years 51 patients were studied prospectively with this infestation, paying particular attention to the duration and severity of the illness, clinical course, CT findings and therapeutic modalities. Patients with parenchymal cysts or calcification without hydrocephalus had a benign disorder presenting commonly with seizures. This type of infestation usually is long-standing, almost never requires surgical treatment, responds to praziquantel therapy and has a good prognosis. In contrast, patients who present with hydrocephalus, large supratentorial cysts, multiple granulomata with cerebral oedema or with vasculitis and cerebral infarction, have an aggressive, acute or subacute illness, presenting with raised intracranial pressure, gait disturbances, mental changes, seizures, cranial nerve palsies, hemisphere syndromes, chronic meningitis and stroke. This malignant form usually requires surgical therapy, does not respond to praziquantel and may produce a fatal outcome or serious sequelae.

Adolescent↗
PubMed1986

Anticysticercous antibodies in serum and cerebrospinal fluid in patients with cerebral cysticercosis.

Fifty-one cases of cerebral cysticercosis proved by surgery or CT scanning were studied prospectively with the ELISA test in order to detect anticysticercous antibodies in blood and CSF. The ELISA test was also performed for detection of antibodies in 20 control patients who had CSF withdrawn during a myelogram and in 119 serum samples of asymptomatic subjects. We found an overall sensitivity of the ELISA test in the blood of 87% with a specificity of 90%. In the CSF we found a sensitivity of 87% with a specificity of 100%. However, when we compared patients with cerebral cysticercosis of a benign type with patients with cerebral cysticercosis of a malignant type we found a serum sensitivity of 75% for the benign group as compared to 93% of the malignant group. The CSF sensitivity was 80% in the benign group and 93% in the malignant group. This difference was statistically significant.

Adolescent↗
PubMed1984

Looking with a paralysed eye: adaptive plasticity of the vestibulo-ocular reflex.

When a patient with a peripheral monocular paresis is forced to look with the paretic eye, head movements induce the sensation of an unstable visual world. The patient behaves as if he had acute bilateral labyrinthine lesions. These symptoms are due to the lack of compensatory ocular movement and the patients complain that the visual objects move in the direction opposite to the head. The patients develop ataxia, nausea, vomiting and past pointing. The symptoms, however, are transient and consistently disappear after approximately 48 hours. The central adaptation to looking and seeing with the paralysed eye is associated with a plastic change of the VOR. This plastic adaptation is probably induced by the large retinal slip produced by the lack of compensatory movement of the eye and can be studied in the normally mobile eye in the dark. The psychophysical adaptation is probably generated by an efferent copy or corollary discharge of the vestibular system to the visual system that cancels the retinal error.

Adult↗
PubMed1983

Temporal course of the threshold and size of the receptive field of the Babinski sign.

The changes of threshold and receptive field of the Babinski reflex, with time, were assessed in ten patients with acute cerebrovascular lesions. It was found that the threshold of the reflex decreased gradually and the size of the cutaneous afferent reflex field enlarged with the passage of time. These findings suggest that there is a gradual release or organisation of the reflex flexor synergy of which the Babinski sign is a modified part.

Afferent Pathways↗