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C Morales Bastos

Publications and source records attributed to C Morales Bastos.

8 recordsLinked to original sources

[Systemic necrotizing vasculitis in autopsy].

OBJECTIVE: To analyze the characteristics of systemic necrotizing vasculitis observed in necropsy emphasizing the non-diagnosed cases until necropsy and to identify the reasons of clinical confusion. MATERIALS AND METHODS: Necropsies of adult patients performed in Hospital General La Paz, Madrid, from 1966 to 1977 were reviewed. Clinical manifestations, analytical changes and involvement of different organs were analyzed. The correspondence degree between clinical and necropsic diagnoses was studied. RESULTS: A total of 18 cases of necrotizing vasculitis were observed out of 3,980 necropsies. The most common clinical manifestations were fever and general syndrome (60%). The organs most commonly involved were kidney (94%) and gastrointestinal tract (56%). Diagnosis was revealed by necropsy in 39% of cases; in these cases, the incidence of heart failure and peripheral neuropathy was significantly lower, whereas digestive hemorrhage and liver, pancreas, adrenal gland, and bladder involvement was significantly higher. CONCLUSIONS: Systemic necrotizing vasculitis in underdiagnosed, which can be partly explained by the lack of specificity of the most common symptoms and the paucity of characteristic clinical and organ-specific manifestations which leads to confusion with more prevalent conditions.

Adult↗

Small arterial granular degeneration in familial Binswanger's syndrome.

A 55-year-old mildly hypertensive woman died after having developed a subcortical dementia during the past 9 years, with focal neurological signs. She presented at the age of 46 years with short episodes of dizziness and diplopia, suggesting that transient ischemic attacks involved the posterior fossa structures. Over the next 8 years, she developed difficulty in walking, urinary incontinence and seizures. On examination in 1989, she was severely demented. There was tetraparesis, bilateral arm and leg spasticity with hyperreflexia and bilateral Babinski signs. She showed epilepsia partialis continua involving the eyes, left hemiface and limbs. CT showed hypodensity of the white matter and lacunes in the basal ganglia and centrum semiovale, moderate hydrocephalus with cerebellar and cortical atrophy. Clinical and radiological features were similar to those of Binswanger's disease. Similar cases had occurred in the family affecting the patient's grandfather, father and two brothers, suggesting an autosomal dominant hereditary disease. Postmortem examination disclosed a Binswanger type of leukoencephalopathy caused by a peculiar microangiopathy characterized by a slightly basophilic small arterial granular degeneration of the medial sheath associated with the presence of ballooned smooth muscle cells with clear cytoplasm. Electron microscopic study revealed degenerative changes in the parietal vessels with notable increase of basal-membrane-type material and electron-dense granular deposits. These lesions could correspond to a specific familial pathology of the small arteries of the brain. They are identical to those reported in some patients with autosomal dominant inheritance. For other patients with similar clinical features and the same familial pattern, reported as "hereditary multi-infarct dementia'' and "chronic familial vascular encephalopathy'', there are no sufficient objective pathological facts to consider that they have the same disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗

[Neuropathology of HIV infection].

Some references about the important neuropathologic lesions observed in patients with AIDS and about the variation on the relative incidence of the processes detected when analyzing clinic and neuropathologic tables, as well as a mention to the confusion created by terminological problems, clinicopathologic disagreement and wrong etiologic attributions, are used as an introduction to the exposition of HIV infection neuropathology. In a first section, Central Neuropathology is described, starting with the disorders considered as primarily caused by HIV. Then, infectious secondary Neuropathology, caused by different viruses, parasites, fungi or bacteria, and neoplastic secondary Neuropathology, mainly represented by localized lymphoma and by the uncommon Kaposi's disease, are analyzed. This section also includes references to cerebrovascular complications, Pediatric Neuropathology and ends with an analysis of cerebral biopsy indications. In the second part, Peripheral Neuropathology is described, splitting up peripheral nerve and muscle pathology.

Acquired Immunodeficiency Syndrome↗