Biomedical subjects

K B Digre

Publications and source records attributed to K B Digre.

48 records · Page 3Linked to original sources

PubMed1989

The association of antiphospholipid antibodies with severe preeclampsia.

Over a 3-year period, we studied 43 women who presented with severe preeclampsia prior to 34 weeks' gestation. Seven (16%) had significant levels of antiphospholipid antibodies, whereas none of the normotensive controls of similar gestational age had antiphospholipid antibodies (P less than .001). Three of the seven women with antiphospholipid antibodies suffered the following complications during the peripartum period: 1) cerebral infarction and episodes of transient monocular blindness; 2) pulmonary embolism, deep venous thrombosis, and an autoimmune flare in the postpartum period; and 3) transient monocular blindness and amnesia after delivery. Our experience suggests that antiphospholipid antibodies are found in a substantial proportion of cases of early-onset severe preeclampsia and have important clinical implications. We suggest that patients with early-onset severe preeclampsia be screened for antiphospholipid antibodies; if antibodies are detected, these women should be considered for prophylactic anticoagulation therapy.

Autoantibodies↗

PubMed1988

Maternal orbital hematoma associated with labor.

We examined two women with orbital hematomas that occurred during labor. Both women developed sudden diplopia, proptosis, and orbital pain. The location of the hematoma was confirmed by orbital echography and computed tomography. The patients were observed without surgical intervention. Neither patient developed clinical or echographic signs of compressive optic neuropathy. Clinical resolution occurred during the following two weeks. Serial standardized orbital echographic examinations documented resolution of the hematomas.

Adult↗

PubMed1988

Pseudotumor cerebri in men.

We describe 29 men with pseudotumor cerebri (PTC) and compare them with aged-matched women with PTC and male control subjects. Pseudotumor cerebri occurs less frequently in men but in a similar age distribution. Although signs and symptoms of PTC are similar in men and women, men may require surgical treatment for impending visual loss. Black men appear to be at greater risk to loss of vision. Even though men with PTC are less likely to be obese than women, they tend to be more obese than control subjects and should be counseled on weight-reduction diets.

Acetazolamide↗

PubMed1988

CT and hemifacial spasm.

Forty-six patients with typical hemifacial spasm had CT. Thirty-eight (83%) were abnormal, including two with surgically documented tumors. Thirty-six had a characteristic dolichoectatic vertebrobasilar artery, with the convexity pointing to the side of the spasm in 92% of the scans. This study suggests that CT is worthwhile procedure in the evaluation of hemifacial spasm and that dolichoectatic vertebrobasilar arteries are very frequently associated with hemifacial spasm.

Adult↗

PubMed1987

Cytomegalovirus infection in a healthy adult associated with recurrent branch retinal artery occlusion.

The authors report a 16-year-old healthy male who developed branch retinal artery occlusions sequentially in both eyes. A few vitreous cells and retinal vasculitis were associated findings. A complete work-up of the patient for an etiology for the occlusions failed to show any possible embolic source. Spinal fluid studies showed increased protein content and lymphocytic pleocytosis. Serologic studies showed a tenfold rise in the cytomegalovirus (CMV) titer. Other viral titers did not rise. CMV could not be cultured from the patient's body. The case represents a possible cause of the so-called idiopathic recurrent branch retinal artery occlusion syndrome.

Acute Disease↗

PubMed1987

Cranial magnetic resonance imaging in eclampsia.

Although the precise neuropathologic basis for eclamptic convulsions remains unclear, intracranial hemorrhage is frequently associated with fatal cases. Magnetic resonance imaging (MRI) is a recently developed neuroimaging technique that appears superior to other processes for defining intracranial anatomy and pathophysiology. This technique has not yet been reported in eclampsia. The authors performed serial MRIs on an eclamptic woman, with findings compatible with previously described neuropathologic changes.

Adult↗

PubMed1986

Opsoclonus in adults. Report of three cases and review of the literature.

Opsoclonus is a rare but distinctive disorder of ocular motility. Although there are many reported cases of opsoclonus in children, there is no large series of cases in adults. In recent years, three cases of opsoclonus in adults have been identified at the University of Iowa, Iowa City. Review of 55 other cases of opsoclonus in adults reported in the literature showed that adults over 40 years of age with onset of opsoclonus should be investigated fully for underlying malignancy. In younger adults with a history of a preceding influenzalike illness, viral titers (acute and convalescent) should be obtained. Also, younger adults should be investigated for other causes of opsoclonus, such as drug or toxin exposure. Treatment is directed toward correcting the underlying process.

Adult↗

PubMed1984

Adherence of Candida species to human epidermal corneocytes and buccal mucosal cells: correlation with cutaneous pathogenicity.

Adherence of microorganisms to epidermal corneocytes may be a prerequisite for cutaneous colonization and infection. Six species of Candida were assayed in vitro for adherence to human epidermal corneocytes and buccal mucosal cells, and compared to previous studies of pathogenicity in a rodent model of cutaneous candidiasis. C. albicans and C. stellatoidea exhibited marked adherence to both epithelial cell types over time, and were cutaneous pathogens in the rodent model. The remaining species showed little or no adherence, and were nonpathogenic to skin. Adherence to corneocytes was not inhibited by ethylenediamine tetraacetic acid, mannan polysaccharide, or concanavalin A lectin. Fresh human serum, but not heat-inactivated serum, inhibited C. albicans adherence by 50%, and was associated with the deposition of complement components, C3 and factor B on blastospores. Adherence to epithelial corneocytes and mucosal cells is a property of pathogenic species of Candida, and may participate in cutaneous colonization and infection mechanisms. Adherence was time-dependent, and did not require divalent cations. Cell wall mannan may participate in the "adhesin" complex. Mannan activation of serum complement and deposition of C3 and factor B on blastospores may provide a protective action by inhibiting Candida adherence to corneocytes.

Candida↗

PubMed1984

Pseudotumor cerebri and pregnancy.

Pseudotumor cerebri (PTC) is most commonly seen in obese women of reproductive age. We studied 109 women with PTC between ages 16 and 44 years. In 11, PTC started during pregnancy. Thirteen women with previous diagnosis of PTC, including two of the aforementioned 11, had an additional 17 documented pregnancies. Patients were matched by age and parity with controls. Obstetric complications occurred more frequently in the controls. Visual loss occurred with the same frequency in pregnant and nonpregnant patients. Treatment of PTC patients in pregnancy should be the same as for nonpregnant PTC patients, except that calorie restriction and diuretic use are contraindicated. Obstetric management is no different from that of normal pregnancy.

Adolescent↗

PubMedDate not supplied

Sneddon's syndrome: a cause of cognitive decline in young adults.

OBJECTIVE: To review the clinical, psychometric, laboratory, and radiologic findings of 6 patients with Sneddon's syndrome (SS) who presented with cognitive dysfunction rather than stroke. DESIGN AND METHODS: Case series. All patients fulfilled were diagnosed as SS based on the co-occurrence of livedo racemosa and neurologic disease. Patients presenting with clinical stroke were excluded. RESULTS: Patients presented with cognitive complaints at an early age and all noted skin lesions from 6 months to 10 years before onset of cognitive symptoms. Associated systemic disorders included hypertension and seizures. Laboratory evidence of a hypercoagulable condition was identified in 4 of 6 cases. Brain MRI scans demonstrated atrophy, especially in parieto-occipital regions and cerebral blood flow on brain SPECT scan was reduced in a similar distribution. CONCLUSION: Patients with SS can develop dementia without antecedent clinical stroke. While the specific pathogenic mechanism of dementia in SS remains speculative, the disease predominantly injures brain tissue in vascular "watershed" territories.

Adult↗

PubMedDate not supplied

Selective MR imaging approach for evaluation of patients with Horner's syndrome.

PURPOSE: To assess the usefulness of MR in the evaluation of patients with Horner's syndrome. PATIENTS AND METHODS: We prospectively performed MR imaging in 33 patients with Horner's syndrome (13 preganglionic and 20 postganglionic) using a protocol specifically designed for pre- and postganglionic varieties of this syndrome. Assignment of patients to pre- or postganglionic categories was performed on the basis of pharmacologic testing. RESULTS: Abnormalities in one-half of the patients with preganglionic Horner's syndrome included lateral medullary infarct, spinal cord/root disease, apical lung tumor, and paravertebral metastatic mass. Three of 20 patients with postganglionic Horner's syndrome had carotid artery dissection. CONCLUSION: Routine scanning of patients who have postganglionic Horner's syndrome with cluster headaches was not helpful in our small series.

Adolescent↗

PubMedDate not supplied

Significance of CT and MR findings in sphenoid sinus disease.

Disorders of the paranasal sinuses, particularly the sphenoid sinus, can be associated with significant disorders of the optic and other cranial nerves. We examined 100 consecutive routine CT scans, 100 posterior fossa CT scans, and 100 MR scans to look for evidence of sinus disease, especially of the sphenoid sinus. The sphenoid sinus was abnormal in 7% of scans by all methods. Other sinuses were more frequently abnormal, including maxillary (23%), ethmoid (34%), and frontal (16%). Although MR was more sensitive in detecting sinus inflammation in the ethmoid and maxillary sinuses, the frequency of visible sphenoid sinus abnormalities detected by MR was not significantly greater when compared with CT. Of those patients with abnormal sphenoid sinuses, 24% had visual problems associated with the abnormality.

Adult↗