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Biomedical subjects

P Batista

Publications and source records attributed to P Batista.

7 recordsLinked to original sources
PubMed2001

HITS in internal carotid dissections.

Carotid dissections can cause neurological deficits either by hemodynamic or embolic mechanisms. Anticoagulants are often used in this setting to prevent neurological deterioration and stroke recurrence. High-intensity transient signals (HITS) detected by transcranial Doppler may be due to microembolism. We investigated the presence and number of HITS in a series of 27 patients with carotid dissection. HITS were detected in 14 (52%) patients and only in cases with a less than 7-day evolution. No association was found between HITS and clinical or imagiological features of the dissection nor with neurological aggravation or treatment type. We failed to demonstrate any relevant clinical significance of HITS in carotid dissection.

Adult↗
PubMed1998

Venous transcranial Doppler in acute dural sinus thrombosis.

The value of conventional transcranial Doppler ultrasound in the diagnosis and monitoring of cerebral vein thrombosis is unclear. Previous studies have suggested the usefulness of this method in two cases with superior sagittal sinus thrombosis that showed increased velocities of deep cerebral veins. The purpose of the present study was to evaluate the deep intracranial venous circulation in patients with that pathology. Venous transcranial Doppler ultrasound was performed with a range-gated 2 MHz transducer in 17 healthy volunteers and in six cases of proven acute superior sagittal sinus thrombosis. Peak systolic, end diastolic and mean blood flow velocities were measured in the basal vein of Rosenthal (BVR) and deep middle cerebral vein (DMCV) through a posterior temporal window. In 16 controls and in one patient, the straight sinus was also studied through an occipital approach. Sex distribution and mean age of controls and patients were similar. Mean blood flow velocities in controls were as follows (mean, SD): DMCV, 10.4, 1.4 cm/s; BVR, 11.3, 1.8 cm/s; straight sinus, 29.5, 9.9 cm/s. Three of the patients with superior sagittal sinus thrombosis showed increased velocities either in the DMCV, the BVR or the straight sinus. One patient showed slightly increased velocities in the BVR, and the other two showed normal venous velocity values. This study confirms the usefulness of conventional transcranial Doppler ultrasound in detecting superior sagittal sinus thrombosis. However, a normal examination does not exclude this diagnosis.

Adult↗
PubMed1997

[Familial infection by the hepatitis C virus].

The aim of this study was to evaluate the prevalence of the antibody to hepatitis C virus (HCV) in the relatives of cases of asymptomatic chronic hepatitis C infection, detected during routine blood donation, and determine risk factors for the presence of the infection in the family setting. Two hundred and eighty-five relatives (spouses, offspring, siblings and parents) of 87 index cases were studied. Anti-HCV was detected using second generation ELISA and RIBA tests. The overall prevalence of anti-HCV in the studied population was 6.7%, higher in spouses (11.7%) and lower in the offspring (2.1%). The presence of HCV RNA was detected in 12 of 45 index cases, using nested PCR. No increased risk of infection was found in the relatives of cases with HCV-RNA positivity. Using a logistic regression model, four factors were identified as significantly associated with an increased risk of hepatitis C in the relatives: the age of the index case, and, as characteristics of the relatives, male gender, past or ongoing hepatitis B virus infection, and being a spouse of an index case.

Adult↗
PubMedDate not supplied

The detection of microembolic signals in patients at risk of recurrent cardioembolic stroke: possible therapeutic relevance.

The clinical predictors and potential therapeutic implications of microembolic signals (MES) were investigated in 104 patients with ischemic stroke or transient ischemic attack associated with high-risk (n = 60) or low-risk (n = 44) cardiac emboligenic conditions. Patients with artificial valves and carotid stenosis were excluded. MES counts were based on 30-min bilateral middle cerebral artery transcranial Doppler (TCD) monitoring recordings. MES were detected in 15 subjects (14%). The mean number of MES per hour was 1.9. MES prevalence and counts were influenced neither by age, gender or type of cerebral event, nor by cardiac disease. MES were more frequently detected and greater in number in patients with multiple cerebral ischemic events and in subjects monitored within 1 month of the last event. By multiple logistic regression, TCD recording within 1 month of the last event [Odds ratio (OD) = 13.5; 95% confidence intervals (CI) = 3.3-54.3] and multiple cerebral events (OD = 4.7; 95% CI = 1.3-17.3) were the best MES predictors. MES were detected in 40% (4/10) of patients on heparin, 5% (2/4) of untreated subjects and 13% (5/39) of those on antiplatelet drugs. For patients on warfarin, MES counts and prevalence were similar in subjects with international normalized ratios (INR) below and within/above the therapeutic range. MES were detected in only 2 out of 16 subjects with INR <2 and in 1 with INR >2. MES detection can be potentially relevant to the selection of antithrombotic treatment in acute stroke associated with cardioembolic disease, but further studies are necessary to assess its effectiveness as an additional guide to monitor oral anticoagulant intensity.

Administration, Oral↗
PubMedDate not supplied

[Ischemic optic neuropathy following a dural arteriovenous fistula. Vascular steal phenomenon].

CASE REPORT: We report the case of a 46-year-old patient, with a dural arteriovenous fistula in the left cavernous sinus fed by dural branches of both carotid siphons, by recurrent branches of the left ophthalmic artery (LOA) and by dural branches of the left external carotid artery. Twenty-four hours after arterial embolisation with polyvinyl alcohol particles, the patient suffered visual loss in the left eye. All feeders were embolized except the recurrent branches of the LOA, which became hypertrophied. Fluorescein angiography of the retina was normal. Transocular Doppler ultrasound showed a turbulent, inverted, low resistance flow in the LOA distal part, and a high resistance anterograde flow in the left central artery of the retina, which accounted for an ischemic optic neuropathy. CONCLUSIONS: The ischemic optic neuropathy resulted from a vascular steal phenomenon. Hypertrophy of recurrent branches of the LOA, after embolization of the remaining feeders, contributed to a low resistance shunt between the LOA proximal part and the left cavernous sinus. This shunt caused the inversion of flow in the distal part of the artery and the subsequent decrease of retrobulbar blood supply.

Central Nervous System Vascular Malformations↗