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Biomedical subjects

R Hernández-Lorido

Publications and source records attributed to R Hernández-Lorido.

8 recordsLinked to original sources
PubMedDate not supplied

[The relation between carotid ultrasound changes and seropositivity to Chlamydia pneumoniae in patients with acute stroke].

INTRODUCTION: Several infectious agents have been found to be involved in atherogenesis over the past decade. Chlamydia pneumoniae is one of the commonest associated agents. In this study we have analysed the possible relationship between a high level of antibodies to Chlamydia, and the presence of carotid ultrasound changes in patients who have had strokes. PATIENTS AND METHODS: We studied 230 patients admitted consecutively to the Stroke Unit in our hospital, with the diagnosis of stroke. All the patients in the group had carotid duplex ultrasound studies to assess the degree of stenosis. All these patients also had serological studies using micro-immunofluorescence to detect antibodies to Chlamydia pneumoniae. RESULTS: Only 35 patients were found to have positive Chlamydia pneumoniae serology. The degree of atheromatosis was similar in the patients with high levels of IgG for Chlamydia pneumoniae and in those with normal serology. There was no statistically significant relation between the degree of stenosis and being seropositive for Chlamydiae. CONCLUSIONS: Our findings suggest that in an unselected population of stroke patients there is no relations between carotid atheromatosis and positive serology findings to Chlamydia pneumoniae. If there is any relationship between Chlamydia pneumoniae and carotid atheromatosis, serology does not seem to be a technique which is suitable for its assessment.

Acute Disease↗
PubMedDate not supplied

[Gabapentin in 50 patients with epilepsy].

OBJECTIVE: To evaluate monotherapy treatment with the anticonvulsant drug gabapentin, its efficacy and tolerability when used in patients with partial and secondary generalized partial epileptic seizures of recent onset who had not received treatment or who, in spite of treatment with other antiepileptic drugs failed to attain control over their seizures. PATIENTS AND METHODS: We made an open prospective study of 50 patients diagnosed as having partial and secondarily generalized partial epileptic seizures. The patients were given treatment at their first visit and them regularly followed up for two years. Treatment was given progressively until a maintenance dose of 1.200 mg/day was reached, and the dose them adjusted individually. RESULTS: We included 50 patients in the study; 78% were treated with gabapentin. Ten percent stopped this treatment because it was ineffective. All the patients who continued their treatment with gabapentin had their seizures reduced by over 50%. This reduction in the number of seizures is statistically significant (p < 0.05) for patients with partial and secondarily generalized partial seizures. Twelve percent of the group of patients stopped their treatment because of side-effects. CONCLUSIONS: When the results of our study are evaluated and compared with those published in the literature, it may be seen that gabapentin is a safe, effective drug which is well tolerated when used as monotherapy for the treatment of patients with partial seizures.

Acetates↗
PubMedDate not supplied

[Evaluation of hemodynamic parameters by transcranial Doppler in patients with leukoaraiosis].

INTRODUCTION: Leukoaraiosis is commonly found in neuroimaging in ancient people. The pathogenic theory that most suitably explains its origin is the vascular one, mainly linked to cerebral hemodynamic abnormalities. The techniques most frequently used in cerebral hemodynamic evaluation (PET and SPECT) are expensive and not widespread. Transcranial Doppler instead is cheaper and much more widespread. OBJECTIVE: Our aim has been to show whether transcranial Doppler is a useful tool for cerebral hemodynamic evaluation in leukoaraiosis. PATIENTS AND METHODS: We have prospectively included 116 patients aged 60-90 who came to the Neurology department with unspecific complaints such as dizziness or mild headache. Patients with recent history of stroke or moderate to severe cognitive impairment were excluded. RESULTS: Mean age was 74.4 +/- 6.3 years old. The prevalence of leukoaraiosis was 68.7%. Leukoaraiosis was significantly correlated with older age, lacunar infarctions, past history of stroke, cognitive impairment and to lower systolic and diastolic velocities in middle cerebral artery (MCA) and higher pulsatility index. Multivariate analysis only retained the lower diastolic velocity in MCA in the model. CONCLUSIONS: Transcranial Doppler can detect hemodynamic abnormalities in patients with leukoaraiosis and is therefore a very useful technique for the evaluation of this entity.

Aged↗
PubMedDate not supplied

[Neurosonological findings in the carotid artery in a sample of patients with lacunar infarction].

INTRODUCTION: Carotid stenosis has been reported as being associated to lacunar infarcts (LI) with variable frequency, but the aetiopathogenic relation between them is still subject to some controversy. AIMS: Our aim was to describe the prevalence of carotid disorders in a neurosonological study of a sample of patients with LI. PATIENTS AND METHODS: We analysed the results of the neurosonological study conducted on patients with clinical-radiological criteria of LI who were admitted to our Stroke Unit during the period of study. RESULTS: We studied 140 patients, and results were normal in only 42% of the cases. Stenosis > 50% was found in 10% of the cases and plaque without stenosis in 40.3% of the patients. In patients without plaque there was an increase in the tunica intima-media thickness in 7.2% of the cases. CONCLUSION: In most of the patients with LI there were anomalies in the study of the carotid performed using ultrasound scanning.

Aged↗
PubMedDate not supplied

[Neurosonological studies in patients over 80 years old].

INTRODUCTION: The link between cardiovascular risk factors and carotid atheromatosis has been shown to be more important in middle aged subjects than in the elderly. AIMS: Our aim was to study the frequency of carotid and intracranial atheromatosis in a population over the age of 80 and to compare the presence of neurosonological anomalies depending on whether the patients have suffered a stroke or not. We also wished to compare the findings according to the sex of the patient. PATIENTS AND METHODS: Patients over the age of 80 were studied at our Neurosonology laboratory using carotid and transcranial Doppler ultrasonography. The patients were analysed according to whether they had suffered an ischemic stroke or not. With regard to the carotid, a distinction was made between normal, non-significant atheromatosis and significant atheromatosis (stenosis > 50%). Intracranially, both the middle cerebral artery (normal, stenosis, microangiopathy and post-stenosis) and the basilar artery (normal, stenosis, microangiopathy and hyperdynamics) were studied. RESULTS: We recorded data concerning 832 patients: 342 males (44.1%), mean age 83.63 +/- 3.25 years, and 527 (63.3%) with stroke. The carotid study was pathological, with a higher frequency in stroke patients (32.1% compared with 41.9%; p = 0.002). The presence of atheromatosis was significantly linked to a higher risk of suffering a stroke and more intensely to its being more severe. Carotid studies were pathological with a higher frequency among males (28.7% compared with 40%; p < 0.001). No significant differences were found intracranially in any of the parameters analysed. CONCLUSIONS: There is a high frequency of carotid atheromatosis in patients over 80 years of age. Regardless of the age, carotid atheromatosis appears even more frequently in patients who have suffered a stroke and in males, and is significantly associated to the risk of suffering a stroke. Intracranially, no differences were found.

Aged↗
PubMedDate not supplied

[Prevalence of neurosonographic disturbances in chronic instability].

INTRODUCTION: Dizziness is a common symptom at the outpatient clinic of family doctors. Its origin is usually multifactorial and its outcome is often benign. However, exists a tendency to relate the dizziness with a cerebrovascular disturbance. AIM. To determine if there are cerebrovascular disorders in patients with chronic dizziness using a non invasive technique. PATIENTS AND METHODS: A prospective study was conducted. It included 404 patients without limit of age. The patients were evaluated in a Neurology Outpatient Clinic, to select those patients with chronic instability. A neurosonographic exam was performed to all those selected patients. This exam included colour duplex of the cervical arteries and transcranial Doppler. RESULTS: Up to 54 % of the patients who were included in the study had a normal carotid study. For the rest of the patients, the thickness intima-media was the most prevalent finding. At the vertebrobasilar system the study of the vertebral arteries was completely normal in 81.7% followed by the presence of microangiopathy in 12.1%. The basilar system was also normal in a high figure (78%) followed by the microangiopathy (17.1%). CONCLUSIONS: The vascular disturbances in the vertebrobasilar system are an exceptional finding in patients with chronic instability.

Adult↗