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T del Ser

Publications and source records attributed to T del Ser.

36 records · Page 2Linked to original sources
PubMed1986

Neurotransmitter changes in cerebrospinal fluid in the Spanish toxic oil syndrome: human clinical findings and experimental results in mice.

Patients with Spanish Toxic Oil Syndrome (TOS) complaining of neuromuscular symptoms had increased levels of homovanillic acid and 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid. Severity of pain and muscle cramps correlated with the magnitude of increment in levels of monoamine metabolites. Mice treated with oleyl anilide, a putative toxic compound found in some stocks of the toxic rapeseed oil, did not present clinical or anatomical findings compatible with TOS. However, biochemical studies in these mice revealed a depletion of serotonin and an elevation of 5-HIAA levels. Our findings suggest that the unidentified toxic agent of the TOS and oleyl anilide induce pharmacological changes in monoamine neurons of the brain.

Anilides↗
PubMedDate not supplied

Risk factors for spontaneous cerebral hematomas. Case-control study.

In a case-control study of 73 cases of cerebral hematoma diagnosed by CT scan, significant risk factors were history of hypertension, chronic alcoholism, evidence of hepatic disease, EKG abnormalities and high hematocrit values. Initial blood pressure was significantly higher in cases, but blood pressure on the third day after admission was not different from controls. Hypertension and alcoholism did not show a clear correlation, but data from other studies explain the role of alcoholism in vascular disease through a relation with high blood pressure. Risk factors were similar in lobar and basal ganglia hematomas.

Adult↗
PubMedDate not supplied

Is subcortical vascular dementia a clinical entity for clinical drug trials?

Several therapeutic trials have been performed for vascular dementia, with drugs differing in type and mechanism of action. The results have been almost invariably inconclusive. Given the current notion that there are different subtypes of vascular dementia according to pathophysiological mechanisms, it is reasonable to suspect that one of the main causes of the disappointing results was that the study samples included patients not fitting with the rationale of selective treatments. Testing this hypothesis is difficult because characterization of patients in relation to different subtypes of vascular dementia is not available for most studies. However, attempts are ongoing to reclassify patients entered in some trials for post hoc subgroup analyses with some preliminary interesting results. We propose that (1) specific subtypes of vascular dementia should be the target in any single trial using a treatment with a proper rationale; and (2) subcortical vascular dementia, caused by small vessel disease leading to lacunar infarcts and subcortical white matter changes, represents a clinically and radiologically well-defined entity to be considered for future trials designed specifically for testing adequate drugs.

Cerebral Cortex↗
PubMedDate not supplied

Nimodipine in subcortical vascular dementia trial.

Vascular dementia (VaD) is a heterogeneous pathology currently regarded as the result of a variety of causes. Different types of VaD can be identified according to different criteria. This heterogeneity might be one of the causes of the controversial results observed, up to now, in clinical trials. Recently, the 10th revision of the International Classification of Diseases (ICD-10) explicitly identified subcortical VaD as a well-defined subgroup. Abnormalities of white matter are clearly detectable with computed tomography or magnetic resonance scans. The clinicoradiological association of dementia, blood hypertension, and other vascular risk factors, extensive white matter lesions, and small subcortical infarcts might be considered as a clinical univocal entity. Following the encouraging results of a preliminary pilot study, the above-mentioned criteria were followed to define a population of patients to be enrolled in a double-blind, parallel-groups, placebo-controlled clinical trial with nimodipine, which has been proposed as a drug that can improve cognitive functions in patients with VaD. The paper discusses the protocol design of this ongoing trial and its main entry criteria, with particular emphasis on the definition of the population to be enrolled. Implication for future trials in subcortical VaD are discussed further.

Aged↗
PubMedDate not supplied

[Findings using magnetic resonance in a patient with non-traumatic anosmia].

INTRODUCTION: The presence of alterations in the neuroimaging in patients with anosmia without traumatic antecedents is not frequent. CASE REPORT: Male aged 38 who came to surgery after having suffered, 6 months earlier, for 1 week, a picture of intense, oppressive holocranial headache, accompanied by fever. Associated with this, an acute complete anosmia also began and persisted up to the moment the patient came for consultation. It was not associated with any infection of the respiratory tract, there was no history of cranial trauma, no ingestion of medicines nor toxins, nor had he been exposed to toxic products. The exploration to which he was submitted only showed an anosmia and was otherwise found to be normal. Cranial MRI showed signal alterations in both lower (orbitary) convolutions of the frontal lobes, in the anterior region of the right temporal lobe and in both olfactory nerves. Tests for HIV serology, parotiditis, hepatitis B and C virus, HSV, VZV, Mycoplasma pneumoniae and lues were negative. The acute onset of the anosmia in midst of a picture of febricula and headaches made us suspect the presence of an infectious aetiology, and the alterations found in the neuroimaging could be due to post encephalic lesions, with a special predilection for olfactory areas. CONCLUSIONS: 1. MRI plays a fundamental role in the topographic and aetiological evaluation of olfactory dysfunctions of a central origin; 2. Affectation of the central olfactory passages of an infectious aetiology in a non HIV patient and with neuroimaging findings is a rare complication.

Adult↗
PubMedDate not supplied

[Dementia with Lewy bodies. Pure and mixed forms].

INTRODUCTION AND METHOD: Dementia with Lewy bodies is a generative brain disease of unknown origin, characterised clinically by progressive mental deterioration, with striking fluctuations and transitory episodes of confusion, hallucinations and psychotic symptoms (hallucinations and paranoid deliria), extrapyramidal signs and hypersensitivity to neuroleptic drugs. The main pathological finding was the abundance of Lewy bodies in the neurons of the cortex, brain stem and other subcortical nuclei. In many cases, however, varying amounts of Alzheimer like degenerative lesions are associated. CONCLUSION: This study analyses the anatomopathological, clinical, diagnostic and therapeutic aspects of this disease.

Aged↗
PubMedDate not supplied

[Neurological complications in a series of 205 orthotopic heart transplant patients].

INTRODUCTION: A heart transplant is the only effective therapeutic option open to many patients with severe heart failure and performing such an intervention is not free of complications. Little is known about the risk factors for neurological complications after a heart transplant. AIMS: The aim of this study was to identify the risk factors for neurological complications following a heart transplant and, more especially, those associated with epileptic seizures, encephalopathy, cerebrovascular accidents (CVA) and headaches. PATIENTS AND METHODS: We conducted a retrospective review of the records of 205 orthotopic heart transplant patients and collected clinical, haemodynamic and laboratory data before, during and after the intervention, using a standardised protocol. RESULTS: 95 patients (48%) presented neurological complications. Their frequencies were as follows: encephalopathy (16.6%), epileptic seizures (13.6%), neuromuscular disorders (10.6%), headaches (10.6%), CVA (10.1%), psychiatric disorders (2.2%) and infection of the central nervous system (2.2%). The risk factors for encephalopathy were post-transplant renal failure (RR: 4.6; CI 95%: 1.4-15), post-transplant hepatic failure (RR: 5.6; CI 95%: 1.5-22) and pre-transplant haemodynamic instability (RR: 4.3; CI 95%: 1.3-14); for epileptic seizures they were a cardiac index of < or = 2 L/min/m2 (RR: 23.8; CI 95%: 2-247) and extracorporeal circulation time > or = 115 min (RR: 11.3; CI 95%: 1-79); and for CVA the risk factor was post-transplant hepatic failure (RR: 12.9; CI 95%: 2.5-66). CONCLUSIONS: Neurological complications often occur after a transplant and are transient. Perioperative haemodynamic instability giving rise to cerebral ischemia and the metabolic disorders secondary to multiple organ failure are determining factors of encephalopathy, epileptic seizures and CVA.

Adolescent↗
PubMedDate not supplied

[Neuro-psychological disorders in hypothyroid dementia. Description of case].

Hypothyroidism is one of the most frequent causes of treatable symptomatic dementia. However a detailed description of its neuropsychologic characteristics in the medical literature is lacking. We have studied a 70 year old patient suffering severe mental deterioration, cerebellopathy, myopathy and hypothyroidism with a complete set of neuropsychologic and psychometric tests: mental mini-examination, Blessed's scale, neuropsychologic examination, WAIS, Bento visual retention test, Rey's picture, words learning, delayed recall of words, verbal fluency, reaction times and maintained attention. This type of dementia is characterized by a low score in all tests which improves progressively with the treatment and it is also accompanied by a lack of language defects, nonconstructive apraxia or agnosia. The recovery involves the attentional field and the memory as well as the two intelligence indices. However this improvement is more apparent in the tests related to attention and visuospatial information processing. It is concluded that hypothyroid dementia in this patient had characteristics "subcortical dementia" and a neuropsychologic deterioration pattern rather nonspecific with a slight predominance of the attentional and visuospatial defects.

Aged↗