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Y Aladro

Publications and source records attributed to Y Aladro.

14 recordsLinked to original sources
PubMed2004

Prevalence and incidence of multiple sclerosis in Las Palmas, Canary Islands, Spain.

OBJECTIVES: To determine the prevalence and incidence of multiple sclerosis (MS) in the city of Las Palmas (Canary Islands, Spain), geographically belonging to north-western Africa, but with European ancestry. METHODS: This population-based survey was conducted for a period of 5 years (1998-2002) in a Sanitary District of Las Palmas city (28 degrees 20' N), with a population of 82,623 inhabitants. Multiple sources were periodically investigated for case ascertainment. Patients with definite and probable MS were included. RESULTS: Sixty-four patients with MS were identified on prevalence day, December 31, 2002. According to Poser's criteria the crude prevalence rate was 77.5 per 100,000 (95% CI: 59.7-98.9). This rate decreased to 73.8 (95% CI: 56.5-94.8) according to McDonald's criteria. Age-adjusted rates for the world and European standard populations were 61.6 (95% CI: 47.1-78.9) and 70.6 (95% CI: 55-89), respectively. Prevalence was higher for women aged 25-44 years. In 17 patients onset of MS occurred within the study period. Average annual incidence was 4.1 per 100,000 (95% CI: 2.4-6.6). CONCLUSIONS: The prevalence and incidence rates in Las Palmas city are close to those reported from Continental Spain and other countries of southern Europe with similar social and ethnic background. These results highlight the role of racial-ethnic factors in the genesis of MS.

Adolescent↗
PubMed2004

[Recurrent ischemic strokes secondary to acquired hypercoagulability in a patient with prostatic adenocarcinoma].

Hypercoagulable states are frequently associated to malignancies. We report the case of a 67 year-old patient with prostatic cancer (T3NxM1) and deep venous thrombosis, whose initial coagulation studies were normal. He was treated with acenocumarol and hormonal blockade with flutamide and leuprolerin acetate. Six months later he developed recurrent brain ischemic strokes in the territories of both median cerebral arteries, that did not respond to anticoagulant treatment. Coagulation studies, showed a procoagulant activity with a probable paraneoplastic origin. We conclude that prostatic adenocarcinoma treated with hormonal blockage may promote a complex procoagulant state leading to recurrent occlusive arterial disease, refractory to anticoagulation.

Adenocarcinoma↗
PubMed1996

Cerebritis due to Listeria monocytogenes: CT and MR findings.

Infections by Listeria monocytogenes are uncommon, with cerebritis being even rarer. We present three cases of cerebritis which occurred during an outbreak of listeriosis. The CT and MR findings at diagnosis and during follow-up are described. Predominant deep white matter lesions with nodular and ring enhancement were seen. The MR yielded a higher resolution of the lesions than CT.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Acute paraparesis associated with dorsal diastematomyelia in an adult].

Diastematomelia presenting in adult life has long been considered a rare occurrence. With the development of modern imagining techniques, cases of adult are being discovered with increasing frequency, but their exact number remains unclear. It occurs most often in the lumbar region, is rarely located above the level of T3 and it present clinical features such as deformity of the food, peculiar posture, or gait disturbance. The symptoms and signs of diastematomelia usually are recognized in children. We are reporting the case of an adult patient who had a forme frustre of Sjögren's syndrome and thoracic diastematomelia presenting as a acute myelopathy. Although in most of patients, the pathogenesis of the neurological deficits could be attributed to lesions such as spondylosis, herniation of a disc, traction injury or the tethering effect derived from an osseous septum or a fibrous band, in our patients was absent. We suggested as contributory cause to damage of the spinal cord a vascular ischemic mechanism during flexion and extension of the spine, and we postulated the role that anti-Ro (SS-A) antibodies play in the immunopathogenesis (mediating or potentiating) vascular injury by altering vascular endothelial function or proliferation.

Aged↗
PubMed1990

[Chorea and systemic lupus erythematosus].

The appearance of chorea due to systemic lupus erythematosus is extremely rare. A greater frequency of circulating anticoagulant, false positive luetic serology and antiphospholipid antibodies has been recently detected in these patients. For this reason, it has been postulated that these could be involved in the genesis of the chorea through a thrombotic mechanism or autoimmune encephalitis. We describe a case or chorea in a female patient with systemic lupus erythematosus.

Adolescent↗
PubMedDate not supplied

[Epileptic crisis and multiple sclerosis: anatomo-clinical correlation].

INTRODUCTION: The prevalence of epilepsy in multiple sclerosis (MS) is low and the occurrence of an epileptic seizure as a first sign of this illness is even more infrequent. The relationship between both these illnesses is not clear; as epilepsy is a common condition, a coincidental association only could exist between the two diseases. OBJECTIVE: To establish a nexus of causality between epilepsy an MS. Clinical case. We present one case of epileptic seizures as the first manifestation of MS. The patient was a woman of 25 years old. The only result of the clinical examination was a right homonymous inferior cuadrantanopsy. The patient presented a high Tibbling index, lesions of demyelination in the subcortical occipital region and semioval centrum in the MRI and a pathological electroencephalogram; also, the visual and auditory evoked potential latency were delayed. CONCLUSIONS: We related he results of the neuroimaging, the clinical examination and the complementary tests of the patient. The appears to be a causal association between epilepsy and MS.

Adult↗
PubMedDate not supplied

[External ventricular drainage in complete infarction of the medial cerebral artery].

INTRODUCTION: Increased intracranial pressure (ICP) due to complete middle cerebral artery territory infarction does not respond to medical treatment and is often followed by transtentorial herniation and death. Some authors have reported good outcome after performing decompressive hemicraniectomy in this condition. The potential clinical benefit of intracranial pressure reduction by means of an external ventriculostomy in such cases is unknown. CASE REPORT: The present paper discusses the case of a 33 year old female who suffered a massive infarction of the territory of the right middle cerebral artery with transtentorial herniation and left lateral ventricular dilation who rapidly improved after performing external ventriculostomy without hemicraniectomy. The brain tissue partial oxygen pressure (PtiO2) was monitored in the left frontal lobe and a fair correlation with clinical events was found. CONCLUSIONS: External ventricular drainage without hemicraniectomy could be lifesaving in some case of massive ( malignant ) hemispheric infarction and more studies on this therapeutic approach would be needed. Monitoring PtiO2 in these patients would be useful in adopting therapeutic decisions.

Adult↗
PubMedDate not supplied

[Familial multiple sclerosis in Canary Islands].

INTRODUCTION: Multiple sclerosis (MS) is an autoimmune disease that occurs in genetically predisposed individuals. Its inheritance is polygenic. Genetic epidemiology studies have shown an increased familial aggregation. AIM. To determine the prevalence of familial MS (fMS) in a series of patients from the Canary Islands. PATIENTS AND METHODS: From a cohort of 266 patients with defined MS, during a 6-year period, we investigated prospectively by personal interviews the presence of MS on first and second degree relatives. We analysed as well the presence of HLA DRB1 in affected families, and also clinical and demographic characteristics in fMS and compared them with sporadic MS (sMS). RESULTS: fMS prevalence was 13.9% (27 non-related families with 50 affected individuals). The HLA DRB01*1501 allele were present in 51,8% of familial cases. We could not found either intrafamilial concordance in clinically affected regions and age of onset or clinical evolution. We have not found any phenotypic differences between familial and sMS. CONCLUSIONS: The prevalence of fMS in our series is comparable to that in other Mediterranean populations. Our results do not support that fMS was a different clinical entity of sMS and intrafamilial concordance in its clinical expression.

Adolescent↗
PubMedDate not supplied

[Autoimmune diseases and multiple sclerosis].

INTRODUCTION: Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system with an unknown origin, although the immunological system plays a crucial role in its pathogenesis. It has been observed that the relatives of MS patients very often have other autoimmune diseases (ADs) and it has been suggested that there may be susceptibility genes that are common to this group of diseases. AIMS: Our aim was to estimate the prevalence of ADs in first and second degree relatives of patients with MS and to determine the coexistence of other ADs in MS patients. PATIENTS AND METHODS: We selected 251 patients with MS defined by the Poser criteria and face-to-face interviews with the patients and/or their relatives were conducted to investigate the following ADs: MS, rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa, autoimmune thyroid disease (ATD), inflammatory bowel disease, myasthenia gravis, type I diabetes mellitus (DMI) and psoriasis. RESULTS. 29.9% of the patients with MS had a first and/or second degree relative with an AD. Prevalence of ADs in first degree relatives was 15.5%, 30% in familial MS and 40% if the patient had both MS and another AD. The most frequent ADs were: MS 27%, psoriasis 18%, ATD 16% and DMI 15%. 15 patients had MS and another AD: six ATD, three DMI, four psoriasis, one inflammatory bowel disease and one myasthenia gravis. CONCLUSIONS: These findings lend support to the existence of susceptibility genes that are common to the different ADs and would act as risk factors.

Autoimmune Diseases↗
PubMedDate not supplied

[An analysis of pre-hospital delay times in stroke care].

INTRODUCTION: Delays in the treatment of a stroke constitute a factor that leads to a more unfavourable prognosis. Shortening the delay time in the health care of these patients is essential in order to reduce the morbidity and mortality rates of this disease. AIMS: Our aim was to analyse the causes that bring about delays in getting stroke patients to hospital. PATIENTS AND METHODS: A prospective analysis was conducted of 133 patients who visited the Emergency Department. A survey carried out during the first 48 hours collected information on the clinical characteristics and the steps followed by the patient before arriving at the hospital. We considered the time that elapsed to be adequate if patients arrived at the hospital in less than 2 hours. A univariate and multivariate analysis was performed to evaluate the factors that could extend this time. RESULTS: The mean time elapsed before the patient reached hospital was 502 minutes (interval: 11-5,700). A total of 42.5% arrived in less than 2 hours and 58.2% got there in less than 3 hours. The univariate analysis showed that females, those with a low cultural level, the most severe cases, those who went straight to hospital and those who used the emergency services all arrived more quickly. In the multivariate analysis only the more severe cases and those who went straight to hospital ran less risk of a delayed arrival. CONCLUSIONS: The time stroke patients take to reach hospital varies greatly. The main factors that influence the time that elapses before arrival are the severity of the symptoms and going straight to hospital.

Aged↗
PubMedDate not supplied

[Non-reabsorptive communicating hydrocephalus: surgical results according to the diagnostic procedure].

Both ex-vacuo and non-reabsorptive hydrocephalus can present with a similar clinical triad of dementia, gait disturbances and incontinence. From a prognostic point of view, however, a great difference exists due to the possibility of surgical treatment with cerebrospinal fluid shunting in non-reabsorptive hydrocephalus. The difficulty lies in a correct preoperative diagnosis. In this study 37 patients aged from 60 to 72 with a clinical history suggestive of non-reabsorptive communicating hydrocephalus were evaluated; the diagnostic tests applied to them were: computerized axial tomography, infusion test with Nelson's technique and intracranial pressure monitoring. A clear correlation was observed between the clinical improvement obtained after a cerebrospinal fluid shunt had been placed and the presence of pathological computerized axial tomography (hydrocephalus without increased sulci with or without trans-ependymal edema) or the pathological infusion test (intracranial pressure increase over 2 mm Hg/min and no decrease back to the basal level once the infusion had ended). No correlation was observed between the different recordings obtained from the intracranial pressure monitoring and the surgical results. The clinical data which most easily revert are the gait disturbance, dementia and incontinence in this order and, more so, in patients with known etiology. Since non-reabsorptive hydrocephalus and ex-vacuo hydrocephalus may co-exist, mostly in elderly patients, it is important to further develop the dynamic studies of intracranial pressure with the aim of offering a more reliable surgical prognosis.

Aged↗
PubMedDate not supplied

[Clinical characteristics and epidemiologic study of a listeriosis outbreak in Grand Canary].

BACKGROUND AND METHODS: Human infections caused by Listeria monocytogenes often present as sporadic cases without any epidemiological relationship among them; however they also appear as outbreaks that are usually detected by an increase in the number of cases diagnosed by hospitals of the geographic area. Between December 1991 and May 1993, twenty four cases of listeriosis were detected in three hospitals of Las Palmas de Gran Canaria; and they were classified as an outbreak. Our report describes its clinical, epidemiological and microbiological aspects. RESULTS AND CONCLUSIONS: Twenty four cases of listeriosis were diagnosed, 12 occurred in pregnant women or neonates (5 and 7 respectively) and 12 in non pregnant adults. All adult infections were community-acquired. The incidence rate was, for the epidemic area, 76.3 cases per million population during the period considered (18 months). Among non pregnant adults, 9/12 patients had some underlying disease and 9/12 presented CNS affection (meningitis and/or cerebritis). In the group of pregnant women, 4 cases occurred in the second trimester and fetal loss was caused; one case was detected in the third trimester and four weeks later the patient delivered an unaffected infant. All cases of neonatal listeriosis presented as early-onset sepsis. Of the 24 strains of L. monocytogenes, 21 were serotype 4, two were serotype 1 and one was not typeable. Strains from 12 patients were available for epidemiological analysis, seven of which corresponded to the same pattern and there were three more different patterns.

Abortion, Spontaneous↗