Encephalopathy with focal lesions due to Mycoplasma pneumoniae

Mycoplasma pneumoniae infections usually produce respiratory symptoms, that only exceptionally involve the nervous system. In this case, the infection generally causes an encephalitic picture characterized by impaired consciousness and seizures, and by normal or non-specific neuroradiological findings. However, four cases of M. pneumoniae infection associated with symmetrical lesions in the putamen and its external surrounding areas, and with extrapiramidal symptoms, have been recently published. We present the case of a patient with a clinical picture characterized by confusion, fever, and seizures, associated with a M. pneumoniae infection. The MRI study showed two symmetrical lesions that involved the areas just outside the putamen and disappeared coinciding with her clinical improvement. The present case would support that the encephalopathy associated with the M. pneumoniae infection shows a tendency to involve a particular region of the brain. Our case might represent the minimal expression of these characteristic lesions, which in the most benign cases would involve the areas immediately outside the putamen, and in other instances the putamen as well.     

Frequency of food intake by adolescent schoolchildren in Cantabria, Spain. Comparison with the consensus document: Food Guidelines for the Spanish Population

OBJECTIVE: To analyze food consumption patterns among schoolchildren in Cantabria and to compare results obtained with Spanish food guidelines for this population group. METHODS: A food frequency questionnaire was the chosen method, with some 53 food types divided into 15 groups. A total of 1,205 teenagers of both sexes aged between 14 and 18 attending 18 secondary schools in Cantabria completed the questionnaire. RESULTS: Milk, bread, fruit, greens and vegetables are the foodstuffs mostly consumed at the recommended frequencies. On the other hand, fish, meat, eggs, dairy products and pulse make up the least adequately consumed categories. Alcoholic drinks are imbibed to a high degree, with beer being the alcoholic most frequently drunk. Spirits are also drunk in larger quantities than wine. Alcohol consumption (beer, wines and spirits) increases significantly with age, being higher among males than females. CONCLUSIONS: Cantabrian schoolchildren follow a food consumption pattern which, generally speaking, does not tally with Spanish food recommendations for their age group. Educational and interventional strategies need to be developed with the aim of modifying such inappropriate food consumption.     

略谈近年来冠心病的诊治进展

冠心病的范围包括(1)静寂性(即无痛性)心肌缺血,(2)慢性稳定型心绞痛,(3)不稳定型心绞痛,(4)非透壁性心肌梗死及(5)急性透壁性心肌梗死等五种。近年研讨的热点为不稳定型心绞痛及急性心肌梗死的临床诊断及治疗。 一、不稳定型心绞痛 不稳定型心绞痛既无心电图的特征性图象,也无心肌酶的增高。它的界定必须依     

Type I familial amyloid polyneuropathy and pontine haemorrhage

A Portuguese female, aged 47 years, who had emigrated to Spain, was admitted to the hospital in 1991 for pontine haematoma. The patient, four siblings and her father were affected by a peripheral neuropathy, indicating autosomal dominant inheritance. The patient presented in the 2nd decade with sensory and motor neuropathy beginning in the lower extremities. Alternating constipation and diarrhoea, and urinary incontinence became uncontrollable. She had to be colostomised, and, eventually, confined to a wheelchair from the age of 43. Neurological examination showed bilateral facial involvement, and severe signs of sensory and motor peripheral neuropathy, and later right hemiplegia. There were abnormalities of atrial rhythm and left bundle branch block. Computerised axial tomography and magnetic resonance images demonstrated left-sided pontine haemorrhage. Nerve conduction studies revealed severe diminution of motor conduction velocity and absence or reduction of amplitude of sensory and motor action potentials. Inanition and a respiratory infection led to her death. Clinical diagnosis was type I familial amyloid polyneuropathy (FAP). Postmortem examination demonstrated amyloid deposits in peripheral nerves, including spinal roots and cranial nerves, leptomeninges, thyroid, breasts, heart, adrenal glands, kidneys, intestines, pancreas, and meningeal and some pontine vascular structures. Advanced pontine haematoma was verified. Cerebral haemorrhage usually occurs with cerebrovascular amyloidosis, but exceptionally with FAP. A minority of patients presenting with CNS haemorrhage showed arteriovenous malformation or embolism [Da Silva Horta and Dias Coelho (1960) Arch de Vecchi Anal Patol Med Clin 31=163–172]. However, amyloid deposition in some small pontine vessels could have played a role in the pathogenesis of haemorrhage in the present case.     

Utility of the sickness impact profile in Parkinson's disease.

The Sickness Impact Profile (SIP) is a questionnaire consisting of 136 items grouped into 12 categories and two dimensions (physical and psychosocial). To characterize its utility in Parkinson's disease (PD), we administered the SIP to 44 consecutive clinic patients with PD. Compared to 44 age- and sex-matched control subjects, PD patients had their greatest dysfunction in the categories of mobility, communication, and home management. The two items that PD patients most commonly endorsed were, "I am having trouble writing or typing" (75%) and, "My sexual activity is decreased" (61%). In general, these treated PD patients had greater dysfunction in the psychosocial than physical dimensions. Two simple PD-specific scales correlated well with the physical dimension score but less so with the psychosocial dimension, suggesting that the SIP assesses more functional domains than the PD-specific scales used. The SIP holds some promise as a broad measure of functional status in PD patients.