Minerva medica
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The authors reports the case of a patient with quadriplegia associated with respiratory failure. A few days before, a paralysis of the oculomotor nerves appeared, which rapidly spreads in cranio-caudal fashion. The occurrence of a similar symptomatology in a patients' relative addressed the diagnosis toward a possible Clostridium botulinum intoxication. Other possible differential diagnoses are reviewed and discussed.
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In normal subjects increasing atmospheres of absolute pressure (ATA) on the cardiopulmonary system, in a hyperbaric chamber, results in a marked diuresis and an increase of circulating concentration of atrial natriuretic peptide (ANP). The present investigation was designed to determine the effect of ATA in a group of 5 sodium-retaining cirrhotic patients on hydro-saline balance, renin-angiotensin-aldosterone system and ANP. After seven days on a 10 mEq sodium intake, each patient was studied on both a control and experimental (4-hour stay at 2-ATA in hyperbaric chamber) day. ⋯ The increasing ATA lacked to induce both diuresis, natriuresis and increase in ANP plasma concentration. In these patients baseline, pre-hyperbaric, mean levels of PRA, aldosterone and ANP were 15.5 +/- 11.5 ng/ml/h, 808.4 +/- 360 pg/ml, 86 +/- 10.1 pg/ml, respectively, and were significantly elevated compared with normal range for control subjects without sodium restriction. In conclusion, increasing pressure at 2-ATA, in a hyperbaric chamber is unable to elicit both diuresis and natriuresis as well as modification on ANP and renin-angiotensin-aldo-sterone system in sodium-retaining cirrhotic patients.
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The authors examine the use of a halo-vest brace in the treatment of fractures of the upper cervical spine. This brace forms a valid alternative to the classic plaster cast in that it is easily positioned, well tolerated by the patient and has a high restrictive capacity for the centre of the fracture. In the cases treated by the authors no complications were reported during treatment, and consolidation time was shortened by 30 days in relation to traditional plaster cast treatment.
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We present a typical case of eosinophilic fasciitis, with transient peripheral eosinophilia, indurative swelling of the legs, perivascular infiltrates of mononuclear cells and eosinophils of the subcutis and deep fascia, increased ESR, fever, anemia, complete response to steroids. We consider the literature on this topic, particularly concerning the following question: is eosinophilic fasciitis a distinct disease entity or a variant of scleroderma?
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The authors analyse the incidence, extent and prognostic significance of lymphocytic infiltration in 80 cases of operated cerebral gliomas (61 high- and 19 low-grade gliomas). The results obtained are discussed in relation to the data previously reported by the literature.