125,130 research outputs found
Doença de Marchiafava-Bignami: uma rara entidade com prognóstico sombrio Marchiafava-Bignami disease: a rare entity with a poor outcome
No full textA doença de Marchiafava-Bignami é uma entidade rara, caracterizada por uma degeneração primária do corpo caloso, associada com o consumo crônico do etanol. A doença pode, ocasionalmente, ocorrer em pacientes não etilistas cronicamente desnutridos. Uma deficiência de vitaminas do complexo B é considerada como a hipótese etiopatogênica principal, uma vez que muitos pacientes obtiveram uma melhora após a administração desses compostos. Algumas vezes, entretanto, tal resposta terapêutica não foi observada. O diagnóstico definitivo da doença de Marchiafava-Bignami pode ser problemático e depende das características de estudos de neuroimagem, especialmente a ressonância magnética. Seu tratamento, dessa forma, é ainda controverso, com resultados variáveis. Como estão implicados fatores nutricionais, analogamente à encefalopatia de Wernicke, alguns autores recomendam a reposição de vitaminas do complexo B, particularmente da B1. O presente artigo relata a forma aguda da doença de Marchiafava-Bignami em um paciente masculino dependente do álcool, que apresentou discreta melhora após a administração parenteral das vitaminas do complexo B. Como consequência de suas más condições neurológicas e imunológicas, ele desenvolveu infecções pulmonares múltiplas e permaneceu, por longo tempo, na unidade de terapia intensiva. Seu óbito ocorreu por sepse causada por um fungo raro, o Rhodotorula mucilaginosa. O artigo é um relato clínico da evolução desse paciente, com a apresentação de seus dados de neuroimagem, acompanhada por uma revisão sobre doença de Marchiafava-Bignami e sobre as infecções por Rhodotorula dentro da perspectiva da unidade de cuidado intensivo.Marchiafava-Bignami disease is a rare affliction characterized by primary degeneration of the corpus callosum associated with chronic consumption of ethanol. The disease may occasionally occur in patients who are not alcoholics but are chronically malnourished. A complex deficiency of group B vitamins is the main etiopathogenic hypothesis, and many patients improve after the administration of these compounds. However, a good response is not always observed. The definitive diagnosis of Marchiafava-Bignami disease can be problematic and is based on features of neuroimaging studies, especially magnetic resonance imaging. Its treatment is still controversial and shows variable results. Because nutritional factors are implicated, as in Wernicke's encephalopathy, some authors claim that replacement of B vitamins is beneficial. The present article is a case report of a severe acute form of Marchiafava-Bignami disease in an alcohol-dependent male patient who improved after the administration of parenteral B vitamins. As a consequence of his neurological and immunologic conditions, he developed multiple pulmonary infections and had a protracted course in the intensive care unit. He eventually died of sepsis associated with an uncommon fungus, Rhodotorula mucilaginosa. The present article reports the clinical and neuroimaging data from this patient and contains a review of Marchiafava-Bignami disease and Rhodotorula infections in the intensive care unit
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Doença de Marchiafava-Bignami: uma rara entidade com prognóstico sombrio
No full textA doença de Marchiafava-Bignami é uma entidade rara, caracterizada por uma degeneração primária do corpo caloso, associada com o consumo crônico do etanol. A doença pode, ocasionalmente, ocorrer em pacientes não etilistas cronicamente desnutridos. Uma deficiência de vitaminas do complexo B é considerada como a hipótese etiopatogênica principal, uma vez que muitos pacientes obtiveram uma melhora após a administração desses compostos. Algumas vezes, entretanto, tal resposta terapêutica não foi observada. O diagnóstico definitivo da doença de Marchiafava-Bignami pode ser problemático e depende das características de estudos de neuroimagem, especialmente a ressonância magnética. Seu tratamento, dessa forma, é ainda controverso, com resultados variáveis. Como estão implicados fatores nutricionais, analogamente à encefalopatia de Wernicke, alguns autores recomendam a reposição de vitaminas do complexo B, particularmente da B1. O presente artigo relata a forma aguda da doença de Marchiafava-Bignami em um paciente masculino dependente do álcool, que apresentou discreta melhora após a administração parenteral das vitaminas do complexo B. Como consequência de suas más condições neurológicas e imunológicas, ele desenvolveu infecções pulmonares múltiplas e permaneceu, por longo tempo, na unidade de terapia intensiva. Seu óbito ocorreu por sepse causada por um fungo raro, o Rhodotorula mucilaginosa. O artigo é um relato clínico da evolução desse paciente, com a apresentação de seus dados de neuroimagem, acompanhada por uma revisão sobre doença de Marchiafava-Bignami e sobre as infecções por Rhodotorula dentro da perspectiva da unidade de cuidado intensivo
Lucio Fontana et Michel Tapié : Géographies d'un devenir = Lucio Fontana et Michel Tapié : The Geography of a devenir
No full textDispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Effect of different pruning methods on growth, yield and quality of the Hazelnut cultivar “Tonda Gentile Romana"
No full textIn Central Italy (Latium region) the pruning of hazelnut is done during the winter when trees are dormant, and it is limited to little interventions of cleaning of the canopy and removal of old branches and suckers. In order to study the effect of different pruning methods on cv. “Tonda Gentile Romana”, two thesis, respectively based on low (thesis A) and high (thesis B) intensity pruning, were carried out and compared whit an un-pruned thesis from 2004 to 2006. Wood removed, vegetative growth, light infiltration at the base of the plots, yield and nut traits, defects and kernel quality were measured, in order to quantify plant response to different intensity of pruning in a medium-vigour cultivar. The results indicate good productivity and vegetative growth in the thesis B at the end of the three years, and yield per hectare slightly decreased only in the first year with respect to thesis A. Light infiltration at the base of the plants was low in un-pruned plots, whereas thesis B was characterized by better light penetration. The intensity of pruning had only a slight effect on nut traits and content and profile of oil, sugars and organic acids
Reversible MR Findings in Marchiafava-Bignami Disease
No full textMarchiafava-Bignami Disease (MBD) is a toxic demyelinating disease often diagnosed in chronic alcoholics. The disease process typically involves the corpus callosum and clinically presents with various manifestations resulting in MBD type A and type B on the basis of clinical condition, extent of callosal involvement and extracallosal involvement at brain magnetic resonance imaging (MRI), and prognosis. The death rate is high. We report a patient affected by MBD type B, who presented an isolated reversible splenial lesion at brain MRI and achieved a favorable recovery
INDAGINE SULLA PRESENZA DI PATOGENI ZOONOSICI IN ALLEVAMENTI DI BOVINE DA LATTE DEL COMPENSORIO LOMBARDO
No full textMilk bacterial quality at farm gate has gradually improved in the last decades in Italy, and in Lombardia. Further more raw milk consumption is raising public concern about the risk of foodborne disease by emerging pathogens. The aim of the present study is to evaluate the real presence of such bacteria in different dairy herds. Two groups of dairy were analized: 22 were located in Milano-Lodi area, and chosen based on bulk milk total bacterial count registred during the last 3 years; they were visited 3 times in different seasons. The second group were 42 dairy located in Como-Lecco area. In all of these herd cows are housed in cubicles and milked in herringbone parlours. The following samples were taken: bulk milk, milk machine filters and 3 environmental samples. Each samples was microbiologically tested for the presence of S.aureus, Salmonella spp., L.monocitogenes, Campyloacter spp.,EHEC,Yersinia enterocolitica and MAP. The presumptive isolation was confirmed by PCR.The presence of MAP was investigaqted by Real-Time PCR. Only S.aureus positive milk samples was higher in the herds. MAP showed similar frequency, but a random distribution. With the exeption of Y.entercolitica, that was isolated in 1 herd, all the other pathogens were never detected in the milk or in the filter. Frequentely we isolated EHEC and MAP in environmental samples, while neither Salmonella spp. Nor Campylobacter spp.. were demonstrated. When proper hygienic procedures during milking are applied, the risk of milk contamination by foodborne pathogens in very low
Marchiafava–Bignami Disease Associated with Spinal Involvement
No full textMarchiafava–Bignami disease (MBD) is a rare disorder of unknown etiology, strongly associated with alcoholism and malnutrition. MBD causes primary involvement of the corpus callosum, leading to confusion, dysarthria, seizures, and frequent death. We report the case of a 54-year-old male without a history of alcoholism or known malabsorption disease, who presented with altered consciousness and neurologic impairment. Complex B deficiency was addressed. Magnetic resonance imaging (MRI) showed typical corpus callosum lesions. The clinical features and radiologic images suggested spinal cord involvement. Brain histopathologic findings were consistent with MBD. Despite vitamin replacement therapy, he had a poor outcome
Síndrome de Marchiafava-Bignami : a propósito de um caso clínico
No full textTrabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021A Síndrome de Marchiafava-Bignami consiste numa rara síndrome neuropsiquiátrica, caracterizada por desmielinização, degeneração e necrose do corpo caloso. Embora o mecanismo fisiopatológico ainda seja incerto, a teoria aceite atualmente associa a afeção do corpo caloso à hipovitaminose do complexo B, devido ao consumo crónico de álcool e desnutrição concomitante que estes doentes apresentam.
A clínica é variável e pouco específica, incluindo sintomas neurológicos comuns e perturbações psicóticas e emocionais, o que dificulta o seu diagnóstico. Tendo unicamente por base a semiologia que estes doentes apresentavam, Brion et al postularam três formas da doença – aguda, subaguda e crónica.
Com o advento das técnicas imagiológicas, principalmente da Ressonância Magnética, tornou-se possível uma deteção mais precoce da síndrome, melhorando o habitual mau prognóstico por possibilitar a hipótese de tratamento a estes doentes. Usando critérios clínico-imagiológicos, Heinrich et al conceberam uma nova classificação das formas da doença, dividindo-as em dois tipos – Tipo A e Tipo B.
Não obstante os avanços no diagnóstico, estes não têm sido acompanhados pela evolução no tratamento a oferecer. Não existe ainda um tratamento padrão, mas é consensual a opção pela suplementação de vitaminas do complexo B, com a administração de tiamina e vitamina B12, e ácido fólico.
Por forma a rever e estruturar a literatura existente referente ao tema, é apresentado um caso de um homem de 52 anos com alcoolismo crónico, internado por um quadro de inquietação psicomotora, atividade alucinatória visual e alterações da marcha, acompanhado de privação alcoólica, a quem foi diagnosticada síndrome de Marchiafava-Bignami, e é descrito o seu tratamento, evolução e prognóstico.The Marchiafava-Bignami disease consists of a rare neuropsychiatric syndrome which is characterized by demyelination, degeneration, and necrosis of corpus callosum. Although the pathophysiological mechanism is still uncertain, the currently accepted theory associates the lesions of the corpus callosum to the complex B hypovitaminosis, due to the chronic alcohol consumption and concomitant malnourishment that these patients show.
The clinical presentation is variable and not specific, including common neurological symptoms and emotional and psychotic disorders, which complicates the diagnosis. Uniquely based on the semiology these patients had shown, Brion et al postulated three forms of the disease – acute, subacute, and chronic.
With the advent of the imaging techniques, especially the Magnetic Resonance Imaging, has become possible an earlier diagnosis of this syndrome, improving the typical poor prognosis since it allows a chance of treatment to these patients. Using clinical-radiological criteria, Heinrich et al created a new disease classification, dividing it in two subtypes – Type A and Type B.
Despite all the diagnostic advances, they have not been accompanied with an evolution in the existing treatments. A standard treatment remains to be found, but it is consensual the suggestion of complex B vitamins supplementation, with the administration of thiamine and vitamin B12, and folic acid.
To revise and structure the existing literature about this syndrome, is presented a case of a 52-year-old male, with history of chronic alcoholism, admitted with a clinical presentation of psychomotor delay, visual hallucinations, and gait disorders, to whom was diagnosed the Marchiafava-Bignami disease, where is described his treatment, evolution, and prognosis
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