43 research outputs found
The charming physician (El médico encantador): neurological conditions in a short story by Silvina Ocampo
ABSTRACT The Argentinian author Silvina Ocampo (1903-1993) left us a vast body of works which are considered outstanding in many ways. In 1960, she published a short story, entitled “El médico encantador” (The Charming Physician), in the renowned literary magazine Sur. The central character of this piece is a family doctor named Albino Morgan, who had a secret truth: in any house he visited, all variety of disease also entered. He brought with him the viruses he disseminated. The narrator of this short story—one of his patients—describes four of Morgan’s diseases. These imaginary neurological conditions allowed Ocampo to explore improbable situations in everyday life. Keywords: neurology; medicine in literature; medicine in art; agnosia; sleep initiation and maintenance disorders
RESUMO A autora argentina Silvina Ocampo (1903-1993) deixou-nos uma vasta obra que Ă© considerada excelente de várias maneiras. Em 1960, publicou um conto, intitulado “El mĂ©dico encantador” (O mĂ©dico encantador), na famosa revista literária Sur. O personagem principal desta obra Ă© um mĂ©dico de famĂlia chamado Albino Morgan que possuĂa uma verdade secreta: em qualquer casa que ele visitava, tambĂ©m entrava toda a diversidade de doenças. O narrador deste conto -um dos seus pacientes- descreve quatro das doenças de Morgan. Estas condições neurolĂłgicas imaginárias permitiu a Ocampo explorar as situações improváveis da vida quotidiana. Palabras-Clave: neurologia; medicina na literatura; medicina na arte; agnosia; distĂşrbios do inĂcio e da manutenção do sono
Cefalea en racimos
La cefalea en racimos es un sĂndrome doloroso primario estereotipado que constituye probablemente la causa de cefalea más severa existente. Se caracteriza por cefalea estrictamente unilateral, de predominio nocturno, con duraciĂłn de 15 a 180 minutos, acompañada de al menos un fenĂłmeno autonĂłmico ipsilateral. Los sĂntomas se presentan varias ocasiones al dĂa (en racimos), tienen periodicidad y comportamiento rĂtmico circadiano. Su incidencia es de 4-15 casos por 100 000, su prevalencia anual es de 53 casos por 100 000, tiene un radio hombre:mujer de 4-9:1 y la edad de inicio más frecuente es de 27 a 31 años. Existe predisposiciĂłn genĂ©tica para la enfermedad existiendo un familiar en primera lĂnea en 3,4-12% de los pacientes afectados. En su fsiopatologĂa están involucrados cambios en el sistema trigĂ©mino-vascular, el seno cavernoso, el tálamo ventral-posterior, la corteza frontal, el cĂngulo, la Ănsula, los ganglios basales y la sustancia gris hipotálamica inferior y posterior. Los cambios autonĂłmicos son debidos a activaciĂłn parasimpática por el nervio facial a travĂ©s del ganglio pterigopalatino y a defciencia transitoria del sistema simpático-cervical. Existe modifcaciĂłn en los niveles del pĂ©ptido relacionado al gen de la calcitonina, pĂ©ptido intestinal vasoactivo, L-arginina-Ăłxido nĂtrico, endotelina-1, testosterona, tirotropina, cortisol, hormona del crecimiento, hormona luteinizante, prolactina y melatonina. El tratamiento se divide en: farmacolĂłgico agudo que incluye oxĂgeno, uso de cámara hiperbárica, triptanos sumatriptán, zolmitriptán, ergotamĂnicos y lidocaĂna intranasal; profláctico transicional y crĂłnico que contiene esteroides, ergotamĂnicos, verapamilo, metisergide, carbonato de litio, ácido valprĂłico y melatonina; y tratamiento invasivo consistente en bloqueo, cirugĂa, entre otros.
Palabras clave: Cefalea en racimos. Sistema trigémino-vascular. Cambios autonómicos.
Cluster headache is a stereotyped primary pain syndrome that is probably the most severe cause of headache existing. It is characterized by strictly unilateral headache, predominantly nocturnal, lasting from 15 to 180 minutes, accompanied by at least one ipsilateral autonomic phenomena. Symptoms occur several times a day (clusters) having a rhythmic periodicity and a circadian behavior. Its incidence is 4-15 cases per 100000, the annual prevalence is 53 cases per 100000., and has a radius male: female 4-9:1. The most common age of onset is 27 to 31 years. There is a genetic predisposition for the disease with the existence of a frst line family member in 3,4-12% of affected patients. Pathophysilogically it involves changes in the trigémino-vascular system, the cavernous sinus, the ventral-posterior thalamus, frontal cortex, the cingulum, the Ínsula, basal ganglia, the inferior and posterior hypothalamic gray matter. Autonomic changes are due to parasympathetic activation by the facial nerve through the pterygopalatine ganglion and transitory defciency of the cervical sympathetic system. There is a modifcation in the levéis of gene-related peptide calcitonin, vasoactive intestinal peptide, L-arginine-nitric oxide, endothelin-1, testosterone, thyrotropin, cortisol, growth hormone, luteinizing hormone, prolactin and melatonin. The treatment is divided in: acute pharmacology including oxygen, the use of hyperbaric chamber, triptans, sumatriptan, zolmitriptan, ergotamine and ¡ntranasal lidocaine, transitional and chronic prophylactic containing steroids, ergotamine, verapamil, metisergide, lithium carbonate, valproic acid and melatonin, and invasive treatment consisting on blockade, surgery, among others.
Key words: Cluster Headache. Autonomic Changes. Trigeminal Vascular System
The charming physician (El médico encantador): neurological conditions in a short story by Silvina Ocampo
Can we study the baroreflex mechanisms with other variables than blood pressure and heart rate?
Korotkoff Sounds - The Improbable also Occurs
Poucas descobertas tiveram um impacto tĂŁo grande e tamanha relevância para a Medicina clĂnica como a medição nĂŁo-invasiva da pressĂŁo arterial diastĂłlica. Vários fisiologistas e clĂnicos talentosos estavam, sem sucesso, em busca de um mĂ©todo nĂŁo-invasivo para determinar a pressĂŁo diastĂłlica. No entanto, a quantificação da pressĂŁo arterial diastĂłlica nĂŁo foi conseguida por qualquer um desses pesquisadores clĂnicos ou fisiolĂłgicos, mas por uma figura improvável e inesperada: Nikolai Sergeevich Korotkoff (1874-1920), um jovem cirurgiĂŁo do exĂ©rcito russo, trabalhando em condições precárias sob as dificuldades de diversas guerras. É fácil descartar o feito de Korotkoff como uma descoberta fortuita semelhante Ă de Alexander Fleming na descoberta da penicilina. No entanto, a recente teoria do cisne negro de Nassim N. Taleb pode servir para ilustrar sua descoberta de uma nova e, talvez, surpreendente, forma
A case of tactile agnosia with a lesion restricted to the post-central gyrus
Tactile agnosia has been described after lesions of the primary sensory
cortex but the exact location and extension of those lesions is not
clear. We report the clinical features and imaging findings in a
patient with an acute ischemic stroke restricted to the primary sensory
area (S1). A 73-year-old man had a sudden onset of a left alien hand,
without left hemiparesis. Neurological examination showed intact
primary sensory functions, but impaired recognition of shape, size
(macrogeometrical) and texture (microgeometrical) of objects; damage
confined to the post-central gyrus, sparing the posterior parietal
cortex was demonstrated on MRI. An embolic occlusion of the anterior
parietal artery was suspected as mechanism of stroke. Tactile agnosia
with impaired microgeometrical and macrogeometrical features′
recognition can result from a single lesion in the primary sensory
cortex (S1) in the right parietal hemisphere, sparing other regions of
the cerebral cortex which presumably participate in tactile object
recognition
The charming physician (El médico encantador): neurological conditions in a short story by Silvina Ocampo
ABSTRACT The Argentinian author Silvina Ocampo (1903-1993) left us a vast body of works which are considered outstanding in many ways. In 1960, she published a short story, entitled “El médico encantador" (The Charming Physician), in the renowned literary magazine Sur. The central character of this piece is a family doctor named Albino Morgan, who had a secret truth: in any house he visited, all variety of disease also entered. He brought with him the viruses he disseminated. The narrator of this short story—one of his patients—describes four of Morgan's diseases. These imaginary neurological conditions allowed Ocampo to explore improbable situations in everyday life
Review Article - The articles of Babinski on his sign and the paper of 1898
In 1896 Joseph François Felix Babinski described for the first
time the phenomenon of the toes; nevertheless in this first paper he
simply described extension of all toes with pricking of the sole of the
foot. It was not until the second paper of 1898 that he specifically
described the extension of the hallux with strong tactile stimulation
(stroking) of the lateral border of the sole. Babinski probably
discovered his sign by a combination of chance observation and careful
re-observation and replication. He also had in mind practical
applications of the sign, particularly in the differential diagnosis
with hysteria and in medico-legal areas. Several of the observations
and physiopathological mechanisms proposed by Babinski are still valid
today, e.g., he realized since 1896 that the reflex was part of the
flexor reflex synergy and observed that several patients during the
first hours of an acute cerebral or spinal insult had absent extensor
responses. He also found that most patients with the abnormal reflex
had weakness of dorsiflexion of the toes and ankles and observed a lack
of correlation between hyperactive myotatic reflexes and the presence
of an upgoing hallux. He discovered that not all patients with
hemiplegia or paraplegia had the sign but thought erroneously that some
normal subjects could have an upgoing toe. Between 1896 and 1903
Babinski continued to think on the sign that bears his name and enrich
its semiological and physiopathological value