Rupture of the dura mater during lumbar laminectomy may result in destruction of the herniated sacral and lumbar nerve roots. This can be avoided by a simple but immediate surgical procedure, details of which are presented here.
Rupture of the dura mater during lumbar laminectomy may result in destruction of the herniated sacral and lumbar nerve roots. This can be avoided by a simple but immediate surgical procedure, details of which are presented here.
Since the initial description by Landau and Kleffner, in 1957, of a syndrome occurring exclusively in children and consisting of aphasia, paroxysmal changes in E.E.G. and, frequently, epileptic seizures, 80 cases have been reported. The acquired speech disorder, sometimes associated with auditory agnosia, differs in symptomatology and development from the usual forms of infantile aphasia. The prognosis, based on the regression or persistence of the aphasia, is favourable in 60% of the cases and unfavourable in 40%. None of the various antiepileptic drugs is consistently effective. The cause of the syndrome remains unknown.
Influence of oral contraceptive therapy on SLE activity was evaluated in 33 female patients with lupus nephropathy. Estroprogestative preparations containing either 50 micrograms (18 cases) or 30 micrograms (11 cases) of ethinylestradiol were used in 29 courses in 28 patients. Onset or exacerbation of clinical SLE activity occurred within 3 months after starting hormonal therapy in 13 cases, an overall incidence of lupus flare-up of 44 percent, involving major renal histological lesions in 5 cases. In contrast, of 16 patients receiving pure progestogen contraceptive therapy with either discontinuous normal dosage progestogens (9 cases) or continuous low-dose norsteroids (7 cases), only one developed clinical or immunological evidence of lupus exacerbation within 3 months of hormonal therapy. We conclude that oral contraceptive therapy using estrogens, even at low dosage, is associated with a high risk of SLE exacerbation. Pure progestogens, which have proven effective and devoid of such unfavorable effects, should be preferred in these patients when hormonal contraception is needed.
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