A catamnestic study of shift-like schizophrenia with long-term remissions

Children with severe Trichuris trichiura infection pose significant social, clinical, and therapeutic problems in Malaysia. Thirty such children were investigated, and mebendazole was found to be safe and effective in the treatment of severe trichuriasis but it had to be given for a longer period than currently recommended. A poor correlation was found between egg load and worm burden in these children. Direct visualization of the rectal and colonic mucosa was the most reliable method of assessing severity in untreated cases, and response to treatment. The eggs of Trichuris that had been exposed to mebendazole were morphologically altered and not viable when incubated. This may be of considerable epidemiological importance.     

Epidemiological study of sleep disorders in patients in Swiss general practice

The aim of the study was to assess the prevalence, severity, associated factors and diagnosis of sleep disorders in general practice. Over 700 patients were investigated with a multiple choice questionnaire in 24 general practices in Switzerland. To assess sleep disorders, criterion A for insomnia according DSM-III-R was applied. The prevalence of sleep disorders was 44%, 64% of these were classified as mild, 31% as moderate and 5% as severe. 50% of the female patients complained about insomnia compared to 36% in males. Retrospectively, 74% of the patients stated having suffered from sleep disorders for more than one year (mild 76%, moderate 69%, severe 75%). 70% of patients with mild, 42% with moderate and 30% of patients with severe insomnia didn't inform their physicians about their sleep difficulties on the occasion of an earlier consultations. Patients with moderate or severe insomnia felt moderately or markedly disabled in their quality of life (71%) and work (58%). To estimate general anxiety and depressive state, self-rating scales were used (STAI, D-S). In comparison to reference values for healthy volunteers, insomniac patients had significantly higher scores on both scales, which were associated with the severity of sleep disorders, corroborating the association of sleep disorders with anxiety disorders and depressions. The physicians diagnosed in 18% of insomniacs a psychiatric disease, in 52% a psychoreactive disorder and in 26% a somatic etiology. The study shows that sleep disorders are a frequent syndrome in general practice and often not reported to the physician; therefore, the patients should routinely be questioned about sleep problems, and associated psychiatric diseases should be considered.     

Atrial fibrillation and flutter as a complication of acute myocardial infarction (author's transl)

Among 909 patients with acute myocardial inarction treated in an intensive care unit between 1970 and 1974, atrial flutter and (or) fibrillation occurred in 124 (13.6%). The incidence of these arrhythmias rose with increasing age and predominantly in paroxysmal form (78%). The clinic mortality of patients with arrhythmias was 42%, while in the remaining 785 it was only 26% (P less than 0.001). Patients with atrial fibrillation and (or) flutter had a higher mean age, more frequently cardiac failure (P less than 0.001) - especially in the prognostically unfavourable severe forms with pulmonary oedema (P less than 0.05) and combined right and left heart failure (P less than 0.001) - and other disorders of impulse conduction or formation and chronic arterial hypertension (P less than 0.01).     

Factors related to delayed treatment and posttreatment symptom severity in Taiwanese patients with benign prostatic hyperplasia

We evaluated the sociodemographic and clinical factors of delayed treatment and posttreatment symptom severity in outpatients with benign prostatic hyperplasia (BPH). The study included 146 BPH patients treated at the National Taiwan University Hospital in early 1997. All patients were treated with alpha-adrenergic antagonists or finasteride for at least 2 weeks. A questionnaire based on Andersen's Health Behavior Model was used to assess various sociodemographic features, while the pre- and posttreatment symptoms severity was rated according to the International Prostate Symptom Score (IPSS). Multiple logistic regression was used to assess the associations of these factors with delayed treatment and posttreatment symptom severity. Subjects who had recently quit smoking or were blue-collar workers tended to delay treatment, while those who chose a medical center as the care provider for chronic diseases tended to be less likely to delay treatment. However, none of these associations were statistically significant. No enabling factors (income, insurance) or need factors (symptom scores) evaluated were associated with delayed treatment. Predisposing factors associated with higher posttreatment symptom severity were delayed treatment (over 12 months) (adjusted odds ratio [OR]: 2.67, 95% confidence interval [CI]: 1.16-6.16), quitting smoking (adjusted OR: 4.47, 95% CI: 1.34-14.94), and having never smoked (adjusted OR: 3.73, 95% CI: 1.15-12.11). Subjects with severe pretreatment symptoms were far more likely than subjects with mild pretreatment symptoms to have severe symptoms after treatment (adjusted OR: 52.69, 95% CI: 54.46-621.90). Our findings, though based on a limited number of subjects, suggest sociodemographic factors rather than objective clinical attributes (prostate specific antigen level, prostate volume, and urodynamic results) are associated with delayed treatment in Taiwanese men with BPH. Both pretreatment symptom severity and sociodemographic factors are related to posttreatment symptom severity.     

Neurologic manifestations in trichinosis]

Neurologic manifestations are present in about 10-20 percent of patients with trichinosis. They could be a serious diagnostic problem in the absence of corresponding epidemiological data and typical symptoms and signs of the disease. In untreated patients the mortality rate is about 50%. Several pathogenic mechanisms are responsible for the neurological complications in trichinosis: obstruction of brain blood vessels by larvae, cysts or granulomas, toxic vasculitis with secondary thrombosis and haemorrhages, granulomatous inflammation of the brain parenchyma and allergic reaction. Neurotrichinosis is manifested with clinical symptoms and signs of meningitis, encephalitis, polyradiculoneuritis, poliomyelitis, myastenia gravis, paresis and paralysis, with the clinical picture of systemic disease of the connective tissue involving the nervous system and, extremely rare, as a sinus thrombosis. Thus, the broad spectrum of neurological lesions in trichinosis is, probably, the results of the fact that Trichinella spiralis larvae, during haematogenic dissemination has no special affinity for particular parts of the nervous system. We present five patients with encephalitis and focal cerebral lesions in trichinosis. In one patient the neurologic manifestations were the only sign of the disease. We believe that all pathogenic mechanisms mentioned above, were involved in the onset of neurological manifestations in our patients. The diagnosis of the disease was based on the clinical picture, epidemiological data, microscopic identification of larvae in the muscular tissue, the presence of antibodies against Trichinella spiralis in cerebrospinal fluid (with preserved blood brain barrier) and in serum confirmed by IIF method, computerised tomography and magnetic resonance imaging of the brain, eosinophilia in the peripheral blood picture. One patient died, and in the remaining patients the course of the disease was favourable; they were discharged from the hospital with minimal neurologic sequelae.     

A study of personality in eating disorders

Some evidence suggests that temperament and personality traits could influence the development and severity of eating disorders. This study was designed to study these aspects. METHODS: 72 patients with DSM-IV eating disorders including 25 anorexia nervosa restricting type, 17 with anorexia nervosa binge eating-purging type and 30 with bulimia nervosa were studied and compared with thirty healthy controls. Personality disorders and temperament were studied with the Eysenck's EPQ, Cloninger's TCI and SCID-II. Impulsive and clinical features were studied with specific rating scales. RESULTS: 61.8% of patients had at least one personality disorder. Avoidant personality disorder was the most commonly diagnosed in anorexia restricting type (25%). Borderline personality disorder was the most frequent in bulimia nervosa and in the binge eating-purging type of anorexia nervosa. Dimensionally, the group of eating disorders presented high scores in neuroticism and low scores in self-directedness. Higher harm avoidance was found in bulimic patients and higher persistence was associated with anorectic patients. Bulimic patients were significantly more impulsive than anorectic and controls. CONCLUSIONS: Temperament and personality traits differ in anorectic and bulimic patients. Bulimic symptoms are linked to impulsive temperament traits and to impulsive personality features. Anorectic symptoms are linked to persistent temperament traits and anxious personality features.     

Clinical description of Parabuthus transvaalicus scorpionism in Zimbabwe

An epidemiological and clinical study of Parabuthus transvaalicus scorpionism was conducted in Zimbabwe. Ten per cent of stings resulted in severe scorpionism. The clinical features of 17 patients with severe envenomation were primarily neuromuscular, with significant parasympathetic nervous system and cardiac involvement. The clinical course was prolonged compared to other scorpion syndromes, and significant therapeutic benefit was demonstrated in terms of hospital stay in response to species specific antivenom. The case fatality rate was 0.3%, with deaths in children below 10 years and adults above 50 years. The mortality rate in the district was 2.8 per 100,000 per year. This syndrome from a buthid scorpion resembles in many respects buthid scorpionism described elsewhere in the world, but shows important differences, notably cardiac involvement in the absence of clinical evidence of circulating catecholamines. The relevance of these findings to buthid scorpionism generally are presented as a hypothesis, in which it is postulated that the cardiac effects of the toxins are direct and primary, and autonomic effects secondary but synergistic, determining the ultimate clinical picture.     

Cardiovascular changes in children with mucopolysaccharide storage diseases and related disorders--clinical and echocardiographic findings in 64 patients

Cardiovascular abnormalities were evaluated in 64 children aged between 1 year 9 months and 25 years with mucopolysaccharidoses (MPS) and related disorders. A heart murmur was heard in 18 patients, but in only 6 was it characteristic for specific valvular lesions. Echocardiography was performed in 63 children. In one girl cardiac lesions were diagnosed on autopsy. In 46 patients (72%), valvular lesions and/or different types of cardiomyopathy were detected. There were no characteristic changes for different types of MPS. In the majority of children in whom dermatan sulphate accumulated, cardiac involvement was the most frequent (88%) and severe. The most common lesion, regardless of MPS type, was thickening of the mitral valve (66%), with regurgitation or stenosis in 28 (44%). Aortic valve thickening was detected in 17 patients (27%), asymmetric septal hypertrophy or hypertrophic cardiomyopathy in 18, congestive cardiomyopathy in 1 and endocardial thickening in 13 patients. Cardiac involvement was less frequent in children with Sanfilippo disease. Two or more echocardiographic examinations were performed in 23 patients. In 19 of them (83%) cardiac changes were more severe during the second examination. One 7-year-old boy with Hunter disease underwent successful mitral valve replacement. CONCLUSIONS; Cardiac involvement is present in most patients with MPS although there are few clinical signs and symptoms. The most common and severe changes are in Hurler, Hunter, Maroteaux-Lamy and I-cell disease, rarely in Sanfilippo disease. Mitral valve deformation is most frequent in all patients. The cardiac lesions are progressive.     

Periodontal repair in intrabony defects treated with a calcium carbonate implant and guided tissue regeneration

OBJECTIVE: To determine mortality and factors that might predict outcome in severe community-acquired pneumococcal pneumonia treated by a standard protocol. DESIGN: Prospective, non-concurrent study. SETTING: Respiratory intensive care unit (ICU) in a teaching hospital. PATIENTS: 63 patients who were diagnosed by positive blood culture or Gram stain and culture of sputum or tracheal aspirate were included. MEASUREMENTS AND RESULTS: Clinical features, severity scores including Acute Physiology and Chronic Health Evaluation (APACHE) II, organ failure and lung injury scores, and the clinical course in the ICU were documented; 79% of patients required mechanical ventilation. Bacteraemia was present in 34 patients (54%); there were no distinguishing clinical features between bacteraemic and non-bacteraemic cases. The overall mortality was 21%, with only 5 deaths (15% mortality) in the bacteraemic group. Shock and a very low serum albumin (< 26 g/l) were the only clinical features that differentiated survivors from non-survivors; lung injury, APACHE II and multiple organ failure scores were all predictive of outcome. The positive predictive value and specificity in predicting death in individuals for the modified British Thoracic Society rule 1 were 26 and 64%; APACHE II > 2057 and 88%; > 2 organ failure 64 and 92%; and lung injury > 233 and 73%, respectively. CONCLUSIONS: These results suggest that even in bacteraemic cases mortality should be below 25% with intensive care management and that conventional scoring systems, while predictive of group mortality, are unreliable in individuals.     

A cross-sectional study of prevalence and etiology of signs and symptoms of temporomandibular disorders in high school and university students

The aim of this study was to evaluate the prevalence and need for treatment of temporomandibular disorders (TMD) in students living in Bauru, Brazil. The role of occlusal and emotional factors was also addressed. The presence and severity of TMD was determined by using a self-reported anamnestic questionnaire composed of 10 questions regarding common TMD symptoms. The symptoms were transposed into a severity classification according to the number and frequency of positive responses. Occlusal evaluation included an analysis of retruded contact position, intercuspal position, anterolateral guidance, and nonworking side contacts during mandibular movements. Palpation of the muscles and temporomandibular joints were performed to detect clinical signs of TMD. A chi square test was used to compare clinical and occlusal data with the presence and severity of TMD. A total of 0.65% of the subjects had severe TMD symptoms, 5.81% had moderate symptoms, and 34.84% had mild symptoms. Those with severe and moderate symptom levels were interpreted to be in need of treatment. Symptoms were found significantly more frequently in females than in males (P < .01). Self-reported emotional tension and parafunctional habits demonstrated strong associations with TMD (P < .01). Occlusion did not seem to influence the presence or severity of TMD. Based on these results, the efficacy of some traditional TMD treatments should be reconsidered, and reversible and conservative procedures should be the first choice for managing TMD patients.     

Nasal secretion analysis in allergic rhinitis, cystic fibrosis, and nonallergic fibromyalgia/chronic fatigue syndrome subjects

Vascular surgery can be safely performed in approximately 60% of patients with advanced peripheral vascular disease, because of the high frequency of concomitant coronary artery disease and consequent increased risk of perioperative cardiac complications. The aim of this study was to validate the hypothesis that endovascular revascularization could be safely applied to high-cardiac-risk patients with a lower incidence of perioperative cardiac complications. One hundred and fourteen patients with peripheral vascular disease referred for revascularization underwent preoperatively a clinical and echocardiographic evaluation, at rest and under dipyridamole stress test, to assess the cardiac risk. Patients with high clinical score (according to Goldman and Detsky), or low left ventricular ejection fraction at rest, or positive dipyridamole stress test, were considered at high cardiac risk. To record adverse cardiac events, all patients were monitored during surgery, postoperatively, and followed up for 18 months after hospital discharge. Forty-eight patients (42%) were found to be at high cardiac risk. In this high-cardiac-risk group, endovascular surgery was performed in 37/48 patients (77%) (group A), while the remaining 11/48 patients (23%) were bypassed with open surgery (group B). Postoperative cardiac complications occurred in 16% of patients in group A and in 45% of patients in group B with two deaths (p < 0.05). At follow-up, 51% of patients in group A and 44% of patients in group B had suffered late cardiac events (p=ns), with 10 deaths in group A and three deaths in group B (p=ns). Limb salvage rate was similar in the two groups (95% group A, 100% group B; p=ns). These data show that high-cardiac-risk patients with limb-threatening ischemia have significantly less perioperative cardiac complications when treated by endovascular procedures instead of bypass surgery. Follow-up data on cardiac events confirm the severity of concomitant coronary artery disease in patients with peripheral vascular disease.     

Mebendazole in the treatment of helminthiasis

Mebendazole, a new broad-spectrum anthelmintic, was used to treat patients with nematode infections--ascariasis, trichuriasis and hookworm. The dosage for adults was 100 mg twice daily for 3 days and for children, 50 mg twice daily for 3 days. Pretreatment and post-treatment egg counts on stool specimens showed that after mebendazole there was a reduction of over 99% in egg count per gram of stool in all three types of infection. The overall cure rates for the infections were as follows: Ascaris lumbricoides, 86.8% (59/68); Trichuris trichiura, 86.0% (37/43); and hookworm, 85.7% (24/28). The drug was equally effective in light and heavy infections. No important side effect was noted with this drug. It is suggested that mebendazole is the drug of choice for trichuriasis and mixed nematode infection.     

Sensation seeking, substance abuse, and psychopathology in treatment-seeking and community cocaine abusers.

Sensation seeking, substance abuse severity, and psychiatric disorders were systematically assessed in a clinical and a community sample of 335 cocaine abusers. In contrast to low-sensation-seeking cocaine abusers, high-sensation seekers exhibited more severe symptoms of substance abuse, exhibited more severe psychosocial impairment, were more likely to be polysubstance abusers, and had an earlier age of onset for substance use and abuse. High-sensation seekers were more likely to report both a lifetime history and family history of antisocial personality, attention deficit disorders and conduct disorder. Sensation seeking was related to several dimensions that are important for defining subtypes of substance abusers and was consistent with other features of a Type II classification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Results and substantiation of surgical strategy in acute suppurative-destructive pyelonephritis in pregnant women

The effectiveness of treatment of acute purulent pyelonephritis in 2.256 pregnant women from 1986 to 1992 was analysed. 95-97% of them had diffuse purulent (nondestructive) pyelonephritis which was cured by drug treatment. Pyodestructive manifestations (apostematosis, carbuncle, abscess of the kidney) of uni- (84.8%) and bilateral (15.2%) pyelonephritis were found in 85 (3.8%) of the patients. Signs of pyoseptic intoxication predominated in the clinical picture. Antibacterial and detoxification therapy was applied in the pre- and postoperative periods. The choice of the surgical tactics and operative method was based on the peculiarities of the clinical course, the revealed complications, and the anatomical changes in the kidney. Nephrostomy and antibacterial therapy are sufficient for curing the apostematic form. Patients with a bilateral affection were treated by operative stage-by-stage kidney drainage (nephrostomy). When economical operations were ineffective clinically (9.4%), secondary nephrectomy was indicated. Primary nephrectomy is an adequate surgical intervention in cases of a total destructive process in the kidney, grave septic manifestations, and a toxic response of the liver. The high proportion of nephrectomies (37.6%) is explained by the clinicoanatomical severity of focal-purulent pyelonephritis and its complications (sepsis) which hazard the life in pregnancy. Pliant surgical tactics in the treatment of severe forms of pyodestructive pyelonephritis ensured clinical cure of 96.5% of patients and uneventful delivery in 91.8% of cases. Death occurred from sepsis and bacteriotoxic shock which developed due to purulent pyelonephritis of pregnancy.     

Seizure control after stimulation of the vagus nerve: clinical outcome measures

Our objective was to determine whether pleural effusion is a predictor of severity in acute pancreatitis and, if so, whether it is an independent predictor. One hundred ninety-six consecutive cases of acute pancreatitis from October 1, 1994, to September 30, 1995, were reviewed. Medical records were analyzed for evidence of pleural effusion by chest radiograph and severe acute pancreatitis by identification of pancreatic necrosis or organ system dysfunction. Data were analyzed to determine if identification of pleural effusion provided an early sign of severity. Among 135 patients who underwent chest radiography, pleural effusion was seen in 16 of 19 (84.2%) with severe pancreatitis and 10 of 116 (8.6%) of patients with mild pancreatitis (p < 0.001). Pleural effusion was noted in severe pancreatitis prior to clinical or computed tomography evidence of severity in only 20% of cases. Pleural effusion is strongly associated with severity in acute pancreatitis but provides independent information on severity in only a minority of cases.     

Lysosomal storage diseases in adults

Most lysosomal storage disorders are known as pediatric diseases. In recent years late onset and adult forms of these disorders have been recognized. The adult form of a given lysosomal storage disorder differs from the childhood disease in several respects. Adult disorders are, with some exceptions, less common than the childhood diseases. The clinical picture is not only less severe, but often shows quite different clinical signs and symptoms than the early onset form. Metachromatic leucodystrophy, GM1 and GM2 gangliosidoses, Gaucher disease and aspartylglucosaminuria are presented as examples of lysosomal storage disorders manifesting as adult diseases. The differences of the early and late onset disorders are discussed in the light of recent results of molecular genetics, residual enzyme activity and pseudodeficiency.     

Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders

BACKGROUND: The aim of this study was to explore patterns and clinical correlates of psychiatric comorbidity in patients with schizophrenia spectrum disorders and mood spectrum disorders with psychotic features. METHOD: Ninety-six consecutively hospitalized patients with current psychotic symptoms were recruited and included in this study. Index episode psychotic diagnosis and psychiatric comorbidity were assessed using the Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P). Psychopathology was assessed by the SCID-P, Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, and Hopkins Symptom Checklist. Awareness of illness was assessed with the Scale to Assess Unawareness of Mental Disorders. RESULTS: The total lifetime prevalence of psychiatric comorbidity in the entire cohort was 57.3% (58.1% in schizophrenia spectrum disorders and 56.9% in mood spectrum psychoses). Overall, panic disorder (24%), obsessive-compulsive disorder (24%), social phobia (17.7%), substance abuse (11.5%), alcohol abuse (10.4%), and simple phobia (7.3%) were the most frequent comorbidities. Within the group of mood spectrum disorders, negative symptoms were found to be more frequent among patients with psychiatric comorbidity than among those without comorbidity, while such a difference was not detected within the group of schizophrenia spectrum disorders. Social phobia, substance abuse disorder, and panic disorder comorbidity showed the greatest association with psychotic features. An association between earlier age at first hospitalization and comorbidity was found only in patients with unipolar psychotic depression. Patient self-reported psychopathology was more severe in schizophrenia spectrum patients with comorbidity than in those without, while such a difference was less pronounced in mood spectrum psychoses. CONCLUSION: These findings suggest that psychiatric comorbidity is a relevant phenomenon in psychoses and is likely to negatively affect the phenomenology of psychotic illness. Further studies in larger psychotic populations are needed to gain more insight into the clinical and therapeutic implications of psychiatric comorbidity in psychoses.     

Transgenerational effects of abusive violence on the children of Vietnam combat veterans

The present study was aimed at the comparative assessment of electrophysiological and clinical data in persons (155 right-handed men) who took part in the Chernobyl clean-up in different periods after radiation. Dynamic evaluation of psychoneurological disorders revealed the growth of incidence and severity of cerebrovascular disturbances accompanied by the signs of organic symptoms' aggravation and encephalopathy in longer periods after radiation. The results of neuropsychological examination also showed the deterioration of patients' state manifested as growth of fatigue, cognitive defects, and emotional impairments. Analysis of the EEG parameters, including power and coherence mapping and 3-d dipole source localization analysis demonstrated the increasing number of patients with the most severe forms of EEG pathology: the "plane" type in combination with fast paroxysmal (beta-band) and slow forms of activity from 45% in 1990-92 to 63% in 1997. The "hypersynchronization" type of EEG activity was typical for the earlier period accompanied by the dominance of the pathological forms of EEG activity in mediobasal structures of the left hemisphere, and brainstem zones vs. diencephalon and the right hemisphere. The later period was characterized by decreasing coherence in symmetrical frontal and front-temporal areas of the left hemisphere, while in the early period the hypersynchronization prevailed in symmetrical central areas and in the right hemisphere. The evidence were obtained to a disconnection between the brain hemispheres. We suppose that the progressive involvement of structures of the limbic-reticular complex (especially, brainstem, mediobasal structures, and white matter) into the pathological process occurs with time in participants of clean-up of the Chernobyl disaster consequences.     

Complications of microvascular head and neck surgery in the elderly

In order to shed light on the clinical picture of patients with Tourette syndrome (TS) treated at medical institutions in Japan, a nationwide survey covering both pediatric patients and psychiatric patients was conducted. We mailed 316 questionnaires on experience in treating TS cases and the patients' present conditions etc. to specialists such as psychiatrists and pediatricians. A total of 164 responded. The survey found 154 TS patients being treated at the time of survey, 45 (29.2%) had obsessive-compulsive symptoms (OCS), and 10 (6.5%) had family histories of TS. It was suggested that TS is often associated with OCS and that familial cases of TS are slightly less common in Japan than they are in the USA. Of the 116 respondents who described their experiences, 85 (73.2%) said that they had treated one or more patients displaying the symptoms of frequent coprolalia, and 42 (36.2%) said that they had treated one or more patients suffering from developmental disorders. Based on these findings, we speculated that the rate of coprolalia in Japan is a little higher than the previously reported 4% and that TS is often associated with developmental disorders.     

Chronic endemic hydroarsenicism

OBJECTIVE: To assess the prevalence and severity of autonomic dysfunction (AD) in patients with systemic lupus erythematosus (SLE). METHODS: Fifty-nine consecutive patients with SLE and 97 healthy controls were assessed for AD using 4 noninvasive tests: heart rate responses to the Valsalva maneuver (Val), maximum-minimum heart rate (MM) response to deep breathing, heart response to standing up (30:15 ratio), and changes in blood pressure to sustained handgrip (Hand). AD was categorized as incipient, definite, severe, or atypical according to criteria proposed by Ewing. Disease characteristics, comorbid conditions, disease activity index [Mexican Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI)], cardiac complaints, and drug history were also documented. Laboratory analysis included rheumatoid factor, antinuclear antibodies, anti-dsDNA antibodies, and anticardiolipin antibodies (aCL). RESULTS: Forty-eight percent of the patients with SLE had one or more abnormal tests compared with 33% of the controls (p=0.05); differences were greater when the severity of the neuropathy was considered: 12 (21%) patients with SLE had definite or severe AD using Ewing's criteria, compared with only 2 (2%) controls (p < 0.001). No statistical associations were observed between AD and age, disease duration, hypertension, Mex-SLEDAI, anti-dsDNA, aCL antibodies, or other drugs. CONCLUSION: The prevalence of AD in SLE using noninvasive tests is high. One-fifth of our patients had definite or severe AD. No significant associations were observed between AD and clinical or serological variables of disease activity. Prospective studies are needed to determine the potential effect of AD in the morbidity of patients with SLE.