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1.
J Med Eng Technol ; 29(3): 137-44, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16019883

RESUMO

PURPOSE: The primary aim of this study was to assess a range of desktop text telephones and to provide comparative data to enable healthcare professionals and users to make informed choices when selecting products. Our second objective was to highlight the effect of different product features on ease of communication. METHODS: We used three methods of evaluation. (1) User trials of seven desktop textphones were carried out by 28 people. (2) The same desktop textphones, along with three portable models, were appraised by two independent assessors. (3) All 10 products were discussed by groups of hearing and hearing-impaired users-112 in all. RESULTS AND CONCLUSIONS: Participant ratings, user comments, and observations of sample conversations all revealed that ease of communication was greatly influenced by the type of technology employed to connect the textphone to the telephone network. Overall, conversations held on text telephones with a direct connection were more successful and produced fewer garbled messages than those made with an acoustic connection. Although individual preferences were expressed, other defining features such as the size of keyboard, display type and size of text did not have a comparable impact on communication. Future research and development could focus on the design of products that would cater simultaneously for the communication needs of hearing, deaf and speech-impaired users.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Comportamento do Consumidor , Correção de Deficiência Auditiva/instrumentação , Análise de Falha de Equipamento/métodos , Desempenho Psicomotor , Distúrbios da Fala/reabilitação , Adolescente , Adulto , Idoso , Criança , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
Stroke ; 31(10): 2402-6, 2000 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11022071

RESUMO

BACKGROUND AND PURPOSE: We sought to define an effective and safe dose of botulinum toxin type A (Dysport) for the treatment of upper limb muscle spasticity due to stroke. METHODS: This was a prospective, randomized, double-blind, placebo-controlled, dose-ranging study. Patients received either a placebo or 1 of 3 doses of Dysport (500, 1000, 1500 U) into 5 muscles of the affected arm. Efficacy was assessed periodically by the Modified Ashworth Scale and a battery of functional outcome measures. RESULTS: Eighty-three patients were recruited, and 82 completed the study. The 4 study groups were comparable at baseline with respect to their demographic characteristics and severity of spasticity. All doses of Dysport studied showed a significant reduction from baseline of muscle tone compared with placebo. However, the effect on functional disability was not statistically significant and was best at a dose of 1000 U. There were no statistically significant differences between the groups in the incidence of adverse events. CONCLUSIONS: The present study suggests that treatment with Dysport reduces muscle tone in patients with poststroke upper limb spasticity. Treatment was effective at doses of Dysport of 500, 1000, and 1500 U. The optimal dose for treatment of patients with residual voluntary movements in the upper limb appears to be 1000 U. Dysport is safe in the doses used in this study.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Espasticidade Muscular/tratamento farmacológico , Fármacos Neuromusculares/administração & dosagem , Acidente Vascular Cerebral/complicações , Braço/fisiopatologia , Toxinas Botulínicas Tipo A/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia , Espasticidade Muscular/fisiopatologia , Fármacos Neuromusculares/efeitos adversos , Razão de Chances , Medição da Dor/efeitos dos fármacos , Estudos Prospectivos , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento
3.
FEBS Lett ; 175(1): 90-4, 1984 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-6383864

RESUMO

The Escherichia coli ribosomal proteins, L7/L12, are dominant over L11 in modulating the binding of RF-1 and RF-2 to ribosomes. The elevated activity of RF-2 on L11-lacking ribosomes over those containing L11 is abolished by IgG against L7/L12 or by removing the L7/L12 proteins. Adding back L7/L12 restores the original phenotype. The stimulatory factor, RF-3, is active on ribosomes depleted of L7/L12 but on those which lack L11 the stimulatory effects are less pronounced or often not seen. RF-3 cannot restore activity with RF-1 or RF-2 to ribosomes lacking both these sets of proteins. The stimulatory effects of an absence of either L11 or RF-3 on the activity of RF-2 are not additive or synergistic.


Assuntos
Escherichia coli/metabolismo , Fatores de Terminação de Peptídeos/metabolismo , Proteínas Ribossômicas/metabolismo , Ribossomos/metabolismo , Sítios de Ligação , Cinética , Mutação
4.
Neurology ; 33(7): 943-6, 1983 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-6683381

RESUMO

In comparison with closely matched controls, patients with Parkinson's disease had reduced scores in tests of odor detection and qualitative discrimination. Olfactory impairment was not related to age, duration of symptoms, treatment, intellectual function, or genetic factors and seemed to be a nonmotor manifestation of the disease.


Assuntos
Doença de Parkinson/fisiopatologia , Olfato , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
Neurology ; 34(2): 198-201, 1984 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6538008

RESUMO

We measured decarboxylation of oral L-dopa in patients chronically treated with L-dopa, and in untreated controls. Chronic L-dopa and carbidopa administration did not affect the extent of whole-body decarboxylation, and it is therefore unlikely that on-off fluctuations are related to chronic changes in the activity of L-aromatic amino acid decarboxylase. The observed duration of action and dose-response properties of carbidopa suggested that current empirically based dose schedules are optimal and supported the concept that decarboxylase inhibitors enhance the clinical effect of L-dopa largely by reducing the extent of first-pass metabolism rather than through an action on the decarboxylase enzyme in cerebral capillaries.


Assuntos
Química Orgânica , Descarboxilação , Levodopa/metabolismo , Doença de Parkinson/metabolismo , Adulto , Carbidopa/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Humanos , Levodopa/uso terapêutico , Masculino , Fenômenos de Química Orgânica , Doença de Parkinson/tratamento farmacológico , Fatores de Tempo
6.
Neurology ; 33(8): 1009-14, 1983 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-6348585

RESUMO

Twenty-four parkinsonian patients compared pergolide and bromocriptine therapy in a randomized double-blind, two-period crossover study. Both drugs were adjusted to an optimal balance between benefits and side effects. The mean daily dose and dose range for pergolide and bromocriptine were 3.3 mg (0.7 to 7.2) and 42.7 mg (5.8 to 87.5), respectively. Adjunctive medications, which for most patients included levodopa (plus carbidopa), were not altered during the study. A similar spectrum of clinical effects was found with both drugs and with lisuride, which was used to treat 13 of the patients in a previous study. Despite neurochemical differences in the antiparkinsonian ergots, their clinical utility is quite similar. We draw attention to hepatotoxicity and pleural reactions that may occur rarely with these drugs.


Assuntos
Bromocriptina/uso terapêutico , Ergolinas/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Idoso , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Humanos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pergolida
7.
Neurology ; 33(7): 815-24, 1983 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-6683366

RESUMO

Among 43 monozygotic (MZ) and 19 dizygotic (DZ) pairs in which an index case had definite Parkinson's disease (PD), only one MZ pair was definitely concordant for PD. When pairs with questionable clinical features were included, 4 of 48 MZ and 1 of 19 DZ pairs were concordant. The frequency of PD in MZ cotwins of index cases with PD was similar to that expected in an unrelated control group matched for age and sex. Although we were unable to identify a single environmental agent, we conclude that the major factors in the etiology of PD are nongenetic.


Assuntos
Doença de Parkinson/genética , Quadrigêmeos , Gêmeos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Risco
8.
Neurology ; 32(1): 69-72, 1982 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-7033825

RESUMO

Twenty-eight parkinsonian patients were studied in a double-blind, crossover comparison of lisuride and bromocriptine. All but two patients completed the study, with each drug adjusted to an optimal dose (mean daily intake of 4.5 mg for lisuride and 56.5 mg for bromocriptine). Treatment with each drug was given for 7 to 10 weeks; three assessments were made at biweekly intervals with optimal dose levels. Conventional antiparkinsonian medications, including levodopa, were not changed. Efficacy and adverse effects were assessed by objective and subjective techniques. The only significant difference was slightly better control of akinesia with bromocriptine. There was considerable variability in the optimal dose of each drug, though the clinical profile of lisuride was quite similar to that of bromocriptine.


Assuntos
Bromocriptina/uso terapêutico , Ergolinas/uso terapêutico , Lisurida/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Adulto , Idoso , Bromocriptina/efeitos adversos , Ensaios Clínicos como Assunto , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Lisurida/efeitos adversos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória
9.
Neurology ; 31(4): 371-6, 1981 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7194429

RESUMO

We studied the actions of lisuride, a dopaminergic ergot derivative, in 20 parkinsonian patients. When the dose was increased gradually, most patients tolerated up to 5 mg daily. Clinical assessment and objective, computer-assisted evaluation revealed improvement in akinesia, rigidity and tremor. Adverse reactions were similar to those seen with levodopa and bromocriptine, but somnolence tended to occur more often with lisuride.


Assuntos
Ergolinas/uso terapêutico , Lisurida/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Adulto , Idoso , Bromocriptina/uso terapêutico , Método Duplo-Cego , Humanos , Lisurida/administração & dosagem , Lisurida/efeitos adversos , Lisurida/farmacologia , Pessoa de Meia-Idade , Movimento , Placebos , Tempo de Reação , Receptores de Serotonina/efeitos dos fármacos , Sono/efeitos dos fármacos
10.
Neuropsychologia ; 27(5): 743-6, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2739897

RESUMO

We report the impaired performance by a group of 27 patients with Parkinson's disease (vs matched controls) on semantic and letter-initial verbal fluency tasks, carried out in both single and alternating category conditions. Individual differences in fluency were significantly correlated with confrontation picture naming scores in the patient group, but not in control subjects. However, the PD patients showed no significant correlation between verbal fluency scores, and rate of reciting days of the week as rapidly as possible. Both controls and patients produced more items when retrieving words from a single category than when alternately retrieving words from two categories. The magnitude of the decrement was nonetheless no greater in the patient than in the control population. This finding shows that "task switching" per se is not impaired in PD. We suggest that the verbal fluency deficit, while it may in part be attributed to motor-speech factors, primarily reflects an underlying cognitive disorder.


Assuntos
Memória , Rememoração Mental , Doença de Parkinson/psicologia , Semântica , Aprendizagem Verbal , Sinais (Psicologia) , Demência/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
11.
Virus Res ; 22(3): 259-79, 1992 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1320792

RESUMO

We have molecularly cloned and determined the nucleotide sequence of the 3' and 5' regions of the genomic RNA of the paramyxovirus simian virus 5 (SV5), including the 3' leader sequence, nucleocapsid protein (NP) gene, large (L) protein gene, and 5' anti-genomic leader (trailer) sequence. The vRNA 3' proximal leader sequence contains 55 nucleotides. The NP gene is 1725 nucleotides in length and encodes a negatively charged protein consisting of 509 residues (MW 56,534). A comparison of the amino acid sequences of 10 paramyxovirus NP proteins indicates a region of high sequence identity near the middle of the protein, and a C-terminal region which is enriched in negatively charged residues. Overall, the SV5 NP protein showed the highest degree of sequence identity with the NP proteins of parainfluenza type 2 virus (58%) and mumps virus (56%). The L gene extends 6804 nucleotides and encodes a positively charged protein consisting of 2255 residues (MW 255,923). The 5' proximal region of the vRNA consists of a 31 nucleotide trailer RNA. The SV5 L protein sequence showed 62% overall identity with the parainfluenza type 2 L protein. Although little overall sequence identity was found between the SV5 and other paramyxovirus L protein sequences, short stretches of extensive amino acid identity were found near the middle of each of the known paramyxovirus L protein sequences, and these common regions may represent sites important for enzymatic activity.


Assuntos
Proteínas do Capsídeo , Capsídeo/genética , Respirovirus/genética , Proteínas Virais/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Linhagem Celular , Clonagem Molecular , DNA Viral , Dados de Sequência Molecular , RNA Viral
12.
Psychiatr Clin North Am ; 9(2): 215-24, 1986 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-3523463

RESUMO

This article presents a comprehensive overview of the subject including historical background, general features and neuropathology, and contributions to clinical phenomenology.


Assuntos
Psiquiatria Biológica/história , Encefalite por Arbovirus/história , Transtornos Neurocognitivos/história , Europa (Continente) , História do Século XX , Humanos , Fases do Sono , Estados Unidos
13.
Adv Neurol ; 37: 1-7, 1983.
Artigo em Inglês | MEDLINE | ID: mdl-6858768

RESUMO

Objective measurements of movement time, reaction time, and gait were compared with a clinical rating performed at the same times on several occasions in 10 patients with Parkinson's disease (PD). Positive correlations between objective measures and clinical evaluation were demonstrated. Movement time was the single most useful index of motor deficit, but no objective tests were more sensitive than clinical evaluations in the detection of motor disorder. It is concluded that there is at present no effective substitute for clinical procedures, although the convenience and future potential of objective measurement justify the further development of such systems for use in the experimental study of PD.


Assuntos
Avaliação de Medicamentos/métodos , Doença de Parkinson/tratamento farmacológico , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/etiologia , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Tempo de Reação , Fatores de Tempo
14.
Ann Clin Biochem ; 24 ( Pt 5): 477-82, 1987 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-3662397

RESUMO

A radioimmunoassay has been developed for the measurement in urine of retinol-binding protein (alpha 2-microglobulin) and used as an index of renal tubular function in adult Type 1 (insulin-dependent) diabetics and to define reference ranges in non-diabetic controls. There was a significantly greater excretion (P less than 0.001) of retinol-binding protein in the diabetic group compared to the controls in both overnight and daytime samples. There was a weak positive correlation with albumin excretion (r = 0.33; P less than 0.01) but no correlation with HbA1, duration of diabetes or arterial blood pressure. The results indicate that retinol-binding protein excretion may be increased in diabetic subjects without increased albumin excretion. The possibility therefore exists that renal tubular damage may occur early in diabetic nephropathy without apparent glomerular dysfunction.


Assuntos
Diabetes Mellitus Tipo 1/fisiopatologia , Túbulos Renais/fisiopatologia , Proteínas de Ligação ao Retinol/urina , Adolescente , Adulto , Albuminúria/urina , Criança , Ritmo Circadiano , Creatinina/urina , Diabetes Mellitus Tipo 1/urina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peso Molecular , Radioimunoensaio
15.
Disabil Rehabil ; 24(18): 970-4; discussion 975-1004, 2002 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-12528676

RESUMO

PURPOSE: To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. METHOD: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and strategies for rehabilitation practice. RESULTS: The focus of rehabilitation for people with a chronic disabling condition is shifting from a biomedical to a client-centred perspective. Conceptions of autonomy vary among individuals and cultures, but a crucial distinction can be made between decisional autonomy (the ability to make decisions without external restraint) and executional autonomy (the ability to act as one wishes). The liberal-individualist account of autonomy over-emphasizes physical independence and does not sufficiently recognize the inter-dependency of all people, including those with disabilities. An ethic of care, complementary to the principle of respect for autonomy, should guide the development of rehabilitation strategies to enhance individual autonomy and participation in daily living. For rehabilitation, this entails an attentive attitude, maximizing opportunities for informed choices, taking full account of each person's preferences, needs and social contexts. CONCLUSIONS: Autonomy is central to client-centred rehabilitation since it is a pre-requisite for effective participation. It is suggested that autonomy, conceived as a basis for participation, is the ultimate aim of rehabilitation.


Assuntos
Pessoas com Deficiência/reabilitação , Autonomia Pessoal , Adaptação Psicológica , Humanos
16.
J Allied Health ; 27(1): 45-9, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9616873

RESUMO

Both countries face considerable challenges to their rehabilitation services. Although contextually different, the problems and challenges are common to both. Two contrasting views of disability have been presented. In the UK disability may be viewed as a disaster, while in Asia illness and disability may be viewed as inevitable. Personal independence is not a universal goal of rehabilitation, because in some cultures dependence on others is an expected consequence of disability. Disability in Indonesia translates into a large burden of care for the family, whereas English families may expect greater help from the government in caring for their relative. Western rehabilitation is increasingly patient directed, whereas the Indonesian model is more likely to be determined solely by professionals. The problems observed by the team in Indonesia were remarkably similar to those experienced in the UK. A patient centered goal setting approach can be considered vital to neurological rehabilitation, although the focus of the goals set is likely to be very different in these two cultures. The fundamental importance of a multidisciplinary team is recognized in both cultures, although team working may not be easy in either situation. Managerial commitment is essential for the survival of a team, yet both structures sometimes fail to provide the necessary support. Hierarchical leadership can inhibit team development both in the UK and in Indonesia, as can frequent rotation of staff. Prescription of therapy by doctors inhibits the development of therapists in both cultures, and therefore the overall effectiveness of the team. In both the UK and Indonesia, the value of rehabilitation as a specialty is not widely recognized. The absence of life and death situations means that services are often out of the public eye, and poorly understood. However, the prevalence of disability will increase the need for rehabilitation services worldwide. Many challenges remain in both the UK and Indonesia to the development of more effective rehabilitation services. Issues like the lack of recognition of rehabilitation as a specialty, the importance of team work, the paucity of managerial support, and increasing demand for rehabilitation services will need to be recognized and addressed. Despite the different approaches to disability in the two cultures, the problems faced are similar. These problems will need to be solved if there is to be significant progress in this multidisciplinary field.


Assuntos
Doenças do Sistema Nervoso/reabilitação , Equipe de Assistência ao Paciente , Centros de Reabilitação/organização & administração , Atitude Frente a Saúde , Características Culturais , Humanos , Indonésia , Intercâmbio Educacional Internacional , Prática Profissional , Reino Unido
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