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1.
J Sports Med Phys Fitness ; 49(3): 285-91, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19861934

RESUMEN

AIM: Clinical examination is sometimes insufficient to assess the severity of lateral collateral ligament (LCL) sprain of the ankle, making it difficult to choose the most appropriate treatment. The aim of this study was to compare the assessment of clinical signs and the ultrasonographic findings in recent LCL sprain of the ankle. METHODS: This was a retrospective cross-sectional study. Spearman's rank correlation test and multiple regression analysis were used to assess correlations between clinical signs and type of ligament injury. Fisher's linear discriminant analysis was used to determine most contributive signs in ligament tear diagnosis. RESULTS: No single clinical sign was correlated with the severity of ligament injury as revealed by ultrasonography in the 34 patients analyzed. Careful assessment of all the usual clinical signs of severity seems to better guide the diagnosis of the presence or absence of ligament tearing. CONCLUSIONS: These results confirm the lack of correlation between clinical examination and the anatomic injury in distension or partial tearing of the anterior talofibular ligament. They raise questions about the usefulness of clinical classifications and suggest a broadening of the indications for ultrasonographic exam in ambiguous situations, particularly for athletes showing few signs of severe injury, in order to ensure optimal treatment and a faster recovery.


Asunto(s)
Traumatismos del Tobillo/diagnóstico por imagen , Ligamentos Laterales del Tobillo/diagnóstico por imagen , Ligamentos Laterales del Tobillo/lesiones , Esguinces y Distensiones/diagnóstico por imagen , Adolescente , Adulto , Estudios Transversales , Diagnóstico Diferencial , Análisis Discriminante , Femenino , Humanos , Masculino , Análisis de Regresión , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Ultrasonografía
2.
Ann Readapt Med Phys ; 49(1): 8-15, 2006 Feb.
Artículo en Francés | MEDLINE | ID: mdl-16122829

RESUMEN

OBJECTIVE: To compare lateral rotator (LR) and medial rotator (MR) muscle strength of both shoulders in a sport involving asymmetrical movements (tennis), symmetrical movements (swimming), and symmetrical and asymmetrical movements (volley-ball). MATERIALS AND METHODS: Retrospective study of 42 healthy elite athletes (18 women: 14 tennis players, 19 swimmers and 9 volleyball players. We evaluated the strength of LR and MR of both shoulders by Cybex Norm isokinetic dynamometer, in the concentric mode, in the modified Davies position, at 2 different speeds (60 degrees and 180 degrees s(-1)) and analysed peak torque of LR and MR and LR/MR ratios. RESULTS: TENNIS: The MR peak torque of the dominant shoulder was significantly higher than that of the non-dominant shoulder. The LR/MR ratio of the dominant shoulder was significantly lower than the non dominant shoulder in women. SWIMMING: The LR strength and LR/MR ratio of the dominant shoulder was higher than the non dominant side in men at 60 degrees/second. Both shoulders showed comparable strength in women. VOLLEYBALL: Shoulder muscular strength was symmetrical. CONCLUSION: The higher strength of MR muscles in the dominant shoulder of tennis players (asymmetrical movements) has been reported in the literature. Athletes show asymmetrical shoulder strength in swimming, a symmetrical sport and similar LR and MR strength in both shoulders in volleyball, a sport with asymmetrical movements. To our knowledge, these results have never been reported before.


Asunto(s)
Lateralidad Funcional/fisiología , Examen Físico/instrumentación , Rango del Movimiento Articular/fisiología , Articulación del Hombro/fisiología , Deportes/fisiología , Adulto , Femenino , Humanos , Masculino , Músculo Esquelético/fisiología , Estudios Retrospectivos , Rotación
3.
J Neurol Neurosurg Psychiatry ; 72(4): 459-62, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11909903

RESUMEN

OBJECTIVES: Botulinum toxin type A is a potent neuromuscular paralyzing agent used in various disorders including cervical dystonia. Two preparations of botulinum toxin are now commercially available ( Dysport and Botox), but much controversy remains about their respective potencies. The aim of the study was to compare the efficacy of Botox with two different ratios of Dysport. METHODS: A double blind, randomised, three period cross over study involving 54 patients with cervical dystonia was performed. The patients received the following treatments in a randomised order: Botox at the usually effective dose, Dysport at a dose of 1:3 (conversion factor of 3 between Botox and Dysport units-that is, one Botox unit=three Dysport units) and at a dose of 1:4 (conversion factor of four). The improvement of the Tsui (primary outcome criteria) and of the TWSTRS pain scales between baseline and a control visit 1 month after each of the three injections, as well as the incidence of adverse events, were assessed. RESULTS: Comparison of the Tsui scores and of the TWSTRS pain scores showed a better effect on impairment and pain with Dysport 1:3 (p=0.02 and 0.04, respectively) and 1:4 (p=0.01 and 0.02, respectively) than with Botox. The number of adverse events was higher with both Dysport treatments. The most frequent adverse event was dysphagia, found in 3%, 15.6%, and 17.3% (Botox, Dysport 1:3 and 1:4, respectively) of the patients. No adverse event required withdrawal of therapy or specific management. CONCLUSIONS: Dysport 1:3 (and Dysport 1:4 to a greater extent) is more efficient than Botox for both impairment and pain in cervical dystonia although with a somewhat higher incidence of minor adverse effects. This strongly suggests that the most appropriate conversion factor between Botox and Dysport units is less than 3 in cervical dystonia.


Asunto(s)
Toxinas Botulínicas Tipo A/farmacocinética , Fármacos Neuromusculares/farmacocinética , Tortícolis/tratamiento farmacológico , Adulto , Anciano , Toxinas Botulínicas Tipo A/efectos adversos , Toxinas Botulínicas Tipo A/farmacología , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fármacos Neuromusculares/efectos adversos , Fármacos Neuromusculares/farmacología , Dolor/tratamiento farmacológico , Dolor/etiología , Equivalencia Terapéutica
4.
Eur Psychiatry ; 15(7): 424-32, 2000 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11112935

RESUMEN

The aim of this study was to investigate for the effects of valpromide on heart rate circadian rhythm in remitted recurrent unipolar and bipolar disorders (DSM-III-R). It consisted of a comparative, randomized, double-blind, repeated cross-over study of valpromide versus placebo over four four-week periods. The primary evaluation criteria was heart rate (HR). Secondary criteria comprised motor activity (MA) and the Bech and Rafaelsen mania assessment scale, Horne and Ostberg questionnaire, Montgomery and Asberg depression rating scale, Spiegel questionnaire, a sleep diary, and Clinical Global Impression. Fifteen patients were included, giving 60 one-month periods (30 valpromide periods and 30 placebo periods). Cosinor analysis of HR and MA data revealed a difference in amplitude (P = 0.037, analysis of variance, one-tailed test). The clinical sleep study shows that the duration of sleep was greater with valpromide than with placebo (P = 0.007, one-tailed test). Similarly, evaluation of the quality of sleep by patients themselves showed valpromide to be superior to placebo (P = 0.045, one-tailed test). The results of analysis of the Spiegel questionnaire also confirm the superiority of valpromide over placebo. Safety and compliance were comparable for the active drug and the placebo. In conclusion, the relatively small sample size requires cautious interpretation of this study. Nevertheless, these initial results show a definite effect of valpromide on a biological rhythm that leads one to suppose that it may be effective through a 'synchronizing' effect.


Asunto(s)
Anticonvulsivantes/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Ritmo Circadiano/efectos de los fármacos , Trastorno Depresivo Mayor/tratamiento farmacológico , Frecuencia Cardíaca/efectos de los fármacos , Ácido Valproico/análogos & derivados , Adulto , Anticonvulsivantes/efectos adversos , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Sueño/efectos de los fármacos , Resultado del Tratamiento , Ácido Valproico/efectos adversos , Ácido Valproico/uso terapéutico
5.
Int J Sports Med ; 21(7): 459-62, 2000 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11071045

RESUMEN

The aim of this study was to assess the effect of the ascent rate on the production of venous circulating bubbles during the decompression following a recreational dive. Twenty-eight recreational divers performed two open water dives at 35 m during 25 minutes. Ascent rate up to the decompression stop was in one case 9 meter per minute (m/min) and in the other case 17 m/min. Circulating venous bubbles were screened using continuous wave Doppler every 10 minutes during one hour after surfacing. Bubbles Doppler signals were graded according to the Spencer scale (from 0 to IV), and the Kisman integrated severity score (KISS) was calculated. Statistical analysis demonstrated a significantly higher bubbles grade and a significantly higher KISS following the rapid decompression compared to the slow one (respectively p = 0.001 and p = 0.0001). In conclusion, these results demonstrate that a 9 m/min ascent rate is safer than a 17 m/min one.


Asunto(s)
Buceo/fisiología , Gases/sangre , Venas/fisiología , Adulto , Descompresión , Humanos , Masculino
6.
Int J Sports Med ; 20(6): 410-4, 1999 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10496123

RESUMEN

Decompression sickness (DCS) is recognized as a multifactorial phenomenon depending on several individual factors, such as age, adiposity, and level of fitness. The detection of circulating venous bubbles is considered as a useful index for the safety of a decompression, because of the relationship between bubbles and DCS probability. The aim of this work was to study the effects of individual variables which can be assessed non invasively, on the grades of bubbles detected 60 min, after diving by means of Doppler monitoring, in a sample of 40 male recreational scuba divers. The variables investigated were: age, weight, maximal oxygen uptake (VO2max) and percentage of body fat (%BF). Bubble signals were graded according to the code of Spencer. The relationships between the bubble grades (BG) and the variables investigated were studied using two methods: the differences between the average values of each variable at each BG were analyzed by the Scheffe test. Then we performed the non-parametric Spearman correlation analysis. Significant differences (P < 0.05) were found (Scheffe test) between average values of the variables at grade 0 and 3 (age: P = 0.0323; weight: P = 0.0420; VO2max: P = 0.0484), except for %BF (P = 0.1697). Relationships with P < 0.01 were found (Spearman correlation) between BG and the variables: age: p = 0.486, P = 0.0024; weight: p = 0.463, P = 0.0039; VO2max: p = -0.481, P = 0.0027; except for %BF: p = 0.362, P = 0.0237. This work showed that bubble production after hyperbaric exposures depends on several individual factors. The effects of age, weight and VO2max are more significant than the effect of %BF. We concluded that to take into account such variables in decompression tables and diving computer programs should allow to adapt the decompression procedures to individual risk factors and reduce the DCS probability.


Asunto(s)
Enfermedad de Descompresión/etiología , Buceo/fisiología , Embolia Aérea , Consumo de Oxígeno , Adulto , Factores de Edad , Composición Corporal , Peso Corporal , Enfermedad de Descompresión/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Factores de Riesgo
8.
Allerg Immunol (Paris) ; 28(1): 19-24, 1996 Jan.
Artículo en Francés | MEDLINE | ID: mdl-8882207

RESUMEN

875 adolescents of both sexes, aged between 12 and 15 years, who had presented with a perennial allergic rhinitis, were included in an open study that was conducted by pediatricians and allergologists on the efficacy of ZYRTEC (CETIRIZINE). There were four evaluations in the study, at Day-10, D 0, D15 and D30 and it was conducted according to the following plan: A first period (D-10 to D 0) to establish the eligibility of the subjects to be tested, and to establish the clinical allergic history, before definitive inclusion at D 0. A second period, of therapy, of 30 days, during which the subjects took a 10 mg tablet of ZYRTEC as a daily dose. Efficacy was evaluated at each visit by scores of intensity of major symptoms (sneezing, nasal discharge, nasal obstruction, nasal pruritus) and secondary symptoms (ocular score ... ) of rhinitis, as well as anterior rhinoscopy. The patients made an auto-evaluation of symptoms at different times. Analysis of the different parameters showed a real efficacy of ZYRTEC, for 30 days of treatment, in young patients. Furthermore, the tolerance of the product is excellent. This study has shown an overall improvement in the symptoms of perennial allergic rhinitis in patients who were treated with ZYRTEC in conditions similar to those of usual medical practice by pediatricians and allergologists.


Asunto(s)
Cetirizina/uso terapéutico , Rinitis Alérgica Perenne/tratamiento farmacológico , Adolescente , Femenino , Humanos , Masculino
9.
Allerg Immunol (Paris) ; 27(8): 300-6, 1995 Oct.
Artículo en Francés | MEDLINE | ID: mdl-8851038

RESUMEN

In this multicenter parallel group randomized trial 254 teenagers, aged 12-15, suffering from perennial allergic rhinitis were investigated. Four evaluations (D-10, D0, D15, D30) were performed according to the following design: a 10-day run-in period (D-10, D0) to determine/establish the patient eligibility and to perform an allergologic checkup. The decision to include the patient was made at D0 according to selection criteria. a 30-day treatment period (D0 to D30). The patient received either cetirizine 10 mg once a day or placebo given in a double blind way according to randomization. Efficacy was assessed at each visit with a nasal symptom score (sneezing, rhinorrhea, obstruction, pruritus) and an ocular symptom score (watery eyes, conjunctival pruritus, red eyes). In addition, an objective evaluation was performed by means of anterior rhinoscopy. Global evaluations by the investigator and the patient on visual analog scales were assessed. Side effects were recorded. At baseline there was no significant difference between the two groups. At day 15 and day 30, all symptoms, subjective as well as objective, were significantly improved in the cetirizine group. Tolerance was good with no significant difference between cetirizine and placebo.


Asunto(s)
Cetirizina/uso terapéutico , Rinitis Alérgica Perenne/tratamiento farmacológico , Adolescente , Método Doble Ciego , Tolerancia a Medicamentos , Femenino , Humanos , Masculino , Factores de Tiempo
10.
Allerg Immunol (Paris) ; 27(5): 147-54, 1995 May.
Artículo en Inglés | MEDLINE | ID: mdl-7662102

RESUMEN

A double blind, randomized, comparative study versus placebo, was done during 6 months in 32 children, aged 4-12 years, who suffer from either allergic asthma or rhinitis or both, slept in a bedroom rich in dust mite, have well documented allergy solely to house dust mite (H.D.M.), and a condition severe enough to require continuous medication. After thorough cleaning, their bedrooms were sprayed on day 0 and day 90 with the total content of a canister containing either Acardust or Placebo. Rooms were cleaned regularly throughout the study period. Each child completed an individual daily score card (scales from 0-3) for asthma, and rhinitis symptoms, medication taken, and any additional symptoms. Peak flow was recorded twice weekly. All the children were examined every month (at the clinic) when also PFF, FEVI, doctor's and patient's opinion of clinical symptoms were recorded according to the same scale (0-3) and dust samples from child's bedroom were examined for H.D.M. antigen content. At day 0, 90 and 180, total IgE and dust mite specific IgE determination was done. At the end of the study, patient's and doctor's opinion about the spray's efficacy were recorded on a scale from 0-3. The results were in favor of Acardust for asthma, according to patient's opinion (p = 0.001), doctor's opinion (p = 0.04) and individual score cards (p = 0.03), and for nasal secretion (p = 0.01), sneezing and lacrimation (p = 0.02); concurrent medication dropped significantly (p = 0.01) in the Acardust group. No side-effects were reported. We consider Acardust a safe and valuable preventive treatment in H.D.M. allergy.


Asunto(s)
Aletrinas , Asma/prevención & control , Insecticidas , Ácaros , Butóxido de Piperonilo , Rinitis/prevención & control , Animales , Niño , Preescolar , Método Doble Ciego , Combinación de Medicamentos , Femenino , Humanos , Masculino
11.
Neurology ; 43(2): 301-5, 1993 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-8437693

RESUMEN

Preclinical research suggests that piracetam (a nootropic drug) may improve cognitive functions, but previous studies have failed to demonstrate a clear benefit for the treatment of Alzheimer's disease (AD). We report a 1-year, double-blind, placebo-controlled, parallel-group study with a high dose of piracetam (8 g/d per os) in 33 ambulant patients with early probable AD. Thirty subjects completed the 1-year study. No improvement occurred in either group, but our results support the hypothesis that long-term administration of high doses of piracetam might slow the progression of cognitive deterioration in patients with AD. The most significant differences concerned the recall of pictures series and recent incident and remote memory. The drug was well-tolerated.


Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Piracetam/administración & dosificación , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/psicología , Análisis de Varianza , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Factores de Tiempo
12.
Therapie ; 46(6): 481-6, 1991.
Artículo en Francés | MEDLINE | ID: mdl-1819154

RESUMEN

The tolerance and efficacy of dopatherapy associated to lisuride or placebo were compared in 74 de novo patients with Parkinson's disease in a prospective randomized trial. Only non depressed and non demented patients, previously treated with low doses of levodopa during less than one year, were included in this study. Mean age was 59 (range 36-68). After 12 months, the mean dosage of levodopa was higher in the placebo group than in the lisuride group (318 +/- 121 and 274 +/- 74 mg daily respectively). We observed a different decrease in the Unified Parkinson's Disease Rating Scale with better scores in the lisuride group than in the placebo group, especially for the motor items (p less than 0.001) and the daily living (p less than 0.0001). The tolerance was similar in the two groups. This trial will be continued in open conditions over a period of 4 years to appreciate the incidence of motor fluctuations in the two groups.


Asunto(s)
Levodopa/uso terapéutico , Lisurida/uso terapéutico , Enfermedad de Parkinson/tratamiento farmacológico , Método Doble Ciego , Evaluación de Medicamentos , Quimioterapia Combinada , Femenino , Humanos , Masculino , Placebos
13.
Br J Clin Pharmacol ; 30(5): 769-73, 1990 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-2271377

RESUMEN

Yawning and spontaneous blink rate (SBR) are two physiological reflexes which have been incompletely examined but one neurobiological step of these two behaviours seems, at least in part, dopamine-dependent. The reference dopaminergic agonist, apomorphine hydrochloride (0.5, 1, and 2 micrograms kg-1 s.c.), was compared with a placebo in a double-blind latin-square design, and was shown to induce yawning and increase SBR in a population of eight healthy volunteers. These two behavioral effects were not dose-related. The individual SBR differences were correlated with the individual number of yawns for all the four treatments at the 10-30 min interval. Thus, parallel yawning and SBR behaviour suggests a similar pharmacological mechanism. Apomorphine-induced yawning and blinking may be therefore of use in the evaluation of central dopaminergic pathways in man.


Asunto(s)
Apomorfina/farmacología , Parpadeo , Bostezo , Adulto , Dopamina , Método Doble Ciego , Humanos , Masculino
14.
Encephale ; 15(6): 543-7, 1989.
Artículo en Francés | MEDLINE | ID: mdl-2612427

RESUMEN

We recently proposed the first scale for evaluating anxiety in psychotics: the "Psychotic Anxiety Scale" (PAS). The first version of this scale was tested in 45 psychotic patients. The multiple correspondence factorial analysis revealed that 4 factors account for respectively 50%, 18%, 17% and 10% of the variance. This scale thus evaluates anxiety along 4 axes: severity of the symptomatology, evolution in time, hetero-aggressiveness and self-aggressiveness. This analysis supports the hypothesis of the lack of specificity for the anxiety in psychotics, but distinguishes the nevrotic anxiety from the psychotic anxiety. The inter-rater reliability was assessed by a method which compared a rater with the others along 2 axes: the severity, and the profile of the assessment. The interrater reliability was unsatisfactory for only three items. They have been modified and a new version of the PAS is proposed.


Asunto(s)
Trastornos de Ansiedad/psicología , Escalas de Valoración Psiquiátrica/normas , Trastornos Psicóticos/psicología , Trastornos de Ansiedad/diagnóstico , Estudios de Evaluación como Asunto , Análisis Factorial , Humanos
16.
Rev Pneumol Clin ; 44(2): 64-7, 1988.
Artículo en Francés | MEDLINE | ID: mdl-3406618

RESUMEN

Our goal was to evaluate the long-term effects of exposure to air pollutants in schoolchildren living in the Gardanne coal-basin. The group consisted of 193 children 9 to 11 years old, 128 living in polluted communities, 65 in low polluted communities. The protocol included a standardized questionnaire and a spirometric evaluation. The prevalence of pulmonary and E.N.T. symptoms was higher in the polluted communities, but a statistically significant difference was only observed for the symptom "wheezing in the chest". The spirometric values, FEV1 and FVC, were very similar in both areas. It is likely that spirometric abnormalities will appear later in those schoolchildren. Indeed, in the same area, studies performed in groups of housewives have demonstrated a higher prevalence of respiratory symptoms, as well as spirometric abnormalities in subjects living in high polluted communities.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Minas de Carbón , Enfermedades Respiratorias/etiología , Niño , Enfermedad Crónica , Estudios de Evaluación como Asunto , Francia , Humanos , Espirometría , Dióxido de Azufre/efectos adversos , Encuestas y Cuestionarios
17.
Arch Environ Health ; 43(1): 22-7, 1988.
Artículo en Inglés | MEDLINE | ID: mdl-3355241

RESUMEN

The influence of daily changes in sulfur dioxide (SO2) levels on the induction of respiratory symptoms was studied during the 1983-1984 winter in 450 children, aged 9 to 11 yr, living in the Gardanne coal-basin, France. In this area, SO2 originates mainly from a coal-fueled power plant. The mean SO2 level during the winter was 22 micrograms/m3 in low-pollution areas and 93 micrograms/m3 in polluted areas, with daily SO2 levels up to 356 micrograms/m3. Children completed a daily diary about respiratory symptoms. In the polluted communities only we demonstrated a significant association between daily SO2 levels (after controlling for temperature and respirable particle variations) and prevalence of upper and lower respiratory symptoms. However, in each polluted town, and for each respiratory symptom, there was no evidence for either a latency period or a delay in the effects of pollutants. Mean daily temperature was also closely correlated with upper and lower respiratory symptoms in most of the polluted and some low-pollution communities. In a second step, the prevalence of respiratory symptoms in each town was compared, during two 2-wk periods, with air pollution levels; higher prevalences were found during the pollution period. In conclusion, moderate daily changes in SO2 levels induce a significant but transient increase in the prevalence of respiratory symptoms in children.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Trastornos Respiratorios/etiología , Dióxido de Azufre/efectos adversos , Contaminantes Atmosféricos/análisis , Niño , Francia , Humanos , Trastornos Respiratorios/epidemiología , Trastornos Respiratorios/fisiopatología , Dióxido de Azufre/análisis
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