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1.
Zhonghua Yi Xue Za Zhi ; 100(3): 207-212, 2020 Jan 21.
Artigo em Chinês | MEDLINE | ID: mdl-32008288

RESUMO

Objective: To find more objective evidence and support for clinical classification of Parkinson's disease by means of tremor analysis in patients with early confirmed Parkinson's disease. Methods: A cross-sectional study was conducted to collect 65 patients with early Parkinson's disease treated in the Third Hospital of Peking University from January 2015 to December 2016. Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr scale (H-Y scale), Mini-mental state examination (MMSE), Hamilton depression scale (HAMD) were recorded in all patients. According to the ratio of UPDRS rigidity score to tremor score, the patients were divided into tremor dominant (TD), postural instability/gait difficulty (PIGD) and mixed types. All patients were examined by tremor analysis and the results were analyzed and compared. Results: Among the 65 patients, the mean age of onset was (63±10) years, the course of disease was (14±8) months. Twenty-one patients were classified to TD group, 28 patients were classified to PIGD type, and 16 patients with mixed type. There was no significant difference in frequency and amplitude of tremor between the three groups (P>0.05), but the proportion of alternating contraction and harmonic resonance of active and antagonistic muscles in TD group was significantly higher (P<0.05). Twenty patients (71.4%) in TD group showed typical Parkinson's disease manifestations in tremor analysis. Only four patients (14.3%) in PIGD group showed the typical manifestations. More patients in PIGD group showed no clear main peak of tremor at rest. Some patients showed 6-8 Hz/sec peak frequency in posture position and simultaneous contraction of the active and antagonist muscles. These two manifestations occured simultaneously in mixed type patients, including 10 cases (62.5%) with typical Parkinson's disease manifestations. Conclusion: As an objective electrophysiological method to evaluate tremor type, tremor analysis can be used as an important assistant method for clinical classification of Parkinson's disease. It can provide information of the pathway of pathological loss in different types and give important hints in prognosis and treatment.


Assuntos
Transtornos Neurológicos da Marcha/fisiopatologia , Doença de Parkinson/classificação , Doença de Parkinson/fisiopatologia , Tremor/fisiopatologia , Idade de Início , Idoso , Estudos Transversais , Feminino , Marcha , Transtornos Neurológicos da Marcha/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Tremor/etiologia
3.
Orv Hetil ; 161(6): 208-213, 2020 Feb.
Artigo em Húngaro | MEDLINE | ID: mdl-32008350

RESUMO

Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. The most important symptom is vertigo, which is triggered by changes in head position and sometimes is accompanied by vegetative symptoms. Furthermore, etiology may be subcategorized into idiopathic and secondary (connected to other vestibular disorder, like Ménière's disease, vestibular neuritis, or vestibular migraine). Aim: To identify such parameter of ultrasound-computer-craniocorpography (US-COMP-CCG), which could be useful in the differentiation of idiopathic and secondary BPPV. Material and method: 135 patients suffering from BPPV and 140 normal vestibular functioning patients were examined with UC-COMP-CCG. Statistical analysis was completed by using IBM SPSS V24 software. Results: 109 patients suffered from idiopathic BPPV (i-BPPV), and 26 patients from secondary BPPV (s-BPPV). Parameters indicating the imbalance were observed in both the standing test and the stepping test. Respectively, remarkable results were given in the forehead covering and the self-spin parameter. Conclusion: By applying and examining both study groups with US-COMP-CCG, we were able to use modern diagnostics and thus have an objective evaluation based on their properties. The objective results from the US-COMP-CCG parameters show the deterioration of the vestibular system as well as the change in values, based on the cause of BPPV in secondary cases. Orv Hetil. 2020; 161(6): 208-213.


Assuntos
Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/etiologia , Diagnóstico Diferencial , Humanos
4.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(1): 47-53, 2020 Jan 24.
Artigo em Chinês | MEDLINE | ID: mdl-32008295

RESUMO

Objective: To identify the incidence of hypertension, overweight/obesity in middle-aged population in China, and explore their impact on cardiovascular events. Methods: From 2009 to 2010, 12 areas were sampled in China, and about 1 000 subjects aged 35 - 64 from each area were enrolled to collect the basic information, physical examination and blood tests were also performed. From 2016 to 2017, data from 8 835 subjects, who completed the 6 years follow-up, were analyzed.Blood pressure and body mass index(BMI) at both baseline and the follow-up, as well as incidence of hypertension, overweight and obesity, were calculated. Cox proportional hazard model was used to investigate the impacts of hypertension, overweight and obesity on cardiovascular events after adjusting confounders. Results: At the end of follow-up, both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels (all P<0.001). The cumulative incidence of hypertension, overweight and obesity within 6 years was 39.3%(1 146/2 918), 11.5%(406/3 544) and 4.3%(302/7 025), respectively. Compared with subjects with both normal BMI and blood pressure, people with overweight, obesity, hypertension, overweight with hypertension, and obesity with hypertension faced significantly increased risk of cardiovascular disease (HRs (95%CIs) were 2.394(1.130-5.073), 3.341(1.454-7.674), 6.047(2.978-12.279), 5.808(2.924-11.539) and 8.716(4.391-17.302), respectively, all P<0.05), after adjusting for other confounders. Conclusions: The incidence of overweight, obesity, and hypertension is high in middle-aged people in China. Overweight, obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.


Assuntos
Doenças Cardiovasculares , Hipertensão , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , China , Seguimentos , Humanos , Hipertensão/complicações , Incidência , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Fatores de Risco
6.
Vnitr Lek ; 65(12): 802-808, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32013524

RESUMO

Thyroid gland function is mediated by thyreoideal hormones, in which iodine is very important structural part. High iodine intake, can initiate thyroid dysfunction. Amiodarone induced hypothyroidism is treated with levothyroxine and amiodarone taking is not interrupted. Amiodarone induced hyperthyroidism is divided into two subtypes, which differ by mechanism of origin and treatment strategy. In patients with cardiovascular disease is higher possibility of getting substances, with high content of iodine in diagnostic-therapeutic examination with contrast or treatment with amiodarone. In this group of patients is necessary to control thyroid function regularly and to hold preventive actions.


Assuntos
Doenças Cardiovasculares , Hipertireoidismo , Hipotireoidismo , Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Doenças Cardiovasculares/complicações , Humanos , Hipertireoidismo/complicações , Hipotireoidismo/etiologia , Iodo , Tiroxina
7.
Medicine (Baltimore) ; 99(7): e19138, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049835

RESUMO

The study assessed the pelvic dimensions by computed tomography (CT) performed for gluteal muscle contracture women, and evaluated the impact of malformations on several essential obstetric parameters.The CT pelvimetry was retrospectively performed in 25 gluteal muscle contracture women selected consecutively whether they had delivery history or not. Among the pelvic inlet plane, the mid plane and the outlet plane, 12 indicators including the transverse diameter of the pelvic inlet, the conjugate vera, the diagonal conjugate, the biischial diameter, the anteroposterior diameter of the middle pelvis, transverse outlet, the posterior sagittal diameter of outlet, the conjugate of the outlet, the anterior sagittal diameter of the outlet, the curvature and length of the sacrum, the angle of pubic arch were collected.Finally, the mean age of these women was 26.6 ±â€Š5.0 years. Most pelvises had anteroposterior elliptical appearance in inlet and size of the female pelvis. The most statistically different and most clinically significant indicator was the biischial diameter, gluteal muscle contracture women were 95.6 ±â€Š9.3 mm and the normal women from other study were 105.0 ±â€Š7.9 mm, the comparison showed a significant difference (P < .001).Generally, most gluteal muscle contracture women had features of anthropoid pelvis which were quite different from normal Chinese female. These results may serve as a basis for future studies to assess its utility and prognostic value for a safe vaginal delivery in gluteal muscle contracture women.


Assuntos
Nádegas/diagnóstico por imagem , Distocia/etiologia , Músculo Esquelético/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Adolescente , Adulto , Nádegas/patologia , Nádegas/fisiopatologia , Feminino , Fibrose , Humanos , Músculo Esquelético/fisiopatologia , Ossos Pélvicos/patologia , Gravidez , Síndrome , Adulto Jovem
8.
Medicine (Baltimore) ; 99(7): e19142, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049837

RESUMO

BACKGROUND: Depression is a kind of chronic and recurrent mental disorder, the main clinical characteristics of the patients are marked and persistent depression. At the same time, it is often accompanied by chronic physical disease, cognitive impairment, and functional damage, which is one of the common diseases that seriously threaten human health. At present, 3 kinds of oral Chinese patent medicine have clinical comparability in the treatment of depression of liver stagnation and spleen deficiency, but there is no evidence for clinical efficacy and safety. Therefore, this study aims to integrate the clinical related syndromes of direct and indirect comparison by using systematic evaluation and network meta-analysis (NMA). According to the data, the different Chinese patent medicines with the same evidence body for the treatment of the disease are collected, analyzed, and sequenced in a quantitative and comprehensive way, and then the advantages and disadvantages of the efficacy and safety between different Chinese patent medicines are screened out to get the best choice scheme, thus providing reference value and evidence-based theoretical evidence for the clinical optimization of drug selection. METHODS: Comprehensive retrieval of China National Knowledge Infrastructure, Chinese scientific journal database (VIP), China biological feature database (CBM) and WANFANG Data Chinese electronic database and the Cochrane Library, PubMed, Web of Science, and EMBASE foreign database. Search and publish the clinical randomized controlled trials of these 3 Chinese patent medicines combined with fluoxetine compared with fluoxetine. The retrieval time is from the establishment of the database to October 31, 2019. The 2 first authors will screen the literatures that meet the inclusion criteria, extract the data independently according to the predesigned rules, and evaluate the literature quality and bias risk of the included research according to the Cochrane 5.1 manual standard. R and Aggregate Data Drug Information System software were used for data consolidation and NMA to evaluate the ranking probability of all interventions. RESULTS: This result will show that the best oral Chinese patent medicine to assist the treatment of liver stagnation and spleen deficiency depression provides reliable evidence. CONCLUSION: This study will provide systematic evidence-based medicine evidence for TCM assisted treatment of depression of liver stagnation and spleen deficiency type, and help clinicians, patients with depression and decision-makers to make more effective, safer, and economic optimal treatment plan in the decision-making process. PROSPERO REGISTRATION NUMBER: CRD42019115695.


Assuntos
Depressão/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Hepatopatias/tratamento farmacológico , Medicina Tradicional Chinesa , Esplenopatias/tratamento farmacológico , Depressão/complicações , Humanos , Hepatopatias/etiologia , Esplenopatias/etiologia , Revisão Sistemática como Assunto
9.
Medicine (Baltimore) ; 99(7): e19149, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049840

RESUMO

This study aimed to compare various visual function parameters for evaluating the quality of life (QOL) of patients with advanced glaucoma with low vision.In total, 44 eyes of advanced glaucoma patients with low vision were included in this cross-sectional study. A moving pattern edge band program was used to assess edge detection ability and the low vision quality-of-life (LVQOL) questionnaire was used for evaluating QOL scores of subjects. Correlation analyses between QOL scores and visual functional parameters including pattern edge band unit, visual acuity (VA), and Mean deviation (MD) of perimetry were performed. The areas under receiver operating characteristic curves (AUROCs) of diverse visual functional parameters were calculated.VA and pattern edge band unit were related to LVQOL score in all subjects. For patients with a decimal VA lower than 0.1, only the pattern edge band showed a significant correlation with the QOL associated with distant activities (P = .031). However, the MD of perimetry was not related to the QOL score. After sorting subjects into 2 groups according to the LVQOL score, VA and pattern edge band unit were significantly different (P < .01 and P = .029, respectively). The AUROC for edge detection ability using pattern edge band was higher than MD of perimetry.Assessment of edge detection ability using pattern edge band was meaningful for predicting QOL associated with visual performance in patients with far-advanced glaucoma. For these patients, edge detection could be used as an additional parameter for visual function with traditional VA and perimetry.


Assuntos
Glaucoma/complicações , Qualidade de Vida , Testes Visuais , Baixa Visão/psicologia , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Baixa Visão/etiologia
10.
Medicine (Baltimore) ; 99(7): e19177, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049850

RESUMO

RATIONALE: Tooth extraction is a common dental surgical procedure. There is a possibility that various complications often occur during third molar tooth extractions. PATIENT CONCERNS: The authors report herein 2 cases of migration of a high-speed dental hand-piece bur during mandibular third molar extraction-one case with the iatrogenic foreign body migrating into the mandibular body and another case with the iatrogenic foreign body migrating into the floor of mouth are reported. DIAGNOSIS: The patient was diagnosed with the iatrogenic foreign body associated with mandibular third molar extraction by imaging examinations. INTERVENTIONS: The authors performed elective surgery to remove the foreign body under general anesthesia in Case 1, and performed emergency surgery to remove the foreign body under local anesthesia in Case 2. OUTCOMES: The foreign bodies were removed, and complete removal of the foreign bodies was confirmed by postoperative x-ray examination. The patients' postoperative courses were uneventful. LESSONS: The selection of adequate surgical procedures and instruments will prevent the occurrence of iatrogenic foreign bodies. If migration accidents occur, their positions should first be confirmed by imaging examinations. Dentists and/or oral surgeons should perform removal operations considering the degree of emergency based on the results of imaging examinations.


Assuntos
Migração de Corpo Estranho/etiologia , Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Adulto , Feminino , Migração de Corpo Estranho/cirurgia , Humanos
11.
Medicine (Baltimore) ; 99(7): e19197, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049857

RESUMO

BACKGROUND: Fatigue is one of the most prevalent and debilitating symptoms of major depressive disorder (MDD). The effective management of depression-related fatigue has an important impact on the patient's abilities, functioning, and quality of life (QOL). Moxibustion has been widely used in Traditional Chinese Medicine to manage fatigue. Recent studies have also demonstrated that moxibustion is effective for treating cancer-related fatigue and chronic fatigue syndrome. However, there is not sufficient data supporting the effect of moxibustion for depression-related fatigue. Therefore, this randomized, assessor-blinded, wait-list controlled trial is designed to evaluate the effectiveness, safety, and feasibility of moxibustion treatment for depression-related fatigue. METHODS: One hundred and seventy-six participants who meet the diagnostic criteria for depression in the International Classification of Diseases, tenth revision (ICD-10), and who also have a score of ≥1 on the 13 item of the Hamilton Depression Rating Scale-17 (HAMD-17), will be enrolled. At study entry, participants will undergo anti-depressant treatment for at least 1 month. Then those who still have a score of ≥1 on the 13 item of the HAMD-17 will be randomly allocated to either a moxibustion group or wait-list control group in a ratio of 1:1. Anti-depressants will be provided for both groups during the whole process of the study period. Participants in the moxibustion group will undergo 14 sessions of moxibustion (over 2 weeks) with anti-depressant treatment, and participants in the wait-list control group will receive only anti-depressant treatment. Subsequently, participants in the moxibustion group will be followed-up for 4 weeks. The primary outcome measure will be the Fatigue Severity Scale (FSS). The secondary outcome measure will be the HAMD-17. Safety will be assessed by monitoring adverse events during the study. Trial feasibility will also be assessed in this study. DISCUSSION: The results of this study may provide evidence for the efficacy of moxibustion as an adjunct to antidepressants for depression-related fatigue, and promote a more widespread foundation for the selection of moxibustion in the clinical setting as well as for future research in moxibustion therapy. TRIAL REGISTRATION: This study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR1800016905).


Assuntos
Depressão/complicações , Fadiga/terapia , Moxibustão , Fadiga/etiologia , Humanos
12.
Medicine (Baltimore) ; 99(7): e19215, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049859

RESUMO

This study compared the surgical outcomes of two surgical methods for treating multilevel cervical spondylotic myelopathy (MCSM) combined with cervical kyphotic deformity (CKD): (1) the ELTA method consisted of expansive open-door laminoplasty (EOLP) followed by three-segment anterior cervical discectomy fusion (ACDF), and (2) the LAPI method consisted of long-segment ACDF followed by long-level posterior instrumented fusion (PIF). Surgical treatment of CKD combined with MCSM remains challenging. Surgical considerations should include adequate spinal cord decompression and restoration of satisfactory cervical sagittal alignment (CSA). In certain situations, a solid PIF structure is vital to prevent failure.We included 105 patients who underwent the aforementioned surgical methods for MCSM combined with CKD from January 2013 to December 2017. The minimum follow-up period was 1 year. Comparative analysis was performed to compare the two surgical strategies' preoperative and postoperative functional outcomes, including a visual analog scale for neck pain, neck disability index, the Japanese Orthopedic Association cervical myelopathy score, and the Nurick score, as well as the CSA radiographic outcomes, including C2-7 Cobb angle, C2-7 sagittal vertical axis, and C7 slope. The risk factors related to reduced improvement in functional status were analyzed.A total of 63 patients underwent ELTA and 42 patients underwent LAPI. Improvements in functional outcomes were considerable in both groups. The mean C2-7 Cobb angle was restored from 7.4°â€Š±â€Š2.1° kyphosis to 8.8°â€Š±â€Š4.7° lordosis in the ELTA group and from 15.3°â€Š±â€Š4.2° kyphosis to 15.8°â€Š±â€Š8.1° lordosis in the LAPI group. The maximal correction angle was 22.6° in the ELTA group and 42.6° in the LAPI group.Although changes in CSA seemed to be significantly correlated with improvements of functional status, the ELTA and LAPI methods were both effective for treating MCSM combined with CKD, when appropriately selected. The ELTA method was indicated for MCSM patients who had a low degree of CKD, whereas the LAPI method was indicated for MCSM patients who had poor function scores and a high degree of CKD.


Assuntos
Vértebras Cervicais/cirurgia , Cifose/cirurgia , Procedimentos Ortopédicos/estatística & dados numéricos , Doenças da Medula Espinal/cirurgia , Espondilose/cirurgia , Idoso , Feminino , Humanos , Cifose/complicações , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/métodos , Estudos Retrospectivos , Doenças da Medula Espinal/etiologia , Espondilose/complicações
13.
Medicine (Baltimore) ; 99(7): e19220, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049860

RESUMO

INTRODUCTION: Injection laryngoplasty is a common procedure for patients with vocal fold dysfunction, but the literature on its benefits has been mainly focused on those related to structural lesions or laryngeal nerve involvement. Stroke patients may be at increased risk of aspiration due to insufficient vocal fold motion. However, how injection laryngoplasty can be of benefit in stroke patients has not been reported yet. PATIENT CONCERNS: Six chronic stroke patients with long-standing swallowing difficulties and who showed severe aspiration despite long-term swallowing rehabilitation. DIAGNOSIS: Laryngoscope evaluation revealed insufficient glottic closure as the cause of aspiration. INTERVENTIONS: Injection laryngoplasty was done per-orally under local anaesthesia with calcium hydroxylapatite (Radiesse Voice, 1-1.5 mL) in an office setting. Respiratory pressures and peak cough flows were assessed at baseline and at 2 weeks follow-up. OUTCOMES: At 2 weeks, the mean peak cough flow (Δ = +95.09 L/min) increased significantly after the procedure. The maximal expiratory (Δ = +18.40 cm H2O) and inspiratory (Δ = +20.20 cm H2O) pressures also improved, indicating that injection laryngoplasty was effective in augmenting respiratory and cough parameters. All cases showed improvement in the Functional Oral Intake Scale (Δ = +4). Feeding tubes were successfully removed. CONCLUSION: Injection laryngoplasty proved to be both successful and safe in improving glottic closure with immediate results in those who had failed to show a positive response after long-term swallowing rehabilitation. The positive and dramatic clinical outcomes were observed through changes in the coughing force. Our case series support the use of injection larygnoplasty as a powerful adjunctive treatment method to prevent aspiration pneumonia in post-stroke patients with vocal fold insufficiency. Pre- and post-injection peak cough flow changes may reflect improvement in glottic closure and indicate the safety of swallowing with reduced risk of aspiration.


Assuntos
Laringoplastia/estatística & dados numéricos , Pneumonia Aspirativa/prevenção & controle , Acidente Vascular Cerebral/complicações , Idoso , Feminino , Humanos , Laringoplastia/métodos , Masculino , Pessoa de Meia-Idade , Pneumonia Aspirativa/etiologia
14.
Medicine (Baltimore) ; 99(7): e19221, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049861

RESUMO

BACKGROUND: To evaluate the effectiveness and safety of a newly designed intrauterine double-balloon catheter to arrest postpartum hemorrhage (PPH) following cesarean delivery (CD) for placenta previa. METHODS: We conducted an open-label, multicenter randomized controlled trial in two referral centers and one general hospital. Women with continuous bleeding after placental delivery following CD for placenta previa, who failed to respond to uterotonics, suturing and uterine devascularization, and in the absence of suspected deeply invasive accreta were eligible subjects. Eligible subjects were randomized to receive intrauterine double-balloon catheter (n = 102) or gauze packing (n = 102). The main outcome was the rate of successful hemostasis without the need for additional surgical interventions. The secondary outcomes included the volume of blood loss during and after CD, the rate of PPH, incidence and amount of blood transfusion, hysterectomy, surgical complications, intensive care unit admission, need for re-laparotomy, length of hospital stay, and readmission. RESULTS: The 224 participants were recruited before delivery, with 20 excluded (14 cases bleeding stopped after uterotonics and/or local myometrium sutures and 6 patients with placental increta). Finally, 102 women were assigned in catheter group and 102 others in gauze group. There was no difference in the rate of successful hemostasis in the catheter and gauze groups (93.1% vs 91.2%, P = .80). Compared with those in the gauze group, women in the catheter group showed significantly less blood loss within 24 hours postpartum (895 [612.3-1297.8] vs 1156 [882.5-1453.3] ml, P < .01), lower rate of PPH ≥1000 ml (42.2% vs 63.7%, P < .01). Accordingly, women in the catheter group had significantly less maternal adverse events such as postpartum anemia, puerperal morbidity, and postpartum pain. CONCLUSION: Uterine tamponade using a double-balloon catheter was as effective as gauze packing in hemostasis, and appeared to be superior in reducing postpartum blood loss and pain following CD for placenta previa. Using double-balloon catheter in managing PPH in this situation may be a preferable alternative to minimize maternal morbidity.


Assuntos
Cesárea/efeitos adversos , Placenta Prévia , Hemorragia Pós-Parto/prevenção & controle , Tamponamento com Balão Uterino/instrumentação , Adulto , Feminino , Humanos , Hemorragia Pós-Parto/etiologia , Gravidez
15.
Rev Med Liege ; 75(2): 73-74, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32030928

RESUMO

Retinitis pigmentosa is the most frequent hereditary dystrophy of the retina, with a global prevalence of 1/4.000. The underlying mechanism involves progressive loss, first of the rod photoreceptor cells, followed by the cone photoreceptor cells. Finally, complete blindness may occur. Genetic transmission is known but most cases are sporadic. Few effective treatments exist nowadays and hence regular follow-up is required in a revalidation center.


Assuntos
Retinite Pigmentosa , Humanos , Retina , Células Fotorreceptoras Retinianas Cones , Células Fotorreceptoras Retinianas Bastonetes , Retinite Pigmentosa/complicações , Retinite Pigmentosa/etiologia
16.
Rev Med Liege ; 75(2): 75-77, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32030929

RESUMO

Moyamoya disease is a rare cerebral vasculopathy. Disease onset is mainly sudden presenting as an ischemic stroke but also sometimes as a brain hemorraghe. Cerebral angiography is the gold standard to confirm the diagnosis. Different therapeutic approaches have been described such as conservative management or endoscopic and surgical approaches. We report the case of a young patient who was diagnosed with a brain hemorraghe following a sudden loss of consciousness.


Assuntos
Doença de Moyamoya , Acidente Vascular Cerebral , Encéfalo/diagnóstico por imagem , Angiografia Cerebral , Humanos , Doença de Moyamoya/complicações , Doença de Moyamoya/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia
17.
Bone Joint J ; 102-B(2): 170-176, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009432

RESUMO

AIMS: We aimed to examine the long-term mechanical survivorship, describe the modes of all-cause failure, and identify risk factors for mechanical failure of all-polyethylene tibial components in endoprosthetic reconstruction. METHODS: This is a retrospective database review of consecutive endoprosthetic reconstructions performed for oncological indications between 1980 and 2019. Patients with all-polyethylene tibial components were isolated and analyzed for revision for mechanical failure. Outcomes included survival of the all-polyethylene tibial component, revision surgery categorized according to the Henderson Failure Mode Classification, and complications and functional outcome, as assessed by the Musculoskeletal Tumor Society (MSTS) score at the final follow-up. RESULTS: A total of 278 patients were identified with 289 all-polyethylene tibial components. Mechanical survival was 98.4%, 91.1%, and 85.2% at five, ten and 15 years, respectively. A total of 15 mechanical failures were identified at the final follow-up. Of the 13 all-polyethylene tibial components used for revision of a previous tibial component, five (38.5%) failed mechanically. Younger patients (< 18 years vs > 18 years; p = 0.005) and those used as revision components (p < 0.001) had significantly increased rates of failure. Multivariate logistic regression modelling showed revision status to be a positive risk factor for failure (odds ratio (OR) 19.498, 95% confidence interval (CI) 4.598 to 82.676) and increasing age was a negative risk factor for failure (OR 0.927, 95% CI 0.872 to 0.987). Age-stratified risk analysis showed that age > 24 years was no longer a statistically significant risk factor for failure. The final mean MSTS score for all patients was 89% (8.5% to 100.0%). CONCLUSION: The long-term mechanical survivorship of all-polyethylene tibial components when used for tumour endoprostheses was excellent. Tumour surgeons should consider using these components for their durability and the secondary benefits of reduced cost and ease of removal and revision. However, caution should be taken when using all-polyethylene tibial components in the revision setting as a significantly higher rate of mechanical failure was seen in this group of patients. Cite this article: Bone Joint J. 2020;102-B(2):170-176.


Assuntos
Neoplasias Ósseas/cirurgia , Fêmur/cirurgia , Próteses e Implantes/efeitos adversos , Implantação de Prótese/efeitos adversos , Tíbia/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Materiais Biocompatíveis , Criança , Análise de Falha de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Polietileno , Desenho de Prótese , Falha de Prótese/etiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Adulto Jovem
18.
Bone Joint J ; 102-B(2): 268-272, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009439

RESUMO

AIMS: Idiopathic scoliosis is the most common spinal deformity in adolescents and children. The aetiology of the disease remains unknown. Previous studies have shown a lower bone mineral density in individuals with idiopathic scoliosis, which may contribute to the causation. The aim of the present study was to compare bone health in adolescents with idiopathic scoliosis with controls. METHODS: We included 78 adolescents with idiopathic scoliosis (57 female patients) at a mean age of 13.7 years (8.5 to 19.6) and 52 age- and sex-matched healthy controls (39 female patients) at a mean age of 13.8 years (9.1 to 17.6). Mean skeletal age, estimated according to the Tanner-Whitehouse 3 system (TW3), was 13.4 years (7.4 to 17.8) for those with idiopathic scoliosis, and 13.1 years (7.4 to 16.5) for the controls. Mean Cobb angle for those with idiopathic scoliosis was 29° (SD 11°). All individuals were scanned with dual energy x-ray absorptiometry (DXA) and peripheral quantitative CT (pQCT) of the left radius and tibia to assess bone density. Statistical analyses were performed with independent-samples t-test, the Mann-Whitney U test, and the chi-squared test. RESULTS: Compared with controls, adolescents with idiopathic scoliosis had mean lower DXA values in the left femoral neck (0.94 g/cm2 (SD 0.14) vs 1.00 g/cm2 (SD 0.15)), left total hip (0.94 g/cm2 (SD 0.14) vs 1.01 g/cm2 (SD 0.17)), L1 to L4 (0.99 g/cm2 (SD 0.15) vs 1.06 g/cm2 (SD 0.17)) and distal radius (0.35 g/cm2 (SD 0.07) vs 0.39 g/cm2 (SD 0.08; all p ≤ 0.024), but not in the mid-radius (0.72 g/cm2 vs 0.74 g/cm2; p = 0.198, independent t-test) and total body less head (1,559 g (SD 380) vs 1,649 g (SD 492; p = 0.0.247, independent t-test). Compared with controls, adolescents with idiopathic scoliosis had lower trabecular volume bone mineral density (BMD) on pQCT in the distal radius (184.7 mg/cm3 (SD 40.0) vs 201.7 mg/cm3 (SD 46.8); p = 0.029), but not in other parts of the radius or the tibia (p ≥ 0.062, Mann-Whitney U test). CONCLUSION: In the present study, idiopathic scoliosis patients seemed to have lower BMD at central skeletal sites and less evident differences at peripheral skeletal sites when compared with controls. Cite this article: Bone Joint J 2020;102-B(2):268-272.


Assuntos
Absorciometria de Fóton , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Escoliose/diagnóstico por imagem , Adolescente , Doenças Ósseas Metabólicas/complicações , Criança , Feminino , Colo do Fêmur/diagnóstico por imagem , Humanos , Masculino , Rádio (Anatomia)/diagnóstico por imagem , Escoliose/etiologia , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto Jovem
19.
Praxis (Bern 1994) ; 109(2): 117-122, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32019457

RESUMO

Retroperitoneal Fibrosis - on the Benefits of Trustworthiness in Everyday Practice Abstract. Despite negative radiology results, the described patient's back pain clearly had to be a somatic one - concluded by his primary care provider because of the patient's trustworthiness. The clinical presentation, histopathology of surgical excision and chemistry (IgG4) revealed the diagnosis of a retroperitoneal fibrosis. The symptoms as well as the fibrosis disappeared due to glucosteroid and rituximab therapy.


Assuntos
Dor nas Costas , Fibrose Retroperitoneal , Dor nas Costas/etiologia , Fibrose , Humanos , Imunoglobulina G , Fibrose Retroperitoneal/complicações , Fibrose Retroperitoneal/diagnóstico
20.
Praxis (Bern 1994) ; 109(2): 87-95, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32019459

RESUMO

Everyone Has Low Back Pain: Degenerative Lumbar Spinal Disorders and Their Treatment Options Abstract. Back pain is one of the most widespread diseases. Up to 84 % of people have low back pain at some point in their lives. Unspecific back pain is treated conservatively. As supportive measure, interventional pain therapy can be performed. Surgery for low back pain should be considered in selected cases only. However, accompanying neurological symptoms are frequent, such as radiation, i.e. sciatica. Typical etiologies are disc herniation or - increasingly frequent, and due to the aging population increasingly frequent - spinal canal stenosis. Surgery has a better prognosis in cases where conservative management failed. If severe neurological symptoms are present, surgery is indicated. Osteoporotic compression fractures cause acute back pain. The decision whether these patients should undergo kypho- or vertebroplasty should be based on guidelines.


Assuntos
Dor Lombar , Doenças da Coluna Vertebral , Estenose Espinal , Idoso , Humanos , Dor Lombar/etiologia , Dor Lombar/terapia , Vértebras Lombares , Prognóstico , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/terapia , Estenose Espinal/complicações , Estenose Espinal/terapia
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