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91.
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H Obaydi MRCPsych FJ Eva MRCPsych BK Puri MRCPsych 《International journal of clinical practice》1995,49(4):192-193
SUMMARY The use of prescribed medication was examined in 34 people with learning disability who underwent a planned resettlement from a hospital into the community. No significant differences were found in the number of subjects receiving antipsychotic, antimuscarinic, antidepressant, and anticonvulsant medication, lithium preparations, and non-psychoactive medication, just prior to discharge and 1 year after discharge. This study indicates that long-stay hospitalised adults with moderate, severe or profound mental retardation can successfully be relocated into the community — in spite of suffering from behavioural and major psychiatric disorders — with the aid of appropriate medication, psychiatric follow-up, and community resources. 相似文献
93.
SK Bhaumick MRCP S Morgan MB ChB BK Mondal FRCP DTM&H 《International journal of clinical practice》1997,51(5):342-342
In neurocardiogenic syncope the normal compensatory response on assuming an upright posture is interrupted after several minutes and replaced by a paradoxical withdrawal of sympathetic activity and increased parasympathetic activity. The resulting reduction in blood pressure is severe, sympathetic activity is inhibited, plasma norepinephrine levels do not increase and the heart rate decreases. The defect is a paradoxical interruption of sympathetic excitation associated with parasympathetic excitation, causing profound vasodilatation and bradycardia. Disopyramide has been shown not only to treat the bradycardia but also to control the hypotension. 相似文献
94.
Purpose
Accumulating evidence suggests that fatigue in chronic inflammatory diseases is generated in the brain by mechanisms involving proinflammatory cytokines. We recently reported a high prevalence of fatigue in patients with mastocytosis, a condition with a constant activation of mast cells and release of a variety of bioactive substances. This observation indicates that mast cells somehow could be involved in the biological mechanisms that generate fatigue. In this case series, we aim to describe how typical triggering factors of mastocytosis attacks, as reported by patients, are accompanied by increased fatigue. Possible mechanisms by which mast cells may contribute to the pathophysiology of fatigue are discussed.Methods
Seven patients with mastocytosis were interviewed regarding triggers and clinical symptoms and signs of mastocytosis, including the presence and severity of fatigue. Fatigue severity during and between attacks was assessed using the fatigue Visual Analog Scale (fVAS).Findings
The most important reported triggers were heat and/or cold, exercise, food, alcohol, and psychological stress. The median fatigue Visual Analog Scale scores were 80 (range 40–91) during attacks and 40 (range 30–72) between attacks Fatigue reportedly impaired social and recreational activities in all 7 patients, and influenced occupational activities in 6.Implications
This case series illustrates that fatigue is common and severe among patients with mastocytosis. Fatigue increases during attacks, which may indicate that mast cell–derived substances are directly involved in the pathophysiology of fatigue. Mast cells could be an underestimated cellular actor in fatigue and other conditions and thus may represent a potential therapeutic target. 相似文献95.
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The classification of the International Headache Society (IHS) published in 1988 has been positively received throughout the world. However, the classification of headaches occurring daily or almost daily has been criticized repeatedly. This criticism is discussed in the present review. It is possible to classify virtually all chronic headache patients using the IHS Classification and there seems to be more need for emphasizing a correct application of the classification than for a revision in this regard. The entity of transformed migraine is disputed and so is the existence of hemicrania continua. Neither of these syndromes has been adequately defined nor studied. Chronic daily headache of sudden onset (new persistent daily headache) is not adequately classified at present and should be included as a separate entity in the next edition of the IHS Classification. In a future revision it should also be possible to classify drug-related headache simply on the basis of drug consumption and without mandatory demands for withdrawal. Better longitudinal studies of patients with chronic daily headache are necessary to evaluate finally whether a revision of the classification of these headache syndromes is necessary. Eventually the ongoing discovery of migraine genes is likely to change radically the classification of migraine. 相似文献