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51.
Ioannis Heliopoulos Miltiadis Papaoiakim Georgios Tsivgoulis Thomas Chatzintounas Konstantinos Vadikolias Nikolaos Papanas Charitomeni Piperidou 《Clinical neurology and neurosurgery》2009
Objectives
Increased common carotid artery intima-media thickness (CCA-IMT) is a risk factor for ischemic stroke and especially large vessel atherothrombotic infarction. However, the potential association of stroke severity with the intima-media thickening has not been previously studied. We sought to investigate the association between CCA-IMT and clinical severity of ischemic stroke in patients with symptomatic extracranial carotid artery stenosis (SCAS).Patients and methods
Consecutive patients with acute, first-ever ischemic stroke and SCAS (50%–99%) were prospectively evaluated. All subjects underwent IMT measurements at the far wall of CCA. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS) on hospital admission and Barthel Ambulatory Index (BI) at hospital discharge.Results
CCA-IMT was strongly correlated to NIH (Spearman's correlation coefficient: r = 0.546, p < 0.001) and BI (r = −0.450, p < 0.001) in the study population (n = 102). A 0.1 mm increase in CCA-IMT was independently associated with increasing NIHSS-scores on hospital admission (β: 0.510; p < 0.001) and decreasing BI-scores at hospital discharge (β: −0.483; p < 0.001) even after adjustment for demographic characteristics and cardiovascular risk factors. After including baseline stroke severity (NIHSS) in the multivariate linear regressions models evaluating early functional outcome, only NIHSS was independently related to BI (standardized linear regression coefficient: −0.776, p < 0.001), while the initial association between IMT and BI did not retain its statistical significance (β: −0.074, p = 0.276).Conclusions
Increased CCA-IMT is independently associated with more severe stroke on admission in patients with SCAS. 相似文献52.
Coronary Heart Disease (CHD) remains the most common cause of death and disability in many developed and developing countries. The evidence presented so far, clearly shows that exercise training leads to favourable improvements in exercise capacity, lipid levels, weight and psychosocial variables for CHD patients. Nevertheless, despite recommendations and government support, the lack of physical activity remains a major health problem, particularly for people with established CHD. The aim of this review was to explore the effects of exercise training on physical and psychosocial function among CHD patients, by analysing the content of relevant research reports. The findings showed that although there is sufficient evidence that exercise training has a number of effects that are beneficial in treatment and secondary prevention of CHD, different aspects of exercise characteristics (mode, frequency, intensity and duration) for different cardiac patient groups, warrant additional investigation. 相似文献
53.
The aim of this study is to investigate the electromagnetic sources of epileptic activity in two patients with juvenile myoclonus
epilepsy (JME). The first patient was a 22-year old female with JME diagnosis by the age of 17 years old. Her initial EEG
recording showed characteristic paroxysmal generalized activity with polyspike–wave complexes. She was on remission for 9
months. The second patient was a 29-year old male with JME diagnosis by the age 18 of years old. He showed an EEG recording
with generalized spike-wave complexes of 3.5–4 Hz and presented a great improvement after therapeutic treatment. The MRI examinations
for both patients did not disclose any focal lesions or areas of abnormal signal intensity or enhancement by contrast media.
Magnetoencephalography (MEG) was recorded with a 122-channel whole-head system, 5 years after the disease onset for the first
patient and 11 years for the second patient. For the first patient dipolar sources of MEG paroxysmal activity were localised
at the vermis with extension up to the occipital region, whereas, for the second patient dipolar sources of MEG paroxysmal
activity were localised at the cerebellar area (vermis and hemisphere). Implication of the cerebellum in JME, as suggested
by MEG data in this study, is in accordance with previous reports employing functional MRI or cerebral blood flow evaluation
in JME. 相似文献
54.
Abstract Combined palsies of cranial nerves, especially of the oculomotor nerves, are distinctly uncommon, even in patients with diabetes
mellitus. We present a patient with type 2 diabetes mellitus, arterial hypertension and hyperlipidaemia, who had simultaneous
oculomotor and trochlear nerve palsies. An MRI scan showed multiple brainstem ischaemic infarcts. The patient was treated
with intensified insulin regimen and clopidogrel. Symptoms gradually improved, and at 9 months there was no further improvement. 相似文献
55.
56.
Papathanasiou E Zamba-Papanicolaou E Pantziaris M Kyriakides T Papacostas S Myrianthopoulou P Pattichis C Iliopoulos I Piperidou C 《Electromyography and clinical neurophysiology》2003,43(7):399-408
OBJECTIVES: To obtain neurogenic vestibular evoked potentials (NVESTEPs) with surface scalp recording using high intensity auditory clicks. The same stimulus is used in myogenic vestibular evoked potentials which has been shown to evoke potentials in the vestibular division of the vestibulocochlear nerve. METHODS: A whole head recording with surface EEG electrodes was performed using high intensity clicks in one normal volunteer to determine the best recording position for vestibular evoked potentials. The results were compared to responses at moderate click intensities used for brainstem auditory evoked potentials (BAEPs). The difference in the location of the two responses on the scalp was assumed to be from the vestibular system. RESULTS: Responses specific to the high intensity clicks were best obtained in the parietal areas, with no reproducible responses obtained in the same area with moderate intensity clicks normally used in BAEPs. Recordings in neurologically normal volunteers showed a consistent response with a negative polarity at around 3 ms, which we therefore called N3. Two case studies are presented. The first case is a patient with unilateral sensorineural hearing loss with NVESTEPs present, suggesting that NVESTEPs is not a cochlear response. The second case is a patient with multiple sclerosis with demyelinating lesions in the pons and an unobtainable NVESTEP response. CONCLUSION: NVESTEPs is a possible new diagnostic technique that may be specific for the vestibular pathway. It has potential use in patients with symptoms of dizziness, subclinical symptoms in multiple sclerosis, and in disorders specific for the vestibular nerve. 相似文献
57.
Papathanasiou E Piperidou C Iliopoulos I Myrianthopoulou P Pilavakis P Papacostas S 《Electromyography and clinical neurophysiology》2005,45(5):263-266
OBJECTIVE: To present a case of unilateral hearing loss in which a brainstem auditory evoked potential (BAEP) disappeared during sleep on the symptomatic side, and to argue that this may actually be a manifestation of a neurogenic vestibular evoked potential (NVESTEP). MATERIAL AND METHOD: Brainstem auditory evoked potentials were performed in the standard manner. RESULT: A poorly organized response was obtained during wakefulness on the symptomatic side that resembled a BAEP. The BAEP for the right ear was better organized. During sleep, the response for the left ear disappeared. CONCLUSIONS: The poor organization of the response of the left ear compared to the right, and its disappearance during sleep, suggests that the response for the left ear was actually an NVESTEP and not a BAEP. The possibility of recording vestibular responses with auditory stimuli may have important implications for BAEP examinations performed during wakefulness that may lead to false negative results, in neonatal screening for hearing loss that use tone stimuli, and also in brain mapping using magnetic resonance imaging (MRI) and positron emission tomography (PET) relating to the auditory cortex. 相似文献
58.
N Papanas G Giassakis K Papatheodorou D Papazoglou C Monastiriotis D Christakidis H Piperidou E Maltezos 《Experimental and clinical endocrinology & diabetes》2007,115(1):58-61
The new indicator test for sudomotor function (Neuropad) has been shown to represent a highly sensitive and reproducible tool for the diagnosis of diabetic peripheral neuropathy. This study aimed to examine the utility of the indicator test in the assessment of the staged severity of neuropathy in patients with type 2 diabetes mellitus. The study included 120 type 2 diabetic patients (58 men) with a mean age of 67.3+/-5.9 years and a mean diabetes duration of 13.1+/-3.2 years. Neuropathy was diagnosed and staged by clinical examination and nerve conduction study, according to the Michigan classification system. Patients were also examined with the indicator test, applied on the plantar aspect of the feet. Time until complete colour change of the test was recorded and stratified into deciles according to the spread of measurements in the study population. Neuropathy was staged as class 0 in 37 patients, class 1 in 44 patients, class 2 in 28 patients and class 3 in 11 patients. Time until complete colour change was 436.5+/-62.9, 740+/-88.1, 1192.5+/-161 and 1817.3+/-127.4 seconds in patients staged as class 0, 1, 2 and 3 respectively (p=0.001). Use of a threshold lower than 530 seconds until complete colour change had 97% sensitivity and 100% specificity for diagnosis of class 0 neuropathy. Use of a threshold lower than 1000 seconds until complete colour change had 100% sensitivity and 97% specificity for class 1 neuropathy. A threshold lower than 1440 seconds had 93% sensitivity and 100% specificity for class 2 neuropathy. A threshold above 1440 seconds had 100% sensitivity and 99% specificity for class 3 neuropathy. A highly significant (Kendall's tau-b=0.848, p=0.001) correlation was shown between time until complete colour change of the test and Michigan class of neuropathy. CONCLUSIONS: It appears that the indicator test contributes substantially to the assessment of the staged severity of neuropathy in patients with type 2 diabetes mellitus. There is excellent agreement between the indicator test and the Michigan classification system. These results suggest a role for the indicator test in the assessment of diabetic neuropathy. 相似文献
59.
Konstantinos M Vadikolias Nikolaos D Artemis Panayiotis D Mitsias John N Heliopoulos Grigorios A Tripsianis Chrisa M Vadikolia Hariklia S Proios Aspasia E Serdari Charitomeni N Piperidou Ioannis A Milonas 《Journal of cerebral blood flow and metabolism》2007,27(11):1870-1877
Functional transcranial Doppler (fTCD) has been used for the identification of cerebral hemispheric dominance in various cognitive tasks. In our study, we have used fTCD with the aim to compare blood flow patterns in the hemispheres not only during the task activation periods but also in the post-stimulus phase. Normal volunteers, 25 right and 25 left-handed, were included. Mean flow velocities (FVs) in the bilateral middle cerebral arteries were recorded during the performance of six cognitive tasks and during the intervals between tasks. The lateralization index (LI) was calculated separately for each test (LI1-6), on the basis of the percent change of blood FV from baseline. To estimate flow fluctuations, a novel index, the LI-variability, was also calculated using a formula constituted by the minimum and maximum mean values recorded at specific time intervals during the entire procedure. Laterization indices, LI-3 and LI-4, corresponding to word generation and reading aloud tasks, produced the highest degree of activation. A perfect agreement (Cohen's kappa=1.000, P<0.001) was observed among LI-3, LI-4, and LI-V. The repetition of recordings gave excellent test-retest reliability in 10 randomly selected participants. Our results suggest that the hemisphere that is characterized as dominant by fTCD maintains a more stable flow pattern during the performance of successive cognitive tasks. Although it could not be considered as a clinically useful tool as yet, this observation introduces a novel parameter such as the stability of blood flow over time, which could potentially provide insight in the study of cerebral functions. 相似文献
60.
Piperidou?Haritomeni Terzoudi?AikateriniEmail author Vorvolakos?Theofanis Davis?Elizabeth Heliopoulos?Ioannis Vadikolias?Konstantinos Giassakis?Georgios Aggelopoulos?Petros Georgiadis?Georgios Karlovasitou?Anna 《Quality of life research》2006,15(5):833-839
This study is presenting the translation and cultural adaptation into Greek of the Quality of Life in Epilepsy Inventory (QOLIE-31).
We adapted the QOLIE-31 to Greek through a procedure of translation–back-translation. Sixty-three patients were interviewed
and completed the QOLIE-31 and the GHQ questionnaires. We re-examined a subset of them after a period of 2–5 weeks to evaluate
the test–retest reliability of the questionnaire. We assessed the convergent validity by comparison of the QOLIE-31 and the
GHQ and QOLIE-31 subscales and external measures. Discriminative validity was evaluated using the method of known-groups comparisons.
The internal consistency was high for the QOLIE-31 and its’ subscales (Cronbach’s α 0.92 and 0.59–0.83 respectively). Test–retest
reliability was acceptable (intra-class correlation coefficient 0.49–0.89 and Pearson’s coefficient 0.53–0.92) for the group
of patients who were re-examined. Comparison of the QOLIE-31 and GHQ scores showed agreement between the two questionnaires
(Pearson’s coefficient −0.61). We demonstrated the discriminative validity by the difference in the QOLIE-31 scores between
patients with different seizure frequencies and different employment status. We concluded that the Greek version of the QOLIE-31
has psychometric properties equivalent to those of the original American-English version and is a valid and reliable instrument. 相似文献