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11.
A. Esquenazi 《European journal of neurology》2006,13(S4):27-34
Spasticity is a widespread, disabling form of muscle overactivity affecting patients with central nervous system damage resulting in upper motor neurone syndrome. There is a range of effective therapies for the treatment of spasticity (e.g. physical, anaesthetic, chemodenervation and neurolytic injections, systemic medication and surgery), but all therapies must be based on an individualized, multidisciplinary programme targeted to achieve patient goals. Appropriate therapy should be based on the extent and severity of spasticity, but spasticity and its consequences, regardless of presentation or cause, are commonly treated with systemic agents. This may be ill-advised as systemic treatment is associated with many undesirable effects. In particular, elderly patients with post-stroke spasticity are at risk from the central adverse effects of systemic medication (e.g. sedation and gait disturbance), which make them more susceptible to falling, with an associated increased risk of fracture. The rising costs of fracture care and its sequelae are fast becoming an international problem contributing to high healthcare expenditure. Botulinum toxin type-A (BoNT-A) treatment is highly effective for some of the more common forms of spasticity and muscle overactivity, and has a favourable profile when compared with systemic agents and other focal treatments. Therefore, the clinical benefits of BoNT-A treatment outweigh the apparent high costs of this intervention, showing it to be a cost-effective treatment. 相似文献
12.
o. goetze a. b. nikodem j. wiezcorek † m. banasch h. przuntek † t. mueller † w. e. schmidt & d. woitalla † 《Neurogastroenterology and motility》2006,18(5):369-375
Predictors of gastric emptying (GE) in patients with idiopathic Parkinson's disease (PD) of a solid and liquid meal are not well defined. For measurement of GE 80 patients with PD were randomly assigned to receive either a solid meal (250 kcal) containing 13C-octanoate (n = 40) or a liquid meal (315 kcal) with 13C-acetate (n = 40). All patient groups were off medication affecting motility and were matched for age, gender, body mass index, disease duration and severity, using Unified Parkinson's Disease Rating Scale (UPDRS). Gastric emptying was compared with a healthy control group (n = 40). Multiple regression analysis was used to determine predictors of gastric emptying. Exactly 88% and 38% of PD patients had delayed GE of solids and liquids respectively. Solid and liquid emptying was similar in women and men. There were no differences in GE in PD patients < 65 years of age when compared with patients > or = 65 years. Multiple regression analysis showed that motor handicaps such as rigour and action tremor are independent predictors of solid GE (r = 0.68, P < 0.001). The severity of motor impairment, but not any other neurological symptom, as assessed by UPDRS is associated with gastroparesis in PD and solid emptying is more likely to be delayed. 相似文献
13.
海王碱性保健饮料是以海带为主要原料的制品。本文通过大鼠游泳耐力和耐缺氧试验证明,海王碱性保健饮料有明显地抗疲劳、抗缺氧作用(P<0.01)。同时我们分析测试了饮料中营养素成分及其含量,本品富含碘、钙、铁、β—胡萝卜素和人体所必需的多种营养素及微量元素。 相似文献
14.
Role of intracortical mechanisms in the late part of the silent period to transcranial stimulation of the human motor cortex 总被引:3,自引:0,他引:3
J.P. Brasil-Neto A. Cammarota J. Valls-Solé A. Pascual-Leone M. Hallett L. G. Cohen 《Acta neurologica Scandinavica》1995,92(5):383-386
Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) of the human motor cortex produce a silent period (SP) following motor evoked potentials (MEPs). The early part of the SP can be explained by decreased alpha motor neuron excitability, whereas the late part is presumably due to suprasegmental mechanisms. In order to determine the level of the suprasegmental contribution to the generation of SPs, we recorded excitatory and inhibitory responses to TMS, TES, and percutaneous electrical brainstem stimulation (PBS) in the voluntarily activated first dorsal interosseous muscle of the hand. Stimulus intensities were set so that PBS and TES induced MEPs with areas equal to or larger than those of MEPs obtained with TMS. This procedure revealed that SPs were 49% and 83% shorter with TES and PBS, respectively, than with TMS. As TMS is more effective than TES or PBS in activating cortical interneurons, these findings support the idea that a significant component of the SP arises from intracortical mechanisms. 相似文献
15.
M. Wensing A. H. Penninks† S. L. Hefle‡ J. H. Akkerdaas§ R. van Ree§ S. J. Koppelman† C. A. F. M. Bruijnzeel-Koomen A. C. Knulst 《Clinical and experimental allergy》2002,32(12):1757-1762
BACKGROUND: The risk for allergic reactions depends on the sensitivity of individuals and the quantities of offending food ingested. The sensitivity varies among allergic individuals, as does the threshold dose of a food allergen capable of inducing an allergic reaction. OBJECTIVE: This study aimed at determining the distribution of minimum provoking doses of hazelnut in a hazelnut-allergic population. METHODS: Thirty-one patients with a history of hazelnut-related allergic symptoms, a positive skin prick test to hazelnut and/or an elevated specific IgE level, were included. Double-blind, placebo-controlled food challenges (DBPCFC) were performed with seven increasing doses of dried hazelnut (1 mg to 1 g hazelnut protein) randomly interspersed with seven placebo doses. RESULTS: Twenty-nine patients had a positive challenge. Itching of the oral cavity and/or lips was the first symptom in all cases. Additional gastrointestinal symptoms were reported in five patients and difficulty in swallowing in one patient. Lip swelling was observed in two patients, followed by generalized urticaria in one of these. Threshold doses for eliciting subjective reactions varied from a dose of 1 mg up to 100 mg hazelnut protein (equivalent to 6.4-640 mg hazelnut meal). Extrapolation of the dose-response curve showed that 50% of our hazelnut-allergic population will suffer from an allergic reaction after ingestion of 6 mg (95% CI, 2-11 mg) of hazelnut protein. Objective symptoms were observed in two patients after 1 and 1,000 mg, respectively. CONCLUSION: DBPCFCs demonstrated threshold doses in half of the hazelnut-allergic patients similar to doses previously described to be hidden in consumer products. This stresses the need for careful labelling and strategies to prevent and detect contamination of food products with hazelnut residues. 相似文献
16.
17.
W. Ziegler D. von Cramon 《European archives of psychiatry and clinical neuroscience》1986,236(1):44-49
Summary This paper deals with a particular aspect of speech motor control in patients suffering from apraxia of speech. Three experiments are reported concerning the phase relations between individual speech gestures. These include the timing of laryngeal, velar and labial movements relative to lingual gestures.A total of 8 patients and 12 normal controls were examined using speech material which was designed according to appropriate phonetic paradigms. Evaluation was performed on the basis of speech signal parameters referring to the kinematics of inter-articulatory phasing. Deviations of the patient group were found in all three experiments. This suggests that disturbed phase relations of individual speech movements are a general feature of apraxic speech. It is further hypothesized that the described motor symptoms are the origin of a variety of phonemic errors. Support for this view is provided by appropriate examples which refer to the examined paradigms. By this argument, much of the disturbed phonemic structure of apraxic speech may be accounted for by timing deficits. 相似文献
18.
高血压高危患者的降压治疗既需降低血压,又需保持足够血流以保障器官灌注。血压降低过度无疑也有一定风险,因此控制皿压需要底线。高危高血压患者的个体差异大,在降压治疗过程中,临床医生既要以循证医学为鉴,叉须遵循个体化治疗原则,把握好降压幅度和速度,坚持高质量平稳降压,才能更好地保护靶器官,减少心脑血管意外的发生。 相似文献
19.
目的探讨烧伤后早期在深Ⅱ度创面削痂手术中使用电动取皮刀准确削痂,对创面进程和愈合质量的影响。方法选择62例深Ⅱ度烧伤患,随机分为二组,均在伤后72h内进行创面削痂手术。术中分别使用电动取皮刀和滚轴取皮刀削痂,观察术中削痂创面出血量、手术所需时间、创面愈合时间及残留肉芽创面的发生事。结果早期对深Ⅱ度创面削痂能降低局部炎症反应。与滚轴取皮刀削痂相比较,用电动取皮刀削痂可降低残留创面的发生率22.6%,缩短病程3.5d。结论电动取皮刀削痂可尽量保存残存的皮肤附件,避免使用滚轴取皮刀削痴过程中经常出现的削痂创面边缘锯齿样切口,也可以避免因术经验、技术的不足所导致的削痴过浅或过深的问题,促进创面愈合和缩短病程,是一种简单易行的削痂方法。 相似文献
20.