Activity level and balance in subjects with mild Alzheimer's disease

To clarify if Alzheimer's disease has an impact on activity level and postural control, we examined 17 elderly diagnosed with mild Alzheimer's disease (MMSE scores 21-29) and 18 age- and gender-matched healthy controls (MMSE scores 27-30) using the Frenchay Activities Index, Bergs Balance Scale, Timed Up & Go and Walking in a Figure of Eight. Mild AD subjects were less active and had lower scores on Bergs Balance Scale, performed Timed Up & Go in longer time and took more steps outside the Figure of Eight, as compared to healthy elderly. This study shows that motor performance is affected already at mild stages of Alzheimer's disease and also that functional performance other than gait may also be impaired.     

Psychosocial aspects of road traffic trauma--benefits of an early intervention?

PURPOSE: To assess the psychosocial consequences of traffic accidents, and to evaluate the effect of an intervention programme to reduce the occurrence and extent of psychosocial residual states. MATERIAL AND METHODS: A telephone interview was conducted with 314 individuals, 1(1/2)-2 years after the accident in 1994-1995. The effect of the intervention programme was studied for inpatients, 68 in the study group, and 89 in the control group. The structured follow-up form included the Impact of Event Scale (IES). RESULTS: Half of those injured had residual physical complaints with negative effects on their work- and economic-situation. An influence on housing or the need for practical assistance was reported by 1-7%. Mental effects were reported by 4/5. IES demonstrated that 1/5 suffered a high degree of intrusion, and this occurred twice as often among females as among males. Situational anxiety occurred more often in the intervention group than in the control group, p=0.02. More individuals in the intervention group than in the control group were satisfied with the medical certificate to the insurance company, p=0.058. CONCLUSIONS: Females were afflicted by mental effects considerably more than males. The intervention programme did not appear to reduce the psychosocial sequelae. The methods within this area need to be further developed.     

Pigment epithelium endoscopic laser surgery for treatment of choroidal neovascularization

PURPOSE: To present a new concept and technique for subretinal surgery. METHODS: Twenty-four eyes of 24 patients with subfoveal choroidal neovascularization (CNV) were included in this study. Nine patients were operated on in Mexico City by one surgeon, 15 patients in Frankfurt by another surgeon. The retina at the posterior pole was detached and subretinal thermal photocoagulation of the CNVs was performed using a 20/19-gauge GRIN rod laser endoscope (Insight Instruments Inc., Sanford, Fla., USA). This procedure was termed PEELS (pigment epithelium endoscopic laser surgery). RESULTS: In 7 patients (Mexico), moderate improvement or stabilization of vision over 6 months or longer was achieved. In 10 out of 12 patients (Frankfurt), stabilization of vision over a follow-up period of 6-18 months was achieved, at least. Serious complications were not observed. Four of the Frankfurt series patients improved their vision. CONCLUSION: PEELS can stabilize or improve vision.     

A qualitative study of coping in the early stage of acute traumatic hand injury

Twenty patients with acute traumatic hand injury were interviewed 8-20 days after the day of the accident. The aim of the study was to identify coping strategies, defined as thoughts or actions used by the hand-injured patients to manage stress factors and resulting emotions in the early stage. Stress factors were reported in an earlier study. The analyses of the interviews followed the first steps in the analytical process described in a modified model of grounded theory. Eleven different coping strategies were identified in the interviews. By "comparing with something worse", "positive thinking", "relying on personal capacity", "distancing" and "distracting attention" the patients tried to play down the seriousness of the problem or situation. Other coping strategies used by the hand-injured were "accepting the situation", "seeking social support", "maintaining control", "solving practical problems by oneself", "pain-relieving actions" and "active processing of the trauma experience." The findings of the study show how important it is to identify the patient's own way of coping with a stressful illness situation in order to give adequate psychosocial support.