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1.
There is some evidence suggesting that Parkinson's disease (PD) patients exhibit lower body weight when compared to age-matched healthy subjects. Low body mass index (BMI) is correlated with low bone mineral density, both of which are major risk factors for hip fractures. Possible determinants of weight loss in PD patients include hyposmia, impaired hand-mouth coordination, difficulty chewing, dysphagia, intestinal hypomotility, depression, decreased reward processing of dopaminergic mesolimbic regions, nausea, and anorexia as the side effects of medication, and increased energy requirements due to muscular rigidity and involuntary movements. It is unclear whether PD patients in general, or only a subgroup of those affected, definitely show lower BMI in the advanced stages of the disease. We therefore recommend that the body weight of PD patients be monitored monthly as the disease progresses, and that a patient's nutrition should be supplemented with sufficient amounts of vitamin D and calcium to reduce the risk of hip fractures and strengthen bone density. Because meal times may coincide with unpredictable off periods associated with akinesia and impaired hand-mouth coordination, PD patients also need flexible food schedules that accommodate the associated symptoms of this disease. 相似文献
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Peritoneal morphology in children treated by continuous ambulatory peritoneal dialysis 总被引:2,自引:0,他引:2
Fritz Schneble Klaus-Eugen Bonzel Rüdiger Waldherr Sebastian Bachmann Helga Roth Karl Schärer 《Pediatric nephrology (Berlin, Germany)》1992,6(6):542-546
Fifty peritoneal biopsies (PB) from 35 patients with end-stage renal disease, treated by continuous ambulatory peritoneal dialysis (CAPD) and aged 2 months to 18 years, were examined by light microscopy (n=50) and/or scanning electron microscopy. PB were performed during surgical procedures immediately before the start of, during, or after the cessation of CAPD treatment. PB from 15 children without renal disease undergoing laparatomy were examined similarly. Before the start of CAPD, a scarcity and shortening of the mesothelial microvilli was observed by scanning electron microscopy. During and after CAPD, variable alterations of mesothelium, interstitium and capillaries were found. The mesothelial layer was absent in all 5 PB obtained during episodes of active peritonitis. In patients treated by CAPD for longer than 6 months, mesothelial denudation was observed more frequently (6/11) than in children treated for shorter periods (1/7) (P<0.08). Fibrosis of the peritoneal membrane was present in about 50% of patients during or after the cessation of CAPD without impairment of peritoneal function. No correlation was found between the presence of fibrosis and the frequency of peritonitis or the duration of CAPD treatment. 相似文献
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OBJECTIVE: The aim of this study was to assess the severity of epilepsy and
its effect on patients lives, and to describe patients' use of and
attitudes to health care. METHOD: A questionnaire was sent to 595 people
with epilepsy identified from 14 general practices in north-west Bristol.
All patients aged 16 years and over receiving anti-epileptic medication for
their epilepsy were included in the study. Areas investigated included
severity of epilepsy and its effect on quality of life, anti-epileptic
medication and its perceived effect, health care utilization and
preferences for health care. RESULTS: Seizure frequency was strongly
associated with adverse effects of epilepsy. Attacks of epilepsy were
experienced at least monthly by 20.4% (95% confidence intervals (Cl)
17.0-23.7%) of patients, 29.4% (25.4-33.4%) took more than one
anti-epileptic drug, 56.1% (50.1-62.2%) reported drug side effects, 74.1%
(70.3-77.8%) would prefer to receive all or most of their epilepsy care in
a general practice setting, and 69.8% (63.5- 76.2%) would like contact with
a primary care-based epilepsy specialist nurse. During the previous year
42.4% (35.9-48.8%) of patients had not seen a doctor about their epilepsy.
Of patients who had attended the general practice only 13.4% (9.6-17.2%)
had regular arrangements to see their GP about epilepsy. Patients receiving
both primary and secondary care had the greatest needs and wants for
improved care. CONCLUSIONS: Structured care, including regular
appointments, co-ordination of primary and secondary care, and increased
monitoring and discussion, may improve the quality of life of people with
epilepsy, but requires evaluation.
相似文献
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We used arthrotomography to study the glenoid labrum in 114 patients. Sixty-nine of the patients had anatomic instability of the shoulder (including recurrent dislocation and subluxation of the shoulder), and 45 patients had functional instability of the shoulder (denoted by chronic pain, clicking of the joint, and the sensation that an unstable condition exists without the objective signs of it). Labral tears were revealed arthrotomographically in 86% of the patients with anatomic instability, while only 40% of the patients with functional instability had labral abnormalities, and these were primarily of minor severity. Fifty-six patients (44 of whom had anatomic instability; 12, functional instability) required surgery. The surgical findings were correlated with the arthrotomographic findings, and no false-positive results were revealed. However, arthrotomography demonstrated only part of the pathologic condition of two patients. These results confirm that there is a strong correlation between labral pathologic conditions and anatomic instability of the shoulder. Arthrotomographic studies have a great impact on the selection of therapy in cases of both anatomic and functional instability of the shoulder. 相似文献
10.
Hausegger KA; Cragg AH; Lammer J; Lafer M; Fluckiger F; Klein GE; Sternthal MH; Pilger E 《Radiology》1994,190(1):199