Efficacy and safety of axillary brachial plexus block for operations on the hand.

An axillary brachial plexus nerve block by a transarterial approach is commonly used to achieve regional anaesthesia for hand surgery. We designed a retrospective study to evaluate efficacy and safety of the technique for acute and elective operations. Anaesthetic records of 189 of all 5520 patients (1996-2000) who had axillary brachial plexus blocks for hand surgery were reviewed, and results compared with complications recorded in the anaesthetic register and in the hand surgery records. Successful axillary block was achieved in 5128/5520 (93%) of patients, according to anaesthetic charts, and primarily in 157/189 (83%), and after supplementation in 171/189 (90%), according to anaesthetic records. Four patients had a toxic drug reaction or axillary haematoma with a transient neurological deficit. Medical complications were recorded in the anaesthetic register in less than 0.7% of axillary brachial plexus procedures. Axillary brachial plexus block by a transarterial approach is effective and safe in hand surgery.     

Wissenstranslation am Beispiel Bewegungsförderung von älteren Menschen: Wie gelangen wissenschaftliche Erkenntnisse in die kommunale Praxis?

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Wissenschaftliche Ergebnisse können eine Wissensquelle für kommunale Akteurinnen und Akteure der...     

Aufbau von Interventionsdatenbanken für mehr Evidenzbasierung in Prävention und Gesundheitsförderung – methodische Überlegungen

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Kommunale AkteurInnen erfahren bei der Entwicklung und Auswahl von Maßnahmen der Prävention und...     

Chick gonadogenesis following early surgical bursectomy

Left ovaries of bursectomized chick embryos were examined on the 17th day of incubation in comparison to normal and sham-operated controls, by histological and histochemical observations. The results show that in bursectomized embryos the cortex appears irregulary developed, with a significant decrease in the mean thickness and in the percentage of the secondary sex cords in the total cortical area. Furthermore, the germinal epithelium appears thicker and the subcortical medulla and the tunica albuginea more compact. The greater activity of the enzyme ⁵–3-hydroxysteroid dehydrogenase ( ⁵3HSD) found in ovaries of bursectomized embryos (histochemical method) could be related to an endocrine dismetabolism affecting the cortical development. On the basis of these results and those of other authors, some hypotheses are advanced. In particular, an action of the bursal factor on GTH receptors could be the factor responsible of the enhanced steroidogenic activity altering the hormonal environment.     

The age of acquisition of words produced in a semantic fluency task can reliably differentiate normal from pathological age related cognitive decline

This study examined differences in the characteristics of words produced by healthy elderly controls and by patients with Alzheimer's disease (AD) in a semantic fluency task (generating words from the categories of animals and fruit). Ninety-six AD patients (MMSE 13-29) and 40 controls matched for age and socio-cultural background completed a semantic fluency task. Length, frequency, typicality and age of acquisition (AoA) values were obtained for each word generated. In comparison with controls, AD patients generated fewer items, and their items were higher in frequency, shorter in length, more typical and earlier in AoA. Discriminant function analysis showed that AoA was the best predictor of group membership (patient/control). The mean AoA of words generated correctly classified 95% of controls and 88% of patients.     

Belief and awareness: reflections on a case of persistent anosognosia

Persisting anosognosia after acute lesions is relatively rare, and no case studies to date have reported functional scanning investigation of this disorder. This is a case report of an 85-year-old right-handed Scottish woman, EN, who showed persistent anosognosia for hemiplegia following a haemorrhagic stroke. Extensive damage in the right hemisphere caused left upper and lower limb flaccid hemiplegia and severe left-sided neglect. Lack of awareness for her deficits was still present 2 years after the stroke, when neurological, neuropsychological, and SPECT examinations were performed. Testing revealed severe left unilateral neglect and poor performance on verbal fluency tasks. EN had age normal memory performance, and her object recognition and praxic abilities were preserved. She showed no global reasoning or language problems apart from her abnormal beliefs. EN believed that she was able to walk and carry out several activities, in a context of other disorders of belief. SPECT scan showed marked hypoperfusion in the right parietotemporal cortex and this extended to the associative cortex in the right frontal regions. The persistence of anosognosia in this patient cannot be explained by memory impairments or global cognitive decline. A possible account might be that alteration in awareness was maintained by contingent right frontal and/or parietal dysfunction causing a suspension or change in the ability to monitor and check the 'real' and especially to assess the veracity of mental contents.     

Independent representations for cursive and print style: Evidence from dysgraphia in Alzheimer's disease

In this paper we describe two mild Alzheimer's disease patients (AF and EZ) who show a double dissociation in written production of cursive and print styles. We analysed their performance on a number of different tasks. Both had no major difficulty in reading, direct copying, or spelling but displayed contrasting patterns of impairment in writing using different styles. AF was impaired when asked to write in cursive, whereas EZ was impaired when requested to write in print. The patients showed no general impairment in retrieving visual forms, but both failed a letter form judgement task, only for the affected style. Evidence from their overall performance adds support to opposing patterns of impairments in both patients. The double dissociation shown by AF's and EZ's performance strengthens previous arguments for independent representations of cursive and print style.     

Independent representations for cursive and print style: Evidence from dysgraphia in Alzheimer's disease

In this paper we describe two mild Alzheimer's disease patients (AF and EZ) who show a double dissociation in written production of cursive and print styles. We analysed their performance on a number of different tasks. Both had no major difficulty in reading, direct copying, or spelling but displayed contrasting patterns of impairment in writing using different styles. AF was impaired when asked to write in cursive, whereas EZ was impaired when requested to write in print. The patients showed no general impairment in retrieving visual forms, but both failed a letter form judgement task, only for the affected style. Evidence from their overall performance adds support to opposing patterns of impairments in both patients. The double dissociation shown by AF's and EZ's performance strengthens previous arguments for independent representations of cursive and print style.