Biomedical subjects
B Nater
Publications and source records attributed to B Nater.
[Oral zolmitriptan (Zomig) in the treatment of migraine crisis].
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Delayed segmental axial dystonia of the trunk on standing after lumbar disk operation.
We report four patients with various degrees of chronic, tonic, mildly painful, or non-painful, kyphoscolioses in orthostatism, which developed weeks, or months, after one or several laminectomies for lumbar disk hernia, in the absence of recurring radicular pain or acute lumbar pain. No family history or personal antecedent, of focal or generalized dystonia was found and the dystonia was not seen in any of the four patients pre-operatively, or during the immediate post-operative period. Only ill-defined lumbar 'discomfort', unlike their pre-operative lumbago, was reported by the patients, before and during the occurrence of the pathologic trunk posture on standing. Asymmetric lumbar muscle tonic contraction and hypertrophy was found on physical examination. In all patients, the kyphoscoliosis was maximal when standing, partially disappeared when seated, and completely when lying down. One patient responded well to clonazepam, but the other three showed no improvement with either clonazepam or local injections of botulinum toxin; L-dopa was ineffective in all cases, and trihexiphenidyle in three.
[Sentinel headache: a premonitory symptom too often unrecognized in intracranial ruptured aneurysm].
Headache is a common complaint in emergency departments, but only a small percentage of patients have a serious disease. Nevertheless, some forms of headache, such as "warning headaches", need special attention. By far the most common symptom associated with aneurysmal minor bleed (warning leak) is a sudden headache that is considered to be a warning symptom of impending aneurysmal rupture. In the presence of sudden severe headache with or without meningeal signs or nausea, subarachnoid hemorrhage should always be considered. Recognition of these warning headaches probably offers the best opportunity of reducing the otherwise serious mortality and morbidity of aneurysmal subarachnoid hemorrhage. This report describes 7 non-consecutive patients presenting warning headaches before major aneurysm rupture. Based on our experience and a review of the literature, we recommend a management algorithm for patients presenting with sudden severe headache.
[Atypical cases of acute headaches of cerebrovascular origin].
Acute headaches can be an important signal of a cerebrovascular event. In some cases, as illustrated in this article, such headaches may have the same characteristics as migraine or be the main feature of unusual types of cerebrovascular disease. Headache should not be underestimated since misdiagnosis of cerebrovascular disease can lead to serious consequences.
[Migraine and cerebrovascular accidents].
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[Stabilization treatments of migraine].
Pathophysiology and principles for diagnosis of migraine, in particular ways to obtain an accurate history between attacks, are presented in the introduction. Identification of migraine triggers is an extremely important part of migraine therapy. Selected pain-relieving drugs should include primarily simple analgesics and antiemetics, while sumatriptan should be reserved mainly for severe migraine attacks. Pharmacotherapy, psychological and physical therapy are all components of a systemic approach to the treatment of migraine. To discontinue overused medication is the first step in the prevention of migraine. A number of available drugs are able to reduce the frequency and severity of migraine attacks. Several considerations should be evaluated before symptomatic and prophylactic therapies are introduced. Our strategies are based on experience collected during the treatment of 82 patients.
[Neurological sequelae following exposure to thermo-oxidative degradation of polyurethane compounds].
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[Symptomatology of ischemic carotid complications].
Clinical features of the carotid artery syndromes are reviewed. Limited infarction cause typical clinical syndromes. However, in most cases, embolic occlusion is multiple and produces various clinical syndromes.
[Acute urinary retention as a manifestation of a myeloradiculitis].
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[Monomelic ischemic neuropathy caused by subclavian artery obstruction].
A case study of acute ischemic monomelic neuropathy due to occlusion of the right subclavian artery is reported. The occlusion was embolic. Clinical examination showed sensory loss and severe distal weakness of the limb without obvious muscle necrosis. EMG showed motor and sensory nerve axon loss, chiefly distally. Despite surgical intervention, the neurological damage was irreversible.
[Current concepts in the treatment of status epilepticus].
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[Disorders of the lumbosacral and pubic plexus: origins, manifestations and approach].
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[Wallenberg's syndrome due to dissection of the vertebral artery].
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[Atypical cervical syndromes: presentation of 2 cases].
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[Cervical myelopathy as a result of ossification of the posterior longitudinal ligament (4 cases)].
Ossification of the posterior longitudinal ligament was demonstrated in four caucasian males with progressive myelopathy. Such a condition is not uncommon in Japan, but has rarely been reported in caucasian subjects. It is not related to spondylarthrosis. Clinical course is usually protracted and can be worsened by mild trauma. Computerized tomography is the best diagnostic tool. Anterior decompressive surgery is theorically warranted in cases of severe myelopathy. Multisegmental laminectomy was performed on two patients, but was followed by little improvement. We discuss the relation between this condition and ankylosing spinal hyperostosis.
Community-based primary prevention of cardiovascular disease in Switzerland: methods and results of the National Research Program (NRP 1A).
The National Research Program 1A on Primary Prevention of Cardiovascular Disease in Switzerland was designed to determine whether community health education can reduce cardiovascular risk factors in whole population groups. Two towns (12,000 inhabitants each) in the French-speaking and two (16,000 inhabitants each) in the German-speaking part of the country were selected for either intervention or comparison. Following baseline screening in 1977 (stratified random samples) and the community intervention program (1978-1980), a final assessment on the initial participants was made at the end of 1980. In intervention towns, 26.2% of the regular smokers quit during this period compared with 18.1% in the reference towns. In addition, a significant net increase in the proportion of hypertensive patients under effective control was observed. A reduction in cholesterol levels was noted in both the intervention and the reference towns, with no difference between them. However, cholesterol levels in a subgroup of women participating in program activities as compared with those not participating were significantly reduced. The program, with extensive involvement of a diversity of community groups, has enjoyed continued support, even after the end of the research experience, thus demonstrating the viability and acceptability of community-oriented preventive action.
[Ergometric validation of a questionnaire on the physical activity in 2 Swiss towns].
A questionnaire concerning physical activity used in the National Research Program No. 1A (PNR 1A) was evaluated by using a physical fitness test on an ergometric bicycle. The values of maximum oxygen consumption correspond to different classes of physical activity set up according to the questionnaire (comparison of groups statistically significant). In addition, it appears that maximal oxygen consumption is in direct relation to the intensity of physical activity during leisure hours, whilst the degree of activity connected with professional or household duties is of very little importance.