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Biomedical subjects

D K Ziegler

Publications and source records attributed to D K Ziegler.

At least 37 records · Page 2Linked to original sources
PubMed1992

Osteomyelitis of the skull base.

Three cases of osteomyelitis of the skull base with associated problems in diagnosis and therapy are discussed. Patients with atypical skull base osteomyelitis are difficult to diagnose as they have no ear abnormalities, but they often develop multiple cranial nerve deficits mimicking symptoms of a posterior fossa mass. We conclude that computed tomographic scans, magnetic resonance imaging studies, bone scans indium-labeled white blood cell scans, and gallium scans are useful in making the diagnosis. A biopsy of the bony lesion often is needed to identify the causative organism and to rule out a tumor. Intravenously administered antibiotics are the mainstay of therapy and should be continued until 1 week after the gallium scan shows no abnormalities. Follow-up gallium scans then are done at 1 week and 3 months after the cessation of antibiotic therapy to search for a recurrence.

Adult↗
PubMed1992

Headache and migraine.

That the 'primary' phenomenon in migraine with aura is neuronal ('spreading depression') seems increasingly probable, but the relationship of migraine with and without aura and of both to tension headache remains uncertain. Depression and migraine are related, but other psychological correlates are controversial. Two new therapeutic agents, with action on 5-hydroxytryptamine (5-HT; serotonin) receptors are of promise.

Arousal↗
PubMed1991

Magnetic resonance image abnormality in migraine with aura.

Cerebral magnetic resonance imaging (MRI) was performed on 18 patients with migraine characterized by aura consisting of both visual symptoms and paresthesias. Fifteen headache-free individuals of the same age range were used as controls. Records were randomized and read in blind fashion by two neuroradiologists. Small subcortical white matter lesions were seen in three migraine cases and two controls. In one migraine case cortical infarctions were seen. In two controls, small areas of increased density similar to those in migraine were seen. No consistent correlation of migraine or its duration with cerebral atrophy was found. It is concluded that identification of both these MRI findings (small subcortical white lesions and cerebral atrophy) as significantly associated with migraine is doubtful.

Adult↗
PubMed1991

Prevalence survey of headache in a rural Mexican village.

Prevalence of headache was studied by house-to-house survey of a small remote Mexican village where the population was characterized by a low income and high rate of illiteracy. Severe headache was found in 8.9% of the male population and in 10.6% of the females. Approximately half of these individuals gave a history suggestive of headache with aura, but reinterview by a neurologist revealed that in one third of such histories the visual phenomena were probably not true aurae. Only in the over 35-year age-group was headache more prevalent in females. 'Incapacitating' headache was usually equated with 'severe' headache and was 10 times as frequent in the over 55-year age-group as in younger people. Sophisticated interviewers (neurologists) obtained different results from less trained interviewers.

Adolescent↗
PubMed1991

Access to health care.

Explore the source record for details and available documents.

Health Services Accessibility↗
PubMed1990

Specific headache phenomena: their frequency and coincidence.

The correlation of specific headache attack characteristics derived from a standardized questionnaire was studied in a consecutive series of 392 patients attending a headache clinic. In patients reporting headache with aura such attacks tended to be infrequent, and the percentage of their headache attacks that were preceded by aura varied widely, many cases having very low percentages. Paresthesias as auras were uncommon and rarely occurred without visual aura. Unilateral headaches were associated with nausea to widely varying degrees. Most patients reported both unilateral headache and headache with tension characteristics. Definite history of hypertension was significantly correlated specifically with migraine with aura (classic migraine).

Adult↗
PubMed1990

HIV-related neuromuscular syndrome simulating motor neuron disease.

A young homosexual man presented with slowly progressive weakness and diffuse fasciculations. Muscle biopsy was compatible with clinical diagnosis of motor neuron disease. The patient died from opportunistic infections related to acquired immunodeficiency syndrome. Autopsy revealed evidence of myelopathy, patchy fiber loss from anterior nerve roots, marked demyelination within intramuscular twigs of peripheral nerves, and primary myopathic features superimposed on advanced neurogenic atrophy of the skeletal muscles.

Adult↗
PubMed1990

Headache. Public health problem.

Headache is, and apparently always has been, a frequent pain syndrome. It is reported in American and Western European societies in very high percentages of the population. Headache, and specifically severe headache, have also been reported as prevalent from a variety of societies worldwide, although prevalence rates have varied (they are very low, for example, in the People's Republic of China). Whether prevalence varies with different socioeconomic groups remains uncertain. Severe headache and specifically migraine is, for reasons still unknown, much more common in women, and, in most studies, is reported to decrease in prevalence in older age groups. Positive family histories are common, but the precise role of genetics is unknown. A major problem in the epidemiologic studies remains the difficulty of uniform definition of headache syndromes.

Cross-Cultural Comparison↗
PubMed1989

Clinical and electrophysiological responses to dietary challenge in migraineurs.

Thirty eight patients with a history of diet-induced migraine were studied with recording of clinical responses, electroencephalography in resting state, in response to photic stimulation, and to hyperventilation and visual evoked potentials. Tests were carried out on an initial baseline day and on a second day, after challenge with chocolate, red wine, cheese, and fasting. Lateralized headache occurred in sixteen subjects (42%), four with scintillating scotomata. Electroencephalograms were abnormal on Day 1 and/or Day 2 in twelve subjects (32%), most abnormalities being non-specific slow waves. In three cases there were paroxysmal features. Electroencephalographic response to hyperventilation was calibrated and was found to be exaggerated in eight subjects (21%) on either Day 1 or Day 2; such response was not related to the occurrence of a headache. Photic simulation showed high frequency driving response (so called "H" response) in all 16 individuals who developed headache but in only 14 out of 22 (64%) who did not (p less than 0.01). Pattern reversal visual evoked responses were normal and failed to show any difference in latency or amplitude between headache responders and non-responders.

Adolescent↗
PubMed1988

Patients' perspectives of the role of care providers in amyotrophic lateral sclerosis.

Interviews with 41 patients with amyotrophic lateral sclerosis regarding their perspectives of the roles of doctor, nurse, and allied health personnel showed that emotional support, information, and access to assistive devices were the primary expectations that they held for each of these professional roles. In addition, physicians were expected to evaluate the progress of the disease, help with immediate problems, and continue research to find a cure. Patients wanted to see a physician at each clinic visit. In being given the diagnosis of amyotrophic lateral sclerosis, patients expected the physician to be straightforward, honest but not premature, sensitive to patients' readiness for information, and to convey some degree of hope. Patients were accurate in their knowledge of the disease, but came to the clinic expecting help in managing the illness.

Allied Health Personnel↗
PubMed1987

Migraine prophylaxis. A comparison of propranolol and amitriptyline.

The comparative efficacy of propranolol and amitriptyline in the prophylaxis of migraine headache was studied in 30 patients in a double-blind, placebo-controlled, crossover design. Headache response to medication was measured monthly by compilation of headache scores derived from quantitative data recorded by patients in a daily diary; at each visit, Zung and Hamilton tests for depression and the Spielberger state test for anxiety were performed. In the absence of clinical toxicity at monthly visits, the decision to maintain the current dose or raise it was made by a computer, which compared current headache score with that of the previous month. Both drugs were superior to placebo. Neither drug was superior to the other. The effectiveness of neither drug correlated with a decrease in anxiety or depression demonstrated by psychological testing.

Adult↗
PubMed1986

A prevalence survey of 'incapacitating headache' in the People's Republic of China.

Two Chinese populations over age 15 were surveyed as to the point prevalence of "incapacitating" headaches in an urban population of 1,525 persons and a rural one of 1,203. Personal interviews were carried out by a team of instructed interviewers; there was 100% cooperation. In both populations, prevalence in women was twice that in men except in the urban population in the youngest age group. Prevalence in the urban was almost exactly twice that of the rural population, with the highest figure occurring in traders.

Adolescent↗
PubMed1985

Naproxen in prophylaxis of migraine.

Naproxen sodium is an inhibitor of platelet aggregation and prostaglandin synthesis and is also a potent anti-inflammatory agent. Because of these properties, it was evaluated in prophylaxis of migraine by a double-blind, placebo-controlled crossover study in 34 patients. Drug "preference" and therapeutic effect were rated by both patient and investigator. Overall, both preferred drug over placebo. An index of migraine activity was calculated from a daily record kept by the patient; it demonstrated a significant reduction in headache severity, duration, disability, and medication needed. Adverse effects were minimal and similar in drug and placebo. Naproxen is a promising agent in the prophylaxis of migraine.

Adult↗
PubMed1985

Trismus. An unusual sign in polymyositis.

Neuromuscular disease is an unusual cause of trismus. However, we describe two patients with severe polymyositis who had difficulty opening their mouths during the acute phase of the illness. Electromyography demonstrated involvement of the masseters, and there was no evidence of myasthenia. The mechanism appeared to be decreased elasticity of the masseter because of inflammation, edema, and perhaps contractures.

Adult↗
PubMed1985

Treatment of central nervous system sarcoidosis with radiotherapy.

This report documents the twelve-year follow-up of a patient with neurosarcoidosis with multiple progressive central nervous system manifestations. Increased somnolence and seizure activity were associated with proliferation of nodular enhancing brain lesions, as seen on serial computed tomographic (CT) scans. Initially he responded to corticosteroid treatment, but gradually this response became unsatisfactory. After whole-brain irradiation with a total dose of 3,000 rads, his clinical symptoms improved with disappearance of the enhancing brain lesions seen on CT scan.

Adult↗