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At least 307 records · Page 17Linked to original sources
PubMed1998

Sleep dysfunction in Parkinson's disease.

The frequency of sleep complaints in patients with Parkinson's disease (PD) is estimated to be between 60-90% and a variety of either disease-related or secondary mechanisms and the dopaminergic treatment itself contributes to the development of different sleep disturbances. These comprise slight, fragmented sleep with increased number of arousals and awakenings, and PD-specific motor phenomena such as nocturnal immobility, rest tremor, eye-blinking, dyskinesias, and other phenomena such as periodic and nonperiodic limb movements in sleep, restless legs syndrome, fragmentary myoclonus, and respiratory dysfunction in sleep. Depression and hallucinations/psychosis further complicate the picture. The incidence of REM sleep behavior disorder (RBD) with nightmares and violent behavior is increased in PD and may occur as a preclinical disease-related symptom. A careful sleep history of patients and their partners, polysomnograms when necessary, motor and psychiatric assessments should precede individual treatment strategies, which include adjusting dopaminergic daytime treatment, benzodiazepines for RBD, reduction of anticholinergic drugs, and, if necessary, clozapine for nocturnal psychosis.

Depression↗
PubMed2001

[The influence of perftoran on the course of acute pulmonary injury syndrome in patients with destructive pancreatitis].

The respiration disorders are revealed in patients with an acute destructive pancreatitis in early and late terms of the disease. Occurrence of an acute pulmonary injury syndrome (APIS) worsens the disease prognosis, enhances mortality. In complex of intensive therapy the perftoran (Russia) infusion in 5 ml/kg of body mass dose are applied in 10 patients with destructive pancreatitis. Main indexes of the blood gases composition and of hemodynamics were controlled. It was established that application of perftoran detains the APIS occurrence in the patients with severe pancreatitis, averts the polyorgan insufficiency occurrence, promotes the various kinds of hypoxia correction, stimulates cardiac activity, raises the blood oxygen capacity, improves microcirculation. Application of perftoran was substantiated in complex of treatment of patients with an acute destructive pancreatitis for prophylaxis of occurrence and for elimination of APIS.

Adult↗
PubMed2001

Awake craniotomy.

Explore the source record for details and available documents.

Brain Mapping↗
PubMed2002

[New trends in mechanical ventilation].

Many ventilatory techniques are employed on the Neonatal Intensive Care Unit, but there is limited evidence supporting the use, in particular of the more recently introduced modes. Randomized trials have demonstrated that high frequency positive pressure ventilation reduced airleaks and patient triggered ventilation was associated with a shorter duration of ventilation. "Rescue" high frequency oscillation was suggested to reduce airleaks and prophylactic high frequency oscillation decrease chronic lung disease, but possibly at the expense of increased intracerebral pathology. Results from anecdotal series suggest that nasal continuous positive airways pressure, volume guarantee and pressure support ventilation have advantages, but the techniques have not been subjected to rigorous testing in large randomized trials. Neonatologists must not be seduced by promising preliminary results. Ventilatory strategies should only be introduced into routine clinical practice if proven efficacious and without long term adverse effects in appropriately sized studies.

Humans↗
PubMed2002

[Assessment of quality of life for home ventilated patients with Duchenne muscular dystrophy].

A social and psychological survey was conducted for patients with DMD submitted to home mechanical ventilation for more than one year. Thirty six were tracheostomized and 16 were using non invasive ventilation. Fifty two patients were recruited: 36 were tracheostomized and 16 were using non invasive ventilation. Mean age was 25 +/- 5 years. In the two groups: 1- the main disagreement was air leaking and cutaneous erosions. 2- when present, headache, dyspnea, sleep troubles and general fatigue were improved by mechanical ventilation. 3- ventilation was considered as improving health but with an increasing of dependencies. 4- Majors disappointment are sexual life (70 percent) and physical status (40 percent) but patients spent more than half time with positive feeling (92 percent). There was no difference between satisfaction evaluation and type of ventilation. Home ventilated patients with DMD have positive assessment of satisfaction. Despite technical disagreement as air leaking, patients feel an improvement of their life and advise other DMD to use early home ventilation.

Adult↗
PubMed2002

[Sleep apnea syndrome and obesity].

Obesity is a main risk factor for sleep apnea syndrome (SAS). The prevalence of SAS is especially high in massive obesity and in visceral obesity. The mechanisms of obstructive apneas in obesity are poorly known, but an increase in upper airway collapsibility probably plays an important role. Several cardiorespiratory complications of SAS, especially systemic arterial hypertension, diurnal alveolar hypoventilation and pulmonary arterial hypertension, are more frequent and more severe in obese patients. An important weight loss resulting from surgical treatment of obesity is often associated with a dramatic decrease in apnea-hypopnea index in patients with massive obesity. In patients with moderate obesity, dietary weight loss is associated with varying degrees of improvement in SAS. Pharyngoplasty and anterior mandibular positioning devices have a low success rate in patients with massive obesity. Nasal continuous positive airway pressure is often the only effective treatment in obese SAS patients.

Heart Diseases↗
PubMed2002

Examining costs of chronic conditions in a Medicaid population.

PURPOSE: To compare health care costs and their components in patients with chronic illnesses. DESIGN: Quasi-experimental retrospective database analysis of an integrated state-Medicaid dataset. METHODS: Nine chronic illnesses and 28 two-disease combinations were evaluated in 284,060 patients. Dependent variables were total cost and the component costs (hospital, physician, home health and medical supplies, and pharmacy). Statistical analysis included analysis of variance (ANOVA) and multiple analysis of variance (MANOVA). RESULTS: The nine chronic illnesses studied were: psychosis, depression, cardiovascular illness, congestive heart failure, diabetes, acid peptic illness, respiratory illness/asthma, hypertension, and anxiety. Psychosis and depression patients had the highest mean yearly costs at $6,964 and $5,505, respectively. Highest component costs were mental health practitioners for psychosis and hospital costs for depression. All other conditions had significantly lower yearly costs. Component costs consisted primarily of pharmacy and hospital costs. Psychosis was a component in 5 of the 7 most costly chronic-disease concurrences. The highest disease-concurrence mean cost was for psychosis and depression ($18,318). CONCLUSIONS: The unique resource needs of different chronic illnesses should be considered in benchmarking and evaluating chronic-disease management programs.

Analysis of Variance↗
PubMed2003

Changes in respiratory condition after thymectomy for patients with myasthenia gravis.

BACKGROUND: Anesthesia without muscle relaxants has been reported to be effective for early extubation after thymectomy, but postoperative respiratory status of the patients has not been studied intensively. METHODS: Fifty-two consecutive patients undergoing thymectomies for myasthenia gravis (MG) were evaluated. RESULTS: Forty-two (81%) of the 52 patients were extubated in the operating room, and 49 (94%) patients were extubated within 24 hours. However, 6 (12%) patients required subsequent reintubation for respiratory support. There was a sudden increase in the respiratory rate (RR) and PaCO(2). The mean value of the increase in PaCO(2) at the time of reintubation was 23 mmHg (12-58 mmHg). The mean value of the increase in RR above the preoperative level at the time of reintubation was 16/min (7-30/min). In univariate analysis, vital capacity (VC), %VC, the preoperative pyridostigmine dose and the duration of surgery correlated with reintubation, but with multivariate analyses, the pyridostigmine dose was the only significant factor related to reintubation. CONCLUSION: The patients who received at least or more than 240 mg of pyridostigmine should be monitored carefully after tracheal extubation.

Adolescent↗
PubMed2003

[Neurophysiology of parkinsonian syndromes].

Neurophysiological investigations may contribute to establish the diagnosis of different parkinsonian syndromes such as multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration, which are often suspected in case of atypical parkinsonian syndrome. They provide a means of objective analysis of certain symptoms (myoclonus for example) and identify the pathophysiological processes underlying these parkinsonian syndromes. This article reviews especially the following electrophysiological tests: autonomic nervous system analysis (sympathetic sudomotor skin response, R-R interval variation, electromyography of the external anal sphincter), surface electromyography and movement recording to investigate myoclonus, somatosensory and motor evoked potentials, brainstem reflexes (mainly the blink reflex), startle reaction, monosynaptic and long latency reflexes and finally the premotor potentials (contingent negative variation, Bereitschaftspotential) and movement-related desynchronization).

Anal Canal↗
PubMed1957

Intermittent positive pressure breathing: a clinical evaluation of its use in certain respiratory diseases.

A series of patients with chronic respiratory insufficiency were treated with intermittent positive pressure breathing, which was combined with administration of bronchodilator drugs of the epinephrine series. Spirographs were made before and after treatment. The series included patients with chronic bronchitis and emphysema, fibrosis of various kinds, senile emphysema and bronchogenic carcinoma. Although the majority showed objective improvement, a significant proportion in all groups did not, and some were made worse, apparently on a basis of check valve mechanisms unresolved by the bronchodilator drug. In cases in which the method benefited the patient, the benefit was greater than that obtained with bronchodilator drugs alone.

Bronchodilator Agents↗