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At least 685 records · Page 38Linked to original sources
PubMed1996

Motor control research in rehabilitation medicine.

Progress in rehabilitation medicine requires an understanding of the basic rules of motor coordination, as well as of the contribution of adaptive processes within the central nervous system to the patterns of impaired movements. We assume that patterns of voluntary movements reflect rules of coordination that are used by the intact central nervous system of healthy persons. In pathological conditions that may include cognitive, central neurological, and peripheral disorders, the central nervous system may reconsider these rules leading to different peripheral patterns of voluntary movements. In such conditions, changed motor patterns may be considered adaptive to a primary disorder. They may even be viewed as optimal for a given state of the system of movement production. We suggest that the emphasis of therapeutic approaches must be placed not on restoring the motor patterns to 'as close to normal as possible', but on assisting the central nervous system to develop optimal adaptive reactions to the original underlying problem.

Adaptation, Physiological↗
PubMed1980

Serologic cross-reactions with sera from patients with echinococcosis and cysticercosis.

Serum specimens from persons with pathologically confirmed Echinococcus granulosus hydatidosis and Taenia solium cysticercosis were tested in indirect hemagglutination tests using both Echinococcus and Taenia antigens. There were cross-reactions with most sera, and it was not possible to distinguish specific reactions by comparing titers with the homologous or heterologous antigens. Using immunoelectrophoresis or double diffusion tests with E. granulosus antigens, the Echinococcus-specific arc 5 was demonstrated in 11 of 21 hydatidosis sera and in 1 of 20 cysticercosis sera.

Adolescent↗
PubMed1976

[Our experience in the surgery of bile ducts].

After a brief review of modern techniques for correct diagnosis and therapy of bile duct pathology, a personal series of 955 operations (between 1-XI-1972 and 30-X-1975) is presented. The need for routine peroperative control of VBP and the usefulness of respecting the papilla where it is anatomo-functionally undamaged are stressed. Personal experience shows that the most rational methodology is after papillotomy the application of a prepapillary Kehr incision through a choledochotomy because this presents fewer complications than the transpapillary Kehr incision in calculosis or stenosis of the VBP where bile duct suture is not advisable. With regard to bilio-digestive anastomosis, indications and limitations are discussed and it is suggested that where the patient's general and local states permit, choledochojejunal anastomosis should permit, choledochojejunal anastomosis should be used, with choledocho-duodenostomy only in special cases. Cholecysto-gastro and cholecystoduodenostomy should be reserved for patients in very serious conditions.

Bile Ducts↗
PubMed1998

[Surgical treatment of parathyroid hyperplasia].

BACKGROUND: To review a series of 11 patients affected by hyperplasia of parathyroid glands and to discuss diagnostic and therapeutic tools. METHODS: A series of 11 patients out of 44 (= 25%) with primary hyperparathyroidism has been retrospectively reviewed. They underwent surgery in I surgical Department of OORR of Bergamo. All 11 patients were submitted to ultrasound and computed tomography examination before surgery, without any localisation of hyperplastic or adenomatous tissue. An exploring cervicotomy was performed with subtotal parathyroidectomy after the anatomopathological result of hyperplasia. RESULTS: No adverse effects related to surgery were observed. All patients could be considered as cured with a median follow-up of 36 months. CONCLUSIONS: Among hyperparathyroidism, hyperplasia is an underhand form and even if the laboratory diagnosis is simple, the imaging techniques cannot always localise the pathologic tissue. Personal experience shows the role of subtotal parathyroidectomy (removal of 3 parathyroid glands and a half of the last one) confirmed by the absence of adverse effects or relapse with a median follow-up of 36 months.

Adult↗
PubMed1999

Computer-based teaching of pathology at the Zagreb University School of Medicine.

AIM: To review the experience gained in transferring USA computer-based teaching system of medical school pathology to Croatia. METHODS: Computer-based teaching program of pathology developed at the University of Kansas School of Medicine, Kansas City, Kansas, USA, was transferred to the University of Zagreb School of Medicine, Zagreb, Croatia. The experimental group of 49 students was enrolled into this computer-based program. Their performance was compared with that of 195 classmates enrolled in the standard course. Objective (performance on the examinations) and subjective data (students' interviews and written evaluations of the course) were analyzed. RESULTS: The computer program was operational 5 months from the inception of the transfer. It was well received by the students, even though many initially complained that it required more effort and a continuous commitment. The major problems concerned scheduling, reflecting various requirements i mposed on students by other departments teaching in parallel with the Pathology course. Objective data gathered so far indicate that the students enrolled in the computer-based program took the first midterm examination at a significantly higher rate than the rest of the class (p<0.001), and passed the examination with significantly better grades (p<0.001). CONCLUSION: Computer-based teaching programs can be readily transferred to other countries. Full implementation of the program, however, may require significant changes in the existing curriculum in the medical school to which such a program has been transferred or considerable modifications in the program adopted for transfer. It appears that the students enrolled in the computer-based program perform better than students in the standard pathology course.

Attitude↗
PubMed1999

[Diagnosis and treatment of acute pulmonary embolism].

Acute lung embolism is an uncommon but recognised complication of deep venous thrombosis. The parameters RTG, ECG, PaO2, PaCO2, LDH, CPK, SGOT, SGPT and pulmonary ventilation/perfusion scan have been examined in 200 patients with pulmonary thromboembolism. For that purpose discrimination values of synopticly relevant RTG findings, arterial blood gas and enzymes analysis results and pulmonary ventilation/perfusion scintigraphy, were observed in a comparative analysis of numerous data that could be integrated as an unique finding in sense of qualitative diagnosis. The most frequent symptom was dyspnea and tachypnea, often accompanied with other symptoms (84%), chest pain (65%), cough (53%), tachycardia (41%), hemoptysis (26%). In 74% of patients pulmonary thromboembolism the significant simultaneous increase of all the mentioned enzymes, except CPK, was found 75%. However, according to the results in 58% of the examined persons the pathologic changes on RTG (infiltrates of the lung, with or without affection of the pleura and changed position of diaphragma) were found, and 71% on ECG. Pulmonary ventilation/perfusion scintigraphy is the precise examination for acute lung embolia. For the routine clinical examination measurement of PaO2, PaCO2, LDH, ECG, x-rays is sufficient (correlation test + 0.56). In this paper we have presented our own diagnostic-therapeutic protocol in of lung emboly.

Acute Disease↗
PubMedDate not supplied

[In vitro oxidation of low density lipoproteins in patients after ischemic stroke].

The aim of this work was the evaluation of low density lipoprotein (LDL) susceptibility to oxidation in the survivors of ischaemic stroke. The investigations were performed in 65 individuals at least three months after the onset of acute symptoms. In 24 patients stroke was caused by alterations in main cerebral arteries, in 19 by considerable narrowing of carotid artery, in 15 by alterations in small cerebral arteries with often accompanying hypertension and/or diabetes (lacunar stroke) and in 7 by embolism of cardiac origin in individuals with cardiac arrhythmia and coronary artery disease. The control group comprised 25 age matched persons without pathological symptoms. Plasma lipids and apolipoprotein B levels were determined as well as two antioxidants: alpha-tocopherol level and superoxide dismutase activity. The evaluation of lipid peroxidation was performed by determining thiobarbituric acid reacting substances (TBARS) and lipid peroxides (LPO) increase after 5 hours oxidation of isolated LDL in vitro in the presence of copper ions. The level of IgG directed against modified LDL was also evaluated. In the patients decreased HDL cholesterol level was observed as well as increased apolipoprotein B. In the group of thrombotic strokes high triglycerides were observed. alpha-tocopherol level was decreased in the group of cerebral strokes. The amounts of oxidation products did not differ between the whole group of patients after stroke and the controls. A significant increase concerned only the group of lacunar strokes. The evaluation of LDL susceptibility to oxidation in patients after stroke by measuring absorption at 234 nm and determining the time period necessary to the onset of intensive LDL oxidation will be the subject of a separate publication.

Acute Disease↗
PubMed2001

[Psychological aspects of contrast obsessions].

The paper presents a clinical-psychological examination of 40 patients with contrast obsessions of homicidal- and suicidal-phobic contents. The cohort of patients was divided into two groups by the prevalence of the possibility to commit either autodestructive and criminal actions (group 1-24 patients) or violence and murder (group 2-16 patients) in clinical picture of contrast phobias with anxious apprehension. It was found that in patients of group 1 pathology of personality presented with disorders of the hysteric-hyperthymic sphere together with features of overanxiety, while in patients of group 2--with disorders of the anancastic-schizoid sphere. Differences between the groups in terms of the objective direction of anxiety were associated with peculiarities of the structure of the personality: in group 1 the choice of the object of anxiety from the individuals of the nearest surrounding or the very patient himself, was determined by diffusion or widening of Ego boundaries and identification of patients with their microsocial environment; in group 2 the choice of such object of the "accidental other" was determined by the fixing, narrowing of Ego boundaries and by separation from the microsocial environment. Chronological direction of the anxiety in group 1 was conditioned by the peculiarities of the imagination function: hypertrophy of fantasy, abundance of the means of the symbolization of intrapsychic experience and emotional style of thinking determined an anticipatory anxiety; while an insufficiency of fantasy, alexythymia and the operational style of thinking in group 2 determined a retrospective anxiety.

Adolescent↗
PubMed2002

The role of hysteroscopy in early diagnosis of endometrial cancer.

The aim of this retrospective study was to compare stage, disease-free survival and overall survival in patients suffering from endometrial cancer who underwent hysteroscopy and those who did not. Between January 1, 1990 and June 30, 2001, 181 patients were referred to our Gynaecologic Department for primary endometrial carcinoma; from clinical charts we reviewed the personal and pathological data of all patients. Patients were divided into two groups: those with hysteroscopy (69 patients) and those without (112 patients). Endometrial biopsy was performed at the end of hysteroscopy. We compared symptoms at diagnosis, stage and survival. Hysteroscopy demonstrates a high diagnostic accuracy for endometrial cancer. In our case series we obtained a sensitivity of 93.10%, specificity of 99.96%, positive predictive value of 98.18% and negative predictive value of 99.85%; when hysteroscopy was associated with endometrial biopsy the sensitivity was 96.55% and specificity 100%. In this study we had a significant difference in stage Ia; in the group with hysteroscopy, stage Ia cases were 23.2% while in the group without, stage Ia cases were 15.2%. Survival in stage Ia only was 100% and 91.7%, respectively, at three and five years. In conclusion hysteroscopy was found to have a very important role in the early diagnosis of endometrial cancer, especially when it is limited to the mucosal surface.

Adult↗
PubMedDate not supplied

[Occupational stress--risk factor in essential arterial hypertension].

The stress was recorded taking into consideration the epidemiological interview, using a standard methodology by filling in the type card the occupational stress (OS) and the family stress (FS). The constitutional factors (behaviour type A, body weight index > 25 Kg/m2) as well as the consumption in excess of salt, have significantly correlated themselves, both in individuals with OS and FS, and in those with the exclusively OS. The modification of biochemical constants (total cholesterol, triglycerides, total lipids, HDL-cholesterol, LDL-cholesterol) significantly associate themselves in persons to which the presence of OS and FS, of the occupational one, respectively was put into evidence (chi 2 = 94.10 for 5 freedom degrees and p < 0.001, chi 2 = 118.94 and p < 0.001, respectively). The prevalence of persons with pathologic values of total lipids was 58.7%, of triglycerides 35.7%, of total cholesterol 12.7%, of LDL cholesterol 27%, and of HDL-cholesterol 44.4%. Measuring the values of systolic and diastolic arterial hypertension an increase above the normal values of limit systolic arterial hypertension at 23.8% and at 12.3% for illness systolic arterial hypertension was found. The evaluation of association of certain cardiovascular risking factors in individuals with occupational stress has permitted a global understanding, useful for the elaboration of some preventive programmes.

Alcohol Drinking↗
PubMed2003

Molecular genetics of Alzheimer's disease: presenilin 1 gene analysis in a cohort of patients from the Poznań region.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by memory loss and personality changes. Pathological hallmarks of AD are: deposition of amyloid plaques and neurofibrillary tangles in the brain, accompanied by neuronal and synaptic loss. The genetic background of AD is heterogeneous and strongly depends on the form of the disease. In most of the families with early-onset AD (EOAD) (10% of the total population of patients), the disease segregates as an autosomal dominant fully penetrant trait. To date, some missense mutations in three genes encoding the amyloid precursor protein, presenilin 1 (PS1) and 2 (PS2) have been found to cause familial EOAD. We screened for mutations in the presenilin genes in a sample of 55 patients with familial or sporadic form of EOAD from the Poznan region. We found 4 missense mutations in the PS1 gene: A246E in exon 7, P267L in exon 8, E318G in exon 9, and L424R in exon 12 among 5 unrelated patients. The frequency of PS1 mutations was 11% (5 of 55) in the whole sample of the patients with EOAD or 50% (3 of 6) if the analysis was restricted to familial cases with a positive history of dementia in the patient's family.

Adult↗