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At least 865 records · Page 48Linked to original sources

[The dorso-mesencephalic syndrome. Electrooculographic study of 2 clinical cases].

Electro-oculographic recordings of horizontal eye movements in two patients with dorso-mesencephalic lesions are analysed. Tracings shows essentially: (A) dysconjugate glissadic dysmetria, with adduction overshoot and abduction undershoot, and (B) instability of ocular fixation. Fixation instability consists of bursts of 2 or 3 bilateral to-and-fro eye movements, of 4 degree or less amplitude. During a burst there is no evident latency between successive ocular movements. Bursts often appear following horizontal refixation saccades, and are then repeated once or twice with regular intervals. In one patient, fixation instability phases are more often elicited by saccades to the right than to the left. The typical occurrence of fixation instability after the fast phase of optokinetic nystagmus is described. The alteration of ocular fixation described in our patients belongs to the general group of "saccadic intrusions" as defined by Daroff et al. (1977). Resemblance with "lightning eye movements" (Atkin and Bender, 1964) and "opposed adducting saccades" in the Sylvian aqueduct syndrome (Ochs et al., 1979) is discussed.

Adolescent↗

BSER abnormalities in a multiple sclerosis patient with normal peripheral hearing acuity.

The measurement of brain stem evoked potentials has proven clinically useful in determining the presence of multiple sclerosis plaques along the auditory areas of the brain stem. Abnormalities in brain stem evoked responses (BSER) have been identified in patients who manifest normal hearing acuity when evaluated via conventional audiometric techniques. The following case presentation illustrates this confounding clinical finding. The patient was a 20-year-old female who had been previously diagnosed as having multiple sclerosis. Within one month after being evaluated by BSER testing, she was struck and killed by lightning. Although she had a detailed history of normal hearing acuity (documented over the last six years), BSER test results yielded significantly abnormal neural conduction times when the left ear was ipsilaterally stimulated. A histopathologic examination of the patient's brain stem verified involvement of the auditory tracts. Thus physical corroboration of the abnormal BSER results was obtained in the presence of normal hearing acuity.

Adult↗

[Pain in humans: experimental facts and hypotheses].

The description of painful phenomena in humans has to take into account its different components: sensory component (relevant to nociception), affective and emotional components. Nociceptor's (physiology is best understood with electrophysiological and neurochemical methods allowing a clear description of hyperalgesia, with its peripheral and spinal mechanisms. A functional model is partly available to explain allodynia, spontaneous burning pain and lightning pain, the three main consequences following deafferentation. At the thalamo-cortical level, one can describe nociceptive pathways and other pathways or neuronal networks involved in the affective and emotional components of pain.

Humans↗

[Insurance medicine in routine forensic medicine].

When the forensic doctor is confronted with a query coming from the insurance medicine, he will perhaps realize, that he has suddenly reached the boundaries of his knowledge. Statutory regulations are partly not yet available and partly contested. This accounts for the fact, that sometimes ten or more expert opinions are formulated for one and the same litigation. In the present paper some themes are randomly selected and reviewed in accordance with scientific findings. Investigated with references pertaining to current points at issues, are the following controversial subjects: a) Victim compensation law b) Nursing insurance law c) Transplantation law d) Acceleration trauma e) Lightning casualties f) Heroin (drug criminality) g) Age determination h) Insurance fraud The practice shows, that the physician's need to search for causality is restricted by juridical thought, be it by legal enactments or by the superior courts' guiding principles.

Disability Evaluation↗

[Clinical variants in the course of a postoperative bleeding stress ulcer].

The results of treatment of 13,246 patients with acute surgical disease of the abdominal organs have been analysed. In 48 patients, bleeding from a stress ulcer occurred. The symptoms of bleeding were studied. The variants of the clinical course of postoperative acute erosion and ulcer, such as the lightning-like, double-phase, single-phase ones, have been distinguished. Their predictive value is shown. In 89.6% of the patients, a postoperative stress ulcer developed in diseases of the hepatopancreatobiliary zone organs.

Acute Disease↗

Effects of a natural marsh fire on larval populations of Culex Salinarius in east Texas.

A natural marsh fire caused by lightning suppressed Culex salinarius larval populations for 2 months following the fire. Removal of emergent vegetation and higher water temperatures rendered burned-area pools unsuitable either for larval development or deposition of eggs or both. With a drop in seasonal ambient temperature and a regrowth of emergent vegetation, the burned areas returned to being suitable larval development sites for Culex salinarius. no differences in water salinity or pH were observed between burned and unburned locations.

Animals↗

[Trigeminal neuralgia and other facial pain--diagnosis and therapy].

The hallmark of trigeminal neuralgia is the abrupt onset of short pains in the face or in a part of the face, described as stabbing, lightning or electric shocks. Attacks are often triggered by cutaneous stimuli to the face or the oral cavity, which may be such minor activities as talking, chewing, brushing the teeth, or even wind blowing on the face. As a result, facial hygiene as well as a good diet may be neglected. Although 1% of the patients may eventually develop the disorder bilaterally, pain does not cross the midline during any single episode. The clinical course is characterized by exacerbations and remissions, but as the disorder progresses, remissions become shorter and exacerbations more severe. Carbamazepine is the most powerful drug for this condition, but side effects may occur. Neurosurgical treatment may then be considered; the different techniques and approaches are mentioned. Other pain conditions in the face will be reviewed. If the trigeminal neuralgia may be considered as a nerve irritation, like the glossopharyngeal neuralgia and the nasociliary neuralgia, nerve lesion may elicit neurogenic or neuropathic pain, characterized by chronic burning pain; post-zoster pain, iatrogenic and posttraumatic pain illustrate this condition. Cluster headache (Horton neuralgia), Sluder's neuralgia and auriculotemporal neuralgia may be related to a dysfunction of the autonomous nervous system. Finally, lesion in the mandibular joint may cause unilateral facial pain.

Analgesics, Non-Narcotic↗

The mortality rate with ECT.

ECT is a low-risk procedure, even in the older cardiac patient who is fast becoming the modal candidate for this therapy. To put the mortal risk with ECT in proper perspective, it is only necessary to note that ECT is about 10 times safer than childbirth, that approximately 6 times as many deaths annually in the U.S. are caused by lightning as by ECT, that two complications of psychotropic drug therapy in younger women-fatal myocardial infarction and fatal subarachnoid hemorrhage-virtually never occur with ECT, and that the death rate reported for ECT is an order of magnitude smaller than the spontaneous death rate in the general population.

Adult↗

Acute asthma epidemics, weather and pollen in England, 1987-1994.

Recent epidemics of acute asthma have caused speculation that, if their causes were known, early warnings might be feasible. In particular, some epidemics seemed to be associated with thunderstorms. We wondered what risk factors predicting epidemics could be identified. Daily asthma admissions counts during 1987-1994, for two age groups (0-14 yrs and > or = 15 yrs), were measured using the Hospital Episodes System (HES). Epidemics were defined as combinations of date, age group and English Regional Health Authority (RHA) with exceptionally high asthma admission counts compared to the predictions of a log-linear autoregression model. They were compared with control days 1 week before and afterwards, regarding seven meteorological variables and 5 day average pollen counts for four species. Fifty six asthma epidemics were identified. The mean density of sferics (lightning flashes), temperature and rainfall on epidemic days were greater than those on control days. High sferics densities were overrepresented in epidemics. Simultaneously high sferics and grass pollen further increased the probability of an epidemic, but only to 15% (95% confidence interval 2-45%). Two thirds of epidemics were not preceded by thunderstorms. Thunderstorms and high grass pollen levels precede asthma epidemics more often than expected by chance. However, most epidemics are not associated with thunderstorms or unusual weather conditions, and most thunderstorms, even following high grass pollen levels, do not precede epidemics. An early warning system based on the indicators examined here would, therefore, detect few epidemics and generate an unacceptably high rate of false alarms.

Adolescent↗

Furious passion confronts the cool logic behind a CEO's hospital appointment.

First, Ontario decided it would close or reduce the operations of 3 Ottawa hospitals and combine 2 others. When the board for the combined hospital named a Parti Québécois confidant the new hospital's CEO, it hoped David Levine's background would go unnoticed. As Charlotte Gray reports, it didn't, and Levine became the lightning rod for a lot of anger.

Anger↗

Electrical burns.

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Burns, Electric↗