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At least 1,675 records · Page 93Linked to original sources
PubMed1999

Deficient activation of the motor cortical network in patients with writer's cramp.

OBJECTIVE: To study regional cerebral blood flow (rCBF) in patients with simple writer's cramp using PET to identify regions that malfunction. BACKGROUND: Several lines of evidence indicate impaired cortical function in patients with focal dystonia, but the precise pathophysiology is still unknown. METHODS: Seven patients with writer's cramp were compared with seven age- and sex-matched control subjects. Control subjects and patients were scanned during sustained contraction, tapping, and writing with the right hand. After realignment and stereotactic normalization of the scans, all tasks were compared with a rest condition. For each task, an intra- and intergroup comparison was performed using statistical parametric mapping. For each condition and within groups, rCBF correlation analysis was performed between some selected regions that were activated during movement. RESULTS: In control subjects and patients, significant increases of rCBF were observed for each task in areas already known to be activated in motor paradigms. The intergroup comparison disclosed less activation in writer's cramp patients for several areas for all three tasks. This decrease reached significance for the sensorimotor cortex during the sustained contraction task and for the premotor cortex during writing. rCBF correlation analysis showed different patterns between control subjects and patients. At rest and during writing, the correlations between the putamen and premotor cortical regions and between the premotor cortical regions themselves were stronger in control subjects. CONCLUSIONS: Deficient activation of premotor cortex and decreased correlation between premotor cortical regions and putamen suggest a dysfunction of the premotor cortical network in patients with writer's cramp possibly arising in the basal ganglia. The dysfunction is compatible with a loss of inhibition during the generation of motor commands, which in turn could be responsible for the dystonic movements.

Adult↗
PubMed1999

Metabolic abnormalities detected by 1H-MRS in dyscalculia and dysgraphia.

Proton MRS was performed in a patient with developmental acalculia. The results indicated a focal, wedge-shaped defect in the left temporoparietal brain region near the angular gyrus, with differential decreases in N-acetyl-aspartate, creatine, and choline. These results support the hypothesis that developmental acalculia, like acquired acalculia, is associated with left posterior hemisphere lesions.

Adolescent↗
PubMed2000

Functional outcomes after gamma knife thalamotomy for essential tremor and MS-related tremor.

Twelve patients with a median age of 75 years underwent gamma knife thalamotomy for essential tremor (ET) (n = 9) or MS-related tremor (n = 3). All 11 evaluable patients noted improvement in action tremor. Six of eight ET patients had complete tremor arrest, and the violent action tremor in all three patients with MS was improved. One patient developed transient arm weakness. Stereotactic radiosurgery for ET and MS-related tremor is safe and effective for patients who may be poor candidates for other procedures.

Activities of Daily Living↗
PubMed2005

Prospective audit of the quality of ENT emergency clinic notes before and after introduction of a computerized template.

This study evaluated the accuracy of notes in an ENT urgent referral clinic, based on a standard of note keeping established within the trust. The results initially failed to meet the set standard and a change of practice was initiated by introduction of a computerized template that allowed for easier and more accurate data entry. After re-evaluation, the notes were found to be accurate and to contain relevant demographic data in more than 90 per cent of cases.

Emergencies↗
PubMedDate not supplied

The basic principles which apply to the writing of prescriptions.

Case Scenario: A woman in a private hospital was prescribed a top-up epidural following a hysterectomy. The junior doctor mistook a dose of 3 ml of a diamorphine for 30 ml. The woman collapsed following its administration and the doctor was unable to use the resuscitation equipment as he had not had the necessary training. Although the consultant was able to revive her, she died a few days later (Kennedy, 2000). Who is liable?

Drug Prescriptions↗
PubMed2004

Cognitive strategy use in school-aged children with developmental coordination disorder.

Over the past decade, cognitive approaches with children with developmental coordination disorder (DCD) have been investigated. Although studies have focused on intervention outcomes, few have documented the components of the approach that support the enhancement of children's performance. This study used systematic observation of videotaped intervention sessions to identify the frequency and type of strategies that four children with DCD used during a cognitive intervention (CO-OP). The strategies used by younger and older children were compared, with differences found in verbal-based strategy use. Cognitive strategy use appears to be more related to the individual child and intervention goal than to age.

Age Factors↗
PubMed2004

Hand preference observed in large healthy samples: classification, norms and interpretations of increased non-right-handedness by the right shift theory.

Healthy children and undergraduates were observed for hand preference and measured for hand skill in representative samples collected over some years. Writing and throwing were observed for 2844 participants drawn from primary, secondary and higher levels of education. The 12 actions of a standard questionnaire were observed for 2388 secondary school children and undergraduates. These findings provide normative data for comparison with selected samples that may be classified in a variety of ways, including subgroups previously defined and ordered for relative hand skill. Differences between the sexes were found only for certain subgroups of right-mixed-handers. Undergraduates were less variable for hand skill asymmetry than schoolchildren. Interpretations in the light of the RS theory show why statistical effects for comparisons with selected groups are likely to be small. Increased non-right-handedness may be caused by several influences on cerebral dominance, natural and pathological.

Adolescent↗
PubMed2006

Transient functional suppression and facilitation of Japanese ideogram writing induced by repetitive transcranial magnetic stimulation of posterior inferior temporal cortex.

The Japanese writing system is unique in that it is composed of two different orthographies: kanji (morphograms) and kana (syllabograms). The retrieval of the visual orthographic representations of Japanese kanji is crucial to the process of writing in Japanese. We used low-frequency repetitive transcranial magnetic stimulation (rTMS) to clarify the functional relevance of the left and right posterior inferior temporal cortex (PITC) to this process in native Japanese speakers. The experimental paradigms included the mental recall of kanji, kana-to-kanji transcription, semantic judgment, oral reading, and copying of kana and kanji. The first two tasks require the visualization of the kanji image of the word. We applied 0.9 Hz rTMS (600 total pulses) over individually determined left or right PITC to suppress cortical activity and measured subsequent task performance. In the mental recall of kanji and kana-to-kanji transcription, rTMS over the left PITC prolonged reaction times (RTs), whereas rTMS over the right PITC reduced RTs. In the other tasks, which do not involve the mental visualization of kanji, rTMS over the left or right PITC had no effect on performance. These results suggest that the left PITC is crucial for the retrieval of the visual graphic representation of kanji. Furthermore, the right PITC may work to suppress the dominant left PITC in the neural network for kanji writing, which involves visual word recognition.

Adult↗
PubMed1997

Human monocytic ehrlichiosis in children.

BACKGROUND: Much of what is known about human monocytic ehrlichiosis (HME) is based upon studies with adult patients. PURPOSE: To review our experience with HME to better understand the epidemiology, clinical manifestations, and outcome of this disease in children. METHODS: Demographic, clinical, and laboratory data were gathered after review of the medical records of patients identified with HME. RESULTS: Twelve patients with an median age of 7.4 years (range, 7 months to 13.7 years) were identified with HME; 10 were white, 7 were male, and 10 were from hometowns of <800 people. Eight patients presented from May through July, and 8 had a history of tick bites. Symptoms demonstrated by the patients during their illness included fever (100%), rash (67%), myalgias (58%), and vomiting, diarrhea, and headache (25%). On presentation, patients demonstrated thrombocytopenia (92%), elevated liver function tests (91%), lymphopenia (75%), hyponatremia (67%), leukopenia (58%), and anemia (42%) on the initial laboratory examination. Four patients presented in shock and 3 required blood pressure support and mechanical ventilation for a median of 10 days (8 to 37 days). These complicated patients required longer hospitalization (19.5 days vs 5. 5 days) and attained higher blood urea nitrogen levels (42.5 mg/dL vs 10 mg/dL) than the patients not presenting with shock. Morbidity associated with HME patients included a decrease in cognitive and neurologic performance. CONCLUSIONS: More information and long-term follow-up is required to understand the full spectrum of disease and morbidity associated with HME in children.

Administration, Oral↗
PubMed2000

[Interictal personality syndrome in non-dominant temporal lobe epilepsy: case report].

The syndrome of interictal personality in non-dominant temporal lobe epilepsy consists of hyposexuality, hyperreligiosity, humorlessness and hypergraphia. Its notification, in 1974, was followed by an extensive search for these traits in broad epileptic populations. Nevertheless, these statistical studies failed to match this syndrome in general temporal lobe epileptics, and its existence became then target of doubt. We report the case of a 35 year-old man presenting partial complex epilepsy, whose singularity lies in his sophisticated drawing abilities. The large amount of buildings and houses he paints expresses his hypergraphia. He also presents hyposexuality and hyperreligiosity. MRI shows right mesial temporal sclerosis. Temporal hyperconnection, caused by a basal temporal irritative focus, is the most probable pathophysiological mechanism. Epileptic fits can be controlled in the majority of cases. However, behavioural symptoms usually do not respond to pharmacological approach or psychotherapy.

Adult↗
PubMed2004

An approach to offline handwritten Chinese character recognition based on segment evaluation of adaptive duration.

This paper presents a methodology for off-line handwritten Chinese character recognition based on mergence of consecutive segments of adaptive duration. The handwritten Chinese character string is partitioned into a sequence of consecutive segments, which are combined to implement dissimilarity evaluation within a sliding window whose durations are determined adaptively by the integration of shapes and context of evaluations. The average stroke width is estimated for the handwritten Chinese character string, and a set of candidate character segmentation boundaries is found by using the integration of pixel and stroke features. The final decisions on segmentation and recognition are made under minimal arithmetical mean dissimilarities. Experiments proved that the proposed approach of adaptive duration outperforms the method of fixed duration, and is very effective for the recognition of overlapped, broken, touched, loosely configured Chinese characters.

Algorithms↗
PubMedDate not supplied

Mail-order prescriptions requiring clarification contact with the prescriber: prevalence, reasons, and implications.

BACKGROUND: Prescription review by pharmacists prior to dispensing is an important step in an overall strategy for preventing medication errors. Contacts with prescribers may be required to clarify missing, unclear, or inconsistent information. While essential to reduce the likelihood of potential patient harm, clarification contacts are time-consuming for pharmacists and prescribers. The scope of the issue and the factors that contribute to it are not well understood. OBJECTIVE: To quantify the frequency of contacts with prescribers that were necessary to obtain clarification of prescriptions and to identify the factors that made these prescriber contacts necessary. METHODS: An analysis was conducted involving new prescriptions received by a national mail-order pharmacy that required clarification contacts with prescribers for quality reasons (i.e., those potentially impacting the accuracy of dispensing). Excluding refills and renewals, the percentage of new prescriptions requiring clarification contacts was calculated and categorized by incoming delivery channel (mail, fax, telephone, etc.). The quality problems that prompted these contacts were categorized according to the problem identified. RESULTS: Among the total of 295378 new prescription orders received during the 1-week study period (from April 7 to April 13, 2002), 8.7% contained quality problems that necessitated clarification contact with prescribers. Prescriptions received by fax transmission and mail were most likely to require clarification as compared with direct telephone conversation and miscellaneous (including electronic) channels. Among prescriptions that required a clarification contact for quality problems, an average of 2.4 problems per prescription was observed. The most common problems were: directions unclear or missing (24.3%); refill quantity unclear, missing, or incorrect (24.3%); dosage unclear (20.2%); drug name or strength unclear (13.2%); missing physician or patient data (11.4%); and missing prescriber signature (3.2%). CONCLUSION: Prescriber clarification contacts are frequently needed to reduce the potential for medication error in the current prescription fulfillment process. While these contacts are necessary to clarify data elements essential to accurate medication dispensing, they are time- and resource-intensive. These study results suggest that alternate prescription order channels, including electronic, could reduce the sizable burden of prescription order clarification in mail-order pharmacy.

Communication↗