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Biomedical subjects

A Alba

Publications and source records attributed to A Alba.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Role of x-ray computed tomography in the preoperative evaluation of aneurysm of the abdominal aorta].

The authors have studied the files of 50 consecutive patients (1987-89) operated for abdominal aortic aneurysm (AAA) and examined with CT. The criteria for inclusion were surgical features. CT can be made more accurate for the study of AAA: Thus the location of the neck of the aneurysm relative to the renal arteries was defined in 94% of all cases. In addition, CT yields information about the wall of the aneurysm, whether it be thickened (3 inflammatory aneurysms were properly diagnosed) or, mor importantly, weakened (solution of continuity in the wall in the "prior-to-rupture" appearance). Owing to the quality of its performances and to its noninvasive character, the authors regard CT with contrast injection as an essential technique for the preoperative assessment of abdominal aortic aneurysm in most cases. The examination must be carried out strictly, especially for the contiguous sections of the renal arteries and their extension to the crural arch. As it demonstrates weakened areas more easily, a more accurate study of the aneurysmal wall with CT might increase the surgical indications for some smaller aneurysms, the potential evolution of which does not seem to be associated with their diameter only.

Aged↗
PubMed1989

Pneumobelt for sleep in the ventilator user: clinical experience.

A pneumobelt with a positive pressure respirator was used for sleep for three patients with chronic respiratory insufficiency secondary to syringomyelia, poliomyelitis, and Friedreich's ataxia respectively. This device was found to be effective in improving and maintaining their daily functioning in the community or institute.

Chronic Disease↗
PubMed1987

A matching-to-sample feedback technique for training self-control of tinnitus.

Thirty individuals with subjective tinnitus aurium of a variety of types and severity were treated with a matching-to-sample feedback procedure. Following initial evaluation measures, the participants' experienced tinnitus sounds were reproduced audiometrically on all characteristics and were presented to them in the noninvolved ear or in both ears when the tinnitus was binaural. This experimental sound was then reduced in 5 decibel (dB) steps within sessions, and participants had the task of concentrating on reducing the loudness of their tinnitus until a match was achieved between it and the experimental sound at each new dB level. Results showed an overall highly significant difference in dB levels from baseline to final training session. Nearly all participants demonstrated a marked reduction in tinnitus loudness, with 84% reducing it by 10 dB to 62 dB and several eliminating it completely. Individual and pathological variables played no role in training or outcome. Our approach appears to have major advantages over other tinnitus treatment strategies in that it provides direct, significant relief and gives the patient the psychological benefit of gaining control over the problem.

Adult↗
PubMed1987

Intermittent positive pressure ventilation via nasal access in the management of respiratory insufficiency.

These are preliminary observations of the introduction of a new technique of noninvasive positive pressure respiratory support for patients with subacute or chronic respiratory failure. Clinical situations where intubation or tracheostomy may have been performed were managed by intermittent positive pressure ventilation via nasal access (NIPPV) with a CPAP mask, or a custom constructed Vel-Foam nose piece. Four patients were managed at home with the use of portable volume ventilators. One patient employed the technique while hospitalized with subacute respiratory failure. Two patients, otherwise dependent on mouth intermittent positive pressure ventilation (MIPPV) 24 hours a day, received necessary dental care with NIPPV support. In a large population with a decade or more follow-up, MIPPV was shown to be an effective noninvasive technique to support respiration in patients with the most severe paralytic respiratory failure. Preliminary observations suggest that NIPPV may compare favorably with MIPPV and deserves more widespread study and application.

Adult↗
PubMed1987

Treadmill training program for a bilateral below-knee amputee patient with cardiopulmonary disease.

This study was undertaken to determine the degree of progress an elderly bilateral below-knee amputee with cardiopulmonary disease could achieve by endurance training on a treadmill. Aspects of medications, orthotic/prosthetic evaluation, and energy expenditure are discussed. The subject was a 63-year-old Class IV cardiac patient with combined restrictive-obstructive pulmonary disease of moderate severity. He had undergone a coronary artery bypass graft (two-vessel) followed by a bilateral below-knee amputation for an ascending dry gangrene. The initial ambulatory aerobic evaluation showed the patient achieving only 50% of predicted maximal heart rate and 20% of maximal oxygen consumption. An individualized daily training program started the patient walking at .5 mph, 0% elevation, for five repetitions at two minutes each. By the end of the six-month training program the workload reached 1.4 mph at 2.5% elevation, for 30 minutes of total external work. The final exercise test evaluation showed an overall increase in age-predicted maximal heart rate (90%) and oxygen consumption (55%). The patient improved from cardiac Class IV to Class II, and therapeutically from Class E (bed rest) to Class C (moderate exercise restriction). These findings suggest a need for endurance training programs for patients with cardiopulmonary disease hindered by additional physical disabilities. The program enabled the participant to engage in significantly higher levels of activity for daily living within the community.

Activities of Daily Living↗
PubMed1986

The primary role of the Erb's point--axilla segment in median and ulnar motor nerve conduction determinations in alcoholic neuropathy.

Motor nerve conduction velocity (MNCV) was explored in the Erb's point-axilla (N-A) nerve segment of median and ulnar nerves, bilaterally, in 10 patients with a history of prolonged heavy drinking but in whom no other predisposing factors to peripheral neuropathy were found. For comparison, MNCV was determined also in the axilla-elbow (A-E), elbow-wrist (E-W) nerve segments, as well as the motor terminal latency (MTL) of the same nerves. A total of 140 nerve segments were tested tested but only 133 results were obtained. Abnormal MNCV or MTL was found in 36 or 27% of all tested nerve segments. From the latter, 38.9% were in the N-A nerve segments. Of N-A nerve segments tested, reduction in MNCV was found in 46.7%. Our results are statistically significant.

Adult↗
PubMed1984

Learned self-control of tinnitus through a matching-to-sample feedback technique: a clinical investigation.

Two cases are reported in which subjective tinnitus aurium was treated with a matching-to-sample procedure. Following baseline evaluations, the subjects' experienced tinnitus was reproduced audiometrically in terms of loudness, frequency, and quality. This was presented to them in the noninvolved ear and was gradually reduced within sessions. The subjects were required to concentrate on reducing their tinnitus until an equal match had been achieved between it and the stimulus sound at each new decibel level. Both subjects gained control over their tinnitus and were able to reduce it markedly from baseline levels. This procedure is viewed as an advance over other techniques not only in that it significantly reduces the tinnitus but in the fact that it is done through the subject's own control, providing psychological benefit as well.

Adult↗
PubMed1984

Respiratory rehabilitation in severe restrictive lung disease secondary to tuberculosis.

There is a need for portable and less expensive devices for patients with chronic respiratory insufficiency. The case of a 44-year-old Hispanic woman is illustrative. The patient had severe restrictive lung disease secondary to right phrenic nerve crush/pneumoperitoneum and left pneumonectomy/decortication for bilateral lower lobe tuberculosis. In 1969, 12 years after her last operation, she developed dyspnea, coryza, and somnolence. She was hospitalized with a PaO2 of 30mmHg; PaCO2 of 77mmHg and a pH of 7.28. Pulmonary function tests showed alveolar hypoventilation and her resting ventilation was between 2.26 to 3.74L/min. Her vital capacity was 1130cc (37% of predicted value) and maximum breathing capacity was 36L/min (44% of predicted value). From 1969, she used a poncho (wraparound) ventilator for her long-term respiratory care and modified the poncho suit to meet her personal needs. In 1971, she discovered that a mouth intermittent positive pressure ventilation (MIPPV) method, often used by patients with neuromuscular disorders, was easier to apply. Since then, she has continued to use a Bantam Respirator with MIPPV and a lipguard/mouthpiece during the night, and the respirator with a mouthpiece for a few hours during the days. However, when she has an upper respiratory infection or feels tired, she finds that she needs the greater rest and comfort that the poncho provides. With the assistance of these two respiratory devices, she has been able to complete her education, marry, and lead a fulfilling life in the community. This patient is considered the first person with severe lung pathology to utilize MIPPV for sleep.

Adult↗
PubMed1981

Long-term rehabilitation in advanced stage of childhood onset, rapidly progressive muscular dystrophy.

The most common cause of death in patients with rapidly progressive neuromuscular disease has been respiratory failure. The medical community and society as a whole have not yet recognized the possibilities for markedly extended life expectancy and prolonged productivity in severely disabled neuromuscular patients with proper medical management and rehabilitation. In a population of 120 patients with early childhood onset, rapidly progressive muscular dystrophy, 29 were in the most advanced stage requiring mechanical ventilation 24 hr/day and had vital capacities of less than 10% predicted for age and height. Of these patients with severely weakened bulbar innervated muscles, 10 have been receiving positive pressure ventilation via indwelling tracheostomy tubes for an average of 3 years. The average age of the 29 patients is 27 years with a range of 15 to 54 years. Of the 29 patients, 24 live in the community. Three are married and have a total of 5 children. Some patients are in professional careers, or active in political and community organizations. The management of and potential for improved quality of life and increased longevity in these patients are discussed.

Adolescent↗
PubMed1980

Recognition of matching tasks and stimulus novelty as a function of unilateral brain damage.

A 96-trial tachistoscope recognition task was given to 15 left-hemisphere-damaged, 12 right-hemisphere-damaged, and 30 non-brain-damaged subjects. Procedure called for a first stimulus presented for 250 msec, a 1-sec. pause, and a second stimulus for 250 msec. The stimuli were 12 animal drawings used in repeated series according to a random schedule. Six animals were familiar and six were novel. For half of the trials, the two pictures were of different animals. Size and position of the animal picture were controlled. Both reaction time and accuracy were independently scored. Judgments of same and different appear to function as if they are governed by different processes. For the control group, measures of same and different judgments do not correlate highly despite high internal consistency of subtests. Recognition of same becomes impaired with brain damage, but more so if the damage is rightsided. Recognition of different judgments shows considerably less sensitivity to the effects of unilateral brain damage.

Aphasia, Broca↗
PubMed1978

The effect of unilateral brain damage on the appearance of question-induced CLEM reactions.

Three groups of subjects--34 non brain damaged, 15 left hemisphere damaged patients, and 15 right hemisphere damaged patients--were administered 40 questions facing the questioner while eye-movement following each question was recorded. 20 of the questions required subjects to indicate how many letters were in a given word. 20 questions tested their visuospatial capacity. The control group revealed a marked tendency to look to the left visual field regardless of the content of the question. The tendency to left-look or right-look, however, was not found to be related to education, age, length of hospitalization, the score on the "letters in a word" test, or the score on the visuospatial test. The left hemisphere damaged group performed remarkably like the control in that they too looked more to the left visual field than to the right. The right hemisphere damaged group, however, did not show a significant difference between left looking and right looking in response to both questionnaires. The findings were discussed in relation to the previous work of Kinsbourne (1972), and Gur, Gur and Harris (1975).

Adult↗
PubMed1978

Reflex conditioning in a spinal man.

A man with a completely transected spinal cord and a spastic neurogenic bladder was conditioned to void upon the presentation of an external stimulus. A classical conditioning paradigm was employed in which strong abdominal shock (unconditioned stimulus) was paired with an initially neutral mild electrical stimulation of the thigh (conditioned stimulus; CS). After the pairing trials, a reliable conditioned response of urination was elicited by the CS alone. The conditioned response did not extinguish over time, and the procedure left the bladder with clinically safe residual amounts of urine. Practical implications of the conditioning technique for the treatment of spastic neurogenic bladder conditions in spinally injured patients are discussed, as is the theoretical significance of conditioning at the reflex level in the absence of cortical involvement.

Abdominal Muscles↗
PubMed1978

Conditioned responding of the neurogenic bladder.

Classical conditioning techniques were employed to condition responding of the spastic neurogenic bladder in a man with quadriparesis and urinary incontinence secondary to spinal cord injury at the cervical level. A neutral stimulus of mild electrical stimulation to the thigh was paired temporally with an unconditioned stimulus (UCS) of stronger electrical stimulation of the lower abdomen, and then was presented alone as a conditioned stimulus (CS) to elicit the conditioned response (CR) of voiding. The previously neutral CS reliably elicited large amounts of urine and left little residual urine in the subject's bladder. Following the experimental sessions, the subject self-applied the CS on a predetermined schedule during his daily routine outside of the laboratory. The CS initially was successful, but after several days the CR exhibited extinction. Additional CS-UCS pairing sessions did not reinstate the responses satisfactorily. Aspects of the experimental procedure and the results are discussed as well as the feasibility of conditioning the human spinal cord in the absence of an intact central nervous system

Abdomen↗
PubMed1978

Median and ulnar nerve conduction determinations in the Erb's point--axilla segment in normal subjects.

Twenty-one median and 22 ulnar nerves were tested in 12 patients for motor nerve conduction velocity (MNCV) and motor nerve conduction time (MNCT) in the segments from Erb's point (N) to axilla (A) bilaterally. It was found that on this segment for both nerves, MNCV values equal to or smaller than 51 m/s or conduction times equal to or longer than 4 ms are to be considered abnormal. For comparative studies and for checking the normality of the tested nerves in their entire length, the more distally located segments in the same nerve were also tested. For diagnostic purposes, the differences between right and left MNCV or MNCT values determined in the same person on N-A segments of homologous nerves were analysed. Motor nerve conduction velocity or MNCT determinations on the N-A nerve segment are expected to replace MNCV determinations on the longer N-AE (AE=100 mm above elbow) nerve segment, which is now in use, for diagnosis of the thoracic outlet syndrome.

Adult↗
PubMed1978

Pilot study of d-penicillamine, vitamins and minerals in multiple sclerosis.

A pilot study of the effect of D-penicillamine in multiple sclerosis (MS) was undertaken because of D-penicillamine's activity against RNA neurotropic viruses, because it is effective against the auto-immune disease, rheumatoid arthritis, and because both viruses and autoimmunity have been implicated in multiple sclerosis. We have treated 16 patients with advanced MS, nine on full doses (2-2.25 grams/day) and seven whose treatment was permanently stopped for reasons other than adverse reactions. There has been some improvement in most of those whose treatment was not withdrawn, and no change or deterioration in those not continued on the therapeutic regimen. Despite use of a high dosage regimen, such as has evoked intolerable side effects in a high percentage of patients with rheumatoid arthritis, we have experienced few side effects in a total of 48 patients suffering from diseases with auto-immune components, a finding we speculate is due to replacement of nutrients inactivated or removed by D-penicillamine, and to supplementation with selected nutrients.

Adult↗