Biomedical subjects

P Panayiotou

Publications and source records attributed to P Panayiotou.

4 recordsLinked to original sources

PubMed2005

Ulnar neuropathy at Guyon's canal: electrophysiological and surgical findings.

Published correlations between electrophysiological and surgical findings are relatively rare in cases of ulnar nerve compression at the wrist, compared to the more common compression of the ulnar nerve at the elbow. We describe a patient who presented with clinical and electrodiagnostic findings of a pure motor ulnar neuropathy involving the territory of the deep branch. Surgical exploration revealed that a ganglion cyst caused compression of the deep ulnar motor branch at Guyon's canal. This case illustrates the usefulness of electrodiagnostic studies in the localization of nerve entrapment prior to surgery.

Adult↗

PubMed1992

[Concomitant depression and its treatment].

Accompanying depression is especially common in elderly, chronically ill patients and rehabilitation patients, where a physical illness and/or disablement is accompanied by depression. Treatment should always be focussed in a "polypragmatic" manner on both physical or psychic symptoms. In particular psychotherapy (see article by Barolin), pharmacotherapy (referred to in this article) and physiotherapy (described further in other literature) are of importance here. Advantage is to be taken of the polar dimensions of different types of antidepressant drugs, namely the increase in drive or sedating effects. However, the increased rate of side effects from some drugs among elderly patients is not to be ignored. Taking the above into consideration, the new antidepressant, Fluctine (Fluoxetine), has proved to be effective among our randomly selected patients. This is on account of its relatively fast onset of action, minimal side effects and its slight increase in drive. The group of non-responders (one third of the patients) showed no decrease in depressive symptoms when other antidepressants were substituted. As expected those patients suffering organic-brain illness responded worse and represent a large percentage of the non-responders. These data prove the results of previous findings that patients with organic-brain illness generally respond worse to antidepressant medication. Thus Fluctine can be recommended for elderly patients with accompanying depression.

Adaptation, Psychological↗

PubMed1991

[15-year-factor analysis of multiple sclerosis].

The authors have conducted a longitudinal survey for a period of 14 years with 171 patients suffering from multiple sclerosis. In each case, therapeutic and diagnostic procedures were in accordance with the latest development. In almost half of the cases with a duration of illness up to 20 years the degree of impairment can be regarded as minimal, which can be used as an argument in favour of conscientious and continuous rehabilitative measures, including psychotherapy (this in opposition to a "rehabilitative pessimism"). Two thirds of the patients have been in employment with full working capacity during the first ten years of their illness. The consequences for social medicine and social policy are self-evident and imperative. In accordance with earlier studies, motor pareses are predominant among the first symptoms of multiple sclerosis, whereas disorders of cranial nerves, of urinary excretion and of cerebral function appear later in the course of the disease. Factor analysis did not yield any clues with respect to the predictability of the development of illness. Psychoreactive depression is relatively common in the earlier stages, later we can find somatogenic (psycho-organic) depressions, which respond relatively poor to treatment. Among the diagnostic tool, analysis of the critical flicker fusion frequency (CFFF) has proved to be very sensitive, by far not as cumbersome as visually evoked potentials and at least as reliable as the later. Therapeutic strategies should include: early treatment of any acute attack, consequent long-term care with modern nursing methods and rational concomitant medication, prophylaxis against infection. Multiple sclerosis represents itself as a problem of long-term rehabilitation, thus emphasizing the necessity of increased commitment to rehabilitation within a general framework of health care, which should include: a) better representation of rehabilitation as a discipline at the universities. b) systematic concomitant research in rehabilitation, c) legal and administrative adaptations, d) the development of a general "rehabilitation mentality" (as we have come to call it), which means involvement with the patient and his environment throughout his entire life-span.

Adult↗

PubMed1990

[Predictors of multiple sclerosis development trends with special reference to "questionable initial manifestations"].

Within 10 years we have had evidence in our department of 173 cases of proven multiple sclerosis (MS) and 63 cases which primarily were called by us: "bland entzündliches Geschehen" (BEG) instead of "possible first onset of multiple sclerosis". 44% of these cases remained as a singular manifestation, whereas 56% developed to established MS. This underlines our proposition of a new classification which does not call such questionable first symptoms as "possible first onset of MS" but as "bland entzündliches Geschehen". This is much less severe and prejudicatory for the bearers of such symptoms. Furthermore we could demonstrate clear correlations between clinical and laboratory findings and the probability of development of MS and the improbability of such a development, respectively. We could not find such predictors up till now in the literature. The several laboratory parameters, relevant for MS (not only with regard to BEG, but also to the whole population which clinically proven MS) could be tested regarding their sensitivity. As a remarkable result, to our knowledge not mentioned so far in the literature, we could demonstrate the flicker-fusion-analysis to be the leading laboratory test. In addition it is a very simple laboratory method, as far as time and money are concerned. It is at least as valid as visual evoked potentials which in the literature are considered to be the most sensible test. Taking into account the few cases examined with the magnet resonance tomography until today, this method, seems to be less sensitive than flicker-fusion-analysis. We do not have a 100% laboratory method at our disposal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗