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PubMed1999

[Writing disorder using a word processor: role of the left hand].

A young female secretary developed a writing disorder, exclusively expressed when using a word processor, following an ischemic vascular event involving the insula and the right posterior parietal region. There was no disturbance of laterality. The neurological examination, completed by neuropsychological tests eliminated any persistent phasic or gnostic disorders. The analysis of the text produced revealed abnormalities leading to the conclusion that the left hand was responsible for all the errors observed. A sensorimotor integration disorder produced a melokinetic apraxia which appeared to be the cause of the writing disorder which would have most likely remained unknown had the subject not been a secretary.

Adult↗
PubMedDate not supplied

[Criteria for the choice of the extracorporeal detoxication method in patients with postoperative renal failure].

Criteria for the choice of a method for extracorporeal detoxication (acetate hemodialysis, intermittent or continuous hemofiltration or hemodiafiltration, or plasmapheresis) were defined on the basis of a detailed examination of cardiorespiratory function (central hemodynamics, oxygen-transporting function of the blood) in 88 patients with acute postoperative renal failure (PRF). Multiple organ failure occurred in 90% of the patients examined in the postoperative period. The severity of visceral and metabolic disorders was the principal criterion in the choice of extracorporeal detoxication method. Hemofiltration is the method of choice for the treatment of PRF combined with multiple organ disorders, primarily with acute circulatory, respiratory, and metabolic disorders, due to its stabilizing effect on the hemodynamics and a wide spectrum of pathologic substances removed by it. Acetate hemodialysis is indicated for patients with PRF and slow recovery of renal function only after elimination of grave hemodynamic and respiratory disorders, provided there are no general cerebral symptoms, because of its negative effect on the circulation and oxygen balance of the organism and central nervous system. Plasmapheresis is a pathogenetically valid method for the treatment of the initial stages of PRF in cases with massive intravascular hemolysis and sepsis, which may be combined with other methods for extracorporeal detoxication, if necessary.

Acute Kidney Injury↗
PubMed1996

Health effects of salicylates in foods and drugs.

There is much (renewed) interest about the effects of salicylates on food intolerance, attention-deficit disorders, and cardiovascular disease. Current evidence for the efficacy of salicylate-elimination diets in the treatment of attention-deficit disorders and hyperactivity is weak, and further investigation is required on the relationship between salicylates and cardiovascular disease.

Asthma↗
PubMed1995

Diet regimen in the treatment of food allergy.

Adverse reactions to food may be mediated by immunological or non immunological mechanisms. The term "food allergy" describes an event in which a definite immunopathological process can be demonstrated and a cause and effect relationship must be present. Symptoms and signs of food allergy may appear in any organ system, depending in part on the age of the subject and on the allergen involved. At present it is generally agreed that the only effective therapy for food allergy is strict elimination of the offending food antigen. Institution of a food elimination diet should be considered comparable to prescribing a medication, which carries along definite risk-benefit ratio. Consequently, appropriate diagnostic measures base on history, skin test, or radioallergosorbent test (Rast) and blind food challenges, must be utilized before implementing special diets. The allergist and other health care professionals must recognize the advantages of elimination diets (improvement of symptoms) as well as disadvantages (increase of the time required to purchase food and prepare meals, impossibility to eat at restaurants, at friends' houses or at school with consequent possible social isolation, nutritional disorders) and choose the most appropriate elimination diet.

Child↗
PubMed1985

The Mezzich MMPI regression formula revisited.

In a sample of depressed psychiatric inpatients, the Mezzich regression formula, based on five MMPI scales, correlated moderately with clinicians' judgments and yielded few false negative diagnoses in identifying patients with unipolar Major Depressive Disorder, but was less effective in eliminating false positives.

Adult↗
PubMed2002

Cockatiel-induced hypersensitivity pneumonitis.

Diagnosing an environmental or occupationally related pulmonary disorder often involves a process of elimination. Unlike commonly diagnosed conditions in other specialties, a cause-and-effect relationship may be implied, yet other factors such as temporality and biologic plausibility are lacking. Our patient was referred with a suspected work-related pulmonary disorder. For several years, she had suffered with dyspnea on exertion and repeated flulike illnesses. She worked at an automobile repair garage that performed a large number of emission tests, and there was concern that her workplace exposures were the cause of her symptoms. After a careful review of her history, physical examination, and laboratory testing, we came to the conclusion that she had hypersensitivity pneumonitis related to pet cockatiels in her home. Clinical points of emphasis include the importance of a complete environmental history and careful auscultation of the chest when performing the physical examination. In addition, we encountered an interesting physical diagnostic clue, a respiratory sound that assisted with the eventual diagnosis.

Animals↗
PubMedDate not supplied

Neighborhood disorder, individual protective factors, and the risk of adolescent delinquency.

Traditionally, violent and delinquent behaviors have been addressed by the criminal justice system, with the focus being secondary and tertiary interventions. During the last decade, the focus on violence as a public health issue has increased. The purpose of this research was to examine how individual protective factors for adolescent delinquency varied according to neighborhood quality. The researcher conducted a secondary data analysis, using data from the National Youth Survey A total of 1,621 adolescents comprised the sample. The majority of the respondents participated in some type of delinquent behavior, with more Blacks reporting participation in violent behaviors. There was a positive relationship between academic history and no participation in delinquent behavior. The regression model for violent delinquency accounted for 10% of the variance in the disordered neighborhoods. Primary prevention efforts, commonly used by public health nurses, should be aimed at eliminating risk factors such as those found in disordered neighborhoods.

Adolescent↗
PubMed2026

Toileting dysfunction in SATB2-associated syndrome: results from a caregiver survey.

BACKGROUND: Toilet training and continence are major developmental milestones, but children with neurogenetic conditions often experience extreme difficulties, sometimes never achieving full continence. These challenges impose ongoing burden on caregivers, especially as children age and require toileting assistance outside the home. SATB2-associated syndrome (SAS) is a rare genetic disorder in which such functional issues have not been systematically studied. We sought to assess bladder and bowel function in individuals with SAS and compare symptoms burden to normative data. METHODS: Caregivers completed a survey that included the Vancouver Symptom Score (VSS) for Dysfunctional Elimination Syndrome. VSS scores were analyzed and compared to published norms. Additional data included toilet training milestones, continence status, urinary tract infections, and bowel treatment history. RESULTS: Of the 32 individuals with SAS represented in the caregiver-reported survey, over half (53%) were not toilet trained, and only 22% were fully trained for both day and night (mean age at toilet training 6.9 years). The SAS group (n = 32) had a median total VSS of 16.0 (range: 6-30), indicating clinically significant dysfunction, while control data (n = 49) reported a median of 5.0 (range: 0-12, p < 0.001), with the greatest differences observed in daytime wetting, nighttime wetting, wetting extent, and fecal soiling. CONCLUSIONS: Individuals with SAS experience markedly elevated elimination symptom burden. Findings support the need for early screening and intervention to promote continence and reduce caregiver strain. A clinical pathway is proposed for screening, evaluation, and management of elimination dysfunction in SAS.

Humans↗
PubMed1988

The diagnostic value of history, physical examination, and the Q-tip cotton swab test in women with urinary incontinence.

One hundred six consecutive women who came to our clinic complaining of urinary incontinence underwent complete urodynamic evaluation. Urologic questions, pelvic examination findings, and the Q-tip cotton swab test results were examined to determine their ability to predict genuine stress incontinence (N = 59) versus other urologic disorders (N = 47). The symptom of stress incontinence, moderate to severe cystocele, and Q-tip cotton swab test result greater than or equal to 30 degrees were more common in women with genuine stress incontinence. Of the other urologic symptoms, only sensory urgency and enuresis were significantly associated with overactive detrusor function and voiding disorders. The combined findings of stress incontinence, cystocele, and no sensory urgency correctly identified 22% of women with genuine stress incontinence and eliminated 96% of women with other urologic disorders. Stress incontinence, moderate to severe cystocele, and no sensory urgency had a positive predictive value of 100%, but a sensitivity of only 10%. When used in series, the Q-tip cotton swab test contributed no additional information to that found by history taking and physical examination.

Aged↗
PubMed1998

Microsecond rotational dynamics of spin-labeled myosin regulatory light chain induced by relaxation and contraction of scallop muscle.

We have used saturation transfer electron paramagnetic resonance (ST-EPR) to study the rotational dynamics of spin-labeled regulatory light chain (RLC) in scallop (Placopecten magellanicus) muscle fibers. The single cysteine (Cys 51) in isolated clam (Mercenaria) RLC was labeled with an indanedione spin label (InVSL). RLC was completely and specifically extracted from scallop striated muscle fibers, eliminating the Ca sensitivity of ATPase activity and isometric force, which were both completely restored by stoichiometric incorporation of labeled RLC. The EPR spectrum of the isolated RLC revealed nanosecond rotational motions within the RLC, which were completely eliminated when the labeled RLC was bound to myosin heads in myofibrils or fibers in rigor. This is the most strongly immobilized RLC-bound probe reported to date and thus offers the most reliable detection of the overall rotational motion of the LC domain. Conventional EPR spectra of oriented fibers indicated essentially complete probe disorder, independent of ATP and Ca, eliminating orientational dependence and thus making this probe ideal for unambiguous measurement of microsecond rotational motions of the LC domain by ST-EPR. ST-EPR spectra of fibers in rigor indicated an effective rotational correlation time (taureff) of 140 +/- 5 microseconds, similar to that observed for the same spin label bound to the catalytic domain. Relaxation by ATP induced microsecond rotational motion (taureff = 70 +/- 4 microseconds), and this motion was slightly slower upon Ca activation of isometric contraction (taureff = 100 +/- 5 microseconds). These motions in relaxation and contraction are similar to, but slower than, the motions previously reported for the same spin label bound to the catalytic domain. These results support a model for force generation involving rotational motion of the LC domain relative to the catalytic domain and dynamic disorder-to-order transitions in both domains.

Animals↗
PubMed2005

Dysfunctional elimination symptoms in childhood and adulthood.

PURPOSE: The dysfunctional elimination syndrome (DES) is rare in adulthood. We evaluate the natural history of DES to identify aspects of the disorder that may be carried into adulthood. MATERIALS AND METHODS: A 2-part questionnaire was devised and self-administered to 191 consecutive women attending a urogynecological clinic (UG) and to 251 normal women. The first section asked for recall of childhood symptoms known to be associated with DES, while the lat-ter section explored current bladder and bowel problems. Data sets from the normal cohort (55) reporting current bladder problems were excluded. Descriptive statistics, chi-square and Mann-Whitney-U tests were used to compare variables. RESULTS: UG patients had significantly higher childhood DES scores than normal women. Overall 41.7% of UG patients could be labeled as having dysfunctional elimination as an adult. Symptoms reported significantly more often in childhood by UG patients than by control women were frequent urinary tract infection, vesicoureteral reflux, frequency, urge incontinence, slow and intermittent urine flow, small volume high urge voids, hospitalization for constipation, frequent fecal soiling and nocturnal enuresis. Higher DES scores correlated significantly with current adult urgency, urge leak, stress incontinence, incomplete emptying, post-void leak, hesitancy, nocturia and nocturnal enuresis. Constipation and fecal incontinence in adulthood also showed a significant association with high DES scores. Logistic regression revealed childhood urgency to be associated with adult DES. CONCLUSIONS: Childhood lower urinary tract dysfunction may have a negative impact on bladder and bowel function later life.

Adolescent↗
PubMed1991

The effects of a maxillary speech-aid prosthesis for the combined tongue and mandibular resection patient.

The purpose of this investigation was to develop a protocol for the fabrication of a prosthesis that would improve speech in individuals who have undergone complete removal of the tongue and mandible. A 60-year-old man was suffering from severe xerostomia and was unable to produce intelligible speech. Speech analysis without the prosthesis revealed a profound articulatory disorder. With the prosthesis, xerostomia was eliminated and the subject had fewer articulatory errors of severity. Improvement in speech intelligibility was significant at p less than 0.001.

Articulation Disorders↗
PubMed1986

Benzodiazepines in the treatment of sleep disorders: pharmacokinetic aspects.

In order to avoid after-effects during the day, slowly eliminated hypnotic agents should not be used in the treatment of sleep disorders. It has become customary to separate long-acting from short-acting benzodiazepines and to use the (terminal) half-life as the principle of classification. This approach is only justified, however, in the case of quickly absorbed benzodiazepines that have no pharmacologically active metabolites and that exhibit one-compartment disposition kinetics. In contrast, the duration of action of benzodiazepines characterized by marked two-compartment disposition kinetics can only be estimated correctly when the potency and all relevant kinetic parameters of the drug preparation and its pharmacologically active metabolites are considered.

Anti-Anxiety Agents↗
PubMed2004

[Psychosomatic aspects of therapy in patients with ischemic heart disease of behavioral type A].

Forty-five patients aged 34 to 67 years who had coronary heart disease (CHD) were examined. Anaprilin was given in a dose of up to 120 mg daily. Concurrently with positive changes in the anginal syndrome there were improved sleep, decreases in hot temper, irritability, anxiety, phobic manifestations, hypochondrical trends, and neurotic asthenization, increased working and social orientation. During anaprilin therapy, cardialgias reduced or disappeared, the incidence of arrhythmia decreased. There was a reduction in the personality profile in the scales "neurotic triad" and "psychoasthenia", significantly diminished reactive anxiety, and a decrease in the blood levels of aldosterone, cortisol, triiodothyronine, and thyroxine. Thus, supplementation of anapriline to the combined therapy for patients with CHD of behavioral type A (BTA) positive affected the clinical course of the disease. Hormonal disorders in BTA CHA may be eliminated by anaprilin. Configuration of the personality profile was leveled in patients with CHA of "coronary" type.

Adult↗
PubMed1989

Genetic epidemiology of Greenland.

The Inuit (Eskimo) gene pool is in many respects similar to that of East Asian populations. Some polymorphisms imply frequent occurrence of disorders comparatively rare in Western Europe (e.g. lactose and sucrose malabsorptions). Low frequencies of alleles for slow isoniazid acetylation and sparteine/debrisoquine oxidation indicate slow elimination of a multitude of drugs. Autoimmune disorders (e.g. rheumatoid arthritis, insulin-dependent diabetes mellitus, Graves' disease and psoriasis) are rare, possibly explained by the associations of these disorders with HLA-alleles rare in the Inuit (e.g. HLA-B8). A correspondingly high incidence of reactive arthritis may be explained by a frequent HLA-B27 allele. The prevalence of disorders due to instability of mesenchymal tissues (e.g. spondylolisthesis, osteoarthrosis, hernia, heart block) still requires a biochemical explanation. Attention is drawn to the urgency of genetic studies in the Arctic because of the accelerating hybridization of the Inuit in all circumpolar areas.

Genetic Diseases, Inborn↗
PubMed1992

[Coronary endarterectomy in the surgical treatment of ischemic heart disease (review)].

The problems are overviewed with performing revascularization of the coronary bed when in diffuse affliction. The unique way how to revascularize a progressive atherosclerotic disorder of the coronary bed consists in elimination of a degenerated portion of the coronary vessel which is endarterectomy (EAE). This method is specially important in ischemic myocardium supplied with so disordered coronary. The EAE of the coronaries is of routine use with some extended working sites. However, they are not rare to take this method with some objections. These are due to a higher risk in performing surgery and scepticism upon the long term patency of the endarterectomized artery. Because of a polymorph character of atherosclerotic process, one should hardly mention some randomized studies able to prove both inconvenience and advantages of the method. Nevertheless, the large sets are known to exist at present which document the benefit of the EAE method from the scope of both immediate and long term results. This method is only efficient under the condition of a perfect technical skill as well as peculiar and total EAE completion. Besides the known "gas EAE" and "manual EAE" techniques, the authors present a new EAE approach developed by their own using the solution which is injected under tension into the separation layer. The EAE method appeared to be valuable on multiple cardio-surgical centres when correctly indicated and performed including the instantaneous recognition and correction of imminent complications. The authors' experience is in accord with the above conditions.

Coronary Artery Disease↗
PubMed1989

Genetic epidemiology of Greenland.

The Inuit (Eskimo) gene pool is in many respects similar to that of East Asian populations. Some polymorphisms imply frequent occurrence of disorders comparatively rare in Western Europe (e.g. lactose and sucrose malabsorptions). Low frequencies of alleles for slow isoniazid acetylation and sparteine/debrisoquine oxidation indicate slow elimination of a multitude of drugs. Autoimmune disorders (e.g. rheumatoid arthritis, insulin dependent diabetes mellitus, Graves' disease and psoriasis) are rare, possibly explained by the associations of these disorders with HLA-alleles rare in Inuit (e.g. HLA-B8). Correspondingly high incidence of reactive arthritis may be explained by a frequent HLA-B27 allele. Prevalence of disorders due to instability of mesenchymal tissues (e.g. spondylolisthesis, osteoarthrosis, hernia, heart block) are still in want of a biochemical explanation. Attention is drawn to the urgency of genetic studies in the Arctic because of the accelerating hybridization of Inuit in all circumpolar areas.

Genetic Diseases, Inborn↗