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At least 127 records · Page 7Linked to original sources
PubMed1998

[Nerve-plasty interventions on the facial nerve in the elderly patient--morphological evaluation of disappointing functional results].

BACKGROUND: Nerve sutures such as facial-facial anastomosis are helpful methods for recovery of facial movements after peripheral nerve lesions. Most of the results on neuronal regeneration were based on experiments with young or young adult animals. In contrary the vast majority of the diseases (cholesteatoma or tumors of the parotid gland) causing facial nerve lesions are in aged patients. METHODS: Therefore, we compared the original data from two recently published articles concerning the axonal outgrowing process after facial-facial-anastomosis in young-adult and aged rats. In additional, we tried to explain the clinically observed postparalytic syndrome (synkinesia, autoparalytic syndrome,...) after surgical interventions on the facial nerve with the experimental results in the rat. RESULTS: As an important result, we could not find spontaneous loss of facial motoneurons on the control side in the aged rats. On the operated side, two results have to be emphasized. The initial regeneration (10-42 days after the operation) showed a significant faster reinnervation in the group of young rats. The aged rats showed an apparent hyperinnervation after axonal outgrow to the mimic muscles has been accomplished. CONCLUSION: Both experimental observations are in agreement with our clinical experiences. After facial nerve surgery, aged patients show a delayed recovery of the mimic functions and a more pronounced postparalytic syndrome. A morphological explanation one can bear is that the delayed reinnervation causes the extreme hyerinnervation, which leads to a simultaneous innervation of different muscles by same facial motoneurons.

Adult↗
PubMed1985

[Uveitis research--between disappointment and hope].

Uveitis, often a severe eye disease, remains a challenge for the ophthalmologist interested in research. At Zürich University eye clinic, Rudolf Witmer has personally carried out much research work on this subject during the last 24 years, as well as stimulating much work around him. The following review studies the results. The etiology of the disease could only be demonstrated in about 10% of the cases, despite innumerable studies performed with various techniques in aqueous humor and serum. However, some typical clinical forms of uveitis could be clearly defined, and the role of the immune system in this disease at least partially investigated. Moreover, quite satisfactory therapeutic results were achieved in many cases, either through the use of immunosuppressive cytostatic drugs, or thanks to special surgical techniques.

Diagnosis, Differential↗
PubMed2006

A scoring system for detection of macrosomia and prediction of shoulder dystocia: a disappointment.

OBJECTIVE: To develop a scoring system for the detection of a macrosomic fetus (birth weight (BW) >or= 4000 g) and predict shoulder dystocia among large for gestational age fetuses. STUDY DESIGN: We retrospectively identified all singletons with accurate gestational age (GA) that were large for GA (abdominal circumference (AC) or estimated fetal weight (EFW) >or= 90% for GA) at >or=37 weeks with delivery within three weeks. The scoring system was: 2 points for biparietal diameter, head circumference, AC, or femur length >or=90% for GA, or if the amniotic fluid index (AFI) was >or=24 cm; for biometric parameters <90% or with AFI <24 cm, 0 points. The predictive values for detection of shoulder dystocia were calculated. RESULTS: Of the 225 cohorts that met the inclusion criteria the rate of macrosomia was 39% and among vaginal deliveries (n = 120) shoulder dystocia occurred in 12% (15/120; 95% confidence interval (CI) 7-20%). The sensitivity of EFW >or=4500 g to identify a newborn with shoulder dystocia was 0% (95% CI 0-21%), positive predictive values 0% (95% CI 0-46%), and likelihood ratio of 0. For a macrosomia score >6, the corresponding values were 20% (4-48%), 25% (5-57%) and 2.3. CONCLUSION: Though the scoring system can identify macrosomia, it offers no advantage over EFW. The scoring system and EFW are poor predictors of shoulder dystocia.

Dystocia↗
PubMed2004

Learning from disappointing outcomes: an evaluation of prevocational interventions for methadone maintenance patients.

To increase rates of employment and improve overall rehabilitation in methadone maintenance treatment, three prevocational trainings, Vocational Problem Solving, Job Seekers Workshop, and the two combined, were evaluated as adjunctive services. Between March 1995 and April 1998, subjects in treatment were interviewed at baseline, randomly assigned to one of the trainings, and followed up at 6 and 12 months postbaseline. None of the three models produced significantly greater employment or better overall rehabilitation. Experience from the study suggests that closer integration of prevocational training with treatment, individualizing efforts to meet training needs, and providing support during job-finding and early job-holding might improve program effectiveness.

Adult↗