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  • 1
    ISSN: 1573-7284
    Keywords: Creutzfeldt-jakob disease ; Dural graft ; Transmission
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 26-year old female who had received a cervical cadaveric dural graft 7 years earlier developed psychotic behavior and generalized myoclonic jerks. Following rapid deterioration and appearance of high-charge sharp periodic waves on electroencephalography she died within two months. We believe that this patient is the first German who acquired Creutzfeldt-Jakob disease by dural implant.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Apnoea testing ; Brain death ; Blood pressure ; Heart rate ; Cardiovascular changes ; Transcutaneous blood gas monitoring ; CO2 insufflation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To determine changes of blood pressure and heart rate during apnoea testing for brain death without (A) and with (B) artificial CO2 augmentation. Design: Prospective, consecutive study. Setting: 12 intensive care units in six towns in Northern Bavaria. Patients and participants: A total of 55 apnoea tests were performed on 55 consecutive patients as part of the determination of brain death, 27 without and 28 with CO2 augmentation. Interventions: Apnoea tests following oxygenation with 100 % O2 either after reduction of ventilatory volume (A) or after insufflation of CO2 during normoventilation (B). In each case, an arterial partial CO2 pressure of at least 8 kPa was documented. Results: All apnoea tests were without serious adverse effects (hypoxia, newly induced cardiac arrhythmia, cardiac asystole). An increased dopamine infusion rate was deemed necessary in only one case of group (A) because of marked systolic hypotension ( 〈 8 kPa). Individual variation of systolic and diastolic blood pressure (BP) did not exceed + 62 to –46 % and + 49 to –52 % respectively, in group (A) and + 35 to –57 % and + 40 to –48 % respectively, in group (B). Variation of heart rate (HR) remained within the range + 24 to –31 % in group (A) and + 37 to –22 % in group (B). Conclusions: HR varied less than BP. The possibility of a marked relative rise or fall of BP in group (A) was equal; in group (B) there was a lower chance of rising BP. The chances for a rise or fall in HR were equal for the two groups. There was a tendency for less variation of cardiovascular parameters in group (B).
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  • 3
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Morbus Parkinson ; Riechvermögen ; Riechprüfung ; Geruchsschwelle ; Olfaktorische Identifikation ; Keywords Olfactory function ; Parkinson's disease ; Odor identification ; Smelling ; Odor detection threshold
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Olfactory dysfunction seems to be one of the most frequent symptoms in idiopathic parkinsonian syndrome (IPS). In contrast to the increasing number of studies providing evidence of the usefulness of olfactory tests in the diagnosis of IPS, clinical assessment of olfactory function is rarely performed. This may be due to the lack of an easy-to-use, inexpensive, standardized, and reliable test. In this study, we administered the newly developed “sniffin' sticks” test to a group of 40 nondemented IPS patients and compared the results with 40 healthy controls matched for age, gender, and smoking habits. In all three subtests including odor identification, odor detection threshold, and odor discrimination, the control group scored significantly better than the IPS group, yielding a specificity and sensitivity of 90% each. Our results indicate that olfactory disturbances in IPS can be found at early stages of the disease, appear bilaterally, and do not correlate with the dominant side of parkinsonism. Therefore, we emphasize that olfactory testing may be a useful tool in the diagnosis of IPS.
    Notes: Zusammenfassung Riechstörungen scheinen eines der häufigsten Symptome bei idiopathischem Parkinsonsyndrom zu sein. Obwohl in einer Reihe von Studien eine Beteiligung des olfaktorischen Systems bei Morbus Parkinson nachgewiesen wurde, werden Riechprüfungen zur klinischen Diagnostik nur selten eingesetzt. Ein Grund ist sicher die mangelnde Verfügbarkeit eines einfach anzuwendenden, ökonomischen, standardisierten und zuverlässigen Testverfahrens. In der vorliegenden Studie verwendeten wir den neuentwickelten Sniffin'-sticks-Test zur seitengetrennten Überprüfung des Geruchssinnes bei 40 Parkinsonpatienten und verglichen die Ergebnisse mit 40 Kontrollpersonen, die nach Alter, Geschlechtszugehörigkeit und Rauchgewohnheiten parallelisiert waren. In allen 3 Untertests der Geruchsprüfung, bestehend aus einer Identifikationsprüfung, Diskriminationsprüfung und Schwellenmessung, erzielte die Kontrollgruppe signifikant bessere Ergebnisse. Die Sensitivität und Spezifität des Testverfahrens betrug je 90%. Unsere Ergebnisse zeigen, dass Riechstörungen bei Morbus Parkinson bilateral und im Frühstadium der Erkrankung auftreten und dass die Überprüfung der Geruchsfunktion eine wertvolle Methode in der klinischen Diagnostik des IPS sein kann.
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  • 4
    ISSN: 1435-1463
    Keywords: Dementia ; neuroimaging ; Alzheimer's disease ; computer assisted tomography ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Structural neuroimaging and dementia are conceptually different being only loosely correlated. Computed tomography or magnetic resonance imaging can never “prove” a clinical syndrome such as dementia, but yield clues as to its cause and the site and extent of pathological changes. Conversely, the type and degree of intellectual deterioration can hardly predict neuroradiological findings. The value of structural neuroimaging lies in detecting or excluding possible causes of dementia and quantifying linear or volumetric parameters of tissue and fluid volume. If based on a presumed or established etiology, however, specific neuropsychological and dementia syndromes may correspond to focal pathological changes seen in well-defined cerebral areas as recent investigations have shown with hippocampal atrophy in Alzheimer's dementia.
    Type of Medium: Electronic Resource
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