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  • Head injury  (1)
  • Isolated partial rupture  (1)
  • Pain  (1)
  • 1995-1999  (3)
  • 1950-1954
Collection
Publisher
Years
  • 1995-1999  (3)
  • 1950-1954
Year
  • 1
    ISSN: 1590-3478
    Keywords: Multiple sclerosis ; Pain ; Symptoms ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario L'occorrenza di sindromi dolorose acute (durata inferiore a 1 mese) o croniche (durata superiore a 1 mese) è stata indagata in 49 pazienti (22 maschi e 27 femmine) con sclerosi multipla definita. Ciascun paziente è stato esaminato due volte con un intervallo di 5 anni tra i due controlli. Tra il primo e il secondo controllo si è osservato un significativo aumento di sindromi dolorose acute e croniche comprendenti tensione e dolore alle estremità, spasmi, lombalgia, segno di Lhermitte e dolori neuralgici. Tale aumento si è verificato sia nei maschi che nelle femmine ed è particolarmente evidente nei pazienti con deterioramento e disabilità.
    Notes: Abstract Forty-nine (22 males, 27 females) patients with definite multiple sclerosis were examined twice with 5 years interval regarding acute (less than 1 month duration) and chronic (more than 1 month duration) pain syndromes. From the first to the second examination a significant increase was found in the number of acute and chronic pain syndromes, including tension and pain in the extremities, spasms, low back pain, Lhermitte's sign and neuralgia. The increase included both men and women. The increase was especially found in patients with deterioration of disability.
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  • 2
    ISSN: 0942-0940
    Keywords: Head injury ; indomethacin reactivity ; hyperventilation ; intracranial pressure ; cerebral blood flow ; cerebral ischaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of this study was to compare the effect of hyper-ventilation and indomethacin on cerebral circulation, metabolism and pressures in patients with acute severe head injury in order to see if indomethacin may act supplementary to hyperventilation. Fourteen severely head injured patients entered the study. Intracranial pressure (ICP), mean arterial blood pressure (MABP) and cerebral perfusion pressure (CPP) were monitored continuously. Within the first four days after the trauma the CO2 and indomethacin vasoreactivities were studied by measurements of cerebral blood flow (CBF) (Cerebrograph 10a, intravenous133Xe technique) and arterio-venous difference of oxygen (AVdO2). Ischaemia was evaluated from changes in CBF, saturation of oxygen in the jugular bulb (SvjO2), lactate and lactate/oxygen index (LOI). Data are presented as medians and ranges, results are significant unless otherwise indicated. Before intervention ICP was well controlled (14.8 (9–24) mmHg) and basic CBF level was 39.1 (21.6–75.0) ml/100 g/min). The arterio-venous oxygen differences were generally decreased (AVdO2 = 4.3 (1.8–8.1) ml/100 ml) indicating moderate luxury perfusion. Levels of CMRO2 were decreased (1.54 (0.7–3.2) ml/100 g/min) as well. Duringhyperventilation (ΔAPaCO2 = 0.88 (0.62–1.55) kPa) CBF decreased with 11.8 (−33.4−29.7) %/kPa and ICP decreased with 3.8 (0–10) mmHg. AVdO2 increased 34.0 (4.0–139.2) %/kPa, MABP was unchanged, CMRO2 and CPP increased (ΔCPP = 3.9 (−10−20) mmHg). AVD (lactate) and LOI were unchanged. No correlations between CBF responses to hypocapnia and outcomes were observed. An i.v. bolus dose ofindomethacin (30 mg) decreased CBF 14.7 (−16.7−57.4) % and ICP decreased 4.3 (−1−17) mmHg. AVdO2 increased 27.8 (−40.0−66.7)%, MABP (ΔMABP = 4.9 (−2−21) mmHg) and CPP (ΔCPP = 8.7 (3–29) mmHg) increased while CMRO2 was unchanged. No changes in AVd (lactate) and LOI indicating cerebral ischaemia were found. Compared to hyperventilation (changes per 1 kPa, at PaCO2 level = 4.05 kPa) the changes in MABP, CPP and CBF were significantly greater after indomethacin, while the changes in AVdO2, ICP, SvjO2, and LOI were of the same order of magnitude. Nocorrelation between relative reactivities to indomethacin and CO2, evaluated from changes in CBF and AVdO2, or between the decrease in ICP after the two procedures were found. Thus, some patients reacted to indomethacin but not to hyperventilation, and vice versa. These results suggest that indomethacin and hyperventilation might act independently, or in a complementary fashion in the treatment of patients with severe head injury.
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  • 3
    ISSN: 1433-7347
    Keywords: Key words Anterior cruciate ; ligament ; Isolated partial rupture ; Knee laxity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The majority of previous studies on partial ruptures of the anterior cruciate ligament (ACL) include a relatively large proportion of knees with associated intra-articular injury or collateral ligament tear that contributes to an increase in the symptoms of instability and further deterioration of knee function. In the present study only patients with isolated, partial ruptures of the ACL were evaluated. Fifty-six patients with one injured knee were examined after a median of 5.3 (range 2.0–12.7) years using the IKDC evaluation form, Lysholm knee function score and Tegner activity score. Of the 56 knees, 6 underwent autologous reconstruction due to early progression to complete rupture. Of 34 knees evaluated for laxity, 25 had a negative Lachman test and 7 a positive (+) Lachman. In 2 knees a Lachman ++ result and a positive pivot shift were found. With instrumented laxity testing 24 knees had 2 mm or less difference in laxity compared with the contralateral uninjured knee. The largest side-to-side difference in knee laxity was 4.5 mm. Lysholm score was median 86 (range 52–100) points, and 62% had good or excellent knee function. A significant decline in activity was seen. Only 10 patients (30%) resumed their preinjury activities. We find that the majority of patients with an isolated, partial rupture of the ACL have an acceptable knee function and a stable knee after a median 5 years follow-up. There is, however, a marked reduction in activity.
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