RESUMEN
OBJECTIVES: The aim of this study was to adapt the "Neuropathic Pain Impact on Quality-of-Life Questionnaire" (NePIQoL) into Turkish and to test its validity and reliability in neuropathic pain patients. METHODS: We enrolled 200 chronic pain patients who admitted to the Neurology Department of Kirikkale University, Faculty of Medicine, in our study. Patients were diagnosed with neuropathic or nociceptive pain based on medical history, physical examination, electromyography and nerve conduction studies, laboratory examinations, and imaging techniques. Discriminant analysis was used to diagnose the neuropathic pain regarding sensitivity and specificity. The original version of the NePIQoL was translated into Turkish by standard procedures. RESULTS: Total NePIQoL scores were statistically different between neuropathic and nociceptive pain patients in both the first and second NePIQoL applications (P < 0.001). Cronbach's alpha coefficient of total 12 items of the first and second applications was 0.95. These results suggest a high validity level for the Turkish version of the NePIQoL. CONCLUSIONS: The Turkish version of NePIQoL appears to be reliable and valid for neuropathic pain impact on quality of life in patients with neuropathic pain.
Asunto(s)
Neuralgia/diagnóstico , Calidad de Vida , Encuestas y Cuestionarios , Traducciones , Adulto , Dolor Crónico/diagnóstico , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Examen Físico , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , TurquíaRESUMEN
OBJECTIVES: We aimed to assess the efficacy of greater occipital nerve (GON) blockade at chronic migraine (CM) treatment. MATERIALS AND METHODS: Patients with CM were randomly divided into two groups of 42. GON blockade was administered four times (once per week) with saline in group A or bupivacaine in group B. After 4 weeks of treatment, blinding was removed; in group A, GON blockade was achieved using bupivacaine, while group B continued to receive bupivacaine, and blockade was administered once per month, then followed for 2 months. Primary endpoint was the difference in number of headache days, duration of headache, and pain scores. RESULTS: Seventy-two of 84 patients completed the study. After 1 month of treatment, number of headache days had decreased from 16.9 ± 5.7 to 13.2 ± 6.7 in group A (P = 0.035) and from 18.1 ± 5.3 to 8.8 ± 4.8 in group B (P < 0.001), (P = 0.004, between groups); duration of headache (hour) had decreased from 24.2 ± 13.7 to 21.2 ± 13.4 in group A (P = 0.223) and from 25.9 ± 16.3 to 19.3 ± 11.5 in group B (P < 0.001), (P = 0.767, between groups). VAS score decreased from 8.1 ± 0.9 to 6.7 ± 1.6 in group A (P = 0.002) and from 8.4 ± 1.5 to 5.3 ± 2.1 in group B (P < 0.001), (P = 0.004, between groups). After blinding was removed (in 2nd and 3rd month), group A exhibited similar results like group B in 3rd month. CONCLUSIONS: Our results suggest that GON blockade with bupivacaine was superior to placebo and was found to be effective, safe, and cost-effective for the treatment of CM. According to our knowledge, this is the first randomized, multicentre, double-blind, and placebo-controlled study in the literature in this field of work.
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Anestésicos Locales/uso terapéutico , Bupivacaína/uso terapéutico , Trastornos Migrañosos/tratamiento farmacológico , Adulto , Anestésicos Locales/administración & dosificación , Anestésicos Locales/efectos adversos , Bupivacaína/administración & dosificación , Bupivacaína/efectos adversos , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/métodosRESUMEN
OBJECTIVE: The aim of this study was to evaluate the psychometric properties of the Brief Pain Inventory (BPI) as well as tests of its reliability, validity, and discriminative utility for estimating the status of chronic pain in neuropathic and nociceptive pain patients. METHOD AND PATIENTS: We enrolled 224 chronic pain (126 neuropathic pain and 98 nociceptive pain) patients. The original version of the BPI was translated into Turkish by standard procedures. An independent clinician determined the pain type. The factor analysis, reliability (internal consistency and test-retest reliability), and validity (agreement with the reference diagnosis and sensitivity, specificity, and positive and negative predictive values) were determined. Discriminant function analysis was then employed to determine whether BPI could differentiate between neuropathic and nociceptive pain. RESULTS: Cronbach's α-coefficient was 0.84 for the test and 0.83 for the retest. BPI scores for subjects did not significantly differ between applications r:0.96 (P < 0.01). Principal axis factoring with oblimin rotation revealed three interpretable factors: severity scale, activity interference, and sleep and mood interference. Compared to the clinical assessment, sensitivity, specificity, and positive and negative predictive values for criterion total BPI score were 79.37%, 46.9%, 65.8%, and 63.9%, respectively. CONCLUSION: The results suggest that Turkish version of BPI is a reliable and valid evaluation measure of neuropathic and nociceptive pain patients. This is the first study reporting the comparison and validation of psychometric properties of BPI in neuropathic and nociceptive pain group. Our data suggest that BPI may able to discriminate the origin of chronic pain.
Asunto(s)
Neuralgia/diagnóstico , Dolor Nociceptivo/diagnóstico , Dimensión del Dolor , Psicometría , Adulto , Anciano , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: The Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) is a 7-item self-report scale developed to identify pain of predominantly neuropathic origin. The aim of this study was to develop a Turkish version of the S-LANSS and to test its validity and reliability in chronic pain patients. METHOD AND PATIENTS: We enrolled 244 chronic pain patients treated at the Neurology Department. The original version of the S-LANSS was translated into Turkish by standard procedures. An independent clinician determined the pain type (neuropathic vs nociceptive). The reliability (internal consistency and test-retest reliability) and validity (agreement with the reference diagnosis and sensitivity, specificity, and positive and negative predictive values) were determined. RESULTS: Two-hundred and forty-four patients with chronic pain (167 women, 43.1 +/- 11.4 years), 137, neuropathic pain and 107, nociceptive pain, were asked to complete the S-LANSS twice. Cronbach's alpha-coefficient was 0.74 for the test and 0.73 for the retest. Total S-LANSS scores for subjects did not significantly differ between applications (P = 0.46). Correlation coefficient was r: 0.97 (P < 0.01), which is fairly high for a self-assessment tool. Compared with the clinical assessment, the sensitivity and specificity of the S-LANSS were 72.3% (95% CI, 64.0-79.6%) and 80.4% (95% CI, 71.6-87.4%), respectively, for both the test and retest. The sensitivity and specificity of the Turkish S-LANSS were similar to those determined in the original validation study. CONCLUSION: This study reports the first validation of a translated version of the S-LANNS into another language. The results suggest that the Turkish version of S-LANSS is a reliable and valid differential diagnostic measure of neuropathic pain in chronic pain patients.
Asunto(s)
Enfermedad Crónica , Lenguaje , Neuralgia/fisiopatología , Dimensión del Dolor , Autoevaluación (Psicología) , Encuestas y Cuestionarios , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor/métodos , Dimensión del Dolor/estadística & datos numéricos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Encuestas y Cuestionarios/normasRESUMEN
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by median nerve compression at the wrist. It results in loss of considerable man days and the effectiveness the various treatment modalities are still debated. AIM: To study the efficacy of gabapentin in patients with CTS. The study aim is to investigate the efficacy of gabapentin in patients with CTS patients who were refractory to the other conservative measures or unwilling for the surgical procedure. MATERIALS AND METHODS: Forty one patients diagnosed as idiopathic CTS were included in the study. Patients were assessed with symptom severity scale (SSS) and functional status scale (FSS) scores of Boston Carpal Tunnel Questionnaire (BCTQ) before and at 1, 3, and 6 months of the treatment. Response to therapy was determined by using SSS and FSS scores of BCTQ. RESULTS: The median dosage of gabapentin was 1800 mg/daily. Side effects were mild and transient. There was a statistically significant difference in both symptom SSS and FSS scores between before and after treatment in patient groups at the end of six months (P < 0.001). According to grading the changes in subscales of BCTQ, of 41 patients, 34.1 and 29.3 had a >or= 40% decrease in SSS and FSS, respectively. CONCLUSION: Gabapentin was found to be partially effective and safe in symptomatic treatment of CTS patients.
Asunto(s)
Aminas/uso terapéutico , Anticonvulsivantes/uso terapéutico , Síndrome del Túnel Carpiano/tratamiento farmacológico , Ácidos Ciclohexanocarboxílicos/uso terapéutico , Ácido gamma-Aminobutírico/uso terapéutico , Adulto , Femenino , Estudios de Seguimiento , Gabapentina , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
To evaluate brainstem excitability in menstrual migraine (MM) patients and compare the electrophysiological parameters of the trigeminocervical reflex (TCR) during the perimenstrual (headache period) and follicular (headache-free) periods with those in healthy controls. Thirty-one patients with MM and 22 volunteer age- and sex-matched healthy women were included in the study. The TCR was studied bilaterally with stimulation of the supraorbital branch of the trigeminal nerve during the perimenstrual period and follicular phase. The electrophysiological parameters of the TCR were compared between MM patients and controls. In controls, there was no statistically significant difference in the mean reflex latencies recorded during the perimenstrual and follicular phases (P > 0.05). In MM patients, the mean reflex latencies recorded during the perimenstrual (headache period) and follicular phase (headache-free) periods were significantly different from each other and from those in controls. The latencies of MM patients during the follicular (headache-free) period were significantly longer than those of controls. Brainstem excitability differed significantly between the perimenstrual (headache period) and follicular phase (headache-free) periods in MM. Furthermore, trigeminal excitability in MM patients was significantly different from that in healthy controls in both phases of the menstrual period.
Asunto(s)
Ciclo Menstrual/fisiología , Trastornos de la Menstruación/fisiopatología , Trastornos Migrañosos/fisiopatología , Umbral del Dolor/fisiología , Nervio Trigémino/fisiopatología , Adulto , Vías Aferentes/fisiopatología , Tronco Encefálico/fisiopatología , Estimulación Eléctrica , Electrodiagnóstico/métodos , Femenino , Humanos , Trastornos de la Menstruación/complicaciones , Persona de Mediana Edad , Trastornos Migrañosos/etiología , Músculos del Cuello/inervación , Músculos del Cuello/fisiopatología , Conducción Nerviosa/fisiología , Neuralgia/diagnóstico , Neuralgia/etiología , Neuralgia/fisiopatología , Nervio Oftálmico/anatomía & histología , Nervio Oftálmico/fisiología , Dimensión del Dolor/métodos , Tiempo de Reacción/fisiología , Reflejo/fisiología , Núcleos del Trigémino/fisiopatología , Adulto JovenRESUMEN
The objective of this study was to investigate the long-term efficacy and safety of botulinum toxin type-A (BoNT-A) for refractory chronic tension-type headache (CTTH). An open-label, prospective study was carried out in the Department of Neurology of Kirikkale University on 28 patients (8 males, 20 females), mean age 35.6 years, diagnosed with moderate/severe CTTH refractory to preventive medications. Each patient received BoNT-A injections once in pericranial muscles. Efficacy and safety data were analysed for 28 refractory CTTH patients who were receiving concomitant headache prophylactic medications at baseline and during the study. The main outcome parameters were reduction of headache frequency and intensity over 1 year. Both parameters were significantly decreased (p<0.05) by the end of the study. Sixty-four percent of patients reported complete headache relief at the final visit, compared to 7% CTTH persisted. BoNT-A also resulted in significant reductions in analgesic consumption (p<0.05). Adverse effects were transient and local. BoNT-A was found to be an effective and safe treatment for refractory CTTH patients with concomitant headache prophylactic medications, resulting in significant reductions in headache frequency, intensity and analgesic consumption which persisted up to 1 year.
Asunto(s)
Toxinas Botulínicas Tipo A/administración & dosificación , Toxinas Botulínicas Tipo A/efectos adversos , Músculo Esquelético/efectos de los fármacos , Cefalea de Tipo Tensional/tratamiento farmacológico , Adulto , Analgésicos/uso terapéutico , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Músculos del Cuello/efectos de los fármacos , Músculos del Cuello/fisiopatología , Fármacos Neuromusculares/administración & dosificación , Fármacos Neuromusculares/efectos adversos , Satisfacción del Paciente , Estudios Prospectivos , Recurrencia , Cefalea de Tipo Tensional/fisiopatología , Tiempo , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: Both basic and clinical research has demonstrated that antiepileptic drugs can be effective in alleviating neuropathic pain. It was hypothesized that oxcarbazepine might be effective in reducing the symptoms of painful diabetic neuropathy. AIMS: To investigate the long-term efficacy and safety of oxcarbazepine in symptoms of painful diabetic neuropathy. MATERIALS AND METHODS: This study included thirty-eight painful diabetic neuropathy patients, which were screened with clinical assessment and electrophysiological studies. The efficacy and safety of oxcarbazepine were evaluated according to the changes in pain intensity and social interference subitems scores of Short-form Brief Pain Inventory besides electrophysiological studies at the end of six months of the treatment. STATISTICAL ANALYSIS: The Students t, Mann-Whitney U and Rank Sum test and Chi-square tests were applied to examine variables differences. The level of statistical significance was chosen to be P<0.05. RESULTS: A significant difference was found in all of subitems of pain intensity and social interference at the end of the study according to the baseline scores. Improvement was observed in 52.7%, 63.1%, 55.3% and 63.2% of patients for worst, least, average and pain right now at the end of six months, respectively. Improvement was observed as 60.6%, 63.2%, 52.6%, 60.5%, 68.4% and 63.2% for general activity, mood, walk, work, people relations, sleep and life enjoyment subitems, respectively. None of these patients had any prominent side effect leading to discontinue the treatment. CONCLUSION: Long-term oxcarbazepine treatment was found to be effective and safe in the symptoms of painful diabetic neuropathy.
Asunto(s)
Carbamazepina/análogos & derivados , Neuropatías Diabéticas/tratamiento farmacológico , Adolescente , Adulto , Anciano , Carbamazepina/efectos adversos , Carbamazepina/uso terapéutico , Diabetes Mellitus Tipo 2 , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oxcarbazepina , Dolor/tratamiento farmacológico , Dolor/etiología , Dimensión del DolorRESUMEN
A unique case of bilateral severe carpal tunnel syndrome due to familial Mediterranean fever is reported. The syndrome was diagnosed by clinical examination and electrophysiological studies. Bilateral transverse carpal ligaments were released and the biopsy specimens revealed systemic type A amyloidosis. Up to our knowledge, the co-existence of bilateral carpal tunnel syndrome and familial Mediterranean fever has not been reported previously in the literature.
Asunto(s)
Neuropatías Amiloides/complicaciones , Síndrome del Túnel Carpiano/etiología , Fiebre Mediterránea Familiar/complicaciones , Adulto , Neuropatías Amiloides/diagnóstico , Neuropatías Amiloides/cirugía , Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/cirugía , Femenino , HumanosRESUMEN
PURPOSE: The objective of this study was to investigate whether the retrobulbar hemodynamics in the ophthalmic (OA), posterior ciliary (PCA), central retinal (CRA), and vertebral (VA) arteries are affected in migraineurs without aura. METHODS: The eyes of migraineurs without aura and those of healthy control subjects were evaluated during both headache and headache-free periods. Retrobulbar and vertebral blood flow velocities in the OA, PCA, CRA, and the extracranial part of the VA were measured bilaterally using color Doppler sonography. The peak systolic and end-diastolic flow velocities and the pulsatility (PI) and resistance (RI) indices were determined for all arteries. RESULTS: In total, we enrolled 30 migraineurs and 31 healthy control subjects. Statistically significant differences between headache-free migraineurs and control subjects were observed in the PI and RI of both right and left PCAs and in the RI of both right and left CRAs. The PI and RI of the left VA of the migraineurs were significantly lower during both headache and headache-free periods than were those of the control subjects. Among the migraineurs, the peak systolic and end-diastolic velocities of the left VA were increased during headache periods relative to those found during the headache-free periods. CONCLUSIONS: The retrobulbar circulation and flow hemodynamics in the left VA may be altered in both headache and headache-free periods in migraineurs without aura. The differences found between migraineurs and control subjects may implicate autonomic dysfunction in migraineurs.
Asunto(s)
Arterias Ciliares/diagnóstico por imagen , Trastornos Migrañosos/fisiopatología , Órbita/irrigación sanguínea , Arteria Retiniana/diagnóstico por imagen , Ultrasonografía Doppler en Color , Arteria Vertebral/diagnóstico por imagen , Adulto , Análisis de Varianza , Velocidad del Flujo Sanguíneo , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Methylphenidate is commonly believed to lower seizure threshold. The safe use of methylphenidate has not been clarified in patients with attention-deficit hyperactivity disorder (ADHD) and concomitant active seizure or electroencephalographic (EEG) abnormalities. Patients with ADHD and active seizures (n = 57) and patients with ADHD and EEG abnormalities (n = 62), 6 to 16 years of age, were included in the study. The safety and efficacy of treatment with antiepilepsy drugs combined with methylphenidate were determined by assessing seizure frequency, changes in ADHD symptoms, the Conners' Rating Scales, EEG differences, and side effects. The Conners' Rating Scales, performed by parents and teachers, and mean total ADHD symptom scores at the beginning of the study and at the end were significantly different (P = .05 for the Conners' Rating Scales and P = .001 for ADHD symptom scores). Methylphenidate had a beneficial effect on EEG. Seizure frequency did not change from baseline. The side effects of methylphenidate were mild and transient Methylphenidate is safe and effective in children with ADHD and concomitant active seizures or EEG abnormalities.
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Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/farmacología , Epilepsia/complicaciones , Epilepsia/tratamiento farmacológico , Metilfenidato/farmacología , Adolescente , Anticonvulsivantes/administración & dosificación , Anticonvulsivantes/farmacología , Niño , Comorbilidad , Electroencefalografía , Femenino , Humanos , Masculino , Resultado del TratamientoRESUMEN
We determined the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among health care workers (HCWs) at Gülhane Military Medical Academy, Haydarpasa Training Hospital in Istanbul, Turkey. Between April 1998 and September 2000, 702 HCWs were included in the study. The blood samples were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and HCV antibody (anti-HCV) using third-generation tests, with confirmation by reverse transcriptase-polymerase chain reaction. Seroprevalence rates were compared with those detected in 5670 blood donors during the same period. HBsAg, anti-HBs and anti-HCV were detected in 21 (3.0%), in 480 (68.4%) and in 2 (0.3%) of 702 HCWs respectively. HBsAg and anti-HCV rates were 2.1 and 0.4% in blood donors, respectively. These data show that the prevalence rates of HBV and HCV were similar with prevalence rates detected in randomized blood donors showing that universal infection-control precautions and encouraging HBV vaccination reduces HCW infection with hepatotropic viruses.
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Hepacivirus/aislamiento & purificación , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Adolescente , Adulto , Donantes de Sangre , Femenino , Personal de Salud , Hepacivirus/genética , Hepatitis B/diagnóstico , Hepatitis B/virología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Virus de la Hepatitis B/genética , Hepatitis C/diagnóstico , Hepatitis C/virología , Anticuerpos contra la Hepatitis C/sangre , Humanos , Masculino , Persona de Mediana Edad , ARN Viral/sangre , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Estudios Seroepidemiológicos , Turquía/epidemiologíaRESUMEN
Iron and ferritin are known to have an important role in stroke as well as in other disorders. This prospective study was designed to determine whether administering ferritin levels might help to estimate the severity and prognosis of stroke. Fifty-one patients with a diagnosis of acute stroke were included in the study within 24 h from onset of symptoms. Serum ferritin and cortisol levels were assayed at admission. Clinical status was determined by the Canadian Stroke Scale at admission and on day 21. Serum ferritin level was found to be higher in patients with large lesion size (P < 0.01), deteriorated neurologic status during clinical follow-up (P = 0.03) and deceased patients (P < 0.01). Serum ferritin level was correlated with neurologic deficit (r = 0.50, P < 0.001). No correlation was found between serum cortisol and ferritin levels (r = 0.07, P = 0.7). Serum ferritin level (P = 0.007; OR = 1.02; 95% CI, 1.01-1.03) and large size of lesion (P = 0.021, OR = 11.92; 95% CI; 1.46-197.12) were independently associated with mortality. Increased serum ferritin levels correlate to severity of stroke and the size of the lesion.
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Ferritinas/sangre , Accidente Cerebrovascular/sangre , Adulto , Anciano , Femenino , Humanos , Hidrocortisona/sangre , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/etiología , Enfermedades del Sistema Nervioso/fisiopatología , Pronóstico , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/complicacionesRESUMEN
Vaccination against HBV is important in order to reduce the incidence of HBV infection. Although the HBV vaccine is among the safest of all vaccines, vaccination against HBV has been associated with side-effects. Herein we present a case of afebrile convulsion after recombinant HBV vaccination.
Asunto(s)
Vacunas contra Hepatitis B/efectos adversos , Convulsiones/etiología , Adulto , Femenino , Virus de la Hepatitis B/genética , Humanos , Vacunación , Vacunas de ADN/efectos adversosRESUMEN
The effect of azithromycin on bronchial hyperresponsiveness was measured in a group of 11 patients with mild asthma. Azithromycin 250 mg orally was administered intermittently to all the patients twice a week for eight weeks. The only other treatment was inhaled beta2 agonist, when required. A histamine inhalation test was performed at the beginning and at the fourth and the eighth week of the study. The mean PC20 values increased significantly over the initial value at the eighth week after the administration of azithromycin (p < 0.05) but mean values for FEV1 and FEV1 percent predicted did not differ significantly. These results suggested that eight weeks of intermittent, low-dose administration of azithromycin in patients with mild asthma might reduce the severity of bronchial hyperresponsiveness.
Asunto(s)
Antibacterianos/uso terapéutico , Asma/complicaciones , Azitromicina/uso terapéutico , Hiperreactividad Bronquial/tratamiento farmacológico , Hiperreactividad Bronquial/fisiopatología , Adulto , Antibacterianos/administración & dosificación , Azitromicina/administración & dosificación , Hiperreactividad Bronquial/etiología , Relación Dosis-Respuesta a Droga , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadRESUMEN
This study was designed to demonstrate bacterial translocation following bile duct ligation and investigate preventive effects of hyperbaric oxygen on obstructive jaundice-related bacterial translocation in an animal model. Hyperbaric oxygen treatment significantly reduced the endogenous colony counts in distal ileum of normal rats both in the short (two days) and long (seven days) term. Endogenous bacteria in distal ileum significantly increased in bile duct ligated rats in the short and long term, and presence of bacterial translocation was proven by bacterial growth in mesenteric lymph nodes, liver, spleen, and blood. Short- and long-term hyperbaric oxygen treatments significantly reduced the intestinal colony counts and prevented the bacterial translocation almost completely in rats with bile duct ligation. It is concluded that obstructive jaundice causes bacterial overgrowth and translocation, and hyperbaric oxygen treatment can prevent both bacterial overgrowth and translocation effectively.
Asunto(s)
Traslocación Bacteriana , Colestasis/microbiología , Oxigenoterapia Hiperbárica , Animales , Sangre/microbiología , Recuento de Colonia Microbiana , Íleon/microbiología , Hígado/microbiología , Ganglios Linfáticos/microbiología , Masculino , Ratas , Ratas Wistar , Bazo/microbiologíaRESUMEN
The impaired perception of bronchoconstriction in asthmatic patients may increase the risk of severe exacerbation. To characterize the perception of bronchoconstriction in elderly asthma patients, we compared the perception in older patients with that of younger patients. To determine the influence of perception of long-standing diseases, we further evaluated the perception in early-onset elderly asthma patients and in late-onset elderly asthma patients. The study group consisted of 80 stable asthmatic patients. The patients were grouped according to their age (group 1, < 60 years, n = 37, group 2, > or = 60 years, n = 43). Each group was separated into two subgroups according to the duration of symptoms (late-onset asthma 1A and 2A, < 5 years, early-onset asthma 1B and 2B, > or = 5 years). A histamine inhalation test was performed for each patient. Dyspnea was assessed by modified Borg scale. The Borg score in forced expiratory volume in 1 sec (FEV1) reduction by 20% was determined as perception score 20 (PS20). The mean perception scores of the elderly asthmatic patients were significantly lower than those of the younger asthmatic patients (group 1, PS20 = 2.35 +/- 0.17; group 2, PS20 = 1.37 +/- 0.12, p < 0.0001). The differences of mean perception score (PS20) between early- and late-onset subgroups were insignificant (IA, 2.63 +/- 0.30 and IB, 2.07 +/- 0.16, p = 0.101; 2A, 1.36 +/- 0.19 and 2B, 1.59 +/- 0.120, p = 0.91). The mean perception scores of male asthmatic patients were significantly lower than those of female patients (p = 0.03). There was a correlation between PS20 and % FEV1 in the younger group (r = 0.392, p = 0.02), but not in the elderly group (r = 139, p = 0.375). The correlation between PS20 and PD20 in both younger and elderly group was insignificant (p > 0.05). Elderly asthmatics perceive less intense respiratory distress for a decrease of 20% in FEV1 than do younger asthmatics. This underperception of bronchoconstriction may result in a delay in medical care during an acute asthmatic episode. Thus, we strongly recommend that elderly asthmatic patients should be followed up more frequently and closely.
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Asma/psicología , Broncoconstricción/fisiología , Percepción , Adulto , Edad de Inicio , Anciano , Asma/fisiopatología , Pruebas de Provocación Bronquial , Estudios de Casos y Controles , Femenino , Histamina , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: The efficacy and safety of valproic acid were assessed as a prophylactic agent in migraine patients who previously derived no significant benefit from conventional prophylactic medications for migraine. PATIENTS AND METHODS: One hundred and twenty patients aged 23-58 years with the diagnosis of migraine without aura. Response to therapy was determined by using a headache calendar detailing the frequency and severity of attacks. Reduction of 50% or greater in the frequency or severity of headache was considered as improvement. RESULTS: Improvement was observed in headache frequency within 67% of patients. Headache severity had been improved in 60% of patients. The mean average dosage of valproic acid was 1,250 mg daily. Most of the side effects are mild and tolerable. CONCLUSION: These results suggest that valproic acid is effective and safe in the treatment of refractory migraine headache.
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GABAérgicos/farmacología , Migraña sin Aura/tratamiento farmacológico , Ácido Valproico/farmacología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Migraña sin Aura/patología , Recurrencia , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
In this article, we report two siblings who have familial cerebellar ataxia and hypogonadism associated with sensorimotor axonal polyneuropathy documented by light microscopy. This combination has not been reported previously in the literature. Cerebellar ataxia and hypogonadism is reviewed according to the clinical and laboratory features of the reported cases in the literature.