RESUMEN
An HTLV-1-infected patient can develop paraparesis that limits their movements. Rehabilitation techniques could improve the motor abilities of these patients. The present study investigates five cases of physical therapy intervention in HTLV-1 patients to evaluate the influence of functional rehabilitation on the tonus and range of motion (ROM) of HTLV-1 patients with spasticity. The patients had a gain of ROM, especially in the lower limb, and reduction in hypertonia/spasticity after functional treatment. The reduction in hypertonia increased the ROM. Thus, functional methods may be valuable for the rehabilitation of HTLV-1 patients with neurological damage.
Asunto(s)
Virus Linfotrópico T Tipo 1 Humano , Hipertonía Muscular/rehabilitación , Ejercicios de Estiramiento Muscular/métodos , Paraparesia Espástica Tropical/complicaciones , Paraparesia Espástica Tropical/rehabilitación , Adulto , Femenino , Humanos , Masculino , Hipertonía Muscular/etiología , Fuerza Muscular/fisiología , Tono Muscular/fisiología , Paraparesia Espástica Tropical/fisiopatología , Calidad de Vida , Rango del Movimiento Articular/fisiologíaRESUMEN
Abstract An HTLV-1-infected patient can develop paraparesis that limits their movements. Rehabilitation techniques could improve the motor abilities of these patients. The present study investigates five cases of physical therapy intervention in HTLV-1 patients to evaluate the influence of functional rehabilitation on the tonus and range of motion (ROM) of HTLV-1 patients with spasticity. The patients had a gain of ROM, especially in the lower limb, and reduction in hypertonia/spasticity after functional treatment. The reduction in hypertonia increased the ROM. Thus, functional methods may be valuable for the rehabilitation of HTLV-1 patients with neurological damage.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Virus Linfotrópico T Tipo 1 Humano , Paraparesia Espástica Tropical/complicaciones , Paraparesia Espástica Tropical/rehabilitación , Ejercicios de Estiramiento Muscular/métodos , Hipertonía Muscular/rehabilitación , Calidad de Vida , Paraparesia Espástica Tropical/fisiopatología , Rango del Movimiento Articular/fisiología , Fuerza Muscular/fisiología , Hipertonía Muscular/etiología , Tono Muscular/fisiologíaRESUMEN
Cronobacter spp. (formerly Enterobacter sakazakii) are rare causes of infant septicemia and meningitis, resulting in death in approximately 40% of cases. Since 1958, 120 cases of Cronobacter infection in infants have been reported, an average of fewer than three cases per year worldwide. Powdered infant formula (PIF), which is not sterile, has been implicated repeatedly as a vehicle of Cronobacter infection; consequently, the World Health Organization (WHO) has issued guidelines for safer preparation, handling, and storage of PIF. This report describes isolation of Cronobacter spp. in two nonhospitalized, unrelated infants (one male and one female) in New Mexico in 2008; one infant developed severe brain injury and hydrocephalus, and the other infant died. An investigation by the New Mexico Department of Health (NMDOH) determined that PIF consumption was the only known risk factor in the two cases, although the sources of the Cronobacter spp. could not be determined. Cronobacter spp. were not isolated from sealed canisters of formula associated with the two infants, and clinical isolates from the infants differed by pulsed-field gel electrophoresis (PFGE). However, a Cronobacter organism was isolated from an opened canister of formula consumed by the male infant and was indistinguishable from an isolate from his postmortem blood culture. Education of formula preparers regarding potential PIF contamination, universal adoption of WHO PIF preparation guidelines, and continued improvement of PIF manufacturing processes might help prevent Cronobacter infection among infants.
Asunto(s)
Absceso Encefálico/microbiología , Cronobacter sakazakii/aislamiento & purificación , Infecciones por Enterobacteriaceae/complicaciones , Fórmulas Infantiles , Infecciones por Enterobacteriaceae/sangre , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/genética , Resultado Fatal , Femenino , Humanos , Hidrocefalia/microbiología , Lactante , Masculino , Hipertonía Muscular/etiología , New MexicoRESUMEN
OBJECTIVE: Compare detrusor muscle of normal and patients with infravesical obstruction, quantifying the collagen and elastic system fibers. MATERIALS AND METHODS: We studied samples taken from bladders of 10 patients whose ages ranged from 45 to 75 years (mean = 60 years), who underwent transvesical prostatectomy for treatment of BPH. Control material was composed of 10 vesical specimens, removed during autopsies performed in cadavers of accident victims, with ages between 18 and 35 years (mean = 26 years). RESULTS: The results of collagen and elastic fibers quantification (volumetric density) demonstrated the following results in percentage (mean +/- standard deviation): collagen in BPH patients = 4.89 +/- 2.64 and 2.32 +/- 1.25 in controls (p < 0.0001), elastin in BPH patients = 10.63% +/- 2.00 and 8.94% +/- 1.19 in controls (p < 0.0001). CONCLUSION: We found that the components of connective tissue, collagen and elastic system fibers are increased in the detrusor muscle of patients with infravesical obstruction, when compared to controls.
Asunto(s)
Colágeno/análisis , Tejido Elástico/patología , Hipertonía Muscular/patología , Músculo Liso/patología , Hiperplasia Prostática/patología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Hipertonía Muscular/etiología , Hipertonía Muscular/cirugía , Prostatectomía , Hiperplasia Prostática/complicaciones , Obstrucción del Cuello de la Vejiga Urinaria/etiología , Obstrucción del Cuello de la Vejiga Urinaria/fisiopatologíaRESUMEN
OBJECTIVE: Compare detrusor muscle of normal and patients with infravesical obstruction, quantifying the collagen and elastic system fibers. MATERIALS AND METHODS: We studied samples taken from bladders of 10 patients whose ages ranged from 45 to 75 years (mean = 60 years), who underwent transvesical prostatectomy for treatment of BPH. Control material was composed of 10 vesical specimens, removed during autopsies performed in cadavers of accident victims, with ages between 18 and 35 years (mean = 26 years). RESULTS: The results of collagen and elastic fibers quantification (volumetric density) demonstrated the following results in percentage (mean +/- standard deviation): collagen in BPH patients = 4.89 +/- 2.64 and 2.32 +/- 1.25 in controls (p < 0.0001), elastin in BPH patients = 10.63 percent +/- 2.00 and 8.94 percent +/- 1.19 in controls (p < 0.0001). CONCLUSION: We found that the components of connective tissue, collagen and elastic system fibers are increased in the detrusor muscle of patients with infravesical obstruction, when compared to controls.
Asunto(s)
Humanos , Masculino , Adolescente , Adulto , Persona de Mediana Edad , Colágeno/análisis , Tejido Elástico/patología , Hipertonía Muscular/etiología , Hipertonía Muscular/fisiopatología , Músculo Liso/fisiopatología , Hiperplasia Prostática/complicaciones , Obstrucción del Cuello de la Vejiga Urinaria/etiología , Obstrucción del Cuello de la Vejiga Urinaria/fisiopatología , Estudios de Casos y Controles , Procesamiento de Imagen Asistido por Computador , Hipertonía Muscular/cirugía , Prostatectomía , Hiperplasia Prostática/cirugíaRESUMEN
OBJECTIVE: To quantify the effect of grades I-II intraventricular hemorrhage (IVH) on the neurosensory and cognitive outcomes of extremely low birth weight infants. STUDY DESIGN: Of 706 extremely low birth weight infants without major malformations admitted to our center from 1992 to 2000, 537 survived to 20 months' corrected age (CA) and had cranial ultrasound studies performed, of whom 490 (91%) had complete neurodevelopmental assessments. Infants with severe cranial ultrasound abnormalities or meningitis were excluded, leaving a population of 362 infants, 258 of whom had a normal cranial ultrasound and 104 had an isolated grade I-II IVH. The groups had similar birth weight (808 vs 801 grams) and gestational age (26.5 vs 26.3 weeks). Outcomes of infants with normal cranial ultrasound were compared with those with grades I-II IVH at 20 months' CA. Outcomes included the Bayley Scales of Infant Development Mental Developmental Index (MDI) and major neurosensory abnormality. Logistic regression was used to assess the effect of grades I-II IVH on outcomes while adjusting for other risk factors. RESULTS: Extremely low birth weight infants with grades I-II IVH had a significantly lower mean MDI score than infants with normal cranial ultrasound (74 +/- 16 vs 79 +/- 14, P = .006). They had higher rates of MDI <<70 (45% vs 25%; OR, 2.00; 95% CI, 1.20 to 3.30; P = .008), major neurologic abnormality (13% vs 5%; OR, 2.60; 95% CI, 1.06 to 6.36; P = .036), and neurodevelopmental impairment (47% vs 28%; OR, 1.83; 95% CI, 1.11 to 3.03; P = .018) at 20 months' CA, even when adjusting for confounding factors. CONCLUSIONS: Extremely low birth weight infants with grades I-II IVH have poorer neurodevelopmental outcomes at 20 months' CA than infants with normal cranial ultrasound. Advanced radiologic imaging may indicate additional brain injury associated with grade I-II IVH, which could explain these outcomes.
Asunto(s)
Encéfalo/fisiopatología , Hemorragia Cerebral/fisiopatología , Parálisis Cerebral/etiología , Ventrículos Cerebrales/patología , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/fisiopatología , Sordera/etiología , Discapacidades del Desarrollo/etiología , Enfermedades del Prematuro/fisiopatología , Trastornos de la Destreza Motora/etiología , Hipertonía Muscular/etiología , Hipotonía Muscular/etiología , Hemorragia Cerebral/complicaciones , Hemorragia Cerebral/patología , Parálisis Cerebral/diagnóstico , Parálisis Cerebral/fisiopatología , Trastornos del Conocimiento/diagnóstico , Sordera/diagnóstico , Demografía , Discapacidades del Desarrollo/diagnóstico , Discapacidades del Desarrollo/fisiopatología , Ecoencefalografía , Humanos , Recién Nacido , Recien Nacido Prematuro , Recién Nacido de muy Bajo Peso , Madres , Trastornos de la Destreza Motora/diagnóstico , Trastornos de la Destreza Motora/fisiopatología , Hipertonía Muscular/diagnóstico , Hipertonía Muscular/fisiopatología , Hipotonía Muscular/diagnóstico , Hipotonía Muscular/fisiopatología , Índice de Severidad de la EnfermedadRESUMEN
Estuda-se a hipertonia espástica post ictus considerando as intervençöes farmacológicas e cirúrgicas para o seu tratamento
Asunto(s)
Humanos , Hipertonía Muscular/etiología , Hipertonía Muscular/terapia , Accidente Cerebrovascular/complicacionesRESUMEN
Se ha reportado que la glicina puede ser usada como una droga espasmolítica. Sin embargo, son pocos los reportes y no son concluyentes. Nuestro propósito ha sido el de evaluar los efectos de la administración oral de glicina (2mg/24hr/4meses) a un grupo de pacientes hemipléjicos espásticos (G1, n=10) mediante los cambios electromiográficos registrados en sus músculos espásticos así como sus antagonistas y compararlos con los obtenidos en otro grupo de pacientes hemipléjicos espásticos a los cuales no se les administró glicina (G2, n=8). Ambos grupos recibieron tratamiento de terapia física durante los cuatro meses del periodo de estudio. Se utilizó un electromiógrafo Cadwell 5200-A para obtener el registro electromiográfico del patrón de interferencia (EMG-P) de los músculos palmar (espástico), radial (antagonista), gemelo interno (espástico) y tibial anterior (antagonista). Se llevaron a cabo dos sesiones de registro: Antes (A) y 4 meses después (D) de el tratamiento. En ambos grupos, la amplitud promedio del registro EMG-PL obtenido de los músculos espásticos, sufrió un decremento, excepto para el Gemelo Interno en el G1, lo que indica una disminución de la hipertonicidad muscular. Por otro lado, la amplitud promedio del registro EMG-PL obtenido en los músculos antagonistas se incremento en G1 y decreción en G2. Las diferencias entre A y D para cada músculo fueron significativas (P 0.02), prueba intragrupal de Wilcoxon) y las diferencias entre G1 y G2 también significativas (P 0.01, Man-Withney). Los resultados indican que la mayor mejoría clínica mostrada por los pacientes del G1, pudieran deberse a un efecto de la glicina, probablemente debido a un incremento de la actividad de los músculos antagonistas. Además del efecto inhibitorio sobre la hiperexcitabilidad de los músculos espásticos
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Electromiografía/métodos , Glicina/farmacocinética , Hemiplejía/fisiopatología , Hipertonía Muscular/etiología , Espasticidad Muscular/etiología , Parasimpatolíticos/administración & dosificaciónRESUMEN
Abordam-se as principais alteraçöes anatomofuncionais dos membros inferiores causadas pela paralisia cerebral e as principais técnicas cirúrgicas de correçäo. Conclui-se que a operaçäo de Eggers que age sobre os músculos biarticulares é a que oferece melhores resultados nos pacientes portadores de contratura em flexäo do joelho por hipertonia muscular e que somente nos casos muito discretos pode-se esperar algum resultado satisfatório usando o método incruento de cura