Articles: patients.
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Appl Neuropsychol Adult · May 1996
Rey complex figure: memory error patterns and functional abilities.
The functional abilities of brain injured persons to live independently, were assessed using the Rancho Los Amigos Scale ratings of functional levels which were compared with memory error patterns on the Rey Complex Figure (Rey 1941) and the Recognition Trial developed by Meyers & Meyers (1995) Memory error patterns were described by Sohlberg & Mateer (1989), the least impaired memory error pattern was Retrieval, while Storage, Encoding and Attention patterns indicated greater defect Spearman rank order correlation revealed the strong association (r(S) = 86) of memory error pattern with Rancho Scale functional ratings In independent subjects 96 % achieved a Retrieval memory error pattern whereas 93% of subjects whose memory error pattern was poorer than a Retrieval pattern were unable to function independently Results indicate that patients obtaining a Retrieval (or better) memory error pattern may be expected to possess adequate cognitive resources for independent functioning.
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Eur J Orthop Surg Tr · May 1996
Post operative infections of the spine: technique, indications and results of the surgical treatment - A retrospective study of 90 cases.
Post operative infection in spine surgery is a well known complication. The authors studied a series of 90 patients in accordance with an homogenous strategy based on the excision of necrotic and infected tissues, associated with appropriate antibiotics. The results are analyzed according to the degree of infection (which is based on the type of germs and their associations), and type of patients, the delay in diagnosis and the anatomical extension of the infected lesions. ⋯ Dans cette série, les auteurs ne signalent aucune complication neurologique dûe à l'infection. Néanmoins, 8 décès sont à déplorer chez des patients fragiles avec signes neurologiques initiaux. Ceci souligne l'importance du traitement général associé à la chirurgie et la nécessité d'un bilan complet de ces malades.
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The antinociceptive effect of alpha(2)-adrenoceptor agonists is mediated by activation of descending inhibiting noradrenergic systems, which modulates 'wide-dynamic-range' neurones. Furthermore, they inhibit the liberation of substance P and endorphines and activate serotoninergic neurones. Despite this variety of antinociceptive actions, there is still little experience with alpha(2)-adrenoceptor agonists as therapeutic agents for use in chronic pain syndromes. ⋯ In isolated cases clonidine has been administered epidurally at a dose of 1500 microg/day for almost 5 months without evidence for any histotoxic property of clonidine. Side effects often observed during administration of alpha(2)-adrenoceptor agonists are dry mouth, sedation, hypotension and bradycardia. Therapeutic interventions are usually not required.
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Spinal clonidine interacts with pre- and postsynaptic alpha(2)-adrenoceptors on afferent neurons in the superficial dorsal horn of the spinal cord: it causes analgesia by inhibition of the synaptic and electrotonic neurotransmission of nociceptive impulses. Epidural doses higher than 4 microg/kg have an analgesic onset time of less than 30 min, reduce pain by more than 70 %; these effects last for 4-5 h. ⋯ The haemodynamic side effects mean close supervision is needed during the first hour after epidural application and limit the use of epidural clonidine to patients who are refractory to the analgesic effects of epidural opioid or local anaesthetics. In these patients excellent results can be achieved either with clonidine alone or with a combination of clonidine and an opioid or a local anaesthetic to exploit the additive or supra-additive interactions of these drugs.
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Blood pressure monitoring · Apr 1996
The elevation of forearm arterial blood pressureduring Riva-Rocci-Korotkoff measurements.
To investigate why the forearm pressure rises above the systemic blood pressure upon the release of occluding cuff pressure during Riva-Rocci-Korotkoff blood pressure measurements and whether this overshoot could, as has been suggested, be used to predict the accuracy of Riva-Rocci-Korotkoff measurements in a certain patient. DESIGN AND ⋯ These findings are consistent with the hypothesis that the diastolic blood pressure overshoot results from increased filling of the forearm vasculature during Riva-Rocci-Korotkoff measurements. The systolic blood pressure overshoot probably results from pulse wave amplification in the partially occluded artery underneath the upper arm cuff. The overshoot phenomenon was not related to Riva-Rocci-Korotkoff errors.