Articles: cations.
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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.
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J Stroke Cerebrovasc Dis · Jan 1995
Transcranial Doppler signals during cerebral angiography and cardiac catheterization.
Cerebral angiography is associated with a 0.45-4% risk of neurological complications and a less than 1% risk of permanent neurological deficit. Recently, air embolism has been implicated as a major cause of these complications. Cardiac catheterization is associated with a neurological complication rate of less than 1%; the predominant mechanism appears to be embolic. ⋯ No spontaneous emboli were seen. None of our 42 patients developed any type of neurological symptoms during or after the procedure. These high-intensity signatures do not represent air embolism exclusively; rather, they are likely a combination of turbulence in the bloodstream created during rapid injection, air emboli, and, perhaps, echogenicity of the contrast medium.
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In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right-left asymmetry indices in a fixed set of regions of interest was compared with the normal asymmetry indices in the healthy controls. ⋯ Two conclusions emerged: (1) visual evaluation of interictal migraine rCBF images is insufficient to pick up abnormalities; (2) almost 50% of the migraine sufferers had abnormal rCBF/asymmetries. However, these are discrete compared with those typically seen during the aura phase of a migraine attack. One explanation to the patchy rCBF patterns might be that they reflect interictal cerebrovascular dysregulation which might to be a common feature in both types of migraine.
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Despite its importance for chronic pain diseases, pain-related disability is a poorly defined concept with theoretical deficits. The distinction between impairment, disability, and handicap proposed by the WHO is an important contribution to clarification of the disability construct. With reference to four criteria (underlying disability construct, degree of behaviour generalization, assessment mode, scope) different assessment procedures of pain-related disability are presented and the advantages and disadvantages of each are discussed. ⋯ The results from four data sets concerning different aspects of reliability and validity confirm the good psychometric properties of the instrument. The instrument can be used in chronic pain research as well as in clinical contexts. It is recommended that subjective disability data be complemented by behavioral observation and additional data sources (e.g. assessment of disability by the spouse/partner).
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Within a prospective longitudinal study of 111 patients with acute radicular pain and lumbar disc prolapse who underwent conservative or surgical treatment, we examined the importance of specific pain coping strategies, which have received little attention in psychological pain research: appeals to "stick it out" on the cognitive level and endurance strategies on the behavioural level. Prior to treatment we conducted a psychological and neurological examination. The psychological tests included the Kiel Pain Inventory (KPI) and the Beck Depression Inventory (BDI). ⋯ Patients in group A were a specially high risk group: at the time of discharge they had no pain, but from the first week after discharge up to the 6-month follow up they had increasing pain. Additionally at the 6 month follow up they seemed less likely to return to work and 8 times more of them had applied for early retirement than in the groups of patients without psychological risk factors. The results suggested several suggestions for modification of medical and psychological therapy for chronic pain patients.