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Transient Improvement (transient + improvement)
Selected AbstractsTransient improvement induced by motor fatigue in focal occupational dystonia: The handgrip testMOVEMENT DISORDERS, Issue 6 2001Alessandra Pesenti MD Abstract Muscle fatigue induced by a previous sustained contraction temporarily decreases the motor output, transiently worsening motor performance. Whether muscle fatigue alters motor performance also in dystonia,a disorder whose main pathophysiological abnormality is motor overflow,remains unknown. To assess the effects of muscle fatigue in patients with focal occupational upper limb dystonia, we studied the effect of a previous maximum fatiguing voluntary contraction on motor performance in 10 musicians with focal occupational dystonia, in 3 musicians with hand motor impairment due to non-dystonic disorders, and in 5 normal musicians. The fatiguing task consisted of grasping a spring handgrip as long as possible until the task failed. In dystonic musicians, a fatiguing contraction significantly improved motor performance. The improvement lasted less than 5 minutes and appeared only after fatigue of the affected upper limb. In contrast, in musicians with non-dystonic motor impairment, motor performance remained unchanged or worsened, and normal musician performance consistently worsened. © 2001 Movement Disorder Society. [source] Effects of repeated injection of intravitreal triamcinolone on macular oedema in central retinal vein occlusionACTA OPHTHALMOLOGICA, Issue 3 2009Lili Wang Abstract. Purpose:, To investigate the effectiveness of repeated injections of intravitreal triamcinolone acetonide (IVTA) in the treatment of macular oedema caused by central retinal vein occlusion (CRVO). Methods:, Seventeen pseudophakic or aphakic eyes of 17 patients (10 male, seven female) with macular oedema caused by CRVO received a repeat injection of 4 mg IVTA, 16 weeks after the first injection of the same dose. The examination included measurements of best-corrected visual acuity (BCVA) for distance and central foveal thickness (CFT) by optical coherence tomography (OCT), preoperatively and 1, 2, 3 and 4 months postoperatively. The values were compared by paired- t test. Side-effects were monitored. Results:, BCVA and CFT were not significantly different before initial and repeat injections. Transient improvements of BCVA and CFT were achieved after both injections. At the end of follow-up, BCVA and CFT were significantly different compared to pre-injection values in the same group (P = 0.032, 0.049 in the initial-injection group and P = 0.001, 0.008 in the repeat-injection group, respectively). However, compared to the initial injection, BCVA measurements were significantly worse at each time-point (P = 0.043, 0.011, 0.010 and 0.012, respectively) after the repeat injection, as were CFT at 1, 2 and 3 months post-injection (P = 0.040, 0.015 and 0.025, respectively). The achieved maximum mean intraocular pressures were 20.00 [standard deviation (SD) 2.06] mmHg and 18.56 (SD 3.65) mmHg after the first and repeat injections, respectively. These values were not significantly different (P = 0.467). No other significant adverse events were noted during the study. Conclusion:, A repeat injection of 4 mg IVTA may not be as effective as an initial injection for the treatment of macular oedema caused by CRVO. [source] Consumers' attitudes, knowledge, self-reported and actual hand washing behaviour: a challenge for designers of intervention materialsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2003D.A. Clayton Cross contamination by microbial pathogens in the kitchen environment may play an important role in many cases of food borne illnesses. Hand washing has been shown to be one of the most important factors in controlling the spread of microorganisms and in preventing the spread of disease. However, educational campaigns such as distribution of information leaflets, workshops, performance feedback and lectures have been, at best, associated with a transient improvement in compliance rates. In addition, the majority of research investigating UK consumers' food safety behaviour has examined self-reported as opposed to actual hand washing behaviour. This research utilises psychological theory in an attempt to understand how one might design a more effective hand washing campaign. Social cognition models were utilised to explore the relationship between consumers' knowledge, attitudes, self-reported and actual hand washing behaviour. The research was conducted in two stages. Firstly, salient beliefs of 100 consumers towards food safety were obtained using open-ended questions. Secondly, the food handling practices of 40 consumers were observed and their food safety attitudes and knowledge determined using structured questionnaires. All the participants were knowledgeable about hand washing techniques, intended to wash their hands and generally had positive attitudes towards the importance of washing their hands. However, none of the participants adequately washed their hands on all appropriate occasions. The attitude statement results suggest measures of perceived behavioural control, perceived barriers and perceived risk may provide developers of food safety intervention materials with more useful information compared with measures of consumers' knowledge or intention. Issues of habit and optimistic bias also need to be given consideration when designing intervention materials to change hand washing behaviour of consumers. [source] Treatment of a Myasthenic Dog with Mycophenolate MofetilJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2000C.W. Dewey DVM, DACVIM (Neurology), DACVS Summary A ten-year-old, male castrated Springer Spaniel was presented for dysphagia, ptyalism, and regurgitation. Evidence of megaesophagus and mild aspiration pneumonia were apparent on thoracic radiographs. A diagnosis of focal acquired myasthenia gravis was suspected and subsequently confirmed with a positive serum acetylcholine (ACh) receptor antibody concentration (3.87 nM/L). A gastrostomy tube was placed shortly after presentation; food and drugs (including azathioprine) were administered through the tube. After transient improvement, the dog suddenly deteriorated clinically, experiencing frequent episodes of regurgitation and developing severe aspiration pneumonia. Mycophenolate mofetil (MMF), a novel immunosuppressive drug with relative specificity for lymphocytes, was instituted every twelve hours via the gastrostomy tube. Within four days of beginning MMF therapy, both clinical evidence of pharyngeal/esophageal dysfunction and radiographic evidence of megaesophagus had resolved. Initially, clinical side-effects of combined MMF/AZA administration were not apparent, but the patient experienced several vomiting episodes during the third week of treatment. The vomiting resolved after decreasing the dose of both drugs. The patient made a full recovery, and a one-month follow-up ACh receptor antibody concentration was normal (0.26 nM/L). After one month of combination therapy, the patient was weaned off of AZA and maintained on MMF as the sole immunosuppressive drug. The dog was subsequently weaned off of MMF on two occasions. Mycophenolate mofetil was reinstituted after the first discontinuation due to the development of profound appendicular muscle weakness two days after stopping MMF; the weakness resolved within 24 hours of reinstituting MMF. A positive ACh receptor antibody concentration (0.89 nM/L) after the second MMF weaning prompted the second reinstitution of MMF. Two months following this second MMF reinstitution, the dog was again serologically negative (0.51 nM/L) for myasthenia gravis. At the time of last followup, the dog remained in clinical remission eight months after initial presentation. The use of MMF to treat acquired myasthenia gravis in dogs has not been reported previously. The literature concerning MMF and its potential use in treating patients with autoimmune diseases is discussed. [source] Molding the sensory cortex: Spatial acuity improves after botulinum toxin treatment for cervical dystoniaMOVEMENT DISORDERS, Issue 16 2007Richard Walsh MB Abstract Disorganization of sensory cortical somatotopy has been described in adult onset primary torsion dystonia (AOPTD). Although botulinum toxin type A (BTX-A) acts peripherally, some studies have suggested a central effect. Our primary hypothesis was that sensory cortical reorganization occurs after BTX-A treatment of AOPTD. Twenty patients with cervical dystonia and 18 healthy age-matched control patients had spatial discrimination thresholds (SDTs) measured at baseline and monthly for 3 months. Mean baseline SDT (±SD) was 1.75 ±0.76 mm in the dystonia group, greater than the control group mean of 1.323 ± 0.45 mm (P = 0.05). Mean control group SDT did not vary significantly over time. A transient improvement of 23% from baseline (P = 0.005) occurred in the dystonia group 1 month after injection, which did not positively correlate with changes in physician and patient ratings of torticollis severity. The presumed mechanism of SDT improvement is a modulation of afferent cortical inputs from muscle spindles. © 2007 Movement Disorder Society [source] The short-term effect of hyperoncotic albumin, given alone or with furosemide, on oxygenation in sepsis-induced Acute Respiratory Distress SyndromeANAESTHESIA, Issue 3 2007M. Kuper Summary Two prospective non-randomised interventional case series were conducted consecutively at a single university hospital mixed intensive care unit, in patients with severe sepsis and acute respiratory distress syndrome. The first series describes the administration of 200 ml of 20% human albumin solution over 120 s in 13 patients, examining the hypothesis that raising plasma albumin should improve oxygenation. The second series describes the effect of administering 30 mg of furosemide intravenously along with the albumin in 15 patients, exploring whether this would produce more sustained improvement in oxygenation than albumin only. Oxygenation and haemodynamic parameters were measured for 4 h, during the period of peak oncotic effect. Hyperoncotic albumin given alone or with furosemide produced only transient improvement in oxygenation and haemodynamics, which was statistically significant only in the patients given albumin alone. Although the plasma albumin remained significantly elevated at 4 h in both series, no sustained improvement in oxygenation was seen. [source] Acute hyperglycemia produces transient improvement in glucose transporter type 1 deficiencyANNALS OF NEUROLOGY, Issue 1 2010Cigdem I. Akman MD Objective Glucose transporter type 1 deficiency syndrome (Glut1-DS) is characterized clinically by acquired microcephaly, infantile-onset seizures, psychomotor retardation, choreoathetosis, dystonia, and ataxia. The laboratory signature is hypoglycorrhachia. The 5-hour oral glucose tolerance test (OGTT) was performed to assess cerebral function and systemic carbohydrate homeostasis during acute hyperglycemia, in the knowledge that GLUT1 is constitutively expressed ubiquitously and upregulated in the brain. Methods Thirteen Glut1-DS patients completed a 5-hour OGTT. Six patients had prolonged electroencephalographic (EEG)/video monitoring, 10 patients had plasma glucose and serum insulin measurements, and 5 patients had repeated measures of attention, memory, fine motor coordination, and well-being. All patients had a full neuropsychological battery prior to OGTT. Results The glycemic profile and insulin response during the OGTT were normal. Following the glucose load, transient improvement of clinical seizures and EEG findings were observed, with the most significant improvement beginning within the first 30 minutes and continuing for 180 minutes. Thereafter, clinical seizures returned, and EEG findings worsened. Additionally, transient improvement in attention, fine motor coordination, and reported well-being were observed without any change in memory performance. Interpretation This study documents transient neurological improvement in Glut1-DS patients following acute hyperglycemia, associated with improved fine motor coordination and attention. Also, systemic carbohydrate homeostasis was normal, despite GLUT1 haploinsufficiency, confirming the specific role of GLUT1 as the transporter of metabolic fuel across the blood-brain barrier. The transient improvement in brain function underscores the rate-limiting role of glucose transport and the critical minute-to-minute dependence of cerebral function on fuel availability for energy metabolism. ANN NEUROL 2010;67:31,40 [source] Clinical and imaging evidence of zolpidem effect in hypoxic encephalopathyANNALS OF NEUROLOGY, Issue 1 2007Christine Brefel-Courbon MD We conducted a randomized, double-blind, placebo-controlled, single-patient (N = 1) trial to evaluate the efficacy of zolpidem in a 48-year-old woman with an akinetic mutism. Motor and cognitive examinations and functional imaging were performed. Acute administration of zolpidem markedly improved motor performance and neuropsychological status. Cerebral metabolism (18F-fluorodeoxyglucose positron emission tomography) increased in postrolandic territories and in frontal cortex. Using the H215O positron emission tomography, we found a drug-induced activation in the anterior cingulate and orbitofrontal cortices. Zolpidem induced a transient improvement in motor and cognitive performances. This paradoxical effect could result from an activation of limbic loops modulating motivational processes. Ann Neurol 2007 [source] Recurrent giant chalazia in hyperimmunoglobulinemia E (Job's) syndromeACTA OPHTHALMOLOGICA, Issue 2007P PATTERI Purpose: To report a case of recurrent, multiple giant chalazia in a patient with hyperimmunoglobulinemia E (Job's) syndrome, a rare autosomal dominant disorder characterized by markedly increased immunoglobulin E levels and recurrent pulmonary and skin infections. Methods: A 50-year-old man was referred with a 4-year history of recurrent, multiple giant chalazia in all eyelids. Medications and surgical intervention produced only transient improvement. The patient also had a history of pulmonary and scalp infection. Results: Laboratory tests disclosed elevated plasma immunoglobulin E (> 500 IU/ml) and eosinophilia. As a result, based on clinical and laboratory findings, a diagnosis of hyperimmunoglobulinemia E (Job's) syndrome was made. Conclusions: Even though rarely, recurrent multiple giant chalazia may occur as an ophthalmic feature of the Job's syndrome. The hyperimmunoglobulinemia E syndrome should be suspected in any case of recurrent giant chalazia. Measurament of plasma immunoglobulin E and eosinophils, along with internal evaluation, are essential to establish a proper diagnosis. [source] Neutrophil apoptosis in preeclampsia, do steroids confound the relationship?JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2004Akiko Fuchisawa Abstract Aim:, To investigate the influence of maternal corticosteroid administration on neutrophil apoptosis in early onset preeclampsia. Methods:, We investigated five groups: early onset preeclampsia (EOPET, <34 weeks, n = 10); late-onset preeclampsia (LOPET, ,34 weeks, n = 7); normotensive intrauterine growth restriction (nIUGR, n = 11); normal pregnancy (NPC, n = 22); and non-pregnancy (n = 10). We examined, by flow cytometry, spontaneous neutrophil apoptosis after 18 h culture (hypodiploid DNA, Annexin V binding, propidium iodide [PI] permeability). Results:, For the 10 women with EOPET exposed to betamethasone in the previous 48 h, we found that neutrophil apoptosis was not inappropriately inhibited, in contrast to our previous findings in women not thus exposed. Neither LOPET nor nIUGR differed from normal pregnancy. Conclusion:, Betamethasone alters the rate of spontaneous neutrophil apoptosis in EOPET. The anti-inflammatory influence of betamethasone may explain some of the differences between our previous and present findings with respect to neutrophil apoptosis in EOPET. Corticosteroids ameliorate the course of antenatal and postnatal preeclampsia. These results may reflect the mechanisms that underlie the transient improvements seen with antenatal dexamethasone use. [source] | ||||||||||