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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 145 (2001), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 136 (1997), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We performed a randomized double-blind study within-group comparison in 11 patients to study the effect of subcutaneous injections of botulinum A toxin in focal hyperhidrosis of the palms. A total dose of 120 mU (mouse units) of botulinum A toxin (Dysport®) was injected into six different sites on one palm, whereas the other was injected with sterile saline. Objective quantification of sweat production was performed using digitized ninhydrin-staincd sheets. Three weeks after treatment, the mean reduction of sweat production in the botulinum A toxin-treated palms was 26% (P〈0·001). after 8 weeks 26% (P= 0·002) and after 13 weeks 31% (P〈0·001).Subjective assessment of sweat production by the patients using a visual analogue scale showed a 38% improvement in the botulinum A toxin-treated palms at 3 weeks (P=0·002). 40% at 8 weeks (P=0·002) and 38% at 13 weeks (P= 0·002). Neither the objective measurement nor the subjective rating showed a statistically significant reduction of sweating in the placebo-treated palms. Three patients reported reversible minor weakness of powerful handgrip after injection at the toxin-treated site, lasting between 2 and 5 weeks.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 134 (1996), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 145 (2001), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background The blocking action of botulinum toxin type A (BTX-A) on cholinergically innervated sweat glands has been used successfully to treat patients with focal hyperhidrosis. Objectives To investigate the long-term efficacy and safety of intradermal injections of BTX-A. Methods We performed an open-label study in 61 patients treated over a period of 3 years for axillary or palmar hyperhidrosis. A total dose of 400 mU BTX-A (Dysport®) was injected into both axillae or 460 mU BTX-A (Dysport®) into both palms. The injections were repeated after relapse. Objective quantification of sweat production was performed using digitized ninhydrin-stained sheets. Results Four weeks after BTX-A treatment the median reduction in sweat production was 71% compared with baseline (P 〈 0·001) in the axillary group and 42% (P = 0·005) in the palmar group. Subjective assessment of sweat production by the patients using a visual analogue scale (0, no sweating; 100, the most severe sweating) showed a significant reduction in both the axillary (P 〈 0·001) and palmar groups (P 〈 0·001). Secondary disturbances due to focal hyperhidrosis interfering with daily activities were markedly improved in both groups. The median time interval between the sets of injections was 34 weeks for axillary hyperhidrosis and 25 weeks for palmar hyperhidrosis. The treatment of palmar hyperhidrosis was complicated by transient but not disabling weakness of the small hand muscles in nine of 21 patients. Conclusions Repeated intradermal injections of BTX-A in patients with axillary and palmar hyperhidrosis are as effective as first treatments.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neural transmission 5 (1993), S. 157-161 
    ISSN: 1435-1463
    Keywords: Parkinson's disease ; sports ; physical activity ; exercise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Physical activity during lifetime was investigated among 32 Parkinson patients (age 65.6±8.1 yrs, mean±SD) retrospectively by means of a structured interview. Data were compared with 31 healthy controls (age 61.7±5.8 yrs). An objective score was obtained by presenting a list of all kinds of sports, subjective estimation of physical activity was done by visual analogous scales. Until the occurrence of the first symptoms (mean=58.5 yrs) the patients did not differ from controls. During the course of disease a striking reduction in physical activity but no complete abandonment of sports was found. Swimming, hiking and gymnastics were the favoured sports in both groups. Learning of new sports seemed to be impossible for the patients.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1435-1463
    Keywords: Melatonin ; Parkinson's disease ; l-dopa ; phase shift ; tremor ; human circadian rhythm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Aim of this study was the characterization of the circadian melatonin profile in de novo Parkinson patients (N=9, age 60.0±3.2 years, mean ± SEM) and the comparison of these profiles with those of controls and Parkinson patients treated with I-dopa/decarboxylase inhibitor (l-dopa/DCI). We collected 14 venous blood samples during a period of 24 hours and measured the serum melatonin levels by a radioimmuno assay. De novo Parkinson patients displayed the nocturnal melatonin peak (acrophase) at the same time as controls and significantly later than l-dopa/DCI treated patients (1:54±15.6 min [average clock time ± SEM in minutes] vs. 1:45±15.6 min vs. 0:13±40.8 min). The amount of secreted melatonin did not differ among the three groups. Stage and duration of Parkinson's disease did not correlate with the amount of secreted melatonin. Patients of the tremor subgroup, however, secreted more melatonin than patients presenting only with rigidity and akinesia. The phase advance in Parkinson patients treated with l-dopa/DCI is possibly due to a central nervous dopaminergic effect elicited by l-dopa administration and not inherent to Parkinson's disease per se.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1435-1463
    Keywords: Saccades ; Parkinson's disease ; fluctuations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the initiation of saccades to visual-guided random time and remembered targets in a group of nine Parkinsonian patients with severe motor fluctuations and in 9 age matched control subjects. In contrast to a marked skeletomotor improvement during the “on” condition, saccadic latencies for both visual-guided random saccades and remembered saccades were increased in the patients during the “on” condition compared to the “off” condition. This result of dissociation between skeletomotor and oculomotor function indicates that common concepts of saccadic initiation in parkinsonian patients do not hold true in patients with severe fluctuations since dopaminergic stimulation seems to increase saccadic latencies in these patients.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1440
    Keywords: Plasminogen activator inhibitor ; Tissue plasminogen activator ; Juveniler cerebraler Insult
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In diseases associated with thrombotic or thromboembolic complications, a reduction in the fibrinolytic potential may contribute to the risk to develop thrombosis. To investigate whether iuvenile cerebral infarction is associated with a permanent defect of the fibrinolytic system we measured the main components of the fibrinolytic system, tissue plasminogen activator (t-PA) and its fast acting inhibitor (PAI) in plasma samples of 21 patients (aged 21–44 years) 3–24 months after the acute event. The data obtained were compared to those from thirteen healthy young volunteers (22–46 years). A direct effect of known risk factors on the fibrinolytic system could be excluded because patients avoided their risk factors immediately after the ischemic cerebral attack. Hypertension and the combination of oral contraceptives and smoking had been the most striking original risk factors. Levels of t-PA antigen and t-PA activity before and after venous occlusion, or PAI activity were not different between patients and controls suggesting that at least a permanent decrease in the activity of the fibrinolytic system does not exist in these patients. However, our findings do not exclude that a temporary defect in fibrinolysis might have contributed to the acute onset of the thrombotic cerebral event possibly induced by the risk factors originally present.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Barthel-Index ; Aktivitäten des täglichen Lebens ; Verhalten ; Kognition ; Mentale Funktion ; Keywords Activities of daily living ; ADL ; Barthel index ; Behaviour ; Cognitive functions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The Barthel Index (BI) is the most commonly used scale for assessing impairment of activities of daily living (ADL). For a global view of patients' abilities and the care needed in everyday neurorehabilitation practice, additional information about basic psychological and cognitive functions is essential. We therefore designed a new disability scale comprised of assessments of consciousness, approachability, orientation, memory, behaviour, emotions, communication, problem solving, perception, and behaviour at night. The scale shows exactly the same inner structure as the BI, with ten items and a score of up to 20 in steps from 0–100% (or 0–20 points). By a careful weighing of the items, the final score of the neuromental index (NMI) should create a clearer picture of both the disabilities and the needed resources. A second aim was to cover a broad range of patients including those in coma and coma remission states and those with only slight neuropsychological or behavioural symptoms. The NMI was examined with a group of 179 neurorehabilitation inpatients and proved to be highly valid, reliable, and practicable. It was designed to enable a global assessment of disability as well as the care resources needed, even in patients with different disability levels in ADL and psychological and cognitive functions.
    Notes: Zusammenfassung Der Barthel-Index (BI) ist die am weitesten verbreitete Beurteilungsskala für die Aktivitäten des täglichen Lebens. Für die Einschätzung von Fähigkeiten und Betreuungsaufwand im Alltag der Neurorehabilitation sind aber auch Störungen der psychischen und mentalen Grundfunktionen, die durch den BI nicht erfasst werden, von wesentlicher Bedeutung. Wir haben eine Skala erstellt, die Fähigkeitsstörungen in den Bereichen Bewusstsein, Kontaktfähigkeit, Orientierung, Verhalten, Emotion, Kommunikation, Gedächtnis, Problemlösung, Wahrnehmung und Nachtruhe einschließt und die in einer 0–100% Skalierung bzw. der Vergabe von 0–20 Punkten für die 10 Items die exakt gleiche Struktur wie der BI aufweist. Es wurde in der Erstellung der Items darauf Wert gelegt, dass der Summenscore die Fähigkeitsstörungen und den Betreuungsaufwand von komatösen bzw. Komaremissionspatienten (am unteren Skalenende) und Patienten mit geringen Vehaltens- oder neuropsychologischen Störungen (am oberen Skalenende) möglichst wirklichkeitsnahe abbildet. Der Neuromentalindex wurde an 179 Neurorehabilitationspatienten bezüglich seiner Testgütekriterien untersucht und erwies sich als in hohem Maß valide, reliabel und praktikabel.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Torticollis spasmodicus ; Blepharospasmus ; Hemifazialer Spasmus ; Therapien ; Botulinumtoxin ; Key words Spasmodic torticollis ; Blepharospasm ; Hemifacial spasm ; Therapies ; Botulinum toxin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Injections with botulinum toxin type A (BTX) are considered the first-line treatment for spasmodic torticollis (ST), blepharospasm (BL) and hemifacial spasm (HFS). Because BTX brings only temporary and partial relief, patients frequently try other additional therapies to minimize their symptoms. The subjective rating of all therapies ever tried by patients with ST, BL and HFS was evaluated by using a simple questionnaire. Two hundred questionnaires were considered (112 TS, 54 BL, 34 HFS). BTX was rated subjectively the best therapy in all three diagnostic groups (median: 2=good effect). Despite Citalopram and physiotherapy (median: 3=average effect), all other therapies were rated with a median of ≥4 (=minimal effect). Patients with ST tried 7.7, patients with BL 2.4 and patients with HFS 2.6 different types of therapy. In conclusion, BTX is the most effective treatment for patients with ST, BL and HFS, as rated subjectively. Further evaluation of therapies additional to BTX injections is recommended.
    Notes: Zusammenfassung Die Botulinumtoxinbehandlung (BTX) gilt als Therapie der Wahl bei Torticollis spasmodicus (TS), Blepharospasmus (BL) und hemifazialem Spasmus (HFS). Da bestehende Beschwerden mit BTX meist nur vorübergehend und manchmal nicht im ganzen Ausmaß beseitigt werden können, werden von Patienten immer wieder andere Behandlungsformen versucht. Mit einem einfachen Fragebogen wurde von Patienten mit TS, BL und HFS eine subjektive Beurteilung aller bisher versuchten Therapien eingeholt. Ausgewertet wurden 200 Fragebögen (112 TS, 54 BL, 34 HFS). BTX wurde in allen drei Diagnosegruppen als subjektiv wirksamste Therapie bewertet (Median: 2=gute Wirkung). Abgesehen von Citalopram und Physiotherapie (Median: 3=durchschnittliche Wirkung) beim TS wurden alle anderen Therapien mit einem Median von ≥4 (=minimale Wirkung) bewertet. Patienten mit TS haben im Durchschnitt 7,7, Patienten mit BL 2,4 und mit HFS 2,6 Behandlungsformen ausprobiert. Zusammenfassend ist BTX die subjektiv wirksamste Behandlung bei Patienten mit TS, BL und HFS. Weitere Untersuchungen über ergänzende Begleittherapien zur BTX-Behandlung sind erforderlich.
    Type of Medium: Electronic Resource
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