Library

feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Intensivpolyneuropathie ; Muskelrelaxanzien ; Muskelschwäche ; Myopathie ; neuromuskuläre Blockade ; Key words Critical illness polyneuropathy ; Myopathy ; Polyneuromyopathy ; Neuromuscular blockade ; Muscle relaxants
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Generalized muscle weakness in critically ill patients can result in prolonged periods of artificial ventilation and longer stays in the intensive care unit. Both neuropathic (critical illness polyneuropathy) and myopathic (critical illness myopathy) abnormalities seem to play an important role for this prolonged weakness. This article reviews its complex differential diagnosis with special emphasis on the current understanding of the neuromuscular syndromes. An efficient diagnostic plan is necessary for the exclusion of other curable causes of prolonged muscle weakness even in the presence of polyneuromyopathic changes. Psychological support of the patient and prophylaxis of secondary complications of prolonged immobilization are crucial when specific therapy is not possible.
    Notes: Zusammenfassung Die prolongierte Muskelschwäche bei Intensivpatienten kann die Entwöhnung von der Beatmung verzögern und auf diese Weise die Dauer der Intensivbehandlung verlängern. Stand der Forschung: Ursächlich kommen insbesondere pathologische Veränderungen am peripheren Nervensystem (sog. Intensivpolyneuropathie) und an der Muskulatur (Intensivmyopathie) in Betracht. Der aktuelle Wissensstand und die Theorien zu ihrer Entstehung werden im vorliegenden Beitrag ausführlich dargelegt. Die Differentialdiagnostik der prolongierten Muskelschwäche des Intensivpatienten ist komplex und verlangt ein effizientes diagnostisches Vorgehen. Konsequenzen: Schwerpunkte sind der Nachweis polyneuromyopathischer Veränderungen und der Ausschluß anderer therapierbarer Erkrankungen ähnlicher Symptomatik. Die psychische Führung des Patienten und die Prophlaxe sekundärer Komplikationen der Muskelschwäche stehen therapeutisch im Vordergrund.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1432-1440
    Keywords: Rheologic parameters ; Reference ranges ; Clinically healthy subjects ; Sex dependency ; Age dependency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To determine reference ranges for rheologic parameters (hematocrit, plasma viscosity, erythrocyte aggregation, erythrocyte rigidity) a randomized study involving 653 subjects was carried out. Conditions of sampling, transportation and storing of blood specimens were established prior to the survey. Only 283 subjects met the criteria for enrollment in the study; the others were rejected because of inconspicuous history, normal findings in physical and Doppler-sonographic examination and absence of the risk factors hypertension, diabetes mellitus, overweight, rheumatic diseases, and smoking. The reference range for hematocrit was determined by an impedance-measuring device to equal 39–52% for males and 34–50% for females. The reference range for plasma viscosity, measured by a capillary-tube-plasma viscometer, was found to vary from 1.14 mPas to 1.34 mPas. The reference values for the standardized erythrocyte aggregation index was determined with the mini erythrocyte aggregometer to range from 8 to 21. Erythrocytes measured with the selecting-erythrocyte rigidometer showed a rigidity reference range between 0.83 and 1.19. Analysis of the results revealed that the parameters were independent of age (except in young children) and sex (with the exception of hematocrit).
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1432-1440
    Keywords: Transcranial Doppler ; Vasomotor Reactivity ; Stroke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1432-1106
    Keywords: Key words Transcranial Doppler ultrasonography ; Cerebral blood flow velocity ; Somatosensory stimuli ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Preparing for and processing of sensory stimuli are energy-requiring processes. We attempted to assess the relative contributions of these processes to increases in regional cerebral perfusion. Nineteen healthy right-handed subjects were examined while they were engaged in detecting tactile stimuli to the index finger 5 s after a cueing tone. Cerebral blood flow velocity (CBFV) modulations in the middle cerebral arteries (MCAs) were continuously measured by bilateral simultaneous transcranial Doppler ultrasonography. Tactile stimuli well above threshold per se did not produce a significant, relative CBFV increase in the contralateral MCA. However, when subjects were expecting a threshold tactile stimulus, there was a significant regional increase in CBFV in the hemisphere contralateral to the attended index finger for approximately 15 s, starting within the first seconds after the cueing. This increase was present even before the tactile stimulus was applied and also in sessions when the stimulus was omitted. We conclude that preparation of the cortex causes a stronger regional cerebral blood flow increase than the processing of the tactile stimulus itself.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 78 (1985), S. 136-141 
    ISSN: 0942-0940
    Keywords: Cerebral aneurysms ; basilar artery ; therapeutic embolization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Some vertebro-basilar aneurysm may not be treatable at a reasonable risk by direct clipping. A possible alternative is transvascular obliteration, using the means of modern interventional neuroradiology in combination with neurophysiological monitoring. These possibilites and related difficulties are outlined and discussed and the example of two cases with different types of vertebrobasilar aneurysms (top of the basilar artery and basilar trunk aneurysm) which have been treated by balloon embolization.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Hereditäre motorische und sensible Neuropathien ; HMSN ; HNPP ; Peripheres Myelinprotein 22 ; Myelinprotein 0 ; Connexin 32 ; Key words Hereditary motor and sensory neuropathies ; HMSN ; HNPP ; Peripheral myelin protein 22 ; Myelin protein zero ; Connexin 32
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Hereditary neuropathies (HMSN) are among the most common genetic diseases in neurology. Various mutations in different genes are known which lead to the most frequent hereditary neuropathies. These mutations concern proteins of the myelin of the peripheral nervous system, as well as a gap-junction protein expressed in peripheral nerves. The molecular mechanisms leading from gene mutation to disease phenotypes are not fully understood. Nowadays, we are able to use DNA analysis for symptomatic, presymptomatic, and prenatal screening. The latter is of questionable value because of the variability in disease severity and outcome. Deeper insights into the molecular pathophysiology will, however, yield new therapeutic strategies in individual patients.
    Notes: Zusammenfassung Hereditäre motorische und sensible Neuropathien (HMSN) zählen zu den häufigsten vererbbaren Erkrankungen des Menschen. In den letzten Jahren wurden Mutationen in verschiedenen Genen gefunden, die als ursächlich für die Entstehung der hereditären Neuropathien angesehen werden müssen. Es handelt sich um Gene, deren Proteinprodukte zum einen Bausteine des Myelins des peripheren Nervensystems darstellen und zum anderen ein Gap-junction-Protein bilden, das die intra- und interzellulare Kommunikation ermöglicht. Es ist nicht bekannt, über welche Zwischenschritte die einzelnen genetischen Veränderungen zum jeweiligen Krankheitsphänotyp führen. Die Pathogenese ist also noch nicht in allen Einzelheiten aufgeklärt. Die molekulargenetischen Befunde erlauben in den weitaus meisten Fällen eine exakte Diagnose auch ohne Zuhilfenahme histologischer Untersuchungen. Ebenso ist eine pränatale Diagnostik möglich, deren Wertigkeit wegen der erheblichen Varianz der späteren Prognose des Krankheitsphänotyps jedoch gering ist. Durch die Aufklärung der Pathophysiologie sind neue, individualtherapeutisch einsetzbare, effektive Behandlungsmöglichkeiten zu erwarten.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Der Nervenarzt 70 (1999), S. 889-898 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Neuronale Plastizität ; Reorganistation ; Somatosensorisch ; Phantom ; Amputation ; Magnetenzephalographie ; Schmerz ; Kortex ; Key words Neural plasticity ; Reorganization ; Somatosensory ; Phantom ; Amputation ; Magnetoencephalography ; Pain ; Cortex
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The mammalian brain is capable of a substantial functional reorganization, manifesting on a cortical somatotopical and on a behavioral level. Possible mechanisms are reviewed based on the work by others and ourselves on somatosensory reorganization in humans. The somatosensory system is characterized by divergent projections from the periphery to the cerebral cortex. Changes in synaptic weights allow for reorganization of sensory processing: On one side, limb amputation will result in a representational “invasion” of the deafferentated cortex from neighboring regions with concomitant perceptual changes. On the other side, sensorimotor training can increase the representational cortical zone of a limb. Plastic changes can be temporary or persistent. Modulating factors like pain and certain drugs seem to induce a permissive state in the cortex resulting in enhanced reorganization. Thus, specific physical training combined with pharmacoceutical modulation holds promise to improve functional recovery after brain lesions.
    Notes: Zusammenfassung Das menschliche Gehirn ist zu massiver funktioneller Reorganisation fähig. Anhand von Ergebnissen der eigenen Arbeitsgruppe und einer Literaturübersicht werden die Grundlagen und Mechanismen dieser Plastizität am Beispiel des somatosensorischen Systems beschrieben. Sensible Bahnen mit ihren Relais-Stationen verlaufen in einander überlappenden Projektionen von der Peripherie zur Hirnrinde. Durch Veränderung synaptischer Gewichtungen können sich funktionelle Hirnkarten umorganisieren und dementsprechend veränderte Wahrnehmungen hervorrufen. Einerseits können z.B. nach einer Gliedmaßenamputation die benachbarten Repräsentanzen des somatosensorischen Homukulus in den deafferenzierten Kortexabschnitt “einwandern”. Andererseits führt sensomotorisches Training einer Gliedmaße zu einer Vergrößerung der zugehörigen kortikalen Repräsentation. Diese Plastizität kann kurzlebig oder anhaltend und damit irreversibel sein. Plastizität ist darüber hinaus modulierbar. So können Schmerzen aber auch Pharmaka zu einer Verstärkung der funktionellen Umorganisation führen. Die Kombination von physiotherapeutischem Training und pharmakologischer Modulation kann die Funktionserholung nach Gehirnläsionen steigern.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Notfall + Rettungsmedizin 2 (1999), S. 419-421 
    ISSN: 1436-0578
    Keywords: Schlüsselwörter Schlaganfall ; Infrastruktur ; Thrombolyse ; Rehabilitation ; Key words Stroke ; Infrastructure ; Thrombolysis ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary New therapeutic approaches for the treatment of stroke require new strategies for early diagnosis, fast transportation to the hospital, immediate diagnostic procedures, recommendations for therapy and early rehabilitation. Systemic thrombolysis can only be performed in a setting of optimal infrastructure. The implementation of stroke units leads to a measurable improvement of long term prognosis i.e. significantly more patients may live independent after their stroke.
    Notes: Zusammenfassung Neue therapeutische Erkenntnisse bei der Behandlung des Schlaganfalls machen neue Konzepte zu Früherkennung, raschem Transport in die Klinik, strukturierter Diagnostik, Akuttherapie und frühem Einsatz der Rehabilitation notwendig. Insbesondere die systemische Thrombolyse mit dem Drei-Stunden Einschlußfenster bzw. die lokale Thrombolyse mit dem Sechs-Stunden Einschlußfenster kann nur bei optimaler Infrastruktur erfolgversprechend eingesetzt werden. Die Einrichtung spezialisierter Einrichtungen zur Behandlung des akuten Schlaganfalls in Form von Stroke Units führt zu einer deutlichen Verbesserung der Prognose, so daß die Rate der Patienten, die nach dem Schlaganfall ein unabhängiges Leben führen können, nachweislich zunimmt.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    ISSN: 1432-1459
    Keywords: Percutaneous transluminal angioplasty ; Vertebral artery ; Stenosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Percutaneous transluminal angioplasty (PTA) of the proximal vertebral artery was performed in 13 patients with stenosis of the proximal vertebral arteries. All of these patients had symptoms indicating vertebrobasilar insufficiency. PTA was performed only if an extreme reduction of the total diameter of both vertebral arteries was present. Only 13 patients have fulfilled the strict selection criteria in the last 3 years. All patients were monitored during the procedure by means of continuous-wave Doppler ultrasound and electrophysiological techniques. After PTA their neurological and vascular conditions were serially examined. Of the 13 patients, 8 showed marked improvement of both subjective and objective clinical symptoms. During an observation period of 2–25 months (average: 15 months) reocclusion of the angioplasty was observed in only 2 cases, without any additional neurological sequelae. Electrophysiological and Doppler sonographic monitoring during PTA helped to minimize the risk of angioplasty.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    ISSN: 1432-1459
    Keywords: Plasma viscosity ; Subcortical arteriosclerotic encephalopathy ; Binswanger's disease ; Haemorheology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Five haemorheological variables (haematocrit, plasma viscosity, red cell aggregation, red cell deformability and yield shear stress) and the plasma fibrinogen concentration were determined in blood samples from 21 untreated patients with subcortical arteriosclerotic encephalopathy (SAE, Binswanger's disease). The results were compared with those obtained in blood samples from 40 untreated patients with lacunar infarcts and from 275 healthy control subjects without vascular risk factors. Pathological (“solid body”) flow behaviour was detected in the blood of both groups of patients (SAE and lacunar infarcts). However, highly elevated plasma viscosity was a consistent feature only of SAE. The authors present the hypothesis that the high plasma viscosity in patients with SAE may account for the progressive degeneration of cerebral white matter. It is postulated that microcirculatory abnormalities due to microrheological changes may be one of the many missing links in the pathophysiology of SAE.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...