Current Issue : July - September Volume : 2016 Issue Number : 3 Articles : 4 Articles
Background: Primary dystonia is a chronic neurological movement disorder that causes abnormal muscle movements.\nPain and emotional distress may accompany these physical symptoms. Behavioural interventions are used to help\npeople with long term conditions improve their quality of life. Little is known about behavioural interventions applied\nto Dystonia. We report a systematic review of studies reporting current evidence of behavioural interventions for\npeople with primary dystonia.\nMethods: We did systematic searches of Medline, PsycINFO, AHMED and CINAHL. We assessed the methodological\nquality of included studies using a risk of bias tool. Any disagreements were resolved by liaising with an independent\nrater. Physiological outcomes such as dystonia severity and psychological outcomes such as sleep and depression were\nselected on the basis that primary dystonia causes motor and non-motor symptoms. No time limit was placed on the\nsearches. A narrative synthesis of the results is presented.\nResults: Of 1798 titles and abstracts screened, 14 full articles were retrieved and inclusion and exclusion criteria applied.\nOf these a final nine were eligible for the review (N = 73). Only two were Randomised Controlled Trials (RCTs). Using the\nMovement Disorders Society (MDS) dystonia classification, that was published after this work started, all of the included\nstudies were of idiopathic adult onset focal dystonia without associated features. These included: blepharospasm (eye\ndystonia) (N = 1), cervical dystonia (neck dystonia) (N = 2), writer�s cramp (hand dystonia) (N = 3) and the yips (N = 3). No\nstudies reported on dystonia that affects two or more body regions. Studies reported good adherence and response\nrates to treatment. Physiological and psychological improvements were noted in all studies at weekly, monthly and\nyearly follow-ups. Caution should be taken when interpreting the results because of the scarcity of RCTs identified, use\nof small sample sizes, and inappropriate statistical methods.\nConclusion: We identified few studies; mainly of poor methodological quality that all studied a focal dystonia. It\nis not possible to draw firm conclusions. Nevertheless, the data suggests that a combined behavioural therapy\napproach including relaxation practice for people with idiopathic adult onset focal dystonia merits further\ninvestigation....
Intramuscular injections can cause damage to arteries, veins and nerves. Achieving maximum effects\nof medications through precise intramuscular (IM) injections must be assured and with certainty,\nparticularly with long-acting injection drugs (LAI). The purpose of this study is to determine\nprecision in IM LAIs of patients with schizophrenia. These evidences estimate ââ?¬Å?Distance from\nthe Epidermis to the Under-Fasciaââ?¬Â (DEUF) and ââ?¬Å?Distance from Epidermis to the Upper-Arm Boneââ?¬Â\n(DEB) of the deltoid muscle. Explanatory variables include body height, weight, body-mass index\n(BMI), deltoid-muscle circumference, fat percentage and muscle mass measured by body composition\nmonitor. Sixty nine subjects are included based on the Diagnostic Statistical Manual of Mental\nDisorders (DSM-IV, 1994), and receive treatments of typical and atypical antipsychotic LAI. There are 46 males and 23 females with average age of 51.41 (Standard Deviati and ranging\nfrom 21 to 81 years who are all right-handed. Ultrasonographic data and those from explanatory\nvariables are calculated using Spearmanââ?¬â?¢s rank correlation coefficients. Multiple regression analysis\n(step-wise method/forced input method) is performed assuming DEUF or DEB as dependent\nvariables. Significant correlations are found with highest adjusted R-square. Paired t-tests show\ndifferences in average values of actual ultrasonographic measurements assigned to DEUF or DEB,\nand the regression equations for accuracy. Ultrasonographic values are assigned multiple-regres-sion equations as true values, and the calculated values are compared with those obtained by regression\nequations. There are no significant differences observed for either the right or left arm.\nThe multiple regression equations for BMI and fat percentages (upper extremity estimation) of\nDEUF, and for BMI and injection site circumference of estimated DEB, successfully value the DEUF\nand DEB. By using these multiple regression equations for IM injection to the deltoid-muscle,\nDEUF can better ensure accurate LAI into the muscle through body monitor, DEB, and measured\nvalues of the deltoid-muscle injection site circumference....
The term paraproteinemic neuropathy describes a heterogeneous set of neuropathies characterized by the presence\nof homogeneous immunoglobulin in the serum. An abnormal clonal proliferation of B-lymphocytes or plasma cells,\nwhich may or may not occur in the context of a hematologic malignancy, produces the immunoglobulins in excess.\nIf malignancy is identified, treatment should be targeted to the neoplasm. Most cases, however, occur as monoclonal\ngammopathy of undetermined significance. Few prospective, randomized, placebo-controlled trials are available to\ninform the management of paraproteinemic neuropathies. Clinical experience combined with data from smaller,\nuncontrolled studies provide a basis for recommendations, which depend on the specific clinical setting in which\nthe paraprotein occurs. In this review, we provide a clinically practical approach to diagnosis and management of\nsuch patients....
Objective. This cross-sectional study analyzes the pattern of ultrasound peripheral nerve alterations in patients with chronic\ninflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) at different stages of\nfunctional disability.Material andMethods. 22 CIDP and 10MMN patients and a group of 70 healthy controls were evaluated with\nan ultrasound scan of themedian, ulnar, peroneal, tibial, and sural nerves. Results were correlated with clinical disability scales and\nnerve conduction studies. Results. Patients with intermediate functional impairment showed relatively larger cross-sectional areas\nthan subjects with either a milder (...
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