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[PMID]:29390334
[Au] Autor:Lee HD; Chang MC
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
[Ti] Título:Degeneration of the corticofugal tract from the secondary motor area in a Parkinson's disease patient with limb-kinetic apraxia: A case report.
[So] Source:Medicine (Baltimore);96(50):e9195, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: In this case report, we describe a Parkinson's disease (PD) patient with limb-kinetic apraxia (LKA) in whom degeneration of the corticofugal tract (CFT) from the supplementary motor area (SMA) was observed in diffusion tensor tractography (DTT). PATIENT CONCERNS: A 63-year-old woman presented with a loss of dexterity in both upper extremities, which indicated LKA, and typical PD-related symptoms, including a gait disturbance with a short step, resting tremor in both upper extremities, and rigidity, and these symptoms had been present for 2 years. The F-florinated-N-3-fluoropropyl-2-ß-carboxymethoxy-3-ß-(4-lodophenyl) nortropane positron emission tomography scanning findings were consistent with PD. Based on the clinical symptoms and imaging findings, we diagnosed the patient with PD. In a coin-rotation test that was used to evaluate the severity of the LKA, the patient's results significantly decreased compared to the results of the normal controls. DIAGNOSES: The DTT showed that the CFTs from the SMAs in both hemispheres were partially torn and thinned. The fractional anisotropy values and CFT volumes in both SMAs were >2 standard deviations lower than those of the normal controls. INTERVENTIONS: The patient was treated with an initial dose of 150/37.5 mg/day of levodopa/benserazide, and the dose was gradually increased to 400/100 mg/day. OUTCOMES: After treatment, although the bradykinesia, rigidity, and resting tremor of the patient significantly decreased, the dexterity of the patient's hands did not improve. LESSONS: These observations indicated degeneration of the CFTs from the SMAs in both hemispheres in the patient. This degeneration might have, at least in part, contributed to the patient's LKA. The results of this study suggest that CFT degeneration could be one of the pathological mechanisms underlying LKA in patients with PD.
[Mh] Termos MeSH primário: Córtex Motor/patologia
Doença de Parkinson/patologia
[Mh] Termos MeSH secundário: Anisotropia
Antiparkinsonianos/uso terapêutico
Benserazida/uso terapêutico
Imagem de Tensor de Difusão
Combinação de Medicamentos
Feminino
Seres Humanos
Levodopa/uso terapêutico
Meia-Idade
Córtex Motor/diagnóstico por imagem
Rigidez Muscular/diagnóstico por imagem
Rigidez Muscular/tratamento farmacológico
Rigidez Muscular/patologia
Atrofia Muscular Espinal/diagnóstico por imagem
Atrofia Muscular Espinal/tratamento farmacológico
Atrofia Muscular Espinal/patologia
Doença de Parkinson/diagnóstico por imagem
Doença de Parkinson/tratamento farmacológico
Tomografia por Emissão de Pósitrons
Tremor/diagnóstico por imagem
Tremor/tratamento farmacológico
Tremor/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Drug Combinations); 0 (benserazide, levodopa drug combination); 46627O600J (Levodopa); 762OS3ZEJU (Benserazide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009195


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[PMID]:28749549
[Au] Autor:Dalakas MC; Rakocevic G; Dambrosia JM; Alexopoulos H; McElroy B
[Ad] Endereço:Department of Neurology, Thomas Jefferson University, Philadelphia, PA.
[Ti] Título:A double-blind, placebo-controlled study of rituximab in patients with stiff person syndrome.
[So] Source:Ann Neurol;82(2):271-277, 2017 Aug.
[Is] ISSN:1531-8249
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In stiff person syndrome (SPS), an antibody-mediated impaired γ-aminobutyric acidergic (GABAergic) neurotransmission is believed to cause muscle stiffness and spasms. Most patients improve with GABA-enhancing drugs and intravenous immunoglobulin, but some respond poorly and remain disabled. The need for more effective therapy prompted a trial with the anti-CD20 monoclonal antibody rituximab. METHODS: This was a placebo-controlled randomized trial of rituximab (2 biweekly infusions of 1g each). The primary outcome was a change in stiffness scores at 6 months. Secondary outcomes were changes in heightened-sensitivity and quality of life scores. Enrolling 24 patients was calculated to detect 50% change in stiffness scores. RESULTS: Randomization was balanced for age, sex, disease duration, and glutamic acid decarboxylase autoantibody titers. No significant changes were noted at 6 months after treatment in all outcomes. Specifically, no differences were noted in the stiffness index, the primary outcome, or sensitivity scores, the secondary outcome, at 3 or 6 months. Quality of life scores improved significantly (p < 0.01) at 3 months in both groups, but not at 6 months, denoting an early placebo effect. Blinded self-assessment rating of the overall stiffness for individual patients revealed improvement in 4 patients in each group. At 6 months, improvement persisted in 1 patient in the placebo group versus 3 of 4 in the rituximab group, where these meaningful improvements were also captured by video recordings. INTERPRETATION: This is the largest controlled trial conducted in SPS patients and demonstrates no statistically significant difference in the efficacy measures between rituximab and placebo. Rituximab's lack of efficacy could be due to a considerable placebo effect; insensitivity of scales to quantify stiffness, especially in the less severely affected patients; or drug effectiveness in only a small patient subset. Ann Neurol 2017;82:271-277.
[Mh] Termos MeSH primário: Rituximab/uso terapêutico
Rigidez Muscular Espasmódica/tratamento farmacológico
[Mh] Termos MeSH secundário: Autoanticorpos/sangue
Método Duplo-Cego
Feminino
Glutamato Descarboxilase/imunologia
Seres Humanos
Fatores Imunológicos/uso terapêutico
Masculino
Meia-Idade
Rigidez Muscular Espasmódica/sangue
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Immunologic Factors); 4F4X42SYQ6 (Rituximab); EC 4.1.1.15 (Glutamate Decarboxylase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1002/ana.25002


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[PMID]:28778915
[Au] Autor:Grotle AK; Garcia EA; Huo Y; Stone AJ
[Ad] Endereço:Department of Kinesiology and Health Education, The University of Texas at Austin, Austin Texas.
[Ti] Título:Temporal changes in the exercise pressor reflex in type 1 diabetic rats.
[So] Source:Am J Physiol Heart Circ Physiol;313(4):H708-H714, 2017 Oct 01.
[Is] ISSN:1522-1539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Previous studies have shown that diabetic peripheral neuropathy affects both unmyelinated and myelinated afferents, similar to those evoking the exercise pressor reflex. However, the effect of type 1 diabetes (T1DM) on this reflex is not known. We examined, in decerebrate male and female T1DM [streptozotocin (STZ)] and healthy control (CTL) rats, pressor and cardioaccelerator responses to isometric contraction of the hindlimb muscles during the early and late stages of the disease. STZ (50 mg/kg) was injected to induce diabetes, and experiments were conducted at 1, 3, and 6 wk after injection. On the day of the experiment, we statically contracted the hindlimb muscles by stimulating the sciatic nerve and measured changes in mean arterial pressure and heart rate. We found that the pressor but not cardioaccelerator response was exaggerated in STZ rats at 1 wk (STZ: 21 ± 3 mmHg, = 10, and CTL: 14 ± 2 mmHg, = 10, < 0.05) and at 3 wk (STZ: 26 ± 5 mmHg, = 10, and CTL: 17 ± 3 mmHg, = 11, < 0.05) after injection. However, at 6 wk, and only in male rats, both the pressor (STZ: 13 ± 3 mmHg, = 12, and CTL: 17 ± 3 mmHg, = 13, < 0.05) and cardioaccelerator responses (STZ: 7 ± 3 beats/min, = 12, and CTL: 10 ± 3 beats/min, = 13, < 0.05) to contraction were significantly attenuated in STZ rats compared with CTL rats. These data indicate that T1DM exaggerates the exercise pressor reflex during the early stages of the disease in both male and female rats. Conversely, T1DM attenuates this reflex in the late stage of the disease in male but not female rats. This is the first study to provide evidence that the pressor and cardioaccelerator responses to skeletal muscle contraction vary depending on the duration of type 1 diabetes.
[Mh] Termos MeSH primário: Pressão Arterial/fisiologia
Diabetes Mellitus Experimental/fisiopatologia
Diabetes Mellitus Tipo 1/fisiopatologia
Frequência Cardíaca/fisiologia
Condicionamento Físico Animal
Reflexo Anormal/fisiologia
Vasoconstrição/fisiologia
[Mh] Termos MeSH secundário: Animais
Estudos de Casos e Controles
Estado de Descerebração
Estimulação Elétrica
Feminino
Membro Posterior
Masculino
Contração Muscular/fisiologia
Músculo Esquelético
Ratos
Ratos Sprague-Dawley
Reflexo
Nervo Isquiático
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE
[do] DOI:10.1152/ajpheart.00399.2017


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[PMID]:28724750
[Au] Autor:Schaefer N; Berger A; van Brederode J; Zheng F; Zhang Y; Leacock S; Littau L; Jablonka S; Malhotra S; Topf M; Winter F; Davydova D; Lynch JW; Paige CJ; Alzheimer C; Harvey RJ; Villmann C
[Ad] Endereço:Institute of Clinical Neurobiology, Julius-Maximilians-University of Würzburg, 97078 Würzburg, Germany.
[Ti] Título:Disruption of a Structurally Important Extracellular Element in the Glycine Receptor Leads to Decreased Synaptic Integration and Signaling Resulting in Severe Startle Disease.
[So] Source:J Neurosci;37(33):7948-7961, 2017 Aug 16.
[Is] ISSN:1529-2401
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Functional impairments or trafficking defects of inhibitory glycine receptors (GlyRs) have been linked to human hyperekplexia/startle disease and autism spectrum disorders. We found that a lack of synaptic integration of GlyRs, together with disrupted receptor function, is responsible for a lethal startle phenotype in a novel spontaneous mouse mutant , caused by a missense mutation, Q177K, located in the extracellular ß8-ß9 loop of the GlyR α1 subunit. Recently, structural data provided evidence that the flexibility of the ß8-ß9 loop is crucial for conformational transitions during opening and closing of the ion channel and represents a novel allosteric binding site in Cys-loop receptors. We identified the underlying neuropathological mechanisms in male and female mice through a combination of protein biochemistry, immunocytochemistry, and both and in electrophysiology. Increased expression of the mutant GlyR α1 subunit was not sufficient to compensate for a decrease in synaptic integration of α1 ß GlyRs. The remaining synaptic heteromeric α1 ß GlyRs had decreased current amplitudes with significantly faster decay times. This functional disruption reveals an important role for the GlyR α1 subunit ß8-ß9 loop in initiating rearrangements within the extracellular-transmembrane GlyR interface and that this structural element is vital for inhibitory GlyR function, signaling, and synaptic clustering. GlyR dysfunction underlies neuromotor deficits in startle disease and autism spectrum disorders. We describe an extracellular GlyR α1 subunit mutation (Q177K) in a novel mouse startle disease mutant Structural data suggest that during signal transduction, large transitions of the ß8-ß9 loop occur in response to neurotransmitter binding. Disruption of the ß8-ß9 loop by the Q177K mutation results in a disruption of hydrogen bonds between Q177 and the ligand-binding residue R65. Functionally, the Q177K change resulted in decreased current amplitudes, altered desensitization decay time constants, and reduced GlyR clustering and synaptic strength. The GlyR ß8-ß9 loop is therefore an essential regulator of conformational rearrangements during ion channel opening and closing.
[Mh] Termos MeSH primário: Receptores da Glicina/genética
Receptores da Glicina/metabolismo
Rigidez Muscular Espasmódica/genética
Rigidez Muscular Espasmódica/metabolismo
Sinapses/genética
Sinapses/metabolismo
[Mh] Termos MeSH secundário: Animais
Líquido Extracelular/metabolismo
Feminino
Células HEK293
Seres Humanos
Ativação do Canal Iônico/fisiologia
Masculino
Camundongos
Camundongos da Linhagem 129
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Neurônios Motores/metabolismo
Mutação de Sentido Incorreto/fisiologia
Estrutura Secundária de Proteína
Receptores da Glicina/química
Índice de Gravidade de Doença
Medula Espinal/metabolismo
Transmissão Sináptica/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptors, Glycine); 0 (glycine receptor alpha1)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1523/JNEUROSCI.0009-17.2017


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[PMID]:28724548
[Au] Autor:Rollins KS; Smith JR; Esau PJ; Kempf EA; Hopkins TD; Copp SW
[Ad] Endereço:Department of Kinesiology, Kansas State University, Manhattan, Kansas.
[Ti] Título:Bradykinin does not acutely sensitize the reflex pressor response during hindlimb skeletal muscle stretch in decerebrate rats.
[So] Source:Am J Physiol Regul Integr Comp Physiol;313(4):R463-R472, 2017 Oct 01.
[Is] ISSN:1522-1490
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hindlimb skeletal muscle stretch (i.e., selective activation of the muscle mechanoreflex) in decerebrate rats evokes reflex increases in blood pressure and sympathetic nerve activity. Bradykinin has been found to sensitize mechanogated channels through a bradykinin B2 receptor-dependent mechanism. Moreover, bradykinin B2 receptor expression on sensory neurons is increased following chronic femoral artery ligation in the rat (a model of simulated peripheral artery disease). We tested the hypothesis that injection of bradykinin into the arterial supply of a hindlimb in decerebrate, unanesthetized rats would acutely augment (i.e., sensitize) the increase in blood pressure and renal sympathetic nerve activity during hindlimb muscle stretch to a greater extent in rats with a ligated femoral artery than in rats with a freely perfused femoral artery. The pressor response during static hindlimb muscle stretch was compared before and after hindlimb arterial injection of 0.5 µg of bradykinin. Injection of bradykinin increased blood pressure to a greater extent in "ligated" ( = 10) than "freely perfused" ( = 10) rats. The increase in blood pressure during hindlimb muscle stretch, however, was not different before vs. after bradykinin injection in freely perfused (14 ± 2 and 15 ± 2 mmHg for pre- and post-bradykinin, respectively, = 0.62) or ligated (15 ± 3 and 14 ± 2 mmHg for pre- and post-bradykinin, respectively, = 0.80) rats. Likewise, the increase in renal sympathetic nerve activity during stretch was not different before vs. after bradykinin injection in either group of rats. We conclude that bradykinin did not acutely sensitize the pressor response during hindlimb skeletal muscle stretch in freely perfused or ligated decerebrate rats.
[Mh] Termos MeSH primário: Bradicinina/farmacologia
Estado de Descerebração/fisiopatologia
Membro Posterior/efeitos dos fármacos
Contração Muscular/efeitos dos fármacos
Músculo Esquelético/efeitos dos fármacos
Reflexo/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Barorreflexo/efeitos dos fármacos
Barorreflexo/fisiologia
Pressão Sanguínea/efeitos dos fármacos
Pressão Sanguínea/fisiologia
Membro Posterior/fisiopatologia
Masculino
Contração Muscular/fisiologia
Músculo Esquelético/fisiopatologia
Ratos
Ratos Sprague-Dawley
Reflexo/fisiologia
Sistema Nervoso Simpático/efeitos dos fármacos
Sistema Nervoso Simpático/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
S8TIM42R2W (Bradykinin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1152/ajpregu.00187.2017


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[PMID]:28639151
[Au] Autor:Ryan TD; Parent JJ; Gao Z; Khoury PR; Dupont E; Smith JN; Wong B; Urbina EM; Jefferies JL
[Ad] Endereço:Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45220, USA. thomas.ryan@cchmc.org.
[Ti] Título:Central Arterial Function Measured by Non-invasive Pulse Wave Analysis is Abnormal in Patients with Duchenne Muscular Dystrophy.
[So] Source:Pediatr Cardiol;38(6):1269-1276, 2017 Aug.
[Is] ISSN:1432-1971
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder caused by mutation of dystrophin. Cardiovascular involvement includes dilated cardiomyopathy. Non-invasive assessment of vascular function has not been evaluated in DMD. We hypothesize arterial wave reflection is abnormal in patients with DMD. Pulse wave analysis was performed on DMD patients with a SphygmoCor SCOR-PVx System to determine central blood pressure and augmentation index (AIx) as an assessment of arterial wave reflection. Results were compared to a control group. A total of 43 patients with DMD were enrolled, and compared to 43 normal controls. Central systolic blood pressure was lower, while both AIx-75 (7.8 ± 9.6% vs. 2.1 ± 10.4%, p 0.01, DMD vs. normal) and AIx-not corrected (16.8 ± 10.1% vs. -3.6 ± 10.9, p < 0.001, DMD vs. normal) were higher in the DMD compared to control. Using multivariable linear regression model, the variables found to have a significant effect on AIx-not corrected included diagnosis of DMD, height, and heart rate (r  = 0.257). The current data suggest that, despite lower central systolic blood pressure, patients with DMD have higher wave reflection when compared to normal controls, which may represent increased arterial stiffness. Overall there appears to be no effect on ventricular systolic function, however the long-term consequence in this group is unknown. Further study is required to determine the mechanism of these differences, which may be related to the effects of systemic steroids or the role of dystrophin in vascular function.
[Mh] Termos MeSH primário: Aorta/fisiopatologia
Doenças da Aorta/fisiopatologia
Distrofia Muscular de Duchenne/complicações
Análise de Onda de Pulso
Doenças Vasculares/fisiopatologia
Rigidez Vascular/efeitos da radiação
[Mh] Termos MeSH secundário: Adolescente
Doenças da Aorta/complicações
Pressão Sanguínea/fisiologia
Determinação da Pressão Arterial
Criança
Seres Humanos
Masculino
Estudos Prospectivos
Artéria Radial/fisiopatologia
Sístole
Doenças Vasculares/complicações
Rigidez Vascular/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1007/s00246-017-1657-y


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[PMID]:28607132
[Au] Autor:Dipla K; Triantafyllou A; Koletsos N; Papadopoulos S; Sachpekidis V; Vrabas IS; Gkaliagkousi E; Zafeiridis A; Douma S
[Ad] Endereço:From the Exercise Physiology and Biochemistry Laboratory, Department of Sports Science at Serres (K.D., S.P., I.S.V., A.Z.) and 3rd Department of Internal Medicine, Papageorgiou Hospital (A.T., N.K., E.G., S.D.), Aristotle University of Thessaloniki, Greece; and 2nd Cardiology Department, Papageorgi
[Ti] Título:Impaired Muscle Oxygenation and Elevated Exercise Blood Pressure in Hypertensive Patients: Links With Vascular Stiffness.
[So] Source:Hypertension;70(2):444-451, 2017 Aug.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study examined in vivo (1) skeletal muscle oxygenation and microvascular function, at rest and during handgrip exercise, and (2) their association with macrovascular function and exercise blood pressure (BP), in newly diagnosed, never-treated patients with hypertension and normotensive individuals. Ninety-one individuals (51 hypertensives and 40 normotensives) underwent office and 24-hour ambulatory BP, arterial stiffness, and central aortic BP assessment, followed by a 5-minute arterial occlusion and a 3-minute submaximal handgrip exercise. Changes in muscle oxygenated and deoxygenated hemoglobin and tissue oxygen saturation were continuously monitored by near-infrared spectroscopy and beat-by-beat BP by Finapres. Hypertensives had higher ( <0.001) central aortic BP and pulse wave velocity versus normotensives and exhibited (1) a blunted tissue oxygen saturation response during occlusion, with slower ( =0.006) deoxygenation rate, suggesting reduced muscle oxidative capacity, and (2) a slower reoxygenation rate and blunted hyperemic response ( <0.05), showing reduced microvascular reactivity. Muscle oxygenation responses were correlated with aortic systolic and pulse pressure and augmentation index ( <0.05; age and body mass index (BMI) adjusted). When exercising at the same submaximal intensity, hypertensives required a significantly greater ( <0.001) increase in BP for achieving similar muscle oxygenation levels as normotensives. This response was correlated with the magnitude of microvascular hyperemia and aortic BP. In conclusion, nontreated patients with hypertension exhibit prominent reductions in in vivo indices of skeletal muscle oxidative capacity, suggestive of mitochondrial dysfunction, and blunted muscle microvascular reactivity. These dysfunctions were associated with higher aortic systolic BP and arterial stiffness. Dysregulations in muscle oxygen delivery/utilization and microvascular stiffness, in hypertensive patients, partially contribute to their exaggerated BP during exercise.
[Mh] Termos MeSH primário: Pressão Arterial/fisiologia
Exercício/psicologia
Hipertensão
Músculo Esquelético
Consumo de Oxigênio/fisiologia
Rigidez Vascular/fisiologia
[Mh] Termos MeSH secundário: Adulto
Monitorização Ambulatorial da Pressão Arterial/métodos
Exercício/fisiologia
Feminino
Seres Humanos
Hipertensão/diagnóstico
Hipertensão/metabolismo
Hipertensão/fisiopatologia
Masculino
Meia-Idade
Força Muscular/fisiologia
Músculo Esquelético/metabolismo
Músculo Esquelético/fisiopatologia
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.117.09558


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[PMID]:28592451
[Au] Autor:Rajput AH; Rajput ML; Ferguson LW; Rajput A
[Ad] Endereço:From the Division of Neurology (A.H.R., A.R.), Saskatoon Health Region/University of Saskatchewan, Rosthern; and Movement Disorders Program (M.L.R.) and College of Medicine (L.W.F.), University of Saskatchewan, Saskatoon, Canada. ali.rajput@saskatoonhealthregion.ca.
[Ti] Título:Baseline motor findings and Parkinson disease prognostic subtypes.
[So] Source:Neurology;89(2):138-143, 2017 Jul 11.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify the significance of baseline motor features to the lifelong prognostic motor subtypes in a Parkinson disease (PD) cohort. METHODS: In a previous study of 166 PD cases, we observed different prognosis in tremor-dominant, akinetic-rigid, and mixed subtypes. This study includes the same cases, but we excluded 10 cases with symptoms of ≥15 years duration at baseline. Relative severity of tremor, bradykinesia/akinesia, and rigidity at baseline were evaluated as predictors of the motor subtypes, which are known to have different prognosis. RESULTS: The most common motor subtype was mixed, followed by akinetic-rigid and then the tremor-dominant. Seventy cases were not receiving antiparkinsonian drugs at baseline. The prognostic subtypes could be predicted at baseline in 85% of all and in 91% of the treatment-naive cases. Sensitivity, specificity, and positive predictive values were strong for the mixed and the akinetic-rigid but weak for the tremor-dominant subtype. CONCLUSIONS: Our data show that motor profile at baseline can predict prognosis in most PD cases. These findings can be incorporated into clinical practice.
[Mh] Termos MeSH primário: Progressão da Doença
Rigidez Muscular/diagnóstico
Doença de Parkinson/classificação
Doença de Parkinson/diagnóstico
Tremor/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Rigidez Muscular/etiologia
Rigidez Muscular/fisiopatologia
Doença de Parkinson/complicações
Doença de Parkinson/fisiopatologia
Valor Preditivo dos Testes
Prognóstico
Sensibilidade e Especificidade
Tremor/etiologia
Tremor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004078


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[PMID]:28552871
[Au] Autor:Mizuno Y; Yamaguchi H; Uehara T; Yamashita K; Yamasaki R; Kira JI
[Ad] Endereço:Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University.
[Ti] Título:A case of stiff-person syndrome due to secondary adrenal insufficiency.
[So] Source:Rinsho Shinkeigaku;57(6):298-302, 2017 06 28.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We report a case of flexion contractures in a patient's legs secondary to postpartum hypopituitarism. A 56-year-old woman presented with a 3-year history of worsening flexion contractures of the hips and knees. On admission, her hips and knees could not be extended, and she had muscle stiffness and tenderness to palpation of the lower extremities. We first suspected stiff-person syndrome or Isaacs' syndrome because of her muscle stiffness. However, multiple hormones did not respond to stimulation tests, and an MRI of the brain showed atrophy of the pituitary gland with an empty sella. A subsequent interview revealed that she had suffered a severe hemorrhage while delivering her third child. She was diagnosed with panhypopituitarism and started on cortisol replacement therapy. After 1 week of treatment with hydrocortisone (10 mg/day), her symptoms quickly improved. We then added 75 µg/day of thyroid hormone. During the course of her treatment, autoantibodies against VGKC complex were found to be weakly positive. However, we considered the antibodies to be unrelated to her disease, because her symptoms improved markedly with low-dose steroid treatment. There are a few reports describing flexion contractures of the legs in patients with primary and secondary adrenal insufficiency. As these symptoms are similar to those seen in stiff-person syndrome, adrenal and pituitary insufficiency should be taken into account to achieve the correct diagnosis and treatment in patients with flexion contractures and muscle stiffness.
[Mh] Termos MeSH primário: Hipopituitarismo/diagnóstico
Síndrome de Isaacs/diagnóstico
Rigidez Muscular Espasmódica/diagnóstico
[Mh] Termos MeSH secundário: Atrofia
Autoanticorpos/sangue
Biomarcadores/sangue
Diagnóstico Diferencial
Esquema de Medicação
Quimioterapia Combinada
Feminino
Seres Humanos
Hidrocortisona/administração & dosagem
Hipopituitarismo/diagnóstico por imagem
Hipopituitarismo/tratamento farmacológico
Meia-Idade
Hipófise/patologia
Hormônios Tireóideos/administração & dosagem
Tiroxina/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Biomarkers); 0 (Thyroid Hormones); Q51BO43MG4 (Thyroxine); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170530
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001008


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[PMID]:28352939
[Au] Autor:Apeldoorn AT; Kamper SJ; Kalter J; Knol DL; van Tulder MW; Ostelo RW
[Ad] Endereço:Rehabilitation department, Noordwest Ziekenhuisgroep, NL-1815 JD Alkmaar, The Netherlands. a.t.apeldoorn@nwz.nl.
[Ti] Título:Rigid shoulder taping with physiotherapy in patients with subacromial pain syndrome: A randomized controlled trial.
[So] Source:J Rehabil Med;49(4):347-353, 2017 Apr 06.
[Is] ISSN:1651-2081
[Cp] País de publicação:Sweden
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the effectiveness of individualized physiotherapy in combination with rigid taping compared with individualized physiotherapy alone in patients with subacromial pain syndrome. DESIGN: A prospective randomized trial with concealed allocation. PATIENTS: A total of 140 patients between 18 and 65 years of age from primary physiotherapy settings. METHODS: The intervention group received individualized physiotherapy and shoulder taping. The control group received individualized physiotherapy only. Primary outcomes were: pain intensit (numerical rating scale) and functioning (Simple Shoulder Test). Secondary outcomes were: global perceived effect and patient-specific complaints. Data were collected at baseline, and at 4, 12 and 26 weeks' follow-up. RESULTS: During the 6-month follow-up period multilevel analysis showed a significant difference between groups favouring the control group on pain intensity (p = 0.02), but not on functioning. Regarding secondary outcomes, a significant difference between groups was found favouring the intervention group for global perceived effect (p = 0.02), but not for patient-specific complaints. CONCLUSION: Rigid shoulder taping, as used in this study, cannot be recommended for improving physiotherapy outcomes in people with subacromial pain syndrome.
[Mh] Termos MeSH primário: Rigidez Muscular/terapia
Síndrome de Colisão do Ombro/terapia
Dor de Ombro/reabilitação
Ombro/patologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Meia-Idade
Modalidades de Fisioterapia
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.2340/16501977-2214



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