Spastic diplegia in children with HIV encephalopathy: first description of gait and physical status

2013 ◽  
Vol 56 (7) ◽  
pp. 686-694 ◽  
Author(s):  
Nelleke G Langerak ◽  
Jacques du Toit ◽  
Marlette Burger ◽  
Mark F Cotton ◽  
Priscilla E Springer ◽  
...  
Keyword(s):  
Spastic Diplegia ◽  
Physical Status ◽  
Hiv Encephalopathy

Incidence of spinal deformities and the relationship with physical status and back pain in ambulant adults with cerebral palsy and spastic diplegia

2019 ◽  
Vol 29 (6) ◽  
pp. 1416-1423
Author(s):  
Nelleke G. Langerak ◽  
Elsabe Britz ◽  
Stewart Dix-Peek ◽  
Jacques du Toit ◽  
A. Graham Fieggen ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Back Pain ◽  
Spastic Diplegia ◽  
Spinal Deformities ◽  
Physical Status ◽  
The Relationship

Architecture of the medial gastrocnemius in children with spastic diplegia

2001 ◽  
Vol 43 (12) ◽  
pp. 796 ◽  
Author(s):  
Adam P Shortland ◽  
Charlotte A Harris ◽  
Martin Gough ◽  
Richard O Robinson
Keyword(s):  
Medial Gastrocnemius ◽  
Spastic Diplegia

CEREBRAL PALSY:A CLINICAL OVERVIEW

2020 ◽  
Vol 3 (1) ◽  
pp. 54-59
Author(s):  
Nargiza Ergasheva ◽  
◽  
Sardor Anorboev ◽  
Gavkhar Kendjaeva ◽  
Keyword(s):  
Brain Area ◽  
Fetal Brain ◽  
Clinical History ◽  
Screening Tests ◽  
Spastic Diplegia ◽  
Team Approach ◽  
Birth Process ◽  
Increased Risk ◽  
Spastic Quadriplegia ◽  
Magnetic Resonance Imaging Mri

Cerebral palsy (CP) is a disorder characterized by abnormal tone, posture and movement. The incidence of CP is 2–4 per 1,000 live births in the world. Prematurityand low birth weight are important risk factors for CP; however, multiple other factors have been associated with an increased risk for CP, including maternal infections and diseases, and abnormal birth process. In most cases of CP the initial injury to the brain occurs during early fetal brain development, later a brain area that is injured cannot function properly in the future. CP is classified clinically based on the predominant motor syndrome—spastic hemiplegia, spastic diplegia, spastic quadriplegia, ataxic and dyskinetic cerebral palsies. The diagnosis of CPis based on a combination of clinical history, use of standardized neuromotor assessment and findings on magnetic resonance imaging (MRI). If there is a suspicionof genetic or inborn metabolic disorders, screening tests should be provided additionally. Because CP is associated with multiple associated and secondary medical conditions, its management requires a multidisciplinary team approach

Postoperative Anesthesia Of Elderly And Senile Patients With Total Joint Replacement Of The Lower Extremities

2020 ◽  
Vol 2 (09) ◽  
pp. 75-81
Author(s):  
Gaziev Z.T. ◽  
Avakov V.E. ◽  
Shorustamov M.T. ◽  
Bektemirova N.T.
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Period ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Lower Extremities ◽  
Multimodal Analgesia ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Physical Status ◽  
Traumatic Injuries

Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities. Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.

Generating publicly available progress notes of authentic quality: A crowdsourcing-based approach (Preprint)

2020 ◽  
Author(s):  
Rina Kagawa ◽  
Yukino Baba ◽  
Hideo Tsurushima
Keyword(s):  
Social Capital ◽  
Medical Education ◽  
Medical Practice ◽  
Patient Privacy ◽  
Patient Anxiety ◽  
Physical Status ◽  
High Quality ◽  
Privacy Concerns ◽  
Progress Notes ◽  
Research And Education

BACKGROUND Sharing progress notes as a common social capital is essential in research and education, but the content of progress notes is sensitive and needs to be kept confidential. Publishing actual progress notes are difficult due to privacy concerns. OBJECTIVE This study aims to generate a large repository of pseudo-progress notes of authentic quality. We focused on two requirements for authentic quality: the validity and consistency of the data, from the perspective of medical practice, and the empirical and semantic characteristics of progress notes, such as shorthand styles used for reporting changes in a patient's physical status, long narrative sentences detailing patient anxiety, and interprofessional communications. METHODS We proposed a practical framework that consists of a simulation of the notes and evaluation of the simulated notes. The framework utilized two human cognitive traits: (1) the ability to use imitation to simulate objects with diverse characteristics without background knowledge and (2) the use of comparison as a strategy for deep thinking. This enabled crowd workers to generate a large number of progress notes. Our framework involved three steps. In step 1, crowd workers imitated actual progress notes decomposed into subject data (S), object data (O), and assessment and plan (A/P). These imitated texts were then shuffled and recomposed in S, O, and A/P in order to create simulated progress notes. In step 2, crowd workers identified the characteristics of actual progress notes based on comparisons between actual and dummy progress notes. These characteristics were clustered based on their similarities. Each cluster exhibited the empirical and semantic characteristics of the actual progress notes. Finally, in step 3, the texts from step 1 that exhibited the identified characteristics from step 2 were evaluated as quality-guaranteed progress notes that met the two requirements. All data were preprocessed to protect patient privacy. RESULTS Step 1: By recomposing the 700 imitated texts, 9,856 simulated progress notes were generated. Step 2: 3,938 differences between actual progress notes and dummy progress notes were identified. After clustering, 166 characteristics were evaluated to be appropriate as empirical and semantic characteristics of the actual progress notes. Step 3: 500 crowd workers demonstrated that 83.0% of the simulated progress notes satisfied at least one of the characteristics obtained in step 2. The crowd workers' artificially-reproduced progress notes were evaluated to determine the most realistic, based on four metrics: disease, morpheme, readability, and reality. CONCLUSIONS Our results demonstrated that crowd workers could generate and evaluate highly professional documents. We have made our large repository of high-quality crowdsourced progress notes publicly available, and we encourage their use in the development of medical education and research.

Muscle Tone Assessment under General Anesthesia for Sjögren-Larsson Syndrome and Spasticity

2021 ◽  
Vol 56 (2) ◽  
pp. 163-165
Author(s):  
George Georgoulis ◽  
Argyrios Dinopoulos ◽  
Emmanouil Gkliatis
Keyword(s):  
General Anesthesia ◽  
Muscle Tone ◽  
Muscle Relaxants ◽  
Spastic Diplegia ◽  
Case Presentation ◽  
Neurosurgical Procedure ◽  
Dorsal Rhizotomy ◽  
Severe Spasticity ◽  
Larsson Syndrome ◽  
Rule Out

Introduction: Study of muscle tone in individuals with severe spasticity (Modified Asworth Scale – MAS:3) under general anesthesia can confirm or rule out the eventual necessity of the impending spasticity relieving ablative neurosurgery by observing the hypertonia reduction and passive range of motion expansion. Therefore, what we measure under muscle relaxants is practically a fixed deformity. Case Presentation: The study was performed on a girl with Sjögren-Larsson syndrome, presenting with icthyosis and spastic diplegia. Proposed intervention was Dorsal Rhizotomy. Under general anesthesia, with and without muscle relaxants, hypertonia was significantly reduced (MAS:1), but the angle of motion did not increase much. Conclusion: We decided not to perform such a neurosurgical procedure. In ambiguous situations, the proposed study can help in decision-making for spasticity treatment.

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