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DerNervenarzt.70680062.eng.abstr
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DerNervenarzt.70680062.eng.abstr
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"In this retrospektive investigation on 659 depressive outpatients , predictors of antidepressant drug response were evaluated . In accordance with the literature , neither demographic variables nor duration of the current episode , severity of depressive symptoms or scores of rating scales showed any clinically relevant relation to outcome . The prognostic value of recovery within the first 2 weeks seems to be the only reliable predictor . In all , 75 % of patients without a significant reduction ( less than 20 % ) of the score in the Hamilton Psychiatric Rating Scale for Depression after 2 weeks of treatment will not fulfill response criteria after 6 weeks . For clinical practice these results imply the necessity of reviewing the applied drug regimen early , i . e . about 2 weeks after beginning , to check for compliance with treatment or an individual problem of resorption or metabolism in order to amend the regimen by increasing dosage and/or adding sleep deprivation , lithium , thyroxine or psychotherapy ."
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DerNervenarzt.70680067.eng.abstr
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DerNervenarzt.70680067.eng.abstr
|
[
{
"id": "DerNervenarzt.70680067.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Suicide on railways ( either by being run over by or jumping in front of a train ) is one of the ' hardest ' suicide methods . In Austria , 617 suicides or attempted suicides on railways were registered between 1990 and 1994. This amounts to 5.73 % of all suicides committed in this period with women showing a higher percentage than men . In both men and women there was a predominance of younger age groups ; the mean age was higher in women than in men ( 48.0 vs 40.4 years ) . There was a significant increase in suicides or attempted suicides on railways after a television report on the stress suffered by train drivers concerning possible suicides . Persuading the mass media to treat the subject of ' suicide ' with reserve and with greater caution , even when not presenting a distinct suicide model , may be of importance in general suicide prevention ."
],
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[
0,
863
]
]
}
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[] |
[] |
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"id": "DerNervenarzt.70680067.eng.abstr-s5-r1-t1.1-t5.1",
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}
] |
DerNervenarzt.70680074.eng.abstr
|
DerNervenarzt.70680074.eng.abstr
|
[
{
"id": "DerNervenarzt.70680074.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We present the case of a 35-year-old patient suffering from schizoaffective psychosis . After 4 weeks on clozapine he developed acute priapism . Possible explanations and pathophysiology are discussed as well as the requirement for sufficient information of the patient . Delay of urgent urologic treatment incrases the risk of irreversible impotence . The patient's history should be evaluated with respect to former unphysiological prolonged erections ."
],
"offsets": [
[
0,
455
]
]
}
] |
[
{
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37,
44
]
],
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}
]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s1-t2",
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],
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76,
85
]
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]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s1-t3",
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60,
85
]
],
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]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s2-t1",
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],
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105,
114
]
],
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}
]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s2-t2",
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"priapism"
],
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[
134,
142
]
],
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}
]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s3-t1",
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],
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171,
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{
"id": "DerNervenarzt.70680074.eng.abstr-s3-t2",
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262,
269
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}
]
},
{
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297,
306
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]
},
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"id": "DerNervenarzt.70680074.eng.abstr-s4-t2",
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320,
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},
{
"id": "DerNervenarzt.70680074.eng.abstr-s4-t3",
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"impotence"
],
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341,
350
]
],
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}
]
},
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"id": "DerNervenarzt.70680074.eng.abstr-s4-t4",
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320,
327
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]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s5-t1",
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]
},
{
"id": "DerNervenarzt.70680074.eng.abstr-s5-t2",
"type": "umlsterm",
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444,
453
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030847"
}
]
}
] |
[] |
[] |
[
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},
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"id": "DerNervenarzt.70680074.eng.abstr-s2-r2-t1.1-t2.1",
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"id": "DerNervenarzt.70680074.eng.abstr-s4-r2-t1.1-t3.1",
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},
{
"id": "DerNervenarzt.70680074.eng.abstr-s4-r3-t4.1-t1.1",
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{
"id": "DerNervenarzt.70680074.eng.abstr-s4-r4-t3.1-t1.1",
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"normalized": []
}
] |
DerNervenarzt.70680077.eng.abstr
|
DerNervenarzt.70680077.eng.abstr
|
[
{
"id": "DerNervenarzt.70680077.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report on a psychosis caused by application of a transdermal scopolamine patch for over 15 days . In the literature there is no mention of a case in which scopolamine had such an influence nor are any cases reported in which paranoid-hallucinatory symptoms cortinued 11 days after removing the patch ."
],
"offsets": [
[
0,
304
]
]
}
] |
[
{
"id": "DerNervenarzt.70680077.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"psychosis"
],
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[
15,
24
]
],
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{
"db_name": "UMLS",
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}
]
},
{
"id": "DerNervenarzt.70680077.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"scopolamine"
],
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64,
75
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],
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"db_name": "UMLS",
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]
},
{
"id": "DerNervenarzt.70680077.eng.abstr-s2-t1",
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"text": [
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108,
118
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]
},
{
"id": "DerNervenarzt.70680077.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"scopolamine"
],
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158,
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"db_name": "UMLS",
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}
]
},
{
"id": "DerNervenarzt.70680077.eng.abstr-s2-t3",
"type": "umlsterm",
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],
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[
228,
250
]
],
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"db_name": "UMLS",
"db_id": "C0135273"
}
]
},
{
"id": "DerNervenarzt.70680077.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
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],
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[
251,
259
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DerNervenarzt.70680094.eng.abstr
|
DerNervenarzt.70680094.eng.abstr
|
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[] |
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DerNervenarzt.70680102.eng.abstr
|
DerNervenarzt.70680102.eng.abstr
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"Various clinico-pathological studies have shown that appr . 20 % of patients with a clinical diagnosis of idiopathic Parkinson's disease ( IPD ) may have neuropathological evidence of alternative causes of parkinsonism . Most of these misdiagnosed \" IPD \" patients meet clinical criteria for either multiple system atrophy ( MSA ) , or progressive supranuclear palsy ( PSP ) , or corticobasal degeneration ( CBD ) . A careful history and physical examination , as well as follow-ups and selected investigations are essential for an accurate clinical diagnosis of these atypical parkinsonian syndromes . The following paper therfore provides a review of clinical features and diagnostic findings in MSA , PSP and CBD , in order to facilitate recognition of these patients ."
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DerNervenarzt.70680122.eng.abstr
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DerNervenarzt.70680122.eng.abstr
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"We studied the effects of stroke unit care in an acute Neurology department on the outcome and the length of hospital stay in acute stroke patients . After an emergency evaluation on admission including CCT , ultrasound studies and ECG the patients were treated on a specialist stroke unit for an average 3.9 days . For 48 +/- 24 h monitoring of blood pressure , ECG , pO2 and transcranial Doppler sonography was instituted . Stroke unit treatment reduced the length of hospital stay from an average 15.8 days in the time period before institution of the stroke unit to 12.9 days . This effect was especially marked in patients with acute occlusion of major intracranial arteries ( before stroke unit treatment : n = 33 ; hospital stay 22.5 days ; after stroke unit treatment : n = 54 ; hospital stay 13.9 days ) . Clinical deterioration in acute ischemic stroke was related to reduction of cerebral blood flow velocities due to blood pressure changes or space occupying effects . Monitoring on the stroke unit allowed immediate treatment of systemic hypotension , cerebral edema or cardiac arrhytmias . Transcranial Doppler sonography revealed HITS in 6/55 acute stroke patients without new clinical symptoms . Monitoring on the stroke unit improved the specific care for acute stroke patients . The length of hospital stay was reduced after stroke unit care ."
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DerNervenarzt.70680129.eng.abstr
|
DerNervenarzt.70680129.eng.abstr
|
[
{
"id": "DerNervenarzt.70680129.eng.abstr-passage-0",
"type": "abstract",
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"Objective : To test the hypothesis of a positive association of hypertension and diabetes mellitus with cerebral small-vessel disease infarct patterns ."
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0,
152
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]
}
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134,
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}
] |
[] |
[] |
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{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r16-t5.2-t3.1",
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{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r17-t5.2-t3.1",
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{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r18-t3.1-t7.1",
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},
{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r22-t3.1-t5.2",
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},
{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r23-t7.1-t3.1",
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},
{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r24-t7.1-t2.1",
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},
{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r27-t5.2-t3.1",
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},
{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r28-t5.1-t2.1",
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{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r29-t5.2-t4.1",
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"id": "DerNervenarzt.70680129.eng.abstr-s1-r31-t7.1-t4.1",
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},
{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r32-t5.2-t2.1",
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{
"id": "DerNervenarzt.70680129.eng.abstr-s1-r33-t7.1-t3.1",
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}
] |
DerNervenarzt.70680135.eng.abstr
|
DerNervenarzt.70680135.eng.abstr
|
[
{
"id": "DerNervenarzt.70680135.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Dural carotid cavernous fistulas ( DCCF ) can be associated with venous thrombosis . We report on a rare case of a patient who developed a venous infarct , which was diagnosed on CT and MRI . The DCCF predominantly drained through a frontobasal cortical vein into the superior sagittal sinus . The shunt volume was small and was therefore thought not to be sufficient to explain the massive ocular signs , such as severe exophthalmus and reduction of visual acuity . We therefore postulated a venous congestion owing to a secondary spontaneous venous thrombosis of the draining venous pathways to be responsible for the ocular signs . Under anticoagulative medication , the patient's signs and symptoms improved gradually . Control angiography after 3 months showed that the DCCF had disappeared . In the presence of DCCF , anticoagulation should always be considered when a venous thrombosis is suspected ."
],
"offsets": [
[
0,
907
]
]
}
] |
[
{
"id": "DerNervenarzt.70680135.eng.abstr-s1-t1",
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"fistulas"
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24,
32
]
],
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"db_id": "C0016169"
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{
"id": "DerNervenarzt.70680135.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"thrombosis"
],
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[
72,
82
]
],
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{
"db_name": "UMLS",
"db_id": "C0040053"
}
]
},
{
"id": "DerNervenarzt.70680135.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"venous thrombosis"
],
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[
65,
82
]
],
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"db_name": "UMLS",
"db_id": "C0042487"
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"id": "DerNervenarzt.70680135.eng.abstr-s2-t1",
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"patient"
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115,
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}
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{
"id": "DerNervenarzt.70680135.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"infarct"
],
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146,
153
]
],
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"id": "DerNervenarzt.70680135.eng.abstr-s2-t3",
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"MRI"
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186,
189
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}
]
},
{
"id": "DerNervenarzt.70680135.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"vein"
],
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[
254,
258
]
],
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"db_name": "UMLS",
"db_id": "C0042449"
}
]
},
{
"id": "DerNervenarzt.70680135.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"sinus"
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[
286,
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]
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]
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"id": "DerNervenarzt.70680135.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"signs"
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[
398,
403
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"db_name": "UMLS",
"db_id": "C0220912"
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]
},
{
"id": "DerNervenarzt.70680135.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"visual acuity"
],
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451,
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},
{
"id": "DerNervenarzt.70680135.eng.abstr-s5-t1",
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]
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{
"id": "DerNervenarzt.70680135.eng.abstr-s5-t2",
"type": "umlsterm",
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],
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551,
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{
"id": "DerNervenarzt.70680135.eng.abstr-s5-t3",
"type": "umlsterm",
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[] |
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] |
DerNervenarzt.70680139.eng.abstr
|
DerNervenarzt.70680139.eng.abstr
|
[
{
"id": "DerNervenarzt.70680139.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cranial dural fistulae are rare ; when they occur , it is usually difficult to detect them at an early stage . With a view to the question of possible progress in diagnosis we now report on seven patients with lateral dural fistulae fed by branches of the external carotid artery . The examination was carried out before selective arteriography using cw-Doppler sonography and colour coded duplex sonography in combination . Sonographic criteria for detection of hyperperfusion take account of flow velocity as well as pulsatility . In all cases hyperperfusion of the external carotid artery and the common carotid artery was detected . In most of these cases pathologic findings were also observed at the occipital artery , and more rarely in the contralateral external carotid artery or the ipsilateral vertebral artery , in addition . A possible source of error arising from confusion of blood vessels was present with the cw-Doppler sonography , but not for colour coded duplex sonography . Therefore , cranial dural fistulae characterized by a high shunt volume can be diagnosed correctly by indirect Doppler sonographic criteria using cw-Doppler and duplex sonography . Direct visualization of the fistula and its nidus requires additional selective arteriography , in the course of which endovascular embolization may be performed ."
],
"offsets": [
[
0,
1339
]
]
}
] |
[
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"text": [
"fistulae"
],
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[
14,
22
]
],
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{
"db_name": "UMLS",
"db_id": "C0016169"
}
]
},
{
"id": "DerNervenarzt.70680139.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"stage"
],
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[
103,
108
]
],
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{
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"db_id": "C0027646"
}
]
},
{
"id": "DerNervenarzt.70680139.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"diagnosis"
],
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[
163,
172
]
],
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"db_id": "C0011900"
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]
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{
"id": "DerNervenarzt.70680139.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"patients"
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[
196,
204
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],
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{
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"db_id": "C0030705"
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},
{
"id": "DerNervenarzt.70680139.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"fistulae"
],
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[
224,
232
]
],
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{
"db_name": "UMLS",
"db_id": "C0016169"
}
]
},
{
"id": "DerNervenarzt.70680139.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"artery"
],
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[
273,
279
]
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"db_id": "C0003842"
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]
},
{
"id": "DerNervenarzt.70680139.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"carotid artery"
],
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[
265,
279
]
],
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{
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"db_id": "C0162859"
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]
},
{
"id": "DerNervenarzt.70680139.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"external carotid artery"
],
"offsets": [
[
256,
279
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] |
DerNervenarzt.70680147.eng.abstr
|
DerNervenarzt.70680147.eng.abstr
|
[
{
"id": "DerNervenarzt.70680147.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Reflex sympathetic dystrophy ( RSD ) is a pain syndrome characterized by somatosensory and motor disturbances , as well as by autonomic and trophic changes . The term is used in a descriptive sense and does not imply specific mechanisms of pathogenesis . We report on a patient who fulfilled the clinical criteria of RSD and who also displayed increasing impairment of peripheral blood supply . Angiography revealed a circumscribed stenosis of the abdominal aorta adjacent to the bifurcation . Disturbances in peripheral circulation as a potential cause of RSD are discussed ."
],
"offsets": [
[
0,
576
]
]
}
] |
[
{
"id": "DerNervenarzt.70680147.eng.abstr-s1-t1",
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"Reflex"
],
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[
0,
6
]
],
"normalized": [
{
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"pain"
],
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[
42,
46
]
],
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{
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s1-t3",
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"text": [
"syndrome"
],
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[
47,
55
]
],
"normalized": [
{
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s1-t4",
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"pain syndrome"
],
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[
42,
55
]
],
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{
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"db_id": "C0391976"
}
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},
{
"id": "DerNervenarzt.70680147.eng.abstr-s1-t5",
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"text": [
"Reflex sympathetic dystrophy"
],
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[
0,
28
]
],
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s2-t1",
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"text": [
"pathogenesis"
],
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[
240,
252
]
],
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"patient"
],
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[
270,
277
]
],
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"criteria"
],
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305,
313
]
],
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"db_id": "C0243161"
}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"blood"
],
"offsets": [
[
380,
385
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005767"
},
{
"db_name": "UMLS",
"db_id": "C0005768"
},
{
"db_name": "UMLS",
"db_id": "C0005835"
}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"supply"
],
"offsets": [
[
386,
392
]
],
"normalized": [
{
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"db_id": "C0243163"
},
{
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]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"blood supply"
],
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[
380,
392
]
],
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{
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"db_id": "C0005839"
}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"Angiography"
],
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[
395,
406
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],
"normalized": [
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"stenosis"
],
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[
432,
440
]
],
"normalized": [
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"aorta"
],
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458,
463
]
],
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{
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"abdominal aorta"
],
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[
448,
463
]
],
"normalized": [
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}
]
},
{
"id": "DerNervenarzt.70680147.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"circulation"
],
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521,
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],
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},
{
"id": "DerNervenarzt.70680147.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0015127"
}
]
}
] |
[] |
[] |
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DerNervenarzt.70680159.eng.abstr
|
DerNervenarzt.70680159.eng.abstr
|
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"Since Manfred Bleuler's description of the clinical picture of late onset schizophrenia over 50 years ago , debate has persisted as to whether it is justifiable to differentiate this as a valid , independent entity from the group of classic schizophrenic disorders with early onset . As this review shows , this question cannot be answered unequivocally even now . It must rather be remarked that we have neither been able to decisively extend our knowledge since Manfred Bleuler's comprehensive contribution , nor managed to achieve a much sounder basis methodologically . The reasons for this are the international conceptual and terminological confusion that has developed around this illness group , and on the other hand the methodological limitations of the empirical studies conducted on this clinical picture so far ."
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[] |
[] |
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DerNervenarzt.70680184.eng.abstr
|
DerNervenarzt.70680184.eng.abstr
|
[
{
"id": "DerNervenarzt.70680184.eng.abstr-passage-0",
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"At the beginning of the 19 th century , institutional care for the insane was established by the various German states . At first , the separation of curable and incurable patients influenced psychiatric care and the construction of hospitals . The combination of care and cure in one hospital in Illenau was a turning point in institutional care . Contradictory tendencies characterized the second half of the 19 th century : the integration with general medicine in the cities , on the one hand , the social separation and cure in the seclusion of the countryside , on the other . The characteristic psychiatric construction in different countries was influenced by individual architects . The following building styles were dominant : in England , panoptic architecture ; in the United States , linear staggered structures ; in France , the \" carrés isolés \" ; and in Germany , the structure of blocks with cross-axes . At the end of the 19 th century , the system of pavilions was internationally accepted ; occupational therapy and mental care in the countryside were introduced . From the First World War until the end of the 1960 s , a standstill in psychiatric buildings was noted in Germany , and institutional care came under increasing criticism . There was a reorientation from the middle of the 1970 s as a result of more effective therapeutic possibilities . A variety of complementary institutions , outpatient and partly inpatient therapies , which were recommended by the \" Psychiatrie-Enquête \" , started to be realized . Smaller units and different models of integration of psychiatric care , such as building the hospital next to a general hospital or psychiatric wards within a general hospital , became relevant criteria for planning the construction of psychiatric hospitals , as did the integration into the community and the city . Principles of organization like the construction of a communicative quiet inner room , or grading the rooms from public to private , were structurally integrated . Specific structural requirements for the construction and design of psychiatric hospitals should be evaluated in more detail by post-occupancy methods ."
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[] |
[] |
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DerNervenarzt.70680196.eng.abstr
|
DerNervenarzt.70680196.eng.abstr
|
[
{
"id": "DerNervenarzt.70680196.eng.abstr-passage-0",
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"For the first time , the present study assessed the achievable predictive value of early self-experienced neuropsychological deficits for the fater development of schizophrenia . Ninety-six patients with DSM-III-R diagnoses mainly of the formerly neurotic or personality disordered field , of whom 81 % had shown such basic disorders at the time of the index examination and therefore were classified as persons at high risk of developing schizophrenia , were re-examined for schizophrenia . After an average follow-up period of about 8 years , more than half of the re-examined sample had developed a schizophrenic disorder according to DSM-III-R . The outcome of schizophrenia versus no schizophrenia was predicted correctly in 77 % of cases by the presence or absence of self-experienced disturbances of perception , thought , speech or action ."
],
"offsets": [
[
0,
848
]
]
}
] |
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DerNervenarzt.70680205.eng.abstr
|
DerNervenarzt.70680205.eng.abstr
|
[
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"A study on the concept and measurement of the basic disorders of schizophrenia is presented . A total of 151 male adult psychiatric inpatients ( 51 with a dual diagnosis of schizophrenia and alcoholism , 50 schizophrenics and 50 alcoholics ) were included . The aims of this study were : ( 1 ) the replication of the previous finding that the Frankfurt Complaint Questionnaire ( FBF ) contains items that discriminate between schizophrenia and alcoholism ; ( 2 ) an empirical comparison between FBF and the Bonn Scale for the Assessment of Basic Symptoms ( BSABS ) ; ( 3 ) testing the relationship between basic and negative versus positive symptoms , as measured by the Positive and Negative Syndrome Scale ( PANSS ) . Regarding ( 1 ) , the former result was replicated . Regarding ( 2 ) , FBF subscales and BSABS categories were shown to be significantly but weakly related , even if identical symptoms were included in the inquiry . Regarding ( 3 ) , FBF and BSABS were found to be more closely related to negative than to positive PANSS items . Theoretical implications and consequences for further research are discussed ."
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] |
DerNervenarzt.70680226.eng.abstr
|
DerNervenarzt.70680226.eng.abstr
|
[
{
"id": "DerNervenarzt.70680226.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Schizophrenic delusion constitutes a fictive reality of its own ; moreover , it transforms the originally experienced psychotically incomprehensible into a structure of meaning . It is assumed that the incomprehensible is reified in the actual delusion by means of structural affinities . Reciprocally , it is through these structural affinities that we can approximate hermeneutically to the characteristics of psychotic existence ."
],
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[
0,
433
]
]
}
] |
[
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"delusion"
],
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22
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"id": "DerNervenarzt.70680226.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"delusion"
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{
"id": "DerNervenarzt.70680226.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"psychotic"
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"db_id": "C0033975"
}
]
}
] |
[] |
[] |
[] |
DerNervenarzt.70680231.eng.abstr
|
DerNervenarzt.70680231.eng.abstr
|
[
{
"id": "DerNervenarzt.70680231.eng.abstr-passage-0",
"type": "abstract",
"text": [
"With the introduction of operationalized diagnostic systems the multiaxial approach became a more important issue . The proposed multiaxial system of ICD-10 consists of three axes : on axis I psychiatric diagnoses are made according to the ICD-10 Clinical Guidelines or Diagnostic Criteria for Research . Axis II ( Disability Diagnostic Scale , DDS ) deals with impairment of psychosocial functioning . On axis III environmental/circumstantial and personal lifestyle management factors are rated . As part of the WHO international field trial , applicability and inter-rater reliability of the system were examined in seven German-speaking centers . In addition axis II was compared with the corresponding axis of DSM-III-R ( Global Assessment of Functioning Scale ) . 45 German clinicians rated 12 case histories written in English ( provided by WHO ) with 488 ratings altogether . Diagnoses on axis I with an average percentage agreement of 65.6 % and a mean K of 0.50 showed a moderate inter-rater reliability . For axis II the intraclass coefficient was 0.62 , and that for the corresponding DSM-III axis was 0.65 : both these axes thus also had a moderate inter-rater reliability . There was a close correlation between the subscales and the global assessment of axis II there was . Wide variation was found in the psychosocial circumstances on axis III , the mean K value being 0.16. In the discussion proposals for the revision process for the multiaxial ICD-10 system are made ."
],
"offsets": [
[
0,
1486
]
]
}
] |
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t1",
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"axes"
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"db_name": "UMLS",
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t2",
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189
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"db_name": "UMLS",
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}
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t3",
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"diagnoses"
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t4",
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t6",
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t7",
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"id": "DerNervenarzt.70680231.eng.abstr-s2-t8",
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"psychiatric diagnoses"
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"id": "DerNervenarzt.70680231.eng.abstr-s3-t1",
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"id": "DerNervenarzt.70680231.eng.abstr-s3-t2",
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"id": "DerNervenarzt.70680231.eng.abstr-s3-t3",
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"id": "DerNervenarzt.70680231.eng.abstr-s3-t4",
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"DDS"
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"id": "DerNervenarzt.70680231.eng.abstr-s4-t1",
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}
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},
{
"id": "DerNervenarzt.70680231.eng.abstr-s4-t2",
"type": "umlsterm",
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"lifestyle"
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457,
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]
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"id": "DerNervenarzt.70680231.eng.abstr-s6-t1",
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662,
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"id": "DerNervenarzt.70680231.eng.abstr-s6-t2",
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"id": "DerNervenarzt.70680231.eng.abstr-s6-t3",
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"id": "DerNervenarzt.70680231.eng.abstr-s7-t1",
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{
"id": "DerNervenarzt.70680231.eng.abstr-s7-t2",
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"id": "DerNervenarzt.70680231.eng.abstr-s8-t1",
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"id": "DerNervenarzt.70680231.eng.abstr-s9-t1",
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"id": "DerNervenarzt.70680231.eng.abstr-s10-t1",
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"id": "DerNervenarzt.70680231.eng.abstr-s11-t1",
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DerNervenarzt.70680239.eng.abstr
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DerNervenarzt.70680239.eng.abstr
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DerNervenarzt.70680245.eng.abstr
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DerNervenarzt.70680245.eng.abstr
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},
{
"id": "DerNervenarzt.70680245.eng.abstr-s2-r2-t4.1-t1.1",
"type": "uses",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680245.eng.abstr-s2-r3-t1.1-t4.1",
"type": "carries_out",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s6-t4",
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},
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"id": "DerNervenarzt.70680245.eng.abstr-s2-r4-t4.1-t2.1",
"type": "uses",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s6-t2",
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},
{
"id": "DerNervenarzt.70680245.eng.abstr-s5-r1-t3.1-t1.1",
"type": "affects",
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{
"id": "DerNervenarzt.70680245.eng.abstr-s6-r1-t4.1-t2.1",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s6-t2",
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},
{
"id": "DerNervenarzt.70680245.eng.abstr-s6-r2-t2.1-t4.1",
"type": "affects",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s6-t4",
"normalized": []
},
{
"id": "DerNervenarzt.70680245.eng.abstr-s6-r3-t4.1-t1.1",
"type": "performs",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s7-t1",
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},
{
"id": "DerNervenarzt.70680245.eng.abstr-s6-r4-t1.1-t4.1",
"type": "affects",
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"arg2_id": "DerNervenarzt.70680245.eng.abstr-s6-t4",
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}
] |
DerNervenarzt.70680251.eng.abstr
|
DerNervenarzt.70680251.eng.abstr
|
[
{
"id": "DerNervenarzt.70680251.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Within the last 20 years , many day-care centers ( Tagesstaetten = TSn ) and drop-in centers ( Psychosoziale Kontakt- und Beratungsstellen = KBSn ) have been set up in Germany . Although these institutions are widespread , there are hardly any empirical studies on the characteristics of their users or on their effects . In this study , 100 patients in TSn and KBSn in Berlin were examined . Social characteristics , psychopathology and attitudes of the patients were investigated . Almost all patients had been in psychiatric hospitals before . The current psychopathology varied greatly and was moderate on average . Two-thirds of the patients were pensioners , most of them living alone with just a few or no friends . Contact with other people and structured day activities were most often mentioned as positive aspects by the patients . The most frequent negative aspect was annoyance by fellow users . Patients in TSn were significantly younger and had higher scores on BPRS subscale anergia . In other variables , there was little difference between patients in the two institutions . The results suggest that both institutions - as intended - care for chronic mentally ill patients with poor social integration . For these patients they provide some compensations for a insufficient social network . Limitations and consequences of the findings are briefly discussed ."
],
"offsets": [
[
0,
1377
]
]
}
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"id": "DerNervenarzt.70680251.eng.abstr-s1-t2",
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"Germany"
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"id": "DerNervenarzt.70680251.eng.abstr-s3-t2",
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"Berlin"
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"id": "DerNervenarzt.70680251.eng.abstr-s4-t2",
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"id": "DerNervenarzt.70680251.eng.abstr-s4-t4",
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"Social characteristics"
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"id": "DerNervenarzt.70680251.eng.abstr-s5-t2",
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"id": "DerNervenarzt.70680251.eng.abstr-s5-t3",
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"psychiatric hospitals"
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"id": "DerNervenarzt.70680251.eng.abstr-s7-t2",
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"id": "DerNervenarzt.70680251.eng.abstr-s8-t1",
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"people"
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"db_id": "C0027361"
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"id": "DerNervenarzt.70680251.eng.abstr-s12-t1",
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"id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"type": "umlsterm",
"text": [
"compensations"
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"db_id": "C0220808"
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},
{
"id": "DerNervenarzt.70680251.eng.abstr-s13-t3",
"type": "umlsterm",
"text": [
"social network"
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}
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},
{
"id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"type": "umlsterm",
"text": [
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243095"
}
]
}
] |
[] |
[] |
[
{
"id": "DerNervenarzt.70680251.eng.abstr-s4-r1-t3.1-t1.1",
"type": "issue_in",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s13-t3",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s4-r2-t4.1-t3.1",
"type": "property_of",
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"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s4-r3-t4.1-t1.1",
"type": "issue_in",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s4-t4",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s4-r4-t2.1-t1.1",
"type": "issue_in",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s5-r1-t2.1-t1.1",
"type": "manages",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s5-r2-t1.1-t3.1",
"type": "uses",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s13-t3",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s5-r3-t3.1-t1.1",
"type": "manages",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s13-t3",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s5-r4-t1.1-t2.1",
"type": "uses",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s7-r1-t1.1-t2.1",
"type": "interacts_with",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s7-r2-t2.1-t1.1",
"type": "interacts_with",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s8-r1-t1.1-t2.1",
"type": "interacts_with",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s13-t2",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s8-r2-t2.1-t1.1",
"type": "interacts_with",
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"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s13-r1-t3.1-t1.1",
"type": "interacts_with",
"arg1_id": "DerNervenarzt.70680251.eng.abstr-s13-t3",
"arg2_id": "DerNervenarzt.70680251.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680251.eng.abstr-s13-r2-t1.1-t3.1",
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"arg2_id": "DerNervenarzt.70680251.eng.abstr-s13-t3",
"normalized": []
}
] |
DerNervenarzt.70680270.eng.abstr
|
DerNervenarzt.70680270.eng.abstr
|
[
{
"id": "DerNervenarzt.70680270.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report on a patient suffering from epilepsy and severe personality changes . Huntington disease was diagnosed by molecular-biological investigation . Clinical characteristics are discussed on the basis of modern concepts of the genetic mechanism . Neuroradiological investigation revealed marked cerebellar atrophy , while typical findings of Huntington disease , such as caudate nucleus volume loss , were lacking . The cerebellar atrophy could be attributable either to long-term phenytoin-medication or to the pathological process itself ."
],
"offsets": [
[
0,
545
]
]
}
] |
[
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"id": "DerNervenarzt.70680270.eng.abstr-s1-t1",
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"patient"
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15,
22
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},
{
"id": "DerNervenarzt.70680270.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"epilepsy"
],
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38,
46
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],
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"db_id": "C0014544"
}
]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"personality"
],
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58,
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],
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"db_name": "UMLS",
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}
]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s2-t1",
"type": "umlsterm",
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"disease"
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91,
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}
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},
{
"id": "DerNervenarzt.70680270.eng.abstr-s2-t2",
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"text": [
"Huntington disease"
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},
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"id": "DerNervenarzt.70680270.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"atrophy"
],
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310,
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"db_id": "C0004255"
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{
"id": "DerNervenarzt.70680270.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"findings"
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334,
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"id": "DerNervenarzt.70680270.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"disease"
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}
]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"nucleus"
],
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383,
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]
],
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"db_name": "UMLS",
"db_id": "C0007610"
}
]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"Huntington disease"
],
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[
346,
364
]
],
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{
"db_name": "UMLS",
"db_id": "C0020179"
}
]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"caudate nucleus"
],
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375,
390
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],
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"db_id": "C0007461"
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]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"atrophy"
],
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435,
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],
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}
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},
{
"id": "DerNervenarzt.70680270.eng.abstr-s5-t2",
"type": "umlsterm",
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"phenytoin-medication"
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},
{
"id": "DerNervenarzt.70680270.eng.abstr-s5-t3",
"type": "umlsterm",
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"phenytoin-medication"
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485,
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],
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"db_id": "C0013227"
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]
},
{
"id": "DerNervenarzt.70680270.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"pathological process"
],
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[
516,
536
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DerNervenarzt.70680274.eng.abstr
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DerNervenarzt.70680274.eng.abstr
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[] |
[] |
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DerNervenarzt.70680285.eng.abstr
|
DerNervenarzt.70680285.eng.abstr
|
[
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"id": "DerNervenarzt.70680285.eng.abstr-passage-0",
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"text": [
"The tethered spinal cord syndrome is more often encountered in children , but does also occur in adults . Its clinical spectrum comprises low back pain , neurological deficits such as distal motor weakness and trophic and sensory disturbances in the legs , urological symptoms and such musculoskeletal signs as scoliosis or foot deformities . In addition , cutaneous lesions or subcutaneous lipomas in the lumbosacral region may be indirect signs of an intraspinal pathology . This consists in a tight , thickened and sometimes shortened filum terminale , an intraspinal lipoma , intradural scar formation or other lesions that lead to conus fixation . The common mechanism of injury of these types of pathologies is an impairment of longitudinal movement of the spinal cord , especially the conus medullaris , which subsequently leads to chronic local ischemia . Diagnosis is most readily achieved by magnetic resonance imaging . Treatment is aimed at the restoration of cord mobility by means of microsurgical release of the conus , the cauda equina and the filum terminale with the aid of cauda equina neuromonitoring . Further progression can be effectively halted ; in fact almost half of the patients actually improve . Therefore , every patient presenting with the clinical diagnosis of tethered cord syndrome should be offered specialized surgical treatment ."
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DerNervenarzt.70680292.eng.abstr
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DerNervenarzt.70680292.eng.abstr
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"id": "DerNervenarzt.70680292.eng.abstr-passage-0",
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"text": [
"Septic encephalopathy ( SE ) is present in up to 70% of all patients with sepsis . In some cases , SE may preceed other parameters of sepsis . Loss of consciousness to a various extent is the leading symptom . CSF findings and CCT are usually unremarkable . EEG is a sensitive parameter to monitor SE . EEG-changes deteriorate in correspondence to the degree of SE . If sepsis can be treated successfully , clinical and electrophysiological signs are completely reversible . SE has a complex etiology . Bacterial endotoxins and other microbial products trigger the release of a multitude of mediators of sepsis . Due to liver dysfunction in sepsis , the brain neurotransmitter profile may be deranged . Other etiological factors include bacteriemia , liver or renal dysfunction , fluid and electrolyte imbalance , hypoglycemia and drug effects . Due to the prognostic significance of early adequate treatment , recognition of SE as a possible initial sign may be crucial for patients with sepsis ."
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DerNervenarzt.70680309.eng.abstr
|
DerNervenarzt.70680309.eng.abstr
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"id": "DerNervenarzt.70680309.eng.abstr-passage-0",
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"Since its first description by H.G. Creutzfeldt and A. Jakob , six forms of human spongiform encephalopathies have been described . Besides Creutzfeldt-Jakob disease ( CJD ) , a new variant CJD ( nvCJD ) , Gerstmann-Straeussler-Scheinker syndrome ( GSS ) , fatal familial insomnia ( FFI ) and potentially familial progressive subcortical gliosis have been reported . The most likely causative agent of these and at least six animal-transmissible spongiform encephalopathies ( TSE ) is a structurally altered form of a regular cellular protein , designated prion . The best known animal forms are bovine spongiform encephalopathy ( BSE ) and scrapie . The clinical spectrum of human spongiform encephalopathies has been expanded in recent years by the discovery of new , partially genetically determined forms . The currently available clinical , neurophysiological , neuroradiological , biochemical and molecular-biological methods permit only a probable diagnosis of CJD . A definite diagnosis can only be achieved by the neuropathological demonstration of the pathological prion protein ( PrPSc ) . The transmission of BSE to humans has neither been shown nor definitely excluded ."
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[] |
[] |
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DerNervenarzt.70680324.eng.abstr
|
DerNervenarzt.70680324.eng.abstr
|
[
{
"id": "DerNervenarzt.70680324.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Sixty-three patients with tick-borne encephalitis were studied for sequelae up to 5 years after the acute illness ( median : 12 months , range : 1-44 months ) . Patients were examined clinically , by neuropsychological testing and by electroencephalography . The clinical presentation during the acute stage was as follows : Meningitis ( M , n=12), Meningoencephalitis ( Me , n=27), Meningoencephalomyelitis ( My , n=15), and Meningoencephaloradiculitis ( R , n=9). A total of 59 patients reported a neurasthenic syndrome after discharge , which correlated with the severity of the acute illness . Twenty patients were not able to work because of reduced stress tolerance , fatigue or an elevated emotional sensitivity , which lasted for 3 months at most . In some patients hypacusis ( n=7), severe dysarthria and dysphagia ( n=4) remained essentially unimproved for years following the acute illness . While in 8/9 patients with radiculitis paresis of the extremities improved well over months to years , improvement was quite limited in all patients with myelitis . In 41/55 patients , investigations by electroencephalography revealed normal findings even within months after acute illness . Persistent cognitive deficits were present only in 7/11 patients with a severe course of disease ."
],
"offsets": [
[
0,
1293
]
]
}
] |
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DerNervenarzt.70680331.eng.abstr
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DerNervenarzt.70680331.eng.abstr
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{
"id": "DerNervenarzt.70680331.eng.abstr-passage-0",
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"The initial antibiotic treatment of bacterial meningoencephalitis has major implications for the course of the disease . The current spectrum of infectious agents must be considered . Antibiotics have to reach sufficient concentrations in the blood and cerebrospinal fluid for a bactericidal action to occur at the site of infection . Frequent problems arising in this condition are : ( 1 ) the non-observation of listerial infections , ( 2 ) the use of antibiotics not sufficiently active against gram-positive bacteria in pneumococal meningitis , ( 3 ) the development of meningitis following the use of ciprofloxacin in respiratory tract infections , ( 4 ) the hasty change in antibiotic regimens in focal parenchymal infections during delayed response to therapy , ( 5 ) the use of bacteriostatic antibiotics , and ( 6 ) the delay in administering sufficient antibiotic therapy during fulminate meningococcal meningitis . Problems arising from these conditions are illustrated by case reports ."
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[] |
[] |
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DerNervenarzt.70680336.eng.abstr
|
DerNervenarzt.70680336.eng.abstr
|
[
{
"id": "DerNervenarzt.70680336.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Azathioprine is an established immunosuppressive agent in the treatment of myasthenia gravis . In rare cases , complications such as hypersensitivity reactions including fever may occur . A 73-year-old patient with the first manifestation of myasthenia gravis was immunosuppressed with azathioprine and prednisolone in addition to pyridostigmine treatment and discharged from hospital without symptoms . Ten days after onset of azathioprine therapy , he developed fever and a myasthenic crisis requiring artificial ventilation . Azathioprine was discontinued . Microbiological and radiological examinations revealed no signs of infection . After clinical improvement azathioprine was restarted , and following a single dose the patient again presented with fever and tachycardia . Azathioprine was discontinued , and all symptoms abated within a day . These symptoms were most probably caused by an azathioprine-induced hypersensitivity reaction . Life-threatening myasthenic crises may occur if such a hypersensitivity reaction remains unrecognized in patients with myasthenia gravis ."
],
"offsets": [
[
0,
1086
]
]
}
] |
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DerNervenarzt.70680342.eng.abstr
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DerNervenarzt.70680342.eng.abstr
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"Legionella is a frequent etiologic agent in the development of both nosocomial and community acquired pneumonias . Involvement of the nervous system is common in Legionella infections . We present a case of Legionnaires ' disease which illustrates distinctive neurologic findings including delirium and cerebellar dysfunction . Furthermore , this paper reviews the neurological and psychiatric features of 609 Legionella infected patients with involvement of the nervous system . The most common signs were disorientation ( 58% ) , headache ( 52.4% ) , and somnolence ( 39.7% ) . Less frequent or rare were : cerebellar dysfunction ( 11.2% ) , hallucinations ( 8.4% ) , agitation or stupor ( 4.1% ) , affective disorders ( 3.1% ) , peripheral neuropathy ( 2.8% ) , pyramidal disturbances ( 2.1% ) , memory loss ( 1.6% ) , seizures ( 1.5% ) , cranial nerve palsies ( 1.5% ) , incontinence ( 0.7% ) , and extrapyramidal disturbances ( 0.3% ) . Cranial CT scans , cerebrospinal fluid findings , and nerve and muscle biopsies were usually unremarkable . Neuropathologic examinations failed to demonstrate specific characteristics . Hyponatremia and serum CPK level elevation were present in up to 89% and 50% of patients , respectively . Prognosis of disturbances of the nervous system was mainly good . We conclude that in the presence of definite neurological findings , pulmonary infection , hyponatremia , and CPK elevation Legionella infection should be considered ."
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DerNervenarzt.70680346.eng.abstr
|
DerNervenarzt.70680346.eng.abstr
|
[
{
"id": "DerNervenarzt.70680346.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Dislocation of the temporomandibular joint results from trauma , articulation disorders and changes in the equilibrium of the masticatory muscles . Previous classifications were mostly oriented on the interrelationships between the anatomical positions of the dislocated articular surfaces , like luxation , subluxation and discus luxation . Etiologically , a distinction is made between traumatic and non-traumatic dislocations . Dislocation of the temporomandibular joint is described as a complication of a number of neurological deseases . We report on a patient who suffered recurrent dislocations of the temporomandibular joint as a complication of multiple sclerosis and whose luxations were successfully treated with botulinum toxin , thus warranting the introduction of the term \" neurogenic dislocation of the temporomandibular joint \" ."
],
"offsets": [
[
0,
847
]
]
}
] |
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DerNervenarzt.70680351.eng.abstr
|
DerNervenarzt.70680351.eng.abstr
|
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"text": [
"During recent years home ventilation has been shown to be useful for a growing number of patients with neuromuscular diseases and respiratory insufficiency caused by weakness of the respiratory muscles . Despite its technical simplicity , home ventilation leads to a number of social , ethical , medical and infrastructural problems . This consensus paper discusses the special situation of patients with neuromuscular diseases in home ventilation and describes the current thinking in the following topics : ( 1 ) definition of home ventilation ; ( 2 ) aims of home ventilation ; ( 3 ) indications and preconditions of home ventilation ; ( 4 ) techniques and forms of home ventilatory support ; ( 5 ) preparation for and practical questions of home ventilation ; ( 6 ) stopping home ventilation ."
],
"offsets": [
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0,
797
]
]
}
] |
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DerNervenarzt.70680358.eng.abstr
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DerNervenarzt.70680358.eng.abstr
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"Molecular genetic research on Charcot-Marie-Tooth I syndrome ( CMT I ) progresses rapidly , still obviously no cure is available for affected individuals . Our aim was to investigate current management in clinical CMT I. 50 patients with Charcot-Marie-Tooth syndrome type I ( CMT I ) were explored for applied means of therapy and use of health care institutions . We documented the number of annual appointments at a neurologist , orthopaedist and psychologist . Previous admissions to hospitals and rehabilitation centres and surgical procedures were assessed . Practice of physiotherapy , occupational and physical therapy were investigated , also administered orthopaedic devices , mechanical devices and technical modification of car and home . Drugs prescribed were listed and the number of patients seeking advice at para-medical institutions was determined . Degree of medical support did not correlate with severity of disease . We observed that persons with marked disability did not uniformly receive adequate therapy . This was partly due to the responsible physicians , and partly due to lacking cooperation of the patients . Support of affected individuals and counselling to our opinion are to be improved . This would require further evaluation of therapies , establishment and distribution of guidelines , as well as motivation of patients , which might be facilitated by the offer of molecular genetic diagnostics ."
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DerNervenarzt.70680365.eng.abstr
|
DerNervenarzt.70680365.eng.abstr
|
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"One of the most widely used neuroimaging procedures in Psychiatry and Neurology is magnetic resonance imaging ( MRI ) . MRI has gained the position of a standard investigation in the differential diagnosis of dementia syndromes . In the clinical diagnosis of Alzheimer's disease ( AD ) MRI helps to improve the diagnostical accuracy . Recently new MRI-based techniques for performing volumetric measurement of cortical and subcortical structures have been developed . First reports indicate that MRI-based volumetric measurements can be accurate in differentiating AD patients from cognitively normal elderly individuals . These new techniques may be useful adjunct in assessing the clinical diagnosis of AD . Results could also yield insight in the fundamental pathology of the degenerative disease . It is the objective of this chapter to summarize and comment on the significance of MRI in the diagnosis and research of AD . Future directions are outlined , including the use of microscopic MRI , the differentiation of white matter signal hyperintensities and the combined evaluation of stuctural MRI and functional imaging techniques ."
],
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DerNervenarzt.70680390.eng.abstr
|
DerNervenarzt.70680390.eng.abstr
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[] |
DerNervenarzt.70680395.eng.abstr
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DerNervenarzt.70680395.eng.abstr
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DerNervenarzt.70680401.eng.abstr
|
DerNervenarzt.70680401.eng.abstr
|
[
{
"id": "DerNervenarzt.70680401.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Vincent van Gogh's illness has been the object of much speculation . Explanations as disparate as acute intermittent porphyria , epilepsy and schizophrenia have been proposed . Many of the diagnostic hypotheses , however , are based on partial or incomplete consideration of the biography and of the reports of his subjective experience in his letters to his brother . Karl Leonhard showed , in a detailed analysis of Vincent's biography , that both the course and symptoms of the disorder were consistent with the diagnosis of a cycloid psychosis ( anxiety-elation psychosis ) . In the present paper , the diagnostic judgement of Leonhard is described and discussed in the light of independent research on van Gogh's letters , his works and biography . The bibliographical sources were investigated for information consistent with a cycloid psychosis , but also for information that might contradict this hypothesis . The course and symptoms of the disorder are presented as comprehensively and systematically as possible and are documented with the respective citations . Furthermore , the most important diagnoses proposed in the literature are critically discussed . Based on this investigation , it was possible to show that only the diagnosis of a cycloid psychosis allowed us to connect all the available information to a typical psychiatric syndrome ."
],
"offsets": [
[
0,
1359
]
]
}
] |
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],
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117,
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"id": "DerNervenarzt.70680401.eng.abstr-s2-t2",
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"epilepsy"
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"id": "DerNervenarzt.70680401.eng.abstr-s2-t3",
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DerNervenarzt.70680417.eng.abstr
|
DerNervenarzt.70680417.eng.abstr
|
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{
"id": "DerNervenarzt.70680417.eng.abstr-passage-0",
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"text": [
"We are reporting about a 35 year old female forensic patient who has a double diagnosis of anorexia nervosa , bingeeating/purging type , and schizophrenia , paranoid type . She repeatedly attacked her therapists and physicians violently . Her aggressive state is a result of her psychotic interpretation of her constant preoccupation with her body image . We discuss problems concerning antipsychotic medication in her case specifically . Furthermore epidemiological aspects of the comorbidity of eating disorders and schizophrenia are considered ; the incidence of schizophrenia in eating disorders seems to be 1-3% , affective and transient psychosis being more common ; the comorbidity of schizophrenia and bulimia nervosa is very rare ."
],
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0,
740
]
]
}
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[] |
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DerNervenarzt.70680421.eng.abstr
|
DerNervenarzt.70680421.eng.abstr
|
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"id": "DerNervenarzt.70680421.eng.abstr-passage-0",
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"text": [
"Psychological changes may precede the neuropsychological symptoms of Alzheimer's disease ( AD ) . In addition , early stages of AD are often accompanied by a depressive disorder . Therefore , we reasoned whether AD patients might profit from psychotherapy . The aim would be to alleviate anxiety , discouragement , and inactivation of patients suffering from the early stages of AD . According to preliminary experience with a small number of treated cases , interpersonal psychotherapy , modified for application in \" late-life \" ( IPT-LL ) , has been found to be useful for the treatment of AD patients . The case of an AD patient is presented who underwent psychotherapy for two years . Besides describing the special features of such treatment , we address the question of how the next relative ( e.g. , the spouse ) may be included in the therapeutic process ."
],
"offsets": [
[
0,
865
]
]
}
] |
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[] |
[] |
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DerNervenarzt.70680425.eng.abstr
|
DerNervenarzt.70680425.eng.abstr
|
[
{
"id": "DerNervenarzt.70680425.eng.abstr-passage-0",
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"Demonstration of BDV-specific serum antibodies , the isolation of BDV from cerebrospinal fluid of neuropsychiatric patients , and the recent demonstration of BDV antigen and BDV-RNA in human brain tissue strongly suggest that BDV can infect humans . Isolation of BD virus from brain tissue is needed for final proof . There is still great controversy about the question of whether BDV antigen , BDV-RNA or BDV can be detected in peripheral blood monocytes or not . Overall , the question of pathogenicity of BDV infection for humans is wide open . Investigations of human cerebrospinal fluid indicate that BDV might cause human lymphocytic meningoencephalitis and so-called symptomatic psychoses in rare cases . Seroepidemiological studies suggest a widely non-specific but possibly pathogenic role of BDV in a spectrum of psychiatric disorders ."
],
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0,
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DerNervenarzt.70680443.eng.abstr
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DerNervenarzt.70680443.eng.abstr
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"High resolution magnetic resonance imaging ( HR-MRI ) and computed tomography ( HR-CT ) of the inner ear are becoming more important for the diagnosis of peripheral vestibular lesions . Modern HR-MRI techniques allow visualization of detailed anatomic features of the vestibulo-cochlear regions as well as pathologic findings in the inner ear such as , neoplastic lesions ( e.g. , small intracanalicular acoustic neuromas ) , anomalies causing vertigo and hearing loss ( e.g. Mondini ' s-malformation , perilymph fistula , vestibular paroxysmia ) , and inflammatory diseases ( e.g. , Cogan's syndrome , labyrinthitis , zoster neuritis ) . HR-CT is still the first examination that should be performed in patients with middle ear diseases ( e.g. , tumor , infection ) , trauma ( e.g. temporal bone fractures ) , or fibro-osseous diseases . Although the imaging of the vestibulo-cochlear system has dramatically improved , there are still several peripheral vestibular disorders that cannot be visualized so far , e.g. , benign paroxysmal positioning vertigo , idopathic vestibular neuritis or Menière's disease ."
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[] |
[] |
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DerNervenarzt.70680459.eng.abstr
|
DerNervenarzt.70680459.eng.abstr
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"The trend in recent neurosurgery is going toward further reduction of invasiveness and avoidance of traumatization of the brain , spinal cord , and peripheral nerves to reduce the risk of neurological and mental deficit . In this way , the duration of hospital stay and disablement can be shortened . An important \" minimally invasive \" technique is neuroendoscopy . The ventricular system and the sub- arachnoid space of the brain give suitable conditions for the use of an endoscope . Non-communicating hydrocephalus is the most frequent indication for an endoscopic ap- proach . However , arachnoid cysts , cystic tumors , and intraventricular lesions may also effectively be treated with an endoscope . Using special instruments , laser devices , and bipolar diathermy , even highly vascularized lesions , such as cavernomas , may be completely resected . Moreover , endoscopes are used in the treatment of various spinal diseases and carpal tunnel syndrome , as well as in endoscopy-assisted microsurgery ."
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[] |
[] |
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DerNervenarzt.70680466.eng.abstr
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DerNervenarzt.70680466.eng.abstr
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"There is a world-wide renaissance of neurosurgical treatments of Parkinson's disease ( PD ) , based on substantial progress in basic sciences . A model of parallel motor circuitry has identified potential targets for lesioning by clarifying the pathophysiological role of the basal ganglia in PD . The internal globus pallidus ( Gpi ) is an essential player as it connects to thalamocortical projections and can be disinhibited by overactivity of the nucleus subthalamicus ( Nst ) . Lesioning of these targets has been successful in MPTP damaged primates . There is clinical use of destructive as well as restorative and stimulative technics . Pallidotomy and thalamatomy have evolved by the use of better neuroradiological and electrophysiological targeting . The first technic is used for treatment of rigidity , hypokinesia and dyskinesias , the latter one has proven to be efficient for tremor . Dopaminergic reinnervation and increased dopaminergic output of the striatum has only been seen after transplantation of fetal cells ; this method however carries immunological and ethical problems . The continuous high frequency stimulation of basal ganglia is the newest technic ; it is highly adaptable to the patient's need and carries a low morbidity profile . Thalamic stimulation is used for the treatment of tremor . The stimulation of Nst and Gpi are proposed for dyskinesias and on/off phenomena . Animal research further focuses on xenotransplantation and implantation of genetically transformed cells or pluripotent precursor cells . - In summary neurosurgical procedures seem to be verey promising ; however longterm comparison studies are needed to define the best ( combination ) treatment ( s ) for the future ."
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DerNervenarzt.70680485.eng.abstr
|
DerNervenarzt.70680485.eng.abstr
|
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"The clinical examination of patients with spinal cord injury can be supplemented by electrophysiological techniques ( somatosensory-evoked potentials ( SSEP ) , motor-evoked potentials ( MEP ) , electroneurography ) to assess the extent and severity of a spinal cord injury . As essential advantage of these techniques in comparison with the clinical examination is that they can be reliably applied even in uncooperative patients . These techniques allow an early prognosis of the functional deficit in patients with acute spinal cord injury . Recordings of tibial nerve SSEP and MEP of the anterior tibial muscle allow to predict the outcome of ambulatory capacity , while recordings of pudendal nerve SSEP allow prognosis of the bladder function to be assessed . In tetraplegic patients median and ulnar nerve SSEP and MEP of the abductor digiti minimi muscle can indicate the development of hand function . Electroneurography allows to differentiate between the proportion of peripheral and central nervous lesions underlying the muscle paresis . This is of prognostic value with regard to the development of muscle tone and consequently for planning therapy . The electrophysiological examinations are of complementary value in the diagnostic assessment of spinal cord lesions , in the prediction of functional outcome , and in monitoring the course of neurological deficits . This is helpful for planning and selection of appropriate therapeutic approaches ( e.g. functional electrical stimulation , application of botulinum toxin , splinting procedures ) within the rehabilitation programme ."
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DerNervenarzt.70680496.eng.abstr
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DerNervenarzt.70680496.eng.abstr
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"Computer-aided analysis of the results of the intrathecal infusion test using our mathematical computation leads to simplification of this investigation , and therefore normal pressure hydrocephalus is more easily diagnosed . Simultaneous measurement of resistance and compliance during a single investigation allows the exertion of the patients to be minimized . In contrast to classic methods it is not necessary that the ICP reaches a plateau . Our mathematical method diverges with the description of a pressure-dependent slope of the function for the resistance from the static examination models . For that we are able to take the non-linearity of the cerebrospinal fluid resorption into consideration . The intrathecal infusion test is a reliable diagnostic method for measuring resistance and compliance in patients suspected of having normal pressure hydrocephalus ."
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DerNervenarzt.70680509.eng.abstr
|
DerNervenarzt.70680509.eng.abstr
|
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"id": "DerNervenarzt.70680509.eng.abstr-passage-0",
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"Abstract Quantitative assessment of thermal and pain sensitivity ( Marstock method on a SOMEDIC Thermotest , Somedic AB Stockholm , Schweden ) was made and the function of autonomic nerveous system ( sympathetic skin response and R-R interval variation ) indicating the function of small nerve fibres ( A-delta and C ) was determined in 44 patients with symptoms of the presumed sensory neuropathy . The function of the large nerve fibres was evaluated by the classic nerve conduction study . The methods of small nerve fibres evaluation exhibited greater sensitivity as the classic nerve conduction study . The dysfunction of small nerve fibre function was morphologically proved by sural nerve biopsy ."
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[] |
[] |
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DerNervenarzt.70680515.eng.abstr
|
DerNervenarzt.70680515.eng.abstr
|
[
{
"id": "DerNervenarzt.70680515.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Ganglionic and synovial cysts ( juxta-facet cysts ) causing nerve root compression are very rare . Magnetic resonance imaging is the best means of diagnosis . The treatment of choice is surgical removal of the cysts , though spontaneous remissions do occur . CT-guided aspiration of the cysts and corticosteroid injection can lead the symptoms to disappear , but only for a short time . In a retrospective study covering a period of 16.5 years , we discovered 24 juxta-facet cysts ( 10 ganglionic and 14 synovial cysts ) with clinical symptoms in a total of 19,107 lumbar and thoracic operations performed to relieve nerve root compression : 16 cysts were located at the level L4-5, 3 at the level L5-S1, 2 at L3-4, and 1 each at the levels L2-3, L1-2, and T10-1. Seven patients complained of radicular pain , and the other 17 patients also had neurological deficits . Fourteen cysts were resected , and in 10 cases the lumbar disc was removed simultaneously . The average follow-up in 23 of the 24 patients was 26.6 months . Most ( 74% ) of the patients became free of pain . Pareses disappeared in 89% and sensory deficits in 73% of cases ."
],
"offsets": [
[
0,
1142
]
]
}
] |
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DerNervenarzt.70680521.eng.abstr
|
DerNervenarzt.70680521.eng.abstr
|
[
{
"id": "DerNervenarzt.70680521.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Dystonia rarely is a consequence of head trauma . In most of these patients lesions of the contralateral caudate or putamen are found . We report a 27-year-old patient who displayed focal dystonia of the right hand with a latency of four months after he had sustained a severe head trauma . The development of a lesion in the contralateral dorsolateral thalamus within the first weeks after the craniocerebral injury is demonstrated with sequential computertomographic and magnetic resonance imaging . There were no lesions of the caudate or the putamen ."
],
"offsets": [
[
0,
555
]
]
}
] |
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8
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{
"id": "DerNervenarzt.70680521.eng.abstr-s1-t4",
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67,
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{
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{
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},
{
"id": "DerNervenarzt.70680521.eng.abstr-s3-t4",
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"hand"
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"id": "DerNervenarzt.70680521.eng.abstr-s3-t5",
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[] |
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DerNervenarzt.70680531.eng.abstr
|
DerNervenarzt.70680531.eng.abstr
|
[
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"id": "DerNervenarzt.70680531.eng.abstr-passage-0",
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"text": [
"The term \" cyclothymia \" is being used with different meanings . DSM-IV and ICD-10 define \" cyclothymia \" or \" cyclothymic disorder \" as a long lasting , subaffective disorder with frequent shifts between hypomanic and ( sub ) depressive states . In the tradition of Kurt Schneider cyclothymia was understood as a synonym for manic-depressive illness exclusively , while different personality typologies speak of a \" cyclothymic \" typus . Historically , the term was first used by the German psychiatrist Ewald Hecker in 1877. The definitions of DSM-IV and ICD-10 seem to be satisfactory in respect to reliability , but the nosological position of \" cyclothymic disorder \" is unclear . We review results concerning clinical symptomatology , comorbidity , biological parameters , personality ( including the question of creativity ) , psycho- and pharmacotherapy as well as clinical course , which leave many questions open . Nevertheless , results in family studies support the idea that at least a fraction of \" cyclothymia \" is a mild or subcinical form of bipolar disorders . Until further research , which is urgently needed , we suggest that the term \" cyclothymia \" should be only used according to the guidelines of DSM-IV and ICD-10."
],
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[
0,
1241
]
]
}
] |
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DerNervenarzt.70680545.eng.abstr
|
DerNervenarzt.70680545.eng.abstr
|
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],
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0,
632
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DerNervenarzt.70680556.eng.abstr
|
DerNervenarzt.70680556.eng.abstr
|
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{
"id": "DerNervenarzt.70680556.eng.abstr-passage-0",
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"The application of a tryptophan-free amino acid mixture ( tryptophan depletion test ) induces a rapid and substantial lowering of both total and free plasma tryptophan . Consequently , the brain serotonin content and also cerebral serotonin function are decreased . This method provides a paradigm to study the role of serotonin in the pathobiology of depressive disorders and their treatment modalities . Untreated depressed patients show few behavioral effects during tryptophan depletion . In depressed patients during an antidepressant or light-therapy-induced stable remission , a transient depressive relapse was induced by tryptophan depletion . Healthy subjects with a genetic risk for affective disorder show worsening of their condition induced by tryptophan depletion . These findings indicate the relevance of altered brain serotonin function in the pathophysiology of affective disorders and strengthen the importance of serotonin in the mechanism of action of antidepressants . Since recently published studies revealed some evidence that the serotonergic system is directly involved in the pathophysiology of various psychiatric syndromes besides depression , it seems to be reasonable to evaluate the validity of the tryptophan depletion test also in non-depressed patients ."
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DerNervenarzt.70680563.eng.abstr
|
DerNervenarzt.70680563.eng.abstr
|
[
{
"id": "DerNervenarzt.70680563.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This study examined the changes from hospital admission to discharge of different categories of cognitive distortions - automatic thoughts , self-concepts and dysfunctional attitudes - in 67 patients with an ICD-10 diagnosis of a depressive episode . Furthermore , the relationships were analyzed between cognitive distortions , degree of depression , and personality dimensions ( isolation tendency , extraversion , rigidity , schizoidia , frustration tolerance and neuroticism ) . There was a significant correlation between automatic thoughts and negative self-concepts on the one hand , and severity of depression on the other upon admission . There was a significant reduction of automatic thoughts and the negativity of self-concepts from admission to discharge . No significant association was observed , however , between the severity of depression and dysfunctional attitudes . In addition , dysfunctional attitudes showed a significant decrease until discharge only in patients with a full remission of depressive symptoms . These results underline the fact that automatic thoughts and self-concepts are more state-dependent than dysfunctional attitudes . Moreover - even taking into account the degree of depression - there was a significant relationship between the personality dimension neuroticism and all cognitive scales upon admission . This indicates that a high degree of neuroticism may facilitate the emergence of negative cognitions during a depressive episode ."
],
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0,
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DerNervenarzt.70680574.eng.abstr
|
DerNervenarzt.70680574.eng.abstr
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"id": "DerNervenarzt.70680574.eng.abstr-passage-0",
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"In addition to psychiatric outpatient treatment , the detoxification of alcoholics in psychiatric hospitals is an important link between medical detoxification and psychosocial inpatient treatment aiming at abstinence . Integrated models of inpatient detoxification and motivation therapy focus on improvement of the motivation of patients towards further treatment of their alcoholism and towards abstinence . In our study 529 alcoholics underwent such treatment lasting between 2 to 3 weeks . A total of 469 patients ( 89% ) were followed up after 8 months ; 242 alcoholics ( 52% of the follow-up sample ; 46% of the whole sample ) achieved the treatment goal and started further treatment , mainly as inpatients . Fifty-four of these patients relapsed before they started further alcoholism treatment , but achieved abstinence afterwards ; 60 ( 25% ) of these 242 patients relapsed after the specific alcoholism therapy ; 227 alcoholics did not start further treatment after the initial detoxification and motivation therapy . In this subpopulation , 113 ( 50% ) relapsed during the follow-up period . Although this is not a controlled study , it can be concluded that integrated inpatient detoxification and motivation therapy has positive effects on the treatment behavior of alcoholic patients and enhances the probability of further abstinence ."
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[] |
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DerNervenarzt.70680586.eng.abstr
|
DerNervenarzt.70680586.eng.abstr
|
[
{
"id": "DerNervenarzt.70680586.eng.abstr-passage-0",
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"text": [
"Lithium therapy in patients with manic-depressive disorder occasionally causes neuropsychiatric side effects even at therapeutic serum levels . Those lithium-induced symptoms can be polymorphous and may be hard to differentiate from other disorders and from other drugs ' side effects . We report the case of a 56-year-old woman with manic- depressive illness , who developed neuropsychiatric side effects from lithium prophylaxis at therapeutic serum levels . The symptoms included disorientation , aphasia , ideatoric apraxia , parkinsonism , restlessness and severe sleep disorder . In contrast to previous reports , the causal role of lithium was underscored by symptom increase after lithium reexposure at therapeutic serum levels . The patient recovered completely after cessation of the lithium prophylaxis ."
],
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[] |
[] |
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DerNervenarzt.70680591.eng.abstr
|
DerNervenarzt.70680591.eng.abstr
|
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"id": "DerNervenarzt.70680591.eng.abstr-passage-0",
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"text": [
"As compared to other tri- and tetracyclics , antidepressant therapy in patients suffering also from cardiac disease with mianserin is known to be relatively safe . Hypertensive effects of mianserin have not been described so far . We report a case of a 64 years old patient with a dilatative cardiomyopathy and left anterior hemiblock , who developed hypertension ( maximum : 180/125 mmHg ) during mianserin treatment . Previous treatment with tranylcypromine has been stopped two weeks before . After discontinuance of mianserin blood pressure rapidly came back to normal values . The possible noradrenergic and serotonergic mechanisms of this phenomenon are discussed in relation to pretreatment with tranylcypromine ."
],
"offsets": [
[
0,
720
]
]
}
] |
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[] |
[] |
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DerNervenarzt.70680593.eng.abstr
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DerNervenarzt.70680593.eng.abstr
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"Binocular depth inversion represents an illusion of visual perception . Such inversion does not occur in all cases , especially when objects with a higher degree of familiarity ( e.g. photographs of faces ) are displayed . Cognitive factors are assumed to override the binocular disparity cues of stereopsis . We tested the hypothesis that during sleep deprivation the human CNS is unable to correct the implausible perceptual information . Measurements of binocular depth inversion in perception of 3D objects were taken in sleep-deprived medical staff and healthy volunteers . The binocular depth inversion scores were highly elevated in the sleep-deprived group in comparison to the healthy volunteers . The data demonstrate a strong impairment of binocular depth inversion after sleep deprivation and support the view that sleep deprivation may be accompanied by a disorganisation of the interaction between sensory input and generation of perceptual hypotheses ."
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DerNervenarzt.70680609.eng.abstr
|
DerNervenarzt.70680609.eng.abstr
|
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{
"id": "DerNervenarzt.70680609.eng.abstr-passage-0",
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"Bilateral symmetric changes in the cerebral hemispheric white matter are found with increasing frequency using CT and MRI techniques . These unspecific canges of the white matter signal are often called leukoaraiosis . They differ from the normal white matter signal . These changes are found with increasing frequency in persons older than 60 years and also patients with dementia and cerebrovascular diseases . The pathogenesis , clinical significance and morphological substrate are unclear . The aim of this review is to summarise the actual knowledge about the etiology and clinical signs and symptoms found in patients with leukoaraiosis . This term should not be used when white matter changes are found in patients younger than 35 years , with an unilateral onset , asymmetric distribution , and extensive changes all over the infra- and supratentorial white matter area . Neuroradiological and clinical criteria are given to differentiate between leukoaraiosis and diseases of the white matter , especially enlarged Virchow-Robin spaces , lacunar infarction , subcortical arteriosclerotic angiopathy ( Binswanger's disease ) , leukoencephalopathy of different origin , and demyelinating diseases ."
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] |
[] |
[] |
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DerNervenarzt.70680620.eng.abstr
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DerNervenarzt.70680620.eng.abstr
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{
"id": "DerNervenarzt.70680620.eng.abstr-passage-0",
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"text": [
"Confusion between syncope and epileptic seizures is a common problem in clinical practice . Recently , new insights into the phenomenology of transient cerebral hypoxia have been gained from video analysis of experimentally induced syncope . Common elements of syncope include multifocal and generalized myoclonus , tonic body extension , automatisms , vocalizations , eye deviations and hallucinations . Thus , it is not the presence or absence of these features but their specific character that distinguishes syncope from epileptic seizures . Other clues for differential diagnosis include precipitating factors , premonitory symptoms and postictal events , such as tongue bites and postictal confusion , which has been identified as the single most powerful factor discriminating syncope from epileptic seizures . In contrast , incontinence and head injury are common in both conditions . Investigations such as electroencephalogram , tilt testing and postictal prolactin or creatine kinase levels may aid diagnosis but are never diagnostic in isolation . In rare cases , hypoxic and epileptic mechanisms may interact within one attack ."
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DerNervenarzt.70680625.eng.abstr
|
DerNervenarzt.70680625.eng.abstr
|
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"To date clinical and experimental investigations have focused on acute strokes and complete infarctions . Histological and immunological staining in animal experiments and improved imaging techniques in patients suggest that selective or incomplete infarction is a common pathomechanism . Incomplete infarction can manifest as laminar necrosis at autopsy and as leukoaraiosis in imaging studies . An important mechanism in the genesis of leukoaraiosis is vascular pathology of the long penetrating arteries of the deep white matter combined with episodes of decreased perfusion pressure or hypotension . We demonstrate that the cumulative effect of repetitive , moderate hypotensive episodes on cognitive performance or cerebral tissue has not been adequately studied and appreciated ."
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785
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[] |
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DerNervenarzt.70680633.eng.abstr
|
DerNervenarzt.70680633.eng.abstr
|
[
{
"id": "DerNervenarzt.70680633.eng.abstr-passage-0",
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"text": [
"Ocular flutter is an ocular motor disorder consisting of involuntary back-to-back saccades in the horizontal plane without a saccadic interval . In opsoclonus , these pathological eye movements occur not only in the horizontal but also in the vertical plane . Originally , opsoclonus was described as irregular , conjugate , chaotic and partially continuous rapid eye movements . In this review , the clinical picture , differential diagnosis , etiology , natural course and therapeutic concepts for these eye movement disorders are described . It is stressed that continuous and intermittent forms of opsoclonus can be distinguished and that these differences usually correlate with the severity of the underlying disease . In contrast , the intermittent forms of opsoclonus and ocular flutter are usually only distinguished by the lack of a vertical eye movement component in ocular flutter ."
],
"offsets": [
[
0,
894
]
]
}
] |
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[] |
[] |
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] |
DerNervenarzt.70680653.eng.abstr
|
DerNervenarzt.70680653.eng.abstr
|
[
{
"id": "DerNervenarzt.70680653.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Decisions regarding the extent of treatment of severely ill patients can be an ethical dilemma when life-prolonging intensive care contradicts the goal of avoiding unnecessary suffering on the part of the patient . Here we present the results of a written survey of physicians on neurological intensive care units in Germany regarding the treatment of patients with basilar artery thrombosis and locked-in syndrome . 52% of the 93 physicians who replied advocated not treating severe infections with antibiotics . 38% were in favor of stopping intensive care . In contrast , 55% recommended intubating the patient in the presence of swallowing disturbances and imminent aspiration . 58% were in favor of discussing these problems in detail with the patient , and 87% advocated discussing them with relatives . Nearly all physicians ( 97% ) recommended using adquate amounts of opiates and benzodiazepines . In very rare cases , 99% would agree to the use of passive ethanasia and 19% to active euthanasia . These findings illustrate the current disagreement on some of the important treatment decisions among physicians on neurological intensive care units . An open exchange of views on these questions could facilitate the appropriate consideration of ethical matters in the treatment of these patients ."
],
"offsets": [
[
0,
1306
]
]
}
] |
[
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],
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34,
43
]
],
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},
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}
]
},
{
"id": "DerNervenarzt.70680653.eng.abstr-s1-t2",
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[
60,
68
]
],
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}
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},
{
"id": "DerNervenarzt.70680653.eng.abstr-s1-t3",
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"care"
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126,
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147,
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]
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{
"id": "DerNervenarzt.70680653.eng.abstr-s1-t6",
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DerNervenarzt.70680659.eng.abstr
|
DerNervenarzt.70680659.eng.abstr
|
[
{
"id": "DerNervenarzt.70680659.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To evaluate signs of peripheral nerve dysfunction , over a period of 31 months all patients treated for more than 14 days in our intensive care unit ( ICU ) had clinical and electrophysiological examination . The results of 78 patients were analysed : 53 had diseases of the central nervous system , 25 suffered from general cerebral hypoxia , mainly after cardiopulmonary reanimation . 54 showed bilateral signs of denervation activity , additionally 10 patients had fibrillation potentials unilateral to their spastic hemiparesis . 19 patients had denervation potentials only in proximal muscles of the upper limbs . Generalized denervation activity developed mainly after septic organ failure . On the other hand 35 patients showed denervation potentials already between day 14 and 21 , suggesting an affection of peripheral nerve function in the first week of ICU treatment . Time course , pattern of distribution and frequency of electrophysiological abnormalities are not generally consistent with alterations of nutrition , metabolism or hypoxia in the course of ICU treatment . Clinical signs of peripheral nerve dysfunction were present in 40% of the patients showing denervation in the EMG ."
],
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[
0,
1201
]
]
}
] |
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DerNervenarzt.70680664.eng.abstr
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DerNervenarzt.70680664.eng.abstr
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"id": "DerNervenarzt.70680664.eng.abstr-passage-0",
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"We report on a 22-year-old schizophrenic patient who attempted suicide and suffered an epidural hemorrhage . 16 days after the neurosurgical operation . After several weeks of treatment with promethazine , 1 day after intake of paroxetin he partially lost consciousness and developed extrapyramidal symptoms and vegetative disorders . Hyper-Ck-aemia up to 680 U/l was observed . Malignant neuroleptic syndrome ( MNS ) was diagnosed , which led to withdrawal of paroxetin and promethazine . He was put on dantamacrine and amantadine until the symptoms resolved . To date there have been few reports on MNS under tricyclic antidepressants and selective serotonin inhibitors . The influence of the central serotonergic system on the pathophysiology of MNS is discussed ."
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DerNervenarzt.70680667.eng.abstr
|
DerNervenarzt.70680667.eng.abstr
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"id": "DerNervenarzt.70680667.eng.abstr-passage-0",
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"Huntington's disease ( HD ) may cause considerable diagnostic problems because of the highly variable clinical features , especially at the beginning of the illness . We report the case of a 21-year-old woman with definite HD whose main symptoms were psychopathological changes that were misinterpreted as schizophrenia for 7 years . One reason for this misdiagnosis was the unusual , very early onset and the remarkable earlier age of onset of HD compared with that of other affected relatives . The phenomenon of earlier onset within one affected family is well documented in the literature in cases with the paternally transmitted mutated gene . Diagnostic landmarks were consideration of the initially mild disturbances of movement and the once again repeated detailed examination of the family history ."
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] |
[] |
[] |
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DerNervenarzt.70680671.eng.abstr
|
DerNervenarzt.70680671.eng.abstr
|
[
{
"id": "DerNervenarzt.70680671.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Improved methods of imaging the cerebral vascular system have increased the detection of traumatic or spontaneous dissection of the vertebral and carotid arteries . Especially MRI allows direct demonstration of intramural hematomas that are a sign of dissection of the vessel wall . We report on a patient who had an acute onset of dysarthria and monocular blurred vision , which recurred several times . Doppler ultrasound showed stenosis in both internal carotid arteries with reduced velocity of the flow ; angiography confirmed the stenosis , showing a long stretch of stenosis ( 70% ) of the right and a short stretch of stenosis ( 60% ) of the left internal carotid arteries . MRI demonstrated a narrowing of the lumen by an intramural mass , whose signal characteristics were typical for blood . The MRI findings were thus consistent with the diagnosis of a spontaneous dissection of the carotid arteries . Since the Doppler ultrasound follow-up showed no change during the following 3 days , we interpreted the MRI findings as an indication of bleeding in an atheroma . The carotid disobliteration , performed first on the left side and later on the right side , confirmed this interpretation . Since stenosis due to a fissuring atheroma or bleeding in an atheroma requires different therapy than a dissection , it is thus important to consider the possible differential diagnosis in interpreting the MRI ."
],
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[
0,
1414
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}
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"id": "DerNervenarzt.70680671.eng.abstr-s1-t3",
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DerNervenarzt.70680674.eng.abstr
|
DerNervenarzt.70680674.eng.abstr
|
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{
"id": "DerNervenarzt.70680674.eng.abstr-passage-0",
"type": "abstract",
"text": [
"An ectasia and enlargement of the basilar artery by a fusiform aneurysm is called megadolicho basilaris . We report five cases with this condition identified at our clinic since 1989 , reflecting an incidence of 0,05 percent ( 5/9300 scans ) . All patients presented with an acute brainstem syndrome ( medullary in 2 , pontine in 1 and pontomedullary in 2 patient ) . With one exception , all cases required intensive care due to respiratory insufficiency . Two patients died , one required total care , and two patients made a good recovery , one of these under therapeutic anticoagulation . All but one patient experienced additional episodes of cerebrovascular ischemia before or after presentation . Vascular risk factors were found in four patients . The detection of a megadolicho basilaris identifies a patient subgroup that is highly prone to vertebrobasilar ischemia and therefore of high significance for neurological intensive care medicine . Recurrence rate for ischemia is high . While even a severe brainstem syndrome may be reversed under anticoagulation in the individual case , presence of multiple vascular risk factors often prevents the employment of this treatment modality ."
],
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DerNervenarzt.70680678.eng.abstr
|
DerNervenarzt.70680678.eng.abstr
|
[
{
"id": "DerNervenarzt.70680678.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Friedreich's ataxia ( FA ) represents a degenerative , genetically determined disease of the nervous system in combination with myocardial affection and in some cases endocrinological disturbances . Manifestation of myocardial involvement usually follows symptoms of nervous system degeneration later in the course , but seems not to be secondary . These cardiac disturbances are the main cause of death in FA-patients . Therapeutic management of heart disease is possible and interdisciplinary neurologic-cardiologic cooperation should start early in the course of FA ."
],
"offsets": [
[
0,
570
]
]
}
] |
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] |
[] |
[] |
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DerNervenarzt.70680683.eng.abstr
|
DerNervenarzt.70680683.eng.abstr
|
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[] |
[] |
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DerNervenarzt.70680696.eng.abstr
|
DerNervenarzt.70680696.eng.abstr
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"id": "DerNervenarzt.70680696.eng.abstr-passage-0",
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[] |
[] |
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DerNervenarzt.70680730.eng.abstr
|
DerNervenarzt.70680730.eng.abstr
|
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"Falling is an everyday risk for elderly people , with the consequence of getting hurt . What exactly the dangers are , especially in people with gerontopsychiatric disorders , has hardly ever been mentioned in today's literature . Therefore this report deals with 887 documented fall cases in 758 gerontopsychiatric inpatients during a cumulative time period of 3845 months . The consequences of the falls according to sex and diagnosis of dementia were devided in four categories , depending on how serious the injuries were . About 65 to 71% of the patients don ' t show any direct consequences , about 10% have serious injuries of which 5% are fractures . There are significantly more dement women than dement men who suffer from fractures . Women over eighty years have significantly fewer serious fall injuries than women in their eighties ; the same phenomenon can be observed in men concerning light injuries ."
],
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0,
917
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DerNervenarzt.70680735.eng.abstr
|
DerNervenarzt.70680735.eng.abstr
|
[
{
"id": "DerNervenarzt.70680735.eng.abstr-passage-0",
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"text": [
"There is an increasing interest in scientific and practical aspects of C/L psychiatry in Germany . The every day C/L work in Germany still differs substantially from the American one . In contrast to Germany and other European countries , C/L psychiatry in the USA has developed into a subspecialty with multiple activities in research and patient care during the last 3 decades . This study was conducted in Germany and the USA in order to evaluate and compare the training and patient care in C/L psychiatry , as assessed by consultants doing the every day C/L work . 227 C/L psychiatrists participated in the study in both countries . There are significant differences in theoretical and practical C/L training . The patient care in American C/L psychiatry is obviously more comprehensive . American C/L psychiatrists take more time for consultations , do more follow-ups , and more frequently organize psychiatric or psychotherapeutic outpatient after-care . These results are suited to support activities to improve quality in Germany C/L psychiatry ."
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1056
]
]
}
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[] |
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DerNervenarzt.70680742.eng.abstr
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DerNervenarzt.70680742.eng.abstr
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DerNervenarzt.70680754.eng.abstr
|
DerNervenarzt.70680754.eng.abstr
|
[
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"id": "DerNervenarzt.70680754.eng.abstr-passage-0",
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"A case of late onset metachromatic leukodystrophy with a clinical picture of paranoid hallucinatory psychosis and severe dyskinesia is described . The problem of diagnostic recognition is discussed . In the case , diagnostic procedures were initiated after atypical clinical course , and established on the basis of MRI and specific biochemical tests ."
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352
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] |
[] |
[] |
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"id": "DerNervenarzt.70680754.eng.abstr-s3-r3-t2.2-t1.1",
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DerNervenarzt.70680759.eng.abstr
|
DerNervenarzt.70680759.eng.abstr
|
[
{
"id": "DerNervenarzt.70680759.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Asperger syndrome is an autistic disorder and was first described by Hans Asperger in 1944 without further acceptance in the literature over almost four decades . Following several publications in the 1980s , for the disorder became more widely known and was first introduced into ICD-10 and DSM-IV as a new diagnosis in 1988 and 1994 , respectively . The etiology is unknown . We present a female patient with typical features of Asperger syndrome , suffering also from epilepsy and internal medical disorders . The associated diseases , diagnostic criteria and possible therapeutic options are discussed ."
],
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[
0,
607
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]
}
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DerNervenarzt.70680769.eng.abstr
|
DerNervenarzt.70680769.eng.abstr
|
[
{
"id": "DerNervenarzt.70680769.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Head trauma ( HT ) and whiplash injury ( WI ) is followed by a posttraumatic headache ( PH ) in approx . 90% of patients . The PH due to common WI is located occipitally ( 67% ) , is of dull-pressing or dragging character ( 77% ) and lasts on average 3 weeks . Tension headache is the most frequent type of PH ( 85% ) . Besides posttraumatic cervicogenic headache or symptomatic , secondary headache due to SDH , SAB , ICB or increased ICP , migraine- or cluster-like headache can be observed in rare cases . Prolonged application of analgetics ( > 4 weeks ) can cause a drug induced headache . In 80% of patients PH following HT shows remission within 6 months . Chronic PH lasting at least 4 years occurs in 20% . Unfavorouble prognostic factors include an age higher than 40 yrs , a low intellectual , educational and socio-economic level , previous HT or a history of alcohol abuse . A prolonged PH due to WI can be expected in patients with initially severe headache , with an extensive decrease of mobility of the cervical spine , with subjective impediment , with depressive mood , with somatic-vegetative complaints , with a history of pretraumatic headache and with increased age . Acute PH is treated with analgesics , antiphlogistics and/or muscle relaxants ; chronic PH with thymoleptics ( e.g. Amitryptiline or Amitryptiline oxide ) . Additional physical therapy ( e.g. wearing a cervical collar for a short time , hydrocollator pack ) , physiotherapy incl. muscle relaxation techniques ( Jacobson ) and psychotherapy can be performed . Medico-legal issues should be solved as soon as possible ."
],
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DerNervenarzt.70680778.eng.abstr
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DerNervenarzt.70680778.eng.abstr
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DerNervenarzt.70680785.eng.abstr
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DerNervenarzt.70680785.eng.abstr
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DerNervenarzt.70680801.eng.abstr
|
DerNervenarzt.70680801.eng.abstr
|
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"id": "DerNervenarzt.70680801.eng.abstr-passage-0",
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"text": [
"Neurological-neuropsychological out-patient rehabilitation in Southern Germany is realized mostly by neurologists and neuropsychologists in out-patient practice . However , profile and quantity of treatment as well as the structure of the health system fail to meet the requirements of out-patient rehabilitation as described in the first part of the study ."
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[] |
[] |
[
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DerNervenarzt.70680813.eng.abstr
|
DerNervenarzt.70680813.eng.abstr
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"id": "DerNervenarzt.70680813.eng.abstr-passage-0",
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[] |
[] |
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DerNervenarzt.70680825.eng.abstr
|
DerNervenarzt.70680825.eng.abstr
|
[
{
"id": "DerNervenarzt.70680825.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The term \" juxta facet cyst \" was coined in 1974 by Kao et al. and combines synovial cysts arising from the synovial outpouchings through areas of weakened or destroyed capsular tissue and ganglion cysts developing from mucinous degeneration of periarticular connective tissue . We have operated on 16 patients with juxta facet cysts during the last 3 years . One cyst was located in the thoracic spine , causing a transverse syndrome ; 15 cysts were located in the lumbar spine , causing nerve root compression . Diagnosis was established preoperatively by MR in 10 and CT in 3 cases , respectively . The definite classification of the cystic processes was made by histopathologic examination . Surgical treatment consisted of resection of the cyst . Postoperatively , all but 2 patients were free of complaints and no recurrence was observed in the mean follow-up period of 15.5 months . Juxta facet cysts are an uncommon finding , but must be considered in the differential diagnosis of epidural compressive syndromes of the spine ."
],
"offsets": [
[
0,
1035
]
]
}
] |
[
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"id": "DerNervenarzt.70680825.eng.abstr-s1-t1",
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"cyst"
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23,
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]
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"db_id": "C0010709"
}
]
},
{
"id": "DerNervenarzt.70680825.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"cysts"
],
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85,
90
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]
},
{
"id": "DerNervenarzt.70680825.eng.abstr-s1-t3",
"type": "umlsterm",
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"tissue"
],
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[
178,
184
]
],
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{
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"db_id": "C0040300"
}
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},
{
"id": "DerNervenarzt.70680825.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"ganglion"
],
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189,
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"id": "DerNervenarzt.70680825.eng.abstr-s1-t5",
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"id": "DerNervenarzt.70680825.eng.abstr-s1-t6",
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"tissue"
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"id": "DerNervenarzt.70680825.eng.abstr-s1-t7",
"type": "umlsterm",
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},
{
"id": "DerNervenarzt.70680825.eng.abstr-s1-t8",
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"ganglion cysts"
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189,
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},
{
"id": "DerNervenarzt.70680825.eng.abstr-s1-t9",
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"text": [
"connective tissue"
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259,
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}
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"id": "DerNervenarzt.70680825.eng.abstr-s2-t2",
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"cysts"
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"id": "DerNervenarzt.70680825.eng.abstr-s3-t1",
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"id": "DerNervenarzt.70680825.eng.abstr-s3-t2",
"type": "umlsterm",
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"spine"
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"id": "DerNervenarzt.70680825.eng.abstr-s3-t3",
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"id": "DerNervenarzt.70680825.eng.abstr-s3-t6",
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"id": "DerNervenarzt.70680825.eng.abstr-s3-t7",
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] |
[] |
[] |
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DerNervenarzt.70680831.eng.abstr
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DerNervenarzt.70680831.eng.abstr
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"Mitochondrial myopathies are characterized by an abnormal aerobic metabolism . The present study examines the serum lactate concentration during standardized aerobic treadmill ergometry and evaluates its relevance for the diagnosis of mitochondrial myopathies . The present study includes 50 volunteers without neuromuscular disorders ( control group ) , 13 patients with mitochondrial , and 14 patients with non-mitochondrial neuromuscular disorders . All members of the control group were able to walk 15 minutes on the treadmill at a constant velocity of at least 5 km/h without exceeding the aerobic threshold ( 2 mMol/l lactate , venous blood ) . Ten patients with mitochondrial myopathies and 4 patients with non-mitochondrial myopathies already exceeded the aerobic threshold at walking velocities of 4 or 5 km/h . Though indicating a reduced aerobic endurance , a pathological test result does not prove the diagnosis of a mitochondrial myopathy . Sensitivity and specificity of treadmill ergometry did not differ significantly from those reported for bicycle ergometry . Thus , using the most common aerobic activity in daily life , treadmill ergometry can be considered as an alternative to bicycle exercise tests in the assessment of mitochondrial abnormalities ."
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[] |
[] |
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DerNervenarzt.70680836.eng.abstr
|
DerNervenarzt.70680836.eng.abstr
|
[
{
"id": "DerNervenarzt.70680836.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Topiramate is a new antiepileptic drug , which is not yet marketed in Germany . The anticonvulsive activity is probably mediated by sodium-channel blockade combined with gabaergic and weak antiglutamtergic properties . We investigated 23 patients with partial seizures in this open prospective study . The efficacy was analysed under stable concurrent antiepileptic drugs . Two of the patients became seizure free . Ten patients had a reduction of seizure frequency of at least 50% . The responder rate was 57% . The maximum daily dosages were 400 to 850 mg . Side-effects without relationship to dose were nervousness and aggression . In two patients an psychotic episode occurred . Dose-related side-effects were ataxia , dizziness , somnolence and dysarthria . This study is underlining that topiramate is efficacious in the treatment of partial onset seizures but also associated with a narrow therapeutic width ."
],
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0,
917
]
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"id": "DerNervenarzt.70680836.eng.abstr-s3-t4",
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"id": "DerNervenarzt.70680836.eng.abstr-s12-t3",
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"id": "DerNervenarzt.70680836.eng.abstr-s12-t4",
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]
}
] |
[] |
[] |
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{
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"type": "interacts_with",
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"arg2_id": "DerNervenarzt.70680836.eng.abstr-s12-t2",
"normalized": []
},
{
"id": "DerNervenarzt.70680836.eng.abstr-s3-r1-t2.1-t3.1",
"type": "associated_with",
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"arg2_id": "DerNervenarzt.70680836.eng.abstr-s12-t3",
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},
{
"id": "DerNervenarzt.70680836.eng.abstr-s3-r2-t5.1-t3.1",
"type": "associated_with",
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"arg2_id": "DerNervenarzt.70680836.eng.abstr-s12-t3",
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},
{
"id": "DerNervenarzt.70680836.eng.abstr-s3-r3-t1.1-t5.1",
"type": "performs",
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},
{
"id": "DerNervenarzt.70680836.eng.abstr-s3-r4-t3.1-t1.1",
"type": "occurs_in",
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"arg2_id": "DerNervenarzt.70680836.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerNervenarzt.70680836.eng.abstr-s3-r5-t3.1-t2.1",
"type": "associated_with",
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{
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},
{
"id": "DerNervenarzt.70680836.eng.abstr-s10-r1-t2.1-t1.1",
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},
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"id": "DerNervenarzt.70680836.eng.abstr-s12-r1-t2.1-t1.1",
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},
{
"id": "DerNervenarzt.70680836.eng.abstr-s12-r4-t4.1-t1.1",
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}
] |
DerNervenarzt.70680839.eng.abstr
|
DerNervenarzt.70680839.eng.abstr
|
[
{
"id": "DerNervenarzt.70680839.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Proximal myotonic myopathy ( PROMM ) is a newly described autosomal dominant inherited disorder characterized by predominant proximal weakness of the legs , mild clinical myotonia or myotonia on electromyograms ( EMG ) , cataracts and slight elevation of liver enzymes . The trinucleotide ( cytosine , thymine , and guanine ) repeat size of the myotonic dystrophy ( DM ) gene is normal . Magnetic resonance imaging of the brain may reveal a peculiar pattern of white matter abnormalities . We describe seven patients in a new family with PROMM . The only symptoms may be subclinical myotonic changes in the EMG or cataracts , but symptoms may also include severe proximal weakness of the legs and painful paraesthesia . PROMM is an important differential diagnosis of myotonic dystrophy ; and because of the proximal weakness it is also a differential diagnosis of other muscle diseases such as limb girdle dystrophy , metabolic and endocrine myopathies , and myositis . Because of the variability of the symptoms , for the definite diagnosis of PROMM it may require the examination of other family members ."
],
"offsets": [
[
0,
1108
]
]
}
] |
[
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"id": "DerNervenarzt.70680839.eng.abstr-s1-t1",
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"myopathy"
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18,
26
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{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t2",
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"disorder"
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},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"weakness"
],
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134,
142
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"db_id": "C0030552"
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]
},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"legs"
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150,
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},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"myotonia"
],
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171,
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"db_id": "C0027125"
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},
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"id": "DerNervenarzt.70680839.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"myotonia"
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183,
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]
},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"cataracts"
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221,
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"db_id": "C0007388"
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},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"liver"
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255,
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"db_id": "C0345904"
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"db_name": "UMLS",
"db_id": "C0023884"
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]
},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"enzymes"
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261,
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"db_id": "C0014442"
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]
},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t10",
"type": "umlsterm",
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"myotonic myopathy"
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9,
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]
},
{
"id": "DerNervenarzt.70680839.eng.abstr-s1-t11",
"type": "umlsterm",
"text": [
"Proximal myotonic myopathy"
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[
0,
26
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"db_name": "UMLS",
"db_id": "C0752354"
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DerNervenarzt.70680845.eng.abstr
|
DerNervenarzt.70680845.eng.abstr
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"id": "DerNervenarzt.70680845.eng.abstr-passage-0",
"type": "abstract",
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"Symptomatic myoclonus syndromes can be caused by a broad range of etiological factors . We report the case of a 40-year-old woman who showed spontaneous and continuous myoclonus with predominance distally and in the arms as the only neurological symptom . CSF evaluation revealed acute neurosyphilis . Six months after antibiotic treatment , the movement disorder had disappeared ."
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] |
[] |
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DerNervenarzt.70680853.eng.abstr
|
DerNervenarzt.70680853.eng.abstr
|
[
{
"id": "DerNervenarzt.70680853.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Treatment with \" nootropic drugs \" of patients suffering from dementia is often described as arbitrary . To define the potential usefulness of nootropic drugs , effects and side effects , economic aspects in comparison to other treatment approaches were studied . A summary of literature published concerning these criteria underlines the efficacy of nootropics in improving the symptoms at the beginning and in postponing the progress of the disease . The majority of substances does not lead to severe side effects . There are not enough studies comparing the effects of the substances or on prophylactic effects . Delayed admission to care units leads to a positi- ve cost effect of nootropics . Thus , also for economic reasons it seems advisable to treat patients with nootropics . Better effects are gained when nootropic treatment is combined with training and changing of the structure of the environment . A proposal for a rational treatment with nootropics is derived from the data ."
],
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0,
993
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]
}
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[] |
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DerNervenarzt.70680870.eng.abstr
|
DerNervenarzt.70680870.eng.abstr
|
[
{
"id": "DerNervenarzt.70680870.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In the past decades the cultural and social status of transsexuals has changed considerably . They have established own organizations , obtained legal rights and acces to health insurance services . The professional point of view has changed as well considerably . Very different personality structures , developmental courses and sexual preferences are described . As differential diagnoses homosexual and transvestitic developments , psychoses , early-onset personality disorders , adolescence crises , culturally induced gender dysphorias , and intersexual disorders have primarily to be considered . In therapy , the old confrontation psychotherapy vs. surgery has widely been relinguish-ed . Patient's age is nowadays much lower . Sex ratio in Germany is approaching for the first time 1:1 . So far worldwide a preponderance of biologically male transsexuals is reported . The total number of adult transsexuals in Germany is estimated 2000-4000 ."
],
"offsets": [
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0,
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]
]
}
] |
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DerNervenarzt.70680878.eng.abstr
|
DerNervenarzt.70680878.eng.abstr
|
[
{
"id": "DerNervenarzt.70680878.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The international discussion on physician-assisted dying as well as the recent development in North Australia and Oregon point to a growing tendency to favour assisted suicide as against killing on request - last not least for reasons of public acceptance . The decision of the Supreme Court of the Netherlands in a case of suicide assisted by a psychiatrist gives the opportunity to discuss the problem from the psychiatric point of view ."
],
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0,
440
]
]
}
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[] |
[] |
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DerNervenarzt.70680888.eng.abstr
|
DerNervenarzt.70680888.eng.abstr
|
[
{
"id": "DerNervenarzt.70680888.eng.abstr-passage-0",
"type": "abstract",
"text": [
"During a 6-month period all patients who had been treated involuntarily in a state-funded mental health unit were studied prospectively . They were interviewed after the first compulsory measure and at the end of treatment . A control group of patients ( not experiencing involuntary treatment ) were interviewed as well . The aim of the study was to establish whether the groups differed with respect to judgement of subjective well-being and satisfaction with treatment . The stability of these judgements over time and especially changes in perception and acceptance of involuntary treatment during the course of treatment were also monitored . The 36 patients in the study group perceived themselves as being far less ill at both time points and were less satisfied with treatment than the 29 control patients . At the end of treatment , all patients judged themselves to be significantly more ill retrospectively and patients of the study group were more satisfied with treatment than at the beginning . When questioned in the days after an involuntary measure , 25% of the patients concerned denied that any measure had taken place against their will ; at the end of the hospital stay this figure had increased to 42% . In contrast , four control patients complained that they had been involuntarily subjected to treatment . In discordance with the previously published literature , the acceptance of involuntary treatment declined over time ."
],
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0,
1449
]
]
}
] |
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"type": "umlsterm",
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DerNervenarzt.70680896.eng.abstr
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DerNervenarzt.70680896.eng.abstr
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DerNervenarzt.70680903.eng.abstr
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DerNervenarzt.70680903.eng.abstr
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"Assisted suicid has become a topic often and controversally discussed in international literature . Psychiatry and mentally ill , however , have been neclected , probably because the question of competence of judgement and will are a major issue in this matter . Two cases are reported , one of a 60-year old man and a women of 87 years , who have committed suicid a few days after having been dismissed from stationary psychiatric care . The reason of admission had been a psychotic event with manifest AIDS-disease in the first , the public utterance of her wish to die with support of , the Swiss \" Help to Die \" organization \" Exit \" , in the latter . Ethics and means of preentive interventions in such cases are discussed ."
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[] |
[] |
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DerNervenarzt.70680907.eng.abstr
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DerNervenarzt.70680907.eng.abstr
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[
{
"id": "DerNervenarzt.70680907.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This article discusses the problem of euthanasia presenting the case of an 82-year-old man with progressive dementia . Difficulties encountered during daily clinical work are described and analysed , in order to clarify decisions on ethical , legal and professional medical grounds . General decisions concerning life-sustaining measures may be qualitatively improved if the situation of the individual is constantly assessed and considered within the treatment process ."
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[] |
[] |
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DerNervenarzt.70680914.eng.abstr
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DerNervenarzt.70680914.eng.abstr
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"id": "DerNervenarzt.70680914.eng.abstr-passage-0",
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"It has known for a long time that Sydenham's chorea and tics , as seen in Gilles de la Tourette's syndrome ( GTS ) , are phenomenologically very similar . Tics may occur as symptoms of acute Sydenham's chorea or persist over years as residual symptoms . Investigations of children suffering from GTS , including obsessive-compusilve symptoms , have provided signs of a poststreptococcal autoimmune process but also shown that treatment based on immunological interventions has been effective . We treated a 14-year-old boy showing all diagnostic criteria of GTS , familial susceptibility , and an increase in the antibody titer of streptococcal antigens with 7S immunoglobulins i.v. over 5 days . Response to this therapy was good regarding motor tics , vocal tics , and behavioral symptoms such as disturbed impulse control which still persisted after 9 months . These findings and the successful therapy underline reports of the literature and point to a pathogenetic mechanism of an immunologically triggered disturbance of the striatal dopaminergic system , at least in a subgroup of GTS ."
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DerNervenarzt.70680917.eng.abstr
|
DerNervenarzt.70680917.eng.abstr
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[] |
[] |
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DerNervenarzt.70680940.eng.abstr
|
DerNervenarzt.70680940.eng.abstr
|
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{
"id": "DerNervenarzt.70680940.eng.abstr-passage-0",
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[] |
[] |
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DerNervenarzt.70680945.eng.abstr
|
DerNervenarzt.70680945.eng.abstr
|
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{
"id": "DerNervenarzt.70680945.eng.abstr-passage-0",
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"Neurological respiratory insufficiency may be the primary cause of admission to an intensive care unit or may develop during care in an intensive care ward . Severe respiratory insufficiency due to nervous system causes either involves a lack of central drive or weakness of the respiration muscles . The former are induced by a wide variety of encephalopathies and the latter by diseases of anterior horn cells , peripheral nerve , the neuromuscular junction , or muscles of the chest wall or diaphragm . In an intensive care unit , it is often not possible clinically to determine whether there is a lack of central drive or a neuromuscular problem . It is now possible by electrophysiological methods to pinpoint the site of nervous system cause of respiratory insufficiency . This review will describe the various electrophysiological techniques currently available and describe how they have been successfully applied in investigating some conditions that cause severe respiratory failure ."
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DerNervenarzt.70680956.eng.abstr
|
DerNervenarzt.70680956.eng.abstr
|
[
{
"id": "DerNervenarzt.70680956.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Incidence and clinical significance of cardiopulmonary complications of acute cerebral lesions are still unclear . Neurogenic pulmonary edema ( NPE ) is characterized as an acute , protein-rich lung edema occurring shortly after cerebral lesions associated with an acute rise of intracranial pressure . NPE is infrequently diagnosed , usually in association with head trauma . Pathophysiological mechanisms include a rise of the pulmonary vascular hydrostatic pressure either due to sympathetic innervation with pulmonary vasoconstriction or increased left-atrial pressure following systemic arterial hypertension or an increase in pulmonary capillary permeability . In contrast to NPE , cardiac complications are frequently observed , most consistently in patients with subarachoid hemorrhage . Typical ECG changes are repolarization abnormalities , similar to those observed in coronary heart disease , and cardiac arrhythmias . The CK-MB may be slightly elevated ; echocardiographic findings show a depressed left-ventricular function . Pathological examination reveals myofibrillar necrosis . Cardiac complications are explained with overactivity of the sympathetic innervation and high levels of circulating catecholamines . For adequate treatment , close cardiac monitoring is required in all patients with acute cerebral lesions ."
],
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DerNervenarzt.70680967.eng.abstr
|
DerNervenarzt.70680967.eng.abstr
|
[
{
"id": "DerNervenarzt.70680967.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A vascular etiology of Parkinson's disease ( PD ) has been long debated . In order to search for an ischemic basis of PD we assessed the clinical symptomatology of a consecutive group of 60 PD patients and compaired their frequency of cerebrovascular risk factors , carotid atherosclerosis and ischemic brain lesions with age-matched groups of stroke patients and normals . There were 16 ( 27% ) subjects with PD who also had symptoms of cerebrovascular disease . The frequencies of carotid stenoses , ischemic brain lesions and most of cerebrovascular risk factors seen in the latter group was comparable with those of stroke patients and significantly higher than in the investigational subsets of patients with \" pure \" PD and normals . Only one ( 1.6% ) individual with PD presented signs suggestive of an ischemic etiology of parkinsonism . These findings suggest that cerebrovascular disease occurs in approximately one fourth of patients with PD , but seldomly is causally related ."
],
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[
0,
989
]
]
}
] |
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"id": "DerNervenarzt.70680967.eng.abstr-s4-t2",
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] |
[] |
[] |
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"id": "DerNervenarzt.70680967.eng.abstr-s2-r1-t7.1-t5.1",
"type": "location_of",
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DerNervenarzt.70680972.eng.abstr
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DerNervenarzt.70680972.eng.abstr
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"id": "DerNervenarzt.70680972.eng.abstr-passage-0",
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"We studied 10 patients with Parkinson's disease and 12 patients with Parkinson-plus-syndrome , trying to improve patients ' gait by application of various external rhythmic stimuli , including metronome stimulation ( 96 beats per minute=middle andante ) . The test course of the patients was 4x10 meters and 3 U-turns . The patients ' gait quality under stimulation was compared with their free walk ( velocity , number of steps , number of freezing episodes ) . Metronome stimulation significantly reduced the time and number of steps needed for the test course and also diminished the number of freezing episodes . March music stimulation was less effective and tactile stimulation ( rhythmically tapping on the patient's shoulder ) even produced negative results . The positive effect of metronome stimulation was also found , when the tests were not performed inside the hospital building , but outside in the hospital parc . Metronome stimulation was comparably effective in both patient sub-groups examined in this study ( M. Parkinson , Parkinson-plus-syndrome ) and seems to be an important additional help in the treatment of these patients . Electronical metronomes are not expensive , easy in handling , and portable . A theoretical explanation of metronome stimulation effectivity in patients with Parkinson's disease still needs to be elucidated ."
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[] |
[] |
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{
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{
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DerNervenarzt.70680978.eng.abstr
|
DerNervenarzt.70680978.eng.abstr
|
[
{
"id": "DerNervenarzt.70680978.eng.abstr-passage-0",
"type": "abstract",
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"Parkinson's disease ( PD ) causes significant expense for the national health care system due to its chronic progressive course , the duration of the disease , the high prevalence and the devastating prognosis . In Germany more than DM 320 million are spent for drugs to alleviate parkinsonian symptoms . The aim of this study was to calculate the economic burden of PD by assessing direct medical costs . Forty patients suffering from idiopathic PD were interviewed at an office of neurological specialists and at an outpatient movement disorder clinic about their use of health care resources 3 months prior to the study . The total annual costs reported were DM 14,500 , consisting of DM 6500 for drug therapy and DM 8000 for other medical services , including hospital inpatient care ( DM 5600 ) , outpatient care ( DM 700 ) , medical sundries ( DM 1100 ) and physiotherapy ( DM 600 ) . The costs were positively correlated to the extent of the disease ( Hoehn and Yahr stage ; HY ) and the occurrence of motor fluctuations/dyskinesias . We found that both drug-therapy expenses and total medical costs doubled from HYI to HYIV . The rarely employed s.c. therapy with apomorphine additionally increased the costs of drug therapy in HYV . The occurrence of fluctuations/ dyskinesias also increased medical expenses by approximately a factor of two . Indirect burden due to increased days off of work , unemployment and earlier retirement are also significant in Parkinson's disease . This study oncludes that a treatment which could prevent or retard disease progression as well as a treatment that delays or reduces motor complications would not only ameliorate the situation of patients suffering from PD , but would also lead to significant reductions in cost for the national health care system ."
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DerNervenarzt.70680985.eng.abstr
|
DerNervenarzt.70680985.eng.abstr
|
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"id": "DerNervenarzt.70680985.eng.abstr-passage-0",
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"text": [
"Gilles de la Tourette syndrome ( TS ) is a neuropsychiatric spectrum disorder of unknown etiology . While several studies have provided evidence that nicotine causes an improvement , only anecdotal reports suggest that alcohol and marijuana influence the symptomatology . Using a structured interview , we questioned a larger group of patients with Tourette syndrome ( n=47) about the use of nicotine , alcohol , and marijuana and their subjective experiences . Of 28 smoking patients only 2 ( 7% ) reported a tic reduction when smoking . Of 35 patients drinking alcohol 24 ( 69% ) noted an improvement . Thirteen patients reported the use of marijuana , of whom 11 ( 85% ) noted a marked improvement . Our results provided strong evidence that the use of both alcohol and marijuana causes much more improvement in TS than nicotine smoking . We suggest that marijuana influences an assumed interaction between cannabinoid and dopamine receptors and , by this , influences the dopaminergic processes in basal ganglia and motor activity ."
],
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0,
1036
]
]
}
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{
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"normalized": []
}
] |
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