摘要:

&NA;It is well known that patients with a chronic medical illness experience major depression at a higher rate than the general population. The purpose of this study was to determine the frequency of depression among patients with myasthenia gravis (MG) who were referred to a Muscular Dystrophy Association clinic. Forty‐five patients with a diagnosis of MG were evaluated with a self‐administered survey regarding various typical somatic and psychologic symptoms of depression (the Beck Depression Inventory [BDI]) and then scored according to the BDI guidelines. Thirty‐three percent of these patients generated scores suggestive of depression (24% were categorized as mildly depressed, 7% as moderately depressed, and 2% as severely depressed). These results suggest that patients with MG patients experience depression at a higher rate than the general population and at a similar rate as patients with other chronic illnesses.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objectives:To determine the frequency and risk factors associated with peripheral neuropathy in a population of patients with hepatitis C virus infection.Methods:Cross‐sectional study. Electrophysiological assessment included bilateral motor and sensory conduction studies of four limbs.Results:Thirty‐one cases and 31 control subjects were studied. Eighteen patients (58%) from the group of patients infected with the hepatitis C virus had evidence of neuropathy. Only 3 (10%) persons from the control group exhibited neuropathy. Among the risk factors for neuropathy in the patients infected with hepatitis C virus, we found the following: positive rheumatoid factor, cryoglobulinemia, and cirrhosis or active hepatitis. Other risk factors were advanced age, prolonged time of evolution, high viral load of the hepatitis C virus, and low complement.Conclusions:The frequency of neuropathy encountered in our study was high (58%). In our study, a positive rheumatoid factor, cryoglobulins, and a high viral load were also associated with the presence of peripheral neuropathy. A high viral load could express possible direct viral damage.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

&NA;Perioperative nerve injuries can be a complication of surgical procedures and accounts for approximately 16% of all anesthesia‐related claims in the United States. Whereas ulnar neuropathy at the elbow is the most common, other nerve injuries of the upper extremity and the phrenic nerve are not rare occurrences. A number of possible etiologies have been proposed to explain perioperative nerve injury to include stretch, compression, ischemia, and metabolic derangement. There appears to be additional factors making some patients more prone to nerve injury than others, for example, the sex of the patient and pre‐existing disease. Also, in some cases there is a discrepancy between the timing of the surgery and the injury manifestations that can be the result of delayed recognition or an insult in the postoperative setting.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Introduction:Glutaric acidemia type II (GA II) typically presents with profound metabolic acidosis, hypoketotic hypoglycemia, and mild dysmorphic features in newborns. Since its description, 11 patients with adult‐onset GA II have been reported.Case Report:A 23‐year‐old woman presented at 6 months gestation with preterm labor and weakness for 3 months. Her weakness worsened to the point of not being able to walk despite treatment with corticosteroids for presumed myositis. Biopsies of skeletal muscle revealed extensive lipid myopathy. Metabolic studies and urine organic acids were suggestive of a multiple acyl‐CoA dehydrogenase deficiency. Immunoblot of skin fibroblasts demonstrated a deficiency of electron transfer flavoprotein‐ubiquinone oxidoreductase. Treatment with carnitine, riboflavin, and diet restrictions improved muscle strength and decreased urine organic acids.Conclusion:This patient had the unique presentation of GA II with only myopathy. In adults with late‐onset weakness, metabolic disorders should be considered in the differential diagnosis.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

&NA;Patients with a small fiber neuropathy often are difficult to diagnose. They frequently undergo various diagnostic studies including quantitative sensory testing (QST) and skin biopsy. We wanted to determine if there was a correlation between findings on a QST study to that of a skin biopsy. Twenty patients were prospectively studied. Nine had an abnormal skin biopsy. Thirteen patients had an abnormal QST. Seven of the nine patients with an abnormal skin biopsy had an abnormal QST. Assuming that skin biopsy is the gold standard for identification of small fiber neuropathies, the sensitivity of QST for detection of such neuropathies is high, provided that both cold and warm sensation thresholds are studied. However, the specificity of QST for small fiber neuropathies is low (46%).

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID