ABSTRACT
BACKGROUND: Correcting of the lack of regularity in steps is a key component of gait rehabilitation in Parkinson's disease. We proposed to introduce adaptive spatial auditory cueing (ASAC) based on verbal instruction "lengthen the step" automatically delivered when the stride length decreased below a predetermined threshold. OBJECTIVES: The present study compared the effect of usual rhythmic auditory cueing versus ASAC used during a walking training in Parkinson's disease. METHODS: Fifteen patients with Parkinson's disease performed both interventions in randomized order, one week apart: a 20-minute walking training with rhythmic auditory cueing, in form of a metronome adjusted on 110% of the patient's own cadence, or ASAC delivered when the stride length is less than 110% of the patient's own stride length. Assessment criteria were walking distance covered during the intervention, speed, step length, cadence, coefficients of variation of step length and step duration, and indexes of spatial and temporal asymmetry during a walking test before and just after the intervention. RESULTS: The walking distance is higher with ASAC compared with rhythmic auditory cueing (rhythmic auditory cueing, 905 (203) m, mean (standard deviation); ASAC, 1043 (212) m; P=0.002). Between-intervention comparison showed some similar effects on walking after the intervention including free speed and step length increases (P<0.05). CONCLUSION: The distance covered during 20-minute walking with ASAC increases by 15% compared to the use of classical rhythmic auditory cueing, while the immediate therapeutic effects show similar spatial-temporal benefits on short-distance walking. Auditory biofeedback cueing promoting the increase in step length might improve gait relearning in Parkinson's disease.
ABSTRACT
PURPOSE: To evaluate the consequences of placing an aortic stent over the renal arteries. MATERIALS AND METHODS: The renal ostia of 11 pigs were covered by Strecker stents placed in the aorta. At 1 month, the degree of renal ostial stenosis was determined by means of angiography and gross pathologic and histologic examination. Any reduction in area of the renal ostia was considered significant. Preprocedure and 1-month serum creatinine levels were also examined. RESULTS: One stent migrated and was excluded from the study. There was one angiographic failure and, among the remaining 18 renal arteries evaluated, one was occluded, six were stenosed, and 11 were patent. Of the 10 samples available for pathologic examination, one was excluded from study because one stent was not fully deployed. A neointima was covering the struts crossing or encircling the renal arteries ostia with a mean area coverage of 43% +/- 30% (range, 0-84%). Serum creatinine levels rose from 71.1 mumol/L +/- 7.1 preoperatively to 94.2 mumol/L +/- 6.7 postoperatively (P < .01). CONCLUSION: An aortic stent placed over the renal arteries in pigs may compromise renal perfusion in the long-term because neointima tends to fill the spaces between the struts.
Subject(s)
Angioplasty/methods , Aorta, Abdominal , Renal Artery Obstruction/surgery , Stents , Animals , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/pathology , Aortography , Follow-Up Studies , Male , Renal Artery Obstruction/diagnostic imaging , Renal Artery Obstruction/pathology , Swine , Tunica Intima/pathologyABSTRACT
One case of giant appendiceal cyst secondary to obstruction is presented. The clinical feature is a pseudotumoral syndrome with the discovery of a cyst of the right iliac fossa by a pre-menopause woman. It is pre-operatively misdiagnosed as an ovarian cyst. Only an appendectomy is made for this benign lesion. The mucoceles of the appendix are rare, considered as an entity of macroscopic anatomy. The review of the literature allow us to recall the histologic classification of these lesions, their diagnostic patterns and their treatment.
