ABSTRACT
Along the years the treatment of Parkinson's disease with L-dopa has revealed unfavorable effects in general after 5-10 years. This has led to the present criteria for treatment of de novo patients that mainly relay on the age, the general strategy being to delay the use of L-dopa as long as possible. However, this practical approach lacks a scientific basis. In a retrospective study data of 155 patients with Parkinson's disease were analyzed with the goal of finding a clinical marker for the critical time point when L-dopa needs to be administrated. The clinical stage of the patients was assessed using the Hoehn and Yahr (H&Y) scale and the severity of the symptoms was measured using the UPDRS score. The results show that there was no relationship between the age of the patients and the therapy (L-dopa vs. no L-dopa) with regard to the clinical outcome. A significant interaction was found however, between the clinical stage (H&Y) and the therapy. Further analysis of this interaction showed that in the H&Y Stages 1-2.5 the UPDRS scores were lower in the patient groups treated without L-dopa. Remarkably, in the H&Y stages 3 and higher the UPDRS scores were lower in the patient groups treated with L-dopa. These results suggest that the clinical stage of the disease (H&Y) might be a better criterion than the age for the time point when L-dopa needs to be administered in de novo patients.
Subject(s)
Antiparkinson Agents/administration & dosage , Levodopa/administration & dosage , Parkinson Disease/drug therapy , Parkinson Disease/pathology , Adult , Aged , Aged, 80 and over , Antiparkinson Agents/pharmacology , Disease Progression , Drug Administration Schedule , Female , Humans , Levodopa/pharmacology , Male , Middle Aged , Patient Care Planning , Prognosis , Retrospective Studies , Severity of Illness IndexABSTRACT
In this work we analyse 23 clinical observations on operated cholecystopathies, with intestinal mucosa metaplasia and we present a study hypothesis that remains to be further verified. The clinical cases have been selected out of out of 1263 cholecystopathies carried out within our department between 1987-1993. Most of the patients were females aged of 30-50 years old and were not known to have gallbladder malformations or biliary lithiasis. The authors are in favour of surgical cure at these patients, only when the well-lead medical cure has failed to give positive results, as a final solution. The histopathological examination of the samples indicating intestinal mucosa metaplasia zones of the gallbladder is the only paraclinical findings that shows useful evidence and confirms the opportunity of the surgical solution in these patients.
Subject(s)
Gallbladder Diseases/pathology , Gallbladder/pathology , Intestinal Mucosa/pathology , Adult , Cholecystectomy , Cholecystitis/pathology , Cholecystitis/surgery , Female , Gallbladder Diseases/surgery , Humans , Male , Metaplasia/pathology , Metaplasia/surgery , Middle AgedSubject(s)
Brain Abscess/etiology , Cerebellar Diseases/etiology , Mastoiditis/complications , Meningitis/etiology , Otitis/complications , Brain/pathology , Brain Abscess/pathology , Cerebellar Diseases/pathology , Humans , Infant , Male , Mastoiditis/pathology , Meningitis/pathology , Otitis/pathology , Time FactorsABSTRACT
Experimentally, bilateral trunkal vagotomy (BTV) generated some early acute modifications represented during the first 14 days by blood stasis, partial thrombosis, inflammatory infiltrates and necrobiosis of the gastric mucosa. The vascular lesions are the first to occur, the tissular ones being secondary. Later on, two and three months after surgery, chronic inflammation and metaplasia of the intestinal type have been detected as well.
