RESUMO
A biomechanical study assessed the comparative mechanical properties of various wire configurations used in transverse and oblique phalangeal fractures. The configurations included crossed, oblique, and intramedullary wire techniques using 0.028-inch diameter (d) or 0.035-inch d Kirschner (K) wires. Six different configurations were tested in both the oblique fracture pattern and in the transverse fracture pattern. The mechanical properties were determined after either oblique or transverse osteotomy and fixation of the proximal phalanx. Each fixation technique was tested in apex palmar, apex dorsal, and lateral bending, as well as in torsion and distraction. The results showed that of the configurations tested, four crossed 0.028-inch d Kirschner wires obtained the highest rigidity in the transverse fracture pattern and three oblique 0.035-inch d Kirschner wires obtained the highest rigidity in the oblique fracture pattern.
Assuntos
Fios Ortopédicos , Traumatismos dos Dedos/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Fechadas/cirurgia , Dispositivos de Fixação Ortopédica , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Traumatismos dos Dedos/fisiopatologia , Fixação Intramedular de Fraturas , Fraturas Fechadas/fisiopatologia , Humanos , Pessoa de Meia-Idade , Movimento , Anormalidade TorcionalAssuntos
Levodopa/efeitos adversos , Lítio/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Adulto , Método Duplo-Cego , Feminino , Humanos , Lítio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/induzido quimicamente , Transtornos dos Movimentos/tratamento farmacológico , Distribuição AleatóriaRESUMO
Six patients with severe parkinsonism complicated by the "on-off" phenomenon were treated with lithium carbonate in addition to regular antiparkinson medications. A randomized double-blind crossover trial of lithium versus placebo was conducted, followed by an open trial of lithium therapy. Five patients had markedly reductions in akinesia (mean, 70%) and improved by one grade in Parkinson staging. This result was more striking in male than in female patients, and in all responders benefit has been maintained during the open phase of lithium treatment (mean follow-up of 36 weeks). In no patient was a reduction in akinesia observed during placebo treatment. Lithium carbonate appears to offer a new and potentially effective approach to treatment of the on-off phenomenon.
Assuntos
Lítio/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Lítio/sangue , Carbonato de Lítio , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Placebos , Fatores de TempoRESUMO
The authors describe a 42-year-old man who developed "on-off" episodes and for whom lithium carbonate proved an effective treatment. They speculate that the predominant effect of lithium in the "on-off" syndrome is to prevent L-dopa desensitization of the dopamine receptor.
