Assuntos
Intoxicação do Sistema Nervoso por Mercúrio/diagnóstico , Mercúrio/administração & dosagem , Mercúrio/efeitos adversos , Humanos , Masculino , Intoxicação do Sistema Nervoso por Mercúrio/cirurgia , Pessoa de Meia-Idade , Síndromes Neurotóxicas/diagnóstico , Síndromes Neurotóxicas/cirurgia , AutoadministraçãoRESUMO
Diabetes is said to account for most cases of neuropathy in the elderly. We reviewed records of 223 young-old (65-79 years) and 77 old-old (>or=80 years) patients referred for evaluation of neuropathic symptoms over a 9-year period. We prospectively validated our findings in 102 consecutive elderly (77 young-old) patients receiving intensive evaluation for neuropathy. Diabetes was the most common cause of neuropathy (41%), but was less common in the old-old (25% versus 46%, P < 0.001). Idiopathic neuropathies were more common in the old-old (39% versus 9%, P < 0.001). Alcoholic and nutritional neuropathies were uncommon in the old-old. Electrophysiological studies showed that most patients had an axonal type of neuropathy. Sural and peroneal response amplitudes were poorly correlated with age. We obtained similar results in our prospective study. The distribution of causes of neuropathies in young-old and old-old patients, in a hospital-based sample, is age-related. Future studies need to include the old-old to better understand the nature of neuropathy in the elderly.
Assuntos
Doenças do Sistema Nervoso Periférico/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Neuropatia Alcoólica/diagnóstico , Neuropatia Alcoólica/epidemiologia , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Seguimentos , Humanos , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/diagnóstico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/epidemiologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
Circadian rhythm sleep disorders may occur after traumatic brain injury. We describe a 48-year-old man who presented with sleep onset insomnia and cognitive dysfunction after a car accident. A diagnosis of delayed sleep phase syndrome (DSPS) was confirmed by sleep logs and actigraphy, which revealed sleep onset in the early morning hours and awakening around noon.
Assuntos
Lesões Encefálicas/complicações , Ritmo Circadiano , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/fisiopatologia , Humanos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , SíndromeRESUMO
AUDIENCE: This exercise is intended for vascular surgeons, neurologists, cardiologists, and primary care physicians caring for persons who are at risk for or who have suffered a stroke. GOAL: To present data from a single institution on the incidence and costs associated with carotid endarterectomy compared with other techniques to diagnose and prevent stroke. OBJECTIVES: 1. Outline the prevalence of stroke in the United States and the role of carotid endarterectomy (CEA) in its treatment. 2. Discuss the various preoperative tests that help determine a patient's suitability for CEA. 3. Discuss the cost implications of stroke prevention.
