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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The traditional medical history and physical examination format is disease rather than disability oriented. It has been shown to be incomplete for the total evaluation of rehabilitation patients. Direct applications of Weed's Problem-Oriented Medical Record have proven to be formidable and cumbersome due to the complexity and diversity of rehabilitation. Therefore, we have developed the Rehabilitation Evaluation System (RES) to document functional rehabilitation management and progress during inpatient hospitalization and outpatient follow-up. The system identifies 18 key rehabilitation areas, each with an individual and objective four-point scale. Utilization of this system in our department has been invaluable in formulating goals and continually evaluating the on-going rehabilitation process. We used the RES with equal facility on 46 rehabilitation inpatients including stroke, amputation, spinal cord injury, multiple sclerosis, orthopedic-trauma, rheumatoid arthritis and poliomyelitis. The mechanics of the RES are presented in detail with a specific patient-example of hemiplegia. Its complimentary use with the Problem-Oriented Medical Record is discussed. Practical advantages are seen in patient care, medical student and resident education, record keeping and research.
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PMID:A rehabilitation evaluation system which complements the problem-oriented medical record. 108 Jun 59

The results of total hip replacement in 39 patients 30 years old or younger were evaluated including 67 Charnley low-friction arthroplasties and one McKee total hip arthroplasty. The average age was 25.9 years with an average follow-up of 39 months, the longest being 8 years, 3 months. The diagnoses included rheumatoid arthritis, ankylosing spondylitis, CDH, Still's disease, and a miscellaneous group. Over-all function did not improve as greatly as in the 9 to 10 year series, but this was due to a higher proportion of patients with severely disabling rheumatoid polyarthritis, hemiplegia, severe obesity, or cardiovascular disease. Wear did not seem to be any greater in this younger age group as compared to previous studies in older patients.
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PMID:Results of low friction arthroplasty in patients thirty years of age or younger. 119 31

A post mortem material of 11 consecutive cases of severe atlanto-axial dislocation (a.a.d.) with cord compression is reported. The total number of deaths from rheumatoid arthritis (RA) during the period of 5 years was 104, and all were autopsied. Neurological symptoms correlated poorly to fatal a.a.d. Hemiplegia was found in three cases, one of which, however, was caused by thrombosis cerebri. Spastic signs were transiently recorded in two patients and dysphagia in a further two. Five patients had a history of recent vomiting. A.a.d. was the sole or main cause of death in 8 cases and contributory in 2. Sudden death occurred in 7 of the cases. Only 2 cases had obtained a correct diagnosis intra vitam. The CNS findings at autopsy consisted of cord compression (11/11 cases), cord malacia (2/11) and cerebral oedema (3/11). One case had polyarteritis and renal amyloidosis and one pulmonary carcinoma with metastatic spread. Signs of active inflammation in the axial joints were present in 4 cases. This study, based on systematic post mortem examinations, revealed an unexpectedly high and not previously reported incidence of fatal medulla compression in RA patients with a.a.d. (10%).
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PMID:Sudden death in rheumatoid arthritis with atlanto-axial dislocation. 121 Dec 12

This study presents particular clinical manifestations in 7 patients with autoiMmune diseases: rheumatoid purpura with right crural nerve paresis (1 case), Stevens-Johnson syndrome with encephalomyeloradicular syndrome (1 case) and left Wallenberg syndrome (1 case), rheumatoid arthritis with right parieto-occipital syndrome (1 case) and Gowers local panatrophy (1 case), systemic lupus erythematosus with confusional state and meningeal syndrome (1 case) and left ictal hemiplegia (1 case). The importance of neurological clinical manifestations at the onset or during the evolution of the autoimmune diseases is emphasized.
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PMID:Particular neurological aspects in vascular autoimmune diseases. I. Rheumatoid purpura, Stevens-Johnson syndrome, rheumatoid arthritis and systemic lupus erythematosus. 260 78

Rheumatoid arthritis is generally a symmetrical polyarthritis characteristically involving small joints. Unilateral disease may occur when limbs are protected by a neurologic defect. Unilateral rheumatoid arthritis occurring in a patient with hemiplegia is here described.
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PMID:Unilateral rheumatoid arthritis in hemiplegia. 684 20

No statistical increase in the prevalence of either diabetes, rheumatoid arthritis or primary hyperparathyrodism was found among the hip fracture patient population. Since the relative risks for these diseases is small, the statistics suggest that these conditions are either noncontributory or represent only a minor risk factor in the overall pathogenesis of hip fractures. About 20% of the hip fracture patients had a history of other identifiable risk factors such as thyrotoxicosis, hemiplegia, malabsorption syndromes and corticosteroid therapy. Of these conditions only thyrotoxicosis could be evaluated by comparison of prevalence rates, and a significant increase was found among the fracture patients. A highly significant correlation was found between the side of a previous hemiplegia and side of he subsequent hip fracture; this may be due to the development of disuse osteoporosis in the hemiplegic limb. Recent reports have shown that a reduction in the number of hip fractures is associated with a high calcium intake or prophylactic estrogen therapy. Preventive therapy in patients with hemiplegia, thyrotoxicosis, or other predisposing conditions leading to osteopenia might result in a further reduction of the hip fracture rate.
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PMID:Examination of prevalence rates of possible risk factors in a population with a fracture of the proximal femur. 689 15

We reported a case of malignant rheumatoid arthritis (MRA) with cerebral infarction associated with a possible cause of lupus anticoagulant. The patient was a 68-year-old woman who had received treatment for rheumatoid arthritis (RA) from 15 to 16 years ago. She consulted to our hospital with a major complaint of right hemiplegia. Brain CT revealed a low density area in the left hemisphere. She was diagnosed as cerebral infarction and hospitalized. Since she was noted to have hypocomplementemia, interstitial pneumonia and pericarditis, she was diagnosed as MRA. Coagulation test disclosed positive lupus anticoagulant (LA). Generally, CNS disorders in MRA are uncommon. Cerebral infarction was complicated in the present case, suggesting the involvement of antiphospholipid antibodies as its pathogenesis.
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PMID:[A case of malignant rheumatoid arthritis with lupus anticoagulant and cerebral infarction]. 777 8

We assessed the functional results of simultaneous proximal carpal carpectomy and radius to distal carpal row arthrodesis. A retrospective review of patients undergoing wrist arthrodesis for degenerative joint disease was performed. Patients with rheumatoid arthritis or spastic hemiplegia were excluded. Simultaneous proximal row carpectomy and radius to distal carpal row arthrodesis was performed in 38 patients using AO plates and 3.5 mm diameter screws. The mean follow-up time was 16 months, the fusion rate was 100%, and the average grip strength was 24 kg force or 79% of the contralateral hand measured at 10 degrees wrist extension. Patients with three or more screws placed in the metacarpal had significantly more plate-related complications and a higher rate of plate removal than those with two screws distally. Simultaneous proximal row carpectomy and radius to distal carpal row arthrodesis did not decrease the postoperative grip strength.
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PMID:Simultaneous proximal row carpectomy and radius to distal carpal row arthrodesis. 780 92

A 37-year old house wife who developed polyarthritis localized to contralateral to hemiplegic side was reported. The patient had been on the physical therapy program for right hemiplegia which occurred at the age of 33. The polyarthritis are chronic and showed significant responses to salazosulfapyridine. Her serum contained rheumatoid factor (RF) of high titer and hand X-ray showed characteristic erosive changes in PIP and MCP joints. Presence of morning stiffness, positive RF, bone erosion, isotope accumulation, HLA-DR4 and responses to DMARD are all consistent with a diagnosis of rheumatoid arthritis. Review of the literature revealed that fifteen patients had been reported in whom occurrence of neurological disorders and rheumatic conditions were described. In most of these patients including the present case, the rheumatic symptoms did not occur or subsided in the hemiplegic side of neurological disorders. Possible mechanisms of inactivation on rheumatic inflammation were discussed.
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PMID:[A case of polyarthritis developed on the non-paralytic side in a hemiplegic patient]. 805 33

The effects of human immunodeficiency virus type-1 (HIV-1) infection on rheumatoid arthritis (RA) are a matter of debate as there is no agreement on the influence of HIV-1 related immunodeficiency on this disease. We describe a patient with RA with symmetric joint erosions and positive rheumatoid factor (RF) who developed classic acquired immunodeficiency syndrome (AIDS) followed by left hemiplegia. RA improved with resolution of bony erosions and disappearance of RF, and reached complete clinical remission only in the paralytic limbs. Our observation suggests that, although essential, cell mediated immune response is not the sole mechanism involved in RA pathogenesis. Other factors such as the nervous system may play an important role.
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PMID:Recovery of erosive rheumatoid arthritis after human immunodeficiency virus-1 infection and hemiplegia. 910 12


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