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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The oral zone reflects the relational modalities of the child: the sensorimotor physiological and psychological behaviour is established according to the development of the facial sphere and its aero-digestive crossroads. In the baby, the mandibular equilibrium and position and the dimensions of the lower part of the face essentially depend upon praxic activities, which drive the mandibular and hyoid displacements. During the period of immaturity, the lingual area is brought into movement with each "sucking-swallowing" action that characterises breast-feeding: the mandibulo-hyoid swing is subordinate to the pharyngo-lingual complex. The analysis of this psycho-motor behaviour reveals imperfect and upsetting "mimics" that modify the balance of the jaw and of the hyo-lingual area during swallowing, which is the second phase of the reassurance breast-feed. The lingual ptosis causes congestion of the airways. These lax children, with a receding chin, are deformed by their oral habits. The clinical picture evidences the constitutional hyperlaxity by examining the parental group -the same facial dystrophies, the same habits resulting in various disorders of general or cervical statics. At the level of the temporomandibular joint, the dysfunction is also accompanied by claudication by mandibulo-hyo-lingual tipping. The general and cervical statics of the baby are thus affected in the course of sleep. It is during paradoxical sleep that the baby's head tips on to the thorax, due to the resultant atonia of the neck muscles. The head, insufficiently supported on its cervical pillar accentuates the asphyxial mechanism provoked by the tipping of the lingual area on the epiglottis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Abnormalities in behavior in the oral and cervical area: reassurance breast-feeding. Considerations on sudden infant death]. 802 52

The purposes of this article are to report a case with temporal arteritis (TA) and to summarize and reanalyze the cases of temporal arteritis associated with fever in published articles for understanding better the clinical features of TA. A case with biopsy-proven TA is reported. The publications with TA and fever were searched by using MEDLINE in English from 1966 to 1999. Three hundred sixty cases of temporal arteritis associated with fever were reanalyzed. The results showed that a case of biopsy-proven TA with typically clinical manifestation was initially misdiagnosed and that the reanalysis of 360 cases revealed that the common clinical findings at presentation were abnormal temporal arteries, headache, low fever, loss of weight, polymyalgia rheumatica, jaw claudication, vision disorder, arthralgis or myalyias, and ear pain and that the uncommon clinical findings at presentation were high fever, malaise, anorexia, breast pain, transient ischemic attack/stroke, cough, mental disorder, diarrhea, and uterine prolapse, etc. Laboratory findings were the range of erythrocyte sedimentation rate (ESR) 14 to 149 with a mean of 97.0 mm/hr, white blood cells being normal or increased in the range of 10.9 to 22.9 x 10(9)/L, hemoglobin level 7 to 16 g/dL, the platelets count increased to 785 x 10(9)/L, and microscopic hematuria. The diagnosis was made by a combination of clinical features, an increased ESR, a response to steroids, and, most specifically, temporal artery biopsy. The initial diagnosis was misdiagnosed in 38.2% of patients. In conclusion, the features of TA associated with fever have not been widely appreciated yet. TA is a common cause of fever of unknown origin (FUO) in the elderly. TA should be considered when patients complain of common and uncommon manifestations. An elevated ESR will aid in the diagnosis of TA, and temporal artery biopsy will provide certainty.
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PMID:Temporal arteritis and fever: report of a case and a clinical reanalysis of 360 cases. 1110 64

The objective of this prospective study was to investigate further the clinical features of patients with giant cell (temporal) arteritis (GCA). All patients diagnosed from July 1999 to March 2001 at the Department of Neurology of the Second Xiangya Hospital in China were included. The final diagnosis was based on clinical manifestations, a temporal artery biopsy, response to steroid, and follow-up. The American College of Rheumatology (ACR) criteria for the classification of GCA were tested in the patients identified. Sixteen patients with GCA were identified; 13 (81.25%) patients fulfilled the 1990 ACR criteria for the classification of GCA. Clinical findings included the following: mean age at disease onset 43.13 years (range 28-60) and 81.25% of the patients under the age of 50 when the disease began; men 93.75%; the common initial symptoms including new headache 62.50% and.visual symptoms 18.75%; the common clinical findings at presentation including new headache 93.75%, temporal artery abnormality 81.25%, visual abnormality 56.25%, and fever 25.00%; raised erythrocyte sedimentation rate (ESR) 68.75%; and uncommon findings including jaw claudication, ptosis, fatigue, syncope, hemiparesis; all 16 patients underwent a temporal artery biopsy; inflammatory cell infiltration 68.75% in arterial wall, fragmented internal elastica 100.00%, fibrinoid necrosis 18.75%, smooth muscle cell changes 62.50%, and thrombosis in the lumen 31.25%. The mean time from symptom onset to suspicion of GCA or biopsy was 5.52 months (range 0.25-24.33); the initial diagnosis was wrong in 87.50% of patients. These examples are too small a number to permit definite conclusion. But the results suggest that GCA may not be a rare disorder in China, mean age at disease onset was relatively young, males may be more susceptible, the clinical features of GCA have not been widely appreciated yet, there was a delay between diagnosis and treatment, and initial diagnosis was wrong in many patients.
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PMID:Giant cell arteritis in China: a prospective investigation. 1214 52

A woman with Takayasu arteritis is reported who presented with constitutional symptoms and persistent thrombocytosis documented since 3 years before the diagnosis. Disease-specific symptoms such as arm claudication, transient loss of vision, and self-remitting eye ptosis present at the time were apparently missed, because she is a non-English-speaking Hispanic woman whose history was obtained through an interpreter. Extensive workup done at the time failed to reach a definite etiology. A computed tomography scan of the chest done because of midthoracic back pain and an elevated erythrocyte sedimentation rate showed circumferential wall thickening and mild surrounding edema throughout the thoracic and abdominal aorta and both carotid arteries consistent with Takayasu arteritis. Prednisone at a dosage of 1 mg/kg twice a day decreased the platelet count within 45 days of its initiation. Takayasu arteritis should be considered in the differential diagnosis of unexplained thrombocytosis, particularly in young women.
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PMID:Reactive thrombocytosis: an early manifestation of Takayasu arteritis. 1635 75

Background. In a group of patients treated surgically for stenosis in the lumbar spine, we compared the pre-operative nature of the pathology of the intervertebral disc as measured by MRI to the treatment outcome. Material and methods. In 30 persons ranging in age from 39 to 68 who reported at least 60% subjective improvement in quality of life after surgery (wide decompression of the spinal canal in the lumbar segment, spondylodesis, transpedicular fixation) the character of the discopathy was evaluated by MRI. Results. In MRI studies from the study group, feature of dehydratation and protrusion of the nucleus pulposus occurred among all patients, while the most common clinical symptom was neurogenic claudication. Non-removal of intervertebral discs protruding less than 6 mm into the lumen of the spinal canal did not cause worse outcome. Conclusion. In this group of patients treated surgically for lumbar stenosis with wide decompression, the fact that a slight protrusion of the intervertebral disc (prolapse <6mm) persists after surgery, in the absence of conflict between the disc and nerve elements, has no influence on treatment outcome.
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PMID:Discopathy in lumbar spinal stenosis. 1767 89

A 19-year-old man with mitral valve endocarditis and prolapse, intracerebral and intracerebellar hematoma, and a mycotic cerebral aneurysm underwent emergency mitral valve replacement during minimal cardiopulmonary bypass (total priming volume, 800 mL; autologous retropriming, activated clotting time <300 seconds) 1 day after undergoing endovascular coil embolization of the aneurysm. Postoperatively, there were no extensions of the intracerebral and intracerebellar hematoma. After intensive rehabilitation therapy, the patient recovered fully except for residual bilateral claudication because of preoperative bilateral embolism to both superficial femoral arteries.
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PMID:Emergency Valve Replacement Under Minimal Cardiopulmonary Bypass for a Patient With Infective Endocarditis and Large Brain Hematoma: A Case Report. 2909 10

A 79-year-old woman presented to the emergency room with a chief complaint of headache of 1 month's duration. Her medical history consisted of hypertension, congestive heart failure, anemia, chronic kidney disease, and hyperlipidemia. She reported the headache as waxing and waning, and occurring bilaterally in the frontal and occipital regions. On examination, she was found to have mild right-sided ptosis and possible early right-sided papilledema. She was also found to have bilateral shoulder tenderness and scalp tenderness. She denied double vision, vision changes, or jaw claudication.
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PMID:Facial Nerve Palsy after Temporal Artery Biopsy. 3216 59