Background: Deep brain stimulation (DBS) at the subthalamic nucleus (STN) or globus pallidus internus (GPi) can effectively treat the motor symptoms of Parkinson's disease, but dual implantation is rare. We report the first cases of additional GPi stimulation as rescue therapy for disabling dyskinesias following successful STN stimulation. Methods: Two patients, initially treated with bilateral STN DBS, underwent subsequent bilateral GPi DBS after the development of refractory dyskinesias within 1 and 6 years of STN surgery. Patients were evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS) before and after surgeries for STN and GPi DBS. Results: GPi DBS effectively suppressed dyskinesias in these patients and improved their quality of life, as demonstrated by their videos and UPDRS scores. Conclusions: Additional bilateral GPi DBS may be considered in the rare instance of patients who develop refractory dyskinesias early or late after bilateral STN DBS.
The oxygen blenders used in disposable oxygen masks from five manufacturers (Hudson, Inspiron, McGaw, Medishield and Vickers) were tested for delivered oxygen concentration and flow. In all concentration ranges the Medishield and McGaw were more accurate than the others. With some exceptions the flow output of these two devices was also adequate. The Medishield blenders which were tested over a wide range of oxygen inflows proved very stable in their delivered oxygen concentration.
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