Subthalamic nucleus (STN) deep brain stimulation (DBS) is the most common surgical treatment for managing motor complications in Parkinson's disease (PD). Ultimately, outcomes depend on a variety of factors including lead location, access and expertize in programming and PD medical management. Nevertheless, achieving ideal programming settings can be difficult in certain patients, leading to suboptimal control of symptoms and stimulation-induced side effects, notably dysarthria and dyskinesia. Interleaved stimulation (ILS) is a newer programming technique that attempts to optimize the stimulation field, improving control of symptoms while minimizing stimulation-induced adverse effects. A retrospective chart review was performed on PD patients receiving STN DBS over the past 12 months. Clinical and demographic data were collected from patients identified as having received ILS. The rationale and clinical efficacy of ILS was analyzed. Nine patients received ILS due to incomplete PD symptom control or stimulation-induced side effects after attempting multiple programming options. Appropriate lead location was confirmed with postoperative MRI except in one case. Following ILS, patients reported improvement in symptoms and resolution of side effects, while preserving adequate control in Parkinsonism with a mean improvement in UPDRS-MOTOR scores of 51.2 %. ILS continues to emerge as a safe and effective programming strategy for maximizing symptom control in PD while diminishing stimulation-induced side effects.
Despite being considered highly subspecialized, neurosurgical diagnosis and care is a field in which all physicians should receive proper education and training. To properly serve patients and produce competent physicians, steps should be taken to re-emphasize the importance of neurosurgical education for medical students.
NEW YORK Squier1 has written an interesting and comprehensive review of the literature on the chemistry of pernicious anemia. Though a number of researches have been made on the pathochemistry of this very fatal disease, its causative factor is still unknown. Whether it is essentially a disease of the gastro-intestinal tract, with atrophy of the gastric mucosa and the absorption either of enterogenous poisons or protein split products, or whether it is a disturbance due to the hemolytic action of toxins elaborated in disease processes, or whether the disease is caused by hypersplenism, are the three main hypotheses in this mooted question. The evidence brought forward by those authors who favor one or the other of these theories is not conclusive. A large number of chemical substances, such as oleic acid, saponins, phenylhydrazin, b-amino-azolyl-ethyl benzaldehyd, p-oxyphenylethylamin, etc., are violent hemolytic agents, and experimentally such poisons will produce anemia and hemoglobinuria, etc., but no definite proofs have been advanced that such substances are actually present in the idiopathic anemias. Iwao has been able to isolate p-oxyphenylethylamin from autolyzing pancreas, putrefying horse flesh and Swiss cheese. It is quite evident that this base may normally arise in the intestine from putrefying food, and it has been demonstrated by Berthelot and Bertrand2 that there is an organism in the intestine-B. aminophiluswhich can produce p-oxyphenylethylamin from tyrosin. Barger and Dale3 have isolated another hemolytic amin, b-imino-azolylethylamin, from the mucosa of the small intestine of the ox. Grawitz4 assumed that intestinal stasis was a great cause in the production of pernicious anemia, due to the absorption of poisons from the decay of food in the alimentary canal. Berger and Tsuchiya5 found that extracts obtained from the mucosa of the intestines of anemic animals have a much stronger hemolytic power than extracts from the mucosa of normal animals. This has, however, been con¬ troverted by Ewald and Friedberger.
Several studies have implicated interleukin 1 alpha (IL-1 alpha) in the pathogenesis of rheumatoid arthritis (RA). We analysed IL-1 alpha intron 6 polymorphism in relation to RA (50 patients with RA and 50 healthy controls). The study of a healthy control population confirmed the existence of the different alleles with a frequency similar to that in the Caucasian populations of northern England. Allele and genotype distributions did not differ significantly between the normal and RA populations, although the allele corresponding to 8 repeats was over-represented in the RA population (8 and 14% in the healthy and RA populations respectively). This suggests that IL-1 alpha intron 6 polymorphism could be part of a complex process involving other unidentified genetic factors in the pathogenesis of RA.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.