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Arthur Conan Doyle – The Unknown Quantity British crime novelist The true way to render age vigorous is to prolong Education never ends discount 40 mg cialis professional mastercard erectile dysfunction at the age of 21, Watson generic cialis professional 20 mg without prescription erectile dysfunction vacuum pumps australia. Thomas and George Underwood buy cialis professional 40 mg overnight delivery vasodilator drugs erectile dysfunction, London () Cyril Connolly – (Description of the first ligation of the aorta in  for left British journalist and writer femoral aneurysm) The one way to get thin is to re-establish a purpose Sir (Vincent) Zachary Cope in life cheap cialis professional 40mg with visa erectile dysfunction doctors huntsville al. The Unquiet Grave Pt I – See Zeta Obesity is a mental state, a disease brought on by boredom and disappointment. A mistake which is commonly made about Attributed neurotics is to suppose that they are interesting. Alan Coren – British humorist and writer Psychoanalysis is spending forty dollars an hour to squeal on your mother. The Act of God designation on all insurance Bartlett’s Unfamiliar Quotations policies; which means, roughly, that you cannot be insured for the accidents that are most likely to Sir Edward Cook – happen to you. Editor of the Westminster Gazette The Lady from Stalingrad Mansions ‘A Short History of Insurance’ The doctors all say we eat too much. Sir Astley Paston Cooper – The Great Doctors—A Biographical History of Medicine p. Dover Publications, New York English surgeon, Guy’s Hospital, London and President of () (original W. Ltd ) the Royal College Surgeons (Eng) (1827 and 1836) The best surgeon, like the best general, is the one Bill Cosby who makes the fewest mistakes. They are pale, skinny people who look half I do not believe, that from the first dawn of dead. Penguin Books, London ()   ·    Nathaniel Cotton – Quentin Crisp – British physician and poet English-born writer Would you extend your narrow span, Life was a funny thing that occurred on the way And make the most of life you can; to the grave. Would you, when medicines cannot save, The Naked Civil Servant Descend with ease into the grave; Calmly retire, like the evening light, Colin Cromar –? Every day, in every way, I am getting better and A History of Colostomy () better. As a doctor you would be well advised to acquaint Abraham Cowley – yourself with your patients’ interests if not their English poet prejudices. Persons living very entirely on vegetables are seldom of a plump and succulent habit. A Short View of the Importance and Respectability of the Quoted on ‘neurosis’ in The Oxford English Dictionary Science of Medicine. An address to the Philadelphia Medical Society,  February () Bishop Richard Cumberland – Creole proverb Bishop of Peterborough, England Sickness comes riding upon a hare, but goes away It is better to wear out than to rust out. The Duty of Contending for the Faith, by Bishop George Horne Sir James Crichton-Brown Marie Curie – – Polish-born doctor and scientist British physician and psychiatrist In science we must be interested in things, not in There is no short-cut to longevity. Vincent Sheean) The Prevention of Senility Thomas Curling – President of the Royal College of Surgeons of England Francis H. Lancet : – () (first description of a colostomy in Letter to his son, Michael Crick,  March () English)    · . Daar English Conservative politician Contemporary medical anthropologist My message to businessmen of this country when Medicine cannot be practised without reference to they go abroad on business is that there is one thing social and cultural values, even in this post- above all they can take with them to stop them modern era. Current British Minister of State for Health as quoted in The Anthropology : – () Observer  February () The strongest possible piece of advice I would give J. Chalmers Da Costa – to any young woman is: Don’t screw around, and Surgeon and writer don’t smoke. They have The Observer ‘Sayings of the Week’,  April () one trait in common, that is, a most unfortunate tendency to longevity. Dubois) keen disappointments, the baffling perplexities, There is only one ultimate and effectual preventive the dread responsibilities, and the numerous self- for the maladies to which flesh is heir, and that is reproaches of one who spends his life as an death. The Medical Career and Other Papers ‘Medicine at the The Trials and Triumphs of the Surgeon Ch. A man who has a theory which he tries to fit to The Medical Career and Other Papers ‘Medicine at the facts is like a drunkard who tries his key Crossroads’ haphazard in door after door, hoping to find one I would like to see the day when somebody would it fits. Letter to Dr Henry Christian,  November () Scottish surgeon and discoverer of ulcerative colitis Nature saw fit to enclose the central nervous The affected bowel gives the consistence and system in a bony case lined by a tough, protecting smoothness of an eel in a state of rigor mortis and membrane, and within this case she concealed a the glands, though enlarged, are evidently not tiny organ which lies enveloped by an additional caseous. Crohn’s disease for the first time) Neurohypophysial Membrane From a Clinical StandpointYale University Press () Danish proverb Fresh air impoverishes the doctor. Darlington – The observer listens to Nature; the experimenter British geneticist questions and forces her to unveil herself. A large proportion of mankind, like pigeons and Attributed partridges, on reaching maturity, having passed through a period of playfulness or promiscuity, establish what they hope and Czech proverb expect will be a permanent and fertile mating Small children stamp on your lap, big ones on relationship. Life was originally from so simple a beginning Quoted by Marvin Corman in Classic articles in colonic and (that) endless forms most beautiful and most rectal surgery. Diseases of the Colon and Rectum : – wonderful have been and are being evolved. Self-destruction is the effect of cowardice in the Letter,  March () highest extreme. I must begin with a good body of facts and not An Essay Upon projects ‘Of Projectors’ from a principle (in which I always suspect some Middle age is youth without its levity, and age fallacy) and then as much deduction as you please. Fiske,  December () Attributed Sir Francis Darwin – Mervyn Deitel ? Davies – British poet Thomas Dekker – Teetotallers lack the sympathy and generosity of English dramatist men that drink. It should never be weariness that he is half dead, he is telling the done with a pin, and still less with the fingers, but truth. On not being Dead, as Reported The Rules of Christian Manners and Civility I      ·   Campbell Greig De Morgan – Charles Dickens – Professor of Anatomy, Middlesex Hospital, London British novelist Today the glands may be free; tomorrow they may Minds like bodies, will often fall into a pimpled, ill- be affected. Today all disease may be distributed conditioned state from mere excess of comfort. Penguin Books, London () impression and assigned his long professional rides, by day and night, in the bleak hill-weather, Joyce Dennys as the true cause of that appearance. There is something in sickness that breaks down That is why practically all Doctors are married. Lord Devlin – Lecture at the Royal College of Physicians, London, May Appeal court judge, House of Lords () In strict legal terminology I doubt if doctors ever As time goes by a new set of relationships between assault; they batter. Polish-born Austrian physician Attributed A physician should not be judged by the success of In the face of such overwhelming statistical his treatment but by the extent of his knowledge. Vermilion, London () As long as medicine is an art, it will not become a science. Churchill Livingstone, Edinburgh () Benjamin Disraeli, Lord Beaconsfield – John Donne   – British Prime minister and novelist English poet Youth is a blunder; manhood a struggle; old age a regret. British Medical Journal (), quoting an old consultant Speech,  June () boss There is no index of character so sure as the voice. They Putting on the spectacles of science in expectation are always congenitally based and never result of finding the answer to everything looked at from accidents in uterine life. P & S Quarterly : , June () British Medical Journal :  () You do one experiment in medicine to convince yourself, then ninety nine more to convince others. The Next Half Century in Medicine Western Journal of Medicine and Surgery :  ()    ·   Michael Drayton – Epidemics have often been more influential than English poet statesmen and soldiers in shaping the course of political history, and diseases may also colour the Past cure, past care. The probability is rather, that eagerness for John Dryden – achievement often leads to a way of life that English poet and playwright renders the body less resistant to infection. He also is but unfortunately, it often causes such a glare that impotent—in fact two excellent properties to it prevents the eyes from seeing the natural objects possess for a quiet day on the river. V The epidemic of syphilis which spread through all Finley Peter Dunne (‘Mr Dooley’) of Europe in the late fifteenth and early sixteenth – century gave many physicians frequent occasions American humorist to observe, often in the form of a personal I wondher why ye can always read a doctor’s bill experience, that a given disease can pass from one an’ ye niver can read his purscription. Baron Guillaume Dupuytren Industrial Medicine and Surgery :  () – Chief surgeon Hôtel Dieu, Paris Throughout nature, infection without disease is the rule rather than the exception.

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Gram-positive cocci in chains are group B or D streptococci cialis professional 20 mg visa erectile dysfunction shake ingredients, since gram-positive cocci in clusters represent S discount 40 mg cialis professional overnight delivery erectile dysfunction young age. With the exception of epididymitis in the elderly purchase 20mg cialis professional fast delivery impotence quoad hoc meaning, community- acquired urosepsis does not require P buy cialis professional 20 mg with amex erectile dysfunction statistics. Table 6 Community-Acquired Urosepsis: Therapeutic Approach Urosepsis- associated syndrome Microorganisms Urine Gram stain Empiric coverage. Urosepsis in Critical Care 293 Table 7 Nosocomial Urosepsis: Therapeutic Approach Urosepsis- associated syndrome Usual uropathogens Urine Gram stain Empiric coverage. The importance of pre-existing urinary tract disease and compromised host defenses. Role of fluoroquinolones in the treatment of serious bacterial urinary tract infections. Efficacy and safety of colistin (colistimethate sodium) for therapy of infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii in Siriraj Hospital, Bangkok, Thailand. Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review. Pseudomonas aeruginosa susceptible only to colistin in intensive care unit patients. Once daily tigecycline therapy of multidrug-resistant and non-multidrug resistant gram- negative bacteremias. Polymyxin B and doxycycline use in patients with multidrug-resistant Acinetobacter baumannii infections in the intensive care unit. In vitro activity of tigecycline and comparators against carbapenem-susceptible and resistant Acinetobacter baumannii clinical isolates in Italy. Treatment with tigecycline of recurrent urosepsis caused by extended-spectrum-beta-lactamase-producing Escherichia coli. Considerations in control and treatment of nosocomial infections due to multidrug-resistant Acinetobacter baumannii. Severe Skin and Soft Tissue Infections 17 in Critical Care Mamta Sharma and Louis D. John Hospital and Medical Center, and Wayne State University School of Medicine, Detroit, Michigan, U. Most of these infections are superficial and treated with regimens of local care and antimicrobial therapy. However, others like necrotizing infections are life-threatening and require a combined medical and surgical intervention. Prompt recognization and treatment is paramount in limiting the morbidity and mortality associated with these infections, and thus a thorough understanding of the various etiologies and presentation is essential in the critical care setting. It is also important to discriminate between infectious and noninfectious causes of skin and soft tissue inflammation. A detailed history and examination are necessary to narrow the possible etiologies of infection. In many instances, surface cultures are unreliable and misleading because surface-colonizing organisms can be mistaken for pathogens. In instances in which the diagnosis is in doubt, aspiration, biopsy, or surgical exploration of the skin can be considered. Typically, soft tissue infections result from disruption of the skin by exogenous factor, extension from subjacent infection, or hematogenous spread from a distant site of infection. Physiological factors that control the bacterial skin flora include humidity, water content, skin lipids, temperature, and rate of desquamation. Besides containing secretory immunoglobulin (IgA), sweat also possesses sufficient salt to create a high osmotic pressure, which may be responsible for inhibiting many microbial species. In spite of these barriers to colonization, the skin provides an excellent venue of various microenvironments. Differences in cutaneous microflora may relate to variability in skin surface temperature and moisture content as well as the presence of different concentrations of skin surface lipids that may be inhibitory to various microorganisms. Colonization with organisms sensitive to desiccation, such as gram-negative bacilli, is not favored. The predominant bacterial flora of the skin is the various species of coagulase-negative staphylococci (Staphylococcus epidermidis, S. Colonization of the anterior nares, perineum, or skin, particularly if the cutaneous barrier has been disrupted or damaged, may occur shortly after birth and may recur anytime thereafter (1–4). Approximately 20% of individuals always carry one type of strain and are called persistent carriers. Carriage rates are higher than in the general population for injection drug users, persons with insulin-dependent diabetes, patients with dermatological conditions, patients with long-term indwelling intravascular catheters, and those with human immunodeficiency virus infection. Other gram-negative bacilli are found more rarely on the skin, and these include Proteus and Pseudomonas in the toe webs and Enterobacter and Klebsiella on the hands. Antibiotics disturb the balance within commensal flora and leave the surface vulnerable to colonization by exogenous gram-negative bacilli and fungi. The principal fungal flora is lipophilic yeasts of the genus Malassezia, and nonlipophilic yeasts such as Candida spp. Primary skin infections occur in otherwise normal skin and are usually caused by group A streptococci or S. A deficiency in the expression of antimicrobial peptides may account for the susceptibility of patients with atopic dermatitis to skin infection with S. Other factors predisposing to skin infections include vascular insufficiency, disrupted venous or lymphatic drainage, sensory neuropathies, diabetes mellitus, previous cellulitis, foreign bodies, accidental or surgical trauma, burns, poor hygiene, obesity, and immunodeficiencies. Extension into the superficial dermis with involvement of lymphatic is typical of erysipelas, whereas cellulitis is an extension into the subcutaneous tissue. A clinically useful distinction with important management implications subdivides soft tissue infections into nonnecrotizing and necrotizing processes (9). The Center for Drug Evaluation and Research for development of antimicrobial drugs has classified skin and soft tissue infection as uncomplicated or complicated. The uncomplicated category included simple abscesses, impetiginous lesions, furuncles, and cellulitis. Compli- cated category included infection involving the deeper layer or requiring significant surgical intervention. Superficial infection in an anatomical site with a risk of gram-negative pathogen or anaerobes such as the rectal area was also considered to be complicated (10). DiNubile and Lipsky classified skin and soft tissue infections to assist clinician in recognizing uncomplicated and complicated infections (11). Classification can also be based according to the severity of local and systemic signs and symptoms of infection, and the presence and stability of any comorbidities. Class 1 patients have no signs or symptoms of systemic toxicity without any comorbidities and can be managed in an outpatient setting. Class 3 patients have toxic appearance, one unstable comorbidity, or a limb-threatening infection, whereas class 4 patients have sepsis syndrome or serious Table 1 Classification of Skin and Soft Tissue Infection Based on Uncomplicated and Complicated Infections and Systemic Syndromes Uncomplicated Complicated Systemic syndromes Superficial: impetigo, ecthyma Secondary infection of diseased skin Scalded-skin syndrome Deeper: erysipelas, cellulitis Acute wound infections: Traumatic Toxic shock syndrome Hair follicle associated: Bite related Purpura fulminans folliculitis, furunculosis Post operative Abscess: carbuncle, Chronic wound infections: Diabetic foot infections cutaneous abscess Venous stasis ulcer Pressure ulcers Perianal infections Necrotizing fasciitis (type 1 and type 2) Myonecrosis (crepitant and noncrepitant) Source: Adapted in part from Ref. Guidelines developed by the Infectious Disease Society of America are written in references to specific disease entities, mechanism of injury, or host factors (13). Classification of skin and soft tissue infections based on uncomplicated and complicated infections, and systemic syndromes is depicted in Table 1. Here we review causes of skin and soft tissue infection with emphasis on severe skin and soft tissue infection, highlighting the clinical presentation, diagnosis, and approach to management in the critical care setting. There are two clinical presentations: bullous impetigo and nonbullous impetigo, and both begin as a vesicle (14).

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Sig- moidoscopy has been shown to reduce mortality 20mg cialis professional amex erectile dysfunction doctors buffalo ny, and the recommended screening interval is 5 years discount cialis professional 40mg otc erectile dysfunction adderall. Sigmoidoscopy carries a perforation risk of 1/1000 order 40mg cialis professional free shipping erectile dysfunction treatment injection cost, while the risk with colonos- copy is three times greater buy cialis professional 40 mg without prescription erectile dysfunction cvs. Colonoscopy detects more advanced lesions and is the screening test of choice in subjects who are at high-risk. Small cell and squamous cell lung cancer account for 85% of all cases of malignant superior vena cava obstruction. Other symptoms include hoarseness, tongue swelling, headaches, nasal congestion, epistaxis, hemoptysis, dysphagia, pain, diz- ziness, syncope, and lethargy. Temporizing measures include diuretics, low-salt diet, oxy- gen, and head elevation. Glucocorticoids may be effective for shrinking the size of lymphomatous masses, but they are of no benefit in patients with primary lung cancer. Chemotherapy is most effective for small cell lung cancer, lymphoma, or germ cell tumors. Intravascular stenting is effective for palliation and may be considered to prevent recurrence. Initial evaluation should include history, physi- cal examination, appropriate imaging, and blood studies based on gender (e. Immunohistochemical staining of biopsy samples using antibodies to specific cell components may help elucidate the site of the primary tumor. Although many immunohistochemical stains are available, a logical approach is represented in the figure below. Additional tests may be helpful based on the appearance under light microscopy and/or the results of the cytokeratin stains. In cases of cancer of unknown primary, cytokeratin staining is usually the first branch point from which the tumor lineage is determined. Cytokeratin is positive in carcinoma, since all ep- ithelial tumors contain this protein. Leukocyte common anti- gen, thyroglobulin, and thyroid transcription factor 1 are characteristic of lymphoma, thyroid cancer, and lung or thyroid cancer, respectively. Imatinib mesylate results in hematologic re- mission in 97% of treated individuals at 18 months and cytogenetic remission of 76%. This is compared to traditional chemotherapy of interferon-α and cytarabine, which resulted in hematologic remission in 69% and cytogenetic remission in only 14% of individuals. More than 87% of individuals who achieved cytogenetic remission had not developed progressive disease at 5 years. This drug taken orally has limited side effects that include nausea, fluid re- tention, diarrhea, and skin rash and is usually well tolerated. If individuals do not achieve he- matologic remission by 3 months or complete cytogenetic remission by 12 months, it is recommended that they proceed to allogeneic bone marrow transplant. While imatinib is the best initial therapy to achieve hematologic and cytogenetic remission, individuals who have a well-matched related bone marrow donor may proceed to early allogeneic transplant, particularly if the individual is <18 years of age. This is done because younger individuals generally have better outcomes following bone marrow transplant than older individuals, and the durability of responses to imatinib mesylate is not known at this time. Interferon-α was previously the first-line chemotherapy if bone marrow transplant was not an option, but it has been replaced by imatinib mesylate. Clinical trials utilizing autologous stem cell transplantation are currently underway to determine if this treatment may be possible following control of disease with imatinib therapy. Leukopheresis is used for control of leukocyte counts when the patient is experiencing complications such as respiratory failure or cerebral ischemia related to the high white blood cell count. Women who experience menarche at age 16 have 40 to 50% the risk of breast cancer of women who experience menarche at age 12 years. Menopause, surgical or natural, occur- ring 10 years before the median age of 52 years reduces the risk of breast cancer by 35%. Women who have the first full-term pregnancy by age 18 have a 30 to 40% reduced risk of breast cancer compared with nulliparous women. These data taken together suggest that a substantial portion of the risk of developing breast cancer is related directly to the length of menstrual life, particularly the fraction occurring before the first full-term pregnancy. Independently of these factors, the duration of maternal nursing is associated with a reduction in breast cancer risk. This may be further characterized by the “mixing study,” in which the patient’s plasma is mixed with pooled plasma. Aspirin can be recommended for primary cardiovascular prevention in patients whose annual estimated risk of a cardiovascular event is >1%. This includes pa- tients over the age of 40 who have two or more major cardiovascular risk factors and patients over age 50 with one major cardiovascular risk factor. The major risk factors in this patient who is >50 are diabetes mellitus and family history. Other contributing risk factors include obesity and a history of tobacco use, although this is not ongoing. Aspirin is equally effective in men and women, and menopausal status does not impact its effi- cacy. In men, aspirin has a greater risk reduction on the incidence of myocardial infarction, whereas in women, there is a greater risk reduction in the occurrence of stroke. The most common side effect of aspirin is major bleeding at a rate of 1–3% yearly. Enteric-coated and buffered prepa- rations decrease, but do not eliminate, this risk. The risk of bleeding is higher if adminis- tered concurrently with other anticoagulant or antiplatelet medications. Usually, these patients have a history of asthma and nasal polyposis (Samter’s triad). The bone lesions are lytic lesions due to increased osteoclast activity, without osteoblastic new bone formation. Of the nonhematopoietic tu- mors, the most common are osteosarcoma, chondrosarcoma, Ewing’s sarcoma, and malig- nant fibrous histiocytoma. The “sunburst” appearance of the lesion and Codman’s triangle in this young man are indicative of an osteosarcoma. Osteosarcomas have a predilection for long bones, whereas chondrosarcomas are more often found in flat bones, especially the shoulder and pelvic girdles. Chondrosarcomas account for 20–25% of bone sarcomas and are most common in adults in the fourth to sixth decades. Most chondrosarcomas are chemoresistant, and the mainstay of ther- apy is resection of the primary as well as metastatic sites. Therefore, its X-linked in- heritance pattern results in approximately 1 in 10,000 male patients being born with some level of dysfunction. Clinically, it is characterized by bleeding into soft tissues, mus- cles, and weight-bearing joints. Therefore, deficiency usually results in ab- normalities of the activated partial thromboplastin time. Nevertheless, there were >20,000 new cases in the United States with >10,000 deaths in 2007. Epidemiologic evidence, such as the higher prevalence in lower socioeco- nomic groups and the maintenance of risk for individuals but not offspring migrating from a high-risk to low-risk environment, suggests an environmental exposure early in life is a risk.

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Physical therapy with as gait analysis employing a foot pressure measurement system proven cialis professional 40 mg erectile dysfunction pump implant. Conclusion: Rehabilitation gait was evaluated before and one month after the treatment by physicians should be aware of the possibility of nonhereditary my- means of gait analysis employing a foot pressure measurement sys- ositis ossifcans in patients with recent trauma/surgery discount cialis professional 40 mg without prescription erectile dysfunction drug therapy. The measurements included gait speed and proportions of stance discount 20 mg cialis professional with mastercard erectile dysfunction hand pump, swing order cialis professional 20mg overnight delivery erectile dysfunction pump implant video, and double support in the gait cycle. Soon after fewer, vomiting and somnolence occurred and the patient was hospitalized. In his history, common cold symptoms 1Gaziantep University, Physical Medicine and Rehabilitation, Ga- were seen and 15 kg loss within 6 months was present. On physical ziantep, Turkey, 2Gülhane Military Medical Academy, Physical examination, deep tendon refexes were hyperactive in upper and Medicine and Rehabilitation, Ankara, Turkey lower limbs; pathologic refexes were present in addition to above- mentioned signs. The patient was hospitalized Lumbar puncture resulted with a positive culture for Cryptococcus for rehabilitation. Results: With help of these fndings the patient was were 2 in upper extremity, hand and lower extremity. He had spas- diagnosed as hemorrhagic stroke Related to Cryptococcal Menin- ticity in elbow fexor and forearm pronators. After medications and physical therapy, patient was during physical examination musculuskeletal sonography was per- signifcantly improved with independent ambulation and activities formed. He or his family did of stroke of unknown origin, particularly in young adults without not report any trauma to his left elbow before or after the stroke. Rehabilitation strategies should be a part of He also did not desribe pain in his elbow, but diffuse pain in left such patients’ management. Shoulder dislocation is commonly seen in stroke patients but radial head disloacation is very rare in stroke patients. In this patient etilogy was unclear whether it was occurred due to 407 a complication of stroke or trauma or congenital anomally. Multiple linear regression analysis was rapid recovery going from dense, faccid hemiplegia to near-nor- applied to evaluate the factors affecting the differencebetween the mal strength and minimal fne motor coordination impairments outcome measure scores on discharge and admission. In Apr 2015, there was a spike in New stroke and Bourges index), motricity index, Ashworth scale, New York City emergency room visits for patients with K2 complica- Functional Ambulation Categories, Mini Mental Status Examina- tions. It is either smoked or consumed in the daily activity domain was noted at 1st and 3rd months. The impaired postural control has the greatest marijuana but with K2 specifc urine tests. Postural control is the marijuana must be considered in the differential diagnosis of pa- best predictor of achieving independent living. A complete drug use history and K2 specifc urine test can help make the diagnosis. Give that Methods: Twenty-fve patients with stroke were randomly divided stroke is the main cause of adult disability, we want to understand into two groups: 12 in ankle stretching group (experimental group) if the same is true in Australia. Material and Methods: Our retro- and 13 in straight leg raising group (control group). We analyzed the patient data on the basis of age range (0–10, spasticity of the ankle joint were assessed by passively move the an- 11–20, etc. Results: Before training, there was no signifcant tal later than older ones, missing the chance for acute therapy and difference between two groups in all the measured parameters. Conclusion: As a 2 weeks training, the spasticity measured under different angular ve- word of caution, the results have yet to be adjusted for catchment locity showed a signifcant difference between the two groups except area changes, new stroke units opening, and changes in population 240°/s ; there was a signifcant difference between the two group on statistics. Nonetheless, our study suggests that stroke is becoming the muscle strength measured at the 60°/s, 120°/s, but not at 180°/s, more frequent in younger Australians. Do1 icine and Rehabilitation, Monastir, Tunisia 1Asan Medical Center, Rehabilitation Medicine, Seoul, Republic of Korea Introduction/Background: Postural problems are common follow- ing stroke and can resulting in a high incidence of falls particu- Introduction/Background: We studied the infuence of leukoaraio- larly in those patients with motor, sensory, cognitive and emotional sis on the functional outcome of subcortical stroke for the subacute impairments. Material and Methods: We retrospectively ana- and its impact on independence social participation and quality of lyzed 152 collected patients with acute subcortical infarct (corona life. Material and Methods: 31 right-handed patients (mean age radiate with or without basal ganglia infarct) at a single center from 61. Of these, the patients who previously had J Rehabil Med Suppl 55 Poster Abstracts 123 history of stoke or cognitive impairment had excluded and forty 415 one patients were enrolled. Cakci 1Dıskapı Yıldırım Beyazıt Education and Reserach Hospital, Physi- ity was graded as mild, moderate, or severe on the Fazekas scale. Rehabilitation Center, Department of Physical Therapy and Reha- Results: Severe leukoaraiosis was diagnosed in 2 patients (4. There to bilateral masseter muscles in early stroke patients with dyspha- were no signifcant difference in the baseline characteristics of the gia. Material and Methods: Ninety-eight patients with dysphagia study cohort by leukoaraiosis severity except for age and modifed within the frst month after ischemic stroke included in this study. Results: During inpatient rehabilitation, were administered at pretreatment, posttreatment, and 1-month he was consulted to psychiatry for suspected hallucinations and posttreatment. Recent studies has showed homocystein tendency of the Delta band power spectra in both brain hemispheres. Ahmad bilitation robot is a new physical therapy technology to provide 1Department of Rehabilitation Medicine, Penang General Hos- high-precision, high repeatability of training and visual, auditory pital, Penang, Malaysia, 2Rehabilitation Physician and Head of comprehensive feedback. Our study was designed to observe the Department, Department of Rehabilitation Medicine- Penang Gen- effect of upper limb rehabilitation robot for upper limb function in eral Hospital, Penang, Malaysia stroke patients. Material and Methods: One hundred patients with acute stroke were randomly divided into a control group (50 cases) Introduction/Background: Intensive rehabilitation medicine ser- and a therapy group (50 cases). All of the patients were treated vices, when offered as an organized and structured inpatient pro- with conventional medical treatment and rehabilitation training. Moreover, these scores continued to rise:12-week and daily sessions of therapy, with an average stay of 3. Conclusion: Robot- in chronic stroke patients and subsequently offers renewed hope based rehabilitation can be applied to patients with acute stroke in and potential for these patients who should no longer be side-lined a clinical setting and may be benefcial for improving the upper as “dead end cases”. The treatment group was treated with and lower limb function in post-stroke patients. Two cases of the observation group At the time of discharge, all of the evaluated items showed a statis- off, shedding 4. Three cases of the treatment group tically signifcant improvement relative to the scores at admission. In upper limb function, there was no statistically signif- cidence of shoulder pain in control group increased (p<0. Hiroshi2 1Tokyo Metropolitan University, Graduate School of Human Health Introduction/Background: The program of prolonged stretching Sciences, Tokyo, Japan, 2Hanno-Seiwa Hospital, Rehabilitation in conjunction with local injections of nerve blocking agents after 3 Center, Saitama, Japan, Saitama Medical University, Department stroke aims to improve upper limb function, but current evidence of Neurology and Cerebrovascular Medicine, Saitama, Japan, of functional benefts of exercise for arm function is discussed. We 4 have evaluated the effects of combination of the stretching train- Saitama Medical University, Department of Rehabilitation Medi- ing and local botulinum-toxin injections. Material and Methods: cine, Saitama, Japan 30 patients with post stroke time from 1 to 15 years were investi- Introduction/Background: It is important to be able to predict gated. Were measured the active and passive movements and rest- whether a patient will be able to walking and activities of daily liv- ing angles of paretic upper limb. Analysis was purpose of this study was to classify stroke patients by their prop- made using Mann-Whitney U-test, Wilcoxon matched pairs test erties into several groups, and investigate their association with and Spearman correlation. Material and Methods: Seventy-two frst attack stroke dle and proximal joints of the 2, 3, 4, 5 fngers decreased after 30 patients with severe hemiplegia at admission were included in this days of the treatment (p=0. No relationships between post stroke time rhage in 51 and subarachnoid hemorrhage in 6.

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