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No organ can make the body sick
Published in Dinesh Kumar Jain, Homeopathy, 2022
Kent also said, “One organ cannot make another organ sick”. But the whole medical knowledge says that one damaged organ always damages the other organ. I am giving a few examples. Chronic obstructive lung disease is a disease of the lung. After sometime, this disease damages the heart, which is labeled as cor pulmonale. Cancer of one organ affects various organs of the body by metastasis. “Carcinoma in the kidney affects adrenal gland, bone, brain, heart, lung, liver, lymph node, ovary, pancreas, skin, spleen, thyroid gland and muscles” (Lee, 1976, p. 538). Similarly, cancer of many organs can affect other organs of the body. Disease of the pancreas gives rise to diabetes mellitus. Diabetes of prolonged duration damages the kidney, eye, and nervous system. Damage in the brain also causes damage to other organs of the body. Brain controls all functions of the body. Damage in the brain leads to hemiplegia, paraplegia, vision loss, speech loss, etc. Hemiplegia means paralysis of half of the body, and paraplegia means paralysis of both the lower limbs. Conclusively, Kent was again wrong in his observations.
PMM2-CDG (Congenital disorders of glycosylation, type Ia)
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
The childhood period from three to 12 years of age [5, 13, 15] is characterized by ataxia and mental impairment (Figure 101.11). Some have dyskinetic or choreoathetotic episodes. Only a few patients have learned to walk. Most sit unsupported after two years; they ultimately learn to stand on tiptoe because of contractures [16]. Most learn to use a wheelchair. Disequilibrium and impaired coordination are prominent. Motor impairment is uniformly seen but the degree of impaired mental development is variable: IQs have ranged from 40 to 60 [6]. Patients understand spoken words but few develop linguistic skills; they speak in staccato fashion. Intellectual regression has not been seen except following stroke-like episodes. Deep tendon reflexes in the lower extremities disappear at this stage, and peripheral neuropathy becomes evident [16]. Retinal degeneration and retinitis pigmentosa is progressive in most [17]. Defective hemostasis, due to the reduced amounts of factor XI and the anticoagulation factors protein C and antithrombin III, leads to thromboembolic complications. Stroke like episodes occur often during pyretic infections. The stroke-like episodes are more prominent in childhood; there may be stupor or coma, and convulsions, as well as hemiplegia, usually with recovery in hours to days. Permanent hemiplegia has been associated with cerebral infarction. Two patients were blind for months after an episode. One patient had an arterial thrombosis in a hand [18].
Death at Depth
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Arterial gas embolism (AGE) may result from high alveolar pressure forcing gas into alveolar capillaries [1] or be due to entry into vessels affected simultaneously while alveoli rupture during distension [6]. Airlock of the left ventricle of the heart is reported to be relatively uncommon [6], with approximately 5 per cent of AGE-affected divers showing cardiac arrest after apnoea and loss of consciousness due to filling of cardiac chambers or great vessels with air [1]. Gas bubbles tend to distribute with the flow contingent upon factors such as position, buoyancy and movements of the diver. In an ascending position, this distribution mainly affects the upper body parts, and particularly the brain. Cerebral arterial gas embolism (CAGE) is the most feared complication of PBT with hypoxia leading to loss of consciousness usually within minutes after surfacing. Further symptoms include hemiplegia, stupor and confusion, visual disturbances, seizures, vertigo and headache [1].
Challenges and opportunities in the care of chronic subdural haematoma: perspectives from a multi-disciplinary working group on the need for change
Published in British Journal of Neurosurgery, 2022
Daniel J. Stubbs, Benjamin Davies, Peter Hutchinson, David K Menon
A chronic subdural haematoma (cSDH) is a collection of altered blood products that can form between the dural membrane and the surface of the brain. Most commonly occurring in older, medically complex cohorts,1–4 cSDH is strongly associated with age.1,5–7 It can lead to neurological impairment through localised perfusion deficits secondary to the mass effect of the cSDH8,9 or through direct distortion of key motor pathways.10 Symptoms may mimic a stroke, including hemiplegia or gait disturbance, headache and worsening cognition.2 Subacute and progressive deficits typically occur over days to weeks, although more acute and/or transient presentations are also possible8 (Figure 1). Current incidence estimates range from 1.7/100,000/year5 to 48/100,000/year,11,12 but several longitudinal studies have demonstrated increased incidence over time, likely driven by aging populations, increased detection linked to access to imaging, and use of anticoagulation.7,11,13–15 Shifting demographics may lead to significant increases in case numbers over the coming decades.12,16
Asymmetric atrophy of the multifidus in persons with hemiplegic presentation post-stroke
Published in Topics in Stroke Rehabilitation, 2021
Wookyung Park, Jongwook Kim, MinYoung Kim, Kyunghoon Min
Lumbar spine MRI scans of persons with hemiplegic presentation between 1 April 2013 and 1 May 2018 were reviewed. The patients’ demographic information and clinical features were also acquired. The inclusion criteria were 1) unilateral hemiplegia caused by a stroke, 2) ability to walk independently (modified Rankin scale [mRS] score 0–3), and 3) available lumbar MRI scans post-stroke. Subjects were excluded if they could not walk independently (mRS score: 4 or 5), if they were quadriplegic, or if they did not have any symptoms of muscle weakness. Patients with evidence of spinal cord injury, myelitis, or previous lumbosacral spine surgery on MRI were also excluded. We selected 26 patients who met the criteria (Figure 1). The stroke phase was defined as the duration from the stroke onset to the date of MRI, as follows: less chronic phase (≤ 9 months' for less chronic phase group) and chronic phase (>9 months).24 The less chronic phase group included 9 patients, and the chronic group comprised 17 patients. This study was approved by the institutional review board (approval no. 2019–05-029). This manuscript conforms to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
Predicting independence of gait by assessing sitting balance through sitting posturography in patients with subacute hemiplegic stroke
Published in Topics in Stroke Rehabilitation, 2021
Hyun Haeng Lee, Jong Won Lee, Bo-Ram Kim, Ho Joong Jung, Dong-Hee Choi, Jongmin Lee
We enrolled patients with first-ever stroke who were able to hold a sitting posture and assessed their sitting balance by using sitting posturography at post-stroke 1 month (window period: 7 days) between December 2016 and May 2017 in university hospital. We enrolled patients according to the following criteria: 1) age ≥20 years; 2) hemiplegia due to stroke; 3) sufficient cognitive function to understand instructions from the therapist (Korean Mini-Mental State Examination [K-MMSE] score ≥10); 4) available scores for other scales evaluating post-stroke balance (Berg Balance Scale [BBS] and Scale for Assessment and Rating of Ataxia [SARA]) performed on the same date as sitting posturography; and 5) evaluation of Functional Ambulation Category (FAC) at post-stroke 2 months. We excluded patients with uncontrolled medical problems, visual field defects, visuospatial hemineglect, or orthopedic and neurological diseases that could compromise sitting balance function. After assessment at post-stroke 1 month, patients received tailored rehabilitation programs according to their functional status, such as muscle strengthening exercises, balance training, and coordination exercise.