Angina Pectoris ; complications ; Cardiomyopathies ; complications ; pathology ; Female ; Humans ; Middle Aged

No abstract available.
Tendons*

No abstract available.
Methylmethacrylate*

No abstract available.
Knee Joint* ; Knee*

No abstract available.
Achilles Tendon*

No abstract available.
Shoulder*

OBJECTIVE: To describe the rate of suicide and explore its possible related factors among patients with X-linked Dystonia Parkinsonism. Specifically, this paper aimed to describe the rate of suicide among patients with XDP based on the Philippine XDP registry and to describe these patients in terms of severity of XDP and psychosocial factors.
BACKGROUND: Chronic progressive neurologic conditions have been associated with serious psychosocial stresses. Suicide among patients with X-linked Dystonia Parkinsonism has been previously reported to be high.
METHODS: A retrospective chart review was done on XDP patients with deaths attributable to suicide. XDP related variables and available psychosocial factors were noted.
RESULTS: The prevalence of suicide among all XDP patients registered is 4.16%. There are 194 deaths in the Philippine XDP registry, 21 of which were attributable to suicide, a proportion of 10.8%. Their mean age at suicide was 44, around 7.76 mean years from the onset of illness. All of the patients were either in generalized dystonia or parkinsonian stage when they had suicide. Psychosocial variables noted were marital and family conflict, and loss of employment. None of the patients had a prior documented psychiatric illness but several of them showed symptoms of depression prior to suicide.
CONCLUSIONS: There is a high rate of suicide among patients with XDP which is comparable to other disabling neurodegenerative diseases. It occurs relatively late in the course where the patient is already in the stage of generalized dystonia or parkinsonism. Possible psychosocial risks include poor family support, marital conflict, loss of employment and symptoms suggestive of depression. The present understanding is that depression and suicide in XDP is more likely reactive to the disease rather than part of its clinical feature. This study supports this view.

Human ; Male ; Female ; Depression ; Dystonia ; Dystonic Disorders ; Family Conflict ; Genetic Diseases, X-linked ; Neurodegenerative Diseases ; Parkinsonian Disorders ; Suicide ;

Background: Neuropathic symptoms and signs are common in the elderly and are often considered normal fi ndings. However, symptomatic polyneuropathy may contribute to disability and falls in the elderly. The prevalence of peripheral neuropathy in the elderly in Malaysia has not been previously reported. The objective of this pilot study is to determine the frequency of symptomatic sensory polyneuropathy in a group of elderly subjects in the community and their possible associated factors. Methods: Cross sectional survey of subjects aged 65 years and above, carried out in an urban neighbourhood in Petaling Jaya. Using a standardised questionnaire, subjects were asked about sensory neuropathic symptoms, associated medical conditions and social habits. They were examined for the ankle refl ex, vibration, joint position, and pinprick sensations. Possible symptomatic sensory polyneuropathy was defi ned as bilateral distal neuropathic symptoms, loss of pinprick sensation and proprioception sense. Results: Of the 100 subjects, 63% had neuropathic symptoms and signs and 20% had possible symptomatic sensory polyneuropathy. Subjects with polyneuropathy complained of more postural instability and giddiness and distal weakness. Diabetes mellitus was associated with the presence of neuropathic symptoms and signs but not with polyneuropathy. Age was signifi cantly associated with polyneuropathy. Conclusion: The frequency of symptomatic sensory polyneuropathy in a group of elderly subj

The concept of empathy was examined in the professional caregiving relationship and its application was extended to the context of informal caregiving. Using the Lazarus and Folkman model. the influence of empathy on the caregiver's experience in the caregiving relationship was illustrated. The effects of the caregiver's empathy on his/her own caregiving outcomes were investigated by examining the relationship between empathy and burnout experience and life satisfaction. Empathy increased emotional exhaustion while increased personal accomplishment and personalization. indicating conflicting relationship between empathy and burnout. This conflict relationship between empathy and burnout can be explained by suggesting the distinct roles of two dimensions of empathy: emotional and caregiving context and to examine the definite roles of two dimensions of empathy were suggested.
Empathy* ; Humans ; Professional Practice*

Postoperative epidural hematoma (EDH) usually present with neurological deficit. Massive EDH presenting with only severe pain without neurological deficit are rare. Atypical presentations of postoperative EDHs may lead to delayed diagnosis and treatment. We present three such cases after posterior cervical spine surgery. Three patients presented with severe neck pain and spasms without motor deficits several days after posterior cervical decompressive procedures. Imaging studies identified compressive EDHs at the surgical site with severe compression of the spinal cord. All were treated with emergent decompression, with resulting improvement of symptoms and pain relief without further neurological sequelae. In conclusion, postoperative EDHs after posterior cervical spine surgery may result in minimal neurological deficit. Our report reminds surgeons to keep this possibility in mind when patients complain of unusually severe neck pain and spasms after posterior cervical spine surgery.
Decompression ; Delayed Diagnosis ; Hematoma* ; Humans ; Neck Pain* ; Neck* ; Postoperative Complications ; Spasm ; Spinal Cord ; Spine*