911 resultados para signs and symbols


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Parkinson's disease (PD) is a common disorder of middle-aged and elderly people, in which there is degeneration of the extra-pyramidal motor system. In some patients, the disease is associated with a range of visual signs and symptoms, including defects in visual acuity, colour vision, the blink reflex, pupil reactivity, saccadic and smooth pursuit movements and visual evoked potentials. In addition, there may be psychophysical changes, disturbances of complex visual functions such as visuospatial orientation and facial recognition, and chronic visual hallucinations. Some of the treatments associated with PD may have adverse ocular reactions. If visual problems are present, they can have an important effect on overall motor function, and quality of life of patients can be improved by accurate diagnosis and correction of such defects. Moreover, visual testing is useful in separating PD from other movement disorders with visual symptoms, such as dementia with Lewy bodies (DLB), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Although not central to PD, visual signs and symptoms can be an important though obscure aspect of the disease and should not be overlooked.

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Progressive supranuclear palsy (PSP) is a rare, degenerative disorder of the brain believed to affect between 1.39 and 6.6 individuals per 100,000 of the population. The disorder is likely to be more common than suggested by these data due to difficulties in diagnosis and especially in distinguishing PSP from other conditions with similar symptoms such as multiple system atrophy (MSA), corticobasal degeneration (CBD), and Parkinson’s disease (PD). PSP was first described in 1964 by Steele, Richardson and Olszewski and originally called Steele-Richardson-Olszewski syndrome. The disorder is the second commonest syndrome in which the patient exhibits ‘parkinsonism’, viz., a range of problems involving movement most typically manifest in PD itself but also seen in PSP, MSA and CBD. Although primarily a brain disorder, patients with PSP exhibit a range of visual clinical signs and symptoms that may be useful in differential diagnosis. Hence, the present article describes the general clinical and pathological features of PSP, its specific visual signs and symptoms, discusses the usefulness of these signs in differential diagnosis, and considers the various treatment options.

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There are two aspects of PD of particular interest to optometrists. First, PD patients can develop a range of visual problems including those affecting eye movement, pupillary function, and in complex visual functions involving the ability to judge distance or make out the shape of an object. Second, the symptoms of PD can be treated successfully using a variety of drugs, some of which have significant ocular adverse reactions (OAR). This article describes the general features of PD, the dopamine neurotransmitter system and its relevance to eye symptoms, the visual symptoms reported in PD, and the OAR that have been reported.

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Progressive supranuclear palsy is a rare, degenerative brain disorder and the second most common syndrome in which the patient exhibits 'parkinsonism', that is, a variety of symptoms involving problems with movement. General symptoms include difficulties with gait and balance; the patient walking clumsily and often falling backwards. The syndrome can be difficult to diagnose and visual signs and symptoms can help to separate it from closely related movement disorders such as Parkinson's disease, multiple system atrophy, dementia with Lewy bodies and corticobasal degeneration. A combination of the presence of vertical supranuclear gaze palsy, fixation instability, lid retraction, blepharospasm and apraxia of eyelid opening and closing may be useful visual signs in the identification of progressive supranuclear palsy. As primary eye-care practitioners, optometrists should be able to identify the visual problems of patients with this disorder and be expected to work with patients and their carers to manage their visual welfare.

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Multiple system atrophy (MSA) is a rare movement disorder and a member of a group of neurodegenerative diseases, which include Parkinson’s disease (PD) and progressive supranuclear palsy (PSP), and referred to as the ‘parkinsonian syndromes’. Although primarily a neurological disorder, patients with MSA may also develop visual signs and symptoms that could be useful in differential diagnosis. In addition, the eye-care practitioner may contribute to the management of visual problems of MSA patients and therefore, help to improve quality of life. This second article in the series considers the visual signs and symptoms of MSA with special reference to those features most useful in differential diagnosis of the parkinsonian syndromes.

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Dementia with Lewy bodies ('Lewy body dementia' or 'diffuse Lewy body disease') (DLB) is the second most common form of dementia to affect elderly people, after Alzheimer's disease. A combination of the clinical symptoms of Alzheimer's disease and Parkinson's disease is present in DLB and the disorder is classified as a 'parkinsonian syndrome', a group of diseases which also includes Parkinson's disease, progressive supranuclear palsy, corticobasal degeneration and multiple system atrophy. Characteristics of DLB are fluctuating cognitive ability with pronounced variations in attention and alertness, recurrent visual hallucinations and spontaneous motor features, including akinesia, rigidity and tremor. In addition, DLB patients may exhibit visual signs and symptoms, including defects in eye movement, pupillary function and complex visual functions. Visual symptoms may aid the differential diagnoses of parkinsonian syndromes. Hence, the presence of visual hallucinations supports a diagnosis of Parkinson's disease or DLB rather than progressive supranuclear palsy. DLB and Parkinson's disease may exhibit similar impairments on a variety of saccadic and visual perception tasks (visual discrimination, space-motion and object-form recognition). Nevertheless, deficits in orientation, trail-making and reading the names of colours are often significantly greater in DLB than in Parkinson's disease. As primary eye-care practitioners, optometrists should be able to work with patients with DLB and their carers to manage their visual welfare.

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Multiple system atrophy (MSA) is a rare movement disorder and a member of the 'parkinsonian syndromes', which also include Parkinson's disease (PD), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB) and corticobasal degeneration (CBD). Multiple system atrophy is a complex syndrome, in which patients exhibit a variety of signs and symptoms, including parkinsonism, ataxia and autonomic dysfunction. It can be difficult to separate MSA from the other parkinsonian syndromes but if ocular signs and symptoms are present, they may aid differential diagnosis. Typical ocular features of MSA include blepharospasm, excessive square-wave jerks, mild to moderate hypometria of saccades, impaired vestibular-ocular reflex (VOR), nystagmus and impaired event-related evoked potentials. Less typical features include slowing of saccadic eye movements, the presence of vertical gaze palsy, visual hallucinations and an impaired electroretinogram (ERG). Aspects of primary vision such as visual acuity, colour vision or visual fields are usually unaffected. Management of the disease to deal with problems of walking, movement, daily tasks and speech problems is important in MSA. Optometrists can work in collaboration with the patient and health-care providers to identify and manage the patient's visual deficits. A more specific role for the optometrist is to correct vision to prevent falls and to monitor the anterior eye to prevent dry eye and control blepharospasm.

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Corticobasal degeneration is a rare, progressive neurodegenerative disease and a member of the 'parkinsonian' group of disorders, which also includes Parkinson's disease, progressive supranuclear palsy, dementia with Lewy bodies and multiple system atrophy. The most common initial symptom is limb clumsiness, usually affecting one side of the body, with or without accompanying rigidity or tremor. Subsequently, the disease affects gait and there is a slow progression to influence ipsilateral arms and legs. Apraxia and dementia are the most common cortical signs. Corticobasal degeneration can be difficult to distinguish from other parkinsonian syndromes but if ocular signs and symptoms are present, they may aid clinical diagnosis. Typical ocular features include increased latency of saccadic eye movements ipsilateral to the side exhibiting apraxia, impaired smooth pursuit movements and visuo-spatial dysfunction, especially involving spatial rather than object-based tasks. Less typical features include reduction in saccadic velocity, vertical gaze palsy, visual hallucinations, sleep disturbance and an impaired electroretinogram. Aspects of primary vision such as visual acuity and colour vision are usually unaffected. Management of the condition to deal with problems of walking, movement, daily tasks and speech problems is an important aspect of the disease.

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Purpose: To compare signs and symptoms of dry eye in keratoconus (KC) patients versus healthy subjects. Methods: A total of 15 KC patients (KC group, n = 15 eyes) and 16 healthy subjects (control group, 16 eyes) were enrolled in this study. The Schirmer I test with no anesthetic, tear break-up time (TBUT), corneal staining characteristics, and ocular surface disease index (OSDI) scores were evaluated for both groups. Impression cytology, combined with/scanning laser confocal microscopy (LCM), was performed to evaluate goblet cell density, mucin cloud height (MCH), and goblet cell layer thickness (CLT). Finally, tear concentrations of di-adenosine tetraphosphate (Ap4A) were assessed. Results were statistically analyzed using Shapiro–Wilk and non-parametric Wilcoxon rank sum tests. Statistical significance was set at p < 0.05. Results: KC patients had lower tear volumes and greater corneal staining than did healthy subjects (p < 0.05). OSDI scores were 44.96 ± 8.65 and 17.78 ± 6.50 for the KC and control groups, respectively (p < 0.05). We found no statistically significant differences in TBUT between groups. Impression cytology revealed lower goblet cell densities in KC group patients versus control group subjects (84.88 ± 32.98 and 128.88 ± 50.60 cells/mm,2 respectively, p < 0.05). There was a statistically significant reduction in MCH and CLT in KC group patients compared with control group subjects. Ap4A tear concentrations were higher in KC group patients than in control group subjects (2.56 ± 1.10 and 0.15 ± 0.12 µM, respectively, p < 0.05). Conclusions: The parameters evaluated in this study indicate that KC patients suffer greater symptoms of dry eye and greater tear instability, primarily due to the decreased mucin production in their tears, than do healthy patients with no KC.

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Background: Poisoning accounts for about 7% of all accidents in children under 5 years and is implicated in over 5% of all childhood deaths in developing countries. Objectives: Due to the potential risks of methadone poisoning in children and increased cases of methadone poisoning among Iranian children, this study was conducted to investigate the clinical signs and symptoms and laboratory findings of methadone toxicity in children. Patients and Methods: The present retrospective, descriptive, cross-sectional study describes the clinical symptoms and signs and laboratory findings of methadone poisoning in children under 12 years old in Shahid Beheshti Hospital, Kashan, during the years 2009 to 2013. Results: Of 58 patients, 33 (56.9%) were male and 25 (43.1%) female (P = 0.294). The mean age of patients was 5.2 ± 1.0 years. All the cases of poisoning happened with methadone syrup, due to unsafe keeping of methadone in mineral water bottles and containers of other drugs. Signs and symptoms included drowsiness (91.4 %), miosis (75.9%), vomiting (69.0%), ineffective breathing (any kind of breathing problem except apnea) (62.1%), apnea (53.4%), cyanosis (43.1%), seizure (8.6%), ataxia (6.9%) and delirium (3.4%). Conclusions: Keeping methadone in appropriate containers and warning methadone consumers about the dangerous side effects of its consumption and the symptoms of methadone poisoning in children may minimize the occurrence of this form of poisoning and its complications in children.

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This paper addresses how, since the 1960s to the present, part of women's video art has broken the traditional representation of women’s body and proposed new forms of recording women's images, explicit or symbolic, using body part close-ups, and not sparing any efforts to ensure the prevention of the cataloguing of women’s bodies according to normative categories, such as gender, race and age, and in this way challenging the Western representation codes that objectify women. The methodology employed had as its primary purpose the examination of the association existing between the micro-sociological level of body gestures and performances in women's videos and the macro-sociological level of social forces such as the dimensions of gender and sexuality. This study concluded that narratives of identity and self-determination are present in women's video pieces contributing to women's empowerment through visual discourses that could possibly point to the production of new signs and symbols, new values and models, but also for the formation of new types of social roles and even a new type of interpersonal relationships.

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Abstract (Mig or mej, själ or sjel? Problems and solutions in the transcription of Swedish song texts): In this article I am pointing out and discussing problems and solutions concerning phonetic transcription of Swedish song texts. My material consists of 66 Swedish songs phonetically transcribed. The transcriptions were published by The Academy of Finnish Art Song in 2009. The first issue was which level of accuracy should be chosen. The transcriptions were created to be clear at a glance and suitable for the needs of interpretation of non Swedish speaking singers. The principle was to use as few signs and symbols as possible without sacrificing accuracy. Certain songs were provided with additional information whenever there was a chance of misinterpretation. The second issue was which geographic variety of the language should be visible in the transcription, Standard Swedish or Finland-Swedish? The songs in the volume are a selection of well-known works that are also of international interest. Most were composed by Jean Sibelius (1865–1957), a substantial number of whose songs were based on poems written by Finland’s national poet, Johan Ludvig Runeberg (1804–1877). Thus I chose to use the variety of Swedish language spoken in Finland, in order to reflect the cultural origin of the songs. This variety differs slightly from the variety spoken in Sweden both on prosodic and phonetic level. In singing, the note-text gives the interpretor enough information about prosody. The differences concern mostly the phonemes. A fully consequent transcript was, however, difficult to make, due to vocal requirement. So, for example, in an unstressed final syllable the vowel was often indicated as a central vowel, which in singing is given a more direct emphasis than in a literal pronunciation, even if this central vowel does not occur in spoken Finland-Swedish.

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Este trabalho busca principalmente reconhecer o que considera ser a dimensão sistemática do pensamento de Paul Ricoeur, fundada, como se acredita, na concepção da consciência como tarefa. Procura outrossim compreender os pressupostos ontológicos e metodológicos de seu pensamento. Pretende mostrar também que, ao perseguir uma simbólica dos sentidos múltiplos, a reflexão concreta de Ricoeur integra, a partir do que ele chama dom da linguagem, o logos filosófico, a episteme que virou ciência e a riqueza pré-filosófica do símbolo. Sua hermenêutica filosófica busca a compreensão do si, da reflexão sobre si mesmo, através da interpretação aplicada sobre os signos e símbolos de uma consciência que não se sabe no princípio, mas ao cabo do desvio de suas obras e de seus atos. A reflexão é a reapropriação daquilo que se é a partir do que é dito a si mesmo pelos signos e símbolos da cultura e das tradições. Paul Ricoeur é apresentado ainda como crítico da consciência imediata e narcísica. Ele constrói seu percurso intelectual de sorte a arbitrar o conflito das diversas interpretações que versam sobre o simbolismo humano. Este trabalho procura mostrar finalmente que o filósofo propõe de fato um novo percurso para a reflexão, através de uma démarche em dois tempos, em que o pensamento reflexivo se desapossa do imediatismo da consciência falsa e comum, para posteriormente se reapropriar das significações mais profundas manifestadas em nosso esforço para existir e nutridas pelo nosso desejo de ser. Eis a trajetória histórica e exemplar que esta dissertação busca evidenciar.

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Ponce comenta y reflexiona en torno a la quinta novela del escritor Francisco Proaño Arandi, El sabor de la condena, publicada en Quito en 2009 por Editorial El Conejo. Se establecen algunas de las claves que configuran esta historia en la que Proaño vuelve a poner en escena las obsesiones que cruzan por sus otras experiencias novelescas. Los personajes, Javier y Male, se mueven en un juego de signos y símbolos que le permiten al lector acceder al misterio que constituye sus vidas, que es un tejido de interrogantes y apariencias continuas. Como en gran parte de sus ficciones, en esta el mundo está reducido a una casa y a una ciudad enigmática y hechizante como Quito, que vuelve a convertirse en referente central. Proaño, al decir de Ponce, es fiel a su estilo y a esa concepción de lo narrativo que se bate entre lo denso y lo moroso, que en él ya es clásica.