54 resultados para Disorientation
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We describe a patient with a topographical disorientation after a stroke of the right mediotemporooccipital lobe including the parahippocampal cortex (PHC). Clinical observations and neuropsychological testing reveal an impairment of allocentric spatial representations as well as impairments of visuospatial learning and memory. These findings are in accordance with the well-known function of the PHC in topographical disorientation. As a new finding, results from oculomotor tasks show additional impairments of the egocentric spatial coordinate frame suggesting that in topographical disorientation due to a lesion of the right mediotemporooccipital lobe not only allocentric but also egocentric visuospatial functions are disturbed.
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The progressive ageing of population has turned the mild cognitive impairment (MCI) into a prevalent disease suffered by elderly. Consequently, the spatial disorientation has become a significant problem for older people and their caregivers. The ambient-assisted living applications are offering location-based services for empowering elderly to go outside and encouraging a greater independence. Therefore, this paper describes the design and technical evaluation of a location-awareness service enabler aimed at supporting and managing probable wandering situations of a person with MCI. Through the presence capabilities of the IP multimedia subsystem (IMS) architecture, the service will alert patient's contacts if a hazardous situation is detected depending on his location. Furthermore, information about the older person's security areas has been included in the user profile managed by IMS. In doing so, the service enabler introduced contribute to “context-awareness” paradigm allowing the adaptation and personalization of services depending on user's context and specific conditions or preferences.
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The aim of this research was to examine the nature and order of recovery of orientation and memory functioning during Post-Traumatic Amnesia (PTA) in relation to injury severity and PTA duration. The Westmead PTA Scale was used across consecutive testing days to assess the recovery of orientation and memory during PTA in 113 patients. Two new indices were examined: a Consistency-of-Recovery and a Duration-to-Recovery index. a predictable order of recovery was observed during PTA: orientation-to-person recovered sooner and more consistently than the following cluster; orientation-to-time, orientation-to-place, and the ability to remember a face and name. However, the type of memory functioning required for the recall face and name task recovered more consistently than that required for memorizing three pictures. An important overall finding was that the order-of-recovery'' of orientation and memory functioning was dependent upon both the elapsed days since injury, and the consistency of recovery. The newly developed indices were shown to be a valuable means of accounting for differences between groups in the elapsed days to recovery of orientation and memory. These indices also clearly increase the clinical utility of the Westmead PTA Scale and supply an objective means of charting (and potentially predicting) patients' recovery on the different components of orientation and memory throughout their period of hospitalization.
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Mestrado em Medicina Nuclear.
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This paper presents and describes the first confirmed occurrence of the Yellow-crowned Night Heron Nyctanassa violacea in the Azores, which also represents the first record for Europe and the Western Palearctic. We also present and discuss subsequent reports of the species in Macaronesia. Several hypotheses may help to explain the occurrence of this species in this part of the Atlantic, including disorientation caused by strong winds and increasing observation pressure. However, further studies are necessary to assess the part played by the different factors in the occurrence of new vagrant individuals/species in Macaronesia.
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Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Electrotécnica e de Computadores
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Inhalation injuries are currently the factor most responsible for mortality in thermally injured patients. Inhalation injuries may occur independently, but generally occur together with skin burn. Smoke inhalation affects all levels of the respiratory system and the extent of the inhalation injury depends on the duration, exposure, amount and toxicity of the fume temperature, concentration and solubility of toxic gases, the occurrence of the accident in a closed space and pre-existing diseases. Smoke inhalation also induces changes in the systemic organs with the need for more fluid for resuscitation. Systemic vasoconstriction, with an elevation in systemic vascular resistance, a fall in myocardial contractility and a great increase in lymphatic flow in soft tissue are the most important changes in systemic organs. On admission of a burn patient there is a high suspicion of inhalation injury when there are signs and symptoms such as hoarseness, strides, dyspnea, carbonaceous sputum, anxiety or disorientation, with or without face burns. The patient with these findings has partial airway obstruction and there is substantial risk complete airway obstruction occurring of secondary to the edema. Patients with suspected inhalation injury should be intubated so as to maintain airway patency and avoid a total obstruction. This group of patients frequently develop respiratory failure with the need for mechanical ventilatory support. Nosocomial infections, sepsis and multiple organ system failure may occur. Late complications of inhalation injury are tracheitis, tracheal stenosis or tracheomalacia and chronic airway disease, which is relatively rare. Early diagnosis of inhalation injury and treatment in a Burn Unit by a group of highly motivated clinicians and a good team of nurses is essential in order to decrease the morbidity and mortality related to inhalation injury.
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A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.
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Dissertação para obtenção do Grau de Mestre em Engenharia Química e Bioquímica
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The voices of Cape Verdean migrant student mothers in Portugal are examined in the light of Archer’s (2003) theory on the ‘inner dialogue’. The article frames the mothers as complex social actors who respond to the uncertainties surrounding unplanned pregnancy through self-reflection and dialogue with and about the world, turning the disorientation of unexpected motherhood into a meaningful project. The analysis reveals how the women’s agency is located within the wider influences of kinship and gender norms and how these are already negotiated in the case of unconfirmed pregnancy.
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A 57-year-old male with no family history was diagnosed with semantic dementia. He also showed some unusual cognitive features such as episodic memory and executive dysfunctions, spatial disorientation, and dyscalculia. Rapidly progressive cognitive and physical decline occurred. About 1.5 years later, he developed clinical features of a corticobasal syndrome. He died at the age of 60. Brain autopsy revealed numerous 4R-tau-positive lesions in the frontal, parietal and temporal lobes, basal ganglia, and brainstem. Neuronal loss was severe in the temporal cortex. Such association of semantic dementia with tauopathy and corticobasal syndrome is highly unusual. These findings are discussed in the light of current knowledge about frontotemporal lobar degeneration.
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We report a case of delusion characterized by a time disorientation with a constant three days advance. Five years previously, the patient had suffered a left hemisphere stroke with aphasia. The delusional belief appeared at the same time as a cortical deafness following a second right hemisphere infarction. There was severe behaviour disturbances which lasted seven months, then cleared without any other change in the clinical picture. The lesions involved the left parietal lobe as well as the temporal and insular regions of both hemispheres.
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Introduction: The coexistence of different molecular types of classical protease-resistant prion protein in the same individual have been described, however, the simultaneous finding of these with the recently described protease-sensitive variant or variably protease-sensitive prionopathy has, to the best of our knowledge, not yet been reported. Case presentation: A 74-year-old Caucasian woman showed a sporadic Creutzfeldt-Jakob disease clinical phenotype with reactive depression, followed by cognitive impairment, akinetic-rigid Parkinsonism with pseudobulbar syndrome and gait impairment with motor apraxia, visuospatial disorientation, and evident frontal dysfunction features such as grasping, palmomental reflex and brisk perioral reflexes. She died at age 77. Neuropathological findings showed: spongiform change in the patient"s cerebral cortex, striatum, thalamus and molecular layer of the cerebellum with proteinase K-sensitive synaptic-like, dot-like or target-like prion protein deposition in the cortex, thalamus and striatum; proteinase K-resistant prion protein in the same regions; and elongated plaque-like proteinase K-resistant prion protein in the molecular layer of the cerebellum. Molecular analysis of prion protein after proteinase K digestion revealed decreased signal intensity in immunoblot, a ladder-like protein pattern, and a 71% reduction of PrPSc signal relative to non-digested material. Her cerebellum showed a 2A prion protein type largely resistant to proteinase K. Genotype of polymorphism at codon 129 was valine homozygous. Conclusion: Molecular typing of prion protein along with clinical and neuropathological data revealed, to the best of our knowledge, the first case of the coexistence of different protease-sensitive prion proteins in the same patient in a rare case that did not fulfill the current clinical diagnostic criteria for either probable or possible sporadic Creutzfeldt-Jakob disease. This highlights the importance of molecular analyses of several brain regions in order to correctly diagnose rare and atypical prionopathies
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Asentotaju kuvaa ihmisen kykyä määrittää oma asento maanpintaan nähden. Maanpinnalla asentotaju on helppo säilyttää, mutta kun ihminen on ilmassa kolmiulotteisessa ympäristössä, g-voimien alaisuudessa, pilvessä, sumussa, sateessa tai pimeydessä, on asentotajun hallinta huomattavasti vaikeampaa. Ilmassa ihmisen aistit saattavat antaa ohjaajalle virheellisiä harha-aistimuksia. Aistiharhoista johtuva asentotajun menettäminen (SD = spatial disorientation) on merkittävä riski ilmailussa. Se aiheuttaa maailmassa vuosittain lentoonnettomuuksia, joista 90 % on fataaleja. Tutkimus on laadullinen tutkimus ja tutkimusmetodina käytettiin dokumenttianalyysiä. Tutkimuksessa pyrittiin eri dokumenttien, kirjallisuuden, aikaisempien tutkimusten ja omien kokemusten pohjalta vastaamaan seuraaviin pää- ja alaongelmiin: Miten asentotajun säilyttämistä vaativissa olosuhteissa voidaan harjoitella? Millaisia tuloksia asentotajukoulutuksella on saavutettu? Miten ja millaisella koulutusohjelmalla Suomen ilmavoimien tulisi aloittaa asentotajukoulutus? Tutkimuksessa selvitettiin sotilaslentäjän toimintakyvyn ja ilmailufysiologian kautta asentotajun muodostumista, eri aistiharhoja ja niiden syntymekanismeja. Tutkimus antaa viitteitä siitä, että asentotajukoulutuksen avulla voidaan parantaa ohjaajan asentotajun hallintaa. Tutkimuksessa pyrittiin asentotajukoulutuksen vaatimusten pohdinnan kautta myös selvittämään, mikä on tehokkain tapa kouluttaa ohjaajien asentotajun hallintaa. Tutkimuksessa perehdyttiin tarkemmin Alankomaiden ja Iso-Britannian ilmavoimien antamaan asentotajukoulutukseen. Tutkimuksessa suunniteltiin em. maiden ilmavoimien asentotajukoulutuksesta saatujen havaintojen ja kokemusten pohjalta Suomen ilmavoimille muutamia asentotajukoulutusvaihtoehtoja.
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El artículo del profesor Mario Caciagli es un aporte pertinente al estudio de las instituciones electorales comparadas, tanto por el segmento temporal de su estudio —cuyo punto de partida es el hecho histórico de la caída del muro de Berlín, evento importante no solo para el mundo alemán, sino también para Occidente— como por la exposición sistemática de los diferentes frentes de valoración de la actividad partidista y del comportamiento de las agrupaciones políticas alemanas en los comicios ocurridos desde la unificación. Las referencias a los antecedentes inmediatos —esto es, la compleja recomposición de Alemania como país después de la Segunda Guerra Mundial— aparecen como complemento y soporte ineludible, pero en una discreta penumbra que no resta luz al período de análisis."-- Roballo Lozan, Julio