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Reanimating hand function after spinal cord injury using nerve transfer surgery 神经移植手术恢复脊髓损伤后的手部功能
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-03-01 DOI: 10.47795/CQZF2655
M. Galea, A. Messina, B. Hill, C. Cooper, Jodie Hahn, Natasha van Zyl
Loss of arm and hand function is a devastating consequence of cervical spinal cord injury. Tendon transfer surgery has traditionally been used to restore key functions including elbow extension, wrist extension and grasp and pinch. The more recent development of nerve transfer surgery enables direct restoration of voluntary control of these functions. While both types of surgery are safe and effective, nerve transfer surgery results in a more open, flexible and natural hand, with more subtle control for a range of activities of daily living.
手臂和手部功能的丧失是颈脊髓损伤的毁灭性后果。肌腱转移手术传统上用于恢复关键功能，包括肘部伸展、手腕伸展、抓握和捏夹。神经转移手术的最新发展使得能够直接恢复对这些功能的自愿控制。虽然这两种类型的手术都是安全有效的，但神经转移手术可以使手部更加开放、灵活和自然，对日常生活的一系列活动有更微妙的控制。
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引用次数: 0
Sleep Drivers 睡眠的司机
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-03-01 DOI: 10.47795/opws3033
Clara Bolton, K. Anderson
Driving while sleepy can have devastating consequences, but it is an under-recognised problem often associated with behavioural factors, medical conditions or medications. All drivers have a responsibility not to drive if sleepy and there are DVLA regulations restricting driving for patients with certain sleep disorders who are at risk of excessive sleepiness at the wheel. However, sleepiness can be difficult for patient and doctor to assess and guidelines open to interpretation. As doctors it is important we give consistent and reliable advice to patients who may be at risk when driving. This review suggests how to assess driving risk, educate patients about risk reduction, and clarifies DVLA guidelines in this area.
在困倦时开车可能会造成毁灭性的后果，但这是一个未被认识到的问题，通常与行为因素、医疗条件或药物有关。所有司机都有责任在困倦的情况下不开车，而且有DVLA规定限制患有某些睡眠障碍的患者开车，这些患者在开车时有过度困倦的风险。然而，睡意对病人和医生来说很难评估，指导方针也有不同的解释。作为医生，重要的是我们要给那些在开车时可能有危险的病人提供一致和可靠的建议。本综述建议如何评估驾驶风险，教育患者如何降低风险，并阐明该领域的DVLA指南。
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引用次数: 0
The fatal illness of Oscar Wilde 奥斯卡·王尔德的绝症
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-02-03 DOI: 10.47795/yffo2946
J. Pearce
The literary genius of Oscar Wilde has been sullied and besmirched by his infamous entanglement with Lord Alfred Douglas for “gross indecency” leading to his subsequent imprisonment for two years. After release he developed what was certified as “cerebral meningitis” in November 1900, from which he died. The much disputed cause is discussed. The claims for neurosyphilis are wholly inadequate; a chronic middle ear infection with cholesteatoma and intracranial suppuration is here suggested as the basis of his fatal illness. Had he lived in the 21st century Oscar Wilde would not have been so cruelly punished, may have received effective treatment, and thus been spared to provide much more of his wit and elegant plays, stories and poetry.
文学天才奥斯卡·王尔德与阿尔弗雷德·道格拉斯勋爵因“严重猥亵”而臭名昭著的纠缠，导致他随后入狱两年，这玷污了他的名誉。出狱后，他于1900年11月患上了经证实为“脑膜炎”的疾病，并因此去世。讨论了争议很大的原因。神经梅毒的说法是完全不充分的;慢性中耳感染合并胆脂瘤和颅内化脓是他致命疾病的基础。如果奥斯卡·王尔德生活在21世纪，他就不会受到如此残酷的惩罚，可能会得到有效的治疗，从而得以创作出更多他的智慧和优雅的戏剧、故事和诗歌。
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引用次数: 0
Cerebral malaria and the story of Quinine and the Fever Trees 脑疟疾和奎宁和发烧树的故事
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-02-03 DOI: 10.47795/zikj9076
J. Pearce
Cinchona bark was first recorded as a cure for malaria by the Spanish in Peru around 1630. A Spanish missionary allegedly learned of the treatment from the Indian natives. Cerebral malaria caused by Plasmodium falciparum is life threatening and one of the commonest encephalopathies in the world. Quinine was the first effective treatment, discovered in the bark of quina-quina, cinchona, ‘the fever tree’ in Peru in 1633. Many tales – many fanciful – relate to its early use. Foremost of the discoverers in 1735 was a group of French scientists in an expedition to Peru directed by the Parisian Academie Royale des Sciences. It was then widely exported and employed in Spain, Italy and Britain to become the standard treatment.
金鸡纳树皮在1630年左右被西班牙人首次记录为治疗疟疾的药物。据说，一名西班牙传教士从印第安人那里得知了这种待遇。由恶性疟原虫引起的脑疟疾威胁生命，是世界上最常见的脑病之一。奎宁是第一个有效的治疗方法，于1633年在秘鲁的“发烧树”quina-quina树皮中发现。许多传说——许多奇思妙想——都与它的早期使用有关。1735年，一群法国科学家在巴黎皇家科学院的指导下前往秘鲁探险，他们是最早的发现者。随后，它被广泛出口，并在西班牙、意大利和英国使用，成为标准的治疗方法。
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引用次数: 0
Arnold's Nerve 阿诺德的神经
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-02-01 DOI: 10.47795/rump8417
Jms Pearce
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引用次数: 1
Pellagra: 4 D's and 8 Points. 糙皮病4 个 D 和 8 个点
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-01-01 DOI: 10.47795/FBFD9966
Adrian Williams

Pellagra has largely been forgotten. This is unfortunate as important lessons are to be learnt for the diseases and social consequences of poverty (and of affluence) that often involve dietary nicotinamide and nicotinamide adenine dinucleotide (NAD) homeostasis. NAD disruption can occur not only from poor diet but from increased consumption of NAD from genotoxic and other stresses. High doses of nicotinamide lead to inhibition of NAD-consuming enzymes and excessive induction of nicotinamide-n-methyl transferase (NNMT) with consequent effects on the methylome giving a mechanism for a new hypervitaminosis-B3.

糙皮病在很大程度上已被人们遗忘。这是令人遗憾的，因为我们可以从贫困（和富裕）带来的疾病和社会后果中汲取重要的经验教训，这些疾病和社会后果往往涉及膳食中的烟酰胺和烟酰胺腺嘌呤二核苷酸（NAD）平衡。NAD 失调不仅可能是饮食不当造成的，也可能是基因毒性和其他压力导致 NAD 消耗量增加造成的。高剂量的烟酰胺会导致抑制消耗 NAD 的酶和过度诱导烟酰胺-甲基转移酶（NNMT），从而对甲基组产生影响，这就是新的维生素 B3 过多症的机制。
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引用次数: 0
Pourfour Du Petit and the cervical sympathetic nerves 第四杜佩蒂和颈交感神经
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2020-01-01 DOI: 10.47795/layq8071
Pearce Jms
François Pourfour du Petit (1664-1741) was a Parisian experimental Neuroanatomist, and Ophthalmologist. Based on his extensive experiences of brain and spinal injuries as a military doctor in the armies of Louis XIV he performed many animal experiments that demonstrated the anatomy and functional significance of the cervical sympathetic nerves, correcting previous errors of Thomas Willis and Raymond Vieussens. He long predated the descriptions of Horner’s syndrome (1869) when he showed that interruption of sympathetic pathways inactivated both the dilator muscle and produces miosis, and the superior tarsal muscle, which produces ptosis and enophthalmos. This was later elaborated by Hare, Weir Mitchell and Claude Bernard.
francois Pourfour du Petit(1664-1741)是巴黎的实验神经解剖学家和眼科医生。作为路易十四军队的一名军医，他在脑部和脊柱损伤方面有丰富的经验，他进行了许多动物实验，证明了颈部交感神经的解剖和功能意义，纠正了托马斯·威利斯和雷蒙德·维耶森斯之前的错误。早在霍纳综合征(1869年)出现之前，他就指出，交感神经通路的中断会使扩张肌和跗骨上肌失活，从而产生缩窄症和睑下垂和眼球内陷。后来由海尔、威尔·米切尔和克劳德·伯纳德详细阐述。
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引用次数: 0
An expert opinion: Optimisation of pharmacological management of multiple sclerosis related spasticity 专家意见:优化多发性硬化症相关痉挛的药物管理
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2019-10-01 DOI: 10.47795/kaib7737
R. Farrell, D. Baker
Spasticity is a frequent symptom in people with Multiple Sclerosis. Whilst many respond to first-line therapies it is estimated that 30-40% will have suboptimal treatment response requiring more specialised management. Such strategies include combination of oral medications, botulinum toxin, nabiximols and consideration of intrathecal therapies; baclofen or phenol. Early expert intervention as outlined in this review can have a positive impact on functional ability and quality of life for people with MS.
痉挛是多发性硬化症患者的常见症状。虽然许多人对一线治疗有反应，但估计有30-40%的治疗反应不理想，需要更专业的管理。这些策略包括联合口服药物、肉毒杆菌毒素、纳比西米和考虑鞘内治疗;巴氯芬或苯酚。本综述中概述的早期专家干预可以对MS患者的功能能力和生活质量产生积极影响。
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引用次数: 0
Choked disc, optic neuritis, and papilloedema 椎间盘阻塞，视神经炎，乳头状水肿
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2019-07-30 DOI: 10.47795/ysmn1469
Jms Pearce
Before the invention of the ophthalmoscope in 1851, doctors were neither able to recognise papilloedema nor to diagnose accurately intracranial hypertension, malignant hypertension and inflammatory and systemic disorders affecting the optic fundus. This paper seeks to uncover early descriptions and experiments that tried to unravel the causes of the swollen optic disc, its mechanism and its clinical significance. Papilloedema is a purely descriptive name that requires the underlying cause to be specified.
在1851年检眼镜发明之前，医生既不能识别乳头状水肿，也不能准确诊断颅内高压、恶性高血压和影响视眼底的炎症和全身性疾病。本文旨在揭示早期的描述和实验，试图解开视盘肿胀的原因，其机制和临床意义。乳头状水肿是一个纯粹的描述性名称，需要明确根本原因。
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引用次数: 0
The Myotonic (Holmes Adie) pupil 肌强直瞳孔
Advances in Clinical Neuroscience Rehabilitation
Pub Date : 2019-05-29 DOI: 10.47795/mxli5114
J. Pearce
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引用次数: 0
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