91 research outputs found
Transkraniaalne aju ultraheliuuring Eesti parkinsoni tõve haigetel
No full textVäitekirja elektrooniline versioon ei sisalda publikatsiooneEestis läbiviidud uurimustöö eesmärgiks oli näidata aju ultraheli uuringu abil Parkinsoni tõve korral tekkivaid muutusi keskajus asuvas musttuumas, mis aitaks seda haigust diagnoosida. Täiendavalt uuriti ka ultraheliuuringu tulemuste seoseid depressiivsete sümptomite esinemisega. Tegemist on innovaatilise meetodiga Parkinsoni tõve diagnoosimiseks, mida Eestis pole varem uuritud. Uuringus osales 300 PT patsienti ja 200 kontrollisikut.
Aju musttuum sisaldab dopamiinirakke, mis Parkinsoni tõvega haigetel haiguse kulu jooksul hävinevad. Läbi kolju tehtava ultraheliuuringu käigus on võimalik mõõta musttuuma piirkonna suurust ja selle kajarikkuse (hüperehhogeensuse) asümmeetria alusel kinnitada Parkinsoni tõve diagnoosi. Uuringul määrati ultraheli diagnostiline väärtus haigete eristamiseks tervetest, mis ühtib varasemalt teistes riikides leitud tulemustega; kõige olulisemaks tulemuse mõjutajaks on vanus. Lisaks näidati erinevust vasaku ja parema ajupoole vahel, mis on seoses esmassümptomite tekkimise poolega.
Lisaks aitab ultraheliuuring kirjeldada depressiivsete sümptomite ilmnemist Parkinsoni tõvega haigetel ajutüves asuvate Raphe tuumade ehhogeensuse esinemise põhjal. Raphe tuumad osalevad virgatsaine serotoniini tootmisel, mille vähenemisel kahjustuse korral võivad tekkida depressiooni sümptomid. Uuring näitas, et ultraheli uuring võimaldab hinnata Raphe tuumade terviklikkust ja on hea meetod varjatud depressiooni sümptomite väljaselgitamiseks.
Läbiviidud uuring oli esimene ulatuslik aju ultraheliuuring Eestis, mis kinnitas ultraheliuuringu diagnostilist väärtust Parkinsoni tõve diagnoosimiseks. Lisaks teaduslikule väärtusele on sellel oluline kliiniline tähtsus seoses uue meetodi rakendamisega Parkinsoni tõve käsitluses.The aim of the research carried out in Estonia was to show by transcranial brain sonography the changes in Parkinson's disease in substantia nigra, which would help diagnose the disease. Transcranial brain sonography is an innovative method for diagnosing Parkinson's disease, which has not been studied in Estonia before.
By sonography examination of the skull, it is possible to measure the size of the substantia nigra echogenicity and confirm the diagnosis of Parkinson's disease on the basis of its asymmetry in substantia nigra hyperechogenicity. The study determined the diagnostic value of SN+ to distinguish patients from healthy ones, which is consistent with the results previously found in other countries. There was a difference between the left and right sides of the SN+ that are related to the onset of the Parkinson’s disease initial symptoms. In addition, age was the most important factor influencing the asymmetry of SN+.
The ultrasound study helps to describe the appearance of depressive symptoms in PD patients based on the occurrence of echogenicity of Raphe nuclei in the brainstem. The study showed that the transcranial brain sonography examination provides an estimate of the integrity of the Raphe nuclei and is a good method for detecting the symptoms of hidden depression.
The conducted study was the first extensive transcranial brain sonography study in Estonia confirming the diagnostic value of ultrasound in the diagnosis of Parkinson's disease.
https://www.ester.ee/record=b5250326~S
Treemorid
No full textTreemorite kui ühtede sagedasemate neuroloogilisete motoorikahäirete erinevate vormide ja tremoroossete sündroomide jaotus põhineb valdavalt kliinilistel kriteeriumitel. Kõiki treemori erinevaid põhjusi arvesse võtva konsensusliku otsuse võttis 1998. a vastu rahvusvaheline Ekstrapüramidaal- ja Liigutushäirete Ühing. Käesolev artikkel võtab kokku selle otsuse määratlused ning ravisoovitused erinevate treemori vormide kohta. Kliiniliste kriteeriumite alusel on eristatud järgmised tremoroossed sündroomid: väljendunud füsioloogiline, klassikaline essentsiaalne, ortostaatiline, sooritus-, düstooniline, parkinsonistlik, tserebellaarne, Holmesi, ravimitest ja toksiinidest indutseeritud, neuropaatiline ning psühhogeenne treemor.
Eesti Arst 2008; 87(6):424−43
Toomas Pauli keerulised küsimused
No full textThe difficult questions of Toomas PaulToomas Paul, born in Tartu in 1939, is a prominent theologian,church historian, New Testament scholar and translator, as wellas an essayist, and a member of Academia Scientiarum et ArtiumEuropaea. He took part in the preparation of the Porvoo CommonStatement (1992) and attended the Lutheran-Orthodox Joint Commissionfor 12 years. Paul has published 19 books and countless articles,and still often gets press coverage concerning current problemsin different fields. He is deeply interested in science and culture andhas held a constant dialogue with physicists, neurologists, historiansand other professionals. His sermons, articles, conversations on theradio and TV have always interested different communities due tohis intellectual spirit, wittiness, honesty and broad mental horizon.At the same time, his chosen topics can be uneasy (data leaks, migration,prostitution, etc.), he is equally critical towards totalitarian andconsumer societies, while he even censures some church activities.Paul studied in Tallinn and worked at eight parish churches inthe countryside from 1960 to 1986. From then on he served at StJohn’s Church in the centre of Tallinn, and, since 1989, at SutlepaChapel on the premises of the Estonian Open Air Museum.Among other things, Paul’s connection to Tartu is that his teacherand collaborator Uku Masing (1909–1985), whose legacy he interpretsand publishes to this day in cooperation with Tartu scholars,resided there. Paul received his doctoral degree (1994, on the historyof Bible translation in Estonia) at the University of Tartu and hastaught at and been a member of the Religious Anthropology ProgramCommittee. Rector Volli Kalm, who presented Paul with the NationalThought Award on behalf of the University of Tartu, called Paul acustodian of basic values and stressed his importance in shaping socialmentality. Paul has been awarded many other prizes.In the article, I present biographical data and briefly characterizePaul as a reader and interpreter of theologians and philosophers likeMeister Eckhart or Spinoza, scientists and others, as well as an author. I am also publishing an unique questionnaire that he presentedto his audience already in the 1960s as a young cleric, and outline thedifficult questions about religion he has raised in his publications.I quote other authors and archival sources of the Consistory of theEstonian Evangelical Lutheran Church, adding passages from Paul’spersonal archives and our correspondence to show why he is highlyrecognised in both the religious and secular societies of Estonia
The Main Risk Factors in Type 2 Diabetes for Cognitive Dysfunction, Depression, and Psychosocial Problems: A Systematic Review
No full textThe aim of this study is to analyze the risk factors that lead to cognitive impairment, depression, and psychosocial problems in type 2 diabetes and discern what aspects they have in common. Type 2 diabetes is associated with a higher risk of cognitive impairment, including dementia, which in turn increases the risk of hospitalization, falls, and premature mortality. In this study, we conducted a systematic review to achieve this goal, including searches on electronic databases such as PubMed, Medline, Web of Science, EBSCO Discovery, EBSCO host, Scopus, and ScienceDirect, from 2016 onwards. Additionally, we carried out manual searches in leading journals in the field. After evaluating and analyzing the articles, 60 remained, focusing on the following four main themes: disorders due to biological, psychological, social, and pharmacological causes that lead to neuropsychological complications. Based on the results, consistently analogous risk factors contributing to the onset of cognitive impairments, depression, and psychosocial predicaments encompass comorbid ailments, dysglycemia, gender, heightened levels of apprehension and anxiety, educational attainment, socio-economic standing, and pharmaceutical interventions. Furthermore, in the realm of type 2 diabetes, factors such as disease duration, adiposity, specifically overweight and obesity, and advancing age were also identified as significant contributors to cognitive impairments and depression. Concomitantly, the absence of a robust support system and social network emerged as a shared risk factor, predisposing individuals to psychosocial challenges and depressive states. These findings emphasize that the risk factors for cognitive impairments, depression, and psychosocial issues for type 2 diabetes are similar, highlighting the importance of psychosocial support, education, and patient-centered treatment to optimize outcomes and quality of life
Depression in Parkinson’s disease: prevalence, pharmacological treatment, and association with brainstem raphe echogenicity
No full textrTMS of the DLPFC in patients with Parkinson’s disease and comorbid treatment-resistant depression: a pilot case study
No full textKiire kuluga dementsus, mis osutus Creutzfeldti-Jakobi tõveks: haigusjuhu kirjeldus
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Prioonhaigused on haruldased neurodegeneratiivsed haigused, mis põhjustavad kiire kuluga dementsuse ja lõpevad alati surmaga. Creutzfeldti-Jakobi tõbi kuulub prioonhaiguste hulka ning sellesse haigestub keskmiselt 1 inimene 1 miljoni kohta aastas. Haiguse sümptomid on mittespetsiifilised ja heterogeensed, mistõttu võib õige diagnoosini jõudmine osutuda sageli keeruliseks. Artiklis on kirjeldatud 70aastase naise haigusjuhtu, kes sattus neuroloogiaosakonda peaajuinfarkti kahtlusega. Edasiste uuringute käigus selgus, et patsiendil esineb Creutzfeldti-Jakobi tõvele iseloomulik kliiniline leid. Naine suri 5 kuud pärast hospitaliseerimist. Prioonvalgu määramine ajukoest osutus negatiivseks. Haigusjuht näitab, kui mitmekülgne on kiire kuluga dementsuse tänapäevane käsitlus ning milliseid haigusi ja sündroome tuleb nendel juhtudel kahtlustada. Artiklis on pakutud välja erinevaid diagnoosimisvõimalusi Creutzfeldti-Jakobi tõve elupuhuseks diagnostikaks.
Eesti Arst 2018; 97(4):213–21
Haigusega kohanemist takistavad tegurid ja profiilid 2. tüüpi diabeediga toimetulekul ning nende seosed tüsistustega.
No full textEffective coping with type 2 diabetes is often hindered by insufficient understanding of the disease, its management, associated comorbidities, complications, and mental health chal - lenges. This study aims to identify barriers to adaptation to type 2 diabetes, examine their associations with complications, and characterize patient adaptation profiles to inform tailored management strategies. A cross-sectional sample of 151 outpatients diagnosed with type 2 diabetes was analyzed. Data were collected using the diabetes obstacles questionnaire-30 and analyzed using statistical methods, including latent profile analysis, to identify distinct adaptation profiles and their association with clinical and demographic factors. The mean age at disease onset was 50.39 years (standard deviation (SD) = 11.02), with an average body mass index (BMI) of 32.90 (SD = 6.64) and a mean glycohemoglobin (HbA1c) level of 7.7% (SD = 1.30). Hypertension (78.1%), retinopathy (33.1%), and neuropathy (22.5%) were the most common complications. Patients expressed fear of diagnosis (mean (M) = 2.99, SD = 1.28), high blood sugar readings (M = 3.19, SD = 1.23), and insulin therapy (M = 3.38, SD = 1.30), along with low motivation for physical activity (M = 3.04, SD = 1.30). Four distinct adaptation profiles were identified, influenced by information needs, social support, and the presence of complications such as neuropathy, which significantly affected adaptation. Adaptation to type 2 diabetes varies significantly across patients, influenced by clinical, psychological, and social factors. Identifying and addressing individual barriers – including the need for tailored education, social support, and comorbidity management – is critical. Personalized medicine approaches that integrate these factors can enhance disease adap - tation and improve outcomes, emphasizing the need for holistic and patient-centered care in diabetes management
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