Tremor is one of the most common disorders in the population of patients diagnosed with movement disorders. In the literature we find several classifications and different types of tremors. Each tremor type has its own characteristics. The most frequently used and widely accepted tremor classification divides tremors according to clinical appearance. First, they are roughly divided into resting tremor and action tremor. Action tremor is then subdivided into postural, kinetic, intention, task specific and isometrictremor. Different types of tremor are further combined into tremor syndromes. Causes and mechanisms of tremor are still unclear. Tremor genesis is explained by four hypothetical mechanisms and one of them is assumed to be dominant for each type of tremor. Correct tremor recognition and diagnosis is necessary for appropriate treatment of tremor patients.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 29488345The paper presents psychobiological mechanisms underlying the placebo effect, and research approaches to determining the effect of placebo on the outcome of treatment.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 30495961Objective: The paper describes the use of expert's knowledge in practice and the efficiency of a recently developed technique called argument-based machinelearning (ABML) in the knowledge elicitation process. We are developinga neurological decision support system to help the neurologists differentiate between three types of tremors: Parkinsonian, essential, and mixed tremor (comorbidity). The system is intended to act as a second opinion for the neurologists, and most importantly to help them reduce the number of patients in the "gray area" that require a very costly further examination (DaTSCAN). We strive to elicit comprehensible and medically meaningful knowledge in such a way that it does not come at the cost of diagnostic accuracy. Materials and methods: To alleviate the difficult problem of knowledge elicitation from data and domain experts, we used ABML. ABML guidesthe expert to explain critical special cases which cannot be handled automatically by machine learning. This very efficiently reduces the expert'sworkload, and combines expert's knowledge with learning data. 122 patients were enrolled into the study. Results: The classification accuracy ofthe final model was 91%. Equally important, the initial and the final modelswere also evaluated for their comprehensibility by the neurologists. All13 rules of the final model were deemed as appropriate to be able to support its decisions with good explanations. Conclusion: The paper demonstrates ABML's advantage in combining machine learning and expert knowledge. The accuracy of the system is very high with respect to the currentstate-of-the-art in clinical practice, and the system's knowledge base is assessed to be very consistent from a medical point of view. This opens upthe possibility to use the system also as a teaching tool.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 30199257In the past, fractures of the mandibular condylar process were, as a rule, treated conservatively. At the Department of Maxillofacial and Oral Surgery ofthe University Medical Centre Ljubljana, Slovenia, our doctrine was changed in 2002 on the basis of preliminary results and reports in the literature, andthese fractures were started to be treated surgically by open reduction andinternal fixation with miniplates and screws, which led to good results anda shorter rehabilitation period. The goal of this study was to determine the safety and efficiency of surgical treatment, as well as to compare long-term results of surgical and conservative treatment, as objectively as possible. PATIENTS AND METHODS: Two groups of patients, which had all sustained a unilateral, extra-articular mandibular condyle fracture, were compared. In the test group, there were 42 surgically treated patients, and inthe control group, 20 conservatively treated patients. Clinical parameters and X-ray images were assessed in both groups and compared by the two tailed Student t test, and in case of attributive variables by the Ž(2) test. Within the surgically treated group, postoperative and intraoperative complications were noted: temporary facial nerve palsy, development of a parotid salivary fistula, disturbance of auricle sensibility due to injury of the greater auricular nerve, miniplate fracture, as well as intraoperative bleeding, postoperative haematoma formation, infection, reoperation due to fragment malposition and other complications. Postoperative scars were also assessed. RESULTS: Statistically significant differences between the surgically and conservatively treated patients were found when comparing clinical parameters as well as X-ray images, the results being better in the surgically treated group. Complications of surgical treatment were also noted, the most importantamong them temporary paresis of facial nerve branches, which occurredin 10 patients (24%). Plate fractures occurred in five patients (12%),in four of them miniplates of sizes less than 2.0mm were used. There were no cases of significant intraoperative bleeding, two cases (5%) required drainage of postoperative haematomas, and one patient (2%) experienced a mild postoperative infection, which was easily controlled with amoxicillin with clavulanic acid. The scar was hidden best if a facelift incision was used, anda hypertrophic scar developed in only one patient (2%). CONCLUSION: Results of surgical treatment of condylar process fractures are superior to the results of conservative treatment, and the procedure is safe with the transparotid surgical approach and adequate surgical technique.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 415660The study evaluated the possible effects of ultrasound (US) on gene expression in brain tissue of rat embryos. Four groups (n = 5 each) of pregnant Wistar Han rats were exposed to US of different durations (55, 100, 145, and 195 seconds) via a multifrequency transducer in the 2-dimensional imaging mode with a pulse duration of 1.29 microseconds, a pulse repetition frequency of 1 kHz, and a derated spatial-peak pulse-average intensity of 222.4 W/cm(2) on day 5, 9, 7, or 13 of gestation. Gene expression profiling was performed in fetal brain tissue by quantitative reverse transcription-polymerase chain reaction arrays. The results indicated substantial alterations in gene expression. The most differentially expressed genes were Adamts5, Gadd45a, Npy2r, and Chrna1, which are implicated in important developmental signaling pathways. On the basis of our findings, routine short US examinations for monitoring fetal development are not contraindicated, but prolonged exposures should be used only when needed to obtain important diagnostic information.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 3532666