• MeSH
• Humans MeSH
• Vision Disorders diagnosis   complications   MeSH
• Vision, Binocular * physiology   MeSH
• Vision Tests methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

BACKGROUND: Concurrent vision and hearing impairment, known as dual sensory impairment (DSI), is associated with increased mortality. We aimed to examine individual and joint associations of DSI and involvement in activities with mortality in a large European nursing home study. METHODS: In total, 2,851 nursing home residents in 59 facilities in eight countries were followed for 1 year in the Services and Health for Elderly in Long TERm Care study. Vision and hearing impairment and average time of involvement in activities were assessed by trained research staff using the interRAI Long Term Care Facilities. Association between DSI and 1-year all-cause mortality was examined using Cox proportional hazards models adjusted for age, sex, facility, diagnoses of coronary heart disease and diabetes mellitus, self-rated health, end-stage disease, and functional and cognitive status. The modifying effect of involvement in activities on the association was investigated by the additive hazard model. RESULTS: DSI, defined as moderate to severe impairment in both senses, was independently associated with a 35% increased risk of 1-year mortality compared with non-DSI. Residents with DSI who were involved in activities did not have higher mortality, while residents with DSI who were not involved in activities had 51% higher mortality than non-DSI residents who were involved in activities, equivalent to approximately 209 additional deaths per 1,000 person-years (p = .012) due to the interaction between DSI and no involvement in activities. CONCLUSIONS: DSI is associated with increased mortality at nursing homes when combined with no involvement in activities.

• MeSH
• Time Factors MeSH
• Geriatric Assessment MeSH
• Humans MeSH
• Human Activities * MeSH
• Survival Rate MeSH
• Hearing Loss complications   mortality   MeSH
• Nursing Homes * MeSH
• Vision Disorders complications   mortality   MeSH
• Proportional Hazards Models MeSH
• Risk Factors MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Case-Control Studies MeSH
• Age Factors MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

OBJECTIVES: To examine whether nursing home residents with concurrent vision and hearing impairment, dual sensory impairment (DSI), have a greater cognitive decline over time than do those without sensory impairment and whether social engagement modifies this association. METHODS: Based on the Services and Health for Elderly in Long TERm Care study, 1,989 nursing home residents who were assessed using the interRAI LTCF at 6-month intervals over 1 year were included. Multivariate linear regression models with time-variant exposure variables of sensory impairment and social engagement using generalized estimating equations were performed to predict cognitive function measured by the Cognitive Performance Scale (range 0-6). RESULTS: Residents with DSI had a greater cognitive decline [changes in Cognitive Performance Scale over 1 year = 1.12 (95% confidence interval = 0.81:1.42)] compared to those with either vision or hearing impairment [0.67 (0.53:0.64)] and those without sensory impairment [0.56 (0.48:0.64)]. A lower level of social engagement was also associated with a greater cognitive decline. The combined exposure variable of sensory impairment and social engagement revealed the greatest cognitive decline for socially disengaged residents with DSI [1.87 (1.24:2.51)] and the potential effect modification of social engagement on the association between DSI and cognitive decline; DSI was not associated with a greater cognitive decline among socially engaged residents, while it was associated among socially disengaged residents DISCUSSION: Cognitive function declines faster in nursing home residents with DSI only when residents were not socially engaged. Therefore, residents with DSI might cognitively benefit from interventions to improve involvement in social life at nursing homes.

• MeSH
• Time Factors MeSH
• Homes for the Aged statistics & numerical data   MeSH
• Geriatric Assessment methods   MeSH
• Interpersonal Relations MeSH
• Cognition * MeSH
• Cognition Disorders * diagnosis   etiology   prevention & control   MeSH
• Humans MeSH
• Linear Models MeSH
• Follow-Up Studies MeSH
• Hearing Loss * complications   psychology   MeSH
• Nursing Homes statistics & numerical data   MeSH
• Vision Disorders * complications   psychology   MeSH
• Prognosis MeSH
• Aged MeSH
• Social Support MeSH
• Social Participation psychology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH

OBJECTIVES: To investigate if dual sensory impairment (DSI) in the form of a combined visual and hearing impairment is associated with the onset of behavioral symptoms in nursing homes. METHODS: A total of 1524 nursing home residents without behavioral symptoms at baseline followed for 12 months in 59 nursing homes from the Czech Republic, England, Finland, France, Germany, Israel, Italy, and The Netherlands. The interRAI instrument for long-term care facilities was assessed by trained staff at baseline and 12 months later. RESULTS: Altogether, 11% of residents had a new onset of behavioral symptoms (wandering, verbal abuse, physical abuse, socially inappropriate behavior, public disrobing, and resisting care) at 12-month follow-up. In multivariate analyses adjusted for potential confounders, DSI residents had significantly higher incidence of new behavioral symptoms at 12-month follow-up, irrespective of the severity of vision and hearing impairments [odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.3:3.4 for mild DSI, OR = 2.5, 95% CI = 1.6:4.0 for moderate DSI, and OR = 2.1, 95% CI = 1.2:3.7 for severe DSI] compared with residents without sensory impairment. Among the different types of symptoms, only abusive behaviors were less likely to be associated with DSI. CONCLUSIONS: This study provides evidence that DSI could play a significant role in the development of behavioral symptoms in nursing home residents. More attention should be paid to DSI even when each of vision and hearing function is only minimally impaired.

• MeSH
• Behavioral Symptoms epidemiology   etiology   physiopathology   MeSH
• Long-Term Care MeSH
• Homes for the Aged * MeSH
• Geriatric Assessment methods   MeSH
• Risk Assessment MeSH
• Confidence Intervals MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Monitoring, Physiologic methods   MeSH
• Multivariate Analysis MeSH
• Odds Ratio MeSH
• Nursing Homes * MeSH
• Sensation Disorders diagnosis   epidemiology   MeSH
• Hearing Disorders complications   diagnosis   MeSH
• Vision Disorders complications   diagnosis   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Aging physiology   MeSH
• Health Services for the Aged MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH
• Geographicals
• Europe MeSH

Autoři představují případ pacienta sledovaného a léčeného 13 roků pro epidermolysis bullosa acquisita a morbus Crohn. Kombinovaná léčba imunosupresivy a kortikosteroidy měla pouze omezený morbostatický efekt. Zpočátku v dermatologickém klinickém obraze dominovala klasická forma, v průběhu onemocnění došlo také k postižení napodobující bulózní pemfigoid a Brunstingův-Perryův pemfigoid. U pacienta se přidružilo významné oční postižení.

The authors present a case of a patient with epidermolysis bullosa acquisita and Crohn's disease. The patient has been treated for 13 years with combined immunosuppressive and corticosteroid therapy with only limited morbostatic effect. Initially, classic form dominated in the clinical picture. Later, a bullous pemphigoid-like and a Brunsting-Perry pemphigoid-like lesions occurred, as well as a significant eye involvement.

• Keywords
• subepidermální puchýře,
• MeSH
• Crohn Disease diagnosis   drug therapy   MeSH
• Adult MeSH
• Epidermolysis Bullosa Acquisita * diagnosis   drug therapy   physiopathology   pathology   MeSH
• Immunoglobulin G blood   MeSH
• Immunosuppressive Agents therapeutic use   MeSH
• Collagen Type VII MeSH
• Humans MeSH
• Eyelid Diseases complications   MeSH
• Corneal Diseases * diagnosis   complications   MeSH
• Conjunctival Diseases diagnosis   complications   MeSH
• Treatment Failure MeSH
• Vision Disorders complications   MeSH
• Disease Progression MeSH
• Antibodies blood   MeSH
• Lacrimal Apparatus * pathology   MeSH
• Visual Acuity MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

Autoři referují o případu oboustranného ischemického poškození cévnatky, sítnice a zrakového nervu u pacientky s náhle vzniklým nebolestivým poklesem zrakových funkcí, které zaznamenala na konci měsíčního cestování po Nepálu spojeného s občasným pobytem v nadmořských výškách okolo 5 000 metrů nad mořem. Při vstupním očním vyšetření byl zjištěn asymetrický edém terčů zrakových nervů více vlevo, jenž byl doprovázen zhoršením zrakové ostrosti a dolním altitudinálním defektem zorného pole. Provedená vyšetření vyloučila infekční, autoimunitní (neinfekční) či demyelinizační etiologii zánětlivých projevů na očním pozadí. Po nasazení terapie kortikosteroidy a acetazolamidem perorálně došlo k postupnému vymizení ischemických a zánětlivých změn na očním pozadí, zůstal však trvalý pokles zrakových funkcí vlevo a tomu odpovídající subatrofie terče zrakového nervu, což je dle dostupné

The authors relate a case of bilateral ischemic damage to the choroid, retina and optic nerve in a patient with sudden painless damage to vision that she suffered at the end of a month in Nepal which involved short trips to altitudes of around 5000 m. At initial ophthalmic examination she presented with asymmetrical oedema of the optic nerve discs, more pronounced in the left eye, with reduced visual acuity and lower altitudinal visual field defect. The results of tests and examinations were negative for infectious, auto-immune and demyelinating aetiology of the fundus. Treatment with corticosteroids and aceazolamid produced good results – resolution of ischemic and inflammatory changes in the fundus. In this case, a permanent deterioration of visual function in the left eye corresponding to subatrophy of the optic nerve head was observed, according to the literature a rare condition.

• Keywords
• ischemická neuropatie optiku, vysokohorská retinopatie,
• MeSH
• Acetazolamide administration & dosage   therapeutic use   MeSH
• Edema diagnosis   complications   therapy   MeSH
• Financing, Organized MeSH
• Fluorescein Angiography methods   utilization   MeSH
• Adrenal Cortex Hormones administration & dosage   therapeutic use   MeSH
• Optic Neuropathy, Ischemic diagnosis   therapy   MeSH
• Middle Aged MeSH
• Humans MeSH
• Retinal Diseases diagnosis   etiology   MeSH
• Optic Nerve Diseases diagnosis   therapy   MeSH
• Vision Disorders diagnosis   complications   MeSH
• Altitude Sickness diagnosis   etiology   complications   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Úvod: Testy rovnováhy jsou běžnou součástí neurologického a otorhinolaryngologického vyšetření. Cílem této studie bylo prozkoumat vliv vertikální a horizontální vizuální stimulace na posturální reflexy měřené kraniokorpografií, za účelem podrobného ověření účinnosti kontroly rovnováhy při narušení vizuálně-vestibulární integrity. Cíl: Cílem studie bylo zjistit vliv vizuální, horizontální a vertikální optokinetické a sinusoidální stimulace na posturální reflexy. Metodologie: Testována byla skupina 40 zdravých jedinců (20 žen, 20 mužů) ve věku 18–52 bez patologické otoneurologické anamnézy nebo příznaků. Za účelem zjištění poruch rovnováhy měřených kraniokorpografií během Rombergova testu byla aplikována horizontální a vertikální optokinetická a sinusoidální stimulace. Výsledky: Zjistili jsme, že vizuální stimulace (optokinetická a sinusodiální) v horizontální rovině vyvolaly silnější posturální poruchy než vizuální stimulace ve vertikální rovině. Jak horizontální, tak vertikální optokinetická stimulace vedla k větším longitudinálním výkyvům těla. Laterální vychýlení těla bylo lépe kontrolováno během vertikální stimulace. Autoři zjistili rozdíly v posturálních reflexech v závislosti na směru jak horizontální, tak vertikální vizuální stimulace. Kontrola rovnováhy byla lepší, byla-li optokinetická stimulace směřována doleva a dolů. Zvýšená intenzita vizuální stimulace (cílová velocita) rovnováhu nezhoršovala.

Introduction: Tests of balance are routine elements of neurological and otolaryngological examination. What follows is a general study of the effectiveness of balance control when visual-vestibular integrity is disturbed, conducted by means of ascertaining the influence of vertical and horizontal visual stimulation on postural reflexes as measured by craniocorpography. Goal: The purpose of the study was to observe the effect of visual, horizontal and vertical optokinetic and sinusoidal stimulation on postural reflexes. Material and method: A group of 40 healthy subjects (20 female, 20 male) aged 18–52 with no pathological otoneurologial history or signs was tested. Horizontal and vertical optokinetic and sinusoidal stimulation was administered in order to observe balance disturbances, as measured by craniocorpography in the course of a R omberg test. Results: It was revealed that visual stimulation (optokinetic and sinusoidal) in the horizontal plane induced stronger postural disturbances than visual stimulation in the vertical plane. Both horizontal and vertical optokinetic stimulation resulted in high longitudinal body sway. Lateral body displacement was better controlled during vertical visual disturbances. The authors observed that the differences in postural reflexes were dependent on the direction of both horizontal and vertical visual stimulation. Balance control was better when the optokinetic incitement was directed to the left and downward. Increased intensity of visual stimulus (target velocity) did not worsen balance.

• Keywords
• kraniokorpografie, vizuální stimulace, otolity,
• MeSH
• Anthropometry MeSH
• Human Experimentation MeSH
• Kinesiology, Applied MeSH
• Humans MeSH
• Otolithic Membrane MeSH
• Vision Disorders complications   MeSH
• Posture physiology   MeSH
• Postural Balance physiology   MeSH
• Rehabilitation MeSH
• Statistics as Topic MeSH
• Photic Stimulation methods   instrumentation   MeSH
• Investigative Techniques MeSH
• Visual Perception physiology   MeSH
• Check Tag
• Humans MeSH

• MeSH
• Child MeSH
• Humans MeSH
• Vision Disorders complications   psychology   rehabilitation   MeSH
• Psychomotor Disorders etiology   MeSH
• Blindness complications   rehabilitation   MeSH
• Education of Persons with Visual Disabilities MeSH
• Persons with Visual Disabilities rehabilitation   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Meeting Abstract MeSH

• MeSH
• Eyeglasses classification   adverse effects   utilization   MeSH
• Vision Disorders etiology   complications   therapy   MeSH
• Aged MeSH
• Accidental Falls prevention & control   MeSH
• Check Tag
• Aged MeSH

Společenské chápání handicapu, reakce na závažnou změnu zdravotního stavu, specifika rehabilitace a hlavní doporučená pravidla dlouhodobého soužití.

• MeSH
• Vision Disorders complications   nursing   rehabilitation   MeSH
• Blindness nursing   psychology   MeSH
• Social Medicine MeSH
• Education, Special MeSH
• Persons with Visual Disabilities psychology   rehabilitation   MeSH
• Publication type
• Handbook MeSH

• Conspectus
• Ortopedie. Chirurgie. Oftalmologie
• NML Fields
• zdravotně postižení
• oftalmologie
• sociální lékařství
• rehabilitační a fyzikální medicína