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PubMed1990

Tension myalgia as a diagnosis at the Mayo Clinic and its relationship to fibrositis, fibromyalgia, and myofascial pain syndrome.

Tension myalgia is a diagnosis that has been in use at the Mayo Clinic for more than 40 years. The term describes a common muscle pain disorder that is conceptually similar to other muscle pain disorders such as fibrositis, fibromyalgia, and myofascial pain syndrome. This article outlines the history of these disorders and proposes "tension myalgia" as a term that unifies these separate diagnoses under one conceptual framework. Because the diagnostic criteria for tension myalgia have been vague, the Department of Physical Medicine and Rehabilitation at the Mayo Clinic has developed specific criteria for generalized, regional, and localized forms of this disorder. The recommended treatment approach includes reassurance, elimination of contributing factors, physical therapy to restore normal neuromuscular function, conditioning, and medications.

Algorithms↗

PubMed1983

Diastolic atrial compression: a sensitive echocardiographic sign of cardiac tamponade.

Nine patients with clinical and hemodynamic evidence of cardiac tamponade underwent M-mode and two-dimensional echocardiography. Pericardial effusion was documented in each patient. Four patients demonstrated respiratory variation in ventricular volumes in association with paradoxical pulse. Right ventricular compression was present in seven. In five patients, echocardiography demonstrated diastolic left atrial compression. In all nine patients, the apical four chamber view revealed diastolic right atrial compression. Drainage of 450 to 1,800 cc of pericardial fluid relieved the cardiac tamponade and eliminated the echocardiographic findings associated with this disorder. These observations suggest that the echocardiographic findings of atrial compression is a sensitive sign of cardiac tamponade.

Adolescent↗

PubMed1993

Congenital abnormalities of the goat.

Congenital abnormalities of genetic and environmental causes constitute a striking proportion of the afflictions seen in goats. These include a variety of malformations and metabolic diseases that could occur in all breeds but tend to exhibit predisposition in some breeds of goats. Genetic abnormalities for which the carrier state is detectable with the aid of enzymes and surface protein markers can be eliminated from goat populations, whereas common polygenic disorders including udder problems in does and gynecomastia in bucks are more difficult to eradicate because the mutant genes responsible for these traits generally do not declare themselves until inbreeding brings together a critical concentration of liability genes to create a crisis. A substantial reduction of common abnormalities in this species, such as intersexuality in dairy breeds, abortion in Angora breed, and arthritis in the Pygmy breed, will require a change in breeders' preference and selection practice. In making these changes, however, the beneficial traits will have to be balanced against the undesirable effects of the selected mutant genes (pleiotropy), which hold the key to success or failure of a breed under domestication.

Animals↗

PubMed2004

Epidemiology of fecal incontinence.

Nursing home residence is by far the most prominent association with fecal incontinence, with a prevalence approaching 50%. In one major survey, urinary incontinence was the greatest risk factor for developing fecal incontinence, and fecal incontinence was the greatest risk factor for developing urinary incontinence. Immobility, dementia, and the use of physical restraints were also important risk factors. Specific diseases associated with fecal incontinence include diabetes, multiple sclerosis, Parkinson's disease, stroke, and spinal cord injury. The surgical procedures lateral internal sphincterotomy for anal fissure, fistulotomy, and ileal pouch reconstruction can result in fecal incontinence. Children who are born with congenital abnormalities, such as imperforate anus, often experience soiling for many years. Future studies to determine the prevalence and etiology of fecal and urinary incontinence will need to first define these conditions and eliminate referral bias. Epidemiologic investigations of both disorders should be performed jointly because the conditions are so often comorbid.

Fecal Incontinence↗

PubMed2002

Reduction of stuttering: the dual inhibition hypothesis.

Treatment for stuttering attempts to reduce or eliminate the observable core markers of the disorder, specifically repetitions and prolongation. In this hypothesis, it is proposed that stuttering may be inhibited by two distinct yet related procedures: active inhibition and passive inhibition. Active inhibition is brought about when the person who stutters makes volitional changes to his or her speaking pattern, such as when employing behavioral modification techniques. Passive inhibition automatically inhibits the involuntary stuttering block and can be induced from an external source, such as altered auditory feedback, or by the use of sufficient active inhibition. It is suggested that passively inhibiting stuttering results in speech that is more automatic, natural sounding, and truly fluent speech than the speech that is derived primarily from active inhibition. Evidence of passive inhibition resulting from active inhibition can be seen when people who stutter exhibit uncontrolled fluency following behavioral therapy.

Humans↗

PubMed1988

Improvement of the nutritional quality of Egyptian and Sudanese sorghum grains by the addition of phosphates.

1. Male broilers (0 to 35 d) were given foods with two types of yellow sorghum substituted for maize in isonutrient diets. Sorghum-based foods were also supplemented with extra phosphorus, to provide a total P of about 8 g/kg; the P being from either orthophosphoric acid or food grade dicalcium phosphate. 2. Both sorghums depressed growth and food:gain ratio and increased the incidence of locomotor disorder to about 0.50 (maize control = 0). Sorghum from Sudan, with higher concentrations of both tannin and phytate, caused more severe anti-nutritive effects than sorghum from Egypt. 3. Within the limits of statistical significance the growth depressing effect of sorghum was completely reversed by extra P. With the more toxic Sudanese sorghum this amelioration was numerically less than complete (growth = 0.94, maize control = 1). Locomotor disorders were also virtually, but not completely, eliminated by phosphorus treatment. 4. Treatment of sorghum by dry-mixing with dicalcium phosphate could form the basis of a simple and economic method for extending the use of high-tannin sorghum in poultry foods. The mode of action of the treatment remains to be determined.

Animal Feed↗

PubMed2001

The effects of eliminating alcohol in a college stadium: the Folsom Field beer ban.

In fall 1996, the University of Colorado at Boulder instituted a ban on beer sales at football games. To evaluate the effects of the ban, the authors collected two types of data: first, they examined the effects of the ban on game-day security incidents; second, they looked at survey data from season ticket holders and students. They administered the surveys after the first two postban seasons to assess ticket holders' attitudes about the new policy. The incident data they found indicated dramatic decreases in arrests, assaults, ejections from the stadium, and student referrals to the judicial affairs office following the ban. Survey data also indicated moderately negative attitudes about the ban among students and some season ticket holders. However, all fans were likely to renew their tickets regardless of their attitudes toward the policy. The study illustrates what can be achieved when alcohol is eliminated from a setting that frequently fosters disorderly and aggressive behaviors.

Adolescent↗

PubMed2004

Molecular and comparative genetics of mental retardation.

Affecting 1-3% of the population, mental retardation (MR) poses significant challenges for clinicians and scientists. Understanding the biology of MR is complicated by the extraordinary heterogeneity of genetic MR disorders. Detailed analyses of >1000 Online Mendelian Inheritance in Man (OMIM) database entries and literature searches through September 2003 revealed 282 molecularly identified MR genes. We estimate that hundreds more MR genes remain to be identified. A novel test, in which we distributed unmapped MR disorders proportionately across the autosomes, failed to eliminate the well-known X-chromosome overrepresentation of MR genes and candidate genes. This evidence argues against ascertainment bias as the main cause of the skewed distribution. On the basis of a synthesis of clinical and laboratory data, we developed a biological functions classification scheme for MR genes. Metabolic pathways, signaling pathways, and transcription are the most common functions, but numerous other aspects of neuronal and glial biology are controlled by MR genes as well. Using protein sequence and domain-organization comparisons, we found a striking conservation of MR genes and genetic pathways across the approximately 700 million years that separate Homo sapiens and Drosophila melanogaster. Eighty-seven percent have one or more fruit fly homologs and 76% have at least one candidate functional ortholog. We propose that D. melanogaster can be used in a systematic manner to study MR and possibly to develop bioassays for therapeutic drug discovery. We selected 42 Drosophila orthologs as most likely to reveal molecular and cellular mechanisms of nervous system development or plasticity relevant to MR.

Animals↗

PubMed1997

Treatment of tardive dyskinesia.

Although the new generation of atypical antipsychotic agents could some day eliminate concerns about tardive dyskinesia (TD), this disorder remains a significant clinical problem for both patients and physicians. Fortunately, many, if not most, cases of TD are mild. For patients with mild to moderate TD, therapeutic efforts are primarily directed at minimizing neuroleptic exposure or, when possible, changing to atypical agents. Most cases of TD do not seem to progress, suggesting that the risk of remaining on typical neuroleptics is probably small. Patients with moderate to severe forms of TD present greater challenges. These patients frequently require medication to suppress their dyskinesias. A variety of suppressive agents have been tried with limited success. No treatment strategy has emerged that is clearly superior or even successful in most patients. Increasing doses of typical neuroleptics may be useful for short-term suppression; however, the long-term efficacy and risk of this strategy have not been studied carefully. Data on atypical neuroleptics are scant. Clozapine's short-term suppressive effects seem, at best, weak, but patients may improve with long-term treatment. Medications with relatively few side effects that may have suppressive efficacy for some patients include calcium channel blockers, adrenergic antagonists, and vitamin E. Gamma-amino-butyric acid agonists agents and dopamine depleters are frequently useful, but have troubling side effects of their own. A variety of other medications have been employed, but are not well studied. For patients with tardive dystonia, anticholinergic agents or botulinum toxin has been particularly effective. Efforts to understand the neurobiology of TD may shed light on this persistent clinical conundrum.

Antioxidants↗

PubMed1985

Risk factors associated with small-for-dates and large-for-dates infants.

Relative risks were calculated to assess the potency of different factors associated with the two extremes of the birthweight distribution. Maternal height affected the chances of having a small-for-dates (SFD) or large-for-dates (LFD) baby to an equal and opposite extent; but the risks associated with maternal weight were greater for LFD than SFD infants. Smoking increased the SFD risk by 3.5 times, whereas the LFD risk was only reduced by a half. Pre-eclampsia was associated with a very high SFD risk (14.6); in the LFD group it was insignificantly raised. The LFD relative risk steadily rose with increasing parity, but in the SFD group it fluctuated around unity. Among multiparae the risks of an SFD or LFD infant when previous siblings had been of relatively low or high birthweight for gestational age, respectively, were much increased. Estimates of attributable risk showed that if pathological factors such as smoking, hypertensive disorders and congenital abnormalities could be completely eliminated the number of SFD babies in this population would be reduced by about 60%; conversely the number of LFD babies would be increased by about 30%.

Birth Weight↗

PubMed1988

Regeneration of D-galactosamine-traumatized rat liver with natural protoberberine alkaloids from Enantia chlorantha.

Experimental liver injury was provoked in test rats with intraperitoneal injections of D-galactosamine. Traumatized rats received further intraperitoneal injections of Hepasor, a protoberberine alkaloid mixture from Enantia chlorantha (Annonaceae). Biochemical assays from blood plasma, serum alanine transferase, serum alkaline phosphatase, serum creatinine, serum hydroxyproline and serum calcium were done and liver and kidney samples for histological processing were taken. The biochemical results obtained indicate a marked influence by Hepasor on the serum alanine transferase activities and serum hydroxyproline values in female rats, but more accidental ones in male rats. A reduction in serum alkaline phosphatase activity and the serum creatinine values was also found, being also dependent on sex. The histological findings in the liver sections of female rats show that 1 week Hepasor therapy greatly furthers the healing process in a D-galactosamine-pretraumatized liver, eliminating megalocytosis, contraction of chromatines and other disorders in the cell architecture. The inhibitory effect of Hepasor on proceeded traumatization caused by D-galactosamine was nearly complete.

Alanine Transaminase↗

PubMed1998

Demyelinating disease of Schilder type in three young South African children: dramatic response to corticosteroids.

Three young children with the Schilder variant of multiple sclerosis were seen within a 3-year period at our hospital. The diagnosis was made on the basis of the typical (but not pathognomonic) clinical and magnetic resonance imaging (MRI) findings after eliminating other demyelinating and post-infectious disorders of the central nervous system. All three patients were treated with prednisone (2 mg/kg/day), which resulted in complete recovery in one patient and mild and moderate residual hemiparesis in the two other patients, respectively. Corticosteroid therapy was continued until the patients' neurologic condition normalized or no further clinical improvement occurred. No relapses were seen after discontinuation of corticosteroid treatment. Computed tomographic (CT) scan and MRI findings after completion of corticosteroid therapy were equally dramatic and corresponded with the clinical improvement. A strongly positive tuberculin skin test and a positive history of contact with adult tuberculosis in two of our patients raise the possibility of a connection between tuberculosis and Schilder's disease.

Anti-Inflammatory Agents↗

PubMed2004

A von Willebrand's factor genomic nucleotide variant and polymerase chain reaction diagnostic test associated with inheritable type-2 von Willebrand's disease in a line of german shorthaired pointer dogs.

Heritable, type-2 von Willebrand's disease (vWD) was studied in a line of German Shorthaired Pointers (GSPs) in which some members had a nucleotide variant in exon 28 of the von Willebrand factor (VWF) gene. A polymerase chain reaction (PCR) diagnostic test for the nucleotide variant was developed to establish the disorder's mode of inheritance and to eliminate it from the line. Thirty-six of the 49 GSPs in the line, 14 unrelated GSP controls, and 71 unrelated dogs of various breeds were tested for the presence of the variant nucleotide. All the dogs with a vWF antigen deficiency (<70% of normal) were either homozygous or heterozygous for the nucleotide variant. The variant was not located in any tested dog in the line or outside of the line with a vWF antigen value greater than 68%. Of the GSPs in the line tested, two were homozygous for the variant, 15 were heterozygous, and 19 were variant free. The collective evidence of this and other studies is consistent with the variant nucleotide being the cause of the type-2 vWD in this line of GSPs and German Wirehaired Pointers. The PCR diagnostic test for the variant nucleotide was successfully used to select and produce progeny that were variant free and vWD free. This test should be effective in the subsequent elimination of this same variant from other lines of dogs.

Amino Acid Sequence↗

PubMed1996

Plasminogen activators and plasminogen activator inhibitor in portal blood from patients with and without gastric malignancy.

BACKGROUND: Plasminogen activators (PA) may be released by the gut and eliminated by the liver. Patients with liver disorders or malignancy often have abnormal plasma levels of PAs. Some tumours may produce PAs. METHODS: In patients undergoing gastric surgery for malignant (n = 18) or benign (n = 21) disorders., blood drawn from the portal vein and a peripheral vein was analysed for tissue-type plasminogen activator antigen and activity (tPA: Ag, tPA: Act), single-chain urokinase-type plasminogen activator activity (scuPA: Act), and plasminogen activator inhibitor antigen and activity (PAI: Ag, PAI: Act). RESULTS AND CONCLUSIONS: In both groups tPA: Act and scuPA: Act levels were significantly higher in portal blood than in peripheral blood, but tPA: Ag and PAI: Act levels did not differ. PAI: Act levels were significantly lower in patients with malignant disease, but levels of the other markers did not differ in the two groups.

Adult↗

PubMed1999

[Herbal medicine--taking a position. Effectiveness and usefulness of herbal preparations].

During the discussion on the elimination of certain groups of drugs and disorders from the list of obligatory services to be remunerated by state health insurances, vague, undefined terms such as "controversial" are being applied to phytopharmaceuticals and their fields of application. This may be traced back to an ignorance and global rejection of available scientific documentation. The rational background of modern phytopharmaceuticals are discussed.

Drug Evaluation↗

PubMed2001

[Optimization of indirect electrochemical detoxication in the treatment of different endogenous intoxications and multiple organ failure syndrome in resuscitation practice].

The authors have made a statistical analysis of clinical groups of patients in the units of resuscitation and intensive therapy of a general profile and of the archive materials of a laboratory of extracorporeal hemocorrection. The ultraviolet and laser photomodification of autoblood, hemosorption, plasmapheresis, ultra- and hemofiltration were used in the complex treatment of these patients. In the experimental group there were 190 patients on whom 333 operations of extracorporeal hemocorrection were made with using indirect electrochemical detoxication (IECD). In the control group there were 527 patients on whom 1048 analogous operations were made without IECD. The statistical processing of the results obtained has shown that IECD method does not have immediate detoxicating properties in relation to middle mass molecules and fails to substantially influence the processes of lipid peroxidation; sodium hypochlorite did not have a deteriorating effect on the clinical-laboratory status of patients with severe organic disorders. IECD was shown to potentiate the elimination potencies of hemosorption, plasmapheresis, ultra- and hemofiltration which resulted in 2.7 times less lethality. The mean bed-day was 2.8 days shorter, the bed-day in the resuscitation unit--1.2 days shorter.

APACHE↗

PubMed2001

[Analysis of heterozygosity levels at P1,TF, PGM1, ACP1, HP, GC, GLO, C3, and ESD loci in pulmonary tuberculosis patients with different treatment outcomes].

Heterozygosity at nine genetic loci (PI, TF, PGM1, ACP1, HP, GC, GLO1, C3, and ESD) was analyzed in pulmonary tuberculosis patients with good (group 1, N = 71) and poor (group 2, N = 35) response to treatment. The observed heterozygosities were compared with the expected values, which were calculated from allele frequencies in a control sample of healthy individuals (N = 328 with all but one locus and 78 with ESD) according to Hardy-Weinberg expectations. The analysis showed that the observed heterozygosities gl of patients significantly differed from the expected values hl in the case of four loci (GC, PI, C3, and ACP1). The observed heterozygosity was higher than expected in three cases (PI, C3, and ACP1) and lower then expected (GC) in one case. When data on each individual locus were compared using Fisher's exact test, both groups of patients proved to significantly differ (PF < 0.05) from the control group in the same four loci. No difference in observed heterozygosity was detected between the two groups of patients. The mean expected heterozygosity was h = 0.386 +/- 0.00674; the mean observed heterozygosity was g = 0.415 +/- 0.02 in group 1, g = 0.402 +/- 0.026 in group 2, and g = 0.371 +/- 0.00955 in the control group. The t test did not reveal a significant difference between the mean values of expected observed heterozygosities. Heterozygosity at individual loci, rather than mean heterozygosity, was proposed as an integral nonspecific indicator of the genetic control of a disease, because the former directly implicates individual marker loci in the development of a disorder, whereas effects of individual loci may eliminate each other when mean heterozygosity is computed. Based on the results obtained, a genetic control was assumed for the development of the tuberculosis process in the lungs.

Alleles↗

PubMed2001

[Sign-report: torsional nystagmus from head-shaking in patients with labyrinth lithiasis of the vertical canal].

The clinical picture of Positional Paroxysmal Vertigo (PPV) induced by vertical canal labyrintholithiasis has been clearly described, eliminating previous interpretations of pathogenesis of this disorder. The diagnosis of PPV is based on the well-known picture of positional paroxysmal Nystagmus. The Authors report a clinical sign which has not previously been reported in the literature: torsional Nystagmus induced by the Head-Shaking Test (HST). The Authors encoutered this sign in 30% of the cases of vertical canalolithiasis and in 50% of the cases diagnosed as vertical cupulolithiasis. This sign was also found in patients with a history of prior positional vertigo and in patients who, after treatment with release maneuver, no longer show clinical signs of positional vertigo. Such Nystagmus was not, however, found in the control group (normal subjects and patients suffering from other vestibular pathologies). In the present study the possible pathogenesis of this sign is discussed and some practical implications are considered.

Calculi↗