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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urinary tract pathology may be no more common in patients with arthritis than among the general population, but its impact may be enhanced by disability. In this survey of 247 patients, as many as 38% of patients with rheumatoid arthritis (RA), 47% of patients with osteoarthritis (OA) and even 34% of patients with soft tissue rheumatism (STR) reported difficulty controlling their urine, confirming that incontinence is a widespread and often under-reported problem. More detailed enquiry in a sample of 90 patients with OA or RA did not suggest specific urinary tract pathology related to the underlying arthritis. Those who reported problems with urinary control were more disabled, and took longer to get to the toilet in their own environment than those without control problems. Twenty-seven per cent of patients felt that their problems would be solved by provision of a downstairs toilet. Timing of tasks performed by patients within their home is suggested as a method for assessing functional ability which encompasses both patient disability and environmental factors.
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PMID:Urinary incontinence among patients with arthritis--a neglected disability. 162 46

This article presents a profile of incontinent elderly in long-term care institutions. One hundred thirty-three frail elderly women were recruited from seven nursing homes in central Pennsylvania for a three-year clinical trial to test the effectiveness of a behavioral therapy on urinary incontinence. All of the patients had more than one medical diagnosis. Eighty percent had cardiorespiratory conditions; the most prevalent diagnoses were cardiovascular diseases. Eighty percent had one or more neurological diseases, including "organic brain syndrome" (47%) and senile dementia (30%); 44% had arthritis/rheumatism. Half of the patients showed severe cognitive impairment; only 12% showed no cognitive impairment. Sixty-three percent were totally dependent; 68% used wheelchairs, 61% were chairbound; 50% had impairments in vision, one-third in hearing, and 14% in speech. Normal bladder capacity, absence of detrusor instability, and satisfactory bladder emptying, as evidenced by low residual urines, was found in 41% of the patients, suggesting that incontinence in this elderly group may not be a primary bladder problem, but rather that mental and physical disabilities may be a more important underlying cause of incontinence in these patients. An important finding in this study is that 34% of the patients had detrusor instability. It is theoretically possible that pharmacologic therapy with anticholinergic agents or imipramine could improve incontinence in this group. Five percent were found to have large residual urine volumes in association with high-capacity bladders suggesting overflow incontinence as the cause of their daily leakage. Pelvic relaxation and stress leakage was far less common in this elderly group of nursing home patients than in young and middle-aged women.
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PMID:Profile of urinary incontinent elderly in long-term care institutions. 189 54

The range of movement of the shoulder in abduction at 45 degrees of flexion was objectively measured using a standard technique in a demographically representative survey of 1000 men and women living in their own homes. Sampling was stratified to obtain approximately equal numbers of those aged 65-74 years and those aged 75 and over. The response rate was 80%. Normal values for shoulder abduction grouped by age and sex are presented as frequency distributions, means and deciles. Information about health problems was also recorded in the survey; the prevalences of these problems and their associations with shoulder abduction have been investigated. Women had significantly lower values for shoulder abduction than men. For both sexes values were on average about 30 degrees lower than those found in younger adults, and about half of the elderly group had values below 120 degrees. The prevalence of specified health problems was high with only 3% of the older group and 6% of the younger group being free from all the specified health problems. There was a significant independent negative association between shoulder abduction and both age and reported health. The associations were more marked in women than in men. This was so for both a cumulated 14-item health index and selected individual health items which included arthritis, lack of mobility and incontinence. The decile values for shoulder abduction for women without these health problems are presented. This provides more appropriate normal data for them; it is more normally distributed and reduces the percentage with a shoulder abduction less than 120 degrees to 30%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Normal values for range of shoulder abduction in men and women aged over 65 years. 278 44

"Pouchitis" is a well recognised complication of restorative proctocolectomy characterised by acute diarrhoea, sometimes with blood, often complicated by incontinence, malaise, arthritis, erythema nodosum and fever. The ileal mucosa is hyperaemic, there may be shallow ulcers and contact bleeding. Biopsies characteristically show villous atrophy, a poly-morphonuclear infiltrate and chronic inflammatory cells, but the histopathological features are often patchy and may be difficult to differentiate from ischaemic ileitis, colonic metaplasia or Crohn's disease. "Pouchitis" is probably due to an overgrowth of intestinal bacteria secondary to stasis but there is some evidence that there may be an ischaemic factor. Most patients respond rapidly to oral metronidazole.
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PMID:["Pouchitis"; histology]. 816 Nov 30

The standard open surgical treatment of thoracic aortic aneurysms is associated with significant morbidity and mortality. Endovascular repair is less invasive and potentially less morbid for patients with multiple risk factors. The authors report their results in 9 consecutive high-risk patients treated with endovascular grafts from January 1998 through June 2000. There were 7 men and 2 women patients with an average age of 75 years. Mean aneurysm diameter was 7.1 cm. All aneurysms were repaired with Gianturco Z-stent polytetrafluoroethylene prostheses. There were no perioperative deaths. Mean length of stay was 6.3 days. Technical success was achieved in all 9 patients. Two patients had neurologic complications following repair (1 patient with transient lower extremity numbness related to spinal arthritis and 1 patient with bowel and bladder incontinence). Both patients were independent with ambulation. Mean follow-up was 15.8 months. There was no evidence of endoleak or stent migration during the follow-up period. These findings support endovascular treatment of high-risk patients with thoracic aneurysm.
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PMID:Endovascular repair of thoracic aortic aneurysms: a paradigm shift in standard of care. 1195 Oct 97

We report a 56-year-old man with adult-onset Sydenham chorea. Since January 2003, he had often troubled other persons, and in October 2003, following an episode of fever in August of the same year, he noticed left shoulder joint pain and involuntary movements of his limbs, especially on the left side. These involuntary movements gradually worsened and he became unable to converse due to psychiatric symptoms. On admission, neurological examination revealed dementia, emotional incontinence, abnormal behavior and chorea in four limbs. Brain MRI disclosed swelling of bilateral caudate heads that was more marked on the right side. Hypermetabolism in bilateral caudate nuclei, especially on the right, was found on FDG-PET study, which was compatible with his left side-dominant chorea and might reflect inflammation as a nature. A gallium scintigram demonstrated excess accumulations in the plural joints of his extremities, which gradually decreased in parallel with joint pain relief. The present case was diagnosed as Sydenham chorea, because of the presence of arthritis, chorea, fever, increased erythrocyte sedimentation rate and elevated CRP. We believe that this is a first report of adult-onset Sydenham chorea accompanied with psychiatric symptoms.
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PMID:[A case of adult-onset Sydenham chorea accompanied with psychiatric symptoms]. 1651 13

We report on the case of a 36-year-old Hispanic woman with a spinal cord infarct, who was subsequently diagnosed with methylmalonic aciduria and homocystinuria, cblC type (cblC). Mutation analysis revealed c.271dupA and c.482G > A mutations in the MMACHC gene. The patient had a past medical history significant for joint hypermobility, arthritis, bilateral cataracts, unilateral hearing loss, anemia, frequent urinary tract infections, and mental illness. There was no significant past history of mental retardation, failure to thrive, or seizure disorder as reported in classic cases of cblC. Prior to the thrombotic incident, the patient experienced increased paresthesia in the lower extremities, myelopathy, and impaired gait. Given her previous psychiatric history, she was misdiagnosed with malingering until hemiplegia and incontinence became apparent. The authors would like to emphasize the recognition of a neuropsychiatric presentation in late onset cblC. Ten other reported late onset cases with similar presentations are also reviewed.
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PMID:Late-onset combined homocystinuria and methylmalonic aciduria (cblC) and neuropsychiatric disturbance. 1785 53

The population of older Americans is expected to represent 20 percent of the total U.S. population in the next 50 years, and older women will comprise the majority of that group. Thus, the health care needs of older women are and will be an increasing concern. A subcommittee of the Public Health Service Task Force on Women's Health, which studied the health issues related to older women, observed that many factors relate to the health care of this group. Several factors, such as the homogeneity of the population over 65 years, the distinction between normal aging and disease, and the impact of socioeconomic concerns on physical and mental health, are important for developing preventive and treatment strategies.Older women die of the same disorders that affect men-heart disease, cancer, cardiovascular disease, and accidental injuries-but are more likely to be afflicted with one or more chronic conditions that can cause limitations in their lifestyles (for example, diabetes, hypertension, arthritis).The subcommittee also highlighted disorders with special implications for older women such as incontinence, osteoporosis, prescription drug misuse, and depression, and recommended that health messages for older women be targeted at both young and old cohorts to encourage health promotion and good health practices at all ages.
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PMID:Health concerns of older women. 1931 90

Cauda equina syndrome is an uncommon complication of ankylosing spondylitis (AS) characterized by the slow and insidious development of severe neurologic impairment. Imaging studies usually show a wide lumbar canal with dural ectasia. No medical or surgical treatment has been proven effective. We managed the care of a 66-year-old man who had longstanding AS and clinical features of cauda equina syndrome, including anal incontinence and buttock hypoesthesia. Magnetic resonance imaging demonstrated no cause for these symptoms other than AS. The patient was treated with infliximab, a monoclonal antibody to tumor necrosis factor alpha that is used for the treatment of active AS. After 3 infliximab infusions, sphincter control and sensation were normal. The treatment was continued, and he was still doing well 1 year later. This is the first report of an effective treatment for cauda equina syndrome complicating AS. Our case report strongly supports an inflammatory mechanism to this condition.
Arthritis Rheum 2009 Jun
PMID:Dramatic efficacy of infliximab in cauda equina syndrome complicating ankylosing spondylitis. 2017 29

Self-neglect is a complex and inadequately understood phenomenon that accounts for the majority of Adult Protective Services cases. This retrospective, record-based study of the characteristics of 210 older adults who were reported to Adult Protective Services and confirmed for self-neglect revealed that common health problems included nutritional frailty, arthritis, and incontinence. Comparisons based upon length of service showed differences in worker-rated social environment risk, client capacity, and activities of daily living performance. Comparisons of findings with those of other studies of self-neglect underscore the need for systematic research on this population.
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PMID:Adult protective services clients confirmed for self-neglect: characteristics and service use. 2197 89


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