Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004093 (asthenia)
 2,650 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are a number of causes of incontinence. The common forms of urinary incontinence, faecal incontinence or double incontinence, are stress related, in that voiding of urine or faeces occurs in response to a sudden increase in pressure in the bladder or anorectum that is not opposed by an adequate pressure increase in the sphincteric region. This weakness of the sphincter mechanism is due to chronic partial denervation of the striated sphincter muscles of the pelvic floor, comprising the external and sphincter muscle and puborectalis (puboanalis) components of the voluntary anal sphincter musculature, and the periurethral and intramural components of the urinary striated sphincter musculature. Denervation of these muscles occurs progressively following injury initiated during childbirth and then sustained by repeated stretch-induced injury during straining behaviour at stool. Age-related changes to this innervation may also be important. Weakness of the pelvic floor, and perineal descent during straining, lead to secondary changes in the anatomy of the bladder neck, of the anorectal angle, and of the smooth muscle of the internal urinary and anal sphincters. The cystometric and anal manometric changes found in patients with stress incontinence are secondary to this neurogenic weakness of the pelvic floor.
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PMID:The neurogenic hypothesis of stress incontinence. 222 58

Eight cases, 5 males and 3 females, of Chiari type 1 malformation aged from 9 to 51 years (mean 33.3 years) were analysed. The average age of the onset of symptoms was 29.6 years, between 7 and 44 years, and that from the onset of symptoms to the presentation to the hospital was 3.3 years ranged from 1 month to 16 years. Pain (87%) in the head or in the cervical region was the most common symptoms, the former was 5 cases and the latter was 2. The next common symptoms were unsteadiness and gait disturbance (50%). Weakness of one or more limbs was the complaints of 3 (38%) of the patients, and sensory impairment was 38%. Other symptoms included stiffness of the neck and shoulder, limitation of the neck movement, abnormal head posture, rectourinary incontinence and so on. In physical examination, foramen magnum compression signs (63%) and cerebellar signs (63% were most common and lower cranial nerve palsy (38%) and intracranial hypertension (25%) were included. Abnormalities of the skull and cervical spine were common on X-ray films. The were cervical fusion or occipitalization and basilar impression. On the angiograms, descended PICA was visualized in all cases. CT metrizamide myelography was performed in 2 cases and MRI was done in 1 case. They could clearly demonstrate the descended tonsils and were found to be the most reliable radiographic examination in the disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study of late onset Chiari type I malformation]. 362 Feb 19

Weakness, falls, incontinence or altered mental states may signal infection in the elderly, while fever may be absent. Bacteria are the most likely cause, and the most common sites are the respiratory system, the urinary tract and the soft tissues. Joint infections and meningitis must be remembered, as must bacterial endocarditis. Herpes zoster may be ameliorated by early treatment with acyclovir. Annual influenza vaccination is recommended, and amantadine may protect against influenza A (not B) during outbreaks. A single pneumococcal vaccination is recommended for those with chronic cardiopulmonary disease or alcoholism or for those who are immunosuppressed. All major hospitals and large nursing homes have committees which can give advice on infection control.
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PMID:Infections in the elderly. 832 95

Weakness of the pelvic floor is in the majority a disease of women. The most frequent complaints are urinary incontinence and visceral descent. The usual methods of gynaecological and urological operations to cure these impairments are demonstrated. Because several patients with a lax pelvic floor suffer from anorectal incontinence a simultaneous interdisciplinary treatment is proposed.
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PMID:[Pelvic floor insufficiency as an interdisciplinary responsibility]. 877 79

The experience of the faeces incontinence treatment in 295 children (age ranged from 1 to 15 years) is presented. Several original operations for surgical correction of the sphincter ani asthenia are proposed. The authors think that radical correction of faeces incontinence in children is necessary as early as at the age 6 to 7 years that is at the beginning of social activity. Efficient use of the above methods of the rectum closing apparatus creation allowed to achieve good results in 77.3-85.7% of the children.
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PMID:[Surgical treatment of fecal incontinence in children]. 1080 Mar 12

Patients with spinal cord injury or multiple sclerosis are often troubled by urinary incontinence due to detrusor (bladder muscle) overactivity. For patients who use intermittent self-catheterisation, empirical treatments for urinary incontinence include: optimisation of catheterisation; anticholinergic drugs; and, in some cases, surgery. The indications of botulinum toxin type A (Botox, Allergan) in France have been extended to cover this situation when anticholinergic drugs are ineffective. Clinical evaluation is based on 2 double-blind randomised placebo-controlled trials in a total of 691 patients who had an average of about 32 episodes of urinary incontinence per week.These trials tested the efficacy of a total dose of 300 or 200 units of botulinum toxin type A. Six weeks after toxin injection into the bladder wall, about 40% of patients had no further episodes of incontinence, compared to 10% of patients who received placebo injections. The median duration of the effect was 42 to 48 weeks after a dose of 200 units (13 to 18 weeks with placebo). It remains to be shown whether botulinum toxin has any long-term benefits in terms of complications (hospitalisation, urinary tract infections, etc.). The main adverse effects of botulinum toxin injections in these patients were urinary tract infections (51% versus 36% with placebo) and urinary retention (18% versus 3%). Both differences were statistically significant, and these events were most frequent in patients who had not yet started to self-catheterise (mainly patients with multiple sclerosis). Cases of autonomic hyperreflexia with favourable outcome were also reported. Botulinum toxin type A has been marketed since the 1990s in other indications. It has been linked to life-threatening adverse effects on tissues at a distance from the injection site, following its diffusion throughout the body. Muscle weakness, asthenia and constipation have been reported. A negative effect on the course of multiple sclerosis cannot be ruled out. Botulinum toxin type A injection into the bladder wall necessitates cystoscopy, an invasive and very inconvenient procedure that requires antibiotic prophylaxis and sometimes anaesthesia. Cystoscopy also carries a risk of punctures and tears, etc. In practice, existing treatment options are unsatisfactory for patients in whom anticholinergic drugs fail to control urinary incontinence due to neurogenic detrusor overactivity. Botulinum toxin type A temporarily prevents incontinence for a few months in about one-third of patients, but it is difficult to administer. In experienced hands, it may be beneficial for patients with very troublesome incontinence who self-catheterise.
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PMID:Botulinum toxin type A and neurogenic urinary incontinence: sometimes beneficial, if used safely. 2336 77

Hysterectomy is the most effective treatment for symptomatic myoma with no possible recurrence. Hysterectomy for myoma is associated with a high rate of patient satisfaction (95%). Quality of life is globally improved by hysterectomy, as is sexuality with less pelvic pain, asthenia, urinary symptoms and impaired mental health. Vaginal and laparoscopic routes should be preferred to diminish blood loss, hospital stay and postoperative pain. Patients with hysterectomy are at twice as much risk of requiring surgical treatment for incontinence later on. Stress urinary incontinence must be looked for during the preoperative history-taking.
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PMID:[Management of myoma: what is the place for hysterectomy and how to perform it?]. 2358 49