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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The continuous electric stimulation of the anal sphincter leads to the onset of a very quick fatigue of the muscle, with a progressive decrease of the amplitude of contraction after 15 min of stimulation. Under the same experimental conditions intermittent stimulation leads to a sustained contraction amplitude. Ts and Tr combinations that can give efficiency rates of contraction above 80 per cent were defined. The results of this study could be applied when intermittent electric stimulation of the pelvic floor is indicated for the treatment of anal or urinary incontinence.
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PMID:Study on the efficiency of electric stimulation of the pelvic floor. 125 29

1. By recording with 2 pairs of wire electrodes from human sacral nerve roots (S3-S5) rhythmic as well as occasional firing was observed in alpha 2 and alpha 3-motoneurons in response to physiologic stimulation of the urinary bladder and the anal canal. The rhythmic firing consisted of periodically occurring impulse trains, most likely produced by true spinal oscillators which drove the motoneurons. 2. Alpha 2-motoneurons, innervating fast fatigue-resistant muscle fibres, were observed to fire with impulse trains of about 2 to 4 action potentials (Ap's). These impulse trains occurred every 110 to 170 msec (5-9 Hz). Alpha 3-motoneurons, innervating slow fatigue-resistant muscle fibres, fired about every 1400 msec (approximately 0.7 Hz) with impulse trains of about 11 to 60 Ap's. Alpha 1-motoneurons, innervating fast fatigue muscle fibres, and gamma-motoneurons were not observed in the continuous oscillatory firing mode. 3. Sphincteric motoneurons were observed most likely in the oscillatory firing mode in response to the sustained stretch (reflex) of the external and sphincter or to retrograde filling of the bladder (urethro-sphincteric guarding reflex), in order to preserve continence. A urethral sphincteric alpha 2-motoneuron increased its mean activity from 0.5 to 18 Ap's/sec during retrograde filling by changing its firing pattern from the occasional spike mode via the transient oscillatory firing mode to the continuous oscillatory mode. Up to a filling of the bladder of 500 ml the mean activity of the stretch receptors, measuring probably mural tension, increased roughly proportionally and the sphincteric motoneuron increased its activity to about 1 Ap/sec in the occasional spike mode. Up to 600 ml, the motoneuron responded in the transient oscillatory mode with mean activities of up to 5 Ap's/sec. With higher bladder fillings, the flow receptors afferents fired additionally, probably according to pressure symptoms, and the motoneuron switched into the continuous oscillatory firing mode and increased its activity up to 18 Ap's/sec at 700 ml. When the bladder was about 800 ml full, the stretch afferent activity decreased, the flow receptor activity increased strongly and the alpha 2-motoneuron activity decreased; the overflow incontinence had probably started. Micturition was not observed, probably because of brain death. 4. It is suggested that one adequate stimulus for an alpha 2-motoneuron of the external anal sphincter to jump into the oscillatory firing mode, was the activity from secondary spindle afferent (SP2) fibres from external anal sphincter muscle spindles.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Oscillatory firing of single human sphincteric alpha 2 and alpha 3-motoneurons reflexly activated for the continence of urinary bladder and rectum. Restoration of bladder function in paraplegia. 193 58

Six patients incapacitating faecal incontinence, in whom conventional treatment had either failed or was contraindicated, were treated by a new technique. A neonanal sphincter was constructed by transposing the gracilis muscle around the anal canal. Chronic neuromuscular stimulation via an implanted electrical stimulator was then used in an attempt to convert the muscle to a slow twitch fatigue resistant muscle. Physiological measurements suggested that this conversion had begun, enabling the neosphincter to mount a sustained contraction. Five patients had their covering stomas closed, and continence was improved in all of them. However, one patient could not cope psychologically with the stimulator, and another patient was continent for long periods only when the neosphincter was used in conjunction with a silastic plug. This new technique may benefit selected patients with incontinence whose only alternative would be a permanent stoma.
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PMID:Construction of a neoanal sphincter by transposition of the gracilis muscle and prolonged neuromuscular stimulation for the treatment of faecal incontinence. 233 92

Forty-six patients with senile dementia and their primary caregivers were studied. The strain score of the caregiver and the mental and behavioural deviation of the patients were estimated. Memory problems, listlessness, apathetic, critical and demanding behaviour and urinary incontinence were the most disturbing features of the patients. Eighty-five percent of the caregivers felt despair and anger and 75% complained of chronic fatigue. There was a statistical significant correlation between caregivers strain on one hand, and duration of symptoms, degree of dementia and deviation of behaviour on the other hand. Elderly women caring for their husbands and daughters caring for their parents were especially at risk. Future services must concentrate on maintaining the ability of caregivers to proceed the caring task.
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PMID:Strain on caregivers of demented elderly people living at home. 335 94

Parenthood by design involves realistic preparation for practical aspects of parenting as well as the romantic illusions fostered by relatives, social pressure, and the media. The ideals do not mention the physical discomfort, exhaustion, jealousy, anger and frustration encountered in a normal puerperium. Many women have not returned to normal sexual activity, work and sports even by 6 weeks after delivery. Perineal discomfort is still experienced by 70% after 10 days, especially in cases of assisted vaginal delivery. Urinary incontinence is present in 20% up to 3 months after normal vaginal delivery. Many women report fatigue as the reason for not resuming sexual intercourse. Family interactions are stressed by the newcomer: rivalry on the part of the husband or siblings is common. Modern education in the attempt to train people for vocational competence has left out parenting. In England, midwives teach classes of 20 women for 5 contact hours in late pregnancy, and are expected to cover all aspects of pregnancy, labor, delivery, baby care, postnatal adjustment and support services. The schools have sex education, fostering freedom in life styles for young people, but little emphasis on responsibility. There are some community organizations such as the La Leche League, the National Childbirth Trust and the Meet-A-Mum Association that offer support during and after pregnancy. Accidental pregnancy with education as crisis intervention is inadequate for the future; parenthood by design would permit couples to experience parenthood as a period of growth based on a fuller understanding of practical reality.
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PMID:Parenthood by design. 363 45

In a study of bacteriuria in elderly (mean age 85 years, range 69 to 101), mostly middle- and upper-class Jewish subjects, attempts were made to determine if bacteriuria without dysuria is otherwise asymptomatic. Seventy-two subjects (59 women and 13 men) without dysuria were questioned about other urinary symptoms (incontinence, frequency, urgency, suprapubic pain, flank pain, fever) and symptoms indicating a lack of well-being (anorexia, difficulty in falling asleep, difficulty in staying asleep, fatigue, malaise, weakness) when they were with and without bacteriuria. Twenty-two subjects had bacteriuria that resolved spontaneously; bacteriuria subsequently developed in 24 nonbacteriuric subjects; and 26 subjects had bacteriuria that resolved with antimicrobial therapy. Subjects occasionally reported urinary symptoms (especially incontinence) and commonly reported symptoms indicating a lack of well-being when they were with and/or without bacteriuria. However, no differences in symptoms were found when bacteriuric subjects were compared with themselves when they were nonbacteriuric. Thus, bacteriuria without dysuria in the elderly appears to be asymptomatic.
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PMID:Lack of association between bacteriuria and symptoms in the elderly. 379 58

The striated musculature of the dog urethra was studied histochemically. Two main groups of muscle fibers could be identified: 1 with slow twitch oxidative fibers, which are fatigue resistant (type 1), and 1 with fast twitch fibers (type 2). The fast twitch fibers were subdivided into glycolytic (fatiguable) and oxidative glycolytic (fatigue resistant) fibers: the latter constitute 20 per cent of all fast twitch fibers. Type 1 constitutes of 35 per cent of the whole musculature and its proportion tends to decrease toward the distal end of the external urethral sphincter. From these observations we infer that type 1 fibers are likely responsible for continence at rest and that type 2 fibers are recruited in stress conditions, for example, during coughing or sneezing. Additional studies are needed to confirm this conjecture. The clinical implications of these studies for the control of incontinence, urinary retention and dyssynergic urethral sphincter are presented.
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PMID:Histochemical study of urethral striated musculature in the dog. 621 91

We evaluated five types of electrical stimulation (continuous, intermittent pseudorandomized, randomized (stochastic), and intermittent randomized) for their effects on muscle contraction and muscle fatigue in 12 patients with urinary incontinence. Continuous stimulation, used in the available commercial stimulators, was not optimal. Randomized (stochastic) stimulation seems to be optimal although this conclusion was not statistically confirmed.
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PMID:Optimal parameters of electrical stimulation in the treatment of urinary incontinence. 696 15

A 24-year-old oil well tester was rendered semiconscious by hydrogen sulfide (H2S). He received oxygen and was hospitalized but released in 30 minutes. The next day, nausea, vomiting, diarrhea, and incontinence of urine and stool led to rehospitalization. These problems and leg shaking, dizziness, sweating, trouble sleeping, and nightmares prevented his return to work. A physical examination, chest x-ray, and pulmonary function tests were normal 39 months after the episode but vibration sense was diminished. Two choice visual reaction times were delayed. Balance was highly abnormal (5 to 6 cm/sec) with eyes closed. Blink reflex latency was slow (R-1 17.5 msec versus normal 14.3 msec). Numbers written on finger tips were not recognized. Verbal and visual recall were impaired but overlearned memory was intact. Cognitive functions measured by Culture Fair, block design, and digit symbol were impaired. Perceptual motor was slow. Scores for confusion, tension-anxiety, depression, and fatigue were elevated and vigor was reduced. Forty-nine months after exposure his reaction time, sway speed, and color vision had not improved. His recall and his cognitive, constructional, and psychomotor speeds had improved but remained abnormal. These deficits are most likely due to H2S. Similar testing of other survivors is recommended.
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PMID:Case report: profound neurobehavioral deficits in an oil field worker overcome by hydrogen sulfide. 823 84

Scientific studies investigating the postpartum period are scarce, and observational studies greatly outnumber controlled trials. Many studies are biased in their assumptions about the social roles of women and men and in the interpretation of observations and treatment strategies. The published literature is fragmentary; few researchers have attempted a comprehensive, biopsychosocial system-oriented view of postpartum health. More research is needed on the occurrence and treatment of such common postpartum problems as urinary incontinence, sexual dysfunction, and back pain. Widespread application of what is already known about support for breast-feeding, prevention of fatigue and depression, contraception, and maintenance of healthy lifestyles will require innovations in healthcare delivery, professional practices, and social policy, particularly in the occupational arena. Many postpartum problems have been found to be iatrogenic and responsive to changes in the routine care of mothers and newborns. Finally, it is clear that women of lower education and socioeconomic status and those with less social support are consistently at higher risk for postpartum and parenting problems; great benefits are likely from interventions that enhance the well-being of these mothers and infants.
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PMID:Postpartum care and breast-feeding. 837 63


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