Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A Portuguese female, aged 47 years, who had emigrated to Spain, was admitted to the hospital in 1991 for pontine haematoma. The patient, four siblings and her father were affected by a peripheral neuropathy, indicating autosomal dominant inheritance. The patient presented in the 2nd decade with sensory and motor neuropathy beginning in the lower extremities. Alternating constipation and diarrhoea, and urinary incontinence became uncontrollable. She had to be colostomised, and, eventually, confined to a wheelchair from the age of 43. Neurological examination showed bilateral facial involvement, and severe signs of sensory and motor peripheral neuropathy, and later right hemiplegia. There were abnormalities of atrial rhythm and left bundle branch block. Computerised axial tomography and magnetic resonance images demonstrated left-sided pontine haemorrhage. Nerve conduction studies revealed severe diminution of motor conduction velocity and absence or reduction of amplitude of sensory and motor action potentials. Inanition and a respiratory infection led to her death. Clinical diagnosis was type I familial amyloid polyneuropathy (FAP). Postmortem examination demonstrated amyloid deposits in peripheral nerves, including spinal roots and cranial nerves, leptomeninges, thyroid, breasts, heart, adrenal glands, kidneys, intestines, pancreas, and meningeal and some pontine vascular structures. Advanced pontine haematoma was verified. Cerebral haemorrhage usually occurs with cerebrovascular amyloidosis, but exceptionally with FAP. A minority of patients presenting with CNS haemorrhage showed arteriovenous malformation or embolism [Da Silva Horta and Dias Coelho (1960) Arch 'de Vecchi' Anal Patol Med Clin 31 = 163-172].(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Type I familial amyloid polyneuropathy and pontine haemorrhage. 831 Aug 8

The aim of the current study was to analyze the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar degenerative disc disease for senior patients. The clinical and follow-up data of senior patients were retrospectively reviewed. Patients were divided into a PTED group and an open surgery group. Parameters were analyzed, including surgery time, intraoperative fluoroscopy time, intraoperative blood loss, postoperative complications, visual analog scale (VAS) and Japan Orthopedic Association (JOA) scores. Compared with the open surgery group, the surgery time and intraoperative blood loss were decreased, while the intraoperative fluoroscopy time was increased, in the PTED group (P<0.001). Significant improvements in VAS and JOA scores were identified within both groups from preoperative to 12 months following surgery (P<0.001). VAS and JOA scores were significantly improved in the PTEN group compared with the open surgery group at 1 week after surgery (P<0.001), but there was no significant difference between groups prior to and at 12 months following surgery. The incidence of venous thrombosis of the lower extremities in the PTED group was decreased compared with the open surgery group (P<0.05). In the open surgery group, patients suffered from multiple postoperative complications, including constipation, urinary system infection, wound infection, gastrointestinal hemorrhagic stress ulcer, pneumonia, pulmonary embolism, mortality following myocardial infarction, mortality following cerebral infarction, and hemiplegia following cerebral hemorrhage. By contrast, patients in the PTED group did not experience any of these complications. In conclusion, PTED resulted in reduced trauma and a lower incidence of severe complications compared with open surgery, which suggests that PTED is a safe and effective minimally invasive surgery for senior patients with lumbar degenerative disc disease.
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PMID:Percutaneous transforaminal endoscopic discectomy in the treatment of senior patients with lumbar degenerative disc disease. 3065 75

Purple urine bag syndrome (PUBS) is a rare syndrome characterized by production of indigo (blue) and indirubin (red) pigments due to bacterial colonization in urinary catheter. The pathogenesis of PUBS is related to the combination of these two pigments produced from the metabolism of tryptophan. Tryptophan turns into indole by deamination, indole turns into indoxyl sulphate by hepatic conjugation and indoxyl sulphate is secreted into urine. Sulphatases and phosphatases enzymes produced by bacteria like Providencia stuartii and Providencia rettgeri, Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli, Enterococcus spp., Morganella morganii, Pseudomonas aeruginosa, Citrobacter spp. and group B streptococci convert indoxyl sulphate to indoxyl. In the urinary tract, oxidation of indoxyl results in the production of indigo and indirubin pigments. These pigments react with polyvinyl chloride (PVC) lining of the urinary catheter bag and the reaction results purple discoloration of urine. Urine discoloration is very important clinical sign in the differential diagnosis of several pathological conditions such as hematuria, urinary system tumors and drug side effects and may be disquieting for patients, families and healthcare workers. Purple urine discoloration is rarely reported in the literature and it is generally associated with urinary tract infection. In this report, a 60 years old woman with a past medical history of significant chronic kidney disease undergoing regular hemodialysis, chronic constipation and hepatitis B was admitted to our neurology clinic because of acute intracerebral hemorrhage. She had confusion and right hemiplegia in her neurological examination and required urinary catheterization due to immobilization. Red coloration was observed in urine on the tenth hospital day. Although this coloration was thought to be hematuria, according to urine examination it was not hematuria. Then urine color turned into purple within two days. The next day, because of fever, full blood count and other blood investigations were performed and urine was sent to the laboratory for culture. Empirical piperacillin-tazobactam and teicoplanin antibiotic treatments were commenced. In the urine culture, 105 cfu/ml Enterococcus faecalis was isolated. According to the antibiotic susceptibility results the therapy was changed and meropenem was added to the treatment. For her constipation, supportive managements such as hydration, nutrition and laxative treatment were applied. After all the treatments, the patient's constipation regressed, the urine had become normal colored and the following urine cultures were not revealed any bacterial growth. As in this case, when the urine discoloration occurs, PUBS should be kept in mind which is especially seen in elderly female patients with chronic constipation, urinary catheterization, urinary tract infection and renal failure.
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PMID:[Purple Urine Bag Syndrome: A Rare Clinical Case]. 3170 43