Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Theories on "Coping" try to explain which resources people use to master crises and conflict situations. Reactions to challenges of life are considered as "coping strategies". In psychosomatic research, the notion of "coping" serves to describe how patients can handle physical or mental illness. Myatrophic (or amyothrophic) lateral sclerosis (ALS) is a rare chronic progressive disease of the nervous system with a gradual loss of motor neurons, resulting in muscular atrophy, weakness and spasticity. Since the etiology is unknown and no curative treatment available, most patients die from respiratory failure within a few years. In a follow-up study on physical disability, medical care and social support in 21 patients with advanced ALS, we tried to address the question how patients get along with such a threatening condition. After semi-standardized clinical interviews with patients and close relatives, two investigators gave independent descriptions of reported or observed "coping strategies" (rated as "not at all-barely-possibly-probably-very probably present"). Considering 17 patients assessed by both raters, significant agreement (Kendall's W) was achieved in three patients only. A comparison of aggregated answers (chi 2-Test) revealed different response sets, since one rater tended to choose extreme scale points, while the other preferred undecided answers. Differences of mean scores were observed in 8 out of 21 items, while significant correlations between investigators were obtained in another 8, including, though, only 2 of those 5 items which both had rated as "probably present" in no less than 50% of the patient sample ("Dejection & Flight-Brooding-Keeping the Situation Open-Distraction-Self-Isolation").(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Assessment of "coping with disease" in patients with amyotrophic lateral sclerosis (ALS): on the use of an interviewer assessment rating scale]. 223 71

The purpose of this study was to develop a simple and reproducible model of scoliosis in the rat without producing direct trauma to the spine, in order to both provide a system for the study of human scoliosis and to ultimately study the conditions under which distraction-induced trauma might occur. Right lateral curvatures were produced in three groups of rats (N = 36, 59, 25) at 18-21 days of age by suturing the inferior angle of the scapula to the ipsilateral bony pelvis. In the first group of animals, it was found that a minimum period of 6 weeks of tethering was required in order to produce permanent structural curvatures after release of the tethering sutures. In the second group of rats, a number of morphologic and histologic changes characteristic of human scoliosis were noted, including apical wedging, deviation of the apical spinous process, pelvic asymmetry, rib hump deformity, vertebral rotation, displacement of the nucleus pulposus, disorganized columnization of disc cartilage cells, and an increased number of Type I muscle fibers in paravertebral muscle on the convex side of the curve. Finally, in the third group of rats, a mild spasticity was seen in the ipsilateral hindlimb in approximately one-third of the animals with curvatures greater than 40 degrees. This spasticity was not associated with a change of latency or amplitude of the somatosensory-evoked potential (SSEP). Each curvature group displayed SSEP characteristics that were not statistically different from unoperated control animals. These results indicate the validity of this model system for the study of scoliosis, and, in particular, its usefulness for the study of operative-induced trauma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Experimental scoliosis in the rat. I. Methodology, anatomic features and neurologic characterization. 305 39

Considerable progress has been made in understanding and treating pain associated with pediatric AIDS. The World Health Organization (WHO) estimates that 1000 new pediatric HIV infections occur daily, with 67% in Africa and 30% in South and Southeast Asia. Perinatally infected children show two types of progression, a precocious form that is usually fatal by the 4th year and a less rapidly progressing form in which survival exceeds 80% at age 7. Neurologic effects are frequently apparent by 3-6 months in the severe form. The pain may result specifically from the HIV infection and its complications, from intercurrent or opportunistic infections, or from examinations and treatment. The emotional pain suffered by pediatric HIV patients is often very great. Seropositive children are more subject to bacterial infections than seropositive adults, and their infections are more recurrent, prolonged, and painful than those in immunocompetent children. Infants with HIV encephalopathy may suffer painful sensations from mild stimuli and extreme irritability and spasticity. Abdominal HIV pain often results from multifactorial etiologies, and the usual therapies may be of little efficacy. Children with full-blown AIDS may complain of joint or muscle pain or headaches that are of unexplained etiology. Indications for painful diagnostic procedures should be carefully considered before the child is subjected to them, and protocols for analgesia should be developed. Pain medications may be selected according to the WHO classification, in accordance with the intensity of the pain. Antidepressants and anticonvulsants may be used for neuropathic pain, and painful spasticity may be reduced with myorelaxants. Children are often responsive to behavioral methods such as relaxation, hypnosis, or distraction.
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PMID:[Pain from AIDS (child)]. 1234 7

We describe an unusual case of a 43-year-old woman who had developed bilateral spontaneous periacetabular fractures secondary to severe myoclonic contractions. The absence of antecedent history of trauma and detection of muscular spasticity at presentation prompted neurologic investigations that led to the diagnosis of multiple sclerosis in this patient. The fractures were treated successfully by open reduction and internal fixation initially. Since fracture reduction was delayed for almost 1 year, a special distraction frame had to be used. Deterioration in the medical condition of the patient with return of severe spasticity caused a dramatic failure of the fixation on one side 2 years later. This case report confirms that fractures, usually requiring high-impact trauma, can and do develop spontaneously in patients with sustained myoclonic contractions, and these fractures can be the presenting indication of an underlying neuromuscular disorder.
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PMID:Bilateral spontaneous periacetabular fracture: an unusual complication of multiple sclerosis. 1509 Dec 75

Distraction osteogenesis is useful for correcting limb length inequality, deformities, or short stature. Despite success with bone formation, soft tissue maladaptations including muscle and joint contracture may lead to undesirable results. Botulinum toxin A has been useful in treating spasticity in cerebral palsy, and has been used clinically in select cases to allay contracture in distraction osteogenesis. This study examines the toxin's efficacy in preventing distraction-induced loss of muscle strength and range of motion. The left tibias of 15 New Zealand White rabbits were distracted 1.5 mm/day until approximately a 20% gain was achieved. Each treatment group was divided into animals injected with saline or botulinum toxin in either the gastrocnemius or tibialis anterior muscles. A control group of two additional animals underwent no surgical procedure. Strength and range of motion were assessed prior to, and following, the experiment. At the study's end, animals were euthanized and muscles were harvested, when lengths and weights were recorded. All muscles injected with botulinum toxin showed decreased wet weight and persistent weakness upon completion of the study. Range of motion decreased in all distracted animals. When the gastrocnemius was injected, its strength was reduced but the tibialis anterior strength was preserved, and the limb achieved 22% greater dorsiflexion than saline controls (p = 0.016). When the tibialis anterior received the toxin, plantarflexion was increased by 23% (p = 0.049). Botulinum toxin injection prior to limb distraction increases the "post-lengthened" excursion of the injected muscle and this increased length may have a protective effect on its antagonist. In toxin-injected gastrocnemius muscles, the level of equinus contracture is reduced due to length gains in the Achilles tendon while the anterior tibialis maintains its ability to generate torque. Injection of botulinum toxin in the gastrocnemius may minimize equinus contracture and protect the anterior tibialis from damage during human tibial lengthening. Longer follow-up studies are needed to ensure that toxin-induced muscle weakness resolves with time.
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PMID:Effects of botulinum toxin A on functional outcome during distraction osteogenesis. 1726 22