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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A controlled randomized double-blind study was done to determine the frequency and severity of leg cramps in 40 patients on dialysis with a history of leg cramps. All patients entered a 2 month placebo washout and were randomized into a 2 month double-dummy phase of quinine 325 mg at bedtime versus vitamin E 400 IU at bedtime. Of the 29 patients completing the study, 16 received quinine and 13 vitamin E. During placebo washout, the vitamin E group had a mean of 10.4 leg cramps per month, and the quinine group had a mean of 10.9. The vitamin E and quinine groups had a 1 month reduction in leg cramps to 3.3 and 3.6, respectively (p < 0.0005 for both groups combined); this was sustained at 2 months. A severity of pain index showed a statistically significant decrease for both groups. The 95% confidence interval for the difference between the number of leg cramps after vitamin E versus quinine treatment (95% confidence interval, -3.8, +3.2) suggests similar efficacy. Quinine and vitamin E were effective treatments for leg cramps in these patients. Considering the potential toxicity of quinine, vitamin E is recommended as the initial treatment of choice for patients on dialysis with leg cramps.
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PMID:Dialysis leg cramps. Efficacy of quinine versus vitamin E. 145 7

In the elderly, arterial disease may not necessarily require operative intervention if the patient is not functionally disabled or can adjust to self-imposed limitations. However, with nonhealing skin lesions, gangrene, impending limb loss, or ischemic rest pain, reconstructive arterial surgery must be considered. Pain at rest signals advanced limb-threatening ischemia. The pattern of pain distribution over the foot distinguishes it from common nighttime leg cramps.
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PMID:Peripheral vascular disease: treatment and referral of the elderly. Part I. 388 86

Sleep disorders are common in midlife and older adults, coinciding with encephalographic changes in sleep patterns, stressful life events, and chronic diseases of aging. Differential diagnosis includes respiratory abnormalities (including obstructive sleep apnea), leg cramps, nocturia, ulcer-related pain, medication use, depression, and anxiety. Sedative-hypnotic agents may be appropriate for selected patients, with short-acting substances preferred in all cases. Dosage and dosing schedules should be discussed with the patient to ensure compliance and to avoid possible misuse of these agents.
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PMID:When your older patient can't sleep: how to put insomnia to rest. 836 64

Sleep disorders occur in 74-98% of patients with idiopathic Parkinson's disease (PD), adversely affecting their quality of life. Sleep disruption takes the form of sleep fragmentation with frequent and prolonged awakenings and daytime sleepiness. Nocturia, difficulty in turning over in bed, painful leg cramps, vivid dreams/nightmares, back pain, limb/facial dystonia and leg jerks are the main causes of nocturnal awakening in PD patients. Sleep disturbance gradually worsens with disease progression, suggesting that it is related to the severity of the disease. Sleep disturbances may be generally considered as part of the normal aging process, being more common in the elderly. However, no significant associations between sleep disturbances and either age or disease duration was found in a survey of 100 PD patients. Disturbed sleep maintenance in PD patients was more severe than in age-matched controls, and nocturnal awakening was frequently caused by nocturia, pain, stiffness and difficulty in turning over in bed. Sleep disturbance is also a complication of chronic levodopa therapy. Recent data suggest that controlled-release levodopa is less likely to cause nocturnal symptoms than standard levodopa, particularly in mild-to-moderate disease. Depression, which is common in PD patients, contributes to sleep disturbance but has a lesser influence than the disease process itself. Hypnotic and sedative agents, as well as anti-depressants if required, are useful in ameliorating sleep disturbances in PD patients; intranasal desmopressin appears to be effective in reducing nocturia.
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PMID:Sleep disorder related to Parkinson's disease. 911 82

The purpose of this cross-sectional survey was to examine subjective sleep quality, and identify factors that disturb sleep in cognitively intact nursing home (NH) residents. We interviewed 51 cognitively intact NH residents using a validated instrument, the Pittsburgh Sleep Quality Index (PSQI). Questions regarding the environment, symptoms suggestive of restless leg syndrome, and periodic leg movements were also asked. Three individuals were unable to answer all the questions and, therefore, analyses were performed on 48 subjects. Seventy-three percent of the subjects were identified as "poor" sleepers based upon a total PSQI score > 5. Factors that disturbed the residents' sleep three or more times a week were: nocturia (71%), environment-related noise or light (38%), pain (33%), feeling too hot (6%) and leg cramps (6%). On multiple regression analysis, poor sleep correlated with depressive symptoms and comorbidity, not with age or gender. Poor sleep quality is common among cognitively intact NH residents. In our study, nocturia, environmental factors and pain were the most commonly perceived causes of sleep disturbance. Poor sleep independently correlated with depressive symptoms and comorbidity. These findings should be kept in mind when evaluating sleep complaints in the nursing home.
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PMID:Factors that disturb sleep in nursing home residents. 925 80

Hesperidin, a bioflavonoid, is an abundant and inexpensive by-product of Citrus cultivation. A deficiency of this substance in the diet has been linked with abnormal capillary leakiness as well as pain in the extremities causing aches, weakness and night leg cramps. No signs of toxicity have been observed with the normal intake of hesperidin or related compounds. Both hesperidin and its aglycone hesperetin have been reported to possess a wide range of pharmacological properties. This paper reviews various aspects of hesperidin and its related compounds, including their occurrence, physical and chemical properties, analysis, pharmacokinetics, safety and toxicity and the marketed products available. A special emphasis has been laid on the pharmacological properties and medicinal uses of these compounds.
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PMID:Chemistry and pharmacology of the Citrus bioflavonoid hesperidin. 1174 57

A 67-year-old white woman developed severe nausea, vomiting, diffuse abdominal cramping pain, and blurred vision followed by a syncopal episode after taking 1 tablet of quinine for leg cramps. Examination was significant for fever, elevated blood pressure, and confusion without any focal neurological deficits. Laboratory studies showed markedly elevated liver enzymes, elevated lactate dehydrogenase, anemia, thrombocytopenia, and acute renal failure. Peripheral smear showed many schistocytes and burr cells. She later recalled taking quinine more than 40 years before while on a trip to the Philippines. The patient was treated with 7 sessions of plasmapheresis with a rapid normalization of her hematological parameters. Three weeks of dialysis support were required before return of renal function to baseline. Re-exposure to quinine can cause a rapid onset of hemolytic uremic syndrome-like syndrome. We are not aware of any cases of hemolytic uremic syndrome-thrombotic thrombocytopenic purpura in response to re-exposure to a single tablet of the drug 40 years after first use.
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PMID:Quinine induced HUS-TTP: an unusual presentation. 1467 3

A leg cramp is a pain that comes from a leg muscle. It is due to a muscle spasm which usually occurs in a calf muscle, below and behind a knee. Leg cramps (often called night cramps) usually occur most commonly at night when in bed. Night leg cramps are involuntary painful contractions of skeletal muscles arose in the calves and soles of the feet. Although in most cases they aren't harmful and resolve easily in some instances they have a long duration and can result in intense pain, disturb normal sleep and make a person feel anxious. Pathophysiology of leg cramps is poorly understood. The aim of our study was to determine the role of metabolic syndrome in relation to night leg cramps. The study included 86 subjects aged 34 to 88 years. Metabolic syndrome group consisted of 40 subjects (10 men (25%) and 30 women (75%)); the control group consisted of 46 persons (9 men (19.5%) and 37 women (80.5%)). According to frequency and intensity of manifestation leg cramps were subdivided into less frequent and frequent leg cramps. Blood samples were analysed for lipids, fasting glucose, red blood cells and electrolytes. Persons were screened for leg vein insufficiency as well. The investigation showed that 77.5% (31/40) of patients with metabolic syndrome had leg cramps, from which 60% (24/40) had frequent leg cramps. In control group 73.9% (34/46) had leg cramps, from which 50% (23/46) had frequent leg cramps. Among known predisposing factors leg cramps most often were associated with deep vein insufficiency and superficial vein varicose. High frequency of night leg cramps in our study is due to female predominance (75% versus 25% women and men, respectively) and age distribution in our study population (from 34 to 88 years old). The investigation showed that people often experience nocturnal leg cramps. Leg cramp is slightly increasing among the patients with metabolic syndrome. Frequent leg cramps were observed in 60% of cases in metabolic syndrome group versus 50% of cases in controls.
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PMID:Leg cramps in relation to metabolic syndrome. 1920 19

BACKGROUND: Recent research indicates that sleep disturbances are common in persons with multiple sclerosis (MS), though research to date has primarily focused on the relationship between fatigue and sleep. In order to improve treatment of sleep disorders in MS, a better understanding of other factors that contribute to MS sleep disturbance and use of sleep medications in this population is needed. METHODS: Individuals with MS (N = 473) involved in an ongoing self-report survey study were asked to report on use of over-the-counter and prescription sleep medications. Participants completed the Medical Outcomes Study Sleep (MOSS) scale and other common self-report symptom measures. Multiple regression was used to evaluate factors associated with sleep problems and descriptive statistics were generated to examine use of sleep medications. RESULTS: The mean score on the MOSS scale was 35.9 (standard deviation, 20.2) and 46.8% of the sample had moderate or severe sleep problems. The majority of participants did not use over-the-counter (78%) or prescription (70%) sleep medications. In a regression model variables statistically significantly associated with sleep problems included depression, nighttime leg cramps, younger age, pain, female sex, fatigue, shorter duration of MS, and nocturia. The model explained 45% of the variance in sleep problems. Of the variance explained, depression accounted for the majority of variance in sleep problems (33%), with other variables explaining significantly less variance. CONCLUSIONS: Regression results indicate that fatigue may play a minor role in sleep disturbance in MS and that clinicians should consider the interrelationship between depression and sleep problems when treating either symptom in this population. More research is needed to explore the possibility of under-treatment of sleep disorders in MS and examine the potential effectiveness of nonpharmaceutical treatment options.
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PMID:Beyond fatigue: Assessing variables associated with sleep problems and use of sleep medications in multiple sclerosis. 2083 67

Treatment for fibromyalgia is largely empiric and supportive, and favors a multidisciplinary approach. Despite treatment, symptomatic relief is often inadequate and temporary. Over 90% of fibromyalgia patients seek alternative medical care. There is much anecdotal evidence that applying a bar of soap to the skin can relieve leg cramps. Expanding on this idea, I created a skin patch from soap-scented oil, which was used to treat muscular pain and spasms. After receiving positive feedback from several patients, I hypothesized that the scent of the oil itself, applied directly to the skin, is responsible for the pain-relieving and muscle-relaxant properties of the skin patch. Furthermore, I hypothesize that this soap-scented oil skin patch is an effective treatment for the pain associated with fibromyalgia.
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PMID:Soap-scented oil skin patch in the treatment of fibromyalgia: A case series. 2119 34


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