Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The DSM-III-R criteria for uncomplicated alcohol withdrawal require the presence of coarse tremor of the hands, tongue, or eyelids plus one of a number of other clinical features. We examined the validity and other characteristics of these items in 137 patients in pure alcohol withdrawal using the reliable and valid Clinical Institute Withdrawal Assessment for Alcohol. The DSM-III-R items of hand tremor amplitude, nausea or vomiting, headache, transient hallucinations, autonomic hyperactivity (increased pulse or sweating), and anxiety correlated significantly with total score and significantly indicated clinical severity. Addition of an "agitation" item improved the correlation. The diagnostic accuracy is greater than 95% if any two or more items are present. The number of positive items, of which tremor can be one, to grade clinical severity shows that a score of 2 indicates "very mild"; 3, "mild"; 4, "moderate"; and 5, "severe.". We propose that an Alcohol Withdrawal Diagnostic Inventory and a DSM-III-R-compatible brief Clinical Institute Withdrawal Assessment for Alcohol are useful for clinical research, where graded symptom characterization is needed. Our data may be helpful in the development of criteria for DSM-IV.
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PMID:Characterization of DSM-III-R criteria for uncomplicated alcohol withdrawal provides an empirical basis for DSM-IV. 202 Dec 96

A dementing syndrome has been identified in a group of psychiatric cases aged 71-90 years, presenting initially with a subacute/acute confusional state, often fluctuating and associated with visual hallucinations and behavioural disturbances. Clinically, these cases did not meet criteria for a diagnosis of Alzheimer's disease, and many were assigned to the multiinfarct dementia group, although no significant ischaemic lesions were evident at autopsy. Mild extrapyramidal features were apparent in a number of cases but the characteristic clinical triad of Parkinson's disease, i.e., tremor, rigidity, and akinesia, was absent. Detailed neuropathological examination revealed Lewy body formation and selective neuronal loss in brain stem and other subcortical nuclei, accompanied by Lewy body formation in neo- and limbic cortex, at densities well below those previously reported in diffuse Lewy body disease. A variable degree of senile degenerative change was present; numerous senile plaques and minimal neurofibrillary tangles in most cases. Neither the clinical nor the neuropathological features of this group are typical of Parkinson's or Alzheimer's disease, but suggest a distinct neurodegenerative disorder, part of the Lewy body disease spectrum, in which mental symptoms predominate over motor disabilities and lead to eventual psychogeriatric hospital admission. In a sequential series of autopsies conducted on clinically assessed demented patients, neuropathological analysis has indicated that such cases may comprise up to 20% of a hospitalized population of demented old people over the age of 70 years, an observation clearly relevant to the diagnosis and management of dementia in the elderly.
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PMID:Senile dementia of Lewy body type. A clinically and neuropathologically distinct form of Lewy body dementia in the elderly. 215 23

Using the presence of widespread cortical Lewy bodies (LB) as the pathologic criteria of diffuse Lewy body disease (DLBD), we describe serial neurologic and mental status examinations in 6 patients with DLBD, 3 patients with Alzheimer's disease (AD), and 1 patient with Parkinson's disease (PD). The 6 patients with DLBD included 3 with neocortical neurofibrillary tangles (NFT) consistent with coincident AD. Most patients with DLBD had gait impairment concurrent with mild to moderate dementia. Abnormalities of tone or resting tremor were also prominent early symptoms in the subjects with DLBD, but not AD. Patients with DLBD frequently had abnormal EEGs with background posterior slowing and a frontally dominant burst pattern at the time of mild to moderate dementia. Agitation, hallucinations, and delusions were frequent early symptoms in DLBD patients. Patients with DLBD without concomitant AD had numerous Alz-50 negative cortical plaques. Patients with DLBD have a distinct clinical syndrome that can be differentiated from AD. Pathologic features, including the absence of Alz-50 immunoreactivity, also differentiate DLBD from AD.
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PMID:Antemortem diagnosis of diffuse Lewy body disease. 217 Aug 65

Thyrotoxic crises occurred in six patients (four women aged 51, 63, 72 and 76 years; two men aged 52 and 63 years). In four patients the crisis was triggered by a contrast medium containing iodine, and in one by amiodarone. The cause of the crisis in the 51-year-old woman remained uncertain. After a latent period of up to two months, T3 and T4 concentrations rose in all the patients, and abnormal findings such as tachycardia, increased blood pressure, dehydration, tremor, restlessness, hallucinations and coma ensued. Because of ineffective conservative treatment, five patients underwent subtotal thyroidectomy. In all five the symptoms and signs of hyperthyroidism were promptly relieved, and the postoperative course was uneventful. The 76-year-old woman was considered unfit for surgery because of her cardiac condition, and she died of left ventricular failure resistant to therapy.
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PMID:[Subtotal thyroid gland resection as therapy for thyrotoxic crises]. 233 59

Levodopa (+ dopa decarboxylase inhibitor) is the most active of all drugs used in the treatment of Parkinson's disease. It acts on both akinesia and rigidity and improves the prognosis of the disease by increasing life expectancy. But levodopa also produces late side-effects: it often induces abnormal movements, fluctuations in motor performance, on-off effects, psychotic hallucinations, etc. Since these late side-effects remain difficult to treat, it is always necessary to assess the benefits and risks of the first treatment with levodopa. Anticholinergic drugs, which mainly act on tremor, must be used with caution since they may induce memory alterations and often confusional states in aged parkinsonians. Dopamine agonists are prescribed as adjuvant therapy in the treatment of the late side-effects of levodopa. New drugs (selegiline), new pharmaceutical preparations (sustained release forms), the first treatment of the disease (levodopa alone versus agonists alone versus levodopa + agonists), together with the new pharmacological approaches (brain grafts, drug infusions) are now under clinical evaluation.
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PMID:[Antiparkinsonian drugs]. 256 51

Fifty seven episodes of severe cytomegalovirus (CMV) infection were treated with iv foscarnet in 13 bone marrow and 33 renal graft recipients. The ranges of the daily dose, duration, average steady state level and total dose were 23-268 mg/kg, 2-46 days, 42-400 mg/l and 2-399 g, respectively. Adverse effects, such as decreased haemoglobin, decreased renal function and increased serum calcium, were observed in a few patients only. Increased liver enzymes, hallucinations and tremor were seen in one uraemic patient and coincided with foscarnet plasma concentrations above 400 mg/l. Among 25 patients evaluated for clinical efficacy, 12 died. Improvements, such as eradication of CMV (8/14 assessable patients), resolution of fever (11/22), and improved laboratory values (13/23) were noted in 17/24 (70%). Controlled trials are warranted on the basis of this study.
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PMID:Pharmacokinetics, safety and preliminary clinical experiences using foscarnet in the treatment of cytomegalovirus infections in bone marrow and renal transplant recipients. 300 83

Ifosfamide was given to 61 patients with malignant solid tumors diagnosed before the age of 21 years. In this phase II study, all patients received 1.6 g/m2/day X 5 iv over 15 minutes followed by mesna at a dose of 400 mg/m2 iv at 15 minutes and 4 and 6 hours after ifosfamide. Responses were observed in five of 15 patients with osteosarcoma, two of ten with neuroblastoma, two of six with Wilms' tumor, two of five with rhabdomyosarcoma, four of eight with other soft tissue sarcomas, one of one with retinoblastoma, one of two with germ cell tumors, one of one with B-cell lymphoma, and one of one with a primitive neuroectodermal tumor. Fifty-nine of 61 patients had received prior alkylating agent therapy which included cyclophosphamide, cisplatin, mechlorethamine, melphalan, or dacarbazine. Fourteen of 19 responses developed in patients whose tumors were resistant to treatment with cyclophosphamide. A patient with malignant Schwannoma who had received no prior chemotherapy developed a complete response which lasted 12 months. A patient with brain metastases of osteosarcoma has had complete response for greater than 2 years. Complete response was also observed in a patient with B-cell lymphoma. Toxicity consisted of mild to moderate nausea and vomiting, transient reversible myelosuppression, occasional elevation of serum BUN or creatinine, and transient neurotoxicity characterized by somnolence, confusion, weakness, tremor, hallucinations, or seizures. We conclude that ifosfamide is an important alkylating agent without apparent complete cross-resistance with cyclophosphamide, and as such should be further investigated for determination of its activity in patients with pediatric neoplasms and considered for incorporation into phase II-III trials for certain tumors.
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PMID:Phase II trial of ifosfamide in children with malignant solid tumors. 310 34

We performed a double-blind parallel study of deprenyl 5 mg BID vs. placebo in treatment of "on-off" oscillations complicating Parkinson's disease. After a 2-week baseline period, treatment was given for 6 weeks with weekly evaluations using the Northwestern Disability Scale and patients' hourly self-assessment of "on-off" status performed at home. Patients on deprenyl experienced significant improvement in time spent in the "on" state. They were also more likely than patients on placebo to experience improvement of severity of tremor and hypomimia during the "on" state. No other areas of disability improved in quality. Side effects such as hallucinations and worsening of choreoathetosis were frequent among the deprenyl group but generally responded to reduction in concomitant levodopa/carbidopa dosage. We conclude that deprenyl is moderately useful in ameliorating "on-off" in a majority of patients.
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PMID:Double-blind trial of R-(-)-deprenyl for the "on-off" effect complicating Parkinson's disease. 312 98

The distribution of cerebral blood flow and metabolism is related to neuronal activity. Cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and oxygen extraction fraction (OEF) in ten patients with Parkinson's disease and five age-matched normal control subjects were measured with positron emission tomography (PET) using 15O2, C15O2 steady state inhalational technique to investigate functional changes of the cortex and the basal ganglia in Parkinson's disease. All patients had no history of cerebrovascular disease and CT scan showed no abnormal findings except for moderate cerebral atrophy in only one patient. When the level of clinical disability was related on the scale of Hoehn and Yahr, one patient was stage I, four were stage II, four were stage III, and one was stage IV. Psychic symptoms which include hallucination, depression, and dementia were recognized in four patients. One of these four patients was mildly demented. Four patients were newly diagnosed and had never been treated with antiparkinsonian medication before. Before the patients had their PET study their antiparkinsonian medication was discontinued for more than three days. But in two patients PET study was performed without discontinuity of antiparkinsonian medication. The values for regional CBF and regional CMRO2 were lower in the patients than in the normal control subjects, especially in the frontal cortex there was a significant decrease of CBF and CMRO2. There was no discrepancy between CBF and CMRO2 both in the patients and the normal control. CBF and CMRO2 in the cortex and the basal ganglia were not correlated with the severity of tremor, bradykinesia, and rigidity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease]. 326 73

Two groups of divers (Group A and B) were compressed to 500 msw with trimix (n = 3) and heliox (n = 3). After 4 d at saturation depth Group A had a gas change to heliox. Both groups were followed with repeated neuropsychological and neurological tests during compression, at stable intermediate depths and at saturation depth. There were marked high pressure nervous syndrome effects during compression for both groups. Only tremor was inhibited by the nitrogen. In addition Group A was impaired due to nitrogen narcosis. During trimix and heliox saturation there was only some recovery in the EEG. Group B had a sustained high tremor during the saturation. On visuomotor and cognitive functions Group B performed up to predive level on the 3rd d at saturation while Group A was heavily impaired during the whole trimix saturation period. Although dizziness and tremor were the main symptoms in Group B, Group A reported concentration trouble, euphoria, and upset stomach during the saturation phase. Minor changes occurred in the EEG during the gas change. There was, however, a marked increase in postural tremor and recovery on cognitive tests relating to the elimination of the nitrogen. Up to the completion of the gas change no severe symptoms were reported. Six hours after the gas change, severe symptoms occurred with visual and auditory hallucinations and myoclonic jerks as the dominant characteristics. Some symptoms lasted for 12 h. During decompression there was a steady normalization in both groups.
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PMID:CNS reactions at 51 ATA on trimix and heliox and during decompression. 383 48


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