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)

Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or "forme fruste" hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: 1. tachycardia -- every case with more than 80 pulse beats being suspect (not specific); 2. urinary histamine -- every case excreting more than 90 mug/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; 3. urinary thyroxine -- every case excreting more than 20 mug/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and beta-blockers. Propyl thiouracil is rarely required.
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PMID:Intermittent hyperthyreosis -- a heat stress syndrome. 5 84

Drug use among athletes has become a recognised problem in sports. Athletes may use drugs for therapeutic indications, for recreational or social reasons, as ergogenic aids or to mask the presence of other drugs during drug testing. Stimulants were some of the first drugs used and studied as ergogenic aids. Amphetamines may increase time to exhaustion by masking the physiological response to fatigue. Caffeine may improve utilisation of fatty acids as a fuel source thereby sparing muscle glycogen. Cocaine and other sympathomimetic drugs have little or no effect on athletic performance. Anabolic steroids appear to have the potential to increase lean muscle mass and strength under certain conditions. Human growth hormone may also be used for an anabolic effect, but data on this effect are lacking. Erythropoietin may represent a pharmacological alternative to blood doping by increasing red blood cell mass. The use of narcotic analgesics is not necessarily ergogenic but can be harmful if used to allow participation of an athlete with a severe injury. According to the American College of Sports Medicine alcohol does not possess an ergogenic effect. However, it may be used to reduce anxiety or tremor prior to competition. Marijuana does not increase strength. Tobacco products may produce psychomotor effects or control appetite which may be beneficial to some athletes. Other drugs used by athletes include beta-blocking agents, diuretics, and a variety of nutritional supplements. In addition, diuretics and probenecid may be taken to mask drug contents in the urine. Whether the ergogenic effects are real or perceived, the potential for adverse effects exists for all of these drugs. Potential health complications represent a serious risk to an otherwise healthy population. Further research on the long term health risks in athletes taking ergogenic drugs is needed.
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PMID:Enhancement of athletic performance with drugs. An overview. 168 20

1. Neuroleptic drugs (antipsychotics) produce numerous side effects which include serious extrapyramidal symptoms consisting of akathisia, dystonia, neuroleptic malignant syndrome, parkinsonian reactions such as postural abnormality, tremor, akinesia or bradykinesia, rigidity, and tardive dyskinesia. 2. Among the complications of neuroleptic chemotherapy, the most serious and potentially fatal complication is malignant syndrome, which is characterized by extreme hyperthermia, "lead pipe" skeletal muscle rigidity causing dyspnea, dysphagia, and rhabdomyolysis, autonomic instability, fluctuating consciousness, leukocytosis, and elevated creatine phosphokinase. 3. Neuroleptic malignant syndrome should be differentiated from malignant hyperthermia, lethal catatonia, and other pathological states producing some of these same symptoms. 4. In addition to neuroleptics, malignant syndrome has been caused by thymoleptics (antidepressants), metoclopramide (antiemetic), metoclopramide combined with cimetidine, tetrabenazine, overdosage of benzodiazepine, phenelzine, dothiepin and alcohol, and amphetamine. 5. Factors leading to and/or facilitating the emergence of neuroleptic malignant syndromes are reportedly organic brain syndrome, dehydration, exhaustion, external heat load, excessive sympathetic discharge, use of long acting neuroleptics, high doses of neuroleptics, rapid dose titration with neuroleptics, abrupt discontinuation of antiparkinsonism agents, and concurrent lithium therapy. 6. Although, the pathogenesis of neuroleptic malignant syndrome is not understood completely, a blockade of dopaminergic receptors in the hypothalamus, spinal cord and striatum, an alteration of dopaminergic-serotonergic transmission in the body, an enhanced synthesis and action of prostaglandin E1 and E2, and a modification of calcium-mediated signal transduction in the body have been suggested. 7. The treatment of malignant syndrome includes immediate withdrawal of neuroleptic drugs, i.v. infusion of dantrolene, and oral administration of bromocriptine; or alternatively i.v. infusion of dantrolene and the combination of levodopa-carbidopa. 8. Other measures to enhance the therapeutic effectiveness of the aforementioned regimens are to include the use of anticholinergic drugs such as benztropine to enhance the effectiveness of bromocriptine, of lorazepam if catatonic symptoms persist, or of electroconvulsive therapy (ECT) if psychotic symptoms persist. 9. These treatments, however, must be "active" rather than "passive", in order to avert fatalities and/or unfortunate sequelae from this iatrogenic and incompletely understood disease.
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PMID:Pathogenesis and treatment of neuroleptic malignant syndrome. 197 19

The ergogenic potential of drugs used by athletes to enhance performance is reviewed, and areas of involvement for pharmacists interested in the problem of drug abuse in athletics are described. Athletes use drugs for therapeutic and recreational purposes, as supposed ergogenic aids, and to mask the presence of other drugs during testing. Because many athletes train for competition and not for health, they may view the risk-to-benefit ratio of ergogenic drugs as favorable and may begin using them at an early age. Alcohol is the drug most commonly used by student athletes. Although alcohol has no ergogenic benefit, it is viewed as a caloric source and an anxiolytic. Amphetamines do not prevent exhaustion but may mask fatigue, which can have dangerous consequences. Anabolic steroids appear to increase strength but frequently cause adverse reactions, primarily involving the hepatic and endocrine systems. Beta-blocking agents have been shown to reduce anxiety, hand tremor, and heart rate in precision sports like archery, but susceptible persons may experience serious adverse effects. Caffeine improves the efficiency of fuel use and reduces fatigue; its use has been banned by several athletic organizations. Neither cocaine nor marijuana causes any increase in strength. Secretion of human growth hormone may be stimulated by a variety of agents, but evidence that any subsequent increases in size and weight occur is lacking. Other substances tried by athletes include vitamins and minerals, naloxone, albuterol, and human recombinant erythropoietin. Opportunities in sports pharmacy exists in the areas of information retrieval and interpretation, drug testing, legislation to reclassify drugs, education, and research.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Abuse of drugs used to enhance athletic performance. 268 62

This open randomized, cross-over study compared the clinical efficacy and patient acceptability of the two bronchodilator delivery systems, terbutaline Turbuhaler (0.5 mg t.i.d.) and salbutamol Rotahaler (0.4 mg t.i.d.), each given for 3 weeks. Thirty-two adult asthmatics (21 males and 11 females with a mean age of 34 years) who demonstrated at least 15% reversibility in PEF or FEV1 in response to terbutaline, were enrolled for study. The median reversibility in FEV1 was 27.5% for the terbutaline-salbutamol group and 21% for the salbutamol-turbutaline group. Two patients discontinued during terbutaline treatment (one due to respiratory infection and one due to tachycardia, exhaustion and tremor) and five patients were lost to follow-up during salbutamol treatment, leaving data from 25 patients for an 'all patients treated' analysis. Mean morning PEF was 426 l min-1 during terbutaline and 410 l min-1 during salbutamol (difference 16 l min-1, 95% CI of difference 3-28 l min-1, P = 0.016), and mean evening PEF was 446 l min-1 during terbutaline and 428 l min-1 during salbutamol (difference 18 l min-1, 95% CI 5-30 l min-1, P = 0.0076). No significant differences were detected in diary symptom scores or in use of additional study drug during the day or night, and no serious adverse events were reported. When asked to state their treatment preferences on the basis of effects, side-effects and overall, more patients preferred Turbuhaler in each case, although no statistically significant differences were detected. In conclusion, terbutaline via Turbuhaler was significantly more effective than salbutamol via Rotahaler in controlling lung function (mean daily PEF) in adults with mild to moderate asthma, and it was the preferred treatment overall in 44% of patients, compared with 16% for Rotahaler (n.s.).
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PMID:A comparison of the clinical efficacy and patient acceptability of terbutaline Turbuhaler and salbutamol Rotahaler, in adult patients with asthma. 873 53

Cumulative fatigue caused by a tapping load is investigated by power spectrum analysis of both physiological tremor of the finger and surface electromyogram (EMG) of the forearm muscle controlling the finger. A load for two hours at a rate of 200 taps/minute is performed on ten male subjects. The physiological tremor and the EMG are measured before and during the load. The measurement is performed under the isometric contraction at 10% maximum voluntary contraction in the m. flexor digitorum superficialis. The total power and the slow wave ratio of the power spectrum are evaluated. During the load, both spectra of the physiological tremor and the EMG show the maximum total power at 30 minutes after the load. The total powers of both spectra, however, decrease in the period after 60 minutes. Namely, the results of the physiological tremor and the EMG for prolonged load show the "paradox of fatigue." In order to elucidate the cause of the paradox of fatigue, the slow wave ratio of the EMG spectrum is studied. The ratio increases during the load. The muscle loaded indicates the state close to exhaustion, and the change of the function of the muscle contraction affects the amplitude of the physiological tremor. Therefore, the criterion judging muscular fatigue is denoted due to the change of the amplitude of the physiological tremor.
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PMID:Paradoxical phenomenon of physiological tremor in prolonged tapping load. 1157 91

Malaria is a protozoan disease caused in humans by the genus Plasmodium of which four species are known: P. falciparum, P. vivax, P. ovale, and P. malariae. It is transmitted through the bite of infected female mosquitoes of the genus Anopheles. Malaria is endemic in tropical and subtropical regions of the world. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Approximately 40% of the world''s population, mostly those living in the poorest nations, are at risk. Much of the deaths due to malaria occur in Africa, mostly among children. The search for prevention and control interventions that are effective and sustainable remains an abiding challenge for national governments and international health agencies. To this end, the World Health Organization and several nongovernmental organizations are investing in the use of insecticide-treated mosquito nets (ITMNs) as a viable option. Trials of ITMNs in the 1980s and 1990s showed that they reduce deaths in young children by an average of 20% and multilateral agencies, spearheaded by Roll Back Malaria (RBM), seek to have 60% of the populations at risk sleeping under ITMNs by 2005. All pesticides are toxic by nature and present risks of adverse effects that depend on toxicity of the chemical and the degree of exposure. While there is agreement that ITMNs can be effective in reducing malaria morbidity and mortality under field trials, a number of factors relating to their sustainability and contribution to health improvement in less-developed countries have yet to be determined. In particular, the adverse effects associated with their long-term use and misuse has yet to be fully evaluated. Although this paper examines potential neurotoxic and neurobehavioral effects of long-term use of ITMNs and discusses priority public health actions for protecting the health of users, it forms the basis for further research.
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PMID:Assessing the health effects of long-term exposure to insecticide-treated mosquito nets in the control of malaria in endemic regions. 1557 22

High frequency stimulation (HFS) has become the main alternative to medical treatment, due to its reversibility, adaptability, and low morbidity. Initiated in the thalamus (Vim) for the control of tremor, HFS has been applied to the Pallidum (GPi), and then to the subthalamic nucleus (STN), suggested by experiments in MPTP monkeys. STN-HFS is highly efficient on tremor, rigidity and bradykinesia and is now widely applied. Criteria for success are correct patient selection and precise electrode placement. The best outcome predictor is the response to Levodopa. The mechanisms of action might associate inhibition of cell firing, jamming of neuronal message and exhaustion of synaptic neurotransmitter release. The inhibition of glutamate STN release could be neuroprotective on nigral cells. Animal experiments support this hypothesis, not contradicted by the long-term follow up of patients. Neuroprotection might have considerable impact on the management of PD patient and warrants clinical trials.
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PMID:Surgical therapy for Parkinson's disease. 1701 57

The amount of documented increase in motor unit (MU) synchronization with fatigue and its possible relation with force tremor varies largely, possibly due to inhomogeneous muscle activation and methodological discrepancies and limitations. The aim of this study was to apply a novel surface electromyographical (EMG) descriptor for MU synchronization based on large MU populations to examine changes in MU synchronization with fatigue at different sites of a muscle and its relation to tremor. Twenty-four subjects performed an isometric elbow flexion at 25% of maximal voluntary contraction until exhaustion. Monopolar EMG signals were recorded using a grid of 130 electrodes above the biceps brachii. Changes in MU synchronization were estimated based on the sub-band skewness of EMG signals and tremor by the coefficient of variation in force. The synchronization descriptor was dependent on recording site and increased with fatigue together with tremor. There was a general association between these two parameters, but not between their fluctuations. These results are in agreement with other surface EMG studies and indicate that the novel descriptor can be used to attain information of synchronization between large MU populations during fatigue that cannot be retrieved with intra-muscular EMG.
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PMID:Motor unit synchronization during fatigue: described with a novel sEMG method based on large motor unit samples. 1820 21

The purpose of this study was to investigate the influence of the force tremor (FT) on mechanomyographic (MMG) signals recorded by a condenser microphone (MIC) and an accelerometer (ACC) during measurement of agonist and antagonist muscles in sustained isometric contractions. Surface electromyographic (EMG) signals and MMG signals by MIC (MMG-MIC) and ACC (MMG-ACC) were recorded simultaneously on biceps brachii (BB) and triceps brachii (TB). Following determination of the isometric maximum voluntary contraction (MVC), 10 male subjects were asked to perform sustained elbow flexion and extension contractions at 30% MVC until exhaustion. We analyzed the root mean square (RMS) for all signals and compared the sum of the power spectrum (SPA) for 3-6 Hz and 8-12 Hz and the ratio of the sum of SPA for 3-6 Hz and 8-12 Hz in SPA for 3-100 Hz (SPA-FT/SPA-(3-100 Hz)) between MMG-MIC and MMG-ACC. During all sustained muscle contractions, the RMS of EMG and MMG-(MIC) was significantly (p<0.05) increased in antagonistic muscle pairs, while the increase was more noticeable for the agonist than for the antagonist. In addition, the antagonist had a significantly (p<0.05) smaller amplitude than the agonist muscle. The RMS of MMG-ACC, however, showed no significant (p>0.05) difference in RMS amplitude and slope between agonist and antagonist muscles during flexion. In extension, the MMG-ACC-RMS amplitude showed a tendency to be higher in the antagonist than in the agonist, while their slopes showed no significant (p>0.05) difference. The SPA for 3-6 Hz and 8-12 Hz in MMG-(MIC) showed a tendency to be higher in the agonist than the antagonist, and the slopes of the agonist were significantly (p<0.05) higher than those of the antagonist in all contractions. In MMG-ACC, SPA and slopes for 3-6 Hz and 8-12 Hz tended not to differ between agonist and antagonist. The SPA-FT/SPA-(3-100 Hz) in MMG-ACC showed that the antagonist was higher than that of the agonist in all contractions. The MMG-(MIC), however, showed a tendency toward no difference between the agonist and antagonist. In the assessment of muscle activity during simultaneous measurement of the agonist and antagonist during sustained muscle contractions, the MMG signal detected by MIC appeared to be less affected by FT than by ACC due to the different inherent characteristics of the two transducers.
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PMID:Comparison of an accelerometer and a condenser microphone for mechanomyographic signals during measurement of agonist and antagonist muscles in sustained isometric muscle contractions. 1853 12


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