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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A cross-sectional epidemiological study was carried out among subjects exposed to mercury (Hg) vapour, ie, a group of 131 male workers (mean age: 30.9 yr; average duration of exposure, 4.8 yr) and a group of 54 female workers (mean age, 29.9 yr; average duration of exposure 7 yr). The results were compared with those obtained in well-matched control groups comprising 114 and 48 male and female workers, respectively. The intensity of current Hg vapour exposure was rather moderate as reflected by the levels of mercury in urine (HgU) (mean and 95th percentile: males 52 and 147 micrograms/g creatinine; females 37 and 63 micrograms/g creatinine) and of mercury in blood (mean and 95th percentile: males 1.4 and 3.7 micrograms/dl; females 0.9 and 1.4 microgram/dl). Several symptoms mainly related to the central nervous system (memory disturbances, depressive feelings, fatigue, irritability) were more prevalent in the Hg-exposed subjects. They were, however, not related to exposure parameters. In both male and female Hg-exposed workers no significant disturbances were found in short-term memory (audioverbal), simple reaction time (visual), critical flicker fusion, and colour discrimination ability. Only slight renal tubular effects were detected in Hg-exposed males and females, ie, an increased urinary beta-galactosidase activity and an increased urinary excretion of retinol-binding protein. The prevalence of these preclinical renal effects was more related to the current exposure intensity (HgU) than to the duration of exposure and was detected mainly when HgU exceeds 50 micrograms/g creatinine. Changes in hand tremor spectrum recorded with an accelerometer were found in the Hg-exposed males only. The prevalence of abnormal values for some hand tremor parameters (total velocity and total displacement in the 2-50-Hz band) was mainly increased in male workers exposed for more than 10 yr. Unlike the renal tubular effects, the preclinical signs of tremor were more related to the integrated exposure than to the current exposure. Since the female workers, who have been exposed to Hg vapour levels usually insufficient to increase their HgU levels above 50 micrograms/g creatinine, did not exhibit any change in hand tremor pattern, the results of the present study tend to validate our previously proposed biological threshold limit value of a HgU of 50 micrograms/g creatinine for workers chronically exposed to mercury vapour.
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PMID:Surveillance of workers exposed to mercury vapour:validation of a previously proposed biological threshold limit value for mercury concentration in urine. 387 86

Nine renal transplant recipients were treated with Cyclosporin A (CyA). Seven of them were high risk patients (diabetics or above 55 years of age) receiving cadaveric grafts. Two were recipients of related grafts and azathioprine had been shown to give them severe GI symptoms. Secondary anuria developed presumably due to nephrotoxicity caused by CyA in 2 of the recipients of cadaveric kidneys. The patients were converted to conventional immunosuppressive drugs and after 2-3 weeks, renal function had recovered in both patients. Seven patients have been maintained on a combination of CyA and oral prednisolone. Four of these patients experienced one or more rejection episodes, all were reversible on treatment with methylprednisolone. Two patients had episodes of increased serum creatinine due to nephrotoxicity by CyA. Recovery occurred when the dose was reduced. Other side effects observed were: Hirsutism (3 patients), gingival hyperplasia (1), tremor (2) and leukopenia (1). Four patients had infectious complications and one died of cytomegalovirus pneumonia. Six patients are well having serum creatinine levels ranging from 89-181 mumol/1, 1 to 11 months after transplantation.
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PMID:Immunosuppression by Cyclosporin A in human renal transplant recipients. 675 83

Two years after a survey of the kidney function in 237 patients given long-term lithium treatment the patients were invited for reexamination. Of 184 patients who came for the reexamination 147 had continued lithium treatment; in 37 patients the treatment had been discontinued. The lithium-treated patients were compared with a group of 68 manic-depressive patients who were about to be given prophylactic lithium treatment but who had not yet started. Neither the patients who continued nor the patients who had discontinued lithium showed any deterioration of glomerular filtration rate as assessed through determination of the 24-h creatinine clearance and the serum creatinine concentration; mean values in the lithium-treated patients were the same as mean values in patients not yet given lithium. Impairment of renal water reabsorption, revealed by increased 24-h urine volume and decreased urine osmolality after DDAVP, had progressed in the patients who continued lithium treatment, and multiple regression analysis revealed the duration of treatment and the serum lithium level to be significant predictor variables. In the patients who had discontinued lithium the changes in renal water handling had decreased. The urine volume was the same as that found in the patients not yet given lithium; maximum urine osmolality had not become fully normalized. Side effects such as thirst, nycturia, tremor, diarrhoea, oedema, and weight gain were found with the same frequency at the second as at the first examination in the patients who had continued lithium. In the patients who had discontinued lithium they were infrequent or absent.
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PMID:Lithium treatment and kidney function. A follow-up study of 237 patients in long-term treatment. 731 82

The new immunosuppressive agent FK506 was used with steroids to treat 22 pediatric patients who received living-related partial liver transplantation. Seventeen recipients survived and 5 died between one and 16 months after transplantation. Three of the 5 patients who died had required intensive care preoperatively. Autopsy findings showed no evidence of rejection. There was no episode of rejection that required retransplantation in any of the patients. Liver allograft dysfunction, which was suspected to be a rejection response, was encountered in 2 recipients with ABO-nonidentical but compatible grafts. However, their clinical and biochemical findings were ameliorated upon steroid pulse therapy or upon augmented FK506 administration without additional potent immunosuppressive agents. Steroid treatment has been discontinued in all surviving patients at 1-9 months after transplantation. Infectious complications encountered in 9 patients included 2 bacterial, 5 viral, and 2 fungal infections. One recipient died of fungal pneumonia. Abnormal increase of serum creatinine level was confined to the complicated patients. Hypertension was a temporary adverse reaction in the early postoperative period, and only one patient needed an antihypertensive drug at 2 months after transplantation. Acute pancreatitis with hyperamylasemia was observed in one patient who was treated successfully with reduction of FK506 administration. Tremor was observed in 8 patients, itching in 4, insomnia in 2, and vomiting in one. Hirsutism, gingival hypertrophy, and lymphoma were not observed. FK506 was highly effective in living-related partial liver transplantation not only in terms of immunosuppressive potential but also because it produced fewer adverse effects.
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PMID:Experience with FK506 in living-related liver transplantation. 767 28

Graft-versus-host disease (GVHD) remains a major obstacle to allogeneic bone marrow transplantation. We administered cyclosporin A (CsA) by continuous intravenous infusion for prophylaxis against GVHD and adjusted the dose to maintain a constant whole blood level. Forty-five patients, ranging in age from 16 to 56, mean 39.5 years, undergoing allogeneic transplantation for various hematological malignancies received CsA as a continuous intravenous infusion. CsA was started on day -1 and continued until day +22 when oral CsA was initiated. The whole blood level of CsA was determined and the dose adjusted to maintain a fixed level. Methotrexate 15 mg/m2 i.v. was given on day +1, followed by 10 mg/m2 on days +3 and +6. CsA administered as a continuous infusion was well tolerated. All patients required multiple adjustments of the infused dose of CsA to maintain the targeted whole blood level. The mean rise in creatinine was 0.89 mg/dl. There was an association between the concomitant administration of amphotericin B and CsA and the development of nephrotoxicity. Hypertension developed in 30/45 patients, and all responded to oral nifedipine. Tremors were noted in 16/45 patients. None of the patients developed serious neurological side effects. Greater than grade-I acute GVHD developed in only 13% of the patients. We conclude that administering CsA as an adjusted dose by continuous intravenous infusion is well tolerated and effective in preventing acute GVHD in patients undergoing allogeneic bone marrow transplantation.
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PMID:Adjusted-dose continuous-infusion cyclosporin A to prevent graft-versus-host disease following allogeneic bone marrow transplantation. 811 Aug 73

We report a 75-year-old man with a ten-year history of parkinsonism, who developed acute delirium. He was well until 65 years of age, when there was an onset of tremor in his left hand. He had been treated with levodopa and trihexyphenidyl with marked improvement. He was doing well until July of 1991 at his age of 75-year-old, when he noted backache; he was found to have a compression fracture of the third lumbar spine. He had to use a wheel-chair most of the time since then. In December 1991, he started to have visual hallucinations and difficulty in swallowing. On December 25 of that year, he developed fever and delirium, and was admitted to our hospital on December 30. On admission, general physical examination was unremarkable except for low grade fever (37.3 degrees C). Neurologic examination revealed an alert but chronically ill patient. Apparently he had visual hallucinations. He was disoriented to all spheres; he could respond only to simple questions. Apparently he was demented. Cranial nerves were intact except for mumbling speech disturbance and masked face. He was unable to stand or walk. He had flexion contracture in his both knee joints. He had paratonic rigidity in all his limbs and marked bradykinesia. Once in a while, myoclonic jerks were seen in both upper and lower extremities. Deep reflexes were diminished bilaterally, and the plantar reflex was not elicited on either side. On laboratory examination, BUN was increased to 72 mg/dl, creatinine to 3.0 mg/dl, and WBC 16,000/microliter. Cranial CT scans were unremarkable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 75-year-old man with parkinsonism and delirium]. 819 65

Glomerulonephritis (GN) is a leading cause of chronic renal failure in dogs. However, little is known about the efficacy of available treatment options for GN in this species. The purpose of this study was to determine the effects of cyclosporine (Cy) administration on the outcome of naturally occurring GN in dogs. Thirteen dogs from 4 institutions were included in the study. Randomization of dogs into placebo-versus Cy-treated groups was stratified according to initial morphological diagnosis and contributing institution. Seven and 6 dogs were assigned to be given placebo or Cy, respectively. The initial Cy dose of 10 mg/kg every 24 hours was adjusted to maintain 24-hour trough, whole blood Cy concentrations between 250 and 400 ng/mL. There were no statistically significant differences between placebo- and Cy-treated groups with respect to serum total protein, albumin, urea nitrogen and creatinine, and plasma protein concentrations; platelet count; urine protein-creatinine ratio; endogenous creatinine clearance; 24-hour urine protein concentrations; or 24-hour urine protein-endogenous creatinine clearance ratio. However, PCV was significantly lower in the Cy-treated group. Decreased appetite, diarrhea, vomiting, weight loss, involuntary shaking, and thrombocytopenia were noted in both treatment groups; however, clinical signs in Cy-treated dogs subjectively were more severe. One Cy-treated dog developed gingival hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of cyclosporine versus standard care in dogs with naturally occurring glomerulonephritis. 852 23

Seven related Bernese Mountain Dogs developed a syndrome Characterized by progressive cerebellar and hepatic disease. Clinically, stiffness in the hind limbs, mild incoordination, and a slight head tremor were first noticeable when pups were 4 to 6 weeks old. The condition progressed, causing pups to assume a wide-based stance. Other signs included head bobbing, spontaneous nystagmus, and, finally, paresis. Hematologic findings included leukocytosis with a left shift; normocytic, normochromic anemia; hypoproteinemia, low serum creatinine, and urea nitrogen concentrations; excessive fasting plasma ammonia concentration; and an increase in concentration of serum bile acids. Portal venography performed on 1 dog revealed a small liver and extensive extrahepatic varicosities. Necropsy revealed cerebellar hypoplasia, nodular liver, extensive abdominal varicosities, and ascites. Histologically, degeneration and depletion of Purkinje's cells and vacuolation, degeneration, and nodular regeneration of hepatic tissues were evident. Preliminary analysis of the pedigree was suggestive of an autosomal recessive pattern of inheritance.
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PMID:Clinical, hematologic, and biochemical features of a syndrome in Bernese mountain dogs characterized by hepatocerebellar degeneration. 863 71

Early signs of alterations in renal and neurological functions were studied in three groups of workers who were exposed to different levels of mercury that were below the current biological exposure index of 35 microg/g creatinine. There were no differences among the three study groups with respect to either motor nerve conduction velocity or tremor frequency spectra of physiological tremors. Also, no significant correlations were found between the results of the neurological tests and any of the present or historical biological monitoring data. In contrast, N-acetyl-beta-D-glucosaminidase was increased significantly in the group with the higher exposure, compared with either the lower-exposure or control groups. N-acetyl-beta-D-glucosaminidase was correlated strongly with mercury concentration in urine and was correlated weakly with historical biological monitoring data; however, there was no correlation with duration of exposure. These results suggest that after exposure to mercury at levels below the biological exposure index, a transient increase in N-acetyl-beta-D-glucosaminidase can be observed, but is not an early indicator of developing renal dysfunction.
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PMID:Effects of exposure to elemental mercury on the nervous system and the kidneys of workers producing natural gas. 863 60

Inorganic mercury is absorbed in small amounts from dental amalgam fillings. Exposure can be calculated by measuring the level of mercury in the blood or urine (u-Hg). The average u-Hg in Norwegians is approximately 2-3 micrograms/g creatinine (approximately 1-2 nmol/mmol creatinine). Classic signs of mercury poisoning occur in a fraction of long-term exposed subjects with u-Hg > 100 micrograms/g creatinine (56 nmol/mmol creatinine). Subtle effects (e.g. enzymuria, altered selenium metabolism, and changes in tremor spectra) have been reported in humans at average levels of 20-35 micrograms/g creatinine (approximately 11-20 nmol/mmol creatinine). There is widespread concern about possible adverse effects of mercury from amalgam fillings. Data on exposure-response relationships make it less likely that low-level mercury exposure from amalgam fillings should cause symptoms or physical signs. Studies of the association between symptoms and amalgam fillings have been negative. Patients with symptoms allegedly caused by mercury from amalgam should undergo thorough medical examination. Based on the patient's symptoms and physical signs adequate time should be allowed for careful recording of medical history, physical examination and relevant laboratory tests.
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PMID:[Mercury exposure from dental amalgam. Risk assessment and clinical evaluation]. 953 43


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