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

Essential tremor (ET) is a neurological disease (and possibly a family of diseases) whose most recognisable feature is an action tremor of the hands and occasionally of the voice and head. Current data support the view that CNS gamma-amino-butyric acid (GABA)-ergic mechanisms may underlie ET and that the tremor may be further modulated by peripheral (muscle) adrenoreceptors. Potential pharmacotherapeutic options, targeted to influence the activity of the neurotransmitter GABA within the CNS and the peripheral adrenergic receptors, are part of the current armamentarium to treat ET. As such, primidone and propranolol remain the mainstays of the therapy for ET. Intramuscular injections of botulinum toxin A may play a role in the treatment of voice and head tremor. Surgical options, which are reserved for patients with severe, medically-refractory tremor, provide adequate tremor control in the majority of patients. As with other progressive neurological disorders of late life, the ability to use neuroprotective medications to intervene in the developing disease to either slow or halt the progression of the pathological process, would involve an understanding of underlying disease mechanisms. The understanding of these mechanisms in ET is limited and further study of these mechanisms is critical for the development of such therapies.
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PMID:Benefits and risks of pharmacological and surgical treatments for essential tremor: disease mechanisms and current management. 1611 52

Deep brain stimulation (DBS) is a safe and successful therapeutic option for patients with dystonia and tremor syndrome who do not respond sufficiently to conservative therapies. The most common target of DBS in patients with dystonia is the internal region of the globus pallidus (GPI). DBS of the GPI leads to long-lasting and remarkable improvement of dystonic movements in about 80% of patients. Recently it could be shown that not only patients with idiopathic dystonia but also patients with secondary dystonia can benefit from DBS although to a somewhat lesser extent. In patients with tremor syndromes, such as essential tremor, tremor-dominant Parkinson's disease or tremor in multiple sclerosis (MS) the intermediate ventral nucleus of the thalamus (VIM) as well as the subthalamic region proved to be promising targets for DBS electrodes. Especially in patients with essential tremor VIM-DBS leads to an often acute reduction of the tremor syndrome. In long-term observations, however, patients with essential tremor showed some tolerability to VIM-DBS leading to a slow increase of stimulation parameters to maintain a stable effect. VIM-DBS in patients with Parkinson's disease is rare and is reserved for elderly patients with pronounced tremor syndrome and little disease progression. Controlled studies and data on DBS in MS tremor are lacking and data are sparse and heterogeneous. Therefore, VIM-DBS in MS tremor patients has to be evaluated individually with caution. In summary patients with tremor syndromes as well as dystonia who cannot be adequately controlled with conservative therapy are good candidates for deep brain stimulation, a therapeutic option with moderate complications and risks and very good outcome for most patients.
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PMID:[Deep brain stimulation for treatment of dystonia and tremor]. 2049 77

Tremor is one of the most frequent movement disorders and covers a wide spectrum of entities summarized in the 1998 consensus statement of the Movement Disorder Society. Essential tremor and Parkinson tremor are most common and are also the most thoroughly studied. Major progress has occurred in the clinical semiology, neuroimaging, epidemiology, and pathophysiology of tremors. Pathology and genetic research are rapidly growing fields of study. Recently described tremor entities include orthostatic tremor, dystonic tremor, cortical tremor, and thalamic tremor. Treatment research methodology has improved substantially, but few double-blind controlled trials have been published. Deep brain stimulation is the most effective treatment for most tremors but is reserved for advanced cases.
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PMID:Milestones in tremor research. 2162 54

Tremor is a hyperkinetic movement disorder characterized by rhythmic oscillations of one or more body parts. It can be disabling and may impair quality of life. Various etiological subtypes of tremor are recognized, with essential tremor (ET) and Parkinsonian tremor being the most common. Here we review the current literature on tremor treatment regarding ET and head and voice tremor, as well as dystonic tremor, orthostatic tremor, tremor due to multiple sclerosis (MS) or lesions in the brainstem or thalamus, neuropathic tremor, and functional (psychogenic) tremor, and summarize main findings. Most studies are available for ET and only few studies specifically focused on other tremor forms. Controlled trials outside ET are rare and hence most of the recommendations are based on a low level of evidence. For ET, propranolol and primidone are considered drugs of first choice with a mean effect size of approximately 50 % tremor reduction. The efficacy of topiramate is also supported by a large double-blind placebo-controlled trial, while other drugs have less supporting evidence. With a mean effect size of about 90 % deep brain stimulation in the nucleus ventralis intermedius or the subthalamic nucleus may be the most potent treatment; however, there are no controlled trials and it is reserved for severely affected patients. Dystonic limb tremor may respond to anticholinergics. Botulinum toxin improves head and voice tremor. Gabapentin and clonazepam are often recommended for orthostatic tremor. MS tremor responds only poorly to drug treatment. For patients with severe MS tremor, thalamic deep brain stimulation has been recommended. Patients with functional tremor may benefit from antidepressants and are best be treated in a multidisciplinary setting. Several tremor syndromes can already be treated with success. But new drugs specifically designed for tremor treatment are needed. ET is most likely covering different entities and their delineation may also improve treatment. Modern study designs and long-term studies are needed.
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PMID:The treatment of tremor. 2414 89

It is well known that some isolates of Staphylococcus aureus produce pathogenic toxin, Panton-Valentine leukocidin (PVL), and that the toxin has been reported to be highly associated with community acquired methicillin resistant S. aureus (CA-MRSA). Currently, the PCR method using specific primers for the PVL gene (LukS-PV-lukF-PV) have been widely used to detect PVL. In this study, we evaluated the PVL-RPLA "Seiken", diagnostic reagent based on a reserved passive latex agglutination reaction with a specific monoclonal antibody for detecting PVL. A total of 630 clinical isolates were used. PCR method detected 34 PVL-positive (28 MRSA and 6 MSSA), and, of these, PVL-RPLA "Seiken" read positive for 32 isolates (27 MRSA and 5 MSSA), the result indicating two false negative occurrences. The concordance rate was 99.7%. In addition the recommended BHI broth, CCY medium, Dolman broth and Todd-Hewitt broth were applied for toxin preparation media. Toxin concentration produced in CCY medium was significantly higher than those in the remaining culture medium (p < 0.05). PVL-RPLA "Seiken" is a method for detecting the PVL in the culture broth by antigen antibody reaction after an overnight shaking culture. This method does not require any expensive equipments or facilities. Thus this reagent provides us with rapid, easy-to-perform, less expensive test method to detect PVL in clinical microbiology laboratories.
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PMID:[Laboratory-based evaluation of PVL-RPLA "Seiken" to detect Panton-Valentine leukocidin produced by Staphylococcus aureus]. 2515 71

During the summer period 2011-2012, seven widow spider bites in Greece were reported to the Hellenic Center for Disease Control and Prevention. Widow spiders (in the genus Latrodectus) are found all over the world, including Europe, Asia, Africa, Australia, and the US. Alpha-latrotoxin (main mammalian toxin) causes the toxic effects observed in humans. Victims should receive timely medical care to avoid suffering. Latrodectus bites are very rarely fatal. All the patients reported having an insect bite 30 minutes to 2 hours before they arrived at the Emergency Department of the local hospital. Severe muscle cramps, weakness, tremor, abdominal pain, and increased levels of creatinine phosphokinase were present in all patients. The Emergency Operation Center of the Hellenic Center for Disease Control and Prevention was informed immediately in all cases. Antivenin was administered to four patients upon the request of their physicians. All patients recovered fully. It is essential that health care workers recognize early the symptoms and signs of Latrodectus bites to provide the necessary care. The management of mild to moderate Latrodectus envenomations is primarily supportive. Hospitalization and possibly antivenin should be reserved for patients exhibiting serious systemic symptoms or inadequate pain control. The most important thing for all of these patients is early pain relief.
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PMID:Latrodectus envenomation in Greece. 2566 33

Currently, the most common surgical treatment for Parkinson's disease is deep brain stimulation (DBS). This treatment strategy is typically reserved for bradykinesia, rigidity and tremor in patients who no longer respond to medication in a predictable manner or who suffer medication-induced dyskinesias. In addition to DBS, ablative procedures like radiofrequency, radiosurgery and focused ultrasound are also utilized for select tremor symptoms. In this review, we discuss evolving surgical techniques, targets, and emerging technology. In addition, we evaluate potential paradigm shifts in treatment, including gene therapy, immunotherapy and cell transplantation. While these new techniques and treatment options are still in their infancy, advances in Parkinson's disease treatment are rapidly expanding.
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PMID:Current surgical treatments for Parkinson's disease and potential therapeutic targets. 3010 37

Although behavior, biology, and ecology of giraffes have been widely studied, little is known about their cognition. Giraffes' feeding ecology and their fission-fusion social dynamics are comparable with those of chimpanzees (Pan troglodytes), suggesting that they might have complex cognitive abilities. To assess this, we tested 6 captive giraffes on their object permanence, short-term memory, and ability to use acoustic cues to locate food. First, we tested whether giraffes understand that objects continue to exist even when they are out of sight. Giraffes saw one of two opaque containers containing food, then containers were closed, and 2 s later giraffes could choose one. Second, we measured giraffes' memory repeating the procedure but with a delay of 30 s, 60 s, or 2 min between closing the containers and subjects' choice. Finally, we investigated whether giraffes could locate food inside one of two identical opaque containers, when the only cue provided was the sound made by food when shaking the baited container, or the lack of sound when shaking the empty container. Our results show that giraffes form mental representations of completely hidden objects, but may not store them for longer than 30 s. Moreover, they rely on stimulus enhancement rather than acoustic cues to locate food, when no visual cues are provided. Finally, we argue that giraffes and other ungulates might be a suitable model to investigate the evolution of complex cognitive abilities from a comparative perspective. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Object permanence in Giraffa camelopardalis: First steps in giraffes' physical cognition. 3037 8

We examine how a simple handshake-a gesture that often occurs at the outset of social interactions-can influence deal-making. Because handshakes are social rituals, they are imbued with meaning beyond their physical features. We propose that during mixed-motive interactions, a handshake is viewed as a signal of cooperative intent, increasing people's cooperative behavior and affecting deal-making outcomes. In Studies 1a and 1b, pairs who chose to shake hands at the onset of integrative negotiations obtained better joint outcomes. Study 2 demonstrates the causal impact of handshaking using experimental methodology. Study 3 suggests a driver of the cooperative consequence of handshaking: negotiators expected partners who shook hands to behave more cooperatively than partners who avoided shaking hands or partners whose nonverbal behavior was unknown; these expectations of cooperative intent increased negotiators' own cooperation. Study 4 uses an economic game to demonstrate that handshaking increased cooperation even when handshakes were uninstructed (vs. instructed). Further demonstrating the primacy of signaling cooperative intent, handshaking actually reduced cooperation when the action signaled ill intent (e.g., when the hand-shaker was sick; Study 5). Finally, in Study 6, executives assigned to shake hands before a more antagonistic, distributive negotiation were less likely to lie about self-benefiting information, increasing cooperation even to their own detriment. Together, these studies provide evidence that handshakes, ritualistic behaviors imbued with meaning beyond mere physical contact, signal cooperative intent and promote deal-making. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Handshaking promotes deal-making by signaling cooperative intent. 3055 Mar 27

Following biological and comparative perspectives, it was posited that acute stressors would activate more primitive modes of action control favoring gross motor actions (e.g., fight or flight) over behavioral precision. Influences of this type should result in more rapid changes in movement velocity subsequent to emotionally upsetting stimulation. In investigating processes of this type, participants in three experiments (total N = 457) were asked to track a moving visual target as smoothly as possible. The introduction of brief, aversive noise blasts was found to destabilize such efforts. In particular, time-locked analyses revealed the presence of an emotion-related increase in tremor that began quickly and persisted for nearly 2 s. In addition, the persistence component was elevated in the context of higher levels of neuroticism (Experiment 2) and emotional reactivity (Experiment 3). The results speak to questions about the emotion-action interface using a method suited to affective chronometry. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Emotion-related variations in motor tremor: Magnitude, time course, and links to emotional temperament. 3119 69


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