Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey on urinary incontinence in 161 (41 male, 120 female) institutionalized elderly was independently performed by urologists and attending nurses. Urinary incontinence was found in 107 cases (66%), with 76 cases (47%) suffering from severe leakage (more than 5 times a day and needs diaper). The prevalences of incontinence and severe leakage were 63% and 52% at geriatric hospitals, 59% and 29% at intermediate care centers and 78% and 63% at nursing homes, respectively. The risk factors for incontinence were consciousness disturbance, urinary urgency, impaired mobility and dementia, and those for severe leakage were apathy, loss of urinary sensation, dementia and impaired mobility. The type of incontinence was considered functional one in 81% of cases. The agreement of the incontinence type evaluated by urologists and that by nurses was found in 90% of incontinent cases. Incontinence was estimated "incurable" in 54% of cases by attending nurses. These observations indicate a high prevalence of severe and "incurable" incontinence in the institutionalized elderly, urgently warranting an effective remedy for the increasing aged society.
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PMID:[A survey on urinary incontinence in the institutionalized elderly]. 140 68

Compared to leukemia, malignant lymphoma and other hematogenous tumors, multiple myeloma rarely metastasizes to the central nervous system. Intracerebral metastasis without involvement of the cranium itself is rarer. We report a case of Ig-G k-type multiple myeloma with metastasis to the left frontal lobe extending to the right basal ganglia without involvement of the cranium. A 71-year-old male complained of exertional dyspnea and lumbago. His laboratory data revealed hyperproteinemia and an abnormal increase in Ig-G (6117mg/dl) in his serum. Serum protein immunoelectrophoresis revealed an IgG k-type band, and Bence-Jones protein was detected in his urine. MMPP, VMCP, VIPP and MP chemotherapy was given, and serum IgG level decreased to a normal range. 21 months after his first admission, incontinence, disorientation, gait disturbance and apathy developed. CT-scan showed an isodense lesion with massive edema in the left frontal lobe and right basal ganglia. On MRI, a Gd-DTPA enhancing lesion was detected extending from the left frontal to the opposite frontal lobe through the splenium. No abnormal skull punched out lesions were noted. Left frontal lobectomy was performed. Histopathology revealed plasmablastic myeloma cells with clear nucleole and eccentric nucleus in the cerebrum. He was diagnosed as having intracerebral metastasis of multiple myeloma without involvement of the cranium. Unfortunately, he died of pancytopenia and pneumonia. Our case suggests the possibility of metastasis via blood into the cerebrum.
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PMID:[A case of multiple myeloma with intracerebral metastasis]. 140 49

1. Normal pressure hydrocephalus (NPH) is a rare but potentially treatable form of dementia. Shunting will improve functioning in 40% to 50% of patients. 2. The classic symptoms of NPH are dementia characterized by mild memory impairment and apathy, ataxic gait, and urinary hesitancy or incontinence. 3. The patient with NPH may present with psychiatric symptoms of depression, paranoia, visual hallucinations, irrational hostility, and aggression or mania. 4. Patients with NPH are indifferent about activities of daily living and personal safety and require close supervision.
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PMID:Normal pressure hydrocephalus. A potentially reversible form of dementia. 161 84

Of 70 autopsied patients with the acquired immune deficiency syndrome (AIDS), 46 suffered progressive dementia that was frequently accompanied by motor and behavioral dysfunction. Impaired memory and concentration with psychomotor slowing represented the most common early presentation of this disorder, but in nearly one half of the patients either motor or behavioral changes predominated. Early motor deficits commonly included ataxia, leg weakness, tremor, and loss of fine-motor coordination, while behavioral disturbances were manifested most commonly as apathy or withdrawal, but occasionally as a frank organic psychosis. The course of the disease was steadily progressive in most patients, and at times was punctuated by an abrupt acceleration. However, in 20% of patients a more protracted indolent course was observed. In the most advanced stage of this disease, patients exhibited a stereotyped picture of severe dementia, mutism, incontinence, paraplegia, and in some cases, myoclonus. The high incidence and unique clinical presentation of this AIDS dementia complex is consistent with the emerging concept that this complication is due to direct brain infection by the retrovirus that causes AIDS.
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PMID:The AIDS dementia complex: I. Clinical features. 372 8

The clinical presentation of three patients with meningiomas at different frontal sites is described. They had been ill for 3, 25, and 43 years before the tumour was demonstrated radiologically. Apathy, incontinence, dementia, and fits were seen in association with middle and superior frontal lesions, and may be mistaken for symptoms of involutional depression or presenile cerebral atrophy. In contrast, excitement and hallucinosis were seen in association with a basal frontal lesion, and may mimic psychotic syndromes like hypomania and schizophrenia, particularly if the tumour encroaches on the third ventricle and adjacent structures. Irreversible loss of myelin and axons in the frontal areas of brain surrounding the tumour may have contributed to the clinical picture of the syndrome shown by these patients.
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PMID:Three cases of frontal meningiomas presenting psychiatrically. 496 22

Examination of 163 nursing home residents revealed chronic brain syndrome of different amount in 84%. Demented patients with clinical evidence of arteriosclerosis had significantly higher values of emotional incontinence, dysphoria, depression and vegetative complaints than those without evidence of arteriosclerosis. Correlation of single psychopathologic parameters with other psychopathologic, neurologic and somatic variables resulted in very different correlation profiles for the following symptoms: emotional incontinence, apathy, dysphoria and euphoria. These changes in personality should be considered to a higher degree in dementia research intending more homogeneous subgroups.
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PMID:[Psychopathology of senile dementias in nursing home residents]. 647 86

A 3-year-old girl with left hemiparesis suffered from bilateral paresis, motor rigidity, gait disturbance, axial hypotonia, dysarthria, apathy, and incontinence. After steroid therapy, mild improvement occurred, but muscle weakness, gait disturbance, and rigidity remained. Leigh encephalopathy was excluded on the basis of muscle biopsy and laboratory findings. Computed tomography and serial magnetic resonance imaging at an early stage revealed right-sided dominant lesions in the putamen and caudate nucleus and later bilateral striatal lesions, appearing as hyperintense signals on T2-weighted images and mixtures of hypo- and hyperintense signals on T1-weighted images. This is the first demonstration of serial magnetic resonance imaging findings in infantile bilateral striatal necrosis.
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PMID:Serial MRI in infantile bilateral striatal necrosis. 802 66

Vascular dementia (VAD) is common, and small vessel disease is one of the most frequent etiologies of the disorder. Lacunar state and Binswanger's disease are the two types of VAD associated with small vessel disease. Lacunar state and Binswanger's disease produce a dementia syndrome with characteristics of subcortical dementia including slowing of information processing, impaired memory, and poor sustained attention. Executive dysfunction includes poor word list generation and verbal fluency (design generation), impaired motor programming with perseveration and impersistence, and difficulty with set shifting. Memory loss in subcortical VAD is characterized by poor retrieval and intact recognition. Apathy is ubiquitous in VAD and depression and psychosis are common. Parkinsonism with prominent gait disturbances in conjunction with pyramidal tract signs, dysarthria, pseudobulbar affect, and incontinence are frequent motor manifestations of VAD with small vessel disease. The lesions of subcortical VAD affect the structures--caudate nucleus, globus pallidus, thalamus-and connecting fibers of frontal--subcortical circuits and produce a clinical syndrome similar to that seen in other subcortical diseases.
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PMID:Vascular subcortical dementias: clinical aspects. 808 75

The meaning of the problem for incontinence suffers is known to be a very significant influence on coping. The present study was based on in-depth qualitative interviews with 28 young or middle-aged women who suffered urinary incontinence. Analysis, aimed at discovering the meaning of their condition for the sufferers themselves, led to the following conclusions. Incontinence is taboo, meaning not only that it is a socially unacceptable topic of conversation (inhibiting the approach of suffers to health professionals), but also that it is difficult for suffers themselves to focus on and think about clearly. Sufferers can react with apathy, or may perpetually teeter on the edge of taking ameliorative action: rational ways of tackling the problem are often not followed. The problem is seen as one of personal control: incontinence is lack of a grip on bodily propriety. Sufferers may feel horribly unique, and also worry that the incontinence is their own fault. They fear a guilty association with despised groups. It is noteworthy that the maintenance of 'normality'--allowing the sufferer to claim that there is no problem and that she is not incontinent--may involve a great deal of work. Although there are indications of defensive denial in sufferers' reactions to the problem, an additional interpretation is that they are fighting to subordinate the problem in favour of other priorities. Implications for practice of each of these features of the meaning of incontinence are drawn out.
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PMID:The meaning of incontinence: a qualitative study of non-geriatric urinary incontinence sufferers. 825

A 54-year-old man developed somnolent akinetic mutism and acute mixed transcortical aphasia following a left thalamo-mesencephalic infarction. He also exhibited behavioural changes, namely apathy, slowness, lack of spontaneity, disinhibition, perseveration, gait apraxia and incontinence consistent with frontal lobe dysfunction. Presumably the akinetic mutism and language dysfunction were due to the thalamic stroke. All the manifestations could be related to interruption of the frontal-subcortical circuitry.
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PMID:Akinetic mutism and mixed transcortical aphasia following left thalamo-mesencephalic infarction. 1022 14


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