Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0235108 (tense)
 2,176 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The treatment of obesity is one of the major measures available today in the field of preventive medicine. In particular, the coronary epidemic of Western civilisation would be halted, and most cases of maturity-onset diabetes prevented, if obesity were to be treated effectively. Anorectic drugs act mainly on the satiety centre in the hypothalamus to produce anorexia. They also have various metabolic effects involving fat and carbohydrate metabolism, but many of these may be secondary to loss of weight. Most of the drugs are related directly or indirectly to amphetamine and in addition act by increasing general physical activity. Anorectic drugs tend to lose their effect after some months, and part of this reduction in effect may be due to chemical alterations produced by the drugs in the brain. All the drugs, with the exception of fenfluramine, have a stimulant effect on the central nervous system in some individuals, resulting in restlessness and nervousness, irritability and insomnia. Fenfluramine commonly produces drowsiness in normal doses, but has stimulant effects with overdosage. Dexamphetamine, phenmetrazine and benzphetamine all tend to cause euphoria and the risk of addiction is therefore considerable. Euphoria occasionally occurs with diethylpropion, phentermine and chlorphentermine, but to a much lesser extent. Side-effects also occur due to sympathetic stimulation and gastro-intestinal irritation. These side-effects may cause some individuals to stop taking the drug, but are never serious or dangerous. Drug interactions may occur with monoamine oxidase inhibitors and to a clinically unimportant extent, with antihypertensive drugs. The anorectic drugs have a very definite part to play in the treatment of obesity, mainly for those individuals who have altered their eating habits but have come to a plateau of weight which they find difficult to get below. The drugs are best given in a long-acting form and can safely be continued as long as weight loss persists, provided that the clinician exercises careful supervision. Dexamphetamine, phenmetrazine and benzphetamine should rarely be used because of the danger of addiction, and chlorphentermine is potentially hazardous for long-term use. Diethylpropion emerges as the drug of first choice, as fenfluramine has a tendency to cause depression and has a higher incidence of side-effects. Fenfluramine is mainly useful for people who are especially tense and for obese maturity-onset diabetics who have been unable to lose weight with the biguanides. Mazindol and phentermine appear to be useful as alternative drugs.
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PMID:Anorectic drugs: use in general practice. 78 35

Fifty-eight outpatients with panic disorder (PD) were examined to determine their clinical features in comparison with a cohort of 52 patients with generalised anxiety disorder (GAD). Both groups were of comparable age, sex, educational level, marital status and ethnicity. PD patients were more likely to complain of palpitations, breathlessness, chest pain, numbness, choking sensations and especially fear of dying. GAD patients tended to complain of feeling tense, insomnia, headaches, weakness, restlessness and muscle aches. PD patients had greater comorbidity especially with agoraphobia and depression. Contrary to other reports, there were more males than females in both groups but alcohol dependence and suicide attempts were relatively rare. PD symptoms seemed more distressing, caused more social and occupational disruption, led to more requests for medical investigations and earlier psychiatric consultations. These factors seemed to suggest that panic disorder is a more severe illness than generalised anxiety disorder.
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PMID:Panic disorder in Singapore: clinical features and comparisons with generalised anxiety disorder. 920 72

In the second stage of the European longitudinal study of pregnancy and childhood (ELSPAC) detailed anamnestic data on the mother were assessed, and objective data on the health status during pregnancy, delivery and on the neonate were assembled. Numerous partial results of the ELSPAC study confirmed that smoking during pregnancy has an adverse effect on the course of pregnancy and foetal development. During pregnancy in smokers proteinuria as well as the diagnosis of suspect foetal retardation were significantly more frequent. During delivery placenta previa and placental abnormalities were recorded more often. The mean duration of gestational age was similar in smokers and non-smokers. The mean birth weight of newborns of women who smoked during pregnancy was on average by 107 g lower as compared with non-smokers. Significant differences were also found in the mean length and head circumference, always to the disadvantage of smokers. Smokers reported significantly more frequently greater fear and restlessness at the onset of labour pains and after return from the maternity home. They get frequently more excited without any reason and are more tense.
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PMID:[Pregnancy and fetal development in smoking and nonsmoking women]. 1056 68

In the advanced stages of dementia of the Alzheimer's type (DAT), affected persons present body language and various behaviours expressing discomfort: shouting, agitation, irritability, aggressiveness, tense movements. Nursing, up until now, has had few available means to ease this discomfort. The authors of the following article have conducted an experimental study measuring the alleviating effects of therapeutic touch on the discomfort of persons in the advanced stages of DAT. Experimental group subjects (n = 16) received 5 sessions of therapeutic touch lasting 12.4 minutes. Control group subjects (n = 11) received 5 sessions of simple presence lasting 10.3 minutes. The authors measured subject discomfort levels using the Discomfort Scale for Dementias of the Alzheimer's Type (DS-DAT). Results show that discomfort levels of persons in the advanced stages of DAT decreased significantly after 5 therapeutic touch sessions, becoming significantly lower than levels in the control group. If care was focused on the whole person and his or her comfort, tools like therapeutic touch would become available to nurses, allowing them to enhance the quality of life of the people in their care.
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PMID:[Therapeutic touch]. 1078 1

Stimulation of the periaqueductal gray matter (PAG) and the deeper layers of superior colliculus (SC) produces both freezing (tense immobility) and flight (trotting, galloping and jumping) behaviors along with exophthalmus (fully opened bulging eyes) and, less often, micturition and defecation. The topography of these behaviors within the distinct layers of SC remains unclear. Therefore, this study compared the defensive repertoire of intermediate (ILSC) and deep (DLSC) layers of SC to those of dorsolateral periaqueductal gray matter (DLPAG) and lateral periaqueductal gray matter (LPAG) [Neuroscience 125 (2004) 71]. Electrical stimulation was carried out through intensity- (0-70 microA) and frequency-varying (0-130 Hz) pulses. Chemical stimulation employed a slow microinfusion of N-methyl-d-aspartic acid (NMDA, 0-2.3 nmol, 0.5 nmol/min). Probability curves of intensity-, frequency- and NMDA-evoked behaviors, as well as the unbiased estimates of median stimuli, were obtained by threshold logistic analysis. Compared with the PAG, the most important differences were the lack of frequency-evoked jumping in both layers of SC and the lack of NMDA-evoked galloping in the ILSC. Moreover, although galloping and jumping were also elicited by NMDA stimulation of DLSC, effective doses were about three times higher than those of DLPAG, suggesting the spreading of the injectate to the latter structure. In contrast, exophthalmus, immobility and trotting were evoked throughout the tectum structures. However, whatever the response and kind of stimulus, the lowest thresholds were always found in the DLPAG and the highest ones in the ILSC. Besides, neither the appetitive, nor the offensive, muricide or male reproductive behaviors were produced by any kind of stimulus in the presence of appropriate targets. Accordingly, the present data suggest that the deeper layers of SC are most likely involved in the increased attentiveness (exophthalmus, immobility) or restlessness (trotting) behaviors that herald a full-blown flight reaction (galloping, jumping) mediated in the PAG.
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PMID:Organization of electrically and chemically evoked defensive behaviors within the deeper collicular layers as compared to the periaqueductal gray matter of the rat. 1591 56

This study assessed the concurrent validity of the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS) and the Hamilton Anxiety Scale (Ham-A) for evaluating anxiety in a group of 46 Parkinson's disease (PD) patients. The magnitude of correlations between the scales was high (all p<0.01), indicating a good concurrent validity. The item-by item analysis indicated that the main characteristics of anxiety in PD patients were 'inability to relax', 'restlessness or inability to feel calm' and 'feeling tense'. The association between anxiety, as measured by the HADS-A, with demographic characteristics or clinical features of PD was not significant, supporting existing data suggesting that anxiety in PD is not closely correlated with the severity of motor symptoms or the degree of disability. The HADS-A may be the most appropriate scale for documenting patient-reported anxiety in depression.
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PMID:Evaluation of anxiety in Parkinson's disease with some commonly used rating scales. 1797 42

There may be a relationship between proton pump inhibitors (PPIs) and iron absorption. PPIs may decrease the amount of iron absorbed gastrointestinally specifically due to alteration of the pH in the duodenum. Restless legs syndrome (RLS) is a sensorimotor disorder that includes an urge to move legs, accompanied or caused by uncomfortable and unpleasant sensations in the legs; the urge to move begins or worsens during periods of rest or inactivity, the urge to move is partially or totally relieved by movement, and the urge is worse or only occurs at night. In the majority of the restless leg syndrome population, the sensation is deep seated, often described as being in the shin bones, and most commonly felt between the knee and ankle. It may be described as a creepy, shock-like, tense, electric, buzzing, itchy, or even numb sensation. A subpopulation of this restless leg syndrome patient population experiences restless leg syndrome associated pain (RLSAP) that has been described as a deep "achy pain." This pain has not been found to be relieved by many of the typical over the counter analgesics. Often, constant movement of the legs appears to be the only remedy, as these sensations usually appear during periods of rest. Furthermore, there appears to be an association between iron deficiency and those suffering from Restless Leg Syndrome (RLS). The authors theorize that there may be a possible correlation between PPIs and the symptoms (e.g. pain) associated with RLS. The authors propose that PPIs, such as omeprazole, may interfere with iron absorption in certain patients and that a subpopulation of patients who develop significant iron deficiency characterized by low serum ferritin levels while on PPIs may also develop RLS-like symptoms (including RLSAP). While there is no robust direct evidence to support any associations of PPIs and iron deficiency or PPIs associated with RLS-like symptoms (including RLSAP), it is hoped that this manuscript may spark research efforts on this issue.
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PMID:Proton pump inhibitors and pain. 1993 88

Because of their physical and general health problems, people with a combination of profound intellectual and severe or profound motor disabilities (PIMD) are at risk of pain-related medical conditions. They are fully dependent on support professionals for the detection and accurate interpretation of nonverbal pain behaviour. These professionals can use a recently developed instrument, the Pain Behaviour Checklist (PBC), to assess pain in post-operative situations for children with PIMD. It is not yet known whether this instrument can also be used to identify pain in both children and adults in daily care situations. The aim of this pilot study was therefore threefold: to establish (1) whether the PBC can be used to identify pain in day-to-day situations in people with PIMD, (2) which behaviours are most frequently identified as indices of pain behaviour, and (3) whether there is a difference in pain-related behaviour between children and adults. In total, 32 people with PIMD participated in the study (16 children with a mean age of 10.4 years and 16 adults with a mean age of 46.7 years). Each participant was videotaped twice during a planned care moment in which we assumed that pain was prevalent. During each observation, pain was scored by the direct support professional using the Visual Analogue Scale (VAS) and by two trained independent observers using the PBC. The reliability (both intrarater and interrater) of the PBC was analysed by calculating Spearman's rho. Validity was analysed by correlating the PBC with the VAS scores; Phi was calculated for both children and adults. Finally, positive scores on each separate item of the PBC were analysed in adults and children in order to discover possible differences between pain behaviour in each group. The interrater reliability of the PBC is .63 (p<.05) and the intrarater reliability was .88 (p<.05). Phi, as a measure of the agreement on pain/no pain between the VAS and the PBC, is .75 (p<.05) in children and .28 (p<.05) in adults. Adults were more likely to exhibit the pain-related behaviours of 'tense face', 'deeper naso-labial furrow' and 'moaning and groaning', whereas children made more 'penetrating sounds of restlessness'. Based on this pilot study, we conclude that the PCB's reliability when used in daily practice with people with PIMD is satisfactory. However, although the validity is good for children, it appears insufficient for adults. It seems that children display different pain-related behaviours than adults. More research is needed into the proper assessment of pain in people with PIMD, especially adults, by health care professionals in daily practice. We also need a better understanding of the extent to which the knowledge and experience of care professionals play a role in detecting (chronic) pain behaviour in both children and adults and of how people with PIMD cope with pain.
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PMID:Pain assessment in people with profound intellectual and multiple disabilities; a pilot study into the use of the Pain Behaviour Checklist in everyday practice. 2144 Apr 13

Researchers say that most ED personnel will experience some form of physical or verbal violence at some point in their careers. However, when such incidents are regularly reported, the patients involved can be flagged in a hospital's computer system, making future events involving the same patients much less likely. Further, when ED personnel are alert to the clues that a patient or family member is becoming agitated, early intervention can usually prevent the situation from escalating to violence. About one-half of all ED personnel will experience a physical assault, and 97%-100% will experience verbal abuse during their careers, according to research. A first step in developing a strategy for dealing with violence is to educate ED personnel about what constitutes workplace violence so that all such incidents can be reported. Experts say many ED workers fail to recognize some instances of violence, based on the intent of the person involved. However, intent should not be a factor, they say. In many cases, empathy and good customer service skills can prevent tense situations from escalating to violence, but experts say that it is important to intervene at the first sign of agitation. ED administrators should gather input from frontline staff on how to most effectively derail instances of violence.
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PMID:Experts: to crack down on violence in the ED, establish a robust system of reporting, educating staff. 2405 47

Smoking is a serious public health problem, and accurate real-time assessment of risk factors associated with smoking is critical to understanding smoking relapse. Negative affect is often described as a critical risk factor related to smoking relapse, and ecological momentary assessment (EMA) methods have been widely used to study real-time relations between negative affect and smoking. However, the factor structure of momentary negative affect ratings is unknown. The current investigation examined the multilevel factor structure and internal consistency of an EMA measure of negative affect. Daily assessments were collected for 1 week prequit and 3 weeks postquit from 113 adult daily smokers receiving nicotine replacement therapy and counseling to quit smoking. Results supported a 2-factor model with correlated but distinct agitation and distress factors, rather than a single-factor model of negative affect. The agitation factor was indicated by these items: impatient, tense/anxious, restless. The distress factor was indicated by these items: sad/depressed, upset, distressed. The 2-factor model had acceptable model fit and consistent factor loadings across 3 separate cessation phases: prequit, postquit with recent smoking, and postquit without recent smoking. The 2 factors were highly correlated, showed good internal consistency, and showed strong associations with theoretically relevant smoking and affect variables. Agitation was more strongly related to urge to smoke, and distress was more strongly related to recent stress. This study provides support for a 2-factor model of an EMA measure of negative affect and highlights distinct facets that may be useful for future investigations of affect and smoking. (PsycINFO Database Record
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PMID:Multilevel factor analysis of smokers' real-time negative affect ratings while quitting. 2753 99


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