Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392674 (exhaustion)
 13,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thefts without motive of pain have been known since the early 19th century. But the problem has not been solved. While they were formerly considered a mental disease, today they are not seen as something special. But they still happen. Only a small percentage of common shop-lifting can be called a psycholopathologic syndrome. Many explanations and analyses have been published which are discussed in detail. In a group described here comprehensively difficult marital situations full of conflict, marital sexual frustration, depression, physical and mental exhaustion and aggressive and suicidal tendencies are found. Theft appears to be closely connected with these. But the pattern of motivation and causation is by no means stereo-typed. In order to clear up such actions one will have to consider as exactly as possible the biographic connection and what happens during the act - quite apart from somatic conditions. Present assessment in reports is totally unsatisfactory. To clear up the controversial questions is urgently necessary.
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PMID:[Thefts without motive of gain as a psychopathologic syndrome (author's transl)]. 0 33

"Self-stimulation" is a phenomenon whereby an animal (including a human being) will repeatedly stimulate its brain electrically, sometimes to the point of exhaustion. This phenomenon is robust and readily reproducible in many areas of the brain, particularly in nuclei and fiber tracts known to be monoaminergic, and it has been the basis for the study of reinforcement and learning mechanisms in the brain. The last 25 years of work on intracranial self-stimulation is reviewed with an emphasis on mechanisms, primarily catecholaminergic. Implications for learning and pain mechanisms are discussed.
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PMID:Brain stimulation and reward: "pleasure centers" after twenty-five years. 11 91

In the differential diagnosis of intermittent claudication some rare myopathies have to be considered. The most frequent is phosphorylase deficiency (McArdle's disease). Exercise-induced muscular pain, weakness, contractures and occasionally myoglobinuria are the most prominent clinical signs. Serum creatine phosphokinase, aldolase and lactic dehydrogenase may be elevated after exertion. In the ischemic forearm test there is no rise of serum lactic acid. The enzyme deficiency can be demonstrated by histochemical and biochemical examination of a muscle specimen. Further, but more infrequent, enzymatic disturbances of glycolysis are phosphofructokinase deficiency and phosphohexoisomerase inhibitor, which also yield an abnormal ischemic forearm test and must be demonstrated histochemically and biochemically. Apart from muscular signs, myopathy with lactic acidosis is associated with palpitation, dyspnea and exhaustion, and a disproportionate rise in serum lactic acid level after exertion. Histochemically and electronmicroscopically demonstrable fat accumulation in the muscle can be a sign of a disturbance in lipid metabolism. This type of exercise-induced myopathy has been reported only in a few cases with carnitine-pylmityltransferase deficiency, which has to be demonstrated biochemically. Muscular contractures also exercise-induced but painless and reversible within seconds may be due to deficient uptake of sarcoplasmic calcium in the tubular system. Dyskalemic paralysis causes painless paresis within minutes of hours after exertion, which disappears within hours to a few days. Myopathy with tubular aggregates can be differentiated from other exercise-induced myopathies by morphology. Myotonia combined with painful contractures characterizes myopathia myotonica.
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PMID:[Exercise-induced muscular weakness, myalgia and contractures. I. A clinical review]. 13 80

Ten adults and ten children exercised maximal voluntary tooth clenching until pains appeared in the jaw muscles, i.e. the muscle pain threshold of tooth clenching was determined. Subsequently, the subjects were instructed to exercise tooth clenching until they were forced to stop because of intolerable pains and exhaustion of the contracting muscles, i.e. the muscle pain tolerance of tooth clenching was recorded, and during these bouts of clenching the pain tolerance of tooth clenching was recorded, and during these bouts of clenching the pain threshold was also determined. In adults, determination of the pain tolerance decreased the pain threshold by 19%, and in children it either decreased the pain threshold by 20% or increased it by 56%. It is proposed to introduce the muscle pain tolerance of tooth clenching as an adjunct in the clinical examination of cases of facial pains presumed to originate from the jaw muscles, but the test should be interpreted with caution.
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PMID:Influence of muscle pain tolerance on muscle pain threshold in experimental tooth clenching in man. 28 68

The patients here concerned had a faulty psychical development. During the caracter-building period of early childhood they were unable, to assert themselves sufficiently enough to be accepted, or to feel that they are loved. Therefore they tried by means of overcompensatory efforts in the sense of extreme adjustment to others, to make up for this lack. Increasingly confined, as a preponderant attitude they finally developed a forced "assistant" pose (W. Schwidder). Under these circumstances the personality of the patients could not develop sufficiently in the way, that they were able to make free decisions by maintaining legitimate interests of selfassertion. As a rule, they did not experience their own subconscious, arbitrary strong protest against their overwhelming neurotic obligations, especially as their "backbone" did not make possible the establishment of any suitable or sufficient representation of their own desires or needs corresponding to the largely obsessional structure of most patients. The vicious circle, leading to the loss of inner balance makes understandable the determinant preponderance of self defense against complete exhaustion of strength. Therefore the necessary relaxation cannot be acquired and at the same time the fixation of the bodily ailments becomes unavoidable. In comparison with the study of Reischauer, with regard to our patients there cannot be established any special imperilled type; by these patients, however, a specific failure in trying to master their lives becomes a probability. By reason of our experiences, even though they are limited and still to be tested in other ways, conservative measures, which stimulate the activeness of the patients are to be preferred. If one interrupts that sort of pliant texture operatively-unless their is an urgent indication-unprofitable results must be expected, which correspond to orthopedic experiences. In the case of chronic manifestations and unusually deep fixation of the syndroms in the psychical area, no real improvement is obtained by psychoanalytic measures. Also, if one should succeed in transferring the patients in the acute state to a mental therapist in spite of the rapid reduction of their somatic pain complex, the prognosis for the more functionally concerned ones would then be burdened cosiderably by the long period of difficult differentiation against the largely somatic progression of the discs.
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PMID:[Psychodynamic factors in disk irritations]. 123 8

Using an ABAB single case design, the effects of a combination therapy (phase A) of computer-assisted attention retraining and Progressive Relaxation (PR) are examined in comparison to those of condition B in which short breaks are used instead of PR. The patient was a 57 year-old man with specific attention deficits following spontaneous subarachnoid haemorrhage (without operation). In both conditions, A and B, the patient ran through three therapy sessions of 45 minutes duration in the course of three days, with 6 minutes of attention retraining alternating with 6 minutes of PR or break, respectively. The results revealed that a) in comparison to the baseline (attention retraining without PR or break), both conditions, A and B, enabled the patient to cope effectively with the 45 minute training sessions without significant increase of complaints (muscular tension, excitement); b) attentional performance (complete test d2) raised up to the average over the whole ABAB experiment; c) attentional performance (tested before and after each phase with a third part of test d2) decreased under the break condition during the individual sessions, while it was unchanged under PR; d) attentional performance at the computer retraining programme ("Bild" by Rigling) partially increased under PR and slightly decreased under break condition; e) there was less excitement and less muscular tension under PR in comparison to the break condition; and f) pain in the joints and exhaustion (both measured with the GBB) were reduced significantly under PR, as opposed to a marked increased in the break condition.
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PMID:[Effect of combination treatment by concentration and relaxation training after subarachnoid hemorrhage (single case analysis)]. 148 99

All patients with systemic lupus erythematosus in a prospective, epidemiologically based study within a defined area in southern Sweden were invited to participate in an investigation of cardiac function. From 1981 to 1988, 101 patients were included in the study, and 75 of them were investigated according to a fixed protocol by echocardiography, Doppler cardiography, electrocardiography (ECG) at rest and at exercise, and myocardial scintigraphy (in patients whose ECG became abnormal during exercise). IgG anticardiolipin antibodies (IgG aCL) were determined by ELISA. Twenty of the 75 patients (27%) had valvular disease and 12 of these (60%) had increased concentrations of IgG aCL, compared with 12 of 55 (22%) without valvular disease (p less than 0.01). Pericardial effusion was detected in 14 patients (19%) during the study period. Mild pulmonary hypertension was found in 11 patients (16%), who also had increased frequency of IgG aCL. Myocardial infarction had occurred in 7 patients, 3 of whom were women less than 40 years of age. Echocardiography revealed regional hypokinesis or akinesis in 5 of the patients with myocardial infarction. Exercise testing revealed low work capacity in 13 of 54 patients (24%), the limiting symptoms being mainly exhaustion or musculoskeletal pain. An abnormal resting ECG was found in 9 of the patients participating in the exercise test. During exercise, abnormal ST-depression was observed in 8 patients, 2 of whom developed angina. Myocardial scintigraphy was performed in 6 of these patients, revealing reversible uptake defects in all. Prolonged glucocorticoid treatment was associated with valvular abnormalities as well as myocardial infarction. Valvular abnormalities and IgG aCL appeared to be risk factors for cerebral infarction.
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PMID:Cardiovascular disease in systemic lupus erythematosus. A study of 75 patients form a defined population. 151 95

Japanese mothers who had newly diagnosed diabetic children responded with shock, defensive retreat, and increased anxiety. During this process, the degree of their isolation was shown as trauma. Although many mothers had a strong reaction and suffered depression, loss of weight, pain, and feelings of exhaustion, they adapted to the diagnosis by the end of 1 year. Compared with an American study (Hamburg & Inoff, 1983), some of the mothers' patterns of coping were similar to those used by mothers in the United States; others were related specifically to accepted Japanese cultural practices. They used several characteristic coping strategies: resignation, holding out, and believing in religion. Nurses need to be aware of the fact that mothers face a variety of psychological stress factors after their children are diagnosed as diabetic. They should be encouraged to feel and express a realistic hope.
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PMID:Japanese mothers' responses to the diagnosis of childhood diabetes. 156 26

Silent myocardial ischaemia is now well-recognised in patients with symptomatic coronary artery disease. Its pathogenesis remains speculative, though diminished sensitivity to pain is thought to be one of the mechanisms involved. Because cardiovascular autonomic dysfunction occurs frequently in diabetic patients, we postulate that it contributes towards painless myocardial ischaemia among them. Forty consecutive diabetic (type II) male patients and ten normal volunteers were studied. Using 5 previously-validated noninvasive tests for autonomic dysfunction, 14 of these diabetic men had definite autonomic neuropathy (at least 2 abnormal tests). All 50 subjects were then exercised on a motor-driven treadmill to either exhaustion or chest pains. Thirty-three diabetic subjects were tested positive, with significant (greater than 1 mm) ST segment depression over at least 2 contiguous leads. Of these, 18 were associated with typical angina but the other 15 stopped because of fatigue or exhaustion (ie painless). Thirteen subjects who had definite autonomic neuropathy (AN+) had positive exercise ECG tests-10 had painless ischaemia, and only 3 had angina. This contrasted with 15 patients who had painful ischaemia and 5 who had painless ischaemia among the group without (AN-)autonomic dysfunction (p = 0.0047, Fisher's exact test). There were no significant differences among the various groups for peak rate-pressure-product, all subjects attaining similar maximal oxygen consumption states during which ischaemic ST segment changes were noted (painful AN+: 21917 +/- 4753; painless AN+: 20117 +/- 6752; painful AN-: 16544 +/- 4063; painless AN-: 22220 +/- 4341, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Association of diabetic autonomic neuropathy with painless myocardial ischaemia induced by exercise. 162 Nov 24

The maxim "once an ulcer, always an ulcer" is still an appropriate description for the chronic nature of peptic ulcer disease. The goals for treating patients with ulcer disease are to relieve symptoms, heal the acute ulcer, reduce the risk of ulcer recurrence and complications, and decrease the economic impact of this chronic disease while maintaining the patient's quality of life. Patients with documented peptic ulcer disease should be carefully evaluated and a treatment plan devised that takes into account the possible need for maintenance therapy. Risk factors that seem to reflect a high likelihood of ulcer recurrence should be identified early in all ulcer patients and attempts made to minimize or correct them in the future. Assuming that a diagnosis of peptic ulcer disease has been firmly established and an adequate period of drug treatment makes complete ulcer healing likely, a reasonable way to proceed is outlined in Figure 4. If the patient is young and generally healthy, has an uncomplicated ulcer and few risk factors favoring ulcer relapse, either no treatment or symptomatic selfcare would be reasonable. If one chooses the latter course, the patient can be given a prescription for 3 to 6 months of medication and told to take full therapy for any recurrent symptoms, continuing the treatment until symptoms are relieved. The failure of such treatment to relieve symptoms after 2 to 3 weeks, the onset of alarming symptoms such as intense pain, vomiting, or melena, or possibly the exhaustion of the 6-month supply of medication with continued mild symptoms should lead to reevaluation. Alternatively, such a patient could be managed with no therapy and seen again if ulcer symptoms recur and reevaluated for further diagnosis and treatment. Obviously, patients who are candidates for these approaches to postulcer healing management are those with a low risk for ulcer recurrence and who are likely to be compliant with follow-up advice. Accordingly, careful patient selection seems most important in prescribing symptomatic self-care or intermittent full-dose maintenance treatment. On the other hand, if the patient has had a complicated course of ulcer disease, such as bleeding, or has a significant number of risk factors that would make early ulcer relapse highly likely, it would be prudent to institute continuous maintenance therapy while working to reduce or eliminate the adverse risk factors. Any relapse of symptomatic ulcer disease during noncontinuous maintenance therapy should indicate the need for return to a continuous dosing program.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Maintenance therapy in peptic ulcer disease. 167 59


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