Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 71-year-old paraplegic woman presented with a complaint of insomnia caused by severe flexor spasms of the lower limbs at night, aggravated for a few hours by taking hot baths. Lidocaine injection of the tarsal tunnel diminished the flexor-withdrawal reflex, which was easily elicited by light pinching or sustained compression over the tarsal tunnel, and strongly suggested the existence of the tarsal tunnel syndrome. Surgical decompression of the tarsal tunnel significantly reduced the flexor spasms both in terms of frequency and of duration.
 ...
PMID:Latent tarsal tunnel syndrome with the provocation of flexor spasms in a paraplegic person. Case report. 747 46

A 71-year-old woman with a 3-year history of excessive daytime sleepiness and an increased need for sleep did not feel restored upon awakening and had daytime fatigue despite a full night's sleep. She was evaluated with polysomnography (PSG). She significantly underestimated her sleep latency and awake time after sleep onset. The following morning, she stated that she had slept all night, when in fact she had extremely poor sleep efficiency and prolonged sleep latency. Another PSG and a two-week long actigraphy confirmed her misperception. Therefore, she perceived physiologic wakefulness, by PSG and actiraphy criteria, as subjective sleep, in direct contrast to 'conventional' sleep state misperception, in which patients usually present with a complaint of insomnia but have normal sleep quality and duration by PSG criteria. This patient may have a previously undescribed variation of sleep state misperception that the authors have tentatively named 'reverse' sleep state misperception.
 ...
PMID:Reverse sleep state misperception. 1571 24

Cushing's syndrome (CS) due to ectopic adrenocorticotrophic hormone (ACTH) is associated with a variety of tumours most of which arise in the thorax or abdomen. Prostate carcinoma is a rare but important cause of rapidly progressive CS. To report a case of severe CS due to ACTH production from prostate neuroendocrine carcinoma and summarise previous published cases. A 71-year-old male presented with profound hypokalaemia, oedema and new onset hypertension. The patient reported two weeks of weight gain, muscle weakness, labile mood and insomnia. CS due to ectopic ACTH production was confirmed with failure to suppress cortisol levels following low- and high-dose dexamethasone suppression tests in the presence of a markedly elevated ACTH and a normal pituitary MRI. Computed tomography demonstrated an enlarged prostate with features of malignancy, confirmed by MRI. Subsequent prostatic biopsy confirmed neuroendocrine carcinoma of small cell type and conventional adenocarcinoma of the prostate. Adrenal steroidogenesis blockade was commenced using ketoconazole and metyrapone. Complete biochemical control of CS and evidence of disease regression on imaging occurred after four cycles of chemotherapy with carboplatin and etoposide. By the sixth cycle, the patient demonstrated radiological progression followed by recurrence of CS and died nine months after initial presentation. Prostate neuroendocrine carcinoma is a rare cause of CS that can be rapidly fatal, and early aggressive treatment of the CS is important. In CS where the cause of EAS is unable to be identified, a pelvic source should be considered and imaging of the pelvis carefully reviewed.
 ...
PMID:Severe Cushing's syndrome due to small cell prostate carcinoma: a case and review of literature. 2858 67