Narcolepsy

2020 ◽  
pp. 5882-5886
Author(s):  
Matthew C. Walker
Keyword(s):  
Quality Of Life ◽  
Muscle Tone ◽  
Mouth Opening ◽  
Symptomatic Treatment ◽  
Sodium Oxybate ◽  
Driving Ability ◽  
Deep Sleep ◽  
Specific Syndrome ◽  
Hla Genotype

Narcolepsy with cataplexy is a specific syndrome of daytime sleepiness, disrupted nocturnal sleep, and episodes of sudden loss of muscle tone—provoked by the anticipation of emotions (in particular laughter)—leading to a tendency to fall, mouth opening, dysarthria or mutism, and facial muscle jerking. It is associated with loss of hypocretin (orexin) neurons in the hypothalamus, hypocretin concentrations in the cerebrospinal fluid below 110 pg/ml, and the HLA genotype DQ B1*0602. A less common form of narcolepsy without cataplexy probably has a different, as yet unknown, pathogenesis. Once established, narcolepsy is lifelong; spontaneous recovery does not occur. Symptomatic treatment—which is essential for school performance, work, driving ability, and quality of life—is with stimulant (e.g. amphetamine) and anticataplectic (e.g. clomipramine) drugs. More recently, sodium oxybate, an anaesthetic, has been used to induce deep sleep overnight, resulting in improvements in all symptoms.

Narcolepsy

2010 ◽  
pp. 4826-4828
Author(s):  
David Parkes
Keyword(s):  
Quality Of Life ◽  
Cerebrospinal Fluid ◽  
Daytime Sleepiness ◽  
Muscle Tone ◽  
Mouth Opening ◽  
Driving Ability ◽  
Specific Syndrome ◽  
Hla Genotype ◽  
Hypocretin 1

Narcolepsy is the specific syndrome of daytime sleepiness with cataplexy, where there is a sudden loss of muscle tone—often provoked by the anticipation of emotions—leading to a tendency to fall, mouth opening, dysarthria or mutism, and facial muscle jerking. It is associated with loss of hypocretin (orexin) neurons in the hypothalamus, hypocretin-1 concentrations in the cerebrospinal fluid below 100 ng/litre, and the HLA genotype DQ B1*0602. Once established, narcolepsy is lifelong; spontaneous recovery does not occur. Treatment—which is essential to restore school performance, work, driving ability and quality of life—is with stimulant (e.g. amphetamine) and anticataplectic (e.g. clomipramine) drugs, supported by a 15-min nap once or twice a day....

scholarly journals Effects of Seasonal Allergic Rhinitis on Driving Ability, Memory Functioning, Sustained Attention, and Quality of Life §

2008 ◽  
Vol 1 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Monique A.J. Mets ◽  
Edmund R. Volkerts ◽  
Erwin A. Dunnebier ◽  
Lieke M. de Senerpont Domis ◽  
Berend Olivier ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Grass Pollen ◽  
Pollen Season ◽  
Performance Test ◽  
Continuous Performance Test ◽  
Driving Ability ◽  
Continuous Performance ◽  
Memory Functioning ◽  
Grass Pollen Season

Objective: The objective of this study was to compare driving ability, memory, and psychomotor performance during grass pollen season with winter season in untreated patients with SAR. Methods: Patients with SAR were trained and tested during the grass pollen season (summer) and winter. An on-the-road driving test during normal traffic conditions was performed. Primary parameter is the Standard Deviation of Lateral Position (SDLP), i.e. the weaving of the car. In addition, a word learning test and continuous performance test were performed and quality of life was assessed. Patients were included if in winter the Total 5-Symptoms Score (T5SS) was < 3 and in summer the T5SS was > 3. Results: 70 patients were recruited of which 22 started the study. Fifteen patients completed the study of which 11 met the inclusion criteria. These 11 patients had a mean T5SS of 6.8 in summer and 0.6 in winter. Patient reported a significantly reduced overall quality of life during grass pollen season (p<0.0001). No significant effects were found on the driving test, except a significant (but not relevant) decrease in mean speed during the grass pollen season (p<0.035). No significant effects were found on the word learning test and continuous performance test. Conclusion: Our data suggest that moderate SAR symptoms do not impair driving ability, memory functioning and continuous performance. However, given the small sample size future studies should confirm these findings.

Efficacy of Celecoxib in Treating Symptoms of Viral Pharyngitis: A Double-Blind, Randomized Study of Celecoxib versus Diclofenac

2002 ◽  
Vol 30 (2) ◽  
pp. 185-194 ◽  
Author(s):  
LLM Weckx ◽  
JE Ruiz ◽  
J Duperly ◽  
GA Martínez Mendizabal ◽  
MBG Rausis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Randomized Study ◽  
Specific Inhibitor ◽  
Symptomatic Treatment ◽  
Double Blind ◽  
Once Daily ◽  
Daily Group ◽  
Throat Pain

This study compared the efficacy and safety of the cyclooxygenase-2 specific inhibitor celecoxib with the conventional non-steroidal anti-inflammatory drug diclofenac in the symptomatic treatment of viral pharyngitis. Adult patients from 27 study centers in Latin America were treated with oral doses of celecoxib 200 mg once daily or 200 mg twice daily, or diclofenac 75 mg twice daily for 5 days in a double-blind, randomized study. The primary efficacy assessment was ‘Throat Pain on Swallowing’ on day 3. In addition, secondary quality-of-life assessments were performed on days 3 and 5. All adverse events and treatment-emergent signs and symptoms were recorded. Data from 313 patients were evaluable for efficacy (105 celecoxib 200 mg once daily, 107 celecoxib 200 mg twice daily, 101 diclofenac 75 mg twice daily). The upper 95% confidence limits for the visual analog scale of ‘Throat Pain on Swallowing’ on day 3 for celecoxib 200 mg once daily relative to diclofenac 75 mg twice daily, and celecoxib 200 mg twice daily relative to diclofenac 75 mg twice daily were 9.26 and 7.83, respectively. All secondary efficacy and quality-of-life measures were clinically similar for the three treatment groups, and no statistically significant differences were detected. The incidences of treatment-emergent adverse events and withdrawals due to adverse events were similar for all groups, but numerically higher among patients taking diclofenac than celecoxib. More patients in the diclofenac group reported gastrointestinal complaints (7.3%) compared with those in the celecoxib groups (4.3% in the celecoxib 200 mg once-daily group and 3.4% in the celecoxib 200 mg twice-daily group). In conclusion, 5 days of treatment with celecoxib 200 mg once daily is as effective as diclofenac 75 mg twice daily in the symptomatic treatment of viral pharyngitis. Celecoxib 200 mg once daily is also as effective as celecoxib 200 mg twice daily in this condition.

Symptomatic Treatment in Multiple Sclerosis

US Neurology ◽  
2013 ◽  
Vol 09 (01) ◽  
pp. 35
Author(s):  
Sandra Bigi ◽  
E Ann Yeh ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Young Adults ◽  
Sexual Dysfunction ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Negative Impact ◽  
Treatment Options ◽  
Symptomatic Treatment

Multiple sclerosis (MS) is a progressive and disabling neurodegenerative disease that primarily affects young adults. Despite significant therapeutic advances in the prevention of relapses, individuals with MS experience a variety of symptoms, most notably fatigue, spasticity, depression, gait and balance difficulties, and sexual dysfunction. These symptoms may interfere with activities of daily living and have a negative impact on quality of life. This review discusses treatment options for these symptoms.

Neoplastic pulmonary lymphangitis: Symptomatic treatment and quality-of-life evaluation in a prospective palliative care series

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19536-19536
Author(s):  
A. A. Dettino ◽  
T. Pagano ◽  
C. Jardim ◽  
T. Takagaki ◽  
D. Deheinzelin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Short Form ◽  
Bone Cancer ◽  
Symptomatic Treatment ◽  
Symptom Improvement ◽  
Karnofsky Performance Scale ◽  
Sf 36 ◽  
Lymphangitis Carcinomatosa

19536 Background: Neoplastic lymphangitis, or lymphangitis carcinomatosa, is a rare and distressing form of lung metastasis, for which symptom improvement is strongly necessary. Since measuring quality of life is an important step toward improving symptom management in cancer patients, and dyspnea in pulmonary lymphangitis is a complex syndrome in end-of-life care, we focused on evaluating a cohort of those individuals. Methods: 52 consecutive patients with neoplastic pulmonary lymphangitis (NPL) were prospectivelly followed in 3 services, with quality of life (QoL) evaluation also, using Medical Outcomes Study 36-item Short-Form Health Survey (SF- 36) and Saint George's Respiratory Questionnaire (SGRQ). Results: 65% (34) of patients were female; age ranged from 37 to 84 years (median: 60). Primary tumor sites were: 28 lung (54%), 18 breast (35%), 5 digestive (9%) and 1 bone cancer. Histological findings were of adenocarcinoma in most cases (71%). Karnofsky performance scale ranged from 10 to 90% (median: 60%); 52% (27) patients had other comorbidities (Charlson index ranged from 6–10; median 7); 48% (25) were previous smokers; hemoglobin levels ranged from 4.9 to 16.7 g/dL (median: 12). We also evaluated 33 patients with echocardiography, and 13 (43%) of them had signs of associated pulmonary hypertension; ejection fraction ranged from 46 to 83% (median: 69%); diastolic dysfunction was present in 22 and pericardial effusion in 10 patients. At accrual, median QoL scores were of: 32% (range: 0–84%) for SF-36 (scale with 0 worst) and 66% (range: 0–100%) for SGRQ (scale with 100% worst). Treatment is showed in a table below. Median survival was of 4 months (range: 0.2–40+ months); 22 (42%) of the patients had an unusual longer survival of more than 6 months, still showing good QoL scores. Conclusions: Despite the fact that QoL is generally poor and survival is short for patients with NPL, some patients may have longer survival time and some improvement is possible with active palliative care. [Table: see text] No significant financial relationships to disclose.

scholarly journals A case study of the effect of cardiovascular training on cerebral palsy

2016 ◽  
Vol 29 (4) ◽  
pp. 713-721
Author(s):  
Jéssica Silva Teixeira ◽  
Luiza Mayara Lima de Jesus Santos ◽  
Nayhara Lemos dos Santos ◽  
Carla Cristine Cunha Casali ◽  
Carolina Marques Carvalho Mitre Chaves
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Muscle Tone ◽  
Muscle Length ◽  
Life Questionnaire ◽  
Walk Test ◽  
Timed Up And Go ◽  
Sf 36 ◽  
Cardiovascular Training

Abstract Introduction: Cerebral palsy (CP) is a non-progressive disorder characterized by changes in muscle tone and voluntary movement, leading to adaptive changes in muscle length and in some cases, resulting in bone deformities and increased energy expenditure while performing activities of daily living. Objective: The aim of this study was to investigate the effects of cardiovascular training by an adult with athetoid CP. Methods: The sample was composed of one patient with athetoid CP. The instruments used were the timed ten-meter walk test; the SF-36 quality of life questionnaire, a six-minute walk test and the Timed Up and Go test. Using an exercise bike and resistance exercises for the upper limbs, the patient underwent 24 sessions lasting fifty minutes each during eight weeks. Results: In all tests, significant improvement was observed at four and eight weeks, especially in the first four, and progressed in the following four weeks. In the post-training period, improvement was observed when compared to pre-training values. The SF-36 questionnaire on quality of life showed increase in some areas and decrease in others. Conclusion: Patients with CP can benefit from a physical training program, which can improve their quality of life and be included in their rehabilitation protocol.

scholarly journals No More Pain in the Gut: Lifestyle Medicine Approach to Irritable Bowel Syndrome

2017 ◽  
Vol 11 (3) ◽  
pp. 223-226
Author(s):  
Tereza Hubkova
Keyword(s):  
Quality Of Life ◽  
Nervous System ◽  
Irritable Bowel Syndrome ◽  
Autonomic Nervous System ◽  
Negative Impact ◽  
Symptomatic Treatment ◽  
Lifestyle Medicine ◽  
Case Presentation ◽  
Irritable Bowel

Irritable bowel syndrome has often underestimated negative impact of quality of life. Traditional symptomatic treatment does not address underlying complex etiology. Superior results might be achieved with combination of lifestyle medicine, correction of underlying microbial imbalances and retraining of autonomic nervous system as demonstrated in this case presentation.

scholarly journals Removable prostheses improve OHRQL and satisfaction of elderly people with rheumatoid arthritis

2020 ◽  
Vol 19 ◽  
pp. e206652 ◽  
Author(s):  
Bruna Fernandes Moreira Alfenas ◽  
Kelly Machado de Andrade ◽  
Talita Malini Carletti ◽  
Renata Cunha Matheus Rodrigues Garcia
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Elderly People ◽  
Temporomandibular Disorder ◽  
Functional Limitation ◽  
Mouth Opening ◽  
Functional Impairments ◽  
Oral Rehabilitation ◽  
The Impact

Rheumatoid arthritis (RA) is an autoimmune disease that affects joint tissues and causes severe physical and functional impairments on quality of life due to muscular and articular pain. The involvement of temporomandibular joint in RA interferes with mouth opening and masticatory process. However, no studies addressed the impact of RA on oral health-related quality of life (OHRQoL) and satisfaction with prostheses use in elderly people. Aim: This study assessed the impact of oral rehabilitation with conventional dentures on the OHRQoL and prostheses satisfaction in elderly patients with RA, associated or not with temporomandibular disorder (TMD). Methods: Forty-five elderly were enrolled and divided into three groups: (1) RA and TMD (n=15, experimental), (2) RA without TMD (n=15, experimental), and (3) without RA and without TMD (n=15, control). The OHRQoL and the prostheses satisfaction were evaluated before and after new oral rehabilitation with partial and/or complete dentures. The OHRQoL and prosthesis satisfaction were assessed and verified through OHIP-14 questionnaire and visual analogue scale, respectively. Results: TMD group exhibited the worst mean values (P<0.05) for all OHIP-14 domains before insertion of new dentures. Group 2 showed worst means (P<0.05) compared to controls for functional limitation and physical pain domains of the OHIP-14, but not in the general score. Patients showed better outcomes of satisfaction with prostheses use only after the new rehabilitation. Conclusion: The use of new and well-fitted dentures improves all domains of OHRQoL in patients with RA and TMD and all groups were satisfied with prostheses use after the new rehabilitation with conventional dentures.

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