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Iranian Journal of Kidney Diseases Mar 2023Despite great advances in hemodialysis, complications during dialysis remain in force. Accurate assessment of dry weight is a determining factor in the prevention of... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Despite great advances in hemodialysis, complications during dialysis remain in force. Accurate assessment of dry weight is a determining factor in the prevention of hemodialysis complications. This study is designed to evaluate the effect of adjustment of ultrafiltration rate, on hemodialysis complications, based on dry weight calculation, by measuring the pre-dialysis serum sodium.
METHODS
In this single-blind clinical trial 50 patients were included. The patients were randomly divided into case and control groups. First, in the intervention group, the blood sodium level was measured before dialysis. Then, the dry weight of the patients was determined, ultrafiltration was adjusted according to the dry weight, and the patients' dialysis program was performed. In the control group, dry weight was determined routinely. Blood pressure, muscle cramps, nausea, and vomiting were recorded in both groups for 3 months.
RESULTS
The results showed a significant difference between the two groups in the rate of postoperative nausea and vomiting (P < .05) and muscle cramps during dialysis (P < .05). There were no significant differences between the two groups in blood pressure drop during dialysis and fatigue after hemodialysis in the first, second, and third months (P > .05).
CONCLUSION
Accurate assessment of dry weight by the pre-dialysis blood sodium formula, reduces muscle cramps, nausea, and, vomiting. DOI: 10.52547/ijkd.7170.
Topics: Humans; Muscle Cramp; Dialysis; Single-Blind Method; Renal Dialysis; Blood Pressure; Drug-Related Side Effects and Adverse Reactions; Postoperative Complications; Sodium; Nausea; Vomiting
PubMed: 37060341
DOI: No ID Found -
Clinical Neurophysiology : Official... May 2023Skater's cramp is a movement disorder in speed skaters. We investigated whether affected skaters matched the disease profile of task-specific dystonia, specifically...
OBJECTIVE
Skater's cramp is a movement disorder in speed skaters. We investigated whether affected skaters matched the disease profile of task-specific dystonia, specifically whether there was evidence of maladaptive muscle activity occurring simultaneously with aberrant movements (jerking). We further examined different skating intensities, positing no change would be more indicative of task-specific dystonia.
METHODS
We analyzed video, kinematic and muscle activity in 14 affected skaters. We measured the angular velocity and electromyographic activity of normalized speed skating strokes using one dimensional statistical non-parametric mapping. Skaters were matched with comparably skilled controls, and filled out a bespoke clinical questionnaire.
RESULTS
Skaters' impacted leg showed over-activation in the peroneus longus, tibialis anterior and gastrocnemius that coincided with higher foot movement compared to their healthy leg and controls. This pattern persisted regardless of skating intensity. Clinical features indicated it was task-specific and painless with common trigger factors including stress, equipment change, and falling.
CONCLUSIONS
We showed aberrant muscular and kinematic activity in a movement disorder in speed skaters indicative of task-specific dystonia.
SIGNIFICANCE
Understanding skater's cramp as a task-specific dystonia could reduce the damage that misdiagnosis and unsuccessful invasive operations have caused. Our quantitative method has value in testing future treatment efficacy.
Topics: Humans; Biomechanical Phenomena; Muscle Cramp; Leg; Skating; Movement Disorders
PubMed: 36948074
DOI: 10.1016/j.clinph.2023.02.168 -
Frontiers in Neurology 2021Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal postures, repetitive movements, or both. Research in... (Review)
Review
Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal postures, repetitive movements, or both. Research in dystonia has been challenged by several factors. First, dystonia is uncommon. Dystonia is not a single disorder but a family of heterogenous disorders with varied clinical manifestations and different causes. The different subtypes may be seen by providers in different clinical specialties including neurology, ophthalmology, otolaryngology, and others. These issues have made it difficult for any single center to recruit large numbers of subjects with specific types of dystonia for research studies in a timely manner. The Dystonia Coalition is a consortium of investigators that was established to address these challenges. Since 2009, the Dystonia Coalition has encouraged collaboration by engaging 56 sites across North America, Europe, Asia, and Australia. Its emphasis on collaboration has facilitated establishment of international consensus for the definition and classification of all dystonias, diagnostic criteria for specific subtypes of dystonia, standardized evaluation strategies, development of clinimetrically sound measurement tools, and large multicenter studies that document the phenotypic heterogeneity and evolution of specific types of dystonia.
PubMed: 33897610
DOI: 10.3389/fneur.2021.660909 -
Anatolian Journal of Cardiology May 2022Venous diseases encompass a large spectrum of abnormalities in the venous system with complaints, such as aching and swelling. Enhanced external counterpulsa-tion,...
BACKGROUND
Venous diseases encompass a large spectrum of abnormalities in the venous system with complaints, such as aching and swelling. Enhanced external counterpulsa-tion, proven safe and effective in patients with coronary artery disease and chronic heart failure, is a technique that increases venous return and augments diastolic blood pres-sure. This study assessed the effects of enhanced external counterpulsation on symp-toms of venous disease using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaire.
METHODS
This study was designed prospectively for evaluating venous symptoms before and after enhanced external counterpulsation treatment. The study population con-sisted of 30 consecutive patients who were admitted to the cardiology clinic. The Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms ques-tionnaire was applied to assess venous symptoms one day before and after enhanced external counterpulsation treatment.
RESULTS
The mean age of the patients was 64.62 ± 9.67 years. After 35 hours of enhanced external counterpulsation, 28 patients (93%) had at least 1 New York Heart Association functional class reduction compared with baseline and 43% of patients had 2 New York Heart Association functional classes improvement. The New York Heart Association class significantly decreased after enhanced external counterpulsation treatment (P<.001). There was a significant improvement in their swelling and night cramps symptoms compared with baseline (P< .001 and P = .05, respectively). Also, The left ventricular ejec-tion fraction significantly increased after the enhanced external counterpulsation treat- ment (P = .02).
CONCLUSIONS
The findings obtained in the present study suggested that patients treated with enhanced external counterpulsation showed a significant reduction in swelling and night cramps symptoms. Although the total VEIN score did not change after the enhanced external counterpulsation procedure, improvement in swelling and night cramps under-lines the beneficial effects of enhanced external counterpulsation through the venousvascular territory.
Topics: Aged; Counterpulsation; Humans; Leg; Middle Aged; Muscle Cramp; Quality of Life; Treatment Outcome; Venous Insufficiency
PubMed: 35552177
DOI: 10.5152/AnatolJCardiol.2022.1350 -
European Journal of Endocrinology Mar 2022To describe clinical, laboratory, and genetic characteristics of three unrelated cases from Chile, Portugal, and Saudi Arabia with severe insulin resistance, SOFT... (Observational Study)
Observational Study
OBJECTIVE
To describe clinical, laboratory, and genetic characteristics of three unrelated cases from Chile, Portugal, and Saudi Arabia with severe insulin resistance, SOFT syndrome, and biallelic pathogenic POC1A variants.
DESIGN
Observational study.
METHODS
Probands' phenotypes, including short stature, dysmorphism, and insulin resistance, were compared with previous reports.
RESULTS
Cases 1 (female) and 3 (male) were homozygous for known pathogenic POC1A variants: c.649C>T, p.(Arg217Trp) and c.241C>T, p.(Arg81*), respectively. Case 2 (male) was compound heterozygous for p.(Arg217Trp) variant and the rare missense variant c.370G>A, p.(Asp124Asn). All three cases exhibited severe insulin resistance, acanthosis nigricans, elevated serum triglycerides and decreased HDL, and fatty liver, resembling three previously reported cases. All three also reported severe muscle cramps. Aggregate analysis of the six known cases with biallelic POC1A variants and insulin resistance showed decreased birth weight and length mean (s.d.): -2.8 (0.9) and -3.7 (0.9) SDS, respectively), severe short stature mean (s.d.) height: -4.9 (1.7) SDS) and moderate microcephaly (mean occipitofrontal circumference -3.0 (range: -4.7 to -1.2)). These findings were similar to those reported for patients with SOFT syndrome without insulin resistance. Muscle biopsy in Case 3 showed features of muscle involvement secondary to a neuropathic process.
CONCLUSIONS
Patients with SOFT syndrome can develop severe dyslipidaemic insulin resistance, independent of the exonic position of the POC1A variant. They also can develop severe muscle cramps. After diagnosis, patients should be regularly screened for insulin resistance and muscle complaints.
Topics: Cell Cycle Proteins; Cytoskeletal Proteins; Dwarfism; Female; Humans; Insulin Resistance; Male; Muscle Cramp
PubMed: 35234134
DOI: 10.1530/EJE-21-0609 -
Annals of Neurology Mar 2023Isolated dystonia is characterized by abnormal, often painful, postures and repetitive movements due to sustained or intermittent involuntary muscle contractions....
OBJECTIVE
Isolated dystonia is characterized by abnormal, often painful, postures and repetitive movements due to sustained or intermittent involuntary muscle contractions. Botulinum toxin (BoTX) injections into the affected muscles are the first line of therapy. However, there are no objective predictive markers or standardized tests of BoTX efficacy that can be utilized for appropriate candidate selection prior to treatment initiation.
METHODS
We developed a deep learning algorithm, DystoniaBoTXNet, which uses a 3D convolutional neural network architecture and raw structural brain magnetic resonance images (MRIs) to automatically discover and test a neural network biomarker of BoTX efficacy in 284 patients with 4 different forms of focal dystonia, including laryngeal dystonia, blepharospasm, cervical dystonia, and writer's cramp.
RESULTS
DystoniaBoTXNet identified clusters in superior parietal lobule, inferior and middle frontal gyri, middle orbital gyrus, inferior temporal gyrus, corpus callosum, inferior fronto-occipital fasciculus, and anterior thalamic radiation as components of the treatment biomarker. These regions are known to contribute to both dystonia pathophysiology across a broad clinical spectrum of disorder and the central effects of botulinum toxin treatment. Based on its biomarker, DystoniaBoTXNet achieved an overall accuracy of 96.3%, with 100% sensitivity and 86.1% specificity, in predicting BoTX efficacy in patients with isolated dystonia. The algorithmic decision was computed in 19.2 seconds per case.
INTERPRETATION
DystoniaBoTXNet and its treatment biomarker have a high translational potential as an objective, accurate, generalizable, fast, and cost-effective algorithmic platform for enhancing clinical decision making for BoTX treatment in patients with isolated dystonia. ANN NEUROL 2023;93:460-471.
Topics: Humans; Botulinum Toxins; Dystonic Disorders; Blepharospasm; Torticollis; Movement Disorders; Neural Networks, Computer
PubMed: 36440757
DOI: 10.1002/ana.26558 -
Turkish Journal of Physical Medicine... Sep 2022Hypocalcemia is a rather uncommon condition that may be encountered in the outpatient setting. It may be associated with a wide range of clinical symptoms and signs. It...
Hypocalcemia is a rather uncommon condition that may be encountered in the outpatient setting. It may be associated with a wide range of clinical symptoms and signs. It is unclear that the primary cause of symptom is hypocalcemia, as these symptoms are usually discrete and ambiguous. Signs of muscle cramp and tetany are considered the expressions of overexcitability of peripheral nerves or central nervous system in case of hypocalcemia in the nerve. In this case, we present a 59-year-old female who presented with persistent muscle cramp and pain of both upper and lower extremities and underwent an investigation that revealed electromyographic changes due to hypocalcemia during an electromyographic study.
PubMed: 36475099
DOI: 10.5606/tftrd.2022.8328 -
Parkinsonism & Related Disorders Feb 2023Skater's cramp is a career-ending movement disorder in expert speed skaters noted to be a likely task-specific dystonia. In other movement disorders, including...
INTRODUCTION
Skater's cramp is a career-ending movement disorder in expert speed skaters noted to be a likely task-specific dystonia. In other movement disorders, including task-specific dystonia, studies have found evidence of central dysregulation expressed as higher inter-muscular coherence. We looked at whether inter-muscular coherence was higher in affected skaters as a possible indicator that it is centrally driven, and by extension further evidence it is a task-specific dystonia.
METHODS
In 14 affected and 14 control skaters we calculated inter-muscular coherence in the theta-band in a stationary task where tonic muscle activation was measured at 10%, 20% and 50% of maximum voluntary contraction. Additionally, we calculated wavelet coherence while skating at key moments in the stroke cycle.
RESULTS
Coherence did not differ in the stationary activation task. While skating, coherence was higher in the impacted leg of affected skaters compared to their non-impacted leg, p = .05, η = 0.031, and amplitude of electromyography correlated with coherence in the impacted leg, p = .009, R = 0.41. A sub-group of severely affected skaters (n = 6) had higher coherence in the impacted leg compared to the left and right leg of controls, p = .02, Cohen's d = 1.59 and p = .01, Cohen's d = 1.63 respectively. Results were less clear across the entire affected cohort probably due to a diverse case-mix.
CONCLUSION
Our results of higher coherence in certain severe cases of skater's cramp is preliminary evidence of a central dysregulation, making the likelihood it is a task-specific dystonia higher.
Topics: Humans; Muscle Cramp; Leg; Electromyography; Skating
PubMed: 36563538
DOI: 10.1016/j.parkreldis.2022.105250 -
Tijdschrift Voor Psychiatrie 2020
Topics: Diagnosis, Differential; Humans; Muscle Cramp
PubMed: 32207125
DOI: No ID Found -
Neuromodulation : Journal of the... Dec 2021Lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) are often accompanied by frequently occurring leg cramps severely affecting patients' life and sleep... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) are often accompanied by frequently occurring leg cramps severely affecting patients' life and sleep quality. Recent evidence suggests that neuromuscular electric stimulation (NMES) of cramp-prone muscles may prevent cramps in lumbar disorders.
MATERIALS AND METHODS
Thirty-two men and women (63 ± 9 years) with LSS and/or LDH suffering from cramps were randomly allocated to four different groups. Unilateral stimulation of the gastrocnemius was applied twice a week over four weeks (3 × 6 × 5 sec stimulation trains at 30 Hz above the individual cramp threshold frequency [CTF]). Three groups received either 85%, 55%, or 25% of their maximum tolerated stimulation intensity, whereas one group only received pseudo-stimulation.
RESULTS
The number of reported leg cramps decreased in the 25% (25 ± 14 to 7 ± 4; p = 0.002), 55% (24 ± 10 to 10 ± 11; p = 0.014) and 85%NMES (23 ± 17 to 1 ± 1; p < 0.001) group, whereas it remained unchanged after pseudo-stimulation (20 ± 32 to 19 ± 33; p > 0.999). In the 25% and 85%NMES group, this improvement was accompanied by an increased CTF (p < 0.001).
CONCLUSION
Regularly applied NMES of the calf muscles reduces leg cramps in patients with LSS/LDH even at low stimulation intensity.
Topics: Electric Stimulation; Female; Humans; Leg; Male; Muscle Cramp; Muscle, Skeletal; Sleep Quality
PubMed: 33169444
DOI: 10.1111/ner.13315