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At least 703 records · Page 39Linked to original sources
PubMed1982

Effect of piracetam on extrapyramidal side effects induced by neuroleptic drugs.

In a double-blind crossover placebo controlled trial the effectivity of piracetam in neuroleptic-induced extrapyramidal side effects was confirmed. 40 psychotic patients treated with neuroleptics in an average daily dose equal to 600 mg of chlorpromazine were included in this study. Akathisia, tremor, muscle rigidity and dyskinesia were evaluated on a 4-point scale. The patients were randomly divided into two subgroups--40 g of piracetam or placebo from identic ampoules were given i.v. with a crossover readministration after 60 min. The intensity of the extrapyramidal side effects was evaluated at 30-min intervals during 2 h. Piracetam was proved to be significantly effective in both subgroups, the onset of its action being between 30 and 60 min after i.v. administration. Possible interpretations of the observed piracetam effectivity are considered. Further trials with piracetam in neurologic complications during neuroleptic treatment, tardive dyskinesia included, are suggested.

Adult↗
PubMed1983

General anesthesia after neuroleptic malignant syndrome.

The neuroleptic malignant syndrome (NMS) is an uncommon and potentially lethal complication of therapy with neuroleptics characterized by pallor, hyperthermia, and extrapyramidal signs (Delay and Deniker, 1968). Malignant hyperthermia (MH) is a rare but often fatal complication of general anesthesia characterized by hyperpyrexia and muscle rigidity, but not related to neuroleptic therapy. For both syndromes, NMS and MH, a common pathophysiology has been considered (Meltzer, 1973; Itoh, 1977; Caroff, 1980). These two syndromes may also be clinically indistinguishable from "acute lethal catatonia" characterized by fever, muscular hypertonicity, and stupor, first described by Stauder in 1934. We now report a case in whom NMS appeared following neuroleptic treatment for a psychotic depressive syndrome. After remission from the NMS, the patient underwent general anesthesia nine times for electroconvulsive therapy (ECT) without ill effect. This case supports the theory of distinct pathogenic mechanisms for both NMS and MH.

Anesthesia, General↗
PubMed1984

[Stiff man syndrome].

Our 51-year old patient developed low back pain and an increase of tonus mainly in the left limb and trunk muscles. Microscopic examination of the muscles and electronmicroscopic examination of the sural nerve and that of the gastronemic muscle did not show any specific deviation. On the basis of spontaneous activity observed during EMG examination, protracted motor activity of great amplitude when moved passively, as well as characteristic clinical symptoms and the disease process Stiff-man syndrome was diagnosed. Considering literature data, we tried applying diazepam (Seduxen and Rivotril)-presumably increasing the praesynaptic inhibition and affecting the reticular system of the brain stem-, as well as GABA medicaments (Lioresal and Depakine) increasing synaptic transport. By giving Seduxen, Rivotril and Baclofen simultaneously a lasting remission of symptoms could be reached. Applying Depakine in combination with the above medicines proved ineffective, presumably because of synergetic side effects.

Axons↗
PubMedDate not supplied

[Effect of an inhibitor of serotonin synthesis--para-chlorophenylalanine on the structure of primary sleep in the frog Rana temporaria].

On the basis of statistical analysis of the EEG of the forebrain in frogs, new data have been obtained concerning neurophysiological nature of the resting forms of the primary sleep. It was found that natural rest occurring with the increase in the rigid muscle tonue (P-2) is identical to the condition which results from injections of parachlorphenylalanine, an inhibitor of serotonin synthesis. New data were obtained showing participation of the posterior hypothalamus in regulation of one of the resting forms of the primary sleep (P-2). Possible homology of the rest of catatonic type (P-2) and anabiosis of frogs is discussed.

Animals↗
PubMed1982

Malignant hyperthermia.

The true incidence of malignant hyperthermia is unknown, but the frequency has been estimated as high as 1/14,000 anesthetic events. Review of the literature reports mortality rates up to 70%. Without prompt medical intervention, it is a uniformly fatal disease. Thus, it behooves the physician to have an awareness of the syndrome and its features, so that early recognition and adequate treatment take place. This paper presents a review of the literature on the occurrence, pathology, symptoms and treatment of malignant hyperthermia.

Acidosis↗
PubMed1983

[Ionic bases of cardioplegic solutions. I. Some implications of the role of ionic equilibrium in the preservation of cardiac metabolism. Experimental study of hypoxia and calcium overloads].

The importance of respecting the ionic equilibrium of cardioplegic solutions was studied experimentally in rat papillary muscle by observing the mechanical and metabolic changes after altering the ionic composition of the washing fluid. The first part of the study demonstrated the nature of the "rigor" of sustained tension induced by the inhibition of the respiratory activity of the mitochondria: this observation showed that this tension was essentially related to the energy deficit induced by poisoning. In the second part, it was shown that calcium overload induced by changing the ionic composition of the nutrient fluid (replacing some of the Na+ ions by K+ or Li+), that is to say related to dysfunction of the Na+-Ca++ exchange induced a contraction which also rapidly evolved to a tension of rigor. This effect was accompanied by a significant reduction in the adenosine triphosphate (ATP) and creatine phosphate (CP) content. The mechanical consequences of prolonged hypoxia or calcium overload are directly related to the reduction in energy reserves producing a marked deficit of ATP in the myofibrils, and resulting in a stable but reversible increase in cardiac muscle rigidity (or rigor). The prevention of calcium overload during the use of cardioplegic solutions is discussed in the context of metabolic myocardial protection. The inhibitory substances of calcium influx such as the calcium antagonist drugs or Mg++ may have an important role to play, in addition to the maintenance of ionic concentrations, especially that of sodium, close to those of the external fluid.

Adenosine Triphosphate↗
PubMed1984

Pharmacological investigations on lonidamine.

The results of a broad pharmacological screening on 1-[(2,4-dichlorophenyl)-methyl] -1H-indazole-3-carboxylic acid ( lonidamine ) a new antitumour agent which also possesses antispermatogenic and embryotoxic effects, are reported. Lonidamine does not affect general behaviour and autonomic functions and is devoid of anticonvulsant, anti-reserpine, anti-apomorphine, anti-amphetamine, antitremor , antipyretic, antiinflammatory and analgesic effects. It also lacks those side effects which are considered characteristic of different antitumour agents, such as thymus and spleen atrophy, delay in skin wound healing and damage to the gastrointestinal mucosa. At doses 40 times higher than that of hydrochlorothiazide, lonidamine produces diuretic effects. The practical importance of these findings in the current therapeutic use of lonidamine appears to be limited. The most typical signs of acute intoxication produced by high doses of lonidamine are salivation, lacrimation, diarrhea, ataxia, muscle rigidity and prostration with superimposed convulsions.

Animals↗
PubMed1984

[Apyretic malignant hyperthermia. Apropos of a case].

A case of a febrile malignant hyperthermia in a patient who was undergoing surgical treatment of recurrent traumatic bone cyst of mandible is presented. M. H. crisis can occur in the absence of both muscle rigidity and elevation of temperature. A potentially fatal outcome of M. H. crisis was avoided by aggressive opportune therapy.

Anesthesia, General↗
PubMed1976

[Paralysis of the intrinsic muscles of the hand].

Palliative treatment of intrinsic muscle paralysis aims at correcting the claw deformity and improving prehension. This treatment will vary according to whether the claw can be actively corrected or not, if M. P. hyperextension is blocked. In the first category it suffices to maintain M. P. joint flexion either by capsulodesis or tenodesis so that the long extensors can extend the interphalangeal joints. Tendon transfers are useful only to reinforce the flexion force of the fingers if there is an associated long flexor tendon paralysis. These transfers should be fixed to the proximal part of the proximal phalanx. If the claw is not actively correctable, associated cutaneous, tendinous or joint lesions must co-exist and these will demand priority treatment. Tendon transfers, if possible, aim to extend the distal phalanges and should be fixed distally on the extensor expansion, knowing however that this carries the risk of swan neck deformity.

Hand↗
PubMed1980

Studies on structural changes of F-actin and myosin in living, intact and damaged muscle fibres by means of polarized ultraviolet fluorescence microscopy.

By means of polarized ultraviolet fluorescence microscopy the structural changes of F-actin and myosin were discovered at the changing a functional state of a living muscle fibre and during spreading degeneration (Zenker's necrosis). The character of conformational changes of F-actin and myosin at activation, contraction, contracture and rigor is similar, but the number of changed macromolecules depends on a fibre state. At fibre local damage in its morphological intact parts there was found an alternation of zones, reflecting two states unusual for a fibre. During spreading degeneration these states transform into irreversible contracture and then into rigor. Similar changes were observed in muscle fibres obtained from denervated muscles.

Actins↗
PubMed1978

[Pathogenesis and treatment of torsion dystonia].

A study of the catecholamine excretion, their precursor DOPA and final metabolites--Homovaniline and vanilylphenylglycolic acid in torsion dystonia, detected certain changes which were different in patients with various clinical forms of the disease. On the basis of clinical and biochemical data 3 forms of torsion dystonia were distinguished: 1) with a prevalence in the clinical picture of muscle rigidity, leading to the development of pathological postures; 2) hyperkinetic forms and 3) mixed forms. In patients of the first group there was a decreased excretion of all catecholamines. On the basis of obtained data the conclusion is made that there is a drop in the intensity of the process of dophamine synthesis and an increase of its catabolism. In the hyperkinetic form, on the contrary, there is a tendency to an increase of dophamine synthesis. It is assumed that there is a drop in the intensity of the process of adrenaline synthesis and an increase of its catabolism. On the basis of biochemical heterogeneity of torsion dystonia the authors recommended different approaches in treating different forms of this disease. In a prevalent muscular rigidity the functions of the dophaminergic systems should be intensified: on the one hand, by administering precursors of dophamine L-DOPA, on the other--by inhibiting antagonistic activity with the aid of different cholinolytic preparations. In a hyperkinetic form a favorable effect is attained by preparations, inhibiting the dophaminergic activity (mainly preparations of the phenothiazine and butyrophenon series).

Carbidopa↗