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PubMed2003

[The study of adaptation syndrome in mixed-infection of tick-borne encephalitis and borreliosis in children].

Twenty two children with mixed-infection of tick-borne encephalitis (TBE) and ixodic tick borreliosis (ITB) were studied. Blood hydrocortisone level was changed in 94.5% of the cases. The most significant activation of hydrocortisone secretion in combination with the most pronounced and prolonged general brain manifestations, was detected in infants. Blood hydrocortisone level correlated with clinical symptoms of combined TBE and ITB infections. Along with higher hydrocortisone level, down-regulation of production of antibodies both to B. burgdorferi and to TBE virus was specific for all children studied.

Adaptation, Physiological↗
PubMed2006

Aspects of digestive tract tumors in Down syndrome: a literature review.

The purpose of this study was to describe the digestive neoplasms found in persons with Down syndrome. Due to intellectual disability, persons with Down syndrome do not convey their symptoms and pain, leading to delayed diagnosis and potentially worse outcome. It is thus important to know which organs are at risk for tumors and possible tumor risk factors. In a review of the literature, we found 13 benign tumors and 127 cancers in 1 fetus, 8 children, and 131 adults with Down syndrome. The review suggests a decreased incidence of digestive cancer, however, with a possible increased incidence of neoplasms of the pancreas and gallbladder. The distribution of cancers is distinct from that in the general population and that in persons with other intellectual disabilities who share the same life conditions, suggesting that constitutional protective factors exist. This review may allow a more specific, adapted medical follow-up for persons with Down syndrome and could help to elucidate the oncogenesis of digestive neoplasms.

Colorectal Neoplasms↗
PubMed2006

Metabolic syndrome components in Indian migrants with type 2 diabetes. A matched comparative study.

OBJECTIVE: To study the metabolic syndrome (MS) in Indian subjects with type 2 diabetes (T2D) in comparing them with controls from the Indian community and from the general population. METHOD: An adapted definition of MS by the Third report of the National Cholesterol Education Program's Adult Treatment Panel III was used. We defined three groups matched for sex and age (+/-5 years). Non parametric tests for comparison of matched samples and conditional logistic regression were used. RESULTS: We selected 71 Indians with T2D (group 1) and two control groups with fasting blood glucose<6.1 mmol/L: 71 Indians (group 2) and 213 subjects from the general population (group 3). Patients were 24 to 76 years-old and each group contained 56% men. Globally, MS was identified in 77% of the group 1 when diabetes was taken into account. When diabetes was excluded there were 47% of MS in group 1, 18% in group 2 and 16% in group 3. The clusters of four factors (hypertension, large waist circumference, hypertriglyceridemia and Low HDL-C) were more common in Indians. The most frequent factors were hypertriglyceridemia and large waist circumference in Indians. Indians with T2D had a 5-fold higher risk of MS than the general population group, OR (95% CI): 4.93 (2.71 - 8.97); P<0.001. CONCLUSION: The high frequency of MS and of hypertriglyceridemia in Indians with T2D highlights the need for screening and management of MS in this population facing a high cardiovascular risk.

Blood Glucose↗
PubMed2006

Prism adaptation improves spatial dysgraphia following right brain damage.

Visuo-manual adaptation to prisms produces a long-lasting improvement of visuo-spatial neglect. Improvement is also observed in tasks that do not involve visuo-manual component and that can all be consider to rely on a rightward (ipsilesional) orienting bias. Here, we report positive effects of prism adaptation on spatial dysgraphia, in a neglect patient following right brain damage. A long-lasting improvement concerned the right-page preference reflecting the ipsilesional bias but also the sloping lines and the broken lines reflecting visuo-constructive disorders in handwriting. Moreover, a transient improvement was also evidenced for the graphic errors. These results reinforce the idea that the process of prism adaptation may activate brain functions related to multisensory integration and higher spatial representations and show a generalization at a functional level. Prism adaptation therefore appears as useful tool in the theoretical attempt to identify the underlying 'core' mechanisms of the neglect syndrome.

Adaptation, Physiological↗
PubMedDate not supplied

[Value and characteristics of physical medicine and health resort medicine in advanced age].

Physical medicine and spa medicine both have the impetus of rehabilitation in common. In addition, they share the therapeutical orientation toward the performance capacity of organs and functional systems, as well as to activities of daily living, the consideration of chronobiological rules of training and adaptation, and an acknowledging of the fact that diseases and, therefore, the basics of rehabilitation are constantly changing. With increasing age the relation of therapy to function resp. rehabilitation becomes increasingly important. Gerontorehabilitation is distinguished from general rehabilitation by the following three characteristics: a) the focus on particular diseases of the elderly, for instance osteoporosis; b) the therapeutical awareness of multimorbidity with the obvious involution of the skeletal muscle mass, the labilization and generalization of vegetative reactions and the special psychosocial situation; c) the consideration of specific reactions of the organism in advanced age to additional and unexpected events (immobilization syndrome, regulative rigidity, long-term adaptation). Gerontorehabilitation has to deal with specific problems of the elderly, problems that may seem medically banal, but which may be partly either serious or at least very inconvenient, e.g., the multifactorial-caused kyphosis, motor deficiency and slowed reactions, the tendency to fall, itching or stinging extremities due to many causes, latent heart insufficiency of undetermined origin, disturbance of sleep and therefore of recreation, and impairment of higher brain functions.

Adaptation, Psychological↗
PubMed1999

Independent frontal-system deficits in schizophrenia: cognitive, clinical, and adaptive implications.

This study examined whether frontal-system impairments in schizophrenia occur independently of one another and whether they have distinct implications for information processing, symptom severity, and adaptive functioning. We assessed 26 medication-free schizophrenic outpatients and 18 normal control subjects on eight frontally mediated tasks, semantic information processing, IQ, the BPRS, and long-term psychosocial adaptation. Schizophrenic subjects showed three types of deficits, which were uncorrelated with one another: (1) Executive dysfunction (inflexible problem solving) was related to decreased use of expectancy during controlled semantic priming, lower intelligence, more severe negative symptoms and stereotyped mannerisms. (2) Disinhibition of responses (to irrelevant stimuli) was associated with increased automatic priming, a trend for more severe hallucinations, and was unrelated to intelligence. (3) Motor dyscoordination (inaccurate, dysfluent motor sequencing) was not related to semantic processing, intelligence, or symptoms. Furthermore, all three impairments were unrelated to generalized slowness, age, sex, illness length, or pre-washout neuroleptic dose. Two deficits accounted for aspects of long-term psychosocial adaptation, even after statistical correction for IQ: Executive dysfunction was associated with younger illness onset, poor purposefulness and planning, impaired social relations, and lower global functioning. Motor dyscoordination was associated with poor treatment outcome and restricted educational advancement. Furthermore, executive and motor deficits interacted significantly; subjects who had both deficits showed the least favorable treatment outcome. These findings are neither consistent with generalized impairment nor with a unitary 'frontal syndrome' in schizophrenia. They provide preliminary evidence for at least three frontal-system deficits (dorsolateral, orbital, and premotor), which are dissociable from one another, can occur without general intellectual impairment, and have distinct implications for long-term adaptive functioning.

Adaptation, Psychological↗
PubMed2004

Cognitive, language, and adaptive behavior profiles in individuals with a diagnosis of Cohen syndrome.

Although the physical characteristics of Cohen syndrome have been studied in considerable detail, data on other aspects of development are relatively limited. We report findings on cognitive, linguistic, and adaptive profiles in a group of 45 individuals clinically diagnosed with Cohen syndrome when aged between 4 and 49 years. The profile of skills observed was consistent with other recent findings. Thus, independence levels generally were poor, but socialization skills as assessed by the Vineland were relatively less impaired. This particular area of strength probably underlies the 'sociable' temperament typically associated with Cohen syndrome. However, the range of cognitive ability was wider than reported in most previous research, raising the issue of whether mental retardation should be considered as a necessary component of the phenotype. The implications for genetic testing are discussed.

Abnormalities, Multiple↗
PubMed1991

[A respiratory syndrome in patients with neurocirculatory dystonia].

The purpose of the work was to evaluate the compensatory and adaptive possibilities of oxygen transport systems in moderate hypoxic hypoxia to define the sensitivity to hypoxia of patients suffering from neurocirculatory dystonia (NCD) with the respiratory syndrome and to elaborate training therapy methods. 40 patients suffering from cardial NCD were examined. Of these, 23 complained of dyspnea. The general hypoxemic test (GHT) was used; parameters of external respiration, hemodynamics, gas composition of blood, and the content of oxidation substrates were examined. Analysis of the clinical picture of respiratory disorders in patients with cardial NCD revealed the differences in their nature. In addition to psychogenic factors of dyspnea, of importance was a decrease in the compensatory and adaptive possibilities of the body as regards hypoxia, which occurs in mental, physical stress, changes in meteorological conditions, in closed premises, and in vegetovascular crises.

Adaptation, Physiological↗
PubMed2003

Exploring the fear of contracting HIV/AIDS among trauma nurses in the province of Kwazulu-Natal.

A qualitative study, using phenomenology as an approach was conducted. The title of the study was "Exploring the fear of contracting HIV/AIDS among trauma nurses in the province of Kwazulu-Natal". Participants were selected on the basis of category (registered nurses), workplace (level one trauma units), and work experience (six months experience in a trauma unit). Twelve nurses participated in the study, six from the state institutions and six from the private institutions. The objectives of the study were to explore the fear of contracting HIV/AIDS, its effect on their personal/working lives and how they coped with it. The findings of the study revealed that trauma nurses perceived themselves to be at risk of acquiring HIV/AIDS from their working environment despite the available precautionary measures. Needlestick injuries appeared to be the main source of fear. They used different coping and defence mechanisms effectively to cope with this fear of contracting HIV and none were in any emotional crisis. Education at different levels and development of support networks has been recommended as the key strategies to decrease these fears. Other recommendations include improving the quality and availability of protective materials and equipment, making HIV/AIDS a notifiable disease as well as improving general and specific beliefs that increase coping.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Insulin resistance and the metabolic syndrome-a challenge of the new millennium.

The term metabolic syndrome is used for describing a cluster of cardiovascular risk factors comprising abdominal obesity, glucose intolerance/type 2 diabetes mellitus, dyslipidaemia and hypertension. A concomitant presentation of all components of the syndrome is rare, therefore, in the view of most experts three out of the four main components are sufficient for defining the syndrome. Another recently identified component of high clinical significance is the impairment of the fibrinolytic system which is now frequently mentioned in extended definitions. This clustering of metabolic risk factors has been described in various combinations and given different names including insulin resistance syndrome or syndrome X. Unfortunately, there is no generally accepted definition so far. The original mentioning of the syndrome goes back to the late sixties, when the metabolic syndrome was described as a 'disorder of genetic adaptation becoming manifest following unrestricted food intake and/or muscular inacitvity'. In its modern meaning this term was propagated by Hanefeld and Leonhardt and by Kaplan, who also called the syndrome the 'deadly quartet' to emphasize its high atherogenic potential.

Humans↗
PubMed2004

Factors influencing the diagnosis of chronic fatigue syndrome.

BACKGROUND: Most of what is believed about chronic fatigue syndrome (CFS) is based on clinic-based studies. These studies may not reflect CFS cases in the population. METHODS: We used data from a population-based study of CFS to identify factors associated with receiving a CFS diagnosis. Wichita, Kan, residents were screened by random-digit dialing. Eligible individuals completed a telephone interview. Respondents meeting CFS criteria were invited for a clinical evaluation to confirm CFS. We analyzed all persons with confirmed CFS. The main outcomes of this study, prevalence and incidence of CFS, are published elsewhere. Herein, we present an exploratory analysis with previous CFS diagnosis as the outcome, predicted by demographic and symptom characteristics. RESULTS: We confirmed CFS in 90 subjects; 14 (16%) had been previously diagnosed as having CFS. Persons in the middle- vs the higher-income group were more likely to have been diagnosed as having CFS (9 [29%] of 31 subjects vs 3 [8%] of 39 subjects; P = .03), as were those with sudden vs gradual fatigue onset (7 [41%] of 17 subjects vs 4 [6%] of 64 subjects; P < .01), those reporting tender lymph nodes (7 [33%] of 21 subjects vs 7 [10%] of 69 subjects; P = .02), and those reporting a sore throat (6 [35%] of 17 subjects vs 8 [11%] of 73 subjects; P = .02). Only 17 (21%) of 81 subjects had sudden fatigue onset, and tender lymph nodes (reported in 21 [23%] of 90 subjects) and a sore throat (reported in 17 [19%] of 90 subjects) were the least common symptoms. CONCLUSION: Most cases of CFS in the population are unrecognized by the medical community; persons diagnosed as having CFS may be different from persons with CFS in the general population.

Adaptation, Physiological↗
PubMed2000

Terminal illness and coping with loneliness.

Loneliness is a universal phenomenon, and its pain is intensified by a diagnosis of a terminal illness. The present study is an investigation of the coping strategies used by HIV/AIDS patients, by individuals diagnosed with cancer, and by the general population. Forty-three HIV/AIDS patients, 38 cancer patients, and 53 participants from the general population answered a 34-item questionnaire. Results indicated that with the exception of reflection and acceptance and religion and faith, those afflicted with HIV/AIDS cope with loneliness significantly differently from members of the other two groups. The findings of this exploratory study suggest that cancer patients and the general population do not differ in the ways they cope with loneliness.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders.

The Short Sensory Profile was used to assess parental report of sensory reactivity across four groups of young children (n = 102). Groups were autism (n = 26), fragile X syndrome (n = 20), developmental disabilities of mixed etiology (n = 32), and typically developing children (n = 24). Groups were comparable on overall mental age (x = 22 months), and clinical groups were comparable on chronological age (x = 31 months). Significant differences were detected at alpha <.01 for tactile sensitivity [F(3,99) = 10.01], taste/smell sensitivity [F(3,99) = 11.63], underreactive/seeks stimulation [F(3,99) = 4.56], auditory filtering [F(3,99) = 19.67], and low energy/weak muscles [F(3,99) = 14.21]. Both children with fragile X syndrome and children with autism had significantly more sensory symptoms overall than the two comparison groups, and children with autism did not differ significantly from children with fragile X syndrome. Both groups were more impaired than developmentally delayed and typically developing children in tactile sensitivity and auditory filtering. Children with autism were more abnormal in responses to taste and smell than all other groups. Children with fragile X syndrome were more abnormal than all other groups in low energy/weak muscles. Sensory reactivity of children with developmental delays was comparable to mental age-matched typically developing toddlers. Correlational analyses indicated that neither overall developmental level nor IQ was related to abnormal sensory reactivity in children with autism or general developmental disorders. However, abnormal sensory reactivity had a significant relationship with overall adaptive behavior.

Adaptation, Psychological↗
PubMed2004

Adaptive skills, cognitive, and behavioral characteristics of Costello syndrome.

Costello syndrome is a rare congenital disorder whose diagnosis is based on clinical findings. The underlying genetic cause has not been identified. Common characteristics include failure to thrive, feeding problems, short stature, coarsening of facial features, developmental delay, mental retardation, skeletal problems, cardiac complications, and increased risk for solid tumors. Given its rarity, existing literature is limited regarding its natural course. Developmental milestones and intellectual functioning have never been systematically studied in this population, therefore this study focused on defining developmental and intellectual attributes. Data was obtained through solicited participation at the 3rd International Costello Syndrome Meeting. A total of 18 children (age 3-20 years) were administered the Leiter-R brief-IQ and the Peabody picture vocabulary test (PPVT)-III to assess nonverbal cognitive functioning and receptive vocabulary. Parents/guardians completed the child behavior checklist (CBCL) and participated in an interview process to complete the survey form of the Vineland adaptive behavior scales to assess emotional/behavioral issues and adaptive behavior. Results indicated that nonverbal cognitive functioning ranged from 1.5 to 4.3 SD below the age mean. Receptive vocabulary skills ranged from average functioning to 4 SD below the age mean. Adaptive behavior composites were all in the low range (2.0 to >5.0 SD below age mean), however there was significant variability in the range of domain scores. CBCL results ranged from normal to clinically significant across various clinical parameters. These data support a generalized descriptive pattern of developmental delay and mental retardation, with noted variability in receptive language, level of adaptive behavior functioning, and emotional/behavioral aspects. Skills and behavior are compared to existing literature of children with various syndromes.

Abnormalities, Multiple↗
PubMed1996

Short-bowel syndrome.

Short-bowel syndrome refers to the clinical sequelae of resection of a substantial portion of the small intestine. Features of diarrhea, dehydration, malabsorption, malnutrition, or weight loss generally occur, at least transiently, when more than 75% of the small intestine is resected, although other factors in addition to residual length affect clinical outcome. Adaptation of the remnant bowel has been well documented to occur over months to years following resection, although the agents responsible for this process are not well defined. Ambulatory total parenteral nutrition has greatly improved the prognosis of this syndrome over the last 25 years. We review the anatomical and the pathophysiological basis of this syndrome, discuss its clinical manifestations, and review current knowledge of intestinal adaptation. We also review medical and surgical therapeutic options for these patients, as well as dietary, enteral, and parenteral nutritional aspects of their care.

Adaptation, Physiological↗
PubMed2001

Abilities and attainment in Smith-Magenis syndrome.

This study reports on cognitive abilities and attainment in 29 children and 21 adults with Smith-Magenis syndrome. There were 13 boys and 16 girls aged 6 to 16 years, and nine men and 12 women aged 16 to 52 years. All had mild to severe learning disabilities* with no differences overall between verbal and performance skills, but with a particular profile of cognitive strengths and weaknesses. Levels of attainment and of adaptive behaviour were strikingly low, and the group of adults emerged as much more dependent on carers than might have been expected from their general level of intellectual functioning. Reasons for this discrepancy are explored in terms of the severe behavioural difficulties characteristic of the syndrome.

Abnormalities, Multiple↗
PubMedDate not supplied

[Human adaptive phenotypes in physiology and medicine].

The study of pathological and physiological features associated with genetic syndromes has gained increasing momentum over the past two decades. In this paper, the definition of adaptive phenotypes is presented and the complexities and obstacles to progress in this field are summarized. This is a problem of general biology and is related to genetic specificity of every organism. The concept of individual norm of man's responses is to a certain extent associated with the doctrine of constitutions. From the practical point of view it is suggested to use in medicine and physiology an individual-constitutional approach and the term adaptophenotype (adaptive phenotype) which means a stable complex of genetic and phenotypical characteristics. It can be determined using clinical, physiological, genealogical, and dermatoglyphic methods, methods of genetic markers, phenotypical analysis, etc. A variety of developmental and physiological characteristics can form the "adaptophenotype" is used in general application, it is used to refer to a broad range of human functioning including pathological characteristics (somatic disorders), psychopathology (mental disorders), physiological and behavior problems. Genetic approaches help reveal not only individual hereditary parameters which manifest as signs but also latent pathological and physiological characteristics that may be used for professional selection. The delineation of adaptive phenotypes is a difficult enterprise, not that should not dissuade clinicians and researchers from undertaking it.

Adaptation, Physiological↗
PubMed2003

Surgical management of the hand in Freeman-Sheldon syndrome.

Freeman-Sheldon syndrome is a rare form of distal arthrogryposis characterized by craniofacial anomalies, a rheumatoid-appearing hand, and pedal deformities. The hand deformities include ulnar deviation of the fingers, camptodactyly, first web space contracture, and hypoplasia of the thumb. Because of clinical variability and rarity, there is no standard management protocol. The authors have developed a systematic method of management of the hand in Freeman-Sheldon syndrome using principles commonly applied to other complex hand problems. In 17 years, the authors have evaluated nine patients. Of 18 hands evaluated, the authors have operated on 15. Good results were achieved in five hands and fair results in 10. There were no cases of useless hands. The authors have been most pleased with the results after crossed intrinsic transfers, centralization of extensor tendons, and intrinsic release of the thumb. Although physical deformities remain, functional adaptation is generally good.

Abnormalities, Multiple↗