STMSO is an OWL 2 ontology for symptomatic treatment for multiple sclrosis patients. The ontology is based on BFO and OGMS.
BFO 2 Reference: In all areas of empirical inquiry we encounter general terms of two sorts. First are general terms which refer to universals or types:animaltuberculosissurgical procedurediseaseSecond, are general terms used to refer to groups of entities which instantiate a given universal but do not correspond to the extension of any subuniversal of that universal because there is nothing intrinsic to the entities in question by virtue of which they – and only they – are counted as belonging to the given group. Examples are: animal purchased by the Emperortuberculosis diagnosed on a Wednesdaysurgical procedure performed on a patient from Stockholmperson identified as candidate for clinical trial #2056-555person who is signatory of Form 656-PPVpainting by Leonardo da VinciSuch terms, which represent what are called ‘specializations’ in [81
BFO 2 Reference: Continuant entities are entities which can be sliced to yield parts only along the spatial dimension, yielding for example the parts of your table which we call its legs, its top, its nails. ‘My desk stretches from the window to the door. It has spatial parts, and can be sliced (in space) in two. With respect to time, however, a thing is a continuant.’ [60, p. 240
BFO 2 Reference: every occurrent that is not a temporal or spatiotemporal region is s-dependent on some independent continuant that is not a spatial region
b is an independent continuant = Def. b is a continuant which is such that there is no c and no t such that b s-depends_on c at t. (axiom label in BFO2 Reference: [017-002])
p is a process = Def. p is an occurrent that has temporal proper parts and for some time t, p s-depends_on some material entity at t. (axiom label in BFO2 Reference: [083-003])
b is a specifically dependent continuant = Def. b is a continuant & there is some independent continuant c which is not a spatial region and which is such that b s-depends_on c at every time t during the course of b’s existence. (axiom label in BFO2 Reference: [050-003])
A material entity is an independent continuant that has some portion of matter as proper or improper continuant part. (axiom label in BFO2 Reference: [019-002])
Hippotherapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse to provide carefully graded motor and sensory input.
ABSST: Actionable Bladder Symptom and Screening Tool
Save energy for what matters most to you. Set priorities, then focus on them. Cut out low-priority tasks
breathing is primarily under the control of the autonomic or “automatic” nervous system — the part of the central nervous system that controls vital functions such as heartbeat and respiration without conscious thought. It is unusual for MS to affect the autonomic nervous system, and therefore uncommon for breathing problems to occur in MS as a direct result of loss of autonomic control.
Brief International Cognitive Assessment for Multiple Sclerosis
Brief Repeatable Neuropsychological Battery (BRNB)
found to be the single most important factor for reducing aspiration pneumonia because it reduces bacteria in the mouth
e.g., lying on one side with the partner approaching from behind
rdfs:isDefinedBy "Problems with concentration/attention, memory impairment, poor word-finding ability, decreased information-processing speed, motor slowing and mental exhaustion. "
Complementary medicine is a term used to describe types of treatments you may receive along with traditional Western medicine.
Double vision A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS, STRABISMUS, OCULOMOTOR NERVE DISEASES, TROCHLEAR NERVE DISEASES, ABDUCENS NERVE DISEASES, and diseases of the BRAIN STEM and OCCIPITAL LOBE.
Swallow once to send the liquid or food down, followed by a dry swallow to clear any residual or particles.
Chilled drinks, ices, and popsicles help keep your body’s temperature in the comfort zone. Make sure you get plenty of water during the day, no matter what else you drink.
Dysphagia is defined as any difficulty in swallowing function. The dysphagia is estimated in one-third of the patients with MS
Eating a well-balanced, low-fat diet, with plenty protein and adequate fluids, energizes your body. Try eating breakfast soon after you get up. Consult with a professional about an appropriate diet.
MS can cause significant anxiety, distress, anger, and frustration from the moment of its very first symptoms.
A Functional Ambulatory Profile (FAP) score can be obtained from the GAITRite system The GAITRite Functional Ambulation System consisting of a GAITRite walkway and clinical stride analyzer, is a simple and convenient way allowing a valid and reliable qualitative spatiotemporal gait analysis
(muscular function, swallowing techniques, adaptation of food consistency)
The GAITRite Functional Ambulation System consisting of a GAITRite walkway and clinical stride analyzer, is a simple and convenient way allowing a valid and reliable qualitative spatiotemporal gait analysis
Hearing loss is an uncommon symptom of MS. About 6 percent of people who have MS complain of impaired hearing. The cause of hearing loss can be due to non-MS related issues but in MS, can be associated with damage to the hearing nerve pathways in the brain and the brainstem.
This is a type of tremor seen in MS. It is generally greatest during physical movement; there is no shaking when a person is at rest.
ICIQ-UI: International Consultation on Incontinence-Urinary Incontinence
ICARS: International Cooperative Ataxia Rating Scale
Tools and questioners that are used to better understanding of MS symptoms.
recall A disorder characterized by systematic and extensive loss of memory.
MACFIMS: Minimal Assessment of Cognitive Function in MS
Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ)
Muscle stiffness and spasms are common MS symptoms, and are often described as 'spasticity'. Muscle spasms or stiffness can affect between 40% and 80% of people with MS at some time. For most people, these are occasional symptoms.
Music therapy is the clinical use of music to accomplish individualized goals such as reducing stress, improving mood and self-expression. It is an evidence-based therapy well-established in the health community. Music therapy experiences may include listening, singing, playing instruments, or composing music.
NEMS: Neuromuscular electrical stimulation
Nystagmus is uncontrolled horizontal and vertical involuntary abnormal eye movement, which persists especially when a person looks to the side.
such as microscopic or telescopic eyewear, a magnifier, a filter or a closed circuit television (CCTV) system.
Oral sex requires less movement than intercourse
Pain can be associated with stiffness or spasms in muscles, or symptoms like Lhermitte's sign, trigeminal neuralgia or optic neuritis. It may also include symptoms affecting the senses that are not always thought of as ‘pain’, like numbness or pins and needles, or a tightness in the chest known as the 'MS hug' or 'MS girdle'. Pain can be one of the most difficult 'invisible’ symptoms to describe and manage. Only the person experiencing it knows how it feels. It has an emotional element – it can cause distress, fear, anger and frustration, which in turn affect how you deal with it.
PENS: Percutaneous Electrical Nerve Stimulation
PEG: Percutaneous Endoscopic Gastrostomy
Schedule your must-do activities for your most energetic times. To help you sleep, drink warm milk 30 minutes before bedtime. Keep exercise equipment and TVs out of the bedroom. If you’ve been trying to fall asleep for more than 30 minutes, get out of the bed and do a quiet activity until you feel tired.
plates and cups with lips minimize food spills
This type of tremor is generally the greatest when a limb or the whole body is being supported against gravity. For example, a person who has a postural tremor will shake while sitting or standing, but not while lying down.
prayer therapy is a type of treatment for medical or psychological conditions that is focused on using prayer as the main method.
generally is greatest when the body part is at rest and is diminished with movement. This type of tremor is more typical of Parkinson's disease than MS.
SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting and are now widely utilized by managed care organizations and by Medicare for routine monitoring and assessment of care outcomes in adult patients.
CIC (Clean Intermittent Catheterization) or intermittent self -catheterization (ISC)
Sexual dysfunction is common in people with MS and is important to assess because patients may be reluctant to self-report. Both men and women with MS may experience difficulty achieving orgasm or loss of libido.
Conditions characterized by disturbances of usual sleep patterns or behaviors. (Source: http://www.ncbi.nlm.nih.gov/mesh/68012893 )
Lowering your body temperature helps you feel refreshed. Cool showers, air conditioning, swimming or pool therapy in cool water, lightweight clothes, and cooling equipment can help you beat the heat
Smoking puts a strain on your lungs, making fatigue worse and compounding the effects of MS. Quit the habit , and breathing and simple activities may not tire you out so much.
rdfs:isDefinedBy "\"A perceived change in function, sensation or appearance reported by a patient indicative of a disease\"."^^xsd:string
Naps give tired muscles a break and pump energy back into your system. A nap for 10–30 minutes can help.
It is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.
Uhthoff phenomenon, also known as Uhthoff sign or Uhthoff syndrome, is a transient worsening of neurological function lasting less than 24 hours that can occur in multiple sclerosis patients due to increases in core body temperature. (https://www.ncbi.nlm.nih.gov/books/NBK470244/)
vetigo is a common symptom of MS. People with MS may feel off balance or lightheaded. Much less often, they have the sensation that they or their surroundings are spinning — a condition known as vertigo. These symptoms are due to lesions — damaged areas — in the complex pathways that coordinate visual, spatial and other input to the brain needed to produce and maintain equilibrium (balance).
rdfs:isDefinedBy "The absence of vision where it existed before. (Source: http://encyclopedia.thefreedictionary.com/vision+loss )"
Cobalt-containing water soluble vitamin that is a coenzyme in the metabolism of fatty acids of odd-chain length and in methyl transfer. (DRI)
Ambulation Problems or Gait difficulties Impairment of the ability to coordinate the movements required for normal ambulation (walking) which may result from impairments of motor function or sensory feedback. (Source: http://www.ncbi.nlm.nih.gov/mesh?term=gait%20ataxia )
Weakness is a common symptom in multiple sclerosis. You may feel that you do not have enough strength or energy to move some or all of your limbs, or your whole body. Weakness and fatigue are closely linked and having one often makes the other symptoms worse.
Weights fastened to the wrists or ankles with Velcro strips can stabilize an affected limb.
Adaptive equipment, such as wrist rests that facilitate writing or typing
involves using ones’ hands to produce downward suprapubic bladder pressure to effectively empty a neurogenic bladder.
If possible, eliminate/reduce medications
Treat depression with psychotherapy and/or antidepressants(s)
Consider nonpharmacological interventions Education (patient and caregiver) Life style modification (exercise and diet) Energy conservation and pacing strategies Work simplification strategies Environmental modification (adaptive aids e.g., cooling vests)
Anticholinergics (must monitor bladder function)
Early Interventions • 2 L fluid intake daily • Diet-fiber/bulk formers/sugar preparations • High fiber balanced diet • Physical activity • Regular time of evacuation Constipation relieved?
Sequential Trials • Stool softeners • Mild oral laxatives • Suppositories/digital stiumation • Enemas Constipation relieved?"
Is patient experiencing emotional symptoms? Do the symptoms suggest normal grieving?
Start treatment Pharmacotherapy: monitor for side effects, increase dose to therapeutic level Psychotherapy: build therapeutic alliance, discuss modality, frequency, goals Continue treatment Monitor for response Monitor for suicide Terminate treatment If in remission at least 12 months If low risk of recurrence Terminate treatment If in remission at least 12 months If low risk of recurrence
Do the symptoms meet criteria for an emotional disorder?
Continued observation. Education as needed
Consult with a mental health profesional
Eliminate dietary irritants IB relieved?
Anticholinergics (must monitor bladder function) IB relieved?
measure of the PVR Significant degree of voiding dysfunction PVR> 100 ml
intermittent catheterization LUT dysfunction relieved?
Antimuscarinic agent Trospium chloride Tolterodine Oxybutynin LUT dysfunction relieved?
Emerging treatment Mirabegron Neuromodulation LUT dysfunction relieved?
intradetrusor onabotulinumtoxinA injection LUT dysfunction relieved?
Removal of triggers, appropriate positioning, physiotherapy, occupational therapy, orthosis Requires drug treatment
Combined treatment baclofen + tizanidine Non-responder
Other possible combinations or intrathecal baclofen
Botox + physiotherapy adjuvant Bad Responder to treatment
Plaster mass-produced orthosis Bad Responder to treatment
The decrease in amount of time that a person can concentrate on a task without becoming distracted.
Facial myokymia is a clinical sign that can occur as a manifestation of demyelinating lesions.
The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. (MeSH definition )
FEES: Fiberoptic Endoscopic Evaluation of Swallowing
Seizures, which are the result of abnormal electrical discharges in an injured or scarred area of the brain, are fairly uncommon in MS.
A tremor can be described as a rhythmic trembling or shaking movement that you cannot control voluntarily. (https://www.mssociety.org.uk/about-ms/signs-and-symptoms/tremor)
Infrequent or difficult evacuation of feces. (Source: http://www.ncbi.nlm.nih.gov/mesh?term=constipation )