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In sharp bends, particularly in the colonic flexures, the axial pushing force conveyed to the distal actively bending tip of the endoscope may cause impaction rather than progression. It is hypothesized that colonoscopes with a very flaccid segment immediately proximal to the distal bending tip might reduce this problem.Two prototype colonoscopes with a flaccid passively bending segment (either progressively graded or ungraded flaccidity) positioned immediately proximal to the distal actively bending tip was evaluated in a single-blinded randomized study. The primary end-point was patients' evaluation of pain.Altogether, 400 patients were randomized 1:1 to examination with a prototype (60 patients to endoscope with graded flaccidity; 141 to the endoscope with ungraded flaccidity) or a standard colonoscope. The groups were similar regarding age, sex and previous abdominal surgery. Severe pain was reported by 7% of patients in the prototype and 18% in the standard group (p = 0.001). There was a trend toward shorter cecal intubation time in the prototype group (mean 14.1 min, 95% CI 12.8-15.3) compared to the standard group (mean 15.5 min, 95% CI 14.3-16.7) (p = 0.12) and similar intubation rates (89% and 85%, respectively). Results for first (ungraded flaccidity) and second (graded flaccidity) generation prototypes collectively were similar to the second generation separately.The concept of an endoscope with a hyper-flaccid segment may facilitate negotiation of sharp bends and reduce pain without compromising cecal intubation rate or intubation time.

Cerebrovascular accidents (CVA) are the leading cause of long-term disability. About 600,000 Americans will have a stroke this year (American Heart Association, 2002). It is estimated that between 29% and 75% of those who suffer from strokes will be affected by upper extremity impairments, including shoulder subluxation, pain, flaccidity, and decreased upper extremity limb function (Wang, Chan, & Tsai, 2000).This meta-analysis examines the effectiveness of electrical stimulation on treating the upper extremities of patients who suffer cerebro-vascular accidents (strokes). Illustrating the efficacy of electrical stimulation on stroke patients may help to influence occupational therapists use of this adjunctive treatment method.

(1982). Ultrastructural changes in drought-induced wilt: a comparison with pathogen-induced flaccidity. Canadian Journal of Plant Pathology: Vol. 4, No. 2, pp. 97-105.

This study is the first attempt to characterize neurological and behavioural consequences of fluid-percussion concussive head injury in the cat. Both animals initially anaesthetized by N2O as well as unanaesthetized, chronically prepared animals were subjected to injury. Injury with a fluid-pressure wave of 1.9-2.5 atm (duration 21-24 ms) produced a brief generalized areflexia. Following this initial response, injury greater than 2.1 atm frequently produced a period associated with hypotonia of postural muscles and suppression of postural motor responses (flaccidity). A close association between flaccidity and other indices of coma such as absence of eye-opening responses was noted. These consequences of injury can occur without fatal apnoae, circulatory collapse or overt intraparenchymal haemorrhages. This result suggests that mechanical stress predominantly restricted to the brain stem in fluid percussion may be sufficient, at least in the cat, to produce coma associated with flaccidity which has been previously documented for acceleration concussion. There was no evidence that fluid percussion produced EEG depression similar to the effects of lesions in the mesencephalic reticular activating system (RAS). Thus, depression of general levels of brain activity including those within the RAS seems not be necessary for production of this form of reversible coma.

The effect of in utero exposure to drugs of abuse on certain neurological and behavioral characteristics of the newborn was studied in 10 infants of drug-dependent mothers. Fourteen newborns of mothers not receiving drugs served as matched controls. Infants exposed to drugs of abuse during fetal life exhibited a high level of arousal and irritability, and extreme muscle tone fluctuations--i.e., a predominant hypertonicity (rigidity) alternating with short periods of a very low tone (flaccidity). These newborns were also highly active, tremulous, and motorically immature, and displayed near-constant crying and disturbed sleep patterns. However, their orientation to external stimuli and the findings on neurological examination were similar to those of control neonates.

Neonatal hypoglycemia is considered not only a diagnosis but also a symptom, and definitive diagnosis is essential. Since hypoglycemia can cause overt seizures, apnea, cyanosis, flaccidity and coma, the physician must actively treat the deficit while attempting to establish its cause. Differential diagnosis should include consideration of the causes of both transient and prolonged or recurrent hypoglycemia.