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Evidence has begun to accumulate that suggests there may be gender differences in the presenting symptoms of acute coronary syndromes (ACS). Identification of gender differences has implications for both health care providers and the general public. Women should be instructed as to the symptoms expected with ACS on the basis of evidence obtained from studies that include both sexes. Twelve studies that identified symptoms of ACS for both women and men were identified through a review of the literature. In several of the studies, which included all types of ACS, women had significantly more back and jaw pain, nausea and/or vomiting, dyspnea, indigestion, and palpitations. In a number of the studies, which solely sampled patients with acute myocardial infarction, women demonstrated more back, jaw, and neck pain; nausea and/or vomiting; dyspnea; palpitations; indigestion; dizziness; fatigue; loss of appetite; and syncope. Men reported more chest pain and diaphoresis in the myocardial infarction sample. Results of these studies showed that women and men experienced the same symptoms with ACS. However, in some studies there were gender differences in the proportion of symptoms. Given the current state of the science, definitive conclusions regarding gender differences in the symptoms of ACS cannot be drawn. Further study is urgently needed to clarify and expand on these findings.
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PMID:Symptoms of acute coronary syndromes: are there gender differences? A review of the literature. 1212 87

A survey study using questionnaire was conducted in 530 people (270 men, 260 women) living or not in vicinity of cellular phone base stations, on 18 Non Specific Health Symptoms. Comparisons of complaints frequencies (CHI-SQUARE test with Yates correction) in relation with distance from base station and sex, show significant (p < 0.05) increase as compared to people living > 300 m or not exposed to base station, till 300 m for tiredness, 200 m for headache, sleep disturbance, discomfort, etc. 100 m for irritability, depression, loss of memory, dizziness, libido decrease, etc. Women significantly more often than men (p < 0.05) complained of headache, nausea, loss of appetite, sleep disturbance, depression, discomfort and visual perturbations. This first study on symptoms experienced by people living in vicinity of base stations shows that, in view of radioprotection, minimal distance of people from cellular phone base stations should not be < 300 m.
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PMID:[Investigation on the health of people living near mobile telephone relay stations: I/Incidence according to distance and sex]. 1216 54

Clinical experience, and a pathology study, of 184 women on Neogynon (.25 mg d-norgestrel and .05 mg of 17-ethinyl estradiol, micro 20) was assessed for a total of 3129 cycles. 53 women were nursing babies before use of the pill, and 44 continued to do so throughout pill usage. Endometrial biopsies were taken premenstrually, during the period of full hormonal effect, for 40 cases before and then 6-12 months after initiation of pill usage; biopsies were studied for effect of the combined steroid on the building up of endometrium. The combination pill was 100% effective, with no failures. 23 cases (12.5%) failed to continue through the 18th cycle. 4 cases stopped after the 2nd cycle and 6 more after the 4th; the remaining stopped after the 12th cycle. No change in menstrual pattern was noticed in 136 (73.9%) of the cases; 14 presented with menorrhagia and endometrial biopsy of one of these showed regressive and mixed endometrial changes. 2 cases of intermenstrual spotting were reported. Hypomenorrhea was reported in 16 cases. Side effects were generally effects on the central nervous system: 7 cases of headache and dizziness, 7 cases of mild depression, and 3 cases of sexual anorexia. No gastrointestinal side effects were reported. 44 cases (of 53) continued lactation, and 9 noticed a progressive decrease in the amount of milk produced. 8 cases gained weight and 13 lost, 2 enough to quit using the pills. Hair loss was a noticeable complaint in 5 cases. Endometrial biopsies revealed grades of arrest of endometrial development. 85% showed a resting endometrial pattern, whereas 15% were atrophic. Endometrial response was rather irregular and mainly of the mixed type in 90% of the cases and about 10% were proliferative.
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PMID:A clinico-pathological study of Neogynon as a new oral contraceptive steroid. 1226 40

In the 1974-86 period, gossypol acetate was taken as an antifertility measure by 16 men. The initial dose was 20 mg/day, with a maintenance dose of 40 mg/week. Antifertility efficacy was obtained in all 16 cases. Azoospermia persisted in 1 case where the gossypol had been taken for 8 years and discontinued for the past 2 1/2 years. Symptoms experienced in the first 2 weeks of gossypol acetate administration included dizziness, anorexia, nausea, fatigue, and stomach discomfort. Results of examinations of blood and urine; functions of the heart, liver, lung, and liver; electrolytes; external genitalia; and sexual performance were all in the normal range. Measurements of semen, plasma biochemistry, and endocrine changes also were within normal limits. However, in the 9 cases in which the average value of plasma testosterone was near the lower limit of normal, the average value of follicle-stimulating hormone was higher than normal and the testosterone/luteinizing hormone ratio was unusually low. Testis biopsy indicated that long-term gossypol treatment affected both germ cells and Sertoli cells. Leydig cells also demonstrated some damage. Gossypol acetate is, in general, considered an ideal male contraceptive because of its long-term effectiveness, reversibility, and lack of severe toxic side effects.
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PMID:Antifertility treating with long term gossypol. 1226 55

This paper describes the explanatory model of green tobacco sickness (GTS) held by migrant and seasonal farmworkers in North Carolina and compares it with a research-based biobehavioral model. GTS is a form of acute nicotine poisoning that affects individuals who work in wet tobacco fields. It is characterized by nausea, vomiting, headache, and dizziness. There are no standard diagnostic criteria for GTS; clinicians must diagnose it based on a combination of symptoms and exposure risk. GTS resembles pesticide poisoning, but treatment is quite different. Many farmworkers in tobacco today are Spanish-speaking immigrants from Mexico with limited experience in tobacco work. In-depth interviews about GTS were conducted with 23 Hispanic farmworkers in central North Carolina to explore their understanding of the problem. Workers generally attributed the symptoms to other aspects of working in tobacco, such as pesticides or heat, rather than nicotine. They cited many of the same risk factors identified in the biobehavioral model, such as wet work conditions and inexperience with tobacco work. Prevention and treatment include a combination of exposure avoidance and common medications. The symptoms of most importance to farmworkers were insomnia and anorexia, both of which impaired the ability to work. This jeopardized their income, as well as their work security. If health care providers understand the explanatory model held by farmworkers, they will be more effective at diagnosing and treating GTS and be better prepared to teach patients how to prevent future episodes.
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PMID:Hispanic farmworker interpretations of green tobacco sickness. 1238 Aug 93

The tolerability and safety of donepezil HCI in patients with mild to moderate Alzheimer's disease (AD) were examined in an integrated analysis of phase II/III placebo-controlled trials. Patients with mild to moderately severe AD (n=1,920) were randomised to receive donepezil (n=1,291) or placebo (n=629). Adverse events, physical examinations and clinical laboratory tests were assessed. A high completion rate (79%) was achieved in these trials. Of the 1,291 patients receiving donepezil only, 142 (11%) withdrew because of an adverse event compared with 43 of the 629 (7%) placebo patients. The most common adverse events included nausea, diarrhoea, headache, insomnia, dizziness, rhinitis, vomiting, asthenia/fatigue and anorexia. Donepezil had no clinically significant effect on any laboratory evaluations and was not associated with hepatotoxicity. These results demonstrate that donepezil is well tolerated and has a favourable safety profile at clinically effective, once-daily doses of 5 mg and 10 mg.
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PMID:Donepezil: tolerability and safety in Alzheimer's disease. 1246 88

In an open-label trial carried out on the northwest border of Thailand, 1596 patients with uncomplicated multidrug-resistant falciparum malaria were randomly assigned to receive atovaquone-proguanil, atovaquone-proguanil-artesunate, or artesunate-mefloquine and were followed up for 42 days. All 3 regimens were highly effective and well tolerated. Fever duration and parasite clearance times were significantly shorter among patients who received artesunate (P<.001). Polymerase chain reaction genotyping confirmed that recrudescence occurred in 13 patients who received artesunate-mefloquine (2.4%), 5 who received atovaquone-proguanil-artesunate (0.9%), and 15 who received atovaquone-proguanil (2.8%). Adding artesunate to atovaquone-proguanil reduced the risk of failure 3-fold (95% confidence interval [CI], 1.1-8.2) and subsequent gametocyte carriage 21-fold (95% CI, 14-30). Gastrointestinal complaints in the first 48 h after initiation of treatment were more common among artesunate recipients, but after day 2, dizziness, sleep disturbance, nausea, vomiting, and anorexia were more common among mefloquine recipients (P< or =.014). Artesunate-atovaquone-proguanil is a highly effective and well-tolerated treatment for multidrug-resistant falciparum malaria.
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PMID:Treatment of uncomplicated multidrug-resistant falciparum malaria with artesunate-atovaquone-proguanil. 1247 69

Addison's disease due to adrenal lymphoma usually manifests as bilateral adrenal enlargement. We report a patient with Addsion's disease in whom the initial overt primary adrenal insufficiency was accompanied by an only slightly enlarged right adrenal gland. The 80-year-old man presented with nausea, anorexia, weight loss, and hyperpigmentation of the skin and buccal mucosa. Addison's disease was diagnosed based on this clinical presentation and laboratory findings of low cortisol and high adrenocorticotropin levels. Computerized tomography (CT) of the adrenal glands revealed a small right adrenal tumor. His family refused to allow percutaneous or surgical biopsy to determine the nature of the tumor. His general condition improved after steroid supplementation. However, about 1 year later, dizziness, fever, night sweats, and edema of the lower legs developed, and adrenal CT scanning revealed that the left adrenal gland had enlarged and now exceeded the size of the right one. Left adrenalectomy was performed and pathology showed a diffuse large B-cell lymphoma. Staging work-up using whole-body CT scanning suggested a stage IIIb lymphoma. Chemotherapy was given, but the disease still progressed and the patient died 4 months after diagnosis. Primary adrenal lymphoma should be considered in the differential diagnosis of Addison's disease, even if only slight enlargement of the adrenal glands is found initially.
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PMID:Adrenal lymphoma and Addison's disease: report of a case. 1263 19

The aim of our study was to evaluate and compare the therapeutic efficacy & safety profile of three different antituberculous regimens for pulmonary tuberculosis. The study sample size included 90 newly diagnosed, sputum positive patients of pulmonary. tuberculosis. 30 each from different groups. The parameters studied were, therapeutic efficacy included weight gain, cough, sputum examination and safety profile: nausea, vomiting, anorexia, gastritis, hepatitis, jaundice diarrhoea, rashes, dizziness, tingling & numbness, flu like symptoms & joint aches. Group-I showed statistically significant weight gain when compared to Group-II. Improvement in cough and conversion to smear negative were seen in 100% of patients in Group-I, 83.3% of patients in Group-II and 93.3% of patients in Group-III. Therapeutic efficacy was highest with Group I regimen, followed by Group III and Group II which was least efficacious. Group II also registered; the maximum cost and highest incidence of adverse effects.
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PMID:Comparative evaluation of efficacy and safety profile of three anti-tuberculous regimens in Mangalore. 1264 66

Hypertension is an important clinical endpoint after renal artery revascularization for renal artery stenosis (RAS). Medication compliance is a critical determinant of blood pressure control. Although factors influencing compliance are known in essential hypertension, they have not been evaluated in studies investigating renal artery revascularization. The aim of this study was to assess the determinants of compliance to antihypertensive therapy in patients with RAS following renal artery stent placement (RASP). A cross-sectional study evaluating blood pressure, antihypertensive medications, quality of life, compliance, and determinants of compliance to antihypertensive therapy was undertaken in 112 patients undergoing RASP. Additionally, cardiovascular risk factors, antihypertensive medications, and cardiovascular history were reported. Self-reported compliance was 79% +/- 24% (scale of 0% [none] to 100% [complete] compliance) in patients after RASP. Determinants of compliance by multivariate analysis included physical symptoms, which correlated negatively to compliance and included loss of appetite (r2 = 0.26, P < 0.0001), dizziness (r2 = 0.06, P < 0.01), and cough (r2 = 0.03, P < 0.05). Systolic blood pressure correlated positively with compliance (r2 = 0.03, P < 0.05). The number or class of antihypertensive medications did not influence compliance. Patients' physical symptoms and level of systolic blood pressure, rather than the number or class of medications, influence compliance in patients with continued hypertension after RASP. Attention to physical symptoms may help to improve blood pressure control in this population.
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PMID:Compliance with antihypertensive therapy after renal artery stenting. 1288 69


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