Gene/Protein Disease Symptom Drug Enzyme Compound
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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among women in South Asia, the complaint of vaginal discharge (often called leukorrhea) is extraordinarily common. From a biomedical perspective, this symptom suggests that reproductive tract infection (RTI) is prevalent in the subcontinent; however, several recent studies provide evidence that the prevalence of RTI is relatively low. Women who do not have RTI frequently report the symptom of vaginal discharge. An anthropological perspective on the cultural meanings of leukorrhea can shed light on this puzzling phenomenon. According to Ayurvedic concepts of health and illness, genital secretions are considered a highly purified form of dhatu, or bodily substance, and loss of this precious substance is thought to result in progressive weakness or even death. Many South Asian women who complain of vaginal discharge also report a variety of somatic symptoms such as dizziness, backache and weakness. The link between unexplained gynaecological symptoms and mental health concerns has been explored by both psychiatrists and anthropologists in South Asia. Leukorrhea may represent a culturally shaped "bodily idiom of distress", in which concerns about loss of genital secretions reflect wider issues of social stress. Problems may arise when a symptom with deep cultural meaning is interpreted in a purely biomedical framework. In the syndromic approach to the treatment of sexually transmitted infections (STIs), health workers are trained to treat women presumptively based on history and a risk assessment, but without clinical or laboratory confirmation of infection. A recent evaluation of this approach demonstrates that many women who complain of vaginal discharge do not have RTI, and are inappropriately treated with antibiotics. It seems likely that women are over-reporting vaginal discharge because of its deep cultural meanings, meanings that need to be understood within an anthropological rather than biomedical framework.
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PMID:Cultural and biomedical meanings of the complaint of leukorrhea in South Asian women. 1134 16

To clarify the mechanisms of gender-related mind/body relationships, the authors analyzed the characteristics of 1,132 outpatients (848 women and 284 men) attending a mind/body medicine clinic. At entry in the program, the patients completed the Medical Symptom Checklist, Symptom Checklist-90 revised (SCL-90R), and Stress Perception Scale. Women reported 9 out of 12 symptoms (fatigue, insomnia, headache, back pain, joint or limb pain, palpitations, constipation, nausea, and dizziness) more frequently than the men did. Being a woman was a predictor of the total number of somatic symptoms endorsed. SCL-90R somatization scores were significantly higher in nonmarried women than in married women. Perceived stress ratings of family and health were higher in women than in men, despite the lower degree of perceived stress concerning work. Women, especially nonmarried women, were more likely to report somatic discomfort. Gender appears to be an important factor in relation to the report of somatic symptoms in stress-related conditions.
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PMID:Effects of gender and marital status on somatic symptoms of patients attending a mind/body medicine clinic. 1140 18

Parecoxib (parecoxib sodium) is an injectable pro drug of valdecoxib, which is a potent and selective inhibitor of cyclo-oxygenase-2. Intravenous (IV) or intramuscular (IM) parecoxib >20 mg has analgesic activity superior to that of placebo and similar to that of IV or IM ketorolac 30 or 60 mg well controlled trials in patients with postoperative dental pain (n = 304 to 457). In a well controlled trial (n = 202), IV parecoxib 20 or 40mg showed analgesic activity greater than that of placebo and IV morphine 4mg and similar to that of IV ketorolac 30 mg following gynaecological surgery Following orthopaedic surgery, the analgesic activity of IV parecoxib 20 or 40mg was similar to that of IV ketorolac 30 mg and superior to that of IV morphine 4 mg or placebo in well controlled trials (n = 175 and 208). IV parecoxib (40 mg twice daily for 7 days) produced significantly fewer gastrointestinal erosions and/or ulcers than ketorolac (15 mg 4 times a day for 5 days) in healthy volunteers in a well controlled trial; effects on upper gastrointestinal mucosa were similar for parecoxib and placebo. Parecoxib is well tolerated after dental, gynaecological or orthopaedic surgery. The most common adverse events irrespective of treatment (parecoxib, ketorolac or placebo) after dental surgery were nausea, alveolar osteitis, dizziness and headache. Nausea, abdominal pain, headache, abdominal fullness, dizziness, back pain, fever, hypoactive bowel sounds, vomiting, tachycardia, somnolence, abnor mal breath sounds and pruritus occurred in > or = 10% of parecoxib recipients after gynaecological surgery. Similar results were seen in placebo recipients.
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PMID:Parecoxib (parecoxib sodium). 1146 74

It is now recognized that the majority of patients on epoetin therapy require intravenous (IV) iron supplementation to maximize the response to treatment. Of the IV iron preparations available, iron sucrose has proved its efficacy and safety; however, there are no guidelines or systematic studies examining the optimum safe dosage regimen for this compound. The aim of the present study was to investigate prospectively a variety of dosing regimens for IV iron sucrose in patients with renal failure to develop treatment strategies for this preparation. A total of 335 iron infusions was administered to 249 patients in this study, which was conducted in four phases. In phase I, 89 patients were administered a dose of 200 mg as an IV infusion over 2 hours. No adverse events were seen. A 500-mg dose by 2-hour infusion was then assessed, but was abandoned after 8 of 22 patients developed reactions characterized by dizziness, hypotension, and nausea. The dose was then reduced to 300 mg by 2-hour infusion for the next 189 patients, and again, no adverse reactions were witnessed. Finally, a 400-mg dose by 2-hour infusion was examined in 35 patients, but 2 patients experienced such symptoms as hypotension, nausea, and lower back pain. Both the 200- and 300-mg doses of IV iron sucrose administered over 2 hours appear to be safe. The incidence of adverse events with the 400- and 500-mg doses administered as a 2-hour infusion seems too high to recommend their routine use, although it may be possible to administer these doses over a longer period.
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PMID:Intravenous iron sucrose: establishing a safe dose. 1168 51

In this paper, recipes for 41 herbal remedies used for treating 25 illnesses in traditional medicine in Swaziland are reported. Preparation of the herbal remedies involved the use of different parts of 47 species from 32 families, some of which have never been described previously in the flora of Swaziland. Descriptions of the plants used, the preparation of each remedy, dosage, route of administration and medical uses are reported. Some of the diseases the remedies are used to treat include asthma, backache, candidiasis, cardiac problems, cough, diarrhoea, dizziness, eye problems, constipation, menorrhagia, painful shoulders, scabies, threatened abortion, toothache, ulcers and vomiting among others. The remedies were obtained from traditional medical practitioners (TMPs) in an ethnomedical survey carried out in the Manzini region of Swaziland. Voucher samples of the plants used for the remedies were collected, identified and deposited in the National Herbarium of Swaziland.
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PMID:Some herbal remedies from Manzini region of Swaziland. 1174 3

An 11-year-old girl presented with headache of 3 months' duration. There was bilateral disc edema. The cerebrospinal fluid pressure was 50 cm of water with normal cerebrospinal fluid cytology and biochemistry. She developed severe headache (different and disabling), dizziness, vomiting, and backache on sitting up 6 hours after lumbar puncture, and lying supine relieved all of her symptoms. Intravenous fluids, analgesics, and complete bed rest did not relieve her symptoms over the next 72 hours. She was completely relieved of her symptoms on receiving two tablets of Caffergot containing 200 mg of caffeine and 2 mg of ergotamine 72 hours after lumbar puncture. The symptoms recurred 48 hours later, and a repeat dose of Caffergot was required. Magnetic resonance imaging (MRI) done 96 hours after lumbar puncture revealed the entire dura overlying the brain, including the posterior fossa, showing intense enhancement on contrast injection with leak at the lumbar puncture site. Oral caffeine (coffee, three times a day) was advised over 1 week. The patient remained asymptomatic, and a repeat MRI scan after 10 days showed complete clearing of the cerebrospinal fluid leak with no dural enhancement. The syndrome of cerebrospinal fluid hypovolemia following lumbar puncture is reported in a girl with idiopathic intracranial hypertension.
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PMID:Syndrome of cerebrospinal fluid hypovolemia following lumbar puncture cerebrospinal fluid leak in a patient with idiopathic intracranial hypertension. 1191 82

Safety and tolerability of sildenafil citrate was assessed in a population subset of 60 Singaporean men with erectile dysfunction taken from the Asian Sildenafil Efficacy and Safety Study (ASSESS-I), a double-blind, placebo-controlled, flexible-dose study. The men, from two centres, with > or = 6 months' history of erectile dysfunction, were randomized to two treatment arms for 12 weeks. One group (30 patients) received sildenafil (initial dose 50 mg taken 1 h before sexual activity for the first 2 weeks, increased to 100 mg or decreased to 25 mg, according to efficacy and/or tolerability). The remaining 30 patients received a matching placebo. Incidence and type of adverse effects were evaluated at 2, 4, 8 and 12 weeks. Nine patients (30.0%) on sildenafil (33.1% in the full ASSESS-I study) and one patient (3.3%) on placebo (22.8% in the full ASSESS-I study) experienced treatment-related adverse events, the most frequent being headache in the sildenafil group (reported by five patients [16.7%]; 11.0% in the full ASSESS-I study). Flushing, visual disturbance, dizziness, insomnia, myalgia and back pain each occurred in one patient in the sildenafil group (3.3%); in the placebo group, one patient (3.3%) had headache. Importantly, the incidence of cardiovascular and respiratory system adverse events were relatively less than in the full ASSESS-I population (cardiovascular 3.3% in the present study versus 10.2% in the full ASSESS-I population; respiratory 3.3% versus 5.5%). All adverse events were transient and mild, and did not lead to treatment withdrawal. There was no effect on sitting blood pressure, heart rate or standard laboratory parameters; more importantly, there was no incidence of myocardial infarction, stroke or priapism. These results should reassure Singaporean patients and their physicians of the safety of sildenafil for erectile dysfunction.
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PMID:Clinical safety profile of sildenafil in Singaporean men with erectile dysfunction: pre-marketing experience (ASSESS-I evaluation). 1202 21

Pain relief for patients with osteoporosis is important to maintain mobility and facilitate physical therapy. Transdermal fentanyl may be useful but has not been studied systematically. Patients with at least one osteoporotic vertebral fracture requiring strong opioids were enrolled and received transdermal fentanyl. Treatment history, pain, ease of physical therapy, and quality of life were recorded at baseline and after 4 weeks. Of 64 patients enrolled, 49 completed the study; 12 withdrew because of adverse events, most commonly nausea, vomiting, or dizziness. Pain at rest and on movement decreased significantly from baseline to final assessment (mean scores 7.84 and 8.55, respectively, at baseline, falling to 3.56 and 4.50 after 4 weeks). Quality of life improved significantly, and 61% of patients were satisfied with the treatment. Ability to undergo physical therapy improved significantly. Transdermal fentanyl is useful for the treatment of severe back pain caused by osteoporosis.
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PMID:Transdermal fentanyl for the treatment of back pain caused by vertebral osteoporosis. 1221 66

Adolescent patients who report physical symptoms that are unexplained by physical disease or pathophysiologic processes are prevalent in health care settings. Physical symptoms with no notable physical pathology are often referred to as medically unexplained symptoms (MUS). Common MUS found in adolescent populations include headaches, abdominal pain, back pain, fatigue, dizziness, numbness and tingling sensations in the limbs, and gastrointestinal symptoms. The most important diagnostic concern is the exclusion of neurologic and other general medical conditions. Failure to diagnose real physical pathology appropriately can have serious, deleterious consequences. However, it is also important for physicians to address psychological and other psychosocial factors that may play a role in the etiology or maintenance of MUS. The onus often falls on the primary care physician to screen for such problems and to make cost-effective and appropriate referrals. This article reviews some alternative treatment guidelines for physicians to assist in the assessment, intervention, and referral process for adolescent patients with MUS. The advantages of integrating psychological screening practices into the evaluation process and present recommendations regarding the management of such patients are discussed.
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PMID:Psychological assessment and treatment of somatization: adolescents with medically unexplained neurologic symptoms. 1227 Aug 4

First-term attrition, defined as failing to complete the contracted first enlistment term, is one of the most serious and costly problems faced by the U.S. Navy. This study was an investigation of 1-year Navy attrition in relation to demographic factors and variables assessed by the Sailors' Health Inventory Program (SHIP) questionnaire, a medical and psychosocial history questionnaire completed by all Navy recruits. Overall attrition, as well as specific categories of attrition (e.g., medical, behavioral, and administrative), were studied. The sample consisted of 66,690 Navy recruits whose status (retention vs. attrition) could be tracked to the 1-year mark. The strongest predictors of overall attrition were educational level, self-reported history of shortness of breath, ever being suspended or expelled from school, history of depression/excessive worry, fainting or dizziness, and recurrent back pain. Many other medical and psychosocial items from SHIP were also predictive of attrition. Similar factors were associated with different categories of attrition (e.g., medical, behavioral). The implications of these findings for attrition reduction strategies are discussed.
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PMID:Predictors of Navy attrition. I. Analysis of 1-year attrition. 1236 69


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