Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Asthenic symptoms (eg, fatigue, lassitude, weakness) are of major concern in family practice setting, yet relatively little research has addressed this issue. A retrospective chart review over a 10-year period was conducted to better characterize these symptoms in a rural family practice providing health care to 508 adult patients. Asthenic complaints were recorded at least once in the medical charts of 164 patients (32%) with a preponderance of female patients. Peak prevalence occurred in the third decade of age and during the summer months. Associated symptoms, mainly pain and dizziness, were reported in 75% of the cases. A cause or diagnosis was not identified by the practicing physician in nearly 50% of the encounters; nevertheless, most episodes resolved spontaneously. Patients could be subclassified into three categories according to the recurrence pattern of their asthenic symptoms during the study period. The largest category (64%) included patients who had a single or two episodes and was thus termed "episodic asthenia." Forty-five patients (27%) with recurrent episodes (mean 4.4, range 3 to 10) were classified as having "recurrent episodic asthenia." A third small group (14 patients, 9%) with persistent complaints over the years but no evidence of the chronic fatigue syndrome were classified as having "chronic persistent asthenia." The proposed classification may help future research of asthenic symptoms in the family practice setting.
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PMID:Asthenic symptoms in a rural family practice. Epidemiologic characteristics and a proposed classification. 198 29

Key safety parameters of sotalol were examined in 1,288 patients entered into recent controlled trials of ventricular (85% of patients) or supraventricular arrhythmias (15%). Most patients were middle-aged male Caucasians with significant heart disease. The most serious adverse event was proarrhythmia, occurring in 56 patients (4.3%). Of these, 27 had hemodynamic compromise due to malignant ventricular arrhythmias. Most had a history of sustained ventricular tachycardia, myocardial infarction, congestive heart failure (CHF) or cardiomyopathy, or a combination of these. The other 29 had nonsevere events; 38% continued taking sotalol. Proarrhythmia was manifested by torsades de pointes in 24 of the 56 patients. No universal causal relation was found with commonly associated factors such as bradycardia, hypokalemia and long QT interval. The mean QT and QTc at baseline within 1 week of a severe proarrhythmic event were greater than those of patients not having proarrhythmia. Nineteen patients (1%) discontinued therapy with sotalol because of drug-related CHF. Predisposing conditions included low initial baseline ejection fraction, history of CHF, cardiomyopathy or cardiomegaly, or both, male gender and age greater than 65 years. Heart failure usually occurred within 7 to 30 days of initiating therapy. The most common reason for premature discontinuation of the drug in patients treated for sustained ventricular tachycardia was ineffectiveness (39%), whereas adverse effects were the most common reasons among patients treated for complex ventricular ectopy (21%). Dyspnea and bradycardia were the most common cardiovascular effects, and fatigue, dizziness and asthenia the most common noncardiac, adverse effects. Although frequently reported, these adverse effects resulted in discontinuation of only 1 to 4% of the patients at risk.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical safety profile of sotalol in patients with arrhythmias. 240 37

The clinical experience of 763 medical practitioners who treated 3,708 hypertensive patients (51% men) with indoramin, administered alone or in combination with diuretics and/or beta-adrenergic antagonists, is reported. All patients had baseline diastolic blood pressure (DBP) of 95 mm Hg or greater, even though most of the patients (62%) already were receiving optimum doses of diuretics (20%), beta-adrenergic antagonists (15%), or diuretics and beta-adrenergic antagonists (27%). After 6 to 10 weeks of indoramin therapy, the DBP of 70% of the patients was 90 mm Hg or lower; another 17% had treated DBP between 91 and 95 mm Hg. Response rates were similar among patients treated with indoramin alone and those who received concomitant antihypertensive treatment. Indoramin doses of 50 mg/day or less (dose range, 12.5 to 125 mg/day) were required in approximately 70% of the patients. Weight gain and reflex tachycardia were not observed. The most frequently reported side effects were drowsiness/tiredness, dizziness, and dry mouth. Only 6% of the patients discontinued indoramin treatment because of side effects. The results of this study indicate that indoramin, administered alone or in combination with diuretics and/or beta-adrenergic antagonists, is a safe and effective antihypertensive agent when used in relatively low doses in clinical practice.
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PMID:Antihypertensive therapy in the Federal Republic of Germany: clinical practice experience with indoramin (Wydora). 242 96

The safety and efficacy of indoramin and prazosin added to hydrochlorothiazide (HCTZ) were compared in a double-blind trial involving 209 patients with mild to moderately severe essential hypertension. Patients whose supine diastolic blood pressure (SDBP) did not decrease to less than or equal to 90 mm Hg after 6 weeks of HCTZ therapy had indoramin or prazosin added to their regimen. Mean SDBP during 6 months of combination therapy with either regimen decreased by approximately 10 mm Hg from that at the final evaluation during HCTZ therapy (p less than 0.001); differences between the groups were not statistically significant. Mean heart rate was unchanged, whereas mean weight increased (p less than 0.001) above final HCTZ values by approximately 2 kg in both groups. Mean weight increased significantly (p less than 0.01) from baseline values, however, only in the prazosin/HCTZ group. Approximately 95% of the patients in each group had clinically significant decreases in SDBP. Fatigue or tiredness and dizziness were the most commonly reported adverse effects, and their frequencies were not significantly different in the two groups. Cardiac arrhythmias occurred only in patients in the prazosin/HCTZ group and were significantly (p less than 0.05) more frequent than among patients in the indoramin/HCTZ group; less severe adverse experiences, i.e., dry mouth, ejaculatory problems, drowsiness, and sedation, were significantly (p less than 0.05) more frequent in the indoramin/HCTZ group. When added to HCTZ, indoramin and prazosin are equally safe and effective in the treatment of hypertension.
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PMID:Antihypertensive effects of indoramin and prazosin in combination with hydrochlorothiazide. 242 99

The antihypertensive efficacy and safety of indoramin, an alpha 1-adrenergic antagonist, were evaluated in 215 elderly patients. Data were collected from patients aged 60 years and older who were treated under similar protocols with indoramin administered alone (n = 58) or in combination with a thiazide diuretic (n = 157). After at least 6 months of treatment, the mean daily dosage of indoramin was higher among patients who received indoramin alone (122 mg/day) than among those who received indoramin plus a diuretic (92 mg/day). Mean supine blood pressure decreased (p less than 0.001) from 174/105 to 152/191 mm Hg in indoramin-treated patients and from 179/101 to 150/91 mm Hg in patients who were treated with indoramin plus a diuretic. Clinically satisfactory blood pressure decreases occurred in the majority of the patients who received indoramin, either alone (69%) or with a diuretic (75%). Both treatments were well tolerated by elderly patients; only 15 patients (7%) discontinued therapy because of adverse effects. Drowsiness, fatigue, and dizziness were the most frequently reported side effects. The results of this analysis indicate that indoramin, administered alone or in combination with a thiazide diuretic, is a safe and effective therapeutic regimen for elderly hypertensive patients.
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PMID:Antihypertensive therapy with indoramin in the elderly. 242 7

This study evaluated the 24-h antihypertensive effect of single daily doses of celiprolol, a beta-1 adrenoceptor antagonist. Patients with supine diastolic BP between 95 and 114 mm Hg started on placebo or celiprolol 200 mg daily for 2 weeks; non-responders received 400 mg daily for 2 weeks and then 600 mg daily for another 2 weeks. Response was defined as a reduction of diastolic BP to 90 mm Hg or below. One hundred ninety patients were evaluated for efficacy, 114 in the celiprolol group and 76 in the placebo group, 84 men and 106 women, mean age 52 years. Blood pressure after 6 weeks fell from 165/103 to 149/92 on celiprolol and from 162/103 to 157/97 on placebo. The fall in systolic and diastolic BP after celiprolol is statistically different (p less than 0.001) from that after placebo. The pulse rate was reduced to a similar extent by the two treatments. The percent of patients with supine diastolic BP either reduced by at least 10 mm Hg or to 90 mm Hg or below, was 66% after celiprolol and 38% after placebo (p less than 0.001). The incidence of adverse reactions was comparable in the two groups: 31% during celiprolol, 25% during placebo. The most frequent reactions observed in both groups were gastrointestinal symptoms, dizziness, fatigue, headache. In conclusion, celiprolol proved to be a safe and effective beta-blocker in the treatment of mild and moderate hypertension.
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PMID:A placebo-controlled double-blind multicenter study of celiprolol in the treatment of mild and moderate hypertension. 242 40

A 30-year-old pregnant woman was admitted to the Cardiology Research Center with syncope, dizziness, and fatigue on exertion. On ECG complete atrioventricular block was diagnosed. Permanent pacemaker implantation was performed with the guidance of ECG and two-dimensional echocardiography and without the use of fluoroscopy.
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PMID:Permanent pacemaker implantation in a pregnant woman with the guidance of ECG and two-dimensional echocardiography. 244 4

A double-blind controlled, randomized, parallel, multicenter 12-week study was conducted to compare the antihypertensive efficacy of lisinopril with that of metoprolol in treatment of moderate to severe hypertension. Initially, 118 patients were recruited on lisinopril and 61 on metoprolol; and for the purpose of efficacy analysis at week 8, 115 patients on lisinopril and 60 on metoprolol were included. The doses of lisinopril or metoprolol were 40-80 mg/day and 100-200 mg/day, respectively. At week 4, the pretreatment diastolic blood pressure of 111 mm Hg was decreased to 97 mm Hg (p less than 0.01) with lisinopril: metoprolol decreased the diastolic blood pressure from 110 to 99 mm Hg (p less than 0.01). Similar decreases were noted at week 8; however, the drop in blood pressure with lisinopril was not significantly different from that with metoprolol. Systolic blood pressure also demonstrated a decrease of about 18 mm Hg with lisinopril and 12 mm Hg with metoprolol (p less than 0.01). This larger decrease in systolic blood pressure with lisinopril was statistically significant at week 4 (p less than 0.05). These decreases in systolic blood pressures were maintained at week 8, again with statistical significance (p less than 0.01). Of the 118 lisinopril-treated patients, four were discontinued from lisinopril therapy because of headache, dizziness, rash, flushing, or lymphadenopathy. Four patients out of 61 (9.8%) were discontinued from metoprolol therapy because of fatigue, somnolence, asthenia, weight gain, flatulence, tremor, or bronchospasm. In conclusion, lisinopril 40-80 mg once daily is as effective as metoprolol 100-200 mg once daily in reducing diastolic blood pressure in patients with moderate to severe hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of antihypertensive efficacy of lisinopril compared to metoprolol in moderate to severe hypertension. 244 53

The safety and tolerability of lisinopril were assessed in 1,476 patients [1,165 hypertensives and 311 patients with congestive heart failure (CHF)] and 211 normal volunteers. The duration of lisinopril therapy ranged from 1 day to 16 months, with a mean duration of 105 days. In the hypertensive population, the most frequent clinical adverse experiences on lisinopril alone were headache, dizziness, cough, and diarrhea. Not all of these adverse experiences were thought to be drug related. Five percent of patients were discontinued because of adverse clinical experiences; cough and dizziness were the most common reasons for discontinuation. Two of 1,165 (0.17%) hypertensive patients treated with lisinopril died, compared to 0.41% of hypertensive patients on other therapies. Neither case was considered to be drug related. In patients with CHF, the most frequent clinical adverse experiences were dizziness, diarrhea, hypotension, fatigue, headache, and rash. Not all of these adverse experiences were thought to be drug related. The percent of CHF patients discontinuing because of an adverse clinical experience was 7.4%; the most frequent causes for discontinuation were hypotension, dizziness, or renal impairment. Twelve deaths occurred in 311 CHF patients treated with lisinopril (3.9%) compared to 4/104 (3.8%) of CHF patients treated with placebo and 2/65 (3.1%) treated with captopril. Hypotension, orthostatic effects, or dizziness following the initial lisinopril dose occurred infrequently in patients treated with lisinopril. In hypertensive patients with normal renal function, including those treated previously or concomitantly with diuretic therapy, a first-dose hypotensive episode was reported in six of 955, or 0.6%. The incidence was higher (6.7%) in hypertensive patients with impaired renal function.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The safety and tolerability of lisinopril in clinical trials. 244 61

The prevalence of selected illnesses and symptoms during 1977-85 was compared between 175 employees potentially exposed to the organophosphate insecticide chlorpyrifos and 335 matched controls with no history of exposure to organophosphates. Subjects were subdivided into three exposure intensity groups on the basis of job title and air monitoring data for dose response testing. This classification scheme was shown roughly to correlate with plasma cholinesterase inhibition in the workers. No statistically significant differences in illness or prevalence of symptoms were observed between the exposed and unexposed groups or among the three exposure subgroups. Potentially exposed employees did report symptoms of dizziness and of malaise and fatigue relatively more often than subjects from the comparison group; however, further analyses by exposure level, process area, or time did not support a relation with exposure. No cases of peripheral neuropathy were seen among the exposed workers. Although the sample size was small and the statistical power limited, the cumulative exposures likely to have been experienced by this workforce exceed those to be expected for individuals using the product as recommended. The absence of exposure related adverse effects, including neurological impairment, is reassuring.
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PMID:Morbidity among employees engaged in the manufacture or formulation of chlorpyrifos. 246 78


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