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)

Ninety children with acute asthma, equally divided into two study groups, were studied to compare the efficacy and safety of nebulized terbutaline with injected epinephrine in the treatment of acute exacerbation. The terbutaline group received 2 ml (5,0 mg) terbutaline solution diluted with 2 ml 0.9% saline for inhalation over 10 minutes; the epinephrine group received 0.01 ml/kg of 1:1000 epinephrine (maximum 0,3 ml) through subcutaneous injection at deltoid area. Spirometry, pulse oximetry, and clinical severity scoring system were evaluated at baseline and again 15 minutes after treatment. The baseline data of the two groups were not significantly different. The clinical severity score and spirometry of both groups were significantly improved after treatment. Compared with the terbutaline group, the epinephrine group had better mean oxygen saturation (SaO2; p < 0.001), frequency of oxygen desaturation (p = 0.0028) and forced expiratory flow 25-75% (FEF25-75%, p = 0.027). For those patients with initial forced expiratory volume in one second (FEV1) lower than 60% of predicted value, epinephrine treatment was more effective in the improvement of FEV1, FEF25-75%, and oxygen saturation (SaO2) (p = 0.011, 0.012, and 0.006, respectively). A Significantly higher rate of adverse effects occurred in patients given epinephrine (47% vs 11%, p = 0.0002); these included pallor, tremor, dizziness, headache, palpitation, soreness of legs, numbness of extremities, cold sweating, general weakness and nausea. Considering the general trend to noninvasive therapy in children and the more frequent adverse effects after epinephrine injection, such nebulized beta-2 agonists as terbutaline appear preferable for initial therapy of acute asthma if oxygen is supplemented to prevent possible hypoxemia. However, parenteral epinephrine still is worth trying, particularly in any severe, life-threatening attack.
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PMID:Terbutaline nebulization and epinephrine injection in treating acute asthmatic children. 890 60

Dizziness in childhood is not an infrequent symptom, but epileptic vertigo is a rare condition in children. Here we report an 8-year-old Japanese boy with epileptic vertiginous seizures. At age 8 years, he visited Nippon Medical School Hospital because of a ten day history of dizziness. The dizziness occurred more than twenty times a day and he was hospitalized. On physical examination, the patient appeared normal and there were no abnormal neurological findings, including eye movement and cerebellar signs. Ophthalmoscopy, otoscopy, vestibular function test and hearing test were normal. Computerized tomography scanning and MR imaging of the head revealed no significant abnormality. The dizziness observed on admission comprised sudden brief attacks of rotatory sensation without amnesia regarding the event. Sometimes the attacks were accompanied by tremor like movement and numbness of the right hand, followed by postictal unsteadiness. Interictal EEG revealed spike-and-wave complexes in the central region dominantly in the light sleep stage. On ictal EEG, seizure discharges were observed to begin in the left central region and they increased in amplitude and subsequently propagated to the frontal and occipital regions. These findings were most suggestive of partial seizures. The patient was treated with carbamazepine and the seizures became well under control.
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PMID:[Epileptic vertiginous seizure in a Japanese boy: a case report]. 894 Aug 79

Arachnoid cysts very rarely occur within the ventricular system, where no arachnoid tissue exists. We present three cases of intraventricular arachnoid cyst with special reference to its origin. The first patient was a 5-year-old boy who complained of headaches and enlargement of his head. A CT scan revealed obstructive hydrocephalus and a large cystic lesion in the right lateral ventricle. The symptoms resolved after fenestration of the cyst and cystoperitoneal shunt. The second patient was a 49-year-old woman who complained of headache and numbness in her left upper extremity. A CT scan and MRI revealed a large cyst in the trigone of the right lateral ventricle. Fenestration of the cyst wall and cystoperitoneal shunt were performed relieving her complaints. The third patient was a 42-year-old man who complained of frequent seizures and dizziness. A CT scan and MRI demonstrated a moderate size cystic mass in the inferior horn of the right lateral ventricle. The symptoms were improved by partial resection of the cyst wall. Immunohistochemical studies and light microscopy confirmed that the cyst walls were composed of arachnoid membrane, implying that the cysts were arachnoid cysts. CT and MRI in these three cases showed widening of the choroidal fissure bordering the cyst wall, occasionally involving a part of the protruding cyst wall. On enhanced CT and MRI, the choroid plexus in the trigone of ipsilateral lateral ventricle was displaced anterolaterally, implying that the cysts had grown from outside the choroid plexus. Postoperative MRI demonstrated the shrunken cyst wall attached to the choroidal fissure. The surgical findings in case 3 also showed that the cyst wall was attached firmly to the choroid plexus. These findings appeared to indicate that the intraventricular arachnoid cyst originated from the arachnoid layer drawn into the choroidal fissure with choroidal vascular mesenchyme.
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PMID:[Intraventricular arachnoid cyst--on the origin of intraventricular arachnoid cysts]. 895 93

Patients are presenting in increasing numbers with multiorgan symptoms allegedly resulting from exposure to environmental chemicals. Among the symptoms expressed by patients with alleged multiple chemical sensitivities (MCS) are profound fatigue, mental confusion, myalgia, depression, anxiety, dizziness, headache, insomnia, loss of appetite, and numbness of the extremities, all in the absence of objective physical signs. Diagnostic criteria to assess the effects of environmental agents on organ systems are sorely needed because patients with MCS often have no tissue pathology or physiological abnormalities, but often do have diagnosable psychiatric illnesses. In treating patients with MCS, the physician should first perform a complete history and physical examination, including a comprehensive evaluation of chemical exposure. If the findings strongly suggest the presence of disease related to particular organ systems, further diagnostic evaluation should be undertaken. If abnormal findings are absent, psychiatric advice may be useful. The physician should keep an open mind about MCS but must also remember that a cause-effect relationship between exposure to multiple chemicals and symptoms has not been established.
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PMID:Multiple chemical sensitivity multiorgan dysesthesia, multiple symptom complex, and multiple confusion: problems in diagnosing the patient presenting with unexplained multisystemic symptoms. 895 67

Use of herbal remedies from medicinal plants (bush medicines) was studied in 622 people with diabetes mellitus attending 17 government health centers on the island of Trinidad, Trinidad and Tobago. Bush medicines were used by 42% of patients surveyed and were used for diabetes by 24%. Bush medicine use was more frequent in Afro-Trinidadians and in those of mixed ethnicity than in Indo-Trinidadians, and was also more prevalent in those with lower educational attainment. Most patients using bush medicines (214/264, or 81%) reported gathering the plants themselves, and 107/264 (41%) took them more frequently than once a week. Patients taking bush medicines mentioned 103 different plants used in remedies. Among the 12 most frequently mentioned, caraili, aloes, olive-bush, and seed-under-leaf were preferentially used for diabetes. Vervine, chandilay, soursop, fever grass, and orange peel were preferentially used for other indications. Patients who reported burning or numbness in the feet or feelings of tiredness, weakness, giddiness, or dizziness used bush medicines for diabetes more frequently than did patients who reported a range of other diabetes-related symptoms. Insulin-treated patients were less frequent users of bush medicines. It is concluded that bush medicines are taken regularly by many patients with diabetes in Trinidad. Plants most frequently used as remedies for diabetes have recognized hypoglycemic activity. Patients' culture, educational background, type of symptoms, and formal medical treatment may also influence the selection and use of bush medicines.
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PMID:Use of medicinal plants for diabetes in Trinidad and Tobago. 912 11

The objectives of this study were to determine the dose limiting toxicity (DLT) and other major toxicities, the maximum tolerated dose (MTD) and the human pharmacokinetics of N1N11 diethylnorspermine (DENSPM), a new polyamine analog which in experimental systems inhibits the biosynthesis of intracellular polyamines and promotes their degradation by inducing the enzyme spermine/spermidine N-acetyl transferase. These objectives were incompletely achieved because of the occurrence of an unusual syndrome of acute central nervous system toxicity which forms the basis of the present report. Fifteen patients with advanced solid tumors were entered into a phase I study of DENSPM given by a 1 h i.v. infusion every 12 h for 5 days (10 doses). The starting dose was 25 mg/m2/day (12.5 mg/m2/dose) with escalation by a modified Fibonacci search. Doses of 25 and 50 mg/m2/day were tolerated with only minor side effects of facial flushing, nausea, headache and dizziness (all grade I). At doses of 83 and 125 mg/m2/day, a symptom complex of headache, nausea and vomiting, unilateral weakness, dysphagia, dysarthria, numbness, paresthesias, and ataxia, was seen in 3 patients, one after 2 courses of 83 and 2 after 1 course of 125 mg/m2/day. This syndrome occurred after drug administration was complete and the patients had returned home. Lesser CNS toxicity was seen in 2 other patients at lower daily doses. Preliminary pharmacokinetics of DESPM measured in plasma by HPLC in 8 patients showed linearity with dose and a rapid plasma decay with a t1/2 of 0.12 h. We conclude that great caution is warranted in administering DENSPM on this schedule at doses of > or = 83 mg/m2/day.
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PMID:Unusual central nervous system toxicity in a phase I study of N1N11 diethylnorspermine in patients with advanced malignancy. 938 45

We studied 9 patients with bilateral vertebral artery occlusion (BVAO). BVAO was confirmed using angiography in order to clarify its clinical feature, mechanism, and long term prognosis. Three patients showed bilateral intra-cranial occlusion, 3 bilateral extra-cranial occlusion, and 3 intra and extra-cranial occlusion. The basilar artery was fed by the posterior communicating artery in 8 out of 9 patients. In one of the 8, reconstitution of the thyrocervical artery was seen. We divided the patients into 4 groups according to MRI findings, as follows: Group 1 with no abnormal finding on MRI (N = 2); Group 2 with deep pontine infarcts and non-territorial small cerebellar infarcts (N = 2); Group 3 with extended pontine infarcts (N = 3); and Group 4 with cerebellar cortical artery infarcts, deep pontine infarcts, and non-territorial small cerebellar infarcts (N = 2). Transient episodes were seen in all patients, 8 patients out of 9 had vertigo/dizziness, 3 tinnitus, 2 diplopia, 2 headache, 2 numbness, and 1 hearing disturbance. These episodes preceded a final attack or complete stroke 2 days to 5 months, and those who had a longer period of episodes in the preceding term tended to have less severe deficits. Six of the patients had vertebro-basiler symptoms after being in the upright position, including all the patients in Groups 2 and 4, which had cerebellar border zone/terminal zone infarcts. These results indicate that the hemodynamic mechanism plays an important role in BVAO. The prognosis was not always grave. Four of the patients could walk independently, 2 could walk with a cane, and 3 were bed ridden (2 of which died). Long-term follow-up data (a mean of 5 years) were obtained in all patients. In the patients who could walk, one had asymptomatic cerebellar infarcts, and one had TIAs frequently. Patients with BVAO often also have TIAs and/or preceding episode and show cerebellar border zone/terminal zone infarcts. This research strongly suggests that hemodynamic mechanism might play an important role in BVAO, and that paying attention to border zone infarction in MRI and transient episodes can lead to earlier diagnosis and treatment.
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PMID:[Bilateral vertebral artery occlusion]. 939 56

Starr County, Texas, a Texas-Mexico border community, was the site of a study involving culturally-appropriate education and group support for Mexican Americans with type 2 diabetes. Data were collected from 63 subjects on frequency of diabetes-related symptoms during the previous month and on self-care symptom treatments. On average, subjects were 57-year-old females, diagnosed with diabetes for 10 years, and exhibiting HbA1c levels of 12.5%. Almost 50% experienced excessive urination, excessive thirst, shakiness/nervousness, and numbness and/or tingling in their extremities. More than 50% of those who experienced symptoms did not view them as serious. Only one subject checked blood sugar levels when symptoms occurred. Significantly higher mean glycosylated hemoglobin levels were found for individuals who experienced dizziness and/or chest pain compared with those who did not. A variety of self-care treatments were employed, including over-the-counter medications and home remedies.
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PMID:Symptom-related self-care of Mexican Americans with type 2 diabetes: preliminary findings of the Starr County Diabetes Education Study. 967 51

Food poisoning due to ingestion of two fishes, Yongeichthys nebulosus and Sillago japonica, occurred in Kaohsiung, Taiwan, in February 1997. Two male persons (48 and 58 years old) were poisoned, with symptoms featured by dizziness, nausea, vomiting, numbness, and difficulty in respiration. All of the specimens of fish retained by the victims were combined and consisted of Yongeichthys nebulosus and Sillago japonica. These retained specimens were assayed for anatomical distribution of toxicity (as tetrodotoxin) and all specimens were found to be toxic. The highest toxicity of specimen was 7,650 mouse units (MU) in Y. nebulosus and 1,460 MU in S. japonica. However, the other specimens re-collected from that fish pier were also found to be highly toxic in Y. nebulosus, but nontoxic in S. japonica. Hence, Y. nebulosus was judged as the real causative fish in this food poisoning. The toxins were partially purified from the methanolic extracts of toxic fishes by ultrafiltration and Bio-Gel P-2 column chromatography. Cellulose acetate membrane electrophoresis and high performance liquid chromatography analyses demonstrated that tetrodotoxin was the causative agent of this food poisoning.
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PMID:Acute goby poisoning in southern Taiwan. 1009 Nov 34

Disorders of the cardiovascular system are common. Heart pain is one of the most frequent complaints leading patients to seek medical help. Although psychologically conspicuous behaviour in patients with functional cardiac complaints are well known, they are--if at all--diagnosed quite late. Descriptive diagnostics of functional cardiac complaints according to the International Classification of Diseases (ICD-10, Chapter 5) are discussed (Figure 1). Possible physical causes of the disease must first be excluded. In a second step it must be clarified whether the complaints even those non-verbally conveyed are due to psychic illness in a narrower sense. Anxiety and depressive disorders must be taken into consideration here. If the patient demonstrates an avoidance behavior in the case of anxiety, than an agoraphobia can be assumed; in episodic paroxysmal fear on can assume panic attacks in which vegetative anxiety equivalents such as shortness of breath, numbness, palpitation of the heart, tachycardia and chest pain are prominent often accompanied by trembling, perspiration, nausea and dizziness. The different depressive disorders are characterized by a dejected mood, loss of interest, loss of enthusiasm and drive reduction; the disorders are divided up according intensity and course. Within the scope of depressive physical symptoms, frequently unpleasant sensations and pain in the chest area are described along with concern, despair, and an increase in self-observation. If no psychic disturbance in a narrower sense can be diagnosed, then the diagnosis of a somatoform disorder allows for this behavior. It is characteristic for this category of illness that the repeated presentation of physical symptoms in connection with the persistent demand for medical treatment may be observed although no physical causes can be demonstrated. The patients insist that their complaints are of a physical origin despite the doctor's assertion that this is not the case. If the symptoms are related to vegetative innervated organs then one speaks of somatoform autonomous functional disorders (F45.3, Table 1). Cardiovascular disorders fall within this scope. Further diagnoses within the spectrum of somatoform disorders are hypochondric and somatization disorders which demonstrate a variety of symptoms and inconsistent and frequently changing complaints. If a descriptive diagnosis can correspondingly be made then further analysis of the disorder must be carried out in order to reach an indication for psychotherapeutic treatment. From a psychodynamic point of view, the personality- and conflict-related background of the disturbance is relevant. Quite often unconscious ambivalent separation conflicted--be they real are fantasized situations of being left or being left alone--may be observed to trigger cardiovascular symptoms. In the cognitive-behavioral therapeutic tradition an exact analysis of the patients symptomatology is carried out in which prior and actual cause factors of the symptoms are looked for. Irrespective of the different approaches, information on the context of the complaints both on a biological, intrapsychic and interpersonal level is necessary for psychosomatic diagnostics. The better the causal conditions are known on the basis of which functional cardiovascular complaints have arisen, the easier it is to recognize those factors that will influence a change and allow a therapeutic approach. This is best done in cooperation with practitioners and internists who still have a key position in the diagnosis and treatment of patients with functional cardiac disorders. The ways and means in which they conduct the anamnesis is decisive in leading their patients to regard psychosomatic diagnostics as being either stuck in the so-called "psycho corner" or as a helpful relationship which they can accept.
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PMID:[Diagnosis of functional heart complaints from the psychosomatic viewpoint]. 1037 96


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