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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Vogt-Koyanagi-Harada (VKH) syndrome, a disease of unknown origin, characterized by inflammation of the uveal tract, retina and meninges, was observed in a patient with Hodgkin's disease (HD) who had been treated with chemotherapy and radiotherapy. Ten years later the patient developed a cluster of neurological symptoms and signs (fever, pain, bilateral hypoacousia, dizziness, uveitis and psychiatric disorder) which were initially interpreted as a relapse of HD. The diagnosis of VKH syndrome was thereafter suspected from the clinical findings, response to therapy and further evolution. During the follow-up (14 months) the patient showed a varying course; hypoacousia remained unaltered while uveitis recurred and only a partial improvement was obtained by immunosuppressive therapy.
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PMID:A case of Vogt-Koyanagi-Harada syndrome in a patient affected by Hodgkin's disease. 276 Jun 48

Patients with osteoarthritis make up the largest group of users of nonsteroidal anti-inflammatory drugs (NSAIDs), but the effects of these agents on the gastrointestinal mucosa of such patients have not been well studied. This article describes a short-term comparison of two widely used NSAIDs, diflunisal and ibuprofen, in patients requiring these medications for their osteoarthritis. Efficacy, tolerability, and endoscopically documented effects of these drugs on the gastric and duodenal mucosa were assessed. Consenting, eligible patients were randomly assigned to one of the two study drugs for a two-week course. Clinical assessments were made after each week of treatment. Fiberoptic endoscopy and laboratory tests were performed before and after the treatment period. Thirty patients completed the study: 16 received diflunisal and 14 received ibuprofen. Similar improvements in pain, joint mobility, functional capacity, and joint swelling and tenderness were observed in both treatment groups. Transient, mild abdominal cramping was reported by two patients in each group; one patient receiving ibuprofen complained of transient dizziness. No patient withdrew from the study because of side effects. Follow-up endoscopy revealed slight (grade 1) changes in the gastric mucosa of two patients in each treatment group. An additional patient in the ibuprofen group had gastric erosions (grade 2) at the end of the study. Endoscopic changes were not correlated with symptoms. Diflunisal and ibuprofen were found to be similarly effective and well tolerated in the treatment of osteoarthritis. Their use may be associated with some gastrointestinal side effects even during short-term use.
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PMID:Diflunisal and ibuprofen: effects on gastric and duodenal mucosa in patients with osteoarthritis. 277 68

The clinical and radiologic findings in 30 patients who sustained injuries to the temporomandibular joint (TMJ) were retrospectively analyzed. Imaging consisted of variable combinations of radiography, tomography, two-compartment arthrography, computed tomography, and magnetic resonance imaging and was performed 2 days to 24 months after injury. Indications for imaging included acquired and/or unstable occlusal disturbances, cephalalgia, facial pain, otalgia, TMJ pain, tinnitus, dizziness, hearing disturbance, masticatory dysfunction, and muscle atrophy. Radiologic findings included internal derangement of the TMJ meniscus, swelling of retrodiskal tissues, joint effusion, mandibular condyle and condylar neck fractures, osteochondritis dissecans, avascular necrosis, degenerative condylar remodeling, osteoarthritis, musculotendinous injuries, and atrophy of masticatory muscles. After imaging studies, seven patients underwent surgery, at which time imaging findings were confirmed; one patient underwent successful aspiration of a painful hemarthrosis. TMJ injuries may result in joint derangement, radiologically demonstrable joint degeneration, masticatory muscle dysfunction, pain, and progressive clinical disability.
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PMID:Temporomandibular joint injuries. 278 Oct 10

This report reviews the gastrointestinal and central nervous system complaints and clinical course in 10 adult patients with abdominal epilepsy. Abdominal symptoms included paroxysmal pain, nausea, bloating, and diarrhea. Nervous system manifestations included dizziness, headache, confusion, syncope and transient blindness. Each patient had specific electroencephalographic abnormalities of a temporal lobe seizure disorder. Anti-convulsant therapy has resulted in the sustained abolition of symptoms in each case.
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PMID:The spectrum of abdominal epilepsy in adults. 280 81

This article concerns itself with three common reactions (local, toxic and anaphylactic) resulting from insect or arthropod bites and stings. A local reaction consists of sharp, localized pain followed by a reddening at the site, which usually resolves itself in 24 hours. A toxic reaction may include gastrointestinal symptoms, fever, headache, dizziness or convulsions, often following an episode of multiple stings. An anaphylactic reaction may be mild (hives, itching) or severe (systemic reactions including airway and cardiovascular symptoms). Even though most bites and stings are not serious, nurse practitioners should be aware of potential death resulting from insect sting allergy. They should teach hypersensitive patients, or patients with a history of a systemic reaction to any agent, about prophylactic measures. Tables showing the characteristics of insects that cause cutaneous lesions in humans, and measures necessary to decrease the risk of being stung, can be used as learning tools to prevent insect sting allergy. Because of the rapid onset of anaphylaxis, life-saving measures include awareness in persons who are hypersensitive, emergency preparedness and preventing bites and stings from occurring.
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PMID:Insect bites and stings: managing allergic reactions. 286 63

One hundred and thirty-two patients with endoscopically confirmed duodenal ulcers were entered into a 4-6-week double-blind trial of famotidine (Fm) and ranitidine (Rn). Seventy patients were randomised to Fm 40 mg at night and Rn placebo and 62 to Rn 300 mg at night and Fm placebo. Gelusil tablets were allowed for ulcer pain, and diary cards were issued. Clinical evaluations were carried out on entry and at 2 and 4 weeks, and endoscopy was repeated at 4 weeks. Patients with an unhealed ulcer at 4 weeks were continued on the same treatment for another 2 weeks and further endoscopy was carried out at 6 weeks. The groups were comparable with respect to age, sex, duration of the most recent attack, initial ulcer size and smoking, but the duration of disease tended to be longer in the Rn-treated group (P less than 0.05). Of the patients available for analysis, 75% of the Fm-treated and 78% of the Rn-treated patients were healed at 4 weeks and 91% of patients in both treatment groups were healed at 6 weeks. Gelusil consumption and symptomatic responses were comparable in the two groups, and no side-effects were noted apart from mild dizziness in 1 patient after a single Fm tablet. The mean initial size of ulcers healed at 4 weeks was significantly less than that of ulcers which were unhealed at 4 weeks (P less than 0.01), and the healing rate among smokers was significantly lower than that among non-smokers--48 of 72 patients (67%) and 41 of 45 (91%) respectively (P less than 0.01). The study shows that Fm 40 mg at night is as effective as Rn 300 mg in duodenal ulcer healing.
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PMID:Comparison of famotidine 40 mg with ranitidine 300 mg at night in short-term duodenal ulcer healing. A South African multicentre study. 288 28

An open study was carried out to determine the clinical efficacy of secnidazole in the treatment of acute and chronic cases of amoebiasis. Patients were given 2 g of secnidazole in a single dose or in two divided doses within a 4 h interval. Details were recorded daily by patients of complaints such as fever, lumbar pain, LBM, dizziness, body weakness, bloody mucoid stools, epigastric pains and other symptoms, before and after treatment. Results were analysed for 45 chronic and five acute cases and showed clinical cure of 98% in chronic and 80% in acute cases. The acute group showed a non-significant change (P greater than 0.05) which could be attributed to the small sample size. The treatment regimen proved effective for the eradication of E. histolytica and only two (4%) remained positive after treatment out of the 50 patients initially positive.
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PMID:Efficacy of a single dose of secnidazole in the treatment of acute and chronic amoebiasis. 290 Mar 39

From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world.
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PMID:Lionfish string experiences of an inland poison center: a retrospective study of 23 cases. 292 30

Meptazinol is a new opioid-type analgesic with mixed agonist/antagonist properties. It may be given orally, intravenously or intramuscularly. In studies in patients with moderate to severe pain of various aetiologies, usually following surgery or in obstetrics, the characteristics of analgesia with meptazinol were comparable to those seen with equianalgesic doses of pentazocine, pethidine or a combination of dextropropoxyphene and paracetamol. Preoperative use and use as a component of anaesthesia require further investigation before conclusions may be drawn on its effectiveness in these areas. Onset of action, recorded in a few studies, was faster than that with the other analgesics but duration was shorter than that of morphine, buprenorphine and pentazocine. Only a small number of patients with chronic pain have received long term therapy with meptazinol; in such patients there was no need for increased doses as treatment progressed. Respiratory depression has only been observed in patients receiving meptazinol as a premedication or while undergoing anaesthesia. Similarly any haemodynamic changes have been limited to preoperative patients or patients undergoing anaesthesia. Like other agonist/antagonist analgesic drugs, the abuse potential of meptazinol seems relatively low, but only wider clinical use for longer periods can establish this with certainty. The most commonly reported side effects have been gastrointestinal in nature, and although the incidence of central nervous system side effects has been relatively low, drowsiness and dizziness have caused occasional problems. Thus, meptazinol is a relatively potent but safe addition to the analgesics available for treatment of the patient with moderate to severe pain.
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PMID:Meptazinol. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy. 299 23

The efficacy of naloxone in reducing the incidence of side effects after intrathecal injection of morphine and the effects of maternal naloxone administration on the condition of the newborn were evaluated in 40 patients. Patients in labor were given a 1-mg intrathecal injection of morphine and, 1 hr later, either a 0.4-mg bolus of naloxone, followed by a 0.4-0.6 mg/hr intravenous infusion of naloxone, or an intravenous bolus of saline, followed by an intravenous infusion of saline. Intrathecal morphine provided at least 50% pain relief in 78% of patients given naloxone, and in 82% given saline. Intravenous naloxone significantly decreased the incidence of pruritus during labor and delivery. There was no significant decrease in the incidence of nausea, vomiting, somnolence, dizziness, or urinary retention in patients given naloxone. Despite placental transfer of naloxone, neonatal outcome was not adversely affected. For both groups, maternal beta-endorphin levels decreased significantly with the onset of analgesia and returned to control levels at delivery. We conclude that intravenous infusion of naloxone reduced pruritus after intrathecal injection of 1 mg of morphine for labor pain without lessening analgesia or adversely affecting maternal or neonatal status.
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PMID:The effects of naloxone associated with the intrathecal use of morphine in labor. 316 Feb 59


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