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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Circulatory regulation in response to postural changes follows mechanical rules, whereby the shifts in volume in the various organs of the body play an essential role. The change from the horizontal to the vertical position is accompanied by a decrease in pressure above the hydrostatic neutral point, i.e. in the cephalic vessels, whereas the capacious vessels in the caudal region are dilated and the venous return becomes sluggish. As a consequence of the different time courses followed by the various circulatory parameters in the wake of counter-regulatory measures, a distinction can be made between an early orthostatic instant regulatory response and a late orthostatic response. Prominent clinical features do not necessarily always consist of non-systemic dizziness, tinnitus, pallor cold sweat and, finally, orthostatic collapse, but general subjective symptoms such as deafness and tingling of the extremities, a chilly sensation and cardiac symptoms may frequently predominante. In the case of development of an autonomic neurotic symptom complex, psychoautonomic symptoms such as general sleep disturbance are observed. Apart from investigations carried out on a surgical tilting table in general practice, other procedures such as the Valsalva manoeuvre, the squatting test and, in most cases, the erect test are performed. Broadly speaking four different reaction types can be distinguished amongst cases of postural hypotension. Drugs with different therapeutic actions are selectively administered according to the pathophysiological characteristics of the individual patient and the sympathetic adrenal counter-regulatory response. Medico-mechanical measures and physical training should not be neglected.
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PMID:[Postural hypotension: pathophysiology and clinical features (author's transl)]. 1 41

Some women undergo induced abortion manifest a series of symptoms such as slower heart beats, irregular heart rate, lowered blood pressure, paleness, dizziness and profuse perspiration. These symptoms, which occur during or after the procedure, are referred to as "a symptom complex." In 1977, 400 pregnant women were studied to determine the cause of this symptom complex: 263 healthy women who received normal treatment; 32 women with heart ailments associated with early pregnancy, who received acupuncture; and 105 women whose heart rates were below 90, who were injected with 0.5 mg atropine. Virtually all of the 263 women had a slower heart rate during the procedure. 33 (12.55%) of these women exhibited the symptom complex, and of these, 23 (69.17%) had cramps, 17 (51.52%) had abdominal swelling, and 2 (6.09%) had backaches. Most of these symptoms occurred when the cervix dilated and after the suction. The duration and seriousness of the symptom complex varied from woman to woman, as did the recovery period, which ranged from 3 to 63 minutes. It was also found that: 1) of the 263 patients, 110 were first time mothers, of whom 15 (13.63%) had the symptom complex; 2) of the 221 healthy women who had abortion by suction, 32 (14.48%) had the symptom complex, while 1 (2.38%) who had abortion by pincers, had the symptom complex; 3) of the 33 women who had the symptom complex, the loss of blood ranged from 10 ml to 200 ml, with an average loss of 50 ml; 4) there appears to be no relationship between the manifestation of the symptom complex and negative pressure; 5) electrocardigrams were taken for 20 of the healthy patients, none of whom showed a quickened heart rate during or after the procedure; and 6) treatment for the symptom complex was by acupuncture or by injection of Atropine. The 32 acupuncture patients suffered only backaches and lower abdominal swelling, but relief of pain was slow. 105 patients were administered Atropine, none of whom manifested the symptom complex. Only 19 women perspired slightly and felt chilled in the limbs, while 3 were nauseous. Of the 33 symptom complex patients, 5 had Atropine, most of whose heart rates returned to normal after 2 seconds to 2 minutes, as did their dizziness, perspiration, and ashen coloring. However, it was found that if no treatment was given after the symptom complex emerged, a majority of the patients returned to normal on their own, some taking as long as an hour. It is believed the occurrence of the symptom complex is directly related to the mechanical stimulus applied to the uterus or cervix, the vigorous shrinkage of the uterus, loss of blood, and the negative pressure suction power of the uterine wall. Further a mechanical stimulus to the uterus can cause an "errant" nervous reflex that will affect the heart rate. This errant nervous reflex can be cut off by an injection of Atropine.
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PMID:[A symptom-complex during artificial abortion (author's transl)]. 26 29

During the course of an obscure illness in a teenage girl it was eventually realized that the diagnosis was 'epidemic neuromyasthenia'. The illness which occurred between February and September 1976 was characterized by fatigue, pallor, headache, nuchal pain, alterations in mentation, dizziness, nausea and vomiting, paraesthesiae, weakness and heaviness of limbs, and a prolonged relapsing course. Investigation brought to light fourteen patients with similar symptoms--twelve female and two male. In view of the shortcomings of retrospective enquiries, especially those involving the assessment of notes made by other people, and the problem of trying to define a nonfatal illness with protean symptoms, many of a nonspecific nature, with few physical findings and negative laboratory studies, caution is necessary. Under these circumstances it is claimed on clinical epidemiological evidence that a diagnosis of 'epidemic neuromyasthenia' could be sustained confidently in three patients and probably in a fourth. Six patients were considered possible cases and four were rejected.
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PMID:'Epidemic neuromyasthenia' in Southwest Ireland. 74 20

Preliminary results of this retrospective-prospective analysis of renal hypertension in 110 children indicate that hypertension may be secondary to a wide variety of acute progresive, and chronic renal diseases which may be either congenital or acquired. Affected children may be detected at any time from infancy through adolescence. Symptoms usually associated with acute glomerulonephritis (i.e., headache, swelling, nausea, vomiting, anorexia, fatigue, dizziness, and fever) occur in both acute and chronic renal diseases associated with hypertension. Headache and swelling are the most common symptoms in this series. Peripheral edema, rales, and increased heart size were found in between 10 and 25% of these children. Differential diagnosis may be approached by a consideration of causes of acute and chronic hypertension. The child with chronic renal disease usually presents with a long history of fatigability, poor growth, and pallor, and laboratory tests reveal elevation of the creatinine and BUN along with anemia, hypocalcemia, and hyperphosphatemia. In contrast, the child with acute renal disease and hypertension presents with a history of prior good health followed by the abrupt onset of signs and symptoms of renal disease; laboratory tests usually reveal modest elevations of creatinine and BUN, anemia is unusual, an abnormal urinalysis is common, and serum calcium and phosphorous levels are usually normal. Renovascular and asymmetric renal parenchymal disease represent uncommon but important conditions because surgery may be curative. Treatment may be surgical, medical, or combined. Surgical conditions include renal trauma, hydronephrosis, asymmetric renal disease, and renal arterial disease. Adequate blood pressure control without medication can be expected following surgery in instances of unilateral involvement with a normal contralateral kidney. Meticulous assessment of the contralateral kidney is needed to determine that it is normal. If surgery is unsuccessful or is not indicated, pharmacologic therapy is initiated with a stepwise regimen starting with the mildest agent (e.g., thiazides) and then adding additional antihypertensive drugs when adequate blood pressure control has not yet been achieved. The goal of therapy is the lowest, safest, tolerated blood pressure levels. Long-term, carefully designed studies of antihypertensive agents for children with renal hypertension are not available. The need for collection and critical analysis of data concerning the clinical course of children with renal hypertension is evident from a review of the literature and from the preliminary data presented in this series. The presentation of such information and a critique of outcome variables will provide a basis for program planning for affected children and improvement in patient care where indicated.
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PMID:Renal hypertension in children. 99 44

A prospective study of symptomatic hypoglycaemia was conducted in 47 children over a 14-week period using a questionnaire completed at home for each episode of hypoglycaemia. Twenty-nine children (62%) experienced 150 episodes during the study. The average incidence was once every 33 days (range 0-5.2 mo-1). Hypoglycaemia occurred more frequently in children with lowest haemoglobin A1 levels. Episodes were not randomly distributed in time; hypoglycaemia occurred significantly more frequently in the evening, in the early morning and around midday. The majority of episodes were judged to be mild but 2 children had nocturnal convulsions and glucagon was used on three occasions. Symptomatic nocturnal hypoglycaemia occurred one or more times in 30% of the children. Daytime episodes were manifested by tremor, feeling weak, dizziness, pallor, and other symptoms and signs. In 46% of cases the cause was not evident to parents or children, but 25% were related to physical activity.
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PMID:A prospective study of symptomatic hypoglycaemia in childhood diabetes. 252 5

One of the important factors in outer space is the absence of gravity (OG). During longterm missions, this factor is responsible for the larger number of anatomical and physiological changes that astronauts experience. The cardiovascular system undergoes these changes with severe intensity, which is part of an adaptation process to the new environmental conditions. The modifications observed in both the anatomy of the cardiovascular system and its hemodynamics occur in two phases. The first phase begins when the astronauts enter into Earth orbit or in interplanetary trajectory and extends until the second or fourth day of the mission. It is characterized by an important shifting of fluids from the lower extremities to the cephalic regions which produces an increase of the venous return and the preload, the heart rate is increased, the blood volume in the thorax is also increased, the cardiac chambers become dilated, and by reflex action, the antidiuretic hormone diminishes, diuresis increases and leads to a virtual state of dehydration. Clinically, the first stage is manifested by headache, dizziness, space disorientation, nausea, anorexia, projectile vomiting, sweating and pallor. This constalation of data is known as "The Space Adaptation Syndrome". The second phase begins at the end of the first phase and finishes toward the fortieth or fiftieth day of the mission.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Behavior of the cardiovascular system in outer space]. 295 26

This was an open-label study in 19 children aged 9-13 years, weighing 27-44 kg, with bronchial asthma. Twenty-four-hour steady-state concentrations of theophylline and its metabolites 1,3-dimethyl uric acid, 3-methyl xanthine and 1-methyl uric acid were assessed after daily dosing of 600 mg (ca 18 mg/kg/day) of the sustained-release theophylline micro-pellet sprinkle system BY158K, for 4 days. The dosing regimen used was an unequal twice-daily dose of 200 mg in the morning after breakfast and 400 mg in the evening after dinner. Twenty-four-hour peak expiratory flow (PEF) profiles were compared before treatment and at steady-state, along with lung function parameters after bronchial provocation. Mean values +/- SD (n = 16) of the steady-state characteristics were Cmin 6.8 +/- 2.1 mg/l, Cmax 14.5 +/- 4.8 mg/l and Cav 10.5 +/- 2.9 mg/l, the plateau time was 11.7 +/- 4.8 hr and peak-trough fluctuation and swing were 72 +/- 21 and 118 +/- 52%, respectively. There was an excellent reproducibility of theophylline pre-dose levels at corresponding time points of the 24-hr sampling period [r = 0.864 (p less than 0.001)]. Mean values +/- SD of the 24 hr average serum metabolite levels were 0.9 +/- 0.2 mg/1 for 1,3-dimethyl uric acid, 0.6 +/- 0.1 mg/1 for 3-methyl xanthine and 0.4 +/- 0.1 mg/1 for l-methyl uric acid. Lung function (n = 17) following bronchial provocation, improved in 10 children after theophylline treatment of 4 days, remained stable in 2 patients and deteriorated in 5 patients. Serum theophylline profiles and PEF profiles ran largely in parallel over the 24-hr period. Six children exhibited typical theophylline induced side-effects, headache (n = 3), nausea (n = 4), dizziness (n = 1), vomiting (n = 4), sleep disturbances (n = 1), pallor (n = 1) and tremor (n = 1), necessitating in 3 children one dose omission/reduction (n = 2) or subsequent dose reduction (n = 1). It has been shown that a twice daily dosing regimen with unequal doses of anhydrous theophylline (BY158K) is well suited to this population of fast metabolisers. The patients were well protected throughout the day, including the critical early morning hours.
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PMID:Steady state pharmacokinetics, metabolism and pharmacodynamics of theophylline in children after unequal twice-daily dosing of a new sustained-release formulation. 367 17

Two groups of 15 women with moderately severe post-partum hypotension were assigned at random to receive treatment with either 200 mg dimetophrine or placebo, orally, over a period of 10 days. Systolic blood pressure increased steadily and significantly during the first 5 days of treatment, from 100.0 +/- 1.2 mmHg to 128.0 +/- 1.2 mmHg with dimetophrine; with placebo, the increase from 99.8 +/- 1.1 mmHg to 104.7 +/- 1.1 mmHg was significantly less. Similar results were observed in diastolic blood pressure measurements. Overall, all 15 patients responded to dimetophrine but only 4 spontaneously recovered on placebo. At the same time, heart rate moved towards normal with dimetophrine (from 82.4 +/- 2.0 to 75.5 +/- 1.1 beats/min); with placebo, significantly less recovery was observed (from 79.5 +/- 2.3 to 78.6 +/- 1.5 beats/min). Concomitant with the recovery of perfusion pressure, the associated symptoms (asthenia, paleness, fatigue, dizziness, sweating, headache, vertigo) significantly decreased in intensity, all except vertigo to a significantly greater extent with dimetophrine than with placebo. Subjective tolerance was good in both groups; clinically relevant variations in haematological or haematochemical parameters measured were absent, except for the expected normalization of leucocyte count.
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PMID:Effective treatment of post-partum hypotension with dimetophrine: a placebo-controlled, double-blind trial. 389 65

In a study of 133 anaemic and 111 non-anaemic hospital patients pallor of recent onset was the only symptom which was significantly associated with the severity of the anaemia. Dizziness in acute blood loss anaemia, and anorexia and painful tongue in vitamin-B(12) deficiency, were the only symptoms which might be helpful in diagnosing the type of anaemia. The frequency of glossitis in patients with megaloblastosis was confirmed, but neither glossitis nor nail changes were significantly more common in patients with iron-deficiency anaemia than in the control patients.
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PMID:Evaluation of diagnostic significance of certain symptoms and physical signs in anaemic patients. 525 52

Although dangling is a common nursing intervention, little research has been conducted to test its effectiveness or to compare various dangling methods. By contrast, abundant information is available about orthostatic responses. In this article the authors explain the physiologic principles underlying orthostatic responses, focusing on blood volume distribution and the role of the mechanoreceptors, discuss typical and atypical responses to dangling and standing, describe clinical manifestations of orthostatic hypotension and syncope, present research-based practice guidelines, and, provide specific recommendations for future research. Because of the wide variability in heart rate and blood pressure responses to orthostasis, the authors stress the importance of signs and symptoms such as nausea, pallor, dizziness, visual dimming, and impaired consciousness in assessing orthostatic tolerance. Studying rituals such as dangling can advance nursing practice, improve patient outcomes, and move nursing to a research-based practice.
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PMID:Dangling: a review of relevant physiology, research, and practice. 759 93


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