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

Orthostatic intolerance (OI) is a cause of significant disability in otherwise healthy women seen by gynecologists. Orthostatic tachycardia is often the most obvious hemodynamic abnormality found in OI patients, but symptoms may include dizziness, visual changes, discomfort in the head or neck, poor concentration, fatigue, palpitations, tremulousness, anxiety, and, in some cases, fainting (syncope). It is the most common disorder of blood pressure regulation after essential hypertension, and patients with OI are traditionally women of childbearing age. Estimates suggest that at least 500,000 Americans suffer from some form of OI, and such patients comprise the largest group referred to centers specialized in autonomic disorders. This article reviews recent advances made in the understanding of this condition, potential pathophysiological mechanisms contributing to orthostatic intolerance, and therapeutic alternatives currently available for the management of these patients.
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PMID:Orthostatic intolerance: a disorder of young women. 1075 21

Although first described about 100yr ago, atrial fibrillation (AF) is now recognized as the most common of all arrhythmias. It has a substantial morbidity and presents a considerable health care burden. Improved diagnosis and an ageing population with an increased likelihood of underlying cardiac disease results in AF in more than 1% of population. AF is associated with an approximately two-fold increase in mortality, largely due to stroke which occurs at an annual rate of 5-7%. Another risk to survival is heart failure, which is aggravated by poor control of the ventricular rate during AF. Usually AF is associated with a variety of symptoms: palpitations, dyspnea, chest discomfort, fatigue, dizziness, and syncope. Paroxysmal AF is likely to be symptomatic and frequently presents with specific symptoms, while permanent AF is usually associated with less specific symptoms. However, in at least one third of patients, no obvious symptoms or noticeable degradation of quality of life are observed. This asymptomatic, or silent, AF is diagnosed incidentally during routine physical examinations, pre-operative assessments or population surveys. Recently, a very large incidence of generally short paroxysms of AF has been seen in patients with implantable pacemakers or defibrillators and these arrhythmias are often silent. Pharmacological suppression of arrhythmia may be associated with a conversion from a symptomatic to an asymptomatic form of AF. Holter monitoring and transtelephonic monitoring studies have demonstrated that asymptomatic episodes of AF exceed symptomatic paroxysms by twelve-fold or more. Although symptoms may not stem directly from AF, the risk of complications is probably the same for symptomatic and asymptomatic patients. AF is found incidentally in about 25% of admissions for a stroke. Studies in patients with little or no awareness of their arrhythmia condition indicate that unrecognized and untreated AF may cause congestive heart failure. In patients with coronary bypass, AF may not only represent risk for immediate postoperative morbidity and increase hospital resource utilization, but being unrecognized, may produce a significant impact on long-term survival and quality of life. Although silent AF merits consideration for anticoagulation and rate control therapy according to standard criteria, whether antiarrhythmic therapy is relevant in this condition remains unclear.
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PMID:Clinical relevance of silent atrial fibrillation: prevalence, prognosis, quality of life, and management. 1093 3

In every year since 1984, cardiovascular disease has claimed the lives of more females than males. More than 450,000 women succumb to heart disease annually, and 250,000 die of coronary artery disease. Despite the proportions, most women believe they will die of breast cancer. The perception that heart disease is a man's disease and that women are more likely to die of breast cancer is alarming. Although women develop heart disease about 10 years later than men, they are likely to fare worse after a heart attack. The poorer outcomes are due, in part, to the failure to identify heart attack symptoms. Approximately 35% of heart attacks in women are believed to go unnoticed or unreported. However, because of increased age, women are more likely to have co-morbid diseases such as diabetes and hypertension. In women, not only is "tightness" or discomfort in the chest a warning sign, but in addition, nausea and dizziness are common indicators of myocardial ischemia. Other symptoms include breathlessness, perspiration, a sensation of fluttering in the heart, and fullness in the chest. In comparison to men, women are less likely to undergo tertiary care interventions such as cardiac catheterization, angioplasty, thrombolytic therapy, and bypass surgery; to participate in cardiac rehabilitation; and to return to work full-time after myocardial infarction. In the past, most research about treatments for heart disease focused on men, and gender differences have been ignored. Recent studies are enrolling enough women to test if there are differences between men and women in outcomes. One of the major areas of research relates to estrogen and hormonal replacement therapy to reduce the relative risk of heart attack and stroke. The Women's Health Initiative is a major NIH-sponsored trial that addresses the issue of primary prevention of cardiac disease by hormonal replacement therapy. The results will be available in 2004. The Heart Estrogen/Progestin Replacement Study (HERS), disappointingly, did not show a significant reduction of coronary events in women taking hormonal replacement therapy, nor did the Estrogen Replacement and Atherosclerosis (ERA) trial of 309 postmenopausal women who underwent coronary angiography. New insight into the role of vitamins, phytoestrogens and other natural sources, and selective estrogen receptor modulators may provide other options for management. Until then, modification of risk factors and healthy life style choices are recommended for reducing the risk of cardiac disease. In fact, the key to a healthy heart in the year 2000 appears closely tied to life style choices. Prevention of disease is the key, and current recommendations are simply to stop smoking, or do not start; treat and control blood pressure >140/90 mm Hg; manage elevated lipids by diet, exercise, and cholesterol-lowering medications (if necessary); treat diabetes; lose weight so that BMI is <25; walk for 20-30 minutes at least three times a week; and take an aspirin tablet daily.
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PMID:Heart disease in women. 1114 May 44

Panic disorder (PD) is one of the most common psychiatric illnesses in Thailand but the picture of PD in Thailand is not clear. Therefore, the objective of this research was to review, summarize, and analyse data from research reports concerning the clinical aspects of PD in Thailand. Relevant papers were searched comprehensively. Four groups of data including prevalence and incidence rates, sex differences, clinical symptoms during panic attacks, and scores of the Hamilton anxiety scale (HAM-A) were extracted where available. Data thus obtained were then grouped and compared. It was found that 2.1 per cent to 12.4 per cent of patients who visited the psychiatric outpatient clinic for the first time were diagnosed as having PD. Males were affected at a similar rate to females with a ranging ratio of female:male from 1.3:1 to 0.67:1. The most common symptoms during panic attacks were palpitations, chest pain or discomfort, and dizziness or vertigo, similar to South American studies. Regarding scores of original HAM-A, mean somatic anxiety scores of PD patients who attended the cardiology clinic were significantly higher than generalized anxiety disorder patients (15.0 vs 9.8, p < 0.05). PD patients who attended the psychiatric clinic had higher mean scores of HAM-A when compared to PD patients who visited the cardiology clinic, but it was not statistically significant (27.7 vs 26.6, p > 0.05). However, the fear item of PD patients at the psychiatric clinic had significantly higher scores (2.1) than the other one (0.7). The difference between these findings and those of Western studies may be caused by cultural factors. Thai men tend to react more promptly to panic attacks and seek medical attention while women mostly attributed their symptoms to "Air Disease". However, incidence rates from other rural areas are lacking. Before conclusions can be drawn, research on epidemiologic data in the community should be further investigated.
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PMID:Panic disorder in Thailand: a report on the secondary data analysis. 1114 81

Dizziness can be associated with otologic, neurologic, medical, and psychiatric conditions. This paper focuses on the interface between otologic and psychiatric conditions. Because dizziness often is situation specific, concepts of space and motion sensitivity (SMS), space and motion discomfort (SMD), and space and motion phobia (SMP) are needed to understand the interface. We present a framework involving several categories of interactions between balance and psychiatric disorders. The first category is that of dizziness caused by psychiatric disorder (psychiatric dizziness), including hyperventilation-induced dizziness during panic attacks. The second category involves chance cooccurrence of a psychiatric disorder and a balance disorder in the same patient. The third category involves problematic coping with balance symptoms (psychiatric overlay). The fourth category provides psychological explanations for the relationship between anxiety and balance disorders, including somatopsychic and psychosomatic relationships. The final category, neurological linkage, focuses on the overlap in the neurological circuitry involved in balance disorders and anxiety disorders.
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PMID:A clinical taxonomy of dizziness and anxiety in the otoneurological setting. 1138 60

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

The mainstay of treatment is a specialized form of physical therapy that intentionally induces symptoms of dizziness with head movements, moving visual targets, and changes in position. Patients must be motivated to experience discomfort during the early stages of rehabilitation, doing the types of activities that they likely have been avoiding. Time must be spent convincing the patient of the necessity to deliberately provoke dizziness in order for the exercises to work. It is important to not overmedicate with vestibular suppressants, and to treat any co-existing mood or anxiety disorder, as these interfere with the adaptive plasticity that is the basis of successful rehabilitation.
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PMID:Chronic Dizziness. 1203 1

A survey study using questionnaire was conducted in 530 people (270 men, 260 women) living or not in vicinity of cellular phone base stations, on 18 Non Specific Health Symptoms. Comparisons of complaints frequencies (CHI-SQUARE test with Yates correction) in relation with distance from base station and sex, show significant (p < 0.05) increase as compared to people living > 300 m or not exposed to base station, till 300 m for tiredness, 200 m for headache, sleep disturbance, discomfort, etc. 100 m for irritability, depression, loss of memory, dizziness, libido decrease, etc. Women significantly more often than men (p < 0.05) complained of headache, nausea, loss of appetite, sleep disturbance, depression, discomfort and visual perturbations. This first study on symptoms experienced by people living in vicinity of base stations shows that, in view of radioprotection, minimal distance of people from cellular phone base stations should not be < 300 m.
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PMID:[Investigation on the health of people living near mobile telephone relay stations: I/Incidence according to distance and sex]. 1216 54

Reactions to oral contraceptive therapy tend to be maximal during the first few months of use. They include nausea or epigastric discomfort, malaise, dizziness, nervousness, fatigue, weakness, leg cramps, headache, and depression. The estrogenic component is thought to be the cause. There may also be a psychogenic basis reflecting apprehension. Breast tenderness is an occasional complaint and intermenstrual spotting or breakthrough bleeding is often reported. Increasing dosage has reduced this symptom. Dysmenorrhea prior to treatment may be improved but occasionally it is aggravated. Drug-induced amenorrhea presents a double problem in that failure to resume medication 7 days after completion of a cycle results in a risk of conception. Episodes of severe uterine bleeding in patients discontinuing use after several months or years have been reported. Other side effects include a skin reaction resembling acne, pruritus, hirsutism, thinning of scalp hair, increased skin pigmentation, and weight gain or loss. Serious vascular complications and hepatic dysfunction have been shown and deviation of thyroid function may be shown by increase of serum protein-bound iodine (PBI). Clinical signs of hyperthyroidism have not been described. Oral contraception is associated with elevated plasma cortisol (hydrocortisone) levels and decreased urinary levels of 17-hydroxycorticosteroids (17-OCHS). Suppression of ovarian activity by oral contraceptives is rapidly reversible. Fear of carcinogenesis has caused much alarm but no proof as of the present time. Safety of long term use will require additional years of experience.
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PMID:Side-effects and possible complications of oral contraceptive drugs. 1225 41

In the 1974-86 period, gossypol acetate was taken as an antifertility measure by 16 men. The initial dose was 20 mg/day, with a maintenance dose of 40 mg/week. Antifertility efficacy was obtained in all 16 cases. Azoospermia persisted in 1 case where the gossypol had been taken for 8 years and discontinued for the past 2 1/2 years. Symptoms experienced in the first 2 weeks of gossypol acetate administration included dizziness, anorexia, nausea, fatigue, and stomach discomfort. Results of examinations of blood and urine; functions of the heart, liver, lung, and liver; electrolytes; external genitalia; and sexual performance were all in the normal range. Measurements of semen, plasma biochemistry, and endocrine changes also were within normal limits. However, in the 9 cases in which the average value of plasma testosterone was near the lower limit of normal, the average value of follicle-stimulating hormone was higher than normal and the testosterone/luteinizing hormone ratio was unusually low. Testis biopsy indicated that long-term gossypol treatment affected both germ cells and Sertoli cells. Leydig cells also demonstrated some damage. Gossypol acetate is, in general, considered an ideal male contraceptive because of its long-term effectiveness, reversibility, and lack of severe toxic side effects.
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PMID:Antifertility treating with long term gossypol. 1226 55


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