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

1. Three oral glucose tolerance tests were performed in each of 32 symptomatic postprandial hypoglycaemic patients (before placebo, before doxepin therapy and after doxepin therapy). Plasma neurotransmitters were determined in parallel with assays of plasma insulin and glucose levels. 2. Three different types of patients were distinguished. Type I showed a low noradrenaline/adrenaline ratio, high dopamine levels and low platelet 5-hydroxytryptamine (serotonin) levels during basal periods. After a glucose load, late peaks of dopamine and free 5-hydroxytryptamine, which coincided with the symptoms but not with the nadir of plasma glucose, were observed. Type II showed a low basal plasma noradrenaline/adrenaline ratio. After a glucose load, progressive increases in adrenaline and decreases in glucose were seen. Adrenergic symptoms coincided with the nadir of glucose. Although type III patients showed hyperinsulinaemia after a glucose load similar to the other types of patient, they did not show hyperglycaemia, but rather exhibited a sustained and progressive reduction in plasma glucose. These patients were characterized by a high basal plasma noradrenaline/adrenaline ratio, high basal plasma levels of 4-hydroxy-3-methoxyphenylethyleneglycol and high basal levels of platelet 5-hydroxytryptamine, all of which increased after a glucose load. Systolic and diastolic blood pressure decreases paralleled reductions in heart rate and glucose. The nadir of plasma glucose occurred simultaneously with the appearance of symptoms (weakness, heartburn, oppressive chest pain, tension headache, abdominal cramps, dizziness, etc.). Therapy with doxepin led to disappearance of the symptoms within 3-4 weeks. Normalization of all other disordered variables (cardiovascular, metabolic and neurochemical, and the clonidine test) paralleled the disappearance of the symptoms. 3. Symptoms varied in the three types of patients and we conclude that they are related to hypoglycaemia-induced disorders of plasma neurotransmitters, rather than to hypoglycaemia per se. We postulate that an uncoping stress situation (type I and II patients) and depression (type III patients) underlie the physiopathological mechanisms.
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PMID:Doxepin therapy for postprandial symptomatic hypoglycaemic patients: neurochemical, hormonal and metabolic disturbances. 167 82

Running of gas-cylinder buses (GCB) fueled with liquefied propane-butane mixture added with ethyl mercaptan odorant leads to undesirable medical and social consequences. Statistically proved was considerably higher morbidity rate among GCS drivers in comparison with petrol-fueled buses' drivers. A questionnaire technique was used to show that most GCB drivers (from 61.8% to 98.2% in different bus depots) had been suffering from the irritating smell of the gaseous fuel and consequent headaches, dizziness, slow reactivity and general weakness, specifically by the end of the working shift. The result of the study proved the necessity to stop further running of GCB until technical improvement of the equipment and normal working conditions for GCB drivers have been attained.
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PMID:[Morbidity with temporary disability of gas-cylinder bus drivers]. 171 52

It is important to recognize patients with gastrointestinal bleeding who are at high risk of having angiodysplasia, because these patients should be evaluated by endoscopy rather than barium studies. Sixty-two clinical and epidemiologic parameters were compared between 47 consecutive patients bleeding from angiodysplasia and 47 consecutive controls bleeding from other lesions admitted to two university teaching hospitals from 1980 through 1989. This study demonstrated statistically significant differences between these two groups. The patients with angiodysplasia generally presented with symptoms and clinical findings compatible with hemodynamically well-compensated, chronic bleeding: they were more likely than other gastrointestinal bleeders to experience weakness or fatigue, less likely to experience dizziness or syncope, and less likely to be orthostatic or hypotensive. They had more prior admissions for gastrointestinal bleeding, particularly for gastrointestinal bleeding of undetermined etiology. They were more likely than other gastrointestinal bleeders to be smokers. Patients with angiodysplasia had a milder hospital course: they had fewer transfusions of packed erythrocytes, shorter hospitalizations, and a lower mortality. The in-hospital mortality of patients bleeding from angiodysplasia was 2.1%. Despite the futility of diagnosing angiodysplasia by barium studies, patients ultimately diagnosed as having angiodysplasia were more often initially evaluated by barium studies than the other gastrointestinal bleeders. The currently identified risk factors for bleeding from angiodysplasia should help to select which gastrointestinal bleeders should be evaluated initially by endoscopy.
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PMID:Changing epidemiology of gastrointestinal angiodysplasia with increasing recognition of clinically milder cases: angiodysplasia tend to produce mild chronic gastrointestinal bleeding in a study of 47 consecutive patients admitted from 1980-1989. 173 98

The present paper is part on an extensive follow-up study aimed at the investigation of the effects of in-patient psychotherapy and at the durability of those effects. Using a psychoanalytic oriented personality-inventory (PSKB, Rudolf 1981) 85 phobic patients were examined at the beginning, at the end, and one year after a 6-8 week in-patient psychotherapy. Our results confirmed some of the generally described personality-characteristics in patients with phobia: the phobic symptoms are often accompanied by physical symptoms (sensation of dizziness, weakness sensation, palpitation, sleep disturbance, heavy sweating and breathlessness) and psychic symptoms (anxiousness, depression, restlessness, reduced self-awareness, pedantry, inhibition of aggressive impulses) which could be influenced by psychotherapy. Furthermore we depicted results which have not yet been published in literature.
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PMID:[Personality markers of phobic patients and their change in psychotherapy. Descriptive results of a catamnestic project of the effectiveness of 6-9 week inpatient treatment]. 177 Dec 26

A 13-year-old boy was admitted to this hospital for evaluation of pitting edema of both legs. Three years ago, he had been diagnosed to have nephrotic syndrome. Two and half years ago, because of persistent heavy proteinuria, poor response to steroids and frequent relapse of disease, a renal biopsy was done; characteristics of IgM nephropathy was shown. About a year previously, the patient felt dizziness and weakness of the left side of his body upon awakening one morning. Neurologic examination showed loss of muscle tone, muscle power and deep tendon reflexes. Sensory and cranial nerve function were intact. Blood pressure was normal. The CT scan of brain showed a patch of low attenuation area in the right temporal region, obliteration of the right cortical sulci and mild compression of right lateral ventricle. A diagnosis of nephrotic syndrome with right cerebral infarction was made. The patient's condition became stable two days later after mannitol infusion, correction of electrolytes, and supportive therapy. According to literature, most cases of nephrotic syndrome complicate with renal thrombosis, pulmonary emboli, and deep vein thrombosis. Few cases complicate with cerebral thrombosis and infarction. If patient have low plasma albumin and anti-thrombin III level, hyperfunction of platelet aggregability and use long-term diuretic therapy, they may be at higher risk of thromboembolic complications. If thromboembolic complications exist, anticoagulation treatment should be instituted. Prophylactic therapy with aspirin or dicumarol is not currently recommended.
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PMID:[Nephrotic syndrome complicated with cerebral infarction: report of one case]. 182 17

Major depression disease is uncommon in children; it occurs mostly in children with a depressed parent or in children under major psychosocial stress such as physical or sexual abuse. Most depression in children is masked, i.e., the child presents with signs or symptoms such as headaches, abdominal pain, muscle weakness, vomiting, dizziness, hyperactivity, or school avoidance. Careful evaluation of the history is required to assist in the diagnosis. Some basic laboratory tests should be done to rule out organic disease. Psychiatric referral should be carried out after an appropriate evaluation.
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PMID:Depression and chronic fatigue in children. A masquerade ball. 187 11

The efficacy of sustained release verapamil (Ikapress) was investigated in 237 hypertensive patients of both sexes in a multicenter trial in family practice. There were 4 groups: patients without previous treatment and those treated with nifedipine, with atenolol, or with a combination of drugs. After 4-7 days of washout, all those with diastolic pressures of 95 mm Hg or above received once daily 240 mg of verapamil for 8 weeks. 27 cases had to be withdrawn because of adverse effects: weakness in 10, constipation in 6, rash in 4, impotence in 3, and in 4, other reasons. In 177 blood pressure was brought under control after 4 weeks of treatment. An additional 33 were controlled after 4 weeks of 360 mg of sustained release verapamil. Response to treatment was similar in the 4 trial groups. Mean systolic and diastolic pressures fell 19 and 16 mm Hg, respectively, and mean pulse rate decreased by 5 beats/min. Constipation was the only side-effect reported by those who completed the trial. However, there was a significant reduction in initial scores for headache, dizziness, numbness and edema after 8 weeks of verapamil and all indices of quality of life were significantly improved. These included scores for general well-being, physical fitness, social activity, job fitness, sexual activity, sleep, concentration and mood. Scores for daytime sleepiness and fatigue also decreased significantly. Thus, sustained-release verapamil in a daily dose of 240-360 mg was shown to be an effective antihypertensive. It had few adverse effects and gave considerable improvement in quality of life.
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PMID:[Sustained release verapamil in essential hypertension]. 193 92

Clinical features are described for 35 cases of endemic food-borne botulism managed at a single medical center over 14 years. Important diagnostic findings included dryness of mucous membranes (90%), weakness (84%), and abnormal pupillary reaction (79%). Sensory examination was normal. Dizziness, dyspnea, and weakness of the extremities were significantly more common in patients requiring assisted ventilation. Transitory neurological deterioration occurred in 38% of patients despite the early administration of trivalent (ABE) equine antitoxin. The short course of respiratory failure suggests that toxin effect is unusually ephemeral with a mean intubation interval of only 8.6 days. Rapid recovery of strength without relapsing respiratory failure followed extubation. Tracheostomy was associated with a high complication rate and was abandoned. Extremely thick, tenacious sputum probably contributed to the high nosocomial pneumonia rate. Empirical antibiotic use to eliminate persistent C. botulinum was associated with unacceptably high nosocomial infection rates (p less than .01). Unexpected significant elevations of blood leukocyte and neutrophil band forms were noted.
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PMID:Endemic food-borne botulism: clinical experience, 1973-1986 at Alaska Native Medical Center. 195 79

Since 1964 we have performed 136 vertebral artery reconstructions representing 4% of all operations on extracranial cerebral arteries by our staff. Fifteen of our patients were under age 55 years and had symptoms of dizziness, bilateral visual disturbances, ataxia, presyncopal episodes, and occasionally localized extremity weakness. Dizziness, often severe and incapacitating, has been the most common and consistent symptom. The diagnosis of vertebral artery lesions was made using aortic arch four-vessel cerebral arteriography. Operations were performed for severely obstructing bilateral vertebral artery lesions and included only unilateral vertebral vein patch angioplasty with or without suture plication of the artery in 13 patients. Unilateral carotid vertebral bypass was performed in one patient and unilateral vertebral reimplantation to the carotid in another. Follow-up averaged 8.9 years, ranging from ten months to 20 years. Eleven of 15 patients have remained asymptomatic and without strokes. Recurrent dizziness was present in three, two of whom had vertebral arteriography showing patent vertebral reconstructions. Another had a stroke related to the anterior circulation in follow-up at nine years. Atherosclerotic obstruction of vertebral arteries does occur in patients in the preatherosclerotic age group. Even atypical symptoms suggestive of vertebrobasilar insufficiency may be associated with isolated correctable bilateral flow-impeding vertebral lesions. These symptoms warrant evaluation with cardiac neurological and cerebrovascular studies. Vertebral angioplasty relieves symptoms and the incidence of stroke during follow-up is low.
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PMID:Vertebral artery angioplasty in patients younger than 55 years: long-term follow-up. 201 81

The cases of seven adults who ingested jack o'lantern mushrooms are presented. All patients experienced nausea and vomiting associated with abdominal cramping, and three reported diarrhea. Four of the seven complained of weakness and dizziness. Two were diaphoretic on physical examination. All seven were given IV fluids and oral activated charcoal in a local emergency department and admitted overnight for observation. Laboratory studies showed three of the seven patients to have mildly elevated liver function tests. One patient had hypokalemia requiring potassium supplementation. All were discharged the following day with normal follow-up examinations and laboratory studies. We recommend that all patients presenting with jack o'lantern mushroom poisoning be observed and rehydrated and have baseline liver function tests and potassium levels obtained.
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PMID:Jack o'lantern mushroom poisoning. 202 97


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