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)

Fosphenytoin is a water-soluble disodium phosphate ester of phenytoin that is converted in plasma to phenytoin. Fosphenytoin is compatible with most common i.v. solutions and can be administered safely through the i.m.route. An additional safety factor is the absence of propylene glycol in the fosphenytoin formulation. Propylene glycol is used as a vehicle in the i.v. phenytoin preparation and by itself may produce serious cardiovascular complications. Studies of the pharmacokinetics, safety, and tolerance of i.v. fosphenytoin have demonstrated that fosphenytoin produces phenytoin plasma concentrations similar to those achieved with oral and i.v. phenytoin, but without significant cardiovascular effects and only minimal discomfort at the injection site. Aside from local reactions, the most common adverse events associated with fosphenytoin have been pruritus and reactions typical of phenytoin (e.g., dizziness, somnolence, and ataxia). Fosphenytoin represents a significant advance in the treatment of patients with seizures who require parenteral therapy.
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PMID:Intravenous administration of fosphenytoin: options for the management of seizures. 864 9

Peripheral vestibular equilibrium disorders may originate in various parts of the labyrinth or the vestibular nerve. Traditionally, the function of the lateral semicircular canals has been assessed with caloric irrigation, and sometimes falsely been interpreted as a vestibular nerve lesion. The vertical semicircular canals are not easily assessed. Caloric testing with the head in different positions is not very helpful, but the canals may pairwise be tested using specific rotational techniques. Often the otolithic organs, capable of detecting linear acceleration forces, are forgotten as a source of vertigo and dizziness. We have implemented horizontal rotatory testing with the subject seated eccentrically facing the direction of rotation as a means of assessing otolithic function. The subject experiences a lateral tilt and is instructed in darkness to put a short light bar in the position he thinks a water surface would have, which is identical to his perceived tilt. In 39 normal subjects, a theoretical tilt of 24 degrees was estimated as approximately 19.5 degrees, and the standard deviation was 6 degrees. A side difference index was proposed to be normal if below 25%. The preliminary findings in a few patients with known labyrinthine lesions are presented. We propose that otolithic as well as lateral semicircular canal functions are useful to monitor in patients with suspected peripheral equilibrium disorders.
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PMID:The subjective horizontal in eccentric rotation influenced by peripheral vestibular lesion. 872 9

We describe a 13-year-old girl who presented with an acute febrile disease accompanied by headache, dizziness, nausea, decreased visual acuity, and diplopia. Examination showed papilledema, enlarged blind spots, and visual field defects with an otherwise normal neurological examination. The diagnosis of idiopathic intracranial hypertension was confirmed by increased intracranial pressure (cerebrospinal pressure > 200 mm water) in the absence of any abnormal radiological findings of the brain. Initially, only positive serology tests showing elevated titers of anti-DNA antibodies and positive tests for anti-Sm and anti-RNP antibodies were found; however, 6 mo later clinical and laboratory findings were compatible with systemic lupus erythematosus (SLE). Our patient illustrates that the possibility of SLE needs to be considered in the differential diagnosis of idiopathic intracranial hypertension.
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PMID:Systemic lupus erythematosus presenting as idiopathic intracranial hypertension. 882 3

A syndrome of acute pulmonary edema has been previously reported among scuba divers in cold, European waters. Because of the temperatures involved, the name "cold-induced pulmonary edema" was coined in the original 1989 description. We report six individuals who developed the identical syndrome, five while diving in Puget Sound and one in the Gulf of Mexico. The four women and two men ranged in age from 24 to 60 yr. They experienced one to six episodes apiece, each with the development severe dyspnea at depth without excessive exertion. Associated symptoms included cough, weakness, expectoration of froth, chest discomfort, orthopnea, wheezing, hemoptysis, and dizziness. Emergency medical evaluation of four divers revealed rales on examination and pulmonary edema on chest radiograph. In one diver with pulmonary edema on chest radiograph, pulmonary capillary wedge pressure was normal when measured acutely. Symptoms resolved either spontaneously over 1-2 days or with standard medial treatment for pulmonary edema. Prior history of cardiovascular disease was negative except for hypertension and mitral valve prolapse in one diver. Cardiac evaluations following recovery from the acute episodes were normal. Episodes in the cold waters of Puget Sound sometimes occurred despite the use of dry suits. Furthermore, one diver developed recurrent episodes in 27 degrees C water off Cozumel, Mexico. Development of pulmonary edema while scuba diving constitutes a distinct clinical entity which may occur in either "cold" or "warm" water. It is not associated with a decompression mechanism. Personnel caring for divers should be aware of the syndrome in order to provide optimal medical management.
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PMID:Pulmonary edema of scuba divers. 906 53

We investigated the effects of caloric stimulation on arterial blood pressure (AP) and neural activity in the hypothalamic paraventricular nucleus (PVN) in anesthetized guinea pigs. Hot water stimulation of the labyrinth produced a decrease in AP in 56 of 73 cases tested, and AP decrease followed by increase in 12 cases. In the cases where AP initially decreased and then increased, 92% of PVN neurons responded as excitatory or inhibitory to caloric stimulation. When the AP change was a decrease alone, the responsive rate of the PVN neurons was 63%, and no change in PVN neural activity was seen in the group which showed no AP change after caloric stimulation. The ratio of the PVN neurons showing inhibition in the group that showed AP decrease-increase sequence was significantly higher than that in the group showing AP decrease alone. AP changes following caloric stimulation were greatly reduced after electric destruction of the anterior and middle parts of the hypothalamus. This indicates that the activation of the hypothalamic neurons by the vestibular input is important to produce the vestibulovasomotor response and its pattern. When the same amount of stimulus was applied periodically to the labyrinth, the AP increment component was increased with time. It is suggested that the pattern of AP changes is greatly influenced by level of consciousness. It is suggested that the basal activity level of the autonomic nervous system, and the variety and magnitude of the vestibular stimuli should be synthetically evaluated when the autonomic nerve function test is applied to patients suffering dizziness.
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PMID:[Changes in arterial blood pressure and hypothalamic neural activity in response to caloric stimulation in guinea pigs]. 907 Nov 19

Fosphenytoin (Cerebyx), is a water soluble prodrug that is rapidly and completely converted to phenytoin. This study reports the injection-site tolerance and safety of intramuscular fosphenytoin (> 10 mg/kg doses) in 60 patients requiring a phenytoin loading dose. Patients received injections at single or multiple sites with volumes ranging from 4 to 30 ml per injection site. The majority of patients had no irritation (erythema, swelling, tenderness, bruising) or complaints of discomfort related to fosphenytoin injection either after injection (95%) or at follow-up (88%). Irritation, when reported, was mild in all cases. Forty of 60 patients (67%) reported transient side effects, primarily involving the central nervous system, such as nystagmus, dizziness or ataxia, which are commonly associated with phenytoin therapy. All patients received prescribed doses; no patient had an injection(s) stopped due to intolerance or side effects. No serious adverse events occurred with intramuscular fosphenytoin. In this study, intramuscular fosphenytoin was demonstrated to be a safe and well tolerated, and in many instances, a preferable alternative to other means of phenytoin loading.
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PMID:Intramuscular fosphenytoin (Cerebyx) in patients requiring a loading dose of phenytoin. 933 83

Methyl t-butyl ether (MTBE) is a gasoline additive that has appeared in private wells as a result of leaking underground storage tanks. Neurological symptoms (headache, dizziness) have been reported from household use of MTBE-affected water, consistent with animal studies showing acute CNS depression from MTBE exposure. The current research evaluates acute CNS effects during bathing/showering by application of physiologically-based pharmacokinetic (PBPK) techniques to compare internal doses in animal toxicity studies to human exposure scenarios. An additional reference point was the delivered dose associated with the acute Minimum Risk Level (MRL) for MTBE established by the Agency for Toxic Substances and Disease Registry. A PBPK model for MTBE and its principal metabolite, t-butyl alcohol (TBA) was developed and validated against published data in rats and humans. PBPK analysis of animal studies showed that acute CNS toxicity after MTBE exposure can be attributed principally to the parent compound since the metabolite (TBA) internal dose was below that needed for CNS effects. The PBPK model was combined with an exposure model for bathing and showering which integrates inhalation and dermal exposures. This modeling indicated that bathing or showering in water containing MTBE at 1 mg/L would produce brain concentrations approximately 1000-fold below the animal effects level and twofold below brain concentrations associated with the acute MRL. These findings indicate that MTBE water concentrations of 1 mg/L or below are unlikely to trigger acute CNS effects during bathing and showering. However, MTBE's strong odor may be a secondary but deciding factor regarding the suitability of such water for domestic uses.
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PMID:A physiologically-based pharmacokinetic model assessment of methyl t-butyl ether in groundwater for a bathing and showering determination. 940 48

The Dead Sea (barometric pressure: 800 mm Hg) is an important balneotherapeutic centre for chronic dermatologic and arthritic diseases. In the past, hypertensive patients have complained sporadically of weakness and dizziness during a stay in the Dead Sea. It was therefore recommended that hypertensives do not stay at these health centres. The aim of our study was to investigate the changes in blood pressure (BP) parameters of 72 hypertensive and normotensive osteoarthritic and rheumatoid arthritic elderly patients during a 2-week stay in the Dead Sea, and to further evaluate the effect of different balneotherapeutic means on these BP changes. Following a primary BP assessment at the out-patient clinic (Beer Sheva barometric pressure: 745 mm Hg), the patients were divided into four groups: (1)thermomineral pool; (2)Dead Sea water baths; (3) combination of the aforementioned treatments; and (4) controls (no balneotherapy). We demonstrated that the systolic BP (SBP) of hypertensives and normotensives decreased by an average of 17 mm Hg and that diastolic BP (DBP) decreased by an average of 8 mm Hg from their basic clinic-measured values. These favourable results were sustained during the first 10 days duration, and by the end of their stay they had diminished slightly. Thermomineral water had an additional lowering effect on the BP of the normotensives, but the SBP of hypertensives increased. Immediately following Dead Sea bath immersion, we noted a temporary increase of SBP in normotensives only. No patient, hypertensive or normotensive, complained of dizziness, malaise, or any other complaint. In our experience, patients feel well at low altitudes, and there is no justification in upholding hypertension as a contraindication to balneotherapy in the Dead Sea.
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PMID:Blood pressure changes at the Dead Sea (a low altitude area). 975 90

A randomized trial conducted in the US and Cuba assessed whether moistening misoprostol in advance of vaginal insertion enhances the efficacy of medical abortion after methotrexate administration. 240 abortion seekers from Pittsburgh, Pennsylvania (US), and Havana, Cuba, with pregnancies of 49 days' gestation or less were randomized either to dip the four 200-mcg misoprostol tablets in water before administration (group 1) or to insert the tablets dry (group 2). The misoprostol dose was repeated in 1-2 days if abortion did not occur. There were no statistically significant differences between groups 1 and 2 in the cumulative rate of abortion after the first misoprostol dose (73.0% vs. 71.3%), after the second misoprostol dose (84.1% vs. 81.1%), or by 35 days after methotrexate administration (95.2% vs. 91.8%). The proportion of women with a continuing pregnancy, defined as the presence of embryonic cardiac activity 2 weeks after methotrexate injection, was slightly but nonsignificantly higher in group 2 (5.7%) than in group 1 (2.4%). The immediate success rate in Pittsburgh was greater, although not significantly, for women who moistened the misoprostol (87% vs. 76%); in Havana, the opposite trend was observed (82% vs. 86%). Cramping began a mean of 2.8 hours after the first misoprostol administration in group 1 and a mean of 3.5 hours later in group 2. Women in group 1 had significantly more diarrhea (36% vs. 21%) and fever/chills (44% vs. 30%) than those in group 2, but rates of nausea, vomiting, dizziness, and headache did not differ. These findings suggest that moistening misoprostol before vaginal application does not significantly improve the efficacy of methotrexate abortion.
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PMID:A randomized trial of the effect of moistening misoprostol before vaginal administration when used with methotrexate for abortion. 1034 81

The causes of Datura intoxication include medication overdose, misuse of edible vegetables, deliberate abuse as a hallucinogen, homicidal or robbery and accidental intoxication from contaminated food. We report an incident of 14 people with Datura intoxication caused by ingesting wild Datura suaveolans for food. The incubation period was 15 to 30 min. The symptoms/signs were dizziness, dry mouth, flushed skin, palpitation, nausea, drowsiness, tachycardia, blurred vision, mydriasis, hyperthermia, disorientation, vomiting, agitation, delirium, urine retention, hypertension and coma. Three patients were hospitalized for 2-3 days. Thirteen persons received supportive fluid therapy. One patient did not receive medical therapy, he induced vomiting and drank a lot of water. Four patients presented with delirium/coma and 3 received physostigmine therapy with good response. One patient was intubated because of coma and respiratory depression. Three persons needed Foley catheterization for urine retention or coma status. One patient had a complication of urinary tract infection and antibiotic management. All patients recovered with no sequelae.
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PMID:Poisoning by Datura leaves used as edible wild vegetables. 1043 80


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