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

The potential of dopamine D(1) receptor agonists to have beneficial effects on cognitive function has been suggested by a body of preclinical evidence. We now report the use of dihydrexidine (DAR-0100), the first full D(1) agonist, in a pilot study assessing single low dose safety and tolerability in patients with schizophrenia. A within-subject cross-over design was used in 20 adults (18-65 years) with SCID-IV diagnosed schizophrenia. Subjects were outpatients with a moderate level of residual negative symptoms, and were on stable dosing of non-D(1)-blocking antipsychotic drugs. Following screening, subjects were hospitalized for 48 h, and at 0800 h each morning scanned on a 3 T MRI scanner for resting brain perfusion, followed by a Blood Oxygen Level Dependent (BOLD) fMRI scan during an N-Back working memory task. They then received 20 mg subcutaneously (SC) of dihydrexidine or placebo over 15 min, followed by 45 min of intermittent MRI scans of perfusion and BOLD activity during the working memory task. Blood was drawn for serum drug levels and subjects were evaluated for clinical and cognitive changes. The procedure was repeated using the opposite challenge 2 days later. Dihydrexidine was well tolerated with no serious adverse events although three subjects had mild dizziness and five subjects experienced nausea. There was no significant effect of drug on clinical interview ratings or delayed (afternoon) neuropsychological performance. No medication interactions were seen. Thus, a single subcutaneous dose of dihydrexidine is tolerated and safe in patients with schizophrenia and does not produce delayed clinical or neuropsychological improvements.
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PMID:A single 20 mg dose of dihydrexidine (DAR-0100), a full dopamine D1 agonist, is safe and tolerated in patients with schizophrenia. 1746 56

Assessing the requirements for in-flight oxygen in passengers with pulmonary limitations can be a challenging task for clinicians. Aeromedical guidelines are available to help identify passengers that may require oxygen in flight. However, little is known about the actual in-flight response to passengers on oxygen. We measured the oxygen response (pulse oximetry) of a 67-yr-old female patient with chronic respiratory failure during a trans-Tasman flight (duration 170 min). This patient was assessed at the respiratory clinic before her journey and resting PaO2 (57 mmHg) indicated the requirement for in-flight oxygen. Bottled oxygen delivered at 2 L x min(-1) via nasal cannula was prescribed for her journey. Preflight SpO2 without supplemental oxygen was 92%. Mean in-flight SpO2 was well maintained at 93% while on oxygen at rest. There were four significant hypoxic events, which included light physical activity while on oxygen (three events; SpO2 to 84%) and a visit to the lavatory (off oxygen; SpO2 to 70%). Dyspnea and dizziness were reported during the lavatory visit. This case illustrates the importance of a preflight medical screening for passengers considered at risk during air travel and provides insight into the response of oxygen supplementation during flight.
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PMID:Episodic hypoxemia in an airline passenger with chronic respiratory failure on supplemental oxygen. 1767 71

Junkyard training involves heavy, cumbersome implements and nontraditional movement patterns for unique training of athletes. This study assessed the metabolic demands of pushing and pulling a 1,960-kg motor vehicle (MV) 400 m in an all-out maximal effort. Six male, strength-trained athletes (29 +/- 5 years; 89 +/- 12 kg) completed 3 sessions. Sessions 1 and 2 were randomly assigned and entailed either pushing or pulling the MV. Oxygen consumption (VO(2)) and heart rate (HR) were measured continuously. Blood lactate was sampled immediately prior to and 5 minutes after sessions 1 and 2. Vertical jump was assessed immediately prior to and after sessions 1 and 2. During session 3 a treadmill VO(2)max test was conducted. No significant differences (p < 0.05) in VO(2), HR, or blood lactate occurred between pushing and pulling efforts. VO(2) and HR peaked in the first 100 m, and from 100 m on, VO(2) and HR averaged 65% and 96% of treadmill maximum values (VO(2)max = 50.3 ml x kg(-1) x min(-1); HRmax = 194 b x min(-1)). Blood lactate response from the push and pull averaged 15.6 mmol.L(-1), representing 131% of the maximal treadmill running value. Vertical jump decreased significantly pre to post in both conditions (mean = -10.1 cm, 17%). All subjects experienced dizziness and nausea. In conclusion, a 400-m MV push or pull is an exhausting training technique that requires a very high anaerobic energy output and should be considered an advanced form of training. Strength coaches must be aware of the ultra-high metabolic and neuromuscular stresses that can be imposed by this type of training and take these factors into consideration when plotting individualized training and recovery strategies.
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PMID:Metabolic demands of "junkyard" training: pushing and pulling a motor vehicle. 1768 75

Red blood cell transfusions are used to treat hemorrhage and to improve oxygen delivery to tissues. Transfusion of red blood cells should be based on the patient's clinical condition. Indications for transfusion include symptomatic anemia (causing shortness of breath, dizziness, congestive heart failure, and decreased exercise tolerance), acute sickle cell crisis, and acute blood loss of more than 30 percent of blood volume. Fresh frozen plasma infusion can be used for reversal of anticoagulant effects. Platelet transfusion is indicated to prevent hemorrhage in patients with thrombocytopenia or platelet function defects. Cryoprecipitate is used in cases of hypofibrinogenemia, which most often occurs in the setting of massive hemorrhage or consumptive coagulopathy. Transfusion-related infections are less common than noninfectious complications. All noninfectious complications of transfusion are classified as noninfectious serious hazards of transfusion. Acute complications occur within minutes to 24 hours of the transfusion, whereas delayed complications may develop days, months, or even years later.
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PMID:Transfusion of blood and blood products: indications and complications. 2140 83

Jamestown Canyon virus (JCV) is a mosquito-borne zoonotic pathogen belonging to the California serogroup of bunyaviruses. Although JCV is widely distributed throughout temperate North America, reports of human JCV infection in the United States are rare. This is the first report of human JCV infection detected in Montana, one of only 15 cases reported in the United States since 2004, when JCV became reportable. On May 26, 2009, a man aged 51 years with no travel history outside of Montana went to a local emergency department immediately following onset of fever, severe frontal headache, dizziness, left-sided numbness, and tingling. His blood pressure was elevated. Stroke was ruled out, oxygen was administered, medication was prescribed for hypertension, and the patient was sent home. One week later, the patient visited his primary-care physician complaining of continued neurologic symptoms consistent with acute febrile encephalitis and recent mosquito bites. Although West Nile virus (WNV) disease was diagnosed based on detection of WNV-immunoglobulin M (IgM) and G (IgG) antibodies, subsequent testing indicated that the WNV antibodies were from a past infection and that his illness was caused by JCV. The final diagnosis of JCV infection was based on positive JCV-specific IgM enzyme-linked immunosorbent assay (ELISA) results and a fourfold rise in paired sample JCV plaque reduction neutralization test (PRNT) titers. This finding represents a previously unrecognized risk for JCV infection in Montana; clinicians should consider JCV infection when assessing patients for suspected arboviral infections.
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PMID:Human Jamestown canyon virus infection --- Montana, 2009. 2161 30

Hydrogen sulfide is a toxic gas produced as a by-product of organic waste and many industrial processes. Hydrogen sulfide exposure symptoms may vary from mild (dizziness, headaches, nausea) to severe lactic acidosis via its inhibition of oxidative phosphorylation, leading to cardiac arrhythmias and death. Treatment is generally supportive. We report the case of a patient presenting with cardiac arrest secondary to hydrogen sulfide exposure treated with both hyperbaric oxygen therapy and therapeutic hypothermia to achieve full neurologic recovery.
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PMID:Utilization of hyperbaric oxygen therapy and induced hypothermia after hydrogen sulfide exposure. 2200 89

Cluster headache is a relatively uncommon primary headache. The exact aetiology of cluster headache is yet unknown. There are rare case reports of cluster like headache in patients who have had vascular insults, either in the form of a dissection or an ischaemic infarct. The case of a 73 year old man is presented, who had a transient ischaemic stroke with dizziness, vomiting, left leg weakness and non-specific occipital headache that resolved in one day. Two days later, he developed features of partial Wallenberg syndrome which was confirmed on magnetic resonance imaging. One day after the onset of Wallenberg syndrome, he developed typical features of cluster like headache ipsilateral to the stroke, site. The headache was treated with traditional therapy of cluster headache including high flow oxygen and verapamil. The patient responded well to the treatment. This case suggests a possible link of lateral medulla to cluster like headache etiology and further emphasizes that semiology of cluster headache can be secondary to central lesions.
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PMID:Cluster like headache in an elderly patient with lateral medullary infarct--does the clue lie somewhere else? 2235 43

Pulmonary hypertension is a disorder characterized by an increase in mean pulmonary arterial pressure (mPAP > 25 mmHg), which is responsible for the transport of blood from the heart to the lungs. Increased pressure leads to decreased flow of blood through the lungs and decreased oxygen deliverance throughout the body. The disorder causes right ventricular hypertrophy and can quickly lead to death, especially with the severe forms of pulmonary hypertension. Symptoms include fatigue, shortness of breath, dizziness and peripheral edema in the lower extremities. Symptoms are usually delayed in appearance and progress slowly, which leads to a late diagnosis and often a poor prognosis. Despite large advances in the last 10 years, there is still about a 15% annual mortality for diagnosed patients. Despite the number of medications available, there are still no cures for this fatal disease. Current therapies include endothelin receptor antagonists, prostacyclin agonists and cGMP-specific 3',5'-cyclic phosphodiesterase (PDE5) inhibitors or combinations. Recent strategies have shown promise in animal models to prevent the onset of pulmonary hypertension when it is induced. However, few of them show a sustained benefit in clinical trials. Strategies for the cure of this debilitating disease should be the focus of future research.
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PMID:Current and future treatment of pulmonary hypertension. 2238 53

Case. A 45-year-old man with a blank medical history presented at the emergency room with dizziness and cyanosis. Physical examination showed cyanosis with a peripheral saturation (SpO(2)) of 85%, he did not respond to supplemental oxygen. Arterial blood gas analysis showed a striking chocolate brown colour. Based on these data, we determined the arterial methaemoglobin concentration. This was 32%. We gave 100% oxygen and observed the patient in a medium care unit. The next day, patient could be discharged in good condition. Further inquiry about exhibitions and extensive history revealed that the patient used MDMA (3,4- methylenedioxymethamphetamine, the active ingredient of ecstasy). Conclusion. Acquired methaemoglobinemia is a condition that occurs infrequently, but is potentially life threatening. Different nutrients, medications, and chemicals can induce methaemoglobinemia by oxidation of haemoglobin. The clinical presentation of a patient with methaemoglobinemia is due to the impossibility of O(2) binding and transport, resulting in tissue hypoxia. Important is to think about methaemoglobin in a patient who presents with cyanosis, a peripheral saturation of 85% that fails to respond properly to the administration of O(2). Because methaemoglobin can be reduced physiologically, it is usually sufficient to remove the causative agent, to give O(2), and to observe the patient.
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PMID:Methaemoglobinemia Induced by MDMA? 2293 27

We report a Japanese breath-hold diver (Ama) who presented neurological disorders after diving. He repeated diving into 25-30 meters depth in the sea for 6 hours. After diving, he felt dizziness and unsteady gait. Neurological examination showed left quadrant hemianopia, bilateral limb ataxia and ataxic gait. Head CT revealed gas bubbles in the left parietal lobe. In CT scan on 3 days after onset, gas bubbles disappeared and low density areas were observed in the bilateral parietal lobes. Brain imaging (DWI, T(2)WI and FLAIR) demonstrated high intensity in the parieto-occipital lobes. Neither pulmonary barotrauma nor intracardiac shunt was detected. He was diagnosed as having neurological decompression illness and therefore underwent hyperbaric oxygen therapy. The pathogenesis of this case was considered to be microbubbles induced by decompression. The present case suggests that repetitive rapid surfacing from the deep sea causes neurological decompression illness even in the breath-hold diver.
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PMID:[Neurological decompression illness in a Japanese breath-held diver: a case report]. 2306 26


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