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

Dysequilibrium disorders such as dizziness, balance and gait changes, and falls are among the most common yet poorly understood medical problems for older persons. A recent analysis of data about people aged 65 and older indicates that dysequilibrium is one of most common diagnoses in short-stay hospitalizations, and it accounts for an average of 4.3 days of medical care. Older people without overt disease of any type tend to perform more poorly on balance tests than do younger people. Gait deficits in many older people are associated with considerable functional impairments. Deficits in postural control are associated with an increased risk of falling. Geriatric dysequilibrium disorders can be caused by one or more factors--vestibular, vascular, visual, neuromuscular, pharmacologic--each of which must be considered to understand and appropriately treat the dysequilibrium. The accurate identification of the cause of dysequilibrium must involve the testing of multiple, interacting systems. The literature suggests that often no clear cause for an older person's dysequilibrium can be found, and indicates the possible existence of presently unappreciated etiologic factors. Progress in understanding these problems probably has been stymied by the fact that only a small, select subgroup of older patients is referred to specialists in otolaryngology. Quite probably, considerable progress on the understanding of the cause, diagnosis, and treatment of geriatric dysequilibria would result from more extensive research collaboration between otorhinolaryngologists, geriatricians, epidemiologists, and other specialists.
Ear Nose Throat J 1989 Dec
PMID:The prevalence of dysequilibrium and related disorders in older persons. 269 17

Ginseng has been used as a tonic for mind and body. A large number of pharmacological studies on ginseng have been done and the variety of effects were shown. In this paper 2 cases of ginseng poisoning has been reported the effects on both eyes were mydriasis and disturbance in accommodation, and the systemic symptoms included dizziness and semiconsciousness, which may be associated with hyperexitability of the sympathetic nerves (adrenergic nerves) due to overdose ginseng.
Yan Ke Xue Bao 1989 Dec
PMID:[Eye symptoms due to ginseng poisoning]. 270 82

A study was conducted in Ibadan, Nigeria over a period of 11 years, 1 January 1976 to 31 December 1986, on 810 patients who agreed to use depo-medro progesterone acetate (DMPA) for contraception. DMPA is a long-acting injectable contraceptive agent which provides protection over a period of time. It is given on a 3-monthly basis, and is thought to be an ideal contraceptive agent for women who have a poor compliance with taking oral contraceptives or do not wish to run the risk of using an intrauterine device. The women's medical histories were recorded and each of the women were thoroughly examined; women with hypertension, diabetes mellitus, positive cervical cytology, or irregular menstrual patterns were excluded from the study. The women were given 3-monthly intramuscular injections, and at each visit all side-effects reported were recorded. If the patient decided to discontinue use, the reasons were also noted and recorded. The results of the study are as follows. 490 (60.5%) of the women had protection for between 3 months and 12 months; 230 (28.4%) had protection for 13-24 months; while only 90 (11.1%) had protection for 25-33 months. Side effects noted were amenorrhoea (36.3%), weight gain (15.8%) and loss (10.6%) abnormal bleeding patterns (12.7%), and minor symptoms such as headaches (2.5%), dizziness (1.5%) and palpitations (1.1%). Reasons for discontinuation included amenorrhoea (16.2%), abnormal bleeding habits, (7%), hypertension (2.2%), and/or the desire to get pregnant (2%). Further discussion is given to the use of DMPA as an enhancement for lactation and an effective option to oral contraceptives.
Afr J Med Med Sci 1988 Dec
PMID:Experience with the use of depo-medroxyprogesterone acetate in a Nigerian population. 285 67

Serum theophylline levels were measured in response to a single daily dose of Uniphyl in asthmatic adults who had previously received sustained-release theophylline preparations (usually Theo-Dur). Nine men and 20 women between the ages of 20 and 75 with a one-second forced expiratory volume (FEV1) of 30 to 75 percent of predicted and with at least 15 percent improvement in FEV1 following an inhaled beta-adrenergic agonist were enrolled. Patients with coexisting major organ system dysfunction were excluded. Maintenance prednisone in a dosage of 20 mg or less each morning and inhaled corticosteroids were allowed. The five-week study included a baseline week when the usual sustained-release theophylline was continued; theophylline blood levels were determined at six to 10 hours on the fifth day. Patients then switched to an equivalent dose of Uniphyl with single morning dosing. FEV1 and serum theophylline levels were observed weekly as during the baseline period. Side effects were carefully monitored throughout the study. Concurrent therapy included inhaled beta agonist in 28, oral prednisone in 11, and beclomethasone in one. Serum theophylline levels were remarkably stable during the four Uniphyl weeks and averaged 15 micrograms/ml. During this time, a small improvement in FEV1 occurred in weeks 2 and 4 (p less than 0.05). Only two patients reported substantial side effects--nervousness and slight morning dizziness--which responded to a downward adjustment of Uniphyl dosage. This study indicated that, in asthmatic patients previously receiving twice-daily theophylline therapy, switching to a daily single dose of Uniphyl maintained stable blood levels with a very low incidence of side effects and a modest improvement to FEV1 at the time of the normal serum peak of theophylline. This study suggests that Uniphyl can replace twice-daily theophylline dosing, which may result in improved patient compliance.
Am J Med 1985 Dec 20
PMID:Theophylline levels and clinical response in asthmatic adults receiving long-term Uniphyl. 286 79

Terazosin, a new selective long-acting alpha1-adrenergic blocking agent, has been shown to be an effective once-daily antihypertensive agent in four of five randomized double-blind placebo-controlled studies of patients with mild to moderate hypertension. In one trial, 24-h monitoring revealed that terazosin produced a sustained blood pressure lowering effect throughout the day. In three fixed-dose trials, steady patterns of blood pressure response during maintenance therapy indicated that tolerance to terazosin did not develop. Favourable changes in the plasma lipid profile were observed, while laboratory data suggested the development of haemodilution. Overall, terazosin was well tolerated. Asthenia, dizziness and peripheral oedema were significantly more common in patients treated with terazosin than with placebo.
J Hypertens Suppl 1986 Dec
PMID:Terazosin: a new alpha 1-blocker for the treatment of hypertension: a review of randomized, controlled clinical trials of once-daily administration as monotherapy. 288 73

The antihypertensive efficacy, lipid effects, and safety of doxazosin, a selective alpha 1-inhibitor for the reduction of coronary heart disease (CHD) risk in hypertensive patients, was assessed in a general medical practice setting. Seven hundred seventy-one patients were entered into the study, which involved three phases: (1) a 2-week baseline period, (2) an 8-week period in which patients received doxazosin, 1 to 8 mg once daily, and (3) a 4-week maintenance period. From baseline to final visit there was a highly significant 27% reduction (p less than 0.001) in calculated CHD risk based on the Framingham equation as a consequence of doxazosin's favorable effects on both blood pressure and serum lipid levels. Efficacy and toleration of doxazosin therapy were good to excellent in most patients. The investigators' global assessment of efficacy of once-daily doxazosin therapy was excellent or good for 82% of patients and fair or poor for only 18% of patients. After 12 weeks, 83% of the patients were considered therapy successes (sitting diastolic blood pressure either less than or equal to 90 mm Hg or greater than or equal to 10 mm Hg reduction not reaching less than or equal to 90 mm Hg) at a mean daily dose of 3.5 mg. Seventy-one percent achieved "normalized" blood pressure control (sitting diastolic less than or equal to 90 mm Hg with a decrease of greater than or equal to 5 mm Hg) at a mean dose of 3.1 mg once daily. By the final treatment visit, systolic/diastolic blood pressures of efficacy evaluable patients were reduced by 20.6/15.3 and 21.0/15.4 mm Hg from a mean baseline of 166/104 and 165/104 mm Hg in the sitting and standing positions, respectively (p less than 0.05). Total cholesterol was significantly decreased (p less than 0.01). Most side effects were mild or moderate and disappeared with or were tolerated on continued therapy. The investigators' global assessment of patient toleration of doxazosin treatment was excellent or good for 89% of the 763 patients evaluated and fair or poor for only 11% of patients. The most commonly reported side effects were headache (8%) and dizziness (7%). No clinically significant laboratory changes were apparent, and no trends were observed with regard to organ systems or correlations with dose or duration of treatment.
Am Heart J 1988 Dec
PMID:Clinical experience with doxazosin in general medical practice. 290 45

In order to evaluate the usefulness of urapidil in the treatment of severe hypertension and in the long-term treatment of essential hypertension, two open multicentre studies were performed. In one study, 34 outpatients with diastolic blood pressure exceeding 105 mmHg following treatment with a combination of a diuretic and a sympatholytic or a diuretic and a beta-blocker were additionally given 15-60 mg urapidil twice a day for 8 weeks or more. The responder rate was 73.5%. The pulse rate did not change throughout. Side effects such as dizziness and malaise were observed in five patients (14.7%), but they were slight and did not require withdrawal of treatment. The other study included 95 outpatients with essential hypertension (World Health Organization stages I or II), 15-60 mg urapidil twice a day for 1 year or more in monotherapy (n = 48) or in combined therapy with a thiazide (n = 47). Under both therapies, diastolic blood pressure was reduced significantly at week 4, further reduced at week 12 and remained stable until week 52. Responder rates were 82.9% in monotherapy and 78.4% in combined therapy. Two patients (4.2%) taking monotherapy and six patients (12.8%) taking combined therapy were withdrawn due to inadequate blood pressure control or to side effects. These results indicate that urapidil is useful in severe and in long-term hypertension.
J Hypertens Suppl 1988 Dec
PMID:Urapidil in patients with severe hypertension and in long-term treatment. 290 99

Vertical nystagmus may occur in caloric testing when only horizontal is expected. We examined this occurrence in 112 normal subjects and in 339 patients with dizziness. Vertical nystagmus was found in 29 percent of normals and in 12 percent of patients with dizziness, more often with hot than cool caloric stimuli and it is always accompanied by horizontal nystagmus. The finding occurred with peripheral and central nervous system diagnoses as well as with patients whose dizziness was considered psychogenic or was undiagnosed. Maximum slow component velocity (SCV) of vertical nystagmus was usually half or less than that of the nystagmus in the horizontal lead. The SCV time profiles of the nystagmus in horizontal and vertical leads differed considerably. Possible origins of vertical nystagmus are discussed. Whatever the origin, it is clear that the finding of vertical nystagmus in routine caloric testing does not automatically denote disease of the central nervous system.
Otolaryngol Head Neck Surg 1986 Dec
PMID:Vertical nystagmus in routine caloric testing. 303 61

A double-blind crossover trial comparing diltiazem (360 mg/day) and nifedipine (120 mg/day) for treatment of stable angina was conducted in 21 of 27 patients with proven coronary artery disease who completed the trial. All patients started with a 2 week placebo period followed by a random assignment to either drug treatment for 3 weeks and subsequent crossover to the other treatment. The two drug treatment periods were separated by a 1 week placebo washout phase and the study was completed with a 1 week placebo phase. There were no significant differences between patients' responses to diltiazem and nifedipine in relation to time to onset of angina, ST depression responses to exercise, heart rate or systolic or diastolic blood pressure. A total of 37 adverse effects were reported with nifedipine compared with 9 with diltiazem in the 22 patients in whom drug safety was analyzed. Additionally, two patients treated with nifedipine were withdrawn from study participation before crossover. There was a significant (p less than 0.05) difference with respect to incidence of edema (7 of 22 patients taking nifedipine, 1 of 22 taking diltiazem) and dizziness (7 of 22 patients taking nifedipine, 0 of 22 taking diltiazem). The most frequent adverse effect reported with diltiazem was rash (3 of 22 patients). Severe adverse effects were reported in four patients: in one with diltiazem (rash) and in three with nifedipine (palpitation in two and headache in one). A reduction in prescribed dosage was required in 37% of nifedipine-treated compared with 6% of diltiazem-treated patients. Efficacy measures were significantly improved above placebo levels by both diltiazem and nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)
J Am Coll Cardiol 1988 Dec
PMID:A randomized double-blind comparison of diltiazem and nifedipine in stable angina. 305 36

The chemical and pharmacologic properties, pharmacokinetics, drug interactions, clinical efficacy, adverse effects, and dosage of propafenone are reviewed. Propafenone is a class IC antiarrhythmic agent that is structurally similar to the beta blockers but that has only weak beta-blocking and calcium-channel-blocking activity. It is well absorbed after oral administration, but systemic bioavailability is only 12% after a 300-mg dose. Among extensive metabolizers (greater than 90% of the United States population), bioavailability seems to vary nonlinearly with dose and increases substantially with food; these effects are not seen in poor metabolizers. Elimination is primarily hepatic, with a mean elimination half-life after oral administration of 5.5 hours in extensive metabolizers and 17.2 hours in poor metabolizers. The relationship between plasma propafenone concentration and clinical response varies considerably among individual patients; therefore, plasma concentrations have limited usefulness in predicting efficacy or electrophysiologic effects. Propafenone is effective in treating ventricular tachycardia and in suppressing premature ventricular complexes (PVCs). It is less effective in the treatment of refractory ventricular tachycardia. Concurrent administration of digoxin, warfarin, or metoprolol with propafenone has been shown to increase the serum concentrations of those three drugs, while cimetidine slightly increases the propafenone concentrations. Additive pharmacologic effect can occur when lidocaine, procainamide, and quinidine are combined with propafenone. Overall, 21% to 32% of patients experience adverse effects, with 3% to 7% of these serious enough to warrant discontinuing therapy. The most common adverse effects are dizziness or lightheadedness, metallic taste, and nausea and vomiting; the most serious adverse effects are proarrhythmic events.(ABSTRACT TRUNCATED AT 250 WORDS)
Clin Pharm 1988 Dec
PMID:Propafenone: a new antiarrhythmic agent. 306 20


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