Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Quantitative EMG from the right frontal and both temporal muscles was studied in 547 adults randomly selected from the general population. The study was part of a multifaceted, epidemiological study of different headache disorders. Surface EMG was recorded by an observer blinded to the persons' history of headache, previous illness and mental state. The present study provides data on amplitude and mean and median frequency levels in migraine and tension-type headache. Chronic headache sufferers had higher amplitude values at rest in their temporal muscles than migraineurs, subjects with episodic tension-type headache and subjects without any experience of headache, probably due to insufficient relaxation. Frequency values during maximal voluntary contraction were decreased in chronic headache subjects and decreased with increasing frequency of headache in the previous year, indicating that chronic fatigue and/or changed fiber type composition exist in frequent headache sufferers. During experimental cold and pain stimulation no significant differences between headache subjects and the rest of the population were detected. Only subjects without any experience of headache had increased amplitude values during pain stimulation. No significant relation of amplitude values to frequency of tension-type headache or migraine in the previous year was detected. In 66 subjects with actual headache amplitude values were increased in the frontal muscle during rest indicating increased tension. Moreover, amplitude values were decreased in both the temporal and the frontal muscles during maximal voluntary contraction indicating submaximal contraction during pain. The present study supports the importance of peripheral factors such as increased fatigability, morphological, and/or metabolic changes in the pathogenesis of tension-type headache. However, the diagnostic value of EMG in migraine and tension-type headache is limited.
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PMID:Quantitative surface EMG of pericranial muscles in headache. A population study. 752 41

After a single-blind, 4-week placebo run-in period, 161 patients were randomized to trandolapril 2 mg once daily (n = 54), nifedipine slow-release (SR) 20 mg twice daily (n = 55), or a combination of both drugs (n = 52) for 16 weeks. Morning predosing supine diastolic blood pressure (DBP) was the primary efficacy measurement. After 16 weeks the intention-to-treat analysis showed no significant difference in supine DBP (mean +/- SEM) between trandolapril (-12.4 +/- 1.5 mm Hg) and nifedipine SR (-15.3 +/- 1.4 mm Hg; p = 0.1). However, the combination therapy was more effective (-18.9 +/- 1.3 mm Hg). Normalized blood pressure at 16 weeks was seen with 54% on trandolapril, 63% on nifedipine SR, and 77% on the combination. Adverse events, possibly related to drug, were more common with nifedipine SR (34%) than with trandolapril (17%; p < 0.05), and in comparison with the combination (21%). Drug-related treatment emergent events, reported by more than 3% of patients (fatigue, palpitations, edema, migraine), were seen only in the nifedipine SR and combination groups. Trandolapril 2 mg proved a well-tolerated and effective antihypertensive agent, comparable to nifedipine SR 40 mg. Furthermore, the combination of the two drugs was shown to enhance the antihypertensive effect of the two compounds alone. Adverse events were less common with trandolapril and the combination than with nifedipine SR alone.
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PMID:Comparison of the efficacy and safety of trandolapril and nifedipine SR in mild-to-moderate hypertension. Investigator Study Group. 752 8

Caffeine is widely consumed in beverages to obtain mild CNS stimulant effects. Long term use produces tolerance to some of the pharmacological effects. Withdrawal of caffeine, even from moderate intake levels, can produce symptoms such as headache, fatigue and anxiety. Caffeine is used therapeutically in combination with ergotamine for migraine headaches and in combination with nonsteroidal anti-inflammatory drugs in analgesic formulations. Caffeine alone is used as a somnolytic, to treat various headache conditions, respiratory depression in neonates, postprandial hypotension and obesity, and to enhance seizure duration in electroconvulsive therapy. In some headache and in pain paradigms, caffeine may produce direct adjuvant analgesic properties, while in other headache conditions (perioperative, postdural puncture) caffeine may be effective by alleviating a manifestation of caffeine withdrawal. Other uses, such as to promote wakefulness, for respiratory stimulation and seizure prolongation, rely on central stimulant properties of caffeine. Effects of caffeine on the vasculature may contribute to the relief of some headaches and in postprandial hypotension. Blockade of methylxanthine-sensitive adenosine receptors is the currently accepted mechanism of action of caffeine.
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PMID:Pharmacological rationale for the clinical use of caffeine. 770 15

During the period of March-October 1993 Norplant was implanted in 58 women who appeared at first, third, and sixth monthly control examinations at the OB/GYN Service, US Army Hospital, Berlin, Germany. The six rods were inserted under local anesthesia within 4-5 minutes. The average age was 24.6 years, and they were counseled individually after watching a video film about the procedure. One month after the implantation the skin appeared normal without hematoma or infection. Only 2 women had a regular menstrual cycle in the course of six months, but no pregnancy occurred. 27 women (46.5%) reported at least one side effect. Most frequent was weight gain (21 cases, or 36.2%); other side effects were headache (8 cases, or 13.2%), loss of hair (5 cases, or 8.6%), mood changes (5 cases, or 8.6%), fatigue (2 cases, or 3.4%), decreased libido (1 case, or 1.7%), and nausea (1 case, or 1.7%). In women aged 20 years or younger fewer problems occurred than in older women (p 0.025). 54 women had also used oral contraceptives. 25 of these (46.3%) had side effects, i.e., headache, migraine, or nausea. There was an association between the side effects of Norplant and those of oral contraceptives (p 0.025). At the end of the study 86.2% of women (50) reported to be satisfied with Norplant, 10.3% of women (6) said they were not satisfied, and 3.4% of women (2) were undecided. Norplant was removed in 6 cases because of side effects. Among these were 3 women with heavy hair loss, 2 with mood changes, and 1 with increasing headaches. Almost 90% of the women accepted Norplant. It is very important to instruct women in detail about the action of Norplant and counsel them in order to reduce the rate of removals.
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PMID:[Norplant and its side effects]. 779 68

The prophylactic effect of tolfenamic acid and propranolol was studied in a randomized double-blind cross-over trial of 76 patients with migraine with or without aura. After a 4-week run-in period patients were randomly allocated to treatment with either tolfenamic acid 100 mg three times daily or propranolol 40 mg three times daily for 12 weeks. After a placebo wash-out period of 4 weeks the patients got the alternative drug for 12 weeks; 56 patients completed the study. Both drugs significantly reduced migraine attacks as judged from the reduction in the efficacy parameters (migraine hours, migraine days, and migraine intensity) in the treatment periods compared with the run-in period. No statistical significant difference in any efficacy parameter was found between the two drugs (level 2 alpha = 0.05, alpha = 0.10). The adverse effects showed no statistical difference in frequency between the 2 treatments. Twenty patients discontinued the study: 12 patients on propranolol and 8 patients on tolfenamic acid. Side effects were the cause of premature discontinuation of study medicine in 9 patients during propranolol treatment (dizziness, fatigue, and fall in blood pressure) and in 5 patients during tolfenamic acid treatment (gastrointestinal symptoms).
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PMID:Tolfenamic acid versus propranolol in the prophylactic treatment of migraine. 797 33

This article reviews, from the practitioner's point of view, more than 1 year of clinical experience of the use of subcutaneously administered sumatriptan succinate in the short-term treatment of migraine and cluster headache with regard to advantages and disadvantages of the drug. In accordance with the results of clinical trials, subcutaneous sumatriptan, also in the practitioner's hands, was found to relieve migraine headaches and all other symptoms associated with migraine in most patients and within a reasonable period. Adverse events, however, are common and were perceived by about 70% of the patients. The most common adverse events were pressure/stiffness in the neck and throat (32%), general tiredness (22%), pressure/tightness over the chest (21%), injection site reactions (16%), and tingling sensations in the head and arms (14%). Headache recurrence within 24 hours is a clinical problem not only for the patient but also for the prescribing physician. About every second (53%) migraineur using subcutaneous sumatriptan reports headache recurrence. Headache recurrence appears to be effectively treated by a second injection. Pending valid information about effects, adverse events, headache recurrence, and how to handle the autoinjector, the compliance and tolerability of subcutaneous sumatriptan appear to be most satisfactory among eligible patients with migraine.
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PMID:Clinical experiences from Sweden on the use of subcutaneously administered sumatriptan in migraine and cluster headache. 798 82

A new, autosomal dominantly inherited syndrome with a bleeding disorder was described in 1985 by Stormorken and his co-workers. In this multifaceted syndrome, there were the following integral components: thrombocytopathia, extreme miosis with Argyll Robertson-like traits, muscular fatigue, a tendency to spasms, asplenia, ichthyosis, dyslexia, etc. Headache with migraine traits was also present in the family in all 4 generations in which this syndrome had been observed. Nasal and conjunctival bleeding were part of the headache picture in some of the individuals exhibiting the hemorrhagic syndrome. While the attack-related bleeding disturbances only involved family members who also suffered from the hemorrhagic syndrome, the headache per se may seem to behave differently: The affected son's headache seems to have developed into a headache with tension headache traits, whereas the other, unaffected, son's headache has common migraine traits. The familial headache which in earlier generations clearly had migraine traits, therefore, may be inherited independently from the hemorrhagic disorder. In other words, a migraine or migraine-like headache is most probably not an obligatory integral part of this syndrome. The thrombocytopathia in this disorder comprises abnormal serotonin storage, uptake, and release (Stormorken and co-workers, to be published). The admittedly somewhat farfetched possibility also exists that the headache, although being similar to migraine, differs essentially from it and may be an expression of the serotonin aberration.
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PMID:The hereditary syndrome of thrombocytopathia, bleeding tendency, extreme miosis, muscular fatigue, asplenia, headache, etc. ("Stormorken's syndrome"): I. The headache. 801 39

In a mailed questionnaire to a sample of Norwegian women 36-55 years of age, 4.4% reported having fibromyalgia. Women with fibromyalgia often had multiple health problems. Compared with other women, more of them reported nervousness, migraine and tiredness. They had many consultations with medical practitioners, but were also frequent users of alternative medicine. Recovery from fibromyalgia was seldom reported. Women with fibromyalgia had especially poor self-rated health status. Many were receiving a disability pension, and the proportion of exists from the labour market was clearly higher among women with fibromyalgia than among women with other chronic diseases. As in the case of many other long-lasting diseases the prevalence of fibromyalgia was somewhat higher in lower than in higher socio-economic groups.
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PMID:[Self-reported fibromyalgia among women aged 36-55 years]. 819 67

Sumatriptan is a potent and selective agonist at the vascular 5HT1 receptor which mediates constriction of certain large cranial blood vessels and/or inhibits the release of vasoactive neuropeptides from perivascular trigeminal axons in the dura mater following activation of the trigeminovascular system. The mode of action of this drug in migraine and cluster headache is discussed. On the basis of a detailed review of all published trials and available data from post-marketing studies, the efficacy, safety, tolerability and the place of oral and subcutaneous sumatriptan in the treatment of both conditions are assessed. A number of double-blind clinical trials have demonstrated that sumatriptan 100 mg administered orally is clearly superior to placebo in the acute treatment of migraine headache and achieves significantly greater response rates than ergotamine or aspirin. In other studies, 70 to 80% of patients receiving sumatriptan 6 mg sc experienced relief of migraine headaches by 1 or 2 h after administration, and patients consistently required less rescue medication for unresolved symptoms. Sumatriptan was also effective in relieving associated migraine symptoms like nausea and vomiting. Sumatriptan was equally effective regardless of migraine type or duration of migraine symptoms. Overall, approximately 40% of patients who initially responded to oral or subcutaneous sumatriptan experienced recurrence of their headache usually within 24 h, effectively treated by a further dose of this drug. In 75% of patients with cluster headache treated with sumatriptan 6 mg sc, relief was achieved within 15 min. Based on pooled study data, sumatriptan is generally well tolerated and most adverse events are transient. Adverse events following oral administration include nausea, vomiting, malaise, fatigue and dizziness. With the subcutaneous injection, injection site reactions occur in approximately 30%. Chest syumptoms are reported in 3 to 5% but have been associated with myocardial ischaemia only in rare isolated cases. The recommended dosage of sumatriptan at the onset of migraine symptoms is 100 mg orally or 6 mg subcutaneously. The recommended dosage for cluster headache is 6 mg sumatriptan sc. Sumatriptan must not be given together with vasoconstrictive substances, e.g., ergotamines, or with migraine prophylactics with similar properties, e.g., methysergide. Sumatriptan should not be given during the migraine aura. It is contraindicated in patients with ischaemic heart disease, previous myocardial infarction, Prinzmetal (variant) angina and uncontrolled hypertension.
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PMID:Migraine and cluster headache--their management with sumatriptan: a critical review of the current clinical experience. 853 93

Syndromes characterized by chronic pain and fatigue have been described in the medical literature for centuries. Fibromyalgia is the term currently used to describe this symptom complex, and considerable research has been performed in the last decade to delineate the epidemiology, pathophysiology, and genesis of this entity. Although fibromyalgia is defined by its musculoskeletal features, it is clear that there are a large number of non-musculoskeletal symptoms, such that we now understand that there is considerable overlap with allied conditions such as the chronic fatigue syndrome, migraine and tension headaches, irritable bowel syndrome, and affective disorders. This article will review our current state of knowledge regarding fibromyalgia and these allied conditions, and present a unifying hypothesis that describes both the pathophysiology of symptoms and the genesis of these disorders.
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PMID:The pathogenesis of chronic pain and fatigue syndromes, with special reference to fibromyalgia. 858 67


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