Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind crossover study of the efficacy of disodium cromoglycate given by mouth to control the cutaneous, gastrointestinal and central-nervous-system manifestations of systemic mastocytosis was carried out in five patients for periods of eight to 32 months. In 15 of 18 trials, disodium cromoglycate produced marked amelioration of the clinical manifestations of pruritus, whealing, flushing, diarrhea, abdominal pain and disorders of cognitive function. By contrast, in all 19 trials with placebo, there was no improvement in these symptoms and signs. Histaminuria and peripheral-blood eosinophilia were unrelated to disease activity and were unaffected by drug therapy. Although it is poorly absorbed after administration by mouth, disodium cromoglycate is of clinical benefit to patients with systemic mastocytosis.
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PMID:Oral disodium cromoglycate in the treatment of systemic mastocytosis. 11 Nov 24

A variety of surgical procedures are available in the treatment of the carcinoid syndrome, the aim being the destruction of liver secondaries and amelioration of symptoms. Dearterialization of the liver may be considered when liver secondaries are extensive and medical treatment inadequate in controlling symptoms. The patient reported here had severe symptoms of epigastric pain, anorexia, flushing, diarrhoea and recurrent syncope and was generally deteriorating rapidly. Complete dearterialization of the liver, however, resulted in a dramatic improvement. Now, 2 years later, the patient's hepatic scan, liver function tests and 24-h urine 5-hydroxyindolacetic acid (5-HIAA) are all within normal limits. Destruction of liver secondaries by dearterialization is a relatively simple procedure. Careful attention should be paid to large quantities of pharmacologically active compounds released from the liver during the procedure. Ascites, jaundice and liver cell failure are definite contraindications to surgery.
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PMID:Complete liver dearterialization and the carcinoid syndrome. 45 92

Multiple endocrine neoplasia (MEN) type II is a genetically inherited disorder characterized by a combination of medullary carcinoma of the thyroid, phaeochromocytomas and, more rarely, hyperparathyroidism. A subgroup of patients who do not have the same genetic inheritance pattern have in addition a Marfanoid habitus and multiple mucosal neuromas. The phaeochromocytomas cause paroxysmal hypertensive crises due to catecholamine surges, and are diagnosed most easily by elevated levels of urinary vanillylmandelic acid. Medullary carcinoma presents as a thyroid nodule and is often associated with flushing or diarrhoea. Measurement of plasma thyrocalcitonin levels permits diagnosis and detection of affected members of the family. It is unusual for hyperparathyroidism to be asymptomatic or to require treatment. Bilateral adrenalectomy should always be performed since both adrenals are involved, even if an overt tumour is only apparent in one. Total thyroidectomy for medullary carcinoma is indicated once the phaeochromocytomas have been removed. Affected families should be regularly screened to detect overt cases.
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PMID:Multiple endocrine neoplasia: Part II. Sipple's syndrome. 55 Mar 88

Serial im injections of 15-methyl-prostaglandin F2 alpha (PGF2a) were used to abort 515 women 10-20 weeks' pregnant in a multicenter, multinational trial. Their mean age was 25, weight 55.3 kg, parity 1.4, and gravidity 2.7. The dosage of 15-methyl-PGF2a was 200 mcg, then 300 mcg every 3 hours for up to 30 hours. 79.3% successfully aborted within 24 hours, 35% were incomplete, and 4 received additional treatment. Mean abortion times were 13.7 hours in multigravidae and 15.7 hours in primigravidae. Side effects included vomiting (2.9 episodes each), diarrhea (2.8 episodes despite routine Lomotil medication), flushing in 14.2%, and cervical laceration in 3 (.6%). It is concluded that this method would best serve to supplement another abortion method that had failed.
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PMID:Prostaglandins and abortion. I. intramuscular administration of 15-methyl prostaglandin F2alpha for induction of abortion in weeks 10 to 20 of pregnancy. World Health Organization Task Force on the Use of Prostaglandins for the Regulation of Fertility. 92 Jul 59

This study examines the efficacy and side effects of 15-methyl-prostaglandins F2alpha (PGF2a) free acid administered intramuscularly for midtrimester abortion. 50 healthy women aged 14 to 37 years and between 12 to 18 weeks gestation were randomly selected from the abortion clinic at the Los Angeles County/USC Medical Center, Women's Hospital to participate in the study. The prostaglandin preparation was supplied in ampules containing 1.1 mg. in 2.2 ml. of aqueous solution. The injection was given every 2 hours until the fetus was expelled or for a maximum of 12 injections. Vital signs of the patients were closely monitored. 46% (23) of the subjects aborted within 12 hours and 90% within 27 hours. Mean injection-abortion time was 13.5 hours (range, 5 3/4 to 27 hours). The effectiveness and rapidity of abortion was related with gestational age: the lower the gestational age, the shorter the abortion time. Women with more than 17 weeks gestation had a higher failure rate. Mean number of injections was 7.5. 5 patients failed to abort with prostaglandin alone, all of them primigravidas and weighing in excess of 150 lbs; supplemental therapy was provided. Side effects and complications associated with 15-methyl-PGF2a included: emesis (66%); diarrhea (76%); flushing (12%); chills (4%); fever of 100 degrees Fahrenheit (12%); pain requiring medication (16%); and blood loss (6%). The success of this method appears to be related to dosage; parity; gestational age; weight of patient; and frequency of administration. Although there were side effects, these were outweighed by rapid abortion time, mild contractions, and ease of administration. Asthma is the only medical contraindication to prostaglandin therapy.
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PMID:Midtrimester abortion with intramuscular injection of 15-methyl-prostaglandin F2alpha. 113 40

APUDomas are rare tumours originating from a variety of endocrine cells localized in different organs. Acute complications from APUDomas usually result from the increased biosynthesis and release of bioactive amines or polypeptide hormones by the tumour. Less frequently, bleeding or compression by the tumour can occur requiring emergency surgery. Increased gastrin production by gastrinomas is the cause of ZES (peptic ulceration and diarrhoea) by gastrin effects on gastric acid secretion. Volume depletion, hypokalaemia, severe bleeding, duodenal perforation, oesophageal stricture and pyloric stenosis are the most dramatic complications. Treatment of these complications and their prevention has been facilitated by the availability of antagonists to H2 receptors and H(+)-K+ proton pump. These medications should control acid output in every patient with ZES. Frequent manifestations of carcinoid tumours, VIPomas and medullary thyroid carcinomas are flushing and diarrhoea. Octreotide, a long-acting somatostatin analogue, has markedly changed the management of these patients, their symptoms decreasing in severity or disappearing in most cases. Octreotide has also been used with success in the prevention and treatment of the carcinoid crisis, a dreaded complication of carcinoid tumours. A better understanding of the pathophysiology of APUDomas has enabled new treatment designs which have considerably ameliorated the quality of life of patients affected by these tumours; efforts must be continued to affect their life expectancy.
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PMID:APUDomas: acute complications and their medical management. 131 Aug 47

Octreotide, a long-acting somatostatin analogue has recently been introduced in the therapy of gastroenteropancreatic endocrine tumors, but home experience has been lacking. With the aim of drawing attention to this therapeutic possibility, a case of malignant carcinoid syndrome treated with octreotide for 18 months is reported. Despite the therapeutic attempts preceding the octreotide administration a gradual progression in clinical symptoms was observed and cardiac failure due to fibrotic and valvular heart disease developed. Cytotoxic chemotherapy, serotonin antagonists or repeated selective embolisation of the hepatic artery only resulted in a short transitional improvement. Octreotide in a dose of 100 micrograms three times daily by subcutaneous injection provided effective and rapid relief from episodic flushing and serious diarrhoea. Plasma level of serotonin and 24-hour urinary excretion of 5-hydroxyindolacetic acid decreased from 6 micrograms/ml to 2 micrograms/ml and from 800 mumol/day to 70 mumol/day, respectively. No changes in the number and extension of liver metastases could be seen after introducing the octreotide treatment. The patient's compensated cardiac status could be preserved and continuous therapy provided an acceptable quality of life.
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PMID:[Treatment of carcinoid syndrome with a somatostatin analogue]. 137 69

Survival in patients with metastatic carcinoid tumors is dependent on control of tumor growth and adequate palliation of vasoactive amine-induced symptoms of flushing, diarrhea, wheezing, and valvular heart disease. Eight patients with carcinoid tumors metastatic to the liver were treated with long-term octreotide acetate therapy (100 to 500 micrograms three times a day), intra-arterial 5-fluorouracil infusion (2 g/day x 5 days), and hepatic tumor chemoembolization. All eight patients became asymptomatic and have remained so with a mean follow-up duration of 22 months from the time of first infusion. Following institution of subcutaneous octreotide acetate, intra-arterial infusion, and tumor chemoembolization, all patients are alive with a mean survival of 40 months from the time of diagnosis of carcinoid syndrome (range: 2 to 108 months). Four patients had greater than a 50% decrease in tumor size after therapy (mean follow-up duration: 10.6 months), and the other four patients have had stable disease after institution of therapy. It appears that combinations of long-term subcutaneous administration of octreotide acetate, intra-arterial 5-fluorouracil, and tumor chemoembolization effectively control progressive liver metastasis and provide excellent symptomatic palliation in patients with hepatic metastasis from functional carcinoid tumors.
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PMID:Effective palliative treatment of metastatic carcinoid tumors with intra-arterial chemotherapy/chemoembolization combined with octreotide acetate. 137 22

26 patients with progressive neuroendocrine tumours received 3 x 10(6)U/m2 interferon alfa (IFN-alpha 2b) subcutaneously thrice weekly, until progression, as outpatients with moderate toxicity. 4/16 carcinoids and none out of 10 endocrine pancreatic tumours showed objective regression. Another 17 patients (68%) had no change. For a median of 34 weeks symptom control was excellent: 9 of 17 patients had major relief from pain, 11 of 13 from diarrhoea, and 7 of 7 from flushing. Thus, low-dose INF-alpha 2b given thrice weekly might be as effective as daily treatment with higher dosages. Treatment was only administered to patients with progression or major symptoms and this did not seem to adversely affect remission quality and survival.
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PMID:Antitumour effect and symptomatic control with interferon alpha 2b in patients with endocrine active tumours. 138 94

The efficacy of the repetitive intravenous dihydroergotamine (DHE) inpatient protocol for refractory headache is well established. We conducted a retrospective and prospective study of long-term headache patients at our clinic to evaluate this regimen in an outpatient setting. Treatment consisted of oral metoclopramide and four doses of DHE, with the total dose equaling 4 mg., administered over two days. Patients were followed for up to 10 weeks while they continued to receive prophylactic medication. Responsiveness was rated in terms of decreased frequency or severity of headache: excellent (75% to 100%), moderate (50-75%), mild (25-50%), and none (0-25%). In the retrospective study, 69% (43/62) of patients with chronic daily muscle-contraction-type headache and severe migraine had an excellent response at two days. An excellent or moderate response was sustained over three weeks in 65% (32/49) of the study group (13 patients were dropped from the study for failing to comply with record keeping requirements). At the 6- and 10-week follow-up evaluations, the majority of patients (76% and 70%, respectively) reported mild or no relief. Among patients with refractory daily headache or frequent severe migraine studied prospectively, 80% (28/35) reported an excellent response at two days. After six weeks, 66% (23/35) showed excellent or moderate relief. For both groups combined, 73% (71/97) of patients showed an excellent response to DHE at two days, with 43% (33/77) sustaining excellent or moderate relief at six weeks. Side effects, including nausea, leg cramps, facial flushing, increased blood pressure, diarrhea, burning at the injection site, and tightness in the throat and/or chest, were generally mild and transient.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Outpatient repetitive intravenous dihydroergotamine. 144 90


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