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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study was made of 309 randomly selected potential service recruits seen over five years by different consultant physicians in an Army hospital. Only nine of 133 referred with a history of asthma were turned down because of an abnormality in their exercise lung function test. Only four of 92 referred for a systolic heart murmur were rejected. Only one was turned down because of a headache or migraine out of 30 referred with that diagnosis. None of nine with supposed high blood pressure nor of five with a past history of pneumothorax was rejected. Of seven referred because of epilepsy, all five with definite evidence of this were turned down. The predictability of the specialist decision in these conditions suggests that more than 80% of all potential recruits referred to hospital with medical problems (at least 800 people yearly in UK) do not need to attend.
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PMID:Potential recruits in medical outpatients--an audit. 226 35

Forty-six of 152 consecutive adult rhinitis patients had perennial nonallergic rhinitis (PNR). Eighty-five percent of those with PNR presented with nasal congestion, whereas 15% presented with rhinorrhea. Their mean age was 40.5 years (range = 21-77), and 74% were female. Patients with perennial nonallergic rhinitis in this series were characterized by ocular pruritus or burning, 28%; frontal headache, 22%; symptoms consistent with asthma, 33%; an unremarkable nasal mucosa, 96%; the absence of nasal polyps, 100%; nasal eosinophilia (greater than or equal to 5%), 10%; nasal neutrophilia (greater than or equal to 25%), 22%; numerous nasal bacteria, 12%; sinusitis, 6%; and a geometric mean IgE of 26.4 U/mL. This experience suggests that PNR is a common problem in a general allergy practice. Nasal obstruction, usually more difficult to treat than rhinorrhea, is the dominant symptom. Unexpected findings were frequent conjunctivitis and nasal neutrophilia.
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PMID:Perennial nonallergic rhinitis: a retrospective review. 248 Jul 28

The recent development of new drug therapies for headache disorders has allowed for the tailoring of treatment to specific patient needs. This paper reviews the pharmacologic management of patients with both headache and concomitant medical illness. The discussion specifically includes the treatment of hypertension, coronary artery disease, mitral valve prolapse, asthma, peptic ulcer disease, obesity, and chronic Epstein-Barr virus infection, occurring concomitantly in patients with headache. Medications that can exacerbate either the headache or concurrent medical condition are noted, and alternative therapies are advised.
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PMID:Management of the headache patient with medical illness. 252 Mar 92

We assessed the efficacy and side effects of oral enprofylline in the maintenance therapy of 206 asthmatics 19 to 71 yr of age. After a 1-wk placebo run-in, patients were randomized to receive in double-blind fashion one of three doses of slow-release enprofylline tablets (150 mg, 300 mg, or 450 mg twice daily) or matching placebo for 4 wk. At baseline, mean (SD) peak expiratory flow rate (PEFR) was 62 (19)% of predicted normal values. The mean increase in morning PEFR 12 h after dosing was: for 450 mg, 14(17)%; for 300 mg, 8(23)%; for 150 mg, 2(11)%, for placebo 0(10)%. The increases over baseline for 450 mg and 300 mg compared with 150 mg and placebo were statistically significant. The mean asthma symptoms score (scale zero to 3) exhibited a dose-related reduction. Significantly less beta 2-receptor agonist inhalations were used in the 450-mg group than in the placebo group. There was a statistically significant increase in headache and nausea with the doses 450 mg and 300 mg given twice daily during the first treatment week compared with 150 mg and placebo. Subsequent to the first week, there were no differences between the active treatments and placebo with respect to the incidence of these and other side effects. We conclude that oral enprofylline, in a dosage of 300 to 450 mg twice daily is an effective and well-tolerated drug that may be useful in the maintenance therapy of asthma.
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PMID:A placebo-controlled dose-response study of enprofylline in the maintenance therapy of asthma. 264 7

1. To test whether nifedipine reduces corticosteroid requirements of patients with asthma, a 16-week double-blind crossover trial comparing nifedipine with placebo was performed. 2. Eight females and seven males with corticosteroid-dependent asthma were studied, ranging in age between 20 and 65 years (mean = 45 years). 3. Results showed that in 12 of 15 patients, nifedipine caused significant reduction in corticosteroid requirements when compared with placebo (P less than 0.01). No side-effects were reported apart from mild headache and leg oedema observed in a few patients receiving nifedipine. 4. It could be concluded that nifedipine has a steroid-sparing effect in steroid-dependent asthma.
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PMID:Nifedipine in corticosteroid-dependent asthma: preliminary study. 268 Jan 86

Theophylline has been demonstrated to be a useful agent in the therapy of chronic asthma. Its use must be tempered with knowledge of its adverse effects and that these effects are related primarily to serum concentration. Accordingly, it is mandatory to monitor serum theophylline concentrations on a regular basis with any patient receiving maintenance therapy with theophylline. It is also necessary to recognise the potential side effects of theophylline therapy, and when such a patient displays symptoms of vomiting, headache or seizures, serum theophylline concentration must be checked even if a recent concentration was within the therapeutic range. The means for monitoring theophylline concentrations are now available even to the average physician who does not have immediate access to a laboratory that can provide timely serum theophylline determinations.
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PMID:Therapeutic monitoring of theophylline. Rationale and current status. 268 38

In this paper we propose a method and discuss the type of data required to estimate age incidence rates from population survey data. While surveys are typically designed to estimate the prevalence of a disease or medical condition, they can also be used to estimate incidence rates. A limitation of survey data, however, is that recall is prone to errors. Three types of errors are common: telescopic, false negative, and false positive reports. Telescopic reports are thought to be the most common. We propose a method to adjust for recall errors by modeling the reported age of onset (ONST) and the time interval since the reported first occurrence of the medical condition (LAG). A number of models were examined using migraine headache data from over 10,000 subjects in Washington County, Maryland. Population surveys should be considered as a relatively inexpensive means for estimating the age incidence of medical conditions, especially for symptom based problems like back pain, asthma, mental illness, and serious headache. We recommend that data be collected on variables which can be used as surrogates for the different types of recall errors. Specifically, the age at interview, the date when the condition was cured or in remission, the severity of the condition, and possibly a specific inquiry as to how certain the respondent is in reporting the date of medical events, should be considered for this purpose.
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PMID:Estimating age incidence from survey data with adjustments for recall errors. 278 70

A case of large epidermoid located in the fourth ventricle is presented, and the patient's uncommon symptomatology of bronchial asthma-like episode is discussed. The value of magnetic resonance imaging (MRI) is also emphasized in the diagnosis of intracranial epidermoid. A 41-year-old male noticed nausea and vomiting on getting up in the morning about 5 years ago. This was followed by bronchial asthma-like dyspnea one year later. About one week prior to admission, headache and gait disturbance started. On neurological examination, he had choked disk and horizontal nystagmus at lateral gaze bilaterally. His gait was slightly ataxic. Computerized tomography (CT) showed a low density mass with a sharp and irregular margin in the mid-portion of the posterior fossa. That lesion was not enhanced with contrast medium. The MRI appearance was that of an inhomogenous and low signal intensity mass with a slightly irregular margin on T1-weighted spin echo (SE) sequences using TR500 msec/TR30 msec (TR500/TE30). The tumor extended into the aqueduct upward and the C1 level of spinal column downward. T2-weighted SE sequences using TR2000/TE90 showed an inhomogenous and high intensity mass with an irregular margin more apparent than in normal brain tissue. The patient was tentatively diagnosed as having a large fourth ventricle tumor. Suboccipital craniectomy was carried out on 4, March, 1988. The tumor was removed totally and histologically, it turned out to be epidermoid. He was discharged without neurological deficit 2 months after surgery. First, with respect to clinical symptomatology, as specified by Bailey, it is characterized by difficulty in standing or walking, vertigo, and less constantly, psychic disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of epidermoid in the fourth ventricle associated with bronchial asthma-like symptom]. 281 68

Ever since xanthines were introduced into asthma therapy, more than 125 years ago, their therapeutic effectiveness has been explained as being due to extrapulmonary rather than, or in addition to, pulmonary drug actions. This article emphasizes that theophylline may have several potentially important effects in the lung. Theophylline relaxes the smooth muscle of large and small airways in humans and animals. Its relaxant effect is relatively independent of the type of mediator that constricts the airway. This suggests that functional antagonism, rather than specific pharmacologic mediator antagonism (e.g., adenosine antagonism), explains its bronchodilator effect. The consistent relaxant property of such xanthines as theophylline distinguishes these compounds from many other classes of established and experimental bronchodilator agents. Furthermore, many anti-inflammatory effects have been noted, suggesting that xanthines might be considered as prophylactic agents. Theophylline may not only attenuate the activity of stationary and blood-borne pulmonary inflammatory cells; it may also exert an anti-inflammatory action by directly affecting targets such as the epithelial lining (increasing the mucociliary transport rate) and the microvasculature (possibly reducing plasma exudation). The experimental anti-inflammatory pharmacology of theophylline is compatible with the observation that theophylline inhibits late pulmonary reactions in patients with atopic asthma and in sensitized animals challenged with allergen. The mechanism(s) of action behind the pulmonary actions of theophylline has not been assessed (neither phosphodiesterase inhibition nor adenosine antagonism may be involved). Central nervous system, gastroesophageal, renal, and metabolic actions of theophylline are briefly reviewed. Headache, nausea, and the relaxation of the lower esophageal sphincter can perhaps be classified as nonexcitatory and inhibitory effects in which the mechanism(s) of action is unknown.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Overview of effects of theophylline. 287 16

The bronchodilator effect of three successive stable plasma terbutaline levels was studied in 10 children with asthma. Each terbutaline plateau was achieved by giving a rapid intravenous infusion of terbutaline, 0.9 microgram/kg, followed by a continuous infusion for 2 hours. Mean plasma terbutaline concentrations (18, 36, and 53 nmol/L at the three plateaus) were found to correlate linearly with the maintenance dose of terbutaline (2.4, 4.5, and 6.3 micrograms/kg/hr, respectively). Mean forced expiratory volume in 1 second increased from 65% to 96%, and mean forced mid-expiratory flow from 32% to 71% of the predicted normal value during the study (p less than 0.01); maximum bronchodilation was obtained at mean terbutaline levels of about 30 nmol/L (range 20 to 60). Effective plasma terbutaline levels were associated with side effects such as headache and tremor in all patients. In addition, heart rate increased from 84 to 116 beats/min, systolic blood pressure rose from 115 to 129 mm Hg, and diastolic blood pressure dropped from 72 to 61 mm Hg during the study. We conclude that a loading dose of 2 micrograms terbutaline per kilogram of body weight over 5 minutes, followed by a continuous infusion of 4.5 micrograms terbutaline per kilogram per hour, is suitable for treatment of severe bronchoconstriction in children. Because of interindividual variations in drug metabolism and clinical effect, dose adjustment should be evaluated at regular intervals.
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PMID:Dose-response relationships of intravenously administered terbutaline in children with asthma. 291 94


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