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

The nociceptive thresholds to mechanical and thermal stimuli in patients with chronic tension-type headache were compared. Palpation of pericranial tenderness was performed in 50 patients and a total tenderness score (TTS) was calculated. Palpation was repeated, and pressure pain thresholds (PPTs) were determined with a pressure algometer in the temporal and occipital regions. In 32 of the patients, pain thresholds for heat and cold and limens for detection of non-painful temperature changes were determined in the hands and the temporal regions. Twenty-four healthy volunteers served as controls. Scores obtained by manual palpation (TTS) at the first and second visit were positively correlated. A negative correlation between headache severity and PPT was found in the temporal region. A positive correlation between PPT in the temporal and occipital region was found, and PPT and TTS were negatively correlated. Thermal pain thresholds were consistently less extreme in patients compared to controls, and patients reporting severe headache on the examination day were those most sensitive to thermal pain. No difference was found between patients and controls with respect to detection of temperature changes. A correlation was found between PPT and the corresponding cold pain thresholds, but no correlation could be demonstrated between TTS and thermal pain thresholds. In conclusion, headache patients had decreased pain perception thresholds. Chronic tension-type headache might be a result of dysmodulation of nociceptive impulses, but it is likely that sensitized nociceptors also play a role.
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PMID:Pressure pain thresholds and thermal nociceptive thresholds in chronic tension-type headache. 278 74

A large hypertensive population of patients in general practice was used to assess the tolerability of nifedipine in previously untreated patients and was compared with other antihypertensive drugs in previously treated patients. A total of 3972 patients with a sitting diastolic blood pressure between 95 and 115 mmHg were treated with 20 mg nifedipine twice daily for 1 month. In non-responders the dose was increased to 40 mg twice daily for a second month; responders continued to take 20 mg twice daily. A total of 2772 patients had been previously untreated for hypertension, whereas 857 had previously been treated with beta-blockers alone or in combination and 346 had received diuretics alone or in combination. Adverse events were recorded for 28 days prior to treatment being initiated with or changed to nifedipine and for two 28-day nifedipine treatment periods. Flushing and headache, which diminished with time, occurred during nifedipine treatment. Ankle oedema did not diminish with time. Reductions were seen in occurrences of dyspnoea, impotence, lethargy and cold extremities.
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PMID:General practice data derived tolerability assessment of antihypertensive drugs. 280 16

Effects of smoking are highlighted in a posthoc analysis of this randomized, double-blind International Prospective Primary Prevention Study in Hypertension (IPPPSH). At the time of entry, 37% of the men and 23% of the women were smoking cigarettes, and only 537 patients changed their smoking status during the trial. In men and women, smoking doubled cardiac and cerebrovascular event rates. Nonsmoking men had fewer myocardial infarctions and sudden deaths when treated with oxprenolol. Smoking status did not affect in-study blood pressure control, the type of drugs, or the combinations used, but smokers were given higher doses of oxprenolol. For a given blood pressure during antihypertensive treatment, rates for cardiac and cerebrovascular events were higher in smokers. Heart rates were higher in both oxprenolol and non-beta-blocker-treated smokers. Smoking dose dependently increased hematocrit level. Among physician-elicited symptoms, dyspnea and cold extremities were more frequent in smokers, whereas dyspnea, headaches, impotence, dizziness, and anxiety states were common, with unsatisfactory blood pressure control (diastolic blood pressure greater than 95 mm Hg). Quality of life may be more jeopardized by smoking, poor blood pressure control, or diuretic use than by beta-blocker-based therapy. In the IPPPSH, the patient who smoked had double the cardiovascular complication rates without cardiac benefit from the beta-blocker despite higher doses given; the higher heart rate and hematocrit level may have been contributing factors.
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PMID:Impact of smoking on heart attacks, strokes, blood pressure control, drug dose, and quality of life aspects in the International Prospective Primary Prevention Study in Hypertension. 289 88

Patients with migraine who believed that red wine but not alcohol in general had a headache-provoking effect on them were challenged either with red wine or with a vodka and diluent mixture of equivalent alcohol content, both consumed cold out of dark bottles to disguise colour and flavour. The red wine, which had a negligible tyramine content, provoked a typical migraine attack in 9 of 11 such patients, whereas none of the 8 challenged with vodka had an attack. Neither red wine nor vodka provoked such episodes in other migrainous subjects or controls. These findings show that red wine contains a migraine-provoking agent that is neither alcohol nor tyramine.
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PMID:Red wine as a cause of migraine. 289 93

The long-term treatment of essential hypertension with terazosin, a new once-a-day alpha 1-adrenergic blocking agent, was evaluated in 364 hypertensive patients who received total daily doses of 1 to 40 mg for 3 weeks to 56 months. Consistent mean decreases in supine and standing systolic and diastolic blood pressures were observed throughout the study for patients treated with terazosin as monotherapy (supine, 9 to 12/10 to 13 mm Hg; and standing, 12 to 18/11 to 14 mm Hg) or in combination with other antihypertensive agents (supine, 12 to 16/12 to 15 mm Hg; and standing, 16 to 22/13 to 19 mm Hg). The most commonly reported adverse experiences were dizziness, headache, asthenia, cold symptoms, and nasal congestion. Adverse effects and metabolic disorders often associated with diuretics and beta blockers such as sexual dysfunction, hyperglycemia, hyperuricemia, hypokalemia, or adverse lipid effects were seen infrequently during long-term treatment with terazosin as monotherapy. Overall, terazosin was shown to be effective, safe, and well tolerated by most patients.
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PMID:Terazosin, a new selective alpha 1-adrenergic blocking agent. Results of long-term treatment in patients with essential hypertension. 290 Dec 67

The prevalence of certain symptoms (eye, skin and airway symptoms, headache, nausea, and fatigue) were studied among hospital workers with and without exposure to glutaraldehyde during cold sterilization work. The exposure to glutaraldehyde and formaldehyde was quantified by hygienic measurements in the breathing zone of the workers. Aldehydes were measured by a specific method, using sorbent tubes with Amberlite XAD-2 coated with 2,4-dinitrophenylhydrazine (2,4-DNF) and analyzed by liquid chromatography. The exposure measurements revealed that the present exposure to glutaraldehyde was intermittent and well below the Swedish occupational exposure limit. In spite of this low exposure, the exposed group exhibited a significantly increased frequency of skin and airway symptoms, as well as headache, in comparison with the unexposed group. A dose-response relationship between the frequency of exposure and the number of symptoms could also be demonstrated. No case of contact allergy to glutaraldehyde was found.
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PMID:Skin and respiratory symptoms from exposure to alkaline glutaraldehyde in medical services. 297 45

Headaches can be of sinugenic origin even if this cause may not be suspected from the case history. Endoscopy of the lateral nasal wall with rigid cold light endoscopes in combination with polytomography or computed tomography usually will reveal the underlying causes hidden from the unaided eye, the operating microscope, and standard x-ray examination. Small lesions in the lesser cells of the ethmoid complex may give rise to headaches, especially when located in the key areas of the ethmoid infundibulum or frontal recess. Many anatomic variations of the structures in the middle meatus can narrow the stenotic clefts even more and thus predispose to more or less intense contact of opposing mucosal surfaces. This may impede or block ventilation and drainage of the ethmoid and surrounding larger sinuses and thus affect those as well. After identification of these underlying causes, functional endoscopic sinus surgery with usually minimal operations often can provide dramatic relief of symptoms that may have been present for months or even years. The neuropeptides recently were newly identified as a group of mediators besides the neurotransmitters noradrenalin and acetylcholine. Substance P (SP) is one of the most important neuropeptides that we can identify in the human nasal mucosa. It mediates pain impulses to the cortex via afferent C fibers. Simultaneously from polymodal receptors in the nasal mucosa, local reflexes are mediated by SP via an axon reflex, causing vasodilatation, plasma extravasation ("neurogenic edema"), and hypersecretion. The receptors can be stimulated by chemical and caloric irritants and also mechanical irritants such as pressure. The pressure exerted on nasal mucosa by polyps or mucosal swelling due to other reasons in the ethmoid clefts, cells, and narrow spaces apparently can be enough to trigger an SP-mediated pain sensation via afferent C fibers. Over the axon reflex an initially small lesion may lead in a vicious circle to quite significant symptoms. The model of "referred pain" explains why the pain is not necessarily felt at its origin, but may be projected onto corresponding dermatomes. The pain-mediating function of SP can be blocked selectively by capsaicin, the pungent component of red pepper, which leads to desensitization of the receptors and degeneration of the afferent C fibers without affecting other sensory qualities. In patients with vasomotor rhinitis we were able to block all the patients' symptoms including headaches by topical administration of capsaicin. After identification of underlying causes with endoscopy and CT, lesions and contact areas should be operated upon if medical treatment fails.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Headaches and sinus disease: the endoscopic approach. 314 Jul 3

Orbital venous vasculitis has been suggested to cause characteristic periorbital pain in patients with pathologic changes in their orbital phlebograms. The orbital pain is characterized by being unilateral, not shifting side, boring and pressing, but not throbbing, increasing on eye strain, exposure to cold, or weather changes, and resistant to analgesics. It is ameliorated by steroids. Fifty patients with symptoms of orbital venous vasculitis were investigated for other symptoms that could be related to the vasculitis. When the 32 female patients were compared with a randomly selected age- and sex-matched control group, there was a significant increase of symptoms of chronic fatigue, cold feet, gut problems such as constipation and/or diarrhea, arthralgia, memory impairment, rotatory vertigo, spontaneous ecchymoses (all, p less than 0.0001), back pain (p less than 0.012), and thrombophlebitis (p less than 0.022) in the patient group. These symptoms, although commonly occurring, seem in these patients to be related to the vasculitis. Blood tests of the fifty patients showed signs of inflammation which did not disagree with the hypothesis of an immunologic cause of the orbital venous vasculitis.
Cephalalgia 1988 Dec
PMID:Systemic symptoms associated with orbital venous vasculitis. 321 27

The occurrence of perceptual disturbances in migraineurs, particularly during the headache-free interval, has been scrutinized rather rarely. This subject was studied via a mail survey in 134 patients presenting perceptual changes before or during their migraine attacks. The patients had to complete a 5-part questionnaire covering history, events before, during as well as after the attack, and the attack-free interval. Sensory alterations during the headache-free interval were not reported by 36.6% of the patients. Alterations of equilibrium and/or spatial orientation, mainly susceptibility to motion sickness, were present in 47.8%, increased sensitivity to cold or heat in 40.3%, intolerance of tight clothes or being touched in 34.3%, altered visual function in 32.8%, changes in olfactory acuity in 31.1%. These percentages show that these 5 types of interictal sensory disturbances may not be rare in migraineurs. The exact frequency of these symptoms and how they correlate with perictal phenomena, sex, age and disease characteristics has to be further studied.
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PMID:The sensorium of the migraineur. 322 63

A number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo-pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints.
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PMID:[Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician]. 328 78


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