Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
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In clinical trials performed in Italy, 2,003 patients, suffering from various infectious diseases, have so far been treated with ofloxacin. In most cases dosages of 200 mg, 300 mg or 400 mg b. i. d. have been used. In all, 130 adverse reactions have been recorded in 116 patients (5.8%): gastrointestinal events (mostly nausea, vomiting and gastric pain) in 4.8% of the patients, neurological events (mostly headache and insomnia) in 0.7%, cutaneous reactions in 0.4% and others in 0.5% cases. The drug-event causal relationship was assessed by the investigators as unlikely in 5.0% of the events, as possible in 47.1%, as probable in 31.4% and as almost certain in 16.5%. The severity of adverse reactions was judged as mild in 55% of the cases, as moderate in 38% and as severe in 7%. In 30 patients (1.5%), treatment was discontinued because of occurrence of side effects. Abnormal laboratory values probably related to treatment were reported in 25 patients (2.1%). Ofloxacin is well tolerated and shows a safety profile comparable with that of the best tolerated oral antibacterials.
Infection 1986
PMID:Safety profile of ofloxacin: the Italian data base. 295 62

Septic shock and invasive infection are diseases caused by humoral mediators of both exogenous and endogenous origin. The search for and identification of these factors has led to the discovery and molecular cloning of cachectin. This pyrogenic cytokine is identical to tumor necrosis factor (TNF) and, when released into the circulation, causes profound shock and multiple organ injury. Cachectin antibodies protect against the lethal effects of mice given endotoxin and baboons given E. coli, a result suggesting that this mediator is both necessary and sufficient to provoke septic shock. Cachectin is produced in humans after endotoxin infusion; the infusion of small doses of TNF is associated with fever, rigors, headache, and hypotension. Septicemic patients also produce cachectin, and during meningococcal infection, patients with the highest serum levels of cachectin die. Chronic cachectin production causes a potentially lethal syndrome of cachexia, anemia, and protein and lipid wasting. Future investigation is being directed toward the development of cachectin antibodies for use in treating the humorally mediated systemic complications of infectious disease.
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PMID:Cachectin: a hormone that triggers acute shock and chronic cachexia. 327 61

This pilot study was carried out on 23 gynaecological patients suffering from salpingitis, salpingitis and pelviperitonitis, Douglas' abscess, and vaginal stump abscess. 21 courses were evaluable for clinical efficacy. The diagnoses had been established mainly by pelviscopy and by clinical gynaecological examinations. The dosage was 2 X 500 mg ciprofloxacin orally every 12 h for 7.6 (5-11) days. Cervical smears collected before therapy revealed the most common pathogens to be Escherichia coli and staphylococci, followed by Proteus mirabilis and streptococci. Clinically ciprofloxacin produced a complete cure in 16 patients (76%), and a clear improvement in four patients (19%). One patient left hospital before completing the therapy. Laboratory tests did not reveal any pathological findings, and ophthalmological examinations (fundoscopy, visus, colour perception) on 16 patients, before and after treatment, likewise did not show any changes. In one patient, therapy had to be discontinued after three days because of pruritic exanthema and vertigo. A second patient complained of strong pain behind the eyes and headache. In both patients these symptoms disappeared completely on discontinuation of treatment. The study showed clinical efficacy of orally administered ciprofloxacin in pelvic inflammatory disease.
Infection 1988
PMID:Is pelvic inflammatory disease an indication for treatment with ciprofloxacin? 328 15

Sinusitis is common in allergic children. We are now aware that the commonest presentation of this disorder in the pediatric age group is persistent cough and purulent rhinorrhea. Headache and facial tenderness, frequently noted in adults with sinusitis, are not common. Much remains to be learned about diagnostic techniques and therapy of sinusitis. Nasal cytology can be valuable for discriminating between allergic and infectious disease, but lacks both sensitivity and specificity. Although there is a high correlation between radiographs showing significant sinus membrane thickening or clouding and recovery of bacteria from antral taps, it is possible to see positive films in asymptomatic individuals. Similarly, films may be unremarkable, although the history and physical examination yield convincingly positive evidence for sinus infection. The clinician must sometimes decide on therapy when the diagnosis is not definitive. Antimicrobial therapy for sinusitis should be given for 3 to 4 weeks in many cases. Amoxicillin remains a good choice for therapy, but antibiotics capable of clearing infections by beta lactamase-producing bacteria should be considered in refractory situations. The value of antihistamines, decongestants, nasal steroids, and cromolyn sodium are unstudied at this time. If several antibiotic courses fail to alleviate the signs and symptoms of sinusitis, surgery is indicated. Antral lavage and creation of nasoantral windows is the usual approach in children. Patients with sinusitis often have concurrent middle ear disease. Patients with current sinusitis have a higher incidence of immunoglobulin disorders than found in a normal pediatric sample. It appears that patients with sinusitis are more often allergic than would be expected from 2 typical population distribution. More evaluation is needed to clarify these associations.
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PMID:Sinusitis in children. 328 28

In the vast majority of cases infections of the paranasal sinus system are rhinogenic. Usually these spread via the middle nasal meatus and the anterior ethmoid to the dependent larger sinuses, especially to the frontal and/or maxillary sinus. If a sinusitis does not heal or is constantly recurring, a focus of infection has remained in a stenotic cleft of the lateral nasal wall, irritating nasal function and where from infection time and again may spread to the dependent sinuses. These Infection foci may be very circumscribed and limited, and not always must present with the typical triad of sinusitis symptoms: pathological secretion, nasal obstruction and cephalgia. Frequently only one of these symptoms prevails. By the means of nasal endoscopy and polytomography these foci can exactly be localized. After clearing the infection foci, which easily can be achieved under endoscopic guidance, mucosal function usually is restored and the dependent larger sinuses heal without having been touched.
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PMID:[Role of the lateral nasal wall in the pathogenesis, diagnosis and therapy of recurrent and chronic rhinosinusitis]. 330 29

Infection with Ehrlichia canis should be suspected in patients with fever, headache, malaise, leukopenia, thrombocytopenia, and a history of recent exposure to ticks. The cytopenia is caused by bone marrow hypoplasia which may be severe. The disease may be confused with spotless Rocky Mountain spotted fever but can be differentiated from this infection serologically with acute and convalescent sea. In humans, recovery has occurred with and without antibiotic therapy. However, prompt antibiotic therapy is advised prior to serologic studies, especially in immunocompromised individuals, splenectomized persons, and patients with AIDS-who may develop a more overwhelming rickettsial infection.
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PMID:Ehrlichiosis: a cause of bone marrow hypoplasia in humans. 336 36

We reviewed the case notes of 23 adult patients infected with Salmonella typhi and admitted to the infectious disease unit, Auckland Hospital between January 1977 and December 1984. Fifteen had typhoid fever and eight were chronic carriers of S typhi. All isolates were sensitive to amoxycillin, chloramphenicol and cotrimoxazole. Ten of those with typhoid fever had recently been in tropical countries, predominantly Pacific Islands. The remaining five all lived in South Auckland and had not travelled out of New Zealand: we suspect that contaminated shellfish collected from the Manukau Harbour in South Auckland were the source. Typhoid fever should be suspected in young travellers returning to New Zealand with fever, diarrhoea, abdominal pain and headache. Similarly this diagnosis should be suspected in Polynesians and Maoris from South Auckland who have not travelled. All but one patient with typhoid fever responded clinically to the initial regimen which was usually oral amoxycillin given for a median 18 days. One other patient relapsed. Cholescystectomy and subsequent oral antibacterials eradicated S typhi from five biliary carriers with abnormal gallbladders. Prolonged high dose oral amoxycillin alone was effective in one of two carrier patients with normal gallbladders. The role of the Department of Health in identifying carriers of S typhi remains important.
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PMID:Salmonella typhi infection in adults is not limited to travellers returning from the tropics. 346 68

Infection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well-developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long-term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism.
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PMID:Osteomyelitis of the base of the skull. 348 33

A multi-centered clinical study was carried out to evaluate the efficacy of ofloxacin in otorhinolaryngological infections in Japan. Ofloxacin was used at a dosage of 300 mg to 800 mg daily for three to 20 days in 206 cases of various infectious diseases in the otorhinolaryngological field such as otitis media, external otitis, paranasal sinusitis, tonsillitis and pharyngolaryngitis. Its efficacy rate was 79.9%. Minor side effects were seen in three cases (1.5%), gastro-intestinal disorders in two and headache in one. The antibacterial activity of ofloxacin was compared with the activity of pipemidic acid, nalidixic acid and norfloxacin against clinically isolated microorganisms. Ofloxacin was highly superior to pipemidic acid and nalidixic acid, and slightly more active than or equivalent to norfloxacin.
Infection 1986
PMID:Clinical efficacy of ofloxacin in the treatment of otorhinolaryngological infections. 354 57

The Ehrlichia are tick-borne rickettsial organisms that cause disease in animals throughout the world but that have been previously recognized as human pathogens only in Asia. We have identified six patients with serological evidence of recent infection with an Ehrlichia: a fourfold or greater rise or fall in titer to Ehrlichia canis. All of the patients reported recent tick bites. Rigors, myalgia, headache, nausea, and anorexia were each reported by five patients. Fever was present in all patients and was accompanied by relative bradycardia and leukopenia in five patients, thrombocytopenia and abnormal liver function test results in four, and anemia in three. Five of the six patients were treated with tetracycline hydrochloride, and all recovered. Infection with Ehrlichia should be considered in patients with unexplained febrile illnesses after tick exposure.
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PMID:Unexplained febrile illnesses after exposure to ticks. Infection with an Ehrlichia? 358 28


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