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

Enoximone, a new phosphodiesterase-inhibitor with positive inotropic and vasodilating activities is available for intravenous use in patients with severe heart failure. A review of the current knowledge regarding the adverse effects of this substance reveals that they are characterized by cardiovascular, central nervous, and gastrointestinal side effects. Adverse effects occurred in 20% of patients and were mostly due to the pharmacological properties of enoximone. Cardiovascular side effects (10%) were the most frequent; ventricular and supraventricular arrhythmias were most common. Two to three percent of the patients experienced hypotension due to the vasodilator activity of enoximone. Headache, insomnia, and anxiety were the most frequent adverse effects on the central nervous system. Three percent of the patients treated experienced vomiting, nausea, abdominal pain, and diarrhea. An increase of liver enzymes and serum glucose could be observed, mostly in patients with previous liver disease or diabetes. Pharmacokinetic drug interactions are not known; possible pharmacodynamic interactions result from the pharmacological properties of the drugs. Intravenous therapy with enoximone causes a few serious side effects that can only be controlled by careful observation of the patients treated.
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PMID:[Tolerance of enoximone in patients with heart failure]. 183 4

The analysed clinico-biological manifestations, evolutive course and treatment of 30 patients with GCA are presented. The most frequent symptoms were fever and headache. 33% of patients had FOD criteria. 26% had various visual alterations. All patients were initially treated with steroids. Of the 26 patients followed up, 21 (81.7%) experienced some sort of complication: Cushing iatrogenic, osteoporosis, vertebrae collapse, aseptic necrosis of the femur head, arterial hypertension, diabetes mellitus, hyperlipidemia, steroid myopathy. 6 patients were treated with cyclophosphamide, following severe complications secondary to steroid therapy, and all of them had a good clinical evolution.
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PMID:[Giant-cell arteritis: the clinico-biological manifestations and the complications secondary to steroid treatment]. 191 67

A spectrum of presentation of phaeochromocytoma in black South Africans is described. Ten patients were reviewed over a 9-year period. Sweating, headache, and palpitations were prominent symptoms in 9 patients; postural dizziness occurred in 5; gastro-intestinal symptoms in 7; diabetes in 3; and hypertension in all. One patient developed a phaeochromocytoma crisis, characterised by hypotension and pulmonary oedema, before operation. One woman presented in pregnancy. Urinary vanillylmandelic acid was elevated in 9 out of 10 subjects tested; plasma catecholamines were elevated in 6 out of 6 tested. Computed tomography detected 7 adrenal tumours and 3 paragangliomas. All patients were stabilised pre-operatively with alpha- and/or beta-receptor blockers. Intraoperative pressor crises were controlled with sodium nitroprusside, phentolamine, or magnesium sulphate infusions. At operation all tumours appeared benign, each was successfully removed, and the diagnosis confirmed on histological examination. There was no operative mortality. Two patients had residual hypertension. This study highlights the various challenges presented by this catecholamine-producing tumour.
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PMID:Phaeochromocytoma. A report of 10 patients. 199 41

Temporal (giant cell) arteritis is a systemic granulomatous vasculitis primarily involving branches of the carotid arteries in patients aged 50 years and greater. Its classic symptoms and signs are headache and elevated erythrocyte sedimentation rate (ESR), but this is not the only presentation. This case is the first reported in a Korean, whose chief complaint was pain in the tongue and headaches and whose ESR was normal. The diagnosis was confirmed by biopsy. Her symptoms abated when treated with prednisone, but she developed diabetes mellitus, osteoporosis, and compression fracture of lumbar vertebrae while being treated. Primary physicians should become aware of the atypical features of this disease, as well as the potential complications of treatment.
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PMID:Temporal arteritis: an atypical presentation. 202 22

A study was undertaken whereby a set of standardized (simulated) patients visited general practitioners without being detected, in a health care system where doctors had fixed patient lists. Thirty nine general practitioners were each visited during normal surgery hours by four standardized patients who were designed to be indistinguishable from real patients. The objective of the study was to see whether the actual performance of general practitioners, as assessed by standardized patients, met predetermined consensus standards of care for actual practice. The patients presented standardized accounts of headache, diarrhoea, shoulder pain and diabetes. The mean group scores of the doctors on the predefined standards of care for the different complaints ranged from 33 to 68%. The results show that standardized patients may be the method of choice in the assessment of the quality of actual care of doctors. It is hypothesized that the substandard scores of the doctors do not reflect inadequate competence, but are a result of the difference between competence and performance.
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PMID:Assessment of the performance of general practitioners by the use of standardized (simulated) patients. 193 Dec 15

Cranial neuropathy affecting the eyes is a possible symptom of type II diabetes. In this article, Dr Dickerman describes a case in which diabetes was diagnosed in a 63-year-old woman who presented with unilateral headache and eye pain.
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PMID:Ophthalmoplegia with headache. Be aware of diabetes. 203 88

Two patients with progressive sarcoidosis who had poor responses and side effects from corticosteroid therapy were treated with cyclosporine. Cyclosporine suppressed conventional markers of inflammation and there was clinical improvement in one patient, but the disease recurred when therapy was discontinued. The second patient who had diabetes mellitus developed unstable glucose metabolism when given cyclosporine. This unstable diabetes mellitus together with side effects of nausea and vomiting resulted in weight loss and inadequate serum therapeutic levels that was associated with a poor therapeutic response to the cyclosporine. The major side effects in both patients were headache and gastrointestinal symptoms, but there was no renal dysfunction. We conclude that while corticosteroids remain the mainstay of sarcoid therapy, when these drugs have not been successful for the skin manifestations of the disease, a trial of cyclosporine may be justified.
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PMID:Cyclosporine and chronic sarcoidosis. 220 12

The authors have studied 30 patients with transient global amnesia aged between 49 and 76 years (median age of 63 years), without focal neurologic signs that have been followed for periods varying between 6 months and 10 years. Three of the patients had recurrent attacks of transient global amnesia, and another three had a stroke, although at some distance from the amnesia attack. Association was noted with certain risk factors including high blood pressure, and angiopathic changes of the eye fundus (in 50% of the patients), dyslipidemia (in 30%), diabetes (in 10%), and essential polyglobulia (in 7%). Coagulation studies including thrombelastograms were carried out in 22 patients, and demonstrated hypercoagulability in 50% of them. Changes in the arterial wall were noted in 85% of the 14 patients in whom carotid sphygmograms were recorded. The presence of these risk factors could explain the occurrence of cerebrovascular accidents in patients with transient global amnesia. Electroencephalograms performed immediately or a short time after the amnesia attack have evidenced in 18 patients rapid-type dysrhythmia, or diffuse theta waves, predominantly located in the deep layers of the left and right temporal areas. The EEG tracings were either flat or normal in the remaining 12 patients. Of the 30 patients presenting with global transient amnesia only two had migraine in antecedents, and another six had headache during the evolution of amnesia. The neurologic examination did not reveal any abnormality in 27 of the patients. Sequelar signs of neurological deficits were noted in the remaining three patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transient global amnesia (a study of 30 cases)]. 223 8

1. To assess the risk of end-stage renal disease (ESRD) associated with the regular use of three classes of non-narcotic analgesics, we performed a case-control study of 340 patients with ESRD on a haemodialysis maintenance program and 673 hospital controls. 2. The overall odds ratio estimate for non-narcotic analgesics taken at least every other day for 30 days or longer before the first symptom of renal disease was 2.89 (95% CI, 1.78 to 4.68). 3. The risk increased in relation to the use duration. 4. The previous regular consumption of combinations containing phenacetin was strongly associated with ESRD (odds ratio, 19.05; 95% CI, 2.31 to 157.4). The odds ratio for previous regular consumption of salicylates was 2.54 (95% CI, 1.24 to 5.20) and for pyrazolones 2.16 (95% CI, 0.87 to 5.32). 5. An analysis for possible confounding by a history of repeated headaches, arthritis, kidney stones, hypertension, and diabetes did not alter the results. 6. The odds ratio estimates for different pathological subgroups of ESRD patients in relation to previous use of any non-narcotic analgesic were glomerulonephritis. 10.57 (95% CI, 1.25 to 89.0), interstitial nephritis, 3.33 (95% CI, 1.21 to 9.17), cystic kidney disease, 0.71 (95% CI, 0.25 to 1.97), and unknown, 5.15 (95% CI, 2.29-11.57). 7. The results of this study suggest that the regular consumption of analgesics should be routinely considered as a risk factor for any non-congenital cause of chronic renal failure. They also suggest that the risk of ESRD associated with the regular consumption of phenacetin is much higher than the risk associated with other non-narcotic analgesics.
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PMID:End-stage renal disease and non-narcotic analgesics: a case-control study. 227 70

Malignant external otitis (MEO) is a disease of the external auditive channel (EAC) due to Pseudomonas aeruginosa which usually involves individuals with diabetes mellitus. It may result in the invasion of the cranial base with cranial neuropathy and a high mortality rate despite therapy. We report the clinical features, diagnostic procedures, evolution and therapy of 8 patients with MEO, seven of which had cranial neuropathy. All patients have diabetes except one who had acquired immunodeficiency syndrome. All had otalgia, otorrhea and headache lasting for several months. Six patients had homolateral (as related to the MEO) facial palsy. One patient with bilateral MEO developed bilateral facial palsy and lesion of the cranial nerves VI (unilaterally) and IX through XII (bilaterally). In all patients P. aeruginosa was cultured from the EAC exudate scintigraphy with 99Tc showed uptake at medium ear and mastoid level in all 8 patients, suggesting a possible osteomyelitis. Scintigraphy with 67Ga was positive in the 6 cases where it was carried out, showing uptake in the soft tissues of the cranial base. Computed tomography was carried out in 6 patients, and it was useful to define the anatomical extent of the disease. The patients received different therapeutic schedules, particularly the combination of a betalactamic and aminoglucoside antibiotics. Follow up was characterized by common recurrences, and one patient died. The importance of early diagnosis and treatment to prevent the extension and recurrence of MEO are discussed. Cranial neuropathy is considered as a poor prognostic finding.
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PMID:[Otitis externa maligna and cranial neuropathy]. 228 52


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