Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 5-year trial of acupuncture therapy in the Finnish NHS is surveyed. In total 348 patients attending Halikko Health Centre in SW Finland were treated with needle-stimulation for a wide variety of chronic pain syndromes. The mean number of acupuncture sessions was 5 in the primary series and 41% of patients received more than one series. An analysis of results showed significant relief of pain (more than 40% reduction on the visual analogue scale) in myofascial syndromes affecting the head, neck, shoulder and arm. Osteoarthrosis of major joints, and backache, responded less favourably. In total 65% of those patients who had taken analgesics before acupuncture therapy, either stopped totally or reduced their dose considerably. Those with headache could significantly more often reduce their drug intake than those with arthritis or osteoarthrosis. More results and discussion will be published in part II later in this Journal.
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PMID:Long-term treatment of chronic pain with acupuncture. Part I. 288 34

One of the putative causes of headache is osteoarthritis of the C2-3 zygapophysial joint. A technique for blocking the third occipital nerve which innervates this joint was devised and used as a screening procedure for headache mediated by this nerve. Seven out of ten consecutive patients presenting with suspected cervical headache were found to suffer pain mediated by the third occipital nerve and stemming from a C2-3 zygapophysial joint. Because third occipital headache may be indistinguishable clinically from tension or other forms of headache, third occipital nerve blocks are advocated as means of establishing this largely unrecognised diagnosis.
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PMID:On the concept of third occipital headache. 301 67

110 patients with benign gastric ulcer and concomitant joint diseases (rheumatoid arthritis, osteoarthrosis) were treated in a comparative short-term clinical trial to assess the relative efficacy of calcitonin (daily 100 MRC of salmon calcitonin intramuscularly), cimetidine (daily 1000 mg orally) and colloidal bismuth subcitrate (De-Nol-four times a day in doses of 5 ml diluted with 15 ml of water). Groups of patients were comparable according to age, sex, duration of ulcer disease, smoking habits, gastric acid secretion and mean ulcer size. The ulcer healing was controlled endoscopically after 2 and 4 weeks of the treatment. There was no significant difference in the ulcer healing rate between three groups neither after 2 weeks (calcitonin-36.7% of healed ulcers, cimetidine-37.5% and De-Nol-35.0% nor after 4 weeks respectively (76.7%, 72.5% and 77.5%). In the calcitonin group a gradual joint pain relief was observed in 84% of patients who complained arthralgia. The moderate side effects (headache, nausea, flush) were observed only in the patients treated with calcitonin (8 subjects). We suggest that calcitonin may be considered as a valid anti-ulcer drug in the peptic ulcer patients with concomitant rheumatological diseases especially with osteoporosis.
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PMID:Calcitonin versus cimetidine or De-Nol in gastric ulcer treatment. An endoscopically controlled trial. 307 78

We tested the current criteria for fibromyalgia. Pain tolerance was measured at tender point and control point sites using a pressure algometer, and responses to 6 standard psychological self-reports were obtained from 125 patients with generalized nonarticular rheumatism, rheumatoid arthritis, or osteoarthritis. Among patients with generalized nonarticular rheumatism, published symptom criteria for fibromyalgia did not correlate significantly with the number of tender points. Only lower generalized pressure point pain tolerance distinguished fibromyalgia from other generalized nonarticular rheumatism. Generalized nonarticular rheumatism mean scores were much higher than controls on tests measuring the tendency to report physical symptoms, including headaches and functional bowel syndrome. It is probable that patients with fibromyalgia do not differ in any important physical or psychological respect from other patients with generalized nonarticular rheumatism except for the presence of tender points. However, the presence of tender points is merely a reflection of the patient's general pressure pain sensitivity and is not indicative of any special localized pathological phenomenon. The concept of fibromyalgia as an entity separate from the rest of generalized nonarticular rheumatism may be an artifact of a physician's approach to the patient. Most patients with generalized nonarticular rheumatism demonstrate an abnormally high frequency of reporting manifold disagreeable symptoms and probably come to the attention of many medical disciplines.
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PMID:Fibromyalgia: generalized pain intolerance and manifold symptom reporting. 326 1

Proquazone is a non-steroidal anti-inflammatory agent (NSAID) which, unlike most other NSAIDs, does not have a free acid group in its structure. It is advocated for use in rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, musculoskeletal disorders, acute inflammatory conditions and acute pain states such as dysmenorrhoea, postoperative pain and headache. Published data in small groups of patients indicate that proquazone 300 to 900 mg/day in 3 divided doses is a possible alternative to aspirin, ibuprofen, indomethacin, and naproxen in rheumatoid arthritis, and to indomethacin and ibuprofen in ankylosing spondylitis. Similarly, proquazone 300 to 900 mg/day is as effective as aspirin, diclofenac, ibuprofen, indomethacin and naproxen in patients with osteoarthritis. Preliminary studies have confirmed the efficacy of proquazone in acute inflammatory disorders, and shown that it provides useful analgesic relief in acute pain states such as dysmenorrhoea, headache and after minor surgery. Evidence from small groups of patients with rheumatoid arthritis treated for a year or more suggests that proquazone may inhibit or arrest progression of bone erosions. However, these encouraging findings clearly need confirmation in a larger number of patients studied under well-controlled conditions. The overall impression from clinical trials to date is that proquazone at dosages of greater than or equal to 900 mg/day produces a high incidence of gastrointestinal symptoms such as diarrhoea (in approximately 30% of patients). However, these effects were usually of mild to moderate severity and transient in nature and in most comparative studies the overall tolerability of proquazone was assessed as being comparable to that of other NSAIDs tested. Similarly, withdrawal from therapy due to side effects was no greater with proquazone than with other NSAIDs evaluated. Initial experience with lower dosages of proquazone (300 to 450 mg/day) suggest that efficacy is maintained and tolerability markedly improved. Thus, at present, proquazone would seem to be as effective as other NSAIDs used in the management of rheumatoid arthritis and osteoarthritis. However, further studies are needed to fully evaluate the efficacy and tolerability of this agent, especially at the lower daily dosages currently recommended, and to clarify whether it does have significant 'disease modifying' potential.
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PMID:Proquazone. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in rheumatic diseases and pain states. 329 21

A personal series of 256 cases of acromegaly/gigantism seen over a 20-year period from 1963 is described. The insidious nature of the condition resulted in delay in diagnosis which was often made by a doctor when seeing the patient for an unrelated problem. Other features which commonly led to the diagnosis being made were headache, change in appearance, carpal tunnel syndrome, amenorrhoea and diabetes. The Hardy system for grading the radiological appearance of the pituitary tumour was used. Widely invasive tumours were not common but tended to occur in patients with younger age of onset and high GH levels. The occurrence of various symptoms and clinical features was noted and the changes resulting from reducing the GH level to normal. The incidence of hypertension, but not of coronary artery disease, is increased and the blood pressure may be reduced following successful treatment. The effects on the upper and lower respiratory tract are reported as well as sleep apnoea and problems associated with anaesthesia. Skin manifestations included sweating, pigmented skin tags, acanthosis nigricans and cutis verticis gyrata. In the skeletal system the incidence of kyphoscoliosis and osteoarthritis especially of the hip is reported: the question of hip replacement is discussed. Diabetes mellitus disappeared in most cases if the acromegaly was cured. In men but not in women the incidence of colloid nodular goitre was increased as was hyperthyroidism in middle-aged women. In two patients a parathyroid adenoma was present: hypercalcaemia was present in five additional patients, but the cause was not determined. The common occurrence of amenorrhoea in the younger women was noted, it was not always associated with hyperprolactinaemia, and often responded to successful treatment of the acromegaly. The association of acromegaly with hirsutism and galactorrhoea is confirmed. The incidence of impotence and loss of libid in the men is discussed: in a proportion of those in whom the acromegaly was cured, potency returned, but in a number depression occurred and what was believed to be psychogenic impotence persisted. Hyperprolactinaemia was found in 49 out of 151 patients with active acromegaly in whom the prolactin level was measured. Previous reports have indicated a doubling of death rates in acromegalics. In this series there were 47 deaths observed compared to 37.2 expected. The increased death rate was in women of all ages and in men under the age of 55, The increased deaths in the women were from cardiovascular and cerebrovascular causes and from breast cancer.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acromegaly. 330 90

Nabumetone, a nonsteroidal anti-inflammatory drug of the naphthylalkanone class, was studied in an open-label fashion to compare the relative single-dose and steady-state kinetics in young healthy male volunteers and in elderly patients with degenerative joint disease. Seventeen healthy male volunteers 21 to 30 years of age and 17 patients 60 to 75 years of age were studied. After a single oral dose of 1,000 mg nabumetone, blood and urine samples were collected over a five-day period. Plasma was assayed for nabumetone and the active metabolite, 6-methoxynaphthylacetic acid, and the urine was assayed for five metabolites. Following this phase, they received daily oral doses of 1,000 mg nabumetone for 14 days. After the final dose, blood and urine samples were again collected for five days for the same assays. These data were fitted to a single compartment model and the derived data are as follows: mean maximal plasma concentration, maximal time concentration, area under the plasma-time curve, elimination rate constant, and elimination half-life in the young group after single dose were 22.9, 8.4, 838, 0.032, and 21.2, respectively, whereas on steady-state, values were 33.6, 4.1, 666, 0.031, and 22.1, respectively. In the elderly group after single dose, these values were 30.2, 10.8, 1,538, 0.024, and 29.2, whereas on steady-state, they were 50.0, 7.2, 1,092, 0.027, and 25.6. The accumulation ratio was 1.6 in the young and 1.8 in the elderly. Side effects in the young were mild and consistent of headaches, epigastric discomfort, nausea, and vomiting, whereas in the elderly they consisted mainly of headaches. No significant changes in complete blood cell count, blood chemistries, or urinalysis were noted. We concluded from these data that the drug does not accumulate if given every 24 hours; therefore, a single daily dose should provide sufficient therapy and that due to a difference in elimination, elderly patients may require a lower dose.
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PMID:Nabumetone kinetics in the young and elderly. 368 2

The long-term tolerability and efficacy of indomethacin were evaluated in a retrospective study of 67 patients with moderate to severe rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis who took the drug daily for periods ranging from three to 20 years. Only patients who had not experienced side effects during the first ten to 14 days of indomethacin therapy were included. No other anti-inflammatory agents were taken along with indomethacin. The average daily dosage ranged from 50 to 150 mg; for 81% of patients, the average daily dosage was 75 to 100 mg. Only nine (13%) of the 67 patients experienced side effects, all of which were transient and mild. Three patients had headache, five patients had gastrointestinal symptoms, and one patient had both gastrointestinal symptoms and headache. Repeated urinalyses did not reveal any significant abnormalities. There were no instances of leukopenia. A comparison of clinical and laboratory assessments at the initial and latest office visits indicated that signs of active inflammation had been well controlled by daily indomethacin therapy. Erythrocyte sedimentation rates were generally lower and hemoglobin values tended to be higher at the latest visit. Clinically, patients appeared to have benefited from the long-term administration of indomethacin with respect to both tolerability and efficacy.
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PMID:Tolerability and efficacy of long-term daily administration of indomethacin for moderate to severe chronic arthritic disorders. 373 Dec 10

A 12-week, double blind study was conducted in 140 patients with osteoarthritis to compare the efficacy and toleration of piroxicam 10-20 mg once daily to indomethacin 75-125 mg in divided doses. Seventy-seven percent of piroxicam and 63% of indomethacin patients completed the study. The number of drop-outs due to side effects in the indomethacin group was twice that in the piroxicam group (p less than 0.05). The frequency of GI side effects was similar in both groups. There were more CNS side effects with indomethacin (headache), and more skin side effects with piroxicam. Piroxicam was comparable to indomethacin with respect to efficacy and offered better toleration and a simplified dosage regimen.
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PMID:Piroxicam vs indomethacin: a double blind multicenter comparative study in osteoarthritis. A Canadian Multicenter Study. 389 35

Data collected from more than 1,800 patients with rheumatoid arthritis or degenerative joint disease in Phase 3 clinical studies of isoxicam (Maxicam) indicated that the drug is well tolerated on both a short-term and a long-term basis. The most common type of adverse reaction to all medications (isoxicam, aspirin, and indomethacin) was gastrointestinal: 22.6 percent with isoxicam, at a dosage greater than 200 mg per day; 14.2 percent with isoxicam at 200 mg per day; 31.6 percent with buffered aspirin at 3,600 to 4,800 mg per day; 24.6 percent with indomethacin at 150 mg per day; and 7.2 percent with placebo. The incidence of tinnitus and deafness was significantly greater with buffered aspirin than with isoxicam, and the number of patients who had at least one episode of dizziness, vertigo, or headache was significantly greater with indomethacin than with isoxicam. In open-label, long-term studies, in which approximately 70 percent of the patients participated, the types and frequencies of adverse effects were similar to those observed with isoxicam during the controlled studies. The overall frequency of withdrawal for adverse reactions during the long-term studies was 11.5 percent, similar to that during the controlled studies. At the recommended dosage for isoxicam of 200 mg per day, the incidence of gastrointestinal ulcers was 0.81 percent, well within the range expected among arthritic patients receiving nonsteroidal anti-inflammatory drugs. From the data collected in Phase 3 clinical studies, it may be concluded that isoxicam is better tolerated than either aspirin or indomethacin and should not create unusual problems in the short-term or long-term treatment of rheumatoid arthritis or degenerative joint disease.
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PMID:Evaluation of the safety of isoxicam. 390 36


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