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)

Clinical features and laboratory findings of 300 inpatients with vibration disease before and after treatments were reviewed. Having been using chain saws or pneumatic hammers for a long period, the patients were afflicted with Raynaud's phenomenon, numbness, pain or stiffness of fingers, pain of elbows and neck, stiffness of shoulders and lumbago. They had high incidences of complaints due to the disorder of the central nervous system, especially of the higher center of the autonomic nervous system; i.e. headache (52.0%), palmar hyperhidrosis (70.0%), forgetfulness (78.2%), fatiguability (61.3%), tinnitus (41.8%), impotence (55.1%), etc. Laboratory findings of the autonomic nerve activity tests, electroencephalograms and audiograms also suggested the disorder of the central nervous system. Treatments during three months had improved significantly the subjective symptoms and the objective findings (p less than 0.05 to 0.001). Thus, vibration disease should be considered as a systemic disease, including disorders of the central nervous system, especially of the higher center of the autonomic nervous system, and disturbances of the peripheral functions.
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PMID:Clinical features and laboratory findings of vibration disease: a review of 300 cases. 91 75

One of the most appealing current pathogenetic concepts is that progressive systemic sclerosis (PSS) is a reaction to repeated episodes of endothelial cell injury. Injury of small arteries and capillary endothelium initiates reactions which involve increased permeability of the vessels, platelet adherence, myointimal cell proliferation, luminal narrowing and heightened sensitivity of the vessel wall. Clinical evidence of the vessel damage is Raynaud's phenomenon, involving both skin and viscera. The Authors evaluated the effects of iloprost on Raynaud's phenomenon in patients with PSS. This drug provides prolonged vasodilation, reduces platelet aggregation and promotes endothelial lining function repair. This last pattern is of primary importance because it may stop the vicious circle: endothelial injury-platelet hyperaggregation-microangiospasm. Five females were recruited, aged 41-66 years, suffering from well-documented (ARA criteria) PSS, associated with typical Raynaud's phenomenon. The trial provided for intravenous infusion of iloprost at a rate of 1-2 ng/kg/min. First treatment consisted of six-hour infusions on six successive days. After this first treatment, weekly infusions during the winter months were carried on. Drug effectiveness was considered through subjective and objective parameters. All patients showed prominent reduction of number, duration and severity of attacks of Raynaud's phenomenon, improvement of prehensile strength, healing of finger ulcerations and improvement or normalization of digital photoplethysmography. So far, the treatment has been prolonged for years in our patients and still goes on. The side effects of iloprost (headache, flushing, nausea) have been very poor. Therefore, iloprost proved to be a valid drug in the management of Raynaud's phenomenon in patients with PSS, but the inconvenience of intravenous administration may limit its routine use.
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PMID:[Effects of long-term iloprost therapy on Raynaud's phenomenon in progressive systemic sclerosis]. 128 Dec 97

Iloprost is an analogue of epoprostenol (prostacyclin; PGI2; a potent but short-lived prostanoid mainly produced in the vascular endothelium) and mimics the pharmacodynamic properties of this compound, namely: inhibition of platelet aggregation, vasodilatation and, as yet ill-defined, cytoprotection. Improved metabolic and, in particular, chemical stability enhance the clinical utility of iloprost. When administered as an intermittent intravenous infusion at less than or equal to 2 ng/kg/min for 2 to 4 weeks, iloprost reduced rest pain and improved ulcer healing in 40 to 60% of patients with critical leg ischaemia, including diabetic patients, and delayed amputation in the majority of responding individuals. Similar benefits have been seen in thromboangiitis obliterans and, in patients with severe Raynaud's phenomenon, shorter courses of therapy reduced the frequency, intensity and duration of ischaemic episodes for at least 6 weeks. The very few comparative trials reported to date (i.e. vs nifedipine in Raynaud's phenomenon; vs low-dose aspirin in thromboangiitis obliterans) have favoured iloprost, but comparisons with more established agents are needed to assess this drug's value in less severe forms of peripheral ischaemia, such as intermittent claudication. At present, iloprost is administered intravenously and this is a limitation to treatment. The potent, rapidly reversible antiplatelet activity of iloprost suits it for use in extracorporeal circulation and for the intraoperative management of heparin-induced platelet activation. Although results in animal models of ischaemic myocardial injury are encouraging, preliminary clinical experience in patients with myocardial ischaemia or infarction has been disappointing. Most patients tolerate iloprost infusion rates of up to 2 ng/kg/min. Headache and flushing are extremely common and are the suggested end-point of dose titration, as higher doses are associated with a significant incidence of gastrointestinal distress and, ultimately, hypotension. Thus, iloprost provides a pharmacotherapeutic option for patients with severe peripheral vascular disease, a condition for which few alternative drug therapies exist. Its potent but short-lived effects make it well-suited to certain therapeutic niches such as the management of intraoperative platelet activation. Prostanoid analogues have far-reaching therapeutic potential and further experience with iloprost will no doubt help to define its clinical applications.
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PMID:Iloprost. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in peripheral vascular disease, myocardial ischaemia and extracorporeal circulation procedures. 137 60

Calcium channel blockers have been used in the treatment of primary and secondary Raynaud's phenomenon (RP), and a beneficial effect was often recorded. The efficacy of slow-releasing nicardipine was assessed in a clinically homogeneous series of RP without underlying diseases in a randomized, double blind, cross-over and placebo controlled trial. Out of twenty-one selected patients (18 women and 3 men, mean age 46 +/- 12 yrs) eighteen completed the study and three dropped out, one for inadequate compliance and two due to headache. After a three-week period, slow-releasing nicardipine (20 mg two times daily) was significantly more useful than placebo: the number of RP episodes per week decreased (p less than 0.02), severity of discomfort and hand disability scores, evaluated after single RP attack, clearly improved (p less than 0.005 and p less than 0.02, respectively). According to clinical improvement, time of peak flow after postischemic reactive hyperaemia test was significantly reduced only after nicardipine (p less than 0.01). These results show that slow-releasing nicardipine is generally well tolerated and can provide effective improvement in RP patients without underlying diseases.
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PMID:Slow-releasing nicardipine in the treatment of Raynaud's phenomena without underlying diseases. 158 24

The effects of 5 mg sublingual nifedipine on a standardized cold provocation test were compared with that of placebo in a double-blind, cross-over trial in 10 patients with Raynaud's disease. The percentage decrease of finger systolic pressure in the cooled finger (as compared with the contralateral control finger) was significantly lower at 10 degrees C (p less than 0.02) and 15 degrees C (p less than 0.05) after nifedipine than after placebo. These improved digital pressure values on cooling were associated with a decreased systolic blood pressure (SBP) from 131.2 (SD 10.8) to 126.2 (SD 10.1) mm Hg (p less than 0.001) and an increased heart rate (HR) from 65.5 (SD 16.1) to 69.6 (SD 16.7) beats/min (p less than 0.002) but without significant changes in diastolic blood pressure (DBP), digital blood flow (BF), or peripheral vascular resistance (PVR) in cutaneous vascular bed. Three patients experienced headache under nifedipine, but this side effect was disagreeable in only one case. These data suggest using low-dose nifedipine (5 mg sublingually) 15-30 min before predictable cold exposure and Raynaud's phenomenon. Such a procedure might be more effective and safer than chronic intake of higher doses of nifedipine, as currently recommended in Raynaud's attacks.
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PMID:Effects of low-dose nifedipine on a cold provocation test in patients with Raynaud's disease. 169 48

Nifedipine antagonises influx of calcium through cell membrane slow channels, and sustained release formulations of the calcium channel blocker have been shown to be effective in the treatment of mild to moderate hypertension and both stable and variant angina pectoris. Preliminary findings also indicate that these formulations are effective in the treatment of Raynaud's phenomenon and hypertension in pregnancy, and that they reduce the frequency of ischaemic episodes in some patients with silent myocardial ischaemia. The exact mechanism of action of nifedipine in all of these disorders has not been defined. However, its potent peripheral and coronary arterial dilator properties, together with improvements in oxygen supply/demand, are of particular importance. A major goal of sustained release therapy is to permit reductions in the frequency of nifedipine administration, preferably to once daily, and thus improve patient compliance. Two new once-daily formulations--the nifedipine gastrointestinal therapeutic system (GITS) and a fixed combination capsule comprising sustained release nifedipine 20 mg and atenolol 50 mg--have exhibited marked antihypertensive efficacy. The GITS preparation has also been used effectively in the treatment of stable angina pectoris, and both formulations appear to be well tolerated. Sustained release nifedipine formulations are generally better tolerated than their conventionally formulated counterparts, particularly with regard to reflex tachycardia. Adverse effects seem to be dose related, are mainly associated with the drug's potent vasodilatory action, and include headache, flushing and dizziness. Generally, these effects are mild to moderate in severity and transient, usually diminishing with continued treatment. Thus, sustained release nifedipine formulations are useful and established cardiovascular therapeutic agents which have demonstrable efficacy in various forms of angina, mild to moderate hypertension and Raynaud's phenomenon. Further, promising results shown by the nifedipine GITS formulation, with its advantage of once daily administration suggest that it is likely to become one of the preferred nifedipine formulations for the treatment of hypertension and the various forms of angina.
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PMID:Sustained release nifedipine formulations. An appraisal of their current uses and prospective roles in the treatment of hypertension, ischaemic heart disease and peripheral vascular disorders. 171 8

Transient global amnesia (TGA) is a well-recognized clinical entity, but its pathophysiology and prognosis have remained arguable. We reported that a 63-year-old woman with scleroderma developed two TGA episodes. The patient sometimes suffered from headaches when Raynaud's phenomenon appeared in her fingers, but she did not experience further cerebrovascular events. This case suggests that the unique clinical presentation of this syndrome may result from an ischemic event, possibly triggered by a vasospastic mechanism like Raynaud's phenomenon.
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PMID:Transient global amnesia and Raynaud's phenomenon in scleroderma. 222 Mar 14

Iloprost, a stable prostacyclin analogue, was given by intravenous infusion to 29 patients with severe Raynaud's phenomenon, 26 of whom had systemic sclerosis (SS), and compared with placebo infusion in a double blind crossover trial. Iloprost significantly lessened the number and the severity of attacks compared with placebo. Nine patients expressed a preference for effectiveness of treatment, eight of these in favour of Iloprost. Thermography failed to show any long term effect of Iloprost. Side effects of headache, flushing, nausea, and vomiting were common, and the inconvenience of intravenous administration may limit its routine use.
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PMID:Infusion of iloprost, a prostacyclin analogue, for treatment of Raynaud's phenomenon in systemic sclerosis. 244 71

Dynamite is at the origin of several pathological processes related to two of its components: nitroglycerin and dinitroglycol. During the various manufacturing phases, these substances enter the body via the lungs or the skin. The most severe disorder remains the wean-off electrical cardiac syndrome with the so-called "Monday morning" sudden death possibility, but asymptomatic myocardial electrical disorders are also reported. Syndromes of permeation and overload essentially result in headaches, peripheral vasodilatation, and Raynaud's phenomenon. Regression of these pathological effects will be obtained through improved collective technical prevention and a broader knowledge of the risks.
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PMID:[Coronary and vascular pathology in dynamite workers]. 250 80

During a 10-day hospitalization, 21 patients suffering from systemic sclerosis (SS) with Raynaud's phenomenon were treated intermittently with intravenous infusions of calcitonin for 5 hours daily. Telethermographically, we measured a significantly shortened rewarming period of the patients' hand after standardized cooling. Up to now, as many as 47 patients with SS have been treated in the same way during 152 10-day cycles of calcitonin infusion. Only 7 patients interrupted the calcitonin therapy because of transient headache or nausea. Allergic reactions have not been observed, so far.
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PMID:[The thermoregulatory effectiveness of calcitonin in progressive scleroderma]. 266 2


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