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

We assessed the efficacy of long-acting nifedipine as monotherapy in 52 patients with mild to moderate essential hypertension in a randomized, controlled crossover study. Good blood pressure control was achieved in 34 of 40 patients (85%) receiving nifedipine (mean daily dose, 52 mg in 2 divided doses) compared with 23 of 40 patients (58%) receiving metoprolol (mean daily dose, 155 mg in 2 divided doses). After treatment for 4 weeks, the mean blood pressures with nifedipine (149.7 +/- 16.6/88.7 +/- 11.1 mm of mercury) and metoprolol administration (163.9 +/- 23.3/94.2 +/- 10.2 mm of mercury) were significantly lower than with placebo (176.7 +/- 17.3/100.9 +/- 7.1 mm of mercury) (P less than .05). The mean systolic pressure during nifedipine treatment was 14.2 mm of mercury lower (95% confidence interval [CI], 3.9 to 24.5 mm of mercury) and mean diastolic pressure 5.5 mm of mercury (95% CI, 0.3 to 10.7 mm of mercury) lower than with metoprolol therapy. Both drugs were reasonably well tolerated, and intolerance requiring withdrawal was encountered in 3 of 45 (7%) patients receiving nifedipine, compared with 1 of 45 (2%) of those taking metoprolol and placebo, respectively. Adverse effects of nifedipine, most of which were transient, included palpitations, headache, facial flushing, and ankle edema. Long-acting nifedipine is a promising agent when given alone for mild to moderate hypertension and can be safely administered in clinical practice.
West J Med 1990 Feb
PMID:Long-acting nifedipine versus metoprolol as monotherapy for essential hypertension. A randomized, controlled crossover study. 240 30

The triphasic oral contraceptive pill was only recently introduced into the Nigerian market. The present study was, therefore, undertaken to evaluate the overall tolerance of Nigerian women to one such triphasic preparation (LOGYNON). One hundred women were systematically allocated to three treatment groups--21 days triphasic group (T-21), 28 day triphasic group (T-28) and a 28 days monophasic group (M-28). The patients were observed for a total of 702 cycles over a 12-month study period. The triphasic was effective in preventing conception as no pregnancies were reported during the entire study period. Intermenstrual spotting occurred in 8.9%, 7.0% and 10.1% of patients on T-21, T-28 and M-28 preparations respectively. Similarly, breakthrough bleeding occurred in 2.7%, 3.1% and 5.6% of women respectively for the three groups. The main reasons for discontinuations were headaches (60.0%) raised blood pressure (20.0%), Weight gain (10.0%) and breast discomfort (5.0%). Even though the clinical performance of both the monophasic and the triphasic preparations were very good, the author concludes that the triphasic drug is preferable because of its lower total dose of cyclic hormones and documented evidence of minimal or no effect on various metabolic processes in the body.
West Afr J Med
PMID:Clinical experience with a triphasic oral contraceptive containing ethinyloestradiol and levonorgestrel in Nigerian women. 248 82

An outbreak of febrile illness at the Police Training Academy in St. Catherine, Jamaica in October, 1986 is described. Influenza A similar to type A/Taiwan/86 (H1N1) was confirmed serologically in 33 cases, and Influenza B similar to type B/Ann Arbor/86 in 1 case. Clinical findings included upper respiratory symptoms (97%) headache (74%), fever (68%), joint pains (39%) and retro-orbital pain (26%). The role of vaccination and chemoprophylaxis in the prevention of influenza is discussed, and the importance of surveillance is stressed.
West Indian Med J 1989 Sep
PMID:An outbreak of influenza in Jamaica (1986). 261 29

Q fever is seldom reported in West Africa. The case of a man returning from Guinea Bissau who presented an acute lobar pneumonia with fever, headache, hematuria and hepatitis was confirmed by high titers of antibody in Phase II indirect immuno-fluorescence which appeared on the twelfth day of fever. Treatment with erythromycin was continued by doxycyclin, and complete resolution of all signs was promptly obtained. Coxiella Burnetii might thus be responsible of cases of unexplained fever with respiratory or hepatic manifestations in West Africa.
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PMID:[Q fever in Guinea-Bissau. 1 case]. 268 Jan 35

A randomly selected sample of 1992 adults (995 men and 997 women) representing four equally sized age groups of 25-, 35-, 50-, and 65-years-old inhabitants of West Bothnia were studied for prevalence of symptoms and clinical signs of mandibular dysfunction. Of the sample 79% completed a questionnaire and a clinical examination. The chewing inability increased with age. Recurrent headaches (once a week or more often) were reported to occur in 11% to 15% of the four age groups, and the duration of headaches was generally more than 2 years. Tooth-clenching, which was the most frequent oral parafunction, was reported significantly more often in women, whereas attrition was more severe in men. The commonest clinical finding was temporomandibular joint clicking, which varied between 13% and 35% in the different age groups. Crepitation was observed more often in women and increased with age. The jaw muscles were more frequently tender to palpation in women and the elderly. The mean maximal mouth opening capacity varied between 55 mm and 44 mm, decreasing with age, and was for the whole sample significantly higher among men. Since signs and symptoms of craniomandibular disorders were common findings in all age groups, routine dental examination should always include functional evaluation of the stomatognathic system.
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PMID:Craniomandibular disorders in adult populations of West Bothnia, Sweden. 275 18

In 984 patients with generalized anxiety disorder who received buspirone in double-blind studies, the incidence of drowsiness (9 percent) did not differ significantly from that (10 percent) reported in 334 patients who received placebo. A probability value of p less than or equal to 0.10 was the criterion for significance. The incidence of drowsiness in buspirone-treated patients was significantly less than that in each of the groups receiving diazepam (32 percent), clorazepate (26 percent), lorazepam (58 percent), or alprazolam (43 percent). The side effects that did occur significantly more frequently in the buspirone group than in the placebo group were dizziness (9 percent versus 2 percent), headache (7 percent versus 2 percent), nervousness (4 percent versus 1 percent), light-headedness (4 percent versus less than 1 percent), diarrhea (3 percent versus less than 1 percent), paresthesia (2 percent versus less than 1 percent), excitation (2 percent versus less than 1 percent), and sweating/clamminess (1 percent versus 0 percent). The severities of these effects were predominantly rated as only mild or moderate. Fatigue occurred less frequently in buspirone-treated patients than in those receiving any of the benzodiazepines, and weakness occurred more frequently in diazepam-treated patients. Depression occurred less frequently in buspirone-treated patients than in those receiving clorazepate, diazepam, or lorazepam. Impotence occurred only in clorazepate- and lorazepam-treated patients. Decreased libido occurred more frequently in diazepam-treated patients, whereas increased libido was more frequent in clorazepate-treated patients. Nausea was reported more frequently in buspirone-treated patients than in those receiving clorazepate, diazepam, or alprazolam; diarrhea occurred more frequently in the buspirone group than in the diazepam group. The mean daily doses of the various treatments were buspirone, 20 mg; diazepam, 20 mg; clorazepate, 24 mg; lorazepam, 3 mg; and alprazolam, 1.5 mg. In an open-field study in West Germany involving 5,414 patients, gastrointestinal-related complaints were the most frequently reported side effects.
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PMID:Review of the side-effect profile of buspirone. 287 Jun 41

The HIV epidemic probably arose in Africa at about the same time as in the West, and there is a significant seroprevalence of HIV in the central African region. However, the epidemiology and clinical course of AIDS are different in Africa and in the West. In Africa males are infected as often as females, and the commonest means of transmission is heterosexual intercourse. Many HIV-infected people are symptomless, but many others present with or progress to generalized lymphadenopathy, pruritus, herpes zoster, herpes simplex, cellulitis, and oral candidiasis. The World Health Organization developed a clinical case-definition of AIDS in Africa, which was found to have a specificity of 90% and a sensitivity of 59% when tested in Zaire. The Kaposi's sarcoma seen in African AIDS patients is more aggressive than that seen in the West and is often visceral. Gastrointestinal AIDS (the "slim" disease) with weight loss and diarrhea is common in Africa, as are oral and esophageal candidiasis. In Africa Pneumocystis carinii pneumonia is rare, but pulmonary tuberculosis is common. Neurological manifestations include cerebral toxoplasmosis, cytomegalovirus infection, headache, and terminal encephalopathy. About 60% of infants born to seropositive women are infected and die within the 1st year of life. Lack of drugs and diagnostic facilities make both diagnosis and treatment of opportunistic infections difficult.
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PMID:Clinical aspects of HIV infection in developing countries. 305 40

Headache following a lumbar puncture is a common and often debilitating syndrome. Continued leakage of cerebrospinal fluid from a puncture site decreases intracranial pressure, which leads to traction on pain-sensitive intracranial structures. The headache is characteristically postural, often associated with nausea and optic, vestibular, or otic symptoms. Although usually self-limited after a few days, severe postural pain can incapacitate the patient. Management is mainly symptomatic, but definitive treatment with the epidural blood patching technique is safe and effective when done by an expert operator.
West J Med 1988 May
PMID:Post-lumbar puncture headache. Etiology and management. 273 31

Confirmation of a causal relationship between hemolytic-uremic syndrome (HUS) and verotoxin-producing Escherichia coli (VTEC) infection is provided by the case of a 22-year-old West German woman. The patient presented with fatigue, nausea, and headache. Ultrasonography revealed enlarged kidneys, and laboratory investigations showed uremia, hemolytic anemia, lactate dehydrogenase, haptoglobin below the detection limit, and thrombocytopenia. She received hemodialysis and drug treatment (heparin, dopamine, and furosemide). To investigate the kinetics of the humoral response to verotoxin, the patient was followed for 3 months. Fecal specimens on day 23 yielded E coli serotype 0111:NM, and stool filtrates on days 16 and 23 showed highly cytotoxic activity for HeLa cells. While the patient's initial serum showed a high IgM immune response against purified Shiga toxin, there was a steady decline in IgM and steady increase in IgG antibodies over the ensuing 3 months. These findings are suggestive of a recent infection by a verotoxin-producing organism. This is the 1st reported case of VTEC-associated HUS with e coli 0111 infection in an adult, and the patient's 4-year history of oral contraceptives (OCs)--ethinyl estradiol and chlormadinoneacetate--is considered to be of etiologic significance. The diminished antibody coating of bacteria in the urinary tract of OC users may have facilitated invasion of verotoxin across the mucosal barrier in this patient. Severe hypertension has been reported previously in OC users with HUS. It is speculated that verotoxin may trigger HUS in longterm OC users, initiating vasoconstriction and microangiopathic hemolysis.
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PMID:Hemolytic-uremic syndrome associated with an infection by verotoxin producing Escherichia coli 0111 in a woman on oral contraceptives. 328 32

Introduction of the birth-control pill is attributed to Dr. Gregory Pincus, an American researcher, who around the mid 1950s carried out a number of tests leading to the manufacture of the first hormone pill effectively inhibiting fertility. First large-scale testing on women was conducted in the West Indies in 1956, following which the oral preparation gained wide acceptance. The hormones used are synthetically-produced derivations of female sex hormones present in the body: estrogens and gestagens or progestogens. The main feature of these oral contraceptives is that they prevent egg release. Addition of synthetic estrogen to the amount already formed naturally will in the first stage of the menstruation cycle prevent growth of an egg in the ovary, and ovulation will not occur. The pills also contain a gestagen, a substance having the same effect as the progesterone which stimulates expulsion of the mucous membrane with menstruation when there has been no implanting of a fertilized egg, so that even though no egg release takes place, there will still be a menstruation-like bleeding. Birth control pills also reduce viscosity in the cervicale membrane, thereby limiting permeability to sperm, and the endometrium atrophies, making it unsuitable for implantation of a fertilized egg. 3 main types of hormonal oral contraceptives have been developed. The first of these is the combined estrogen-gestagen pill. All in this group contain a constant amount of the 2 hormones, and are taken for 21 days, after which there is a 7 day pause. It was found that use of this type of pill created a risk of thromboses and high blood pressure. Therefore, the newer pills of this type have lower estrogen contents. A recent Canadian study showed that heavy smokers may still risk getting high blood pressure, however. Nor should this type be used by nursing women. A second type are the multi-phase combination pills. In the 2-phase subgroup, 1 pill containing sufficient estrogen to prevent egg release is taken in the early phase of the cycle, followed in the last stage by a pill containing both estrogen and gestagen. In some of these a small amount of gestagen is in the first-phase pill, thus giving the same contraceptive effects as in the combination pills. There are also 3-phase pills, with 5 containing estrogen taken in a middle phase. These are assumed to give fewer menstrutional disruptions. The last type are the so-called "mini pills" or gestagens. These are taken every day without pause, so that with a constant application of gestagen, the cervical membrane remains viscous and sperm will therefore not be able to penetrate. All 3 types of pill can cause serious side effects such as thromboses and hypertension, but most side effects, such as headaches and nausea, are less serious.
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PMID:[Drug information. This is how hormonal contraceptives act]. 363 45


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