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

Carbon monoxide (CO) has the toxic effects of tissue hypoxia and produces various systemic and neurological complications. The main clinical manifestations of acute CO poisoning consist of symptoms caused by alterations of the cardiovascular system such as initial tachycardia and hypertension, and central nervous system symptoms such as headache, dizziness, paresis, convulsion and unconsciousness. CO poisoning also produces myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, erythrocytosis, leucocytosis, hyperglycemia, muscle necrosis, acute renal failure, skin lesion, and changes in perception of the visual and auditory systems. Of considerable clinical interest, severe neurological manifestations may occur days or weeks after acute CO poisoning. Delayed sequelae of CO poisoning are not rare, usually occur in middle or older, and are clinically characterized by symptom triad of mental deterioration, urinary incontinence, and gait disturbance. Occasionally, movement disorders, particularly parkinsonism, are observed. In addition, peripheral neuropathy following CO poisoning usually occurs in young adults.
 ...
PMID:Carbon monoxide poisoning: systemic manifestations and complications. 1141 Jun 84

This study aimed to determine final year medical students' knowledge and perception of physiotherapy services within South Australia, and to identify any need for further education about physiotherapy within the undergraduate medical course. A survey of medical students at two universities found that physiotherapists enjoyed a positive reputation, especially when compared with alternative health practitioners. Although general knowledge was high, medical students were largely unaware that physiotherapists work in occupational health settings and offer treatments for Parkinson's disease, incontinence and headaches. The medical students had received little formal education about physiotherapy throughout their undergraduate course and clinical experience had been their major source of information. The findings suggest that medical students need more information about physiotherapy services.
 ...
PMID:An investigation into medical students' knowledge and perception of physiotherapy services. 1167 39

This analysis reviews clinical trials of the efficacy and safety of tolterodine for use in overactive bladder. It also compares the safety and efficacy of tolterodine and previously available pharmacotherapy. The MEDLINE database (1966 to present) was searched for all English language randomized controlled trials with keyword tolterodine. The search retrieved 10 randomized controlled trials involving tolterodine. Studies ranged from 2 to 12 weeks in duration. Nine trials studied tolterodine vs. placebo, 6 compared tolterodine vs. oxybutynin, 6 compared different doses of tolterodine, and 1 compared immediate-release and extended-release tolterodine. Doses of tolterodine were 0.5-4 mg bid or 4 mg extended-release daily, and doses of oxybutynin were 5 mg bid or tid. All studies found a benefit of tolterodine over placebo in decreasing symptoms of overactive bladder. Parameters significantly improved by tolterodine include number of voids per day, urine volume per void, number of incontinent episodes per day, pad use, maximal cystometric capacity, residual volume, volume at first detrusor contraction, and volume at normal desire to void. Tolterodine 2 mg bid was consistently of equal efficacy as oxybutynin 5 mg tid. Adverse events with both medications were mostly dose-related autonomic nervous system events. The most common adverse event was dry mouth, which was both more frequent and more severe with oxybutynin 5 mg tid than with tolterodine 2 mg bid. Dry mouth did not generally result in discontinuation of medication with either drug. Most drug withdrawal was because of blurred vision or headache. Tolterodine 2 mg bid caused less dose reduction, patient withdrawal, and adverse events, especially dry mouth, compared with oxybutynin 5 mg tid. A single trial found tolterodine extended-release 4 mg/day to have improved efficacy for decreasing urge incontinence episodes along with lower frequency of dry mouth vs. immediate-release tolterodine 2 mg bid. At 4 mg bid, tolterodine caused urinary retention. Neither drug significantly altered any laboratory tests, nor was there clear evidence of electrocardiographic abnormalities induced by either drug. In all randomized controlled trials to date, tolterodine 2 mg bid is an equally effective alternative to oxybutynin 5 mg tid, while causing less intense and less frequent dry mouth or need for treatment withdrawal.
 ...
PMID:Tolterodine: a clinical review. 1170 85

Dural ectasia is defined as a ballooning of the dural sac which is more common in patients with connective tissue disorders such as the Marfan syndrome. Several studies have shown that dural ectasia may be associated with such conditions as back pain, headaches, radiculopathies, or incontinence. We present a case of a 52 year old woman with Marfan syndrome who presented with a significantly large anterior sacral meningocele without having associated symptoms. In light of this case, we recommend that asymptomatic Marfan patients with dural ectasia should be closely observed without need for immediate surgical intervention.
 ...
PMID:Dural ectasia and back pain: review of the literature and case report. 1217 51

This study explores the evidence-based background for treating chronic anal fissure with topically applied nitroglycerin (NTG): in part the general effect of NTG and in part how its effect compares to that of surgery, which has been claimed to have long-term complications like incontinence for flatus and faeces. Ten randomised clinical trials published up to July 2001 were retrieved. In five of six studies, NTG had an effect on healing that was better than that of placebo or lignocaine. Headache is a common side effect of the treatment. Lateral internal sphincterotomy, the operation of choice for chronic anal fissure, and topical NTG were compared in four trials. Surgery had a better healing rate, but more late complications. The results suggest that in 31-65% of patients an operation could be avoided with NTG therapy. Topically applied 0.2% nitroglycerin three times a day for four weeks is therefore the primary choice in the treatment of anal fissures. But the possibility still remains that the observed effect of NTG may be the outcome of publication bias.
 ...
PMID:[Treatment of chronic anal fissure with topically applied nitroglycerin ointment. A systematic review of evidence-based results]. 1221 50

We report on the case of a 20 year old woman with no previous psychiatric history, who displayed a first episode of catatonia with acute onset. Symptoms started plainly with sudden general impairment, intense asthenia, headache, abdominal pain and confusion. After 48 hours, the patient was first admitted to an emergency unit and transferred to an internal medicine ward afterwards. She kept confused. Her behaviour was bizarre with permanent swinging of pelvis, mannerism, answers off the point and increasingly poor. The general clinical examination was normal, except for the presence of a regular tachycardia (120 bpm). The paraclinical investigations also showed normal: biology, EEG, CT Scan, lumbar puncture. Confusion persisted. The patient remained stuporous, with fixed gazing and listening-like attitudes. She managed to eat and move with the help of nurses but remained bedridden. The neurological examination showed hypokinaesia, extended hypotonia, sweating, urinary incontinence, bilateral sharp reflexes with no Babinski's sign and an inexhaustible nasoorbicular reflex. The patient was mute and contrary, actively closed her eyes, but responded occasionally to simple instructions. For short moments, she suddenly engaged in inappropriate behaviors (wandering around) while connecting back to her environment answering the telephone and talking to her parents. The patient's temperature rose twice in the first days but with no specific etiology found. During the first 8 days of hospitalization, an antipsychotic treatment was administered: haloperidol 10 mg per os daily and cyamemazine 37.5 mg i.m. daily. Despite these medications, the patient worsened and was transferred to our psychiatric unit in order to manage this catatonic picture with rapid onset for which no organic etiology was found. On admission, the patient was stuporous, immobile, unresponsive to any instruction, with catalepsy, maintenance of postures, severe negativism and refusal to eat. A first treatment by benzodiazepine (clorazepate 20 mg i.v.) did not lead to any improvement. The organic investigations were completed with cerebral MRI and the ruling out of a Wilson's disease. Convulsive therapy was then decided. It proved dramatically effective from the first attempt; 4 shocks were carried out before the patient's relatives ask for her discharge from hospital. The patient revealed she had experienced low delirium during her catatonic state. The clinical picture that followed showed retardation with anxiety. She was scared with fear both for the other patients and the nursing team. She kept distant and expressed few affects. The treatment at the time of discharge was olanzapine 10 mg per os. She was discharged with a diagnosis of catatonia but with no specific psychiatric etiological diagnosis associated. She discontinued her follow-up a few weeks later. After one year, we had no information about her. Catatonia has now become rare but remains a problem for clinicians. We reviewed data concerning short term vital prognosis and psychiatric long term prognosis in catatonia. Lethal catatonia is associated with acute onset, both marked psychomotor and neurovegetative symptoms. In the light of literature, there is no proband clinical criterion during the episode that is of relevant diagnostic value to ascertain the psychiatric etiology.
 ...
PMID:[Catatonia de novo, report on a case: immediate vital prognosis and psychiatric prognosis in longer term]. 1264 Mar 30

A 38-year-old man was admitted to our hospital with headache, dysarthria and paraparesis. Brain CT and diffusion MRI disclosed cerebral infarction at bilateral anterior cerebral artery (ACA) territories. His symptoms and signs deteriorated in several days despite intensive antithrombotic therapy, resulting in right hemiparesis, akinetic mutism, memory disturbance, change of personality, urinary incontinence, forced grasping, and starting delay of speech and motion. Cerebral angiography demonstrated occlusion with contrast pooling at the right ACA A2 portion. Stenosis and dilatation were found at left ACA A2 portion. An intimal flap was also demonstrated on serial angiography. This case was diagnosed as cerebral infarction caused by dissection of bilateral ACA. Although no definite primary arteriopathy was demonstrated, bilateral dissection could be occurred simultaneously.
 ...
PMID:[A case of juvenile cerebral infarction caused by bilateral anterior cerebral artery dissection]. 1266 Nov 8

Diagnosis of chronic anal fissure is easy and common in clinical practice. Little is known about the etiology and pathogenesis of this disorder. Current investigations consider anal sphincteric hypertonia and ischemia as primary factors in the appearance and maintenance of this lesion. Recurrence rate after healing is high, so anal fissure may be a chronic disease that evolves depending on sphincteric features. Conservative measures to avoid constipation, including fiber intake, are useful to improve symptomatology, achieve healing, and reduce recurrence. Surgical treatment is the most effective procedure for chronic anal fissure. Lateral internal sphincterotomy achieves healing in most cases (more than 95%) and the recurrence rate is low (1% to 3%). However, permanent fecal incontinence may appear after surgery and available data about this complication are controversial. In recent years, chemical sphincterotomy has been developed as an option in the treatment of chronic anal fissure. This medical option aims to achieve the effectiveness of surgery without side effects, by means of a temporary decrease of anal pressures that allows fissures to heal. Local injection of botulinum toxin into the anal sphincter is the most successful medical option, nearly as effective as surgery and without significant adverse effects (transitory episodes of mild fecal incontinence). Although more studies are needed to establish the method of administering this treatment, in our opinion botulinum toxin is an effective option in a high percentage of cases, especially in patients who risk developing incontinence. Compared with botulinum toxin, topical nitroglycerine ointments, which produce a transitory sphincteric relaxation, have the advantage of being a simple and accessible procedure. However, we think that this option should not be a first choice because its effectiveness is lower compared with surgery (about 60% to 70%), its compliance with the application could be poor, and it has a greater percentage of side effects (eg, headache). Other topical treatments (eg, calcium channel antagonist or cholinergic agonists agents) appear to be as effective as nitroglycerine agents and do not have significant adverse effects, but little data exist about these options. In our opinion, treatment of chronic anal fissure must be individualized, depending on the clinical profile of patients. Medical treatment, especially injection of botulinum toxin, should be taken into account if risk for developing incontinence is suspected.
 ...
PMID:Chronic Anal Fissure. 1274 25

A generally accepted grading system for patients suffering from chronic hydrocephalus has not been established yet. Therefore we designed a new grading system, which focuses on five symptom categories: gait disturbances, mental disorder, incontinence, headache, dizziness. For each category clearly circumscribed degrees of handicaps are defined. For each degree a value between 0-6 points is assigned in concordance to the severity of handicap. To get a generally accepted validation of the obstruction, the assigned values were oriented on the values provided in Germany to evaluate the degree of obstruction for insurances.[nl]In contrast to the established gradings of Stein and Langfitt and the Black Rating Scale our grading allows a more exact acquisition of the clinical presentation of a patient. Our experiences with the grading seemingly indicate also, that it is reliable. Because the grading allows an incorporation of measurable data such as psychometric analysis or gait analysis, our grading is useful as well for everydays' practice as for scientific purpose.
 ...
PMID:[A grading system for chronic hydrocephalus]. 1297 45

We studied a series of 93 patients diagnosed with craniopharyngioma during a 15-year period with respect to presenting symptom, clinical course and management. The majority (62%) of patients were men, and had presented with neurological symptoms (75%), with headaches (82%) being the most common presenting symptom. The incidence of certain endocrine and ophthalmic symptoms varied little from that in the literature, on the other hand, the incidence of certain other symptoms did differ markedly from the literature. For example, loss of libido and amenorrhoea were seen at a much lower frequency than that stated in the literature. Hypertension, sensorimotor symptoms and urinary incontinence were not seen at all in our patients. In most cases diagnosis was made by a cranial CT scan, which is more sensitive than plain radiography for detection of enlarged sella turcica (69% vs. 24%; P < 0.001). In over 90% of cases, therapy consisted of removal of a variable portion of the tumour, with or without radiotherapy. Post-operative mortality was substantially reduced in cases treated by radiotherapy (P < 0.05). The most common post-operative complications in all cases were recurrence of disease, panhypopituitarism and diabetes insipidus.
 ...
PMID:Presentation and outcome of 93 cases of craniopharyngioma. 1496 70


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>