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 17-year-old boy with known moyamoya disease developed an acute subdural hematoma after a mild head trauma. He had been confined to a wheelchair with contracture in the upper and lower extremities due to juvenile rheumatoid arthritis since age 1 year. He had undergone encephalo-duro-arterio-synangiosis (EDAS) on the right and encephalo-myo-synangiosis (EMS) on the left at 13 years of age. He was admitted with headache, nausea, and vomiting after a fall from his wheelchair at age 17. Computed tomography on admission showed a large acute subdural hematoma in the right fronto-temporal region but no bleeding at the EDAS or EMS sites. Cerebral angiography 12 weeks after the head trauma revealed a remarkable reduction in the spontaneous transdural external-internal carotid anastomoses in the right frontal region. The acute subdural hematoma was probably caused by rupture of the spontaneous transdural anastomoses.
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PMID:Acute subdural hematoma in young patient with moyamoya disease--case report. 137 64

We refer the results of an open non-comparative study aimed to evaluate the clinical efficacy of Diclofenac sodium in the treatment of Polyarticular Juvenile Chronic Arthritis. We decided to use this drug to investigate if it exerts also in younger patients the anti-inflammatory and analgesic effects known in adults. We treated 26 patients (14 girls and 12 boys) aged 2-16 years; the disease duration ranged between 3 months and 14 years. Treatment was started only if previous anti-inflammatory drugs had been considered ineffective after a prolonged use (3-12 months). None was on basic therapy. No wash-out period was used for ethical reasons. During the trial period other additional symptomatic or anti-inflammatory drugs were not used. Diclofenac sodium was given by tablets and/or suppositories at the mean daily dosage of 2.4 mg/kg (min. 0.3-max. 5, according to disease activity) for a period of 2-52 months. Diclofenac sodium was particularly effective on joint pain and morning stiffness but also on joint swelling, and functional capacity. We noticed a tendency of JRA to improve during the trial period. The drug was well tolerated; one patient stopped because of headache, another continued the treatment only per os because of intolerance of rectal administration.
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PMID:[Clinical efficacy of sodium diclofenac in chronic juvenile polyarthritis]. 223 63

In part II of a two-part series, the psychological aspects of painful medical conditions and their treatment are reviewed. While considerable attention has been devoted to the study of personality, family characteristics, treatment of recurrent abdominal pain, growing pains and headaches, with few exceptions these studies have significant methodological problems. Studies of the psychological aspects of pain associated with such pediatric disorders as cancer, sickle cell anemia, juvenile rheumatoid arthritis, and burns are generally only beginning to emerge, but at least a few of the single-case studies show appropriate attention to methodology. Areas needing further research are discussed.
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PMID:Psychological aspects of painful medical conditions in children. II. Personality factors, family characteristics and treatment. 354 Aug 11

Thirty-four patients with juvenile rheumatoid arthritis, who were treated with flurbiprofen at a maximum dose of 4 mg/kg/day, had statistically significant decreases from baseline in 6 arthritis indices after 12 weeks of treatment. Improvements were seen in the number of tender joints, the severity of swelling and tenderness, the time of walk 50 feet, the duration of morning stiffness and the circumference of the left knee. The most frequently observed side effect was fecal occult blood (25% of patients); however, there was no other evidence of gastrointestinal (GI) bleeding in these patients. One patient was prematurely discontinued from the study for severe headache and abdominal pain. Most side effects were mild and related to the GI tract.
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PMID:Flurbiprofen in the treatment of juvenile rheumatoid arthritis. 356 95

A regular control of nonsteroidal anti-inflammatory drug (NSAID) plasma levels may be useful to avoid undesirable side-effects to monitor therapeutic progress to see if patients are complying with their prescription. Trying to establish a relationship between the plasma concentration of a drug and its clinical effects requires a few prerequisites which may or may not be fulfilled according to the NSAID (e.g. a drug acting by itself, a reversible action, no tolerance to the drug, a highly specific and sensitive enough analytical method of the drug, similar free drug concentrations in the plasma and at the receptor sites,...), the most important of them-which is also probably the most difficult to fulfil in the case of rheumatic diseases-being that the clinical effect of the drug must be easily measured. In fact, the evidence for a good correlation between clinical effects and drug plasma levels are very scarce in the field of NSAID. The best correlation was obtained with salicylates for which ranges of plasma concentrations needed for observing therapeutic effects in rheumatoid arthritis as well as in juvenile rheumatoid arthritis have been established. Similar correlations have been made for side effects such as tinnitus or headaches as well as for toxic manifestations of salicylism. However, many individual variations have been described and there is considerable overlap between therapeutic and toxic concentrations. According to different authors there are or there are no correlations between phenylbutazone plasma levels and either is therapeutic or its side-effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Correlation plasma levels, NSAID and therapeutic response. 389 Nov 99

Auranofin (triethylphosphine gold) was administered to 21 patients with juvenile rheumatoid arthritis during an open-ended, open-label, noncontrolled trial designed to establish safety and preliminary efficacy. Initial dosage was 0.1 mg/kg/day; incremental increases to 0.2 mg/kg/day were allowed. Aspirin (80 mg/kg/day), tolmetin (20 to 40 mg/kg/day), and naproxen (400 to 600 mg/m2/day) were allowed as rapidly acting anti-inflammatory agents. All patients attained measurable plasma concentrations of gold during the study. Clinically significant improvement (greater than 25%) occurred in more than half the patients with regard to the number and severity of joints with swelling, pain on motion, and tenderness. The number of joints with active arthritis decreased by at least 25% in nine of the 19 patients. Group mean changes between the initial and final visit indicated improvement in all articular disease indices measured. Eleven of 16 patients with an elevated erythrocyte sedimentation rate showed decreases of at least 25%. The group given the higher dosage had a greater proportion of responders with decreases in erythrocyte sedimentation rate. Four of six patients whose sera contained rheumatoid factor showed decreases in its titer. Discontinuation of auranofin was necessary in two patients because of headaches and because of hematuria and anemia associated with a severe flare of polyarticular disease, respectively. The results from this trial are sufficiently encouraging to merit a double-blind trial of auranofin in children with juvenile rheumatoid arthritis.
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PMID:Auranofin in the treatment of juvenile rheumatoid arthritis. 640 27

Pharmacologic management of juvenile rheumatoid arthritis is only one of several modalities necessary for effective control. The stepping stones to proper management include a planned long-range program, physical therapy with swimming, good health habits, and consultation with other health professionals who are part of the management team. Pharmacologic therapy includes nonsteroidal anti-inflammatory drugs initially, occasionally corticosteroids, and slow-acting antirheumatic drugs, including injectable gold when therapeutic response is inadequate. Early experiences with oral gold are reported here. Auranofin (triethylphosphine gold) was administered to 21 patients with juvenile rheumatoid arthritis during a segment I, open ended, open-label, noncontrolled trial designed to establish safety and preliminary efficacy. Initial dosage was 0.1 mg/kg per day; incremental increases to 0.2 mg/kg per day were allowed (with usual increase to 0.15 mg/kg per day). Aspirin (80 mg/kg per day) or tolmetin (20 to 40 mg/kg per day), or naproxen (400 to 600 mg/m2 per day) were allowed as rapidly acting antiinflammatory agents. Stable measurable plasma concentrations of gold were attained in all patients during the study. More than half the patients sustained clinically significant improvement (greater than 25 percent) with regard to the number and severity of joints with swelling, pain on motion, and tenderness. In nine of the 19 patients, the total number of joints with active arthritis decreased by at least 25 percent. All articular disease indices measured indicated improvement of group mean changes between the initial and final visit. Eleven of 16 patients with an elevated erythrocyte sedimentation rate showed decreases of at least 25 percent. The group given higher dosages had a greater proportion of responders in regard to decreases in erythrocyte sedimentation rate (nine of 11 patients). Four of six patients whose serums contained rheumatoid factor showed decreases in the titers. Discontinuation of auranofin was necessary in two patients: one because of headache and one because of hematuria and anemia associated with a severe flare-up of polyarticular disease. The results from this trial reveal sufficient patient improvement to plan a double-blind trial of auranofin in children with juvenile rheumatoid arthritis.
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PMID:Early experiences with auranofin in juvenile rheumatoid arthritis. 641 99

We studied 50 patients (28 male and 22 female) with the hyper-IgD and periodic fever syndrome. Most patients originated from Europe, namely The Netherlands (28 cases; 56%), France (10 cases, 20%), and Italy (3 cases, 6%), but 1 patient was from Japan. A hereditary component is suggested by 18 patients coming from 8 families. The syndrome is typified by a very early age at onset (median, 0.5 years) and life-long persistence of periodic fever. Characteristically, attacks occur every 4-8 weeks and continue for 3-7 days, but the individual variation is large. Attacks feature high spiking fever, preceded by chills in 76% of patients. Lymphadenopathy is commonly present (94% of patients). During attacks, 72% of patients complained of abdominal pains, 56% of vomiting, 82% of diarrhea, and 52% of headache. Joint involvement is common in the hyper-IgD syndrome with poly-arthralgia in 80% and a non-destructive arthritis, mainly of the large joints (knee and ankle), in 68% of patients. Eighty-two percent of patients reported skin lesions with some attacks; these demonstrated vasculitis histologically. Serositis has been seen in only 3 patients (6%), while amyloidosis has not been recorded in any of the patients with this syndrome. Immunizations precipitated attacks in 54% of patients. All patients had a persistently elevated serum IgD level (> 100 U/mL), and in 82% of cases the serum IgA was likewise elevated. During attacks there is an acute-phase response adjudged by leukocytosis, neutrophilia, and increased ESR. The etiology remains to be elucidated, and treatment is supportive. The hyper-IgD syndrome is distinct from other periodic fever syndromes like systemic-onset juvenile rheumatoid arthritis, adult-onset Still disease, and familial Mediterranean fever.
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PMID:Hyperimmunoglobulinemia D and periodic fever syndrome. The clinical spectrum in a series of 50 patients. International Hyper-IgD Study Group. 819 36

We report a 38-year-old male with recurrent cerebral infarction, who had a history of juvenile rheumatoid arthritis and suffered from ischemic necrosis of the jejunum at the age of 34 years. When the patient showed gastrointestinal symptoms, amyloid deposits were found with colon biopsy. The patient experienced recurrent episodes of headache and left homonymous lower quadrantanopsia at the age of 38 years. CT and MRI of the head revealed cerebral infarction in the right parieto-occipital region. At this time, amyloid deposits were detected in the mucosa of the stomach, duodenum, and rectum. Immunostaining revealed that amyloid fibrils were composed of amyloid A (AA) protein. It is possible that AA type amyloidosis may be of importance in the etiology of cerebral infarction in the young adult.
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PMID:Central nervous system involvement in amyloid A type amyloidosis. 890 38

A 22-year-old Caucasian woman with a 6 year history of persistently active, systemic onset juvenile rheumatoid arthritis (JRA) developed symptoms of headache, dry cough, nausea, vomiting, abdominal pain, diarrhea, and dehydration associated with a high fever, elevated liver enzymes, and lymphopenia. Subsequent investigation revealed acute infection with parvovirus B19. Following clinical improvement over 10-14 days solely with supportive care, her underlying disease remained in remission for about 7 months.
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PMID:Remission of juvenile rheumatoid arthritis after infection with parvovirus B19. 1055 14


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