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 total of 930 patients have been evaluated for safety in a programme of clinical trials for lisinopril-hydrochlorothiazide combination treatment. Combination therapy with these two agents is generally well tolerated. In clinical trials, adverse experiences in patients treated with a lisinopril-hydrochlorothiazide combination were dizziness (7.5%), headache (5.2%), cough (3.9%), fatigue (3.7%), orthostatic effects (3.2%), diarrhoea (2.5%), nausea (2.2%) and upper respiratory tract infection (2.2%). Withdrawals from treatment have been relatively infrequent comprising dizziness (0.8%), headache (0.3%), cough (0.6%), fatigue (0.4%), diarrhoea (0.2%), orthostatic effects and nausea (0.1% each). The most common laboratory adverse experiences in patients on therapy with the lisinopril-hydrochlorothiazide combination are: increases in serum glucose, triglycerides, uric acid, serum creatinine, blood urea nitrogen and blood urea; and decreases in serum potassium. However, in individual controlled studies, the addition of lisinopril to treatment with hydrochlorothiazide results in attenuation of some of the potentially adverse metabolic affects of the diuretic. Adverse experiences in the patients treated for periods of 50 weeks or more, the elderly and the renally impaired are similar to those seen in the total population. Overall the available data indicate that a fixed dose combination of lisinopril-hydrochlorothiazide is a well-tolerated therapeutic option in patients with mild-to-moderate hypertension.
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PMID:Review of international safety data for lisinopril-hydrochlorothiazide combination treatment. 166 80

An outbreak of severe haemorrhagic illness began in the municipality of Guanarito, Portuguesa State, Venezuela, in September, 1989. Subsequent detailed study of 15 cases confirmed the presence of a new viral disease, designated Venezuelan haemorrhagic fever. Characteristic features are fever, toxicity, headache, arthralgia, diarrhoea, conjunctivitis, pharyngitis, leucopenia, thrombocytopenia, and haemorrhagic manifestations. Other features include facial oedema, cervical lymphadenopathy, nausea/vomiting, cough, chest or abdominal pain, and convulsions. The patients ranged in age from 6 to 54 years; all were residents of rural areas in central Venezuela, and 9 died. Infection with Guanarito virus, a newly recognised arenavirus, was shown by direct culture or by serological confirmation in all cases. Epidemiological studies suggest that the disease is endemic in some rural areas of central Venezuela and that it is rodent-borne. Venezuelan haemorrhagic fever has many similarities to Lassa fever and to the arenavirus haemorrhagic fevers that occur in Argentina and Bolivia.
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PMID:Venezuelan haemorrhagic fever. 168 54

Most of the symptoms from a malignant tumor are caused by local invasion by the tumor, or obstruction, either at the site of the primary disease or by metastases. However, tumors can produce symptoms at a remote site. Patients with gastrointestinal malignancy may present with symptoms which include dysphagia, nausea, vomiting, abdominal pain, diarrhea, bleeding and ascites. Palliation gastrectomy delays or prevents these symptoms. About 30% of gastric carcinomas are inoperable at the time of presentation. Chemotherapy is rarely effective in the palliation of gastric carcinoma. Laser irradiation can be delivered to assay site accessible to fibreoptic endoscopy, which is an advantage over endocavity irradiation or diathermy fulguration. Ascites is a common and disabling implication in patients with advanced malignant disease. Spironolactone will increase urinary sodium excretion significantly and control their ascites. If spironolactone fails to control, useful control can be achieved by draining the ascites. Patients with carcinoma of the lung may present with symptoms that include cough, bloody sputum and dyspnoea. Pain in the chest wall is usually secondary to invasion of the parietal pleura, ribs or intercostal nerves. Lesions in the medial portion of the right upper lobe, or mediastinal metastases, may invade or compress the superior vena cava, causing venous hypertension with oedema of the head and arms. The patients may complain of dyspnoea, dysphagia, stridor and headaches. Radiotherapy can be expected to improve the quality of life for these patients. Successful palliation of symptoms is almost related to tumor regression. The problems of obstruction and bleeding from malignant tumor is common. Recently, laser techniques have been applied to aid in palliation of these problems. Malignant effusion may occur early and be the first signs of metastases. The aim of therapy is to evacuate the fluid and induce pleural adhesion. One of the sad situations that we have to face is the patient with recurrent cancer which complains of various symptoms. The relief of symptoms is the most important palliative therapy to them.
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PMID:[Palliative therapy in cancer. 3. Palliation of the symptoms from a malignant tumor (1)]. 169 82

Some patients report rhinitis symptoms after exposure to environmental tobacco smoke (ETS), but objective assessments of this response have been lacking. Furthermore, the mechanism of this response is unknown. We assessed the frequency of ETS-related symptoms by administering a questionnaire to 77 healthy nonsmoking young adults who were participating in an unrelated study. Of the subjects 34% (26 of 77) reported one or more rhinitis symptoms (congestion, rhinorrhea, or sneezing) following ETS exposure. We then exposed 10 historically ETS-sensitive (ETS-S) and 11 historically ETS-nonsensitive (ETS-NS) subjects to 15 min of clean air followed by 15 min of sidestream tobacco smoke (CO concentration of 45 parts per million). At selected time points during these procedures we recorded symptoms, posterior nasal resistance, and spirometry and performed nasal lavages. ETS-S but not ETS-NS subjects reported significant (p less than 0.01) increases in nasal congestion, headache, chest discomfort or tightness, and cough following exposure to sidestream tobacco smoke. Rhinorrhea symptoms were greater and more prolonged in ETS-S subjects compared to ETS-NS subjects. Significant (p less than 0.01) increases in perception of odor and in eye, nose, and throat irritation occurred in both study groups, but ETS-S subjects reported significantly more nose and throat irritation. No significant changes in posterior nasal resistance occurred in the ETS-NS group but a significant increase occurred in the ETS-S subjects, with the resistance rising from 3.8 +/- 0.5 cm H2O/L/s (mean +/- SE) preexposure to a peak of 8.0 +/- 2.7 cm H2O/L/s 20 min after completion of the smoke exposure (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Upper respiratory tract environmental tobacco smoke sensitivity. 171 Aug 79

A total of 555 hypertensive patients took part in a 2-year multicenter, open-label study to determine the efficacy, tolerance, and safety of long-term therapy with ramipril. In the beginning, all patients were to receive 5 mg of ramipril/day. The dosage was then adjusted in accordance with response to treatment and ranged from 1.25-20 mg of ramipril daily. Of these patients, 129 also received 25 mg of hydrochlorothiazide daily at some point during the trial. To evaluate whether tolerance to ramipril developed during long-term treatment, a subgroup of 202 patients was analyzed for efficacy maintenance. Prior to enrolling in the 2-year study, these patients had received ramipril monotherapy in a short-term, double-blind study and had been classified as responders, i.e., their diastolic blood pressure had been maintained at less than or equal to 90 mm Hg. At the end of 104 weeks of treatment, 45.9% of patients were on 2.5 mg of ramipril alone and 43.6% were on 5 mg of ramipril alone. Only four patients required the addition of 25 mg of hydrochlorothiazide. No clinically important changes occurred, and kidney function was well maintained. The most frequently reported adverse events excluding intercurrent illnesses were dizziness/vertigo (6%), asthenia (4%), nausea (3%), headache (2%), and abdominal pain, gastrointestinal disorder, rash, and increased cough (1% each). Ramipril was safe, effective, and well tolerated in the long-term treatment of patients with mild-to-moderate essential hypertension.
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PMID:Antihypertensive efficacy, tolerance, and safety of long-term treatment with ramipril in patients with mild-to-moderate essential hypertension. 172 24

In this study, the tolerability and safety of ramipril, as monotherapy and in combination with a low dose of furosemide, were assessed in patients with mild-to-moderate hypertension in general practice. After a placebo run-in phase, patients received ramipril as monotherapy in a dose of 2.5 to 5 mg daily for 6 weeks. Nonresponders (diastolic blood pressure greater than 90 mm Hg) entered a double-blind treatment period, and received either 10 mg of ramipril daily, or 5 mg of ramipril in combination with 20 mg of furosemide daily. The tolerability of the study medication was assessed by reported adverse events, and by monitoring blood cell count, electrolytes, serum creatinine, fasting blood glucose, and apolipoproteins AI and B. Of a total of 770 patients who entered the placebo run-in phase, 661 patients were enrolled in the first active treatment period. The most commonly reported adverse events were headache, cough, dizziness, asthenia, cramps, diarrhea, and nausea, but not all of these events were related to ramipril treatment. A total of 38 patients discontinued active treatment due to nonserious adverse events, mainly cough, dizziness, or diarrhea. There appeared to be a relationship between the prevalence of cough and ramipril dosage; however, an increased incidence of cough was also observed during outbreaks of influenza in France. There were no significant changes in laboratory variables during the study.
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PMID:Tolerability of ramipril in a multicenter study of mild-to-moderate hypertension in general practice. 172 26

A case of spinal cord sarcoidosis was reported with special reference to MRI findings. A 15-year-old man was admitted to our hospital because of gait disturbance for last six months. Neurological examination on admission showed spastic paraparesis and posterior column signs. MRI of the cervical spinal cord revealed diffuse swelling and low intensity signal in T1-weighted sequences, diffuse high intensity signal in T2-weighted, and multiple micro-nodular lesion in Gd-DTPA enhanced T1-weighted. At first multiple sclerosis was suspected, although the data of cerebrospinal fluid was not suggestive. Four weeks after admission general fatigue, fever, cough, and headache appeared and the neurological symptoms got worse. Chest film and CT revealed diffuse small nodular shadows in the lung field. Abdominal ultrasonography and CT showed hepatosplenomegaly. The general condition became worse in spite of antibiotic and antituberculotic drug therapy, but remitted spontaneously in four weeks. MRI findings also exacerbated and improved during the same period, being compatible with neurological manifestations. The diagnosis of sarcoidosis was made by transbronchial lung biopsy which revealed sarcoid granuloma. Multiple small nodules on Gd-DTPA enhanced T1-weighted MRI had not been reported in patient with spinal cord sarcoidosis.
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PMID:[A case of spinal cord sarcoidosis with interesting MRI findings]. 178 58

This multicenter trial compared the efficacy and safety of isradipine and enalapril in 160 patients with essential hypertension. Patients received isradipine or enalapril for 10 weeks after a placebo wash-out period of three to five weeks. Dosage was titrated for six weeks on the basis of blood pressure (BP) response and was then maintained for the remainder of the study. Isradipine reduced systolic and diastolic BP by 12 and 9 mm Hg, respectively, and enalapril by 10 and 7 mm Hg, respectively (between-treatment difference P less than .05 for diastolic BP). Overall, isradipine resulted in a higher responder rate, particularly among patients who had higher entry BPs. Fifteen enalapril-treated patients and four isradipine-treated patients discontinued treatment (four taking enalapril and none taking isradipine withdrew because of lack of efficacy). The most frequently reported adverse reactions were headache, dizziness, and edema in the isradipine group, and cough, headache, and chest pain in the enalapril group. Both drugs produced significant reductions in BP, but, in this study isradipine was more effective. The drugs were similarly well tolerated.
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PMID:A multicenter comparison of the safety and efficacy of isradipine and enalapril in the treatment of hypertension. 182 8

Oral administration of spiropent (clenbuterol), 20 mcg on waking in the morning and 40 mcg before sleep, daily for 2 months, was studied in 34 patients, 19 males and 15 females, aged between 27 to 73 years (mean 47.8 +/- 17.5), who had chronic reversible airways obstruction as defined by the A.T.S.'s criteria. Assessments were made before and after the trial by monitoring lung function parameters and patient's comment on efficacy, side effects and comfort. Except 5 patients, 2 suffering from severe headache and 3 from poor control of asthma who had withdrawn from this study after one week of treatment, all patients completed the trial. Six out of 29 patients who completed the trial needed additional steroid treatment and 9 needed beta 2-agonist inhalation during the treatment period. The results showed improvement of FEV1 more than 15% in 21 patients (72%), FVC in 17 patients (59%) and PEFR in 20 patients (69%). These increases were significant (p less than 0.0001). However, only 12 patients (41%) had marked subjective improvement at the end of treatment. Cough (21%), headache (10%), nausea (7%) and dizziness (3%) were the commonest side-effects. No clinical or statistical difference was found in changes of vital signs and laboratory parameters. In conclusion, clenbuterol was effective and well-tolerated in the majority of patients enrolled in this study with minimal side-effects and good compliance. It may be used for long-term treatment of chronic reversible airways obstruction at lower cost.
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PMID:Spiropent (clenbuterol): another choice for patients with chronic reversible airways obstruction. 184 57

We review the 257 patients hospitalized for meningitis in the Cantonal University Hospital, Geneva between 1st January 1980 and 31st December 1986. 104 patients had acute bacterial meningitis (32 Str. pneumoniae, 21 N. meningitidis, 10 Listeria monocytogenes, 8 streptococci, 5 H. influenzae, 5 staphylococci, 4 gram negative bacilli and 19 without identified bacteria), 124 patients had viral meningitis and 29 meningitis of other etiologies (6 tuberculous meningitis, 2 fungal meningitis, 1 leptospiral meningitis, 5 neoplastic meningitis--one already counted because of a meningitis due to Staph. epidermidis--2 meningitis consecutive to a meningeal irritation, 4 already treated meningitis of undetermined etiology, 2 chronic meningitis and 8 meningoencephalitis). The total mortality was 14.4%. It was zero in viral meningitis and 28% in bacterial meningitis (47% in cases of Str. pneumoniae, 5% in cases of N. meningitidis, 20% in cases of Listeria monocytogenes, 38% in cases of streptococci, 0% in cases of H. influenzae, 60% in cases of staphylococci, 50% in cases of gram negative bacilli, 16% in cases of unidentified bacteria). The striking difference in mortality emphasizes the importance of recognizing a bacterial etiology in order to institute antibiotic therapy as soon as possible. The delay between admission and lumbar puncture averaged 15 hours (range 0.25-96 h) in patients with acute bacterial meningitis and 6.3 hours (0.5-80 h) in patients with viral meningitis. The delay between admission and institution of the antibiotics averaged 5.3 hours (1-48 h) in cases of acute bacterial meningitis and 4.8 hours (0.5-48 h) in cases of viral meningitis. A better clinical workup may provide a reliable diagnosis sooner. In the collective with bacterial and viral meningitis headaches, fever or nuchal rigidity were present in over 80% of the cases. The following features were significantly associated with a bacterial etiology: age over 30 years, alcoholism, concomitant neoplasm, cough, coma, pulmonary rales, new neurological signs or petechia. At least one of these 4 latter signs was present in more than 70% of the cases with acute bacterial meningitis compared to 6% in cases of viral meningitis. Thus the clinical presentation alone serves to recognize the meningitis and to differentiate between a bacterial or viral etiology, thus permitting an immediate therapeutic decision without waiting for complementary investigations. The 104 patients with acute bacterial meningitis were treated with antibiotics: 60 with penicillin, 17 with ampicillin and 26 with other antibiotics; one case did not receive antibiotics. More than the half of the cases with viral meningitis have got antibiotics (52%).
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PMID:[Meningitis in adults in Geneva. Review of 257 cases]. 185 79


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