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)

The present study was conducted to derive pediatric mianserin pharmacokinetic parameters, which were compared to those from healthy young adults, and to obtain preliminary information regarding the utility of mianserin for the management of hyperkinesis in children. The sample consisted of six prepubescent children with hyperkinetic behavior disorders who had not responded, or had developed tolerance to, stimulant medication. Mianserin pharmacokinetics were derived from plasma samples obtained over a 36- to 50-hour period following a single oral dose which ranged from 0.28 to 0.72 mg/kg. Children evidenced a significantly faster elimination half-life and a significantly smaller apparent kinetic volume of distribution than did adults, whereas maximum plasma concentration, time to maximum concentration, and apparent oral plasma clearance were similar. Ratings of behavioral deviance were obtained from teachers and parents during placebo and mianserin titration to a maximum dose of 40 mg/day. Although half the children showed some decrease in hyperactivity ratings, the small sample size and high variability of response preclude conclusions regarding the efficacy of mianserin for childhood hyperkinesis. Possible side effects in our sample included akathisia, excitability, insomnia, and migraine-like headache, as well as cardiovascular effects of tachycardia and two instances of minor electrocardiographic change. Our pharmacokinetic findings will be of import should mianserin prove useful for such childhood disorders as depression and/or enuresis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mianserin pharmacokinetics and behavior in hyperkinetic children. 359

Sleep disturbances being considered as a risk factor for headache and the enuretic episode being defined, preliminary data are reported on a clinical epidemiological survey into the greater risk that headache enuresis represents for women despite the fact that the phenomenon is more common among men. Finally it is hypothesised that there is only one qualitative and/or quantitative pathogenetic mechanism that may be transmitter type, or in the light of recent studies, receptorial.
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PMID:[Enuresis: clinico-epidemiologic study. Preliminary communication: its relation to essential headache]. 373 78

Primary care physicians have become increasingly reluctant to refer children for tonsillectomy and adenoidectomy (T and A) during the past years while antimicrobial therapy for pharyngotonsillitis and otitis media has become more common. Consequently, more children retain tonsils and adenoids throughout the childhood years. Airway compromise from adenotonsillar hypertrophy is reported in 11 cases-8 with insidious onset, 3 with acute onset. Typical symptoms occurring during sleep include snoring, snorting, enuresis and obstructive apnea. Daytime symptoms included hyponasal speech, oral respiration and morning cephalgia. Methods of assessing children with adenotonsillar hypertrophy and airway compromise included polysomnography and acoustic analysis of respiratory sounds. It appears that airway compromise from adenotonsillar hypertrophy is more common now that fewer children are undergoing T and A, is being more commonly recognized because of improved methods of assessment, or both.
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PMID:Adenotonsillar hypertrophy and upper airway obstruction in evolutionary perspective. 708 27

A survey carried out in the Shimshon family health centre in the rural area of Jerusalem revealed that 24 per cent of new patient-doctor contacts were for psychosomatic disorders.The three major. disorders-back pain, headache and abdominal pain-were present in almost 79 per cent of all psychosomatic contacts. Other common disorders were chest pains, palpitations, malaise and nocturnal enuresis. Classic illnesses such as peptic ulcer or asthma were less common. The incidence of peptic ulcer, asthma, atopic dermatitis and chest pains was higher among males than females; rates for headache, palpitations and malaise were higher for females than males. Back pain, headache and abdominal pains occurred differently among the five ethnic groups of the study population. Therapeutic care is carried out through assessment and study of the patient and his or her family.
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PMID:Psychosomatic disorders in a rural family practice in israel. 727 96

The purpose of this study is to determine the efficacy of desmopressin (DDAVP), a synthetic analogue of antidiuretic hormone, as an alternative therapy in the management of spinal cord injured (SCI) patients with neurogenic bladder dysfunction unresponsive to conventional therapy. Seven SCI patients (three men and four women) were treated with DDAVP after urodynamic evaluation. Despite treatment with anticholinergic agents, urodynamic evaluation demonstrated uninhibited detrusor contractions exceeding 30 cm H2O pressure at less than 300 ml cystometric capacity in all seven patients. Three patients had been managed with intermittent self-catheterization, but had socially unacceptable short intervals between catheterizations. Two women with incomplete injury were afflicted with significant nocturia (> 3 episodes/night). The remaining two patients managed with intermittent self-catheterization were troubled with nocturnal enuresis. The patients received 10 micrograms intranasal DDAVP once every 24 hours. Prior to DDAVP administration, the four patients who used DDAVP nightly experienced a median of four episodes of nocturia. After one month of DDAVP treatment, two patients had only one episode of nocturia per night and in the other two patients, nocturnal enuresis was completely eliminated. Three patients used daytime DDAVP administration at work to avoid frequent catheterization. The median period between bladder catheterizations increased from 2.5 hours before DDAVP to 6 hours while using DDAVP. Symptomatic improvement persisted during the follow-up period of 6-20 months (mean = 12). Side effects were infrequent; only one patient complained of transient headaches. Neither hyponatremia nor serum electrolyte abnormalities occurred. Our preliminary results suggest that DDAVP is safe and effective in the symptomatic management of complicated neurogenic bladder dysfunction in selected SCI patients.
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PMID:DDAVP in the urological management of the difficult neurogenic bladder in spinal cord injury: preliminary report. 786 58

Desmopressin is a commonly used, well-tolerated agent for the treatment of primary nocturnal enuresis and central diabetes insipidus. Intranasal desmopressin provides symptomatic relief with few serious complications. A 29-year-old woman with a long history of primary nocturnal enuresis began treatment with intranasal desmopressin. Although the enuresis ceased, she developed throbbing headaches, nausea, vomiting, paresthesia, lethargy, fatigue, and altered mental status over the next 7 days. When she came to the emergency room her sodium concentration was 127 mmol/L. The history of desmopressin use was not obtained at that time. She was treated with intravenous fluids and discharged. The symptoms returned and worsened over the next 4 days, and she returned to the emergency room stuporous. A repeat sodium was 124 mmol/L, and she was admitted. The history of desmopressin use was still not available. Medical evaluations included computerized tomography, lumbar puncture, complete blood counts, serum chemistries, and serologies. The next morning the woman was improved and informed clinicians of her desmopressin use. Without other causes for the hyponatremia, she was diagnosed with the syndrome of inappropriate antidiuretic hormone, presumably caused by desmopressin. Within 24 hours of fluid restriction and cessation of desmopressin, her symptoms and hyponatremia resolved. A review of the literature found 11 children and 2 adults in whom intranasal desmopressin was associated with hyponatremia, all of whom experienced seizures or altered mental status. Our patient illustrates the importance of early recognition and treatment of hyponatremia before the onset of seizures. When vague symptoms develop during desmopressin therapy, hyponatremia must be considered as part of the differential diagnosis. It may also be prudent to screen for electrolyte abnormalities in patients taking this agent to prevent serious iatrogenic complications.
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PMID:Intranasal desmopressin-induced hyponatremia. 888 98

Desmopressin is used for the treatment of nocturnal enuresis. Side effects reported with intranasal desmopressin are transient headache, nausea, abdominal cramps and water intoxication with hyponatremia and grand mal seizure. We report a case of water intoxication with low serum sodium and grand mal seizure in a healthy child treated for enuresis with desmopressin. The child experienced abdominal cramps and nausea prior to the convulsions. A computerised tomography scan of the brain gave the suspicion of increased intracranial pressure ICP. The child recovered fully. We therefore recommend that parents and child are fully informed about the administration and the risk of desmopressin. If a child on desmopressin treatment experiences abdominal cramps, nausea or headache the drug should be discontinued and a physician contacted for control of serum sodium. Temporary withdrawal of desmopressin should also be considered in cases of acute illness influencing water balance.
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PMID:[Acute water intoxication caused by intranasal desmopression--Minirin]. 919 Jul 22

To study the main predictors of childhood preschool headache, 1443 families expecting their first child were followed from the onset of pregnancy to the child's sixth year of life. Subject selection was based on stratified randomized cluster sampling. Of the children, 14.9% (144) suffered from headache disturbing daily activities at the age of 6 years. The mother's assessment of the infant's poor health (OR 2.5, 95% CI 1.1 to 5.8) and feeding problems (OR 1.9, 95% CI 1.1 to 3.2) at the age of 9 months predicted later occurrence of headache. At 3 years, depression and sleeping difficulties (according to Achenbach's psychological test) and recurrent difficulties in falling asleep (OR 3.2, 95% CI 1.5 to 7.2) were strong predictors. Headache in other family members (OR 3.5, 95% CI 2.0 to 5.9), especially in the mother (OR 1.7, 95% CI 1.2 to 2.4), predicted preschool headache in a child. At the age of 5 years, travel sickness (OR 2.8, 95% CI 1.5 to 5.1), nocturnal enuresis (OR 1.8, 95% CI 1.1 to 3.0), and the presence of long-term disease (OR 1.8, 95% CI 1.1 to 3.0) were strong predictors of later headache. At the same age, concentration difficulties (OR 2.3, 95% CI 1.3 to 4.2), behavioral problems (OR 2.7, 95% CI 1.1 to 6.4), unusual tiredness (OR 3.8, 95% CI 1.0 to 13.5), and, conversely, high sociability (OR 1.5, 95% CI 1.0 to 2.2) predicted headache. The three last-mentioned psychological factors seemed to be associated with concentration difficulties at the age of 5, which was found to be the strongest predictor. The parents of child headache sufferers often became aware of the child's problems long before the emergence of headache.
Headache 1998 Jan
PMID:Factors of early life as predictors of headache in children at school entry. 950 99

The response to nasal continuous positive airways pressure (nCPAP) of a wide variety of symptoms recognized to be associated with obstructive sleep apnoea syndrome (OSAS) was examined. Fifty-six consecutive patients with OSAS, confirmed by polysomnography (mean (SD) apnoea-hypopnoea index (AHI) 49.6 (22.6) events x h(-1), Epworth score 15.4 (5.0)), were asked to complete paired symptom evaluation questionnaires, before treatment and again after 4 months of nCPAP. The response rate was 80%. A control group of 21 consecutive OSAS patients of similar age, body mass index (BMI), AHI and Epworth score to the treated group but managed with conservative measures, completed the same questionnaires on two occasions, 4 months apart. The nCPAP-treated group showed significant reductions (Wilcoxon matched pairs test) in the symptoms of daytime sleepiness, restless sleep, heartburn, nocturia, enuresis, headache and nocturnal sweating, whereas controls showed no significant changes in these symptoms. There were no changes in BMI, smoking, alcohol consumption or exercise habits in either group. It was concluded that, in addition to improvements in symptoms of daytime sleepiness and restless sleep, a wide range of other symptoms may improve significantly with nasal continuous positive airways pressure therapy.
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PMID:Subjective efficacy of nasal CPAP therapy in obstructive sleep apnoea syndrome: a prospective controlled study. 1041 8

The ultimate objective of our epidemiological research is to complete a longitudinal population-based study to document the prevalence and impact of acute, recurrent, and chronic pain in children and adolescents. As the first phase of our epidemiological research, we developed a comprehensive screening instrument for identifying children with acute, recurrent, and chronic pain, the Pain Experience Interview. We designed this interview to provide information about the lifetime and point prevalence of various pains, and also to provide information about the intensity, affect, duration, and frequency of children's pain. The primary objective of this study was to validate the Pain Experience Interview using the discriminant validation procedure of group differences. The secondary objectives of our study were to obtain descriptive data on children's acute, recurrent, and chronic pain experiences and to conduct exploratory analyses on age- and gender-related differences in children's pain experiences. We interviewed 187 children from five different health groups (arthritis, cancer, enuresis, recurrent headaches, and healthy) to provide distinct subsets of children with respect to their acute, recurrent, and chronic pain experience, and from four different age groups (5-7, 8-10, 11-13, and 14-16 years) to provide distinct subgroups with respect to children's developmental level. To test the interview we determined a priori several study predictions about children's pain experiences. These included four predictions about the common response patterns that we would expect to observe for all children based on our understanding of acute pain caused by trauma/disease, and six predictions about the distinct response patterns that we would expect to observe based on the known differences among children in their experiences of headache, acute treatment-related pain, recurrent pain, and chronic pain. All study predictions were confirmed, demonstrating that the Pain Experience Interview is a valid screening instrument for differentiating children with different types of pain problems. The interview can provide estimates for the lifetime and point prevalence of various pains in children, and data on the intensity, affect, duration, and frequency of their pain experiences.
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PMID:A survey of children's acute, recurrent, and chronic pain: validation of the pain experience interview. 1086 46


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