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Though there has been increased emphasis on women's health and on community participation in the development of health policy, 'ordinary women' have seldom been asked about their major health concerns. This paper reports on a survey of a stratified random sample of 356 women in Hamilton. Among their main worries regarding health were various cancers and heart disease. The health problems they had experienced in the previous six months which had bothered them most were stress, arthritis, being overweight, migraines/chronic headaches and tiredness. On the basis of these and similar data presented here, it is argued that such community surveys provide an important source of data. They identify somewhat different priorities than approaches which rely on the opinions of experts and other key informants.
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PMID:Women's views of their main health problems. 147 66

This study represents a secondary data analysis of two double-blind and placebo-controlled clinical trials of lithium, performed to contrast side effects associated with lithium administration to those associated with placebo. The sample consisted of 91 hospitalized children, aged 5.12 to 12.92 years (mean 9.16), diagnosed as having conduct disorder characterized by severe aggressiveness and explosiveness. Daily doses of lithium ranged from 250 to 2100 mg. During the entire treatment period, more side effects were seen in the lithium group than in the placebo group, whereas during the therapeutic dose period, the difference between side effects in the two groups diminished. The most common side effects seen exclusively with lithium administration included enuresis, fatigue, and ataxia. Increased aggressiveness was observed in 4 children who received placebo. Vomiting, headache, and stomachache were the most common side effects experienced by patients in both lithium and placebo groups. However, more patients experienced these side effects in the lithium group than in the placebo group.
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PMID:Side effects associated with lithium and placebo administration in aggressive children. 148 Jul 37

In a cross-sectional study of headache disorders in a representative general population, the prevalence of migraine and tension-type headache was assessed in relation to various psychosocial factors. The random sample comprised 1000 25-64 year old men and women of whom 740 attended the investigation. The headache disorders were classified on the basis of a clinical interview, a physical and a neurological examination using the operational diagnostic criteria of the International Headache Society. None of the sociodemographic variables: marital status, cohabitation, educational level, occupational category or employment status were significantly associated with migraine or tension-type headache. In the univariate analyses tension-type headache was significantly associated with a high Neuroticism score on the Eysenck Personality Questionnaire whereas migraine was not. Variables on work conditions and psychosocial factors significantly associated with the headache disorders in univariate analyses were subjected to multivariate analysis. Migraine was significantly associated with exposure to chemicals and fumes at work in women and poor self-appraisal of health in men. In the univariate analyses tension-type headache was significantly related to a series of psychosocial variables. In the multivariate analyses it remained associated with a current feeling of fatigue in both sexes, time-pressure at work in women and exposure to fumes in men.
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PMID:Migraine and tension-type headache in a general population: psychosocial factors. 148 19

One of a novel series of compounds (AMAPS or arylmethylaminopropanediols), 773U82-HCl has shown significant antitumor activity in in vitro and in in vivo tumor systems, but has less animal CNS toxicity than the lead compound in the same series (crisnatol). This study was designed to evaluate the pharmacokinetics, qualitative and quantitative toxicities of 773U82-HCl and to determine the recommended phase II dose (MTD) of 773U82-HCl given as a short infusion daily for 3 days every 3 weeks. Twenty-nine patients with refractory malignancies received 79 courses over 9 dose levels during this study. Doses ranged from 50 to 1060 mg/m2/d x 3 days. Due to the possibility of local hemolysis with concentrations > 1.5 mg/ml, drug was administered in solutions containing < or = 1.5 mg/ml. Because large volumes were needed at the higher dose levels, the infusion duration was increased from 2 hours to 4 hours. Mild to moderate nausea, vomiting, fatigue, dizziness and headaches were observed. Myelosuppression was the dose limiting toxicity. The recommended phase II dose and schedule was determined to be 800 mg/m2/d x 3d every 3 weeks. 773U82-HCl plasma concentration-time data were analyzed using a two-compartment pharmacokinetic model. The t1/2 beta averaged 6 hours and the total body clearance was 75.9 L/hr/m2. The volume of distribution (Vdss) was large, averaging 470 L/m2.
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PMID:Phase I evaluation of 773U82-HCl in a two-hour infusion repeated daily for three days. 148 1

The aim of this study was to verify long-term therapeutic efficacy and tolerance of dihydroergocristine (DHEC, CAS 17479-19-5) in a double blind placebo controlled study, in elderly patients with psychosyndrome characterized by memory and behaviour impairment. Two hundred patients, aged more than 65 years, were randomly divided into two groups of one hundred each. The first group received one 6-mg DHEC tablet daily for four months and the other group received placebo. The evaluation parameter for efficacy was the neuropsychological test SCAG (Scale of Clinical Assessment for Geriatrics), administered before and after 30, 60 and 120 days. The results showed a significant difference between DHEC and placebo with regard to total and partial scores of SCAG as well as to single items (mental alertness, recent memory, disorientation, anxiety, mood depression, emotional lability, motivation, uncooperativeness, fatigue, headache, tinnitus). After as few as thirty days of DHEC treatment the severity of mental and psychological symptoms was markedly decreased (p vs placebo < 0.01), as documented by significant positive changes of SCAG items. The four-month double blind period was followed by a two-month single blind period, during which patients of both groups received placebo. At the end of these two months, SCAG total score was unfavourably increased in patients previously administered DHEC, although scores were still significantly lower both versus baseline and versus previous placebo patients. Safety was good (placebo: one case of diarrhea; DHEC: one case of gastralgia and dizziness). Nine patients dropped out for reasons unrelated to treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Controlled study of the effect of dihydroergocristine on organic brain psychosyndrome]. 149 63

To our knowledge there is no study that answers the question, whether low blood pressure itself or the fall of blood pressure during standing have a negative effect on pregnant women. These patients suffer from signs of reduced central and/or peripheral blood flow like fatigue, headache, cold extremities, paresthesia, flickering, black outs and dizziness. In addition, it is of interest whether frequency, occurrence and intensity of these hypotensive symptoms alter during pregnancy. In a longitudinal study 12 hypotensive pregnant women were compared with 13 normotensive and later on in a randomized study 102 clinical healthy pregnant women were tested with a modified orthostatic test over defined time periods during pregnancy. Blood pressure and heart rate were registered in one minute intervals over 30 minute period with an automatic Dinamap measuring device. This period was subdivided in a 10 minutes lying period, 10 minutes standing period followed by a 10 minutes lying period. In addition, the pregnant women were asked about frequency, occurrence and intensity of typical hypotensive symptoms. The frequency of subjective symptoms were related to low blood pressure (p less than 0.001) but not to the fall in blood pressure during standing. The occurrence of different hypotensive symptoms (p less than 0.05) and their intensity (p less than 0.01) were most often in early pregnancy and decreased until term. We conclude that the subjective symptoms were twice as much during early pregnancy than during late pregnancy and were more often in patients with low blood pressure. Furthermore, fatigue, headache and cold extremities occur frequently during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hypotonic symptoms and pregnancy]. 149 47

The effects of the exposure to ozone in the central nervous system are unknown, as it is doubtful if ozone enters beyond the respiratory tract. However, ozone exposure impairs human performance and induces subjective complaints such as fatigue, lethargy and headache. We studied electrographic aspects of sleep-wake organization in cats, and found that paradoxical sleep was promptly reduced during ozone exposure, followed by a dose-related increase of slow-wave sleep. These findings suggest that high concentrations of ozone or its reaction products induce striking changes in sleep patterns.
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PMID:Sleep-wake disorganization in cats exposed to ozone. 150 89

A cross sectional study of biological markers of neurochemical function in peripheral blood cells, and self reported nervous system symptoms, was conducted among 60 workers exposed to styrene in three reinforced plastics plants and 18 reference workers not exposed to styrene or other solvents. Concentrations of styrene in the air at the plants ranged from less than 1 to 160 ppm. Biomarkers of neurochemical function measured were: sigma receptor binding in lymphocytes, monoamine oxidase type B (MAO-B) activity in platelets, and serotonin uptake by platelets. Blood styrene concentration was used as the exposure index to take account of the use of protective equipment and dermal uptake. Four blood styrene exposure groups were defined as: non-exposed (reference) and exposed to less than 0.05, 0.05-0.19, and greater than or equal to 0.20 micrograms/ml. The prevalences of headache, dizziness, light headedness, fatigue, irritability, memory loss, and feeling "drunk" at work increased with increasing blood styrene concentration. No effect on sigma receptor binding was seen. A slight positive correlation was found for uptake of serotonin, which has been used as an exposure related effect indicator in previous studies of workers exposed to solvents. The MAO-B activity decreased with increasing blood styrene concentration; the mean (SE) MAO-B values for the four groups were 34.2 (3.0), 28.1 (5.3), 20.1 (4.8), and 16.9 (7.7) pmol/10(7) cells/min. The MAO-B activity also correlated negatively with the number of reported nervous system symptoms, whereas no associations were seen between prevalence of symptoms and either serotonin uptake or sigma receptor binding. The findings for MAO-B activity are consistent with previously reported experimental data, and suggest that MAO-B may be a useful marker of styrene neurotoxicity.
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PMID:Peripheral markers of neurochemical function among workers exposed to styrene. 151 48

The diagnosis of PMS depends on the identification of a core symptom complex, including behavioral symptoms of either irritability, accompanied by an internal state of anxiety or depression, and fatigue. (Fatigue is the most common symptom of PMS.) At least one core physical symptoms, bloating of the abdomen or extremities, breast tenderness, and headache also is required to establish the diagnosis. Although these core symptoms are required, none is pathognomonic for the disorder and the timing of the symptoms with respect to the menstrual cycle also must be established. This can only be done accurately using valid and reliable prospective recording instruments, such as COPE. Personality factors, the degree of psychosocial stress faced by the woman, and biochemical markers have little utility in establishing the diagnosis. The literature with respect to the prevalence of PMS in the population, effective treatments for the disorder, and the diagnosis of the disease must be interpreted by recognizing the inclusion in these studies of women with comorbid psychiatric disease, invalid and unreliable symptom inventories, and inadequate characterization of menstrual cycle phases. There are sociologic reasons why the true prevalence and treatment response to interventions may not be seen by the clinician. Nonetheless, the availability of effective treatment for the disorder necessitates accurate diagnosis of the syndrome based on the strict criteria presented. Additional research founded on the development of psychoneuroendocrine models is likely to provide insight into both the pathophysiology and treatment alternatives for PMS.
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PMID:Issues in the diagnosis and research of premenstrual syndrome. 152 87

This multi-center trial was carried out to assess the therapeutic potential of recombinant tumor necrosis factor (rTNF) as the first form of systemic therapy for advanced carcinomas of gastric and pancreatic origin. To be eligible patients were required to have no overt sign of coagulopathy and hepatic function studies with enzymes less than two times beyond the normal range. Twenty nine patients with gastric cancer and 26 with pancreatic cancer were entered from various institutions in the Southwest Oncology Group with 27 and 22, respectively, meeting eligibility criteria. Drug treatment consisted of rTNF (Genentech) given at a dose of 150 micrograms intravenously for five consecutive days every 3 weeks; 50% dose reduction was made for acute intolerance such as hypotension or severe fever and chills. Although eight patients with gastric cancer and five patients with pancreatic cancer received four or more courses of treatment, no objective antitumor responses were recorded. As in other trials common toxicities of rTNF included nausea and vomiting, chills and fever, hypotension, headache, myalgias, fatigue and malaise. However, in this trial, other toxicities became prominent: four episodes of symptomatic disseminated intravascular clotting occurred among patients with pancreatic cancer. Eleven with this disease and five with gastric cancer manifested laboratory findings of abnormal amounts of fibrin split products, and/or hypofibrinogenemia, and/or thrombocytopenia after treatment began. Other laboratory abnormalities that were commonly encountered included hyperglycemia, hypertriglyceridemia, anemia, neutropenia and an elevation in liver enzymes. We conclude that rTNF does not demonstrate antitumor efficacy against adenocarcinomas of the stomach and the pancreas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High incidence of coagualopathy in phase II studies of recombinant tumor necrosis factor in advanced pancreatic and gastric cancers. 152


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