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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Influenza infection is a significant cause of morbidity and mortality in immunocompromised hosts, but its importance in adult cancer patients is largely undescribed. We therefore conducted a prospective study of the incidence and clinical features of influenza infection in patients with acute or chronic leukemia. The cohort, which consisted of all adult leukemia patients undergoing remission-induction chemotherapy during the 1991-1992 influenza epidemic, was followed prospectively for development of signs and symptoms of acute infection of the upper or lower respiratory tract. Of these 294 patients, 111 received chemotherapy as inpatients and 183 as outpatients. Throat swabs and nasal washes for viral culture were obtained from all symptomatic patients, who were then followed until all signs and symptoms resolved. Symptoms of respiratory tract infection developed in 37 leukemia patients (13%). Among these, influenza (A/Beijing/ H3N2) caused 3 (21%) of the 14 infections that developed during hospitalization but only 1 (4%) of the 23 that developed in the community (P = 0.14). Influenza patients presented with fever, rhinorrhea, nasal congestion, headache, and myalgia; those with other infections presented with signs and symptoms of lower respiratory tract infection (productive cough, rales, or rhonchi). Development of pneumonia was common in influenza patients, 1 of whom died from secondary fungal and gram-negative pneumonia. Influenza A virus infections accounted for a substantial portion of acute respiratory infections among adult leukemia patients during a community epidemic. Most infections appeared to be nosocomial and the most likely sources were visitors or hospital personnel. Immunization of household contacts and hospital staff may reduce the risk of influenza infection and its pulmonary complications in leukemia patients.
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PMID:Epidemiology of influenza A virus infection in patients with acute or chronic leukemia. 765 81

A deviated nasal septum not only can cause a blocked nose, but may also be associated with headaches. This study evaluates the nature of these headaches, the effect of submucous resection of the nasal septum, and the factors associated with postoperative headache relief. Deviated nasal septa were corrected by submucous resection in 99 men and 17 women. Patients were studied at 4 to 48 months (mean 18 months) postoperatively. Fifty-five of the 116 patients studied (47.4%) had preoperative recurring headaches. Thirty-five of the 55 patients with headaches (63.6%) experienced relief (complete or partial) of their headaches at a mean follow-up period of 18 months. Patients were more likely to be relieved of their headaches following submucous resection if the headaches were most intense over the frontal region, pressurelike in nature, and if the submucous resection resulted in relief of nasal obstruction. It is possible that headaches recur in the long term, and it is postulated that central mechanisms play a role.
Headache
PMID:Headaches associated with nasal obstruction due to deviated nasal septum. 767 57

Because cluster headache is short-lasting and tends to occur during the early morning hours, physicians rarely witness an attack. Accurate diagnosis is important because effective treatments are available. The diagnosis is made from the history of temporal pattern, reddening and tearing of the affected eye, and ipsilateral nasal congestion. An additional diagnostic aid is to invite patients to demonstrate how they respond to attacks. The pain, one of the worst known, causes extreme restlessness. 50 patients showed how they walk around, sit (or kneel) and rock, and clutch the affected side of the head. Diagnostic value apart, the patient will often be relieved to learn that bizarre behavioural responses are not a mark of insanity.
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PMID:Behaviour during a cluster headache. 810 27

Autonomic dysreflexia (AD) is a syndrome that consists of facial flushing, excessive sweating, nasal congestion, throbbing headache and paroxysmal hypertension which may occur in response to bladder distension in patients with spinal cord lesions above the T6 level. We report the case of a C2 quadriplegic patient who developed clinical features of AD along with cortical blindness and seizures after administration of meglumine (Hypaque) for diagnostic cystogram.
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PMID:Seizures and cortical blindness after meglumine (hypaque) administration: a variant of autonomic dysreflexia. 812 Mar 39

We studied the relation between the amount of textile and other soft fiber wall materials used in the office and the symptoms related to sick building syndrome in two identical, mechanically ventilated, eight-story office buildings. The study population consisted of 400 workers (85% of the source population): 264 males (66%) and 136 females (34%). A self-administered questionnaire inquired about the occurrence of symptoms and related personal and environmental determinants. The office environment was assessed concurrently. Exposure was defined as the surface area of textile or other soft wall material (SWM) in the office. The outcomes were formed using the 7-d prevalences of individual symptoms, including mucosal irritation score (eye irritation, nasal dryness, nasal congestion, pharyngeal irritation); allergic reaction score (eye irritation, nasal congestion, nasal excretion, sneezing); asthma reaction score (wheezing, breathlessness, cough); skin reaction score (dryness, itch, or irritation, rash); and general symptom score (headache, lethargy). In the logistic regression controlling for potential confounders, the adjusted odds ratio for the symptoms of mucosal irritation was 1.82 (95% confidence interval [95% CI] = 1.14, 2.90) in the low-exposure group, compared with the unexposed reference group; and 2.46 (95% CI = 1.15, 5.28) in the high-exposure group, compared with the reference group. Corresponding odds ratios for the symptoms of allergic reaction were 1.82 (95% CI = 1.14, 2.90) and 3.16 (95% CI = 1.41, 7.09). No difference was found in the risk for asthmatic or skin reactions or general symptoms. The results support a hypothesis that textile and other soft-fiber wall materials used in the office environment are possible determinants of sick building syndrome.
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PMID:Textile wall materials and sick building syndrome. 818 88

We examined the prevalence of chronic sinusitis among children who presented to allergy clinics with chronic (> or = 3 months) respiratory symptoms. Ninety-one patients, ranging from 2 to 17 years of age with 62% male and 72% white, completed the study. Fifty-nine percent of patients had positive skin test results, and 25.3% had chronic asthma. Paranasal sinuses were examined by coronal sinus computed tomographic scan. Sixty-three percent (58 to 91) had chronic sinusitis, 5.5% (5 of 91) had concha bullosa, 1% (1 of 91) had foreign body, and 19% (19 of 91) had deviated nasal septums. Among symptoms of sneezing, nasal congestion, postnasal drip, coughing, wheezing, rhinorrhea, and headache, no single symptom was an acceptable predictor of abnormality on computed tomographic scan examinations. Combining the symptoms of moderate to severe rhinorrhea and cough with minimum sneezing had a specificity of 95% and a sensitivity of 38% in predicting the presence of chronic sinusitis. Allergic rhinitis (p = 0.27), mild deviated nasal septum (p = 0.11), unobstructive concha bullosa (p = 0.13), and passive exposure to cigarette smoke (p = 0.53) were not risk factors associated with sinus abnormalities. Age (r = 0.30, p = 0.004) in pediatric patients with chronic respiratory symptoms was the single risk factor significantly associated with abnormalities on sinus computed tomographic scan. Seventy-three percent of children 2 to 6 years of age, 74% of children 6 to 10 years of age, and 38% of children older than 10 had chronic sinusitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic sinusitis among pediatric patients with chronic respiratory complaints. 825 16

Previous studies of patients outcomes after sinus surgery have generally described only a summary measure of overall change in symptoms or health status. This paper describes an outcomes-based longitudinal study of sinus symptom prevalence among thirty-one patients treated with endoscopic surgery for chronic sinusitis. Patients completed structured data collection forms to quantify the prevalence of commonly experienced sinus-related symptoms during an eight-week period both before surgery and six months after undergoing sinus surgery. Significant decreases in nasal symptom prevalence (post-surgery versus pre-surgery) were noted for headaches, nasal drainage, nasal congestion, sinus infection, and breathing difficulties. In addition, the proportion of subjects who rated their current health as "better" compared to one year previously increased from 27% pre-surgery to 58% six months after sinus surgery. These findings aid in quantifying the magnitude of improvement experienced by sinus surgery patients and provide further evidence that endoscopic sinus surgery represents an effective treatment for chronic sinusitis.
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PMID:Symptom relief after endoscopic sinus surgery: an outcomes-based study. 822 97

A subcutaneous injection of 6 mg sumatriptan rapidly and effectively stopped attacks of cluster headache. After a time lag of 4-14 minutes (mean 7 minutes) pain dramatically dropped to zero within seconds to single minutes (mean 56 seconds). This rapid effect may indicate that mere vasoconstriction is the mechanism behind the beneficial effect of sumatriptan in cluster pain. The findings support a scenario in cluster headache where an inflammation in the cavernous sinus affects the sympathetic fibers traversing the cavernous region. This leads to the miosis, ptosis and forehead anhidrosis but also to a dilated internal carotid arterial tree distal to the lesion. The dilatation, in combination with an obliterated drainage of the cavernous sinus by the inflammatory process, leads to progressive stasis in the sinus, to cause the painful attack. The attack terminates when the enhanced load on the sinus is reduced by constriction of vessels supplying the sinus, as is achieved by administration of sumatriptan. The present observation that other accompanying symptoms during attacks (nasal congestion, rhinorrhea, lacrimation and swelling of eyelids) disappeared in parallel with the pain points to the possibility that these symptoms may be directly related to venous stasis or activation of pain fibers, rather than resulting from a primary parasympathetic activation.
Headache 1993 Jan
PMID:Subcutaneous sumatriptan in cluster headache: a time study of the effect on pain and autonomic symptoms. 838

A series of 95 consecutive patients who have had a polypectomy was investigated with regard to clinical history and the morphology of the polyps. The results were compared with a series of 203 patients with allergy, of whom 12 had been polypectomized. The study revealed that a high percentage of the 95 patients had subjective complaints, particularly nasal congestion, nasal discharge, sneezing, headache, snoring and a loss of smell. The latter was present in nearly 58% of the patients, and persisted long after the operation in a third of the cases. More than 50% of the 95 patients had had 3 or more polypectomies. Rather few patients suffered from allergy-like conditions. Eighty-two of the 95 polyps were of the ordinary, oedematous, eosinophilic type; 7 were neutrophilic, fibro-inflammatory; 5 showed pronounced hyperplasia of the seromucinous glands, and 1 was a so-called polyp with atypical stroma. Only 6% of the 203 patients with allergy had had a polypectomy. Ten of the 12 polyps removed from the series of patients with allergy were of the ordinary type and 2 of the fibro-inflammatory type. A review of the literature is done concerning the association between nasal polyp and different diseases. The results of the present study support the concept that allergy is not the only cause for nasal polyps and that the accumulation of eosinophilic granulocytes observed in most polyps is often not related to allergy.
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PMID:The so-called 'allergic' nasal polyp. 844 21

A number of cytokines are used as haemopoietic growth factors and this review focuses on toxicities associated with granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-1, IL-3, IL-4, IL-6 and macrophage colony-stimulating factor (M-CSF). Both GM-CSF and G-CSF, currently approved for clinical use, are generally well tolerated by the majority of patients during short term administration. Constitutional symptoms and bone pain are the most frequently reported adverse effects, but they are rarely treatment-limiting. Reactivation of rheumatoid symptoms, and exacerbation of autoimmune thyroiditis or autoimmune haematological disorders have sometimes been described. Severe cardiovascular complications include the possibility for arterial thromboses and the vascular leak syndrome, which is more specifically observed with GM-CSF. Reports of several cases and small series of patients have suggested that growth factors might increase the pulmonary toxicity of chemotherapy, a possibility that remains debated and requires further attention. Generalised or local cutaneous reactions are frequently noted with GM-CSF. Leukocytoclastic vasculitis was observed with both growth factors, while neutrophilic dermatoses have been mostly described with G-CSF. Exacerbation of psoriasis and isolated anaphylactic reactions have appeared with GM-CSF and G-CSF. The hepatotoxic potential of the growth factors is not clearly established, but the occurrence of coagulation abnormalities has recently been reported. Renal and biological disturbances are usually transient. Long term treatment with GM-CSF and G-CSF also seems to be well tolerated, but the possible occurrence of several adverse events, i.e. bone disorders, leukaemia, unmasking or acceleration of underlying disease, require further investigation in patients receiving prolonged treatment, as in myelodysplasia. Finally, antibodies against growth factors have been reported only with GM-CSF. Other cytokines are still under investigation. Flu-like and constitutional symptoms, sometimes dose-limiting, have been reported with IL-1, IL-3, IL-4 and IL-6, while M-CSF was occasionally associated with such adverse effects. More specific adverse events, also frequently considered as dose-limiting toxicities, include hypotension with IL-1, severe headache or skin rash with IL-3, and nasal congestion and gastroduodenal lesions with IL-4. Severe capillary leak syndrome has been reported only with IL-4. M-CSF toxicity is minimal and limited to reversible but sometimes dose-limiting thrombocytopenia and ophthalmological symptoms with the recombinant product. Again, the safety of long term administration of these cytokines has not yet been determined, and IL-3-induced disease progression in myelodysplastic patients has been suggested.
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PMID:Clinical toxicity of cytokines used as haemopoietic growth factors. 865 81


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