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

Temporal arteritis is a systemic disease with local temporal artery symptoms, generalized constitutional symptoms and ocular involvement which affects the elderly. A study was undertaken to assess the clinical features of patients with temporal arteritis in a large multispecialty clinic practice. The study group consisted of 516 patients with clinical suspicion of temporal arteritis, of which 97 (18.8%) had a positive biopsy for arteritis. The records of these 74 females and 23 males were retrospectively reviewed for clinical implications of the disease. The average age of the cohort was 71.7 years, and male to female ratio was 1:3.2. There were 95 caucasians and 2 blacks. The most common clinical findings at presentation were abnormal temporal artery (65.9%), headache (64.8%), myalgias or arthralgias (46.6%), visual symptoms (37.1%) and fever (35.1%). Multiple symptoms were present in 97% of the patients. The erythrocyte sedimentation rate was > 50 mm per hour in 91% of patients. Corticosteroids were used to treat 95/97 patients. Twenty-seven (28%) of the patients completed treatment over an average 36.3 months. Sixty-eight (72%) other patients were either lost to follow-up, died, or continue on therapy. Complications of corticosteroid treatment occurred in 43 (44.3%) of patients, and complications of temporal arteritis occurred in 14 (14.4%). A review of biopsy data showed no difference in length of biopsy or yield of biopsy in the patients with positive and the patients with negative histology. Temporal arteritis is a systemic disease which responds well to corticosteroid treatment. Complications of the disease as well as of treatment make definitive diagnosis imperative.
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PMID:Temporal arteritis. Clinical implications for the vascular surgeon. 144 81

To document the clinical presentation of malignant accelerated hypertension in Nigerians, 56 patients were studied between 1987 and 1989 (30 months). Age range was 16 to 55 years with 59% in the range of 30-49 years; 47 were male. Mean systolic and diastolic blood pressures were 217 mmHg and 146 mmHg, respectively. Thirty patients had grade III and 26 grade IV hypertensive retinopathy. Mean body mass index was only 22.4 in the 21 patients who had no evidence of fluid retention. Seventy-five percent of patients had no awareness of hypertension. Essential hypertension accounted for 66%, chronic renal disease 32% and renal artery stenosis 2% of cases. The most common clinical features were headaches (80%), fatigue (68%), oliguria (52%), heart failure (46%), weight loss (41%), and poor vision (21%). Multiple symptoms were common and 24 patients had both renal and cardiac failure. Laboratory features included microscopic haematuria (100%) and proteinuria (100%). In 37 patients with essential hypertension, renal failure was a complication in 60%. Microangiopathic haemolytic anaemia was present in 23 patients. In addition to eight deaths from renal failure in the acute stage, 23 of these patients required long-term dialysis. Thus, malignant accelerated hypertension was associated with high morbidity, especially renal failure; it primarily afflicted patients in their prime years. Known survival at one year was 37.5%, but some patients were lost to follow-up.
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PMID:The clinical presentation of malignant hypertension in Nigerians. 195 31

Somatization is common among children and adolescents. A consecutive series of 112 children and adolescents who fulfilled the ICD-10 clinical diagnostic criteria for somatoform disorders attended at a psychiatric consultation center were included in this study to delineate the pattern of presenting features and to find out associated abnormal psychosocial situations and disabilities. Out of 112 cases 52 were boys, 60 girls, of them 59 were children and 53 adolescents. Polysymptomatic presentation was commoner (92%) than monosymptomatic presentation (8%). Pain was the most prevalent symptom. Children showed significantly higher rates of abdominal complaints and adolescents showed higher rates of headaches. All cases reported an average of 14.21 somatic symptoms. Boys and girls reported an average of 13.75 and 14.61 somatic symptoms respectively and this difference between two groups was not significant. Whereas children reported an average of 12.66 somatic symptoms and adolescents reported an average of 15.94 somatic symptoms. The difference was significant. Differences were also found in the diagnostic categories of somatoform disorders. Girls reported higher rates of somatization disorder and persistent somatoform pain disorder than that of boys. Children reported higher rates of undifferentiated somatoform disorder and somatoform autonomic dysfunction. In contrast, adolescents reported higher rates of somatization disorder. Abnormal psychosocial situations were found to be associated with predisposition, onset, and course of the disorders in majority of the cases and most common was parental overprotection. Remarkable social impairments particularly, in the domains of academic and peer relationship were found among the cases. Findings suggest that somatoform disorders in children and adolescents are frequent in clinical practice. Better understanding of these disorders can promote early diagnoses and timely treatments and improve the quality of life by preventing negative consequences.
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PMID:Somatoform disorders in children and adolescents. 1450 83