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

A randomized, double-blind, placebo-controlled study was conducted in 43 healthy volunteers to compare the effects of policosanol (20 mg day-1), aspirin (ASA) (100 mg day-1) and combination therapy (policosanol 20 mg day-1 plus ASA 100 mg day-1) on platelet aggregation. The healthy volunteers were randomly treated for 7 days. Both, platelet aggregation and coagulation time were measured at baseline and after therapy. When policosanol was administered platelet aggregation induced by ADP (37.3%), epinephrine (32.6%) and collagen (40.5%) were significantly reduced. Meanwhile, aspirin significantly reduced platelet aggregation induced by collagen (61.4%) and epinephrine (21.9%) but not ADP-induced aggregation. Combined therapy significantly inhibited aggregation induced by all the agonists reaching the highest reductions of platelet aggregation induced by collagen (71.3%) and epinephrine (57.5%). Coagulation time did not change significantly in any group. No subject withdrew from the trial. Four volunteers reported mild adverse experiences during the study: three ASA-treated cases referred headache, epigastralgia and nose bleeding, meanwhile one patient receiving combination therapy reported gum bleeding. The present results demonstrate that policosanol (20 mg day-1) is as effective as ASA (100 mg day-1). Moreover, combination therapy shows some advantages compared with the respective monotherapies.
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PMID:Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. 942 18

The authors present the case of a 65 year-old female who was admitted to the emergency room with epigastric pain, headache, palpitations, nausea, vomiting and sweating. The laboratory tests performed showed elevation of CK and CK-MB and the ECG presented sinus tachycardia. T-wave inversion and prolonged QT interval. The echocardiogram was normal. The patient was admitted to the ICU and during the standard myocardial infarction treatment (including beta-blocker) a wide range of the arterial pressure (230/140 to 70/40 mm Hg) was registered. In view of these new data, the hypothesis of pheochromocytoma and catecholamine induced myocarditis was suggested and later confirmed by high levels of plasmatic and urinary catecholamines. The abdominal echography. CT and MRI showed a large retroperitonal and para-aortic mass. The administration of phenoxybenzamine (30 mg/day) led to the normalization of the ECG and arterial pressure and the respective clinical improvement. The anatomopathological exam, after surgical removal, confirmed our hypothesis. Sixteen months after the surgical procedure the patient is assymptomatic, with normal arterial pressure and normal levels of plasmatic and urinary catecholamines.
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PMID:[Extra-adrenal pheochromocytoma simulating acute myocardial infarction]. 1060 62

Levofloxacin, the optical S-(-) isomer of ofloxacin, was compared with ofloxacin in the treatment of complicated urinary tract infections (UTIs). Patients eligible for the trial were randomly assigned to either a daily 300 mg of levofloxacin or 600 mg of ofloxacin for 10 consecutive days. The double blind design was achieved by a double-dummy technique utilizing placebo of both test drugs. Efficacy variables measured were: urine white blood cell counts for the effects on pyuria, urine cultures for effects on bacteriuria, subjective symptoms, and overall clinical efficacy which combined results from effects on bacteriuria, pyuria and subjective symptoms. Safety endpoints were the incidence of adverse events and laboratory test monitoring after a 10-day treatment. A total of 104 patients were enrolled into this trial and 46 patients were evaluable for efficacy endpoints. Most patients with culture-negative (48 cases), mixed flora (5 cases), and less than 10,000 colony forming units/mL of bacteria (3 cases) were excluded from analyses. None of the demographic and baseline characteristics were significantly different between treatments (p > 0.05). Therapeutic effects upon bacteriuria for both treatment groups were similar with a response rate of 90.0% for levofloacin and 88.5% for ofloxacin. Efficacy on the subjective symptoms revealed response rates of 90.0% in the levofloxacin group and 80.7% in the ofloxacin group, with the overall clinical efficacy of 90% in the levofloxacin and 84.6% in the ofloxacin groups. All the efficacy variables measured between treatments were not statistically different which indicated an equivalent efficacy in the treatment of complicated UTIs (p > 0.05). Of the 104 patients exposed to the test medications, only three having adverse effects. One developed epigastralgia in the levofloxacin group, and 2 developed a headache in the ofloxacin treatment. All events were moderate in severity and were resolved quickly after medication. Four laboratory data abnormalities were observed (defined by 25% as exceeding the normal range), and were considered to not be related to the test medications. Both antibiotics were efficacious in the treatment of complicated UTIs (response rates ranging from 80 to 90%) and were well tolerated. Levofloxacin demonstrated comparable antibacterial effects and safety profiles with double potency dosage, compared to the ofloxacin.
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PMID:Randomized, double-blind, comparative study of levofloxacin and ofloxacin in the treatment of complicated urinary tract infections. 1156 68

In Maputo 133 consecutive eclamptic patients were compared with 393 non-eclamptic referent women. Significant risk factors for eclampsia were age < or = 18 years, household size < or = 3 individuals, unwanted pregnancy, walking to antenatal clinics and, in the thrid trimester, headache, foot oedema, hand or face oedema, epigastric pain, visual disturbance, ear buzzing and dizziness. Significantly more cases than referents reported no blood pressure measurements in antenatal clinics. It is concluded that the quality of antenatal clinics can be improved by enhanced community awareness of danger signs, by early recognition of risk factors and by better management of prodromal symptoms of eclampsia.
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PMID:Risk factors in Mozambican women with eclampsia: a case-referent study. 1247 11

A retrospective review of 302 cases of eclampsia treated at the Specialist Hospital Gombe (SHG), between January 1st 1997 and December 31st 1999 is presented. Intrapartum eclampsia was the commonest presentation, occurring in 166 (55.0%) patients. Headache, blurred vision, and epigastric pain preceded the first episode of seizure in 272 (90.0%) of the cases. The diastolic blood pressure of 110 mmHg or more was recorded in 102 (33.8%) of the study group. Eclampsia was more common among teenage mothers 202 (66.9%), and primigravidae 222 (73.5%). Spontaneous vaginal delivery occurred in 159 (52.6%) of the patients. Caesarean section was performed in 122 (40.4%) of the cases. Pyrexia was the commonest morbidity. There were 35 maternal deaths giving a case fatality rate of 11.6%. There were 111 (36.8%) perinatal deaths during the study period. Expanded sections in mass media education of the general populace and counselling young women on care during pregnancies are suggested. The provision and use of life-saving treatment is paramount, at the same time efforts towards eliminating the conditions that created the unbooked emergencies are crucial.
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PMID:The analysis of eclamptic morbidity and mortality in the Specialist Hospital Gombe, Nigeria. 1476 49

A multicenter, randomized, triple blind and controlled trial was designed to determine whether the combination with thioctic acid (TA), an antioxidant agent, can reduce the intolerance rate to Benznidazol (BZ) in patients infected with Trypanosoma cruzi. Four regimens were assigned randomly for 3 age intervals, administrating placebo or TA orally at daily doses of 50 to 100 mg in association with BZ at a dose of 5 mg/k/day for 30 days. In some, medication was given during a run-in period. Safety controls were carried out on days 10, 20, 37 and 52 days after therapy initiation. A total of 249 patients between 15 and 44 years old were enrolled. At the end of the trial, 70.3% of the patients had completed the treatment, while 17.7% required its suspension due to BZ related adverse reactions. The proportion of individuals affected with at least one side effect ranged from 54.8% to 58%; however, none were serious. Reported side effects included: cutaneous maculopapular rush (28%), pruritus (13.6%), headache (8%), epigastralgia (6.2%), fever (6.2%), fatigue (4.3%), nausea (4%), myalgias (4.3%), others (21.5%). The incidence of these reactions did not differ significantly among the 4 therapeutic regimens, nor even among the age intervals considered. It can be concluded that the association with TA did not prevent the occurrence of adverse reactions related to BZ administration. However, a single month cycle of this parasiticide permitted a high compliance rate to therapy among infected outpatients.
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PMID:[Treatment of Chagas disease with benznidazole and thioctic acid]. 1583 Aug

Dengue fever is an acute febrile viral disease, which frequently presents with high fever, headache, bone pain and skin rash. Acute pancreatitis and seizure are rare manifestations of dengue virus infection. A 66-year-old woman with diabetes mellitus presented with epigastralgia, nausea, vomiting, diarrhea and fever. Acute pancreatitis, abnormal liver function and thrombocytopenia were diagnosed at a local hospital. After persistent fever, thrombocytopenia and seizure developed she was transferred to our medical center. Dengue virus infection was confirmed by serology study and dengue hemorrhagic fever grade II was diagnosed. No further neurological symptoms occurred and pancreatitis improved gradually after supportive care. She recovered and had no sequelae at 1 year follow-up. Acute pancreatitis and seizure may be manifestations of dengue virus infection, especially in patients with delayed diagnosis, prolonged fever and thrombocytopenia.
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PMID:Dengue hemorrhagic fever complicated with acute pancreatitis and seizure. 1554 56

Eclampsia is a well-recognised major cause of maternal death and perinatal morbidity and mortality. The incidence of eclampsia, its presentation patterns, maternal and perinatal outcomes were investigated in a retrospective study conducted at the University of Benin Teaching Hospital, Nigeria over an 8-year period, 1995 - 2002. There were 103 cases of eclampsia of 7835 deliveries, giving an incidence of one in 76 (1.32%). The mean age of the women was 27.1 +/- 5.6 years. Eclampsia significantly (P < 0.001) occurred in nulliparous and unbooked mothers. Eighty-nine (86.4%) of the patients developed fits in the predelivery stage; 85 (83%) of the patients had at least one premonitory symptom including headache (82.4%) visual disturbance (10.6%) and epigastric pain (7%). There were nine stillbirths and 16 early neonatal deaths for a perinatal mortality rate of 214/1000. The major causes of perinatal mortality were prematurity and birth asphyxia. Eleven maternal deaths occurred with a maternal case fatality rate of 10.7% and a maternal mortality ratio from eclampsia of 140/100 000. The clinical causes of deaths were cardiopulmonary failure, acute renal failure, haemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and cerebrovascular accident. Timely referral of high-risk patients coupled with availability of emergency obstetric and neonatal care services would reduce the incidence eclampsia associated mortality and morbidity in our facility.
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PMID:Maternal and fetal outcome in eclamptic patients in Benin City, Nigeria. 1576 83

A 34-year-old grand multipara (para 7, 4 alive) was managed at the National Hospital, Abuja, Nigeria for acute renal failure due to HELLP syndrome following referral from a peripheral hospital. She presented with a history of vomiting, headache, epigastric pain, loss of consciousness and tonic/clonic seizures. Though she was unsure of her exact dates, clinically the gestational age was estimated at 22 weeks. She was managed in the intensive care unit, following delivery of a macerated fetus within 15 h of hospital admission. The patient received mechanical ventilation and three sessions of haemodialysis as part of her successful management while in the intensive care unit. The uncommon presentation of eclampsia and HELLP syndrome before obvious preeclampsia is discussed, as well as the other signs and symptoms and patient management. The case also highlights the resource-poor environment of peripheral and tertiary hospitals in Nigeria.
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PMID:Acute renal failure due to HELLP syndrome and acute renal failure in mid gestation. 1593 39

Strongyloides stercoralis infection is a disease caused by an intestinal parasite. This helminth is highly prevalent in tropical and subtropical areas. The preferred treatment is ivermectin, and thiabendazole as a second option available in certain Peruvian institutions. The purpose of the study was to assess the efficacy and tolerability of thiabendazole (25 mg/kg/day) administered twice a day (after meals) for three days in individuals with S. stercoralis chronic infection. The study was conducted at Hospital de La Merced, Province of Chanchamayo, Peru (endemic area), during a 90 day period. The study included 32 individuals (22 female and 10 male, average age +/- SD = 9.31 +/- 8.11 years) with a diagnosed S. stercoralis infection. Follow up tests were eosinophil count, hematocrit, agar plate feces culture, and Baermann technique modified by Lumbreras. Healing rate was 90.6%. The average eosinophil count in healed patients significantly decreased (1168 to 665 eosinophils/cc, p=0.006) as compared to the treatment failure group, which showed a slight increase (618 to 897 eosinophils/cc, p=0.125). Hematocrit increased in both groups (2% and 3%, respectively). Adverse effects were headache, dizziness, and epigastralgia in 6.2% of individuals. It was concluded that the studied scheme showed a high effectiveness rate and was well tolerated. Therefore this scheme may be taken into account for control programs of this parasite in hyperendemic areas.
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PMID:[Thiabendazole for the control of Strongyloides stercoralis infection in a hyperendemic area in Peru]. 1633 89


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