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

Idiopathic intracranial hypertension is a diagnosis most frequently made in young, overweight women. The chief hazard to the patient is permanent visual loss due to chronic papilledema. After the diagnosis has been clearly established using lumbar puncture and imaging techniques, the neurologist is involved in helping to lower the intracranial pressure, control the headaches, and encourage weight loss. Careful vision monitoring is essential and should be done in collaboration with an ophthalmologist. Visual fields, fundus photographs, intraocular pressure measurement, and visual acuity should be performed at each follow-up visit. The use of visual evoked response and repeated measurement of intracranial pressure by lumbar puncture do not provide data that help to guide therapeutic decisions. Indications for surgery are loss of visual field or decline in visual acuity in the fact of medical therapy, persistent headache, or the inability to perform visual-function studies. Optic nerve sheath fenestration and lumbar peritoneal shunt both appear to be effective surgical means to reduce the pressure on the optic disc. A neurologist and an ophthalmologist working together provide the evidence on which to base rational decisions in the care of the patient with idiopathic intracranial hypertension.
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PMID:The rational management of idiopathic intracranial hypertension. 267 6

We have evaluated the effects of dextrofenfluramine treatment on body weight control during a 90 day period, in obese patients on a calorie-restricted diet. The weight loss in dextrofenfluramine-treated patients was significantly higher than in placebo group. The rate of weight loss was linear up to the end of the trial in d-fenfluramine patients. Neural disturbances (vertigo, headache, depression) were the most frequent side effects observed in both the d-fenfluramine and in the placebo-treated groups, without significant differences between the groups. A total number of 23 patients in the dextrofenfluramine group and 20 patients in the placebo group complained side effects. Six patients (five in the d-fenfluramine group and one in the placebo group) discontinued the treatment, due to the side effects. No modifications of the biochemical parameters considered (fasting blood glucose, bilirubin, alkaline phosphatase, creatinine, blood cell counts, asparate-amino transferase (AST), alanine-amino transferase (ALT), total plasma and HDL cholesterol, and triglycerides) were observed at the end of the trial. A significant reduction of total serum cholesterol was observed in both groups at the end of the period of treatment. In conclusion, dextrafenfluramine was proved to be in short term trials an effective and safe tool in overweight control in obese patients.
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PMID:Efficacy and safety of dexfenfluramine in obese patients: a multicenter study. 305 15

A report is given on 12 patients (6 men, 6 women) presenting primary Empty Sella who were admitted as inpatients with a provisional diagnosis of a hypophyseal tumour. The most frequent first symptom was uncharacteristic cephalgia. Visual disturbances and an impairment of potency/libido were only mentioned in the second place. 5 of the 12 patients were adipose and overweight, 2 of them additionally showed hypertensive blood pressure values. 2 female patients suffered from galactorrhoea. The typical "Empty Sella Patient" frequently described in the literature - the overweight medium-aged woman was an exception among our patients. Besides the ascertainment of the ophthalmological findings and the performance of a complete endocrinological function diagnosis the respective radiological diagnosis was established: native sellar picture, sella tomography, computer tomography, angiography and pneumocephalography. A high informative value in the differential-diagnostic demarkation from a hypophyseal tumour has until now been attributed to pneumoencephalography with an intracellar accumulation of air being considered to prove the presence of an empty sella. Under modern examination conditions, however, a computer-tomographic clearing will in most cases be possible.
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PMID:[Diagnosis and differential diagnosis of primary empty sella]. 361 5

We performed a double-blind crossover trial of challenges with 30 mg of aspartame per kilogram of body weight or placebo in 40 subjects who reported having headaches repeatedly after consuming products containing aspartame. The incidence rate of headache after aspartame (35 percent) was not significantly different from that after placebo (45 percent) (P less than 0.50). No serious reactions were observed, and the incidence of symptoms other than headache following aspartame was also equivalent to that after placebo. No treatment-related effects were detected in vital signs, blood pressure, or plasma concentrations of cortisol, insulin, glucagon, histamine, epinephrine, or norepinephrine. Most of the subjects were well educated and overweight and had a family or personal history of allergic reactions. The subjects who had headaches had lower plasma concentrations of norepinephrine (P less than 0.0002) and epinephrine (P less than 0.02) just before the development of headache. We conclude that in this population, aspartame is no more likely to produce headache than placebo.
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PMID:Aspartame and susceptibility to headache. 365 89

The effects of three different hypocaloric diets on serum electrolytes, metabolites and enzyme activities were investigated for 3 weeks in 40 overweight patients. A 600 kcal mixed diet was as effective with regard to daily weight reduction as complete fasting or a low-energy protein diet. Only the patients of the last two groups complained of orthostatic dysregulation, nausea, headache and dryness of the skin. Neither a decrease in serum potassium, an increase in creatinine nor any other side-effects were observed in the mixed diet group. - Since the 600 kcal mixed diet can be carried out under ambulant conditions it is preferable to the other reducing diets.
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PMID:[The effects of various reducing diets in adiposity (author's transl)]. 678 Aug 23

Twenty one sequential ultrafiltration dialysis were performed to 14 patients with chronic hemodialysis, with a duration of the dialysis treatment from 2 months to 5 years. Dry ultrafiltration--2.1-5.2 litres filtrate was obtained within 90 minutes. The sequential dialysis has numerous advantages over the usual hemodialysis. Apart from the good tolerance of the patients with overweight, some other indications for its performance was stressed upon in the paper, namely: cardiac asthma, arterial hypertension difficult to correct by hemodialysis and drugs, osteodystrophia, itching during dialysis and after it, vomiting and headache during dialysis and in-between dialysis periods, pains in the legs. The patients tolerated the procedure without any complaints.
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PMID:[Clinical use of sequential ultrafiltration with chronic hemodialysis patients]. 726 38

Empty sella is an anatomical condition caused by herniation of the subarachnoid space into the pituitary fossa through an incompetent sellar diaphragm. Headache seems to be one of the most frequently reported symptoms. We studied 13 headache patients (12 females, 1 male) presenting with primary empty sella (PES) on CT scan. The characteristics of the headache were analyzed and plasma levels of pituitary hormones or cortisol assessed. We confirmed the nonspecific nature of the headache in PES even though the majority of our patients complained of daily headache, mostly localized anteriorly. Hormone plasma levels were within normal range in all the patients assessed. However, four patients reported earlier endocrine disorders and more than half of the patients presented with obesity. In our opinion, PES should be suspected in middle-aged overweight women with daily headache even in the absence of endocrine symptomatology.
Headache
PMID:Empty sella and headache. 784 53

Renal biopsy of 32 patients who developed renal complications after treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) were studied. The treatment with NSAIDs in these cases was used for many reasons such as: headaches, toothaches, dysmenorrea, osteochondrosis, polyarthritis and acute respiratory infections. The renal function of these patients, before the treatment with NSAIDs was normal. The renal biopsies were studied by light, electron and immunofluorescence microscopy. In 32 cases treated with NSAIDs renal changes were shown. There types of morphological changes were found: focal glomerulonephritis with crescents (FGN)(5 cases), acute tubulo-interstitial diseases (ATID)(8 cases) and lipoid nephrosis with tubulo-interstitial nephritis (LN)(19 cases). FGN and ATID possibly represent a hypersensitive reaction of predominantly humoral (FGN) or cellular (ATID) mechanisms. These types of reaction are also seen to occur with the use of various drugs (most commonly with penicillin type antibiotics). LN on the other hand is rarely, if ever, seen with any drugs but NSAIDs and therefore seems to be a characteristic change for NSAIDs and possibly related to the inhibition of renal prostaglandin synthesis by NSAIDs. NSAIDs-associated renal dysfunction is mainly observed in patients of an increased use of NSAIDs with ineffective circulatory plasma volume (advanced age, cardiovascular disease, overweight and hypovolemia of various causes).
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PMID:NSAIDs associated nephropathy. 964 Sep 73

Nurses are not very well, according to a survey conducted among nurses in the northern region of Sydney. Smoking is the most common health risk. Fifty per cent of nurses smoke. This rate is double that of the population living in Northern Sydney. A tobacco knowledge questionnaire indicated nurses are not as well informed as they could be about the health consequences of smoking. As well, heavy smokers report the highest amount of severe anxiety. Nurses, especially young nurses, report considerable anxiety generated by the nursing profession and depression is common, specifically among the younger nurses. Sixteen per cent of nurses are severely overweight, 42% over 30 years of age are substantially overweight. Nurses also take more sleeping tablets and exercise less than people in the general population and are also more prone to respiratory tract infections, headaches and backaches. Some explanations of the poor health status of nurses are offered and ways of improving the health of nurses discussed.
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PMID:How are you, nurse? 1026 95

Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure of unknown cause. It is a disorder, predominantly of overweight women in the childbearing years. The major morbidity of the disease is visual loss. Damage to the visual system occurs at the optic nerve head. This damage is most likely due to axoplasm flow stasis and resultant intraneuronal ischemia. Management of IIH begins with educating the patient about the disease and its potential outcomes. I recommend modest dieting and following a low-salt regimen with caution against overuse of fluids. Acetazolamide and Lasix appear to be efficacious. Patients failing medical therapy have optic nerve sheath fenestration performed if visual loss is the main morbidity. Shunting procedures are considered if headache is the main symptom. Most patients respond well to therapy, but idiopathic intracranial hypertension may recur throughout life.
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PMID:Idiopathic intracranial hypertension: mechanisms of visual loss and disease management. 1087 79


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