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

Sinusitis can occur as an acute, subacute, recurrent acute, or chronic clinical disease process in children. Sinusitis most often manifests as a prolongation or complication of a viral upper respiratory tract infection. Because children average six to eight upper respiratory tract infections per year, sinusitis is probably a more frequent diagnosis in the pediatric age group compared with adults who average two to three upper respiratory infections per year. Upward of 5 to 13% of children may experience sinusitis, but precise incidence data are not available because many imaging techniques currently available are inappropriate procedures for a prospective pediatric survey. Symptoms of acute sinusitis in children can vary from the more common persistent, purulent rhinorrhea and cough to the less common symptoms of fever, headache, facial pain, and swelling. Recurrent acute and chronic sinusitis may be associated with another condition such as a host-defense defect, cystic fibrosis, asthma, or a local condition that predisposes to obstruction of the sinus ostia such as nasal polyps, deviated septum, foreign body, or allergic inflammation. Diagnosis of sinusitis can be made on the basis of a careful history and physical examination with radiography reserved for confirmation of clinical impression or documentation of disease. Although fiberoptic rhinoscopy is used more frequently as an adjunct in adults for the evaluation and management of sinusitis, more studies need to be performed to document its clinical usefulness in children.
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PMID:Diagnosis of sinusitis in children: emphasis on the history and physical examination. 152 32

It is well known that autonomic phenomena, such as lacrimation, rhinorrhea, and Horner's syndrome, are associated with the pain attacks in episodic cluster headache. In order to elucidate the cause of these symptoms we studied plasma free and sulphoconjugated catecholamines in cluster headache patients during the pain attacks and in the following hours, as well as during the remission period. No change in these amine levels was found. We conclude that dysautonomic symptoms are not reflected in plasma catecholamine modification.
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PMID:Sympathetic adrenomedullary activity in cluster headache. 160 25

This double-blind, double-dummy, parallel-group study was undertaken in 40 patients with seasonal allergic rhinoconjunctivitis during the 1990 hay fever season. The patients were randomized and treated for seven days with either 120 mg terfenadine or 10 mg loratadine, each drug taken once daily in the morning. The severity of nasal congestion, rhinorrhea, sneezing, nasopharyngeal itching, and itchy, watery, red eyes was evaluated before and at the end of treatment. The global severity of symptoms was ranked daily by the patient on a diary card. Both treatment groups experienced a significant improvement of symptoms after treatment (p < 0.01), without any significant difference between the two study drugs. Terfenadine and loratadine significantly improved symptom severity by 69 and 55% compared with the baseline values, respectively. Headache and fatigue were reported in three loratadine-treated patients, and sedation in one patient. No side effects were observed in patients receiving terfenadine. This study confirmed that terfenadine 120 mg once daily is a safe and effective treatment for hay fever.
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PMID:Comparative effects of terfenadine and loratadine in the treatment of hay fever. 166 95

These studies of cluster headache (CH) focus on two key features of pain transmission: a) sensory nerves when stimulated, as well as the expected afferent transmission, also display an efferent function which affects capillaries, glands, and smooth muscle (of the iris in CH); substance P (SP) and allied transmitters such as Vasoactive Intestinal Peptide (VIP) and Calcitonin Gene-Related Peptide (CGRP) are the main agonists of this dual afferent-efferent function; b) impaired pain transmission (deafferentation-like condition) provokes a rostral spread of neuronal irritability and automatic firing ("quasi epileptic foci") producing a clinical predilection for pain with the generation of "spontaneous" pains along the sensory pathways. The substrates studied in the present experiments are the iris, salivary glands, and nasal mucosa. 1) Iris: the conjunctival instillation of SP induces isocoric miosis both in CH sufferers and in normals, thus excluding gross SP receptoral dysfunction of the iris muscle in CH. Electrical stimulation of extraocular (infratrochlear) endings of the first branch of the trigeminal nerve provokes a miosis, which is significantly less in the symptomatic eye than in the contralateral one. This miosis is ascribed to a retrograde release of SP, induced by electrical stimulation of the trigeminal ophthalmic branch. The relatively poor miosis in the painful eye could correlate with a deficient release of SP from the sensory terminals in the iris. 2) Salivary glands: an increase of substance P-like immunoreactivity is found in the saliva taken from the asymptomatic side, but not from the painful side during a cluster headache attack, thus showing at this level also an asymmetry as previously shown in other head structures. 3) Nasal mucosa: intranasal application of capsaicin, a powerful releaser of SP from sensory terminals, evokes an immediate burning pain in the ipsilateral nasal, ocular, and temporal areas, as well as lacrimation and rhinorrhea. A gradual decrease (tachyphylaxis) of these phenomena is consistently observed after few days of daily nasal administration of capsaicin. When this treatment is applied to CH patients, a rapid decrease in the number and intensity of attacks, and even disappearance of symptoms accompanies the decline of the capsaicin-induced manifestations. Local (nasal) capsaicin, in spite of evoking immediately the same vegetative (rhinorrhea, lacrimation, conjunctival congestion) and in part nociceptive (transient nasal, ocular, temporal burning) phenomena of CH, never has been able to provoke delayed spontaneous-CH like attacks. Such delayed provoked attacks, one of the most pregnant phenomena in CH investigations, are almost constantly evoked by systemic stimuli.(ABSTRACT TRUNCATED AT 400 WORDS)
Headache 1990 Jan
PMID:Substance P theory: a unique focus on the painful and painless phenomena of cluster headache. 168 82

Some patients report rhinitis symptoms after exposure to environmental tobacco smoke (ETS), but objective assessments of this response have been lacking. Furthermore, the mechanism of this response is unknown. We assessed the frequency of ETS-related symptoms by administering a questionnaire to 77 healthy nonsmoking young adults who were participating in an unrelated study. Of the subjects 34% (26 of 77) reported one or more rhinitis symptoms (congestion, rhinorrhea, or sneezing) following ETS exposure. We then exposed 10 historically ETS-sensitive (ETS-S) and 11 historically ETS-nonsensitive (ETS-NS) subjects to 15 min of clean air followed by 15 min of sidestream tobacco smoke (CO concentration of 45 parts per million). At selected time points during these procedures we recorded symptoms, posterior nasal resistance, and spirometry and performed nasal lavages. ETS-S but not ETS-NS subjects reported significant (p less than 0.01) increases in nasal congestion, headache, chest discomfort or tightness, and cough following exposure to sidestream tobacco smoke. Rhinorrhea symptoms were greater and more prolonged in ETS-S subjects compared to ETS-NS subjects. Significant (p less than 0.01) increases in perception of odor and in eye, nose, and throat irritation occurred in both study groups, but ETS-S subjects reported significantly more nose and throat irritation. No significant changes in posterior nasal resistance occurred in the ETS-NS group but a significant increase occurred in the ETS-S subjects, with the resistance rising from 3.8 +/- 0.5 cm H2O/L/s (mean +/- SE) preexposure to a peak of 8.0 +/- 2.7 cm H2O/L/s 20 min after completion of the smoke exposure (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Upper respiratory tract environmental tobacco smoke sensitivity. 171 Aug 79

Acute sinusitis in adults is manifested by fever, facial pain and purulent rhinorrhea, but children--who rarely have headache or facial tenderness--have persistent cough in addition to fever and purulent rhinorrhea. Sinus transillumination is diagnostically useful only in adults. In children, maxillary sinus radiographs are indicated. New studies show ultrasound examination to be less sensitive than plain radiographs. Cultures obtained by aspiration of the maxillary sinuses are useful in complicated cases. Amoxicillin is still effective as first-line treatment, but treatment failure requires a prompt change to trimethoprim-sulfamethoxazole or ciprofloxacin. Nosocomial sinusitis requires coverage for gram-negative bacteria, including Pseudomonas aeruginosa. Immunocompromised patients, including those with acquired immunodeficiency syndrome, require treatment for fungal organisms. Decongestants are of unproven value. Referral for irrigation and surgical drainage is indicated for recurrent or recalcitrant sinusitis. Flexible endoscopy allows visualization and debridement of diseased tissue in cases of chronic sinusitis.
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PMID:Acute sinusitis: diagnosis and treatment update. 146 11

The SSCT findings of the SNP pattern are nearly diagnostic for this entity. SNP is characterized by the major findings of nasal polypoid masses and infundibular enlargement. Patients may also show individual sinus involvement with polypoid masses and/or opacification of the paranasal sinuses without visualization of polypoid masses. The presence of polypoid masses within the sinuses also can be inferred if the major findings are present, especially if there are the minor findings of nasal septal and sinus trabeculae attenuation and bulging of the lateral ethmoid sinus walls. Air/fluid levels are frequent in SNP but do not always indicate acute sinusitis. Patients typically present with nasal stuffiness and rhinorrhea. They often have facial pain and less often headaches. Common associations exist between SNP and atopy (either allergic or nonallergic), asthma, infection, cystic fibrosis, and aspirin intolerance. Therapy may be either medical or surgical, with steroids being the mainstay of the medical treatment. FESS provides a relatively atraumatic means of removing polyps and creating better sinus drainage. Regardless of the type of therapy, recurrences are common, requiring repeated bursts of systemic steroids, nasal steroid maintenance, and frequent additional surgical procedures. Identification of the SNP pattern on SSCT helps the otolaryngologist to institute an appropriate therapy aimed at alleviating symptoms. The SSCT is adequate for evaluation of SNP in the vast majority of cases and serves as a detailed road map for the treating endoscopic surgeon.
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PMID:Sinonasal polyposis. 178 79

Intracranial mycotic aneurysm of extravascular origin is reported. A 64 year-old male developed headache and visual disturbance. Computed Tomography (CT) revealed high density mass lesion with contrast enhancement in the intra- and suprasellar lesion. He was then admitted to our hospital under the diagnosis of pituitary adenoma. But he suddenly complained of headache and loss of vision during hospitalization. An emergency operation using the transsphenoidal approach was performed. The pathological diagnosis was craniopharyngioma. Postoperative radiation therapy was carried out using a tumor dose of 50Gy. Two months after the operation, he suffered from rhinorrhea and high fever. He was admitted again and treated with high doses of antibiotics. Two weeks after admission, he suddenly lost consciousness. A CT scan revealed an aneurysm of the anterior temporal artery. Immediately, removal of the hematoma and resection of the aneurysm were performed. Microscopic examination showed that inflammatory cells had infiltrated the aneurysmal wall, and lymphocytes and plasma cells had gathered around the microabscess. This rare case is discussed with other related cases in the literature.
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PMID:[A case of bacterial aneurysm following Hardy's operation]. 189 Oct 58

During 1988, an endemic outbreak of aseptic meningitis was noted in the Kaohsiung area. Throughout the year, a total of 89 cases were identified by cerebrospinal fluid (CSF) examination at the Pediatric Department of Kaohsiung Medical College. The peak incidence was from June to October. Scattered cases still occurred during November and December. The male to female ratio was 1.7:1 and the age distribution ranged from 1 month to 15 years old. Two peaks of age distribution were observed; one in infancy and the other in the 4-7 year old age group. Most of them exhibited fever (94.4%), headache (68.9%), and vomiting (68.5%). Other associated symptoms and signs included neck stiffness, sore throat, cough, Brudzinski's sign, abdominal pain, seizure, dizziness, rhinorrhea, diarrhea, Kernig's sign, skin rash, hyperemic conjunctiva, apnea, and oral ulcers. Most of them had CSF white blood cell (WBC) counts less than 1000/mm3, normal or mild elevated protein, and normal CSF/plasma sugar ratio. Three patients were found to have a virus in their CSF without pleocytosis. Virus isolations from CSF throat swabs and/or rectal swabs were performed in 65 patients, half of them (35/65, 53.8%) had positive results including echovirus type 9 (sixteen), echovirus type 30 (eighteen), and adenovirus type 3 (one). Echovirus type 9 was predominant during July and August whereas echovirus type 30 became predominant after September. All patients recovered spontaneously without any sequelae.
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PMID:Clinical observations and virological study of aseptic meningitis in the Kaohsiung area. 198 74

A 145-acre potato field adjacent to Dorris, California, was treated with ethoprop (Mocap) to control nematodes. Ethoprop releases n-propyl mercaptan, a highly odorous and volatile gas, as a degradation product of the pesticide. An epidemiological investigation was undertaken by the California Department of Health Services because community residents sought medical attention for odor-related illness. Elevated health effects were found among those who reported smelling a strong odor (n-propyl mercaptan has a characteristic onion-like odor). In a logistic regression analysis, the most highly elevated 6-wk health effect incidence risks, expressed as odds ratios (ORs) adjusted for age, sex, and current cigarette smoking status, were for headache (OR = 5.08), diarrhea (OR = 3.80), runny nose (OR = 5.31), sore throat (OR = 3.58), burning/itching eyes (OR = 5.64), fever (OR = 3.59), hay fever attacks (OR = 3.50), and asthma attacks (OR = 6.0). Based upon these elevated health effects, it is recommended that human exposures to n-propyl mercaptan be minimized to the extent practicable.
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PMID:Acute health effects from community exposure to N-propyl mercaptan from an ethoprop (Mocap)-treated potato field in Siskiyou County, California. 147 22


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