Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Auranofin (triethylphosphine gold) was administered to 21 patients with juvenile rheumatoid arthritis during an open-ended, open-label, noncontrolled trial designed to establish safety and preliminary efficacy. Initial dosage was 0.1 mg/kg/day; incremental increases to 0.2 mg/kg/day were allowed. Aspirin (80 mg/kg/day), tolmetin (20 to 40 mg/kg/day), and naproxen (400 to 600 mg/m2/day) were allowed as rapidly acting anti-inflammatory agents. All patients attained measurable plasma concentrations of gold during the study. Clinically significant improvement (greater than 25%) occurred in more than half the patients with regard to the number and severity of joints with swelling, pain on motion, and tenderness. The number of joints with active arthritis decreased by at least 25% in nine of the 19 patients. Group mean changes between the initial and final visit indicated improvement in all articular disease indices measured. Eleven of 16 patients with an elevated erythrocyte sedimentation rate showed decreases of at least 25%. The group given the higher dosage had a greater proportion of responders with decreases in erythrocyte sedimentation rate. Four of six patients whose sera contained rheumatoid factor showed decreases in its titer. Discontinuation of auranofin was necessary in two patients because of headaches and because of hematuria and anemia associated with a severe flare of polyarticular disease, respectively. The results from this trial are sufficiently encouraging to merit a double-blind trial of auranofin in children with juvenile rheumatoid arthritis.
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PMID:Auranofin in the treatment of juvenile rheumatoid arthritis. 640 27

Pharmacologic management of juvenile rheumatoid arthritis is only one of several modalities necessary for effective control. The stepping stones to proper management include a planned long-range program, physical therapy with swimming, good health habits, and consultation with other health professionals who are part of the management team. Pharmacologic therapy includes nonsteroidal anti-inflammatory drugs initially, occasionally corticosteroids, and slow-acting antirheumatic drugs, including injectable gold when therapeutic response is inadequate. Early experiences with oral gold are reported here. Auranofin (triethylphosphine gold) was administered to 21 patients with juvenile rheumatoid arthritis during a segment I, open ended, open-label, noncontrolled trial designed to establish safety and preliminary efficacy. Initial dosage was 0.1 mg/kg per day; incremental increases to 0.2 mg/kg per day were allowed (with usual increase to 0.15 mg/kg per day). Aspirin (80 mg/kg per day) or tolmetin (20 to 40 mg/kg per day), or naproxen (400 to 600 mg/m2 per day) were allowed as rapidly acting antiinflammatory agents. Stable measurable plasma concentrations of gold were attained in all patients during the study. More than half the patients sustained clinically significant improvement (greater than 25 percent) with regard to the number and severity of joints with swelling, pain on motion, and tenderness. In nine of the 19 patients, the total number of joints with active arthritis decreased by at least 25 percent. All articular disease indices measured indicated improvement of group mean changes between the initial and final visit. Eleven of 16 patients with an elevated erythrocyte sedimentation rate showed decreases of at least 25 percent. The group given higher dosages had a greater proportion of responders in regard to decreases in erythrocyte sedimentation rate (nine of 11 patients). Four of six patients whose serums contained rheumatoid factor showed decreases in the titers. Discontinuation of auranofin was necessary in two patients: one because of headache and one because of hematuria and anemia associated with a severe flare-up of polyarticular disease. The results from this trial reveal sufficient patient improvement to plan a double-blind trial of auranofin in children with juvenile rheumatoid arthritis.
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PMID:Early experiences with auranofin in juvenile rheumatoid arthritis. 641 99

In 37 pregnancy women preterm labour was inhibited with intravenous administration of ASA. 20 patients (Group I) had a combined treatment of ASA and Fenoterol. 7 pregnant women (Group II) without successful labour inhibition under Fenoterol were treated with ASA subsequently. In a third group of 10 women we administered ASA alone. The treatment was considered as successful if signs of preterm labour stopped and pregnancy maintained for 7 days or more. In the first group 16, in the second group all patients had been treated successfully. In group III we succeeded in labour inhibiting for more than 7 days in 6 cases. An initial loading dose of 5.5 to 7.0 mn/min ASA had been infused for 24 hours. If preterm labour was stopped, the dosage had been reduced. In all patients dose related but reversible symptoms of vertigo, tinnitus, headache and hyperventilation were seen. Furthermore we found a non-dose-dependent prolongation ( by 30% or normal) of bleeding time. In the fetus respectively the newborn an affection by this ASA treatment could be excluded. We propose inhibition of preterm labour by i.v. ASA administration in all pregnant women if beta-mimetic drugs are not successful or an intolerance is diagnosed. Contraindications for ASA therapy are mentioned.
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PMID:[Clinical study of the labour inhibiting effects an side effects of acetylsalicylic acid (ASA) (author's transl)]. 690 69

Plasma aspirin and salicylate levels were measured at intervals over a two hour period during migraine attacks in 10 subjects given 900 mg oral aspirin alone, in 10 subjects given 900 mg oral aspirin plus 10 mg oral metoclopramide, and in 10 subjects given 900 mg oral aspirin plus an intramuscular injection of 10 mg metoclopramide. Higher peak aspirin and salicylate levels occurred in patients given aspirin with metoclopramide. Aspirin tended to appear in plasma earlier in patients given aspirin with oral metoclopramide than in patients given aspirin alone, or aspirin with intramuscular metoclopramide. Patients given aspirin with oral metoclopramide tended to obtain better early pain relief than the other two treatment groups, though by one hour from dosage use of injected metoclopramide was also associated with better pain relief.
Cephalalgia 1982 Mar
PMID:Aspirin treatment of migraine attacks: plasma drug level data. 711 42

We present an unusual case of postoperative headache in a child after an epidural block. A seven-year-old girl (ASA 1) was scheduled to undergo a urological procedure under general anaesthesia combined with an epidural technique for intra- and postoperative analgesia. Although there was no evidence of dural puncture when the block was performed, the patient developed a headache postoperatively. The headache, which was accompanied by neck pain, appeared in the sitting or standing position and was relieved by decubitus. According to the mother, her child had never complained of those symptoms in the past. After independent evaluation by an anaesthetist and a neurologist, a postdural puncture headache (PDPH) was considered the most likely diagnosis. As oral analgesics failed to provide relief, and epidural blood patch (EBP) using 10 ml autologous blood was performed under light sedation. This was followed by resolution of the symptoms. Epidural injections of opioids and local anaesthetics are becoming increasingly popular for pain management in children. This implies that there may be an increasing number of unintentional dural punctures that may result in more PDPHs in children. Epidural blood patches are effective in treating PDPHs in adults but their use has been reported very rarely in children. Resolution of the patient's symptoms following EBP supported the diagnosis while illustrating that EBP can be useful in the treatment of PDPH in children.
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PMID:Epidural blood patch in a seven-year-old child. 755 1

Aspirin is commonly used to treat migraine attacks, although sumatriptan, a much more expensive treatment, is also effective. We compared a combination of lysine acetylsalicylate (equivalent to 900 mg aspirin) and 10 mg metoclopramide (LAS+MTC) with oral sumatriptan (100 mg) and placebo in 421 patients with migraine. LAS+MTC was as effective as sumatriptan with a decrease of headache from severe or moderate to mild or none of 57% and 53%, respectively, for the first migraine attack treated. Both treatments were better than placebo (success rate 24%, p < 0.0001). LAS+MTC was significantly more effective in the treatment of nausea than sumatriptan (p < 0.0001) and was better tolerated (adverse events in 18% and 28%, respectively, p < 0.05). LAS+MTC is as effective as sumatriptan in the treatment of migraine attacks. It is also much cheaper.
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PMID:The effectiveness of combined oral lysine acetylsalicylate and metoclopramide compared with oral sumatriptan for migraine. 756 25

The effects of aspirin on the contingent negative variation (CNV) of 16 healthy, right-handed volunteers were studied in accordance with a placebo-controlled double-blind crossover design. Early and late CNV factors were measured. Aspirin caused a statistically significant decrease of the early wave and an increase of mean amplitude of the late wave. A central action of aspirin, affecting noradrenergic and dopaminergic structures, may be responsible for the CNV changes.
Cephalalgia 1995 Apr
PMID:The effects of aspirin on the CNV in healthy individuals. 764 Dec 47

The purpose of this study was to determine the rate and quality of recovery when general anaesthesia was induced with a mixture of thiopentone and propofol, compared with thiopentone or propofol alone. Sixty ASA class I and II women scheduled for out-patient laparoscopic surgery underwent induction of anaesthesia with either (i) thiopentone, (ii) propofol, or (iii) a mixture of the two, in a randomized, double-blind fashion. Anaesthesia was then maintained using nitrous oxide, isoflurane and fentanyl. A psychometric test was administered before and after surgery, and the time taken to reach a series of recovery milestones was noted. Patients were discharged as soon as they were ambulant and had satisfactory control of pain and nausea with oral agents. They were telephoned at 24-48 hr later, and asked to rate their experience of a list of side effects on an ordinal scale. Patient groups were demographically comparable and underwent surgery of the same duration. Those receiving thiopentone were discharged after a mean time of 3 hr 25 +/- 58 min (SD). The corresponding figures for propofol and the thiopentone/propofol mixture were 2 hr 40 min (+/- 49) and 2 hr 48 min (+/- 68) respectively. The recovery time between thiopentone and the other two regimes was different (P < 0.05). All three groups experienced equally frequent and severe nausea, headache, tiredness and other side effects during the next 24 hr. It is concluded that induction with a mixture of thiopentone and propofol leads to a similar rate and quality of recovery to that of propofol above.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Recovery characteristics following induction of anaesthesia with a combination of thiopentone and propofol. 758 23

One hundred and twenty-eight ASA I-III patients less than 40 yr of age, undergoing orthopaedic or trauma lower limb surgery, were allocated randomly to receive either continuous spinal anaesthesia (CSA) using a 32-gauge polyimide microcatheter with a permanent stylet (Rusch/TFX Medical, Duluth, GA, USA) or single-dose spinal anaesthesia (SDSA) with a 24-gauge x 103-mm Sprotte spinal needle (Pajunk, Germany). Plain bupivacaine (0.5%) was used as the local anaesthetic. The initial doses were 1 ml (5 mg) of CSA and 3 ml (15 mg) of SDSA, while the re-injection doses were 1 ml (5 mg) in the CSA group. SDSA was quicker to perform: mean 4.4 (SD 1.6) min compared with 6.2 (2.6) min for CSA (P < 0.01). Times to onset and surgical anaesthesia were also significantly greater in the CSA group (P < 0.01). The quality of the block was better in the SDSA group (P < 0.05), but was associated with greater haemodynamic instability (P < 0.05). The segmental level of analgesia was significantly lower in the CSA group (median T10 (range T12-T8)) than in the SDSA group (T9 (T11-T5)) (P < 0.05). There were no significant differences in the incidence of postoperative complications, with two mild spinal headaches in both groups. We conclude that CSA using a microcatheter in young patients is difficult to perform and affords no advantages over SDSA with a small gauge atraumatic needle.
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PMID:Comparison of continuous spinal anaesthesia using a 32-gauge catheter with anaesthesia using a single-dose 24-gauge atraumatic needle in young patients. 788 Jun 57

Acetylsalicylic acid (ASA, CAS 50-78-2) and ibuprofen (IB) are commonly used over-the-counter drugs for short-term treatment of pain of different origin. Ibuprofen lysinate (IBL, CAS 57469-76-8) is a water soluble form of ibuprofen for rapid absorption. This single blind, randomized, controlled study compared the incidence and severity of irritation of gastric and duodenal mucosa in normal healthy subjects (n = 45) following administration of IBL (Dolormin) 800 mg/d, ASA 2000 mg/d or placebo for 3 consecutive days. Gastric and duodenal mucosal injury were assessed endoscopically using a severity scale of 0-4 for mucosal erosions and mucosal hemorrhages. Mean gastric hemorrhage and erosion scores for ASA and IBL were significantly higher than those for placebo. In addition, ASA was found to be significantly more irritating to gastric mucosa than IBL, in both the incidence and severity of gastric erosions. No duodenal hemorrhages were detected in this study. The incidence of duodenal erosions was significantly higher in the ASA group (64%) than in both the IBL (6%) and placebo groups (0%) which were not significantly different. Only one subject (in the placebo group) reported an adverse experience (mild headache) during the study. The data suggest that both active treatments are more injurious to the gastric mucosa than placebo when given for 3 days to normal healthy volunteers, but that IBL 800 mg/d is significantly less injurious to the gastric and duodenal mucosa than ASA 2000 mg/d.
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PMID:Effects of ibuprofen lysinate and acetylsalicylic acid on gastric and duodenal mucosa. Randomized single-blind placebo-controlled endoscopic study in healthy volunteers. 794 19


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