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

A review of the relevant literature strongly suggests that several medical and laser treatments presently used in glaucoma therapy, and other potential treatments under investigation, reduce IOP, at least, in part, by stimulating endogenous PG synthesis. There are four lines of evidence leading to this conclusion. (1) PGs are potent ocular hypotensive agents. (2) Adrenergic and cholinergic agonists stimulate PG synthesis by ocular tissues in vitro. (3) Epinephrine and ALT cause elevation of PG levels in the aqueous humor in vivo. (4) PG synthesis inhibitors such as indomethacin or flurbiprofen block, or partially inhibit, the reduction of IOP produced by epinephrine, para-aminoclonidine, forskolin, vanadate, verapamil, arachidonic acid, and ALT in rabbits, cats, monkeys, and/or humans. This last finding has great clinical importance with regard to the efficacy of such treatment modalities as epinephrine and ALT, since it indicates that these modalities may be less effective in reducing IOP in glaucoma patients who are taking systemic PG synthesis inhibitors - such as aspirin or indomethacin - for arthritis, cerebrovascular disease, arteriosclerotic coronary vascular disease, headache, or the common cold. Other surgical procedures for glaucoma such as cyclocryotherapy or other cyclodestructive procedures may also reduce IOP in part by stimulating local PG synthesis. Since PGs are produced in various ocular tissues and some of these PGs are highly potent ocular hypotensive agents, their potential role in mediating the reduction of IOP produced by medical or surgical modalities of glaucoma therapy must always be considered. Furthermore, these considerations support the concept that topical application of an appropriately selected PG, or its derivative, may provide a more direct means of lowering IOP than some of the currently used procedures or therapeutic agents.
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PMID:The role of endogenous prostaglandins in clinically-used and investigational glaucoma therapy. 250 30

A study involving an injectable contraceptive regimen utilizing 2 commercially available hormonal preparations, medroxyprogesterone acetate (Depo-Provera, The Upjohn Company) and estradiol-17 beta-cyclopentylpropionate (Depo-Estradiol Cypionate, The Upjohn Company), is described. 90 multigravidas received intramuscular injections of 50 mg of medroxyprogesterone acetate and 10 mg of estradiol-17 beta-cyclopentylpropionate as a contraceptive every 5 weeks, for a total of 1155 periods. The injections were found to be safe and completely effective. In 15% of the therapeutic cycles, bleeding did not appear for a period of 30 or more days. In 14%, bleeding and/or spotting lasted for longer than 9 days during a 30 day period. The incidence of aminorrhea increased somewhat after the first 10 months of treatment. Endometrial biopsies showed a "suppressed" endometrium. Adrenal pituitary responsiveness to metyrapone was found to be normal in 17 of 21 patients tested. Although almost half of the patients presented some complaints during the study, these were mostly transient and minor in nature. Headache was the complaint most frequently observed (14%), but it was generally limited to 1 cycle. The monthly injectable contraceptive regimen may be useful in a particular population of patients who, for various reasons, cannot tolerate or cannot be relied upon to take oral contraceptives. The authors believe that because of the high incidence of alterations in the bleeding pattern while on the therapeutic regimen, as well as the frequent occurrence of aminorrhea following discontinuation of therapy, the use of such a contraceptive regimen in the general population might not be desirable.
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PMID:Evaluation of an injectable progestin-estrogen as a contraceptive. 491 52

Clinical characteristics of cerebral infarctions occurring in 15 women (aged 22-51) who had taken oral contraceptives for an average of 24.8 months are described. Aside from 5 atypical cases, the 10 remaining women suffered marked increases in headache pain for only 3 months before their strokes. The subjective severity increased progressively, and in at least 6, the duration of each headache increased. Frequency of headaches in 9 women increased noticeably during the prodrome, and in some was almost constant for a week before the infarct. However only 5 patients had or had just had headaches at the exact time of the stroke. The spatial aspects of headache locations imply etiological relationship to the infarct which follows. Upon recognition of the clinical characteristics of such headache in women taking oral contraceptives, the medication should be stopped immediately. Absolute withdrawal should be recommended for patients with increasing vascular headache and headache associated with focal neurological symptoms. Hypertension in patients with the slightest sign of increasing headache should be cause for discontinuation of the pill. Following withdrawal of the oral contraceptive, synthetic narcotics are the only therapy advised. Vasoconstrictor drugs may aggravate the vasoconstrictor phase leading to infarction.
Headache 1968 Oct
PMID:The clinical characteristics of headache during impending cerebral infarction in women taking oral contraceptives. 573 Jan 19

Thirty-eight patients underwent transsphenoidal microsurgical treatment of non-neoplastic intrasellar cysts: 36 had cyst drainage and biopsy of the cyst wall, and in two the cyst was totally removed. Surgical morbidity was 8%. The mean follow-up time was 46.3 months; 100% patient follow-up evaluation was achieved. Sixteen female patients (mean age 24.6 years) had pars intermedia cysts: 88% had menstrual irregularities, 63% had galactorrhea, 31% had headache, and 56% had hyperprolactinemia. Within these groups, menstrual cycles returned in 86%, galactorrhea ceased in 90%, headaches resolved in 80%, and serum prolactin levels were restored to normal in 66%. Eight females and three males had Rathke's cleft cysts (mean age 34.0 years): of these 11 patients, 91% had headaches and 18% had hyperprolactinemia; of the eight females, 63% had amenorrhea and 63% had galactorrhea. Within these groups, serum prolactin levels normalized in 50%, and 80% noted reduced headache. Of the females, 80% had return of menses and 50% noted cessation of galactorrhea. Six males and two females had arachnoid cysts (mean age 42.2 years): 50% had headaches; 50% were asymptomatic. Preoperatively, 50% of these patients had hypothyroidism and 25% had adrenal hypofunction. Postoperatively, 75% of patients with headache noted improvement, and 33% of patients with abnormal thyroid function had normal function. Adrenal function did not improve. Three patients had an intrasellar cysticercosis cyst, epidermoid cyst, and postoperative cyst, respectively. All had evidence of partial hypopituitarism; none improved postoperatively. The results indicate that different types of pituitary cysts produce different clinical syndromes, and suggest that simple transsphenoidal drainage and partial removal of the cyst wall can provide safe and effective therapy.
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PMID:Transsphenoidal treatment of non-neoplastic intrasellar cysts. A report of 38 cases. 668 30

In 29 patients suffering from chronic renal failure intraocular pressure was measured during different therapeutic regimens. Conventional hemodialysis (principle of transport diffusion, n = 15) led to an increase in IOP after one hours treatment. In individuals complaining of headaches during dialysis a marked increase in IOP was observed indicating a disequilibrium syndrome. Hemofiltration is characterized by mass transfer and exchange of plasma water. When this treatment was applied to 6 patients IOP was elevated during the second hour. Simultaneous hemofiltration/hemodialysis (n = 8) had no influence on IOP behaviour. Statistically there was no correlation between the behaviour of serum osmolarity, arterial blood pressure, loss of body weight and IOP.
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PMID:[Effect of serum osmolarity, arterial blood pressure and volume loss on IOP during hemodialysis, hemofiltration and simultaneous hemofiltration/hemodialysis (author's transl)]. 690 45

Bosentan, a specific mixed antagonist of endothelin receptors with no vasoconstrictor activity, inhibits neurogenic plasma extravasation (NPE) within rat dura mater. This would predict efficacy in aborting migraine attacks, without causing cardiovascular side-effects. We investigated the efficacy of 250 mg i.v. bosentan in a randomized, double-blind, placebo-controlled, clinical trial. Improvement from moderate/severe to mild/no headache at 2 h (primary efficacy measure) occurred in 5/23 (22%) of bosentan-treated and in 9/25 (36%) of placebo-treated patients (effect difference -14%; 95% CI -52%, 24%). Thus, inhibition of NPE may not predict clinical efficacy of experimental antimigraine drugs. Vasoconstrictor action may be needed.
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PMID:Endothelin antagonist bosentan blocks neurogenic inflammation, but is not effective in aborting migraine attacks. 895 32

A multicenter, parallel-design, randomized, double-masked study was conducted to compare the efficacy and safety of 2% dorzolamide with those of 0.5% betaxolol in the treatment of elevated intraocular pressure (i.o.p). A total of 311 adults with ocular hypertension or open-angle glaucoma were randomly allocated to receive either 2% dorzolamide administered topically TID or 0.5% betaxolol administered topically BID plus placebo administered topically QD for 12 weeks. After the washout of previous ocular hypotensive drugs, patients with IOP > or = 23 mm Hg in at least one eye at 10 AM or 4 PM on study day 1 were randomly allocated to receive one of the study treatments. Throughout the study, IOP was measured 2 and 8 hours after instillation of study medication for the morning peak effect (hour 2) and afternoon trough effect (hour 8). After 12 weeks of therapy, the mean change in IOP was not significantly different between the dorzolamide and betaxolol treatment groups at hour 8 (-3.6 mm Hg in both groups) or hour 2 (-5.4 vs -5.3 mm Hg, respectively). The differences between treatments (and 95% CIs associated with these differences) in mean IOP changes from baseline were 0.02 mm Hg (-0.870 to 0.901) for hour 8 and -0.14 mm Hg (-0.959 to 0.685) for hour 2. The ocular adverse experience (AE) most frequently reported by patients was ocular burning and/or stinging, and the most frequently reported nonocular AEs were taste perversion, upper respiratory infection, and headache. Only the incidence of taste perversion was significantly different between treatment groups (14.6% for the dorzolamide group and 0.0% for the betaxolol group). Two percent of patients in each treatment group discontinued the study due to AEs. This study confirmed the similar IOP-lowering effect of 2% dorzolamide and 0.5% betaxolol. Both treatments were generally well tolerated, and their safety profiles were similar.
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PMID:Comparison of the efficacy and safety of 2% dorzolamide and 0.5% betaxolol in the treatment of elevated intraocular pressure. Dorzolamide Comparison Study Group. 966 61

A multicenter, randomized, investigator-masked, parallel-group trial compared bimatoprost and latanoprost for efficacy and safety in patients with glaucoma or ocular hypertension. Patients received bimatoprost 0.03% (n = 119) or latanoprost 0.005% (n = 113) once daily in the evening for 3 months. Visits were at prestudy, baseline (day 0), week 1, and months 1, 2, and 3. Primary outcome measures were mean IOP and the percentage of patients achieving IOP of 17 mm Hg or lower at 8:00 AM. Secondary outcome measures were diurnal IOP measurements (8:00 AM, 12 noon, 4:00 PM, 8:00 PM) at month 3 and safety measures including adverse events. Mean IOP was lower with bimatoprost than with latanoprost at all time points during the 3-month follow-up, although the between-group difference was not always statistically significant. At month 3 at 12 noon, mean IOP was as much as 1.0 mm Hg lower with bimatoprost (P = .021). Target pressures of < or = 17 mm Hg were reached more often with bimatoprost than with latanoprost at 8:00 AM (53% vs 43%; P = .029). Over all diurnal measurements at month 3, low target pressures of < or = 13, < or = 14, and < or = 15 mm Hg were achieved significantly more often with bimatoprost (P < or = .006). Both drugs were safe and well tolerated. Conjunctival hyperemia was more common with bimatoprost, while headache was more frequent with latanoprost. Bimatoprost provided lower mean pressures than latanoprost at every time point throughout the study and was statistically superior in achieving low target pressures. More patients reached low target pressures with bimatoprost.
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PMID:Three-month comparison of bimatoprost and latanoprost in patients with glaucoma and ocular hypertension. 1157 23

The features of the symptoms, laboratory tests and pathological characteristics of adrenal cortical and medullary hyperplasia were studied. In 6 cases of hypercatecholaminenia, plasma norepinephrine (NE), epinephrine (E), catecholamine (CA) and 24-h urinary vanillylmandelic acid (VMA), 17-hydroxycorticosteroid (OHCS) and 17-ketosteroid (KS) were determined. Adrenal glands were examined by CT scan and 131I-MIBG imaging. Pathological examination was performed after operation. The results showed that in 6 cases of hypercatecholaminenia (3 men and 3 women) aged from 34-50 years, the clinical features were just like "pheochromocytoma", for example, episodic headache, perspiration, palpitation, pallor, apprehension, nausea, tremor, anxiety and so on. Plasma levels of CA, NE and E were elevated in all 6 cases. 24-h urinary samples obtained at the onset revealed elevated VMA in 1 case. 24-h urinary cortisol was obviously elevated in all 6 cases. 24-h urinary 17-OHCS, 17-KS was normal. B-type ultrasound, CT, MRI and 131I-MIBG revealed 9 lateral adrenal gland diffuse or nodular enlargement in 6 cases. Pathologic examination showed adrenal cortical and medullary hyperplasia. Clinically, adrenal cortical and medullary hyperplasia resembled "pheochromocytoma". The most significant feature of this disease was both elevated plasma CA and 24-h urinary cortisol obviously. Pathologic examination showed adrenal cortex nodular hyperplasia and medullar diffuse or limit hyperplasia. Whether it is an independent disease or symptoms of the other disease has not final conclusion up till now.
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PMID:Adrenal cortical and medullar hyperplasia--a retrospective analysis of 6 cases. 1267 82

Adrenal ganglioneuromas are rare tumors originating from the neural crest tissue of the sympathetic nervous system. The clinical presentation for most patients is asymptomatic, and most of these tumors are hormone silent. We report a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient. A 46-year-old woman was admitted to our hospital with a 2-month history of right flank pain, and a 2-year history of paroxysmal hypertensive attacks associated with headaches, palpitations, nervousness, and sweating. Abdominal CT and MRI revealed a solid round tumor approximately 4 cm in diameter on the upper pole of the right kidney. Urinary levels of dopamine and homovanillic acid were slightly elevated, although urinary levels of metanephrine and normetanephrine were suppressed. The urinary levels of epinephrine, norepinephrine, and vanillylmandelic acid were within normal limits. Right adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. In conclusion, this is a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient.
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PMID:Dopamine-secreting adrenal ganglioneuroma presenting with paroxysmal hypertension attacks. 1817 86


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