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

The authors have studied the effects of Nitrendipine, orally given in a dose of 20 mg, once a day for 30 days, in patients with mild to moderate hypertension. Twelve patients initially entered the study but four of them discontinued the treatment during the first week, because of unwanted side-effects: headaches, palpitation, sensations of burning skin. The remaining eight patients underwent a comparative evaluation at the end of a placebo period (DO) and at the end of the active treatment (D30), including successively: an automatic blood pressure recording with a Bard-Sentron device for 3 hours, then a determination of plasma renin activity, aldosterone and catecholamines, and finally a measurement of the blood pressure with a mercury manometer, at rest and during a standardized exercise on an ergometric bicycle. At D30, the Nitrendipine tablet was given one hour after the beginning of the automatic recording. The blood pressure measured with the mercury manometer (i.e. approximately 2 hours after the dose of Nitrendipine) significantly decreased from D0 to D30, at rest and during exercise, respectively from 161.5/104.6 to 132.8/82.5 mmHg and from 210.0/116.8 to 190.0/95.6 mmHg. The automatic recording provided, at D0, a mean blood pressure value of 152.4/90.6 mmHg; at D30, this mean value was as high as 142.6/90.7 mmHg during the hour preceding the dose of Nitrendipine (NS) and as high as 129.2/78.6 mmHg during the 2nd hour following the intake of the tablet (p less than 0.01). Plasma aldosterone and plasma renin activity significantly (p less than 0.05) increased from D0 to D30, whereas catecholamines did not change.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the antihypertensive effect and tolerability of a new delayed-action calcium channel blocker: nitrendipine, prescribed as a single daily dose of 20 mg]. 381 62

Mercury levels in air, urine, blood, and hair were studied for workers (14 women, 2 men, ages 18-44 a) employed in a small thermometer factory (metallic mercury vapor exposures) with generally inadequate engineering and hygienic arrangements. At exposure levels of 50-99 microgram/m3 (5 workers), 100-149 microgram/m3 (3 workers) and 150-200 microgram/m3 (7 workers), respectively, the mean mercury levels were 299, 449 and 628 nmol/l in urine; 105, 122 and 143 nmol/l in blood, and 4.2, 8.5 and 12.2 mumol/kg in hair (1 cm from base). Headache, irritability-hair loss, and wrist and ankle pain were the most frequently occurring symptoms. The correlation coefficients between the measured mercury levels in air for individual workers and mercury in urine, blood, and hair (1 cm from base) were r = 0.92, r = 0.79, and r = 0.42, respectively. Mercury determinations for segmental hair cuts indicated peaks and drops in absorption/deposition consistent with data on the vacations of the individual mercury levels of 150-770 nmol/l may be helpful when current thresholds of exposure/absorption are reconsidered.
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PMID:Mercury exposure and effects at a thermometer factory. 710 Aug 46

1. We report two cases of acute mercury vapour intoxication in humans. The mercury vapour was released from smelting alloys (gold-mercury amalgam). The alloy was apparently contaminated with an unknown amount of mercury. 2. Within half an hour of the incident, the victims began having moderate headache, nausea, lumbar pain and shortness of breath at rest. The patients were treated with BAL (2,3 dimercaptopropanol), followed by DMSA (2,3 dimercaptosuccinic acid). 3. Serial measurements of mercury metal in plasma and in urine were made for ten days. 4. The results suggest that in spite of the treatment, relatively high concentrations of mercury remain in the plasma for a very long time, and this could be explained by the progressive release of mercury from red blood cells and tissues after oxidation. However, BAL and DMSA did not seem to be the most efficient antidotes. They reduce the plasma inorganic mercury uptake at concentrations of < 50 micrograms I-1.
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PMID:Elemental mercury vapour toxicity: treatment and levels in plasma and urine. 771 4

Analysis and treatment of dental and medical factors that can cause burning mouth were performed in 25 consecutive patients according to a treatment protocol. The effect of the dental and medical treatment on the burning mouth was evaluated. The sick leave profile was presented. Apart from burning mouth symptoms, the patients reported several oral and general symptoms, such as gustatory changes, xerostomia, back and joint muscle pain, headache, and dizziness. The most common dental diagnoses were temporomandibular joint, masticatory, and tongue muscle dysfunction and lesions in the oral mucosa. The most common medical diagnoses were low serum iron and hypersensitive reaction to mercury. None of the patients tested exceeded the limit of 100 nmol Hg/l urine. Replacement of amalgam fillings was the most common dental therapy, followed by treatment of dysfunction in the masticatory system. Iron replacement was the most frequent medical treatment. The patients had over 50% more days per year sick leave than an age- and sex-matched normal population. A follow-up found that the burning mouth had disappeared in 32% of the patients. This study confirms the opinion that burning mouth is multicausal. Hypersensitive reaction to mercury was more frequent than expected, but replacement of amalgam fillings relieved burning mouth in only two of five such patients, and one of these two patients had hypersensitive reactions to both mercury and gold. One reason that so many patients continued to have burning mouth might have been neglect of dental, medical, or both diagnoses. Another reason might be that assessment of the psychologic status of the patients and psychologic treatment when indicated were not done.
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PMID:Clinical study of patients with burning mouth. 781 55

In order to determine if there are any residual effects of long-term exposure to mercury vapor, neurobehavioral tests were given to ex-mercury miners about 18 years after the cessation of mercury exposure. Seventy-six male ex-mercury miners who had been exposed to relatively high concentrations of mercury vapor (over 1.0 mg/m3) and with a past history of mercury intoxication were compared to age (+/- 3 years)-, sex-, and years of education-matched controls. Although the extent of the workers' symptoms caused by mercury poisoning, termed erethismus merculialis, markedly decreased after the cessation of exposure, the prevalence of neurological symptoms (such as hand tremors, headaches, and slurred speech) and symptoms of senility (such as low-back pain, loss of sexual desire) in the ex-miners was significantly higher than those in the controls. Matched-pair analysis showed that performances of motor coordination, Simple reaction time, and Short-term memory in the ex-miners were significantly deteriorated compared to those of controls. There are slight but persistent effects on neurobehavioral function, especially on motor coordination function, among mercury miners more than 10 years after the cessation of exposure.
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PMID:Subjective symptoms and neurobehavioral performances of ex-mercury miners at an average of 18 years after the cessation of chronic exposure to mercury vapor. Mercury Workers Study Group. 834 36

A total of 217 patients with essential hypertension were enrolled by 25 Canadian centers in this double-blind, parallel study to compare the efficacy and safety of enalapril administered alone or in combination with hydrochlorothiazide. After a 4-week placebo period, patients were given 10 mg of enalapril for 2 weeks. At the end of the 2 weeks of therapy, patients were maintained on the same dose of enalapril, titrated to a higher dose of enalapril, or received combination therapy with hydrochlorothiazide if their diastolic blood pressure remained > 90 mmHg. Patients in group 1 received enalapril 10 mg or 20 mg and those in group 2 received enalapril 10 mg alone or combined with hydrochlorothiazide 25 mg. The maintenance phase lasted 8 weeks. A standard mercury sphygmomanometer was used to measure blood pressure at each visit. The mean decrease in supine diastolic blood pressure (SDBP) was 16 mmHg in groups 1 and 2; the mean decrease in supine systolic blood pressure (SSBP) was 19 mmHg in group 1 and 20 mmHg in group 2. Eighty percent of the patients in group 1 and 81% of those in group 2 had an SDBP < or = 90 mmHg at the final visit. To achieve this control, 67% of the patients received enalapril 10 mg and 33% received enalapril 20 mg in group 1. In group 2, 70% of the patients received enalapril 10 mg and 30% received enalapril 10 mg plus hydrochlorothiazide 25 mg. Eighteen patients in group 1 and 17 patients in group 2 experienced one or more minor adverse events. The most frequently reported adverse events were headache, asthenia, abdominal pain, nausea, and dizziness. No major adverse events were observed. We conclude that enalapril used alone reduces blood pressure in the majority of patients with mild to moderate essential hypertension. When blood pressure is not controlled by enalapril alone, hydrochlorothiazide can safely be added to the regimen.
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PMID:Enalapril and enalapril-hydrochlorothiazide in the treatment of essential hypertension. The Enalapril-Hydrochlorothiazide in Essential Hypertension Canadian Working Group. 851 44

Hair mercury analysis was carried out on a sample of 219 people living in the main gold mining zone of Colombia, 27 inhabitante of Cartagena City being taken as control sample. For data analysis the sample was divided by occupation and the corresponding the hair mercury concentrations (mean +/- SD) were found to be 5.23 +/- 5.78, 2.83 +/- 3.27, 2.4 +/- 2.02 and 1.33 +/- 0.74 micrograms/g for fishermen, miners, people of various other activities and the control sample, respectively. According to variance analysis and the Newman Keuls test, there were significant differences (p < 0.01) between the mercury concentrations for fishermen and those for the other groups. No significant differences were found for hair mercury and sex, non was any correlation with age detected; however, a low positive correlation (R = 0.15, p < 0.01) with the frequency of the consumption of fish was noted. The main symptoms of mercury poinsoning observed in the persons exposed were headache, oral lesions, metalic taste, loss of memory, and irritability.
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PMID:[Hair mercury levels in different occupational groups in a gold mining zone in the north of Colombia]. 873 Dec 77

A 17 year-old boy was admitted to the hospital because of severe hypertension (200/130 mmHg), headache, irritability, and sweating. Initial biochemical tests suggested pheochromocytoma, being treated with nifedipine, clonidine and propranolol. However, with report of exposure to mercury vapor, twenty-four-hour urine screening and measurement of blood mercury confirmed intoxication. The patient underwent courses of chelation therapy with dimercaprol (BAL) and penicillamine with remission of symptoms and normalization of blood pressure after 2 months. This case has relevance for current practice reflecting similarity between mercury intoxication and hypertension secondary to pheochromocytoma.
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PMID:[Arterial hypertension due to mercury intoxication with clinico-laboratorial syndrome simulating pheochromocytoma]. 873 21

The antihypertensive efficacy of calcium antagonists could depend on the concentration of circulating renin. To investigate this hypothesis, 102 hypertensive men or women were included in this study. After an initial 2 week placebo period, the patients were administered slow-release nicardipine, 50 mg twice a day for twelve weeks. The blood pressures were measured with a mercury sphygmomanometer at inclusion (S2) and after 12 weeks of treatment (S14), in addition to home automeasure during the week before inclusion and the two weeks preceding the final visit. The plasma renin activity (RA) was measured at S2 and S14. Its value at inclusion was used to differentiate patients with low renin (< or = 11 ng/l) from those with normal (> 11 < or = 17 ng/l) or high renin activity (> 17 ng/l). The blood pressure measured by sphygmomanometer or automeasure was significantly lower at the end of the active treatment period (SBP: -8 mmHg; DBP: -9.5 mmHg; and SBP: -5.8 mmHg; DBP: -5.7 mmHg respectively); the reduction in blood pressure was significantly higher in the group with low RA than in the group with high RA. The reductions in SBP measured in the morning and evening and in DBP measured in the morning were significantly greater in the group with low RA than in the group with high RA. The reduction of SBP measured in the morning at midday, and in the evening was correlated to the basal value of RA. Mild side effects were observed in 20 patients leading to the interruption of treatment in 11 cases because of headache. The best antihypertensive response is observed in patients with low plasma RA. This could explain the good response to calcium antagonists usually observed in elderly hypertensives.
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PMID:[Relation between plasma renin level and antihypertensive response to nicardipine]. 874 14

The efficacy and safety of trandolapril alone and in combination with a calcium channel blocker were evaluated in 13,147 hypertensive patients over 60 years old. Two patient groups were constituted. After a 2-week wash-out period, the patients in group I received monotherapy with trandolapril 2 mg/day for 4 weeks. Trandolapril was continued for another 4 weeks in responding patient, otherwise the dosage of trandolapril was doubled or another antihypertensive was added. Group 2, composed of patients previously treated with a calcium channel blocker with insufficient efficacy, was treated according to the same treatment regimen, but the calcium channel blocker was maintained throughout the study. 13,147 patients (group 1: 11,329 patients, group 2: 1,818 patients) with a mean age of 68 +/- 7 years were followed. After 4 weeks of treatment, the blood pressure measured by mercury sphygmomanometer decreased from 176 + 11/99 +/- 8 mmHg to 164 +/- 12/87 +/- 7 mmHg (p < 0.0001). This blood pressure fall was similar in group 1 (-22 +/- 12/-12 +/- 8 mmHg) and in group 2 (-21 +/- 11/-12 +/- 8 mmHg). In the pure systolic HT subgroup treated by trandolapril monotherapy, the antihypertensive effect predominantly affected the SBP (-23 +/- 12/- 4 +/- 6 mmHg). The antihypertensive effect was correlated with the initial blood pressure. In group 1, in the case of insufficient response to trandolapril monotherapy, the addition of a calcium channel blocker was the strategy which achieved the most marked antihypertensive effect (ANOVA, p < 0.0001). This bitherapy was more effective than the trandolapril+diuretic combination (-18 +/- 11/- 11 +/- 8 mmHg and -15 +/- 10/- 9 +/- 7 mmHg, respectively (p < 0.001). A total of 1,270 adverse events were reported by 996 patients (7.6%), leading to discontinuation of treatment in 372 patients (2.8%). The most frequent adverse effects were cough (2.8%), headache (0.8%), vertigo (0.8%) and nausea (0.5%). Only one minor equivalent of angioneurotic oedema was reported. In conclusion, trandolapril is effective and well tolerated in elderly hypertensive patients. In the case of pure systolic HTA, its action is essentially exerted on SBP. The combination of trandolapril+calcium channel blocker appears to be the most effective strategy in the case of incomplete blood pressure control by trandolapril alone.
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PMID:[Evaluation of trandolapril alone or in combination with a calcium channel blocker in hypertensive patients over 60 years of age]. 874 62


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