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

Thirty patients with persistent chronic daily headache, unresponsive to various combinations of pharmacological and nonpharmacological treatment were selected for an open label study using divalproex sodium. All patients had normal liver function tests. After a baseline observation period of 1 month, patients were given divalproex sodium 1000 to 2000 mg per day, for a period of 3 months. Blood valproic acid levels were kept between 75 and 100 mcg/ml. Liver function studies and blood ammonia levels were obtained periodically. Based on weekly headache index, headache-free days, dysfunctional days and patients' general well-being rating and physicians' global assessment, two thirds of the patients improved significantly. The common side effects included weight gain, tremor, hair loss and nausea. Liver functions were unaffected by treatment. The possible mechanism of action of valproate in headache is discussed. Valproate appears to be a worthwhile addition to the prophylactic treatment of chronic recurrent headache.
Headache 1991 Feb
PMID:Valproate in the treatment of persistent chronic daily headache. An open label study. 203 76

We report a 17-year-old female case of ornithine transcarbamylase (OTC) deficiency who died of brain edema due to hyperammonemic attack. The patient had a brother with OTC deficiency who had died of hyperammonemia at 17 years of age. She firstly had a symptom of headache, nausea, vomiting and myalgia at 14 years old and twice thereafter. On admission she had a severe disorientation and vomiting. The plasma ammonia level was 89 micrograms/dl, then increased to 400 micrograms/dl in five hours. In addition to plasma exchange, hemodialysis and then peritoneal dialysis for next 5 days, parenteral sodium benzoate and arginine were administered. Although the plasma ammonia level improved gradually, her consciousness never returned and she died of severe brain edema with uncontrollable hypotension on day 8. Histology of a necropsy liver sample showed fatty metamorphosis of hepatocytes mainly with fine lipid droplets. Electron micrograph of hepatocytes showed crystalloid inclusions in mitochondria. Significance of the clinical course and the treatment during hyperammonemic crisis was discussed.
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PMID:[Abrupt onset and rapid deterioration in the course of congenital ornithine transcarbamylase deficiency: a case report]. 221 May 91

In newly constructed houses and buildings in which self-leveling mortar containing casein has been used, residents and office employees have noted a bad odor and have complained of headache, eye and throat irritation, and tiredness. These problems were suspected to result from the degradation products emitted from the mortar. Samples obtained from dry mortar powder and from mortar in buildings where casein was used and from control buildings were found to contain microorganisms (mean of 10(2) culture forming units/g). Environmental species were predominantly found, e.g., Bacillus, Clostridium, Micrococcus, and Propionibacterium. Fungi were found occasionally; no evidence of bacterial degradation was found. Headspace and gas chromatographic-mass spectrometric analysis of air from the newly constructed houses and from hydroxide-degraded casein revealed the presence of amines in the 0.003-0.013 ppm range and the presence of ammonia and sulfhydryl compounds, all of which in low concentrations can cause the symptoms observed. These substances, however, were not detected in control buildings.
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PMID:Self-leveling mortar as a possible cause of symptoms associated with "sick building syndrome". 238 18

"Environmental tobacco smoke" (ETS) is the term used to characterize tobacco combustion products inhaled by nonsmokers in the proximity of burning tobacco. Over 3800 compounds are in tobacco smoke, many of which are known carcinogens. Most ETS exposure is from sidestream smoke emitted from the burning tip of the cigarette. Sidestream smoke is hazardous because it contains high concentrations of ammonia, benzene, nicotine, carbon monoxide, and many carcinogens. Nonsmokers chronically exposed to ETS are believed to assume health risks similar to those of a light smoker. Children of parents who smoke have more respiratory infections, more hospitalizations for bronchitis and pneumonia, and a smaller rate of increase in lung function compared to children of parents who do not smoke, particularly during the first year of life. Among adults with preexisting health conditions such as allergies, chronic lung conditions, and angina, the symptoms of these conditions are exacerbated by exposure to ETS. The acute health effects among healthy adults include headaches, nausea, and irritation of the eyes and nasal mucous membranes. The evidence for a relationship between ETS and cancer at sites other than lung is insufficient to draw any positive conclusions. For lung cancer, studies have consistently shown an excess risk between 10% and 300%, with a summary relative risk of 1.3 (95% confidence interval = 1.1-1.5). A dose-response relation is suggested but difficult to assess completely. Histologic types of lung cancer are generally similar to those most closely associated with active smoking, although other histologic types have also been found. Both excess relative risks and the dose responses are underestimates of the true excess risk and of the range of dose-response effect. Although the temporal relationship between exposure and disease occurrence is established, many questions are unanswered. The findings are consistent with many known biologic effects of active smoking and are partially analogous to the biologic effects of direct smoke inhalation. As many as 5000 nonsmokers are estimated to die annually from lung cancer as a result of exposure to ETS. There is great potential for prevention of these premature deaths. The two major preventive actions are (a) eliminating the source by reducing the amount of direct smoking and (b) limiting the level of exposure by restricting where tobacco can be smoked. Specific preventive actions include smoking cessation, smoking prevention, restriction of advertising, increased taxation on tobacco, and adoption of stringent nonsmoking policies in the workplace, schools, and public places.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Health hazards of passive smoking. 328 40

Headaches may occur in as many as 25% of hypertensive patients and generally bears little relationship to level of diastolic blood pressure. Previous observations, in normotensive patients, suggested that abnormalities in both potassium and ammonia metabolism might be related to the pathogenesis of these headaches. The present study was undertaken to see whether these factors also occurred in hypertensive patients with headaches. The present observations were made in thirteen hypertensive patients with vascular headaches. The major findings include potassium levels of 3.45 +/- 0.25 mEq/L; CO2, 29.85 +/- 1.21 mEq/L; blood ammonia, 41 +/- 8.40 U mol/L and an alkaline pH of the urine. The blood ammonia levels, when factored by the BUN, yielded elevated ammonia to BUN ratios (3.81 +/- 1.82). These findings are similar to those previously observed in normotensive patients with vascular headaches. The profile of hypokalemia and/or alkalosis, increased blood ammonia to BUN ratios and a relatively alkaline urine appears to be a commonly observed pattern in patients with vascular headaches. These data suggest that a biochemical basis exists for the genesis of vascular headaches in patients with hypertension.
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PMID:The pathogenesis of vascular headaches in patients with hypertension; the role of the ammonia-potassium axis. 364 6

A conceptual approach that relates vascular headaches, bowel and bladder dysfunction to abnormalities of the "ammonia potassium axis" is presented. Hypokalemia alters smooth muscle function of both the bowel and bladder and results in the elaboration of an alkaline urine. The occurrence of an alkaline urine, along with bladder dysfunction and urinary stasis, predisposes to recurrent urinary tract infections. Hypokalemia and/or alkalosis increases the renal return of ammonia, exposes the brain to chronically higher concentration of ammonia and facilitates its passage into the central nervous system. Increased levels of blood ammonia predispose to hyperventilation which results in a superimposed respiratory alkalosis on a pre-existing hypokalemia and/or alkalosis therefore causing intense cerebral vasoconstriction. Varying degrees of cerebral ischemia and hypoxia occur and give rise to higher brain concentrations of ammonia. Vasodilatation occurs during the headache phase and may be a consequence of the sudden increase of brain ammonia and/or due to the release of other vasoactive mediators. As a consequence of increased blood ammonia, a reduction of protein intake may result in the alterations of amino acid precursors for brain uptake and therefore further interferes with the modulation of cerebral blood flow and brain function.
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PMID:The hypokalemic, bowel, bladder, headache relationship; a new syndrome. The role of the potassium ammonia axis. 651 31

An hygienic survey for hydrogen sulfide, methyl mercaptan and its derivatives and sulfur dioxide in kraft mills and in sulfite mills revealed concentrations varying from 0 to 20 ppm hydrogen sulfide, 0 to 15 ppm methyl mercaptan and comparable amounts of dimethyl sulfide with dimethyl disulfide up to 1.5 ppm. The greatest emissions were detected at chip chutes and evaporation vacuum pumps. Batch operations yielded clearly higher sulfur dioxide concentrations (up to 20 ppm) as compared to a continuous ammonia-base digester. Furthermore, there was a strong correlation with the season in the sulfite mills where higher concentrations were found in the winter when natural ventilation was poorer. As to the health effects, the exposed workers complained of headaches and a decrease in concentration capacity more often than matched controls. The number of sick leaves was greater in the exposed workers than among the controls.
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PMID:Exposure to hydrogen sulfide, mercaptans and sulfur dioxide in pulp industry. 651 22

A 46-yr-old man with cirrhosis presented with mental confusion, headache, and nausea. Colloid liver scintigraphy showed a defect in the hilar area, and portograms after superior mesenteric arteriography demonstrated varicose veins in the same area. Computed tomography revealed a sausage-shaped low-density channel connecting the hepatic hilum and the inferior vena cava, and bolus injection contrast enhancement demonstrated transit of contrast medium from the portal vein directly into the inferior vena cava through this channel. Real-time ultrasound demonstrated a large conduit contiguous from the portal vein to the inferior vena cava through and behind the liver. The catheter introduced into the inferior vena cava opacified a large opening of this shunt below the right and left hepatic vein openings. Measurements of blood pressure, ammonia, and PaO2 clearly indicated that portal vein blood was being shunted through this channel. These findings are highly suggestive of a portosystemic shunt through a patent ductus venosus.
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PMID:An unusual portal-systemic shunt, most likely through a patent ductus venosus. A case report. 688 18

Amino acid levels in plasma were measured by amino acid autoanalyser in 130 convulsive children. The levels of taurine, serine and tryptophan were significantly lower in convulsive children as compared to normal control; in contrast, isoleucine, homocystine, GABA, histidine, arginine and ammonia were higher. The children with paroxysmal disorders (headache, dizziness and abdominal epilepsy) had the highest levels of isoleucine, histidine and arginine and the lowest levels of glutamate and cystein. Clinical seizure activity within 6 months prior to the test seemed to have no obvious effect on the plasma amino acid pattern, except for the levels of glycine and arginine tended to return to normal, and the level of GABA was significantly increased in patients with the seizure being controlled. The patients treated with carbamazepin as a single anticonvulsant had the highest GABA level compared to those with other anticonvulsants. Hyperglycinemia and hyperammonaemia were also noted in patients who took valproic acid. The levels of serine, isoleucine and phenylalanine in the CSF within 6 hours after convulsion were significantly lower than the normal control; while asparagine, tyrosine, lysine and arginine were significantly higher. The concentration of ammonia in the CSF was also elevated after convulsion as compared to the normal control. Amino acids play an important role in the generation of epilepsy and recently there has been an increasing number of studies to help determine their effects during an epileptic attack. However, there still is much debate and controversy on this topic. Therefore, further studies are needed and researchers should carefully consider factors that might affect the accurate assessment of the results.
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PMID:Alteration of amino acid in plasma and cerebrospinal fluid of children with seizure disorders. 851 Jan 96

The purpose of this paper is to examine the potential effects of livestock odors on the health and well-being of neighbors. Complaints of odor nuisance have become more frequent in communities surrounding areas with high concentrations of livestock. This increase in complaints from livestock odors parallels increased complaints of odor in general, including ammonia, diesel exhaust, beauty products, cleaners, and paints. Persons who report symptoms from odors generally find problems with many different types of odorous compounds. A review of recent studies suggests that the main complaints of health symptoms from odors are eye, nose, and throat irritation, headache, and drowsiness. Sensory irritation (pungency) can be produced by a broad range of odorous volatile organic compounds from trees, flowers, foods (pepper and ginger) as well as emissions from livestock operations. Odors can also potentially affect mood and memory. Further research is required to assess fully the health impact of odors in order to establish recommendations for air quality guidelines based on scientific data.
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PMID:Livestock odors: implications for human health and well-being. 962 40


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