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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aforementioned stress reduction techniques can be useful for some people, but not all individuals will benefit to the same degree with a similar technique. Those who manifest severe stress symptoms, such as ulcers, hypertension, and migraine headaches, are advised to seek a medical evaluation before attempting relaxation or any other type of stress reduction method. The relaxation skill most beneficial for an individual's own needs might be best sought through a qualified therapist. Those who desire reduction in general tension, or who wish a rejuvenation during the workday, may well benefit from less controlled stress reduction techniques, such as taped instructions, breathing, and imagery methods. A trained therapist can provide the most appropriate relaxation method for an individual's needs. We, as health care providers, can enlighten our patients about methods which can aid them in dealing with anxiety and stress and thus gain better control over the pace of their lives and ours.
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PMID:Relaxation skills for the patient, dentist, and auxiliaries. 353 28

Headache is a common affliction of humanity. The physician evaluating a patient who happens to have a history of headaches may naturally consider them as part of the disease when formulating a diagnosis, thus attributing undue significance to ordinary functional headaches. This may account for the myths that unruptured aneurysms or arteriovenous malformations cause headache and that migraine can eventually lead to stroke. Sometimes, however, headaches do warn of cerebrovascular disease or occur as part of that disease. The presence of headache may aid in or hinder diagnosis. Clues that a headache may indicate cerebrovascular disease are onset after the age of 35; pain described as "the worst headache ever"; persistent localization and progressive worsening of pain; and risk factors for cerebrovascular disease, such as advancing age, hypertension, bruits, and heart disease.
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PMID:Headache in cerebrovascular disease. A common symptom of stroke. 358 61

Cafergot is a combination of ergotamine tartrate and caffeine and may cause symptoms of peripheral vascular insufficiency. Iatrogenic ergotism should be suspected in any patient exhibiting ischemic symptoms while receiving this medication. Progression to fulminant necrosis and gangrene can occur. Two cases are presented and the management reviewed. This effect of ergotamine tartrate and caffeine may be an idiosyncratic hypersensitivity reaction with therapeutic doses or may result from excessive medication. Iatrogenic ergotism occurs most often in women in their mid-thirties with migraine syndrome. By alpha-adrenergic agonism, as well as by possible interactions with prostaglandins, calcium, and serotonin, ergotamine causes vasoconstriction of both arteries and veins. The angiographic pattern of spasm, collateral formation, and intravascular thrombi is typical. Treatment of ergotism depends on the severity of the symptoms and the possibility of gangrene. Discontinuation of ergotamine, cigarette smoking, and caffeine may be all that is necessary in most patients. Nitroprusside is the drug of choice in the treatment of acute vascular insufficiency from ergotism, but in a less urgent situation, prazosin has also been effective. Intra-arterial balloon dilatation has also been helpful. Other forms of therapy have been supportive and the results inconsistent. Cafergot should be used with extreme caution in patients with renal or hepatic failure, peripheral vascular disease, or pregnancy. Relative contraindications include hypertension, ischemic heart disease, and Raynaud's phenomenon.
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PMID:Recognition and treatment of arterial insufficiency from cafergot. 372 91

When taken regularly, oral contraceptives (OCs) are 99% effective in preventing pregnancy. This information sheet identifies the difference between the 28-day or 21-day packet of pills and reviews how OCs work and how they affect the menstrual cycle, what do do if one misses a pill, side effects, and ensuring maximum protection. The only difference between the 28-day and the 21-day packet of pills is the 7 inactive pills in the 28-day packet. With the 28-day pack, one starts the packet on the 1st day of menstrual bleeding, taking the pill from the shaded section marked with the appropriate day. One continues to take the pills every day, in the direction indicated by the arrows. The next period will occur when one returns to the inactive pill section. With the 21-day packet, the 1st packet is started on the 5th day of menstrual bleeding, whether or not the bleeding has stopped. One's menstrual period will occur 2-4 days after finishing the last packet. The pill prevents pregnancy by changing the hormone balance in the body to stop ovulation. Menstrual periods tend to become shorter and lighter. If a pill is missed the forgotten pill must be taken as soon as possible, even if it means taking 2 pills in 1 day. The most common side effects include nausea, breast tenderness, and breakthrough spotting. More serious side effects include migraine headaches and high blood pressure. Diarrhea and vomiting may reduce the absorption of the pill; to ensure maximum protection in those cases, one should keep taking the course of the pill but use additional contraception until the end of the packet.
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PMID:The pill. 380 Jul 76

The 5-hydroxytryptamine (5HT)-system of human blood platelets consists of a relatively specific uptake mechanism for 5HT at the plasma membrane, intracellular storage organelles (dense bodies), a metabolizing enzyme (monoaminoxidase B) and a 5HT2-receptor whose stimulation leads to activation of the phosphatidylinositide turnover, a rise in free cytoplasmic Ca2+, phosphorylation of proteins and a shape change reaction. There is neither a relevant 5HT-biosynthesis nor a marked physiological 5HT-turnover in platelets. Under physiological conditions the platelet 5HT-system may have a role as a scavenger for free extracellular 5HT and in hemostasis. Disturbances which have been described in pathophysiological states include impairment of 5HT-uptake (hypertension, migraine), impairment of 5HT-storage (storage pool deficiencies, thromboembolic disorders, hypertension) and increased sensitivity to activating agents like 5HT (cardiovascular disorders, diabetes). Besides their role in physiology and pathophysiology platelets may be useful partial models for vascular smooth muscle cells.
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PMID:The 5-hydroxytryptamine system of blood platelets: physiology and pathophysiology. 381 34

Presenting symptoms in 4 patients with acute benign cerebral angiopathy were headaches over several days, with a transient neurologic disorder in two cases. Angiography showed diffuse and segmental distal narrowing alternating with dilatations. In one patient, the radiologic anomalies persisted to a milder degree in the same region 2 months later, while the reduced cerebral blood flow failed to return to normal. The pathophysiology of this syndrome would appear to result initially of vasospasm in particularly reactive subjects, especially young women. Its cause appears to vary from one case to another: post-partum disorders, infection or inflammation, meningeal hemorrhage, paroxysmal hypertension. Adjuvant factors could be unusual effort, medication or a migraine context. In spite of this pathogenetic uncertainty this angiopathy in usually considered as an isolated, benign and non-relapsing disease.
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PMID:[Benign acute cerebral angiopathy. 4 cases]. 383 97

A case of nevoid basal-cell carcinoma syndrome in a four years old girl with preceding familiar history is reported. In her epithelioma father numerous basocellular, milia cysts, mandibular cysts, dentition disorders, brain falx calcifica ted and hiperkeratosis of the sole of the feet were described. Clinically, the girl presented initial migraine and vomits together with macrocephalus, bossing forehead, hypertelorism, physical disorders, retarded maturation, "keel" thorax, genu recurvatum, hallux valgus, hammerfinger, pigmented nevus and hyperkeratosis of the sole of the feet. Radiologically diastasis of the skull suture with jagged image, endocranial hypertension, signs of macrocephalus of the facial bones, calcification of the brain falx, bridge of the sella turcica, bifid ribs and fusion of the ribs was observed. The axial computed tomography showed calcification of the vermix cerebelosus and severe hydrocephalus suggesting the presence of an occupant mass. After total surgical removal of the mass, the histological examination revealed a medulloblastoma. The skin biopsy of a cutaneous nevic element showed a basal-cell epithelioma. With the exception of an ovarian fibroma and fusion of the vertebras non appreciable because of the age. With the exception of the ovarian fibroma and the fusion of the vertebras, the patient showed the same characteristics as those described in the classification of Gorlin. The importance of this paper communication lie on the preceding familiar history, infrequency, compromise of different systems, malignant tendency of the cutaneous lesions and frequent association with non cutaneous neoplasias.
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PMID:[Basal cell nevus syndrome. Presentation of 2 cases. 1 associated with medulloblastoma]. 388 60

Until relatively recently, it was generally believed that hypomagnesemia was a rare entity in clinical practice. It is clear, however, from newer studies that the overall incidence of hypomagnesemia in hospitalized patients can range from 7 to 52%. The greatest association of hypomagnesemia in hospitalized patients appears to be in hypokalemic states and in patients confined to intensive care units. Most of these patients demonstrate cardiovascular abnormalities, ranging from cardiac arrhythmias and atrial fibrillation to hypertension. On the basis of primarily epidemiologic and experimental findings, it has been suggested that there may be a strong association between the dietary intake of Mg (and errors in the Mg metabolism and distribution of Mg in the body), the concentration of this element in the myocardium and blood vessels, and the risk for development of cardiac arrhythmias, sudden death ischemic heart disease, hypertension, transient ischemic attacks, strokes and pre-eclampsia-eclampsia. During the past 5-6 years, a considerable amount of new, quantitative clinical evidence has been found which lends considerable support to these tenets. Clinical trials utilizing Mg as a therapeutic tool to treat refractory arrhythmias, digitalis toxicity-associated arrhythmias, myocardial infarctions, diabetic angiopathy, transient ischemic attacks, cerebral resuscitation, hypertension and 'classical' migraine are under way, and to an extent have been successful. Careful assessment of serum, blood cells, and urine for free versus bound Mg should be done routinely in cardiovascular disease and high-risk patients.
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PMID:New perspectives on the role of magnesium in the pathophysiology of the cardiovascular system. I. Clinical aspects. 391 80

After years of episodic monocular visual loss, two migraineurs suffered sudden, persisting loss of vision from retinal vascular occlusion. One was a 34-year-old woman with systemic lupus erythematosus who showed abnormalities of the cilioretinal arterial and retinal venous circulations. The other was a 62-year-old man with hypertension and arteriosclerosis who had a central retinal vein occlusion. Persisting monocular visual loss is a rare consequence of migraine. Our cases suggest a role for venous lesions. Occlusion of retinal vessels in some migraineurs may result from the synergistic effect of another vascular disorder with the migraine.
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PMID:Vascular retinopathy in migraine. 394 97

A survey of 67 pregnancies in 51 professional women (physicians, psychologists, nurses, administrators, etc.) revealed the occurrence of symptoms of cognitive dysfunction such as forgetfulness, disorientation, confusion and reading difficulties in 28 pregnancies occurring in 21 women. These were unrelated to such factors as age of delivery, percentage weight gain, the baby's sex or birth weight, alcohol consumption, smoking, a history of migraine or allergy or other symptoms occurring during pregnancy such as sleepiness and lack of concentration, irritability, loss of interest in job or nightmares. Nor was there any correlation with hypertension, proteinuria, glycosuria, ketonuria, anemia, or morning sickness. Furthermore, these cognitive disturbances were not related to depression or sleep deprivation. Despite these symptoms, none of the women suffering from them were forced to interrupt their professional activities during pregnancy. The syndrome of benign encephalopathy of pregnancy should be recognized so that simple precautions can be taken to prevent any interference with professional or other activities. The etiology of the syndrome is unknown.
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PMID:Benign encephalopathy of pregnancy. Preliminary clinical observations. 395 58


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