Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sumatriptan is a selective 5-HT1-like agonist, which is effective in the treatment of migraine and cluster headache. It has been rigorously assessed in clinical trials involving over 7000 patients who have treated over 35,000 migraine attacks. Both subcutaneous and oral sumatriptan provide a high level of efficacy with 86% of patients obtaining relief after a single 6 mg injection (at 2 h) and 75% after 100 mg oral sumatriptan (4 h), compared with up to 37% in the placebo-treated group (P < 0.001). The onset of effect is rapid, occurring 10 min after injection and 30 min after the tablet. Oral sumatriptan (100 mg) has been evaluated against ergotamine, 2 mg, plus caffeine, 200 mg (as Cafergot); and against aspirin, 900 mg, plus metoclopramide, 10 mg. Headache relief was superior in sumatriptan-treated patients; 66% obtaining relief at 2 h, compared with 48% on Cafergot (P < 0.001). The percentage of patients obtaining complete relief of headache (Grade 0, no pain) was significantly higher with sumatriptan (40%) than with Cafergot (14%) at 2 h. Associated symptoms such as nausea, vomiting and photophobia are effectively relieved by sumatriptan, whereas Cafergot provoked nausea and vomiting in a proportion of patients. Headache relief with sumatriptan was also superior to that seen with aspirin plus metoclopramide. Sumatriptan was as effective in the relief of accompanying nausea and vomiting as aspirin plus metoclopramide. The efficacy of sumatriptan is maintained after repeated long-term use; over a six-month period efficacy was comparable in the first and last attacks, regardless of how many attacks were treated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sumatriptan in the acute treatment of migraine. 838 52

This double-blind, placebo-controlled, multicenter, crossover study investigated the efficacy and tolerability of sumatriptan administered for up to three separate migraine attacks. One hundred twenty adults received sumatriptan (SC, 6 mg; three attacks) and placebo (one attack). Patients completed questionnaires assessing the impact of migraine on their lives and the performance of sumatriptan relative to their usual acute therapies. Sumatriptan statistically outperformed placebo on all efficacy measures, including pain severity; presence/absence of nausea, vomiting, phonophobia, and photophobia; rescue medication use; and clinical disability. Efficacy was consistently maintained with repeated administration. For all attacks, pain relief 90 minutes postdose occurred in 86% to 90% of sumatriptan-treated patients, compared with 9% to 38% of placebo-treated patients. Sumatriptan was well tolerated, and the frequency and severity of adverse events did not change with repeated administration. Patients' perceptions of sumatriptan were consistent with clinical data demonstrating the drug's high degree of efficacy and tolerability.
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PMID:Efficacy of subcutaneous sumatriptan in repeated episodes of migraine. 839 50

We report on a tourist returning from Thailand, who presented with classical dengue fever. While in Thailand a 36-year-old Swiss female laboratory assistant suddenly developed fever, devastating headache, retro-ocular pain, myalgia and arthralgia, photophobia, nausea and diarrhea. In addition she suffered from epistaxis, urogenital and skin bleeding, and a morbilliform exanthema. After her return to Switzerland we noted lymphadenopathy and splenomegaly, enanthema and laboratory findings of mild hepatitis, thrombocytopenia and leukopenia. The diagnosis of dengue virus infection was verified serologically. Apart from a long lasting convalescent asthenia we observed restitutio ad integrum within days under symptomatic therapy. Epidemiological clinical and diagnostic aspects of dengue virus infection are discussed.
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PMID:[Imported dengue fever following a stay in the tropics]. 842 57

This study presents the history and clinical findings in 80 patients suffering from tension-type headache diagnosed according to the criteria (group 2) proposed in 1988 by the Headache Classification Committee of the International Headache Society (IHS). The aim of this investigation was to evaluate the extent to which the symptomatology in our cases still corresponds with the clinical picture of tension headache described in the older literature. A positive family history of headache was obtained in 59% of the patients; mothers of headache patients were affected five times more often than fathers; a history of migraine was reported as frequently as tension-type headache in the families of the investigated patients. The first manifestation of headaches arose almost exclusively in the first four decades of life, whereby two peaks (15-20 and 35-40 years) were observed in patients with the episodic form. Headache in younger patients showed no distinct diurnal pattern; headache in older patients, however, predominantly occurred immediately after awakening from sleep or in the morning. Changes of weather and psychosocial stress were the most frequent precipitating factors; additionally, the premenstrual period, occupational stress, and sleep deprivation were precipitating factors in female patients. Bilateral pain was most often located in the occipital/nuchal, in the frontal, and the periorbital regions. Headache was usually described as pressing/tightening in quality. Difficulties in concentration and the need of rest were the most important associated symptoms. Photophobia, phonophobia and autonomic symptoms were less frequent and are probably partially drug-related and may also be due to the fact that the selected group of patients suffered from severe forms of headache. 33 of our 80 patients belonged to the subgroup "with disorders of pericranial muscles" (IHS criteria: groups 2.1.1., 2.2.1). A remarkable low percentage of patients, especially of the male sufferers, reported regular smoking and/or drinking habits. Oral contraceptives influenced neither frequency nor intensity of headache attacks. Signs of depressive disorders were present in 28% of the female patients. The differences in symptomatology of tension-type headache between patients with episodic and chronic forms, between female and male patients, and also between younger and elderly patients are documented and have to be taken into account in the diagnostik evaluation of this condition.
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PMID:[Tension headache--new evaluation of symptomatology based on International Headache Society diagnostic criteria]. 844 54

The aim of the present study was to assess the efficacy and tolerability of single oral doses of 50 mg and 100 mg of diclofenac-K compared to placebo in migraine sufferers during three attacks. The study was conducted in a double-blind, randomized, placebo-controlled, three-period, within-patient comparative trial; 72 migraine patients were treated with diclofenac-K (50 mg or 100 mg) or placebo at six centres (1 in Sweden and 5 in Finland). The primary efficacy end-point was the change in pain intensity assessed on a 100 mm Visual Analogue Scale (VAS) at 120 min after taking the study medication. We found that 50 mg and 100 mg of diclofenac-K reduced the pain intensity significantly better than placebo (p = 0.003 and p = 0.001, respectively), without difference between the doses; 100 mg diclofenac-K was significantly better than placebo in improving phonophobia, photophobia, working ability and need for rescue medication. Diclofenac-K 50 mg or 100 mg is an effective and well-tolerated acute treatment for migraine headache and its associated symptoms. The higher dose of diclofenac-K was only marginally more effective than the lower dose.
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PMID:Diclofenac-K (50 and 100 mg) and placebo in the acute treatment of migraine. 849 53

We examined two women who had keratic precipitates, minimal intracameral cells and flare, diffuse iris stromal atrophy, posterior subcapsular cataract, and vitreous opacities in their left eyes. No ocular pain, photophobia, or posterior synechia was noted. Their right irises appeared brown. Heterochromia was evident in both patients. Recurrent subconjunctival hemorrhages were also in their affected left eyes. It is possible that subconjunctival hemorrhages in our patients may be associated with Fuchs' heterochromic iridocyclitis.
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PMID:Recurrent subconjunctival hemorrhages in patients with Fuchs' heterochromic iridocyclitis. 857 Jan 56

311C90 is a novel, centrally and peripherally, acting 5-hydroxytryptamine1D receptor agonist. We investigated the efficacy and safety of 1, 5, and 25 mg of oral 311C90 in the acute treatment of migraine in a randomized, double-blind, placebo-controlled, parallel-group clinical trial involving 84 patients. The proportion of patients in whom the headache improved within 2 hours from moderate or severe to mild or no pain (primary efficacy measure) was 15% for placebo-treated patients and 27% (1 mg), 62% (5 mg), and 81% (25 mg) for patients treated with 311C90. Treatment differences compared with placebo were 12% (95% CI - 12, 37; p = 0.460) for 1 mg 311C90, 47% (CI 21, 73; p < 0.005) for 5 mg 311C90, and 66% (CI 43,89; p < 0.001) for 25 mg 311C90. Photophobia and nausea also showed improvement after 311C90. Adverse events were generally mild and transient in all treatment groups. There were no clinically significant changes in ECG recordings, blood pressure, or laboratory tests. Oral 311C90 (5 and 25 mg) is highly effective and well tolerated in the acute treatment of migraine. The response rates and treatment differences compared with placebo in this study suggest possible superiority over existing antimigraine therapies. This needs to be confirmed in formal comparative trials.
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PMID:311C90, a new central and peripherally acting 5-HT1D receptor agonist in the acute oral treatment of migraine: a double-blind, placebo-controlled, dose-range finding study. 861 25

A red eye is a common complaint, often related to benign conditions. However, a red eye in conjunction with symptoms such as photophobia, pain, and decreased visual acuity is an important clue to a much more serious disorder. Iritis is one of these but is reversible with proper use of mydriatic and cycloplegic agents and corticosteroids. Heightened clinical suspicion is necessary for timely diagnosis. The examiner should be skilled in the use of a slit lamp or should refer the patient to an ophthalmologist for immediate evaluation. Once the diagnosis is made, treatment with topical corticosteroids is imperative. Close monitoring is required because overuse of corticosteroids has ominous side effects.
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PMID:Iritis. How to recognize and manage a potentially sight-threatening disease. 863 71

The group of 60 patients suffering from chronic non-infected reaction of conjunctivits, showing irritation, conjunctival hyperemia, pain and photophobia, have been treated in the open observational clinical trial comparing the efficiency, safety and local tolerance of diclofenac sodium eye drops 0.1% (Naclof) versus dexamethasone eye drops (Dexamethasone oph. 0.1%) during a period of 30 days. Both medications were locally well tolerated. Naclof caused some slight temporary burning slightly more frequently than dexamethasone but the difference was not statistically significant (Naclof 89.7% tolerability and Dexamethasone 89.1% tolerability). The two drugs were equally effective in the treatment of chronic non-infected conjunctivitis. All the patients have shown a gradual improvement of the symptoms as well as of the objective sings. The dexamethasone group showed an increase in intraocular pressure at the third and fourth visit. However, these differences are not statistically significant either.
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PMID:[Naclof in the treatment of chronic non-infectious conjunctivitis]. 865 25

Many common ophthalmologic conditions may present as a red eye. Most are not vision-threatening and can be easily treated. Vision-threatening symptoms and signs include sudden diminution in visual acuity, ocular pain, photophobia and the presence of circumcorneal injection (the so-called cilary flush) on examination. Corneal, uveal tract and anterior chamber problems often require ophthalmologic consultation, but these conditions are less common than blepharitis, lid problems, dry eyes and conjunctivitis.
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PMID:The red eye: diagnosis and treatment. 896 43


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