Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Consequences of obstructive sleep apnea syndrome in children include reduced performance during day, behaviour problems, diurmal hypersomnia, psychomotor development delay, severe forms of cor pulmonale, systemic hypertension, growing delay and death. This paper describes the clinical case of a 3-year-old girl with perennial symptoms of nasal obstruction characterized by nocturnal snoring, oral breathing, nasal voice, sleep apnea, nasal pruritus and rhinorrhea. Her treatment is also described.
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PMID:[Non-surgical treatment in case of obstructive sleep apnea syndrome in children. Report of a case]. 1496 87

Fournier's gangrene is a genital and perineal necrotizing fascitiis with a rapid evolution. It's an affection caused by aerobic and anaerobic micro-organisms, eventually associated with a superinfection by micetes. It has characterised by a deep oedema associated with lancinating pain and itching in external genitalia, rapidly evolves to perineal tissues necrosis and purulence. At this stadium patient's general conditions are still serious and patient may be comatose. When toxaemia is over, demarcation of necrotic areas can be remarkable and granulation start growing. Fournier's gangrene seems to be related to an ischemic necrosis caused by obliterative endoarteritis and thrombosis of internal pudendal and deep and superficial external pudendal artery. The infection gateway may be subcutaneous tissue lesion associated to trauma or surgical procedures in immunodeficient organism. Diagnosis is mainly clinical but a superficial ecography could be useful to demonstrate thickening in subcutaneous tissue with normal testicles. Both of them were middle aged males, heavy smokers, affected by hypertension and COPD. In both cases there was polymicrobial Gram positive bacterial infection. Antibiotic systemic therapy and topic therapy were administered. The patient also received hyperbaric oxygen therapy. Thirteen days after the admittance, the infection was defeated and we could start the surgical cover. To cover the scrotal wound we have used split-thickness skin grafts taken from the right thigh. These grafts took at 100% and the patient was discharged seven days after surgical operations. Follow-up at six months and at one year showed any functional limitation and a good aesthetic result.
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PMID:[Fournier's gangrene: remarks on two clinical cases]. 1501 33

The purpose of this study was to evaluate haemodynamic stability, perioperative analgesia and neonatal outcome following intrathecal 0.5% bupivacaine 7.5 mg with varying doses of fentanyl, in parturients with pregnancy-induced hypertension. Forty-five parturients with pregnancy-induced hypertension scheduled for caesarean section were randomly allocated to receive 7.5 mg bupivacaine with saline 1 mL (group B), fentanyl 10 microg (group Bf10) or fentanyl 20 microg (group Bf20) intrathecally. Heart rate, blood pressure, and sensory block were recorded at regular intervals. Pain, nausea, vomiting, pruritus or any other side effects were sought. Neonatal outcome was assessed using Apgar score and umbilical artery blood gas analysis. Adequate surgical anaesthesia was established in all three groups. There was a statistically significant fall in mean arterial pressure in all three groups within 4-6 min of subarachnoid block (P<0.05), but the decrease in MAP was <20% of baseline in all three groups. Pain and discomfort during surgery were experienced more frequently in group B than in groups Bf10 and Bf20 (P<0.05). Duration of postoperative analgesia was significantly longer in group Bf20 (5.55+/-1.18 h) than in group Bf10 (3.97+/-2.12 h) and group B (3.27+/-1.8 h) (P<0.05). Neonatal outcome was similar in the three groups. Intrathecal fentanyl with low dose bupivacaine provides good surgical anaesthesia and prolongs the duration of analgesia without haemodynamic or neonatal compromise in patients with pregnancy-induced hypertension undergoing caesarean delivery.
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PMID:Effect of varying doses of fentanyl with low dose spinal bupivacaine for caesarean delivery in patients with pregnancy-induced hypertension. 1547 49

Chronic renal failure (CRF) is a polymorphic disease whose management need frequently multiple drugs administration and multidisciplinary approach. Thirteen years after the beginning of haemodialysis treatment in Senegal, we aimed to evaluate the management of chronic renal failure in Dakar University Hospital Internal Medicine Department. We analysed retrospectively 243 CRF in patients managed during the last three years in this department. Most of these patients (43.6%) were under 46 years old. The sex ratio (M/F) was 1.31. The clinical symptoms were distributed as follow: high blood pressure (85.6%), anorexia (61.73%), anaemia (83.9%) and pruritus (12.3%). More than one third (37.04%) of patients had a clearance of creatinine under 10 ml/mn, at the diagnosis, and therefore required chronic haemodialysis. Only 8.23% of cases had the opportunity to get a medical treatment. Five machines ware available at this unity). The deficience of dialysis and nephrology personal is obvious in our practice. The majority of CRF patients can not afford the treatment cost. Therefore, medical training, prevention and screening of renal diseases seem to be the best way to solve this public health problem in developing countries.
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PMID:[Chronical renal failure in one Dakar Hospital Department]. 1577 28

PTK787/ZK 222584 (PTK/ZK) is an oral angiogenesis inhibitor targeting vascular endothelial growth factor (VEGF) receptor tyrosine kinases, including VEGFR-1/Flt-1, VEGFR-2/KDR, VEGFR-3/Flt-4, the platelet-derived growth factor receptor tyrosine kinase and the c-kit protein tyrosine kinase. The objective of this Phase I study was to evaluate the safety, tolerability, biologic activity and pharmacologic profile of PTK/ZK administered orally, twice daily, on a continuous dosing schedule in patients with primary refractory or relapsed acute myeloid leukemia (AML), secondary AML, poor-prognosis de novo AML or advanced myelodysplastic syndrome (MDS). Acute myeloid leukemia patients for whom PTK/ZK monotherapy was ineffective could receive PTK/ZK combined with standard induction chemotherapy. Sixty-three patients received PTK/ZK at doses of 500-1000 mg orally b.i.d. Safety and pharmacokinetic data were collected. Responses were evaluated according to standard bone marrow and peripheral blood criteria. At 1000 mg b.i.d., dose-limiting toxicities of lethargy, hypertension, nausea, emesis and anorexia were observed. Other adverse events related to PTK/ZK were dizziness, weakness, fatigue, diarrhea and pruritus; these were generally mild and reversible. Pharmacokinetic data showed that steady state was reached by day 14, there was no accumulation with repeat dosing and there was no significant increase in exposure at steady state beyond the maximum tolerated dose (MTD). Complete remission was observed in five of 17 AML patients treated with PTK/ZK combined with chemotherapy. In conclusion, the MTD of PTK/ZK is 750 mg orally b.i.d. The drug is generally well tolerated and can be given in combination with chemotherapy for patients with MDS and AML.
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PMID:Phase 1 study of PTK787/ZK 222584, a small molecule tyrosine kinase receptor inhibitor, for the treatment of acute myeloid leukemia and myelodysplastic syndrome. 1661 23

Hypertrophic scars and keloids are 2 forms of excessive cutaneous scarring that occur in predisposed individuals. The healing process varies greatly among patients, and the risk of a bad scar evolution is unpredictable. Keloids create disfiguring scars with associated erythema and pain or pruritus or restricted range of motion, and are a major cause of morbidity. A fortuitous observation was made by the first author of this study who, at age 54, developed an erythematous and painful postsurgical abdominal keloid scar after undergoing left colectomy for colon adenocarcinoma. Four months later, after treatment with low-dose enalapril (10 mg, once a day) for mild arterial hypertension, her keloid scar rapidly improved and she eventually made a complete recovery. second case involved a 70-year-old female with diabetes who was affected by a long-standing postsurgical abdominal keloid scar of 2 years' duration. She was intentionally treated with the same low dose of enalapril, and, after 6 months of therapy, the bad scar showed marked improvement. We conducted an exhaustive search of the literature pertaining to the wound healing process, specifically to determine whether angiotensin-converting enzyme (ACE) inhibitors have a healing effect on wounds. ACE inhibitors are known to induce reduction of left ventricular collagen content and to attenuate remodeling during the postinfarctual period (thus improving ventricular function), and they have been shown to exert a pulmonary antifibrotic effect. After conducting this literature search, it became apparent that no data on cutaneous scars and ACE inhibitors are available. During the posttraumatic or postoperative stage, it is useful to achieve the best possible aesthetic results and to decrease the risk of a disfiguring keloid scar, thereby avoiding revision surgery; to this purpose, an early treatment with a low dose of enalapril is a possible solution, even if further confirmatory observations are needed.
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PMID:Low-dose enalapril in the treatment of surgical cutaneous hypertrophic scar and keloid--two case reports and literature review. 1741 37

Family medicine as a discipline is more than other specialties oriented to holistic approach to patient. The physician has to know and use the possibilities of clinical, first of all somatic but also psychosociological medicine, and to continuously evaluate and follow-up results of his/her own work. The aim of the article is to present differences in clinical judgment before and after postgraduate study in family medicine. A 60-year-old woman living with her disabled son is presented. She visited her family physician many times complaining of a number of symptoms: itching, hypertension, sleep disturbance, poor general condition, trembling. It took ten months to diagnose hyperthyroidism and to begin appropriate therapy. Polysymptomatolgy of the disease based on the patient's psychological and family situation was the reason for the long-lasting wandering to definitive diagnosis. Analysis of the case revealed that neither clinical nor holistic approach was properly used in family medicine. The wrong clinical approach could be explained by fact that this physician worked for years without specialization or continuing education in family medicine. The authors conclude that postgraduate education as part of professional training in family medicine enables physicians to recognize and distinguish the interference of psychological, somatic and environmental factors, which is a major characteristic of good family practice.
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PMID:["Training cum research" an obligatory form of continuing medical education in Croatia]. 1759 52

A 60-year-old woman presented to our clinic with a complaint of a dermatitis that had recurred 2 or 3 times a month for the past 5 years. No trigger episode or obvious pattern of recurrence was noted. She reported some itching or burning as a prodromal symptom. Recurrence has been at multiple sites, in a dermatome pattern, including areas around the arm, face, back, abdomen, knees, and ears. Each occurrence is at a different anatomic site (and she only has lesions at this 1 site during each occurrence. For example, after formation and resolution at 1 site (ie, the right medial forearm) the patient will then have a later recurrence at another site (ie, the upper left part of the back). The patient has no complaints of fevers, chills, or adenopathy. Medical history includes type 2 diabetes and hypertension. Results of a basic laboratory screening at the time were all within normal limits. No other contributory history was noted. On examination, the medial arm just proximal to the elbow had clusters of vesicles (Figure). Viral culture performed on the lesion confirmed our suspicion of the presence of herpes simplex virus (HSV). The patient was started on valacyclovir and asked to return if no improvement was noted. To date the patient has not returned to the clinic.
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PMID:One hundred twenty recurrences of herpes simplex virus in an immunocompetent patient. 1761 75

To assess the associations between job stress and somatic symptoms and to investigate the effect of individual coping on these associations. In July 2006, a cross-sectional study was conducted during a periodic health check-up of 185 Japanese male office workers (21-66 yr old) at a Japanese company. Job stress was measured by job demand, control, and strain (=job demand/control) based on the Job Content Questionnaire (JCQ). Major somatic symptoms studied were headache, dizziness, shoulder stiffness, back pain, shortness of breath, abdominal pain, general fatigue, sleep disturbance, and skin itching. Five kinds of coping were measured using the Job Stress Scale: active coping, escape, support seeking, reconciliation, and emotional suppression. Comorbidities of hypertension, diabetes, obesity, depression, and anxiety were also evaluated. The most frequently cited somatic symptom was general fatigue (66%), followed by shoulder stiffness (63%) and sleep disturbance (53%). Of the five kinds of coping, only "active coping" was significantly and negatively associated with the number of somatic symptoms. The generalized linear models showed that the number of somatic symptoms increased as job strain index (p=0.001) and job demand (p=0.001) became higher, and decreased as active coping (p=0.018) increased, after adjusting for age and comorbidities. There was no statistical interaction among active coping, the number of somatic symptoms, and the three JCQ scales. Reporting somatic symptoms may be a simple indicator of job stress, and active coping could be used to alleviate somatization induced by job stress.
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PMID:The association of the reporting of somatic symptoms with job stress and active coping among Japanese white-collar workers. 1795 68

Intrahepatic cholestasis of pregnancy is the most common liver disorder unique to pregnancy in women without hypertension. The cause of intrahepatic cholestasis of pregnancy is still under discussion but genetic and hormonal factors are predominant. The main symptom is skin pruritus, associated with increase in serum transaminase activities and bile acid concentrations. Intrahepatic cholestasis of pregnancy carries a risk for the pregnancy because of preterm delivery and sudden intrauterine fetal death. Ursodeoxycholic acid (usually 1000mg per day or 15mg/kg per day) is currently the most effective pharmacologic treatment. Ursodeoxycholic acid reduces pruritus, transaminases and bile acid levels and probably prematurity without adverse effects. Obstetric management is still under debate. The majority of authors recommend active management with elective delivery usually before or at 38 weeks of gestation according the severity of cholestasis. Prospective controlled studies are required to confirm the benefit of ursodeoxycholic acid treatment on fetal outcome and to clarify the obstetrical management near term.
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PMID:[Intrahepatic cholestasis of pregnancy]. 1800 44


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