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)

Remifentanil hydrochloride is a new, ultrashort-acting opioid metabolized by nonspecific plasma and tissue esterases. We conducted this multicenter study to examine the hemodynamic response and recovery profile of premedicated children undergoing strabismus repair who were randomly assigned to receive one of four treatment drugs (remifentanil, alfentanil, isoflurane, or propofol) along with nitrous oxide and oxygen for maintenance of anesthesia. Induction of anesthesia was by nitrous oxide, oxygen, and halothane or nitrous oxide, oxygen, and propofol. Anesthesia was then maintained with remifentanil 1.0 microgram/kg over 30-60 s, followed by a constant infusion of 1.0 microgram.kg-1.min-1, alfentanil 100 micrograms/kg bolus followed by a constant infusion of 2.5 micrograms.kg-1.min-1, propofol 2.5 mg/kg bolus followed by a constant infusion of 200 micrograms.kg-1.min-1, or isoflurane 1.0 minimum alveolar anesthetic concentration. The infusions of the anesthetics and the administration of the inhaled gases were adjusted clinically by predetermined protocols. Elapsed time intervals from the end of surgery to the time the patients were tracheally extubated and displayed purposeful movement, as well as the time the patients met the postanesthesia care unit (PACU) and hospital discharge times, were recorded. Heart rate and systolic and diastolic blood pressure were measured at fixed intervals. In addition, cardiovascular side effects (bradycardia, hypotension, and hypertension) as well as vomiting, pruritus, agitation, and postoperative hypoxemia were also noted. There were no significant differences in patient demographics among the treatment groups. There was no difference in the early recovery variables (times to extubation and purposeful movement) or the times to PACU and hospital discharge among groups. There were significant differences in side effects among the groups. Patients who received remifentanil had higher PACU objective pain-discomfort scores than those who received alfentanil and propofol. Patients anesthetized with alfentanil had a greater incidence in the use of naloxone and a greater incidence of postoperative hypoxemia compared with those anesthetized with remifentanil. The incidence of postoperative hypoxemia was the same for remifentanil, propofol, and isoflurane groups. There were no significant differences in the incidence of emesis among the four groups, and all four groups had similar hemodynamic profiles. We conclude that remifentanil appears to be an effective drug for anesthesia. Its hemodynamic and recovery profile appear similar to other comparable drugs. Based on previous pharmacokinetic studies, the 1.0 microgram.kg-1.min-1 infusion may be twice the 50% effective dose observed in adults. In this study, the relative "overdose" of remifentanil was well tolerated and did not prolong recovery.
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PMID:A randomized multicenter study of remifentanil compared with alfentanil, isoflurane, or propofol in anesthetized pediatric patients undergoing elective strabismus surgery. 914 19

The effectiveness and safety of fluticasone propionate aqueous nasal spray (200 micrograms once daily for 4 weeks) were compared with those of loratadine (10 mg once daily for 4 weeks) in 114 adults and adolescents with seasonal allergic rhinitis in this multicenter, double-blind, double-dummy, randomized, parallel-group study. Patients recorded their nasal symptoms (nighttime and daytime obstruction, sneezing, itching, rhinorrhea, and overall discomfort) using a 4-point scale (0 = no symptoms, 3 = very frequent symptoms) in daily diaries. Clinicians assessed patients' nasal symptoms (nighttime and daytime obstruction, sneezing, itching, and rhinorrhea) using a 4-point scale at every scheduled visit. Clinicians and patients assessed the overall effectiveness of treatment at the end of the study. Fluticasone propionate improved clinician-rated total nasal symptom scores (defined as the sum of five nasal symptoms) more than loratadine at the 2-week and 4-week assessments (P < or = 0.008). Clinicians give fluticasone propionate better global ratings than loratadine (P = 0.04). After 4 weeks of treatment, between-group differences in clinician-rated individual nasal symptoms favored fluticasone propionate (P < 0.05), with the exception of nasal itching (P = 0.11). These findings were confirmed by between-group differences in the percentages of symptom-free days calculated from patient-recorded daily diary-card data. Both treatments were well tolerated. The incidence of adverse events between groups was similar. Fluticasone propionate aqueous nasal spray 200 micrograms administered once daily in the morning was more effective than loratadine 10 mg administered once daily for the treatment of seasonal allergic rhinitis.
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PMID:Fluticasone propionate aqueous nasal spray compared with oral loratadine in patients with seasonal allergic rhinitis. 918 29

The author is describing their own clinical experience with the treatment of vaginal candidosis during pregnancy with the application of a single dose clotrimazole 500 mg (Canesten 1) with only one vaginal globule. In 77.5% of the pregnancy women is obtained a perfect result with disappearing of the clinical symptoms (pruritus, increasing bleeding, discomfort during excretion of urine) and negativisation of the microbiological results. The author is making the conclusion, that the treatment with a unique vaginal globule can be useful in light and acute cases of mycotic colpitis in pregnant patients. A recommendation is given for follow-up of the pregnant patients in the last 3-4 weeks of the pregnancy, for a candidosis check-up and prescription of an adequate treatment.
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PMID:[The treatment of vaginal candidiasis during pregnancy with a single dose of clotrimazole]. 925 73

While clinical drug trials in photodermatoses may be complex because of the fickleness of these disorders in their reproducibility following ultraviolet exposure, such investigations require the same general principles of careful design as those in any other disciplines. The ideal clinical trial in photodermatology is both randomized and double-blind. Precise diagnostic terminology and monitoring of sun exposure must be employed. Polysulphone film badges are the most suitable personal dosimeters to date for these studies. Assessment of itching and discomfort may be reliably performed by the use of a visual analogue scale. Symptoms may also be assessed, but less precisely, by means of a diary record. Only by the use of controlled trials, however, will anecdotal dogma be prevented from inappropriately entering the therapeutic armamentarium of the dermatologist who manages such light sensitive conditions.
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PMID:Controlled drug trials in photodermatoses. 936 Nov 20

Lichen sclerosis is a chronic inflammatory skin disease that causes substantial discomfort and morbidity, most commonly in adult women, but also in men and children. Any skin site may be affected (and, rarely, the oral mucosa) but lichen sclerosus is most common in the anogenital area, where it causes intractable itching and soreness. In children, the disorder may be confused with changes seen in sexual abuse. Progression to destructive scarring is common. There is increased risk of developing vulval cancer, and there are links with penile cancer. Patients should be kept under long-term review. Lichen sclerosus can occur without symptoms, and the exact prevalence is uncertain. It occurs most commonly in women at times of low sex hormone output. The underlying cause is unknown, but there seems to be a genetic susceptibility and a link with autoimmune mechanisms. The wart virus and the spirochaete borrelia have been suggested but not substantiated as infective triggers. The Koebner phenomenon is known to occur (lichen sclerosus occurs in skin already scarred or damaged), so trauma, injury, and sexual abuse have been suggested as possible triggers of symptoms in genetically predisposed people. The treatment of choice for anogenital lichen sclerosus is potent topical corticosteroid ointment for a limited time. Circumcision may be indicated in men, and surgery may be considered in women, to relieve effects of scarring or to treat coexisting carcinoma. Current research aims to identify a treatable cause of lichen sclerosus, to identify patients at risk of scarring and of malignant disorders, and to find target pathways for therapeutic intervention.
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PMID:Lichen sclerosus. 1034 6

The objective of this study was to assess the efficacy and tolerability of transdermal clonidine in inner-city African-American and Hispanic-American patients with essential hypertension. A multiclinic open-label, prospective trial for 12 weeks was used. Dose titration was based on office blood pressure (BP) measurements of > 140/90 mm Hg. Clinical sites were community-based primary care centers. Untreated and treated hypertensive patients whose diastolic BP exceeded 90 mm Hg were administered transdermal clonidine at 0.1 mg or 0.2 mg delivery daily. The drug was titrated after 1 month if diastolic BP was greater than 90 mm Hg. At 12 weeks of treatment, change in blood pressure from baseline as well as adverse effects and patient satisfaction were assessed. A total of 357 patients entered the treatment phase of the study, and 315 patients (244 African-Americans, 67 Hispanic-Americans) had evaluable data. Transdermal clonidine significantly (P <.001) lowered BP in all patients by 15.7/12.8 +/- 18.1/9.6 mm Hg, and heart rate was reduced by 3 +/- 9 beats/min (P <.001). There were no differences in BP reduction according to race and ethnicity, gender, or age. The most common adverse effects were pruritus or discomfort at the patch site, dizziness, dry mouth, and fatigue. Eleven percent of the patients discontinued treatment because of one of these adverse effects. A large proportion of patients (67%) reported that transdermal clonidine was more convenient to use than oral therapy. Transdermal clonidine, alone or in combination with other antihypertensive therapies, significantly lowered BP and heart rate in inner-city hypertensive patients. The drug was generally well tolerated, with 89% of the patients remaining in the trial. Patient acceptability was high with the once-weekly treatment, which is an important feature for this particular hypertensive population.
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PMID:Clinical experience with transdermal clonidine in African-American and Hispanic-American patients with hypertension: evaluation from a 12-week prospective, open-label clinical trial in community-based clinics. 1042 43

Valaciclovir is a prodrug of acyclovir with more favourable bioavailability. Twice daily oral administration of valacyclovir is recommended in patients with genital herpes. A double-blind, randomized, controlled, multicriteria equivalence trial was conducted to determine whether od treatment with valacyclovir 1000 mg is as effective as bd treatment with 500 mg in patients with recurrent genital herpes. A total of 922 immunocompetent outpatients were treated with either regimen for 5 days; treatment was self-initiated at the first symptoms of the next recurrence. The principal outcome measures were the percentage of lesions healed at day 6, time to healing, time to cessation of pain, discomfort or itching, the percentage of abortive episodes and safety. Equivalence was assessed by comparison of 80% confidence limits for each measure; the two regimens were regarded as equivalent if the lower confidence limit was higher than a pre-determined equivalence limit calculated to show a maximum 10% inferiority of valacyclovir 1000 mg od against valaciclovir 500 mg bd. Intention-to-treat analysis showed that the two treatments were equivalent for each outcome measure. Hence, it is concluded that valacyclovir 1000 mg od is as effective as 500 mg bd. as self-initiated therapy in patients with recurrent genital herpes.
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PMID:A double-blind, randomized study assessing the equivalence of valacyclovir 1000 mg once daily versus 500 mg twice daily in the episodic treatment of recurrent genital herpes. Genival Study Group. 1058 14

A questionnaire study of Swedish public employees with frequent and different types of VDT work (n = 2,025) was conducted. Eight different kinds of eye discomfort were examined, and an additive index was constructed. Eye discomfort was statistically related to aspects of work organization. The highest levels of discomfort were reported by computer-aided design (CAD), data entry, and word processing groups; groups with mixed VDT tasks displayed the lowest level of symptoms. Time spent at a VDT, low degree of work control, time pressure, and high pace of work were all associated with relatively high levels of eye discomfort. There was significant interaction between experience of stress and time spent at a VDT with respect to both the eye discomfort index and three specific symptoms (itching, gritty feeling, and dryness). Whereas dryness, smarting, and itching of the eyes seem most strongly related to work conditions, redness and watery eyes seem most weakly related.
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PMID:Work Content and Eye Discomfort in VDT Work. 1060 34

An epidemiological investigation regarding the ocular symptoms of 213 subjects working in the operating theatres of a hospital of the eastern Sicily was conducted. Information was gathered via a questionnaire designed to identify the ocular symptoms that occurred most frequently during working hours in the operating theatre. The questionnaire was administered by a specialist in Occupational Health, before any decision was made to investigate the indoor air quality. The microclimate parameters (temperature, relative humidity, number of air changes/hour, air velocity, illumination levels) of the operating theatres were also studied. The results of the epidemiological investigation showed that 154 subjects out of 213 (72.3%) reported a lack of eye comfort. The most frequently reported symptoms were fatigue (35.21%) and heaviness (34.27%), followed by burning (25.82%), redness (25.35%), lacrimation (17.84%), itching (2%), blinking (20%), foreign body sensation (19%) and photophobia (10%). The study of the indoor climate of the operating theatres showed that the number of air changes/hour and illumination level were not consistent with those recommended by the Italian Regulatory Authority. Others parameters were considered to be satisfactory. The Authors conclude that the low illumination level may be responsible for the high percentage of subjects suffering from eye fatigue and heaviness. The ineffective rate of room air exchange, possibly interacting with chemicals and aerosols, is thought to be responsible for the other ocular symptoms experienced by the workers. The present study suggests that the operating theatre environment might be a cause of the ocular discomfort often complained of by health care workers. Further studies are needed in this area.
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PMID:[Symptoms of ocular discomfort and microclimate: epidemiologic and environmental survey in operating rooms]. 1092 Jun 20

Seven centres investigated the therapeutic efficacy and tolerability of policresulene associated to cinchocaine administered locally as ointment, suppositories or both formulations in 2287 patients with hemorrhoid pathology. The studies were conducted with a standardised protocol and case report forms and with the same score criteria for rating efficacy and tolerability according to the physicians and the patients. Highly satisfactory results were achieved in 1904 patients (83.2%) according to the investigators criteria. Patients rated the outcome most satisfactory for 1881 cases (82.2%). The following were found to be the principal indications: external and internal hemorrhoids associated with bleeding, acute anal fissures, rhagades and perforated or incised perianal thrombosis, anal eczema and anal pruritus, proctitis and wound treatment after proctologic surgery. None of the investigators found any serious adverse event. Mild to moderate adverse reactions in 10% of the patients were local discomfort, pruritus, burning or irritation. Such symptoms occurred at the beginning of treatment. The favourable effects of policresulene are attributed to its unique mechanism of action. The highly acid characteristics of the substance causes a selective coagulation of the necrotic tissues leaving healthy tissues unaffected. The desquamation and remotion of the necrotic tissues induces rapid wound cleansing, and a reactive hyperemia of the treated area enhancing epithelization. Its highly acid pH produces a marked bactericidal action on the most common pathogens and C. albicans as well. Policresulene has hemostyptic properties producing vasoconstriction of the myofibrils of the blood vessels arresting profuse bleeding from large areas. The local anesthetic cinchocaine contributes to the initial pain relief. None of the formulations contains corticosteroids which makes this preparations also suitable for long term treatment periods.
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PMID:[Analytical review of multicenter studies with polycresulene for hemorrhoidal pathologies]. 1097 23


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