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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This clinical study concerns thirty women with vaginal infections caused by Trichomonas and Candida, showing major inflammatory reactions and painful symptomatology: smarting, pruritus, oedema. Its aim is to measure the activity of benzydamine, the first NSAID to appear as a vaginal solution for local application in the treatment of vaginal inflammation and painful symptomatology. The product is prescribed with the etiological treatment. Benzydamine vaginal douche acts most rapidly on local discomfort, the foremost criterion of this study. From the very first application all the patients have noticed substantial relief which can only be attributed to benzydamine and allows for a better observance of the etiological treatment. Owing to its efficacy and immediate action on vaginal inflammation, benzydamine is a real therapeutic contribution to gynecology.
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PMID:[Value of benzydamine, the first anti-inflammatory vaginal solution]. 260 90

Artificial tears, commonly prescribed for correction of the dry-eye syndrome, are formulated with suitably preserved aqueous polymeric solutions to promote corneal wetting without causing such side-effects as burning, itching, blurred vision and scratchiness. Four of the most commonly used commercial tear-replacement solutions were investigated after complaints of irritation by some users. The solutions were tested for tonicity, viscosity and pH and found to be in the tolerable range (tonicity equivalent to 0.5-1.5% m/v sodium chloride, viscosity 1-15 centipoise and pH 4-9). A double-blind cross-over study was conducted on 16 subjects and the degree of discomfort (non-irritant, irritant, and highly irritant) was determined subjectively. Results indicated that 3 of the tear solutions were acceptable. However, over 50% of the subjects reported irritation from the solution comprising polyvinyl alcohol 1.4% m/v preserved with 0.5% m/v chlorobutanol. To identify the cause of irritation, two extemporaneously prepared controls containing polyvinyl alcohol 1.4% m/v, with and without chlorobutanol 0.5% m/v as preservative, were also included in the study. The irritant response was found to be caused by the presence of chlorobutanol in the formulation. An attempt is made to identify and explain formulation properties likely to elicit adverse responses.
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PMID:Irritation associated with tear-replacement ophthalmic drops. A pharmaceutical and subjective investigation. 264 9

A double-blind study of patients selected at random compared the analgesic and adverse effects of intrathecal methadone (1 mg) with those of intrathecal morphine (0.5 and 1 mg). The study was conducted on 30 patients who underwent major orthopedic or urologic surgery. The intrathecal opioid was administered at the end of surgery, and assessments began 1 h thereafter and continued for 20 h. Pain measurements, supplementary analgesia requirements, and adverse effects were recorded. Intrathecal morphine (0.5 and 1 mg) provided effective and prolonged analgesia. Methadone, however, was unable to ensure the same degree of analgesia; consequently, the median pain scores were consistently higher following methadone than morphine (0.5 and 1 mg) (P less than 0.05). The time to the onset of discomfort severe enough to require supplemental morphine was longer after intrathecal morphine than that following methadone (24 and 29 h with morphine 0.5 and 1 mg; 6.5 h with methadone; P less than 0.05). Respiratory depression (increases PaCO2) was not associated with methadone and morphine 0.5 mg but was common following morphine 1 mg (P less than 0.05). Facial pruritus was unique to intrathecal morphine. Urinary retention requiring bladder catheterization was more frequent following morphine than methadone, although this was not statistically significant. Nausea and vomiting were common to all groups. Intrathecal morphine (0.5 and 1 mg) provides superior postoperative analgesia to 1 mg methadone. Various explanations for the observed differences between the drugs are discussed, including the possibility that the dose of methadone used in the subarachnoid space was inadequate and that a larger dose might have produced an effect equal to that of morphine.
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PMID:Intrathecal methadone and morphine for postoperative analgesia: a comparison of the efficacy, duration, and side effects. 235 28

A randomised double-blind study compared the dose-response relationship of intrathecal diamorphine (0, 0.25, 0.75, 1.5, and 2.5 mg) for postoperative pain relief, in 35 subjects who underwent total knee replacement surgery. Assessments commenced 2 h after the opioid injection and continued for 20 h. Pain, analgesic effect, supplementary analgesic requirements and adverse effects were noted. Intrathecal diamorphine was unable to delay the initial perception of discomfort. It was, however, capable of postponing the onset of severe pain requiring analgesic supplementation (control 5.25 h vs approximately 8 h: P less than 0.05). There was no significant difference in the quality of analgesia between the groups. Pruritus was the only undesirable feature unique to intrathecal diamorphine administration. Intrathecal diamorphine was safe and was not associated with clinically apparent respiratory depression. Its effects were inconsistent and its use was associated with irritating side effects. Possible explanations for the erratic behaviour of the diamorphine are discussed.
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PMID:Intrathecal diamorphine: a dose-response study. 233 97

The author describes the therapeutic results in 48 patients with chronic anal fissure by means of internal lateral sphincterotomy (ILS). He operated patients where the complaints did not recede after conservative treatment supplemented by divulsion of the anus. In 43 patients (89.58%) in the course of two to three weeks the anal fissure healed. Only four patients (8.33%) experienced after operation a slight discomfort such as itching in the perianal region. A relapse after temporary improvement occurred in one patient (0.49%). ILS is a simple and safe operation performed under general anaesthesia after precise differentiation of the internal sphincter. The results of surgical treatment are very satisfactory the marked painfulness recedes immediately after operation, the fissure heals rapidly after relaxation of the spasm of the internal sphincter. Postoperative treatment is simple, the percentage of complications is small. None of the patients operated in the authors' department developed incontinence.
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PMID:[Personal experience with the treatment of chronic anal fissures using internal lateral sphincterotomy]. 281 87

In an eight-week, multicenter open-label study of enalapril monotherapy for mild-to-moderate essential hypertension, data for 115 of the 276 participants between the ages of 55 and 75 years (whites, n = 90; blacks, n = 25) were analyzed. These data were compared with similar data for the study subset of 92 younger patients between the ages of 21 and 45 years (whites, n = 58; blacks, n = 34). The most striking finding was the overall lack of significant differences in response between older and younger patients. There were, however, significant differences in response to therapy between the two racial groups studied. In the older group, normotension was achieved in 66% of white patients and 60% of black patients with a single daily dose of enalapril ranging from 5 to 40 mg; the group means, 13 +/- 1 mg in whites vs 22 +/- 2 mg in blacks, differed significantly (P less than 0.05). Thirty-one percent of older white patients attained normotension with a daily dosage of 5 mg, whereas only 4% of black patients in this age group did so. Only 4% of the older white patients but 24% of the older black patients reached the highest recommended daily dosage of 40 mg of enalapril. Adverse reactions occurred in 11% of the older white patients and 16% of the older black patients (a nonsignificant difference), consisting mostly of gastrointestinal discomfort, malaise, dizziness, and pruritus. There were no significant biochemical abnormalities, the only consistent change being a slight increase in mean plasma potassium from 4.34 to 4.45 mEq/L in older whites (P less than 0.05). Enalapril appeared to be generally effective and well tolerated in the management of mild-to-moderate hypertension in the older subset of patients in this study. Efficacy and tolerability data for older and younger patients were comparable.
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PMID:Efficacy and tolerability of enalapril monotherapy in mild-to-moderate hypertension in older patients compared to younger patients. 283 Sep 74

Proposed mechanisms, clinical features, prevalence, and treatment of phenothiazine-induced cholestatic jaundice are reviewed, and interactions between phenothiazines and other drugs that could theoretically alter the risk of cholestasis are described. Phenothiazine-induced jaundice is classified as a form of cholestatic hepatocanalicular hepatotoxicity and as an acute liver disease. Occasionally cholestatic jaundice may progress to chronic liver disease. The mechanism of hepatotoxicity is not completely understood but may involve a combination of physiochemical, immune, and direct toxic effects. Based on proposed mechanisms, concomitant use of drugs that alter microsomal hepatic enzyme function or have metabolic pathways that interfere with or overlap with those of the phenothiazines could be expected to potentiate or reduce the risk of cholestasis. The estimated prevalence of jaundice with chlorpromazine is 1-2%. The prevalence of jaundice with other phenothiazines is probably similar. The onset of jaundice usually occurs during the first one to four weeks of therapy. In most cases, discontinuation of the offending drug is the only treatment required. Jaundice usually resolves without sequelae two to eight weeks later. Pruritus can be relieved by topical corticosteroid or analgesic therapies or by oral antihistamines or bile acid sequestrants if topical therapy is ineffective. Whenever possible, reinstitution of neuroleptic therapy should be delayed until the reaction has resolved. Selection of a nonphenothiazine neuroleptic agent may be preferred. Phenothiazine-induced cholestatic jaundice occurs relatively infrequently and is usually self-limited; topical agents and oral antihistamines can alleviate the discomfort associated with the reaction.
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PMID:Phenothiazine-induced cholestatic jaundice. 290 41

In March 1981, a 53-year-old man presented with itching and was diagnosed as having myelofibrosis. There was gradual enlargement of the spleen over the following 5 yr. His spleen had to be removed in February 1986 because of physical discomfort. 3 months post-splenectomy he became polycythaemic. Bone marrow examination was consistent with severe myelofibrosis. It was possible to demonstrate erythropoietin-independent BFU-E from peripheral blood, and ferrokinetic studies showed that erythropoiesis was localised to the liver with little bone marrow activity. Thus, despite severe marrow fibrosis, liver erythropoiesis was now polycythaemic, suggesting the coexistence of myelofibrosis and polycythaemia vera.
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PMID:Development of polycythaemia vera in a patient with myelofibrosis. 291

Hematoporphyrin derivative (HpD) is a photoactive, oncophilic substance that produces cutaneous photosensitivity as its only significant side effect. Twenty-three patients who received systemic HpD and the usual light-avoidance precautions were studied prospectively to determine the incidence and severity of cutaneous phototoxicity (CP). Seventeen of the 23 patients (74%) reported CP, including three patients (18%) who experienced blister formation. Symptoms of CP occurred for a mean duration of 6 weeks (range 5-23 weeks). Lack of compliance with restrictive photoprotective measures was felt to be a major contributing factor. Other HpD-related complications included skin hyperpigmentation, ocular discomfort, pruritus, pain at injection site, and urticaria. CP and the restrictive measures to avoid it represent major disadvantages of the clinical use of HpD.
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PMID:Prospective study of cutaneous phototoxicity after systemic hematoporphyrin derivative. 296 70

21 patients were followed up on an average of 28 months following excision of pilonidal sinus and Z-plasty. There were 2 recurrences (10%), 3 hypertrophic scars (14%) and hypaesthesia of the skin flaps in almost every patient. 2 out of 3 patients (67%) were satisfied with the results. 5 suffer from the cosmetic appearance, 5 from pruritus, 3 (14%) have problems with clothing. About 1/3 experience discomfort when sitting and sporting. This morbidity causes us to recommend Z-plasty only in cases of a recurrence with strong discomfort or frequent recurrences.
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PMID:[Morbidity of Z-plasty in the treatment of pilonidal sinus]. 306 55


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