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

20 out of 36 children (aged two to eight years) with atopic eczema completed a twelve-week, double-blind, controlled, crossover trial of an egg and cows' milk exclusion diet. During the first and third four-week periods, patients on an egg and cows' milk exclusion diet received a soya-based milk substitute (trial period) or an egg and cows' milk preparation (control period). Response was assessed in terms of eczema activity, number of areas affected, pruritus, sleeplessness, and antihistamine usage while on the two diets. During the middle period patients resumed their normal diet to minimise any carry-over effect. 14 patients responded more favourably to the antigen-avoidance diet than to the control diet, whereas only 1 responded more favourably to the control diet than the trial diet. Patients experienced more benefit during the first diet period than the second, whatever the nature of the diet. There was no correlation between a positive prick test to egg and cows' milk antigen and response to the trial diet.
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PMID:A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema. 7 38

An association between the ingestion tryptophan and a syndrome characterized by scleroderma-like skin abnormalities, fasciitis, and eosinophilia has recently been recognized in the United States. We report the clinical and histopathological findings in nine patients and the results of biochemical analyses of tryptophan metabolism in seven patients with this syndrome. Edema of the extremities, frequently accompanied by pruritus, paresthesia, and myalgia, developed in the nine patients (six women and three men; age range, 30 to 66 years) 1 to 18 months after the start of therapy with tryptophan (1.5 to 3.0 g daily) for insomnia, depression, or obesity. Five patients were taking drugs (benzodiazepines) known to inhibit hypothalamic-pituitary-adrenal function, and one had adrenal insufficiency. All had blood eosinophilia in the acute phase of their illness (mean eosinophil count [+/- SD], 3.62 +/- 2.87 X 10(9) cells per liter). All had histopathological changes in the dermis and subcutaneous tissue typical of scleroderma, and seven patients had eosinophils. The fascia was inflamed and fibrotic, and adjacent skeletal muscle often showed perifascicular inflammation. Tryptophan was discontinued in all patients, and eight received prednisone. The cutaneous symptoms improved, but only two patients had complete resolution of their illness. The patients had plasma levels of tryptophan before and after an oral dose of tryptophan that were similar to those in normal subjects. Plasma levels of L-kynurenine and quinolinic acid, which are metabolites of tryptophan, were significantly higher in four patients with active disease than in three patients studied after eosinophilia had resolved or in five normal subjects (P less than 0.001)--findings consistent with the activation of the enzyme indoleamine-2,3-dioxygenase. This illness resembles eosinophilic fasciitis and probably represents one aspect of the recently reported eosinophilia-myalgia syndrome. The development of the syndrome may result from a confluence of several factors, including the ingestion of tryptophan, exposure to agents that activate indoleamine-2,3-dioxygenase, and possibly, impaired function of the hypothalamic-pituitary-adrenal axis.
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PMID:Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan. 231 25

Forty-eight chronic hemodialysis (HD) patients (pts) completed questionnaires that used linear analogue scales (LAS), yes/no responses, and demographic data collection to characterize sleep disorders. Twenty-five pts (52%) reported problems sleeping. These pts graded sleep problems significantly higher than those without sleep problems (6.5 +/- 3 vs. 1.8 +/- 2, p less than 0.001 by LAS). Those with sleep disorders were more likely to smoke cigarettes (13/25 vs. 6/23, p less than 0.05) and have bone pain (14/25 vs. 6/23, p less than 0.05). No differences among pts with and without sleep problems were seen in age, gender, time on dialysis, caffeine intake, pruritus, feelings of sadness, worry, or anxiety, or Kt/V values (1.5 +/- 0.2 vs. 1.4 +/- 0.2, p less than 0.13). Restless legs (84%), onset insomnia (76%), and nighttime (76%) and early A.M. waking (72%) characterized the sleep disorders; symptoms suggesting nocturnal myoclonus were less common (20%). We conclude that sleep disorders are common in HD pts and may be exacerbated by tobacco use, bone pain, and restless legs. Kt/V does not correlate with sleep disorders. Further examination of this problem, including formal sleep studies, is needed.
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PMID:Characterizing sleep disorders in chronic hemodialysis patients. 175 Dec 35

Among the most common of health problems, allergies afflict more than one of every six Americans. In the allergic reaction, mast cells degranulate, releasing inflammatory mediators such as histamine. These mediators in turn cause smooth muscle contraction, itch, mucus secretion, and vascular leakage. A number of pharmacologic agents, including the H1 receptor antihistamines and the sympathomimetic decongestants, have been developed in an attempt to minimize such effects. Antihistamines were first used clinically 50 years ago. Currently taken by approximately 30 million Americans each year, they are grouped by structure into six classes. Until recently, all of the classes, or first-generation antihistamines, were thought to be relatively equal in efficacy and, because of their ability to cross the blood-brain barrier, they all caused varying degrees of sedation. The effects of antihistamines on psychomotor reflexes and driving skills, antihistamine-induced drowsiness, and the interaction of antihistamines with alcohol and tranquilizers are reviewed. The centrally acting first-generation agents, and the performance decrements these agents commonly induce, are compared with the newer, nonsedating, second-generation antihistamines (eg, terfenadine, astemizole, cetirizine, and loratadine). Although decongestants do not appear to cause impaired performance, this needs to be evaluated further, particularly with regard to decongestant-induced insomnia.
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PMID:Antihistamine- and decongestant-induced performance decrements. 197 Aug 34

We examined the predictive value of urea kinetics for patient outcomes in CAPD by measuring dialysis index (DI; a means of quantifying CAPD dose using urea kinetics), KT/V and normalized protein catabolic rate (PCRN) on 222 occasions in 76 new patients at the time of starting CAPD and at subsequent six month intervals. We investigated how these indices altered with time and in relation to each other, and how they correlated with a wide range of subsequent patient outcomes. DI, KT/V and PCRN all tended to decrease with time on CAPD (P less than 0.0004, less than 0.0001 and 0.0005, respectively). DI and KT/V were highly correlated with each other (r = 0.89, P less than 0.0001) and both correlated with PCRN (r = 0.57, P less than 0.0001 and r = 0.60, P less than 0.0001, respectively). DI and KT/V both correlated inversely with subsequent values for serum creatinine (P less than 0.0001), urea (P less than 0.0002), potassium (P less than 0.02) and phosphate (P less than 0.002), and directly with bicarbonate (P less than 0.0001). PCRN correlated inversely with serum creatinine (P less than 0.0002) and directly with urea (P less than 0.0001) and with the number of blood transfusions received (P less than 0.03). None of these indices correlated with levels of hemoglobin, PTH, alkaline phosphatase or albumin, or with nerve conduction velocity or any other subsequent clinical outcomes including death, technique failure, hospital days, peritonitis rate and subjective indices of fatigue, pruritus and insomnia. We conclude that the urea kinetic model is predictive of some biochemical outcomes but not of clinical outcomes in CAPD patients.
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PMID:Lack of correlation between urea kinetic indices and clinical outcomes in CAPD patients. 205 26

Hemodialysis can remove only substances that are highly diffusable, non protein bound and with small and middle-molecular weights. The combination of Hemodialysis-Hemoperfusion (HD-HF) takes advantage of both techniques. Uremic patient could reduce the number of weekly dialysis sessions. Fourteen uremic patients were submitted twice a week to a combined HD-HP treatment for 16 months. Polymethacrylate coated charcoal was inserted in the dialysis circuit before the dialyzer. The treatment resulted in improvement of: MNCV (30.5 + -6 to 38.7 + -5.6 m/sec.) subjective symptoms (disappearance of pruritus and insomnia) and hematological status (red blood cells 3.1 x 106 to 4.02 x 106; and hematocrits 28.3 to 36.1). Good control of serum biochemistries. Creatinine and urea clearances of 228 and 236 ml/min respectively. Significant removal of middle-molecules uremic toxins determinated by gel-filtration on Sephadex G15. In conclusion, we state that combined HD-HP improves the detoxication possibilities in chronic uremia.
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PMID:Our experience with combined hemodialysis-hemoperfusion treatment in chronic uremia. 344 35

Symptoms due to estrogen deficiency begin in the perimenopausal years and progress as serum levels of this hormone decrease Vasomotor instability, manifested by hot flushes or night sweats, may persist for several months to a few years. Psychologic symptoms include anxiety, tension, depression, insomnia, palpitations, and headaches. Atrophy of the genital epithelium may result in senile vaginitis with symptoms of irritation, burning, pruritus, dyspareunia, and even vaginal bleeding. Even the lower urinary tract mucosa is dependent upon estrogen. Postmenopausal osteoporosis affects 25 to 50% of older women and increases the risk for vertebral, hip, and other fractures. Estrogen therapy for menopausal complaints has received adverse publicity because several reports have indicated that unopposed estrogens increase the risk of endometrial cancer. Added progestogen not only negates this risk but reduces the incidence of endometrial adenocarcinoma in estrogen-progestogen users to less than that observed in untreated women. Estrogen replacement therapy does not increase the risk of breast cancer; the incidence of this malignancy, however, was also less in the estrogen-progestogen users when compared with either the untreated women or from that expected from the national cancer surveys. In evaluating postmenopausal women for hormone replacement, the benefits of estrogen-progestogen therapy must be weighed against possible risks.
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PMID:The menopause. 351 23

The efficacy of an antigen-free diet on the activity of atopic dermatitis was examined in a double-blind study, comprising 33 adults with severe atopic dermatitis. The antigen-free diet (Vivasorb) was compared to a placebo diet during three weeks of hospitalization. Twenty-five patients were evaluable, two of whom had their diet stopped after a few days due to exacerbation. Nine patients improved, while 16 patients were unchanged. Among those who improved five patients had Vivasorb and four placebo diet. In the remaining group 11 patients had Vivasorb and five had placebo. Four patients reported of less pruritus, sleeplessness and antihistamine consumption (three Vivasorb, one placebo) while 21 did not (13 Vivasorb, eight placebo). Thus, there were no significant differences between the groups. Paraclinical studies of circulating eosinophilocytes, serum IgE, orosomucoid, HLA-antigens, and immunofluorescence of skin biopsies showed no differences between the Vivasorb and the placebo groups. The results from the examination of this relatively small number of patients suggest that elementary intolerance plays little role in the etiology of atopic dermatitis in adults.
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PMID:Antigen-free diet in adult patients with atopic dermatitis. A double-blind controlled study. 608 25

A group of 78 women with sudden flushes and associated disorders (pruritus vulvae, headache, anxiety, instability, depression, libido disturbances) related to the menopause were treated with one or two capsules of veralipride daily for 20 days. Excellent or good results were obtained in 54 of the 69 patients (78 p. cent) with sudden flushes, and 29 of the 57 cases (51 p. cent) with associated disorders. The difference in scores before and after treatment is very highly significant (p < 0.001). Clinical tolerance was good as only 2 cases of minimal galactorrhea. 2 cases of mastodynia, 3 cases with mild drowsiness, 2 patients with nervous tension or insomnia, 3 with digestive disorders, 1 with vertigo, and 1 with mild visual disturbances were observed. No modifications in the biological parameters studied were noted. Blood prolactin levels increased during treatment but returned to normal levels 4 days after discontinuation of therapy. No significant modifications in FSH, LH, E2, or E3 plasma levels were noted at the end of the study. Veralipride appears, therefore, to be the prototype for non-hormonal therapy of menopausal disorders.
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PMID:[A new therapeutic approach to menopausal sudden flushes and psychofunctional disorders (author's transl)]. 625 60

"Topics in the Primary Care Medicine" Presents articles on common diagnostic or therapeutic problems (such as dizziness, pruritus, insomnia, shoulder pain and urinary tract infections) encountered in primary care practice that generally do not fall into well-defined sub-specialty areas and are rarely discussed thoroughly in medical school, house staff training, textbooks and journals. Often the pathophysiology is poorly understood and clinical trials to assess the effectiveness of diagnostic tests or therapies may be lacking. Nevertheless, these problems confront practitioners with practical management questions. The articles in this series discuss new tests and therapies and suggest reasonable approaches even when definitive studies are not available. Each article has several general references for suggested further reading. We hope this series is of interest and we welcome comments, criticisms and suggestions.
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PMID:Falls in the elderly: a clinical approach. 683 37


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