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

This retrospective study was undertaken to assess the efficacy and safety of epidural morphine in providing analgesia following Caesarean section under epidural anaesthesia. The morphine was administered as a single bolus, following delivery, in doses ranging from 2 to 5 mg. The charts of 4880 Caesarean sections, performed on 4500 patients, were reviewed. The duration of analgesia and the occurrence of any symptoms which might be side-effects of the epidural morphine were recorded. The duration of analgesia was 22.9 +/- 10.1 hr and was not correlated with the dose of epidural morphine. Eleven per cent of the patients required no supplemental analgesia during the first 48 hr. Twelve patients (0.25 per cent) had respiratory rates less than 10 breaths per minute, on at least one occasion. No serious sequelae resulted from these periods of bradypnoea. Pruritus occurred in 58 per cent of patients, nausea and vomiting in 39.9 per cent and dizziness in ten per cent. Herpes simplex labialis was recorded in 3.5 per cent of patients. Epidural morphine is thus confirmed as an effective analgesic technique post-Caesarean section with 3 mg being the optimal dose. Even in this young healthy patient population, clinically detectable respiratory depression occurs so clinical respiratory monitoring is indicated.
Can J Anaesth 1990 Sep
PMID:Epidural morphine for analgesia after caesarean section: a report of 4880 patients. 220 31

Urinary incontinence is common in aged women, may precipitate nursing home admission, and may prompt use of a urine collection device, usually an indwelling urethral catheter. The safety and efficacy of a new external urine collection device for women that is affixed to the perineum by an adhesive developed for ostomy bags was evaluated. Applied to 26 aged women, 78% of 2,264 devices were leak-free for 24 hours and 49% for 48 hours. The incidence of new bacteriuria was less than half that found in our earlier studies of long-term urethral catheters in the same institution. Perineal erythema was infrequent and preexisting decubitus ulcers improved or did not change. Four patients were withdrawn, one each because of periurethral itching, diminished urine output, recurrent wetness, and fracture of the proximal femur associated with severe osteoporosis. This device may offer an alternative to urethral catheters for management of urinary incontinence but should not be used on women with urine retention and should be used with care on women with severe osteoporosis. Controlled trials must determine effects upon bacteriologic complications and health-care costs.
J Am Geriatr Soc 1990 Sep
PMID:An external urine collection device for incontinent women. Evaluation of long-term use. 221 36

The appropriate use of phosphate binders, calcium supplements and especially calcitriol therapy has significantly decreased the incidence of overt secondary hyperparathyroidism in dialysis patients. Nevertheless some patients may still need parathyroidectomy, especially in the event of severe clinical signs and symptoms such as persistent hypercalcemia, pruritus, calcifilaxis, or extensive extra-skeletal calcification. Since aluminum-induced bone disease may resemble hyperparathyroidism in dialysis patients, whenever parathyroidectomy is contemplated the diagnosis of secondary hyperparathyroidism must be firmly established. Thus, a bone biopsy is mandatory prior to parathyroidectomy. It is our experience that once the patient goes to surgery the most important factor in the surgical approach is the presence of a skilled surgeon who has extensive experience in parathyroid gland surgery. The data comparing subtotal parathyroidectomy with total parathyroidectomy and autotransplantation are similar. The most important shortcoming is the lack of long-term follow-up. Recently, new data by several investigators has been advanced reintroducing total parathyroidectomy. Long-term observations in patients who despite total parathyroidectomy still have normal PTH levels are of special interest. In addition, long-term follow-up of these patients has shown that normal plasma calcium and phosphorus levels may be maintained without the use of Vitamin D; this occurred in the presence of active mineralization. However, our major objection to this procedure is the risk of aluminum-induced bone disease. At the present time we feel that the relative high incidence of recurrent hyperparathyroidism following subtotal parathyroidectomy is a reasonable trade off for the risk of aluminum bone disease which may develop in absence of PTH.(ABSTRACT TRUNCATED AT 250 WORDS)
Kidney Int Suppl 1990 Sep
PMID:Parathyroidectomy in chronic renal failure: indications, surgical approach and the use of calcitriol. 221 49

A thirty-six-year-old man experienced acute, severe, generalized pruritus. His scratching was erroneously interpreted as lewd and indecent behavior. He was arrested. Results of the history and physical examination led to the diagnosis of fiberglass dermatitis, which prompted a dismissal of the charges. Although many societies have looked askance at persons with certain skin diseases (such as leprosy) and at scratching in public since at least biblical times, we are not aware of any prior reports of incarceration for excoriation.
Cutis 1990 Sep
PMID:Incarceration for excoriation. 222 31

We conducted a study of the prevalence and clinical characteristics of aquagenic pruritus (AP) in 996 employees at a general hospital. Forty-five of them claimed that they had AP, thus giving a reported prevalence of 4.5%; 12 were excluded for various reasons and a detailed workup was carried out in 33 people. In more than 75% of the cases AP had started before age 30 and lasted for over 10 years in 42%. The onset of AP occurred within 5 min of exposure in 76% of the cases and usually lasted between 10 and 30 min. In most cases no association could be demonstrated between AP and each of the following factors: place, season, time of day, water temperature, type of soap, towelling or mental stress. AP in at least one other family member was found in 33% of the cases.
Isr J Med Sci 1990 Sep
PMID:Aquagenic pruritus: prevalence and clinical characteristics. 222 61

Systemic mast cell disease (SMCD) is a rare disease often associated with symptoms of general malaise, pruritus, diarrhea, vomiting, fever, urticaria pigmentosa, hepatosplenomegaly and lymphadenopathy. We reported a case of SMCD associated with cutaneous xanthoma and serum hyper IgE. Skin biopsy revealed xanthomas and diffuse infiltration of mast cells in the dermis. The association of SMCD with xanthoma was reported in the literature for only one case. The hyper IgE could be due to the defect of IgE receptors on the cell membrane of mast cells of dysfunction of T and/or B cell. Any of the treatment using H1 and H2 receptor blockade, disodium cromoglycate, adrenocorticosteroid or chemotherapy (VEPA) were not effective. The patient died of pulmonary edema and multiple organ failure 7 months after the diagnosis was established. The crush method for the cytological examination of bone marrow was considered more useful than smear method for the diagnosis of SMCD.
Rinsho Ketsueki 1990 Sep
PMID:[Systemic mast cell disease associated with cutaneous xanthomas and markedly elevated serum IgE]. 224 20

Allergic rhinitis is a classic example of a type I immunological reaction. After allergic provocation tests a biphasic reaction is seen in the respiratory tract that is more pronounced in the lower than in the upper respiratory tract due to the physiological changes during the nasal cycle. The early phase of the immediate reaction starts some minutes after allergen provocation. After 5-10 h the nasal symptoms (discharge, blockage, sneezing and itching of the nose) reappear, a phenomenon which is called the "late-phase response" (LPR). The LPR is of great clinical importance in the pathophysiology of perennial allergic rhinitis and phenomena such as nasal priming and nasal hyper-reactivity. The most important effector cell of the early phase of the immediate reaction is the mast cell, whereas basophils, eosinophils and neutrophil granulocytes seem to be more important for the LPR. There is also evidence for morphological and functional heterogeneity of mast cells in man. The role of the chemotactically immigrated eosinophils in allergic reactions has not been clear until now: the eosinophil-derived mediators may enhance or inhibit the allergic reaction. Also the eosinophils show different morphological and functional states (so-called hypo- and hyperdense eosinophils). The symptoms of allergic rhinitis (sneezing, discharge, blockage, itching of the nose) are caused by different mediators, of which the most important is histamine. Other mediators or modulators of the allergic reactions are leucotrienes, prostaglandins, PAF, serotonin, and the kallikrein-kinine and complement systems. In recent years many regulatory peptides have been detected in the human nasal mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)
HNO 1990 Sep
PMID:[Current pathophysiologic aspects of allergic rhinitis. I]. 226 46

PUPP is a specific eruptive dermatosis in pregnancy, clinically characterized by erythematous papules and plaques with intense itching in periumbilical localization. This disease typically tends to spread to the extremities without involving the head and neck regions. The differential diagnosis of PUPP can be established by immunological and microscopical investigations. Since PUPP is a benign disease with a good prognosis and spontaneous clearing, we recommend only mild symptomatic treatment.
Z Hautkr 1990 Sep
PMID:[Pruritic urticarial papules and plaques in pregnancy]. 226 74

Generalized pruritus may be symptomatic of dermatologic disease or it can be a manifestation of a systemic disorder. When the cause of generalized pruritus is not immediately evident, careful clinical and laboratory evaluation and close follow-up are needed to ensure appropriate diagnosis and treatment.
Cleve Clin J Med 1990 Sep
PMID:Evaluation and treatment of generalized pruritus. 226 63

Focal acantholytic dyskeratosis consistent with the clinical and histological features of Darier's type of transient acantholytic dermatosis occurred in a man with myelodysplasia. Topical steroids and systemic antihistamines provided temporary and moderate relief from pruritus, but failed to control the dermatosis.
Cleve Clin J Med 1990 Sep
PMID:Myelodysplastic syndrome and transient acantholytic dermatosis. 226 70


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