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)

Use and efficacy of hyperbaric oxygen therapy (HOT) in liver disease has not been established. A prospective control study of HOT in liver diseases was undertaken. Sixty cases were selected for this study (30 with HOT and 30 with conventional therapy only). Almost equal number of Hepatitis B virus surface antigen (HbsAg) positive cases were included in both groups. All patients were male. Only cases with serum bilirubin over 10 mg/dl were included in this study. It was found that study cases recovered faster, gained appetite and had an earlier sense of well-being. There was faster disappearance of pruritus, earlier achievement of normal liver function, HbsAg negativity and overall shorter duration of hospital stay and convalescence. Short term adverse effects were unremarkable.
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PMID:Hyperbaric oxygen therapy in parenchymal liver disease. 1099 61

Key questions remain unresolved regarding the advantages and limitations of colloids for fluid resuscitation despite extensive investigation. Elucidation of these questions has been slowed, in part, by uncertainty as to the optimal endpoints that should be monitored in assessing patient response to administered fluid. Colloids and crystalloids do not appear to differ notably in their effects on preload recruitable stroke volume or oxygen delivery. Limited evidence nevertheless suggests that colloids might promote greater oxygen consumption than crystalloids. It remains unclear, in any case, to what extent such physiological parameters might be related to clinically relevant outcomes such as morbidity and mortality. Recent randomized controlled trial results indicate that, at least in certain forms of fluid imbalance, albumin is effective in significantly reducing morbidity and mortality. Much further investigation is needed, however, to determine the effects of colloid administration on clinically relevant outcomes in a broad range of critically ill patients. The ability of administered colloids to increase colloid osmotic pressure (COP) constitutes one mechanism by which colloids might reduce interstitial oedema and promote favourable patient outcomes. However, the applicability of this mechanism may be limited, due to the operation of compensatory mechanisms such as increased lymphatic drainage. Attempts to increase COP might also be less useful in states of increased vascular permeability such as acute respiratory distress syndrome, although this issue has by no means been settled by empirical data. Colloids are clearly more efficient than crystalloids in attaining resuscitation endpoints as judged by the need for administration of far smaller fluid volumes. Among the colloids, albumin offers several advantages compared with artificial colloids, including less restrictive dose limitations, lower risk of impaired haemostasis, absence of tissue deposition leading to severe prolonged pruritus, reduced incidence of anaphylactoid reactions, and ease of monitoring to prevent fluid overload. The cost of albumin, nevertheless, limits its usage. Crystalloids currently serve as the first-line fluids in hypovolaemic patients. Colloids can be considered in patients with severe or acute shock or hypovolaemia resulting from sudden plasma loss. Colloids may be combined with crystalloids to obviate administration of large crystalloid volumes. Further clinical trials are needed to define the optimal role for colloids in critically ill patients.
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PMID:Albumin and artificial colloids in fluid management: where does the clinical evidence of their utility stand? 1125 94

The purpose of this study was to determine the safety and pharmacokinetics of a eutectic mixture of local anesthetics (EMLA) used to ameliorate postburn pruritus after application onto newly formed, intact skin in children. EMLA was applied once to an itchy site where healed skin had formed. Serial blood samples were collected to measure lidocaine, prilocaine, o-toluidine, and methemoglobin. Maximal plasma concentration, minimal plasma concentration, time to achieve the maximal plasma concentration, elimination half-life, and area under the concentration-time curve were calculated. Vital signs, oxygen saturation, clinical signs of hypoxia, and itch intensity were measured. Five children had 15.7 +/- 2.54 g (+/- SD) of EMLA applied to a skin surface area of 93.0 +/- 37.0 cm2. Lidocaine and prilocaine concentrations were below toxic levels; o-toluidine was not detected. Methemoglobin remained between 1 and 3%; patients did not exhibit any clinical signs of hypoxia. Mean oxygen saturation was 98.9 +/- 0.01%. The mean number of pruritic episodes and antihistamine breakthrough doses were greater in the 2 prestudy control days compared with study day 3 (P = 0.01 and P = 0.03, respectively). Skin at the site of EMLA application remained anesthetized for 12 to 13 hours. In this small pilot study, EMLA seems to be a safe, novel treatment for postburn pruritus in burned children when applied to newly healed, intact skin.
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PMID:Safety and pharmacokinetics of EMLA in the treatment of postburn pruritus in pediatric patients: a pilot study. 1140 47

The development of ultrapurified hemoglobin-based oxygen carriers has eliminated many problems associated with whole-blood transfusions in other species. We hypothesized that the administration of polymerized ultrapurified bovine hemoglobin (PUBH) would result in improved hemodynamic parameters in ponies with normovolemic anemia without adverse effects on renal function or coagulation times. Normovolemic anemia was induced in 6 healthy adult ponies. Over a 3-day period, at least 45 mL/kg of whole blood was withdrawn from each pony until a target PCV of <12% was attained. Plasma was separated from the red blood cells via centrifugation and readministered to the ponies on each day. After the final plasma transfusion, 15 mL/kg of hetastarch (control, n = 6) or 15 mL/kg of PUBH (treatment, n = 6) was administered at 10 mL/kg/h IV. Administration of PUBH at a rate of 10 mL/kg/h was not associated with any adverse effects in 5 of the 6 ponies. One pony experienced an anaphylactoid reaction during infusion of PUBH. The reaction, characterized by intense pruritus, tachycardia, and tachypnea resolved shortly after stopping the infusion. Ponies receiving PUBH had significantly lower cardiac indices (P = .03) and heart rates (P = .002) than control animals. A significantly greater increase in central venous pressure was observed in the PUBH group compared to the hetastarch group (P = .02). No adverse renal or coagulation effects were observed with PUBH infusion. These results suggest that PUBH improves hemodynamics and oxygen transport parameters in horses experiencing normovolemic anemia. Patients should be monitored closely during infusion for any adverse reactions.
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PMID:Effects of a polymerized ultrapurified bovine hemoglobin blood substitute administered to ponies with normovolemic anemia. 1214 Dec 99

Clinically, one must be able to differentiate between an allergic reaction and an adverse reaction. Clinical manifestations of allergic reactions range from urticaria and rash to bronchoconstriction, laryngeal edema, hematologic disorders, and other serious reactions. Many drugs administered in the perioperative setting can cause allergic reactions. Antibiotics such as penicillins, beta-lactam antibiotics, and sulfonamides are the most common class of drugs that produce allergic reactions. A detailed allergy history is important when deciding if a patient can receive a drug that may cross-react (eg, a cephalosporin in a patient with a penicillin allergy). Vancomycin can cause a reaction that ranges from erythema and pruritus to clinically significant hypotension. Proper dilution and rate of administration are essential in minimizing the histamine from vancomycin that is thought to produce this reaction. "Sulfa allergy" describes an allergy to sulfonamide antibiotics; a patient with a "sulfa allergy" is not allergic to drugs containing sulfur, sulfites, or sulfates. Although true allergic reactions to opioids are rare, naturally occurring compounds like morphine and codeine can cause allergic reactions. After stopping the offending drug, mild allergic reactions can be managed with diphenhydramine, with or without a steroid. Significant allergic reactions require more aggressive management with oxygen, intravenous fluids, epinephrine, and histamine blockers.
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PMID:Allergic reactions to drugs: implications for perioperative care. 1247 5

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

In a randomized, double-blind study, conducted in 60 patients after caesarean section, we compared epidural morphine (5 mg) with intravenous morphine patient-controlled analgesia (PCA). Efficacy of pain relief (visual analogue scale), comfort, satisfaction and side-effects were studied. In the PCA group, pain scores were higher (P < 0.005) from the third hour onward. The degree of comfort was similar. Overall satisfaction for the first 24 postoperative hours was higher in the epidural group when assessed on a graded scale from 0 to 10, but equal when assessed using qualitative terms. Haemodynamic and respiratory tolerance were identical without any episodes of respiratory depression or oxygen desaturation in either group. The epidural morphine group showed a higher incidence of pruritus requiring specific treatment (P < 0.005). Nausea was reported to be equal in the two groups. Consumption of morphine was higher in the PCA group. We conclude that epidural morphine analgesia, though of good quality, was associated with more pruritus. Morphine PCA, although producing a lesser degree of analgesia compared to epidural morphine, gave good satisfaction.
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PMID:Analgesia after caesarean section: patient-controlled intravenous morphine vs epidural morphine. 1532 Dec 87

The aim of this prospective, randomized, controlled clinical trial was to define the opioid analgesic requirement after a remifentanil (REMI)-based anesthetic with spinal anesthetic blockade (SAB+REMI) or without (REMI) spinal blockade for open-heart surgery in children. We enrolled 45 patients who were candidates for tracheal extubation in the operating room after cardiac surgery. Exclusion criteria included age <3 mo and >6 yr, pulmonary hypertension, congestive heart failure, contraindication to SAB, and failure to obtain informed consent. All patients had an inhaled induction with sevoflurane and maintenance of anesthesia with REMI and isoflurane (0.3% end-tidal). In addition, patients assigned to the SAB+REMI group received SAB with tetracaine (0.5-2.0 mg/kg) and morphine (7 mug/kg). After tracheal extubation in the operating room, patients received fentanyl 0.3 mug/kg IV every 10 min by patient-controlled analgesia for pain score = 4. Pain scores and fentanyl doses were recorded every hour for 24 h or until the patient was ready for discharge from the intensive care unit. Patients in the SAB+REMI group had significantly lower pain scores (P = 0.046 for the first 8 h; P =0.05 for 24 h) and received less IV fentanyl (P = 0.003 for the first 8 h; P = 0.004 for 24 h) than those in the REMI group. There were no intergroup differences in adverse effects, including hypotension, bradycardia, highest PaCO(2), lowest pH, episodes of oxygen desaturation, pruritus, and vomiting.
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PMID:Postoperative analgesia after spinal blockade in infants and children undergoing cardiac surgery. 1584 70

Incidence rate of vitiligo among children, its adverse effect on psycho-emotional state of children, uncertainty in the etiology and pathogenesis and relative ineffectiveness of existing treatment approaches stimulates attempts to elaborate new methods of management of this disease. It is well known, that melanin is formed from tyrosine by enzyme tyrosinase. Cuprum is a cofactor of this photochemical process. In a number of experiments it was shown that keratinocytes derived from vitiligo lesions produce increased number of superoxide anions (hyperactive oxygen and nitric oxide). In patients with generalized vitiligo misbalance of oxidant and antioxidant systems are observed. Taking into account above-mentioned the aim of this study was the analysis of effectiveness of complex treatment with cuprum sulfate and Vitix in infants with vitiligo. Under medical supervision there were 27 children 7-17 years old with vitiligo (15 boys and 12 girls). Duration of illness varied from 1 month to 11 years, area of lesion - from 1 to 40%. Foci of vitiligo had different shapes and dimensions of depigmentation. Preparation Vitix was applied directly to the lesions and surrounded affected area. Duration of the treatment was 6 months. Restoration of pigmentation was observed by the following patterns: diffuse in 9, follicular in 5 and peripheral in 3 cases. Improvement of clinical condition was observed in 56% of patients. Erythema with mild itching and erythema with peeling were observed as the side effects. Due to the ability to re-establish the free radicals physiological equilibrium in epidermal cells (melanocytes and keratinocytes) vitix shows principally new impact on skin with depigmentation. The effect of this preparation is based on melon's extract rich in antioxidants (catalases and superoxide dismutase).
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PMID:[Cuprum sulfate and vitix in the treatment of vitiligo in children]. 1590 24

Occupational and environmental exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested to provoke inflammatory and/or allergic disorders, including asthma, rhinitis, and dermatitis. The molecular mechanisms of this PAH-mediated inflammation remain to be clarified. Previous studies implied the involvement of PAHs as irritants and allergens, with the reactive oxygen species generated from the oxygenated PAHs believed to be an exacerbating factor. It is also possible that PAHs contribute to the pathogenesis through activation of aryl-hydrocarbon receptor (AhR)-mediated transcription, since PAHs are potent inducers of the AhR. To address this point, we generated transgenic mouse lines expressing the constitutive active form of the AhR in keratinocytes. In these lines of mice, the AhR activity was constitutively enhanced in the absence of ligands, so that any other direct effects of PAHs and their metabolites could be ignored. At birth, these transgenic mice were normal, but severe skin lesions with itching developed postnatally. The skin lesions were accompanied by inflammation and immunological imbalance and resembled typical atopic dermatitis. We demonstrate that constitutive activation of the AhR pathway causes inflammatory skin lesions and suggests a new mechanism for the exacerbation of inflammatory diseases after exposure to occupational and environmental xenobiotics.
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PMID:Constitutive expression of aryl hydrocarbon receptor in keratinocytes causes inflammatory skin lesions. 1622 87


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