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

Intramuscularly administered methylprednisolone sodium phosphate (Medrol Stabisol) in single doses of 40, 80, or 160 mg (methylprednisolone equivalents) had a similar effect as the same doses of methylprednisolone sodium succinate (Solu-Medrol) with regard to eosinophil suppression, elevation of glucose, white blood count differential shifts (lympholytic effect), urinary excretion of sodium and potassium, and localized (pain) and systemic side effects. The average plasma methylprednisolone concentration was approximately 20% higher after the intramuscular administration of methylprednisolone sodium phosphate than after methylprednisolone sodium succinate. The differences in plasma methylprednisolone levels produced by the two esters suggest that either hydrolysis of the succinate ester occurs more slowly or the succinate ester distributes more extensively. This difference in plasma level, however, is not reflected in any other pharmacologic evaluation of the two esters, e.g., both eosinophil depression and hyperglycemic response were identical. No clinically significant changes in the vital signs, standard hematology, and clinical chemistry parameters evaluated were noted after 21 successive doses (q.i.d. for five days with one dose in the morning of day 6) of 80 mg methylprednisolone sodium phosphate. An increase was noted in the systolic blood pressure from a pretreatment mean of 113 mm Hg to a posttreatment mean of 123 mm Hg and an increase in the body weight from a pretreatment mean of 177 pounds to a posttreatment mean of 183 pounds. No signs of adrenal suppression were found as judged by plasma cortisol and ACTH levels. Six (6/12) subjects of the methylprednisolone sodium phosphate group, one (1/12) subject of the vehicle group, and one (1/12) subject of the placebo (sterile saline) group reported the following systemic side effects: gas in stomach, headaches, anorectal itching, and dryness of itching of the skin. No trend was observed for any side effect reported. In these double-blind, randomized studies, single (40, 80, and 160 mg) and multiple (80 mg) intramuscular doses of methylprednisolone sodium phosphate were tolerated in healthy volunteers as well as the same doses of methylprednisolone sodium succinate and similar volumes of vehicle or placebo.
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PMID:The clinical pharmacology of methylprednisolone sodium phosphate. I. Intramuscular route of administration. 32 97

A multicenter, double-blind, parallel-group, dose-tolerance study was conducted to evaluate the safety of fluticasone propionate aqueous nasal spray, a potent new corticosteroid preparation. Ninety-seven adult patients with moderate to severe seasonal allergic rhinitis during the fall weed season received either placebo or fluticasone propionate in doses of 50, 200, or 800 micrograms twice daily for 4 weeks. Safety evaluations included adrenal function evaluation by morning plasma cortisol concentration, response to ACTH stimulation, and 24-hour urinary free cortisol excretion. There was no evidence of effects on adrenal function at any dose. The severity, nature, and frequency of adverse events were similar across all treatment groups, including placebo. Drug-related adverse events were consistent with local nasal irritation. The groups receiving fluticasone propionate showed greater improvement in nasal symptoms (obstruction, rhinorrhea, sneezing, and itching) than did the placebo group. The results demonstrate that fluticasone propionate aqueous nasal spray is safe in doses up to 1600 micrograms per day and effective in the treatment of seasonal allergic rhinitis.
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PMID:Dose tolerance study of fluticasone propionate aqueous nasal spray in patients with seasonal allergic rhinitis. 186 54

Low-frequency (2 Hz) transcutaneous electrical nerve stimulation (TNS) may produce prolonged and widespread sympatho-inhibition resulting in improved skin microcirculation with increased skin temperature in patients with peripheral vascular insufficiency. The method has previously been used successfully to improve peripheral circulation in such patients and to accelerate healing of chronic skin ulcers of various etiology. The present report deals with healing of atopic eczema and relief of pruritus by low-frequency TNS treatment in a patient who was followed for 2 years, the first 8 months with daily recordings of the effects, and then for an additional 16 months during which period TNS only occasionally was used. TNS also produced increased plasma levels of ACTH, cortisol and vasoactive intestinal polypeptides (VIP). The mechanisms of the favourable clinical effects are discussed.
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PMID:Successful treatment of itching and atopic eczema by transcutaneous nerve stimulation. 289 Feb 72

Poison ivy contact dermatitis is fairly common in the suburbia of this country among amateur gardeners and children. It commonly inflicts its poison on the exposed parts of the limbs. The vesicular or bullous skin lesions are quite disturbingly itchy. Scratching the itchy lesions often spreads the condition by transplanting the remanent resinous toxin to other parts of the body. Though they are usually self-limiting, the intense itch is the main motivation for a patient to seek medical care. The conventional treatment is basically ineffective. During the summer of 1987 we treated four such cases of dermatitis with acupuncture upon their request to mollify their unbearable itch. They originally consulted with us for other problems. There were three males and one female. Their ages were between 29 and 63. Three cases were relatively mild and the fourth one was fairly severe. In the milder cases, their itch subsided in a few hours and skin lesions were healed in about two days after one treatment. In the severe case the itch subsided in about two days and most of the skin lesions dried up in four days after the first treatment and were healed almost completely after three sessions of acupuncture treatment. The plausible anti-inflammatory mechanism of acupuncture with the involvement of ACTH and/or cortisol was discussed.
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PMID:Acupuncture for poison ivy contact dermatitis. A clinical case report. 289 97

Peptides of diverse structure stimulate grooming in rodents and other mammals. Peptide-induced grooming may be observed in several motivational contexts, with or without strong alternative response tendencies. Bombesin-like peptides elicit grooming route dependently in the rat and hamster, independently of, or concomitantly with, changes in ingestive behaviors or resting. The pattern of body surfaces groomed after i.c.v. BBS is in proportion to the representation of body surfaces in somatosensory but not motor cortex of rat. A bombesin-like peptide may be a neurotransmitter in somatosensory afferent processing, and grooming after i.c.v. BBS may reflect a response to alteration of cutaneous sensation. Bombesin is a putative satiety signal in the control of feeding and ethanol intake, but the satiation effects of systemic BBS can be dissociated from the grooming effect of central BBS. Thus, bombesin may perform independent and site-specific functions in the control of behavior. Grooming produced by BBS is not affected by naloxone, involves a different proportion of motor acts than is observed in normal or ACTH-induced grooming, and no cross-tolerance has been reported between ACTH and BBS in the rat. These properties of bombesin-induced grooming indicate multiple, separable mechanisms of peptide-induced grooming and scratching. Cholecystokinin-like peptide-induced grooming is observed after central injection in the rat and is unaccompanied by changes in feeding or resting. The well-documented satiety action of systemic CCK-like peptides is not accompanied by excessive grooming, so multiple, site-specific behavioral roles are also indicated for CCK-like peptides in control of behavior. CCK-8 exhibits short-term cross-tolerance with ACTH in elicitation of grooming, and central CCK-8 is co-localized with CRF and stimulates ACTH and corticosterone release in the rat. Thus, CCK-8 may induce grooming by increasing CRF or ACTH activity. These properties of CCK-like peptide-induced grooming indicate convergent neuroendocrine mechanisms that may explain some, but not all, peptide-induced grooming syndromes. Further characterization of the qualitative topographic, neuropharmacological, and neuroanatomical differences and species specificities of peptide-induced excessive grooming should provide a basis for understanding how brains coordinate grooming. Knowledge of the processes of neuropeptide control of grooming may provide potential peptide-based controls of grooming-related clinical disorders such as pruritus and allergic reactions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Bombesin and ceruletide-induced grooming and inhibition of ingestion in the rat. 329 65

Marked nocturnal pruritus in patients with atopic eczema (AE) may depend partly on alterations in circadian neuroendocrine rhythms, e.g. cortisol rhythm. We analysed the serum cortisol levels every 2 h between 8 p.m. and 8 a.m. and at 2 p.m. (profile I) in 20 adult in-patients with florid AE not pretreated with any systemic corticosteroid or ACTH therapy (profile I). The results were compared with those recorded in 19 healthy women. In 14 patients we checked the profiles again after marked improvement of AE (profile II). On profile I, the lowest cortisol levels were after midnight for 9 of the 20 patients, while on profile II this was true for 12 of the 14 tested. The mean cortisol levels over the period examined were found to be approximately the same for patients and controls for profile I, yet the mean level on profile II was found to be lower. The mean time interval between minimum and maximum cortisol levels was shorter in patients with AE than in controls (8.5 h), and was shorter still on profile II (4.6 h). The shift in the serum cortisol minimum after midnight resulted in an extremely steep rise in the cortisol level between the level in the late hours of the night, and the 24 h-maximum in the early morning hours.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Are shifts in circadian cortisol rhythm an endocrine symptom of atopic eczema?]. 335 51

Thirty patients with seasonal allergic rhinitis entered a double blind study comparing budesonide (nasal spray, 400 micrograms/d) and i.m. injection of 80 mg methylprednisolone acetate. Symptoms were assessed over a "run in" period of 3-7 days followed by a treatment period of 3 weeks. Pollen counts were evaluated daily. Both the systemic and topical corticosteroid treatment resulted in a significant improvement of nasal and ocular symptoms and were accompanied by reduced antihistamine intake. A comparison of the two treatments in relation to the pollen count yielded statistically significantly fewer nasal symptoms, such as itching, secretion, and sneezing in the budesonide-treated group. Nasal blockage and ocular symptoms remained unchanged, but the use of eyedrops was significantly reduced in the methylprednisolone-treated group. Side effects of both treatments were mild and the incidence negligible. Methylprednisolone-treated patients had a significantly lower cortisol value after 7 days but still had a normal response to ACTH-stimulation. We conclude that the acute symptoms of allergic rhinitis are at least as well ameliorated by regular topical application of budesonide as by a single injection of methylprednisolone acetate. The accompanying allergic conjunctivitis may require additional treatment.
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PMID:Clinical comparison of systemic methylprednisolone acetate versus topical budesonide in patients with seasonal allergic rhinitis. 336 27

Fifteen patients with endogenous Cushing's syndrome were treated with metyrapone and/or amino-glutethimide. The duration of the therapy varied from 19 up to 365 days. In patients with Cushing's disease, metyrapone (0.5-2.5 g/day) and aminoglutethimide (0.5-1.5 g/day) seemed equally effective in reducing the cortisol excretion (54 +/- 9 vs 40 +/- 7%). The majority of these patients also showed a clinical improvement. In 1 patient with adrenal adenoma, metyrapone induced a remission. In another patient with adrenocortical cancer, and in 2 with the ectopic ACTH syndrome, the cortisol excretion was significantly reduced by the combination of metyrapone and aminoglutethimide but no obvious clinical improvement was observed. Side effects i.e. rash and pruritus attributed to aminoglutethimide was seen in 3 patients which necessitated the omission of treatment in 2. On metyrapone a moderate hypertrichosis was observed in 1 patient. In conclusion both metyrapone and aminoglutethimide were useful as adjunctive therapy in Cushing's syndrome.
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PMID:Aminoglutethimide and metyrapone in the management of Cushing's syndrome. 389 89

To determine the relative efficacy, compare the incidence of adverse events, and ascertain the systemic glucocorticoid effect of the nasal application of several doses of budesonide, 406 patients with seasonal ragweed-induced allergic rhinitis were randomized in a double-blind, parallel group design to receive intranasal budesonide aqueous pump spray (Rhinocort Aqua) 32 micrograms, 64 micrograms, 128 micrograms, 256 micrograms, or placebo once daily for 4 weeks. A total of 231 adults and 175 children participated in the study conducted at 14 centers in two geographic regions, the Midwest and the Northeast United States, during the 1994 ragweed season. Pollen counts were collected at each site by the Rotorod method. The primary efficacy parameter was the change from baseline nasal index score (NIS) for the overall study population--defined as the sum of scores for nasal congestion, runny nose, and sneezing. The study was powered only to evaluate the overall study population for statistical significance. Significant differences in NIS were observed in each active treatment group compared with placebo (p < or = 0.003). Compared with placebo, budesonide aqueous spray significantly reduced individual symptoms of runny nose and sneezing at all doses (p < or = 0.008), and nasal congestion and nasal itching at all doses except 64 micrograms (p < or = 0.022). In the Midwest pollen belt where the 1994 ragweed season was representative of a typical pollen season, it was possible to establish a dose-response relationship for comparison of budesonide aqueous spray 256 micrograms versus 32 micrograms (p = 0.017). The incidence of adverse events was similar between budesonide aqueous-treated and placebo-treated patients. Importantly, there was no effect of budesonide aqueous spray on basal or ACTH-stimulated plasma cortisol levels in either adults or children at the end of 4 weeks of treatment. Intranasal budesonide aqueous pump spray, administered once daily, was efficacious and was generally well tolerated in both adults and children with seasonal allergic rhinitis.
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PMID:Intranasal budesonide aqueous pump spray (Rhinocort Aqua) for the treatment of seasonal allergic rhinitis. Rhinocort Aqua Study Group. 980 42