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

Itching is a common condition in elderly patients and probablpy is caused by a combination of factors, low humidity being one of the most important. After determining that the patient does not have systemic pruritus, the physician should give advice about trying to increase the ambient humidity and about bathing, eg, to decrease the number of baths or showers, use warm water rather than very hot water, and soap only the axillary, anal, and pubic areas. In some instances the use of steroid creams or lotions may be helpful.
Postgrad Med 1975 Dec
PMID:Problems of aging: relieving itching in the geriatric patient. 123 16

Because evidence from uncontrolled, unblinded studies suggested fewer side effects from epidural hydromorphone than from epidural morphine, we employed a randomized, blinded study design to compare the side effects of lumbar epidural morphine and hydromorphone in 55 adult, non-obstetric patients undergoing major surgical procedures. A bolus dose of epidural study drug was given at least 1 h prior to the conclusion of surgery, followed by a continuous infusion of the same drug for two postoperative days. Infusions were titrated to patient comfort. Visual analog scale (VAS) pain scores, VAS sedation scores, and subjective ratings of nausea and pruritus were assessed twice daily. The two treatments provided equivalent analgesia. Sedation scores and prevalence of nausea did not differ significantly between groups. Prevalence of pruritus, however, differed significantly on postoperative day 1, with moderate to severe pruritus reported by 44.4% of patients in the morphine group versus 11.5% in the hydromorphone group (P < .01). On post-operative day 2, reports of pruritus by patients receiving morphine remained higher than those among the hydromorphone-treated subjects, although this difference was no longer statistically significant (32% vs. 16.7%, P = .18). We conclude that lumbar epidural morphine and hydromorphone afford comparable analgesia, but the occurrence of moderate to severe pruritus on the first postoperative day is reduced by the use of hydromorphone.
Anesthesiology 1992 Dec
PMID:Morphine and hydromorphone epidural analgesia. A prospective, randomized comparison. 128 25

Itch is a distinct sensation arising from the superficial layers of skin and mucous membranes. It is elicited by histamine and probably other endogenous chemicals that excite subpopulations of unmyelinated primary afferents and spinal neurones projecting through the anterolateral quadrant to the brain. The two popular views, which propose either that itch is signalled by a labelled line system of peripheral and central itch-specific neurones or that itch is the subliminal form of pain, both fail to explain convincingly many known features. Alternative theories emphasize central processes that extract the relevant information from afferents with broad sensitivity spectra for pruritogenic and noxious stimuli. Thus, itch presents an irritating challenge for the specificity theory of somatosensation.
Trends Neurosci 1992 Dec
PMID:Itching for an explanation. 128 50

Ten adult patients with a medical history of immediate allergic reactions following ingestion of minute amounts of codfish were examined together with 27 control subjects (8 nonatopics, 7 pollen allergics, and 12 suffering from atopic dermatitis) all regularly ingesting codfish without experiencing reactions. All 37 subjects were evaluated by skin prick test, RAST, and histamine release test in order to determine the value of these commonly used diagnostic tests. The results were compared to titrated, oral, double-blind, placebo-controlled food challenges (DBPCFCs) with fresh codfish undertaken in the 10 patients, whereas all control subjects were classified as challenge-negative according to their questionnaires. Totally, 7 of 10 medical histories were confirmed by DBPCFC, and in these most of the reported symptoms proved reproducible. Oropharyngeal itching and swelling occurred as the first symptom, always preceding the onset of any accompanying symptom. For identification of DBPCFC-positive subjects, skin prick test and RAST proved to be the most sensitive tests (7/7), and all tests showed specificities of 90-97%. The skin prick test still seems reliable but does not, however, exclude the need for DBPCFC.
Allergy 1992 Dec
PMID:Codfish allergy in adults. Identification and diagnosis. 128 56

We are reporting the case of a 23-yr-old patient who had recurring episodes of acute pancreatitis characterized by the typical abdominal pain, elevated serum levels of pancreatic enzymes, and enlargement of the pancreas and edema on sonogram. These episodes were accompanied by facial erythema with conjunctival injection, generalized pruritus, diarrhea, and eosinophilia, and they were induced by the consumption of milk. The serum levels of IgE specific to cow milk proteins and to beta-lactoglobulin were increased. We suggest that these episodes are caused by a milk allergy (milk), that has been described as an unusual cause of acute pancreatitis.
Int J Pancreatol 1992 Dec
PMID:Acute pancreatitis associated with milk allergy. 128 25

It is well known that cutaneous pain causes c-fos gene expression in the dorsal horn neurons. The present study examined whether or not an itching sensation had the same effect on these neurons. In order to produce an itching sensation, cotton balls soaked in histamine solutions of different concentrations were applied to the lower limbs of rats and then the treated area was scratched with the tip of a pair of forceps. After 2 h, the number of neurons showing Fos-like immunoreactivity was significantly increased in a dose-dependent manner in the ipsilateral dorsal horn when compared to saline-treated and scratched controls. When scratching with the forceps was omitted, the number of these neurons was reduced to one-third, but was still significantly higher than in controls treated only with saline. Expression of Fos-like immunoreactivity in these animals was markedly reduced by morphine pretreatment (10 mg/kg, i.p.), suggesting that the transmission of both itch and pain is blocked by morphine.
Brain Res 1992 Dec 25
PMID:Histamine-caused itch induces Fos-like immunoreactivity in dorsal horn neurons: effect of morphine pretreatment. 129 Oct 36

Patients with the acquired immunodeficiency syndrome (AIDS) often develop unusual skin complications. We describe a case of a 58-year-old man with AIDS who had a history of multiple transfusions with anti-hemophilic factor A. He developed papulovesicular and lichenified skin lesions on his head, face, neck and the extensor aspects of his extremities accompanied by severe pruritus. Atopic dermatitis was suspected; however, intensive treatment with a potent topical corticosteroid and a systemic antihistamine failed. In addition to the decreased subset of CD4-positive lymphocytes characteristic of AIDS, this patient showed an elevated level of serum IgE particularly specific for Candida albicans, probably because he had a chronic candidial infection of the digestive tract. Oral administration of anti-fungal agents Diflucan and Fungizone produced almost complete relief from the atopic dermatitis-like skin disease within 2 weeks.
J Dermatol 1992 Dec
PMID:An AIDS patient with atopic dermatitis-like eruption responsive to systemic anti-fungal treatment. 129 91

An investigation of human infection with Onchocerca volvulus and the resulting clinical disease was carried out for the Nigerian National Onchocerciasis Control Programme between July and August 1989 [corrected]. The survey covered 10.6% of the rural population in 41 savanna villages of central Nigeria. Of the 8451 self-selected individuals examined, 900 (10.6%) had skin microfilariae (Mf). There were differences between villages in both endemicity and intensity of infection, but in general the number of both Mf carriers and cases of clinical onchocerciasis increased with age. The disease in the Mf carriers showed as blindness (0.8%), onchocercal nodules (0.6%), leopard skin (1.6%) and pruritus (2.8%). Of 35 persons with lymphatic complications, 19 had hanging groin, 10 had elephantiasis and six had hydrocoele. Onchocerciasis was mesoendemic in the rocky northern escarpments, and became hypoendemic and sporadic in the southern uplands of sedimentary geological origin.
Ann Trop Med Parasitol 1992 Dec
PMID:Human onchocerciasis in the lower Jos Plateau, central Nigeria: the prevalence, geographical distribution and epidemiology in Akwanga and Lafia local government areas. 130 6

A total of 118,925 individuals in four Nigerian states was treated for onchocerciasis between February and December, 1991, using centralized and house-to-house distribution of ivermectin. Pre-treatment prevalences of the disease ranged between 28% and 90%. Only 0.7% of those treated reported adverse reactions within three days of treatment: 230 individuals (0.19%) had headache, 210 (0.17%) general body pains, 150 (0.12%) pruritus, 120 (0.10%) oedema, 80 (0.06%) fever, 20 (0.02%) dizziness, 15 (0.01%) vomiting, 10 (0.01%) diarrhoea, and 25 individuals (0.02%) noticed that they passed intestinal worms. Treatment in the endemic communities continues. The results show that mass treatment of onchocerciasis with ivermectin is quite safe and the drug's acceptability increases its potential as the drug of choice for control of onchocerciasis in Nigeria.
Ann Trop Med Parasitol 1992 Dec
PMID:Preliminary observations on the distribution of ivermectin in Nigeria for control of river blindness. 130 7

The safety and efficacy of patient-controlled analgesia used for postoperative pain relief were evaluated. Cumulative 24-hour requirements were analyzed for possible correlation with patient characteristics. All patients who used a patient-controlled analgesia device for postoperative pain relief were reviewed from June to October 1991. The device Baxter's basal/bolus infusor with patient control module, was used to deliver fentanyl in 379 patients. The fentanyl requirement, verbal analog pain score, first passage of flatus, side effects, sedative score, and degree of satisfaction were examined. The fentanyl requirement during the first 24 hours after operation was analyzed with regard to age, body weight, and sex. The daily fentanyl consumption in the first three postoperative days was 928 +/- 352 micrograms (n = 338), 553 +/- 259 micrograms (n = 220), and 490 +/- 222 micrograms (n = 71), respectively. The requirement for fentanyl during the first 24 hours after surgery was significantly higher than for the next two days (p-value < 0.001). Fentanyl consumption correlated well with body weight, and inversely with age. No difference was found between fentanyl consumption and sex (p-value = 0.4687). The mean time to the first passage of flatus in patients with abdominal surgery was 54.6 +/- 26.4 hours. The incidence of nausea, vomiting, and dizziness was similar, about 20% of patients. Itching was noted in 7% of patients. Oversedation (class 4) was found in three patients during the first operative day, the sedative score for other patients were around class 1-3. No patient exhibited signs of respiratory depression or withdrawal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
Ma Zui Xue Za Zhi 1992 Dec
PMID:[The efficacy of intravenous fentanyl patient-controlled analgesia for postoperative pain relief]. 134 40


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