Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prospective epidemiologic data of the American Cancer Society disclosed that reported usual sleep durations among groups who complained of insomnia and sleeping pill use "often" overlapped with those of groups who had no complaints. Reports of insomnia were not consistently associated with increased mortality when several factors were controlled; however, men who reported usually sleeping less than four hours were 2.80 times as likely to have died within six years as men who reported 7.0 to 7.9 hours of sleep. The ratio for women was 1.48. Men and women who reported sleeping ten hours or more had about 1.8 times the mortality of those who reported 7.0 to 7.9 hours of sleep. Those who reported using sleeping pills "often" had 1.5 times the mortality of those who "never" used sleeping pills. These results do not prove that mortality could be reduced by altering sleep durations or by reducing hypnotic prescribing. Rather, studies are needed to determine the causes of these mortality risk factors.
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PMID:Short and long sleep and sleeping pills. Is increased mortality associated? 76 Jun 93

The youthful habits and family attitudes of medical students who later developed or died from one of five disease states were different from those of healthy classmate controls to begin with. In medical school, the total disorder group had significantly more nervous tension, anxiety, and anger under stress, had more insomnia, smoked more cigarettes, and took alcoholic drinks more frequently. Individual disorder group means were significantly different from each other. The mental illness group showed the most nervous tension, depression, and anger under stress and the malignant tumor group the least. The malignant tumor group resembled the healthy control group in these respects. The suicide, mental illness, and malignant tumor groups had low mean scores for closeness to parents, while the hypertension and coronary occlusion group means were slightly higher than the control group mean. Thus psychologic differences in youth have predictive potential in regard to premature disease and death.
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PMID:Precursors of premature disease and death. The predictive potential of habits and family attitudes. 98 20

Despite some evidence that neuroleptic medication is overused or misused in long-term care facilities for the elderly, there has been virtually no attention paid to the pattern of use of antidepressants in these facilities. All patients in long-term care in a geriatric hospital and a home for the aged who were receiving antidepressants were identified; 10.5% of the patients in the hospital and 12.7% in the home for the aged were receiving an antidepressant. The rate of use of antidepressants on the different units ranged from 0% to 26.8%. The most commonly prescribed antidepressant was doxepin followed by nortriptyline. The mean dose of antidepressant was 34.8 mg. Although depression was the most common reason for the prescription of an antidepressant (69% of patients receiving one), other reasons included pain, agitation, aggression, and insomnia. Patients had been receiving antidepressants for up to 10 years, with a mean duration of 32 months. The majority of patients (60%) had a history of depression predating their institutional admission. Patients receiving antidepressants were compared to a group not receiving antidepressants, who were matched for age, sex, unit, and attending physician. Patients receiving antidepressants were more likely to have a history of stroke (33.8% versus 16.9%). There was no significant difference between the two groups regarding the prevalence of dementia, Parkinson's disease, thyroid disease, malignant tumor, congestive heart failure, or diabetes mellitus. Prospective studies are required to determine the efficacy of antidepressants in this population and to identify factors that can predict a positive response to treatment.
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PMID:Pattern of use of antidepressants in long-term care facilities for the elderly. 141 68

Fifty-four patients with advanced malignancies were treated on this phase I trial of coumarin and cimetidine. The dose of coumarin was escalated, with three patients treated at each dose level, while the cimetidine dose was held constant at 300 mg four times daily. Patients received coumarin alone as a single daily oral dose for 14 days; on day 15, cimetidine was added and both drugs were continued until progression of disease. This trial was initiated with patients receiving coumarin at 400 mg daily and closed at 7 g daily with four of five patients on this dose experiencing nausea and vomiting. Treatment was generally well tolerated over a wide range of coumarin doses. Symptomatic side effects were few, mild, and usually self limited. Side effects included insomnia, nausea, vomiting, diarrhea, and dizziness. Two patients withdrew from therapy because of daily nausea and vomiting. Typically, nausea, vomiting, and dizziness occurred 2.5-3 hours after a dose of coumarin. In most patients, these side effects abated spontaneously with continuation of therapy. There was no significant hematologic or renal toxicity. Hepatotoxicity occurred in only one patient and was manifested by asymptomatic abnormal elevations of serum hepatic transaminases. This toxicity was reversible upon interruption of therapy. Objective tumor regressions were observed in six patients with renal cell carcinoma. Responses occurred at coumarin doses ranging from 600 mg to 5 g daily. Coumarin is a relatively nontoxic, oral, outpatient therapy that warrants further investigations for the treatment of human malignancies. Because of its low toxicity, there is potential for combining coumarin with chemotherapeutic and/or biological agents in an attempt to improve on efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phase I evaluation of coumarin (1,2-benzopyrone) and cimetidine in patients with advanced malignancies. 176 68

Benzodiazepines have so many uses in cancer patients that the physician may target more than one advantage as he considers choice of drug and dose. Nausea, pain, and anxiety may be treated simultaneously. Since these patients are often taking a number of medications, the simplest regimen has the most benefit. These drugs treat reactive anxiety, insomnia, claustrophobia, and panic disorder. As they treat anticipatory anxiety and phobia, they mitigate anticipatory nausea and a component of post-treatment nausea. With chemotherapy itself, they cause sedation, suppress recall of treatment, limit vomiting, and are seen as desirable by patients. They suppress the restlessness associated with metoclopramide and other dopamine-antagonist antiemetics. The analgesic effects are best seen in conditions of high anxiety, muscle spasm, and deafferentation syndromes. The advantages of sedative and antipsychotic effects may be exploited to suppress the psychiatric complications of high-dose corticosteroids.
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PMID:Strategic use of benzodiazepines in cancer patients. 183 Oct 42

Sleep disturbances are common in cancer patients, but there are few specific data on their prevalence. Among other things, sleep problems may be a symptom of the cancer itself, part of a stress reaction to having cancer, a sequela to some other cancer symptom such as pain, or a side effect of cancer treatment. Insomnia is the more common sleep problem, although hypersomnia also occurs. Most insomnias are related either to pain or to psychophysiologic factors. Treatment should start with identification of a specific cause of sleeplessness; after that, behavioral interventions, medication, or psychotherapy may be helpful. When using medications, keep in mind possible complications, such as daytime sedation, tolerance, and rebound insomnia.
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PMID:Management of sleep problems in cancer patients. 183 74

The chemistry, pharmacology, pharmacokinetics, assay methodologies, adverse effects, and dosage of levamisole are described, and the clinical studies of levamisole therapy in patients with colorectal carcinoma are reviewed. Levamisole is a synthetic, orally active agent that has antihelmintic and immunomodulatory properties. It is capable of inducing T-cell differentiation and restoring depressed effector functions of peripheral lymphocytes and phagocytes to normal. The drug is well absorbed from the gastrointestinal tract after oral administration and is extensively metabolized by the liver. Gas chromatography and high-performance liquid chromatography are the most common methods used to measure concentrations of levamisole in biologic fluids. Levamisole combined with fluorouracil has been associated with a one-third reduction in recurrence and risk of death in patients with surgically resected Dukes stage C colon cancer; this combination is now recommended as standard therapy in these patients. Uses in patients with rectal carcinoma, Dukes stage B colon cancer, metastatic colon cancer, other malignancies, or nonmalignant disorders remain investigational. Common adverse effects include nausea, abdominal pain, vomiting, diarrhea, metallic or altered taste, flulike symptoms, mood elevation, insomnia, hyperalertness, dizziness, and headache. The most serious adverse effect associated with levamisole is granulocytopenia. The FDA-approved dosage of levamisole is 50 mg orally every eight hours for three days every two weeks. Levamisole therapy is to be initiated no earlier than 7 and no later than 30 days after surgery and is to be continued for one year. Levamisole combined with fluorouracil has been associated with a one-third reduction in recurrence and risk of death in patients with resected stage C colon cancer. Further research is needed to more clearly define the mechanism of action, optimum dose and scheduling, and clinical efficacy of levamisole in treating other malignancies.
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PMID:Levamisole in the adjuvant treatment of colon cancer. 200 37

An analysis was carried out on the extent to which staff responded to the relatives of cancer patients who had been admitted to the Consie Walters Hospice Care Centre, and the Pain Centre, both located in Kingston, Jamaica. Although no relationship was found between frequency of intervention and relatives' (caregivers') health, grief reactions were found to be related to a need for staff interaction. The more caregivers reported that they needed staff emotional support and practical assistance, the more intensely they reported grief, and the greater were their reports of anxiety and insomnia. Age was found to influence the relationship between adjustment and receiving intervention.
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PMID:Do relatives of terminally ill patients also benefit from hospice care? 208 69

A 52-year-old woman presented to the office about 2 and 1/2 years after the death of her husband from cancer. She had multiple hemodynamic and cardiovascular disorders such as hypertension, angina, tachycardia, dysmenorrhea, cardiac ectopics, and very cold hands and feet. The patient complained of tension and insomnia but refused to take any medications because of allergic responses to them. Hence, a relaxation and psychotherapeutic approach was adopted. Psychometric testing revealed extreme defensiveness (including repression). The patient had never mourned for her husband. Therapy helped her overcome her bereavement, tension, and insomnia. In addition, many of her physical manifestations subsided considerably during therapy.
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PMID:Repression and somatization: a case history of hemodynamic activation. 224 1

The care given to 26 dying patients, and their families, being nursed in a hospital where there was no specific terminal care facility was studied. These patients were dying from both malignant and non-malignant disease. Anorexia, sleeplessness, coated or infected mouths, pain, and pressure sores were seen in half of the patients. Fear about caring for the patient at home and lack of information were the problems most frequently identified by the relatives. As a result of this study a multidisciplinary team specialising in symptom control and supportive care has been established. On average half of the total number of patients dying from cancer in the hospital are supported by the team. The number of complaints from relatives of dying patients has been drastically reduced since the team was formed.
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PMID:Survey of distressing symptoms in dying patients and their families in hospital and the response to a symptom control team. 245 15


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