-
Cleveland Clinic Journal of Medicine 1991According to widely accepted theory, migraine is a self-limited neurogenic sterile inflammation characterized by initial cerebral vasoconstriction, subsequent... (Review)
Review
According to widely accepted theory, migraine is a self-limited neurogenic sterile inflammation characterized by initial cerebral vasoconstriction, subsequent extracranial and intracranial vasodilation, sterile inflammation, and secondary muscle contraction. It is characterized by recurrent attacks of headache, usually unilateral and accompanied by nausea, vomiting, and, often, other symptoms. Frequency, duration, and intensity of attacks are widely variable. Migraine affects more women than men, and is often related to menses. Patients with classic migraine experience visual or neurologic prodromes, but vague "premonitions" occur in both classic and common migraine. Precipitating factors include foods, alcohol, medications, visual stimuli, changes in routine, and stress. The first-line agent for abortive therapy is ergotamine; corticosteroids are indicated for prolonged headache. Propranolol is recommended for daily prophylactic therapy, and alternatives include calcium channel blockers, nonsteroidal anti-inflammatory agents, and tricyclic antidepressants.
Topics: Combined Modality Therapy; Female; Humans; Migraine Disorders; Precipitating Factors; Pregnancy
PubMed: 1893557
DOI: 10.3949/ccjm.58.3.257 -
Indian Journal of Pediatrics Sep 2001Long-term management of asthma includes identification and avoidance of precipitating factors of asthma, pharmacotherapy and home management plan. Common precipitating... (Review)
Review
Long-term management of asthma includes identification and avoidance of precipitating factors of asthma, pharmacotherapy and home management plan. Common precipitating factors include viral upper respiratory infections, exposure to smoke, dust, cold food and cold air. Avoidance of common precipitating factors has been shown to help in better control of asthma. Pharmacotherapy is the main stay of treatment of asthma. Commonly used drugs for better control of asthma are long and short acting bronchodilators, mast cell stabilizers, inhaled steroids, theophylline and steroid sparing agents. After assessment of severity most appropriate medications are selected. For mild episodic asthma the medications are short acting beta agonists as and when required. For mild persistent asthma: as and when required bronchodilators along with a daily maintenance treatment in form of low dose inhaled steroids or cromolyn or oral theophylline or ketotifen are required. Moderate persistent asthma should be treated with inhaled steroids along with long acting beta agonists for symptom control. For severe persistent asthma the recommended treatment includes inhaled steroids, long acting beta agonists with or without theophylline. If symptoms are not well controlled, a minimal dose of oral prednisolone preferably on alternate days may be needed in few patients. Newer drugs like leukotriene antagonists may find a place in control of exercise-induced bronchoconstriction and mild and moderate persistent asthma. Patients should be followed up every 8-12 weeks. On each follow up visit patients should be examined by a doctor, compliance to medications should be checked and actual inhalation technique is observed. Depending on the assessment, medications may be decreased or stepped up. For exercise induced bronchoconstriction: cromolyn, short or long acting beta agonists may be used. In children with seasonal asthma, maintenance treatment according to assessed severity should be started 2 weeks in advance and continued throughout the season. These patients should be reassessed after discontinuing the treatment. Parents should be given a written plan for management of acute exacerbation at home.
Topics: Anti-Asthmatic Agents; Asthma; Child; Health Education; Humans; Immunotherapy; Nebulizers and Vaporizers; Precipitating Factors; Severity of Illness Index
PubMed: 11980467
DOI: No ID Found -
Revista Gaucha de Enfermagem Oct 2018To describe the precipitating factors of heart failure decompensation between adherent and non-adherent patients to treatment.
OBJECTIVE
To describe the precipitating factors of heart failure decompensation between adherent and non-adherent patients to treatment.
METHODS
Cross-sectional study of a multicenter cohort study. Patients over 18 years of age with decompensated heart failure (functional class III/IV) were eligible. The structured questionnaire was used to collect the data and evaluate the reasons for decompensation. The irregular use of medication prior to hospitalization and inadequate salt and fluid intake were considered as poor adherence to treatment.
RESULTS
A total of 556 patients were included, mean age 61 ± 14 years old, 362 (65%) male. The main factor of decompensation was poor adherence, representing 55% of the sample. Patients who reported irregular use of medications in the last week had a 22% greater risk of being hospitalized due to poor adherence than the patients who adhered to treatment.
CONCLUSION
The EMBRACE study showed that in patients with heart failure, poor adherence was the main factor of exacerbation.
Topics: Cohort Studies; Cross-Sectional Studies; Female; Heart Failure; Humans; Male; Medication Adherence; Middle Aged; Precipitating Factors; Self Report
PubMed: 30365756
DOI: 10.1590/1983-1447.2018.20170292 -
Nurse Practitioner Forum Sep 1999Lymphedema is not uncommon after breast cancer surgery or radiation therapy and can appear days or even years after the causative event. Unfortunately, it is often... (Review)
Review
Lymphedema is not uncommon after breast cancer surgery or radiation therapy and can appear days or even years after the causative event. Unfortunately, it is often missed by health care professionals, and patients suffer needlessly. The author discusses the nurse practitioner's role in prevention, diagnosis, and treatment of this debilitating disorder.
Topics: Breast Neoplasms; Female; Humans; Lymphedema; Nurse Practitioners; Nursing Assessment; Patient Education as Topic; Precipitating Factors; Time Factors
PubMed: 10614361
DOI: No ID Found -
American Family Physician Jan 2006Benign paroxysmal positional vertigo, acute vestibular neuronitis, and Meniere's disease cause most cases of vertigo; however, family physicians must consider other... (Review)
Review
Benign paroxysmal positional vertigo, acute vestibular neuronitis, and Meniere's disease cause most cases of vertigo; however, family physicians must consider other causes including cerebrovascular disease, migraine, psychological disease, perilymphatic fistulas, multiple sclerosis, and intracranial neoplasms. Once it is determined that a patient has vertigo, the next task is to determine whether the patient has a peripheral or central cause of vertigo. Knowing the typical clinical presentations of the various causes of vertigo aids in making this distinction. The history (i.e., timing and duration of symptoms, provoking factors, associated signs and symptoms) and physical examination (especially of the head and neck and neurologic systems, as well as special tests such as the Dix-Hallpike maneuver) provide important clues to the diagnosis. Associated neurologic signs and symptoms, such as nystagmus that does not lessen when the patient focuses, point to central (and often more serious) causes of vertigo, which require further work-up with selected laboratory and radiologic studies such as magnetic resonance imaging.
Topics: Algorithms; Diagnosis, Differential; Ear Diseases; Humans; Nervous System Diseases; Physical Examination; Precipitating Factors; Vertigo
PubMed: 16445269
DOI: No ID Found -
AANA Journal Dec 1997Complex regional pain syndrome (CRPS) is a progressive, chronic illness that is enigmatic because the mechanisms for its pathogenesis have yet to be determined.... (Review)
Review
Complex regional pain syndrome (CRPS) is a progressive, chronic illness that is enigmatic because the mechanisms for its pathogenesis have yet to be determined. Syndromes synonymous with CRPS are reflex sympathetic dystrophy, reflex neurovascular dystrophy, causalgia, algoneurodystrophy, sympathetically maintained pain, clenched fist syndrome, and Sudek's syndrome. The diagnosis of CRPS is categorized into three stages: acute, dystrophic, and atrophic. CRPS is most often precipitated by peripheral trauma (crushing injuries, lacerations, fractures, sprains, burns, or surgery) to soft tissue or nerve complexes. The pathogenesis for CRPS has been speculated as being either a disease process of the peripheral nerves, a disease process of peripheral soft tissue, or a disease process of the spinal cord. Patients suffering from CRPS may be limited in their ability to function in a self-directed, independent fashion. A longitudinal study of CRPS on 1,348 patients revealed that 96% of the study subjects still suffer some pain and disability regardless of the duration of the disease or course of treatment. Although the primary etiology for CRPS is not clearly understood, key progress has been made in terms of establishing a psychological as well as therapeutic treatment plan once the diagnosis has been made.
Topics: Activities of Daily Living; Humans; Longitudinal Studies; Precipitating Factors; Reflex Sympathetic Dystrophy
PubMed: 9464011
DOI: No ID Found -
Journal of Microbiology, Immunology,... Oct 2023Despite increasing concerns about the association between remdesivir and bradycardia in severe coronavirus disease 2019 (COVID-19) patients receiving remdesivir,...
BACKGROUND
Despite increasing concerns about the association between remdesivir and bradycardia in severe coronavirus disease 2019 (COVID-19) patients receiving remdesivir, information on its clinical course and precipitating factors is limited. Our aim was to investigate possible triggers of bradycardia after remdesivir administration.
METHODS
We retrieved the medical records of hospitalized severe and critical COVID-19 patients who received remdesivir from May 1, 2021 to June 30, 2021. Bradycardia was defined as two episodes of a heart rate (HR) < 60 bpm in 24 h. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminability of heart rate pattern on the occurrence of bradycardia. The precipitating factors of bradycardia were examined by a logistic regression model.
RESULTS
Regardless of bradycardia status, the median heart rate dropped during remdesivir treatment (from 85 to 72 bpm, p < 0.001), with the heart rate dropping considerably within the first two days of remdesivir treatment. Among various heart rate descriptors, HR ratio had the best discrimination (AUC = 0.7336), and a reduction in HR ratio by 14.65% was associated with bradycardia. Intensive care unit (ICU) admission was associated with an increased risk of bradycardia (odds ratio: 3.41; 95% CI: 1.12-10.41).
CONCLUSIONS
In severe COVID-19 patients receiving remdesivir, the risks of bradycardia were influenced by a substantial reduction in heart rate during the first two days of remdesivir treatment and ICU admission. These findings suggest that clinical practitioners should intensively monitor heart rates during remdesivir treatment.
Topics: Humans; COVID-19; SARS-CoV-2; Heart Rate; Bradycardia; Precipitating Factors; COVID-19 Drug Treatment; Intensive Care Units
PubMed: 37407291
DOI: 10.1016/j.jmii.2023.06.004 -
Proceedings of the Society For... Oct 1959
Topics: Coagulants; Fibrinogen; Humans; Precipitating Factors; Streptococcus; Streptococcus pyogenes
PubMed: 14404332
DOI: 10.3181/00379727-102-25172 -
Lancet (London, England) Oct 1994
Topics: Adolescent; Adult; Child; Child, Preschool; Electroencephalography; Epilepsy; Epilepsy, Generalized; Female; Humans; Infant; Male; Photic Stimulation; Play and Playthings; Precipitating Factors
PubMed: 7934490
DOI: 10.1016/s0140-6736(94)90625-4 -
Heart Rhythm Jan 2017
Topics: Coronary Artery Disease; Death, Sudden, Cardiac; Humans; Myocardial Ischemia; Precipitating Factors
PubMed: 27697623
DOI: 10.1016/j.hrthm.2016.09.028