Vertigo - part 2 - management in general practice.
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BACKGROUND: Vertigo is a common clinical problem managed by general practitioners. OBJECTIVE: This article focuses on the acute management of a vertigo attack, specific management of conditions causing vertigo, and the long term management issues associated with chronic vertigo. DISCUSSION: Supportive treatment, antiemetic and vestibular blocking agents help relieve an acute vertigo attack, however the prolonged use of such medications is not recommended. Specific treatments for various conditions causing vertigo are available, however, the majority of patients are managed symptomatically. The patient's ability to drive safely should be carefully assessed according to Austroads guidelines and advice from an ear, nose and throat surgeon should be sought when in doubt. There is evidence to support the efficacy of vestibular rehabilitation programs for unilateral peripheral vestibular disorder and these programs should be considered. A simple program including patient education and home based exercises can be sufficient. (+info)
Nutrient-sensitized screening for drugs that shift energy metabolism from mitochondrial respiration to glycolysis.
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Neutrophil-infiltrated paw edema induced by mannose-binding Dioclea violacea lectin.
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BACKGROUND: The potential edematogenic effect and the pharmacological characterization of a glucose-mannose-binding lectin from Dioclea violacea (DvL) were investigated. METHODS: Paw edema was induced with DvL in control animals, and in animals pretreated with glucocorticoid or with blockers of histamine, nitric oxide synthase, cyclooxygenase, platelet activating factor (PAF), bradykinin and lipoxygenase. RESULTS: DvL-induced paw edema paralleled with an increase in vascular permeability and myeloperoxidase (MPO) activity. DvL-induced edema could be prevented by pre-treatment with the lectin-binding sugar alpha-D-methyl mannoside. Dexamethasone, meclizine and Nomega-nitro-L-arginine methyl ester hydrochloride (L-NAME) inhibited this effect. CONCLUSIONS: DvL induces edema, increase in vascular permeability and neutrophil infiltration. The edematogenic activity involves the lectin mannose-binding sites and is associated with histamine, cytokines and nitric oxide, since it could be treated with meclizine, dexamethasone and L-NAME. (+info)
Meclizine inhibits mitochondrial respiration through direct targeting of cytosolic phosphoethanolamine metabolism.
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