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PubMed1992

[Changes in the peripheral circulation of children with severe forms of acute intestinal infections].

Photoelectroplethysmography of the skin of the end phalanx of the right hand thumb was used in 100 children with grave forms of acute intestinal infections and in 31 healthy babies to study changes in peripheral circulation. The patients demonstrated the lowering of the skin blood content, in proportion to the degree of dehydration, as well as an increase of postcapillary resistance to the blood flow in the skin and subcutaneous fat, seen not only in the acute disease period but also in the stage of early convalescence.

Acute Disease↗
PubMed1984

[Diagnostic difficulties in herpes zoster].

The authors have analysed the clinical and laboratory findings in 170 patients with herpes zoster (HZ). Of these, 21 patients (12.3%) had been erroneously diagnosed before the appearance of herpetic eruption as having other diseases (erysipelas, renal colic, acute pancreatitis, acute abdomen, and so forth). The authors point to the difficulties encountered in making the diagnosis at the initial disease period with emphasis on the great importance for early diagnosis of HZ of the analysis of the clinical findings, prodromal period and hemogram data.

Abdomen, Acute↗
PubMed1997

Quantitative cytomegalovirus (CMV) antigenaemia during antiviral treatment of AIDS-related CMV disease.

In order to assess the value of quantitative measurement of cytomegalovirus (CMV) antigenaemia as a marker for the guidance of antiviral chemotherapy in the AIDS setting, 33 patients with CMV complications and showing at least 20 pp65-positive polymorphonuclear leucocytes per 2 x 10(5) cells, received either ganciclovir or foscarnet as induction and maintenance therapy. Antigenaemia was assessed every 1-4 weeks. During acute-phase antiviral therapy, a significant decrease of CMV antigenaemia (>50% of pretreatment levels) paralleled clinical improvement in 2-7 weeks in 32 of 33 subjects. In ten of 24 evaluable patients followed up during a further 4-12 months, disease relapses occurred concurrently with an increase of CMV antigenaemia in seven cases, while three cases of relapsing retinitis did not show a significant increase in antigenaemia. All patients with recurrent disease had a favourable response to further treatment, including halted clinical progression and significant decrease in antigenaemia. In HIV-related CMV disease, periodic monitoring of quantitative CMV antigenaemia proves useful in evaluating response to antivirals, in guiding therapeutic management and in predicting disease relapses.

AIDS-Related Opportunistic Infections↗
PubMed1990

[Epidemiological aspects of spinal diseases in the GDR in 1979 to 1988].

The socio-economic impact of disorders of the spine and the back has obtained an increasing importance in all industrial countries. Considering indicators of public health and national economy, namely temporary sickness incapacity for work, invalidity (insured persons in the GDR), utilization of hospital services (total population of the GDR), of rheumatological dispensaries as well as of the general practitioner, frequencies have been studied and trends pursued by means of serial analyses in a 10-year period. Diseases of the spine and the back within diagnostic class XIII/ICD, 9th revision, 1975 (diseases of the musculoskeletal system and connective tissue) have caused--nearly 2/3 of all cases of sickness incapacity for work--1/3 of the incidence of disability pensions--about 1/3 of the utilization of hospital services--about 1/5 of the utilization of rheumatological dispensaries--more than 50% of all cases consulting the general practitioner. As to the indicators sickness incapacity for work, incidence of disability pensions and discharges from the hospital, the serial analyses of the period from 1979 to 1988 have shown that the diseases of the spine and the back have the highest increase within the group of class XIII.

Adult↗
PubMed1993

Crohn's disease presenting as isolated jejunitis years after childhood colitis.

We present a case of a patient who had documented ulcerative colitis as a child and later presented with isolated Crohn's jejunitis. Although rare, Crohn's disease must be considered in those patients with segmental inflammation of the small bowel and a prior history of inflammatory bowel disease involving the colon. Patients with colitis that do not show specific criteria for either ulcerative colitis or Crohn's disease should be classified as indeterminant colitis, and a small bowel series is indicated. It may be indicated to obtain a small bowel series in patients with any form of colonic inflammatory bowel disease, periodically, after diagnosis.

Child, Preschool↗
PubMedDate not supplied

[Level of certain carbohydrate components in blood serum and urine of patients at extensive periods since suturing for perforated gastroduodenal ulcers].

The duration of gastric impairment before perforation as well as morphological features of sutured ulcer were shown to influence the protective functions of the gastric and duodenal mucosal membrane as shown by estimation of hexose, fucose and sialic acids in the blood serum and urine of 128 patients within later periods after suturing perforated gastroduodenal ulcers. Inhibition of the mucosal membrane protective functions in gastroduodenal tissues was increased with a longer disease period before perforation and with more distinct pathomorphological alterations of the perforated ulcer.

Carbohydrate Metabolism↗
PubMed1990

[The role of functional disorders of the autonomic nervous system in the pathogenesis of multiple sclerosis].

As far as the teaching of multiple sclerosis (MS) is concerned, many problems remain unsolved, particularly those of etiology and pathogenesis. Observations confirmed the significance of 2 symptoms of multiple sclerosis (Kh. G. Khodos, 1954), namely: 1) unusual changeability of the disease clinical manifestations in respect of heat and cold factors, 2) secondary amenorrhea in 30% of women afflicted with MS. Both symptoms may have differential diagnostic importance, indicating, in the authors' opinion, paramount significance of autonomic nervous system dysfunction in the disease pathogenesis and of some characteristic symptoms, for they are likely to be observed in the early disease period.

Adolescent↗
PubMed2002

Encephalocraniocutaneous lipomatosis.

BACKGROUND: Encephalocraniocutaneous lipomatosis (ECCL) is a relatively new, nonhereditary, but congenital, neurocutaneous syndrome with unilateral cutaneous tumors and ipsilateral ophthalmologic and neurologic malformations. The syndrome is rare, with only 25 cases reported since first communication in 1970. The primary clinical features noted for almost all cases are as follows: (1) unilateral porencephalic cysts with cortical atrophy, (2) ipsilateral lipomatous hamartoma of the scalp, eyelids, and outer globe of the eye, (3) cranial asymmetry, (4) marked developmental delay and mental retardation, (5) seizures, and (6) spasticity of the contralateral limbs. OBJECTIVE: We discuss underlying pathophysiology, diagnostic difficulties, differential diagnosis, and therapeutic possibilities of the syndrome. CONCLUSIONS: The syndrome seems to be more frequent than it was thought. ECCL may remain unrecognized, as some patients may not represent the full clinical spectrum of the disease. Periodic neurologic and cardiologic assessment with echocardiography and electrocardiography should be carried out in all patients with ECCL because of a possible progressive disease course.

Abnormalities, Multiple↗
PubMed1990

[The functional characteristics of the enzymatic antioxidant system in the erythrocytes and neutrophils of the blood of patients with generalized forms of meningococcal infection].

Patients with meningococcal infection, meningitis and with a mixed form of the disease were demonstrated to have unbalance in the redox system of glutathione during the all disease periods till the clinical recovery. Activation of glutathione peroxidases to hydrogen peroxide and tertiary butyl hydroperoxide in erythrocytes was coupled, during the whole disease, with unbalance of the time-course of changes in the interrelated enzymes--superoxide dismutase and glutathione peroxidase to hydrogen peroxide, while in neutrophils, the balance of those enzymes remained unimpaired. Glutathione transferase activity appeared reduced both in erythrocytes and neutrophils. Potential mechanisms by which the redox system of glutathione and superoxide dismutase may be deranged in meningococcal infection are under discussion.

Acute Disease↗
PubMed1995

von Willebrand factor in juvenile dermatomyositis.

OBJECTIVE: To evaluate whether plasma von Willebrand factor (vWF) levels are a useful indicator of disease activity in juvenile dermatomyositis (DM). METHODS: Serum vWF levels were prospectively measured in 15 patients with juvenile DM and were compared to serum muscle enzyme levels, muscle strength, and presence of extramuscular manifestations. RESULTS: 6/15 active disease periods were accompanied by an increase in vWF; 9 were not. Elevated vWF levels did not relate to the presence of active skin disease or calcinosis. vWF was not consistently related to muscle strength, CPK, or aldolase in the study group. Two patients had elevations of vWF in association with viral infections while their DM was quiescent. CONCLUSION: An elevated vWF level is often indicative of a disease exacerbation in DM, and thus may be helpful in managing difficult cases. However, it is not consistently elevated in, nor specific for active disease in DM. It therefore cannot be recommended as a routine test in patients with DM. When used, results should be interpreted with caution.

Adolescent↗
PubMed1987

Air-bone gap in Menière's disease after exposure to overpressure.

Equal loss in sensitivity for air and bone conduction and poor speech discrimination are considered characteristic of the hearing impairment in Menière's disease. Periodic pressure changes applied to the middle ear produced an air-bone gap in 16 out of 19 patients with advanced Menière's disease. The air-bone gap was associated with an improvement in speech discrimination scores. Subsequently, the air-conduction hearing loss decreased. The shapes of psychoacoustic tuning curves of patients with the air-bone gaps showed an improvement in frequency resolution. The curves remained elevated in threshold, however, which indicates an attenuation of the sound stimuli. The relative change in bone conduction sensitivity was interpreted as an early sign of improvement in the inner ear mechanics, caused by exposure to pressure changes.

Air Pressure↗
PubMed1978

Subacute phenytoin intoxication syndrome.

Phenytoin sodium intoxication of subacute onset may occur in cases of nonepileptic patients who receive phenytoin for suppression of cardiac arrhythmias. The case reported here is of a syndrome that consisted of dementia, cerebellar dysfunction, and peripheral neuropathy. Withdrawal of phenytoin was followed by a slow improvement in the syndrome. Awareness of the features of subacute phenytoin intoxication in cardiac patients is important because this entity may mimic cerebrovascular disease. Periodic monitoring of serum phenytoin concentrations is advisable.

Arrhythmias, Cardiac↗
PubMed1979

[Clinical characteristics of the early postshock period in traumatic disease].

The clinical course of an early (up to 14 days) postshock period of traumatic disease in 112 patients, treated for a combined trauma complicated with shock, has been studied. It has been established that within first 2 days after shock more than half of the patients develop increased coagulative activity of the blood, which rises still more in the following period. Progressive anemia, connected apparently with hemopoietic depression, is characteristic of the postshock period. In the second period (3--14 days after trauma) 60% of examined patients showed hypokalemia. A great percentage of inflammatory complications is likely to be due to the decrease of the defense--adaptative mechanisms, resulting from changes of the reactivity in the injured after shock.

Adult↗
PubMed2003

[High summer temperatures and mortality in the Czech Republic 1982-2000].

The heat-stress-related mortality, which is among main impacts of periods of high summer temperature on society, was reported in many European countries, but analyses focusing on central European population have been rare. Results of the analysis for the period of 1982-2000 in the Czech Republic indicate that heat stress leads to a considerably increased all-causes mortality and mortality due to cardiovascular diseases. Periods with the highest deviations of the daily number of deaths from a baseline (in all-year data) are influenza epidemics and heat waves; the distribution of days with the highest excess mortality in a year is clearly bimodal, showing a main peak in winter and a secondary one in summer. Summer days with a considerably increased mortality are almost entirely days with a positive temperature deviation from the seasonal course. Deviations of mortality from the baseline exceed 100 deaths daily (more than 30% relative increase) in heat wave peaks, and the excess total mortality during the severe 1994 heat waves was +456 deaths (+10.3%) for June 17 to 30, and 8 deaths (+12.3%) for July 24 to August 8. The relative increase in mortality due to cardiovascular diseases was even more pronounced. The mortality displacement effect played an important role, since it was estimated to account for as much as 52% of the total number of victims for the June 1994 heat wave and 48% for the July-August heat wave. People who would die soon without oppressive weather conditions make about half of the total number of deaths, which is a larger value compared to what other studies reported. The increased mortality is observed at maximum (average, minimum) daily temperatures higher than 25 degrees C (18 degrees C, 14 degrees C) and their anomalies from mean seasonal courses larger than 3 degrees C. The same values hold for both the total and cardiovascular mortality. The mortality response at high temperatures is more pronounced in females than males. Correlations between mortality and temperature variables (including heat index) are positive and statistically significant (P = 0.01), stronger for deviations of meteorological variables from seasonal courses than for raw values, in females than males, and for heat index than for any temperature variable and summer simmer index. The unlagged correlations are stronger than correlations with lags 1-3 days; positive values of correlation coefficients hold for lags 0 to 3 days only while at lags of 4 to 25 days, the link is negative (mostly statistically significant) which demonstrates the mortality displacement effect and its time extent.

Adolescent↗
PubMed2004

Clinical significance of azathioprine active metabolite concentrations in inflammatory bowel disease.

BACKGROUND AND AIMS: There are conflicting reports on the role of azathioprine (AZA) thioguanine nucleotide (TGN) metabolites in optimising therapy for inflammatory bowel disease (IBD). The aim of this study was to investigate TGN intrapatient variation, and the relationship between TGN concentrations and disease activity in IBD patients taking long term constant dose AZA. METHODS: TGN and methylmercaptopurine nucleotide (MeMPN) concentrations were measured at intervals over a two year period. Disease activity was assessed at each clinic visit using the Crohn's disease activity index or Walmsley simple index for ulcerative colitis. RESULTS: Serial TGNs were measured in 159 patients (3-14 TGN assays, median 6). Intrapatient variation in TGN concentrations was 1-5-fold (median 1.6); the incidence of non-compliance was 13%. At the end of two years, 131 patients were evaluable at TGN steady state. Of this group, patients who remained in remission had significantly higher mean TGN concentrations than those patients who developed active disease (median TGNs 236 v 175, respectively; median difference 44 pmol (95% confidence interval 1-92); p = 0.04). MeMPN concentrations were not related to AZA efficacy or toxicity. CONCLUSIONS: This study has shown that lower TGN concentrations were linked to the development of active disease, and that TGNs may act as useful markers of compliance. However, it is clear that repeat TGN measurements are required for an unambiguous index of active metabolite exposure. In view of the high intrapatient variability in TGN production over time, TGN measurements may not be currently advocated for routine clinical use.

Adolescent↗
PubMed1990

[Value of the study of various erythrocyte enzymes in determining the nature of cerebral stroke in the acute period].

Activities of catalase, superoxide dismutase, glyceraldehyde phosphatedehydrogenase and glucose-6-phosphate dehydrogenase implicated in the process of hemoglobin oxygenation were studied and compared in 40 patients with ischemic and in 30 patients with hemorrhagic brain strokes in the most acute disease period (days 1-2). A well-defined relationship was revealed between the brain stroke pattern and enzymatic activity which is likely to be determined by varying degree of body adaptation under hypoxia developing in ischemic and hemorrhagic brain strokes. It is assumed that the clinico-enzymatic correlations discovered might be employed as additional criteria in the differential diagnosis of the brain stroke pattern.

Acute Disease↗