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PubMed1992

[The results of a retrospective examination of patients with acute rheumatic fever].

The authors describe the results obtained during retrospective examinations of 45 subjects who suffered from acute rheumatic fever 10-14 years before. Of these, 19 subjects were treated with prednisolone in the acute disease period, 16 with indomethacin, and 8 subjects with voltaren. The examinations were mostly randomized (30 subjects); no differences in the anti-inflammatory effect were discovered. Heart disease was found in 9 persons (20%). Of these, 6 were treated with prednisolone, 2 with indomethacin, and 1 with voltaren. The disease relapses were recorded in 4 of them, the signs of valvulitis in the past were shown only by 2 persons (echocardiographically). 12 persons (27%) had mitral valve prolapse which had not been diagnosed on the first admission to the hospital, with any clinical signs of hypermotility lacking. In 18 persons (40%) having no valve lesions (disease, prolapse), an x-ray examination revealed a slight increase of the heart size, estimated as a manifestation of postmyocardial cardiosclerosis. Thus, it has been shown that modern anti-inflammatory therapy does not prevent the development of heart disease. Apparently, its onset is related to specific proneness in some of the patients.

Follow-Up Studies↗

PubMed1983

[Metabolism of various biogenic amines in acute viral neuroinfections].

The metabolism of biogenic amines was examined in 62 patients with various acute viral neuroinfections. The control group consisted of 57 persons. Depending on the process character and disease period variations of the levels of serotonin, 5-hydroxyindolylacetic acid, coeruloplasmin and histamine were discovered. A comparison of the results obtained with the clinical course of the diseases revealed a certain correlation, especially in patients with acute meningoencephalitis.

Acute Disease↗

PubMedDate not supplied

[Role of immunity in hypodermyiasis in cattle].

Immunity, especially aquired one, was found to play an important role in preventing the animals against falling ill with hypodermatosis. According to the results obtained, the intensity and duration of immunity, as the main factors of non-susceptibility, depend on the infection intensity, recurrence of the disease, periods of mortality or warble flies larvae and fatness of animals.

Animals↗

PubMed1994

[The characteristics of the interferon system parameters in typologically different groups of patients with borderline mental disorders during treatment].

Lymphocyte gamma-interferon production and levels of serum interferon were studied in 94 patients with borderline psychiatric disorders on treatment. It was shown that parameters of interferon system in the acute disease period and their dynamics through the treatment depend on typological features of personality and initial level of interferon production. The patients with aggressive features of personality in acute disease exhibit significantly higher levels of serum interferon than those in patients with submissive features which drop after recovery. The same tendency occurred in hysterical patients (hystero-expressive and hystero-impressive types). These findings may be due to different reaction of immune system to chronic emotional stress in different types of personality.

Acute Disease↗

PubMed1988

Relative risk models for assessing the joint effects of multiple factors.

A goal of analyses of occupational cohort data is the specification of how covariate information relates to age-specific disease risks. In describing this relationship, certain assumptions or models must be defined. For example, the usual standardized mortality ratio assumes a constant multiplicative increase in the age and calendar period disease rates of an exposed cohort over rates in a unexposed referent group. For analyzing several exposures, some of which may be continuous, such as cumulative dose, dose rate, duration of employment, and smoking patterns, or for analyzing complex associations between disease rate and covariates, flexible regression procedures are required. Using a crossclassification of the data and a Poisson probability model, relative risk regression methods are outlined. Breslow and Storer [1985], Guerrero and Johnson [1982], and Thomas [1981] propose general models for the relative risk as alternatives to, but which include, the usual exponential form. We review these models, discuss some limitations (in particular when there is more than one covariate) and present alternatives. Methods and models are illustrated by examining the joint effects of radon exposure and tobacco use on lung cancer mortality among a group of uranium miners.

Adult↗

PubMed1999

Outcome of moderate carotid artery stenosis in patients who are asymptomatic.

PURPOSE: The incidence rate of disease progression and stroke after the diagnosis of a moderate (50% to 79%) carotid stenosis was determined by means of color-flow duplex scanning. METHODS: During a 4-year period, 344 male veterans with moderate internal carotid artery stenoses, on one or both sides, were examined at regular intervals for a mean period of 25 months. Carotid color-flow scans were obtained semiannually. Clinical follow-up was performed to determine the incidence rate of amaurosis fugax, transient ischemic attacks, nonhemispheric symptoms, and strokes. RESULTS: New neurologic symptoms developed in 75 patients (21.8%). Fifty-one (14.8%) had ipsilateral symptoms during follow-up: 18 amaurosis fugax (5.2%), 14 transient ischemic attacks (4%), 5 nonhemispheric symptoms (1.4%), and 14 strokes (4%). Twenty-four patients (6.9%) had contralateral symptoms: 20 strokes (5.8%) and 4 transient ischemic attacks (1.2%). Life-table analysis showed that the annual rate of ipsilateral neurologic events was 8.1%, and the annual rate of stroke was 2.1%. Seventy-five patients (22%) died in the follow-up period. Disease progression to 80% to 99% stenosis or occlusion occurred in 71 of 458 vessels (15.5%). The internal carotid arteries that showed evidence of disease progression had a significantly higher initial peak systolic velocity (251 vs 190 cm/s; P <.0001) and end diastolic velocity (74 vs 52 cm/s; P < 0.0001). Black patients and patients with ischemic heart disease were at a higher risk for disease progression. We could not identify any atherosclerotic risk factors that reliably predicted patients in whom future ipsilateral neurologic symptoms were more likely to develop. However, there was an increased risk of stroke associated with progression of disease. CONCLUSION: Patients who are asymptomatic and who have moderate carotid stenoses are at significant risk for neurologic symptoms and death, but have a relatively low incidence rate of ipsilateral events. The initial flow characteristics in the stenotic vessel are predictive of future disease progression, but they are not helpful in identifying patients in whom symptoms will develop.

Adult↗

PubMed1999

[Clinical significance of allergen specific immunotherapy in adult house-dust-mite-sensitive bronchial asthma: impact on disease severity and medical cost].

The objective of this study was to evaluate the clinical significance of allergen-specific immunotherapy in house-dust-mite-sensitive adult bronchial asthma. Fifty patients treated with rush immunotherapy using house dust antigen were examined. The disease severity was compared between before and a year after the maintenance immunotherapy: reduction in the severity was observed in 27 patients (54.0%) following the treatment. The response rate was greater in the patients with step 3 (moderate, persistent) or step 4 (severe, persistent), disease period less than 10 years, or reversible airway obstruction. Patients who showed favorable clinical response also demonstrated the reduction in medical costs. These results suggest that allergen immunotherapy reduces the disease severity and medical cost in a certain population of adult atopic asthma.

Adolescent↗

PubMed2005

[Primary lymphoma of the thyroid--diagnostic and treatment problems. The case report].

The authors present the case of primary malignant thyroid lymphoma and problems with distinguishing between Hashimoto's thyroiditis and primary thyroid lymphoma. Primary malignant thyroid lymphoma (PMTL) is a rare disease and difficult to diagnose. The appearance of PMTL may be preceded by Hashimoto's thyroiditis. The biopsy is useful but often only surgical treatment allows to establish diagnosis. The treatment of PMTL includes surgical treatment, chemo- and radiotherapy. The prognosis depends on the disease period.

Aged↗

PubMed2000

Thyrotoxic periodic paralysis in a Caucasian man in treatment for Graves' disease.

Thyrotoxic periodic paralysis (TPP) is the main secondary form of hypokalemic periodic paralysis and is mostly associated with Graves' disease. Initially diagnosed in Asian countries, TPP has been sporadically reported in different populations of the Western World. Increased Na+/K(+)-ATPase activity seems to be responsible for the marked hypokalemia observed during the transient paralysis attacks. We report on a 35-year-old Italian man without history of hypokalemic periodic paralysis and hyperthyroidism, in treatment for Graves' disease, who suffered episodes of flaccid paralysis even with normal thyroid hormone levels. An insulin-glucose provocation test confirmed our diagnosis. Oral and parenteral potassium reverse the symptoms. Monitoring of thyroid function is also important to prevent further attacks.

Adult↗

PubMedDate not supplied

Rhythms and periodicity in health and disease.

Biorhythms longer than the circadian that influence reactions of people and characterizes some diseases have not received much medical attention. The lay press describes cycles of 23, 28 and 33 days said to regulate moods, intellectual ability and efficiency, respectively. Whether or not three overlapping cycles actually regulate three different vague reactions may be questioned. Of interest, however, are rhythms of similar tempo which control mensis, cyclic changes in male hormones and a number of periodic diseases. Although reports of more than 2500 cases of periodic diseases have been published, physicians generally are skeptical on the subject. Incorrect diagnosis leads to unnecessary testing, surgical exploration and medication.

Biological Clocks↗

PubMed2000

[Clinico-diagnostic evaluation of changes in ATPase activity, lipid peroxidation and stability of red cell membranes in patients suffering from hemorrhagic fever with renal syndrome].

AIM: To examine morphofunctional and metabolic features of erythrocytes affecting blood rheology in patients with hemorrhagic fever with renal syndrome (HFRS) for assessment of the disease severity. MATERIAL AND METHODS: 130 HFRS patients were examined using clinical, laboratory, serological tests and fluorescent antibody test. Activity of transport ATPase and content of lipid peroxidation (LPO) products in erythrocyte membranes were measured. These membranes stability was assessed by osmotic and acid resistance in different disease periods. RESULTS: Inhibition of Na+, K+, Ca+ active ATPase of erythrocyte membrane occurred in all the examinees, LPO products rose. The membrane stability was more disturbed in moderate and severe HFRS, especially in polyuretic period. CONCLUSION: Depression of ATPase activity, growth of LPO content in erythrocytes, their relationships can be used as indicators of red cell metabolic disorders, abnormal blood rheology, and eventually, in the disease prognosis. Early membrane defects detected by osmotic and acid resistance can improve the disease diagnosis and provide data on the condition's severity.

Adenosine Triphosphatases↗

PubMed2000

The psychological refractory period in Parkinson's disease.

The Psychological Refractory Period paradigm was used to investigate whether patients with Parkinson's disease showed disproportional deficits in regulating responses to two sequential presented stimuli. The first task required a speeded key-press response to an auditory stimulus, and the second task required a speeded key-press response to a visual stimulus. The stimulus onset asynchrony (SOA) between Task 1 and Task 2 was 50 msec., 150 msec., and 650 msec. According to the bottleneck model, the SOA manipulation should not affect performance on Task 1, but reaction time for Task 2 should increase as the SOA between the two tasks decreased. The increase in reaction time for Task 2 was referred to as the Psychological Refractory Period. In this study, both patients with Parkinson's disease and normal controls showed classical effects. More importantly, although the 22 patients with Parkinison's disease took longer to respond to both Tasks 1 and 2 than the 20 normal controls, the effects of the Psychological Refractory Period for the two groups were of the same magnitude. The results suggest that Parkinson's disease affects only the response-execution stages rather than the response-selection stages, based on the central bottleneck model.

Acoustic Stimulation↗

PubMed2003

[Angiotropic lymphoma (intravascular lymphomatosis)--2 case reports].

Described are two cases of angiotropic lymphoma where eventually autopsy elucidated nonspecific neurologic symptoms. One patient suffering ambiguous encephalitic syndrome died three months later, the second one passed away after an unusually long three-year period of progressive dementia and cumulative motoric dysfunction. The autopsy disclosed pure intravascular malignant lymphoid aggregates (LCA, CD 20, Bcl 2-positive) in the brain and kidney of both patients. In the patients with the longer disease period, a dissemination to lung was also found. Definitive diagnosis was issued as a B cell type of angiotropic lymphoma. Skin, lymph nodes, spleen, and bone marrow were not affected in any case. The clinical differential diagnosis algorithm did not involve this rare etiology in these particular uncommon neurologic cases and even brain biopsy performed in both women did not recognize the substantiality of the disease.

Brain Neoplasms↗

PubMed1987

Experimental infection of piglets by aerosols of Rhodococcus equi.

The purpose of this study was to investigate experimental infection of the piglet as a model of Rhodococcus equi pneumonia in the foal. Three litters of eight piglets each were exposed to an aerosol of 3.4 X 10(7) R. equi per piglet per day for seven consecutive days. Over the next 23 days the piglets were observed for clinical signs of disease. Periodically after infection one piglet from each litter was killed, the lungs were cultured quantitatively for R. equi and the gross and microscopic pulmonary lesions were assessed. The only clinical evidence of disease was the occurrence of elevated temperatures in the infected piglets. Rhodococcus equi was slowly cleared from the piglets' lungs during the 23 days following aerosolization. Piglets sacrificed seven to ten days after aerosolization had the most extensive pulmonary lesions, consisting of severe consolidation of the cranioventral lobes. Microscopic examination revealed thickened interalveolar septa and alveoli containing many neutrophils and macrophages with intracytoplasmic Gram-positive coccobacilli. The pulmonary lesions in these piglets differed from those of naturally infected foals in that they were not characterized by macrophage-rich abscesses and the infection gradually resolved.

Actinomycetales Infections↗

PubMed2001

[Treatment of cluster headache].

INTRODUCTION: The cluster headache (CH) is one of the most severe types of head pain. It is a typical example of a periodic disease and the International Headache Society classification recognizes two forms of this disease: episodic and chronic CH. Its prevalence is about 0.1 to 0.4% in the general population. CURRENT KNOWLEDGE AND KEY POINTS PATHOPHYSIOLOGY: A global hypothesis is still lacking to explain the pain, the vasodilation, the autonomic features (ipsilateral lacrimation, conjunctiva injection, rhinorrhea, partial Horner syndrome, etc.) and the periodicity of the CH. Pain and vasodilation seem secondary to an activation of the trigeminal vascular system and the periodicity of the attacks is thought to be due to a dysfunction of hypothalamic biologic clock mechanisms. Treatment of acute CH attacks. The most effective agents are oxygen inhalation and subcutaneous sumatriptan, a 5HT1B and D receptor agonist which has vasoconstrictor and anti-neurogenic inflammation properties by blocking the release from the trigeminal-sensitive fibers of neuropeptides such as CGRP and substance P. With subcutaneous sumatriptan, headache relief is very rapid, within 5 to 10 min. Prophylactic treatment of CH: The number of attacks per day varies from one to three, but some patients can have four to eight per day and acute treatments fail to provide sufficient relief or give rise to side-effects. Several different regimens have been proven effective. FUTURE PROSPECTS AND PROJECTS: Contraindications and side-effects of the drugs limit the choice of the prophylactic treatment: corticosteroids in a tapering course, verapamil and methysergide are the most useful treatments of the episodic form. Lithium carbonate is more effective for the chronic stage of CH, but side-effects are often troublesome. Numerous other medications have been used for prophylaxis: valproate, capsaicin, beta-blockers. Unfortunately, double-blind studies are often lacking and are difficult to realize due to spontaneous variable remission of episodic CH. When adequate trials of drug therapies show a total resistance to the treatments, surgery may be considered. Radiofrequency trigeminal rhizotomy is the treatment of choice with 70% of beneficial effects. Risks and complications have to be discussed in balance with the benefit of the different surgical procedures.

Anti-Inflammatory Agents↗

PubMed2005

[Neurohumoral changes in acute intestinal obstruction].

Neurohumoral changes were studied in 431 patients with acute intestinal obstruction and in experiments in 165 small laboratory animals with the model of small intestine ileus. The results were obtained on the basis of estimation of the concentration of catecholamines, acetylcholine-like substances, serotonine, histamine, their metabolism products in blood plasma and of the cardiointervalography data. The neurohumoral changes were shown to appear as early as the initial stage of the disease and to be progressing when the disease period became longer. The prevailing sympathetic activity was dependent on the decreased acetylcholine-like substances in blood plasma and tissues. The serotonine and histamine metabolism changed depending on the stage of the disease.

Acute Disease↗

PubMedDate not supplied

[Beta-thalassemia and glucose-6-phosphate dehydrogenase deficiency].

Twenty subjects--patients with anemia and their close relatives representing 7 families, were tested for thalassemia. Heterozygotic beta-thalassemia was detected in 17 cases. The national composition of this patient population was as follows: 7 Pathans (Afghanistan), 1 family; 2 Armenians (Georgia), mother and son; 2 Tajiks, sibs; 2 patients of mixed Russian-Ukrainian-Polish-Azerbaijan origin, mother and son; 1 Russian-Arab child and his Arab father (Syria); 1 Uzbek woman and 1 Russian child. The mean content of Hb in the blood for patients with heterozygotic beta-thalassemia is 110 +/- 3.8 g/liter, that of HbA2 fraction 4.8 +/- 0.26% and of HbF fraction 2.6 +/- 0.39%. Clinical manifestations of the disease varied, being more grave in children than in adults. In an Armenian family from Batumi thalassemia minor was diagnosed in the mother and son, whereas in the father and other son a periodic disease was revealed. In a family of 7 members from Afghanistan thalassemia minor was found in 4 representing the paternal line, minimal thalassemia was suspected in 3, and a deficiency of glucose-6-phosphate dehydrogenase in red blood cells was revealed in 5: in the mother and 4 children. No increase of methemoglobin level was revealed in either of the examinees.

Adolescent↗

PubMed1985

[Kidney function in diabetic patients with diabetes of a duration less than 15 years].

All diabetics of a closed population were examined in respect to their renal function by means of their level of serum creatinine. 1,380 out of 1,490 diabetics (type I and type II) have their diabetes less than 15 years. The serum creatinine values are increased in 24.9% of these diabetics. The frequency of chronic renal insufficiency rose steply after a diabetes period of 15 and more years. A classification of the diabetics in groups with equal diabetes period showed that renal insufficient diabetics are significant older than those with normal renal function. The results of the investigation emphasize the demand to enclose the nephropathy in the diagnostic scale of diabetics with short disease period, too, to become therapeutic effectively very early.

Adolescent↗