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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Egyptian workers at sewage treatment plants (STPs) work and live in areas, which are highly infested with arthropods. Most of these diseases cause, febrile, influenza like illness, headache, backache, abdominal pain, and fatigue. To determine arboviral etiology in those workers, 264 serum samples were obtained from the workers in four STPs during January and October 1999. Enzyme linked immunosorbent assay (ELISA) was performed for immunoglobulins (IgG and IgM), for the detection of West Nile (WN), Sindbis (SIN), Rift Valley fever (RVF), Sandfly Naples (SFN) and Sandfly Sicilian (SFS) viruses. The results showed that (WN) has the highest prevalence (143/264, 54.14%), followed by (SFN) (58/264, 21.97%) then (RVF) (23/264, 7.95%), while, only one recent infection for each of RVF, SFS and SFN (1/264, 0.38%) and 3 persons for SIN viruses. Out of the four STPs Helwan workers' exhibited the highest infection rate for most of the studied arboviruses WN, SFN, SIN and SFS.
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PMID:Infection by certain arboviruses among workers potentially at risk of infection. 1721 41

This study was designed to study patients with intolerance to pesticide smells. Ten subjects chosen were complaining of vague symptoms such as headache, dizziness, fatigue, nausea, vomiting, abdominal pain, myalgia, flu-like symptoms, etc., whenever exposed to the pesticide smells even at low intensity. To determine whether the etiology of this kind of pesticide hypersensitivity was of organic or psychiatric nature, all the subjects underwent tests as follows: complete blood cell count, urinalysis, and blood chemistry as routine tests; esophogastroduodenoscopy and abdomen ultrasonography for the gastrointestinal symptoms; chest x-ray, pulmonary function tests, and electrocardiography for the respiratory and/or cardiac symptoms; nerve conduction velocity and brain magnetic resonance imaging (MRI) for peripheral and central nerve system symptoms; and K-WAIS, Rey-Kim memory test, Rorschach, Mini Mental State Examination (MMSE), and Minnesota Multiphasic Personality Inventory (MMPI) for psychoanalysis. Of the 10 cases in which the chief complaint was headache, symptoms of two cases were caused by maxillary sinusitis. Another two showed typical multiple chemical sensitivity (MCS) or idiopathic environmental intolerance (IEI). Six out of the 10 cases, whose symptoms closely resembled the others, did not conclusively meet the criteria of classic MCS or IEI. The subjects of this case shared vague fears, both fear of pesticides and hypochondriasis. Some subjects faced financial insecurity and social uncertainty; others felt uneasy about the future of their farming life. Thus, to help verify the causes of MCS or IEI, which is strongly suggestive of pesticide smells, diagnosis needs a dual approach: on the anima and soma. Psychoanalysis can delve into the mental status of the patients to see whether the patients are aware of their symptoms. Clinical tests can see through the physical structure and functions of the organs on which patients' complaints are centered.
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PMID:Pesticide-initiated idiopathic environmental intolerance in South Korean farmers. 1749 36

Although a large number of studies have reported the causes of the exacerbation of ulcerative colitis (UC), the effect of influenza vaccination on the relapse of UC has not been reported. We experienced a case of prompt exacerbation of quiescent UC due to influenza vaccination. A 39-year-old woman was diagnosed as UC 4-years ago and was well controlled with oral mesalazine. She experienced abdominal pain and frequent bowel movements with hematochezia 3 days after the vaccination. On admission, laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein. Sigmoidoscopy showed marked edematous mucosa on rectum and sigmoid colon with fine ulceration and spontaneous bleeding. She recovered from the exacerbation of UC after steroid treatment. Vaccination should be administered to the patients with inflammatory bowel disease with the caution of its possible side effects.
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PMID:[A case of ulcerative colitis relapsed by influenza vaccination]. 1752 21

Gemcitabine is the only cytotoxic agent approved by FDA for the treatment of pancreatic carcinoma. Gemcitabine has a relatively safe profile. Major side effects include bone marrow suppression and flu-like syndrome. Transient abnormalities of liver transaminase enzymes are seen in two third of patients: elevations of alkaline phosphatase and bilirubin are less common, but severe hepatic toxicity is uncommon. Four case reports regarding severe hepatic toxicity of gemcitabine leading to rapid deterioration in patients' health status and death have been reported. We report the fifth case in which liver functions were within normal limits but liver toxicity was preceded by radiological findings on the MRI. We describe a 61-year-old male with stage T4N1M0 who initially received gemcitabine-oxaliplatin (GemOx) regimen was switched to gemcitabine-capecitabine (every two weeks schedule) after four months of therapy due to lack of response. Restaging CT scan after eight-weeks showed new multiple foci of low attenuation resembling simple cysts. MRI of the abdomen was performed which revealed early and active fibrosis. Hepatitis panel were negative. Subsequently the patient developed nausea, vomiting, abdominal pain and weight loss and was referred for palliative radiotherapy. Gemcitabine was discontinued and follow-up CT scan two months later showed stable lesions in the liver. In conclusions, four cases of gemcitabine-induced liver toxicity has been reported in the literature. Such toxicity is manifested by elevated liver transaminases and more common in the presence of liver metastasis. However, our case showed that gemcitabine-induced liver toxicity can be detected by MRI, before liver enzymes start to rise and discontinuation of gemcitabine can prevent further liver toxicity and fibrosis. Report of such cases is encouraged as it will bring awareness among clinicians caring for such patients receiving gemcitabine.
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PMID:Gemcitabine-induced liver fibrosis in a patient with pancreatic cancer. 1762 1

An overlap of symptoms in irritable bowel syndrome (IBS) exists across subtype groups. Symptoms include intestinal gas, diarrhea, dyspepsia, bloating, abdominal pain, and constipation. The unifying symptom may be excessive intestinal gas as a by-product of intestinal microbial fermentation. Abnormal fermentation of food takes place when gut microbes expand proximally into the small intestine instead of being confined predominantly to the colon. Such proximal expansion of indigenous gut microbes or small intestinal bacterial overgrowth (SIBO) may lead to activation of host mucosal immunity and an increase in intestinal permeability to result in flu-like extra-intestinal symptoms that accompany the classic IBS symptoms of altered bowels. The presence of methane on lactulose breath testing is associated with constipation-predominant IBS. Antibiotic therapy may be appropriate to treat underlying SIBO in IBS patients. Seventy-five percent improvement of IBS symptoms was reported in a double-blind, placebo-controlled study once antibiotics succeeded in treating bacterial overgrowth. Once a good clinical response and normalization of the lactulose breath test are achieved, a prokinetic agent may be used to stimulate phase III of interdigestive motility to delay relapse of bacterial overgrowth.
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PMID:Bacterial concepts in irritable bowel syndrome. 1771 56

The importance of oseltamivir as a strategy for the treatment of influenza has been recognized; however, the risk of acute hemorrhagic colitis should be considered, although it is rare. This report describes a case of acute hemorrhagic colitis in a 61-year-old Japanese man after the oral administration of oseltamivir for influenza A. A definitive diagnosis of influenza A was made using a rapid diagnosis kit. Abdominal pain, diarrhea, and hematochezia occurred the day after the first administration of oseltamivir (The patient had taken two capsules of oseltamivir). Endoscopic examination revealed extensive acute hemorrhagic colitis. Histopathological examination of the colonic mucosa revealed small atrophic glands with partial deciduation of the epithelium and a decrease in the number of goblet cells. Hemorrhage and mild infiltration of inflammatory cells were observed as well. These changes were suggestive of an ischemic change. A culture test showed normal flora.
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PMID:Acute hemorrhagic colitis associated with oral administration of oseltamivir for the treatment of influenza A. 1772 91

Sudden fatal cases of influenza B infection in a 4-year-old girl and a 2-year-old boy are presented. Both children complained of abdominal pain without respiratory, neurologic or cardiac symptoms; additionally the girl had vomiting within 2 days of death. Autopsy revealed histological changes in the respiratory system consistent with a viral infection. Influenza B infection was identified by immunohistochemistry in the girl and real-time polymerase chain reaction in the boy. Additional testing including cultures, toxicology, and screening for metabolic disorders were negative. These cases illustrate the usefulness of viral testing, especially for influenza, in the medical legal autopsy of children even when the classic respiratory symptoms of flu are lacking.
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PMID:Sudden death in toddlers caused by influenza B infection: a report of two cases and a review of the literature. 1827 59

Infective abdominal aortic aneurysms due to Haemophilus influenza are rarely reported. We report a case in a 65 year old female presenting with abdominal pain, weight loss, pyrexia and elevated inflammatory markers. The patient was found to have an abdominal aortic aneurysm clinically and on CT scanning. At surgery, an inflammatory aneurysm was successfully repaired using an autogenous vein panel-graft. Tissue samples were analysed using the polymerase chain reaction, identifying H. influenza as the causative organism. H. influenza is a scarcely reported cause of infective aortic aneurysms. The mechanism of infection is unknown. Reference is made to existing reports of such infection.
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PMID:Infective abdominal aortic aneurysm due to Haemophilus influenza identified via the polymerase chain reaction. 1835 90

Influenza A/H5N1 infection has become the major emerging infectious disease of global concern again since late 2003. A history of exposure to dead or sick poultry or wild birds occurs in over 60% of cases of human H5N1 infection. The incubation period of avian-to-human transmission is generally between 2 and 5 days and the median duration of symptoms before hospitalization is about 4.5 days. The clinical spectrum has ranged from asymptomatic infection or mild influenza-like illness to severe pneumonia and multi-organ failure. Fever > 38 degrees C, cough and dyspnoea are the major symptoms on presentation, whereas gastrointestinal symptoms such as watery diarrhoea, vomiting and abdominal pain are common early in the course of the disease. In contrast, upper respiratory tract symptoms are less prominent in human H5N1 infection when compared to seasonal influenza. Laboratory features of human H5N1 infection include leucopoenia, especially lymphopenia, elevated amino-transaminases, thrombocytopenia, prolonged prothrombin time and activated partial thromboplastin time, increased D-Dimer, increased serum lactate dehydrogenase and creatinine phospho-kinase, and hypoalbuminemia. A low absolute lymphocyte count on admission is associated with more severe disease and death. Radiographic abnormalities include multi-focal airspace consolidation, interstitial infiltrates, patchy or lobar involvement, with rapid progression to bilateral and diffuse ground-glass opacities consistent with ARDS. However, none of the clinical, laboratory and radiographic features are specific to H5N1 infection. A detailed exposure history needs to be elicited, including any close contact with sick or dead poultry, wild birds, other severely ill persons, travel to an area with A/H5N1 activity or work in laboratory handling samples possibly containing A/H5N1 virus.
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PMID:Review of clinical symptoms and spectrum in humans with influenza A/H5N1 infection. 1836 21

A 63-year-old male was admitted to our hospital with diabetic ketoacidosis. He had flu-like symptoms 10 days before admission and developed thirst, polyuria and anorexia with 9 kg of body weight loss in a week. Plasma glucose level on admission was 983 mg/dL and HbA1c was 7.5%. Despite high levels of serum pancreatic enzymes, lack of severe abdominal pain and no morphological change of pancreas in the abdominal CT scan eliminated the complication of classical acute pancreatitis. These findings suggested the diagnosis of fulminant type 1 diabetes. However, urinary and plasma C-peptide levels showed that insulin secretion was not completely depleted at onset. Furthermore, an examination of islet-related antibodies revealed the presence of high titer anti-GAD antibody. His HLA typing showed that DRB1*0901-DQB1*0303 and A24 were present. He has been doing well with continuation of insulin therapy. Over two years after onset, his plasma C-peptide level was gradually lowered, and anti-GAD antibody was still positive. Taken together, this is a rare case of abrupt onset autoimmune type 1 diabetes with transient but apparent exocrine pancreatic impairment at onset. Similar cases should be accumulated to clarify pathophysiological similarities and/or differences between fulminant type 1 diabetes and abrupt onset autoimmune type 1 diabetes.
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PMID:A case of abrupt onset autoimmune type 1 diabetes mimicking fulminant type 1 diabetes. 1968 7


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