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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Ludwig Lung Cancer Study Group aims to investigate the role of immunotherapy as adjuvant treatment modality in operable non-small cell bronchial carcinoma. The participants are 12 european clinics and institutes. With a proven accrual of 350 patients per year the group offers a sharp tool in clinical oncology with regards to bronchial carcinoma. The accrual phase of the first trial was closed on February 2, 1979 with 475 patients, starting a new protocol on February 5, 1979. The ongoing randomized clinical trial aims to determine if intrapleural administration of corynebacterium parvum (c. p.) can increase the tumor recurrence-free interval or increase survival. Furthermore the study aims to identify high and low risk patient subgroups after biological and immunological investigations. The possibility of giving c. p. intrapleurally in humans was investigated in a phase-I-toxicity study. A dose of 7 mg has been adopted for the clinical trial since this dose combines a measureable systemic effect (increase of leucocyte and monocyte counts) with acceptable toxicity. The main morbidity was fever, flu-like symptoms and chest pain.
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PMID:[Hematological observations in patients following immunostimulation through intrapleural application of Corynebacterium parvum]. 23 58

A large outbreak of haemorrhagic fever (subsequently named Ebola haemorrhagic fever) occurred in southern Sudan between June and November 1976. There was a total of 284 cases; 67 in the source town of Nzara, 213 in Maridi, 3 in Tembura, and 1 in Juba. The outbreak in Nzara appears to have originated in the workers of a cotton factory. The disease in Maridi was amplified by transmission in a large, active hospital. Transmission of the disease required close contact with an acute case and was usually associated with the act of nursing a patient. The incubation period was between 7 and 14 days. Although the link was not well established, it appears that Nzara could have been the source of infection for a similar outbreak in the Bumba Zone of Zaire.In this outbreak Ebola haemorrhagic fever was a unique clinical disease with a high mortality rate (53% overall) and a prolonged recovery period in those who survived. Beginning with an influenza-like syndrome, including fever, headache, and joint and muscle pains, the disease soon caused diarrhoea (81%), vomiting (59%), chest pain (83%), pain and dryness of the throat (63%), and rash (52%). Haemorrhagic manifestations were common (71%), being present in half of the recovered cases and in almost all the fatal cases.Two post mortems were carried out on patients in November 1976. The histopathological findings resembled those of an acute viral infection and although the features were characteristic they were not exclusively diagnostic. They closely resembled the features described in Marburg virus infection, with focal eosinophilic necrosis in the liver and destruction of lymphocytes and their replacement by plasma cells. One case had evidence of renal tubular necrosis.Two strains of Ebola virus were isolated from acute phase sera collected from acutely ill patients in Maridi hospital during the investigation in November 1976. Antibodies to Ebola virus were detected by immunofluorescence in 42 of 48 patients in Maridi who had been diagnosed clinically, but in only 6 of 31 patients in Nzara. The possibility of the indirect immunofluorescent test not being sufficiently sensitive is discussed.Of Maridi case contacts, in hospital and in the local community, 19% had antibodies. Very few of them gave any history of illness, indicating that Ebola virus can cause mild or even subclinical infections. Of the cloth room workers in the Nzara cotton factory, 37% appeared to have been infected, suggesting that the factory may have been the prime source of infection.
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PMID:Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team. 30 55

A case report of mesenteric venous thrombosis with small bowel infarction in a 38-year-old woman who had been taking oral contraceptives is reported. The patient was admitted complaining of severe abdominal pain and vomiting for 36 hours. On admission, temperature was 37.5 degrees C and pulse 120/minute. Abdominal rigidity and left-sided abdominal tenderness were present. X-ray of the abdomen showed 2 distended loops of small bowel and 3 fluid levels. Serum amylase was normal. White cell count was 10,000/cu mm. There was a history of abdominal pain and diarrhea over a period of several years. For 6 months she had been taking Ovulen (mestranol .1 mg and ethynodiol diacetate .5 mg) for menstrual irregularity. 2 weeks earlier she had suffered an influenzalike illness with pleuristic chest pain, loin pain, urinary frequency, and dysuria. Chest X-ray and intravenous pylography were then reported as normal. At immediate operation, a 15 cm segment of ileum was found to be infarcted. Semipurulent fluid was present in the abdomen and areas of fibrinous peritonitis were observed. The involved segment of ileum was resected. A small thrombus was extracted from a mesenteric vein. Initial postoperative course was good but 3 days after operation chest pain, dyspnea, and giddiness developed and cardiac arrest followed. Resuscitation was successful. Pulmonary angiography then showed thrombi in all branches of the pulmonary artery. After heparin therapy symptoms improved and the patient left the hospital in 2 weeks, her condition being stabilized with warfarin and dipyridamole (Persantin). The diagnosis was confirmed by histological examination. Early recanalization of a mesenteric vein was noted. Other reported cases have shown an average prodromal phase of 4 or 5 days. The long-term diarrhea was considered as not connected with the present illness but the presumed influenza illness 2 weeks earlier may have been due to a pulmonary embolism. Of reported cases, 5 of 13 have died. Early diagnosis, prompt surgery, and heparin therpay are considered important.
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PMID:Mesenteric venous thrombosis associated with oral contraceptives: a case report. 106 70

Jurors on criminal trials carry a considerable burden of responsibility. They determine the defendant's fate. Additionally, during trials they can be exposed to stressful, frightening, and sordid aspects of life. The stressfulness varies depending upon the nature of the trial, its length, the nature of the testimony and evidence, the jurors' interpersonal relationships, the difficulty establishing guilt or innocence, the public's attitude, etc. These experiences can create psychological and/or physical discomfort that can be transient and mildly or moderately intense, or more serious and constitute illness. The authors have studied juries of four criminal trials--two murder cases, one child abuse case, and one obscenity case. Forty jurors were interviewed. Twenty-seven had one or more discomforting physical and/or physiological symptoms. These involved gastrointestinal distress (10 jurors); generalized nervousness (4 jurors); heart palpitation (6 jurors); headaches (4 jurors); sexual inhibitions (4 jurors); depression (4 jurors); anorexia (4 jurors); faintness (2 jurors); and numbness, lump in throat, chest pain, hives, and flu (1 juror each). Seven of the jurors became clearly ill. Illnesses included: peptic ulcer reactivation and hives, phobic reaction, anxiety state and increased alcohol use, hypertensive episode and visual scotomata, sexual inhibition, chills, fever, and depression, and post-traumatic stress disorder.
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PMID:The occupational hazards of jury duty. 142 62

A 55-year-old Japanese woman was admitted to our hospital, complaining of flu-like symptoms and left-sided chest pain. Her chest X-ray films revealed a solitary coin lesion in the left middle lung field. She had traveled to California and Arizona 3 months before being taken ill. Because of negative result in sputum cytology and trans-bronchial lung biopsy examination, open lung biopsy and wedge resection was performed. Histological examination revealed endosporulating spherules in a caseous lesion of the epithelioid granulomas, and fungal cultures demonstrated barrel-shaped arthropores. Pulmonary coccidioidomycosis was diagnosed. Coccidioidomycosis is a rare fungal disease found in certain endemic areas in the southwestern region of the United States. She had been infected during her travels in America, and this is the second case in Japan who had taken surgical intervention for pulmonary coccidioidomycosis.
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PMID:[A case of pulmonary coccidioidomycosis]. 194 May 30

Coccidioides immitis is the cause of coccidioidomycosis, the fungus has been found extensively in the Southwestern United States, and Mexico, and certain areas of Central and South America. Some climatic conditions, such as hot summers with little winter frost, combined with arid, alkaline soils produce ideal circumstances for preservation of the arthroconidia. Children and other human groups are infected by dustbone arthroconidia or by contact with infected soils. There has been limited epidemics of infantile coccidioidomycosis, however, only very few have been verified as to the source of the outbreak by the soil-culture of the fungus. The primary pulmonary infection is usually asymptomatic, but it may resemble influenza with cough, fever, and chest pain. Chronic pulmonary lesions are rare in children. Erythema multiforme an erythema nodosum have been described, namely in females. Arthralgias occurs in some patients. The disseminated form is similar to tuberculosis with lungs, lymph nodes, bones, joints, abdominal organs and skin being the frequently affected sites. Meningitis and limited dissemination to one of few sites is more common in mexican children than adults. Serologic tests are very useful in moderate to severe illnesses. Precipitins can be easily detected by immunodifusion. Higher and persistent complement fixation titers are observed in severe and disseminated infection. Conversion of a skin test with coccidioidin or spherulin from negative to positive strongly suggest coccidioidomycosis. Most cases do not require treatment, but amphotericin B or ketoconazol, are the standard therapy in severe pulmonary disease or disseminated forms, and surgery has been advocated for localized, persistent or drug-resistant, progressive lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Coccidioidomycosis in children]. 266 35

Recombinant gamma interferon (r-GIFN) demonstrates in vitro and in vivo characteristics that contrast with those of alpha and beta interferons. It has relatively weak antiviral properties, yet relatively potent immunomodulatory effects. A phase I trial was performed with r-GIFN (specific activity 2.6 X 10(6) IU/mg protein), administered as a continuous intravenous (IV) infusion over 24 hours for five days (Cl X 5) and repeated every 28 days. This schedule was chosen based on the short half-life of r-GIFN in animal systems and the in vitro augmentation of biologic effects with continuous exposure to interferons. Twenty-one patients with refractory solid tumors received 46 evaluable courses of therapy. The dose-limiting toxicities included fever, flu-like symptoms, cardiovascular toxicity, and neurotoxicity. The cardiovascular toxicity included hypotension and one episode of cardiac ischemia with chest pain. Neurotoxicity consisted of lethargy and confusion. These toxicities were reversible, and although dose-limiting, occurred sporadically throughout all dosage levels. Mild to moderately severe non-dose-limiting toxicities included nausea and vomiting, leukopenia, and liver function abnormalities. Other infrequent toxicities included hypocalcemia, diarrhea, constipation, and alopecia. The maximally tolerated dose of r-GIFN on this schedule is 0.5 X 10(6) IU/m2/d. Partial responses were seen in one patient with metastatic melanoma and in one patient with renal cell carcinoma. Toxicity and antitumor activity were seen at doses where interferon serum levels could not be detected by radioimmunoassay. In addition, the toxicity and antitumor activity seen were at much lower doses than previously described for shorter infusion schedules of other recombinant gamma interferon preparations. Differences in biologic activity of interferon preparations and/or differences in scheduling may account for this variability. Although this study defines a recommended phase II dose of r-GIFN based on the maximally tolerated dose, the optimal therapeutic index may exist at a lower dosage level.
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PMID:A phase I clinical trial of recombinant DNA gamma interferon. 310 84

Four hundred and fifty-three adults in 25 British hospitals entered a prospective study of community-acquired pneumonia. A microbiological diagnosis was established in 67 per cent; Streptococcus pneumoniae (34 per cent). Mycoplasma pneumoniae (18 per cent) and Influenza A virus (7 per cent) were the commonest microorganisms. Our observations support the view that most of those in the microbiologically negative group (33 per cent) had S. pneumoniae infection. In addition to cultures of blood and sputum the most useful initial tests were for sputum pneumococcal antigen and serum mycoplasma specific IgM. Twenty-six patients (5.7 per cent) died, seven within 48 h of admission. Multivariate analyses showed age, absence of chest pain, absence of vomiting, previous treatment with digoxin, tachypnoea, diastolic hypotension, confusion, leucopenia, leucocytosis, and raised blood urea levels were significantly correlated with death. Patients had a 21-fold increased risk of death if they had two of the following: admission respiratory rate greater than or equal to 30/min, admission diastolic BP less than or equal to 60 mmHg, urea greater than 7 mmol/l during admission. Mortality was not related to aetiology except that all three patients with combined Influenza A virus and Staphylococcus aureus infection died. Nine patients had legionella pneumonia; none died. No patients who died from pneumococcal pneumonia, mycoplasma pneumonia or staphylococcal pneumonia had received an appropriate antibiotic before admission. Such deaths are possibly preventable. Assisted ventilation was used in 22 patients of whom 14 survived. Hospital stay in survivors averaged 10.8 days; after six weeks 79 per cent were fit for normal activities, and 55 per cent showed resolution of radiographic signs of pneumonia. We recommend that antibiotics should be given as early as possible and chosen always to cover S. pneumoniae, and in addition M. pneumoniae during outbreaks, and S. aureus during influenza epidemics.
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PMID:Community-acquired pneumonia in adults in British hospitals in 1982-1983: a survey of aetiology, mortality, prognostic factors and outcome. The British Thoracic Society and the Public Health Laboratory Service. 311 95

During an eight-month study, acute serum samples were obtained from all 228 patients admitted with chest pain to a coronary-care unit. On admission a history of a recent influenza-like illness was given by the same proportion (5%) of those subsequently shown to have myocardial infarction, angina, or miscellaneous diagnoses. Myocardial infarction was diagnosed in 105 patients and serum samples were obtained from all of the 93 survivors during convalescence. Sera were also obtained from 99 age and sex matched controls from the same geographical area. Sera from the cases and controls were tested for Coxsackie B antibodies by microneutralisation. In 3 patients with MI and 2 controls significant increases in antibody titre occurred which indicated recent infection. The distribution of type-specific antibodies, geometric mean titres, seropositivity rates, and the prevalence of raised antibody titres were all identical in the cases and the controls. These results do not accord with observations in uncontrolled series which suggested a causal relation between infections with Coxsackie B viruses and myocardial infarction.
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PMID:Coxsackie B virus infections and myocardial infarction. Results from a prospective, epidemiologically controlled study. 610 74

We prospectively studied 110 adult patients coming to Black Lion Hospital between August 1987 and July 1989 with community acquired pneumonia (CAP) for various etiologic agents and clinical and radiographic presentation. Streptococcus pneumoniae was the most common offending pathogen in 72% and 67.5% from sputum and lung aspirate (LA) Gram stain respectively, and in 41% by pneumococcal serotyping of sputum. Blood and LA culture grew Streptococcus pneumoniae in 4 (6%), Staphylococcus aureus in 4 (6%), Enterobacteriaceae in (3%), Pseudomonas, Klebsiella and Streptococcus viridans in one case each. Non-bacterial pathogens included Mycoplasma pneumoniae in 3 (3%), Influenza A in 4 (4%), Influenza B in 3 (3%) and psittacosis/LGV in 4 (4%). Fever, cough, chest pain, tachypnea and coarse crepitations/bronchial breathing were the most common presenting signs and symptoms. Thirty per cent had associated diarrhoea and vomiting initially and 9% had altered state of consciousness at admission. Six patients came in a state of shock. Thirty-nine per cent had underlying illnesses. Ninety-three per cent had either segmental or lobar consolidation. Parapneumonic effusion occurred in 14%. The mortality was 11%. Tachypnea, the presence of underlying illness, altered state of consciousness, extreme leucocytosis and the presence of bilateral and multilobar lung involvement were found to be signs of poor prognosis. Our finding is similar to those from other African countries, except that we are reporting psittacosis/LGV for the first time in Africa.
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PMID:Community acquired pneumonia in adults in Addis Abeba: etiologic agents, clinical and radiographic presentation. 803 77


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