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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Measles is a highly contagious respiratory virus infection, with typical clinical symptoms including maculopapular rash, fever, cough, coryza, and conjunctivitis. Despite implementation of widespread vaccination programs throughout the world, the rates of global morbidity and mortality are still considerable. This study was performed to design a reliable indirect enzyme-linked immunosorbent assay (ELISA) to measure measles-specific immunoglobulin M (IgM). First, human IgM was purified, and then an anti-IgM antibody was produced in rabbits and purified in a multistep process. The rabbit IgG against human IgM was conjugated with peroxidase. Measles virus-infected Vero cells produced viral antigen. One hundred serum samples from infants of 9 to 18 months of age, mostly vaccinated, were evaluated for determining the presence of specific IgM antibodies against measles virus. The samples were also evaluated for neutralizing antibodies against measles virus by a microneutralization test (MNT). By comparing the results of the ELISA with those of MNT, it was demonstrated that ELISA had a sensitivity and specificity of 100 and 92%, respectively. On the other hand, when the results obtained by our ELISA system were compared with those of an imported measles virus IgM ELISA kit (EIAgen; Adaltis Italia SPa, Bologna, Italy), a high level of agreement was shown (k = 0.926).
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PMID:Development of an enzyme-linked immunosorbent assay for immunoglobulin M antibodies against measles virus. 1273 45

Since the 1960's, CS has become the main riot control agent in use by police and army forces throughout the world. The first post-exposure symptom is a burning sensation in the eyes, nose and throat. At a later stage, lacrimation, rhinorrhea, conjunctivitis, sore throat and salivation appear. These symptoms are followed by chest pain and dry cough, and if the substance is swallowed, it may cause nausea and vomiting. This article reviews the physical properties of CS, the main dispersing techniques, the clinical signs and symptoms of exposure, including information on mutagenicity, carcinogenesis, pregnancy safety, and will introduce guidelines for treatment after exposure.
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PMID:[Medical aspects of the lacrimator CS]. 1285 35

Acute human immunodeficiency virus (HIV) seroconversion illness is a difficult diagnosis to make because of its nonspecific and protean manifestations. We present such a case in an adolescent. A 15-year-old boy presented with a 5-day history of fever, sore throat, vomiting, and diarrhea. The patient also reported a nonproductive cough, coryza, and fatigue. The patient's only risk factor for HIV infection was a history of unprotected intercourse with 5 girls. Physical examination was significant for fever, exudative tonsillopharyngitis, shotty cervical lymphadenopathy, and palpable purpura on both feet. Laboratory studies demonstrated lymphopenia and mild thrombocytopenia. Hemoglobin, serum creatinine, and urinalysis were normal. The following day, the patient remained febrile. Physical examination revealed oral ulcerations, conjunctivitis, and erythematous papules on the thorax; the purpura was unchanged. Serologies for hepatitis B, syphilis, HIV, and Epstein-Barr virus were negative. Bacterial cultures of blood and stool and viral cultures of throat and conjunctiva showed no pathogens. Coagulation profile and liver enzymes were normal. Within 1 week, all symptoms had resolved. The platelet count normalized. Repeat HIV serology was positive, as was HIV DNA polymerase chain reaction. Subsequent HIV viral load was 350 000, and the CD4 lymphocyte count was 351/mm3. HIV is the seventh leading cause of death among people aged 15 to 24 in the United States, and up to half of all new infections occur in adolescents. Our patient presented with many of the typical signs and symptoms of acute HIV infection: fever, fatigue, rash, pharyngitis, lymphadenopathy, oral ulcers, emesis, and diarrhea. Other symptoms commonly reported include headache, myalgias, arthralgias, aseptic meningitis, peripheral neuropathy, thrush, weight loss, night sweats, and genital ulcers. Common seroconversion laboratory findings include leukopenia, thrombocytopenia, and elevated transaminases. The suspicion of acute HIV illness should prompt virologic and serologic analysis. Initial serology is usually negative. Diagnosis therefore depends on direct detection of the virus, by assay of viral load (HIV RNA), DNA polymerase chain reaction, or p24 antigen. Both false-positive and false-negative results for these tests have been reported, further complicating early diagnosis. Pediatricians should play an active role in identifying HIV-infected patients. Our case, the first report of acute HIV illness in an adolescent, emphasizes that clinicians should consider acute HIV seroconversion in the appropriate setting. Recognition of acute HIV syndrome is especially important for improving prognosis and limiting transmission. It is imperative that we maintain a high index of suspicion as primary care physicians for adolescents who present with a viral syndrome and appropriate risk factors.
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PMID:Acute human immunodeficiency virus syndrome in an adolescent. 1452 19

We conducted a survey to determine the accuracy of the clinical diagnosis of measles in Zimbabwe. Between December 1996 and February 1997, we collected blood samples and clinical and demographic information from a sample of 105 children with a clinical diagnosis of measles. A clinical case of measles was defined as a person with a history of fever, rash for three or more days, and either cough, coryza, or conjunctivitis. A laboratory-confirmed case of measles or rubella had IgM antibodies against measles virus or rubella virus respectively. A total of 91% of children met the clinical case definition. Among those who met the clinical case definition for measles, 72% were IgM-positive for measles virus only, 23% were IgM-positive for rubella virus only, 3% were IgM-positive for both measles and rubella viruses, and 2% were IgM-negative for both viruses. This study demonstrates the importance of considering selective laboratory confirmation of measles in periods of high disease incidence when the effectiveness of the vaccine is questioned.
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PMID:Negative impact of clinical misdiagnosis of measles on health workers' confidence in measles vaccine. 1497 83

An accurate system of identifying and classifying suspected measles cases is critical for the measles surveillance system in the United States. To examine the performance of the clinical case definition in predicting laboratory confirmation of suspected cases of measles, we reviewed 4 studies conducted between 1981 and 1994. A clinical case definition was examined that included a generalized maculopapular rash, fever (>or=38.3 degrees C, if measured), and either a cough, coryza, or conjunctivitis. Serological confirmation of measles was done either by hemagglutination inhibition assay, complement fixation assay, or enzyme immunoassays. The positive predictive value of the clinical case definition decreased from 74% to 1% as incidence decreased from 171 cases/100000 population to 1.3 cases/100000 population. Sensitivity was high, and for the larger studies with the most precise estimates, sensitivity was 76%-88%. The low positive predictive value of the clinical case definition in settings of low incidence demonstrates that serological confirmation is essential to ensure an accurate diagnosis of measles when measles is rare.
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PMID:Evaluation of the measles clinical case definition. 1510 4

This study was designed to evaluate the effects of furniture production, mainly including fir tree (aberia mulleriana), on respiratory health of young workers and to compare the results with those obtained from previous studies. Sixty-four furniture-decoration students (57 males and 7 females) and 62 controls (54 male, 8 female) from different departments in the same school were included into the study. All participants were assessed with a questionnaire (concerning history of occupational exposure, work-related respiratory and other symptoms, smoking history, previous asthma history), full physical examination, spirometric evaluation and chest radiograph. Participants then performed serial monitoring of peak expiratory flow rates (PEFR) at work and away from work within a month. Mean age of students was 20.9 +/- 3.7 years, 20.5 +/- 2.6 years in controls. There was no difference between study and control groups with regard to age, gender, smoking status and previous asthma history. Reported cough (23.4 % vs. 8.1 %) and shortness of breath (18.8 % vs. 6.5 %) were significantly higher in furniture-decoration students than in controls (p = 0.016 and p = 0.034, respectively). Furniture-decoration students had higher conjunctivitis (34.4 % vs. 9.7 %, p = 0.001) and rhinitis (34.4 % vs. 19.4 %, p = 0.044) history when compared with controls. Both students and controls were normal in terms of respiratory examination. PEF recordings were performed for approximately one month. Diurnal variability greater than 20 % was seen in 12/64 (18.7 %) of students at work, whereas it was detected in 4/62 (6.4 %) of controls (p = 0.034). When comparing for the presence of diurnal variability greater than 20 % in weekends, no difference was found between groups (p = 0.457). In conclusion, early detection of work-related respiratory changes by serial monitoring of peak expiratory flows should save the workers from hazardous respiratory effects of the furniture production, especially in young population.
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PMID:Respiratory symptoms and peak expiratory flow rates among furniture-decoration students. 1523 93

Dominant mutations in the CIAS1 gene cause a spectrum of autoinflammatory diseases such as familial cold autoinflammatory syndrome, FCAS, which is characterized by episodes of urticaria, arthralgia, fever and conjunctivitis after generalized exposure to cold. We here describe patients of two German families with the 592G-->A, V198M mutation, which has been described to induce FCAS before. However, in our patients the clinical phenotype was very different from this disease. They never had urticaria, cold induced fever or conjunctivitis; instead the following symptoms occurred: Very regular periodic fever, irregular severe febrile episodes, relatively mild arthralgia, dry cough, cardiomyopathy, nephropathy and euthyroid thyroiditis all being reversible. We conclude that the clinical phenotype associated with mutations in the CIAS1 gene is much broader than assumed before.
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PMID:Periodic fever, mild arthralgias, and reversible moderate and severe organ inflammation associated with the V198M mutation in the CIAS1 gene in three German patients--expanding phenotype of CIAS1 related autoinflammatory syndrome. 1524 11

The aim of the study was to examine criteria for ill children in child-care centers. A questionnaire on practices of exclusion/return of children according to specific signs and symptoms was mailed to the directors of care centers in central Israel. Thirty-six of the 60 questionnaires (60%) were returned by mail and the reminded were completed in personal visits to the CCCs achieving a response rate of 100%. About half (51.7%) used "common sense" and "personal feelings" to exclude children and to allow their return, and 29 (48.3%) used the guidelines of the Ministries of Education and Health or other authorities. The percentage of centers excluding children by signs/symptoms was as follows: high fever (>38 degrees C), 100%; low-grade fever, 76.7%; asthma exacerbation, 80.0%; heavy cough, 75.0%; eye discharge or conjunctivitis, 83.3%; diarrhea and vomiting more than twice per day, 100%; rash, 72.3%; otalgia, 46.7%; and infected skin lesion, 66.7%. Only four centers excluded children with head lice. Most centers required a physician's note on return of a child after high fever (76.7%), eye discharge or conjunctivitis (48.3%), and from 75 to 80%, respectively, for frequent vomiting and bloody or mucinous diarrhea. The results show that exclusion practices among child-care centers (CCCs) vary widely, suggesting the need for the establishment of a uniform exclusion and return policy in Israel, with distribution of clear, up-to-date guidelines on the prevention and control of communicable diseases to all day-care centers. In a simple way, this study identified attitudes concerning the exclusion/return of sick children in CCCs and was useful for the discussion of the related policy with CCCs responsible and national health and educational authorities.
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PMID:Exclusion of ill children from child-care centers in Israel. 1559 Feb 28

Measles is the most contagious of the childhood exanthems and is the leading cause of vaccine-preventable deaths in children, mostly in developing countries. The prodromal stage, consisting of high fever and the triad of cough, coryza, and conjunctivitis, is followed by a caudal progressing rash over a period of 2 to 3 days. With a worldwide vaccination program in place, mortality and morbidity have decreased substantially. Receipt of the live attenuated vaccine generally causes no or only mild side effects such as a low-grade fever and a subtle rash. We report a 1-year-old boy who, 10 days after vaccination, developed vaccine measles which was clinically indistinguishable from the natural disease. Vaccine virus was detected by polymerase chain reaction in the patient's nasopharyngeal secretions.
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PMID:Vaccine-associated "wild-type" measles. 1580 1

This study describes an epizootic of respiratory tract disease caused by influenza virus infection in a large population of equines in Luxor and Aswan, Upper Egypt, during the winter of 2000. The epizootic started in January and the infection rate reached its peak in February before gradually decreasing until the end of April, 2000. Horses, donkeys and mules of all ages and both sexes were affected. Free movement of the infected equines and direct contact between the animals at markets facilitated the rapid spread of the disease. The cause of the epizootic was established by use of serological testing and the identification of the influenza virus in nasal secretions. Egg inoculation and the haemagglutination test were used to detect the influenza virus. Both haemagglutination inhibition (HI) and agar gel precipitation tests were performed to identify the isolated influenza virus using reference antisera against A/Equi-1 (H7N7) and A/Equi-2 (H3N8). Antibodies against the equine influenza virus were demonstrated in 416 (95.6%) out of 435 collected sera using the HI test. High rectal temperature, inappetence, conjunctivitis, redness of nasal mucosa, a serous to mucopurulent nasal discharge and a harsh dry cough were the most common clinical manifestations. Stress factors, such as using equines for heavy transportation and drawing, precipitated the onset of the disease, intensified the clinical syndrome, delayed recovery and facilitated secondary bacterial infection. The present study suggested that the absence of a vaccination programme against equine influenza was one of the principal causes of the spread of infection during this outbreak. In conclusion, the implementation of a national equine influenza vaccination programme, using an effective updated vaccine, is essential in Egypt.
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PMID:An epizootic of equine influenza in Upper Egypt in 2000. 1586 87


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