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

Clinical and laboratory data on severe acute respiratory syndrome (SARS), particularly on the temporal progression of abnormal laboratory findings, are limited. We conducted a prospective study on the clinical, radiologic, and hematologic findings of SARS patients with pneumonia, who were admitted to National Taiwan University Hospital from March 8 to June 15, 2003. Fever was the most frequent initial symptom, followed by cough, myalgia, dyspnea, and diarrhea. Twenty-four patients had various underlying diseases. Most patients had elevated C-reactive protein (CRP) levels and lymphopenia. Other common abnormal laboratory findings included leukopenia, thrombocytopenia, and elevated levels of aminotransferase, lactate dehydrogenase, and creatine kinase. These clinical and laboratory findings were exacerbated in most patients during the second week of disease. The overall case-fatality rate was 19.7%. By multivariate analysis, underlying disease and initial CRP level were predictive of death.
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PMID:Clinical manifestations, laboratory findings, and treatment outcomes of SARS patients. 1520 Aug 14

Influenza viruses from chickens (H5N1) have caused outbreaks in children from both Vietnam and Thailand in 2004. All infected patients presented with fever and cough. Striking laboratory findings included leukopenia and thrombocytopenia. All children who developed progressive pneumonia with acute respiratory distress syndrome died. However, very few children received antiviral therapy.
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PMID:Avian influenza virus infection of children in Vietnam and Thailand. 1529 39

Docetaxel (75 mg m(-2) 3-weekly) is standard second-line treatment in advanced non-small-cell lung cancer (NSCLC) with significant toxicity. To verify whether a weekly schedule (33.3 mg m(-2) for 6 weeks) improved quality of life (QoL), a phase III study was performed with 220 advanced NSCLC patients, < or =75 years, ECOG PS < or =2. QoL was assessed by EORTC questionnaires and the Daily Diary Card (DDC). No difference was found in global QoL scores at 3 weeks. Pain, cough and hair loss significantly favoured the weekly schedule, while diarrhoea was worse. DDC analysis showed that loss of appetite and overall condition were significantly worse in the 3-week arm in the first week, while nausea and loss of appetite were more severe in the weekly arm in the third week. Response rate and survival were similar, hazard ratio of death in the weekly arm being 1.04 (95% CI 0.77-1.39). A 3-weekly docetaxel was more toxic for leukopenia, neutropenia, febrile neutropenia and hair loss; any grade 3-4 haematologic toxicity was significantly more frequent in the standard arm (25 vs 6%). The weekly schedule could be preferred for patients candidate to receive docetaxel as second-line treatment for advanced NSCLC, because of some QoL advantages, lower toxicity and no evidence of strikingly different effect on survival.
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PMID:A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL 01 study. 1555 71

The authors present a case of a 26-year-old man, under investigation for Cushing syndrome, who presented acutely with a dry cough and fever. The blood tests were unremarkable apart from a moderate to severe leukopenia. Imaging tests were suggestive of an atypical pneumonia, which was proven to be Pneumocystis carinii pneumonia (PCP) on cytology examination of a bronchoalveolar lavage (BAL). The acute lung changes were demonstrated on a whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) study. After treatment, a follow-up study showed complete resolution of these changes. The authors suggest that FDG PET may have a role to play in the diagnosis and, in particular, the monitoring of PCP in immunocompromised patients.
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PMID:FDG-PET imaging in Pneumocystis carinii pneumonia. 1616 46

The aim of this study was to evaluate the clinical, epidemiological and demographical features of adult measles cases admitted to our hospital, during the measles epidemic which emerged in Europe and in our country in the year 2001. A total of 35 adult measles cases (10 male, 25 female) ages between 16-36 (mean age: 23.1 +/- 4.6) years were detected between January and June 2001. The diagnosis was based on the clinical findings, however only 11 of the cases could be serologically confirmed with the presence of measles IgM antibody positivities. Fever (91.4%), cough (94.3%) and conjunctivitis (77.1%) were the most common symptoms. All of the patients had maculopapular rash, and the presence of Koplik spots, lymphadenopathy and hepatomegaly were observed in 77.1%, 57.1%, and 5.7% of patients, respectively. Leukopenia and elevated liver enzymes were detected in 28.5% and 37.2% of the patients, respectively. Pneumonia was the most common complication which was seen in 20% of the patients. Of the cases 2.9% exhibited otitis media and 17.1% diarrhea. Spontaneous abortus occurred in one of the three pregnant women. In conclusion, measles is still an important public health problem in our country, and since it may lead to severe complications and economic and labor loss, an effective elimination programme should be obtained by the use of vaccine in two doses and effective strategies for the immunization of the target populations.
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PMID:[Evaluation of 35 adult measles cases detected in a measles outbreak]. 1742 55

The aim of this study was to assess morbidity and the incidence of adverse effects during interferon (IFN)-alpha-2a treatment of patients with chronic hepatitis B. This prospective study included 48 consecutive patients with chronic hepatitis B who underwent IFN-alpha-2a treatment from January 2003 to August 2005. Adverse effects related to IFN treatment were recorded during this period and for 6 mo after treatment. Adverse effects that led to dose reduction or early discontinuation of IFN treatment were examined. Complete response was reported in 25% of patients. At least 1 adverse effect was documented in 88% of patients. Flu-like symptoms were the most frequently observed adverse effects (88%), and thrombocytopenia (63%), leukopenia (54%), and anemia (23%) were also reported. Bleeding occurred in 2 patients. Other adverse effects included neuropsychiatric signs (21%), alopecia (19%), weight loss (17%), thyroid disorders (19%), menstrual cycle irregularities (8%), skin lesions (8%), and dry cough (4%). Adverse effects that led to dose reduction or early discontinuation of IFN treatment occurred in 19% of patients and included impotence, depression, seizure, thyroid disorders, severe thrombocytopenia, and intestinal bleeding. These effects were found to be unrelated to treatment response. No relationship was detected between patient age, duration of treatment, and adverse effects of IFN. Although IFN-alpha-2a treatment induced various adverse effects in patients with chronic hepatitis B, most of these effects were reversible or could be ameliorated. Adverse effects that led to dose reduction or early discontinuation of IFN treatment were found to be unrelated to complete response.
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PMID:Adverse effects of high-dose interferon-alpha-2a treatment for chronic hepatitis B. 1802 21

A 51-year-old previously healthy man, an ex-smoker, was admitted to the authors' medical department with a 3-month history of dry cough; intermittent fever; painless, ulcerated cutaneous lesions over the trunk and limbs (Figure 1); and progressive weight loss. He was of Greek descent. His medical history was remarkable for nasal polyps, which were surgically removed 15 years earlier. Initially, he had been treated with antibiotics, without improvement. Several days before admission, chest radiography revealed pulmonary infiltrates in the left lower lobe. On admission, physical examination revealed a well-orientated man in mild distress, with inspiratory rhonchi at the lower part of the left lung and scattered erythematous nodules of variable size, some of which were ulcerated. Laboratory values were notable for leukopenia, 3.3 x 10(9)/L; total protein, 5.9 g/dL; globulin, 2.2 g/dL; serum glutamic oxaloacetic transaminase, 86 IU/L; serum glutamic pyruvic transaminase, 71 IU/L; and lactate dehydrogenase, 519 U/L. Computed tomograph (CT) of the chest showed multiple alveolar opacities bilaterally (Figure 2). Fiberoptic bronchoscopy did not reveal any important pathologic findings. Results of bronchial biopsy, cytology of bronchoalveolar lavage, washing, brushing, and sputum following bronchoscopy were negative. CT of the brai and sinonasal area revealed an abnormal low-density mass in the left nasal area. CT findings of the abdomen were negative, as were results of a bone marrow biopsy. There was no evidence of immunosuppression. The differential diagnosis, considering the evidence described, included granulomatous or infectious diseases, angiocentric lymphoproliferative lesions, and lymphomas. Biopsy of a skin lesion showed lymphoproliferative infiltration of the dermis with a follicular and angiocentric growth pattern and regional epidermal necrosis. Immunohistochemical stains showed that the tumor cell were positive for CD56 and CD3 (cytoplasmic positivity) and expressed the cytotoxic proteins T-cell intracellular antigen and granzyme B (Figure 3) They lacked TdT, CD34, CD7, CD8, TCL-1, and CD123. Findings from an in situ hybridization study for Epstein-Barr virus were negative. Give this result, molecular analysis ofT-cell receptor (TCR) gene rearrangements was performed using polymerase chain reaction-based TCR-gamma gene, wit negative results. The morphology and the immunophenotype were consistent with natural killer/T-cell lymphoma, nasal-type. Nasal involvement must be first excluded to proceed to the diagnosis of nasal-type natural killer-cell lymphoma. Indeed, histologic examination of the nasal mass revealed its polypoid nature. Thus, the authors were led to the diagnosis of extranodal extranasal natural killer/T-cell lymphoma, nasal-type, CD56-positive, Ep stein-Barr virus-negative, TCR-negative. The patient received combination chemotherapy and completed 4 cycles of cyclophosphamide, doxorubicin vincristine, and prednisone every 14 days for 2 months. Skin lesions improved, and there was no fever soon after the initiation of therapy. Reevaluatio after the fourth cycle, however, disclosed pulmonary infiltrations as well as leukemic infiltration of the central nervous system. The patient had receive systemic salvage chemotherapy and intrathecal infusions of methotrexate. Although the lung lesions had diminished at that time, the patient develope paraplegia, his clinical course rapidly deteriorated, and he eventually died.
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PMID:Extranodal natural killer/T-cell lymphoma, nasal-type. 2083 28

Since its first recognition, the 2009 pandemic influenza A (H1N1) virus rapidly spread worldwide. We observed the clinical characteristics of 167 hospitalized patients who were confirmed by testing pharyngeal or nasopharyngeal swabs with the use of a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay. The mean age of the 167 hospitalized patients was 4.1 years, and 58.7% were male. The most common symptoms and signs were fever (91.6%), cough (82.6%), pharyngeal congestion (95.2%), and swollen tonsils (34.1%). The major complications were bronchitis (19.2%), bronchial pneumonia (10.8%), neutropenia (49.7%), and leukopenia (38.9%). The duration of hospitalization, fever and the course of disease in the patients who were treated with oseltamivir were shorter than in those who were treated with ribavirin. All of the patients fully recuperated from the 2009 epidemic influenza A (H1N1) infection with one exception.
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PMID:Clinical features of 167 children with the novel influenza A (H1N1) virus infection in Xi'an, China. 2273 94

We studied cases of visceral leishmaniasis (VL) over a 2-year period among immunocompetent patients who presented to a rural medical college in West Bengal, India to determine a clinical and hematological profile among these patients. We studied a total of 36 cases of VL; the male to female ratio of the cases was 1.6:1 and the mean age was 20.1+/-11.1 years. A detailed history, physical examination, hemogram, bone marrow or splenic aspiration and chest x-ray were conducted on all cases. A CT-scan of the thorax and fiberoptic bronchoscopy were performed in selected cases. Fever and splenomegaly were present in all cases. Weakness, abdominal pain, bleeding, and hepatomegaly were seen in 63.9, 27.8, 8.3 and 58.3% of cases, respectively. Pancytopenia, bicytopenia, leukopenia and thrombocytopenia were seen in 58.3, 41.7, 61.1 and 83.3% of cases, respectively. Five patients (13.9%) had cough, 2 (5.6%) had hemoptysis, 6 (16.7%) had an abnormal chest x-ray and 3 (8.3%) had localized reticulo-nodular opacities on a CT-scan of the thorax. Bronchoalveolar lavage showed gram-positive cocci in 2 cases (5.6%). One patient died of acute respiratory distress syndrome. Cytopenia was common among the series of VL patients. Pulmonary complications, usually secondary infection, were less frequent (found in 13.9% cases) but was fatal in one patient.
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PMID:Clinico-hematological profile of visceral leishmaniasis among immunocompetent patients. 2369 21

Scrub typhus is an acute febrile illness caused by orientia tsutsugamushi, transmitted to humans by the bite of the larva of trombiculid mites. It causes a disseminated vasculitic and perivascular inflammatory lesions resulting in significant vascular leakage and end-organ injury. It affects people of all ages and even though scrub typhus in pregnancy is uncommon, it is associated with increased foetal loss, preterm delivery, and small for gestational age infants. After an incubation period of 6-21 days, onset is characterized by fever, headache, myalgia, cough, and gastrointestinal symptoms. A primary papular lesion which later crusts to form a flat black eschar, may be present. If untreated, serious complications may occur involving various organs. Laboratory studies usually reveal leukopenia, thrombocytopenia, deranged hepatic and renal function, proteinuria and reticulonodular infiltrate. Owing to the potential for severe complications, diagnosis, and decision to initiate treatment should be based on clinical suspicion and confirmed by serologic tests. A therapeutic trial of tetracycline or chloramphenicol is indicated in patients in whom the diagnosis of scrub typhus is suspected. The recommended treatment regimen for scrub typhus is doxycycline. Alternative regimens include tetracycline, chloramphenicol, azithromycin, ciprofloxacin, rifampicin, and roxithromycin. Treatment of pregnant women with azithromycin was successfully done without relapse and with favorable pregnancy outcomes. Hence, early diagnosis and treatment are essential in order to reduce the mortality and the complications associated with the disease. We searched the English-language literature for reports of scrub typhus in children, pregnant women, and non-pregnant patients with scrub typhus, using the MEDLINE/PubMed database, which includes citations from 1945 to the present time. We used the search terms 'scrub typhus', 'scrub typhus' and 'pregnancy', 'scrub typhus' and 'children', 'scrub typhus' and 'complications', 'scrub typhus' and 'treatment'.
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PMID:Scrub typhus. 2382 10


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