Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
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Mycoplasma pneumoniae (M. pneumoniae) infection in infants had been considered to be very rare, but recently some clinical cases have been reported. We experienced an epidemic of M. pneumoniae infection in a nursery school, and compared M. pneumoniae infection in infants with that in preschool and school children to investigate the features of infantile M. pneumoniae infection. We obtained the following clinical findings in 15 infantile patients with M. pneumoniae infection: The maximum body temperature scarcely increased to 38.5 degrees C or more and the period of high temperature and cough was shorter in infant patients than in preschool and school aged patients. Stridor occurred in 4 patients but skin disorder was not observed. In the laboratory findings, the white blood cell count tended to increase with no changes in neutrophil/lymphocyte ratio and CRP increased slightly. M. pneumoniae antibody was negative in all the patients except 3 and old hemagglutination tests were positive in only 4 patients. The chest X-ray examinations showed a mild increase in the hilar shadow. However, the sequentially located homogeneous shadow which is commonly seen in preschool and school aged patients was not detected. M. pneumoniae antibody scarcely increased in infantile patients but M. pneumoniae was isolated by throat culture from 14 of the 15 patients who were diagnosed as having M. pneumoniae infection.
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PMID:[Mycoplasma pneumoniae respiratory tract infection prevailing among infants at a nursery school]. 129 57

This paper presents preliminary findings about morbidity observed in a prospective epidemiological study in a village community near Khartoum during 1977-1979. A total of 293 under-five children in 310 households were followed up for two years. Each household was visited twice monthly and information of the disease pattern was collected. Cough, fever and diarrhoea were found to be the commonest cause of morbidity. The average incidence being 296, 292 and 217 episodes respectively per 100 children per year. Vomiting, skin disease and conjunctivitis occurred at a much lower rate. Measles was observed in 14% of children under one year of age. The incidence of whooping cough was low an no outbreak occurred during the two years of observation. The seasonality of various diseases, their severity and age distribution is discussed and compared over the two year period.
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PMID:Morbidity patterns among under-five children in a rural community in Sudan. 724 43

Low formaldehyd-concentrations were measured in three Cologne schools (mean 1 = 0,4425; mean 2 = 0,5725; mean 3 = 0,1292 ppm). As the main sources of emission were identified formaldehyd-urea-bound chip-plates in acoustic-ceilings and wainscots. To study the connection between the complaints of pupils and CH20-emissions 1594 pupils of these schools were questioned using a specially elaborated questionnaire. The questions concerned multiple complaints and disturbances of health as well as their anamnesis in chronological relationship with school attendance. Compared to controls consisting of 497 pupils of a school, where no CH2O-emitting chip-plates were used, the inquiry showed a significant increase (p less than 0,00005) of so-called functional disturbances (headache, disorder of concentrating ability, dizziness, nausea), affections of the respiratory tract (irritation of the mucosa of the nose and the pharynx, dry cough) and irritation of the conjunctiva. In regard to the anamneses, the difference between the investigation-group and the control-group was even more significant and additional complaints such as somnipathy, abdominal pain, skin disease were observed frequently. Comparing the normal distribution of so-called functional disturbances in pupils found in literature, the examined group of this study showed an even higher rate of the relative accumulation. The repeated investigation in one school (n = 328) 8 months after removal of the emission-sources demonstrated a very clear reduction of complaints by an average of 71,2 per cent.
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PMID:[Damages to health in schools. Complaints caused by the use of formaldehyde-emitting materials in school buildings]. 737 30

The objective of this study was to determine the safety and efficacy of atovaquone and proguanil hydrochloride combination therapy for the prophylaxis of Plasmodium falciparum malaria in at-risk nonimmune subjects in South Africa. This open-label trial was conducted at research sites in South Africa during the main malaria transmission season, February through July. The study volunteers were temporarily living in, or traveling to, a malaria-endemic area. They received I tablet of 250 mg atovaquone and 100 mg proguanil hydrochloride once daily for up to 10 weeks. Subjects were monitored using sequential clinical and laboratory assessments. Thick blood smears were stained and evaluated by a central laboratory. An immunochromatographic test for P. falciparum was also used for on-site patient management. Prophylactic success was summarized using a 95% confidence interval for the proportion of subjects who did not develop parasitemia or who withdrew due to a treatment-related adverse event. A total of 175 subjects (15% women) were enrolled in the trial. The mean duration of drug exposure was 8.9 weeks. The combination of atovaquone and proguanil hydrochloride was well tolerated. The most frequently reported adverse events considered possibly related to study treatment were headache (7%), abdominal pain (2%), increased cough (2%), and skin disorder (2%). No serious adverse events were reported, and no treatment-emergent effects were noted for any laboratory variables. One subject who was noncompliant with therapy developed parasitemia, and 3 subjects withdrew due to a treatment-related adverse event (2 subjects with headache and 1 with nausea and dizziness). The prophylaxis success rate was 97%. In this study, atovaquone and proguanil hydrochloride combination therapy had an excellent safety and efficacy profile for prophylaxis of P. falciparum malaria in nonimmune subjects.
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PMID:Safety and efficacy of atovaquone and proguanil hydrochloride for the prophylaxis of Plasmodium falciparum malaria in South Africa. 1036 39

We encountered a 55-year-old man with pulmonary involvement in acute febrile neutrophilic dermatosis (Sweet's syndrome). He had been treated with steroids for Sweet's syndrome for 2 years, and on September 17, 1998 presented with a cough and a fever of 38.9 degrees C. Physical examination revealed fine crackles at the bases of both lungs. Chest radiography and computed tomography demonstrated reticular and nodular infiltrates in both lungs. Treatment with a variety of antibiotic agents and an antifungal agent was not effective. Sputum culture was sterile and bronchial washings were negative for infectious pathogens. Transbronchial biopsy revealed a mild chronic interstitial infiltrate and an inflammatory exudate in bronchiolo-alveolar tissue. The pulmonary lesions and cutaneous lesions were resolved by intradermal injections of triamcinolone acetonide in addition to oral prednisolone. Although the apparent neutrophilic infiltrates cited by earlier reports were not observed in transbronchial biopsy specimens, the clinical course in this case suggested that our patient had Sweet's syndrome with pulmonary involvement.
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PMID:[Pulmonary involvement in acute febrile neutrophilic dermatosis (Sweet's syndrome)]. 1084 3

Atopic dermatitis is a typical chronic inflammatory skin disease that usually occurs in individuals with a personal or family history of atopy. Children with atopic dermatitis frequently present IgE-mediated food sensitization, the most commonly involved foods being egg and cow's milk. However, controversy currently surrounds whether food allergy is an etiological factor in atopic dermatitis or whether it is simply an associated factor, accompanying this disease as one more expression of the patient's atopic predisposition. Approximately 40 % of neonates and small children with moderate-to-severe atopic dermatitis present food allergy confirmed by double-blind provocation tests but this allergy does not seem to be the cause of dermatitis since in many cases onset occurs before the food responsible for allergic sensitization is introduced into the newborn's diet.Studies of double-blind provocation tests with food in patients with atopic dermatitis demonstrate mainly immediate reactions compatible with an IgE-mediated allergy. These reactions occur between 5 minutes and 2 hours and present mainly cutaneous symptoms (pruritus, erythema, morbilliform exanthema, wheals) and to a lesser extent, digestive manifestations (nausea, vomiting, abdominal pain, diarrhea), as well as respiratory symptoms (wheezing, nasal congestion, sneezing, coughing). However, these reactions do not indicate the development of dermatitis.Some authors believe that responses to the food in provocation tests may also be delayed, appearing mainly in the following 48 hours, and clinically manifested as exacerbation of dermatitis. However, delayed symptoms are difficult to diagnose and attributing these symptoms to a particular foodstuff may not be possible.Delayed reactions have been attributed to a non-IgE-mediated immunological mechanism and patch tests with food have been proposed for their diagnosis. In our experience and in that of other authors, the results of patch tests with cow's milk do not seem very specific and could be due, at least in part, to the irritant effect of these patches on the reactive skin of children with atopic dermatitis.The involvement of foods in atopic dermatitis will always be difficult to demonstrate given that an exclusion diet is not usually required for its resolution. Food is just one among several possible exacerbating factors and consequently identification of its precise role in the course of the disease is difficult. Further double-blind prospective studies are required to demonstrate the effectiveness of exclusion diets in the treatment of atopic dermatitis.Apart from the controversy surrounding the etiological role of foods, the most important point in atopic dermatitis is to understand that the child is atopic, that is, predisposed to developing sensitivity to environmental allergens; in the first few years of life to foods and subsequently to aeroallergens. Consequently, possible allergic sensitization to foods should be evaluated in children with atopic dermatitis to avoid allergic reactions and to prevent the possible development of allergic respiratory disease later in life.
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PMID:[Etiologic implication of foods in atopic dermatitis: evidence against]. 1198 42

We present a 30-year-old man admitted with generalized cutaneous lesions, fever and cough. Examination of skin biopsies of a papular lesion revealed dense neutrophilic infiltration of the upper dermis, so these lesions were diagnosed as neutrophilic dermatosis. Peripheral blood examination and bone marrow findings confirmed the diagnosis of myelodysplastic syndrome with excess blasts. The cutaneous lesions improved after administration of corticosteroid and follow-up bone marrow examination revealed a normocellular marrow. One year later he referred with acute myelogenous leukemia (AML-M0). Unfortunately, he did not respond to treatment and died a few months later due to disease progression.
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PMID:Generalized neutrophilic dermatosis: a rare presentation of myelodysplastic syndrome. 1580 94

Under conditions of a maximum security laboratory, four cross-bred sheep were inoculated intradermally only or intradermally and intratracheally with a West African isolate of sheep pox virus. All sheep had increased temperature and depression by the fourth or fifth day after infection. Nasal and lacrimal discharge and coughing occurred in all sheep but were more severe in sheep receiving the virus via the tracheal route. From the fifth day after infection, numerous papular erythematous skin lesions developed at the inoculation sites. These were 3-7 mm in diameter and gradually became nodular. Some of these lesions healed and others coalesced to form tumorlike masses. In one sheep, euthanized 14 days after intradermal and intratracheal inoculation, nodular lesions were found in the skin around the eyes, nostrils, oral and perianal regions, the mucosa of the rumen and throughout the lungs. Histologically, skin nodules were characterized by ischemic necrosis, vasculitis, microvesicualtion, eosinophilic cytoplasmic inclusions in the dermal epithelial cells and vacuolar nuclear degeneration. The pulmonary lesion was that of proliferative alveolitis with occasional cytoplasmic inclusions in the alveolar cells and macrophages. Ultrastructurally, large cuboidal virus particles were found both in the skin lesion and inoculated tissue cultures. The sheep pox virus structure was easily distinguished from contagious ecthyma virus, a parapoxvirus which causes sporadic disease in Canada. Serum neutralizing antibodies developed in all the sheep by 14 days postinfection.The clinical and pathological characteristics of experimental sheep pox produced with this West African isolate were similar to those caused by Neethling virus of lumpy skin disease in cattle.
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PMID:Sheep pox: experimental studies with a west african isolate. 1742 83

A 78-year-old woman visited a local clinic because of cough and fever, and was prescribed levofloxacin, carbocisteine, and cold medicine (salicylamide, acetaminophen, anhydrous caffeine, promethazine methylene disalicylate). The following day, erythema appeared on the trunk, and spread. Multiple pustules independent of hair follicles developed on the erythema mainly in the skin folds. Histopathological examination revealed subcorneal pustular dermatosis. The clinical course and characteristics of the rashes led to a diagnosis of acute generalized exanthematous pustulosis (AGEP). Although the administration on levofloxacin, carbocisteine, and cold medicine were discontinued, the rashes recurred. We reviewed the patient's history, and found that she had a history of taking the over-the-counter drug Kerorin, and had taken a dose of Kerorin on the day before the first examination and before the recurrence. The ingestion of Kerorin was regarded as an incidental oral administration test, which was positive. Thus, oral administration tests with Kerorin and its ingredients acetylsalicylic acid and anhydrous caffeine were positive, leading to a diagnosis of AGEP caused by Kerorin.
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PMID:[Case of acute generalized exanthematous pustulosis caused by Kerorin]. 1798 92

Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterized by low serum levels of AAT, the main protease inhibitor (PI) in human serum. The prevalence in Western Europe and in the USA is estimated at approximately 1 in 2,500 and 1 : 5,000 newborns, and is highly dependent on the Scandinavian descent within the population. The most common deficiency alleles in North Europe are PI Z and PI S, and the majority of individuals with severe AATD are PI type ZZ. The clinical manifestations may widely vary between patients, ranging from asymptomatic in some to fatal liver or lung disease in others. Type ZZ and SZ AATD are risk factors for the development of respiratory symptoms (dyspnoea, coughing), early onset emphysema, and airflow obstruction early in adult life. Environmental factors such as cigarette smoking, and dust exposure are additional risk factors and have been linked to an accelerated progression of this condition. Type ZZ AATD may also lead to the development of acute or chronic liver disease in childhood or adulthood: prolonged jaundice after birth with conjugated hyperbilirubinemia and abnormal liver enzymes are characteristic clinical signs. Cirrhotic liver failure may occur around age 50. In very rare cases, necrotizing panniculitis and secondary vasculitis may occur. AATD is caused by mutations in the SERPINA1 gene encoding AAT, and is inherited as an autosomal recessive trait. The diagnosis can be established by detection of low serum levels of AAT and isoelectric focusing. Differential diagnoses should exclude bleeding disorders or jaundice, viral infection, hemochromatosis, Wilson's disease and autoimmune hepatitis. For treatment of lung disease, intravenous alpha-1-antitrypsin augmentation therapy, annual flu vaccination and a pneumococcal vaccine every 5 years are recommended. Relief of breathlessness may be obtained with long-acting bronchodilators and inhaled corticosteroids. The end-stage liver and lung disease can be treated by organ transplantation. In AATD patients with cirrhosis, prognosis is generally grave.
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PMID:Hereditary alpha-1-antitrypsin deficiency and its clinical consequences. 1856 11


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