Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A fifty-year-old Portuguese man presented with a six-month history of low back pain, which initially was mechanical and slowly became inflammatory. Secondarily, he complained of right atypical sciatalgia. He did not report any fever, loss of weight, cough nor personal or familial history of tuberculosis. General examination was normal. Neurologic examination showed weakness of the extensors of the right leg, with a symmetric increased reflexes of the lower extremities suggesting a pyramidal syndrome without Babinski's sign. Laboratory data were normal as well as chest radiographs. Dorsolumbar gadolinium enhanced MRI revealed an intramedullary ringlike enhancing mass at T12 level. Lumbar puncture showed 11 WBC/mm3 (95 p. 100 lymphocytes), a normal protein and glucose content. PCR and culture for Mycobacterium tuberculosis were negative. Within a few days, he developed meningoencephalitis with fever, CSF examination revealed then 360 WBC/mm3 (65 p. 100 lymphocytes and 17 p. 100 neutrophils), a protein content of 7 g/l and a glucose level of 1.7 mmol/l. The clinical picture was then suggestive of tuberculosis and a specific therapy with rifampin, izoniazid, pyrazinamid, ethambutol and steroids was started. Clinical improvement and a second CSF culture that revealed one month later Mycobacterium tuberculosis complex confirmed this diagnosis. Ten months later, the patient was asymptomatic with a normal MRI. To our knowledge, this is the first total recovery of an intramedullary tuberculoma on medical therapy alone, confirmed by MRI normalization. We reviewed also 19 recent cases of tuberculomas in the literature, intending a therapeutic attitude when discovering an intramedullary ringlike enhancing mass on MRI.
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PMID:[Intramedullary tuberculoma: a case report]. 977 87

Identification of workers who are at high risk and at low risk as a result of participation in the cleanup of the consequences of the accident at the Chernobyl nuclear power station ("liquidators") is important both for scientific research and for the medical care of the individuals involved. Using register data for 36,700 liquidators, the authors estimated the relationships between radiation doses and the following factors: time of arrival at the accident zone, irradiation conditions, and possible health effects following the exposures. The analyses took into account types of work (decontamination, cordon work, building); places and circumstances of work (inside or outside or with machinery); and the use of individual protection measures. Included in possible effects on health were changes in hematologic indexes, weakness, headache, dryness or tickling of the throat, cough, facial hyperemia, metallic taste, anorexia, nausea, vomiting, heaviness in the epigastric region, and instability of defecation. With the help of mathematical models, the rating for each factor was assessed, and on this basis the liquidators were subdivided into risk groups. For workers for whom dose information was not available, probable doses could be calculated. The three most influential variables were time of starting work, type of work done, and the number of health effects.
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PMID:Estimation of Radiation Exposures of "Liquidators" of the Chernobyl Nuclear Power Station; Identification of Risk Groups. 989 Nov

As patients with HIV/AIDS are living longer with the illness, pain and symptom management are increasingly important health issues. This article will discuss the assessment and management of such common problems as pain, fatigue and weakness, dyspnea and cough, anorexia and weight-loss, nausea and vomiting, sleep disorders, dry mouth, diarrhea, itching, and fever and night sweats.
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PMID:Palliative care: pain and symptom management in persons with HIV/AIDS. 992 83

Respiratory complications are common in the terminal stages of multiple sclerosis and contribute to mortality in these patients. When respiratory motor pathways are involved, respiratory muscle weakness frequently occurs. Although it is well established that weakness of the respiratory muscles produces a restrictive ventilatory defect, the degree of muscle weakness and pulmonary function are poorly related. Respiratory muscle weakness was observed in patients with normal or near normal pulmonary function. Expiratory muscle weakness is more prominent than inspiratory muscle weakness and may impair performance of coughing. Subsequently, in addition to bulbar dysfunction, respiratory muscle weakness may contribute to ineffective coughing, pneumonia, and sometimes even acute ventilatory failure may ensue. Respiratory muscle weakness may also occur early in the course of the disease. Recent studies suggest that the respiratory muscles can be trained for both strength and endurance in multiple sclerosis patients. Whether respiratory muscle training delays the development of respiratory dysfunction and subsequently improves exercise capacity and cough efficacy, prevents pulmonary complications or prolongs survival in the long-term remains to be determined.
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PMID:Respiratory muscle involvement in multiple sclerosis. 1006 97

Protection of the lungs against ventilator-induced lung injury is becoming one of the main concerns in pediatric and neonatal intensive care. High frequency ventilation using a constant distending pressure with small variations during respiratory cycles allows adequate recruitment. High frequency oscillation is the most promising HFV mode especially in premature neonates but clinical studies are contradictory. Nitric oxide, an inhaled gas with specific pulmonary vasodilating effects, has become a powerful tool in the treatment of pulmonary arterial hypertension alone or in combination with HFO, but studies have failed to show improvement in survival in neonates as well as in children with ARDS. Tracheal gas insufflation, in addition to conventional ventilation, by washing dead space during exhalation, improves gas exchange while lowering tidal volume. It is however still experimental. Maintenance of spontaneous ventilation during conventional ventilation improves gas exchange, hemodynamic functions, mobilization, active coughing, and avoids prolonged muscle weakness. Non invasive modes of ventilation like BiPAP have certain indications in pediatrics but need to become more familiar to the pediatric intensivist.
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PMID:New tools in ventilatory support: high frequency ventilation, nitric oxide, tracheal gas insufflation, non-invasive ventilation. 1009 36

A 22-year-old female noted a low grade fever and swelling of the cervical lymph nodes in May 1997, and later developed a dry cough. She was diagnosed to have interstitial pneumonitis, and then administration of corticosteroids alleviated her symptoms. On February 6, 1998, however, a high fever recurred and her swollen cervical lymph node on the right side was biopsied on February 9, 1998. A histological examination revealed an increased number of histiocytes and karyorrhexis of the lymphocytes in the paracortical areas, and she was therefore diagnosed to have histiocytic necrotizing lymphadenitis. She could not fully elevate her arm on February 16, 1998. On admission, her cervical lymph node was swollen on the left side. A neurological examination revealed a marked weakness of the right deltoid muscle, moderate weakness of the right latissimus dorsi, triceps and brachioradialis muscles and also a mild weakness of the serratus anterior, supra- and infra-spinatus, and biceps brachii muscles. The muscle power of the other muscles were normal and no muscle atrophy was evident. Winging of the right scapula was observed. The deep tendon reflexes were normal in all four limbs, and her sensation was also normal. No cerebellar sign was found. The Jackson, Spurling, Allen, Morley and Adson tests were all negative. ESR was mildly elevated to 18 mm/hr, but CRP was negative. RF, ANA and anti-SS-A and SS-B antibodies were positive, whereas LE-test, direct and indirect Coombs tests and other autoantibodies were negative. Needle EMG disclosed fasciculation potentials in the right triceps muscle and polyphasic waves in the right deltoid muscle. MRI showed gadolinium-enhancement of the right brachial plexus. Although an abnormal accumulation of gallium was detected in the right parotid and bilateral submandibular glands, no sicca symptoms were found and the Schirmer test findings were normal. Oral prednisolone (50 mg/day with gradual tapering) alleviated both her symptoms and the gadolinium-enhancement of the right brachial plexus. As a result, her right upper limb paresis was thus considered to have been caused by right brachial plexus neuritis, which was probably associated with histocytic necrotizing lymphadentis. Although acute cerebellar ataxia and meningitis have previously been reported to be complicated with histiocytic necrotizing lymphadenitis, this is the first report to describe the complication of peripheral neuritis with this condition.
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PMID:[A case of subacute necrotizing lymphadenitis complicated with brachial plexus neuritis]. 1020 79

Noninvasive long-term ventilation is consensually advocated when daytime hypercapnia > 6 kPa at steady state in chronic restrictive pulmonary syndromes. Several mechanisms can cause the occurrence of hypercapnia in these diseases. They may involve impairment of lung mechanics or airway function and cough, ventilation-perfusion mismatching, blunted central ventilatory drive or respiratory muscle fatigue. These abnormalities may occur while awake or during sleep. From a practical point of view, imperative ventilation, a palliative technique that aims to supply respiratory muscle weakness, and preventive ventilation, aimed at delaying respiratory handicap, should be distinguished between. The latter is offered to patients who do not fulfil any criteria for mechanical ventilation. Otherwise, the underlying disease markedly influences both pathophysiology and outcome. This implies that the available modes of ventilatory support should be assessed in each disease. Several findings have been published about Duchenne's muscular dystrophy. Mechanical ventilation, usually using noninvasive methods, is offered to patients with either hypercapnia or a forced vital capacity < 20% of the predicted value. Nevertheless, based on our experience, deterioration of the restrictive syndrome should be followed by a tracheostomy. By contrast, early ventilation, offered to patients free of symptoms and whose forced vital capacity are within 20-50% pred and with normal arterial blood gas levels, achieves no benefit.
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PMID:Is early noninvasive mechanical ventilation of first choice in stable restrictive patients with chronic respiratory failure? 1021 81

Theophylline toxicity has been recognized since its introduction into clinical medicine. Clarithromycin is a new oral macrolide antibiotic with excellent antibacterial activity and rare adverse effect. Patients with upper respiratory infection are often treated with theophylline and clarithromycin concurrently. We report a case of acute renal failure due to acute rhabdomyolysis caused by the interaction of theophylline and clarithromycin. A 72-year-old man visited our hospital because of coughing and a sore throat continuing for 1 week. He was diagnosed as having the common cold with a bronchial asthmatic symptom and was prescribed 200 mg/day of sustained-release theophylline for the treatment of asthma for 7 days. One week later, he visited our hospital again. Radiographic study of the chest revealed mild interstitial pneumonia and 200 mg/day of sustained-release theophylline and 400 mg/day of clarithromycin were administrated concomitantly. Five days after the second visit, the patient was admitted to our hospital because of generalized twitching, muscular weakness, high fever and serious general condition. He experienced generalized muscular twitching and tremor. Blood urea nitrogen was 106.1 mg/dl, serum creatinine was 7.4 mg/dl, serum creatinine kinase (CK) was 36,000 IU/l (normal 15-130 IU/l), CK isozyme revealed the following ratio: BB 0%, MB 1% and MM 99%. He was diagnosed as having acute renal failure with rhabdomyolysis caused by the interaction of theophylline and clarithromycin. Hemodialysis therapy was started. After 5 weeks, his serum creatinine was markedly decreased. It is well-known that clarithromycin enhances the serum concentration of theophylline by inhibition of the cytochrome P450-dependent pathway in hepatocytes. Theophylline toxicity may be enhanced when clarithromycin is administrated concomitantly, especially to elderly patients with dehydration.
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PMID:[A case of acute renal failure with rhabdomyolysis caused by the interaction of theophylline and clarithromycin]. 1044 97

Respiratory complications, such as pneumonia and atelectasis, are major causes of mortality and inhibit rehabilitation programs in spinal cord injury. Tetraplegic patients cannot cough enough to clear their sputum because of expiratory muscle weakness, mainly of the abdominal muscles. However, tetraplegics are still able to activate some muscles during coughing. Some tetraplegics, even though they cannot contract the abdominal muscles, can cough effectively. It was supposed that some accessory expiratory muscles were activated during coughing in tetraplegics. We, therefore, studied the peak expiratory flow rate, expiratory muscle strength, and the activities of the pectoralis major and latissimus dorsi muscles in 11 complete tetraplegics. Peak expiratory flow rate was measured by spirometry. Expiratory muscles strength was assessed by maximal expiratory mouth pressure; muscle activity was assessed by means of the root mean square voltage obtained by surface electromyography. The results showed that peak expiratory flow rate, maximal expiratory mouth pressure, and root mean square of these two muscles were correlated with neurological level. Peak expiratory flow rate was correlated with peak expiratory flow rate. Peak expiratory flow rate was correlated with the root mean square voltage of the pectoralis major and latissimus dorsi muscles. It was supposed that these two muscles were activated as accessory expiratory muscles and play an important role in expiratory function in tetraplegic patients.
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PMID:Expiratory function in complete tetraplegics: study of spirometry, maximal expiratory pressure, and muscle activity of pectoralis major and latissimus dorsi muscles. 1049 57

Analyzing the case histories of 5 patients with Goodpasture's syndrome who have admitted to an emergency clinic for suspected tuberculosis leads to the conclusion that the onset of the disease appeared as intoxication and lung damage, and evolving general weakness, fever, cough. Hemopoiesis appeared just when overall clinical manifestations appeared, it varied from single sputum blood filaments to more frequent mows of pure red blood sputum for several weeks, but there was never an increasing hourly progressively and this failed to cause a rapid drop of hemoglobin. Anemia is attributable by pulmonary blood imbibition, intoxication, and suppressed hemopoiesis in renal failure rather than by external blood loss as hemoptysis.
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PMID:[Goodpasture's syndrome as a cause of pulmonary hemorrhages]. 1075 Apr 32


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