Gene/Protein Disease Symptom Drug Enzyme Compound
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Phosphate diabetes has been considered as rare and to occur almost exclusively in children. Upon examination of adult patients with rheumatic or kidney diseases it has, however, been found that the combination of hypophosphataemia and hyperphosphaturia is not so rare. This paper deals with 24 adult patients of this type, whom we have found during 6 months. Their mean serum phosphorus concentration was 0.7 mmol/l (range 0.5--0.8). Mean phosphate clearance was 31 ml/min/1.73 m2 (range 16--51). The diagnoses were myalgia, dorsalgia (n = 7), papillitis calcificans (n = 5), prostatitis or prostate accretions (n = 4), dizziness (n = 2), kidney stones, tubular defect, interstitial nephritis, medullary sponge kidney (1 case each), two patients had transplanted kidneys. Asthenia was a common additional diagnosis. The patients' complaints have been pain in the muscles, joints, bones (18 cases), tiredness (10 cases), dizziness (8 cases), shakyness, numbness, burning sensation (7 cases), tenderness in the muscles and bones ("the princess-on-the-pea syndrome") (7 cases). The most common findings upon examination were bone tenderness (13 cases), reduced manual power (8 cases), positive Romberg test (3 cases), slight muscle atrophy (2 cases), waddling gait (2 cases). The most common findings encountered in the laboratory, besides hypophosphataemia and hyperphosphaturia, were high pH in the urine, hyperaminoaciduria, and phosphate crystals in dried urine.
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PMID:Mild phosphate diabetes in adults. 30 93

Symptoms of poisoning occurred in 19 persons in the Rhein-Main region in October 1976, after they had eaten mussels (Mytilus edulis) imported from Vigo, Spain. Mild oral paraesthesias, tingling in the fingertips and feet were followed by generalised numbness and dizziness. All symptoms disappeared within 48 hours. They had been caused by saxitoxin which is produced by a dinoflagellate and accumulated in the mussels, as confirmed by testing confiscated samples of mussels. Toxin concentration ranged from 6000 to 20 000 MU (mice units) per 100 g mussel meat.
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PMID:[Poisoning after ingestion of mussels (mytilus edulis) (author's transl)]. 89 97

Koro, a psychogenic anxiety syndrome interfering with genital body image and sexual functioning, has hitherto been described as occurring mainly in isolated cases of South Chinese males. The present communication reports an epidemic outbreak in November 1976 in Northeastern Thailand where within a few days at least 200 patients, most of them Thai and two-thirds males, were treated at local hospitals. Main presenting symptoms were acute anxiety, in some cases leading to fainting, (subjective) shrinking of the penis and impotency in men, shrinking and/or itching of the external genitals and frigidity in women; further complaints included initial nausea and dizziness, abdominal pains, headaches, facial numbness. All patients recovered after brief symptomatic intervention. Popular opinion and news media echoed the patients' paranoid projection of viewing the epidemic as caused by Vietnamese food and tobacco poisoning in a hideous assault against the sexual vitality and general health of the Thai people, in the context of a specific socio-cultural and politico-historical situation. It appears that an adequate interpretation of Koro and of analogous hysterical symptom formation would have to go beyond the hitherto applied psychoanalytic models by considering the specific sociodynamic factors involved in the pathogenesis of such phenomena.
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PMID:[Mass-hysteria with Koro-symptoms in Thailand]. 90 91

Two groups of patients treated by short (Milan) and long (Newcastle) haemodialysis were compared for incidence of symptoms and biochemical control. Short dialysis corrected urea and creatinine as well but control of potassium and phosphate were similar. The only apparent penalties to be paid by short dialysis patients were a higher incidence of itching, tingling or numbness, impairment of vibratory sense and difficulty in controlling blood pressure. The short dialysis group had higher haemoglobin and less dyspnoea, muscle weakness and dizziness after dialysis.
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PMID:A comparison of short and long haemodialysis. 93 42

Forty six bereaved relatives were assessed by a general practitioner four to eight weeks after the bereavement. In 36 (78.3 per cent) the immediate reaction to bereavement was one of numbness or stupefaction; in seven (15.2 per cent) emotional relief occurred; and in three cases (6.5 per cent) there was no obvious immediate reaction. The numbness reaction was limited in duration to a week or less in 31 of the 36 instances.At four to eight weeks after bereavement 29 (63.0 per cent) of the subjects continued to experience difficulty in coming to terms with their loss. Twenty subjects reported guilt feelings and a similar number expressed aggressive reactions. The bereaved subjects tended to increase their consumption of cigarettes and alcohol, while their appetite and weight tended to be reduced. Thirty six (78.3 per cent) of the subjects reported physical symptoms, notably headache, dizziness, generalised aches, and abdominal complaints.THE MOST PROMINENT PSYCHOLOGICAL FEATURES OF BEREAVEMENT WERE FOUND TO BE: preoccupation with thoughts of the deceased, idealisation of the lost person, depressive mood, and loneliness.The findings are discussed and reference made to the role of the family doctor in the management of bereavement reactions.
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PMID:A study of bereavement in general practice. 95 95

Bilateral vasomotor responses and sweat gland activities under the control of cervical sympathetic nerves were examined simultaneously by photo-electric plethysmogram (PTG) and skin potential reflex (SPR) in patients with nonspecific complaints in the head-cervicobrachial regions such as headache, dizziness, tinnitus, pain or stiffness of the neck and shoulder, and dullness or numbness of the arms. 137 out of those 355 patients (38.6%) were revealed to have laterality in vasomotor responses, but it was only 3 in 60 normal control subjects (5%) that showed the laterality in vasomotor responses. These results supported the assumption that the cervical sympathetic dysharmony--imbalance between the right and left sides of cervical sympathetic functions--played an important role in causing their various vegetative complaints in the head-cervicobrachial regions.
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PMID:Plethysmographic study in the patients with non-specific complaints in the head-cervico-brachial regions: with a special reference to laterality in vasomotor responses and "cervical sympathetic dysharmony". 126 64

Symptoms as an important sign of the effects of methyl bromide were studied in 56 male workers (37 currently exposed and 19 previously exposed) in a methyl bromide factory. The workers were 18 to 62 yr of age (mean age: 41) and were exposed from 1 to 25 yr (mean: 7 yr). They were compared to 56 age-matched referents with a standardized questionnaire. The results of pairwise comparison of the symptoms of the age-matched pairs of exposed and referent subjects showed that the occurrence of dizziness, numbness, paresthesia and weakness of extremities, nightmares, fatigue and dry and scaly skin was statistically significantly higher among the workers than among the referents. When the symptoms during the work shift (acute symptoms) were compared, irritation symptoms such as itching, bullae or reddish swollen hands and runny noses with nasal irritation were reported significantly more often in the exposed groups. The correlation of the symptoms among the exposed workers suggested that chronic symptoms are closely related to acute irritation symptoms and exposure duration. The results suggest that symptom inquiry is useful for detecting the possible effects of exposure to methyl bromide.
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PMID:Symptoms among workers with long-term exposure to methyl bromide. An epidemiological study. 165 69

Iloprost, a stable prostacyclin analog, was evaluated clinically for its ability to ameliorate the symptoms of peripheral neuropathy associated with diabetes. In an open, nonrandomized trial, 13 diabetic patients with neuropathy but without proliferative retinopathy received an intravenous infusion of Iloprost at a dose of 10 micrograms, at a rate of 0.1 micrograms/kg/h, twice daily for two weeks. The administration of Iloprost relieved the majority of such subjective symptoms as pain, numbness or sensation of cold and to a lesser extent, such autonomic symptoms as dizziness. In contrast, there was little evidence of objective improvement, e.g., in motor nerve conduction velocity. Iloprost treatment significantly inhibited the platelet aggregation rate stimulated by collagen in vitro. In the one patient tested, thermography revealed an increase in skin temperature by more than 2 degrees C. Side effects associated with Iloprost included headache (3 patients) or aggravation of pain in the extremities (2 patients) and could be ameliorated by slowing the infusion rate or by discontinuing the drug (one patient). Iloprost appears to be safe and effective for relieving the symptoms of diabetic neuropathy. Our results provide the rationale for a double-blind, clinical trial in larger populations of diabetics with peripheral neuropathy.
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PMID:Clinical efficacy of a stable prostacyclin analog, iloprost, in diabetic neuropathy. 170 9

Somatic symptoms are one of the leading reasons for medical outpatient clinic visits, with the most common symptoms having a prevalence of 10% or more. However, the usual diagnostic workups are often unproductive, with less than 1 in 5 symptoms having an organic explanation after the initial physical examination and laboratory testing. Therapy appears more effective for some symptoms than for others. Of patients with unspecified pain or gastrointestinal complaints, greater than 70% state that some type of treatment has been helpful, whereas less than 50% of individuals with fatigue, dizziness, numbness, insomnia, sexual dysfunction, anxiety, or depression report any relief. Future educational efforts and research need to focus on that majority of symptoms that are either psychiatric or unexplained, in order to improve our current evaluation and management strategies.
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PMID:Symptoms in medical patients: an untended field. 173 31

Clinical symptoms were studied in 69 consecutive patients below the age of 40 years who were attending the emergency unit because of unexplained chest pain. In a structured interview a few weeks after the emergency visit, only one-third of the patients reported that they believed in the doctor's diagnosis; they believed in a psychological or cardiac origin of the pain more often than the doctors. The chest pain was most often described as oppressive and/or stabbing. In 95% of cases it was central or left-sided. Associated symptoms were commonly reported, breathlessness being most commonly reported by two-thirds of the patients, followed by dizziness, palpitation and numbness/tingling. Mental symptoms such as tiredness, anxiety and tension were frequently reported. On the basis of the background literature the aetiology is discussed. We conclude that immediate symptom analysis, including psychosomatic symptoms, particularly breathing problems, is of central importance.
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PMID:Clinical symptoms in young adults with atypical chest pain attending the emergency department. 189 50


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