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Query: UMLS:C0018681 (headache)
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We report epidemiologic, clinical, laboratory, and biopsy findings in 14 cases of nephropathia epidemica. The patients were between 19 and 49 years of age. The onset of the disease was characterized by high fever, nausea, headache, backache, abdominal pain, proteinuria, oliguria, hematuria, and uremia. The symptoms subsided rapidly during the polyuria phase, which followed the oliguria stage. Because of renal failure, hemodialysis was required in eight cases. Edema of eyelids, conjunctival injection and hemorrhages, transitory myopia, and acute glaucoma were the most common eye abnormalities. Renal biopsy specimens showed glomerular changes, with mild swelling of the epithelial cells of Bowman's capsule, thickening of the basement membrane of glomerular capillaries, glomerular adhesions, inflammatory cell infiltration, leukocytoclasis and hemorrhages in the interstitium, and eosinophilic hyaline degeneration and vacuolization of the epithelial cells of the proximal tubuli.
JAMA 1977 Aug 22
PMID:Nephropathia epidemica. The Scandinavian form of hemorrhagic fever with renal syndrome. 1 20

Workups by physicians in response to five common complaints in a sample of 104 men and women--52 married couples--were evaluated by chart audit. For the total group of complaints, back pain, headache, dizziness, chest pain, and fatigue, the physicians' workups were significantly more extensive for men than they were for women. These data tend to support the argument that male physicians take medical illness more seriously in men than in women.
JAMA 1979 May 18
PMID:Response of physicians to medical complaints in men and women. 15 67

A patient with systemic lupus erythematosus had chills, fever, and headache on four separate occasions after ibuprofen ingestion. One such episode was accompanied by cerebrospinal fluid findings compatible with meningitis. Drug rechallenge under controlled conditions established the relationship between ibuprofen ingestion and meningitis.
JAMA 1978 Mar 13
PMID:Ibuprofen-induced meningitis in systemic lupus erythematosus. 30 2

In March 1977, a large volume of the industrial chemical hexachlorocyclopentadiene (HCCPD) was dumped into a municipal sewage system in Kentucky. We evaluated the health effects of exposure to HCCPD in 145 sewage treatment plant workers. We found that 85 (59%) had noted eye irritation, 65 (45%) had headaches, and 39 (27%) had throat irritation. Symptoms occurred throughout the plant; however, highest attack rates occurred in primary sewage treatment areas. Medical examination of 41 employees three days after the plant was closed showed proteinuria and elevation of serum lactic dehydrogenase levels; these findings were not present three weeks later. This episode demonstrates the toxicity of HCCPD and emphasizes the vulnerability of sewage workers to chemical toxins in wastewater systems.
JAMA 1979 May 18
PMID:Occupational exposure to hexachlorocyclopentadiene. How safe is sewage? 43 Aug 18

Three young women with systemic lupus erythematosus who were given ibuprofen for arthritis voluntarily discontinued taking the drug. On reinstitution of therapy, profound hypotension, fever, and headaches developed within hours, without other identifiable cause. A possible relationship to salicylate intolerance was considered. Because of these apparent side effects, we stress caution in the use of ibuprofen in systemic lupus erythematosus, particularly if there is any history of salicylate intolerance.
JAMA 1979 Jun 15
PMID:Acute adverse reactions to ibuprofen in systemic lupus erythematosus. 43 58

On Sept 21, 1973, during and following a football game at which they had participated, 57 members of an Alabama high school marching band (and one accompanying adult) experienced an illness characterized by headache, nausea, weakness, or dizziness. Six girls fainted. Thirty-six students were treated at a hospital emergency room. Those who had played wind instruments and had worn heavier uniforms including an impermeable plastic jacket overlay were affected earlier and more frequently than the others. Several organic causes were examined in an epidemiologic investigation and considered unlikely to explain the epidemic. Female preponderance, a bimodal epidemic curve, hyperventilation, relapses, and clinical features characterized by subjective complaints in the absence of physical findings suggested a syncopal reaction to heat exacerbated and propagated by mass hysteria.
JAMA 1977 Nov 28
PMID:Epidemic faintness and syncope in a school marching band. 57 63

Three incidences of carbon monoxide poisoning occurred owing to defective heating systems. Twelve persons were affected; of these, three lost their lives. Because the symptoms of carbon monoxide poisoning closely resemble flu and other common illnesses, correct diagnosis was not made as promptly as it might have been. Hemorrhages were found in the nerve fiber layer of the retina in all five of the patients who had been exposed for more than 12 hours. It is our contention, therefore, that complete examination of the patient should always include ohthalmoscopy, and that the finding of retinal hemorrhages, in addition to nausea, headache, and dizziness, should aler the physician to the possibility of carbon monoxide poisoning.
JAMA 1978 Apr 14
PMID:Retinal hemorrhages in subacute carbon monoxide poisoning. Exposures in homes with blocked furnace flues. 63 61

The cases of six patients with Philadelphia Legionnaires' disease were studied during the acute phase and throughout the following year. This multisystems disease process developed abruptly with symptoms of chills, fever, myalgias, and headache. The unusual clinical association of fever with relative bradycardia was noted frequently. Pneumonia developed after the first few days and rapidly progressed to life-threatening respiratory failure despite penicillin and cephalosporin therapy. Improvement occurred within 48 hours after tetracycline or chloramphenicol was administered. No permament sequelae were noted on the one-year follow-up examination, and no secondary cases of infection occurred.
JAMA 1978 Sep 08
PMID:Legionnaires' disease. Clinical findings and one-year follow-up. 68 92

Eight patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) and average resting Pao2 of 66 mm Hg were studied clinically and physiologically at sea level and after ascent to 1,920 m. At sea level the patients were symptomatic but not disabled. After ascent the patients had only mild symptoms of fatigue and insomnia, and one had severe headache during exercise on the first day. Funduscopic changes were not observed, nor did cardiac or pulmonary findings change. Resting sea level Pao2 dropped to 51.5 mm Hg within three hours of ascent, and the Paco2 fell from 37.8 to 33.9 mm Hg. Over the next three days, the Pao2 increased to 54.5 mm Hg as hyperventilation continued. At exercise, sea level Pao2 dropped from a mean value of 63 to 46.8 mm Hg at altitude. Pulse rates at rest or exercise did not change. Normal values for 2,3-diphosphoglycerate (2,3-DPG) did not change after ascent at 16 and 42 hours. We believe aircraft flight or travel to moderate altitudes for this type of COPD patient is safe. Preexisting hypoxemia resulting from disease may facilitate the adaptation of patients to severe hypoxia and may prevent symptoms similar to acute mountain sickness.
JAMA 1978 Sep 29
PMID:Short-term adaptation to moderate altitude. Patients with chronic obstructive pulmonary disease. 68 52

Benign intracranial hypertension (BIH) is a recognized syndrome of unknown origin that conventionally has been diagnosed by excluding an underlying space-occupying lesion using invasive contrast procedures. Computerized tomography (CT) scanning of the head is a safe, accurate method of defining intracranial structures that were previously only discernible by invasive studies. Seven patients with headaches, papilledema, normal mental status, normal brain scan, and normal electroencephalogram had normal CT scans of the head. Patients suspected of BIH can be spared invasive contrast procedures if the CT scan of the head is normal.
JAMA 1976 Aug 23
PMID:Computerized tomography and benign intracranial hypertension. 78 38


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