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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1974 an epidemic of tertian malaria has been spreading around the Adana and Tarsus townships in southern Turkey, with a peak incidence of 115 500 cases in 1977. A further increase is to be expected because the insect vectors have become resistant to insecticides. Since 1975 eleven children and three adults have been treated for P. vivax malaria. They had all stayed in the epidemic area during the transmission season which lasts from July to October. Because of a long primary latent period seven patients only developed first manifestations of the disease six to nine months after leaving Turkey. The classical malarial paroxysms were missing during the first weeks of the primary attack. Several children had a febrile illness over weeks with headache, vomiting, abdominal pain, hepatosplenomegaly, high blood-sedimentation rate and severe haemolytic anaemia, so that appendicitis or septicaemia had been suspected. Tetracyclines and trimethroprimsulphamethoxazole were able to suppress the disease without preventing relapses.
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PMID:[Tertian malaria in children and adults from an epidemic region in southern Turkey (author's transl)]. 36 41

Lymphoid adenohypophysitis is an autoimmune disorder. Eighteen percent of the multipartums are reported to have autoantibodies to pituitary tissues. The symptoms in lymphoid adenohypophysitis, such as hypopituitarism and sellar tumors, exhibit spontaneous remission. The pituitary is a feasible target organ in other autoimmune diseases of the endocrine system. Of these patients, 19/287 showed a positive immune reaction with pituitary tissue antigens. Our three female patients with sellar and suprasellar mass were clinically diagnosed as having lymphoid adenohypophysitis, because of the spontaneous regression of tumors, or presence of immunologically and endocrinologically abnormal findings. The first case was a 31-year-old woman who had amenorrhea and galactorrhea syndrome for two years after delivery of her second child. CT scan revealed a supraseller enhanced mass lesion. She had concomitant signs of recurrent meningeal irritations. The number of cells in the CSF increased, though the protein concentration increased only slightly. During a one-year close observation, the suprasellar mass spontaneously regressed. The second patient was a 66-year-old woman. In 1945, she underwent hysterectomy and oophorectomy for appendicitis followed by adnexitis. She was admitted because of episodes of headache, vomiting and visual field defect in 1983. CT scan also showed a contrast enhanced mass in the suprasellar region. She had two episodes of high fever. After the treatment with antibiotics and anti-inflammatory agents for 4 months, the tumor disappeared. The third case was a 20-year-old female. She had neither neurological nor endocrinological abnormality, except for attacks of vertigo, nausea and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lymphoid adenohypophysitis, with special reference to 2 cases with sellar tumors spontaneously disappearing on the CT]. 377 4

Five myofascial pain syndromes, some mimicking more serious diseases, have been presented. They were diagnosed as and treated for: headache, shoulder bursitis, lumbar herniated disc with radiculopathy, angina pectoris and appendicitis. An understanding of these pain problems, produced from trigger points in muscles and ligaments, is important in order to differentiate myofascial pain syndromes from more dangerous diseases and to avoid unnecessary and expensive diagnostic procedures.
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PMID:Myofascial pain syndromes--the great mimicker. 892 61

The purpose of this study was to determine the frequency with which general pediatricians perform a rectal examination on children with a complaint of acute abdominal pain and to determine factors associated with performing a rectal examination. Children were eligible for the study if they were 2 to 12 years of age and presented to the clinic or emergency department of a municipal teaching hospital with a complaint of abdominal pain of less than or equal to three days' duration. Measured variables included demographic characteristics and presenting signs and symptoms. For each patient, a clinical reviewer (1) assigned a final diagnosis, (2) determined whether a rectal examination had been performed, and (3) assessed the clinical contribution of the rectal examination findings. For 1,140 children presenting for a nonscheduled visit with acute abdominal pain, a rectal examination was performed on 4.9% (56/1,140). Using multiple logistic regression, children were more likely to have a rectal examination performed if they had abdominal tenderness (odds ratio [OR] = 3.3 and 95% confidence interval [CI], 1.8 to 6.0), a history of constipation (OR = 6.0 and 95% CI, 2.3 to 15.3), or a history of rectal bleeding (OR = 9.1 and 95% CI, 2.9 to 29). Children were less likely to have had a rectal examination performed if they presented with associated symptoms of cough (OR = 0.32 and 95% CI, 0.14 to 0.74), headache (OR = 0.15 and 95% CI, 0.05 to 0.46), or sore throat (OR = 0.28 and 95% CI, 0.08 to 0.91). The final diagnoses of 12 children who had clinically contributory findings on rectal examination included: constipation (5), gastroenteritis (3), appendicitis (2), abdominal adhesions (1), and abdominal pain of unclear etiology (1). General pediatricians infrequently perform a rectal examination on children who present with a complaint of acute abdominal pain. Clinical factors affect the likelihood of whether a rectal examination is performed.
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PMID:Use of the rectal examination on children with acute abdominal pain. 959 98

Previous studies of specialist care have shown that the onset of acute myocardial infarction occurs most frequently on Mondays; however, the septadian pattern in the reasons for referrals from primary care to secondary care has not been examined previously. We examined daily variations in rates of referral from primary to secondary care in central and northern Finland, using International Classification of Primary Care codes, during two weeks (30 November to 6 December 1992, and 28 November to 4 December 1994) before and after the introduction of a reform in the system of financing health care. Monday peaks were observed in the occurrence of angina pectoris, fractures of the tibia/fibula, lumbar disc lesions, and infections of the eye. Tuesday peaks were found in the occurrence of headache. Two peaks (on Tuesday and Thursday) were observed for patients with suspected appendicitis. Many problems of primary health care leading to referral to secondary care are not random events but occur in a weekly pattern. Further investigation is needed within these subgroups of patients to identify the causes of this variation.
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PMID:They call it stormy Monday--reasons for referral from primary to secondary care according to the days of the week. 1081 61

We report 12 patients [5 males, mean age 28 years (SD 4.6)] presenting with clinical features suggestive of acute appendicitis who were later diagnosed as having dengue fever (DF). Seven were admitted to hospital by surgeons and then referred to physicians due to thrombocytopenia (one of them following appendicectomy). Five were admitted to medical wards and then referred to surgeons due to abdominal pain. The mean time from onset of fever to abdominal pain was 2.2 d (SD 0.9). Clinical features included: right iliac fossa tenderness in 12 patients, rebound tenderness in nine, vomiting in nine, erythematous rash in eight, arthralgia/myalgia in eight, headache in six, diarrhea in three and palatal petechiae in three. All patients had C-reactive protein <12mg/l, and DF was confirmed serologically. Leucocytopenia and thrombocytopenia occurred by the third or fourth day of illness in all patients. Seven had free fluid around the appendix on abdominal ultrasound. The mean duration of abdominal symptoms and signs was 1.8 d (SD 1.3). DF may present with features suggestive of acute appendicitis in dengue-endemic areas. A carefully obtained history, clinical examination and a full blood count done on the third or fourth day of illness may help to differentiate DF from acute bacterial appendicitis.
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PMID:Dengue fever mimicking acute appendicitis. 1736 95

We report the case of a 28-year-old woman who presented simultaneously with superior sagittal sinus thrombosis and thyroid crisis, and was subsequently found to have protein C deficiency. February 3, 2003, she admitted complaining of abdominal pain. The diagnosis of appendicitis was made, and she was operated on under lumbar anaesthesia. Day 7, she developed acute headache and distal weakness of the left lower limb. On examination she was alert, with a temperature of 38 degrees C, a sinus tachycardia of 124/min and blood pressure 164/84 mmHg. Neurological examination revealed neck stiffness and left hemiparesis, predominantly in her lower limb. Gadlinium-enhanced brain MRI revealed extensive superior sagittal sinus thrombosis. CT scan demonstrated infarction in the right frontal cortex, and subarachnoid hemorrhage adjacent to the right cerebellar tentorium. The patient was treated with a free radical scavenger edarabon, and glycerin. No anticoagulant therapy was instituted. Over the next 24 hours, her condition worsened. She became comatose, as well as developing a generalized tonic-clonic seizure. Day 12, laboratory examinations revealed an undetectable TSH-level CTSH (thyroid stimulating hormone) <0.005 mcIU/ml), with a level of free thyroxin 7.77 ng/dl (0.9-1.7), free triiodothyronin 29.6 pg/ml (2.3-4.3), and positive anti-TSH receptor antibodies determined subsequently. Coagulation factor VIII activity was 155% (normal range 60-150). Protein C deficiency (antigen 59%, activity 49%) was also present, suggesting a congenital type I heterozygous deficiency. A diagnosis of thyroid crisis on the basis of Graves' disease was made. The patient remained comatose and died on Day 16, with renal failure. The patient had protein C deficiency, a well-established risk factor for cerebral venous thrombosis (CVT). However, additional risk factors are required in most cases to precipitate CVT. In our case, this trigger was most likely thyroid crisis, suggesting that thyrotoxicosis, probably through hypercoagulability, may be a predisposing factor for the development of CVT.
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PMID:[Thyroid crisis and protein C deficiency in a case of superior sagittal sinus thrombosis]. 1737 Jun 53

A previously fit and well 18-year-old woman presented to the accident and emergency department following referral by her general practitioner with a provisional diagnosis of appendicitis. The history obtained from the patient revealed the presence of a bitemporal headache with associated neck stiffness, photophobia and vomiting for approximately 1.5 weeks. The patient complained of abdominal pain localised to her right iliac fossa and anorexia for approximately 1 week. She also noted the presence of a cough productive of green sputum for 3 weeks. A chest radiograph was obtained which showed a large area of consolidation in the right lower lobe consistent with infection and a linear density in keeping with a metallic foreign body. Following review of the chest radiograph, the patient was interviewed further and recalled having inhaled a pushpin approximately 1 year before her presentation. Aspiration of foreign bodies is relatively common in children and is often associated with delayed diagnosis and high morbidity. To prevent delayed diagnosis, characteristic symptoms and clinical and radiological signs of foreign body aspiration should be checked in all suspected cases and a low index of suspicion for ordering additional imaging or using bronchoscopy for diagnostic purposes should be employed.
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PMID:Delayed presentation following accidental inhalation of a pushpin. 2002 18

Emergency medicine physicians aim to stabilize or restore vital functions, establish diagnosis, initiate specific treatments and adequately orientate patients. This year, new evidences have improved our knowledge about diagnostic strategy for patients with acute non traumatic headache, treatment of acute atrial fibrillation and outpatient management of acute pulmonary embolism. Reducing injection pain of local anesthetics, reducing irradiation by using alternative diagnostic tools in appendicitis suspicion, and identification of trauma patients who benefit from tranexamic acid administration are other illustrations of the efforts to improve efficacy, safety and comfort in the management of emergency patients.
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PMID:[Emergency medicine: updates 2011]. 2230 38

A 45-year-old man presented with a rare case of glioblastoma associated with intratumoral abscess formation manifesting as headache and vomiting after an appendectomy. Computed tomography and magnetic resonance imaging demonstrated a ring-enhanced lesion mimicking malignant glioma. Craniotomy and tumor removal were performed. Abscess formation within the intra-axial tumor was found intraoperatively. Histological examination revealed glioblastoma with abscess, and the etiological agent was anaerobic Gram-negative bacilli. The suspected route of microbial migration and colonization in this tumor was bacteremia from appendicitis.
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PMID:Glioblastoma associated with intratumoral abscess formation. Case report. 2236 93


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