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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-one patients with brucellosis wereinvestigated. Four patients with the classical manifestations of acute brucellosis presented no problems in diagnosis. The other 17 patients suffered from chronic disease and had no history of any acute episode of brucellosis. The most common symptoms in this group were tiredness, fatigue, depression, arthralgia and muscular pains. Abdominal pain and pain in the temperomandibular joints were marked in some patients. Most of these patients had been receiving psychiatric treatment. Clinical examination was largely negative, but lymphadenopathy was found in 9 cases. Brucella meningo-encephalitis was diagnosed in 7 patients who complained of severe headache. Problems in the diagnosis of chronic brucellosis with an insidious onset are discussed.
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PMID:Clinical aspects of chronic brucellosis. 81 22

Medical barriers to family planning (FP) are identified as contraindications, eligibility, process hurdles, the provider of contraception, provider bias, and regulation. These obstacles to FP are considered practices which may have a medical rationale in some manner but are scientifically unjustified. The denial or interference in obtaining contraception is unacceptable. Examples are given of barriers, i.e., eligibility criteria such as lack of headaches or history of diabetes. Obstacles that deter oral contraception (OC) are a by-product of testing requirements, repeat visits, and long waits. OC provision does not require a physician's prescription; a trained technician can perform similar functions. When a provider such as community-based distributor is limited in provision of methods, women are not given the right to choose from a full menu. Medical barriers occur due to the ignorance about the safety of contraceptives, the benefits of FP, and the role of health professionals in service delivery. Clinics tend to be curative rather than preventive. In place of careful thinking, there are rules in a hierarchical medical system suitable for treatment of complicated life-threatening illness. Barriers are complicated, interrelated, and situational. The solutions suggested are 1) informing the health community and mobilizing medical leadership, 2) defining and treating the FP seeker as a client and not a medical patient, and 3) engaging in more epidemiological research to assess the risk/benefits of contraceptive use and operations research to evaluate ways to reduce medical restrictions. The position that obstacles are an example of quality of care does not support the Bruce-Jain FP quality of care framework. Health and FP services may be integrated but contraceptive usage should not be at the expense of health care. The obstacles are not just in developing countries where it would appear that access to FP far outweighs the risks of maternal mortality from pregnancy. Providers are not the target is creating a win-win-win situation for the client, the provider, and organized public health.
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PMID:Medical barriers to access to family planning. 809 86

A young Mexican woman had headache and left arm weakness develop shortly after immigrating to the United States. A solitary cerebral cysticercus was found at surgery, but, instead of the expected finding of clear fluid, the cyst contained pus from which Brucella melitensis was cultured. Although the patient had no signs or symptoms suggestive of brucellosis, agglutination studies revealed IgM and IgG antibodies consistent with active brucellosis. Clinicians should be alert to the possibility of multiple infections in immigrants from countries where parasites and bacteria that are uncommon in the United States are endemic.
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PMID:Concomitant neurocysticercosis and brucellosis. 224 97

A 36-year-old Hispanic man came into the emergency department with nonspecific symptoms (headache, myalgias, low-grade temperature, and low white blood cell count) and was diagnosed with brucella meningitis. The patient said he had consumed unpasteurized goat's milk and cheese in Mexico, and had been treated 3 months previously for a febrile illness diagnosed as Malta fever (brucellosis). Cultures of both the blood and cerebrospinal fluid yielded Brucella melitensis. Blood agglutinin results for B abortus were positive at greater than 1:160. Unpasteurized milk and cheese are consumed in many countries where brucellosis is endemic. Emergency physicians are occasionally confronted with patients from developing countries with diseases that require rapid and specific diagnosis for optimal treatment.
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PMID:Brucella meningitis. 229 33

A 4-year-old boy developed symptoms consistent with brucellosis and was treated with combined streptomycin and tetracycline. He had a high brucella agglutinin titer. However, he continued to have headache and papilledema. A brain CT revealed 6 large abscesses. Brucella melitensis was isolated from abscess material. The boy recovered completely after drainage therapy.
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PMID:Brucellosis in a child complicated with multiple brain abscesses. 275 44

The clinical pattern of 400 cases of brucellosis in Kuwait is presented. The disease was acute in 77 per cent, sub-acute in 12.5 per cent and chronic in 10.5 per cent of cases. Raw milk was the major source of infection. The major features on presentation, irrespective of the course of the disease, were fever, sweating, headache, rigors, arthralgia, myalgia, and low back pain. Hepatosplenomegaly was present in 41 per cent of cases and in 32 per cent neither liver nor spleen were palpable. The haematologic findings were not specific and hepatic dysfunction (shown by liver enzyme abnormalities) was common. Skeletal (26 per cent) and genital (8.5 per cent) changes and neurobrucellosis (7 per cent) were the major complications. The ELISA was the most sensitive and reliable diagnostic test especially in relation to chronic brucellosis and neurobrucellosis. ELISA allowed the determination of brucella-specific immunoglobulins (Ig)G, IgM and IgA in the CSF, and provided profiles of Ig, in sera, which were different in patients with chronic (elevated IgG and IgA) from those with acute (elevated IgM alone or IgG, IgM and IgA) brucellosis. Treatment with tetracycline, doxycycline or rifampicin gave a cure rate of over 91 per cent in acute and subacute brucellosis. Co-trimoxazole was associated with a relapse rate of 50 per cent. Two drug combinations of streptomycin and tetracycline, streptomycin and rifampicin or streptomycin and doxycycline were effective, but one of five patients with chronic brucellosis relapsed. A combination of streptomycin, tetracycline and rifampicin with or without steroids was used successfully in neurobrucellosis, septicaemic shock and subacute bacterial endocarditis.
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PMID:Human brucellosis in Kuwait: a prospective study of 400 cases. 305 Oct 80

A retrospective study of chest radiographs in patients with brucellosis was undertaken at King Khalid University Hospital, Riyadh. The commonest presenting symptoms were fever, back and joint pains, excessive sweating, headache, and cough. Different chest radiographic abnormalities were detected, including soft miliary mottling, parenchymal nodules, consolidation, chronic diffuse changes, hilar or paratracheal lymphadenopathy and pneumothorax. Soft miliary mottling and pneumothorax have not been described before. The high incidence of lung abnormalities is most probably due to the chronicity of the disease in the present series.
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PMID:The chest radiograph in brucellosis. 333 40

Three hundred seventy-nine Kuwaiti patients with brucellosis were admitted to Adan General Hospital, Kuwait, during the period 1984-1985. Of these 231 were males and 148 were females. Diagnosis was based on symptoms and signs compatible with the disease and on the detection of significantly elevated antibody titer and/or positive blood culture. The primary means of exposure were the consumption of raw milk and contact with goats, sheep, or camels. Patients most frequently presented with fever (91%), chills (40%), sweats (39%), gastrointestinal symptoms (30%), headache (23%), respiratory symptoms (23%), and musculoskeletal symptoms (22%). The major signs were osteoarticular involvement (37%), hepatosplenomegaly (27%), and lymphadenopathy (9%). Different regimens of treatment were used, but the highest rate of cure was achieved with triple therapy--tetracycline, streptomycin, and rifampin.
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PMID:The nature of human brucellosis in Kuwait: study of 379 cases. 335 31

Forty patients with brucellosis were hospitalized and clinical and laboratory findings of patients were recorded, treatment regimens were discussed. Twenty-five of the patients were males and 15 of the patients were females. Leukopenia 21.62%, anemia 27.02% and ESR elevation 83.87% were found. Fever and exhaustion were present all of the patients. Arthralgia, nonproductive cough, gastrointestinal symptoms, headache and night sweating were the other common symptoms. Hepatomegaly, splenomegaly, hepatosplenomegaly and ronchus were imported physical examination findings. First choice treatment solution was tetracycline-streptomycin combination and this combination succeed 89.19 in percent. Relapses were treated with rifampicin.
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PMID:[Brucellosis: clinical and laboratory findings and treatment in 40 patients]. 344 17

Chronic intracranial hypertension in the presence of hydrocephalus and/or arachnoiditis is a rare presentation of neurobrucellosis. The present case is exceptional because neither hydrocephalus nor arachnoiditis were present. Brucellosis was diagnosed by serological tests. The patient developed asthenia, anorexia, weight loss, violent headaches, explosive vomiting, bilateral papilloedema, diplopia with paralysis of the abducens nerves, left supranuclear facial paralysis and left hemiparesis. A skull radiograph showed destruction of the sella turcica. Rapid recovery was attained with the use of antibiotics. The pathogenesis of this intracranial hypertension syndrome with destruction of sella turcica is discussed.
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PMID:Chronic intracranial hypertension secondary to neurobrucellosis. 381 88


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