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

A clinical, epidemiological and virological investigation was conducted on patients in two general practices in Cambridge, England, during an influenza epidemic between February and April 1963. The epidemiological pattern differed from that of the 1957-58 Asian influenza epidemic in that the overall incidence was considerably lower (3.2%) and that the highest attack rates were not in school children but in pre-school children (71.5 per 1000 persons).Virological investigation confirmed the diagnosis of Influenza A2 infection in 56 of 63 patients (89%). Isolations were made in 29 of 51 specimens tested. Serological studies revealed that the complement fixation test was more reliable than hemagglutination - inhibition or neutralization tests. Clinical features resembled those reported in previous epidemics, cough, headache and limb pains being prominent features.
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PMID:Asian influenza in 1963 in two general practices in Cambridge, England. 582 80

This article reports a case of needlestick transmission of human T-lymphotropic virus type III (HTLV-III) infection to a health care worker in the UK from a patient who was presumably infected while in Africa. The patient, a white woman who had lived in central southern Africa, presented at the hospital with general malaise, dry cough, and fever. Lung biopsy revealed Pneumocystis carinii pneumonia infection, and the patient was seropositive for HTLV-III infection with a titer of 260. The patient reported that she had been unwell for 2-3 years. She had none of the accepted risk factors for acquired immunodeficiency syndrome (AIDS), and neither she nor her husband had visited the US, the Caribbean, or Zaire. Serum from the husband was positive for HTLV-III antibodies at a titer of 450. Despite intensive management and treatment with pentamidine, the patient died. During management of this case, a nursing staff member sustained a needlestick injury to the finger while resheathing a hypodermic needle. A small amount of blood was probably injected. 13 days later, the health care worker developed a severe flu-like illness with sore throat, headache, myalgia, and facial neuralgia. A macular rash and generalized lymphadenopathy were also noted. Serum drawn 27 days after the incident was negative for anti-HTLV-III infection, but titers on days 49 and 57 were 12 and 24, respectively. This contrasts with experience in the US, where needlestick injuries in health care workers have not resulted in either disease or transmission. It is assumed that the patient acquired AIDS in Africa, and that the infection was transmitted heterosexually. This case raises the possibility of differences in infectivity and other characteristics between HTLV-III viruses of US and African origin.
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PMID:Needlestick transmission of HTLV-III from a patient infected in Africa. 615 Mar 72

Sixty patients with acute viral encephalitis admitted to The London Hospital in the last fifteen years have been reviewed. These consisted of 12 patients with known viral infection, 29 patients with acute viral infection of undetermined type, and 19 patients in whom an encephalitic illness followed a viral infection (post-infection encephalitis). The patients with primary viral encephalitis presented with an inflammatory brain disorder, including headaches and fever, and developed focal or diffuse neurological signs. Patients with post-infection encephalitis, usually following a 'flu'-like illness, presented with an acute neurological disturbance. The results of investigations, including virological studies, CSF examination, electroencephalography and neuroradiology, are described. Biopsy or autopsy material was available in 11 patients and these pathological findings supported the clinical classification of these patients. The mortality was highest in patients with herpes simplex virus encephalitis and lowest in patients with post-infection encephalitis. A considerable morbidity was found, not only in patients with primary viral encephalitis, but also in patients with encephalitis of unknown aetiology and post-infection encephalitis.
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PMID:Acute viral encephalitis: its diagnosis and outcome. 625 3

This study was designed to evaluate the clinical tolerance to multiple IM injections of rDNA-produced human alpha-2 interferon (IFN) (Schering-Plough 30500) in patients with solid tumours. IFN was administered in escalating IM doses in separate groups of patients daily for 14 days and then twice weekly for a further 10 weeks. The dosage levels were 1, 3, 10, and 30 million U/injection. Subjective toxicity could be divided into two types, acute and chronic. The acute reactions took the form of an influenza-like syndrome consisting in chills, rigors, headache, tremor, nausea, vomiting, and myalgia. These symptoms were dose-related but tachyphylaxis developed with continued dosing. The chronic toxicity consisted of malaise, lethargy, fatigue, anorexia, and confusion. These symptoms were not so dose-dependent and tended to become more severe with prolonged treatment. Objective toxicity consisted of myelosuppression and liver dysfunction. Granulocyte counts below 1.0 X 10(9)/l were seen in three patients at the 30-million-U level, with platelet counts less than 100 X 10(9)/l in two of these. Elevation of the liver enzymes were seen in all five patients treated at 30 million U, but returned to normal after 1 week without IFN in all but one patient. A tolerable dose (IM) for phase II/III studies lies between 3 and 10 million U for daily scheduling and between 10 and 30 million U for twice-weekly injections.
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PMID:A phase I toxicity study of human rDNA interferon in patients with solid tumours. 646 93

We analyzed the effects of an accidental tenfold overdose of influenza vaccine that was given to 31 young healthy members of the Israel Defense Forces. A clinical workup and serological tests were performed after the vaccination in order to quantify any side effects or complications and relate them to immunogenicity of the vaccine administered. A small age-matched control group of 20 soldiers of the Israel Defense Forces who received normal doses (0.5 ml) of vaccine was subjected to the same examinations. A low vaccine efficacy was noted with the recommended 0.5-ml dose (7 micrograms of hemagglutinin of each influenza type), shown by low fourfold titer rises. A significantly higher number of fourfold changes was noted, as expected, in the study group that received 5.0 ml. Pre- and postvaccination geometric mean titers (GMT) in the control group for A/Bangkok (H3N2), A/Brazil (H1N1) and B/Singapore rose from 21.42 to 47.56, from 13.89 to 45.74 and from 10.44 to 11.68, respectively. In the study group the elevation was significantly more pronounced, GMT rising from 19.15 to 83.54, from 16.81 to 96.60 and from 10.00 to 18.88, respectively. Some minor reactions, such as headache and general malaise, were observed in both the study and control groups, but were more frequent in the former. No severe immediate or long-term local and systemic side effects were noted in either group. The findings presented emphasize the high safety limits of the vaccine used, but also highlight its poor immunogenicity.
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PMID:Accidental tenfold overdose of influenza vaccine: a clinical and serological study. 646 61

In the absence of recognized pneumonitis, psittacosis is unlikely to be considered as a cause of infection in patients with febrile illnesses. To identify findings useful in the diagnosis of psittacosis, the clinical and roentgenographic characteristics of 46 cases that occurred in two outbreaks among workers in turkey processing plants were reviewed. Headache (96% of patients), chills (93% of patients), and fever (89% of patients) were the most common symptoms; a nonproductive cough occurred in 65% of patients. Rales or rhonchi were detected in only six (18%) of 33 patients examined, but 21 (72%) of 29 patients receiving a chest film had roentgenographic evidence of pneumonia. We conclude that few diagnostically useful symptoms or signs occur in patients with psittacosis but that roentgenographically confirmed pneumonitis may occur commonly in patients with little clinical evidence of pneumonitis. A history of exposure to birds, in an individual with a flu-like illness, appears to be the single best clue to the diagnosis of psittacosis.
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PMID:Psittacosis. A diagnostic challenge. 649 78

Four hundred twenty-six volunteers aged 16 to 83 years were given experimental doses of inactivated monovalent [A/USSR/77 (H1N1)] and trivalent [A/USSR/77 (H1N1), A/Texas/77 (H3N2), B/Hong Kong/72] influenza vaccines as part of a double-blinded, placebo-controlled, national collaborative study. Local reactions at inoculation sites occurred in less than 6.6% of volunteers. Systemic reactions, generally consisting of low-grade fever, myalgia, or headache, lasting less than 24 hr, did not occur more frequently in vaccinees than in placebo recipients. Vaccines containing lower doses of the A/Texas/77 (H3N2) hemagglutinin (8-10 micrograms) and B/Hong Kong/72 hemagglutinin (6-9 micrograms) produced hemagglutinin-inhibiting (HAI) antibody responses equivalent to those produced by higher doses (15-28 and 19-28 micrograms, respectively) in all age groups. Single injections of vaccines containing lower doses of A/USSR/77 (H1N1) hemagglutinin (4-7 micrograms) induced titers of HAI antibody of greater than 1:40 in 93% of volunteers greater than or equal to 26 years of age but in only 58% of volunteers less than 26 years of age. In this latter group, two injections containing higher doses (10-19 micrograms) induced better antibody responses. Vaccines containing approximately 6-15 micrograms of hemagglutinin of each antigen can be expected to be well tolerated and to induce good HAI antibody responses in a one- or two-dose regimen, depending on the age group.
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PMID:Serologic responses and systemic reactions in adults after vaccination with monovalent A/USSR/77 and trivalent A/USSR/77, A/Texas/77, B/Hong Kong/72 influenza vaccines. 662 89

Symptoms consistent with hypersensitivity pneumonitis (HP) occurred in 26 of 50 employees working in a localized area of a large factory. This area was served by a single heating-cooling unit utilizing a water humidification system. The illness consisted of flu-like symptoms with fever, chills, headache, cough, dyspnea. Most of the subjects affected demonstrated precipitating antibodies to a variety of organisms associated with HP, and inhalation challenge with water from the humidification system resulted in the reproduction of symptoms in one employee with a history suggestive of HP. Removal of the humidification system has resulted in a "cure" in that symptoms have not recurred during a one year followup period since the removal.
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PMID:Humidifier lung. An outbreak in office workers. 676 70

The serologic responses and the side effects resulting from the administration of a new subunit vaccine against influenza were compared with those of a currently available whole-virus vaccine in an elderly population. The subunit vaccine is prepared by cleavage of the hemagglutinin and neuraminidase surface antigens from the virus with a cationic detergent, cetyltrimethylammonium bromide. The resulting vaccine is more selectively reduced to these primary antigens than are the available subunit vaccines produced by the use of lipid solvents that disrupt the viral membrane [1]. Previous studies in younger individuals with new subunit preparations of earlier H3N2-subtype viruses as well as influenza A/New Jersey/76 (HswN1) and B/Hong Kong/73 viruses indicated that antibody responses in primed, although not in unprimed, populations wee comparable to those induced by whole-virus vaccines and that side effects were few [2,3]. There were not statistically significant differences in the serologic responses of the vaccine recipients except that the percentage of recipients who achieved titers of HAI antibodies of 1:10 or 1:20 to influenza B/Singapore/222/70 virus after vaccination was greater in the subjects who received the subunit vaccine. There were no statistically significant differences in the percentage of recipients with an antibody response (fourfold or greater in titer) or in the geometric mean titers of HAI antibodies after vaccination between those who had received the trivalent influenza virus vaccine in 1979 and those who had no history of vaccination in 1979. Mild redness and/or tenderness were noticed at the injection site between 6 and 48 hr after vaccination in 16 subjects who received the subunit vaccine and in four subjects who received the subunit vaccine and two who received the whole-virus vaccine (P less than 0.01 by chi 2 test). One patient in each group complained of headache; four subjects who received the subunit vaccine and two who received the whole-virus vaccine complained of fatigue.
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PMID:Responses of elderly subjects to a new subunit influenza virus vaccine. 705 32

During the 1980 influenza B outbreak in King County, Washington, 11 children whose asthma had previously been controlled with a stable theophylline dose, developed theophylline toxicity on this same dose. Two had seizures, eight had nausea and vomiting, and three had headaches. All had clinical evidence of a febrile viral illness. The toxicity appeared to be related to decreased theophylline clearance, which gradually returned to preillness levels over a period of one to three months. Six of ten children had serologic evidence of influenza B, which is presumed to be the cause of the altered clearance. In children receiving chronic theophylline therapy, symptoms of vomiting, headaches, or seizures during a viral illness may be due to theophylline toxicity rather than the virus. Such patients should have an immediate serum theophylline determination, even if previous levels have been in the therapeutic range.
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PMID:Altered theophylline clearance during an influenza B outbreak. 707 Aug 95


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