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

Legionella pneumophila is the cause of Legionnaires' disease, and Pontiac fever, an influenza-like condition without pneumonia. We present a case of Pontiac fever after exposure to a hot tub contaminated with L pneumophila. A 37 y/o wf presented to the office with acute onset of sore throat, fever, headache, and myalgia. Patient was hospitalized 3 days later because of worsening shortness of air. Chest x-ray was normal. Patient was treated with 2 days of IV erythromycin and was discharged home on oral erythromycin. Her Legionella IFA was 1:16,384. Two days later, she developed chest tightness, pleuritic chest pain, and increasing shortness of air but did not have any cough or sputum production. She was re-hospitalized with a diagnosis of Pontiac fever and treated with IV erythromycin plus oral rifampin. A repeat chest x-ray remained normal. After a detailed epidemiologic history was obtained, it was noted that she became ill after using a hot tub, which her two children also used and they themselves developed a self limited illness. Water from the hot tub was positive for L pneumophila by DFA, culture, and PCR. Patient improved gradually with therapy and was discharged home. This report emphasizes the importance of a complete epidemiologic history in the diagnosis of respiratory infections. It also demonstrates that aquatic environment can be contaminated with Legionella and serve as a source of infection.
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PMID:Hot tub legionellosis. 885 93

Extensive data generated from early phase I trials have demonstrated important schedule-dependent differences in gemcitabine's toxicity profile and activity. Frequent drug administration produced a high incidence of toxicities: in the daily schedule, flu-like symptoms (fever, malaise, and headache) were experienced and in some patients idiosyncratic episodes of severe hypotension; in the twice-a-week schedule the dose-limiting toxicity was thrombocytopenia. Less frequent drug administration was better tolerated (dose-limiting toxicity was myelosuppression), but little efficacy was observed. These three schedules were not followed up in phase II studies. Instead, a weekly schedule was selected in which gemcitabine was given as a 30-minute infusion once a week for 3 weeks followed by a week of rest. In this schedule, gemcitabine provided a combination of activity and acceptable tolerability, with dose-limiting toxicity being thrombocytopenia at doses of 790 to 1,500 mg/m2. An understanding of the clinical pharmacology of this novel agent has resulted in a second generation of phase I trials that attempt to increase dose intensity, maintain an acceptable toxicity profile, and improve the efficacy in minimally pre-treated or untreated patients. Most of the studies used the weekly schedule of drug administration. Strategies include escalating dose and increasing infusion duration. At present, the gemcitabine dose with the best balance of activity and tolerability is weekly doses of 1,000 mg/m2 administered over 30 minutes. However, additional studies will be needed to explore completely the newer strategies for dose intensification described in this overview.
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PMID:Phase I studies with the novel nucleoside analog gemcitabine. 889 78

A container truck leaked 800 L (200 gallons) of hydrochloric acid (HCl) near a mobile home park in Louisiana in August 1993. The investigating officer and residents became acutely ill with burning and tearing eyes, burning throats, headache, chest pain, shortness of breath, and flu-like complaints. Twenty months later, 45 exposed adult subjects and 56 age-matched referents underwent neurobehavioral testing, including balance, reaction time, blink-reflex latency, and spirometry. They also completed health questionnaires and a profile of mood states. The exposed subjects differed significantly from referents by t test and by covariance analysis for balance, simple and two-choice visual reaction time, digit symbol, and for placing pegs in a pegboard. Proximity to the HCl spill increased sway speeds and impaired pulmonary midflow rates. Chronic neurobehavioral dysfunction and airways obstruction were found after environmental HCl exposure.
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PMID:Effects of a hydrochloric acid spill on neurobehavioral and pulmonary function. 889 78

Aprotinin aerosol has been previously shown to have protective effects in experimental influenza- and parainfluenza-induced bronchopneumonias in animals. This paper presents the results of controlled clinical studies to evaluate the therapeutical efficiency of aprotinin aerosol in natural influenza and parainfluenza infections in human beings. A total of 52 patients were followed up. They received either soda (placebo) or aprotinin inhalations thrice a day for 4-5 days. The following mean duration (in days) of symptoms was found in the control (placebo-treated) and aprotinin-treated patients. These were: 2.5 versus 1.8 for fever, 2.0 versus 1.5 for headache, 2.9 versus 1.8 for weakness, 3.9 and 2.8 for common cold, 3.1 versus 1.6 for sore throat, 4.9 versus 2.8 for pharyngeal hyperemia, 4.9 versus 4.0 for cough, and 3.5 versus 1.3 for hoarse voice (p < 0.05). Inhaled aprotinin was well tolerated by the patients and caused no topical irritating effects and allergic reactions. The findings demonstrate the noticeable clinical efficacy of aprotinin aerosol in human influenza and parainfluenza.
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PMID:[Clinical effectiveness of aprotinin aerosol in influenza and parainfluenza]. 892 22

Do persons who utilize the services of the alternative therapist demonstrate a greater self-care response to illness? This cross-sectional study was done to compare the health perceptions and self-care response to minor illness among users of conventional medical care and alternative therapy. Data were collected with a pre-tested, self-administered questionnaire to 99 patients of medical practitioners and 74 of alternative therapists. Results indicated statistically significant differences in some health perceptions such as ways to improve general health and responsibility for personal health. For both groups there were similarities in socio-demographic characteristics and self-care responses to minor illness, such as headaches, constipation, diarrhoea, sinus congestion and colds or flu. Also, results reflected a common practice of self-management of minor illness and an overlap in attendance by patients to both groups of practitioners. Recommendations are made for the public to be guided in its practice of self-management of minor illness and that a regulatory body be set up to govern the practice of alternative therapy in Jamaica.
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PMID:Health perceptions and self-care response to illness among users of medical and alternative health services in St Andrew, Jamaica. 895 26

The intramuscular administration of interferon-beta (IFN-beta) at a dosage of 6 million units three times per week for 6 months has been evaluated in 90 patients included in a multicenter, randomized, controlled trial for the treatment of chronic hepatitis C. Transaminase levels were significantly reduced in IFN-beta-treated patients (p = 0.015) and were significantly lower with respect to those of the untreated controls (p = 0.040 at 6 months). Four treated (8%) and one untreated (2.5%) patients had normal transaminase values after 6 months. At study end (12 months), three quarters of the IFN-beta-treated patients had sustained transaminase normalization, whereas the untreated case had relapsed. Hepatitis C viremia was cleared in 6 (12%) treated patients but in none of the untreated controls (p = 0.058). Side effects of IFN-beta were infrequent (a mild flu-like syndrome in < 10%, asthenia in 16%, anorexia in 8%, headaches and weight loss in 8%, and hair loss in 4%). Leukocyte and platelet counts decreased during IFN-beta treatment, but no dose modifications were necessary. Such decreases were not statistically significant when compared with the levels in the untreated controls. Intramuscular IFN-beta at the dosage used has little efficacy in the treatment of chronic hepatitis C. Because of IFN-beta tolerance, higher doses and alternate routes of injection might prove beneficial for the treatment of this disease.
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PMID:Multicenter randomized, controlled study of intramuscular administration of interferon-beta for the treatment of chronic hepatitis C. 904 68

Endotoxins are lipopolysaccharides from the outer cell wall of Gram-negative bacteria. Exposure to endotoxins can take place in industries where organic material is handled, in agriculture, in garbage handling, and sewage treatment. Byssinosis defined as Monday chest tightness and slight dyspnoea in the work place has been related to endotoxin exposure in cotton mills, but studies indicate that similar symptoms may be found in other work places. Other symptoms are: Headache, nausea, gastrointestinal symptoms and influenza-like symptoms. Several studies have shown a decrease in FEV1 following exposure to endotoxins. The relationship between exposure to organic dust, microorganisms, endotoxins and other chemicals in the work place and disease needs further research.
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PMID:[Exposure to endotoxins in the environment. Occurrence and health hazards]. 918 80

In Europe, Chlamydia psittaci is a relatively common cause of abortion in sheep and other mammals. Psittacosis in humans is typically described as a mild-to-moderate flu-like illness. If psittacosis is acquired during pregnancy, it can present as a severe, progressive, febrile illness, with headache, disseminated intravascular coagulation, abnormal liver enzyme studies, and impaired renal function. Only cases with significant fetomaternal morbidity and mortality have been reported. Recovery from this disease follows termination of pregnancy and appropriate antibiotic therapy. Direct exposure of gravid humans to infected products of conception is the most commonly reported mode of transmission. Diagnosis is suggested by the placental histopathologic findings, which consist of an intense, acute intervillositis, perivillous fibrin deposition with villous necrosis, and large irregular basophilic intracytoplasmic inclusions within the syncytiotrophoblast. Commercially available genus-specific monoclonal antichlamydial antibody is available for the rapid confirmation of the diagnosis. In the United States, only two cases of gestational psittacosis have been previously reported. In contrast to the experience in Europe, both cases were associated with psittacine birds. This is the first reported instance of ovine-related gestational psittacosis documented in the United States. Gravid patients should be warned to avoid contact with sheep and their products, particularly during the spring lambing period.
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PMID:Gestational psittacosis: case report and literature review. 919 79

Forty-nine subjects were enrolled in a study comparing two dosages of parenterally administered interferon (IFN)-beta in combination with cryotherapy for the treatment of anogenital warts. Subjects were randomized to receive subcutaneous injections of either 2 x 10(6) or 4 x 10(6) IU/m2 of IFN-beta (Biogen) three times a week for a total of 6 weeks. Cryotherapy was administered concomitantly by aerosolization of liquid nitrogen at 10-day intervals. Systemic side- effects were modest in intensity and included fever, chills, myalgia, and headaches (flu-like symptoms). During the first 2 weeks of therapy, they were more common in the high dose group than in the low dose group (P = 0.02). Using survival analysis, there was no significant difference between the two groups in rates of resolution of warts present at baseline (P = 0.62). However, the rate of new lesion formation during the study was significantly lower in the high dose group (P = 0.04).
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PMID:A randomized, double-blind trial of parenteral low dose versus high dose interferon-beta in combination with cryotherapy for treatment of condyloma acuminatum. 922 60

During the months of September 1993 through February 1994, an outbreak of hemorrhagic fever occurred in the city of Jayapura, the provincial capital of Irian Jaya, Indonesia. Seventy-two patients (age range = 1-41 years) with suspected dengue hemorrhagic fever (DHF) were enrolled into the outbreak investigation conducted during October-November 1993. The pediatric patient population consisted of 36 individuals ages 1-12 years of age with a similar male to female ratio. From clinical histories obtained from the children diagnosed with DHF (n = 23), the predominant complaints were fever (100%), headache (96.7%), vomiting (47.8%), abdominal pain (39.1%), back/bone pain (39.1%), cough (39.1%), sore throat (21.7%), convulsions (17.4%), and eye pain (13.0%). Clinical findings of the same pediatric patients included a positive tourniquet test result (100%), thrombocytopenia (100%), hemoconcentration (100%), skin petechiae (43.5%), epistaxis (39.1%), and maculopapular rash (26%). All four of the children diagnosed with DHF grade IV had hepatomegaly, pleural effusion, ascites, cold perspiration, and confusion. Serologic data demonstrated that a majority (46 of 70, 68.7%) of the individuals assessed did not have significant levels of IgM specific for dengue viruses at the time of their admission. However, the nine successful dengue virus isolations were only from these serononreactive cases (19.6%). From the other patients assessed, 11.4% had a primary (or first exposure) serologic response to dengue virus antigen (predominantly IgM); 17.1% had a secondary (or subsequent exposure) serologic response to the same dengue antigens (predominantly IgG response) and 5.7% (four adults) had indeterminate serologic data that could not differentiate between reactivity to dengue or Japanese encephalitis virus antigen preparations. Virus culture of blood samples produced nine dengue virus isolates: DEN- 1 (2), DEN-2 (1), and DEN-3 (6). Japanese encephalitis and influenza viruses were not isolated from blood and pharyngeal specimens, respectively, from any of the patients. Thus, this first reported outbreak of DHF in Irian Jaya, Indonesia was found to be attributed to dengue viruses types 1, 2, and 3.
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PMID:The first reported outbreak of dengue hemorrhagic fever in Irian Jaya, Indonesia. 924 17


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