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

Dengue, a major public health problem throughout subtropical and tropical regions, is an acute infectious disease characterized by biphasic fever, headache, pain in various parts of the body, prostration, rash, lymphadenopathy, and leukopenia. In more severe or complicated dengue, patients present with a severe febrile illness characterized by abnormalities of hemostasis and increased vascular permeability, which in some instances results in a hypovolemic shock. Four distinct serotypes of the dengue virus (dengue-1, dengue-2, dengue-3, and dengue-4) exist, with numerous virus strains found worldwide. Molecular cloning methods have led to a greater understanding of the structure of the RNA genome and definition of virus-specific structural and nonstructural proteins. Progress towards producing safe, effective dengue virus vaccines, a goal for over 45 years, has been made.
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PMID:The dengue viruses. 222 37

A double-blind controlled, randomized, parallel, multicenter 12-week study was conducted to compare the antihypertensive efficacy of lisinopril with that of metoprolol in treatment of moderate to severe hypertension. Initially, 118 patients were recruited on lisinopril and 61 on metoprolol; and for the purpose of efficacy analysis at week 8, 115 patients on lisinopril and 60 on metoprolol were included. The doses of lisinopril or metoprolol were 40-80 mg/day and 100-200 mg/day, respectively. At week 4, the pretreatment diastolic blood pressure of 111 mm Hg was decreased to 97 mm Hg (p less than 0.01) with lisinopril: metoprolol decreased the diastolic blood pressure from 110 to 99 mm Hg (p less than 0.01). Similar decreases were noted at week 8; however, the drop in blood pressure with lisinopril was not significantly different from that with metoprolol. Systolic blood pressure also demonstrated a decrease of about 18 mm Hg with lisinopril and 12 mm Hg with metoprolol (p less than 0.01). This larger decrease in systolic blood pressure with lisinopril was statistically significant at week 4 (p less than 0.05). These decreases in systolic blood pressures were maintained at week 8, again with statistical significance (p less than 0.01). Of the 118 lisinopril-treated patients, four were discontinued from lisinopril therapy because of headache, dizziness, rash, flushing, or lymphadenopathy. Four patients out of 61 (9.8%) were discontinued from metoprolol therapy because of fatigue, somnolence, asthenia, weight gain, flatulence, tremor, or bronchospasm. In conclusion, lisinopril 40-80 mg once daily is as effective as metoprolol 100-200 mg once daily in reducing diastolic blood pressure in patients with moderate to severe hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of antihypertensive efficacy of lisinopril compared to metoprolol in moderate to severe hypertension. 244 53

A 17-year-old male was admitted to our hospital complaining of fever, headache and nausea. On physical examinations cervical and inguinal lymphadenopathy and hepatosplenomegaly were noted. Neurological examination revealed meningeal signs. Blood examination showed slightly increased lymphocytes and atypical lymphocytes (1-4%), increased ESR, CRP (2+), slightly elevated EBV VCA IgG (X20), and normal EBV VCA IgM (less than X 10). Initial pressure of CSF was 195mmH2O, cells 46/3mm3, protein 50mg/dl. Slowing of back ground activity of EEG such as theta and delta wave was noted. CT scan revealed normal. During the course EBV VCA IgG elevated to X160, EBV VCA IgM elevated to X20. Slight respiratory disturbance, photophobia, and dysosmia were noted. One month later, clinical symptoms and laboratory data improved, the patient was discharged. Forty days after the discharge, headache was excerbated and increased CSF protein (100mg/dl) and pleocytosis (33/3mm3) were noted. The patient was readmitted to the hospital. After 2 weeks in the hospital, symptoms were diminished and laboratory findings revealed normal. During 2 years before the third admission he was asymptomatic and could enjoy the college life. At age 19, he was admitted to our hospital complaining of fever, headache and nausea. Neurologically slight meningeal irritation was noted. Blood examination revealed 1% atypical lymphocytes. EBV VCA IgG was elevated (X320) and EBNA was X80. CSF protein was slightly increased (52mg/dl). During the clinical course CSF protein was elevated to 105mg/dl and cell count to 502/3mm3 (N: L = 27: 409, with 66 atypical lymphocytes). Persistent hiccup was noted. After 50 days CSF findings were improved and he was discharged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of recurrent Epstein-Barr virus meningitis]. 254

Forty-four patients, including 26 adults and 18 children under 15 years of age, were referred for evaluation of recurrent or persistent illnesses, with symptoms including pharyngitis, lymphadenopathy, fever, headaches, arthralgia, fatigue, depression, dyslogia, and myalgia. Thirty-nine patients were positive for Epstein-Barr virus antibody with antibody levels compatible with active infection for at least 1 year. Antiviral capsid antigen and anti-early antigen titers of patients were significantly greater (p less than 0.001) than age-group-matched controls. The frequency, number, duration, and patterns of symptoms, as well as patient sex, were compared by age in study patients seropositive and seronegative for Epstein-Barr virus. Illness patterns were not associated with changes in specific antibody titers or clinical findings. Lymphocyte phenotype and function analyses were done in 11 of the 39 patients positive for Epstein-Barr virus antibody; no consistent differences from normal were found. Only 1 of 32 patients had circulating interferon, in contrast to 7 of 7 patients with acute infectious mononucleosis. There were many adverse consequences of the illness. Epstein-Barr virus infection may not be self-limiting, and the virus may be associated with clinically recognizable illness other than infectious mononucleosis in children as well as in adults.
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PMID:Evidence for active Epstein-Barr virus infection in patients with persistent, unexplained illnesses: elevated anti-early antigen antibodies. 257 66

During a recent outbreak of Rhodesian sleeping sickness in the Lambwe Valley no asymptomatic Rhodesian sleeping sickness patients were found although 54% of the primary patients had mild symptoms and 9% were stuporous or comatose at presentation. The duration of symptoms was three months or less in 90% of the patients. Headache, weakness, joint and back pains and weight loss were claimed by at least 75% of the patients, while 82% of the females reported amenorrhoea and 70% of the males claimed impotency. Physical examination revealed lymphadenopathy in 86% but fever in only 36% of the patients, while chancres were found in only 16%. Patients had significantly lower levels of haemoglobin and thrombocytes than controls and their erythrocyte sedimentation rates were elevated. A comparison of both blood group and haemoglobin type between patients and controls yielded no significant differences. Fifty-seven per cent of the primary patients reporting mild symptoms had abnormal levels of leucocytes in their CSF. All relapse patients had abnormal CSF parameters. Levels of serum urea nitrogen were significantly elevated in patients, but SGOT, SGPT and total bilirubin were not. Levels of albumin and beta-globulin in patients were significantly lower than controls while gamma-globulin was elevated. Mean serum IgM levels in patients were elevated to nearly three-fold those of controls, but 35% of the individual patient values fell within the 95% range of control values. Some patients had extended prothrombin and thrombin times while fibrinogen levels were significantly elevated. No patients reported haemorrhage, and none was seen.
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PMID:Presenting features of Rhodesian sleeping sickness patients in the Lambwe Valley, Kenya. 261 98

Erythema migrans is the distinctive cutaneous marker of Lyme borreliosis. The clinical picture is variable but at some point in its evolution, erythema migrans presents as a red, centrifugally expanding, annular plaque. Erythema migrans may appear as a solitary lesion or in multiplicity. It may be accompanied by extra cutaneous signs and symptoms as fever, headache, musculoskeletal discomfort, and regional lymphadenopathy. The diagnosis of erythema migrans is based primarily on clinical findings because serologic tests to detect elevated antibody levels to Borrelia burgdorferi are frequently negative during the first few weeks of the illness. Identification of Borrelia burgdorferi from skin biopsy specimens obtained from erythema migrans lesions microbiologically or histopathologically will confirm the clinical diagnosis of erythema migrans.
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PMID:Cutaneous manifestations of Lyme borreliosis. 268 22

Lyme disease, which is caused by the tick-borne spirochete Borrelia burgdorferi, usually begins with a characteristic skin lesion erythema chronicum migrans (ECM), that may be followed by neurological or cardiac abnormalities and is accompanied by malaise, fatigue, fever, myalgia, headache, lymphadenopathy and is often followed by arthritis. The disease takes its name from Lyme, Connecticut, where the full spectrum of illness was first described in 1975. It is known to be a multisystemic infectious disease. Because culture and direct visualisation of spirochetes are often negative in Lyme disease, serological testing has been the only practical laboratory aid in diagnosis and primarily clinical findings.
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PMID:[Lyme disease]. 269 64

A 67-year-old man was admitted in October 1987 with complaints of nausea, headache, dizziness and speech disturbance. Hematological examination showed pancytopenia. Bone marrow aspiration failed with a dry tap. A month later, the second aspiration showed hypocellular marrow containing 18.2% of lymphoma cells. Physical examination showed splenomegaly and lymph node swelling. Polyclonal hypergammaglobulinemia was not observed. A lymph node biopsy exhibited typical histology of immunoblastic lymphadenopathy (IBL)-like T cell lymphoma. Surface marker CD3 and CD4 positive cells were dominant. The patient complained of epigastric pain and occult blood was positive in stool. Gastrofiberscopic examination disclosed well differentiated adenocarcinoma in situ located on a polyp, and polypectomy was performed. Lymphoma was treated with cyclophosphamide, doxorubicin, vinblastine and prednisolone. Splenomegaly and lymph node swelling were reduced in size but the effect was temporary. Thereafter the patient has been treated with cyclophosphamide, doxorubicin, vindesine, prednisolone and etoposide every 3 weeks. This is our first case report of IBL-like T cell lymphoma associated with early gastric cancer.
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PMID:[IBL-like T cell lymphoma associated with early gastric cancer: a case report]. 278 12

In the course of a prospective immunoepidemiological study of homosexual men in Sydney, seroconversion to the AIDS-associated retrovirus (ARV) was observed in 12 subjects. Review of the clinical files defined an acute infectious-mononucleosis-like illness in 11 subjects. The illness was of sudden onset, lasted from 3 to 14 days, and was associated with fevers, sweats, malaise, lethargy, anorexia, nausea, myalgia, arthralgia, headaches, sore throat, diarrhoea, generalised lymphadenopathy, a macular erythematous truncal eruption, and thrombocytopenia. In 1 subject an incubation period of 6 days after presumed exposure to ARV was determined and in 3 subjects seroconversion took place 19, 32, and 56 days after onset. Comparison of T-cell subsets before and after the acute illness showed inversion of T4:T8 ratio in 8 subjects, due to increased numbers of circulating T8+ cells. These findings support the notion of an acute clinical, immunological, and serological response to infection with ARV which should be considered in the differential diagnosis of mononucleosis-like syndromes in groups at high risk for the development of AIDS.
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PMID:Acute AIDS retrovirus infection. Definition of a clinical illness associated with seroconversion. 285 99

The burrowing asp, Atractaspis bibronii, causes a significant proportion of cases of snakebite near Empangeni, Natal. Data from 8 cases are presented. All were in rural Zulus, and the bites were usually inflicted on the foot during summer nights, in or near the patient's home. There was no sexual bias, but over 50% of the victims were under 14 years of age. Envenomation was mild, characterised by moderate to intense pain and localised swelling, regional lymphadenopathy with occasional discoloration, blistering or necrosis at the bite site. Neurological signs were absent, but symptoms of headache, painful eye movements, dry mouth and hoarseness were recorded. Minor haematological abnormalities were detected in a few patients. Treatment involved analgesics and limb elevation, with antibiotic cover and intravenous fluids when necessary. Antivenom is not effective and was not used. There were no deaths.
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PMID:Observations on the bite of the southern burrowing asp (Atractaspis bibronii) in Natal. 292 81


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