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Data from clinical trials with benazepril suggest that the safety profile of benazepril is similar to that of other angiotensin-converting enzyme (ACE) inhibitors. Treatment-related side effects occurred in 20% of benazepril-treated patients and in 18% of patients receiving placebo. The most commonly reported side effects with benazepril were headache, dizziness, and fatigue. The incidence of side effects was not affected by the degree of hypertension, age, gender, race, dosage, or the degree of renal impairment. Side effects believed to be related to the pharmacologic action of ACE inhibitors as a class include symptomatic hypotension, which occurred at a relatively low rate with benazepril, and hyperkalemia and elevation of serum creatinine, which occurred to the same extent with benazepril as has been noted with other ACE inhibitors. The mechanism of cough as an ACE inhibitor side effect is unknown; the incidence was similar to that with other ACE inhibitors. Rash and taste disturbance have occurred rarely with benazepril. The incidence of neutropenia and of proteinuria was the same in both the benazepril and placebo groups. Renal failure in hypertensive patients treated with benazepril has not been reported. Overall, benazepril is generally well tolerated by hypertensive patients. The incidence of most side effects is comparable to that with other ACE inhibitors and placebo.
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PMID:Safety profile of benazepril in essential hypertension. 189 40

On the basis of a literature review and eight cases of our own, we analyzed 37 cases of Mycoplasma pneumoniae (MP) infection and Stevens-Johnson syndrome (SJS). Our clinical and laboratory findings do not differ from those reported in the literature for MP infection with no exanthem or for SJS of various etiologies. Eighty percent of the children presented with symptoms of upper respiratory tract infection (URTI) (cough, fever, sore throat, malaise, headache), with a mean of 10 days (range 1 to 30) before skin rash broke out. Skin manifestations occurred in 94.2% of the patients after 3 to 21 days (mean 10.3 days) of fever. The exanthem, composed predominantly of maculopapular and vesicular, was distributed chiefly on the trunk and extremities and lasted less than 14 days in 87.8% of the patients. Stomatitis was observed in 91.6% of the patients and conjunctivitis in 50%. No consistent pattern seems to emerge by which one could predict the existence of MP infection causing SJS. The complications of SJS associated with MP seem less frequent (2.7%) and much less severe than in cases where SJS arises from other reported causes. Because coincidence cannot be excluded from the assessments of the degree and rate of improvement for the few patients treated with corticosteroid, from the low frequency of complications, and from the mortality rate of zero in this series of patients, the use of corticosteroids for SJS associated with MP infection is questionable.
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PMID:Mycoplasma pneumoniae infections and Stevens-Johnson syndrome. Report of eight cases and review of the literature. 189 14

Results of Yusho annual inspection were reviewed from the view point of correlation of PCBs, PCQs and PCDFs concentration in blood or subcutaneous adipose tissue and clinical findings. To make discussion quantitative, fifteen terms of clinical findings on Yusho disease were quantified on the severity by evaluating (+) as 2 points, (+-) as 1 point and (-) as 0 point. First, the temporal variations of the severity of clinical findings on 5 Yusho patients were figured. Additionally, the temporal variations of blood triglyceride and PCBs concentration, and GOT were also surveyed. The adopted terms of clinical findings were general malaise, cough, sputum, headache, abdominal pain, peripheral neuropathy, soreness of joints, deformity of nails, comedo formation, acne-like eruption, secondary infection, scar formation, disorder of Meibomian glands, edema of eye lids and increased discharge from the eyes. During the investigated period from 1972 to 1988 the total score of clinical findings clearly decreased on two patients who had high score, tended to decrease on two other patients, and was not clear on another patient. Secondly, the correlation coefficients were calculated between each of PCDFs, PCBs or PCQs concentration in subcutaneous adipose tissue or blood and the total score at the year in which the adipose tissue and blood were taken. For the female patients the correlation coefficient of PCDFs concentration in subcutaneous adipose tissue and total score of clinical findings was the highest of all (r = 0.9885). However, for the male patients it was not available because the number of the subjects was only two. Thus far it has been reported that the powers of PCBs gas chromatogram pattern and PCQs concentration as criteria for Yusho diagnosis are low as for the subjects who belonged to the border area between Yusho patients and normal persons. This survey suggests that PCDFs concentration in subcutaneous adipose tissue can be a potent criterion that has a high correlation with the clinical findings of Yusho.
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PMID:[Studies on the application of residual PCBs, PCQs and PCDFs concentrations to Yusho diagnosis]. 191 1

Case 1 was a 55 year old female whose primary complaint was pyrexia. Anamnesis consisted of a fever at a 39 degrees C level beginning on September 15, 1987 with headache and muscle pain. The patient was examined by a nearby physician. Despite taking medication, there was no break in the fever. The patient was examined and admitted to this institution on September 18. Case 2 was a 32 year old female whose primary complaint was pyrexia and an abnormal sensation in the pharynx. Anamnesis consisted of a fever at a 39 degrees C level beginning on February 13, 1989 and the manifestation of a cough beginning on February 17. Although the fever broke on February 20, as the abnormal sensation in the pharynx persisted, the patient was examined and admitted to this institution on February 21. Case 3 was a 42 year old male whose primary complaint was pyrexia. Anamnesis consisted of a fever of 38 degrees C, cough and a sensation of pressure in the right precordia beginning on November 18, 1989. The patient was examined and admitted to this institution on November 21. Chest X-rays revealed the presence of atypical pneumonia in all three cases. As a significant rise in antibodies to the Chlamydia of parrot fever was observed in the cases at the time of admittance as well as after admittance, treatment was begun by administration of Minocycline.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Three cases of psittacosis]. 191 7

An open multicenter trial was performed in 242 subjects with chronic obstructive airways disease between August 1987 and April 1989. Two hundred thirty-six subjects were evaluated with regard to safety (m 137, f 99, mean age 49.4 (18-77) years) and 204 subjects with regard to therapeutic efficacy (m 120, f 84, mean age 49.2 (18-77) years). Twelve micrograms (one puff) formoterol was given by metered-dose inhaler twice daily. Investigations were performed at days 0, 14, and subsequently in monthly intervals. Twenty-one patients (10.3%) were sufficiently treated by formoterol alone. One hundred and eighty-three (89.7%) required additional medication, which could be reduced in 90 cases (45.6%). Initially symptoms were present in 201 of 204 patients. At 1 year, 43 patients (21.1%) were symptom-free. At day 0 32.4% of the patients felt "very good" or "good." At 1 year the rate increased to 68.1%. Raw decreased from 0.52 +/- 0.26 (0.06-2.11) kPa.L-1.S at day 0 to 0.33 +/- 0.14 (0.06-0.88) kPa.L-1.S (= -43.5%) at 1 year. FEV1 increased from 1.90 +/- 0.80 to 2.54 +/- 0.97 L (33.7%). The global assessment of therapeutic efficacy was classified as "very good" in 51% (patients) and 47% (doctors), respectively, and as "good" in 38.7% and 42.0%, respectively. Tolerability was "very good" in 82.3% (patients, doctors), and "good" in 12.7% (patients) or 13.7% (doctors). The treatment did not influence blood pressure or heart rate. Twenty-nine patients (12.3% of 236) reported unwanted 39 side effects, such as tremor (6.36%), headache (2.54%), dryness of the mouth (1.27%), cough (0.85%), and dizziness (0.85%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Multicenter 1-year trial on formoterol, a new long-acting beta 2-agonist, in chronic obstructive airway disease. 197 87

During 1988, an endemic outbreak of aseptic meningitis was noted in the Kaohsiung area. Throughout the year, a total of 89 cases were identified by cerebrospinal fluid (CSF) examination at the Pediatric Department of Kaohsiung Medical College. The peak incidence was from June to October. Scattered cases still occurred during November and December. The male to female ratio was 1.7:1 and the age distribution ranged from 1 month to 15 years old. Two peaks of age distribution were observed; one in infancy and the other in the 4-7 year old age group. Most of them exhibited fever (94.4%), headache (68.9%), and vomiting (68.5%). Other associated symptoms and signs included neck stiffness, sore throat, cough, Brudzinski's sign, abdominal pain, seizure, dizziness, rhinorrhea, diarrhea, Kernig's sign, skin rash, hyperemic conjunctiva, apnea, and oral ulcers. Most of them had CSF white blood cell (WBC) counts less than 1000/mm3, normal or mild elevated protein, and normal CSF/plasma sugar ratio. Three patients were found to have a virus in their CSF without pleocytosis. Virus isolations from CSF throat swabs and/or rectal swabs were performed in 65 patients, half of them (35/65, 53.8%) had positive results including echovirus type 9 (sixteen), echovirus type 30 (eighteen), and adenovirus type 3 (one). Echovirus type 9 was predominant during July and August whereas echovirus type 30 became predominant after September. All patients recovered spontaneously without any sequelae.
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PMID:Clinical observations and virological study of aseptic meningitis in the Kaohsiung area. 198 74

Twenty six cases of a spotted-fever-like illness have been identified over a 17 year period in the population of about 1000 of Flinders Island, Tasmania. The usual features were high fever, headache, myalgia, slight cough, arthralgia without joint swelling and a maculopapular rash which did not resemble the common exanthems. Twelve cases had a focal skin lesions. Available evidence implicates ticks as the vector.
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PMID:Flinders Island spotted fever: a newly recognised endemic focus of tick typhus in Bass Strait. Part 1. Clinical and epidemiological features. 198 7

There are several protozoan infections that cause relatively benign illness in normal individuals but result in severe disease manifestations in patients with AIDS. These diseases include Pneumocystis carinii pneumonia, CNS toxoplasmosis, cryptosporidiosis, and isosporiasis. Pneumocystis carinii pneumonia (PCP) caused by Pneumocystis carinii, is the most common opportunistic infection in AIDS. It is seen in more than 80% of individuals with this syndrome. Although historically classified as a protozoan, this organism shares many biochemical characteristics with fungi. The onset of PCP may be insidious, and cough and dyspnea are the most common presenting symptoms. Auscultation of the lungs is often unremarkable, but diffuse infiltrates are commonly seen on chest radiographs. The diagnosis of PCP can be confirmed by identifying the organism on specimens obtained by sputum induction or bronchoalveolar lavage. Trimethaprim-sulfamethoxazole is the treatment of choice but is unfortunately associated with leukopenia and rash in many individuals. Both trimethaprim-sulfamethoxazole and aerosolized pentamidine are used prophylactically in patients at high risk for initial or relapsing infection. The appropriate use of these agents has resulted in improved survival for AIDS patients with PCP. Toxoplasmosis, due to Toxoplasma gondii, affects the central nervous system in patients with AIDS. Headache is a common presenting symptom, and both seizures and paresis can occur. A diagnosis of toxoplasmosis is strongly suspected in symptomatic individuals with ringed mass lesions noted on head CT. Patients with this condition are treated with a combination of sulfadiazine, pyrimethamine, and folinic acid. Cryptosporidiosis and isosporiasis are coccidian protozoan diseases that can result in severe, acute, and chronic diarrhea in immunocompromised individuals. Cryptosporidiosis is the more common of the two and is caused by an unknown species of the genus crytosporidium. Isosporiasis is due to infection with Isospora belli. Dehydration and weight loss are a common result of infection with either agent. A definitive diagnosis can be made by examining an acid fast stain of a diarrheal stool specimen and demonstrating oocysts that are specific for each of these organisms. Fluid replacement and general supportive care are essential in the treatment of both of these diseases. Spiramycin is an unproven treatment modality that is often used in patients with cryptosporidiosis. Isosporiasis responds to initial therapy with trimethaprim-sulfamethoxazole, followed by prophylaxis with pyrimethamine. The adoption of safe sexual practices that minimize fecal-oral contamination should decrease the future prevalence of these diseases and other enteric parasitic infections.
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PMID:Parasitic diseases. Diseases associated with acquired immunodeficiency syndrome. 201 33

We have discussed several miscellaneous headache disorders not associated with structural brain disease. The first group included those headaches provoked by "exertional" triggers in various forms. These include benign cough headache, BEH, and headache associated with sexual activity. The IHS diagnostic criteria were discussed. Benign exertional headache and cough headache were discussed together because of their substantial similarities. In general, BEH is characterized by severe, short-lived pain after coughing, sneezing, lifting a burden, sexual activity, or other similar brief effort. Structural disease of the brain or skull was the most important differential diagnosis for these disorders, with posterior fossa mass lesions being identified as the most common organic etiology. Magnetic resonance imaging with special attention to the posterior fossa and foramen magnum is the preferred method for evaluating these patients. Indomethacin is the treatment of choice. The headache associated with sexual activity is dull in the early phases of sexual excitement and becomes intense at orgasm. This headache is unpredictable in occurrence. Like BEH, the headache associated with sexual activity can be a manifestation of structural disease. Subarachnoid hemorrhage must be excluded, by CT scanning and CSF examination, in patients with the sexual headache. Benign headache associated with sexual activity has been successfully treated with indomethacin and beta-blockers. The second miscellaneous group of headache disorders includes those provoked by eating something cold or food additives, and by environmental stimuli. Idiopathic stabbing headache does not have a known trigger and appears frequently in migraineurs. Its occurrence may also herald the termination of an attack of cluster headache. Indomethacin treatment provides significant relief. Three headaches triggered by substances that are eaten were reviewed: ingestion of a cold stimulus, nitrate/nitrite-induced headache, and MSG-induced headache. For the most part, avoidance of these stimuli can prevent the associated headache. Lastly, we reviewed headache provoked by high altitude and hypoxia. The headache is part of the syndrome of AMS during its early or benign stage and the later malignant stage of HACE. The pain can be exacerbated by exercise. The best treatment is prevention via slow ascent and avoidance of respiratory depressants. Acetazolamide and dexamethasone have proved useful in preventing this syndrome.
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PMID:Cough, exertional, and other miscellaneous headaches. 202 Feb 26

In January 1991, a woman in Wisconsin contacted her local public health department to report that she and her two children had become ill after her landlord painted the walls and ceilings of two rooms of her apartment. Reported symptoms included a burning sensation in the nose and forehead, headache, nose bleed, cough, loss of appetite, nausea, and vomiting. The woman, who was in the third trimester of pregnancy, also complained of a persistent odor from the paint and provided an empty bottle of a paint additive used for mildew control. The label indicated that this product contained 25% bis(tributyltin) oxide (TBTO) as its only active ingredient.
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PMID:Acute effect of indoor exposure to paint containing bis(tributyltin) oxide--Wisconsin, 1991. 202 73


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