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Query: UMLS:C0018681 (headache)
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With the aid of a questionnaire form we have gathered information about the clinical picture of patients suffering from primary ciliary dyskinesia. The study group numbered 34 persons, whose diagnosis was confirmed by electron microscopy. Chronic cough and common cold symptoms are present from shortly after birth. Twenty-three respondents reported respiratory tract problems in the neonatal period. The dysfunctional cilia result in chronic respiratory tract infections (chronic bronchitis; bronchiectasis; pneumonia; chronic sinusitis, rhinitis or otitis media). These lead to the following complaints: frequent blowing of the nose (in 32 pat.; 94%), chronic productive cough (in 28 pat.; 82%), chronic common cold (in 26 pat.; 77%), hearing problems (in 24 pat.; 71%), shortness of breath (in 23 pat.; 68%), frequent headache (in 13 pat.; 38%) and sore throat (in 9 pat.; 27%). In order to prevent the invalidating consequences of this disorder appropriate steps should be taken as soon as possible. These should include physiotherapy and adequate antibiotic therapy.
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PMID:[Primary ciliary dyskinesia; a questionnaire study of the clinical aspects]. 258 63

Cocaine use often has profound effects on the body. Medical complications that may be seen in users include headache, sexual dysfunction, violent behavior, chronic cough, seizures, and myocardial infarction. The type of cocaine used and the method of use often determine the kind of problems that occur. Patients may be reluctant or unable to offer information about their drug use during evaluation, so awareness of the medical consequences of cocaine use and a high index of suspicion are essential.
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PMID:Is your patient using cocaine? Clinical signs that should raise suspicion. 763 Aug 45

Among 182 episodes with ARF (PaCO2 > 50 torr) in 400 episodes of COPD patients who were admitted to Chulalongkorn Hospital during the period 1982 to 1986, despite conservative treatment, 66 developed severe acute respiratory failure requiring assisted ventilation. Patients with a history of chronic cough, pneumonia as a precipitating factor and more severe ARF on admission, as indicated by palpitation, headache, cyanosis, alteration of consciousness, cor-pulmonale and decompensated acidosis (pH < 7.30), were likely to require mechanical ventilation. Indications for mechanical ventilation were carbon dioxide narcosis (43 episodes), severe hypoxemia despite on a high FIO2 (one episode), various combination parameters of respiratory muscle fatigue, cardiovascular instability (22 episodes). The major complications of mechanical ventilation were pneumonia, sepsis, pneumothorax, UGI bleeding of 16, 8, 5 and 9 episodes, respectively. The average duration of assisted ventilation and hospitalization were 15.8 and 19.02 days, respectively. The mortality rate was 50 per cent in the mechanical ventilation group compared with 9.8 per cent in the non-mechanical ventilation group. Increased mortality rate was found in those with pneumonia as the precipitating factor (68.4 vs 14.3%, respectively, in comparing the two groups). Complications of mechanical ventilation, which included pneumonia, sepsis, fluid overload, hyponatremia and persistent acidosis, were high-risk factors for the non-surviving group.
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PMID:Mechanical and non-mechanical ventilation of respiratory failure in chronic obstructive pulmonary disease. 822 88

The physician must be alert to the possibility of unsuspected sinusitis when evaluating a patient with chronic cough, sore throat, fever of unknown origin, supraglottitis, pneumonia, or headache. This article presents four cases in which atypical or asymptomatic sinusitis was discovered that could have caused significant or potentially life-threatening complications. In each case, the sinusitis was initially unsuspected. A complete nasal evaluation is warranted following decongestion of the nasal cavity when conditions are present. A screening sinus computed tomography scan may be indicated when sinusitis is strongly suspected even in the absence of typical clinical symptoms. Exact identification of the organism causing the infection may require sinus aspirate or tissue culture.
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PMID:The many faces of atypical sinusitis. 825 95

The impact of chronic sinusitis on children has become more apparent as the awareness of the disease has increased. Consequently, the knowledge of its effect in the pediatric patient has expanded dramatically. Functional endoscopic sinus surgery (FESS) has become the primary surgical modality for treatment of this illness in children who have not responded to optimal medical management. A retrospective study was conducted in patients from 7 months to 17 years of age who were treated with FESS for chronic sinusitis refractory to medical therapy. Using a comprehensive parental questionnaire and a review of the medical charts, results were analyzed from these post-FESS children. Parents of the children were interviewed with a mean follow-up time of 21.8 months postoperatively. Factors discussed included chronic nasal obstruction, purulent nasal discharge, postnasal drip, chronic cough, halitosis, headaches, behavioral problems, allergies, and asthma symptoms. This preliminary investigation suggests that FESS is effective in treating medically recalcitrant severe chronic sinusitis in children.
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PMID:Functional endoscopic surgery in children: a retrospective analysis of results. 836 Dec 92

The aim of this study was to investigate some of the health problems among cement workers in the United Arab Emirates (UAE). A cross-sectional sample of 304 workers was selected randomly from four cement factories in four Emirates. Most of the workers (88%) were from India, married (84%) and had received primary education or above (93%). Smoking was prevalent among 27% of the workers and about 24% consumed alcoholic beverages. Personal hygiene was found to be satisfactory among the workers. The main health symptoms reported by the cement workers were chronic cough, chronic bronchitis, burning, itching and runny eyes, headache and fatigue. Chronic bronchitis (p < 0.007), burning, itching and runny eyes (p < 0.002) and fatigue (p < 0.004) were significantly increased with age of workers. Smoking was significantly associated with chronic cough (p < 0.03) and chronic bronchitis (p < 0.01). However, the chance of smokers getting respiratory health problems was two to five times greater compared with non-smokers. Future studies on the health of workers in UAE should include more investigations using specialised equipment to detect and diagnose health problems.
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PMID:Health status of cement workers in the United Arab Emirates. 856 87

A 57-year-old white man sought medical attention because of chronic cough and fever of unknown origin. An extensive work-up over 4 weeks, including repeated blood cultures, chest roentgenograms, a gallium scan, and computed tomographic scans of the sinuses, chest, and abdomen, was nondiagnostic. The patient was referred to our institution for bronchoscopy. Further analysis of his history revealed that he had a headache in conjunction with the cough and an episode of a flashing color design in his left eye 1 week before assessment. The erythrocyte sedimentation rate was 115 mm in 1 hour. A biopsy of the temporal artery showed granulomatous inflammation of the vessel wall with multinucleated giant cells, histiocytes, lymphocytes, plasma cells, and few eosinophils. The multinucleated giant cells were closely related to the fragmented elastic lamina. Corticosteroid therapy resulted in prompt resolution of the chronic cough and fever. Giant cell arteritis should be considered in the differential diagnosis of chronic cough.
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PMID:Giant cell arteritis manifesting as chronic cough and fever of unknown origin. 937 79

The results of the recording of respiratory symptoms and the measurement of lung function in 136 male postal workers employed as mail carriers were studied. In addition, the prevalence of chronic respiratory symptoms in 87 male nonexposed control workers was also examined. There was a significantly higher prevalence of chronic bronchitis (25.0%) and sinusitis (38.9%) in mail carriers than in control workers (13.8%; P < 0.05 and 2.3%; P < 0.01). A logistic regression analysis performed on the results of the study of chronic respiratory symptoms of mail carriers indicated a significant (P < 0.001) effect of smoking in this cohort, with the exception of occupational asthma. Mail carriers who smoked had a significantly higher prevalence of chronic cough (45.3%), chronic phlegm (39.1%), chronic bronchitis (39.1%) and sinusitis (53.1%) than mail carriers who were nonsmokers (18.1%; 12.5%; 12.5% and 26.4% respectively.) (P < 0.01). A high prevalence of acute symptoms developing during the work-shift was recorded, in both smokers and nonsmokers, being highest for upper airway symptoms, headache (50.0%), nasal catarrh (42.6%), and eye irritation (57.4%). The results of tests for average measured ventilatory capacity (as a percentage of predicted capacity) were significantly lower than expected, particularly for maximum flow rates at the last 25% of the vital capacity (FEF25), in both smokers (68.5%) and in nonsmokers (74.2%). A multivariate analysis of lung function parameters indicated a significant effect of employment conditions. The only major identifiable occupational exposure of mail carriers was to ambient air pollution for an average of 6 h per day as well as to adverse meteorological conditions. The measured ambient concentrations of major outdoor pollutants, primarily total suspended particulates, sulfur dioxide (SO2) and black smoke exceeded considerably the recommended Croatian maximum air quality standards over the past 10 years. Our study of mail carriers demonstrated that these workers were subject to respiratory symptoms associated with their smoking habits. Lung function findings suggested that occupational exposures, possibly to atmospheric pollution in combination with adverse meteorological conditions, may have led to lung function impairment in these workers.
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PMID:Respiratory findings in mail carriers. 1074 12

This study had three objectives: firstly, it aimed to examine an appropriate model for preventing and controlling the risk of meningococcal disease as a result of an epidemic carrying by returning pilgrims at Hat Yai International Airport; secondly, it aimed to establish the number of meningococcal carriers among pilgrims returning from Saudi Arabia; thirdly, it considered the health problems that arose during the Hajj pilgrimage. A structured questionnaire was used to collect data from 374 pilgrims at the Hat Yai airport checkpoint between March 15th and April 2nd, 2001. Each subject provided a naso-pharyngeal swab and reported on their health status by postcard once they had reached their homes 7-10 days later. It was found that most of the pilgrims were from Satun Province (23%). The average age was 50.5 years (range 20 to 86; SD 12.8). More than half of the pilgrims had some knowledge of meningococcal meningitis. Most, about 80.7%, knew that vaccination against meningococcal infection is required before traveling to Saudi Arabia. About 77.8% were vaccinated at the Provincial Health Office (PHO) in their hometown. Nearly 19% had underlying diseases such as chronic cough, asthma, diabetes, hypertension, headache and rheumatism. During their pilgrimage some were troubled by symptoms of respiratory tract disease, fever and headache. All had negative laboratory results. Only 16.6% returned postcards describing their self-assessed health status. About 30.6% described themselves as healthy. Among those who reported sick, coughs, sore throats and stomach aches were prevalent. Health education and public information about vaccine need to be strengthened. The best place to get the vaccination is their hometown PHO. Trained health personnel, instead of tour leaders or guides, should pay attention to the health of the pilgrims. The tour leaders are an important target group for improved health knowledge because most pilgrims will trust and follow them. Even though there were negative laboratory results, it is worth having a good surveillance system for meningococcal meningitis in order to prevent epidemics and reduce mortality among returning pilgrims.
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PMID:Surveillance for meningococcal carriage by Muslims returning from the Hajj to Hat Yai Airport, Thailand. 1297 92

This paper reports an audit of clinical outcome in 455 consecutive patients (1100 consultations) presenting for private homeopathic treatment of a chronic illness in which conventional treatment had either: failed, reached a plateau in effect, or was contra-indicated by side effects, age or condition of the patient. Three hundred and four patients (66.8%) derived benefit from homeopathic treatment. One hundred and forty-eight patients (32.5%) were able to stop or maintain a substantial reduction in their conventional drugs. The 10 most frequent clinical conditions treated were eczema, anxiety, depression, osteoarthritis, asthma, back pain, chronic cough, chronic fatigue, headaches and essential hypertension. These 195 patients constitute 43% of the total, 151 of them (77%) were improved. The success rate of treatment is similar between age ranges. There was a difference in outcome between the sexes in adults: 296 females treated, success rate 71.3%; 159 males treated, success rate 58.5%. Two patients (0.4%) had prolonged aggravation of their presenting complaints apparently attributable to homeopathic treatment.
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PMID:Audit of outcome in 455 consecutive patients treated with homeopathic medicines. 1622 98


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