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

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

A seventy-two-year-old man with hypertensive cerebral hemorrhage acutely developed severe headache, nausea, vomiting, agitation, and disorientation with abrupt rise in blood pressure on the sixth day after the onset. At that time, there were no remarkable changes in focal neurologic deficits, and repeated brain CT scans revealed a small hematoma located in the right basal ganglia without further enlargement or herniation. Blood chemistry and arterial gas analysis were within the normal ranges except for a slight rise in blood urea nitrogen. Similar episodes occurred three times within two days, and each time the cerebral symptoms disappeared in accordance with lowering of blood pressure by antihypertensive therapy. Complication of hypertensive encephalopathy was strongly suggested. The authors discuss the pathophysiology of this encephalopathy in relation to cerebral hemorrhage.
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PMID:Transient encephalopathy related to rapidly and markedly elevated blood pressure in acute stage of hypertensive cerebral hemorrhage--relationship to hypertensive encephalopathy--a case report. 317 64

Ciprofloxacin is a new quinolone antimicrobial agent with activity against a broad spectrum of gram-negative and gram-positive organisms, including Pseudomonas aeruginosa and methicillin-resistant strains of staphylococci. The efficacy and safety results of 80 clinical studies of the oral form of ciprofloxacin are reported. Drug safety was assessed in 2236 courses in 2203 adult patients treated primarily in the United States. Data from 1676 courses were suitable for analysis of drug efficacy. The unit dose for most patients ranged from 250 mg to 750 mg (median, 500 mg), usually given every 12 hours. The duration of treatment ranged from 3 to 231 days (median, 10 days). Predominant among 1722 infections were those of the urinary tract (43%), skin structures (29%), and respiratory tract (19%); the remainder were bone and joint infections (5%), bacteremias (2%), and intra-abdominal (1%), gastrointestinal (1%), and pelvic infections (less than 1%). Signs and symptoms of infection resolved in 79% of all cases; a further 15% improved, and 5% failed to improve. Pathogens were eradicated in 89% of urinary tract infections and persisted in 5%; 80% of patients still had sterile urine at the 3-to 6-week follow-up. In 81% of nonurinary tract infections, pathogens were eradicated; they persisted in 11%, and superinfection occurred in less than 5%. After treatment, 89% of the 2253 causative organisms were eradicated and 2% were reduced to clinically insignificant counts; 8% persisted. Of 411 isolates of P. aeruginosa, 77% were eradicated, as were 97% of 421 Escherichia coli and 80% of 248 Staphylococcus aureus isolates. Also eradicated were 95% of 166 Klebsiella, 96% of 139 Proteus mirabilis, 100% of 20 other Proteus, 94% of 123 Enterobacter, 100% of 68 Haemophilus influenzae, 96% of 49 Citrobacter, 89% of 45 Serratia, 95% of 41 Streptococcus pneumoniae, 91% of 43 Salmonella, 100% of 38 Morganella morganii, and 100% of 35 Providencia isolates. Adverse reactions were judged probably or possibly drug-related in 14.8% of courses; drug treatment had to be stopped prematurely in 3.5%. The most frequent reactions were gastrointestinal complaints (chiefly nausea, diarrhea, and vomiting), metabolic disorders (elevated SGOT, SGPT, serum creatinine, or blood urea nitrogen), and nervous system effects (dizziness, light-headedness, restlessness, tremor, and headache). Crystalluria, judged to be related to ciprofloxacin, occurred in two patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial. 336 Sep 68

264 women (about 50% private patients), all less than 40 years old and none with history contraindicating oral contraception, were started on a regimen with Ovral (.5 mg norgestrel and .05 mg ethinyl estradiol). Medication started on Day 5 of a menstrual cycle. Then therapy followed a 3 weeks on, 7 days off schedule. Patients continued for 1-22 cycles (mean 7 cycles) for a total of 1918 cycles. Despite the omission of 42 doses by 32 patients, no pregnancies occurred. The percentages of cycles with average flow, spotting, breakthrough bleeding, and dysmenorrhea were 74.4, 2.5, .4, and .6, respectively. The incidence of amenorrhea, .2%, was spectacularly low in comparison with findings in other studies. Papanicolaou smears (483) were all normal (Class I or II). Morphologic changes seen at endometrial biopsy (61) were similar to those produced by other available progestogen-estrogen compounds. No significant variation from control findings (1878) were found in 1463 laboratory studies. The studies included leukocyte and differential counts (724), and determinations of hemoglobin and hematocrit (388), fasting blood sugar and blood urea nitrogen (114), bilirubin and liver function (61), and renal function (176). Minor symptoms (nausea, vomiting, headache, etc.) were few and disappeared after the first few cycles. The preparation suppresses ovulation (probably through action of the estrogen), probably alters the cervical mucus to inhibit sperm penetration, possibly interferes with nidation, and may interfere with follicular development.
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PMID:Norgestrel, a low dose, oral progestogen for fertility contro. Supplementary report. 564 94

Compilation of recent data on 1130 female volunteers from 17 US sites enrolled in a study of a new low dose combination oral contraceptive (OC) containing .15 mg levonorgestrel and .03 mg ethinyl estradiol are reported. All clients had complete histories and physical examinations at entrance and at 6 month intervals during treatment, and about 20% also had blood sugar, blood urea nitrogen, and liver profile determinations. Follow-up evaluation was performed after the 1st and 3rd cycles and every 3 cycles thereafter to determine patterns of pill taking, bleeding episodes, untoward effects, and concomitant medication. Clients ranged in age from 15-40 with mean age of 23.6; 76.1% were white, 11.9% black, 7.5% Hispanic, and 4.4% Oriental. 61.9% were of proven fertility and 92% had regular cycles. 48.1% of the study population had not used female hormones or been pregnant within 60 days of enrollment. A total of 11,064 cycles over a maximum 31 cycles of treatment are reported. Despite 1-6 or more missed pills in 1623, or 14.7% of the cycles, only 3 pregnancies were reported, only 1 presumed to be a method failure, for a use-effectiveness Pearl index of .35/100 women years of usage. Use of the formulation resulted in a mean cycle length of 28.5 days. 92.7% of cycles ranged from 26-30 days, almost equal to pretreatment values. The frequency of light menstrual flows increased. Breakthrough bleeding was reported in 669 cycles, or 6.0%, while spotting occurred in 852 cycles, or 7.7%. Amenorrhea was reported after 194 cycles (1.8%). No reports of post-pill amenorrhea were made. Incidence of side effects was very low. Only acne, breast discomfort, dysmenorrhea, gastrointestinal symptoms, headache, nausea, and vaginal discharge were reported in more than 1.0% of cycles. The pill had essentially no effect on weight or blood pressure, and produced no clinically significant laboratory abnormalities in hematology, urine, blood sugar, blood urea nitrogen, or liver profile determination. A total of 515 subjects (45.6%) discontinued use of the drug for various nonmedical reasons. Another 146 women (12.9%) discontinued use and gave medical reasons; 132, or 11.7%, were commonly reported side effects of OCs such as breakthrough bleeding, headache, and nausea. Clinical trials with the formulation have shown it to be a safe and effective ultra-low dose combined OC agent whose mode of action is primarily gonadotropin suppression and subsequent anovulation.
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PMID:A new ultra-low-dose combination oral contraceptive. 640 5

This review surveys tea-production technology, chemistry of raw and manufactured tea as well as tea tasting appraisal and chemical analysis of manufactured tea. The paper describes the healthful properties of tea, gives general information on the tea plant and manufactured tea, and presents classification of teas as related to the processing of black green, yellow, and red tea, green pressed tea as well as instant tea and tea dyes. The paper discusses the chemical composition of raw and manufactured tea as well as approaches to the evaluation of tea quality--tea tasting appraisal and chemical analysis. The paper is supplied with the conclusions and references. The section on the healthful properties of tea discusses various aspects of catechin effects--vitamin P, antimicrobial, antioxidative and radioprotective effects. Also described are favorable effects of tea alkaloids--caffeine, theobromine, theophylline that dilatate cerebral vessels and alleviate headaches. The section on the production of different teas (black, green, yellow, red, instant teas, and tea dyes) considers technological methods and biochemical bases of various types of tea manufacture. The role of tea leaf enzymes in the oxidative processes determining the tea quality is discussed in detail. This section also describes the contribution of thermochemical processes into the formation of tea flavor. The compounds dictating tea taste and aroma are discussed, particularly tannins and catechins, volatile oils, nitrogen compounds, and some other substances.
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PMID:The biochemistry and technology of tea manufacture. 699 21

Twenty-four men were refueling a missile when a large spill of oxidizer occurred. Three crewmen were exposed to very high concentrations of the oxides of nitrogen. One died within minutes. Severe respiratory distress syndrome developed in the other two, one of whom survived. Twenty-one other workers were exposed to minimal to moderate concentrations of the gas. Most remained asymptomatic while six had shortness of breath, cough, or hemoptysis. The three with persistent symptoms received corticosteroid therapy; the complaints resolved in two. Corticosteroid therapy for four asymptomatic patients who had moderate hypoxemia two weeks after the accident may have aborted the second stage of nitrogen dioxide injury. Six patients with minimal exposure had persisting headaches, visual disturbances, and emotional difficulties. These latter findings may represent an unusual complication of exposure to these gases.
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PMID:The McConnell missile accident. Clinical spectrum of nitrogen dioxide exposure. 741 84

The purpose of this study was to determine the effects of recombinant human GH (rhGH; 0.025 mg/kg.day) and one of two doses of recombinant human insulin-like growth factor-I (rhIGF-I; 0.015 and 0.060 mg/kg, twice daily) on body composition in elderly women. Sixteen healthy elderly women (mean age +/- SEM, 71.9 +/- 1.3 yr) were randomly assigned to receive either rhGH (GH; n = 5), low dose rhIGF-I (n = 6), or high dose rhIGF-I (n = 5). A 2-week predrug baseline period was followed by 4 weeks of hormone treatment, with a standardized diet fed throughout. All groups experienced a significant increase in serum IGF-I and IGFBP-3 levels over the treatment period, accompanied by significant decreases in IGF-II (P < 0.05). Fat mass decreased in all groups, with significant increases in lean body mass and nitrogen retention occurring in the high dose IGF and GH groups. Total body water did not change, whereas increases observed in intracellular fluid approached significance (P = 0.06). These anabolic changes were accompanied by numerous negative side-effects in the GH and high dose IGF groups, including headaches, lethargy, joint swelling/pain, and bloatedness. The low IGF dose was well tolerated. These results demonstrate that the administration of rhGH and rhIGF-I for 4 weeks results in anabolic changes in body composition in elderly women.
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PMID:The effects of recombinant human insulin-like growth factor-I and growth hormone on body composition in elderly women. 753 17

Infection-induced malnutrition, the most common form of cytokine-induced malnutrition, results from the actions of proinflammatory cytokines, ie, tumor necrosis factor (TNF) and interleukins 1,6, and 8 (IL-1, IL-6, and IL-8). During acute generalized infections, these cytokines initiate the acute-phase reaction. This reaction is quite stereotyped, and includes fever, malaise, myalgia, headaches, cellular hypermetabolism, and multiple endocrine and enzyme responses. In addition, there is heightened catabolism of muscle proteins and many amino acids; flux of free amino acids into the liver; hepatic synthesis of acute-phase plasma proteins; sequestration of iron and zinc; gluconeo-genesis; insulin resistance; impaired cellular uptake of fatty acids from plasma triglycerides; sizable losses of body nitrogen, potassium, magnesium, phosphate, and zinc; retention of body salt and water; heightened metabolic degradation and/or loss of vitamins; and an activation of the immune system. The pathogenesis of cytokine-induced malnutrition is thus vastly different from the malnutrition caused by uncomplicated starvation. Cytokine-induced malnutrition can have a devastating effect on the immune system and its functions. Although proinflammatory cytokines are found in mucosal fluids, where they contribute to the pathogenesis of inflammatory bowel diseases, it is not known whether cytokines play a role in toxigenic, secretory diarrheas such as cholera, which cause huge losses of body water, electrolytes, and bicarbonate while exhibiting no systemic manifestations of an acute-phase reaction.
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PMID:Herman Award Lecture, 1995: infection-induced malnutrition--from cholera to cytokines. 757 15

The effects of a new dihydropyridine calcium channel blocker, amlodipine, on blood pressure (BP) and renal function were studied in spontaneously hypertensive rats (SHR). These effects were compared with those of an angiotensin-converting enzyme (ACE) inhibitor, enalapril. In addition, the effects of amlodipine on BP and renal function were studied in hypertensive patients with renal impairment. In five of six nephrectomised salt-loaded SHR, increases in BP, urinary excretion of protein and serum creatinine were attenuated by the administration of 2 mg/kg/day of amlodipine. The progression of renal histological damage was also markedly decreased. The protective effects of amlodipine against renal damage were similar to those of enalapril. However, the mechanisms of action of these two agents seem to differ as, unlike enalapril, amlodipine did not significantly dilate the efferent arteriole in hydronephrotic perfused rat kidney. In a clinical study, 2.5-5 mg/day of amlodipine was administered once a day for 8-10 weeks to 39 hypertensive patients with renal impairment (serum creatinine > or = 1.5 mg/dl to < 5 mg/dl) or renal parenchymal disease (serum creatinine < 5 mg/dl). A significant reduction in BP (reduction of mean BP > or = 13 mm Hg) was observed in 28 patients (80%). Headache was experienced as a side-effect in one of 35 patients (2.9%). With respect to the influence of amlodipine on renal function, mean values of blood urea nitrogen and serum creatinine were unchanged for the total group whereas a slight elevation of serum creatinine was observed in four of 35 patients (11.4%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal effects of amlodipine. 778 8


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