Gene/Protein Disease Symptom Drug Enzyme Compound
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The prevalence of depressive and other symptoms were studied in Finnish men aged 65 to 84 years and living either in eastern (n = 310) or in southwestern (n = 378) Finland. The Zung self-rating depression scale showed depressed affect, fatigue and suicidal thoughts to be more common in the east, but indecisiveness to be more prevalent in the south-west. The mean of the sum scores in the Zung scale was 37.8 (+/- 8.4) for the eastern and 37.2 (+/- 8.3) for the south-western population, and no differences were found between the areas in this respect. However, many of the other symptoms, including somatic and psychosomatic (such as pains, dyspnea, nausea, impaired memory, apathy, itching skin and sight disturbances) were more common among men living in eastern Finland. The former findings support the idea that there are differences in the affects between men living in the east and men living in the south-west, but, as a whole, depressive symptoms are equally prevalent in both elderly male populations. The latter finding may reflect the well-known differences in the prevalences of somatic diseases between these two areas.
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PMID:Prevalence of depressive and other symptoms in elderly Finnish men. 396 9

We questioned 113 patients with subsequently diagnosed sustained ventricular tachycardia (VT) regarding the symptoms that prompted their seeking hospital treatment, eliciting the following: 15% of patients had lost consciousness, 15% had near syncope, 35% had mild lightheadedness and 35% had no cerebral symptoms. Patients with preexisting congestive heart failure or a VT rate of 200 beats per minute or greater more often lost consciousness. Other symptoms included palpitations in 57% of patients, chest pain in 27%, dyspnea in 25%, weakness in 6%, nausea or diaphoresis in 3% each and flushing in 2%. In approximately 50% of patients who had mild lightheadedness or no cerebral symptoms, their condition was incorrectly diagnosed as supraventricular tachycardia based on the absence of severe symptoms during the tachycardia. In some patients, VT may be associated with mild or atypical symptoms. The differentiation of supraventricular from ventricular tachycardia should be based on electrocardiographic criteria and should not be influenced by the nature or severity of a patient's symptoms. The severity of cerebral symptoms is at least partially related to the VT rate and a patient's underlying heart disease.
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PMID:Clinical symptoms in patients with sustained ventricular tachycardia. 399 9

Amrinone, a new inotropic agent, was used to treat 24 patients with chronic congestive heart failure who were classified as clinically stable and who were in New York Heart Association's classes II and III. Patients were treated for up to 30 months (mean, 12.5 months). Exercise tolerance improved in 20 patients, but only eight experienced significant improvement in symptoms of fatigue, dyspnea, and orthopnea and only nine tolerated the drug without apparent side effects. Eight were unable to continue amrinone therapy because of limiting side effects. The most significant adverse effects were cardiac arrhythmias, thrombocytopenia, abnormal results of liver function tests, diarrhea, fever, and nausea. Amrinone has a narrow therapeutic-toxic ratio, but a significant proportion (42%) of patients tolerate and benefit from amrinone therapy.
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PMID:Clinical effects and side effects of amrinone. A study of 24 patients with chronic congestive heart failure. 399 60

Divers breathing compressed air are restricted to 45 m depth because of the narcotic effects of nitrogen and toxic action of oxygen at increased pressures. Substitution of oxygen-helium for compressed air has permitted divers to reach 600 m. However, at depths greater than 160 m, signs and symptoms of the high pressure nervous syndrome (h.p.n.s.) occur, with tremors, myoclonic jerking, nausea, vomiting, fatigue, somnolence, e.e.g. changes, dyspnoea, and poor sleep with nightmares. It has been the objective of this Laboratory to ameliorate the symptoms of pressure-induced h.p.n.s. by the addition of small amounts of 'narcotic' nitrogen to the oxygen-helium mixture to form the Trimix breathing gas. In 1973, comparative experiments with oxygen-helium and the same divers, during compressions in only 33 min to 219.5 m and 305 m, showed such Trimix to be effective with 10% (by volume) nitrogen. Simulated dives, termed ATLANTIS, have been made with Trimix over the last 4 years to depths in excess of 610 m for 11 days, 650 m for 4 days and 686 m for 1 day. The objectives were to determine the effects of either slow or rapid rates of compression, and either 5% or 10% (by volume) nitrogen in Heliox, on the presence of h.p.n.s. or nitrogen narcosis. Measurements were made of intellectual and psychomotor performance, electrophysiological function of the brain and reflexes, lung and cardiovascular function, including arterial gas analysis at rest and work, blood chemistry and psychiatric and psychological status. The results permit the conclusion that divers may be compressed safely to depths as great as 686 m. The technique requires a slow exponential compression over days, with frequent stages lasting 14 h or more, the use of 5-8% (by volume) nitrogen in Heliox and careful selection of the divers.
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PMID:Probing the limits of human deep diving. 614 71

Water intoxication from intravascular absorption of non-electrolyte irrigating fluid is a well-known and often serious complication of transurethral resection of the prostate. The amount of absorbed fluid depends on the duration of the operative procedure, the number of transected open venous sinuses and the hydrostatic pressure of the irrigating fluid. Arterial hypertension, bradycardia, mental agitation, confusion, headache, nausea, dyspnoea, convulsions and pulmonary edema are the typical syndromes. In this case, severe Angina Pectoris was the first alarming symptom.
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PMID:[Angina pectoris -- an early sign of water intoxication during transurethral prostatectomy (author's transl)]. 617 35

In 203 patients with clinical symptoms of coronary artery disease, cardiac and extracardiac side effects of the dipyridamole test were investigated. Following dipyridamole (0.75 mg/kg body wt. i.v.), heart rate increased significantly, whereas arterial blood pressure remained almost constant. Dyspnea was noted in 80 cases (40.5%). In 48 patients (23.6%) rhythm disturbances were recorded; 58.1% suffered from extracardiac side effects such as congestion in the head, vertigo, heaviness of arms and legs, sensations of heat, upper abdominal pain, and nausea. A detailed report is given of 4 cases with extraordinary symptoms during or after the injection of dipyridamole. A life-threatening status anginosus with dyspnea, ST-segment elevation, and cardiac arrhythmia was observed in one of these cases. High-dose dipyridamole cannot be considered to be harmless. The test should not be performed without continuous ECG monitoring and other safety measures.
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PMID:[How dangerous is the dipyridamole test?]. 619 53

Eighty-two patients with pityriasis versicolor were treated orally with ketoconazole in tablet form (200 mg). The tablets were taken at least 90 min before a meal, and patients who received only one tablet daily were told to refrain from bathing except immediately before ingestion of the drug and only once a day. Dosage of ketoconazole varied from a single dose of 400 mg to 200--400 mg per day for four weeks. Seventy-seven patients reported no adverse effects. There were reports from others of headache, gastralgia, nausea, dyspnea, dizziness, or tinnitus. In most affected patients, these symptoms stopped with the first meal eaten after initiation of treatment. Follow-up examinations were performed at different intervals. The maximal therapeutic effect of ketoconazole was seen three to six weeks after initiation of therapy. Seventy-eight patients were considered cured; one had received only one tablet. Only hypopigmented macules remained. Examination of these areas with a Wood lamp revealed no fluorescence, and scrapings examined with the light microscope did not contain Malassezia furfur. These results indicate that ketoconazole is effective in the treatment of pityriasis versicolor, but the problem of protecting susceptible persons from infection and reinfection remains.
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PMID:Treatment of pityriasis versicolor with ketoconazole. 625 36

We describe the case of a 58-year-old man who presented to the hospital with central abdominal pain, nausea, fever, chills, and dyspnea. While in the hospital, jaundice appeared and the liver function tests revealed features of both cholestasis and hepatocellular injury. He developed gram-negative septicemia and died on the sixth hospital day. Autopsy disclosed a perforated terminal ileal diverticulum and a contiguous mesenteric abscess. There was also severe phlebitis of mesenteric venous radicles which extended superiorly to the intrahepatic portal venules and veins. The portal veins were surrounded by multiple hepatic abscesses that varied in size from microscopic to 2.5 cm. This appears to be the first report in the world literature of suppurative pylephlebitis and hepatic abscesses resulting from a perforated ileal diverticulum. The subject of small bowel non-Meckelian diverticulosis is reviewed because of the rarity of this condition and the diagnostic challenges it poses.
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PMID:Perforated diverticulum of the terminal ileum. A previously unreported cause of suppurative pylephlebitis and multiple hepatic abscesses. 642 54

Contrast media reactions may be classified as anaphylactoid, vasomotor, severe or life threatening, and fatal. Anaphylactoid reactions mimic immunoglobulin E-mediated hypersensitivity in that signs may consist of urticaria, angioedema, wheezing, dyspnea, hypotension, or shock. These reactions occur in 2% to 8% of all contrast media infusions. Vasomotor reactions occur in 5% to 8% of patients and consist of nausea, vomiting, flushing, and warmth. Severe reactions during which there is a concern for life occur about once per 1000 procedures. Fatalities have occurred in from 1:3000 procedures for intravenous cholangiography to between 1:10,000 to 1:100,000 procedures for intravenous urography. The pathogenesis of contrast media reactions is unknown, and various mechanisms may be associated with different clinical features. Radiocontrast media infusions can cause rises in plasma histamine and complement activation by either classic or alternate pathways or nonsequentially, yet adverse reactions may or may not occur. Abnormalities in the complement system or an increased conversion of prekallikrein to kallikrein has been demonstrated in some patients who have had anaphylactoid reactions. It is unknown if these mechanisms can explain the pathogenesis of anaphylactoid contrast media reactions. When patients who have had definite anaphylactoid reactions require a repeat procedure, the incidence of reactions ranges from 35% to 60% for intravascular infusion. Pretreatment with prednisone and diphenhydramine has been demonstrated to reduce this reaction rate to 9% in 465 procedures. Prednisone-diphenhydramine and ephedrine have further reduced the reaction rate to 3.1% in 192 procedures. These results are statistically significant (X2 = 5.4996, p = 0.019). Emergency equipment should be available should a severe reaction occur.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Contrast media reactions. 649 Nov 7

A railroad accident in Somerville, Massachusetts, led to spillage of phosphorus trichloride liquid. Attempted clean-up with water led to the liberation of phosphorus trichloride, phosphoric acid, hydrochloric acid, and phosphorus oxides. Seventeen people exposed to this mixture were studied. Patients experienced eye irritation, lacrimination, nausea, vomiting, and dyspnea. Six patients had transient elevation of lactic dehydrogenase. Although all patients had normal chest roentgenographic findings, pulmonary function tests showed statistically significant decreases in vital capacity (p = 0.02), maximal breathing capacity (p = 0.02), forced expiratory volume in one second (p = 0.02), and maximal expiratory flow rate at 25 percent of vital capacity (p = 0.05) in those closest to the accident site. Further, patients exposed for less than one and a half hours had significantly greater maximal expiratory flow rates at 25 percent of vital capacity when compared with patients who had been exposed longer (p = 0.02). In seven patients, repeated pulmonary function tests one month later showed improvement, suggesting strongly that the acute effects may have been due to phosphorus trichloride toxicity.
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PMID:Phosphorus trichloride toxicity. Preliminary report. 650 58


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