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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

According to the best of our knowledge the second case of acute intoxication with captan was described. In this paper a 22-year old female was admitted to the Department of Toxicology with a nausea, weakness, numbness of upper limbs and substernal pain. She said that these symptoms began two hours after suicidal ingestion of 5.0 g of captan. At admission the patient was alert. Temperature was 37 degrees C, heart rate 100-120 b/min., BP 100-120/60-70 mm Hg and breathing rate 17/min. WBC were slightly elevated 12.4 x 10(3)/microl as well as the creatine kinase activity 329 U/L. ECG showed inversion of a T segment in V1-V4 leads. ECHO-sound made in 4th and 120th day after the onset of intoxication showed no changes, with EF--70%. Temporary increase of creatine kinase activity as well as the presence of inverted T segment in V1-V4 leads may suggest cardiotoxic effects of captan during acute intoxication.
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PMID:[Acute oral suicidal intoxication with captan--a case report]. 1552 24

The purpose of this longitudinal study was to explore changes in symptom distress in newly diagnosed Taiwanese breast cancer patients during the initial 4-week postoperative period. The research instruments, including a demographic questionnaire and the Symptom Distress Scale, were used to obtain data on postoperative day 2 and at weeks 2, 3, and 4. In total, 39 patients with a mean age of 48 years participated in this study. Data were analyzed using descriptive statistics, t tests, one-way ANOVA, and repeated-measures ANOVA. Results revealed that the level of symptom distress significantly decreased from postoperative day 2 to week 4. Loss of appetite and a poor outlook increased; nausea frequency, fatigue, and insomnia decreased then increased; and frequency and the level of pain, coughing, tightness/tenderness in the chest wall, weakness, and numbness in the arm of the operative side all decreased over the 4-week study period. Age, stage of disease, and type of surgery were all related to symptom distress. Results of this study may provide reassurances about what can be expected after breast cancer surgery.
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PMID:Symptom distress changes during first postoperative month in newly diagnosed Taiwanese breast cancer patients: a longitudinal study. 1604 87

Adjuvant chemotherapy protocols used to treat women with breast cancer have evolved over the last decade and have dramatically altered the symptoms and symptom experiences of these women. The purpose of this study was to identify symptoms, symptom experiences, and resulting symptom distress encountered by women with breast cancer undergoing surgery and receiving current chemotherapy protocols. Convenience sampling was used to recruit 20 women for this study. Women were asked to tell their story and transcripts were analyzed using Colaizzi's procedural steps. Six themes emerged. The most important theme was that symptom experiences and symptom distress, similar among all 20 women, were congruent with the type of treatment. After surgery, women complained of numbness, pulling, and body image changes; while receiving Adriamycin and Cyclophosphamide, symptoms of intense nausea and hair loss caused distress; while receiving Paclitaxel, symptoms of intense bone pain and peripheral neuropathy caused distress. This study provides oncology nurses with a clear description of the symptoms, symptom experiences, and symptom distress women with breast cancer encounter during present-day treatment protocols. Knowing the symptoms and symptom experiences, as well as when they occur during treatment, provides oncology nurses with an opportunity to share with women about to start treatment for breast cancer the expected "normative" symptom experience. This in turn would allow women to anticipate symptoms, employ management strategies, and empower them to improve their cancer experience.
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PMID:Symptom, symptom experiences, and symptom distress encountered by women with breast cancer undergoing current treatment modalities. 1619 30

Subtyping panic disorder by predominant symptom constellations, such as cognitive or respiratory, has been done for some time, but criteria have varied considerably between studies. We sought to identify statistically symptom dimensions from intensity ratings of 13 DSM-IV panic symptoms in 343 panic patients interviewed with the Anxiety Disorders Interview Schedule for DSM-IV Lifetime Version. We then explored the relation of symptom dimensions to selected illness characteristics. Ratings were submitted to exploratory maximum likelihood factor analysis with a Promax rotation. A three-factor solution was found to account best for the variance. Symptoms loading highest on the first factor were palpitations, shortness of breath, choking, chest pain, and numbness, which define a cardio-respiratory type (with fear of dying). Symptoms loading highest on the second factor were sweating, trembling, nausea, chills/hot flashes, and dizziness, which defines a mixed somatic subtype. Symptoms loading highest on the third factor were feeling of unreality, fear of going crazy, and fear of losing control, which defines a cognitive subtype. Subscales based on these factors showed moderate intercorrelations. In a series of hierarchical multiple regression analyses, the cardio-respiratory subscale was a strong predictor of panic severity, frequency of panic attacks, and agoraphobic avoidance, while the cognitive subscale mostly predicted worry due to panic. In addition, patients with comorbid asthma had higher scores on the cardio-respiratory subscale. We conclude that partly independent panic symptom dimensions can be identified that have different implications for severity and control of panic disorder.
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PMID:Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder. 1629 63

We report an outbreak of ciguatoxin poisoning after barracuda fish ingestion in southern Taiwan. Three members of a family developed nausea, vomiting, watery diarrhea, and myalgias about 1 hour after eating three to ten eggs of a barracuda fish. Numbness of the lips and extremities followed the gastrointestinal symptoms about 2 hours after ingestion. Other manifestations included hyperthermia, hypotension, bradycardia, and hyperreflexia. Bradycardia persisted for several days, and one patient required a continuous infusion of intravenous atropine totaling 40 mg over 2 days. Further follow-up of the patients disclosed improvement of neurologic sequelae and bradycardia, but sensory abnormalities resolved several months later. In conclusion, ciguatoxin poisoning causes mainly gastrointestinal and neurologic effects of variable severity. In two patients with ciguatoxin poisoning after barracuda fish egg ingestion, persistent bradycardia required prolonged atropine infusion.
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PMID:Short report: persistent bradycardia caused by ciguatoxin poisoning after barracuda fish eggs ingestion in southern Taiwan. 1635 6

Cerebrospinal fluid (CSF) volume depletion syndrome is due to leakage of cerebrospinal fluid through lesions of the dural sac at the level of the cranial base or of the spine. When past medical history is negative for recent trauma or surgery, the term spontaneous intracranial hypotension (SIH) is used. SIH is characterized clinically by orthostatic headache, neck pain, nausea, emesis, horizontal diplopia, tinnitus, plugged ear, hearing difficulties, blurring of vision, facial numbness, and upper limb radicular symptoms. In SIH, brain and cervical MR scans show a diffuse pachymeningeal gadolinium enhancement that ends at the site of CSF leakage. The application of epidural blood patches has been proposed as an effective therapy for SIH. Here we describe a case of SIH with very unusual headache features; the patient reported a paradoxical pattern of postural headache provoked by clinostatic position. The CSF leakage was identified at the convexity of the skull and headache disappeared following treatment with fluid, analgesics and steroids.
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PMID:Headache in cerebrospinal fluid volume depletion syndrome: a case report. 1673 1

Cerebrospinal fluid (CSF) volume depletion, due to CSF leakage or CSF shunt overdrainage, is typically indicated when patients present with orthostatic headaches, with or without several other symptoms: neck or interscapular pain, nausea, emesis, diplopia, changes in hearing, visual blurring, facial numbness or weakness, and radicular upper-limb symptoms. Cerebrospinal fluid pressures typically are quite low and head magnetic resonance images typically reveal diffuse pachymeningeal gadolinium enhancement, with or without evidence of sagging of the brain and less frequently with subdural fluid collections, enlarged cerebral venous sinuses or pituitary gland or decreased ventricular size. Magnetic resonance imaging has revolutionized detection of spontaneous CSF leaks, leading to identification of far more cases and recognition of several clinical/imaging forms of presentation of the disorder. These forms, which are different from the "typical" presentation, include a group with consistently normal CSF pressures (normal pressure), another group without abnormal meningeal enhancement (normal meninges), and a group without headache (acephalic). Each of these forms can be seen in a setting of documented and ongoing CSF volume depletion. Awareness of CSF volume depletion is increasing, and its clinical and imaging spectrum is broadening.
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PMID:Cerebrospinal fluid volume depletion and its emerging clinical/imaging syndromes. 1685 67

A descriptive study was conducted on self-reported symptoms and self-care by 37 adults receiving chemotherapy primarily for leukemia, lymphomas, or breast cancer or radiation therapy for head and neck or lung cancers. The Therapy-Related Symptom Checklist and demographic and interview forms on self-care for identified symptoms were used. Severe symptoms on the Therapy-Related Symptom Checklist subscales fatigue, eating, nausea, pain, numbness in fingers/toes, hair loss, and constipation were reported by patients on chemotherapy. Those on radiation therapy reported severe symptoms on the eating, fatigue, skin changes, oropharynx, and constipation subscales.Self-care strategies were in the following categories, using complementary medicine as framework: diet/nutrition/lifestyle change (eg, use of nutritional supplements; modifications of food and of eating habits; naps, sleep, and rest); mind/body control (eg, relaxation methods, prayer, music, attending granddaughter's sports events); biologic treatments (vitamins); herbal treatments (green mint tea); and ethnomedicine (lime juice and garlic). The first category was predominantly used by patients in both treatment types. Medications were prescribed also to help control symptoms (eg, pain and nausea). Symptom monitoring and self-care for symptoms identified may be facilitated by the Therapy-Related Symptom Checklist; based on reported symptom severity, care providers may prioritize interventions. A larger study needs to be done on (a) the use of the Therapy-Related Symptom Checklist as a clinical tool to assess symptoms that oncology patients experience during therapy; (b) whether care providers, based on patient-reported symptom severity, can prioritize interventions--and how this influences the efficiency of care; (c) the self-care strategies used by patients on chemotherapy or radiation therapy or both; and (d) how useful these strategies are in alleviating symptoms.
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PMID:Cancer treatment, symptom monitoring, and self-care in adults: pilot study. 1700 7

Medial medullary infarct (MMI) is a rare type of brain stem infarction. Its clinical picture was characterized by contralateral hemiparesis, deep sensory disturbance, and ipsilateral hypoglossal paresis, but conjugate deviation or nystagmus is uncommon as initial symptom. Case 1: A 73-year-old man developed vomiting and vertigo. Examination revealed right conjugate deviation and horizontal nystagmus beating toward the left side, and numbness on his right upper limb,but no hypoglossal nerve palsy. Cranial MRI demonstrated an infarction in the left paramedian region of the upper medulla and thrombus of the left vertebral artery. Case 2: A 74-year-old man suffered from dizziness and nausea. He showed left conjugate deviation and right-beating horizontal nystagmus without Horner syndrome or hypoglossal nerve palsy. MRI disclosed an infarction in the right upper medial medulla. MRA revealed the right dissecting vertebral artery. Case 3: A 71-year-old man developed vertigo when watching at TV. He showed transient left conjugate deviation and transient motor paresis on the left upper limb. MRI showed the thickened wall of the right vertebral artery but no abnormal ischemic lesion. Digital subtraction angiograms revealed the dissecting right vertebral artery. All ischemic events limited to the upper third of the medulla were caused by the vertebral artery lesions, and prognosis was good. The unilateral MMI lesion in the nucleus prepositus hypoglossi and/or the medullary reticular formation caused contralesional shift of the eyes and ipsilesional nystagmus. The upper MMI will be characterized by a triad of contralateral hemiparesis, deep sensory disturbance and abnormal ocular motor findings.
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PMID:[Conjugate deviation in ischemia of medial medullary oblongata--report of three cases]. 1737 Jun 54

A 37-year-old man presented with acute dizziness, nausea, headache and fever. Later on, he developed diplopia, swallowing difficulties, numbness and ataxia. MRI on day 6 showed hypo-intense, contrast-enhancing lesions on TI-weighted scans in the brainstem and cerebellum. Cerebrospinal fluid (CSF) findings on day 6 included pleiocytosis, a mildly-elevated protein level and mildly-decreased glucose level. CSF and blood cultures were initially negative for both bacteria and viruses. Acute disseminated encephalomyelitis (ADEM) was suspected and dexamethasone therapy was started. On day 26, a blood culture was positive for Listeria monocytogenes. The diagnosis 'Listeria rhombencephalitis' was made and the patient was treated with amoxicillin. This resulted in good recovery. In patients with a subacute onset of progressive cranial nerve dysfunction, ataxia, CSF pleiocytosis, and MRI lesions in the brainstem and cerebellum, Listeria rhombencephalitis should be considered. Early diagnosis and treatment improve the prognosis.
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PMID:[Rhombencephalitis due to Listeria monocytogenes]. 1790 63


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