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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient was evaluated because of edema, pruritus and generalized painless lymphadenopathy. Laboratory tests showed marked eosinophilia without known etiology. CT scan of abdomen revealed multiple lymph nodes in retroperitoneal area. Lymph node biopsy was reported as sinus histiocytosis, bone marrow biopsy showed hypercellularity with marked infiltration of normal eosinophils. During his admission he developed Coombs positive hemolytic anaemia. Once he was stable, a laparotomy was performed and the patient died two days later because of septic shock. Autopsy revealed sinus histiocytosis with massive lymphadenopathy (SHML) with extranodal involvement of duodenum, spleen and prostate; septic liver and spleen, pyelonephritis, marked infiltration of eosinophils in lymph nodes, spleen, liver duodenum and lungs. To the best of our knowledge, this is the first case report of the association of SHML and Idiopathic Hypereosinophilic Syndrome (HES).
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PMID:Association of sinus histiocytosis with massive lymphadenopathy and idiopathic hypereosinophilic syndrome. 298 Jul 26

An open, noncomparative study at 8 rheumatology centers in Brazil assessed the efficacy and safety of auranofin (AF) when given for up to 24 months. The study enrolled 80 patients with classic or definite rheumatoid arthritis (RA); disease was severe in 20 (25%), moderate in 55 (69%), and mild in 5 (6%). Patients received auranofin, 3 mg twice daily, and varying doses of anti-inflammatory drugs (aspirin, nonsteroidal anti-inflammatory drugs, and corticosteroids). Sixty patients (75%) completed the full 24 months of therapy. No patients were withdrawn from therapy because of insufficient therapeutic effect. There was statistically significant improvement (p less than 0.001) in 9 clinical parameters of disease activity, evident as early as 3 months after beginning AF therapy, increasing steadily over 12 months, and remaining at improved levels for another 12 months. Improvements in some parameters were particularly striking. By 24 months, assessment of well-being had increased by 150%, intensity of pain had decreased by 66%, and duration of morning stiffness had decreased by 78%. The average daily dose of anti-inflammatory drugs also decreased over time. The safety profile of AF was similar to that found in comparable trials. Ten patients (12.5%) were withdrawn because of adverse events: 6 for diarrhea (7.5%), 2 for proteinuria (2.5%), and 1 each for pruritus and anemia (1.25%). Adverse events occurred in 24 of 80 patients; some reported more than one adverse event. The most common adverse events were loose stools (20 patients) or diarrhea (11 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy of auranofin as demonstrated by improvement in clinical parameters and decrease in anti-inflammatory usage: a long-term, multicenter study. 329 82

In order to evaluate the efficacy of dexamethasone (dex) in reducing the toxicity of therapy with lymphokine-activated killer (LAK) cells and interleukin-2 (IL-2), we treated six patients receiving this form of immunotherapy with intravenous (IV) dex, 4 mg every six hours. Compared with a control group of 27 patients not receiving dex with their immunotherapy, these corticosteroid-treated patients were able to tolerate the administration of more IL-2, yet experienced significantly less toxicity. Dyspnea, confusion, fever, mean peak serum creatinine, and bilirubin levels during treatment were significantly reduced in corticosteroid-treated patients, with a corresponding decrease in pruritus in this group as well. Overall weight gain was not different between groups, although a curtailment of weight gain temporally related to dex treatment was seen in some patients. Hematologic side effects, including anemia, eosinophilia, and thrombocytopenia, were not reduced by dex. These results suggest that dex can inhibit at least some of the toxic side effects of LAK cell and IL-2 therapy. Because of the concern that the therapeutic effect may also be abrogated, future studies combining corticosteroids with this form of immunotherapy should be undertaken with caution.
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PMID:Reduction of toxicity of interleukin-2 and lymphokine-activated killer cells in humans by the administration of corticosteroids. 349 32

The papilla of Vater, diminutive as it may be, forms the nidus for a variety of clinical disorders. Owing to its crucial location at the confluence of the bile and pancreatic ducts, many of these clinical disorders lead to an impedance to the flow of secretions from the liver and pancreas. Thus, most symptomatic papillary disorders present with a rather predictable and monotonous conglomeration of symptoms. The common clinical presentations of papillary disorders include abdominal pain, jaundice, fever, pruritus and pancreatitis. Rarely, gastrointestinal bleeding leading to anaemia and weight loss may also be observed. The advent of ERCP rekindled interest in diseases of the papilla. The major duodenal papilla is more accessible now than ever before. The endoscopist can visualize the papilla within minutes and take an appropriate tissue sample using different biopsy techniques. Definitive diagnosis is thus possible in most patients with papillary tumours. Along with ERCP, the miniaturization of a perfusion system with minimal compliance enabled us to accurately evaluate sphincter of Oddi (SO) dynamics. This in turn gave us a wealth of information on the physiology of the sphincter of Oddi. In addition, ERCP manometry led to a resurgence of interest in SO dysfunction, especially papillary stenosis. Several characteristic manometric abnormalities have been identified recently. Finally, the introduction of endoscopic sphincterotomy (ES), nearly a decade ago, opened a new chapter in the therapeutic approach towards papillary disorders. While the technique was initially applied in the management of common bile duct stones in postcholecystectomy patients who were high operative risks, the indications for ES steadily increased during the past decade. Experience over the years led us to be convinced that ES is equally effective in the management of a variety of papillary disorders, including choledochoduodenal fistula, choledochocele, papillary tumours and SO dysfunction. Most recently, other ancillary procedures such as endoprosthesis insertion have emerged as yet another useful therapeutic modality. Such internal biliary stents have been shown to be suitable in establishing biliary drainage in ampullary neoplasms when the operative approach is considered risky.
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PMID:Diagnosis and treatment of diseases of the papilla. 373 20

In a study of 46 patients with nodular prurigo (NP), potential metabolic causes of pruritus, such as anaemia, hepatic dysfunction, uraemia and myxoedema, were present in 50%. Focal causes of pruritus were important in 37% and included insect bites, venous stasis, folliculitis and nummular eczema. Psycho-social disorders were recorded in over 50% of patients and were considered relevant in 33%. Clinical and histological appearances ranged from classical NP to chronic lichenified eczema. Neural hyperplasia was not a prominent feature.
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PMID:Nodular prurigo--a clinicopathological study of 46 patients. 406 79

Chronic intermittent hemodialysis may relieve some medical problems of terminal uremia (for example, azotemia, acidosis, hypertension, neuro-muscular disorders, bleeding, pericarditis) to such a degree that many patients are able to resume their normal activity. There remain, however, problems which are not readily changed by hemodialysis (anemia, peripheral neuropathy, pruritus, sexual impotence, renal osteodystrophy). These, together with medical problems possibly caused by hemodialysis (for example, osmotic disequilibrium, errors in dialysate composition, hepatitis, hemosiderosis, isoimmunization from blood transfusions, shunt problems and psychological problems of dependency upon the artificial kidney) represent a limitation of the present type of hemodialysis therapy.
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PMID:Some medical problems of chronic hemodialysis. 486 55

Cefotaxime (CTX) was used for 129 cases in respiratory tract and other infections; 57 cases of pneumonia, 20 cases of bronchopneumonia, 20 cases of acute bronchitis, 14 cases of chronic bronchitis, 7 cases of acute exacerbation of bronchiectasia or pulmonary emphysema, 4 cases of suppurative diseases of the lung, 1 case of pyothorax, 1 case of retropharyngeal abscess, 3 cases of pleurisy and 1 case of urinary tract infection. (A case was excepted on clinical evaluation.) CTX was administered by intravenous injection or drip infusion at a daily dose ranging from 0.5 to 8 g, for a term of 2 to 61 days. The total dose patients received ranged from 3 to 226 g. The results obtained were as follows. Clinical effects; excellent in 45 cases, good in 63 cases, fair in 9 cases, poor in 7 cases and unevaluable in 4 cases. The efficacy rate was 87.1% (108/124). Bacteriological effects; eliminated in 30 cases, decreased in 8 cases, unchanged in 2 cases and replaced in 1 case. The elimination rate was 75.6% (31/41). Side effects and abnormal laboratory findings; general itching, fatigue in lower extremities and albuminuria in 1 case each, and anemia in 2 cases. Increased number of eosinophiles and elevated GOT in 1 case each, elevated GOT and GPT in 3 cases and elevated GOT, GPT and A1-P in 2 cases. These symptoms or abnormal laboratory findings disappeared after the discontinuation or termination of CTX therapy. In view of the above, CTX may be considered to be a clinically useful antibiotic against respiratory tract infections.
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PMID:[Clinical evaluation of cefotaxime in internal medicine]. 631 10

Intravenous miconazole can produce responses in patients with various manifestations of coccidioidal disease, even if they have failed to respond to amphotericin B. In 4 large series of 33, 33, 46 and 31 courses of miconazole for skin and soft tissue, chronic pulmonary, meningeal and skeletal coccidioidomycosis, response rates of 40, 72, 31 and 32%, respectively, were achieved; 60, 75, 78 and 56%, respectively, of those responding subsequently relapsed at the site(s) of earlier involvement. This suggests that the therapeutic effect of the relatively brief courses used (mean, 1 to 3 months) is fungistatic in vivo. Common side effects of intravenous miconazole include phlebitis, pruritus, anaemia, thrombocytosis, hyponatraemia, nausea, hyperlipidaemia, vomiting, central nervous system effects, and rashes. The place of miconazole relative to amphotericin B and ketoconazole has not been determined, and requires further comparative studies. Information on the results of different regimens, particularly longer courses, would also be of interest.
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PMID:Miconazole in the treatment of coccidioidomycosis. 635 86

Twenty-six adult patients were entered in a phase I trial of carboplatin, a new cisplatin derivative with reduced potential for nephrotoxicity. All patients had solid tumors and the median World Health Organization performance score was 2 (0-3). Twelve patients had not received prior chemotherapy. The drug was administered as a 15-minute IV infusion, without pre- or posthydration, at daily doses of 40-125 mg/m2 for five consecutive days. Antiemetics were given only if needed. Thrombocytopenia and neutropenia were dose related and dose limiting. One patient died from septic shock at the highest dose level. Nonhemolytic anemia was also encountered. Nausea and vomiting were experienced by most patients but gastrointestinal intolerance was severe in only two patients. One patient had hypercreatininemia, which was minor and rapidly reversible. Other toxic effects consisted of negligible fatigue, paresthesia, pruritus, local pain, stomatitis, headache, and alopecia. Although none of the patients achieved a partial or complete response, antitumor effect was strongly suggested in two patients with thyroid and cervix cancer, respectively. Carboplatin is an attractive candidate for phase II trials. In good-risk patients, such trials could be initiated at a daily dose of 100 mg/m2 for five consecutive days every five to six weeks.
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PMID:Phase I study of carboplatin given on a five-day intravenous schedule. 636 28

A 39 years old black woman with systemic lupus erythematosus developed tense bullae on erythematous bases on the flexor surfaces of the forearms and oral cavity. Some blisters healed with atrophy and pruritus was a striking feature. The diagnosis of systemic lupus erythematosus was based upon the following criteria: the typical blush in the butterfly area, alopecia, a painful macular papular eruption on the palms and fingers, fever, arthralgia, anemia, leukopenia, elevation of erythrocyte sedimentation rate and positive ANA. Histologic examination showed a subepidermal bulla formation and perivascular inflammatory infiltrate containing lymphocytes and eosinophils. By indirect immunofluorescence no autoantibodies were detected. Direct immunofluorescence showed deposition of linear IgG. High doses of prednisone brought about clinical remission but there was no response to sulfone. The patient is on maintenance dose. The authors discuss the differences between the three diseases and conclude that the bullous eruption cannot be classified.
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PMID:[Bullous eruption in systemic lupus erythematosus]. 638 91


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