Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We measured total creatine kinase (CK), CK-MB isoenzyme, and the MB isoforms in 202 serum and plasma samples from nine groups of patients and normal individuals: 39 with acute myocardial infarction (MI), divided according to time between the onset of chest pain and blood collection (1-6 h, 7-12 h, and 13-48 h); 26 with chest pain for whom an MI was ruled out, sampled at admission; 17 undergoing bypass surgery or cardiac catheterization, sampled within 6 h after either procedure; 17 with acute skeletal muscle injury, sampled within 8 h after injury; 30 marathon runners immediately after a race; 17 runners and other athletes > 12 h after training or a race; 12 with cerebral injury or seizures, sampled at admission; 8 with closed head injury, sampled at admission; and 38 normal subjects. CK-MB (relative index) and MB isoforms (MB2/MB1) were respectively increased in 15% and 75% of MI patients 1-6 h after onset, 94% and 94% after 7-12 h, and 88% and 8% after 12 h, and in 87% and 82% of cardiac surgery patients. MB isoforms were increased in most patients with acute skeletal muscle trauma and in subjects examined after exercise, but were within normal limits in patients for whom MI was ruled out, patients with cerebral trauma, and normal individuals. The relative index of MB/total CK was normal in essentially all individuals in the last groups, including those with acute skeletal muscle trauma. We concluded that the CK-MB isoform ratio is increased in both acute skeletal muscle injury and MI. The isoform ratio is most useful for distinguishing recent from old (> 12 h) injury.
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PMID:Creatine kinase MB isoforms in patients with skeletal muscle injury: ramifications for early detection of acute myocardial infarction. 145 74

Ambulatory care centers have emerged as a new health care resource in many communities. Little information is available about the services that these centers offer to pediatric patients. A national survey of 254 ambulatory care centers was undertaken to determine their characteristics, including the number of pediatric patients seen, staffing patterns, and pediatric equipment and supplies available. Most clinics were located in urban areas and were within 5 miles of a hospital. They were staffed primarily by physicians who were board certified in emergency medicine, internal medicine, or family medicine. Not all centers had registered nurses on duty and few used extended-role nurses or physicians's assistants. The centers saw an average of 18 patients younger than 18 years of age per day. Some ambulatory care centers received emergency medical service and private ambulance calls and encountered serious illness such as chest pain, seizures, and anaphylaxis; the majority, however, handled mainly minor injuries and illnesses. Although most had pediatric equipment and supplies, some did not have a complete set of pediatric resuscitation equipment even though they were part of the emergency system offering care to the pediatric population.
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PMID:Emergency medical services and the pediatric patient. III: Resources of ambulatory care centers. 186 19

The knowledge and opinions of health professionals of Botucatu about the frequency and severity of thirteen symptoms and signs of diseases were studied with a view to comparing then with the opinions of Botucatu's urban population. Four hundred and thirty-five active health professionals (physicians, nurses, nurse aides, health workers (orderlies) and others were interviewed. Most of them were women, with ages ranging from 25 to 44. The health workers (orderlies) were the most numerous category. In general, the last five symptoms included in the form: bloody sputum, vaginal bleeding, breast lump, seizures and bloody urine, were considered less frequent and more serious as compared with the first eight symptoms: shortness of breath, fever, weakness, back pain (backache), chest pain, headache, cough and diarrhoea. Among the categories, the physicians differed from the other categories in less frequently attributing high scores to frequency and severity. The clinicians gave more value to these two factors than the surgeons for almost all symptoms. The comparison with the opinions of the laymen interviewed showed similar tendencies although the laymen regarded frequency and severity as more significant.
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PMID:[Analysis of health and life conditions of the urban population of Botucatu, SP (Brazil). III. Knowledge and opinions of health professionals about symptoms of diseases, 1984]. 209 96

Autonomic neural impulses that accompany discharges during a seizure can cause a variety of cardiac manifestations, including cardiac arrhythmias, sudden death, anginal chest pain, neurogenic pulmonary edema, and symptoms of pheochromocytoma. Either generalized or focal seizures may generate such signs and symptoms. A better appreciation of cardiac problems caused by epilepsy is helpful in preventing misdiagnosis, because the clinical picture in such a patient may be confusing.
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PMID:When epilepsy masquerades as heart disease. Awareness is key to avoiding misdiagnosis. 223 80

Electroconvulsive therapy (ECT) is known to produce increases in heart rate and blood pressure during seizure activity due to sympathetic stimulation and systemic catecholamine surges. These intense, brief hemodynamic changes can adversely affect myocardial oxygen supply and demand. In patients with compromised myocardial circulation, ECT can unmask undiagnosed cardiac disease. In this case report, ECT was performed on a 64-year-old white male with negative cardiac history. The patient awakened complaining of chest pain and ST wave depression was noted on the electrocardiogram. Cardiology consultation and cardiac catheterization were followed by coronary artery bypass surgery for significant coronary artery stenosis prior to resumption of ECT treatments. The physiological changes that occur during ECT are discussed, as well as pitfalls in evaluation of these patients for ECT treatment.
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PMID:Electroconvulsive therapy--induced hemodynamic changes unmask unsuspected coronary artery disease. 231 May 79

In a medical emergency, when rapid diagnosis is essential, a thorough examination of the skin often provides clues to the underlying illness. Dermatologic lesions may suggest the etiology of common medical emergencies, such as coma, seizure, shock, chest pain, hemorrhage, respiratory distress, acute abdomen and acute psychosis. Since examination of the skin is rapidly and easily performed, it should be included in the evaluation of a patient with a medical emergency.
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PMID:Skin clues to medical emergencies. 240 77

Because the initiation of IV lines by emergency medical technicians-Intermediates (EMT-Is) appeared to delay the patient's transport to the hospital, we undertook a retrospective study of 370 patients to compare prehospital care rendered by EMTs (EMT-A equivalent) and EMT-Is in a rural setting. Our study was limited to acute medical conditions in which protocols called for IV lines (124 patients with chest pain, 122 with acute respiratory distress, 99 with seizures, and only 25 with cardiac arrest) (the cardiac arrest cases were too few for statistical significance). We found that the difference in scene times for EMTs and EMT-Is not attempting IV lines was 6.1 and 6.9 minutes, respectively. The average scene time of EMT-Is attempting an IV line was 19.6 minutes (P less than .001) compared with EMT times, or times for EMT-Is not attempting an IV line. One hundred twenty-eight of 370 patients received IV medication within ten minutes of arrival in the emergency department, and ten of these patients had their IV lines initiated successfully in the field. Thirty-nine percent of patients with ED IV lines received IV medication within ten minutes of arrival, while only 21% of patients with a field IV line received medication in this period (P less than .05). We conclude that initiating a field IV line in this specific patient population significantly increased scene time and did not improve the chances of these patients receiving IV medication within ten minutes of arrival in the emergency department.
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PMID:Prehospital care by EMTs and EMT-Is in a rural setting: prolongation of scene times by ALS procedures. 271 61

The results of 1,680 consecutive urine and serum toxicologic screens from 1,120 patients, performed in a children's hospital during a 19-month period were surveyed. Among this sample, 52 (4.6%) patients had specimens that contained cocaine and/or metabolite. Fifteen specimens contained ethanol, a benzodiazepine, or a narcotic in addition to cocaine. Four patients were neonates, whereas three were infants from 1 to 7 months of age. The remaining 45 patients were adolescents with a mean age of 19 years. Among the adolescents, 11 had a significant chronic illness. In 19 patients (37%), cocaine exposure was unsuspected until the results of testing for toxic substances were known. The reasons for hospital evaluation included depression/attempted suicide in 19 patients, seizure in five, chest pain in 5, motor vehicle accident in three, syncope in three, abdominal pain in two, pneumomediastinum in two, accidental self-immolation in one, and apnea in one. Twenty patients required medical hospitalization for a total of 268 patient-days. One patient, a neonate, died. There is a striking prevalence of cocaine exposure in the pediatric age group. Among adolescents, this exposure may occur despite the presence of chronic illness. Although the age distribution appears bimodal, infants and young children may also have unsuspected exposure to this toxin. Greater awareness of cocaine exposure in childhood will be needed by primary and tertiary care pediatricians to identify affected children and provide appropriate intervention.
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PMID:Cocaine exposure among children seen at a pediatric hospital. 278 99

We performed a one-year prospective survey of emergency medical responses to travelers at an international airport to observe the frequency and type of emergencies experienced in flight and before and after travel. Emergency personnel evaluated a total of 1107 people; 754 (68%) were travelers, 232 (21%) were employees of the airport or airlines, and 118 (11%) were area residents. Of the 754 travelers, 190 (25%) experienced their problem during flight; the aircraft made an unscheduled landing for seven of these travelers. The frequency of in-flight emergencies was 1 per 753 inbound flights, or 1 per 39,600 inbound passengers. The most common emergency problems among all travelers were abdominal pain, chest pain, shortness of breath, syncope, and seizures; 25% of the emergencies were caused by minor trauma. The majority of emergencies among air travelers (75% [564/754]) happened on the ground within the air terminal. Most problems (84% [633/754]) were effectively handled by personnel trained as emergency medical technicians. The types of problems encountered suggest that the "doctors only" medical kit now required aboard US air carriers contains clinically useful items and should continue to be required on board.
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PMID:Frequency and types of medical emergencies among commercial air travelers. 229 87

All patients who presented to the emergency department as a result of cocaine intoxication during a one-year period were reviewed retrospectively. One hundred thirty-seven cases were reviewed. Patients presented with a wide variety of chief complaints including altered mental status (40%), chest pain (21%), syncope (19%), suicide attempt (13%), palpitations (12%), and seizures (12%), as well as numerous other complaints. There was only one death. Few patients required treatment within the ED; sixteen required hospitalization.
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PMID:Emergency department presentation of cocaine intoxication. 291 84


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