Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients who use PermCath as the vascular access for long-term hemodialysis are occasionally confronted with catheter-related infections. Recently, we have treated 17 patients suffering from PermCath-related sepsis. The clinical presenting features were leukocytosis in 14/17, high fever and shaking chill during dialysis in 12/17, and signs of exit site infection in 3/17. No shock was found. All patients received clinical evaluation to exclude infection sources other than from blood and inside the catheter, such as pulmonary, genitourinary, hepatobiliary and cutaneous systems. Blood drawn from both PermCath and peripheral vein was sent for bacterial culture. Bacterial culture of the blood samples from PermCath revealed Staphylococcus sp. in 7/17, Pseudomonas sp. in 5/17, Enterobacter sp. in 4/17, Streptococcus sp. in 1/17. Fourteen blood samples from peripheral vein showed positive culture results identical to those from PermCath, but negative study were noted in three other patients. The patients were divided into two treatment groups: Group I: systemic antibiotics without PermCath removal in 7, Group II: "locked-in" retention in addition to systemic anti-biotics in 10. Antibiotics were empirically chosen according to bacteriological studies. In the "locked-in" retention treatment, antibiotics were retained into both the inflow and outflow PermCath lumens in the exact volume of each lumen for 24 hours. The antibiotics solutions were replaced on a daily basis. The same antibiotics were also given intravenously. Duration of treatment depended on clinical progression and follow-up blood culture results and ranged between 13 and 24 days. The schedule of dialysis was not changed through the period of PermCath-related sepsis. The sepsis was cured in all group II cases but not in 2 of group I and resulted in mortality in these 2 patients. The PermCaths were preserved in 5/7 in group I with two mortality cases and all except one preserved in group II patients without mortality. We suggested that "locked-in" retention in addition to systemic antibiotics is the treatment of choice for the patients with PermCath-related sepsis. This method also preserves the functional integrity of PermCath, which is the lifeline vascular access of the patients with exhausted native vessels.
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PMID:Treatment of PermCath-related sepsis in uremic patients. 910 2

A 47-year-old man with hepatocellular carcinoma (HCC) at anterior and medical segment in the liver was treated with hepatic arterial infusion of Zinostatin Stimalamer-lipiodol suspension (SMANCS). After the 2nd infusion of SMANCS, the accumulation of lipiodol in the tumor was not good (Grade II), so additional administration was undertaken at five-weeks intervals. His systolic blood pressure immediately decreased from 120 to 60 mmHg, and he had numbness of hands, shaking chills, sweating, chest pain and numerous urticaria-like red exanthema. In spite of treatment by anti-shock agents such as steroid and catecholamines, these symptoms did not disappear, but antihistaminics greatly improved them without any serious side effects. Because of the remarkable effects of the antihistaminics and possibility of antibody production (IgE) after repeated infusions of high molecular SMANCS, this patient may have suffered anaphylactic shock caused by massive histamine release from mast cells.
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PMID:[An anaphylactic shock case after hepatic arterial infusion of zinostatin stimalamer suspension improved by anti-histaminics]. 921 13

Hydroxyurea (HU) is generally regarded as an effective and well-tolerated drug for the treatment of the chronic myeloproliferative syndromes. It has rarely been implicated as a cause of drug fever. We report two patients with primary thrombocythaemia and one patient with polycythaemia vera who developed fever and shaking chills during treatment with HU. Infection was highly suspected and all patients were examined extensively. The fever subsided after discontinuation of therapy with this drug. However, the fever recurred within 1 day after rechallenge. The mechanism of HU-induced fever remained unclear, but the experience in our patients and the reviewed cases in the literature are highly suggestive of a hypersensitivity reaction. Clinicians should be aware of this rare adverse effect.
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PMID:Fever caused by hydroxyurea: a report of three cases and review of the literature. 936 Apr 12

Panic disorder is a chronic and debilitating illness. In this article, we present an algorithm of the diagnosis and treatment of the illness. We place much importance upon the patient variables associated with the treatment decisions. We emphasize strong patient involvement in treatment as a way to become panic free and improve level of functioning. Panic disorder is defined in DSM-IV1 as "The presence of recurrent panic attacks followed by at least one month of persistent concern about having another panic attack, worry about the possible implications or consequences of the panic attack, or a significant behavioral change related to the attacks." A panic attack is defined as "a discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes." 1) Palpitations, pounding heart or accelerated heart rate; 2) sweating; 3) trembling or shaking; 4) sensations of shortness of breath or smothering; 5) feeling of choking; 6) chest pain or discomfort; 7) nausea or abdominal distress; 8) feeling dizzy, unsteady, light-headed or faint; 9) derealization or depersonalization; 10) fear of losing control or going crazy; 11) fear of dying; 12) paresthesias; 13) chills or hot flashes. The following hypotheses have been used to conceptualize panic disorder from a psychiatrist's perspective.
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PMID:Panic disorder: a different perspective. 949 26

An 82-year-old man was admitted because of abdominal pain and a shaking chill. His medical history revealed ileocecal resection because of ileitis associated with a Yersinia infection 3 years before admission. One year later he was readmitted because of bowel obstruction due to recurrent ileitis. He was treated with trimethoprim-sulfamethoxazole for two weeks because of positive serological tests for Yersinia and made a full recovery except for chronic diarrhoea. On the current admission, stool cultures yielded Campylobacter upsaliensis. Further analysis showed severe non-specific ulcerative ileitis without colitis. A diagnosis of Crohn's disease was made. The patient was treated with prednisone and mesalazine and made a full recovery. The chronic diarrhoea disappeared. The course was complicated by a cerebro-vascular thrombosis and severe thrombocytosis due to polycythaemia vera. Treatment with hydroxyurea was effective in lowering the thrombocyte count.
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PMID:[Clinical decision making in family practice. A patient with abdominal pain and chills]. 975 68

During April 30-July 26, 1998, 20 patients at a major medical center (hospital A) in Los Angeles County, California, developed severe shaking chills often accompanied by fever, tachycardia, and/or a decrease of > or =20 mm Hg in systolic blood pressure within 3 hours after receiving intravenous (IV) gentamicin. Receipt of IV gentamicin was the only medication or procedure temporally associated with reactions among all of the patients. No deaths or serious sequelae were associated with the reactions. Similar incidents were reported by hospital personnel from six other states to CDC or the Food and Drug Administration (FDA) during April-August 1998. All reported reactions were associated with once-daily dosing regimens of gentamicin (lot numbers 170704, 180031, 180133, and 180191) produced by Fujisawa USA, Inc. (Deerfield, Illinois). On August 13, the Los Angeles County Department of Health Services and CDC initiated an investigation with the assistance of hospital A personnel. This report summarizes the results of this investigation at hospital A, which found that gentamicin with endotoxin levels within the U.S. Pharmacopeia (USP) standards may deliver endotoxin amounts above the threshold for pyrogenic reactions with once-daily dosing.
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PMID:Endotoxin-like reactions associated with intravenous gentamicin--California, 1998. 981 10

By using data from the Bremer Adolescent Study, this report presents findings on the frequency, comorbidity, and psychosocial impairment of panic disorder and panic attacks among 1,035 adolescents. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Panic disorder and other psychiatric disorders were coded based on DSM-IV criteria using the computerized-assisted personal interview of the Munich version of the Composite International Diagnostic Interview. Panic disorder occurred rather rare, with only 0.5% of all the adolescents met the DSM-IV criteria for this disorder sometimes in their live. Panic attack occurred more frequently, with 18% of the adolescents reported having had at least one panic attack. Slightly more girls than boys had panic attack and panic disorder. The occurrence of panic attack and panic disorder were the greatest among the 14-15 year olds. The experience of having a panic attack was associated with a number of problems, the most frequent being avoiding the situation for fear of having another attack. Four most common symptoms associated with a panic attack were that of palpitations, trembling/shaking, nausea or abdominal distress, and chills or hot flushes. Panic disorder comorbid highly with other psychiatric disorder covered in our study, especially with that of major depression. Among those with a panic disorder, about 40% of them were severely impaired during the worst episode of their illness. Only one out of five adolescents with panic disorder sought professional help for emotional and psychiatric problems. The implication of our findings for research and clinical practice are discussed.
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PMID:Frequency of panic attacks and panic disorder in adolescents. 998 46

There are special considerations when performing cardiopulmonary bypass (CPB) on a patient with malaria. A 70-year-old female with a recent history of severe aortic stenosis was scheduled to undergo elective aortic valve replacement. One week prior to surgery, the patient developed shaking chills and fever, with a positive malaria smear. An extensive literature search was undertaken to determine the effect of CPB on a patient with active malaria, but no prior reference was found. One major concern was the lysis of red blood cells while on bypass. The surgery was performed uneventfully, following 2 weeks of treatment with primaquine phosphate.
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PMID:Cardiopulmonary bypass on a patient with malaria. 1041 Dec 53

It has been previously shown that antibiotics given before hospitalization significantly reduce the proportion of positive blood cultures in community-acquired pneumonia (CAP). The aim of this prospective study was to compare the utility and cost-benefits of blood cultures in patients, hospitalized for moderate CAP, who had or had not received antibiotic therapy prior to admission. During 1 year, 53 patients were included and separated into two groups: group 1 patients had not received antibiotic treatment prior to admission (n = 30), whereas group 2 patients had been treated with antibiotics (n = 23). Within the first 48 hours, a set of blood cultures was collected if the body temperature was higher than 38.5 degrees C or in the case of shaking chills. A total of 136 blood cultures was collected; 74 in group 1 and 62 in group 2. Bacteraemia was significantly more frequent in group 1 than in group 2, 5/30 patients vs. 0/23, respectively (P < 0.05). The cost of negative blood cultures was valued at 13,939.2 FF in group 1 and 13,164.8 FF in group 2, respectively 464.6 +/- 244.3 FF and 569.3 +/- 233.4 FF per patient (n.s.). Moreover, blood cultures were the method of diagnosis in only one of the five patients with bacteraemia and in no case did a positive blood-culture result influence the initial therapeutic regime. Thus, our results suggest a reduced clinical utility and cost-benefit of blood cultures in patients hospitalized for moderate CAP who have received an antibiotic treatment prior to admission.
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PMID:Utility of blood cultures in community-acquired pneumonia requiring hospitalization: influence of antibiotic treatment before admission. 1046 80

A previously healthy 15-year-old female was admitted to our hospital complaining of nausea and vomiting. She did not complain of diarrhea. A physical examination revealed a lower right quadrant abdominal tenderness without rebound or spontaneous pain and a knocking pain of the costovertebral angle. A high fever, knocking pain of costovertebral angle, and urinary findings including Gram's stain, lead us to suspect a urinary tract infection, cefotiam was administered intravenously. Spiking fever with shaking chills continued for three days, and three sets of blood cultures were positive for Salmonella Oranienburg, but her urine culture was negative. Her history was taken again, revealing an intake of a processed squid product. The product was confirmed by the local public health center to be Salmonella Oranienburg. Finally food poisoning by Salmonella Oranienburg with sepsis was diagnosed. With cefotiam she became better and was discharged from the hospital on the 10th hospital day. During admission to the hospital she did not experience any diarrhea, and her stool culture was negative. Epidemics of Salmonella Oranienburg food poisoning are relatively rare in the literature. In Japan, one has arisen as a result of contamination of a processed squid product in March 1999. However, there have been no cases without so-called gastroenteritic symptoms (abdominal pain and diarrhea) who were previously healthy and developed sepsis caused by Salmonella Oranienburg, reported in Japan. Even in previously healthy patients, with an epidemic situation of non-typhoidal salmonellosis, salmonella sepsis must be ruled out. Among such cases, those who present with spiking fever and shaking chills should be given antibiotic therapy after taking appropriate cultures.
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PMID:[Sepsis due to Salmonella Oranienburg--a case report]. 1048 26


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