Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 14 extensively pretreated patients with advanced and progressive malignancy were given 140 infusions of autologous plasma that had been perfused over staphylococcal protein A bound to an agarose gel (Sepharose). Infusions ranged in volume from 35 ml to 260 ml (mean, 70 ml), and the quantity of protein A used ranged from 1 to 30 mg per 100 ml of plasma (mean, 10 mg). Acute toxic reactions included fever (21%), chills (18%), nausea (17%), vomiting (8%), pain (9%) and bronchospasm (2%). Four patients did not have an acute toxic reaction and no chronic or cumulative toxic effects were identified. In two patients there was objective tumor regression and in five there was stabilization of disease lasting from 4 to 12 weeks. Further study of this treatment modality is warranted.
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PMID:Treatment of advanced malignancy with plasma perfused over staphylococcal protein A. 662 80

One hundred ninety-two liver abscesses in 190 patients were treated: 109 by needle aspiration, and 83 by operation. Mortality and complication rates were lower in the aspiration group, and the average hospital stay was shorter. This was true for both pyogenic and sterile abscesses, the latter being presumed to be amebic, although trophozoites were recovered from liver pus in only two patients. Patients with pyogenic abscess were, on the average, considerably younger than patients with the condition in the United States for reasons that are not immediately apparent. The preponderance of amebic abscesses found in men is less than usual, again for reasons that are not clear. Both pyogenic and amebic abscesses were commonly associated with fever, chills, and tenderness and pain in the right upper abdomen and hepatomegaly on physical examination. We found metronidazole effective in the treatment of both pyogenic and amebic abscesses.
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PMID:Experience with liver abscess. 669 5

Lyme disease, caused by a tick-transmitted spirochete, typically begins with a unique skin lesion, erythema chronicum migrans. Of 314 patients with this skin lesion, almost half developed multiple annular secondary lesions; some patients had evanescent red blotches or circles, malar or urticarial rash, conjunctivitis, periorbital edema, or diffuse erythema. Skin manifestations were often accompanied by malaise and fatigue, headache, fever and chills, generalized achiness, and regional lymphadenopathy. In addition, patients sometimes had evidence of meningeal irritation, mild encephalopathy, migratory musculoskeletal pain, hepatitis, generalized lymphadenopathy and splenomegaly, sore throat, nonproductive cough, or testicular swelling. These signs and symptoms were typically intermittent and changing during a period of several weeks. The commonest nonspecific laboratory abnormalities were a high sedimentation rate, an elevated serum IgM level, or an increased aspartate transaminase level. Early Lyme disease can be diagnosed by its dermatologic manifestations, rapidly changing system involvement, and if necessary, by serologic testing.
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PMID:The early clinical manifestations of Lyme disease. 685 26

The case is described of a 32-year old woman with an 8 year history of oral contraceptive (OC) use who developed vascular complications. Significant findings in the patient's history included an appendectomy and repeated biliary colic dating back 7 years. The patient sought help for an attack of hepatic colic with vomiting, chills, and fever, dyspepsia, and intolerance of fats. Pain was noted on palpation and the clinical and sonographic findings indicated hepatomegaly. Based on the other clinical and laboratory findings, a preliminary diagnosis of infected hepatic hydatidic cyst was made and the intrahepatic hematoma was drained. The postoperative diagnosis was a large hematoma occupying the greater part of the right hepatic lobe. A pleural hemorrhage occurred during postoperative hospitalization and was treated medically, but 4 days after discharge from the hospital the patient returned with a pleural hemorrhage that required drainage. Hydatidosis is endemic in the region of Spain where the case occurred, and the grounds for differential diagnosis are specified. Several illustrations including sonograms, X-rays, and results of computerized axial tomography are included and explained. With the increasing use of OCs in Spain, it is likely that more such cases will be seen.
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PMID:[Hepatic hematoma and pleural hemorrhages caused by prolonged ingestion of oral contraceptives]. 687 43

In this study, we present 117 cases of solitary pyogenic liver abscess. The average age was 30, and the most important clinical findings were pain (81.8%), chills and fever (52.2%) and hepatomegaly (64.1%). The laboratory findings were as follows: leukocytosis (61.4%), elevated sedimentation rate (71.6%), BUN over 50 mgs (15.3%), average SGOT: 20.1, SGPT: 20.3, and alkaline phosphatase: 82.6 mU. X-ray examination revealed pathological findings in the right pleural cavity and diaphragm in 61.5% of cases. Radioisotope scanning of the liver was helpful in 88.5% of cases. The preoperative diagnosis was correct in 72%. The abscess was located in the right lobe in 83.8%, in the left lobe in 14.5%, and in both lobes in 1.7%. The average abscess volume was 500 cc, and the pus was sterile in 77.7%. The overall complication rate was 31.6%, and the mortality rate was 17.9%. The patients were treated by early systematic surgical drainage.
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PMID:Solitary pyogenic liver abscess: a statistical analysis of 117 cases. 688 94

Sixty-five cases of nosocomially acquired Legionnaires' disease are reported and the world literature is reviewed. The etiologic agent, Legionnella pneumophila, has been isolated from several environmental sources at outbreak sites. Legionnaires' disease appears to be acquired by inhalation and is primarily manifested by severe, potentially fatal, pneumonia. Characteristic clinical disease consists of high fever with relative bradycardia, dry cough, chills, diarrhea, and pleuritic pain. Although no single feature is pathognomonic, the clinical presentation is usually sufficiently characteristic to suggest the diagnosis. The diagnosis of Legionnaires' disease during acute illness may be established by culture of Legionella pneumophila, or by demonstration of the bacterium using special stains. However, in most instances, the physician must make a presumptive diagnosis based on the clinical presentation in order to institute appropriate antimicrobial therapy. Retrospective confirmation of the diagnosis may be made by serologic studies in most instances. Erythromycin is, at this time, the drug of choice for the treatment of Legionnaires' disease. A prompt salutory response following institution of erythromycin therapy is typical.
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PMID:Legionnaires' disease: report of sixty-five nosocomially acquired cases of review of the literature. 699 73

The authors' previous surgical adjuvant trial in patients with malignant melanoma at high risk of recurrence has shown no difference in disease-free interval or survival between patients randomized to surgery + BCG or surgery alone. Reported here is a subsequent nonrandomized trial in 30 similar patients who received surgery + Corynebacterium parvum (CP) 4 mg I.V. daily x 5, followed by 4 mg S.C. weekly for up to three years. After I.V. C. parvum, chills, fever, headache, and hypertension were common. After S.C. C. parvum, varying degrees of local induration, erythema, and pain were experienced. Dose reduction was necessary for 14 patients during I.V. treatment and for six patients during S.C. treatment. A marked decrease in absolute lymphocyte count and a decreased proliferative response of lymphocytes to common antigens in vitro was observed after 2-3 days of I.V. C. parvum. Lymphocyte reactivity to mitogens decreased, particularly with Con A. Marked increase in nitroblue tetrazolium reduction by granulocytes was seen in 20 patients. Although changes in delayed cutaneous hypersensitivity reactions to recall antigens followed no consistent pattern, reactivity to DNCB increased in 18 patients. In addition, median time to recurrence was 33 weeks, significantly shorter than in the previous trial, but the survival distribution was no different from before. It can be concluded, therefore, that the administration of C. parvum in this dose and schedule had essentially no effect on the outcome of these patients.
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PMID:Surgical adjuvant therapy of malignant melanoma with corynebacterium parvum. 701 2

Acute suppurative cholangitis is characterized by obstruction, inflammation, and pyogenic infection of the biliary tract associated with the clinical pentad of fever (and chills), jaundice, pain, shock, and central nervous system depression. The disease occurs most commonly in the elderly who have a history of calculous biliary tract disease. The disease represents a true surgical emergency. Appropriate antibiotic therapy and immediate surgical decompression of the biliary tract are essential and carry a mortality rate of approximately 33 per cent. Nonoperative management is uniformly fatal. If inadequately treated or untreated, the disease follows a fulminant course of progressive systemic sepsis, hepatic abscess formation, and heptic failure leading ultimately to death. Acute suppurative cholangitis, the most serious sequela of calculous biliary tract disease, is preventable by early elective surgical treatment for benign biliary tract disease.
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PMID:Acute suppurative cholangitis. 702 98

Five patients with two periampullary choledochoduodenal fistulas diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) are described. In two patients both fistulas were on the oral prominence of the papilla, whereas in the remaining three, one of the two fistulas was more proximal. All five patients presented with right upper abdominal pain, which was associated with chills, fever and jaundice in two. ERCP revealed choledocholithiasis in two patients, cholecystolithiasis in one, hepatocholedocholithiasis in one, and bile duct dilatation without stone in one. A previous history of pain episodes accompanied by jaundice was obtained in four cases, and surgical bougienage of the papilla had been performed during previous common bile duct exploration in two, which may be responsible for the occurrence of multiple fistulas by possible false passage.
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PMID:Multiple choledochoduodenal fistulas in the periampullary region. 714 Jun 54

During the period 1966-1976, 32 children from 6-16 years of age were admitted to the surgical service of Nemazee Hospital for hydatid disease. There were 16 males and 16 females. Eighteen patients had cysts of the liver, 13 had cysts of the lungs and 1 had a cyst of the orbit. Sixteen patients each had multiple cysts and 16 each had a single cyst. The location of multiple cysts were: liver in 10 patients, liver and kidney in 1, liver and cul-de-sac in 1, lungs in 3, lung and spine in 1 patient. Six patients had the disease in the right lobe of the liver, one in the left lobe and 11 had the disease in both lobes or the central part of the liver. There were 10 infected cysts: 7 in the lungs und 3 in the liver. Except for one recurrent cyst of the liver, all cysts were primaries. The incidence of hydatid disease in children compared to the incidence in the adult in the same period was 1 child to 12 adults (8.3%). The symptoms during the symptomatic period included abdominal mass, hepatomegaly, pain and jaundice in cysts of the liver; chest pain, cough and hemoptysis in cysts of the lung and chills and fever in both. Surgical management consisted of evacuation of the contents and resection of that part of the pericyst that was not covered by normal tissue. The pericyst was totally resected only when it was heavily fibrotic and resection was safely feasible, or when the pericyst was calcified. Two patients died, one following operation for hydatid cyst of the liver; the other died before the operation due to rupture of infected cyst of the lung into the bronchus and consequent respiratory arrest. Postoperative complications were prolonged bile drainage in two patients, in which both patients ceased their bile drainage spontaneously; one abdominal wound infection and one empyema occurred after operations for an infected cyst of the liver and an infected cyst of the lung respectively. The abdominal wound healed secondarily and empyema resolved after drainage. Enucleation of the endocyst or evacuation of the contents and parital excision of the pericyst were the safest management. The least-encountered complication of total excision was excessive blood loss.
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PMID:A ten-year survey of hydatid disease (Echinococcus granulosus) in children. 714 53


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