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 phase I study to determine the toxicity and immunologic effects of iv administered aqueous suspensions of mycobacterial cell wall skeleton (CWS) and CWS combined with trehalose dimycolate (TDM) was performed. A total of 26 patients received suspensions of either CWS or CWS/TDM given iv every 1 or 2 weeks in set doses of either 100, 250, 500, or 1000 micrograms/m2. The major dose-limiting side effects for both preparations were fever and chills at a dose of 1 mg/m2. This was more severe with the combined CWS/TDM. There was no renal or pulmonary toxicity. There was evidence of hepatic toxicity, with increases in the alkaline phosphatase and gamma glutamyl transferase, especially with high doses of CWS/TDM. Both the CWS and CWS/TDM groups had an increase in their wbc count. In the patients receiving CWS alone, there was a decrease in the peripheral blood monocytes. In the CWS/TDM group, there was an increase in the serum lysozyme, suggesting macrophage activation. No antitumor effect was seen in this phase I study. Aqueous suspensions of CWS and CWS/TDM can be administered safely iv over a period of time, with evidence of an effect on hematologic parameters.
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PMID:Phase I study of iv mycobacterial cell wall skeleton and cell wall skeleton combined with trehalose dimycolate. 688 55

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

The authors report the cases of 4 patients with jaundice following the administration of ajmaline. The disease had a pseudo- angiocholitic onset with fever, chills and pruritus in the 4 patients and abdominal pains in 2 patients. Serum transaminase activity and serum alkaline phosphatase activity were increased in the 4 patients. Blood eosinophilia was found in 3 patients. Liver lesions included predominantly centrilobular cholestasis, mild hepatocytic lesions, and portal inflammation. After the interruption of the drug administration, recovery occurred in the 4 patients. Two patients resumed the intake of ajmaline; transient hepatitis recurred in these 2 patients.
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PMID:[Hepatitis due to ajmaline. Report of cases and review of the literature]. 718 70

A phase II multiinstitutional clinical trial was conducted to evaluate the safety and efficacy of the subcutaneous outpatient administration of recombinant human interleukin-2 and alpha-interferon in patients with progressive metastatic renal cell carcinoma. One hundred and forty-five patients were entered on this study between October 1989 and May 1991. Among 134 patients evaluable for treatment response, there were six complete (4.5%) and twenty partial (14.9%) responders, with an overall response rate of 19.4% (95% confidence interval, 13-26%). The median duration of complete remissions was 228 (range 51(+)-520+) days; the median duration of partial tumor regressions was calculated at 226 (range 112-473+) days. The overall median survival from start of therapy was 14.2 (range 1-23+) months. Fever, chills and general fatigue occurred in the majority of patients treated and were measured at grade II, III and IV in up to 55%, 24% and 3% of all evaluable patients, respectively. Three patients each developed grade III hypotension, dyspnea and diarrhea; two patients each had grade III and grade IV elevations of alkaline phosphatase; two and one patients respectively, exhibited grade III anemia and grade IV thrombocytopenia; two patients experienced severe cutaneous toxicity. The majority of patients received treatment in the outpatient setting. In summary, the outpatient use of subcutaneous interleukin-2 and alpha-interferon was effective in patients with advanced metastatic renal cell carcinoma; it was associated with less toxicity and thus, could improve the therapeutic index of interleukin-2 based biologic therapy when compared against high dose intravenous therapy.
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PMID:Subcutaneous recombinant interleukin-2 and alpha-interferon in patients with advanced renal cell carcinoma: results of a multicenter Phase II Study. 780 70

Liver abscess is a rare but serious complication of Crohn's disease. Intra-abdominal abscesses, fistulous disease, and metronidazole or steroid therapy have all been reported to be important predisposing factors in the pathogenesis of the disease, and the mortality has been reported to be high. We report six patients who developed a liver abscess as a complication of Crohn's disease. Three patients presented with a liver abscess as the first manifestation of Crohn's disease and two others had quiescent disease at presentation. The diagnosis was delayed by 1-8 wk after the onset of fever because of the paucity of signs indicating a hepatic infection. None of the patients had intra-abdominal abscesses, active fistulas, or metronidazole therapy before the onset of symptoms. The only predisposing conditions identified were two minor skin infections in patients developing staphylococcal liver abscesses. Nonoperative catheter drainage was successful in four of the six patients. One patient required surgical placement of drains, and the patient with the longest delay before diagnosis required hepatic lobectomy because of extensive necrosis. Shaking chills, fever with leukocytosis, and an elevated alkaline phosphatase are suggestive of a liver abscess and should prompt an ultrasound examination. Catheter drainage with antibiotic therapy is effective if the liver abscess is diagnosed before extensive necrosis has occurred. Minor skin infections may predispose to staphylococcal liver abscess in some cases.
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PMID:Liver abscess in Crohn's disease. 801 70

Ninety-seven hepatolithiasis cases were reviewed retrospectively. Primary hepatolithiasis was about equal in both sexes, with most patients under 39 years of age. Most secondary hepatolithiasis patients who were female-predominant, were older than 40. Common presenting symptoms were abdominal pain, either epigastric or right upper quadrant of abdomen as noted in 93%; chills and fever in 70%; nausea and vomiting in 49.5%; jaundice was noted only in 39% of the patients. Blood tests showed elevation of alkaline phosphatase in 79.8%, and gamma-GT in 88.3%. Left branch involvement was much more common that right. Escherichia coli (E. coli) was the main organism isolated in most of the cases. Abdominal ultrasonography reached a diagnostic rate of 91.01%, and the condition could be missed in cases of intrahepatic muddy stones, pneumobilia and misidentification of the location of the stones. Endoscopic retrograde cholangiography (ERC) showed a clearer picture of the biliary tree, but failed in cases of distorted anatomy because of previous operation, stones impacted in the ampulla orifice, presence of diverticulum or poor opacification of the bile duct because of stricture or stone impaction.
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PMID:Hepatolithiasis, a clinical study. 838 53

We determined the safety and efficacy of deoxycholate-amphotericin B (d-AmB) mixed with Intralipid (IL) as the initial treatment of AIDS-associated cryptococcal meningitis in a phase II, multicentre, non-comparative open study, assessing two dosages of ILd-AmB: 1 mg/kg (group A, n = 9) and 1.5 mg/kg (group B, n = 6). Patients were treated daily for 2 weeks, then three times weekly for 4 weeks. The ILd-AmB dosage was decreased due to toxicity in three patients in each group. Serum creatinine increased significantly on day 14 in group A and on day 7 in group B. Nephrotoxicity, (serum creatinine level > 165 mumol/L) was noted in two and five patients in groups A and B, respectively. Nine adverse haematological events were noted (seven cases of anaemia requiring transfusion, and two cases of neutropenia < 750/mm). Two patients had an increase in serum alkaline phosphatase. In each cohort, 15% of the infusions were associated with fever and/or chills. Successful outcome was obtained in half of the patients. We conclude that, in AIDS patients with cryptococcosis, tolerance to ILd-AmB was acceptable when the daily dosage did not exceed 1 mg/kg, but the higher 1.5 mg/kg daily dosage was associated with an unacceptable rate of nephrotoxicity. Neither of these relatively high daily dosages of ILd-AmB achieved an improved rate of successful outcomes compared with lower daily dosages of conventional d-AmB in glucose.
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PMID:Amphotericin B in a lipid emulsion for the treatment of cryptococcal meningitis in AIDS patients. 885 63

A 23-year-old black woman presented with abdominal pain of sudden onset, high fever, chills, and an elevated serum alkaline phosphatase level. Examination revealed a tender abdominopelvic mass consistent with an ovarian mass. Her medical history was significant for an osteosarcoma of the left humerus removed 7 years earlier and excision of multiple pulmonary and chest wall metastases 2 years earlier. Exploratory laparotomy revealed a solid hemorrhagic left ovarian mass and ascites. There was no other evidence of disease. A left salpingo-oophorectomy was performed. Pathological examination of the mass showed metastatic osteosarcoma. Four months later, the patient died of widespread osteosarcoma. The clinicopathologic features of ovarian osteogenic sarcomas reported in the literature are reviewed. Pain, fever, and elevated serum alkaline phosphatase levels may be the presenting clinical features of this rare ovarian tumor.
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PMID:Osteosarcoma metastatic to the ovary: a case report and review of the literature. 898 36

Amifostine is a protective agent of normal tissue from adverse effects of radiochemotherapy. It is the prodrug that is dephosphorylated by alkaline phosphatase on plasma membrane into the active form named WR-1065. More than 90 per cent of the drug is cleared from plasma in 6 minutes and the peak tissue concentration is 10-30 minutes after intravenous administration. Amifostine has the selective property to protect normal tissue but not cancer cells by mainly scavenging free radicals induced by radiation and chemocytotoxic agents. Both preclinical and clinical studies of this drug provide the significant protection of hematopoietic progentitors from a broad range of cytotoxic agents such as cyclophosphamide, cisplatin, vinblastine, carboplatin, mitomycin-C, fotemustine, doxorubicin, daunorubicin and radiation as well. Moreover, this drug can protect other normal organs or tissues including kidney, salivary gland, liver, heart, lung and small intestine. Amifostine is quite safe, the two major side effects are vomiting and hypotension, and the minor effects are flushing, sneezing, dizziness, chills, metallic taste etc. The drug was approved by the FDA of U.S.A. for use as a cytoprotectant in cyclophosphamide and cisplatin treatment for advanced ovarian cancer and non small cell lung cancer.
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PMID:Amifostine and hematologic effects. 1080 97

The clinical case of one patient with fever of unknown origin, due to granulomatous hepatitis of tuberculous etiology was presented. The patient was a a 50-year-old woman, with 50 days illness characterized by chills, 39 degrees C fever and heavy diaphoresis. She had a record of seven malaria cases. She looked thin and pale at the initial physical examination. During the evolution, she developed pancytopenia, massive hepatosplenomegaly, jaundice, and anasarca. The patient underwent screening tests for infection, neoplasias, collagenosis, and granulomatous diseases. The laboratory tests showed transaminase-alkaline phosphatase dissociation, which led to the final diagnosis of tuberculosis, through the histological examination of the liver parenchyma. The specific treatment against tuberculosis caused remission of fever, ascites, and hepatomegaly and normalization of liver tests, with satisfactory clinical evolution.
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PMID:[Granulomatous tuberculous hepatitis as cause of fever of unknown origin]. 1252 48


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