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In 1985, at a WHO workshop on AIDS in Bangui, Central African Republic, a clinical case definition of AIDS was developed for developing countries. This 1st definition contained 4 major criteria (chronic asthenia, major weight loss, chronic fever, and chronic diarrhea) and 6 minor criteria (chronic cough, persistent lymphadenopathy, herpes zoster, recurrent herpetic infection, pruritic dermatitis, and oropharyngeal candidiasis). Kaposi's sarcoma and cryptococcal meningitis were sufficient by themselves for the diagnosis of AIDS. In children, the temporary definition of AIDS consisted of 3 major clinical criteria (weight loss and/or abnormally slow growth, chronic diarrhea lasting more than 1 month, and fever lasting more than 1 month), and 6 secondary clinical criteria (generalized lymphadenopathy, oropharyngeal candidiasis, repeated common infections such as otitis and pharyngitis, persistent cough, generalized pruritic dermatitis, and confirmed maternal HIV infection). The revised Bangui definition was evaluated in 174 adult patients hospitalized at the Mama Yemo Hospital of Kinshasa, Zaire. 46% of 174 patients met the criteria of the WHO/Bangui definition. Overall, the sensitivity of the definition for HIV-1 infection was 59%, the specificity was 90%, and the positive predictive value (PPV) was 74%. However, the clinical case definition of African AIDS lacks specificity when it is applied to patients suffering from cachectic syndromes. The Bangui definition was also evaluated at the pediatric ward of Mama Yemo Hospital with 159 hospitalized children whose mean age was 33 months. 21 (13%) were infected by HIV-1. The sensitivity of the definition was 35%, its specificity was 86%, and its PPV was 26%. Although the specificity was relatively high, the low values of sensitivity and PPV underline the weakness of the Bangui clinical case definition for diagnosing pediatric AIDS cases.
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PMID:World Health Organization clinical case definition for AIDS in Africa: an analysis of evaluations. 133 10

Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather.
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PMID:Fibromyalgia syndrome. New associations. 146 72

The author investigated in a representative sample of 431 subjects aged 60-64 years and in 1171 subjects above 65 years by the method of standardized interviews the prevalence of subjectively perceived health complaints--pain and its localization, dyspnoea, insomnia and general weakness and restricted locomotion. Health complaints were recorded already at the age of 60-64 years in a relatively high percentage--71.7%; chronic cough and digestive complaints equally frequently as in subjects above 65 years. In 11.6% of subjects aged 60-64 years locomotion was restricted, at the age above 65 years in 31.2% of the respondents. Subjectively perceived health complaints influence the lifestyle in advanced age, they influence the need and consumption of health care. In medical practice it is necessary to search for these complaints in an aimed way, to disclose their causes and influence them by early treatment. This could contribute to the improvement of the quality of life in advanced age.
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PMID:[Subjective health problems in persons 60-64 years of age and over 65]. 262 77

A total of 136 patients were studied in three Upazillas of Laxmipur, Barisal and Madaripur districts were selected for health awareness campaign program. According to the existing data, these villages were ranked as high exposure. Demographic data of the patients investigated are showing pigmentation was seen in all--136 cases, keratosis was found only in 110 cases, and skin ulcer was detected in 13 cases. The predominant features are indicating respiratory sign and symptoms followed by conjunctival congestion and redness of eyes. Weakness was predominant symptom, and all most all cases reported weakness. There were few smokers (n = 16) and analyses were confined to non-smokers (n = 94). A total of the 94 subjects participated in this study. The sex ratio was 1:1.3 (male vs. female). The relative risk of chronic cough increased with age (RR=2.12, for 26-50 age group; RR=2.30 for age group more than 51) reflecting chronic exposure, but the 95% confidence intervals included unity. The relative risk of chronic bronchitis increased with age (RR=2.68, for 26-50 age group; RR=2.30 for age group more than 51) reflecting chronic exposure, but the 95% confidence intervals also included unity. The findings presented here provide evidence that ingestion of inorganic arsenic in drinking water may results in increases risk of chronic cough and bronchitis.
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PMID:Non-cancer effects of chronic arsenicosis in Bangladesh: preliminary results. 1263 34

We report a 40-year-old man who has Marfan's syndrome and was recently diagnosed to have pulmonary tuberculosis when he presented with chronic cough. He was admitted with bilateral lower limb weakness which was ascending in nature. He eventually required ventilation. It was initially thought to be isoniazid-neuropathy. However, stopping the drug did not improve the condition and the patient developed bilateral lower motor neuron 7th cranial nerve palsy. Nerve conduction, MRI and CSF studies were done to confirm a first case report of AMSAN variant progressing to CIDP in a patient with Marfan's syndrome and pulmonary tuberculosis.
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PMID:AMSAN variant of Guillain Barre syndrome progressing to chronic inflammatory demyelinating polyneuropathy in a patient with Marfan's syndrome and pulmonary tuberculosis. 1651 22

We studied a four-generation pedigree of a Japanese family with hereditary neuropathy to elucidate the genetic basis of this disease. Twelve members of the family were enrolled in this study. The clinical features were neurogenic muscle weakness with proximal dominancy in the lower extremities, sensory involvement, areflexia, fine postural tremors, painful muscle cramps, elevated creatine kinase levels, recurrent paroxysmal dry cough, and neurogenic bladder. We performed a genome-wide search using genetic loci spaced at about 13 Mb intervals. Although nine chromosomes (1, 3, 4, 5, 6, 10, 17, 19, and 22) had at least one region in which the logarithm of odds (LOD) score was over 1.0, no loci fulfilled the criteria for significant evidence of linkage. Moreover, we analyzed an extra 14 markers on 3p12-q13 (the locus of hereditary motor and sensory neuropathy, proximal dominant form) and an extra five markers on 3p22-p24 (the locus of hereditary sensory neuropathy with chronic cough) and observed LOD scores of <-3 on both 3p12-q13 and 3p22-p24. Mutation scanning of the entire coding regions of the MPZ and PMP22 genes revealed no mutations. We conclude that the disorder described here is a newly classified hereditary motor and sensory neuropathy with autosomal dominant inheritance.
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PMID:Hereditary motor and sensory neuropathy with proximal dominancy in the lower extremities, urinary disturbance, and paroxysmal dry cough. 1866 16

In this case report a 10 year old Freiberger mare with a Mycobacterium avium subsp. avium infection is presented. This infection leads to a tuberculosis like disease with granulomatous alterations particularly of the intestines and lungs and is only sporadically reported in horses of Central Europe. Diarrhoea, mastitis and neck stiffness as well as dyspnoea and chronic cough are more specific symptoms of the infection, while weight loss, weakness and lethargy are nonspecific signs. As these clinical signs can occur in many other diseases, the diagnosis of mycobacterial infection is difficult and consists of rectum or distal colon biopsies and staining for acid-fast bacilli and bacteriological culture of granulomatous lesions. Classification of M. avium subsp. avium was achieved by PCR-RFLP. Even though an infection with Mycobacterium avium subsp. avium is rare, it belongs to the differential diagnosis of granulomatous diseases.
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PMID:Infection with Mycobacterium avium subspecies avium in a 10 year old Freiberger mare. 1972 33

Canine bronchomalacia (BM) is characterized by weakness leading to collapse of the bronchial wall. A prospective study of 18 affected dogs (age range: 1-15 years) was undertaken to characterize the clinicopathological and histological features of BM. Poodles and Yorkshire terriers were commonly affected. Half of the dogs were overweight or obese. The clinical presentation was a mild, wheezing, chronic cough and pulmonary crackles were heard in 28% of the dogs. Compatible radiographic changes were present in 61% of the dogs. Using bronchoscopy, both lungs were affected in half of the animals, whereas in the others the disease appeared to affect predominantly the left lung. Analysis of bronchoalveolar lavage fluid and biopsies of bronchial mucosa revealed pure or mixed neutrophilic inflammation. Underlying infectious bronchitis was considered possible in 56% of the dogs. It was concluded that canine BM may present as an isolated clinical entity associated with infection and/or inflammation.
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PMID:Canine bronchomalacia: a clinicopathological study of 18 cases diagnosed by endoscopy. 2117 26

An 11-year-old, spayed female, teacup poodle was evaluated for a chronic cough, lethargy, hindlimb weakness, and reluctance to exercise. Thoracic radiographs revealed megaesophagus and aspiration pneumonia. Serum antibodies against acetylcholine receptors confirmed the diagnosis of myasthenia gravis. The unusual clinical history and case outcome are discussed.
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PMID:Acquired myasthenia gravis in a poodle. 2153 24

Bronchomalacia is defined as diffuse or segmental bronchial weakness and easy compressibility. We present a rare case of a 67-year-old man with chronic cough as a consequence of focal bronchomalacia caused by persistent extrinsic compression of the left lower lobe bronchus by the descending aorta and the left lower lobe branch of the pulmonary artery. Focal bronchomalacia discovered during adulthood is most often acquired and can be attributed to extrinsic compression by abnormal blood vessels due to hypertension and lung transplantation or to bronchial disease processes. The natural history of bronchomalacia is typically progressive.
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PMID:An unusual case of persistent extrinsic bronchial compression. 2316 71


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