WorldWideScience

Sample records for asthenia

  1. [Use of methylphenidate in palliative patients with asthenia: a review].

    Science.gov (United States)

    Saralegui, A; Palacio, P; Royo, P

    2013-01-01

    Asthenia (or fatigue) is one of the most common symptoms in palliative patients. Methylphenidate is currently being assessed for treating this condition. A review of related literature published to date was performed, revealing methylphenidate to be a safe drug which could decrease fatigue in palliative patients with a tolerable side-effects profile. PMID:24008532

  2. Ocular findings in quarter horses with hereditary equine regional dermal asthenia

    Science.gov (United States)

    The objective of this study was to compare ocular structures of Quarter Horses homozygous for hereditary equine regional dermal asthenia (HERDA) with those of Quarter Horses not affected by HERDA (control horses) and to determine the frequency of new corneal ulcers for horses with and without HERDA ...

  3. Different Perspectives on Asthenia in Astronauts and Cosmonauts: International Research Literature

    Science.gov (United States)

    Sandoval, Luis; Shea, Camille; Otto, Christian; Leventon, Lauren

    2010-01-01

    The Behavioral Health and Performance (BHP) Element is one of the six elements within the NASA Human Research Program (HRP) and is responsible for managing four risks: a) The Risk of Performance Decrements due to inadequate Cooperation, Coordination, Communication and Psychological Adaptation within a Team (Team), b) the Risk of Performance Errors due to Sleep Loss, Circadian De-synchronization, Fatigue and Work Overload (Sleep), c) Risk of Behavioral Conditions (BMed), and d) the Risk of Psychiatric Disorders (BMed). The aim of this report is to address some of the recommendations made by the recent NASA HRP Standing Review Panel for the Behavioral Medicine Risk of Psychiatric Disorders. Such recommendations included: a) the inclusion of important national and international literature in English and non-English language materials; including journals, books, magazines, conference reports and b) an extensive literature review of certain types of psychological states to predict, detect, and assess adverse mental states that may negatively affect the psychological well being of the astronauts, specifically asthenia. This report was a collaborative international work effort focused on the evaluation and determination of the importance of continuing research on asthenia as a possible psychological problem that might affect the optimal psychological functioning among crewmembers during long-duration space flight missions. Russian medical personnel (flight surgeons and psychologist) have observed symptoms of asthenia (weakness, increased fatigue, irritability, and attention and memory disorders) in cosmonauts after four months in space (Myasnikov& Zamaleddinov1996; Grigorieve, 1996 ) and believe that asthenia is one of the greater risks that will affect crews? optimal psychological functioning.

  4. 消渴从气虚论治浅探%Slake from the Qi Asthenia Treatment

    Institute of Scientific and Technical Information of China (English)

    安文灿; 金莉; 安文铎

    2012-01-01

    Objective: Expound the basic pathogenesis of diabetes. Methods: Make a preliminary interpretation through the combination of huangdi neijing and clinical research and experimental study. Results: Chinese medicine to benefit vital energy in the treatment of diabetes can improve their clinical delay the development of complications. Conclusion: The basic pathogenesis of diabetes was Qi asthenia.%目的:探讨糖尿病的基本病机.方法:结合《黄帝内经》等理论依据和临床研究、实验研究系统论证.结果:采用益气中药治疗糖尿病能够改善其相关临床症状以及实验指标,延缓并发症的发生和进展.结论:糖尿病的基本病机为气虚.

  5. Effect of Reinforcing Qi and Moistening Intestine Oral Liquid on Anorectal Manometry of Asthenia Type Constipation Patients

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To study the change of anorectal manometry in asthenia type constipation patients and effect of reinforcing Qi and moistening intestine oral liquid (RQMI) on it. Methods: The total of 135 cases were divided into healthy group, RQMI treated group, Maren pill (MRP) treated group and prepulsid (PPS) treated group, their anal maximal voluntary squeez pressure, rectoanal contraction reflex, rectoanal inhibitory reflex, defecation reflex, rectal volume sensory threshold and rectal maximal tolerable volume were observed. Results: The rectal sensory function of patients weakened obviously and anal sphincter reactivity reduced as compared with those of healthy person (P<0.01), and both were improved by RQMI treatment (P<0.05). Conclusion: RQMI is superior to MRP and prepulside in improving anorectal dynamic abnormality in constipation patient of asthenia type.

  6. Perspectives on Asthenia in Astronauts and Cosmonauts: Review of the International Research Literature

    Science.gov (United States)

    Sandoval, Luis; Keeton, Kathryn; Shea, Camille; Otto, Christian; Patterson, Holly; Leveton, Lauren

    2012-01-01

    The Behavioral Health and Performance Element (BHP) is one of the 6 elements in the NASA Human Research Program (HRP) and is responsible for managing 4 of the identified and named risks to human health and performance from human space exploration: a) Risk of Behavioral Conditions (BMed), b) Risk of Psychiatric Disorders (BMed), c) Risk of Performance Decrements due to inadequate Cooperation, Coordination, Communication and Psychological Adaptation within a Team (Team), and d) Risk of Performance Errors due to Sleep Loss, Circadian De-synchronization, Fatigue and Work Overload (Sleep). Each risk is reviewed by a NASA HRP Standing Review Panel (SRP), and recently the Behavioral Medicine Risk of Psychiatric Disorders was reviewed. The aim of this report is to address one of the recommendations made by that panel, specifically the recommendation that the "literature on asthenia should be evaluated (possibly as a psychological or psychosomatic / psycho-physiological analogue of chronic fatigue syndrome)" (SRP p. 4), in addition to General Recommendation 4, which states that "all reviews must include non-English language materials as well as materials appearing in conferences reports, books, and other non-refereed journal outlets" (SRP p. 2).

  7. Astenia en cáncer avanzado y uso de psicoestimulantes Asthenia in advanced cancer and the use of psychostimulants

    Directory of Open Access Journals (Sweden)

    M.A. Portela

    2011-12-01

    Full Text Available La astenia es el síntoma más frecuente en enfermos con cáncer avanzado y probablemente, el que más influye en la calidad de vida del paciente oncológico ya que interfiere en su actividad física y social. En la mayor parte de los casos el tratamiento es sintomático. Hay un interés creciente en el uso de psicoestimulantes para el tratamiento de astenia. Metilfenidato y modafinilo son dos psicoestimulantes que han sido ya probados en estudios controlados en astenia del paciente con cáncer avanzado, encontrándose eficaces, particularmente en pacientes con estadíos más avanzados, muy cansados.Asthenia is the most frequent symptom in patients with advanced cancer and is probably what most affects the quality of life of oncology patients since it interferes in their physical and social activity. Treatment in the majority of cases is symptomatic. There is growing interest in the use of psychostimulants for treating asthenia. Methylphenidate and modafinil are two psychostimulants that have already been tested in controlled studies on asthenia of the patient with advanced cancer; they have proved to be efficient, particularly in patients in very advanced stages who are very tired.

  8. Explanation on the Molecular Mechanism of "Lack of Vital Essence Resulting in Deficiency Syndrome" of Asthenia Cold Syndrome and Asthenia Hot Syndrome Rats%基因芯片技术阐释虚寒证与虚热证大鼠“精气夺则虚”的分子机制

    Institute of Scientific and Technical Information of China (English)

    韩冰冰; 王世军

    2013-01-01

    目的:采用基因芯片技术阐释虚寒证与虚热证大鼠“精气夺则虚”的共同分子机制.方法:使用中药复方建立虚寒证、虚热证大鼠模型,基因芯片检测大鼠肝脏基因表达,筛选差异表达基因并进行聚类分析,荧光定量PCR验证芯片结果.结果:聚类结果显示虚寒模型组与虚热模型组基因表达轮廓具有相似性,与空白对照组有差异.虚寒模型组、虚热模型组与空白对照组相比较,存在共有差异表达基因28条,其中16条免疫应答相关基因.结论:虚寒证与虚热证大鼠均出现了免疫应答相关基因表达的显著改变,这可能是虚寒证与虚热证大鼠“精气夺则虚”的分子机制.%Objective:To explain the molecular mechanism of "lack of vital essence resulting in deficiency syndrome" in both asthenia cold syndrome rats and asthenia hot syndrome rats by gene chip technology.Methods:The Asthenia cold and hot syndrome rats models were induced by compound preparation of Traditional Chinese Medicine.The liver gene expression in each group was detected by gene chip.We selected the differential expression genes,analyzed the genes by cluster and conducted the significant analysis on the genetic function of differential genes.A part of genes were selected to test the accuracy of results by RT -PCR.Results:The cluster analysis showed the profile of genes expression of asthenia cold model group was similar to asthenia hot model group.Both asthenia cold model group and asthenia hot model group were different from control group.Among asthenia cold model group,asthenia hot model group and control group,there were 28 strips of differential expression gene,among which 16 stips were about immune response.Conclusion:Obvious changes have been both arose in asthenia cold model group and asthenia hot model group about genes immune response,which is possibly the molecular mechanism of "lack of vital essence resulting in deficiency syndrome".

  9. Enfoque del síndrome de astenia crónica The chronic asthenia syndrome: A clinical approach

    Directory of Open Access Journals (Sweden)

    Pablo Young

    2010-06-01

    Full Text Available El término astenia deriva del griego (¢sqsneia, a: privación, sin, esthénos: vigor, fuerza, significa ausencia de fortaleza, vigor o fuerza. Es un síntoma difícil de definir, que implica un conjunto de sensaciones vagas, distintas para cada individuo. Es un motivo habitual de consulta representando hasta el 30% de la consulta ambulatoria. A su vez, la fatiga crónica representa del 1 al 10% de estos casos, y el 0.2- 0.7% del total pertenece al síndrome de fatiga crónica. Es importante saber diferenciar la astenia de la debilidad y de la disnea, ya que los pacientes habitualmente le dan el mismo significado. El factor tiempo en la astenia es útil para su caracterización. Se definió a la fatiga como prolongada cuando su duración es mayor a un mes y crónica cuando la misma supera los 6 meses. La sistematización de las entidades capaces de provocar astenia deberá guiar la búsqueda de síntomas y signos físicos, así como la indicación de estudios complementarios. La depresión es la causa más común de fatiga, representando aproximadamente la mitad de los casos. El tratamiento más efectivo de la astenia es solucionar la causa subyacente; no obstante hasta un 20% de los pacientes queda sin diagnóstico. El diagnóstico de síndrome de fatiga crónica es de exclusión y se deben usar los criterios del consenso internacional del año 1994¹. En cuanto a su tratamiento, existe evidencia a favor de utilizar ejercicio físico graduado y terapia cognitiva. La alta frecuencia del síntoma conlleva un enorme costo social y económico consumiendo recursos de manera desmesurada, por lo que es importante que los médicos estén familiarizados con este síntoma.The term asthenia comes from the Greek (¢sqsneia, a: privation, without; esthénos: vigor, force, it means absence of strength, vigor or force. It is a symptom, difficult to define, with a set of vague sensations, different for each patient. It is a frequent cause of consult, almost

  10. Development Situation of Syndrome Differentiation and Treatment on Pulmonary Asthenia%肺痿中医证治相关问题探讨

    Institute of Scientific and Technical Information of China (English)

    马锦地; 谢洋

    2015-01-01

    肺痿是指肺叶痿弱不用的慢性虚损性肺系疾病,为多种肺系疾病的慢性转归,预后不佳.近年来,中医药治疗肺痿的研究作为一项热点,取得了一定的成果.本文从肺痿的病因病机、辨证分型、中医药治疗等方面进行概述,为肺痿的中医药治疗提供理论基础和依据.%Pulmonary asthenia is one of the chronic consumptive lung diseases because of the weakness of pulmonary lobe. It would be the outcome of many chronic lung diseases with poor prognosis. In recent years, preventing and treating pulmonary asthenia by traditional Chinese medicine (TCM) has been one of the research focuses and some fruits have been received. This paper summarized pulmonary asthenia from the aspects of etiology and pathogenesis, syndrome differentiation, TCM treatment so as to provide theoretical basis and proofs for treatment of pulmonary asthenia by TCM.

  11. 肾虚与衰老机理中西医研究概况%Mechanism of Kidney Asthenia and Aging Research

    Institute of Scientific and Technical Information of China (English)

    刘梦云; 韩旭

    2011-01-01

    衰老是人类生命过程中无法避免的规律,文章从肾虚的角度,通过对中国古典医学文献进行引证分析,并从西医自由基、内分泌、免疫、基因方面阐述肾虚与衰老的关系,得出肾虚是导致衰老的重要因素之一,只有补肾固精,才能起到延缓衰老、改善衰老症状,最终延长人类寿命.%Aging is the process of human life that can not avoid. In this article, from the perspective of kidney asthenia, we confirm the relationship between aging and kidney asthenia, not only from the classical Chinese medical literature analysis, but also from the modern medicine theory of radicals, endocrine, immune and genetic. We form the view that kidney asthenia is the important factor of aging. In order to improve symptoms of aging, eventually prolong human life, invigorating the kidney is the most important thing.

  12. Research on Molecular Mechanism of “Yin Asthenia with Internal Heat” in Asthenia Hot Syndrome Rats by Gene Chip Technology%基因芯片技术研究虚热证大鼠阴虚内热的分子机制

    Institute of Scientific and Technical Information of China (English)

    韩冰冰; 王世军

    2013-01-01

    目的:通过基因芯片技术研究虚热证大鼠肝全基因表达谱的改变,阐释虚热证大鼠“阴虚内热”的分子机制.方法:使用中药复方附子、肉桂、干姜建立虚热证大鼠模型,应用基因芯片检测各组大鼠肝脏基因表达,筛选差异表达基因,进行基因功能分类注释,荧光定量PCR验证芯片结果.结果:虚热模型组与空白对照组比较有99条基因差异表达,主要涉及防御应答,固醇代谢等功能.结论:虚热证阴虚内热的分子机制可能与刺激应答相关基因及固醇代谢相关基因两类基因的异常表达相关.%To explain molecular mechanism of “Yin Asthenia with Internal Heat” in asthenia hot syndrome rats by analysis the whole gene expression profile of the hver in rats with asthenia hot syndrome.Methods:The Asthenia hot syndrome rats models were induced by compound preparation of Traditional Chinese Medicine of Aconitum carmichaeli,Cinnamomi Cortex,Rhizoma Zingiberis.The liver gene expression in each group was detected by gene chip.We selected the differential expression genes and conducted the significant analysis on the genetic function of differential genes.A part of genes were selected to test the accuracy of results by RT-PCR.Results:As compared to the control group,in asthenia hot model group there were 99 strips of differential expression gene,mainly about function of defense response and sterol metabolic process.Conclusion:The abnormal expression of genes about defense response and sterol metabolic process in asthenia hot syndrome rats is possibly related to the substance foundation of asthenia hot syndrome.

  13. Clinical Observation on Thermal Moxibustion Therapy for Treating Uroschesis and Enuresis of Asthenia Type%热敏灸治疗虚证癃闭临床研究

    Institute of Scientific and Technical Information of China (English)

    李哲

    2012-01-01

    目的:探讨热敏灸疗法治疗虚证癃闭的临床疗效.方法:将47例虚证癃闭遗溺患者采用随机数字表法分为治疗组和对照组.对照组22例以传统针刺百会、关元、三焦俞等腧穴治疗;治疗组25例进行热敏灸疗法治疗,3个疗程后根据目视模拟计量表减分率判定疗效.结果:治疗组治愈9例,显效12例,有效4例,无效0例,有效率100%;对照组治愈5例,显效8例,有效6例,无效3例,有效率86.36%.两组有效率比较,差异有统计学意义(P<0.05),治疗组优于对照组.结论:热敏灸疗法治疗虚证癃闭疗效显著.%Objective:To investigate the clinical efficacy of thermal moxibustion therapy in treating uroschesis and enuresis of asthenia type. Methods: 47 cases of uroschesis and enuresis of asthenia type were randomly divided into the treatment group and the control group according to the random number method. 22 cases in the control group were given the traditional acupuncture treatment of puncturing Baihui, Guanyuan and Sanjiao with syndrome differentiation and treatment, while 25 cases in the treatment group were given thermal moxibustion therapy. After three courses of treatment, the therapeutic effects were determined according to the reducing rate of the visual analog scale. Results: In the treatment group, 9 cases were cured, 12 cases were markedly effective, 4 cases were effective and the effective rate was100% ; in the control group 5 cases were cured, 8 cases were markedly effective, 6 cases were effective, 3 cases were ineffective and the effective rate was 86. 36%. Comparison of the therapeutic effects in both groups showed the difference was statistically significant (P<0. 05) and the treatment group was superior to the control group. Conclusion: The thermal moxibustion therapy has significant therapeutic effect in treating uroschesis and enuresis of asthenia type.

  14. Association of severity and sex with vasoactive substance and sexual hormone level in patients with vascular dementia in the type of kidney asthenia and blood stasis syndrome

    Institute of Scientific and Technical Information of China (English)

    Jian Du; Jing Cai; Shuanghong Shen

    2006-01-01

    BACKGROUND: Kidney asthenia is the basic cause of the development of vascular dementia (VD). Kidney asthenia lasting for a long time will result in blood stasis. Also, the cause of VD may have relationships with endothelin (ET), nitric oxide (NO), homocysteine (HCY), estrogen (E2), and testosterone (T).OBJECTIVE: To observed clinical curative effect of the kidney tonic, pancreas tonic, and blood tonic with promoting blood circulation components in treating kidney asthenia with blood stasis syndrome of VD.DESIGN : Case controlled study.SETTING: Geriatric Institute of Integrated Medicine, Fujian College of Traditional Chinese Medicine.PARTICIPANTS: A total of 70 patients, including 39 males and 31 females aged 60-80 years, were selected from Department of Neurology, Pingshan Hospital from May 2000 to September 2002. Diagnostic criteria were used for probable VD of the American Psychiatric Association. Diagnostic and Statistical of Manual of Mental Disorder, 4th ed (DSM-Ⅳ), 1994 revised, mini-mental state examination (MMSE), and criteria of kidney asthenia with blood stasis with mixed weak and sthenia syndrome of Guidelines of Clinical Research of New Chinese Medicine in Treating Dementia. According to score of kidney asthenia with blood stasis syndrome, they were classified to three groups: mild (n =22), moderate (n =33) and severe (n =15). All of them with complete chest X-Ray, ECG, blood chemistry and other related examinations, exclusive of cardiovascular, liver, kidney diseases, homeopathy and psychiatry diseases. And hereby we also select 30 normal people as the comparing group, having no substantial diseases in heart, brain, kidney, liver, lung and other main organic systems after medical examination. Of this group, 11 were males and 19 were females, ranging from 62 years old to 78 years old. There were no obvious differences between the above two groups in sex, age, and education level after statistical analysis. All patients observed in Pingxi Hospital

  15. 论真寒假热之虚寒与实寒%Discuss Asthenia or Sthenia Cold of True Cold and False Heat

    Institute of Scientific and Technical Information of China (English)

    李静; 李如辉

    2015-01-01

    Objective] Differentiate and analyse the asthenia or sthenia attribute about the cold attribute of true cold and pseudo hot syndrome, further to simply make a summary.[Method] In order to compare with other doctor’s viewpoint and prove the opinion from the etiology and pathogenesis, clinical symptoms, clinical application and so on, by researching the related literature and theoretical works.[Result]Pathological condition of inner true cold and outer false heat appears because Yang deficiency of spleen and kidney is so long that yin exopathogen is in stasis and yang fails to transport and transform ying, further to repel yang outside in the etiology and pathogenesis. Clinical symptoms show that the red zygomas looking like being made up, low spirit, coldblooded and huddling up body, chilly limbs, drinking much and hot, diarrhea with undigested food in the stool and extreme weak pulse and even no feelings. In clinical application, the prescription is sini tang and the main medicines are fuzi and ganjiang which restore yang and get rid of cold. [Conclusion]True cold and pseudo hot syndrome belongs to asthenia-cold. And no matter in disease diagnosis even in clinical treatment, it has an important theoretical and practical significance to distinguish and clear the asthenia or sthenia attribute.%[目的]辨清真寒假热证之真寒的虚实属性,并简要总结。[方法]习读相关文献资料及理论书籍,分析、比较各医家主张,且从病因病机、临床症状、处方用药等几个方面全面论证真寒假热证之真寒的虚实属性。[结果]真寒假热证,从病因病机上说,是由于病程日久导致脾肾阳虚,阴寒邪气壅滞于体内,阳不化阴,使得阴阳不相顺接,从而将阳格拒于外,出现内真寒、外假热的病理状态;从临床症状上看,则表现为两颧泛红如妆、精神不振、畏寒蜷缩、四肢厥冷、口渴喜热饮、下利清谷、脉无力欲绝等一派虚寒之象

  16. 针灸对脾虚犬消化功能指标的影响%Effects of Acupuncture on Digestive Function Indicator in Dogs with Splenic Asthenia Syndrome

    Institute of Scientific and Technical Information of China (English)

    石达友; 李盛强; 宋晓琳; 代雪立; 肖敏华; 郭世宁

    2011-01-01

    本试验通过注射利血平复制犬脾虚证动物模型,观察犬临床体征、体重及部分消化功能指标的变化,并研究针灸对各项指标的调整作用.试验结果显示,在实验犬出现脾虚证后,其体重显著低于空白对照组( P<0.05);在经针灸治疗7d后,实验犬的胃蛋白酶、胰蛋白酶活性与胃动素水平均显著高于未经治疗的实验犬(P<0.05),而胃泌素与生长抑素均显著低于未经治疗的实验犬(P<0.05).结果表明,通过针刺脾虚犬足三里、脾俞两穴位,对改善脾虚犬临床症状、增加体重及恢复正常消化功能等方面具有明显的功效.%In this thesis, it made a splenic asthenia modeling by injection of reserpine. The clinical symptom, body weight and the part of digestive function indicator were observed. And it made a study about effect of acupuncture treatment on the observed indexes. The results showed that the body weight significantly decreased (P<0. 05) after the dog appeared splenic asthenia syndrome. After acupuncture treatment the dog with splenic asthenia syndrome for 7 days, the activity of pepsin and trypsin and the contents of motillin significantly increased (P<0. 05), but the contents of gastrin and somatostatin significantly decreased (P<0.05), compared without treated splenic asthenia dogs. The finding showed that it had an effect of acupuncture treatment splenic asthenia dogs in Zusanli and spleen points on improvement of clinical symptoms, weight gain and restoration of normal digestive function.

  17. 地塞米松磷酸钠诱导大鼠阴虚状态的实验研究%Empirical study of yin asthenia state of rats induced by dexamethasone sodium phosphate

    Institute of Scientific and Technical Information of China (English)

    倪莉; 张冰; 刘小青; 王雪雅; 陈彬; 赖永金; 刘欣; 金锐

    2012-01-01

    Objective: To imitate yin asthenia reaction in clinic by observing pathological appearance of rats induced by dexamethasone sodium phosphate. Methods: Intramuscular injection with dexamethasone sodium phosphate (0.35mg/kg) of rats to make yin asthenia model which then were intragastricly administrated with solution of six tastes Rehmaniae Bolus. Analysis of the pathological feature of yin asthenia model induced by dexamethasone sodium phosphate by observing and detecting correlated symptoms and laboratory index when experiment completed. Result: During the period of model making (on day 10 and 21), compared with the normal group, common symptoms and correlated biochemical indicators of rats in the model group all changed at different extent. At the end of the experiment (on day 21), compared with the model group, some abnormal index can be adjusted to normal of rats in six tastes Rehmaniae Bolus group. Conclusion: From the point of analogy with clinical pathological appearance and disproof by treating with six tastes Rehmaniae Bolus, influences on multisystem of rats induced by dexamethasone sodium phosphate correspond to pathological appearance of yin asthenia state which is the imitation of clinical yin asthenia state.%目的:观察地塞米松磷酸钠诱导大鼠的病理表现以模拟临床阴虚反应.方法:以0.35mg/kg地塞米松磷酸钠肌肉注射大鼠造阴虚模型,并给模型组大鼠灌胃六味地黄丸溶液,观察和检测相关症状及实验室指标,以分析所造阴虚模型的病理特点.结果:造模期间(第10、21天时),与正常组比较,模型组大鼠的一般症状表现及相关客观生化指标都发生不同程度的改变.实验结束时(造模21d即灌胃lld时),与模型组比较,六味地黄丸组部分异常指标可被调节到正常水平.结论:从与临床病理表现类比及六味地黄丸对其治疗反证,可知地塞米松磷酸钠对大鼠多系统的影响,符合阴虚状态的

  18. 基因芯片技术研究虚寒证大鼠肝全基因表达谱%Study of Gene Chip Technology on Whole Genome Expression of Liver of Rats with Asthenia Cold Syndrome

    Institute of Scientific and Technical Information of China (English)

    韩冰冰; 王世军; 于华芸; 赵海军; 王媛

    2011-01-01

    Objective;To study the whole genome expression of liver on asthenia cold syndrome rats by gene chip technology. Methods:The Asthenia cold syndrome rats models were induced by compound preparation of traditional Chinese medicine of Raw Gypsum,Radix gentianae、Cortex Phellodendri 、Anemarrhenae Rhizoma.The liver gene expression in each group was detected by gene chip. We selected the differential expression genes and conducted the significant analysis on the genetic function of differential genes. A part of genes were selected to test the accuracy of results by RT - PCR. Results: As compared to the control group,in asthenia cold model group there were 99 strips of differential expression gene, mainly about function of response to stimulus. Conclusion ; Many strips of gene about response to stimulus were down - regulated in asthenia cold syndrome rats, which induced down regulation of function about immune response,defense response,response to other organism. The substance foundation of asthenia cold syndrome was possibly related to these genes.%目的:采用基因芯片技术研究虚寒证大鼠肝全基因表达谱的改变.方法:使用中药复方生石膏、龙胆草、黄柏和知母建立虚寒证大鼠模型,应用基因芯片检测各组大鼠肝脏基因表达,筛选差异表达基因,进行基因功能分类注释.荧光定量PCR验证芯片结果.结果:虚寒模型组与空白对照组比较有99条基因差异表达,主要涉及刺激应答功能.结论:虚寒证可能通过多种刺激应答相关基因的下调,导致免疫应答功能、防御应答功能及对其他生物体刺激应答功能的降低.虚寒证的物质基础可能与此类基因的异常表达相关.

  19. 论“虚不受补”及状态辨治策略%Discussion of “too asthenia to nourish” and the strategy from syndrome differentiation and treat-ment according to the view of state

    Institute of Scientific and Technical Information of China (English)

    唐光华; 周仙仕

    2015-01-01

    After thinking over the clinical dilemma of the“too asthenia to nourish”, the author put forword that the reason of “too asthenia to nourish” was inappropriate nourishing treatment. Mostly, we didn’ t realize that the further reason of“too asthenia to nourish” was complicated, which was inefficient by nourishing directly. The treatment used the strategy from syndrome differentiation to recognize patient sta-tion, analyze the pathogeny of disease and handle with the relationship of actual situation of disease and the pathogenic factors. We can use the treatment of nourishing by clearing or adjusting. What’ s more, we can adopt the strategy by adjusting the function of the spleen and the stomach as well as dispelling dampness and stasis. With the comprehensive measures, we may both nourish and adjust the weak patients.%本文对临床常见“虚不受补”困境进行了思考和探索,提出“虚不受补”的主要原因是补不得法与措施不当。其深层原因是未能认识到“虚不受补”是一种复杂状态,采用线性思维下的“直补”策略常常不能有效解决。临证可从状态辨治思路,识状态,析病机,并处理好虚实及内外邪气等关系,采用调补、通补之法,兼顾重视调脾胃、畅气机等策略,综合施治,实现虚者可补,虚体可调。

  20. Clinical application observation of shenling baizhu powder in damp abundance due to splenic asthenia%参苓白术散在脾虚湿盛证中的临床应用观察

    Institute of Scientific and Technical Information of China (English)

    鄢宏亮

    2015-01-01

    ABSTRACT:Objective To observe and analyze clinical application observation of shenling baizhu powder in damp abundance due to splenic asthenia. Method From July 2014 to March 2015 28 cases of patients in our hospital with spleen deficiency and dampness syndrome were selected as research object, use shenling baizhu therapy for them, and observe and analyze clinical effect. Result through treatment of shenling baizhu powder, 28 cases with damp abundance due to splenic asthenia were significantly improved, and cured basically. Conclusion shenling baizhu powder has ideal curative effect for damp abundance due to splenic asthenia, which has high clinical application value.%目的:观察分析参苓白术散在脾虚湿盛证中的临床应用。方法选取2014年7月至2015年3月于我院进行诊治的28例脾虚湿盛证患者作为研究对象,对这些患者予以服用参苓白术散治疗,观察分析临床效果。结果通过参苓白术散治疗,28例脾虚湿盛证患者病情均得到显著改善基本治愈。结论参苓白术散能对脾虚湿盛证具有理想的治疗效果,具有极高的临床应用价值。

  1. Asthenia-cold Syndrome in Patients with Primary Dysmenorrhea Based on Urine Metabolomics%基于GC-TOFMS的虚寒证原发性痛经患者尿液代谢组学

    Institute of Scientific and Technical Information of China (English)

    徐丁洁; 徐洪; 赵舒; 曹颖; 董玉山; 成秀梅; 杜惠兰

    2013-01-01

    Objective:To compare the differences between the asthenia-cold syndrome in patients with primary dysmenorrhea and normal group in urinary endogenous metabolites,and elaborate the path physiological mechanisms of the asthenia-cold syndrome in patients with primary dysmenorrheal.Method:N-methyl-N-(trimethylsilyl) tri-fluoroacetamide (MSTFA) was selected as derivatization reagent to detect urine metabolites at the second day in menstrual cycle (MC2) of the two groups using gas chromatography-time of flight mass spectrometer (GC-TOFMS),drawn the total ion chromatogram (TIC) of each group,combination with unsupervised principal component analysis (PCA) for the multi-dimensional statistical analysis to look for variability material between the two groups.Result:Compared with the normal group,twelve variability materials in asthenia-cold group were detected.They were fructose,maltose,arbinofuranose,isocitric acid,lactic acid,hippuric acid,glycine,serine,threonine,palmitic acid,octadecanoic acid,and erythritol.Among the total materials only lactic acid in asthenia-cold group was higher than in the normal group ; the rest materials in astheniacold group were all lower than in the normal group.Conclusion:Asthenia-cold syndrome of the primary dysmenorrheal patients and the normal group suggested significant difference in urine metabolites.These variability materials are related to several metabolic pathways such as glycolmetabolism,amino acid metabolism,fatty acid metabolism and disturbance of enterobacteria.%目的:比较虚寒证原发性痛经患者与正常组尿液内源性代谢物的差异,从整体角度阐释其病理生理学机制,深化中医整体观在现代实验研究中的应用.方法:采用病证结合模式,基于气相色谱-飞行时间质谱(GC-TOFMS)技术,以N-甲基-N-三甲基-硅基三氟乙酰胺(MSTFA)作为衍生化试剂,检测虚寒证原发性痛经患者及正常组月经周期第2天(MC2)尿液代谢产物,得出两组总离子

  2. Study on the Correlation between Chronic Asymptomatic HBV Carriers of Yin Asthenia Constitution and Genotypes of HLA-DRB1and HLA DQA1Alleles%慢性无症状HBV携带者阴虚体质与人类白细胞抗原-DRB1、DQA1基因多态性的联系

    Institute of Scientific and Technical Information of China (English)

    过建春; 肖丽娜; 荀运浩; 王宇芳; 李春青; 石伟珍; 施军平

    2012-01-01

    目的 探讨慢性无症状HBV携带者(chronic asymptomatic HBV carrier,ASC)阴虚体质与人类白细胞抗原(human leukocyte antigen,HLA) -DRB1、HLA-DQA1基因多态性的内在联系.方法 将105例ASC患者进行中医体质分型及分组:阴虚质组47例和非阴虚质组58例.采用聚合酶链反应-序列特异性引物(PCR-SSP)技术测定HLA-DRB1、HLA-DQA1等位基因型.结果 阴虚质组HLA-DRB1*09、HLA-DQA1*0301的基因频率明显低于非阴虚质组(分别为12.1% vs 27.8%,19.1% vs 39.7%),差异有统计学意义(P<0.01);HLA-DRB1*11、HLA-DQA1*0501的基因频率明显高于非阴虚质组(分别为12.1% vs 4.3%,28.7%vs9.5%),差异有统计学意义(P<0.05,P<0.01).结论 HLA-DRB1*09和HLA-DQA1*0301可能是ASC非阴虚体质患者的分子基础;HLA-DRB1*11和HLA-DQA1* 0501可能是ASC阴虚体质患者的分子基础.%Objective To study on the correlation between chronic asymptomatic HBV carriers (ASC) of yin asthenia constitution and genotypes of HLA-DRB1 and HLA DQAt alleles. Methods Totally 105 ASC were assigned to two groups according to their constitutions, i. e. , the yin asthenia group (47 cases) and the non-yin asthenia group (58 cases). The genotypes of HLA-DRB1 and HLA DQA1 alleles were determined using PCR-SSP. Results The gene frequency of HLA-DRB1 * 09 allele and HLA-DQA1 * 0301 aliele (being 12. 1 % and 19. 1%) were obviously lower in the yin asthenia group than in the non-yin asthenia group (being 27. 8% and 39. 7%, P<0. 05). The gene frequency of HLA-DRB1 * 11 allele and HLA-DQA1 * 0501 allele were obviously higher in the yin asthenia group (being 12. 1% and 28. 7%) than in the non-yin asthenia group (4. 3% and 9. 5%), showing statistical difference ( P < 0. 05, P < 0. 01 ). Conclusions HLA-DRB1 * 09 allele and HLA-DQA1 *0301 allele might be the molecular bases for non-yin asthenia patients with ASC. HLA-DRB1 * 11 allele and HLA-DQA1 * 0501 allele might be the molecular bases tor yin asthenia

  3. 童康颗粒治疗小儿脾虚夹积型厌食的临床疗效观察%Clinical efficacy observation on Tongkang granula in treating pediatric anorexia of splenic asthenia and food accumulation type

    Institute of Scientific and Technical Information of China (English)

    张伟; 孙丽敏

    2012-01-01

      目的:探讨童康颗粒治疗小儿脾虚夹积型厌食的疗效.方法:观察治疗小儿厌食症60例,其中治疗组27例给予童康颗粒口服治疗,对照组33例给予四磨汤口服液口服治疗.治疗4周后,治疗组临床总有效率为95.15%,对照组总有效率为80.12%,在改善患儿食欲食量和体重方面,二者均有疗效,但治疗组优于对照组.结果:童康颗粒能有效改善脾虚夹积型厌食症患儿的厌食状况,使患儿体重增加.结论:童康颗粒组疗效优于四磨汤口服液组.%  Objective: To investigate the efficacy of Tongkang granula in treating pediatric anorexia of splenic asthenia and food accumulation type. Methods: 60 cases of pediatric anorexia were divided into two groups, 27 cases in the treated group and 33 cases in the control group. The treated group was given Tongkang granula for oral administration and the control group was given Simo decoction oral liquid. After treated for 4 weeks, the total effective rate of the treated group was 95.15% and that of the control group was 80.12%. Both two groups were effective in improving the appetite and weight of children, and the treated group was more effective. Results: Tongkang granula was effective in treating pediatric anorexia of splenic asthenia and food accumulation type and increasing children’s weight. Conclusion: Tongkang granula was more effective in pediatric anorexia than Simo decoction oral liquid.

  4. Effects of Jianpi Xiaoji granules on gastric juice, gastric acid exudation and pepsin activity in rats of spleen asthenia%健脾消积颗粒对脾虚大鼠胃液、胃酸的分泌及胃蛋白酶活性的影响

    Institute of Scientific and Technical Information of China (English)

    李红; 蒋晓煌; 蒋孟良; 谢小全

    2012-01-01

    目的:探讨健脾消积颗粒对脾虚大鼠胃液、胃酸分泌及胃蛋白酶活性的影响.方法:用大黄造成大鼠脾虚模型后,再灌服健脾消积颗粒药液,于末次灌胃后1h,测定大鼠胃液、胃酸分泌量、胃蛋白酶活性.结果:健脾消积颗粒的胃液、胃酸分泌量和胃蛋白酶的活性与模型组比较,差异具有统计学意义(P<0.05或P<0.01).结论:健脾消积颗粒对脾虚大鼠的健脾作用机制之一与其能使脾虚大鼠的胃液、胃酸分泌增加、胃蛋白酶活性提高有关.%OBJECTIVE To investigate the effects of Jianpi Xiaoji granules on gastric juice, gastric acid exudation and pepsin activity in rats of spleen asthenia. METHODS The model rats of spleen asthenia were induced by rhubarb, then feed Jianpi Xiaoji granules. The quantity of gastric juice, gastric acid exudation and pepsin activity were mensurated after the last of feed 1 h. RESULTS There was significant difference in the quantity of gastric juice, gastric acid exudation and pepsin activity of rats of spleen asthenia between the Jianpi Xiaoji granules and model group (P<0. 05 or P<0. 01). CONCLUSION The Jianpi Xiaoji granules can promote the secretion of gastric juice, gastric acid and pepsin activity in rats of spleen asthenia.

  5. 基因芯片技术研究附子对虚寒证大鼠肝全基因表达谱的影响%Influenceof Aconiti Lateralis Radix Praeparata on asthenia cold syndrome rats with whole genome gene expression of liver by gene chip technique

    Institute of Scientific and Technical Information of China (English)

    韩冰冰; 王世军; 张发艳; 赵海军; 王成岗

    2012-01-01

    Objective; To study the influence of Aconiti Lateralis Radix Praeparata on asthenia cold syndrome rats with whole genome gene expression of liver by gene chip technique. Method: The asthenia cold syndrome rat models were established by administering traditional Chinese medicine raw Gypsum Fibrosum, Gentianae Radix, Phellodendri Chinensis Cortex and Anemarrhenae Rhizo-ma. After treated with Aconiti Lateralis Radix Praeparata, the rats' liver gene expressions were detected using gene chip. Differential expression genes were screened for gene function annotation, and some genes were selected to check the accuracy of the results by RT-PCR. Result; Compared with the asthenia cold model group, the asthenia cold treatment group showed 212 differential expression genes, mainly involving function of immune response and oxidoreductase activity. Conclusion: Aconiti Lateralis Radix Praeparata is proved to have an effect on up-regulating immune response-related genes and oxidizing oxidoreductase activity-related genes of asthenia cold syndrome rats and may be a molecular mechanism for classical warm-nature medicine Aconiti Lateralis Radix Praeparata in warming meridians and dissipating cold.%目的:采用基因芯片技术研究附子对虚寒证大鼠肝全基因表达谱的影响.方法:使用中药复方生石膏、龙胆草、黄柏、知母建立虚寒证大鼠模型,附子治疗后应用基因芯片检测大鼠肝脏基因表达,筛选差异表达基因,进行基因功能注释,荧光定量PCR验证芯片结果.结果:虚寒治疗组与虚寒模型组比较有212条基因差异表达,主要涉及免疫应答及氧化还原酶活性相关基因.结论:附子能够上调虚寒证大鼠的免疫应答相关基因及氧化还原酶活性相关基因,可能是经典热药附子温阳散寒作用的分子机制.

  6. Impact on Gastric Mucosa Histopathology of Atrophic Gastritis by Traditional Chinese Drug Prescription Based on Asthenia Syndrome Depression Syndrome Poison Syndrome Static Blood Syndrome%从虚郁毒瘀立法组方对萎缩性胃炎鼠模型胃黏膜病理的影响

    Institute of Scientific and Technical Information of China (English)

    王常松; 王启国; 俞杰; 闵莉; 吴银盘

    2011-01-01

    Objective: To observe intervention of the traditional Chinese drug prescription based on asthenia syndrome, depression syndrome, poison syndrome, static blood syndrome on gastric mucosa histopathology, of atrophic gastritis.Methods: Alcohol, deoxysodium cholate, ammonia solution, indometacin and disorder between feeding and fasting were used to build the mode]of atrophic gastritis, which were treated respectively by the high-dose, mid-dose, low-dos traditional Chinese drug prescription based on asthenia syndrome, depression syndrome, poison syndrome, static Blood syndrome, and their therapeutic effects were appreciated by the degree of gastric mucosa inflammation and atrophy, thickness of gastric mucosa.Results: The degree of gastric mucosa inflammation and atrophy, thickness of gastric mucosa became better by means of the model of atrophic gastritis treated by mid-dose of the traditional Chinese drug prescription based on asthenia syndrome, depression syndrome, poison syndrome, static blood syndrome.Conclusions: The therapeutic effect of atrophic gastritis treated by the traditional Chinese drug prescription based on asthenia syndrome, depression syndrome, poison syndrome, static blood syndrome is reliable.%目的:观测从虚郁毒瘀立法组方对萎缩性胃炎鼠模型胃黏膜病理形态的干预作用.方法:采用乙醇+去氧胆酸钠+氨水+吲哚美辛+饥饱失常综合法复制萎缩性胃炎鼠模型,并用从虚郁毒瘀立法组方低、中、高剂量分别进行干预,从对胃黏膜炎症及萎缩分度、胃黏膜厚度方面的影响观测各剂量组的治疗效果.结果:从虚郁毒瘀立法组方中剂量组可明显改善萎缩性鼠模型胃黏膜的炎症和萎缩程度,以及胃黏膜的厚度.结论:从虚郁毒瘀立法组方治疗萎缩性胃炎疗效可靠.

  7. 石榴皮水煎液对脾虚泄泻模型小鼠血清sIgA等影响的实验研究%Experimental Study on How Granatum Affecting Immunologic Function of Rats of Spleen Asthenia Type

    Institute of Scientific and Technical Information of China (English)

    吴苗敏; 单丽娟

    2012-01-01

    Objective; To make an approach to the relationship between the spleen asthenia and immunologic function by observing how granatum invigorating the spleen to arrest diarrhea of the rats of spleen asthenia. Methods-.40 clean grade Kunming rats were randomly divided into 4 groups:normal,treated,model, control groups. The model rats were fed with the liquid of folium scnnae to make the spleen asthenia model and treated with the granatum, then their feeding behavior, activity, fur, fecal frequency and so on were observed; the rats'content of sIgA,celiac phagocytic cells percentage and phagocytic index were tested by RIA;the rats'thymus and spleen weight change were tested;the spleen thymus pathological changes were tested by HE staining technique. Results:The model rats appeared to be less active,curling up lying, gathering, feeding rate decreasing, loose stool and so on. It is almost accordant to the symptoms of spleen asthenia. The content of slgA, celiac phagocytic cells percentage and phagocytic index in mode group were increased compared with those in the normal one( P 0. 05) . Conclusion;Granatum can improve the symptoms of spleen asthenia,it may be related to the gastrointestinal mucosa protection and the immune mechanism.%目的:观察石榴皮对脾虚泄泻小鼠的止泻作用并初步探讨脾虚泄泻与机体免疫功能之间的关系.方法:以清洁级昆明小鼠40只,随机分组(正常组、模型组、治疗组、对照组),采用苦寒药物灌胃致小鼠脾虚泄泻模型,治疗组以石榴皮水煎液反佐验证治疗,同时设立对照组(思密达),观察实验小鼠一般情况,以放射免疫法测定小鼠血清分泌性免疫球蛋白A(sIgA)含量等指标.结果:造模后小鼠出现活动减少、蜷卧、扎堆、摄食次数减少、大便稀溏等变化,符合脾虚泄泻证表现.治疗组小鼠症状明显改善,血清sigA含量、T淋巴细胞百分率及转化率、腹腔吞噬细胞百分率及吞噬指

  8. 药竹罐疗法治疗脾胃虚寒型胃脘痛的疗效观察及护理%Therapeutic effect of drug bamboo jar therapy to treat patients with spleen asthenia and stomach cold type of epigastralgia and nursing care of them

    Institute of Scientific and Technical Information of China (English)

    肖艳平; 周元林

    2011-01-01

    [目的]探讨药竹罐疗法治疗脾胃虚寒型胃脘痛的疗效及护理.[方法]将336例脾胃虚寒型胃脘痛病人随机分为观察组和对照组,每组168例.对照组予奥美拉唑、克拉霉素、胶体果胶铋、甲硝唑等药物治疗,按胃脘痛常规护理.观察组在此基础上配合药竹罐疗法,施以中医特色护理,包括饮食指导、生活起居指导、穴位经络养生指导、皮肤护理及调摄情志等.[结果]观察组临床疗效显著优于对照组(P<0.05);两组病人满意度及住院时间比较,差异有统计学意义(P<0.05).[结论]药竹罐疗法并配合中医特色护理治疗脾胃虚寒型胃脘痛可提高疗效、缩短住院时间、提高病人满意度.%Objective: To probe into the therapeutic effect of drug bamboo jar therapy to treat patients with spleen asthenia and stomach cold type of epigas tralgia and nursing care of them.Methods:A total of 336 patients with spleen asthenia and stomach cold type of epigastralgia were divided into observation and control groups randomly 168 cases each.Patients of control group were accepted omeprazole, clarithromycin, colloidal bismuth pectin, and metron idazole, and routine nursing were given.Besides that, patients of observation groups were treated with drug bamboo jar therapy.And they were given traditional Chinese medical characteristics nursing including diet guidance, living sitting instruction, acupoints and meridian health guidance, skin nursing care and emotion - thought adjusting and so on.Results: The clinical therapeutic effect of patients in observation group was significantly better than that of control group cases (P<0.05).And in terms of satisfaction degree and average hospital stay of patients, there were statistical significant difference between the two groups (P<0.05).Conclusion: Drug bamboo jar therapy combined with traditional Chinese medical characteristics nursing to treat patients with spleen asthenia and stomach cold type of

  9. 金匮肾气丸对肾阳虚小鼠血浆内皮素一氧化氮含量的影响%Effects of Kidney-Qi Bolus on Level of Endothelin and Nitrous Oxide in Plasm of Mice with Renal-yang Asthenia

    Institute of Scientific and Technical Information of China (English)

    刘欣; 兰金美; 李冬梅

    2011-01-01

    Objective: To investigate the effects of the Kidney-Qi Bolus on the level of Endothelin ( ET )and nitrous oxide ( NO ) in the plasm of mice with renal yang asthenia, for finding out furtherly its molecule mechanism of warm-yang action.Methods: To establish the mouse model of renal yang asthenia syndrome by peffusing the stomach with adenine 30mg/100g body weighted continuously for 30 days, at the same time, as well as perfusing mice with the Kidney-Qi Bolus in the Kiclney-Qi Bolus group and detect the ET and NO levels in plasma on the last day.Results: Levels of ET were significantly higher in plasma of the renal yang asthenia mice than those of the normal-control( P<O.05 ), but lower in the Kidney-Qi Bolus group( P<0.05 ),and levels of NO were lower but insignificantly in the Kidney-Qi Bolus group than these two groupa(P>0.05).Conclusion: The Kidney-Qi Bolus could inhibit ET going-up in the plasm and thus correct the imbalance of vasoconstrictive and vasodilative factors under the state of Renal-yang asthenia, it is also one of the molecule mechanism of warm-yang action.%目的:了解金匮肾气丸对肾阳虚状态下血浆内皮素、一氧化氮含量改变的影响,以进一步明确其温肾壮阳(温阳)作用的分子机制.方法:用腺嘌呤灌胃复制小鼠肾阳虚模型,并在肾阳虚形成过程中予金匮肾气丸干预,通过硝酸还原酶法和放射免疫法分别检测血浆一氧化氮(NO)和内皮素(ET)的含量.结果:血浆内皮素含量在肾阳虚组高于正常对照组(P<0.05),在金匮肾气丸组则低于肾阳虚组(P<0.05),一氧化氮在肾阳虚组低于正常对照组及金匮肾气丸组,但3组间比较无统计学意义(P>0.05).结论:金匮肾气丸可抑制血浆ET水平升高而纠正肾阳虚状态下缩血管与舒张血管因素的动态平衡失调,这也是其温阳作用的分子机制之一.

  10. Exploration on Proteomics of Tongue Coating in Patients with Chronic Gastritis of Spleen-asthenia and Damp-heat Syndrome%慢性胃炎脾虚湿热证患者的舌苔蛋白质组学初探

    Institute of Scientific and Technical Information of China (English)

    刘晓谷; 蔡淦; 何磊; 程亚伟; 王文静; 王忆勤

    2012-01-01

    目的:比较慢性胃炎脾虚湿热证患者与正常志愿者舌苔蛋白质谱的差异,筛选慢性胃炎脾虚湿热证的特征性舌苔蛋白标志物,并建立特征性舌苔的诊断模型.方法:收集30例慢性胃炎脾虚湿热证患者(实验组)和30例正常志愿者(正常组)的舌苔,经表面增强激光解析离子化飞行时间质谱( SELDI-TOF-MS)检验并筛选舌苔蛋白标志物,经生物信息学分析建立预测模型.结果:在质荷比1 000~15000范围内检测到189个差异蛋白峰.与正常组相比,实验组的差异蛋白质谱峰表达值较高(P<0.05);通过聚类分析,两组蛋白质谱峰值显示的聚类性质明显不同;利用主成分分析,两组舌苔样本的分布有明显差异,可有效分离;构建的慢性胃炎脾虚湿热证特征性舌苔诊断模型预测正确率为91.67%,灵敏度为100.00%,特异性为83.33%.结论:本研究所构建的特征性舌苔诊断模型能对慢性胃炎脾虚湿热证做出较为准确的判断,可为慢性胃炎脾虚湿热证的临床诊断提供一定的客观依据.%Objective: To compare the differences of protein spectrum of tongue coating between patients with chronic gastritis of spleen-asthenia and damp-heat syndrome and healthy volunteers, filter the characteristic protein markers of tongue coating in patients with chronic gastritis of spleen-asthenia and damp-heat syndrome, and establish the characteristic diagnosis model of tongue coating. Methods: The tongue coating of thirty patients with chronic gastritis of spleen-asthenia and damp-heat syndrome ( experimental group) and thirty healthy volunteers (normal group) was collected, the protein markers of tongue coating were filtered by surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS), and the prediction model was established by bioinformatics analysis. Results; There were 189 different protein peaks in the range of 1 000 to 15 000 of mass-to-charge ratio

  11. 大鼠脾虚证与血清甲状腺激素及下丘脑、胸腺细胞核T3受体关系%RELATIONSHIP BETWEEN SPLEEN-ASTHENIA SYNDROME AND SERUM THYROXIN,T3 RECEPTORS OF HYPOTHALAMUS CELLS & THYMUS T LYMPHOCYTE NUCLEI IN RATS

    Institute of Scientific and Technical Information of China (English)

    李刚; 夏天; 王宗仁; 张仲海

    2001-01-01

    目的:探讨脾虚证与血清甲状腺激素及下丘脑、胸腺细胞核T3受体的关系。方法:成年SD大鼠32只随机分为4组(每组8只):A组(正常组)、B组(脾虚组)、C组(治疗组)、D组(自复组)。采用放射配基分析法,测定各组大鼠血清T3、T4、FT3、FT4、γ-T3及下丘脑、胸腺细胞核T3受体的含量。结果:B、D组大鼠血清T3、T4、FT3、FT4含量均较A、C组低,有显著差异(P<0.05或P<0.01);各组间血清γ-T3含量无显著性差异;B、D组下丘脑、胸腺细胞核T3受体含量较A、C组低,有显著差异P<0.01)。结论:血清甲状腺激素及下丘脑、胸腺细胞核T3受体的水平降低,可导致甲状腺激素生物效应低下,经由神经内分泌免疫调节环路,削弱免疫功能,这可能是脾虚证的一种重要病机。%Objective:To study the relationship between Spleen-asthenia syndrome and serum thyroxin,T3 receptors of hypothalamus cells & thymus T lymphocyte nuclei in rats.Method:Rhubarb decoction was used to develop spleen-asthenia syndrome in SD adult rat.32 rats were averagely divided into four groups at random:Group A(control group),group B(spleen-asthenia group),group C(group treated with Sijunzi decoction),group D(spontaneous rehabilitation group).The radioimmunoassay was applied to measure serum thyroxin levels and the contents of T3 receptors of hypothalamus cells and thymus T lymphocyte nuclei of every rat.Result:The serum levels of T3,T4,FT3,FT4,the contents of T3 receptors of hypothalamus cells and thymus T lymphocyte nuclei in group B,D were lower than those in group A,C.The difference between them was significant.Serum level of γ-T3 in four groups had no significant difference.Conclusion:The decline of T3,T4,FT3,FT4 serum levels,and the contents of nuclear T3 receptors in hypothalamus cells & thymus T lymphocytes can influence the activity of thyroxin,then the immunity function will be impaired via

  12. Clinical Significance of Body Surface and Tongue Temperatures and Body Surface Humidity on Diagnosis of Chronic Gastritis of Syndromes of Spleen and Stomach Asthenia-cold and Stomach-yin Deficiency%慢性胃炎脾胃虚寒证与胃阴亏虚证体表温度、湿度及舌温度变化的临床意义

    Institute of Scientific and Technical Information of China (English)

    李果刚; 程建丽; 张妍妤; 王欢

    2011-01-01

    目的:探讨慢性胃炎脾胃虚寒证与胃阴亏虚证患者体表温度、湿度及舌中温度变化的临床意义.方法:运用寒热湿诊测仪测定慢性胃炎脾胃虚寒证和胃阴亏虚证患者的手心、手背、手臂尺肤、额头、舌中温度及手心、手背、手臂尺肤、额头湿度,并与正常志愿者的体表、舌中温度及体表湿度进行比较分析.结果:与正常对照组比较,胃阴亏虚组患者的手心温度、手背温度、尺肤温度、额头温度和舌中温度均显著升高(P<0.05),而脾胃虚寒组患者的手心温度、手背温度、尺肤温度、额头温度则显著降低(P<0.05);脾胃虚寒组患者的手背湿度、尺肤湿度、额头湿度均显著降低(P<0.05).结论:慢性胃炎的虚寒证与虚热证患者其体表温度及湿度存在一定的差异性,通过检测其定量值可能对慢性胃炎虚寒证与虚热证的诊断有一定的参考价值.%Objective: To explore the clinical significance of body surface and tongue temperatures and body surface humidity on diagnosis of chronic gastritis of syndromes of spleen and stomach asthenia-cold and stomach-yin deficiency. Methods: The cold-heat-dampness diagnostic instrument was applied to test the body surface (including the palm, the back of the hand, the forearm and forehead) and tongue temperatures and body surface (including the palm, the back of the hand, the forearm and forehead) humidity of patients with chronic gastritis of syndromes of spleen and stomach asthenia-cold and stomach-yin deficiency, and the temperatures and humidities were compared with the normal volunteers. Results: Compared with the normal control group, the temperatures of the palm, back of the hand, forearm, forehead and tongue in stomach-yin deficiency group increased significantly (P <0.05) , while the temperatures of the palm, back of the hand, forearm and forehead in spleen and stomach asthenia-cold group decreased obviously ( P < 0. 05 ) s the

  13. Effect of Electroacupuncture on Differentiation and Proliferation of Hippocampal Nerve Stem Cells in Splenic Asthenia Pedo-rats%电针对脾虚证幼鼠海马区神经干细胞增殖和分化的影响

    Institute of Scientific and Technical Information of China (English)

    卓缘圆; 杨卓欣; 吴家满

    2011-01-01

    Objective To observe the effect of electroacupuncture (EA) on the differentiation and proliferation of nerve stem cells in the hippocampal dentate gyrus (DG) in splenic asthenia pedo-rats so as to study its central mechanism. Methods A total of 72 SD male rats were randomly assigned to normal control group (n = 24). Model group (n=24) and EA group (n=24) which were further divided into 7 d, 14 d , 28 d and 49 d time-points (n = 6). Splenic asthenia model was established by intrape-ritoneal injection of reserpine and gavage of Dahuang (.Radix et Rhizoma Rhei) fluid. EA was applied to bilateral "Zusanli" (ST 36) and "Sanyinjiao" (SP 6) for 20 min, once daily for 7, 14,28 and 49 days respectively. Brdu, Nestin, gliai fibrillary acidic protein (GFAP), and neuron-specific enolase (NSE) expression in the DG of hippocampus were detected by immunohistochemis-try double staining. Results Compared with the normal control group, the numbers of Brdu, Brdu/GFAP, Brdu/NSE immunorea-ctive (IR) positive cells in the DG of hippocampus on day 7 and 14, and that of Brdu/Nestin IR-positive cells on day 7 were decreased considerably in the model group (P0.05). Conclusion EA of ST 36 and SP 6 can effectively suppress splenic asthenia syndrome-induced decrease of the numbers of Br-du, Brdu/GFAP, Brdu/Nestin and Brdu/NSE IR-positive cells in the DG of hippocampus at the early stage in the splenic asthenia rats, which may contribute to its effect in improving splenic asthenia symptoms in clinic by promoting the proliferation and differentiation of some nerve stem cells in the hippocampus.%目的:通过观察电针对脾虚证幼鼠海马齿状回区神经干细胞增殖和分化的影响,探讨电针对中枢神经细胞损伤的保护和治疗作用.方法:4周龄SD雄性大鼠,随机分为正常组、模型组、电针组,每组各24只.3组再分别随机分为7、14、28和49 d等4个亚组,每亚组6只.用利血平腹腔注射联合大黄灌胃造脾虚证模型.造模结束后,电

  14. 月经病虚寒证患者T细胞亚群与生殖激素的变化%The Changes of Type Ⅰ and Type Ⅱ T Lymphocytes and Reproductive Hormone in Menopathy of Asthenia Cold Syndrome Patients

    Institute of Scientific and Technical Information of China (English)

    刘艳芹; 段彦苍; 杜惠兰

    2013-01-01

    目的:通过分析虚寒型月经病患者外周血T细胞亚群与生殖激素水平的变化及二者的相关关系,探讨妇科虚寒证的内分泌-免疫学发病机理.方法:分别采用放射免疫分析法和流式细胞技术检测虚寒型月经病患者、正常人各30例生殖激素与T细胞亚群的变化,分析其相关性.结果:虚寒组较正常组E”T、LH、FSH、及Th2、Th2/Th1、Tc2、Tc1、Tc2/Tc1降低,Th1升高,均有统计学意义.Th2、Th2/Th1与E2呈正相关,Th1与E2呈负相关;Th2、Tc2、Th2/Th1与T呈正相关;Th1与FSH呈负相关.结论:月经病虚寒证患者生殖激素分泌减少,Th2、Tc2、Tc1细胞水平下降,Th1细胞水平上升,机体内分泌-免疫调节功能紊乱而发生月经病.%Objective:By analyzing the changes ofrelations between type Ⅰ and type ⅡT lymphocytes and reproductive hormone in menopathy of asthenia cold syndrome patients,and the relations between them,initially approach partly etiopathogenesis of it from endocrine-immunological means.Methods:Adopt radio immunoassay and flow cytometry to respectively detect reproductive hormone and type Ⅰ and type Ⅱ T lymphocytes of thirty asthenia cold syndrome patients and health adults,analyze relations between them.Results:Compared with normal group,contents of E2 、T、LH、FSH were decreased,had statistically significant.The percentage of Th2、Th2/Th1 、Tc2、Tc1 、Tc2/Tc1 decreased,Th1 increased.The level of Th2、Th2/Th1 and E2 was a positive linear correlation,Th1 and E2 was a negative linear correlation ;Th2、Tc2、Th2/Th1 and T was a positive linear correlation,Th1 and FSH was a negative linear correlation.Conclusion:Reproductive hormone of menopathy of asthenia cold syndrome patients were lower,the percentage of Th2、Tc2、Tc1、Tc2/ Tc1 decreased,Th1 increased,organism endocrine-immunological modulation function disordered,finally caused menopathy.

  15. Experimental Study on Constitution of Erythrocyte Membrane and Change of Transmembrane Information Transmission in Male Rats of Kidney asthenia%肾虚雄性大鼠红细胞膜组分及跨膜信息传递变化的实验研究

    Institute of Scientific and Technical Information of China (English)

    郑洪新; 崔家鹏; 刘景峰; 林庶茹; 夏淑杰

    2001-01-01

    The constitution and function of erythrocyte membrane and the changes of transmembrane information transmission in rats of kidney asthenia were investigated.In this study,a model of male rat of kidney asthenia was established by excision of sexual gland.The activities of protein kinase C (PKC),Ca2+-Mg2+-ATPase,Mg2+-ATPase in erythrocyte membrane and content of membrane phospholipid were observed.The results show that the activities of protein kinase C(PKC)and Ca2+-Mg2+-ATPase in erythrocyte membrane in the model group are significantly lower than those in the control group(P<0.01).The contents of PC and PI in erythrocyte membrane are significantly lower(P<0.01),that of PS is significantly lower (P<0.05) and that of SM is significantly higher(P<0.01).The kidney-tonifying traditional Chinese drugs can increase the activities of protein kinase C(PKC) and Ca2+-Mg2+-ATPase,decrease the content of SM(P<0.01) and increase the content of PC,PI,PS(P<0.01).It is concluded that the change of constitution and function of membrane in male rats of kidney asthenia can have effect on the asymmetry,fluidity and transmembrane information transmission.The kidney-tonifying traditional Chinese drugs can increase the activities of some of enzyme in membrane,correct some of constitution of membrane,such as SM,PC,PI,which can restore the constitution and function of membrane and the transmembrane information transmission,thus have the preventive and therapeutic effect on the diseases of kidney asthenia.%目的:探讨肾虚对细胞膜的结构和功能及其跨膜信息传递的影响以及补肾中药的作用机制。方法:通过手术去势切除性腺造成雄性大鼠肾虚动物模型,施加补肾中药,以红细胞膜蛋白激酶C(PKC)、Ca2+-Mg2+ATP酶、Mg2+ATP酶活性变化和膜磷脂组分含量为观察指标。结果:肾虚模型对照组红细胞膜蛋白激酶C(PKC)、Ca2+-Mg2+ATP酶活性明显低于正常对照组(P<0.01);红细

  16. Glial asthenia and functional paralysis: a new perspective on neurodegeneration and Alzheimer´s disease.

    OpenAIRE

    Verkhratsky, Alexei; Marutle, Amelia; Rodríguez-Arellano, JJ; Nordberg, Agneta

    2014-01-01

    Neuroglia are represented by several population of cells heterogeneous in structure and function that provide for the homeostasis of the brain and the spinal cord. Neuroglial cells are also central for neuroprotection and defence of the central nervous system against exo- and endogenous insults. At the early stages of neurodegenerative diseases including Alzheimer's disease neuroglial cells become asthenic and lose some of their homeostatic, neuroprotective, and defensive capabilities. As...

  17. Astenia en cáncer avanzado y uso de psicoestimulantes Asthenia in advanced cancer and the use of psychostimulants

    OpenAIRE

    Portela, M.A. (María Angustias); Sanz, A; MARTÍNEZ M; Centeno, C. (Carlos)

    2011-01-01

    La astenia es el síntoma más frecuente en enfermos con cáncer avanzado y probablemente, el que más influye en la calidad de vida del paciente oncológico ya que interfiere en su actividad física y social. En la mayor parte de los casos el tratamiento es sintomático. Hay un interés creciente en el uso de psicoestimulantes para el tratamiento de astenia. Metilfenidato y modafinilo son dos psicoestimulantes que han sido ya probados en estudios controlados en astenia del paciente con cáncer avanza...

  18. Cranial irradiation in children with lymphoblastic acute leukemia: results and damages. [Incidence of asthenia, anorexia, somnolence, and lethergy as related to irradiation procedure

    Energy Technology Data Exchange (ETDEWEB)

    Cecchetti, E.; Brandoli, V.

    1979-03-01

    From 1973 to 1976, 81 children with lymphoblastic acute leukemia were treated with cranial prophylactic irradiation at the Istituto di Radioterapia ''L. Galvani'' del'Universita di Bologna. We divided the patients into 6 groups according to different characteristics. At the beginning of 1978 the survival rate was 82%; 60 patients (74%) were in complete continuous remission. We studied the encephalic post irradiation syndrome that is present in children over 2 years of age only when doses are higher than 2500 rad and in children under 2 years of age when doses exceed 2000 rad. This complication occurs frequently in the experience of other authors; however, it is absent under certain doses with which it is possible to obtain the same good results. We feel that among the different techniques and methods, the best radiological treatment is daily bilateral cranial irradiation for patients early in remission; we recommend doses of 2400 rad for children above 2 years of age and 1950 rad for those under 2 years.

  19. Clinical experience for treating infantile nephrotic syndrome by asthenia in origin and asthenia in superficiality and sequenced differentiation of symptoms and signs%从本虚标实、序贯辨证论治小儿肾病综合征临床体会

    Institute of Scientific and Technical Information of China (English)

    张汶娟; 刘素云; 任献青

    2013-01-01

      全国名老中医丁樱教授、知名专家翟文生教授以及任献青博士在临床中积累了丰富的治疗小儿肾病的经验。本文对其进行了总结整理。%The national distinguished veteran TCM doctors DING Ying, the famous expert ZHAI Wen-sheng and Doctor REN Xian-qing have abundant experiences on treating infantile nephrotic syndrome. In this article, their experiences were summarized.

  20. Acupuncture Clinical Research about Protracted Withdrawal Syndrome of Opium-addicts of Asthenia of qi and Blood%针刺治疗阿片类药物依赖稽延性戒断症状气血两虚型临床观察

    Institute of Scientific and Technical Information of China (English)

    苏彩霞; 李煜; 徐平; 虎力

    2009-01-01

    目的:探讨同一针刺方法对3组稽延性戒断症状毒瘀蕴结-气血两虚型(简称气血两虚型)患者疗效影响.方法:根据成癌程度将75例患者分为A、B、C 3组,每组25例,用同一针刺方法进行治疗,同时记录针刺前、第5、10、15次症状积分.结果:3组临床总有效率分别为A组:68%,B组:72%,C组:80%.组间比较无显著性差异(X2=1.061,P=0.588>0.05).结论:针刺华佗央脊、内关等穴位对3组阿片类药物依赖稽延性戒断症状气血两虚型患者有显著的疗效.

  1. 3.TRADITIONAL CHINESE MEDICINE

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920220 Studies on plasma cortisol concen-tration and blood leukocyte content of gluco-corticoid receptors in patients with asthenia-cold asthenia-heat syndrome.ZHANG Guan-gyu (张广宇),XLE Zhufar (谢竹藩).Tradit & West

  2. Pharmacologic and therapeutic features of sulbutiamine.

    Science.gov (United States)

    Van Reeth, O

    1999-03-01

    Asthenia is the most frequent medical reason for people seeking help from their physician. In 75% of cases, the cause is functional (either reactive or psychiatric) and in 25% it is organic. In order to provide patients with rapid relief of symptoms, appropriate antiasthenic treatment should be initiated immediately, while at the same time, adequate clinical and laboratory assessments should be performed to detect the underlying cause of asthenia. Sulbutiamine, a highly lipophilic thiamine derivative, is the only antiasthenic compound known to cross the blood-brain barrier and to be selectively active on specific brain structures directly involved in asthenia. This article reviews the current knowledge on the effects of sulbutiamine in animal models and in various forms of human asthenia. PMID:12973384

  3. ASTHENIC DISORDERS IN ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION: MANAGEMENT POTENTIAL OF MELDONIUM

    Directory of Open Access Journals (Sweden)

    M. E. Statsenko

    2015-09-01

    Full Text Available Aim. To assess the effect of meldonium (in combination with antihypertensive therapy on the severity of asthenic syndrome (AS in elderly patients with arterial hypertension (HT.Material and methods. Patients (n=180, >65 years old with HT (grade 1–2 and secondary somatogenic AS (assessed by the MFI-20 scale. The patients were randomized into 3 groups according to the scheme of treatment. Group 1 — intermittent treatment with meldonium (500 mg once daily for 3 months followed by a break 3 months; 2 courses. Group 2 — continuous treatment with meldonium (500 mg once daily for 12 months. Group 3 — control (receive only antihypertensive drugs. Evaluation of AS was assessed by MFI-20 scales at baseline and at week 52 of treatment.Results. AS signs attenuation was found in groups 1 and2. In group1 a number of patients with general asthenia decreased on 70.5% (p<0.05, with physical asthenia — on 47.7% (p<0.05, with reduced activity — on 33.3%, reduced motivation — on 25%. In group2 a number of patients with general asthenia decreased on 60% (p<0.05, physical asthenia — on 39.7%, reduced activity — on 79.9% (p<0.05, reduced motivation — on 12.2%, mental asthenia — on 77.7% (p<0.05. In group 3 no significant changes in these parameters were found. Moreover a number of patients with mental asthenia increased on 45.4% (p<0.05.Conclusion. Meldonium included into antihypertensive therapy can reduce the symptoms of secondary somatogenic AS. More pronounced antiasthenic effect can be achieved with meldonium taking regime 500 mg daily continuously for 52 weeks.

  4. [Asthenic disorders and cognitive dysfunction in patients with tension headache].

    Science.gov (United States)

    Chutko, L S; Surushkina, S Iu; Rozhkova, A V; Iakovenko, E A; Bykova, Iu L; Nikishina, I S

    2013-01-01

    The article is devoted to the study of cognitive dysfunction in patients suffering from tension headaches. Patients had attention and memory dysfunction, higher levels of anxiety, asthenia and subclinical symptoms of depression. The high efficacy of cerebrolysin in the restoration of cognitive dysfunction confirmed by the data of clinical, psychological and neuropsychological studies was shown. PMID:23739500

  5. Self-Esteem, Locus of Control and Various Aspects of Psychopathology of Adults with Visual Impairments

    Science.gov (United States)

    Papadopoulos, Konstantinos; Paralikas, Theodosis; Barouti, Marialena; Chronopoulou, Elena

    2014-01-01

    The exploratory study presented in this article looks into the possible differences in psychosocial aspects (self-esteem and locus of control) and aspects of psychopathology (depression, anxiety, melancholia, asthenia, and mania) amongst sighted adults and adults with visual impairments. Moreover, the study aims to examine the possible…

  6. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of a health claim related to citrulline-malate and faster recovery from muscle fatigue after exercise pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    number of studies were provided with hospitalised patients or outpatients who presented with various forms of asthenia or fatigue. No conclusions could be drawn from these studies for the scientific substantiation of the claim. No conclusions could be drawn from one study carried out in athletes, owing...

  7. Docetaxel rechallenge after an initial good response in patients with metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Oudard, Stéphane; Kramer, Gero; Caffo, Orazio;

    2015-01-01

    were associated with reduced OS. Docetaxel rechallenge increased the incidence of grade ≥3 sensory neuropathy, nail disorders and asthenia/fatigue. CONCLUSIONS: Docetaxel rechallenge is a management option for responders to docetaxel with a PFI of >6 months, but did not prolong survival. Potential...

  8. 从脾胃论治冠心病理论探讨%Theoretical discussion of treatment of coronary heart disease from spleen and stomach

    Institute of Scientific and Technical Information of China (English)

    庄贺

    2013-01-01

    It is discussed that the rules of occurrence,development of coronary heart disease from the relationship between the heart and the spleen and stomach. The foundation of the disease is asthenia in origin and asthenia in superficiality,the asthenia in origin is mainly described as deficiency of the heart,the liver and the kidney,and one principal reason of the asthenia in superficiality is that stagnated phlegm obstructing the channels, stagnation of Qi and blood may bring about pain the stagnated phlegm results from the spleen and the stomach. Even though the coronary heart disease is closely related to the dysfunction of the heart governing blood vessels, whether the function of the spleen and stomach works normally plays a significant role in the onset of the coronary heart disease as well.%从心与脾胃的关系进行分析,探讨冠心病的发生、发展规律,认为冠心病属本虚标实证,本虚多为心肝肾之不足,标实多为痰瘀阻络,不通则痛,其痰瘀又与脾胃密切相关.所以冠心病虽与心主血脉功能失常有密切的联系,但从发病过程来看,脾胃功能正常与否亦起重要的作用.

  9. Muscular disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920747 Studies on HLA and acetylcholinereceptor antibody in patients with my-asthenia gravis. XU Wenzhen (徐文桢), etal. Dept Neurol, West China Med Univ, Chengdu,610000. Chin J Neurol & Psychiat 1992; 25(3):150-153. Human leucocyte antigen (HLA) and acetyl-choline receptor antibody (AchRab) titer in the

  10. The Correlation Analysis between Spleen Deficiency and Gastric Mucosal Injury%脾虚与胃黏膜损伤相关性的理论探讨

    Institute of Scientific and Technical Information of China (English)

    施甜; 朱方石; 徐婷婷

    2011-01-01

    This research studies the correlation between spleen asthenia and gastric mucosal injury from 4 aspects of pathogenesis, pathology, syndrome, and therapy. The results indicated that the pathological condition of spleen asthenia supply objective bases for the gastric mucosal injury, meanwhile, the gastric mucosal injury is easy to aggravate spleen asthenia. There is a correlativity of mutual causes and effects between the two diseases. The standpoint may supply the rationale for therapeutic principles of "Treat from spleen asthenia" treating the gastric mucosal diseases.%本文就脾虚与胃黏膜损伤的相关性从中医发病学、痛机关联现、证型归纳属性及治法归类等4个方面,进行了理论探讨.认为中医脾虚的病理状态为胃黏膜损伤提供了客观条件,而胃黏膜损伤因素则又易加重脾虚证侯,二者间存在着互为因果的相关关系.其观点为构建“从脾虚论治”胃黏膜损伤性疾病的治则观提供了理论基础.

  11. 药物中毒性周围神经病变肌电图分析%EMG analysis of peripheral nerve lesion resulting from drug toxicity

    Institute of Scientific and Technical Information of China (English)

    张昆林; 马莎; 毛小川

    2003-01-01

    @@ INTRODUCTION Peripheral nerve lesion resulting from drug toxicity is caused by drugs which interrupt some enzymes in process of nervous metabolism and lead to loss of myelin sheath or axis- cylinder degeneration. Some drugs used in clinic can lead to peripheral nerve lesion. Patients showed symptoms such as numbness, asthenia.

  12. Addison’s Disease: A rare case report

    Directory of Open Access Journals (Sweden)

    Sanjay N. Agrawal

    2015-04-01

    Full Text Available A female patient presented with progressive weakness, asthenia and generalized hyperpigmentation. The characteristic hyperpimentation pointed towards possibility of Addison’s disease which was proved by markedly decreased plasma cortisol levels, hyponatremia and hyperkalemia. This could be one of the very few cases of Addison’s Disease reported.

  13. 养阴清肺法治疗感染后气道高反应性咳嗽%Discussion of Tonifying Yin and Clearing Lung Method in Treating Airway Hyperreactivity Cough Post Infectionem

    Institute of Scientific and Technical Information of China (English)

    陈新; 车德亚

    2013-01-01

    Objective;To study the application of tonifying yin and clearing lung method in treating airway hyperreactivity cough post in-fectionem. Methods:To discuss the pathogenesis characteristic of airway hyperreactivity cough post infectionem from lung impairment caused by pathogen dryness and qi-yin asthenia. Results: Lung impairment caused by pathogen dryness and qi-yin asthenia are the internal condition of airway hyperreactivity cough post infectionem and asthenia in origin and asthenia in superficiality is the precipitating factors. Conclusion: Lung impairment caused by pathogen dryness and qi-yin asthenia are the basic pathogenesis characteristics of airway hyperreactivity cough post infectionem. Tonifying yin and clearing lung provides new thread and method in treating airway hyperreactivity cough post infectionem in clinic.%目的:探讨养阴清肺法在感染后气道高反应性咳嗽中的运用.方法:从燥邪伤肺、气阴两虚等方面阐述感染后气道高反应性咳嗽的中医病机特征.结果:燥邪伤肺、气阴两虚是感染后气道高反应性咳嗽发生的内在条件,本虚标实是其发病的必然因素.结论:燥邪伤肺、气阴两虚是感染后气道高反应性咳嗽的基本病机特征,临床选用养阴清肺法治疗,为感染后气道高反应性咳嗽的治疗提供了新的思路和方法.

  14. Correlativity Between Patterns of Hypertension in TCM and Polymorphism of COX-2%高血压病中医证型与COX-2基因多态性的相关性研究

    Institute of Scientific and Technical Information of China (English)

    唐靖一; 王佑华; 汤诺; 刘萍; 张鞠华; 梁逸强; 周莉; 周翊峰; 周端

    2012-01-01

    Objective: To observe the correlativity between patterns of hypertension in TCM and distribution of COX-2 polymorphism, and try to provide a new objective evidence for pattern identification. Methods: One hundred and seventy-eight cases with hypertension were divided into four patterns; hyperactivity of liver fire pattern, hyperactivity of yang due to asthenia of yin pattern , exuberance of phlegm-damp pattern and asthenia of both yin and yang pattern. Seven hundred and twenty-five healthy people were in normal control group. The gene polymorphisms on loci-1290A/G, -1195G/A, and -765G/C which located in COX-2 gene promoter of peripheral blood cells were detected by polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP). The genes were divided into different patterns, and the correlativity between patterns and expression of COX-2 was analyzed. Results: There was a statistical difference in the distribution of COX-765G/C gene between experimental group and control group; there was correlativity between polymorphism of COX-1195G/A and occurrence of hyperactivity of liver fire pattern and hy-peraelivity of yang due to asthenia of yin pattern. The genotype frequency of GG and CG + CC in excess patterns( hyperactivity of liver fire, exuberance of phlegm-damp) was increased obviously than in asthenia patterns (hyperactivity of yang due to asthenia of yin, asthenia of both yin and yang). Conclusion; The genovariation of COX-1195G/A may be the important factor in hyperactivity of liver fire pattern and hyperactivity of yang due to asthenia of yin pattern; the GG and CG + CC gene frequency on loci-765G/C may be related to the pattern identification of asthenia and asthenia in hypertension.%目的:研究原发性高血压病患者环氧化酶-2(COX-2)基因多态性的分布及其与高血压病中医辨证分型的关系,为中医辨证论治提供新的客观依据.方法:选择178例高血压病患者,辨证分型为肝火亢盛型、阴虚阳亢

  15. Analysis on Constitutional Types of Male Infertility Groups in 108 Cases%108例男性不育症人群中医体质类型分析

    Institute of Scientific and Technical Information of China (English)

    林兆丰; 蒙浩; 陈润东; 洪灵

    2012-01-01

    目的:通过108例男性不育症患者问卷调查,对其中医体质类型质进行初步的分析.方法:体质量表调查法对108例男性不育症人群实施中医体质辨识.结果:单一体质类型63例占58.33%,复合体质类型45例占41.67%,总体体质类型前10位依次为和平质31例占28.7%,湿热质15例占13.89%,湿热痰湿质7例占6.48%,气虚湿热质、气虚阳虚质各6例,分别占5.56%,气虚质5例占5%;湿热阳虚质、特禀质、阴虚质各4例,分别占3.7%,湿热血瘀质3例占2.78%.结论:男性不育患者和平质者占相当比例,而体质偏颇者则以湿热体质及湿热复合体质为主,气虚、阳虚、痰湿及其复合体质互见的体质特点.而阴虚、血瘀、特禀质及其复合体质相对较少.%Objective: To analyze the physical compositions on male infertility by Traditional Chinese Medicine constitution questionnaire of 108 cases. Method: By using a physical scale survey, the research analyzed the physical constitution types of the 108 cases of the sample population. Result: The single constitution types had 63 cases ( 58% ), complex types 45 cases ( 41.67% ) .The top 10 of the total types accounted in order, constitution of yin-yang harmony 63 cases ( 28.7% ), damp-heat 15 cases ( 13.89% ), phlegm-dampness with damp-heat 7 cases ( 6.84% ), qi asthenia with damp-heat 6 cases ( 5.56% ), qi-yang asthenia 6 case ( 5.56% ), qi asthenia 5 cases ( 5% ), the yang asthenia with damp-heat, yin asthenia, allergic constitution all had 4 cases ( 3.7% ), constitution of blood stasis with damp-heat 3 cases ( 2.78% ). Conclusion : Constitution of yin-yang harmony is quite a lot in male infertility; meanwhile, constitution of damp-heat and that of complex constitution are the majority in partial constitution. Constitution of qi asthenia, yang asthenia, phlegm-dampness always combined to compound constitution types. On the other hand, type of yin asthenia, blood stasis , qi stagnation

  16. An Effect Analysis of 186 Cases of Chronic Pharyngitis Treated with Chinese-Western Medicine%中西医结合治疗慢性咽炎186例疗效分析

    Institute of Scientific and Technical Information of China (English)

    岳镛

    2000-01-01

    中西医结合治疗慢性咽炎是按中医治法以辩证分型为主,将慢性咽炎分为:肺阴虚损、肝郁气滞、肝肾阳虚三型.根据不同的症状进行中医辩证施治,同时配合中西医局部治疗,以达到疗效的目的.%To treat the chronic pharyngitis with Chinese medicine commbined with westmedicine is to divide the disease into three types according to the syndrome differentiation theoryin Chinese medicine. These three types are asthenia of pulmonary yin, hepatic depression and qistangnation, hepatic and renal yang asthenia. In order to get good effect, treat the different typesbased on syndrome differentiation in Chinese medicine, meanwhile, do some local treatment.

  17. 论吴澄《不居集》之学术贡献%Discussion on Academic Contribution of WUCheng "BuJuJi"

    Institute of Scientific and Technical Information of China (English)

    张秀芳; 李净

    2011-01-01

    WUCheng,a Qing dynasty doctor of Xin an physicians,not only summarized asthenic disease according to therapy methods of older generations for asthenia syndrome but also created a new theory of exogenous evil caused asthenia syndrome. Some formulas of treating deficiency of spleen Yin made great contribution to theory of spleen and stomach.%清代新安医家吴澄的医学著作博采前贤治虚损之法,总结阐述了内损之理,又结合自己的临症心得,创外感致虚之说,合而汇为治虚之大成,同时又全面阐述了脾阴虚的证治方药,对脾胃学说有着积极的贡献.

  18. By Traditional Chinese Medicine Explain "Xu and Shi"%在中医经典中观"虚实"

    Institute of Scientific and Technical Information of China (English)

    李燕翀; 孙凯; 郭蕾; 张俊龙

    2011-01-01

    The basis of clinical diagnosis in TCM,the eight principles,refers to yin and yang ,exterior and interior,cold and heat as well as asthenia and sthenia.But there is no agreement on the principle of asthenia and sthenia.In the hope of making a definite defination for it,which are discussed in this article by quatation of Neijing,Nanfing and all the medicine works in history.%八纲辨证自古就是中医临床诊断的基础,其中阴阳、表里、寒热的概念争议不大,但是虚实却是众说纷纭.从、和历代医家三方面加以论述,希望通过经典之语论,能让众人对虚实的概念有个统一而明确的认识.

  19. 《续名医类案》中惊悸案例分析%The Case Analysis of Palpitation in Supplement to Classified Medical Records of Celebrated Physicians

    Institute of Scientific and Technical Information of China (English)

    刘金凤

    2015-01-01

    就《续名医类案》中惊悸相关案例进行分析,认为本病的病变部位主要在心,证候特点是虚实相兼,以虚为主,故补虚是治疗的基本原则,临证时当视脏腑亏虚情况辨证治之。%Being documented in Supplement to Classified Medical Records of Celebrated Physicians, the cas-es of palpitation were analyzed in the paper. The location of the palpitation was recognized to be the heart with the syndrome characteristic of combination of asthenia and sthenia and the asthenia as the dominant syndrome, so that the basic principle for treating it is reinforcing deficiency and the doctor should differentiate the deficiency condi-tions of the viscera in clinic.

  20. Chronic eosinophilic pneumonia: a paediatric case

    OpenAIRE

    Tassinari, Davide; Di Silverio Carulli, Chiara; Visciotti, Francesca; Petrucci, Roberta

    2013-01-01

    Chronic eosinophilic pneumonia (CEP) is a rare disorder in children, characterised by respiratory and systemic symptoms, with a generally good prognosis. A 11-year-old asthmatic girl was admitted to our clinic with a 3-month history of progressive cough, dyspnoea, weight loss and asthenia. Peripheral blood eosinophilia, multiple bilateral pulmonary infiltrates to the x-ray, multiple nodules with a surrounding ground-glass halo and peripheral predominance to the chest CT suggested the diagnosi...

  1. Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

    OpenAIRE

    Kim, Sang Ock; Han, Sang Young; Baek, Yang Hyun; Lee, Sung Wook; Han, Ji Sun; Kim, Byung Geun; Cho, Jin Han; Nam, Kyung Jin

    2011-01-01

    Sorafenib, a multitargeted tyrosine kinase inhibitor, has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC). As the clinical use of sorafenib increases, many adverse effects have been reported, such as hand-foot skin reaction, diarrhea, anorexia, asthenia, alopecia, weight loss, hypertension and arterial thromboembolism. However, there are no prior reports of splenic infarction as an adverse effect of sorafenib. Here, a case of splenic infarction in a pat...

  2. Molecular biomarker discovery and physiological assessment of skeletal muscle in cancer cachexia

    OpenAIRE

    Stephens, Nathan Andrew

    2014-01-01

    Cachexia affects up to two thirds of all cancer patients with progressive disease. It is a syndrome characterised by weight-loss, anorexia, fatigue, asthenia, peripheral oedema, and is responsible for around 20% of cancer deaths. Cachectic patients suffer loss of both muscle mass and adipose tissue (with comparative sparing of visceral protein) and the lean tissue loss appears resistant to nutritional support. Progress in the treatment of cancer cachexia has been hampered due t...

  3. Androgen deficiency and aging in men.

    OpenAIRE

    Swerdloff, R S; Wang, C

    1993-01-01

    Androgen levels decrease with age in men. Androgen deficiency in men older than 65 years leads to asthenia, a decrease in muscle mass, osteoporosis, and a decrease in sexual activity. Androgen deficiency has been reported to cause changes in mood and cognitive function. The combination of these factors results in impaired quality of life in older men. Androgen replacement therapy in hypogonadal men increases bone and muscle mass, enhances muscle and cardiovascular function, and improves sexua...

  4. Scurvy in a patient with AIDS: case report

    OpenAIRE

    André Luiz Maltos; Luciana Ligia da Silva; Aderbal Garcia Bernardes Junior; Guilherme Vannucchi Portari; Daniel Ferreira da Cunha

    2011-01-01

    We report the case of a 35-year-old homeless alcoholic and illicit drug user, with AIDS, who was admitted to the emergency unit complaining of asthenia and a weight loss of 30kg over the preceding three months. Clinical and laboratory data confirmed a diagnosis of marasmus, bacterial pneumonia, chorioretinitis caused by Toxoplasma gondii and oral Candida infection. The patient also presented loss of tongue papillae, gingival hypertrophy, perifollicular hyperkeratosis and hemorrhage, coiled, c...

  5. Pioglitazone Treatment Increases Survival and Prevents Body Weight Loss in Tumor–Bearing Animals: Possible Anti-Cachectic Effect

    OpenAIRE

    Beluzi, Mércia; Peres, Sidney B.; Henriques, Felipe S.; Rogério A L Sertié; Franco, Felipe O.; Kaltinaitis B Santos; Knobl, Pâmela; Andreotti, Sandra; Shida, Cláudio S.; Neves, Rodrigo X.; Farmer, Stephen R.; Seelaender, Marília; Fábio B Lima; Batista Jr., Miguel L.

    2015-01-01

    Cachexia is a multifactorial syndrome characterized by profound involuntary weight loss, fat depletion, skeletal muscle wasting, and asthenia; all symptoms are not entirely attributable to inadequate nutritional intake. Adipose tissue and skeletal muscle loss during cancer cachexia development has been described systematically. The former was proposed to precede and be more rapid than the latter, which presents a means for the early detection of cachexia in cancer patients. Recently, pioglita...

  6. Fatal Toxoplasma gondii Dissemination in a Heart Transplant Recipient: Description of a Case

    OpenAIRE

    S. Mastrobuoni; Dell'Aquila, A. M.; Herreros, J.

    2012-01-01

    A 45-year-old heart transplant recipient presented with fever, anorexia, asthenia, and lethargy. She had received heart transplantation only 5 weeks earlier for primary systemic amyloidosis with severe cardiac involvement. Serum sodium was low, and tacrolimus through level was high. Blood cultures and serology tests for infection were negative, and atypical pneumonia was suspected. Despite broad antibiotic, antiviral, and antifungal treatment, the patient clinical condition rapidly deteriorat...

  7. Assessment of Red Blood Cell Parameters and Peripheral Smear at Different Temperatures in Case of Cold Agglutination Disease

    OpenAIRE

    Gupta, V.

    2014-01-01

    Cold agglutination disease (CAD) is characterized by an auto-antibody which is able to agglutinate red blood cells (RBCs) at temperatures lower than that of the body, and subsequently to activate the complement system responsible for lysis of RBCs. Patients show hemolytic anemia of varying degrees of severity, which arise or worsen upon exposure to low temperatures. We describe a case who presented with fever and symptoms of asthenia. His investigations yielded bizarre RBC parameters which le...

  8. Adenoma velloso de recto con alteración hidroelectrolítica severa. Informe de dos casos

    OpenAIRE

    Ernesto Sierra-Montenegro; José Luis Rocha-Ramírez; Eduardo Villanueva-Sáenz; Iván de la Serna-Ortiz; José Manuel Fernández-Rivero; René Soto-Quirino

    2007-01-01

    Background: Approximately 10 % of all colorectal adenomas are constituted by villous adenomas. Their relationship with hydroelectrolytic depletion is rare. We report two cases with villous adenoma that presented hydroelectrolytic depletion with clinical and surgical management, exclusively. Clinical cases: Case 1. Patient was a 76-year-old female with hypertension and 3 months evolution of symptoms such as asthenia, adynamia, unexplained weight loss, and abundant mucus with diarrhea. Serum po...

  9. Miscarriage following dengue virus 3 infection in the first six weeks of pregnancy of a dengue virus-naive traveller returning from Bali to Italy, April 2016.

    Science.gov (United States)

    Zavattoni, Maurizio; Rovida, Francesca; Campanini, Giulia; Percivalle, Elena; Sarasini, Antonella; Cristini, Graziella; Tomasoni, Lina Rachele; Castelli, Francesco; Baldanti, Fausto

    2016-08-01

    We report miscarriage following dengue virus (DENV)-3 infection in a pregnant woman returning from Bali to Italy in April 2016. On her arrival, the woman had fever, rash, asthenia and headache. DENV RNA was detected in plasma and urine samples collected the following day. Six days after symptom onset, she had a miscarriage. DENV RNA was detected in fetal material, but in utero fetal infection cannot be demonstrated due to possible contamination by maternal blood. PMID:27526349

  10. Persistent detection of Zika virus RNA in semen for six months after symptom onset in a traveller returning from Haiti to Italy, February 2016.

    Science.gov (United States)

    Nicastri, Emanuele; Castilletti, Concetta; Liuzzi, Giuseppina; Iannetta, Marco; Capobianchi, Maria R; Ippolito, Giuseppe

    2016-08-11

    A man in his early 30s reported in January 2016 a history of fever, asthenia and erythematous rash during a stay in Haiti. On his return to Italy, ZIKV RNA was detected in his urine and saliva 91 days after symptom onset, and in his semen on day 188, six months after symptom onset. Our findings support the possibility of sexual transmission of ZIKV and highlight the importance of continuing to investigate non-vector-borne ZIKV infection. PMID:27541989

  11. Microcirculatory changes and skeletal muscle oxygenation measured at rest by non-infrared spectroscopy in patients with and without diabetes undergoing haemodialysis

    OpenAIRE

    De Blasi, Roberto Alberto; Luciani, Remo; Punzo, Giorgio; Arcioni, Roberto; Romano, Rocco; Boezi, Marta; Menè, Paolo

    2009-01-01

    Introduction Haemodialysis has direct and indirect effects on skin and muscle microcirculatory regulation that are severe enough to worsen tolerance to physical exercise and muscle asthenia in patients undergoing dialysis, thus compromising patients' quality of life and increasing the risk of mortality. In diabetes these circumstances are further complicated, leading to an approximately sixfold increase in the incidence of critical limb ischaemia and amputation. Our aim in this study was to i...

  12. Hypokalemic periodic paralysis as first sign of thyrotoxicosis

    OpenAIRE

    Trifanescu, RA; Danciulescu Miulescu, R; Carsote, M; Poiana, C

    2013-01-01

    Background: periodic paralysis related to hypokalemia is seldom reported in thyrotoxicosis, and it usually occurs in Asian males. Patients and methods: Two Romanian (Caucasian) young patients presented with hypokalemic paralysis. TSH, FT4, TT3 was measured by immunochemiluminescence. Case report 1. Patient O.R, aged 19, presented marked asthenia and lower limbs paralysis, following high carbohydrate meal. He declared 10 kg weight loss on hypocaloric diet and mild sweating. Biochemical data re...

  13. Erratum

    OpenAIRE

    Barrese V; Miceli F; Soldovieri MV; Ambrosino P; Iannotti FA; Cilio, MR; Taglialatela M

    2012-01-01

    Barrese V, Miceli F, Soldovieri MV, Ambrosino P, Iannotti FA, Cilio MR, Taglialatela M. Neuronal potassium channel openers in the management of epilepsy: role and potential of retigabine. Clinical Pharmacology: Advances and Applications. 2010;2:225–236.On page 233, left-hand column, second paragraph, line 17 forward, it says:“The most common reasons for discontinuation were dizziness, confusion, somnolence, and asthenia, with the highest proportion of withdrawals in patien...

  14. Multi-district coronary tree involvement in a 17-year-old girl with Williams–Beuren syndrome

    OpenAIRE

    Serena, Tiziana; Valerio, Enrico; Castaldi, Biagio; Reffo, Elena; Milanesi, Ornella

    2015-01-01

    We describe a case of 17-year-old Chinese girl referred to our Pediatric Cardiology Unit for asthenia, reduced exercise tolerance, and dyspnea. Past medical history was relevant for multiple chest pain episodes in childhood and several syncopal episodes, for which the patient had been never evaluated. Clinical examination, electrocardiogram, and echocardiography were compatible with Williams–Beuren syndrome; such condition was later confirmed by genetic analysis. Cardiac magnetic resonance im...

  15. Effect of Sipjeondaebo-Tang on Cancer-Induced Anorexia and Cachexia in CT-26 Tumor-Bearing Mice

    OpenAIRE

    Youn Kyung Choi; Ki Yong Jung; Sang-Mi Woo; Yee Jin Yun; Chan-Yong Jun; Jong Hyeong Park; Yong Cheol Shin; Sung-Gook Cho; Seong-Gyu Ko

    2014-01-01

    Cancer-associated anorexia and cachexia are a multifactorial condition described by a loss of body weight and muscle with anorexia, asthenia, and anemia. Moreover, they correlate with a high mortality rate, poor response to chemotherapy, poor performance status, and poor quality of life. Cancer cachexia is regulated by proinflammatory cytokines such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor- α (TNF- α ). In addition, glucagon like peptide-1...

  16. Multiple-System Atrophy with Cerebellar Predominance Presenting as Respiratory Insufficiency and Vocal Cords Paralysis

    OpenAIRE

    João Manuel Quinaz; Ramon Andrade Bezerra de Mello; José Manuel Dias da Costa; Maria José Rosas; Diana Ferreira

    2010-01-01

    Background. MSA (Multiple System Atrophy) may be associated either with Parkinsonism or with cerebellar ataxia (MSA-c subtype). It is considered a rare disease, but many patients are misdiagnosed as suffering from idiopathic Parkinson's disease. In this paper, we report a case of a patient admitted with respiratory failure and vocal cords paralysis due to MSA-c. Case Report. A 79-year-old Caucasian woman was admitted in March 2010 with dyspnea, asthenia, stridor, and respiratory failure needi...

  17. First Report of Orchitis in Man Caused by Brucella abortus Biovar 1 in Ecuador.

    OpenAIRE

    Ron-Roman, Jorge; Saegerman, Claude; Minda-Aluisa, Elizabeth; Benitez-Ortiz, Washington; Brandt, Jef; Douce, Richard

    2012-01-01

    Abstract. We present a 44-year-old man from a rural community in northern Ecuador who worked on a cattle farm where he was involved with primary veterinary care, including assistance during births (or calving) and placenta retention and artificial insemination, with minimal precautions. In September of 2009, quite abruptly, he developed asthenia and hypersomnia without any apparent cause or symptoms like fever, chills, or night sweats. On November 14, 2009, he suffered from pain and edema in ...

  18. Cancer cachexia

    OpenAIRE

    Raghu Dhanapal; T R Saraswathi; N Govind Rajkumar

    2011-01-01

    Cancer cachexia is a wasting syndrome characterized by weight loss, anorexia, asthenia and anemia. The pathogenicity of this syndrome is multifactorial, due to a complex interaction of tumor and host factors. The signs and symptoms of cachexia are considered as the prognostic parameters in cancer patients. This review gives an emphasis on the various mechanisms involved in cachexia and an insight into head and neck cancer cachexia.

  19. Electrocardiographic pattern combined with echocardiographic wall motion abnormalities in stress related cardiomyopathies: clinical and pathophysiological insights

    OpenAIRE

    Berti, Marco; Ghizzoni,Giuseppe; Gualeni,Anna; Cantamessa,Paola; Oneglia,Carlo

    2012-01-01

    We report five cases of stress related cardiomyopahies that occurred in post-menopausal women (age range from 49 to 90) consecutively admitted to our Department in the last year in different clinical settings: typical anginal pain, carotid endarterectomy, pulmonary edema, cardiogenic shock, and severe asthenia. Apical left ventricular involvement was observed in three patients in conjunction with ECG mild ST segment elevation in anterior precordial leads resembling acute anterior myocardial i...

  20. Qiu Baoguo's Experience in Treating Refractory Hypertension%邱保国主任医师辨治难治性高血压经验

    Institute of Scientific and Technical Information of China (English)

    崔莉芳; 罗继红; 李志毅

    2014-01-01

    邱保国主任医师认为,高血压的病因总不离“风、火、痰、瘀”,其病理过程是一个本虚标实的演变过程,本虚在先,标实在后,病位在肝、肾,严重者可损及心、脑,发生心、脑、肾等靶器官损害,而致难治性高血压的出现。临床辨证施治分为肝阳上亢证、阴虚阳亢证、痰湿阻逆证和冲任失调证四型,应注意证候之间的兼夹转化,从而更好的指导临床辨证施治。%Chief physician Qiu Baoguo thinks that the causes of hypertension are" wind,fire,phlegm,blood stasis",the pathological process is evolution of asthenia in origin and asthenia in superficiality,asthenia in origin ahead,asthenia in superficiality behind. Dis-ease location is liver,kidney,seriously damagement of heart and brain,and the occurrence of heart,brain,kidney,and other target organs damaged in modern medicine,then refractory hypertension is formed. Clinical syndrome differentiation can divide into excessive rising of liver-yang syndrome,yin deficiency and yang excess syndrome,phlegm dampness obstruction syndrome,and disorder of Chong-Ren syn-drome,the doctors should pay attention to the complications and changes of TCM syndromes,so as to better guide the clinical syndrome differentiation.

  1. Surgical therapy and comprehensive treatment of 46 cases of thymoma%胸腺瘤外科治疗及综合处理46例探讨

    Institute of Scientific and Technical Information of China (English)

    郑兆斌; 郑云; 林博云; 黄旭杰

    2000-01-01

    @@ 胸腺瘤有浸润性生长的生物特性,合并重症肌无力(My-asthenia gravis,MG)者,更加重了外科治疗的复杂性.我们自1983年3月~1993年5月收治手术并经病理证实的胸腺瘤46例,报告如下.

  2. Role of adrenocortical dysfunction in the pathogenesis of poisoning syndromes due to some industrial toxins (aromatic nitro compounds, lead)

    Energy Technology Data Exchange (ETDEWEB)

    Makotcenko, V.M.

    1974-10-01

    Comparative study is presented of adrenocortical dysfunction in workers chronically exposed to aromatic nitro compounds and to lead. The chronic intoxications produced by aromatic nitro compounds and by lead are characterized by a slight reduction in adrenocortical activity, which plays an important part in the pathogenesis of certain syndromes such as asthenia, gastric secretion disorders, lead anemia and lead polyneuritis. It is desirable to take measures to normalize corticosteroid formation when chronic occupational poisoning is being treated. (CIS Abstr. Vol. 2)

  3. Kala-azar in a Brazilian child

    Directory of Open Access Journals (Sweden)

    Michael K. Hole

    2011-04-01

    Full Text Available We report the case of a six-year-old Brazilian girl referred for splenomegaly who first presented with fever, asthenia, and weight loss. Geographical location, clinical exam, and blood laboratories suggested kalaazar. Serology confirmed kala-azar diagnosis, but direct evidence of the parasites was not made. A treatment by meglumine antimoniate is given under hospital surveillance for two weeks. Thereupon, the patient is asymptomatic and all tests are normal.

  4. Advances on study of chronic obstructive pulmonary disease with traditional Chinese medicine%慢性阻塞性肺疾病中医药研究进展

    Institute of Scientific and Technical Information of China (English)

    邱维敏; 卢兴华

    2014-01-01

    Chronic obstructive pulmonary disease(COPD) is more common in clinical, which is equivalent to Chinese medicine's "lung inflation" "cough" "phlegm" "asthma" category. The basic pathological features of COPD is asthenia in origin and asthenia in superficiality, asthenia in superficiality in the acute stage is urgent, Phlegm, blood stasis, heat is main, asthenia in origin in the stability period is main, lung, spleen and kidney deficiency are more common. The ideal treatment method is lack now, more and more studies confirm that COPD patients can receive better treatment effect by using traditional Chinese medicine treatment. This study will make a summary from basic and mechanisms research of COPD.%慢性阻塞性肺疾病临床较为常见,属于“肺胀”“咳嗽”“痰饮”“喘证”范畴。其基本病理特征为本虚标实,急性期以标实为急,以痰、瘀、热较为多见,稳定期以本虚为主,肺脾肾虚损为多见。目前尚缺乏理想的治疗方法,越来越多的研究证实慢性阻塞性肺疾病患者采用中医药治疗能够收到较好的效果。本文从中医药对慢性阻塞性肺疾病的基础研究及机制研究两个方面做一总结。

  5. Clinical experience of Professor WEI Xu-xing in treating DPN%韦绪性教授治疗糖尿病周围神经病变临证经验

    Institute of Scientific and Technical Information of China (English)

    郭素芳; 崔敏; 张爱玲; 韦绪性

    2012-01-01

      Professor WEI Xu-xing considers that diabetes is mainly because asthenia in origin and asthenia in superficiality. There are different types of deficiency on vital energy, blood, Yin and Yang, and the deficiency on both vital energy and blood was common. Asthenia in origin also has different types, stagnation of blood, and stagnation of phlegm, cold coagulation and pyretic arthralgia in collaterals. Deficiency and stagnation are promoting agents, while asthenia and impotency of qi and blood were the key points leading to appendicular muscles anaesthesia and aches. On the basis of the characteristics, deficiency of both vital energy and yin and stagnation of arteries and veins, the Xiaodan Tongbi decoction is effective in treating peripheral neuropathy of diabetes (DPN).%  韦绪性教授认为,本病乃本虚标实之证。本虚有气、血、阴、阳之不同,尤以气阴两虚为多见,标实则多为瘀血、痰阻、寒凝、燥热痹阻脉络。“虚”、“瘀”是本病的促进因素,气血“不荣”与“不通”并存是导致肢体肌肉麻木不仁、疼痛的关键。根据本病多为气阴两虚,脉络瘀阻证之特点,所研制的消瘅通痹汤治疗糖尿病周围神经病变效果显著。

  6. Syndrome study on hemodialysis patients with hypertension%维持性血液透析患者高血压的中医证候研究

    Institute of Scientific and Technical Information of China (English)

    董阳; 李敬华

    2011-01-01

    目的 探讨维持性血液透析者高血压病的证候规律.方法 本文采用"症状计量辨证方法"制定中医证候调查表,对105例维持性血液透析高血压病例进行调查,总结其中医证候规律.结果 阴阳两虚证出现率居各正虚证候之首,其次是阴虚证、气阴两虚证、阳虚证,出现率最低的是气虚证.湿浊证出现率居邪实证型之首,然后依次是气滞证、血瘀证、水停证.结论 该病主要证候特点是正虚为主,兼有邪实,虚实夹杂.%Objective To investigate the distribution of syndromes in hospitalized hypertensive patients with maintenance hemodialysis. Methods A investigation-table of Chinese medicine was established and used in 105 eases for survey in clinic to discover the regularity. Results The occurrence rate from high to low of asthenia syndrome symptoms was: deficiency syndrome of both yin and yang, yin asthenia, deficiency of both vital energy and yin, yang asthenia, and the deficiency of qi. The occurrence rate from high to low of evil domination was: turbid damp, stagnation of qi, blood stasis, and fluid stagnation. Conclusions The clinical feature of hypertensive patients with maintenance hemodialysis was mainly asthenia of healthy energy combining with sthenia evil.

  7. Postinfectious syndrome of convalescentsixodes tick-borne borreliosis

    Directory of Open Access Journals (Sweden)

    O. N. Sumlivaya

    2014-01-01

    Full Text Available The aim: to study the psycho-vegetative status of the quantitative contents of serotonin in blood platelets in patients after the Ixodes tick-borne borreliosis, to evaluate the clinical efficiency treatment by adamantilfenilamin of postinfection asthenia.Materials and methods: there was clinical supervision and inspection conducted of 118 convalescents borreliosis after a course of inpatient treatment. All patients were examined using psychovegetative tests. Platelet serotonin concentration levels were measured by enzyme immunoassay. For the treatment of postinfectious asthenia 36 convalescents received adamantilbromfenilamin in a dose of 100 mg for 25 days.Results: when tested convalescents marked change in indicators of emotional and personality disorders. Quantitative study of blood platelet serotonin content revealed a significant decrease in this indicator relative to control values. Study the correlations between obtained when testing the psycho-emotional parameters and platelet serotonin levels showed a negative correlation between serotonin and an indicator of reactive anxiety (R = -0,81, p <0,05. To correct these violations convalescents with severe asthenia postinfection were treated adamantilfenilamin. Established clinical efficacy contributing to the improvement of the quality of life.Conclusion: the research of neurotransmitter serotonin in patients during the convalescence period after borreliosis possible to evaluate the extent of potential damage to the nervous tissue in the inflammatory process and its involvement in the formation of anxiety and depressive symptoms. adamantilbromfenilamin can be recommended for rehabilitation patients with residual effects in the form of postinfectious asthenia.

  8. 肾脏病患者外感的中医辨证论治%Traditional Chinese Medicine Syndrome Differentiation-Treatment for the Exogenous Iinsults of Renal Disease

    Institute of Scientific and Technical Information of China (English)

    徐建龙

    2012-01-01

    Objective:To explore the TCM syndrome differentiation-treatment for the exogenous insults of renal disease. Methods:Exogenous pathogenic factor induced induction and aggravation of renal disease, therefore, summarize the common syndrome pattern of infectious diseases to improve clinical effect from clinical reality and analysis of clinical manifestation. Results: The common syndrome pattern of infectious diseases includes wind cold,wind hot,fire wrapped by cold,exogenous insults by qi asthenia and qi-blood asthenia and complement syndrome. Conclusion; Exogenous insults of renal disease are distinguished asthenia-sthenia and interior-exterior firstly. The treatment should be exterior firstly and interior secondly, asthenia requiring tonification and sthenia syndrome requiring purgation, exogenous pathogens elimination as important.%目的:探讨肾脏病患者外感的中医辨证论治思路.方法:从临床实际出发,对肾脏病外感后的临床表现进行归纳分析,从而提取外感病常见中医证型的辨证要点,进而提高临床疗效.结果:肾脏病外感常见证型包括风寒、风热、寒包火、气虚外感和气血(阴)两虚,此外尚可见外感余证.结论:肾脏病患者的外感,首辨表里虚实,治疗当先表后里,虚则补之,实则泻之,以祛除表邪为要.

  9. 肾为先天之本与补肾中药对基因的影响分析%Kidney is the Congenital Base and the Analysis of the Effects of Kidney-strengthing Herbs on Gene

    Institute of Scientific and Technical Information of China (English)

    韩丽萍; 魏敏惠

    2003-01-01

    Dwells upon the theory in TCM-Kidney is the congenital base of the body \\ the relationship between kidney and heredity and the influence of kidney-strengthing herbs on the regulation of genes expression, analyses the main effect of kidney in TCM in the process of heredity and the interrelation between kidney and the regulation on genes,expression. This article is to probe into the essence of kidney asthenia in TCM according to the gene theory.

  10. Leukemia cutis resembling a flare-up of psoriasis

    OpenAIRE

    Ferreira, M; Caetano, M.; I. Amorim; Selores, M

    2006-01-01

    Abstract Leukemia cutis represents a skin infiltration by leukemic cells. Clinically it can mimic a wide variety of dermatoses. We describe the case of a 64-year-old man with psoriasis who presented with a 4-day history of erythematous, slightly scaly, asymptomatic plaques distributed on the trunk and upper-extremities, and associated asthenia, myalgias, and anorexia. A skin biopsy revealed a leukemic infiltrate. Studies of peripheral blood and bone marrow provided a diagnosis of acute mon...

  11. Hodgkin's Lymphoma Revealed by Hemophagocytic Lymphohistiocytosis in a Child

    OpenAIRE

    Sarra Benmiloud; Mohamed Hbibi; Sana Chaouki; Sana Abourazzak; Moustapha Hida

    2014-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a severe life-threatening disorder, responsible for extensive phagocytosis of hematopoietic cells and causing a multisystem organ failure. If lymphomas are common causes of HLH, the association with Hodgkin’s lymphoma is rarely described in children. We report a case of a 9-year-old boy presenting with HLH as an initial manifestation of Hodgkin’s lymphoma. He has been suffering from persistent high fever, asthenia, weight loss, and hepatosplenomegal...

  12. Study of the relation between Body Constitution and incidence tendency of depression or anxiety%体质与抑郁、焦虑发病倾向关系的调查研究

    Institute of Scientific and Technical Information of China (English)

    邓红月; 陈玉玲

    2011-01-01

    目的 探讨体质与抑郁、焦虑发病倾向的关系.方法 采用问卷方式对社区居民进行调查.结果 偏颇体质的抑郁、焦虑发病倾向高于平和体质的;气虚、湿热、气郁体质易有抑郁发病倾向,气虚、阳虚、湿热、气郁、特禀体质易有焦虑发病倾向.结论 不同体质的抑郁、焦虑发病倾向差异有统计学意义.在抑郁、焦虑的预防中可以针对体质因素进行干预.%Objective To discuss the relation between Body Constitution and incidence tendency of depres sion or anxiety. Methods The community residents were investigated with questionnaire. Results The incidence tendency of depression and anxiety with Biased Constitution was larger than with Peace. The Qi-asthenia, Damp-heat, Qi-stagnation constitutions had high tendency of depression. The Qi-asthenia, Yang-asthenia, Damp-heat, Qi-stagna tion and allergic constitutions had high tendency of anxiety. Conclusion Different constitution has distinct difference of incidence tendency, which can be used in preventing depression and anxiety.

  13. Chronic pain syndrome at tunnel neuropathies of peripheral nerves. integrative approaches to therapy

    Directory of Open Access Journals (Sweden)

    Yemelyanov A. Y.

    2012-06-01

    Full Text Available

    Painful chronic tunnel syndrome is almost always connected with asthenia and a various degree of anxiety and depressive syndrome. The goal of the research is to investigate prevalence and expressiveness of depressive and astheniс disorders in patients with chronic tunnel pain syndrome and to fnd accommodation of choice. 54 patients with chronic painful tunnel syndrome (35 (64,8 % male, 19 (35,2 % female, mean age 39,7+10,9 years have been examined and treated. Different acupuncture methods in complex treatment were accompanied by a positive dynamics of both subjective and objective clinical neurological and psychological symptoms. Anxiety have been revealed in 79,6 % of patients, depressive syndrome — in 57,3 % of patients, asthenia — in 85,2 % of patients. Acupuncture is tolerable, compare and have not got backside effects. Inclusion of acupuncture in complex treatment chronic tunnel pain syndrome allows to reduce a pain syndrome and asthenia, to normalize psychological condition of the patient.

  14. Correlation Between the Levels of hs-CRP and Differentiation of Symptoms and Signs for Classification of Syndrome%冠心病不稳定型心绞痛中医辨证分型与hs-CRP的相关性研究

    Institute of Scientific and Technical Information of China (English)

    官颖; 官捷

    2013-01-01

    目的:探讨不同中医证型冠心病不稳定型心绞痛患者hs-CRP水平,及与冠状动脉狭窄程度的相关性.方法:本研究共收集符合纳入标准的冠心痛不稳定型心绞痛患者121例.分为气虚血瘀、痰瘀互阻、阳虚寒凝、心脾两虚及心肾阴虚5种证型.另外选取非心绞痛患者60例作为对照.检测各组hs-CRP水平,并对入选患者进行相应的冠状动脉造影检查,分析hs-CRP与冠状动脉狭窄程度、中医证型之间的相关性.结果:气虚血瘀组、痰瘀互阻组和阳虚寒凝组hs-CRP含量均高于心脾两虚组和心肾阴虚组(P<0.05),而且冠状动脉血管病变损害程度也高于心脾两虚组和心肾阴虚组,且主要以重度狭窄为主(P<0.05);hs-CRP与狭窄程度总积分相关性比较发现hs-CRP与狭窄程度呈正相关(r=0.68752,P=0.01).结论:气虚血瘀和痰瘀互阻是冠心病不稳定型心绞痛发作期主要证型,hs-CRP的含量与冠状动脉血管狭窄程度呈正相关,是冠心病不稳定型心绞痛预后的预测因子.%Objective: To explore correlation between the level of hs - CRP and the type of syndrome in unstable angina pecto-ris ( UAP). Methods:121 UAP patients were divided into 5 syndrome groups according to diagnostic criteria: deficiency of vital en- ergy and blood stasis syndrome; sputum stasis hinder mutually syndrome; yang asthenia and cold accumulation syndrome; cardio-splenic asthenia syndrome; heart and kidney yin asthenia syndrome. The content of hs - CRP and coronary arteriongraphy were detected for each group, to study the correlation between the level of hs - CRP and the type of syndrome and coronary artery stenosis in UAP. Results: hs - CRP level of deficiency of vital energy and blood stasis syndrome, sputum stasis hinder mutually syndrome and yang asthenia and cold accumulation syndrome were higher than that of cardiosplenic asthenia syndrome, heart and kidney yin asthenia syndrome (P < 0. 05 ) , meanwhile the

  15. 广西城乡居民3000例中医体质类型分布调查%The survey of the distribution of TCM constitution of 3000 adults in urban and rural area of GuangXi province

    Institute of Scientific and Technical Information of China (English)

    邓小敏; 邱全; 柳彬; 周艳; 陆斌

    2012-01-01

    Objective To survey the distribution of TCM constitution of Guangxi adults.Methods "Identification questionnaire of constitution in TCM" was performed to identify the TCM constitution types of 3000 adults who were taken medical examination in the first affiliation hospital to GuangXi TCM university Health Administration Center or of permanent residence in Nanning,Wuming,Qinzhou,Hezhou.Results 612 cases (20.4%) had constitution of phlegm-dampness in 504 cases (16.8%) had constitution of phlegm-dampness,431 cases (14.3%) had constitution of yang asthenia,422 cases (14.1%) had constitution of qi asthenia,353 cases (11.8%) had constitution of damp-heat,348 cases (11.6%) had constitution of yin asthenia,159 cases (5.3%) had constitution of qi stagnation,100 cases (3.3%) had constitution of blood stasis,and 71 cases (2.4%) had allergic constitution.Conclusion There were 9 kinds constitutions in the adults of GuangXi province.The constitution of yin-yang harmony was the most among all.Most male had phlegm-dampness or damp-heat constitution.Most female had yang asthenia,qi asthenia,qi stagnation or yin asthenia constitution.%目的 初步调查广西成年人中医体质类型分布情况.方法 采用标准化的《中医体质分类与判定自测表》对到我院治未病中心接受体检以及长期在南宁市、武鸣县、钦州市、贺州市生活的成年人共3000例进行问卷调查、评估.结果 3000例被调查者中,平和质612例(20.4%)、痰湿质504例(16.8%)、阳虚质431例(14.3%)、气虚质422例(14.1%)、湿热质353例(11.8%)、阴虚质348例(11.6%)、气郁质159例(5.3%)、血瘀质100例(3.3%)、特禀质71例(2.4%).结论 9种体质在人群中均存在,平和质所占比例较高,男性以痰湿质、湿热质多见,女性以阳虚质、气郁质、阴虚质和气虚质为主.

  16. Research Progress Traditional Chinese Medicine For CAG And PLGC%中医药对慢性萎缩性胃炎及胃癌前病变研究进展

    Institute of Scientific and Technical Information of China (English)

    刘华一; 杨阔

    2012-01-01

    Chronic atrophic gastritis ( CAG) is gastric mucosal epithelium and gland atrophy, mucosa becoming thinner or accompanied by intestinal metaplasia,atypical hyperplasia for characteristics. CAG is listed as stomach cancers precancerous lesions of disease or precancerous condition, and on the basis of comorbid intestinal metaplasia and are called precancerous lesion of gras-tic cancer( PLGC ). TCM holds that the pathogenesis is mixture of asthenia and sthenia, asthenia syndrome is the spleen qi asthenia or splean-stomach yin deficiency, sthenic symptoms such as qi stagnation, blood stasis, dampness originating. Traditional Chinese medicine in clinical treatment of this disease no matter in clinic or in an experiment has obtained the better grades, accumu-lat a large amount of effective experience.%慢性萎缩性胃炎以胃黏膜上皮和腺体萎缩、黏膜变薄或伴有肠腺化生、不典型增生为特征.慢性萎缩性胃炎被列为胃癌的癌前疾病或癌前状态,而在其基础上伴发的肠上皮化生和异型增生则称为胃癌的癌前病变.中医认为其病机多属虚实夹杂、本虚标实,本虚为脾胃气虚或脾胃阴虚,标实多为气滞、血瘀、痰湿(浊)为患.中医治疗本病无论在临床还是在实验方面均取得了较好的成绩,积累了大量有效的经验.

  17. Association Between Insulin Resistance and Phlegm Blood Stasis in Hperlipodemia%高脂血症痰瘀证候与胰岛素抵抗的关系

    Institute of Scientific and Technical Information of China (English)

    袁肇凯; 黄献平; 简亚平; 李跃南; 贺福元; 孙贵香

    2004-01-01

    Objective: The purpose of this investigation was to explore the characteristics of insulin resistance existing in the pathological development of phlegm and blood stasis of hyper lipodemia. Method : All the patients of hyper lipodemia were divided into three group:35 cases of the syndrome of obstruction of the channels and collaterals from phlegm and blood stasis,33 cases of the syndrome of spleen-asthenia with accumulation of phlegm and 29 cases of the syndrome of non-phelgm and nom-blood stasis. At the same time 30 casses of normal group were observed. Then the integral of symptomand sign, fasting plasma glucose (FPG), fasting insulin (FINS), insulin sensitive index (ISI), insulin secretion function index(IS), lipid peroxide(LPO) and superoxide dismutase(SOD) were measured and done correlation analysis. Result : In both the syndrome of obstruction of the channels and collaterals from phlegm and blood stasis and the syndrome of spleen-asthenia with accumulation of phlegm there was an increasing tendency of FPG, FINS, IS and LPO from the control group to non-phelgm and non-blood stasis to the syndrome of spleen-asthenia with accumulation of phlegm to the syndrome of obstruction of the channels and collaterals from phlegm and blood stasis, but ISI and SOD decreased by turns.Simultaneously, there was obvious realation between the integral of symptom and sign of accumulation of phlegm and FPG or ISI(AII P < 0.05,0.01). However,the same association existed between the integral of symptom and sign of blood stasis and FINS or ISI(AII P < 0.05,0.01 ), in which the changes of ISI and the degree of correlation were more evident than the former. Conclusion: Insulin resistance has a certain effect on the the phthological development of phlegm and blood stasis.

  18. Analysis of literature on experts' opinions concerning syndrome elements of diabetes mellitus%基于专家观点的糖尿病证候要素提取文献分析

    Institute of Scientific and Technical Information of China (English)

    黎元元; 郭蕾; 高思华

    2012-01-01

    目的 分析基于专家观点的糖尿病中医证候的出现率,并提取确立其证候要素.方法 对1980年以来国内公开报道的有关糖尿病中医辨证分型的相关文献进行分析,从文献中的专家观点提取证候要素,并运用2检验对其进行多组间的比较.结果 气阴两虚、阴阳两虚、阴虚热盛与其他各组比较均有显著性差异,是糖尿病最常见的中医证候;肝肾阴虚、阴虚燥热、气滞血瘀、肺胃燥热也可认为是糖尿病的常见证候.阴虚、气虚、阳虚、内热在专家观点中出现频率很高(>80%),与其他出现频率较低的各证候要素相比具有显著性差异(P0.001) but with marked significance from the types of others such as blood stasis, Qi stagnation, dampness, phlegm (P<0.01). Conclusion The syndrome elements of Diabetes mellitus arranged according to the frequency of reference are: Yin asthenia, Qi asthenia, Yang asthenia, internal heat, blood stasis, internal dryness, Qi stagnation, dampness, phlegm.

  19. Clinical Application of Qi-blood Zheng Differentiation in Dermatology%气血辨证理论在皮肤病中的应用

    Institute of Scientific and Technical Information of China (English)

    马兰

    2013-01-01

    目的:探讨气血辨证理论在皮肤病中的临床应用.方法:以气血辨证理论为基础阐述皮肤病的病因、病机及临床表现,从脾虚湿盛、气虚血燥、血虚风胜、气血两虚、气滞血瘀、血热、气血不和等7个方面进行探讨.结果:皮肤病大多与气血有关,按照气血辨证理论基本可以判断皮肤病的司属.结论:气血辨证理论对皮肤病的治疗有重要的指导意义.%0bjective:To investigate the clinical application of qi-blood zheng differentiation in dermatology.Methods:Expound the etiology,pathogenesis and clinical manifestations of skin disease based on the theory of qi and blood syndrome differentiation as well as damp abundance due to splenic asthenia,qi asthenia,blood deficiency and predominant wind,qi-blood asthenia,qi-stagnancy and blood stasis,blood heat and qi-blood disharmony.Results:Use qi-blood zheng differentiation theory can judge the skin disease for many skin diseases associated with the qi and blood.Conclusion:Qi-blood zheng differentiation theory has important guidance significance in treating skin diseases.

  20. Panobinostat plus bortezomib and dexamethasone versus placebo plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma

    DEFF Research Database (Denmark)

    San-Miguel, Jesús F; Hungria, Vânia T M; Yoon, Sung-Soo;

    2014-01-01

    patients were enrolled between Jan 21, 2010, and Feb 29, 2012, with 387 randomly assigned to panobinostat, bortezomib, and dexamethasone and 381 to placebo, bortezomib, and dexamethasone. Median follow-up was 6·47 months (IQR 1·81-13·47) in the panobinostat group and 5·59 months (2·14-11·30) in the placebo...... group. Common grade 3-4 laboratory abnormalities and adverse events (irrespective of association with study drug) included thrombocytopenia (256 [67%] in the panobinostat group vs 118 [31%] in the placebo group), lymphopenia (202 [53%] vs 150 [40%]), diarrhoea (97 [26%] vs 30 [8%]), asthenia or fatigue...

  1. Scurvy in a patient with AIDS: case report

    Directory of Open Access Journals (Sweden)

    André Luiz Maltos

    2011-02-01

    Full Text Available We report the case of a 35-year-old homeless alcoholic and illicit drug user, with AIDS, who was admitted to the emergency unit complaining of asthenia and a weight loss of 30kg over the preceding three months. Clinical and laboratory data confirmed a diagnosis of marasmus, bacterial pneumonia, chorioretinitis caused by Toxoplasma gondii and oral Candida infection. The patient also presented loss of tongue papillae, gingival hypertrophy, perifollicular hyperkeratosis and hemorrhage, coiled, corkscrew-like hair, anemia, hypoalbuminemia, increased C-reactive protein levels and low serum vitamin C levels. The patient developed severe gastric hemorrhage, with hemodynamic instability and terminal disseminated intravascular coagulopathy.

  2. Mechanism of the inhibitory effect of endogenous histamine on epilepsy in rats

    Institute of Scientific and Technical Information of China (English)

    ChenZhong

    2004-01-01

    Clinical data demonstrated that long-term epilepsy, especially among children, or ingesting anticonvulsant drugs over time are likely to result in cognitive deficits (e. g. memory or attention problems as well as other CNS side effects such as psychomotor speed abnormalities, somnolence, asthenia, and dizziness. New drug therapy has been expected. The histaminergic neuron system seems to be involved in various physiological and behavioral functions including sleep - wake cycles, stress behavior, neuroendocrine, learning and memory through histamine HI, H2 and H3 receptors. The role of brain histamine in regulating seizure susceptibility has been studied, and a possible anticonvulsant action of endogenous histamine has been postulated

  3. Marketingový plán pro Bertiny lázně

    OpenAIRE

    SOBOTKOVÁ, Michaela

    2009-01-01

    This thesis was elaborated on the topic: Marketing plan for a spa. The main objective of my bachelor thesis was to create a marketing plan for spa. I elaborated it for a company Bertiny lázně Třeboň s. r. o. Bertiny lázně provides recondition and relax stays, suitable for erg asthenia and reduced capability dispositions, improvement of physical condition, convalescence, or overweight reduction and many other services. The next objective is the creation of macro and micro environment. For the ...

  4. Giant left atrial myxoma in an elderly patient: natural history over a 7-year period.

    Science.gov (United States)

    Bajraktari, Gani; Emini, Merita; Berisha, Venera; Gashi, Fitnete; Beqiri, Arton; Zahiti, Bedri; Selmani, Hamza; Shatri, Faik; Manaj, Rexhep

    2006-01-01

    We present the case of a 71-year-old woman with a 7-year history of a giant left atrial myxoma. The myxoma was attached to the atrial septum and occupied almost the entire left atrial cavity. The patient was hospitalized 4 times because of dyspnea on exertion, palpitations, fatigue, general asthenia, and weight loss. During prior hospitalizations, the patient had refused cardiac surgery. She developed several complications, including atrial fibrillation, mitral and tricuspid regurgitation, mesenteric embolism, pulmonary edema, and thrombotic stroke. We herein describe the natural history of left atrial myxoma in an elderly patient over a 7-year period. PMID:17024671

  5. [Giant renal cyst as cause of colic obstruction].

    Science.gov (United States)

    Vos, B; Laureys, M

    2009-01-01

    A 97-year old woman presented with a 2-months history of asthenia, loss of appetite, nauseas and intermittent diarrhea. She presented an important colic distension associated to an inflammatory syndrome. Microbiological documentation (blood, urine, saddles stool) was negative. Abdominal computed tomography (CT) showed a 15 cm of diameter (giant) right cortical renal cyst with colic obstruction by external colic compression. A percutaneous cyst drainage was performed allowing the evacuation of 1,500 cc. The fluid culture was positive for Raoultella ornithinolytica and Enterococcus faecalis. No antibiotics were given but inflammatory syndrome remained within normal value. Colic function remained normal. PMID:19517907

  6. How to Treat Pain in the Hepatic Region Due to Chronic Hepatitis?

    Institute of Scientific and Technical Information of China (English)

    林宗广

    2004-01-01

    @@ Chronic viral hepatitis type B and C both have the symptoms of pain in the hepatic region, asthenia, poor appetite, abdominal fullness, among which pain in the hepatic region is the most commonly seen. According to the author's clinical experience, treatment based on accurate TCM differentiation can not only eliminate pain in the hepatic region but also restore the hepatic function at the same time. Differentiation includes analysis of the nature of the hepatic pain and the accompanying symptoms, and the treatment is aimed at the differentiated symptoms. The following are methods of treatment.

  7. Fibromyalgia syndrome: definition and diagnostic aspects

    Directory of Open Access Journals (Sweden)

    A. Alciati

    2011-09-01

    Full Text Available Although the term “fibromyalgia” (FM is relatively new, the condition characterised by chronic musculoskeletal pain that is accompanied by numerous extra-skeletal symptoms has been described in the medical literature for many years under different names. The term “fibrositis,” which was originally used in 1904 by Sir William Gowers to define a type of lumbalgia, became a synonym for diffuse musculoskeletal pain until 1976 (1. In the mid-1970s, Smythe and Moldofsky used the term “fibrositic syndrome” to describe the presence of tender points (TPs, sleep disturbances and other accompanying symptoms such as asthenia...

  8. Residual tissue post splenectomy detected by splenic scintillography with erythrocytes damaged by heat

    International Nuclear Information System (INIS)

    Feminine of 26 years old with diagnostic of purple thrombocytopenic idiopathic to those 4 years of age, tried with steroids and splenectomy at 11 years old. Pathway practically asymptomatic until 4 months ago she had presented asthenia, adynamia and general uneasiness, with platelet figures of 40,000 plat/microliter. It was carried out scintillographic study with damaged erythrocytes for post surgical remainder search. Its were took two-dimensional images and tomography by single photon emission (SPECT), being knitted splenic residual in area of anatomical projection of the spleen. (Author)

  9. Detoxication and antiproteolytic therapy of radiation complications

    Energy Technology Data Exchange (ETDEWEB)

    Yakhontov, N.E.; Klimov, I.A.; Lavrikova, L.P.; Martynov, A.D.; Provorova, T.P.; Serdyukov, A.S.; Shestakov, A.F. (Gor' kovskij Meditsinskij Inst. (USSR))

    1984-11-01

    49 patients with uterine cervix and ovarian carcinomas were treated with detoxication and antiproteolytic therapy of radiation-induced side-effects. The therapy permits to complete without interruption the remote gamma-therapy course and to reduce patients in-hospital periods by 10+- 1 days. The prescription of hemoder intravenous injection in a dose of 450 ml and contrical intramuscular injection (10000 AtrE) in cases of pronounced manifestations of radiation-induced side-effects (asthenia, leukopenia, enterocolitis) for 3 days should be considered an efficient therapy.

  10. Angiomatoid fibrohistiocytoma - radiological findings; Fibro-histiocitoma angiomatoide - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Aurea Valeria Rosa Mohana; Dinoa, Vanessa de Albuquerque; Teixeira, Sonia Marcelino [Hospital Universitario Antonio Pedro (HUAP), Niteroi, RJ (Brazil). Servico de Radiologia; Marchiori, Edson; Vianna, Alberto Domingues [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Morais, Heleno Pinto de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Patologia

    1997-05-01

    The authors report a case of an 11-year-old girl with asthenia, anemia and right supraclavicular tumor. The chest roentgenogram and computed tomography showed a heterogeneous soft tissue mass with peripheral calcifications, beside the scapula. The histologic diagnosis after surgery was an angiomatoid fibrous histiocytoma. This rare type of tumor tend to occur in young adults and have a borderline feature, and it is described in the literature as a low-grade, malignant fibrous histiocytoma. the authors describe its radiological and histological findings. (author) 6 refs., 2 figs.

  11. Chronic lead poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Hess, K.; Straub, P.W.

    1974-02-19

    A detailed description is given of the complex pathological picture observed in the case of a worker with 30 years' occupational exposure to lead in an accumulator factory (evolution of the disease, clinical findings, autopsy). In spite of a typical clinical picture, lead is not held responsible for the terminal encephalopathy, in view of the fact that Alzheimer's syndrome was discovered at autopsy. However, the neurovegetative asthenia and progressive kidney disease without hypertonia, but with uraemia, which preceded the encephalopathy are in all probability due to chronic lead poisoning. The article discusses the diagnosis and symptomatology of chronic lead poisoning, encephalopathy and kidney disease.

  12. Micronodular inflammatory pseudotumor of the liver presenting in a patient with hemochromatosis; Presentacion en forma micronodular de seudotumor inflamatorio hepatico en un paciente con hemocromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, F.; Ysamat, R.; Canis, M. [H. R. U. Reina Sofia. Cordoba (Spain); Roman, G. [Hospital Infant Margarita. Cabra Cordoba (Spain)

    1999-07-01

    Inflammatory pseudotumor is a benign lesion of unknown etiology that is characterized histologically by a chronic inflammatory infiltrate and fibroblast proliferation. The presenting signs include pain in right upper quadrant, palpable mass or hepatomegaly, fever asthenia and weight loss. Ultrasonography and computed tomography show a solitary mass. The presence of more than one lesion is uncommon and the masses generally measure more than 2 cm. We present a case of diffuse micronodular inflammatory pseudotumor of the liver in a patient with cirrhosis of the liver secondary to hemochromatosis. (Author) 8 refs.

  13. A case of suspect “cyanosis”

    Directory of Open Access Journals (Sweden)

    Elisabetta Antonucci

    2013-05-01

    Full Text Available CLINICAL CASE A 70-year old woman was admitted to our hospital because of fever, asthenia and a suspected stroke. Her medical history showed a congenital cardiopathy (Patent Foramen Ovale, PFO. Skin and oral mucosa pigmentation, orthostatic hypotension, hypoglycemia and hyponatriemia arose the suspect of Addison’s disease. The diagnosis was confirmed by the evaluation of basal levels of plasma ACTH and serum cortisol, and serum cortisol levels after ACTH stimulation. Abdominal CT scan showed atrophy and calcification of adrenal glands. CONCLUSIONS In most cases, Addison’s disease is provoked by autoimmune destruction of the adrenal cortex; however, in our reported patient, tuberculosis could be a possible cause.

  14. Study on the Relevance between Cirrhosis Syndrome Types of TCM and Biological Detection Indexes%肝硬化证型与生物学指标相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘倩; 王晓素

    2012-01-01

    Objective:Chromic hepatitis B liver cirrhosis differentiation of symptoms and signs for classification of syndrome and relevance of biological indicators were studied, so as to provide some reference for liver cirrhosis differentiation of symptoms and signs for classification of syndrome. Methods: 170 liver cirrhosis patients chosen by adoption standards were investigated systematically. General states of health, case history, general state of health were collected for syndrome differentiation. Liver function ( ALT, AST, AKP, GGT, Alb, PA, STB, CB, BA ), HA, PT, lipid ( CHO, TG, HDL, LDL, Apo-Al ), and other indicators of modern medicine were detected simultaneously. Information database was established to understand the distribution characteristics of the disease. One-factor ANOVA was applied to investigate the relevance between the differentiation of symptoms and signs for classification of syndrome and objective index. Results : Endoretention of damp-heat and hepatic and renal yin deficiency are most common in syndrome types of TCM distribution. For endoretention of damp-heat and asdthenic splenonephro-yang, AST is higher. While for splenic asthenia phlegmatic hygrosis, AST is very low. The difference between endoretention of damp-heat and splenic asthenia phlegmatic hygrosis is significant (P hepatic and renal yin deficiency> blood stasis resistanre> endoretention of damp-heat> splenic asthenia phlegmatic hygrosis> asdthenic splenonephro-yang (P blood stasis resistance> splenic asthenia phlegmatic hygrosis> stagnation of liver-QI> hepatic and renal yin deficiency> endoretention of damp heat (P endoretention of damp heat> splenic asthenia phlegmatic hygrosis> blood stasis resistance> hepatic and renal yin deficiency> stagnation of liver-QI (P asdthenic splenonephro-yang >blood stasis resistance> splenic asthenia phlegmatic hygrosis> hepatic and renal yin deficiency> depression of liver-QI. Stagnation of liver-QI, hepatic and renal yin deficiency, splenic

  15. Clinical studies of patients with peptic ulcer TCM constitution%消化性溃疡患者中医体质的临床研究

    Institute of Scientific and Technical Information of China (English)

    徐瑾; 刘军

    2014-01-01

    Objective To investigate the clinical characteristics of TCM constitution in patients with peptic ulcer. Methods Used the cross-sectional study method, through the questionnaire survey to collect the general situation of patients and determine physical type. Descriptive analysis and χ2 test and other sstatistical methods to analyze the law of patient’s TCM constitution,as well as the relevance of Hp infection, diet etc. Results Patients with constitution of yang asthenia were the most, accounting for 21.5%. There were significant differences in infecting Hp, which between patients of constitution of yang asthenia and others (P<0.05). In the warm food for a significant difference between the two(P<0.01). Conclusion Constitution of yang asthenia is multiple physical in the patients, and it is susceptible to Hp. There is a certain correlation between fitness and diet. In future work should focus on prevention and treatrment of the patients who have constitution of yang asthenia.%目的:探讨消化性溃疡患者中医体质的临床特点。方法采用横断面研究方法,通过调查问卷收集患者的一般情况、判断体质类型,采用描述性分析、χ2检验等统计学方法,分析消化性溃疡患者体质的分布规律及其与Hp感染、饮食等的相关性。结果消化性溃疡患者体质以阳虚质患者最多,占21.5%,阳虚质患者较非阳虚患者感染Hp有显著差异(P<0.05)。在温热饮食方面,阳虚质患者与非阳虚患者存在差异(P<0.01)。结论阳虚质为消化性溃疡的易感体质,且易感染Hp。体质与饮食有一定的相关性。在今后的防治工作中应重点关注阳虚质人群。

  16. Residual tissue post splenectomy detected by splenic scintillography with erythrocytes damaged by heat; Tejido residual postesplenectomia detectado por centellografia esplenica con eritrocitos danados por calor

    Energy Technology Data Exchange (ETDEWEB)

    Rivera B, B.; Garcia C, E.S.; Garcia O, J.R. [Centro Medico ABC, Departamento de Medicina Nuclear, Mexico, D.F. (Mexico)

    2005-07-01

    Feminine of 26 years old with diagnostic of purple thrombocytopenic idiopathic to those 4 years of age, tried with steroids and splenectomy at 11 years old. Pathway practically asymptomatic until 4 months ago she had presented asthenia, adynamia and general uneasiness, with platelet figures of 40,000 plat/microliter. It was carried out scintillographic study with damaged erythrocytes for post surgical remainder search. Its were took two-dimensional images and tomography by single photon emission (SPECT), being knitted splenic residual in area of anatomical projection of the spleen. (Author)

  17. 中医体质与皮肤粗糙度、平滑度、皱纹的相关性研究%Study on the relationship between Traditional Chinese Medicine Constitution and smoothness ,roughness and texture

    Institute of Scientific and Technical Information of China (English)

    徐艳明; 王雪; 张宁; 杨智荣; 井丽巍; 李艳微; 刘国良

    2012-01-01

    Objective The paper aims to study the relationship of women skin's smoothness,roughness.texture and the constitution of traditional Chinese Medicine in the region of Heilongjiang Province. Methods 105 female volunteer were chosen, they were classified physically according to Wang Qi's "Seven Classification",and the parameter value of smoothness,roughness,texture in the skin of visor,canthus,neck,pleurobranch,backside and cubitus were detected. Results Compared with the gentle group, the value of roughness of jowl in constitution of yin asthenia, constitution of qi stagnation are decreaed (P<0.05). The value of texture of canthus in constitution of yin asthenia, constitution of qi asthenia, constitution of qi stagnation are increased (P<0.05),the value of texture of antebrachium in constitution of damp-heat are increaed (P<0.05). The value of roughness of canthus in constitution of yang asthenia are increaed (P< 0.05),the value of roughness of neck in constitution of qi stagnation are increaed (P<0.05). Conclusion The different constitution of traditional Chinese Medicine affects roughness,smoothness and texture differently.%目的:研究黑龙江籍汉族女性体质与皮肤粗糙度,平滑度,皱纹的关系.方法:选取105名女性健康自愿者,根据王琦的“七分法”对其进行体质分型并检测其面颊、眼角、颈部、侧胸部、背部、前臂屈侧皮肤的平滑度,皱纹,粗糙度.结果:与平和体质相比,阴虚体质、气虚体质、气郁体质面颊部平滑度明显降低(P<0.05);气虚体质、气郁体质眼角部位,湿热体质前臂屈侧部位皱纹明显增加(P<0.05);阳虚体质眼角部位,气郁体质颈部明显粗糙(P<0.05).结论:不同体质不同部位的皮肤粗糙度,平滑度,皱纹存在一定的差异性.

  18. A Clinical Study on Characteristics of TCM Syndrome Elements in Upper Airway Cough Syndrome%上气道咳嗽综合征中医证素特点的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈文喜; 洪敏俐; 刘朝辉; 杨朝阳; 郑伟斌; 黄小华; 李灿东

    2012-01-01

    Objective: To investigate the characteristics of syndrome elements in patients with upper airway cough Syndrome (UACS). Methods: Patients with UACS who met the inclusion and exclusion criteria of UACS were observed by syndrome elements differentiation methods. The syndrome elements of the disease location and the disease nature were extracted by syndrome elements differentiation. The features of TCM pathology of UACS were analyzed with mathematical statistics methods. Results: The syndrome element of the disease location lung appeared more frequently than exterior, liver and stomach. The syndrome element of the disease nature phlegm appeared more frequently than heat, qi stagnation, dampness, cold, retention of fluid, yin asthenia, yang asthenia, qi asthenia and blood asthenia. And only the average integrals of syndrome elements lung and phlegm were above 150,which were regarded as severe lesion. Conclusion: The core disease location of UACS is lung, which could company with exterior, liver and stomach. The primary disease nature of UACS was phlegm which could be concurrence of cold and heat, deficiency and excess. The production of phlegm due to lung qi depression is the key pathological mechanism of UACS.%目的 探讨上气道咳嗽综合征(UACS)患者中医证素特征.方法 采用“证素辨证”方法,提取患者病位、病性证素,对其进行统计分析,探讨本病的中医病理特征.结果 UACS病位证素肺频数显著高于表、肝、胃;病性证素痰频数显著高于热、气滞、湿、寒、饮、阴虚、阳虚、气虚、血虚;并且只有肺和痰两个证素平均积分超过150,为重度病变.结论 UACS核心病位在肺,可兼表、肝、胃;病性以痰为主,寒热虚实互见,肺气郁而生痰是UACS的核心病理机制.

  19. Study on Correlation between Thoracic Obstruction Syndrome and Result of Coronary Angiography%胸痹辨证分型与冠状动脉造影结果相关性分析

    Institute of Scientific and Technical Information of China (English)

    江磊磊; 刘福明; 梅晓云

    2012-01-01

    Objective: To study the relation between thoracic obstruction syndrome and result of coronary angiography, so that the objective proof and treatment of thoracic obstruction diagnosis can be offered. Methods: Retrospective study was carried on 844 thoracic obstruction patients with coronary angiography results,and the relation between thoracic obstruction syndrome and results of coronary angiography was studied. Results:Statistical analysis showed that there was obvious difference in obstruction numbers (P =0.001 )and obstruction degree( P =0. 003 ) in different syndromes. The max obstruction proportion was phlegm and blood-stasis group among the three branches obstruction, subsequent proportion was Qi asthenia and blood-stasis group. The max obstruction proportion was also phlegm and blood stasis group in positive cases with coronary angiography .subsequent proportion was Qi asthenia and phlegm-stasis group. Conclusion: The most dangerous syndrome of thoracic obstruction is phlegm and blood stasis,and Qi asthenia and blood-stasis and Qi asthenia and phlegm-stasis are less dangerous syndromes.%目的:探讨胸痹证型与冠状动脉造影结果的关系,为胸痹的诊断及治疗提供客观依据.方法:对心内科确诊为胸痹且行冠状动脉造影的844例患者进行回顾性调查,观察胸痹各证型与冠状动脉造影结果的关系.结果:经统计学检验,不同证型在阻滞支数上有极显著性差异(P=0.001),在阻塞程度上有极显著性差异(P=0.003).3支阻塞比例最高者为痰瘀互结组,其次为气虚血瘀组;冠脉造影阳性者中,比例最高者亦为痰瘀互结组,其次为气虚痰瘀组.结论:痰瘀互结证为胸痹最危险证型,其次为气虚血瘀和气虚痰瘀证.

  20. New Line of Investigation in Rehabilitation of Patients Suffered from Hemorrhagic Fever with Renal Syndrome

    Directory of Open Access Journals (Sweden)

    G. M. Khasanova

    2011-01-01

    Full Text Available A new educational program for patients suffered from hemorrhagic fever with renal syndrome was worked out and applied into practice for the first time. It was revealed that patient teaching increased patient complianceand improved rehabilitation results for sure. Asthenia symptoms, arterial hypertension and inflammatory processes in uringenital system were recorded more rarely with such patients for certain. The efficiency of this educational program in combined rehabilitation after cases of hemorrhagic fever with renal syndrome proves its advisability of wide application in medical and preventive treatment institutions.

  1. Peculiarities of occurrence and progress of border-line conditions under low radiation dose rate impact

    International Nuclear Information System (INIS)

    In past years more and more attention is drawn to condition of psychic health of population groups working under unhealthy labor conditions. In relation to this there were studied peculiarities of occurrence and progress of affective disorder at Institute of Atomic Energy of the National Nuclear Center of the Republic of Kazakhstan employees. The study conducted showed high level of affective disorder occurrence and intensity of asthenia manifestations in a number of cases prevailing, in essence, affective disorders. Where at asthenia disorders do not correlate with the intensity of somatic background. It is necessary to note that environment factors played considerable role in formation of depression in the examined persons. Investigation results indicate the necessity to elaborate large prophylactic, therapeutic and rehabilitation actions for persons, that are deemed mentally healthy and not needing psychiatric help, for the purpose of detection and elimination of erased affective disorders. In the field of mental disease prophylaxis the group of disorders determined as 'pre-disease' or 'border-line variants of psychic health' are of interest. (author)

  2. Generalized skin rash due to zoledronic acid%唑来膦酸致全身皮疹

    Institute of Scientific and Technical Information of China (English)

    刘剑锋; 冯巧飞

    2012-01-01

    1例57岁女性患者因重度骨质疏松症给予碳酸钙和骨化三醇口服,1周后,给予唑来膦酸5 mg溶于0 9%氯化钠注射液100 ml静脉滴注.第2天,患者出现发热、全身皮疹,头晕、乏力、关节疼痛及双下肢肌肉酸痛.立即给予地塞米松、氯雷他定.第7天,患者头晕、乏力、关节疼痛及双下肢肌肉酸痛等症状消失,体温降至正常.第10天皮疹完全消退.%A 57-year- old woman received oral calcium carbonate and calcitriol for severe osteoporosis. One week later, an IV infusion of zoledronic acid 5 mg dissolved in 0. 9% sodium chloride solution 100 ml was given. On day 2, she developed fever, generalized skin rash, dizziness, asthenia, as well as joint pain and muscle aches in her lower limbs. She was given dexamethasone and loratadine immediately. On day 7, her clinical symptoms such as dizziness, asthenia, as well as joint pain and muscle aches in her lower limbs disappeared, and her body temperature returned to normal. On day 10, her skin rash completely disappeared.

  3. 赵坤教授治疗小儿秋季腹泻的经验%Experience of Professor ZHAO Kun in treating autumn diarrhea

    Institute of Scientific and Technical Information of China (English)

    李芳; 赵坤

    2012-01-01

      赵坤教授认为小儿秋季腹泻病因病机乃外邪侵犯,脾虚湿盛而致。以从“湿”治泄为基本原则,并辨虚实寒热。根据症候表现将秋季腹泻分为寒湿泻、湿热泻、伤食泻、脾胃虚弱四型。分别用藿香正气散加味、葛根黄芩黄连汤加味、自拟健脾止泻汤加味、参苓白术散或七味白术散加减,临床疗效显著。%  Professor Zhao Kun considered that pediatric autumn diarrhea was caused by encroachment of exogenous evil and damp abundance due to splenic asthenia, therefore, it should be treated in the basic principle of treating diarrhea from dampness and distinguishing asthenia and sthenia, chills and fever. Autumn diarrhea was separated into four types on the basis of symptoms, cold-damp diarrhea, hygropyretic diarrhea, diarrhea due to improper diet and weakness of the spleen and stomach. It was effective if treated with modified Huoxiang Zhengqi powder, modified Gegen Huangqin Huanglian decoction, modified Jianpi Zhixie decoction, and Shenqin Baizhu powder or modified Qiwei Baizhu powder, respectively.

  4. Wuji Baifeng Wan White Phoenix Bolus of Black-Bone Chicken 乌鸡白凤丸

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@*Source It is a modified recipe from "Shoushi Baoyuan" (Preserving Essence to Extending Life-span) by Gong Tingxian of Ming Dynasty in beginning of 17th century, the imperial hospital listed as specific drug for royal palace. Carried in Pharmacopoeia of P.R.China (1995 Edition) *Chief Ingredients Black-bone chicken, Antler glue, Turtle shell, Oyster shell, Mantis egg-case, Ginseng root, Milkvetch root, Chinese angelica root, White peony root, Nutgrass flatsedge rhizome, Lucid asparagus root, Licorice root, Rehmannia root, Prepared rehmannia root, Chuanxiong rhizome, Stellaria root, Red sage root, Chinese yam, Gordon euryale seed, Deglued antler powder. *Explanation The black-bone chicken can replenish Liver and Kidney, Qi and blood, serve as principal drug; Antler glue, Mantis warm Kidney Yang while Turtle and Oyster shell, Asparagus, Stellaria nourish Yin to clear asthenia heat, Ginseng, Milkvetch, Yam, Licorice, Euryale tonify Spleen Qi, and Chinese angelica, Chuanxiong, Peony, Rehmannia, Red sage replenish blood and regulate menstruation. *Function Replenishing Qi and nourishing blood, regulating menstruation and arresting vaginal discharge *Indication Deficiency of both Qi and blood, pathological wasting and asthenia, aching and weak loins and knees, irregular menstruation, metrorrhagia metrostaxis, leukorrhagia

  5. Wuji Baifeng Wan White Phoenix Bolus of Black-Bone Chicken

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    *Source It is a modified recipe from "Shoushi Baoyuan" (Preserving Essence to Extending Life-span) by Gong Tingxian of Ming Dynasty in beginning of 17th century, the imperial hospital listed as specific drug for royal palace. Carried in Pharmacopoeia of P.R.China (1995 Edition)  *Chief Ingredients Black-bone chicken, Antler glue, Turtle shell, Oyster shell, Mantis egg-case, Ginseng root, Milkvetch root, Chinese angelica root, White peony root, Nutgrass flatsedge rhizome, Lucid asparagus root, Licorice root, Rehmannia root, Prepared rehmannia root, Chuanxiong rhizome, Stellaria root, Red sage root, Chinese yam, Gordon euryale seed, Deglued antler powder.  *Explanation The black-bone chicken can replenish Liver and Kidney, Qi and blood, serve as principal drug; Antler glue, Mantis warm Kidney Yang while Turtle and Oyster shell, Asparagus, Stellaria nourish Yin to clear asthenia heat, Ginseng, Milkvetch, Yam, Licorice, Euryale tonify Spleen Qi, and Chinese angelica, Chuanxiong, Peony, Rehmannia, Red sage replenish blood and regulate menstruation.  *Function Replenishing Qi and nourishing blood, regulating menstruation and arresting vaginal discharge  *Indication Deficiency of both Qi and blood, pathological wasting and asthenia, aching and weak loins and knees, irregular menstruation, metrorrhagia metrostaxis, leukorrhagia……

  6. Nourishing Kidney, Invigorating Spleen and Clearing away Turbidity Therapy for Chronic Renal Failure%益肾健脾清利化浊法治疗慢性肾功能不全

    Institute of Scientific and Technical Information of China (English)

    叶景华; 张彤; 盖云; 蔡艳

    2011-01-01

    The dysfunction of spleen and kidney is the fundamental pathogenesis of chronic renal failure (CRF) and its pathology manifests mixture of asthenia and sthenia, and deficiency in the root and excess in the branch.The deficiency in the root is asthenia of spleen and kidney and the excess in the branch is the retention of dampness, turbid and stasis.So nourishing kidney and invigorating spleen are the key of treatment based on syndrome differentiation of CRF, and clearing away turbidity is the emphasis for dispelling pathogenic factor.%脾肾功能失常是慢性肾功能不全的根本病机,病变过程为虚实夹杂、本虚标实.本虚为脾肾虚衰,标实为湿、浊、瘀毒留滞,因此,益肾健脾为慢性肾衰辨证论治的关键,而清利化浊为消除慢性肾功能不全增恶因素的重点.

  7. 老年人干咳的临床特点及治疗分析%Clinical Characteristics and Treatment Analysis of Dry Cough in the Aged People

    Institute of Scientific and Technical Information of China (English)

    冯建庄

    2009-01-01

    因发病原因、年龄、个体差异、用药情况、所患疾病不同,老年人干咳证型各异,临床以虚证为多(虚则肺肾气虚或者气阴两虚),又可见虚实夹杂(卫外不固则外邪易于侵袭而内外合邪):且受多种因素影响(如药物、便秘、腰腿疼及中风、消渴、心悸等合并症);投药当轻灵、施治宜平稳,以免因咳嗽诱发其他疾病而出现意外.%The symptoms of dry cough in the aged people differs due to different cause, age, individual difference, and medication. Clinically, the disease mainly shows as asthenia type (qi deficiency of lung and kidney or deficiency of both qi and yin), or complication of sthenia and asthenia (invasion of external pathogens combined with internal pathogens), besides it affected by many factors (such as medicines, constipation, stroke, diabetes, and palpitation). Therefore, medicines should be used in lights dose and smartly to prevent accidents caused by induced factors.

  8. Investigation and Analysis of Dunhuang Ancient Decoction for Treatment of Seborrhea Dermatitis%治白屑头风痒的敦煌古医方考析

    Institute of Scientific and Technical Information of China (English)

    王凤仪; 赵党生

    2015-01-01

    Objective: The prescription principles of 5 ancient decoctions selected from Dunhuang inherited medical literatures for treating seborrhea dermatitis were analyzed in the paper to define the main diseases the decoc-tions treated, including seborrhea dermatitis, tinea capitis and alopecia areata. The syndromes can be classified into asthenia and sthenia and the prescription should be chosen according to diseases and syndromes differentiation as well as identification of the sthenia and asthenia.%分析了敦煌遗书医药文献中涉及治疗白屑头风痒类疾病的5首古医方的组方含义,明确了5首敦煌古医方主治疾病包括白屑风、白秃疮、油风。证型可分虚实两大类,临床应当辨病辨证、分别虚实而择方使用。

  9. Progress in the treatment of chronic nephritis proteinuria with traditional Chinese medicine%慢性肾炎蛋白尿的中医治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    闫丽丽; 盛梅笑

    2010-01-01

    慢性肾炎蛋白尿的主要病机特点为本虚标实证,脾肾气虚为本,风邪、湿热、瘀毒为标,湿热贯穿于病程的始终.治法从脾、肾、肝、肺等入手,兼以清利湿热、祛风、摄精固涩等,久病重症者可加用虫类药物,配合活血化瘀也具有较好的疗效.%The main characteristic in pathogenesis of chronic nephritis proteinuria is asthenia in origin and asthenia in superficiality,which is Qi deficiency of spleen and kidney seaing the deficient foundation,and pathogenic wind,dampness-heat,and toxic-stasis injuring the body for the whole process of disease.The main therapeutic method is treating from spleen,kidney,liver,and lung,accompanied by the methods of clearing heat,removing dampness,expelling wind,and tonifying kidney to control nocturnal emission.In addition.patients with severe chronic illness should add worm medicines and medicines for promoting blood circulation to remove stasis.

  10. 周耀庭教授治疗喘证经验%Experience of Zhou Yaoting for treating asthma

    Institute of Scientific and Technical Information of China (English)

    张伟伟

    2012-01-01

    The experience of professor Zhou Yaoting for treating asthma is discussed. Zhou Yaoting can efficiently treat based on syndrome differentiation many kinds of asthma caused by inner drink evil, outer wind and cold; outer cold and inner heat, hot phlegm; inner phlegm, Qi asthenia in spleen and lung; Yang asthenia in kidney, refusal of Qi in kidney; food sputum attack, outer cold evil and other complicated cases. Zhou Yaoting also thinks it's important to dispel cold, resume the functions of lung for treating asthma.%本文阐述了周耀庭教授治疗喘证的经验.辨证论治治疗饮邪内伏、外感风寒;外寒里热、兼有热痰;痰饮内伏、脾肺气虚;肾阳虚衰、肾不纳气;食痰上犯,外感寒邪等复杂情况的喘证.并强调在治疗喘证时散寒邪、恢复肺宣发肃降功能的重要意义.

  11. Clinical management of carbamazepine intoxication during anti-tubercular treatment: a case report

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    Massimo Calderazzo

    2015-06-01

    Full Text Available We describe a 67-year-old man with medical history of focal post-stroke seizure and type 2 diabetes mellitus treated with carbamazepine, clobazam, gliclazide, insulin glargine, and omeprazole we visited for the onset in the last 7 days of asthenia, cough with mucus, breathing difficulty, chest pain, and weight loss. After clinical and laboratory tests, pulmonary tuberculosis was diagnosed, and a treatment with isoniazid, ethambutol, pyrazinamide rifampicin, and pyridoxine was started. Therapeutic drug monitoring of tuberculosis treatment documented that all drugs were in normal therapeutic range. Four days after the beginning of the treatment, we documented the improvement of fever, and three days later the patient showed sleepiness, visual disorder and asthenia. Clinical and pharmacological evaluation suggested a carbamazepine toxicity probably related to a drug interaction (Drug Interaction Probability Scale score = 6. The impossibility to switch carbamazepine for another antiepileptic drug, due to a resistant form of seizure, induced the discontinuation of tuberculosis treatment, resulting in the normalization of serum carbamazepine levels in one day (10 µg/ml and in the worsening of fever, requiring a new clinical and pharmacological evaluation. The titration dosage of carbamazepine and its therapeutic drug monitoring allowed to continue the treatment with both antitubercular drugs and carbamazepine, without the development of adverse drug reactions. To date, tuberculosis treatment was stopped and clinical evaluation, radiology and microbiology assays documented the absence of tubercular infection and no seizures appeared (carbamazepine dosage 800 mg/bid; serum levels 9.5 µg/ml.

  12. 亚健康状态人群的中医辨识及影响因素%Chinese Medicine Identification and Effective Factors Analysis in Sub-healthy People

    Institute of Scientific and Technical Information of China (English)

    黄彦; 黄袆; 张太君; 江洪; 成建国

    2012-01-01

    目的 调查重庆市体检人群,并对其中的亚健康状态人群的相关特点进行分析,了解重庆市亚健康状态人群的流行病学特点及相关中医体质特征、心理状态、应对方式等及其相关影响因素.方法 采用《个人身心健康调查量表》进行流行病学横断面调查,利用EPI软件建立数据库,以SPSS软件进行数据处理和统计分析.结果 亚健康状态以30岁以下人群发生率最高,以大专以上学历人群多见,职业特点以脑力劳动为主,与过度劳累、经济困难、人际关系不协调、婚姻问题等应激事件密切相关.亚健康状态人群中医体质主要以阳虚质和气虚质为主;SCL-90量表各因子阳性结果发生率明显高于健康人群,社会应对方式趋向以消极应对为主,生活质量评价明显低于健康人群水平.结论 亚健康状态是心身相关的失衡状态,对于亚健康状态人群的干预,需要综合考虑其心理及社会适应能力,尽量避免应激事件的发生,并注重对中医阳虚质和气虚质人群的重点干预.%Objective: To investigate epidemiology characters, relative TCM constitution characters, mentation, coping methods and other relative factors. Methods: Individual physical and moral health investigation scale was used to complete epidemiology cross section investigation. EPI software was used to establish database. SPSS was used to analyze data and do statistical analysis. Results: Sub-health status was common in these people below 35 years old and above junior college educational background. Their career characters were headwork mainly, closely related with some stress events:Overwork, Financial difficulties, Interpersonal disharmony, Marriage issue etc. Sub-health people were maily asthenia constitution especially yin asthenia and yang asthenia; Each factor average in SCL-90 scale was higher than that in healthy people. Society coping methods tended to depression and their life quality scores

  13. Correlation between Syndrome Differentiation and Treatment Uariation of Metabolic Syndrome and Urine Trace Albumin and Intima Media Thickness%代谢综合征中医辨证分型与尿微量白蛋白及颈动脉内膜中层厚度关系

    Institute of Scientific and Technical Information of China (English)

    赵娜; 刘莉; 隋艳波

    2015-01-01

    Objective:To explore the relationship between the urine trace albumin and intima media thickness among Met-abolic Syndrome ( MS) patients with different traditional Chinese medicine( TCM) syndromes, and to provide some ob-jective basis for syndrome differentiation and treatment variation.Methods:Eighty patients were enrolled and assigned to inter-stagnation phlegm and blood stasis type, Qi stagnation and dampness obstruction type, Qi asthenia of the spleen and kidney type, asthenia of Qi and Yin type according to TCM syndrome.Ccompare the general information,the urine trace albumin and intima media thickness among them.Results:MAU of MS patients with inter-stagnation phlegm and blood stasis type was higher than Qi stagnation and dampness obstruction type and Qi asthenia of the spleen and kidney type ( P<0.05 ); IMT of MS patients with inter-stagnation phlegm and blood stasis type was much greater than Qi stagnation and dampness obstruction type (P<0.01), and was also greater than Qi asthenia of the spleen and kidney type and asthenia of Qi and Yin type (P<0.05).Conclusion:MS patients with inter-stagnation phlegm and blood sta-sis type shouldpay more attention to the prevention and treatment of renal and vascular complications,and urine trace al-bumin and intima media thickness can be a reference of traditional Chinese medicine in patients with MS.%目的:探讨代谢综合征( MS)患者不同中医证型的尿微量白蛋白及颈动脉内膜中层厚度的关系,为中医辨证论治提供一定的客观依据。方法:选择MS患者80例,根据中医证候分为痰瘀互结型,气滞湿阻型,脾肾气虚型和气阴两虚型。对患者的一般资料、尿微量白蛋白检测结果及颈动脉内膜中层厚度进行比较。结果:MS痰瘀互结型患者的MAU高于气滞湿阻型及脾肾气虚型( P<0.05);MS痰瘀互结型患者的IMT大于气滞湿阻型(P<0.01),大于脾肾气虚型及气阴两虚型(P<0.05)

  14. The symptoms of pathological fatigue, apathy, and depression in patients after stroke

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    M. A. Kutlubaev

    2015-06-01

    Full Text Available Objective: to comparatively analyze the rate and correlation of the symptoms of pathological fatigue, apathy, and depression in patients in the termination phase of an acute stroke period.Patients and methods. The symptoms of asthenia (pathological fatigue, apathy, and depression were comparatively investigated in 105 patients at 3–4 weeks after stroke. The fatigue rating scale, apathy rating scale, and hospital anxiety and depression (HAD scale were used to evaluate the symptoms of pathological fatigue, apathy, and depression. The level of anxiety was also estimated using the appropriate HAD subscale and the Epworth daytime sleepiness scale; the magnitude of cognitive impairments was judged from the Montreal cognitive assessment. The type, basin, and recurrence of stroke were registered. The severity of neurological deficit was evaluated using the U.S. National Institutes of Health Stroke Scale (NIHSS; limited functional capacities were estimated by the modified Rankin scale (mRS. The presence of prestroke fatigue was also determined.Results and discussion. The symptoms of asthenia were observed in 56% of the patients and associated with the severity of poststroke disability. The symptoms of apathy were detected in 10.5% of the patients; those of depression were present in 18% and determined by the magnitude of neurological deficit and the degree of poststroke disability and cognitive impairments. All the three phenomena were correlated with the magnitude of anxiety, daytime sleepiness, and between them. This suggests that they may complicate a reciprocal course in some cases. The symptoms of depression, asthenia, and apathy may also develop on their own, which is borne out by their different rates and correlations. Each of these phenomena requires an individual approach to diagnosis and treatment.Conclusion. The symptoms of pathological fatigue are most common and least specific in patients with mild poststroke neurological deficit

  15. Clinical and epidemiological aspects of a hepatitis E outbreak in Bangui, Central African Republic

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    Komas Narcisse P

    2011-04-01

    Full Text Available Abstract Background Outbreaks of hepatitis E frequently occur in tropical developing countries during the rainy season due to overflowing drains, short-circuiting of networks of clean water and use of contaminated water from wells. Hepatitis E virus (HEV infections are usually accompanied by general symptoms of acute liver disease. This study was conducted to define the clinical and epidemiological aspects of the HEV outbreak that occurred in May 2004 in Bangui. Methods Blood samples were collected from 411 patients aged 1-87 years, most of whom presented with jaundice, asthenia or signs of uncomplicated malaria, for a transversal study from June 2004 to September 2005. Patients were recruited at 11 health care centres, including two referral hospitals, after they had given informed consent. The diagnosis of HEV was made with a commercial ELISA test to detect IgM and/or IgG antibodies. HEV RNA was amplified by RT-PCR to confirm the presence of the viral genome. Results The most frequent clinical signs found were jaundice (93.4%, vomiting (50.7%, hepatalgia (47.4%, hepatomegaly (30.9% and asthenia (26.8%, which are the general clinical signs of hepatic disease. Acute hepatitis E was found in 213 patients (51.8% who were positive for HEV IgM antibodies. The IgG anti-HEV seroprevalence during this outbreak was high (79.5%. The age group 18-34 years was more frequently infected (91.2% than those aged 1-17 (78.0% or over 34 (64.9% (p -6. RT-PCR performed on 127 sera from the 213 IgM-HEV-positive patients was amplified, and the presence of the viral genome was found in 65 samples. Conclusion Although no specific clinical signs exist for hepatitis E infection, people presenting with jaundice, vomiting, hepatalgia, asthenia, hepatomegaly or distended abdomen with no signs of uncomplicated malaria in tropical developing countries should be sent to a laboratory for testing for hepatitis E.

  16. Elevated muscle enzyme levels due to aztreonam%氨曲南致肌酶水平升高

    Institute of Scientific and Technical Information of China (English)

    段丹丹; 李建华

    2012-01-01

    1例47岁女性患者因盆腔炎给予氨曲南1.0 g入0.9%氯化钠注射液250 ml静脉滴注2次/d,替硝唑0.4 g静脉滴注2次/d,保妇康栓1粒/d(阴道给药).用药第4天患者出现乏力,实验室检查示肌酸激酶(CK) 764 U/L,乳酸脱氢酶(LDH)357 U/L,α-羟丁酸脱酸酶(α-HBDH) 293 U/L.次日停用氨曲南,其他药物未变.停用氨曲南第5天乏力缓解,CK 257 U/L,LDH 351 U/L,α-HBDH 162 U/L;第9天乏力消失,CK 166 U/L,LDH 331 U/L,α-HBDH 156 U/L,均在正常范围内.%A 47-year-old female received an IV infusion of aztreonam 1.0 g in 0. 9% sodium chloride 250 ml twice daily, an IV infusion of tinidazole 0. 4 g twice daily and vaginal administration of one Baofukang (保妇康 ) suppository once daily for pelvic inflammation. Four days after drug administration, the patient developed asthenia. Laboratory tests revealed the following levels; creatine kinase ( CK ) 764 U/L, lactate dehydrogenase ( LDH ) 357 U/L, a-hydroxybutyrate dehydroge nase( α-HBDH ) 293 U/L. Aztreonam was withdrawn and her other medications remained unchanged. On the fifth day after aztreonam withdrawal! her asthenia improved. She had a CK level of 257 U/L, a LDH level of 351 U/L and a a-HBDH level of 162 U/L. On the ninth day after aztreonam withdrawal, her asthenia disappeared. Her CK( 166 U/L ), LDH ( 331 U/L ) and a-HBDH ( 156 U/L ) levels were within normal range.

  17. Cluster Analysis Research of TCM Syndrome of Knee Osteoarthritis%膝关节骨性关节炎中医证素的聚类分析研究

    Institute of Scientific and Technical Information of China (English)

    黄木全; 王勇

    2012-01-01

    Objective:Study the pathomechanism of knee osteoarthritis( KOA) and provide basis for the treatment. Methods:Observe syndrome represent of 232 cases with KOA by syndrome analysis method. Analyze the syndrome pattern and pathogenesis through cluster a-nalysis. Results:The syndrome pattern is kidney, liver, spleen, qi. asthenia, blood-deficiency, yang deficiency, haemostasis, pathogen dampness,qi stagnation and phlegm muddy in 232 cases with KOA. Cluster analysis has 8 species;kidney asthenia with qi-stagnancy and Blood stasis, spleen and kidney debility with downward flow of dampness, liver and kidney debility with haemostasis and liver and kidney debility with phlegm blocking. Conclusion:KOA pathogenesis based on kidney asthenia. Liver and spleen imbalance,blood stasis and phlegmatic hygrosis endogeny are the main pathogenesis characteristics.%目的:探讨膝关节骨性关节炎(KOA)中医病理机制,为该病的治疗提供依据.方法:采用证素分析的方法,观察232例KOA患者的证素表现,并对其常见证素进行聚类分析,总结其常见证型,探讨其病机.结果:232例KOA患者,常见证素有肾虚、肝虚、虚脾、气虚、血虚、阳虚、血瘀、湿邪、气滞、痰浊,聚类分析为8类,证候推断为肾虚兼气滞血瘀、脾肾亏虚兼湿邪下注、肝肾亏虚兼瘀血、肝肾亏虚兼痰瘀阻滞四个证型.结论:KOA病机以肾虚为基础,肝脾失调,血瘀、痰温内生,是其主要病机特点.

  18. Clinical Experience of Professor Gu Renyue in Treating Rheumatic Heart Disease%顾仁樾教授辨治风湿性心脏病经验撷英

    Institute of Scientific and Technical Information of China (English)

    梁知; 章怡祎

    2012-01-01

    The wind, dampness, heat and toxin are the main exogenous pathogenic factors ot rheumatic heail disease, and the asthenia of qi and yin is ihe endopenous pathogenic iaclor. The therapeutic methods are applied based on different phases of rheumaliic heart disease. In the mime of the disease, stagnation nf llie hear! hloml and funclNms of spleen and storoanh should nOL be neglected%风湿性心脏病外因常由风湿热毒邪合而为病,内因多为气阴两伤.治疗应根据其发展的不同阶段分而治之,整个病程中要始终注意“心血瘀阻”这一病理环节,且不可忽视脾胃的作用.

  19. Type I autoimmune hepatitis, inverted psoriasis with psoriatic arthropathy and type 2 diabetes mellitus as complications of a chronic B virus hepatitis treated with interferon - Case report

    Directory of Open Access Journals (Sweden)

    George Săraci

    2012-06-01

    Full Text Available We present the case of a 31 year old male patient, admitted in the 3rd Medical Clinic Cluj-Napoca for asthenia, fatigue, effort hepatalgia,pain located in the legs and small joints of the hands. Patient has been diagnosed a year ago with chronic B viral hepatitis and receivedPeginterferon alpha 2a treatment. After performing clinical and paraclinical exams we established that patient suffers from type I autoimmunehepatitis, inverted psoriasis with psoriatic arthropathy, recent onset of type II diabetes mellitus. These conditions are likely to appear consecutivelyto Interferon therapy. The markers for B virus hepatitis (Ag-HBs, IgM-HBc, AgHBe, ADN-HBV were negative. The evolution was favorableafter therapy with immunosuppressants, corticoids, oral antidiabetics and antisecretors.

  20. Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

    Institute of Scientific and Technical Information of China (English)

    Sang Ock Kim; Sang Young Han; Yang Hyun Baek; Sung Wook Lee; Ji Sun Han; Byung Geun Kim; Jin Han Cho; Kyung Jin Nam

    2011-01-01

    Sorafenib, a multitargeted tyrosine kinase inhibitor, has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC). As the clinical use of sorafenib increases, many adverse effects have been reported, such as hand-foot skin reaction, diarrhea,anorexia, asthenia, alopecia, weight loss, hypertension and arterial thromboembolism. However, there are no prior reports of splenic infarction as an adverse effect of sorafenib. Here, a case of splenic infarction in a patient with HCC who was treated with sorafenib is reported.The patient had no other predisposing factors to explain the splenic infarction except for the administration of sorafenib. The splenic infarction improved after sorafenib was discontinued; however, the HCC progressed.

  1. [Approach to the diagnosis and treatment of chronic anemia secondary to gastrointestinal diseases].

    Science.gov (United States)

    Rodríguez-Moranta, Francisco; Rodríguez-Alonso, Lorena; Guardiola Capón, Jordi

    2014-12-01

    Iron deficiency anemia is the most common type of anemia and can cause asthenia, cognitive and functional impairment, and decompensation of underlying diseases. Iron deficiency anemia is not a disease but is the result of a potentially serious medical problem. Consequently, patients should always undergo investigation of the underlying cause. In men and postmenopausal women, the condition is caused by gastrointestinal loss and malabsorption of iron. In this group, recommended procedures are gastroscopy, colonoscopy and serological testing for celiac disease. If the results of these tests are negative, repeat examinations and iron therapy should be considered. In treatment-refractory or recurrent anemia, the small intestine should be investigated. In this case, the procedure of choice is capsule endoscopy. Iron deficiency anemia should always be treated until iron deposits have returned to normal levels. A wide variety of preparations are available, in both oral and parental formulations. PMID:25443541

  2. Giant right atrial myxoma

    International Nuclear Information System (INIS)

    Primary tumors of the heart are rare, their estimated incidence ranging between 0.0017-0.19%, and among them cardiac myxomas are the most common (50%). Right atrial localization is uncommon, occurring only in 15-20% of cases. Their clinical presentation ranges from an asymptomatic status to the presence of constitutional symptoms or symptoms pointing to the presence of cardiac obstruction or pulmonary embolism. A case is presented of a 36-year-old male patient with a history of asthenia, palpitations and reduced functional capacity. Transthoracic echocardiography revealed a large mass in the right atrium which prolapsed into the right ventricle and obstructed the tricuspid valve. The patient underwent cardiopulmonary bypass surgery and the mass (9x9 cm) was removed without any complication. Histological examination confirmed the diagnosis of myxoma.

  3. Bilineal Acute Leukemia Associated With Fanconi Syndrome: The First Case Report

    Directory of Open Access Journals (Sweden)

    Ghasem Miri-Aliabad

    2016-05-01

    Full Text Available Fanconi syndrome is a metabolic disorder involving dysfunction of the renal proximal tubules, resulting in excessive urinary excretion of several metabolites. Various factors may lead to Fanconi syndrome, as it may be a genetic disease with primary or secondary etiologies, or may be acquired. In this study, we report a unique case of Fanconi syndrome with development of a relatively rare acute leukemia, a condition that has not been reported before. The case was an 8-year-old boy with familial occurrence of Fanconi syndrome, presenting with pallor, asthenia, recurrent infections, growth failure, and a variety of biochemical and hematological abnormalities. After physical examination, radiographic studies, and comprehensive laboratory analyses, Fanconi syndrome associated with bilineal acute leukemia, of myeloid and T-lymphoid lineages, was diagnosed.

  4. Bilineal Acute Leukemia Associated With Fanconi Syndrome: The First Case Report.

    Science.gov (United States)

    Miri-Aliabad, Ghasem; Sadat-Hosseini, Maryam; Dorgalaleh, Akbar

    2016-06-01

    Fanconi syndrome is a metabolic disorder involving dysfunction of the renal proximal tubules, resulting in excessive urinary excretion of several metabolites. Various factors may lead to Fanconi syndrome, as it may be a genetic disease with primary or secondary etiologies, or may be acquired. In this study, we report a unique case of Fanconi syndrome with development of a relatively rare acute leukemia, a condition that has not been reported before. The case was an 8-year-old boy with familial occurrence of Fanconi syndrome, presenting with pallor, asthenia, recurrent infections, growth failure, and a variety of biochemical and hematological abnormalities. After physical examination, radiographic studies, and comprehensive laboratory analyses, Fanconi syndrome associated with bilineal acute leukemia, of myeloid and T-lymphoid lineages, was diagnosed. PMID:27617066

  5. Experience of analogue thinking method in treating ulcer caused by scald%取象比类法治疗烫伤性溃疡的体会

    Institute of Scientific and Technical Information of China (English)

    邹瑞婵; 张国骏

    2013-01-01

    The application experiences of clinical diagnosis and treatment was analyzed by analogue thinking method. Using thinking model of traditional Chinese medicine Yin-Yang and five elements theory were exactly considered in the medical practices. Application of Yin,Yang,exterior,interior,cold,heat,asthenia,sthenia about differentiation of the eight principles was necessary.%以取象比类法解析临床诊治运用体会,贯穿中医天人整体恒动观思维模式,运用阴阳五行学说,总归阴、阳、表、里、寒、热、虚、实八纲辨证的灵活应用.

  6. Churg-Strauss syndrome and hemorragic vasculitis

    Directory of Open Access Journals (Sweden)

    Rui Moreira Marques

    2011-12-01

    Full Text Available Churg-Strauss syndrome (CSS is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2nd, 3rd and 4th fingers of the lefthand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome.

  7. Prolonged QT interval in a man with anorexia nervosa.

    Science.gov (United States)

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  8. An Evaluation of Significance of Herbal Acupuncture on Treating Limb Impediment Among the Children with Development Disabilities

    Directory of Open Access Journals (Sweden)

    Huh Young-Jin

    2004-02-01

    Full Text Available Objectives : This study was conducted to establish a standard and classify suitability in the treatment of limb impediment among the children with development disabilities using bee venom and eight principles herbal acupuncture. Methods : 10 patients with pediatric development disabilities with limb impediment as the main symptoms were chosen in this study. Bee venom herbal acupuncture and eight principles herbal acupuncture treatments were rendered and evaluated responses as well as pursuing most proper treatment methods. Results : 1. Bee venom herbal acupuncture showed a significant effects when used as supplement treatment technique for the children with partial movement, but insignificant for the children whom were unable to move. 2. Bee venom was effective for severe limb impediment and limb asthenia, whileas eight principles herbal acupuncture effective for mild limb impediment and spasticity. 3. Bee venom herbal acupuncture used in conjunction with eight principles herbal acupuncture for treating limb impediment among the children with development disabilities showed general improvement by intensifying muscular strength.

  9. [Isolation of Mycobacterium avium-intracellulare from a hepatic biopsy].

    Science.gov (United States)

    Ruiz, Aroldo; Mederos, Lilian; Capó, Virginia

    2002-01-01

    A 64 years-old patient, who was a farmer suffering from chronic fever for two years, loss of weight and acute asthenia, was studied. He was admitted to "Pedro Kourí" Tropical Medicine Institute where the studies were conducted and revealed a globular sedimentation rate of 116 mm in 2 hours, and anemia of 9,8g% hemoglobin. The laparoscopic study indicated hepatic granulomatosis that was confirmed by hepatic biopsy in which a sample was taken from the liver to be microbiologically and cytologically examined. By microbiological methods, a non-pigmented slowly-growing strain was isolated, which was classified by conventional diagnostic techniques for the non-tuberculous mycobacteria classification and the alternative diagnosing technique known as bidimensional thin layer chromatography to confirm the previous classification and set the mycolic acid patterns. The isolated strain belonged to group III of Rynyon and was identified as Mycobacterium avium-intracellulare. PMID:15849945

  10. Folk medicine used to heal malaria in Calabria (southern Italy

    Directory of Open Access Journals (Sweden)

    Tagarelli Antonio

    2010-09-01

    Full Text Available Abstract In Italy, malaria was an endemic disease that was eradicated by the mid-20th century. This paper evaluates the prophylactic and therapeutic remedies used by folk medicine to cure malaria in Calabria (southern Italy. The data has been collected by analysing works of physicians, ethnographers, folklorists and specialists of the study of Calabrian history between the end of the 19th century and the 20th century. The data collected have allowed us to describe the most common cures used by the Calabrian people to treat malaria and the most evident symptoms of this disease, such as intermittent fever, hepato-spleenomegaly, asthenia and dropsy. This approach uncovered a heterogeneous corpus of empirical, magical and religious remedies, which the authors have investigated as evidences of past "expert medicine" and to verify their real effectiveness in the treatment of malaria.

  11. [Technical guidelines for the prevention, diagnosis and treatment of Zika virus infection].

    Science.gov (United States)

    Barrera-Cruz, Antonio; Díaz-Ramos, Rita Delia; López-Morales, Ana Belem; Grajales-Muñiz, Concepción; Viniegra-Osorio, Arturo; Zaldívar-Cervera, Jaime Antonio; Arriaga-Dávila, José Jesús

    2016-01-01

    Infection Zika virus is an emerging disease in the Americas region, which is caused by Zika virus (ZIKV), an arbovirus of the flavivirus genus. The ZIKV is transmitted by the bite of Aedes mosquitoes, both in urban and jungle area. After the mosquito bite, the disease symptoms usually appear after an incubation period of three to twelve days. The infection may be asymptomatic or presented with fever and not purulent conjunctivitis, headache, myalgia, arthralgia, asthenia, maculopapular rash, edema in lower limbs and, less frequently, retro-orbital pain, anorexia, vomiting, diarrhea or pain abdominal. Symptoms last for 4-7 days and are self-limiting. Neurological and autoimmune complications are rare. Since 2014 it has been detected native circulation of Zika virus in the Americas. So far, there is no specific antiviral treatment or effective vaccine, so it's giving priority symptomatic and supportive treatment for the acute phase and make an early diagnosis of atypical and severe forms. PMID:26960050

  12. Thyrotoxic Hypokalemic Periodic Paralysis (THPP: a challenge for the Emergency Medicine physician in Western countries. A case report

    Directory of Open Access Journals (Sweden)

    F. Stella

    2012-03-01

    Full Text Available Thyrotoxic hypokalemic periodic paralysis (THPP is an endocrine emergency with sudden onset of acute muscle hypo-asthenia associated with severe hypokalemia and normal acid-base balance, due to thyrotoxicosis. It may develop in patients of Asian and Native American descent, but it is very rare and undiagnosed in Western countries. Standard treatment includes β-blockers and thyrostatic drugs, but hypokalemia should not be treated with high potassium doses due to the risk of hyperkalemic rebound. Since early diagnosis and correct treatment can prevent life-threatening cardio-pulmonary complications, the emergency physician should keep in mind this rare possibility. We report a case of a 43 year old Caucasian man presenting at ED with tetraparesis as the first symptom of thyrotoxicosis with no other remarkable symptoms or signs.

  13. Features of emotional sphere of the teachers working in a zone of radiation contamination

    International Nuclear Information System (INIS)

    Availability of negative changes in the development of emotional sphere of teenagers has allowed to assume, that the teachers, working with the surveyed schoolboys, have similar problems. For check of this hypothesis were investigated both the emotional world of the base schools teachers and understanding by the teachers of a pedagogic of the contents of the schoolboys emotional experiences. The features of emotional sphere of the teachers working in conditions of increased radiation, are displayed in a high level of a situational and personal alarm worrying, decrease of activity of a mood, deterioration of a general condition, strengthening of asthenia emotions. The found out changes are displayed stronger at those teachers, which live on territory with a higher level of radiation contamination. A necessity of rendering of a psychological aid for the teachers working at an a zone of the Chernobyl NPP accident is shown

  14. Erratum

    Directory of Open Access Journals (Sweden)

    Barrese V

    2012-03-01

    Full Text Available Barrese V, Miceli F, Soldovieri MV, Ambrosino P, Iannotti FA, Cilio MR, Taglialatela M. Neuronal potassium channel openers in the management of epilepsy: role and potential of retigabine. Clinical Pharmacology: Advances and Applications. 2010;2:225–236.On page 233, left-hand column, second paragraph, line 17 forward, it says:“The most common reasons for discontinuation were dizziness, confusion, somnolence, and asthenia, with the highest proportion of withdrawals in patients receiving retigabine 1200 mg/kg.72 In RESTORE 1, where retigabine was used at 1200 mg/kg, urinary or renal disorders were observed in 12% of patients.”In this passage, both instances of “retigabine 1200 mg/kg” should be “retigabine 1200 mg/day.”Read original article

  15. [Massive pericardial effusion as initial manifestation of hypothyroidism].

    Science.gov (United States)

    Thirone, Ana Cláudia Pelegrinelli; Danieli, Rafael Vinícius; Ribeiro, Vanessa Marajó Fernandes Corrêa

    2012-08-01

    The aim of this study is to report a rare case of massive pericardial effusion as initial manifestation of hypothyroidism. A previously healthy 21-year-old female patient suddenly began presenting dyspnea at rest and lower limb edema. Routine laboratory tests performed at admission showed hypothyroidism (TSH 146.14 mUI/L) and echocardiography showed significant pericardial effusion. Therapy was instituted with levothyroxine, resulting in clinical improvement without pericardiocentesis. The patient was followed up for 1 year, with total remission of dyspnea and edema. However, she developed typical symptoms of hypothyroidism, and remained with asthenia, dyslipidemia, weight gain, and mild pericardial effusion at the end of one year, even with the optimization of the levothyroxine dose. This case highlights the need for early investigation of hypothyroidism in patients with pericardial effusion. PMID:22990643

  16. First report of orchitis in man caused by Brucella abortus biovar 1 in Ecuador.

    Science.gov (United States)

    Ron-Román, Jorge; Saegerman, Claude; Minda-Aluisa, Elizabeth; Benítez-Ortíz, Washington; Brandt, Jef; Douce, Richard

    2012-09-01

    We present a 44-year-old man from a rural community in northern Ecuador who worked on a cattle farm where he was involved with primary veterinary care, including assistance during births (or calving) and placenta retention and artificial insemination, with minimal precautions. In September of 2009, quite abruptly, he developed asthenia and hypersomnia without any apparent cause or symptoms like fever, chills, or night sweats. On November 14, 2009, he suffered from pain and edema in the right testicle that coincided with pain in the abdomen. Clinical, serological, and bacteriological investigations confirmed the first case of unilateral orchitis in man in Ecuador caused by Brucella abortus biovar 1. Because brucellosis is a neglected disease, special attention should be given to it in the training of medical and veterinary students. PMID:22826490

  17. Phyllodes tumor of the breast with lung metastasis

    International Nuclear Information System (INIS)

    The case report of a 63-year-old patient is described, who was admitted to 'Dr. Juan Bruno Zayas Alfonso' Teaching General Hospital of Santiago de Cuba due to persistent dry cough, little expectoration (sometimes yellowish), asthenia and loss of weight. On physical examination a tumor was palpated in the right breast, which was confirmed through sonography and mammogram. The results of the fine-needle biopsy were positive for neoplastic cells, consistent with carcinoma. Chest radiography and computerized axial tomography revealed the presence of lung metastatic images, reason why tumor excision with a safety margin of 2 cm was performed. The presence of phyllodes tumor was confirmed by means of the histopathologic study, so that it was necessary to indicate 3 cycles of chemotherapy (CISCYVADACT scheme), of which only two were administered as the old woman had an unfavorable course and she died 3 months later

  18. Analysis of traditional chinese medical identification and effective factors about sub-healthy people with depressive tendency*%亚健康抑郁倾向人群的中医辨识及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    黄彦; 黄祎; 张太君; 江洪; 成建国

    2013-01-01

    目的 了解亚健康抑郁倾向人群的基本特征,明确其体质类型、心理状态、应对方式、应激事件发生等.方法 采用进行横断面调查,利用EPI软件建立数据库,以SAS8.1软件进行统计分析.结果 抑郁倾向女性易发生,20~40岁人群发生率最高,大专以上学历最多见,职业以党政机关办事人员及专业技术人员为主,并与家庭不和、人际关系不协调、生活环境改变等应激事件有关;抑郁倾向人群以虚性体质(阳虚、阴虚)为主,SCL-90量表各因子阳性结果发生率高于健康人群(P<0.01),社会应对方式以消极应对为主,生活质量评分低于健康人群水平(P<0.05).结论 亚健康抑郁倾向人群女性多见,以虚性体质的高学历、脑力劳动者为主,同时与家庭不和、人际关系不协调、生活环境改变等特定应激事件有关.%Objective To find out traditional chinese medical constitution characters, mentation, coping style and other related factors in sub-healthy people with depressive tendency. Methods Individual Physical and Moral Health Investigation Scale was used to complete epidemiology cross section investigation;EPI software was used to establish database;SAS8. 1 was used to analyze data and complete statistical analysis. Results The depressive tendency of sub-healthy people was more common in women, and the incidence rate of depressive tendency was highest in 20 - 40 years old age, especially in well-educated people with junior college educational background. And the main careers with more common depressive tendency were government functionaries and professionals. The depressive tendency was closely related to some stress events, such as disharmony of family, uncoordinated interpersonal relationship, and the changes of living environment etc. People with depressive tendency were more common in asthenia constitution (yang asthenia,yin asthenia). And the incidence of positive results of each factor in SCL-90

  19. Autosensibilization of organism in different pathologic states and radiotherapy of oncologic patients

    International Nuclear Information System (INIS)

    A certain relation has been found between the state of patients and the number of autohemolysins in peripherical blod when studying autohemolysins in persons With acute myocardial infarction, pneumonia and in oncologic patients exposed to radiotherapy. Persons weakened by the progress of myocardial infarction had the highest titers of autohemolysins. The sharp jump-like increase in autohemolysins quantity testifying to a high degree of autosensibilization always preceded the relapse of infarction and pneumonia. High indexes of autohemolysins in oncologic patients exposed to radiotherapy in most cases were also determined against a background of marked autosensibilization (cutaneous breaking out, cutaneous itch, general asthenia). The data obtained confirm nonspecificity of autohemolisis reaction, its relation with autoagressive processes

  20. Sulbutiamine counteracts trophic factor deprivation induced apoptotic cell death in transformed retinal ganglion cells.

    Science.gov (United States)

    Kang, Kui Dong; Majid, Aman Shah Abdul; Kim, Kyung-A; Kang, Kyungsu; Ahn, Hong Ryul; Nho, Chu Won; Jung, Sang Hoon

    2010-11-01

    Sulbutiamine is a highly lipid soluble synthetic analogue of vitamin B(1) and is used clinically for the treatment of asthenia. The aim of our study was to demonstrate whether sulbutiamine is able to attenuate trophic factor deprivation induced cell death to transformed retinal ganglion cells (RGC-5). Cells were subjected to serum deprivation for defined periods and sulbutiamine at different concentrations was added to the cultures. Various procedures (e.g. cell viability assays, apoptosis assay, reactive oxygen species analysis, Western blot analysis, flow cytometric analysis, glutathione (GSH) and glutathione-S-transferase (GST) measurement) were used to demonstrate the effect of sulbutiamine. Sulbutiamine dose-dependently attenuated apoptotic cell death induced by serum deprivation and stimulated GSH and GST activity. Moreover, sulbutiamine decreased the expression of cleaved caspase-3 and AIF. This study demonstrates for the first time that sulbutiamine is able to attenuate trophic factor deprivation induced apoptotic cell death in neuronal cells in culture. PMID:20809085

  1. [Adverse efects of riluzole (Rilutek) in the treatment of amyotrophic lateral sclerosis].

    Science.gov (United States)

    Roch-Torreilles, I; Camu, W; Hillaire-Buys, D

    2000-01-01

    Amyotrophic lateral sclerosis (ALS) is a rapidly fatal degenerative disorder of the motoneurones which was without any effective therapy until 1997. Riluzole (Rilutek) has been the first patented drug used in its specific treatment. In order to evaluate the tolerability profile of this molecule, a Pharmacovigilance study was undertaken in the Department of Neurology B at the Montpellier University Hospital. A total of 153 patients were studied and all observed side-effects were listed in the French bank of Pharmacovigilance. Riluzole induced one or more adverse effects in 50.3 per cent of patients. The most frequent were gastrointestinal disturbances, hepatotoxicity and asthenia. Dermatological, haematological, neuropsychiatric and metabolic side-effects were also reported. This study shows an acceptable safety profile for riluzole. Due to its mode of action, riluzole could potentially be used in the treatment of other neurodegenerative diseases involving glutamate excitotoxicity. Subsequently, Pharmacovigilance will have to be carried out to establish the proper use of riluzole. PMID:10967703

  2. Clinical manifestations and case management of Ebola haemorrhagic fever caused by a newly identified virus strain, Bundibugyo, Uganda, 2007-2008.

    Directory of Open Access Journals (Sweden)

    Paul Roddy

    Full Text Available A confirmed Ebola haemorrhagic fever (EHF outbreak in Bundibugyo, Uganda, November 2007-February 2008, was caused by a putative new species (Bundibugyo ebolavirus. It included 93 putative cases, 56 laboratory-confirmed cases, and 37 deaths (CFR = 25%. Study objectives are to describe clinical manifestations and case management for 26 hospitalised laboratory-confirmed EHF patients. Clinical findings are congruous with previously reported EHF infections. The most frequently experienced symptoms were non-bloody diarrhoea (81%, severe headache (81%, and asthenia (77%. Seven patients reported or were observed with haemorrhagic symptoms, six of whom died. Ebola care remains difficult due to the resource-poor setting of outbreaks and the infection-control procedures required. However, quality data collection is essential to evaluate case definitions and therapeutic interventions, and needs improvement in future epidemics. Organizations usually involved in EHF case management have a particular responsibility in this respect.

  3. Diagnostic criteria of the state of the distributed brain stem regulatory structures in cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Pogorelov A.V.

    2014-11-01

    Full Text Available The clinical-neurophysiological study of 62 patients with history of subtentorial ischemic stroke was carried out in order to determine the criteria of dysfunction of morphologically distributed stem regulatory structures. It was revealed that these disorders are sustainable with the possibility of recourse and influence on the course of stroke. It was marked the influence of this disorders on the levels of consciousness, severity of state, recovery rate, asthenia level, sleep function. Manifestations of cerebral cardiac syndrome, impaired attention, orientation reaction, speed of sensomotoric acts are also marked. Patients with these disorders have low rates of recovery of functions. Neurophysiological criteria of these disorders are the lack of expressive reactions in electroencephalography, reduction of their overall level, instability of rhythm - generating structures and others.

  4. Syndrome of Inappropriate Antidiuretic Hormone Secretion Due to Amantadine: 3 Cases in the Literature

    Directory of Open Access Journals (Sweden)

    Akif Acay

    2014-02-01

    Full Text Available To report a patient who developed a syndrome of inappropriate antidiuretic hormone secretion (SIADH related with amantadine. A 62 year-old male, who has been followed for Parkinson%u2019s disease for 16 years. Three months ago, amantadine added to his existing treatment. About 4 weeks after the initiation of treatment, confusion, constant sleepiness, lethargy, asthenia, fatigue and muscle weakness appeared. The blood anlysis showed hyponatremia, so he was diagnosed as SIADH and amantadine treatment was stopped. Then his symptoms gradually improved and the sodium levels was turned into the normal ranges. Amantadine may cause SIADH should be used with caution in patients with Parkinson%u2019s disease.

  5. Health care of people at work. Workers exposed to lead. I. Inorganic lead

    Energy Technology Data Exchange (ETDEWEB)

    Waldron, H.A.

    1978-01-01

    The risks associated with exposure to inorganic lead and the means by which these risks can be minimized are outlined. Lead is used to make a variety of metal products, the grids and oxides in storage batteries, pigments, chemicals, and also for lead plating. In the United States about 70% of the total lead consumption is related to transportation. Uptake of inorganic lead is by ingestion and inhalation. About 90% of the total body burden of lead is contained within the skeletal tissues. Lead is excreted in the kidney, in sweat, and in milk. Toxic effects are directed against the blood, the nervous system, and the kidney. Symptoms of lead poisoning are abdominal pain, constipation, vomiting, asthenia, paresthesia, psychological symptoms, and diarrhea. Physical and biological monitoring can serve to protect workers. Diagnosis of lead poisoning is not easy. Treatment involves removal from exposure and/or treatment with a chelating agent.

  6. Simultaneous Hodgkin′s disease and kaposi sarcoma in a renal transplant recipient

    Directory of Open Access Journals (Sweden)

    Yaich S

    2010-01-01

    Full Text Available A 38-year-old women underwent first cadaver kidney transplantation. Her panel re-active antibody was 0%, and she had never previously been transfused nor pregnant. She received induction therapy with antithymoglobulin (ATG as standard protocol and maintained on immuno-suppressive treatment of cyclosporine A, mycophenolate mofetil (MMF, and prednisone. Nine months after transplantation, she presented with anorexia, asthenia and weight loss. Cutaneous Ka-posi′s sarcoma and a Hodgkin disease were diagnosed. MMF was discontinued and cyclosporin A was switched to sirolimus. She also received a poly-chemotherapy associated with 4 courses of rituximab. Twelve months later, the patient had normal graft function and both malignancies were in complete remission.

  7. 功能性便秘中医证候分布与焦虑抑郁相关性研究%Correlative Study on Distribution of TCM Syndromes and Anxiety-Depression in Functional Constipation

    Institute of Scientific and Technical Information of China (English)

    刘绍能; 蔡冬; 燕东; 吴红梅; 刘慧敏

    2011-01-01

    目的 观察功能性便秘患者的中医证候分布及其与焦虑抑郁的相关性.方法 对151例确诊为功能性便秘患者进行中医辨证分型,然后采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)进行测评,同时纳入 25 例健康人作为测评对照.结果 功能性便秘以脾胃气虚证(47例)、阴虚肠燥证(46例)为多,较少的还有气机郁滞证(34例)、脾肾阳虚证(16例)、肠胃积热证(8例);功能性便秘患者的HAMA得分(11.23±5.556)及HAMD得分(6.71±4.805)均明显高于健康对照(4.44±2.04 3、3.48±2.417);其中气机郁滞证患者的HAMA和HAMD得分均高于其他各证型(P<0.01).结论 功能性便秘患者以脾胃气虚证、阴虚肠燥证为多见,并有明显的焦虑、抑郁倾向,其中气机郁滞证者更为突出.%Objective To research the relation between distribution of TCM syndrome and anxiety- depression in functional constipation (FC). Methods One hundred and fifty-one FC cases were differentiated by TCM syndromes, and measured with Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), at the same time, 25 healthy persons were brought into the research as control. Results FC were more distributed to be spleen Qi asthenia and intestinal Yin asthenia, less were depression and stagnation of Qi, asthenic yang of spleen and kidney, intestine and stomach pyretic syndrome. HAMA (11.23±5.556) and HAMD (6.71±4.805) score of FC patients were higher than normal control (4.44±2.043, 3.48± 2.417). HAMA and HAMD score of depression and stagnation of Qi patients were all higher than other syndromes (P<0.01). Conclusion FC are more distributed to be spleen Qi asthenia and intestinal Yin asthenia, and are liable to suffer from anxiety-depression, especially depression and stagnation of Qi patients.

  8. Morphological study of the bone marrow in patients injected with ThO/sub 2/

    Energy Technology Data Exchange (ETDEWEB)

    Parreira, F.; Carneiro de Moura, M.

    1979-02-01

    The action of radiation on proliferative activity of blastic elements is already very well known. The particularity of our cases comes from the fact that radiation starts from the cells of RHS, where a radioactive substance was fixed many years before our observations. We can conclude, from these results, that the pathogenesis of anemia can be explained through proliferative asthenia. Alterations of granuloblastic series, although not so often, can be explained in a similar way. What is more difficult to be interpreted is noncorrelation between results of myeloid-erythroid radio and leukocyte count in peripheral blood. In fact, in bone marrow, myeloid series seems to be more depressed but, peripherically, anemia is more frequent. Correlation between the degree of bone marrow hypoplasia and the period of action of radiation was not observed.

  9. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

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    Rita de Cássia de Souza-Lima

    2013-10-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  10. Investigation on Distributed Feature of TCM Syndrome and Syndrome Elements about Polycystic Ovary Syndrome from Modern Literature%从现代文献探讨多囊卵巢综合征的中医证候及证候要素分布特点

    Institute of Scientific and Technical Information of China (English)

    刘新敏; 华强

    2011-01-01

    Objective To probe into the characteristics of traditional Chinese medicine syndromes and their elements distributions in polycystic ovary syndrome.Methods Literatures on polycystic ovary syndrome in past 15 years were collected, and a database was set up by using Eexcel.The frequencies of syndromes and their elements were analyzed.Results Out of the 36 syndromes obtained from the standardization of syndrome nomenclature, the top three were kidney asthenia and phlegm-blood stasis,kidney asthenia and phlegm-dampness, kidney asthenia and blood stasis.There were 16 single syndromes,deficiency of kidney yang, phlegm-dampness and blood stasis were the top three.Kidney, liver and spleen were the top three of all the 5 disease locations.Yang deficiency, phlegm-dampness and yin deficiency were the top three pathogenicity types.Conclusion Viscera that polycystic ovary syndrome refered to were mainly kidney, liver and spleen.Single syndrome was mainly kidney asthenia (kidney yang deficiency,kidney yin deficiency), phlegm-dampness and blood stasis.The compound syndromes that composed by single syndromes were more.It was showed that the pathology characteristics of polycystic ovary syndrome was complexity.%目的 通过分析多囊卵巢综合征的现代文献,探讨多囊卵巢综合征常见中医证候及证候要素的分布规律.方法 以中国期刊全文数据库为检索源,检索1994-2009年有关多囊卵巢综合征的现代文献,应用Excel建立数据库,对证候及证候要素的频次进行分析.结果 经初步规范后获取证候名称36个,出现频次居前3位的是肾虚痰瘀、肾虚痰湿和肾虚血瘀;单证候16个,频次居前3位的是肾阳虚、痰湿、血瘀;病位类证候要素5个,出现频次居前3位的是肾.肝、脾;病性类证候要素10个,出现频次居前3位的是阳虚,痰湿、阴虚.结论 多囊卵巢综合征涉及的脏腑主要是肾、肝.脾,单证候主要是肾虚(肾阳虚、肾阴虚)、痰湿、血瘀,而

  11. Characteristics of the Elderly Patients with Coronary Heart Disease%试论老年冠心病的特点

    Institute of Scientific and Technical Information of China (English)

    刘子龙; 康立源

    2015-01-01

    The incidence of coronary heart disease is increasing year by year in china.Coronary heart disease has become the main rea-son of death in elderly patients.Coronary heart disease of elderly patients has special symptoms, athogenesis and treatment.Clinical symptoms are complex and nutypical.As for treating it, the situation is more serious and treatment effect becomesbad, with more com-plications ,which making treatment difficult.The reason of coronary heart disease in Western medicine is coronary atherosclerosis, al-though the reason is not entirely clear atherosclerosis.Various risk factors are adverse to old people.Coronary heart disease is equiva-lent to thoracic obstruction in traditional Chinese Medicine.Elder organs become weaker than ever,various organs congestion can cause thoracic obstruction.The etiology of elderly coronary heart disease is more asthenia than specific disease.Most of the cause is asthenia in origin and asthenia in superficiality.The Western medicinetreatment of coronary heart disease should pay attention to the physiologi-cal characteristics of the elderly, sensitivity to medicine for old people to change.The increasing of adverse drug reaction, so Medica-tion should be closely tracking effect and adverse reaction and Timely adjustment of treatment.For the elderˊs PTCA, it should strictly evaluatethe indicators of patientsˊbody and should not blindly pursue operation treatment.Traditional Chinese medicine makes Nouris-hing asthenia and Getting rid of Pathogenic factor as the treatment of law.It should not only pay attention to the heart, but also attached to the heart and other organsbased on syndrome differentiation.%冠心病的发病率在我国逐年递增,已成为老年患者死亡的主要原因。老年冠心病有其特殊的症状、病因病机及治疗特点,临床症状复杂且多不典型,程度较重且预后偏差,合并症较多,治疗棘手。其病因西医认为是冠状动脉粥样硬化,粥样硬化

  12. Reversible Pulmonary Hypertension Associated with Whipple’s Disease

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    A. Villa

    2012-01-01

    Full Text Available We describe a case of Whipple’s disease with pulmonary hypertension in a 72-year-old woman in whom the pulmonary hypertension resolved completely after antibiotic therapy. She was admitted to study with a 2-months history of weight loss, diarrhoea, abdominal pain, asthenia, inappetence, and fever. She did not have dyspnoea or respiratory symptoms. A casual echocardiogram showed a pulmonary artery systolic pressure of 95 mmHg. Forty days after starting antibiotic therapy, an echocardiogram showed a complete normalisation of right ventricular involvement. Whipple’s disease is a rare and multisystemic disorder in which pulmonary involvement is not a well-known finding. Although Whipple’s disease is not generally considered as a possible cause of pulmonary hypertension, such awareness is important because it may be potentially resolved with antibiotic therapy.

  13. Relationship between Motor Function and TCM Syndromes in Early Recovery Stage after Ischemic Stroke%缺血性脑卒中恢复早期气虚和阴虚阳亢证的变化与运动功能的关系

    Institute of Scientific and Technical Information of China (English)

    谢梓菁; 邹忆怀; 李宗衡

    2013-01-01

    目的:探讨缺血性脑卒中恢复早期气虚和阴虚阳亢证的变化与运动功能的关系.方法:采集数据库中缺血性脑卒中患者在入组第1天和第21天的中医四诊信息,Fugl-Meyer运动功能量表的评分,改良Ashworth痉挛评定量表的分级等数据,将所得数据进行差异性检验、相关分析等统计分析,观察缺血性脑卒中恢复早期气虚证和阴虚阳亢证的变化,探索其证候与肢体运动功能恢复进程的相关性.结果:入组第21天气虚证和阴虚阳亢证与运动功能的相关系数分别为-0.342(P< 0.01)和-0.282(P<0.01),Ashworth分级与阴虚阳亢证的相关系数为0.262(P< 0.05).结论:缺血性脑卒中发病第二个时点运动功能与气虚证、阴虚阳亢证呈负相关,其中以分离运动最为显著,患肢的肌张力与阴虚阳亢证呈正相关.%Objective To investigate the relationship between motor function and qi deficiency syndrome, yin-asthenia and yang-hyperactivity syndrome in the early stages of ischemic stroke. Methods Using existing data from a data base, this research investigated a total of 62 ischemic stroke patients, to whom assessments were administered at baseline and at 3-week follow-up. The assessments included the Modified Ashworth Scale, Fugl-Meyer Assessment, and the Traditional Chinese Medicine (TCM) symptom score. Difference test, correlative test and regression analysis were performed to investigate the relationship between TCM syndrome and the process of motor recovery after ischemic stroke. Results The coefficients of correlation between motor function and qi deficiency syndrome, yin-asthenia and yang-hyperactivity syndrome are - 0.342 ( P < 0.01) and - 0.282( P < 0.01), respectively. The coefficient of correlation between Modified Ashworth Scale and yin-asthe-nia and yang-hyperactivity syndrome is 0.262(P < 0.05). Conclusions At 3-week follow-up, there is a significantly negative correlation between qi deficiency syndrome and motor

  14. Regorafenib: A novel tyrosine kinase inhibitor: A brief review of its therapeutic potential in the treatment of metastatic colorectal carcinoma and advanced gastrointestinal stromal tumors

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    P Thangaraju

    2015-01-01

    Full Text Available Regorafenib is a novel oral multitargeted tyrosine kinase inhibitor having both antitumor and anti-angiogenic activities. Regorafenib was recently approved by US Food and Drug Administration in February 25, 2013 in the treatment for patients with advanced gastrointestinal stromal tumor and for the treatment of patients with metastatic colorectal carcinoma after disease progression or intolerance to imatinib mesylate and sunitinib therapy. Oral regorafenib demonstrates a high level of efficacy with acceptable tolerability with the 160 mg daily for 3 weeks followed by 1 week off schedule; a continuous schedule could be of interest. Hypertension, mucositis, hand foot skin reaction, diarrhea and asthenia are the most common side-effects. Regardless of these encouraging results, studies investigating, adjuvant and neoadjuvant settings are awaited, as well as trials using regorafenib in combination with chemotherapy or other targeted therapies. Clinical trials investigating regorafenib in other tumor types are ongoing.

  15. Desmoplastic malignant mesothelioma of the pericardium: Description of a case and review of the literature

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    Antonello Nicolini

    2011-01-01

    Full Text Available Desmoplastic mesothelioma (DMM is a rare and highly lethal subtype of diffuse malignant mesothelioma and is often difficult to distinguish from reactive pleural fibrosis. The term "desmoplastic" refers to the growth of fibrous or connective tissue. We report the clinical, radiological, and pathological features of a primary DMM of the pericardium and a short review of the literature. A 72-year-old man was admitted presenting shortness of breath, cough, and asthenia. Computed tomography scan showed thickenings and effusions both in the pleura and in the pericardium. Histopathological diagnosis was performed by surgical pericardial biopsy and confirmed by autopsy. The patient had a history of asbestos exposure. Primary mesothelioma of the pericardium is a rare tumor occurring in the fourth to seventh decades with nonspecific symptoms and a rapid clinical course. The diagnosis is difficult and often needing a surgical pericardial biopsy. The prognosis is poor although newer antiblastic drugs seem to prolong survival times.

  16. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

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    Rita de Cassia de Souza-Lima

    2013-07-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  17. Safety and treatment patterns of multikinase inhibitors in patients with metastatic renal cell carcinoma at a tertiary oncology center in Italy

    International Nuclear Information System (INIS)

    Multikinase inhibitors (MKIs) sunitinib and sorafenib have become a standard of care for metastatic renal cell carcinoma (mRCC). This study assessed safety and treatment patterns for these agents in a real-world clinical practice setting in Italy. A retrospective medical record review was performed at a tertiary oncology center in Italy. The study included MKI-naïve non-trial patients ≥18 years old, with a histological diagnosis of mRCC, and who received sunitinib or sorafenib as first MKI during 9/2005-7/2008. Data were collected on adverse events (AEs), treatment modifications (discontinuations, interruptions, dose changes), and reasons for these modifications. 145 patients were included; 85 received sunitinib and 60 received sorafenib as first-line MKI. Median treatment duration was 6.6 (sunitinib) and 5.8 (sorafenib) months. 97.6% and 70.0% of patients receiving sunitinib and sorafenib, respectively, experienced ≥1 AE; 27.1% and 31.7% had ≥1 grade 3/4 AE. The most common any grade AE for sunitinib was fatigue/asthenia (81.2%), followed by mucositis/stomatitis (58.8%) and decreased taste sensation (42.4%), while for sorafenib this was fatigue/asthenia (43.3%) followed by hand-foot syndrome (38.3%) and diarrhea (31.7%). Treatment discontinuation, interruption, and dose reduction due to AEs occurred in 11.8%, 23.5%, and 30.6%, respectively, of patients receiving sunitinib, and 5.0%, 23.3%, and 36.7%, respectively, of patients receiving sorafenib. In this retrospective study, most patients experienced ≥1 AE during first-line MKI treatment. AEs were reported frequently and resulted in treatment modifications in 40% of patients receiving sunitinib and 45% of patients receiving sorafenib. These results suggest a need for additional effective and more tolerable treatments for mRCC

  18. Analysis on the typical medical record of hypertension from Professor WENG Wei-liang%翁维良教授治疗高血压病验案分析

    Institute of Scientific and Technical Information of China (English)

    于大君

    2011-01-01

    Professor WENG Wei-iang has been working on cardiovascular diseases for more than 50 years, and has accumulated lots of experience. This article simply summarizes Professor WENG's experience on his treating hypertension by analyzing his 3 typical medical records. Professor WENG divided hypertension into 2 stages. One is sthenia syndrome and the other is asthenia in origin and asthenia in superficiality. Different treatment should be prescribed in these two stages. Hypertension commonly occurs in a constitution with Sputum and haemostasis. To this, promoting blood flow and eliminating phlegm should be used.%翁维良教授从事心血管疾病临床和科研工作已50余年,对高血压病的治疗积累了丰富经验.文章通过对翁教授治疗高血压病的3个典型验案进行分析,初步总结了翁教授治疗高血压病的经验,即疾病初期,以实证(肝火上炎、肝阳上亢)多见,治以祛邪为主(清肝平肝);疾病日久,则多属于本虚标实(阴虚阳亢、瘀血阻络),宜标本兼治(滋补潜阳、活血通络).同时针对高血压病痰湿体质多见的特点,则宜活血祛痰.

  19. Analyze the Origin and Development of Asthma%哮喘病的名义源流

    Institute of Scientific and Technical Information of China (English)

    郑海英

    2011-01-01

    从病名、病因病机、证候3个方面对哮喘病的源流进行考证.哮喘之发,有内外二因、虚实两端.内因五脏虚损,而以肺肾两虚为最,痰热胶固,亦属病根;外因六淫侵袭,而以风寒、风热为主.接触过敏物质,为常见诱因.邪气滞肺为实,肺肾不足为虚.内外相因,哮喘发作.在临床治疗哮喘时,必须辨证求因,审因论治.%The research devotes to three factors of the origin of asthma, like disease name, pathogenesis and clinical presentations. There are two reasons causing the asthma including the internal and external reason and the asthenia. The deficiency of lung and kidney is the most serious in the five Zang-viscern. At same time, phlegm coagulation is the root cause of the illness as well. On the other hand, the outside cause is mainly from the six exogenous factors, such as wind-cold and wind-heat. And exposures to allergens are usual common causes, too. It is asthenia when the pathogenic factor stays in the lung, while the lung and kidney is deficiency. Thus, asthma is onset during the process of internal and external effect. And from the elaborating above, we must seek for the disease reason dialectically in order to treat determination based on syndrome differentiation of asthma.

  20. 益脾理肠汤治疗慢性结肠炎脾胃虚弱型疗效分析

    Institute of Scientific and Technical Information of China (English)

    邓定建

    2014-01-01

    目的:观察益脾理肠汤治疗慢性结肠炎脾胃虚弱型的临床疗效。方法:70例随机分为治疗组35例和对照组35例,治疗组服益脾理肠汤(自拟),对照组服柳氮磺吡啶肠溶片,治疗4周后观察疗效。结果:总有效率治疗组88.6%、对照组62.9%,两组比较差异有统计学意义(P<0.05)。结论:益脾理肠汤治疗慢性结肠炎脾胃虚弱型疗效较好。%To observe the clinical therapeutic effect of Supplementing Spleen and Regulating Intestine Decoction on chronic colitis with asthenia of the spleen and the stomach type. Method: 70 cases were divided into 2 groups randomly, 35 cases in the study group while 35 cases in the control group. The study group were treated with self- made Supplementing Spleen and Regulating Intestine Decoction by oral administration while the control group were treated with sulfasalazine colonosoluble capsules. The therapeutic effect was observed after 4 weeks’ treatment. Result: The total effective rate was 88.6% in the study group and 62.9% in the control group with significant difference(P<0.05). Conclusion: Supplementing Spleen and Regulating Intestine Decoction has good therapeutic effect on chronic colitis with asthenia of the spleen and the stomach type.

  1. Studies on the Relationship of the Syndromes and the TCM Constitution of the Henoch-Schonlein Purpura Nephritis Patients%紫癜性肾炎患者证候与中医体质类型关系研究

    Institute of Scientific and Technical Information of China (English)

    乔会秀

    2012-01-01

    Objective: To survey the TCM constitutional characteristics and syndromes in the patients with the henoch-schonlein purpura nephritis, study the relationships between constitutions and syndromes and provide the basis for preventing and treating henoch-schonlein purpura nephritis with Chinese medicine. Methods: The constitutional types were investigated by applying the standard in Classification and Determination of TCM constitutions. The questionnaire designed by assigned physicians was used to survey TCM syndrome types. The correlation between constitutional characteristics and TCM syndromes was analysed. Results: Among 120 patients with Henoch-schonlein purpura nephritis, the wind-heat invading collaterals syndrome for 32.5%, Bleeding due to blood-heat syndrome 26.7%, hyperactivity of fire due to yin deficiency syndrome23.3%, Qi deficiency bleeding syndrome 17.5%, allergic constitution 21.6%, damp-heat constitution 19.2%, yin asthenia constitution 17.5%, qi asthenia constitution 13.3%, blood stasis constitution 11.7%. The constitution of phlegm. The wind-heat invading collaterals syndrome was correlated significantly to the allergic constitution ( P<0.01 ). And bleeding due to blood-heat syndrome was correlated significantly to the blood stasis constitution and damp-heat constitution ( P<0.05 ) . The hyperactivity of fire due to yin deficiency syndrome was correlated to the yin asthenia constitution,( P<0.01 ) . The Qi deficiency bleeding syndrome was correlated significantly to the qi asthenia constitution (P<0.01 ). Conclusion: The constitutional types of the patients with the henoch-schonlein purpura nephritis mostlv allergic constitution and damp-heat constitution. The syndrome types are mostly the syndrome of the wind-heat invading collaterals syndrome and bleeding due to blood-heat syndrome. There is a correlation between the the wind-heat invading collaterals syndrome and the allergic constitution, bleeding due to blood-heat syndrome and the blood stasis

  2. 亚健康门诊人群中医体质的分布情况分析%Retrospective analysis on the TCM constitution distribution of sub health clinicpopulation

    Institute of Scientific and Technical Information of China (English)

    万里红; 宋登丽; 余葱葱

    2014-01-01

    目的:研究亚健康门诊人群中医体质的分布情况。方法:对2009-2013年四川省中西医结合医院亚健康门诊收治的96例亚健康患者的临床资料进行回顾性分析,采用瑞康中医体质辨识系统分析其中医体质的分布特点。结果:本组亚健康人群的年龄段为11-70岁,主要集中在20-40岁的年龄段(占比为52.08%),其次为40-60岁的年龄段(占比达36.44%)。在本组亚健康人群中,中医体质为平和体质者占31.3%,中医体质为偏颇体质者占69.7%(其中阳虚体质、阴虚体质、痰湿体质者均占10%以上)。在本组亚健康人群的中医体质中,居前3位的中医体质分别为阳虚体质、阴虚体质、痰湿体质。在本组男性亚健康人群中,平和体质者占40.9%,偏颇体质者占59.1%(其中阳虚体质、痰湿体质者均占10%以上)。本组女性亚健康人群的中医体质分布情况是:在本组女性亚健康人群中,平和体质者占23.08%,偏颇体质者占76.92%(其中阳虚体质、阴虚体质者均占10%以上)。结论:40岁左右是人们发生亚健康的主要年龄段,有阳虚、痰湿体质的男性是进行亚健康干预的重点人群。%Objective:Study on the TCM constitution distribution of subhealth clinicpopulation.Method:Adopting the retrospective analysis,extracting 96 cases in sub health clinic from the year of 2009 to 2013,using the TCM constitution system to analysis the TCM constitution characteristics of distribution of sub health population.Result:people with constitution of yin-yang harmony accounted for 31.3%,constitution of yin-yang biased accounted for 69.7%.In the constitution of yin-yang biased,the top three is constitution of yang asthenia,yin asthenia and phlegm-dampness,each of them is accounted for more than 10%.The proportion of male,who is in the constitution of yin-yang harmony ,is twice than the female,the top two constitution of yin-yang biased of

  3. Relation between expression of CDX2 and p21~(WAF1) protein in colorectal cancer and TCM deficiency syndrome%结直肠癌组织CDX2、p21~(WAF1)蛋白表达与中医虚证相关性的研究

    Institute of Scientific and Technical Information of China (English)

    田君才; 戴伟平; 张桂霞; 李昌吉; 杜国亮

    2010-01-01

    目的 研究结直肠癌组织CDX2及p21~(WAF1)蛋白表达,探讨其在结直肠癌发生发展中的病理意义.在此基础上研究CDX2及p21~(WAF1)蛋白表达与中医虚证的相关性.方法 以酒泉市人民医院的结直癌手术切除标本45例为研究对象,收集病理资料进行辨证分型.采用免疫组化EliVision法检测癌组织、癌旁组织中CDX2、及p21~(WAF1)的表达.结果 CDX2、p21~(WAF1)在结直肠癌组织中的阳性率分别为86.7%、35.6%.结直肠癌组织中CDX2与p21~(WAF1)表达无相关性.p21~(WAF1)蛋白表达在虚证组(11.76%)明显低于实证组(41.67%)和虚实夹杂证组(56.25%),其差异有统计学意义(x~2=7.385,P=0.025).CDX2蛋白表达在虚证、实证、虚实夹杂组间差别无统计学意义.结论 CDX2及p21~(WAF1)阳性率在痛及切缘组织中有显著性差异,二是因可能与结肠痛发生发展相关.CDX2与p21~(WAF1)之间无相关性.p21~(WAF1)表达降低提示结直肠癌患者预后不良.p21~(WAF1)表达在虚证组中明显低于实证、虚实夹杂证组.%Objective To study the expression of CDX2 and p21~(WAF1) protein in colorectal cancer and its correlation with the progression of colorectal cancer., and to explore the eorrelativity of CDX2 and p21~(WAF1) genes expression with TCM deficiency Syndrome. Methods Immunohistochemical method was used to detect the expressions of CDX2 and p21~(WAF1) in45 patients of colorectal carcinoma tissues and peri-cancerous tissues, who received the treatment at the People's Hospital of Jiuquan City between April, 2000 and August, 2005. According to TCM syndrome differentiation, the patients were divided into sthenia syndrome group and asthenia syndrome group and sthenia-ashenia syndrome group. Analyze the Correlation between CDX2 and p21~(WAF1) expression and TCM syndrome. Results The positive rate of CDX2 and p21~(WAF1) was 86.7% and 35.6% respectively in colorectal carcinoma tissues. There was no correlation between CDX2 and p21~(WAF1

  4. Infección por Citomegalovarius con compromiso hepático en adultos inmunocompetentes Cytomegalovirus infection with hepatic involvement in immunocompetent adults

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    Claudia Vujacich

    2006-06-01

    presented fever and asthenia, mild to moderate increase of transaminases and serological findings compatible with recent cytomegalovirus infection. We excluded patients with a history of transfusions, drug abuse, immunodeficiencies, preexistent hepatic impairment or serological findings compatible with acute hepatitis A, B and C (HAV, HBV, HCV and Epstein Barr virus (EBV. The laboratory diagnosis of recent cytomegalovirus infection was made by especific IgM detection (ELISA or a significant increase of specific IgG. The most frequent symptoms were fever (85% and asthenia (83%, followed by cephalea (25%, splenomegaly (20%, adenomegalies (22%, pharyngitis (25%, myalgias (25% and hepatomegaly (19%. All the patients showed moderate increase of transaminases and lymphomonocytosis (73/73. In average, ALT was increased by 6 fold and AST by 3.5 fold. The clinical characteristics that differentiate CMV infection from Epstein-Barr infection are the lesser frequency of adenomegalies and pharyngitis in the former. The differential diagnosis of CMV infection with hepatic involvement from acute hepatitis A and B, is based on the absence of jaundice, the lower elevation of transaminases, the intense lymphomonocytosis and the presence of specific IgM against CMV that are characteristic of CMV infection. In conclusion, in previously healthy young adults with fever, intense asthenia, lymphomonocytosis and moderate increase in transaminases levels, cytomegalovirus infection should be investigated.

  5. Psychosocial value of space simulation for extended spaceflight

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    Kanas, N.

    1997-01-01

    There have been over 60 studies of Earth-bound activities that can be viewed as simulations of manned spaceflight. These analogs have involved Antarctic and Arctic expeditions, submarines and submersible simulators, land-based simulators, and hypodynamia environments. None of these analogs has accounted for all the variables related to extended spaceflight (e.g., microgravity, long-duration, heterogeneous crews), and some of the stimulation conditions have been found to be more representative of space conditions than others. A number of psychosocial factors have emerged from the simulation literature that correspond to important issues that have been reported from space. Psychological factors include sleep disorders, alterations in time sense, transcendent experiences, demographic issues, career motivation, homesickness, and increased perceptual sensitivities. Psychiatric factors include anxiety, depression, psychosis, psychosomatic symptoms, emotional reactions related to mission stage, asthenia, and postflight personality, and marital problems. Finally, interpersonal factors include tension resulting from crew heterogeneity, decreased cohesion over time, need for privacy, and issues involving leadership roles and lines of authority. Since future space missions will usually involve heterogeneous crews working on complicated objectives over long periods of time, these features require further study. Socio-cultural factors affecting confined crews (e.g., language and dialect, cultural differences, gender biases) should be explored in order to minimize tension and sustain performance. Career motivation also needs to be examined for the purpose of improving crew cohesion and preventing subgrouping, scapegoating, and territorial behavior. Periods of monotony and reduced activity should be addressed in order to maintain morale, provide meaningful use of leisure time, and prevent negative consequences of low stimulation, such as asthenia and crew member withdrawal

  6. Early versus deferred treatment for smoldering multiple myeloma: a meta-analysis of randomized, controlled trials.

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    Minjie Gao

    Full Text Available Whether patients with smoldering multiple myeloma (SMM needed to receive early interventional treatment remains controversial. Herein, we conducted a meta-analysis comparing the efficacy and safety of early treatment over deferred treatment for patients with SMM.MEDLINE and Cochrane Library were searched to May 2014 for randomized controlled trials (RCTs that assessed the effect of early treatment over deferred treatment. Primary outcome measure was mortality, and secondary outcome measures were progression, response rate, and adverse events.Overall, 5 trials including 449 patients were identified. There was a markedly reduced risk of disease progression with early treatment (Odds Ratio [OR] = 0.13, 95% confidence interval [CI] = 0.07 to 0.24. There were no significant differences in mortality and response rate (OR = 0.85, 95% CI = 0.45 to 1.60, and OR = 0.63, 95% CI = 0.32 to 1.23, respectively. More patients in the early treatment arm experienced gastrointestinal toxicities (OR = 10.02, 95%CI = 4.32 to 23.23, constipation (OR = 8.58, 95%CI = 3.20 to 23.00 and fatigue or asthenia (OR = 2.72, 95%CI = 1.30 to 5.67. No significant differences were seen with the development of acute leukemia (OR = 2.80, 95%CI = 0.42 to 18.81, hematologic cancer (OR = 2.07, 95%CI = 0.43 to 10.01, second primary tumors (OR = 3.45, 95%CI = 0.81 to 14.68, nor vertebral compression (OR = 0.18, 95%CI = 0.02 to 1.59.Early treatment delayed disease progression but increased the risk of gastrointestinal toxicities, constipation and fatigue or asthenia. The differences on vertebral compression, acute leukemia, hematological cancer and second primary tumors were not statistically significant. Based on the current evidence, early treatment didn't significantly affect mortality and response rate. However, further much larger trials were needed to provide more evidence.

  7. Mixed panniculitis responding to cyclosporin-A with a 12-month follow-up: a case report.

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    Migliore, A; Bizzi, E; Santacroce, C M; Tarquini, E; Massafra, U; Vacca, F; Martin Martin, L S

    2009-01-01

    Panniculitides represent a heterogeneous group of inflammatory diseases involving subcutaneous fat. Subcutaneous fat is normally organized into adipose cells, adipocytes, and septa of connective tissue. The inflammation involving such tissues can be more represented in septa (septal panniculitis) or in lobules (lobular panniculitis) or be equally distributed in both (mixed panniculitis). A bioptical study is necessary in order to discern between different forms. Vascular involvement is also different in such diseases, as it can interest arteries, or veins, or both. Different grades of fat necrosis can also be observed, such as adipocytes without nuclei, lipophagic necrosis, liquefactive fat necrosis, microcystic fat necrosis, ischaemic fat necrosis. Panniculitis can be idiopathic or secondary to other diseases such as systemic sclerosis, rheumatoid arthritis, systemic erithematous lupus and many others. Therapies usually vary on the single patient but the general orientation leads to the use of immunosuppressive drugs such as thalidomide, corticosteroids, cyclosporin-A, hydroxychloroquine and cyclophosphamide. We report a case of a 19-year-old female affected by primary mixed panniculitis, associated with fever and deep asthenia, that resolved in a few weeks and was maintained with oral cyclosporin-A. PMID:20074481

  8. Macrophagic myofasciitis in childhood: a controversial entity.

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    Rivas, Eloy; Gómez-Arnáiz, Mercedes; Ricoy, Jose R; Mateos, Fernando; Simón, Rogelio; García-Peñas, Juan J; Garcia-Silva, Maria T; Martín, Elena; Vázquez, María; Ferreiro, Ana; Cabello, Ana

    2005-11-01

    Macrophagic myofasciitis is an unusual inflammatory myopathy, which has been almost exclusively reported in French adults with diffuse arthromyalgias and asthenia. It is characterized by an infiltrate of densely packed macrophages, with granular periodic-acid-Schiff positive content, on muscle biopsies at the site of vaccination. The presence of aluminum inclusions in these macrophages points to an inappropriate reaction to aluminum used as an adjuvant in some vaccines. Although in adults this entity is well defined, less than 15 cases have been reported in children. This study describes seven children, younger than 3 years of age, with typical lesions of macrophagic myofasciitis on quadriceps muscle biopsy. In five cases, biopsies were performed to exclude mitochondrial pathology. All the children developed hypotonia and motor or psychomotor delay, associated with others symptoms. Abnormal neuroimaging was evident in six cases. Spectrometry studies detected elevated levels of aluminum in muscle in three of four cases tested. Despite the wide use of vaccines in childhood, macrophagic myofasciitis was rarely observed in children and its characteristic histologic pattern could not be correlated with a distinctive clinical syndrome. PMID:16243223

  9. Iron deficiency: from diagnosis to treatment.

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    Polin, Vanessa; Coriat, Romain; Perkins, Géraldine; Dhooge, Marion; Abitbol, Vered; Leblanc, Sarah; Prat, Frédéric; Chaussade, Stanislas

    2013-10-01

    Iron deficiency is the most frequent cause of anaemia worldwide. It impairs quality of life, increases asthenia and can lead to clinical worsening of patients. In addition, iron deficiency has a complex mechanism whose pathologic pathway is recently becoming better understood. The discovery of hepcidin has allowed a better clarification of iron metabolism regulation. Furthermore, the ratio of concentration of soluble transferrin receptor to the log of the ferritin level, has been developed as a tool to detect iron deficiency in most situations. The cause of iron deficiency should always be sought because the underlying condition can be serious. This review will summarize the current knowledge regarding diagnostic algorithms for iron deficiency anaemia. The majority of aetiologies occur in the digestive tract, in men and postmenopausal women, and justify morphological examination of the gut. First line investigations are upper gastrointestinal endoscopy and colonoscopy, and when negative, the small bowel should be explored; newer tools such as video capsule endoscopy have also been developed. The treatment of iron deficiency is aetiological if possible and iron supplementation whether in oral or in parenteral form. New parenteral formulations are available and seem to have promising results in terms of efficacy and safety. PMID:23582772

  10. A ten-year follow-up of human leptospirosis in Uruguay: an unresolved health problem

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    Felipe Schelotto

    2012-04-01

    Full Text Available Leptospira spp. are delicate bacteria that cannot be studied by usual microbiological methods. They cause leptospirosis, a zoonotic disease transmitted to humans through infected urine of wild or domestic animals. We studied the incidence of this disease in the Uruguayan population, its epidemiologic and clinical features, and compared diagnostic techniques. After examining 6,778 suspect cases, we estimated that about 15 infections/100,000 inhabitants occurred yearly, affecting mainly young male rural workers. Awareness about leptospirosis has grown among health professionals, and its lethality has consequently decreased. Bovine infections were probably the principal source of human disease. Rainfall volumes and floods were major factors of varying incidence. Most patients had fever, asthenia, myalgias or cephalalgia, with at least one additional abnormal clinical feature. 30-40% of confirmed cases presented abdominal signs and symptoms, conjunctival suffusion and altered renal or urinary function. Jaundice was more frequent in patients aged > 40 years. Clinical infections followed an acute pattern and their usual outcome was complete recovery. Laboratory diagnosis was based on indirect micro-agglutination standard technique (MAT. Second serum samples were difficult to obtain, often impairing completion of diagnosis. Immunofluorescence was useful as a screening test and for early detection of probable infections.

  11. Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

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    Claudia Cambrea Simona

    2014-02-01

    Full Text Available Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body, high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a

  12. Cardiac tamponade as first manifestation of a lung neoplasm.

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    Pamela Medina A.

    2014-04-01

    Full Text Available INTRODUCTION: In cardiac tamponade, there is a filling restriction of the heart due to increased pressure of the pericardial cavity secondary to pericardial effusion. Pressure can reach values greater than that of the right heart cavities, compromising their filling, and, secondarily, affecting the preload of the left ventricle. CASE REPORT: A 52-year old male, with type 2 diabetes mellitus, consulted to the emergency department of Víctor Ríos Ruiz Hospital of Los Angeles, Chile for epigastric colic pain, nausea, vomiting, abdominal distention, choluria, oliguria, anorexia, constipation, asthenia, adynamia and malaise. He is admitted to the surgery ward on the suspicion of acute cholecystitis. Abdominal ultrasound showed perihepatic and perisplenic free fluid and increased caliber of the inferior vena cava, associated with bilateral pleural effusion. Hypotension, paradoxical pulse and jugular engorgement developed, so he is transferred to the ICU where echocardiography confirmed cardiac tamponade. Pericardiocentesis was performed, which showed malignant cells on microscopy. A computerized tomography (CT scan showed a solid mass in the left inferior lung lobe, a nodule in the middle lobe and multiple mediastinal and hiliar bilateral lymphoadenopaties. DISCUSSION: Malignant pericardial effusion commonly presents as cardiac tamponade, being the lung cancer its main etiology. The prognosis of pericardial effusion in lung cancer is rather ominous, with an overall survival of less than 3 months.

  13. An overview of the brucellosis epidemic conditions in Iran

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    fallah rostami Fatemeh

    2016-01-01

    Full Text Available Brucellosis is as one of the most important infection common disease between human and cattle, which nowadays considered as one of serious health systems dilemma specifically in developing countries.Among brucellosis different species are the cause of infection, 4 species namely B.melitensis, BSuis, B.abortus , B.canis are the most major cause of disease in human(1.Indeed, in Iran that is considered as an endemic area of hygienic organization, B. melitensis is as the most prevalent cause of infection in human. This bacterium generally will transfer to human from contact with contaminated animals or the consumption of cattle production such as unpasteurized dairy (raw milk, soft cheese, cream or even via breathe can transfer to human. But the transfer of infection from person to person is very infrequent.Of course there is some evidence of transfer in a bone marrow transplanting. The most prevalent clinical symptoms of this disease are fever, night sweat, asthenia and anorexia (2.Naturally this infection involved different systems and organs in human body and the one of most major part of body can be mentioned to nervous system, muscuskeletal and also some organs like joints, heart and liver.Diagnosis of this infection can be made by some various laboratory tests like SAT, 2ME. But some misdiagnosis instances are very common. Thus, World Health Organization (WHO exposed in its report that the number of infected cases are maybe ten folds more than scale which stated by health organizations.

  14. Severe gastroduodenitis in a young man secondary to a hyperinfection for strongyloides stercolaris

    International Nuclear Information System (INIS)

    Patient that arrived to the emergency room with intense upper abdominal pain associated to abdominal distension, nausea and emesis of alimentary content, symptoms that begun five months before The patient referred some episodes of liquid diarrhea (neither mucous nor bloody), hyporexia, asthenia and adynamia that became progressive until limitation of his physical activity, taking him to prostration in bed and caquexia. The day before the consult he presents with melanemesis and vomit with total intolerance to the oral intake, associated to diarrheic dark stools which took him to the emergency room. During the diagnostic evaluation a severe gastroduodenitis due to a Strongyloides infection is evidenced, which is documented by gastric and duodenal biopsies. The patient also has an associated infection of HTLV-1 virus. With the diagnosis of a strongyloides hyperinfection, a treatment with ivermectine is started, with complete resolution of the symptoms. After showing the case in detail, we make a review of the literature about the treatment of this parasitic infection and its association with HTLV-1

  15. Pharmacological treatments for fatigue associated with palliative care: executive summary of a Cochrane Collaboration systematic review

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    Mochamat; Cuhls, Henning; Peuckmann‐Post, Vera; Minton, Ollie; Stone, Patrick; Radbruch, Lukas

    2016-01-01

    Abstract Background In palliative care patients, fatigue can be severely debilitating and is often not counteracted with rest, thereby impacting daily activity and quality of life. Further complicating issues are the multidimensionality, subjective nature and lack of a consensus definition of fatigue. The review aimed to evaluate the efficacy of pharmacological treatments for fatigue in palliative care, with a focus on patients at an advanced stage of disease, including patients with cancer and other chronic diseases. Methods We considered randomized controlled trials concerning adult palliative care with a focus on pharmacological treatment of fatigue compared with placebo, application of two drugs, usual care or a non‐pharmacological intervention. The primary outcome had to be non‐specific fatigue (or related terms such as asthenia). We searched the CENTRAL, MEDLINE, PsycINFO and EMBASE, and a selection of cancer journals up to 28 April 2014. Two review authors independently assessed trial quality and extracted the data. Results We screened 1645 publications of which 45 met the inclusion criteria. In total, we analysed data from 18 drugs and 4696 participants. There was a very high degree of statistical and clinical heterogeneity in the trials. Meta‐analysis of data was possible for modafinil, pemoline, and methylphenidate. Conclusions Due to the limited evidence, we cannot recommend a specific drug for the treatment of fatigue in palliative care patients. Some drugs, which may be beneficial for the treatment of fatigue associated with palliative care such as amantadine, methylphenidate, and modafinil, should be further researched. PMID:27066315

  16. Phenibut (beta-phenyl-GABA): a tranquilizer and nootropic drug.

    Science.gov (United States)

    Lapin, I

    2001-01-01

    Phenibut (beta-phenyl-gamma-aminobutyric acid HCl) is a neuropsychotropic drug that was discovered and introduced into clinical practice in Russia in the 1960s. It has anxiolytic and nootropic (cognition enhancing) effects. It acts as a GABA-mimetic, primarily at GABA(B) and, to some extent, at GABA(A) receptors. It also stimulates dopamine receptors and antagonizes beta-phenethylamine (PEA), a putative endogenous anxiogenic. The psychopharmacological activity of phenibut is similar to that of baclofen, a p-Cl-derivative of phenibut. This article reviews the structure-activity relationship of phenibut and its derivatives. Emphasis is placed on the importance of the position of the phenyl ring, the role of the carboxyl group, and the activity of optical isomers. Comparison of phenibut with piracetam and diazepam reveals similarities and differences in their pharmacological and clinical effects. Phenibut is widely used in Russia to relieve tension, anxiety, and fear, to improve sleep in psychosomatic or neurotic patients; as well as a pre- or post-operative medication. It is also used in the therapy of disorders characterized by asthenia and depression, as well as in post-traumatic stress, stuttering and vestibular disorders. PMID:11830761

  17. Epidemiological and clinical analysis of hepatitis virus A infections during three successive outbreaks in Sfax (Tunisia) between 2007 and 2010.

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    Gargouri, S; Fki Berrajah, L; Ayadi, I; Messedi, E; Jallouli, H; Hammami, A; Karray-Hakim, H

    2016-05-01

    to describe the epidemiological and clinical characteristics of HAV infection during three successive outbreaks occurring between 2007 and 2010 in the governorate of Sfax. epidemiological and clinical characteristics were retrospectively analyzed from the outbreak investigations. The diagnosis of acute hepatitis A was confirmed by ELISA detection of immunoglobulin M serum antibodies to HAV. 443 patients were identified and 159 of them investigated. Their mean age was 12.2 years and the M/F ratio was 0.9. The most affected age groups were 6-10 years (35%) and 11-15 years (33%). The most likely sources of contamination were drinking water from wells or tanks and direct transmission. The most frequent symptoms included asthenia, digestive disorders, and jaundice. Two cases of fulminant hepatitis were reported, one lethal. our results show that HAV endemicity in the governorate of Sfax has dropped from high to intermediate as demonstrated by the increasing age at primary HAV infection. Strengthening health education and improving access to drinking water would reduce the transmission risk of HAV in our regions. PMID:27412977

  18. Influence of methods of physical rehabilitation on quality of life in patients with toxic hepatitis

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    Shmatova E.A.

    2013-11-01

    Full Text Available He purpose was to improve the state of the quality of life in patients with chronic toxic hepatitis in-patient treatment phase by the use of comprehensive program of physical rehabilitation. We examined 84 patients, including 55 - and 29 men - women. Quality of life was measured using a questionnaire SF - 36. The data obtained were compared with those of healthy people - donors. Found that patients significantly reduced quality of life condition. A program of physical rehabilitation with the use of complex tools: physiotherapy, massage, segmental massage, treatment status, respiration system Yoga. On 10 - 15 day in-patient revealed a positive trend against other major symptoms of the disease. At 6 - 7 day disappeared signs asthenia, improved mood, appetite, depression and aggression disappeared, abdominal pain, heaviness in the right upper quadrant. It has also the normalization of the excretory function of the gastrointestinal - intestinal tract. Patients pay attention to the improvement of the symptoms: dyspnea, normalize heart rate, decrease pain and numbness in the legs.

  19. Epididymoorchitis as the First Finding in Patients with Brucellosis

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    Ayhan Karaköse

    2013-01-01

    Full Text Available Purpose. Acute scrotal pain as the first symptom of brucellosis is rarely observed. We aimed to evaluate the data of male patients with brucellosis and epididymoorchitis as the initial diagnosis. Material and Methods. The data of seven patients presented with testicular pain, hyperemia, swelling, and increased fever were reviewed. Concomitant focal diseases as well as clinical, laboratory, and radiological findings were retrospectively evaluated. Results. The mean age of the patients was 22.28 ± 7.78 (16–35 years. All patients presented with scrotal pain, swelling, and increased sweating. Additional findings included fever, asthenia, arthralgia, dysuria, shiver and rash, weight loss, and vomiting in 6, 5, 4, 4, 3, 2, and 1 patient, respectively. In all of 7 patients, the agglutination tests of Rose-Bengal and Wright were positive. Coombs test was positive only in 3 patients. The patients underwent antibiotic and conservative treatment. No relapse was observed following the treatment. Conclusion. In endemic regions, epididymoorchitis caused by brucellosis should be considered in the differential diagnosis of patients presenting with acute scrotal pain. Clinical and serological findings are sufficient for the diagnosis. Conservative management combined with antibiotic therapy is adequate for managing brucellar epididymoorchitis.

  20. Phase I study of afatinib combined with nintedanib in patients with advanced solid tumours

    Science.gov (United States)

    Bahleda, Rastislav; Hollebecque, Antoine; Varga, Andrea; Gazzah, Anas; Massard, Christophe; Deutsch, Eric; Amellal, Nadia; Farace, Françoise; Ould-Kaci, Mahmoud; Roux, Flavien; Marzin, Kristell; Soria, Jean-Charles

    2015-01-01

    Background: This Phase I study evaluated continuous- and intermittent-dosing (every other week) of afatinib plus nintedanib in patients with advanced solid tumours. Methods: In the dose-escalation phase (n=45), maximum tolerated doses (MTDs) were determined for continuous/intermittent afatinib 10, 20, 30 or 40 mg once daily plus continuous nintedanib 150 or 200 mg twice daily. Secondary objectives included safety and efficacy. Clinical activity of continuous afatinib plus nintedanib at the MTD was further evaluated in an expansion phase (n=25). Results: The most frequent dose-limiting toxicities were diarrhoea (11%) and transaminase elevations (7%). Maximum tolerated doses were afatinib 30 mg continuously plus nintedanib 150 mg, and afatinib 40 mg intermittently plus nintedanib 150 mg. Treatment-related adverse events (mostly Grade ⩽3) included diarrhoea (98%), asthenia (64%), nausea (62%) and vomiting (60%). In the dose-escalation phase, two patients had partial responses (PRs) and 27 (60%) had stable disease (SD). In the expansion phase, one complete response and three PRs were observed (all non-small cell lung cancer), with SD in 13 (52%) patients. No pharmacokinetic interactions were observed. Conclusions: MTDs of continuous or intermittent afatinib plus nintedanib demonstrated a manageable safety profile with proactive management of diarrhoea. Antitumour activity was observed in patients with solid tumours. PMID:26512876

  1. A first in human, safety, pharmacokinetics, and clinical activity phase I study of once weekly administration of the Hsp90 inhibitor ganetespib (STA-9090) in patients with solid malignancies

    International Nuclear Information System (INIS)

    This phase I study investigated the maximum tolerated dose (MTD), safety, pharmacokinetics and antitumor activity of ganetespib in patients with solid malignancies. Patients were enrolled in cohorts of escalating ganetespib doses, given as 1 hour IV infusion, once weekly for 3 weeks, followed by a 1-week rest until disease progression or unacceptable toxicity. Endpoints included safety, pharmacokinetic and pharmacodynamic parameters and preliminary clinical activity. Fifty-three patients were treated at doses escalating from 7 to 259 mg/m2. The most common adverse events were Grade 1 and 2 diarrhea, fatigue, nausea or vomiting. Dose-limiting toxicities (DLT) observed were: one Grade 3 amylase elevation (150 mg/m2), one Grade 3 diarrhea and one Grade 3 and one Grade 4 asthenia (259 mg/m2). The MTD was 216 mg/m2 and the recommended phase 2 dose was established at 200 mg/m2 given IV at Days 1, 8, and 15 every 4 weeks. There was a linear relationship between dose and exposure. Plasma HSP70 protein levels remained elevated for over a week post treatment. Disease control rate (objective response and stable disease at ≥ 16 weeks) was 24.4%. Ganetespib is well tolerated as a weekly infusion for 3 of every 4 weeks cycle. The recommended phase II dose is 200 mg/m2, and is associated with an acceptable tolerability profile. http://www.clinicaltrials.gov/NCT00687934

  2. Idiopathic Parkinson's disease: vocal and quality of life analysis

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    Luiza Furtado e Silva

    2012-09-01

    Full Text Available OBJECTIVE: To compare voice and life quality of male patients with idiopathic Parkinson's disease, with individuals without disease (Control Group. METHODS: A cross-sectional study that evaluated the voice of individuals with Parkinson's disease, the group was composed of 27 subjects, aged from 39 to 79 years-old (average 59.96. The Control Group was matched on sex and age. Participants underwent voice recording. Perceptual evaluation was made using GRBASI scale, which considers G as the overall degree of dysphonia, R as roughness, B as breathiness, A as asthenia, S as strain and I as instability. The acoustic parameters analyzed were: fundamental frequency, jitter, shimmer, and harmonic to noise ratio (NHR. For vocal self-perception analysis, we used the Voice Related Quality of Life protocol. RESULTS: Fundamental frequency and jitter presented higher values in the Parkinson's group. NHR values were higher in the Control Group. Perceptual analysis showed a deviation ranging. The vocal disorder self-perception demonstrated a worse impact on quality of life. CONCLUSIONS: Individuals with Parkinson's disease have an altered voice quality and a negative impact on quality of life.

  3. Work-related voice disorder

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    Paulo Eduardo Przysiezny

    2015-04-01

    Full Text Available INTRODUCTION: Dysphonia is the main symptom of the disorders of oral communication. However, voice disorders also present with other symptoms such as difficulty in maintaining the voice (asthenia, vocal fatigue, variation in habitual vocal fundamental frequency, hoarseness, lack of vocal volume and projection, loss of vocal efficiency, and weakness when speaking. There are several proposals for the etiologic classification of dysphonia: functional, organofunctional, organic, and work-related voice disorder (WRVD.OBJECTIVE: To conduct a literature review on WRVD and on the current Brazilian labor legislation.METHODS: This was a review article with bibliographical research conducted on the PubMed and Bireme databases, using the terms "work-related voice disorder", "occupational dysphonia", "dysphonia and labor legislation", and a review of labor and social security relevant laws.CONCLUSION: WRVD is a situation that frequently is listed as a reason for work absenteeism, functional rehabilitation, or for prolonged absence from work. Currently, forensic physicians have no comparative parameters to help with the analysis of vocal disorders. In certain situations WRVD may cause, work disability. This disorder may be labor-related, or be an adjuvant factor to work-related diseases.

  4. Voice characteristics of patients with glottic carcinoma analyzed using 'RBH' and 'GIRBAS' scales

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    Mitrović Slobodan

    2003-01-01

    Full Text Available Introduction Subjective voice analysis represents a diagnostic tool in phoniatry and is a part of everyday practice if a phoniatrist has a 'trained ear'. Material and methods This clinical prospective study included a sample of 20 male patients with malignant tumors involving one vocal cord - right or left. All patients underwent otorhinolaryngological and phoniatric examinations. Subjective acoustic analysis was done when patients pronounced numbers from 1 to 10. Afterwards, voice quality was evaluated separately by two professionals using a 4-levels scale: RBH scale (roughness-breathiness-hoarseness and GIRBAS scale (grade-instability-roughness-breathiness-asthenia-strain. Results 60% of patients presented with vocal cord immobility. Subjective acoustic analysis revealed hoarseness in 100% of patients (the most frequent value was Mod=3 intense hoarseness in 45% patients. Instability existed in 100% of patient (40% moderate, 40% intense. Strained voice existed in 100%, most frequently intense (45%. Conclusions All patients with glottic carcinoma presented with hoarseness, strain and instability of phonation. Non vibration of vocal cord significantly affects the degree of dysphonia, roughness, strain and instability. Aerodynamic changes affect voice hoarseness. RBH scale is simple, but GIRBAS scale described more psyhoacoustic phenomena most important in patients with glottic carcinoma.

  5. Toxicity and clinical tolerance of lonidamine.

    Science.gov (United States)

    Robustelli della Cuna, G; Pedrazzoli, P

    1991-04-01

    The new anticancer agent lonidamine has been recently revisited for the treatment of various solid tumors, due to its peculiar and unusual mechanism of action (ie, interference with energy metabolism of tumor cells, morphologically displayed by the appearance of "condensed mitochondria"). First generation trials have in fact demonstrated therapeutic activity and an unusual toxicity profile. Lonidamine is devoid of conventional side effects induced by antiproliferative agents (ie, myelosuppression, stomatitis, cystitis, alopecia, renal, hepatic, and cardiac toxicity). No serious or life-threatening adverse reactions have been recorded even over long term treatment periods. Given as a single agent (in daily doses ranging between 300 and 900 mg) lonidamine induces the following side effects: myalgia, testicular pain, asthenia, ototoxicity, nausea and vomiting, gastric pain, and drowsiness. Hyperesthesia and photophobia have also been reported. In combination with radiotherapy (in oral daily doses ranging between 300 and 450 mg) lonidamine was well tolerated, without any reported evidence of additional toxicity. When associated with cytotoxic agents no enhanced toxicity was observed. In particular, myelosuppression and other conventional nonhematological adverse reactions were never greater than would be expected with chemotherapy alone. The same applies to toxicity and tolerance of lonidamine when used concurrently with hypertermia. The data collected from large series of cancer patients treated with this new agent show that lonidamine is a safe drug whether used alone or in combination with other effective anticancer treatments. The reported therapeutic efficacy and the peculiar toxic profile make lonidamine an interesting new drug for future clinical trials. PMID:2031192

  6. Analysis of Chen Xiuyuan's Differential Treatment of Puerperal Disorders%陈修园辨治产后病探析

    Institute of Scientific and Technical Information of China (English)

    崔为

    2009-01-01

    This article summarizes Chen Xiuyuan's differential therapy for puerperal disorder. In response to the physiological and pathological characteristics of puer-peral disorders, the author advanced many points in treating the disease, including that the asthenia and sthenia of puerperal alternate chill and fever or postpartum lochia should be discriminated clearly, paying attention to spleen-stomach, removing blood stasis first, applying warm and supplement therapy simultaneously and purgative therapy shouldn't be applied to postpartum constipation ,etc.%总结陈修园关于产后疾病的辨治方法 ,针对产后生理、病理特性,提出对产后寒热、恶露等症,需明辨虚实、真假;治疗产后病证注重脾胃,以祛瘀为先,温补相兼,以及产后便秘不宜轻下等诸多临证要旨和观点.

  7. 病络学说与皮肤病的治疗%Theory of abnormal collateral and the theatment of skin disease

    Institute of Scientific and Technical Information of China (English)

    李元文; 姜颖娟; 张丰川; 孙占学; 赵丽娟

    2011-01-01

    This article theoretically explained the development of theory of collateral disease and the relationship between its and skin disease, and clinically discussed the treatment of stubborn skin disease with the method of unblocking therapy, drew a clear distinction between asthenia and sthenia , chills and fever during the treatment of abnormal collateral, and also shared the external treatment using herbs to treat skin disease due to abnormal collateral, in order to find a shortcut for the treatment of refractory skin diseases.%从理论角度探讨了病络学说的形成,及其与皮肤病的发展关系.并结合临床实践讨论了"以通为用"从络论治顽固性皮肤病,病络治疗应分清虚实寒热,并介绍了病络所致皮肤病的一些中药外治法.期望为顽固性难治性皮肤病的治疗探寻一条捷径.

  8. Characterization of Reemerging Chikungunya Virus

    Science.gov (United States)

    Sourisseau, Marion; Schilte, Clémentine; Casartelli, Nicoletta; Trouillet, Céline; Guivel-Benhassine, Florence; Rudnicka, Dominika; Sol-Foulon, Nathalie; Roux, Karin Le; Prevost, Marie-Christine; Fsihi, Hafida; Frenkiel, Marie-Pascale; Blanchet, Fabien; Afonso, Philippe V; Ceccaldi, Pierre-Emmanuel; Ozden, Simona; Gessain, Antoine; Schuffenecker, Isabelle; Verhasselt, Bruno; Zamborlini, Alessia; Saïb, Ali; Rey, Felix A; Arenzana-Seisdedos, Fernando; Desprès, Philippe; Michault, Alain; Albert, Matthew L; Schwartz, Olivier

    2007-01-01

    An unprecedented epidemic of chikungunya virus (CHIKV) infection recently started in countries of the Indian Ocean area, causing an acute and painful syndrome with strong fever, asthenia, skin rash, polyarthritis, and lethal cases of encephalitis. The basis for chikungunya disease and the tropism of CHIKV remain unknown. Here, we describe the replication characteristics of recent clinical CHIKV strains. Human epithelial and endothelial cells, primary fibroblasts and, to a lesser extent, monocyte-derived macrophages, were susceptible to infection and allowed viral production. In contrast, CHIKV did not replicate in lymphoid and monocytoid cell lines, primary lymphocytes and monocytes, or monocyte-derived dendritic cells. CHIKV replication was cytopathic and associated with an induction of apoptosis in infected cells. Chloroquine, bafilomycin-A1, and short hairpin RNAs against dynamin-2 inhibited viral production, indicating that viral entry occurs through pH-dependent endocytosis. CHIKV was highly sensitive to the antiviral activity of type I and II interferons. These results provide a general insight into the interaction between CHIKV and its mammalian host. PMID:17604450

  9. Clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre in Kashmir

    International Nuclear Information System (INIS)

    Objectives: To study the clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre. Methods: The study was conducted on a group of 1141 patients suspected of having HIV/AIDS on clinical grounds. Screening was done using different Elisa's as advised by NACO and those confirmed as HIV positive were studied for their clinical spectrum and different demographic parameters. Results: Out of 1141 patients tested, 26 proved to have HIV 1 infection with no case of HIV 2 detected. Mean age of presentation was 40.04 +- 7 years, main age group affected 31-40 years and a male: female ratio of 4.2:1 was observed. More than 42% were non Kashmiris with armed forces outnumbering all other occupational classes. Heterosexual transmission was the commonest with married out numbering unmarried. Fever, asthenia and weight loss were the predominant symptoms and pulmonary tuberculosis and oropharyngeal candidiasis commonest opportunistic infections. Conclusion: The clinical and demographic profile of HIV/AIDS patients in Kashmir is largely similar to the rest of India. Kashmir no longer stands immune to the menace of HIV/AIDS. With increasing globalization, frequent travel and change in social values the state is likely to witness an alarming rise in new cases unless a multi pronged approach is undertaken to control the spread. (author)

  10. [Spanish consensus statement for diagnosis and treatment of paroxysmal nocturnal haemoglobinuria].

    Science.gov (United States)

    Villegas, Ana; Arrizabalaga, Beatriz; Bonanad, Santiago; Colado, Enrique; Gaya, Anna; González, Ataúlfo; Jarque, Isidro; Núñez, Ramiro; Ojeda, Emilio; Orfao, Alberto; Ribera, José-María; Vicente, Vicente; Urbano-Ispizua, Álvaro

    2016-03-18

    Paroxysmal nocturnal haemoglobinuria (PNH) is an acquired clonal disorder of the haematopoietic progenitor cells due to a somatic mutation in theX-linked phosphatidylinositol glycan class A gene. The disease is characterized by intravascular haemolytic anaemia, propensity to thromboembolic events and bone marrow failure. Other direct complications of haemolysis include dysphagia, erectile dysfunction, abdominal pain, asthenia and chronic renal failure (65% of patients). The disease appears more often in the third decade of life and there is no sex or age preference. Detection of markers associated with glucosyl phosphatidyl inositol deficit by flow cytometry is currently used in the diagnosis of PNH. For years, transfusions have been the mainstay of therapy for PNH. A breakthrough in treatment has been the approval of the humanized monoclonal antibody eculizumab, which works by blocking the C5 complement protein, preventing its activation and therefore haemolysis. Several studies have confirmed that treatment with eculizumab avoids or decreases the need for transfusions, decreases the probability of thrombosis, improves the associated symptomatology and the quality of life in patients with PNH, showing an increase in survival. Because of rapid advances in the knowledge of the disease and its treatment, it may become necessary to adapt and standardize clinical guidelines for the management of patients with PNH. PMID:26895645

  11. Fluorodeoxyglucose-positron emission tomography/computed tomography in the staging and evaluation of treatment response in a patient with Castleman's disease: a case report

    Directory of Open Access Journals (Sweden)

    Pelosi Ettore

    2008-04-01

    Full Text Available Abstract Introduction Castleman's disease is a rare lymphatic polyclonal disorder that is characterised by unicentric or multicentric lymph node hyperplasia and non-specific symptoms and signs including fever, asthenia, weight loss, enlarged liver and abnormally high blood levels of antibodies. Case presentation We present the case of a 74-year-old man with Castleman's disease. The disease was detected with a contrast-enhanced computed tomography (CT scan and a fluorodeoxyglucose (FDG-positron emission tomography (PET/CT study; diagnosis was made with histopathology. After treatment with surgical excision followed by chemotherapy, the disease response was evaluated using both diagnostic techniques. However, only the PET study was able to identify the spread of the disease to the abdominal lymph nodes, which were both enlarged and normal size, and, after treatment, to evaluate the disease response. Conclusion Based on the results of previous case reports and on those of the present study, it seems that Castleman's disease has a high glucose metabolic activity. Therefore, the use of PET can be considered appropriate in order to stage or restage the disease and to evaluate the response of the disease to treatment.

  12. Rural tourism: a risk factor for schistosomiasis transmission in Brazil.

    Science.gov (United States)

    Enk, Martin Johannes; Amaral, Graciela Larissa; Costa e Silva, Matheus Fernandes; Silveira-Lemos, Denise; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; Correa-Oliveira, Rodrigo; Gazinnelli, Giovanni; Coelho, Paulo Marcos Zech; Massara, Cristiano Lara

    2010-07-01

    This paper reports an outbreak of acute schistosomiasis among 38 tourists who rented a country house in the district of Igarapé, the metropolitan region of Belo Horizonte, Brazil, during a holiday period in 2006. A total number of 32 individuals were positive for Schistosoma mansoni. Results of stool examinations revealed individual S. mansoni egg counts per gram of faeces (epg) ranging from 4-768 epg with a geometric mean egg count of 45. The most frequent clinical symptoms were abdominal pain (78.1%), headache (75%), fever (65.6%), dry cough (65.2%) and both diarrhoea and asthenia (59.4%). A malacological survey of the area, where 22 specimens of Biomphalaria glabrata were collected, revealed three (13.6%) specimens eliminating Schistosoma cercariae. This investigation re-confirms a recently described pattern of schistosomiasis infection, resulting in the acute form of the disease and connected to rural tourism, which contributes to the spread of the disease among the middle-class and into non-endemic areas. The lack of specific knowledge about acute schistosomiasis among health services causes an increased number of unnecessary diagnostic procedures and delays in accurate diagnosis and treatment, resulting in considerable discomfort for the patients. PMID:20721505

  13. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

    Science.gov (United States)

    Faraji, Fardin; Didgar, Farshid; Talaie-Zanjani, Afsoon; Mohammadbeigi, Abolfazl

    2013-01-01

    Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient's history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control. PMID:24250168

  14. Skin Rashes on Leg in Brucellosis: a Rare Presentation.

    Science.gov (United States)

    Shahcheraghi, Seyed Hossein; Ayatollahi, Jamshid

    2015-01-01

    Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region. PMID:26069179

  15. A tolerance study of single and multiple dosing of the selective dopamine uptake inhibitor GBR 12909 in healthy subjects.

    Science.gov (United States)

    Søgaard, U; Michalow, J; Butler, B; Lund Laursen, A; Ingersen, S H; Skrumsager, B K; Rafaelsen, O J

    1990-10-01

    GBR 12909 selectively blocks dopamine uptake and its biochemical and pharmacological profiles suggest that it may possess antidepressant activity and be of value in treatment of Parkinson's disease. The tolerance, pharmacokinetics and influence on psychomotor performance of GBR 12909 were investigated in a randomized placebo-controlled double-blind study. Four healthy subjects were administered oral single doses of 100, 200 and 300 mg GBR 12909 and placebo, and four other healthy subjects received, 50, 100 and 150 mg GBR 12909 and placebo once daily for 7 days. The intermediate and highest doses resulted in mild to moderate side-effects such as difficulties in concentrating, asthenia, feeling of drug influence and palpitations. No changes were observed in haematological and clinico-chemical parameters. A dose-related effect on ECG was observed with a slight reduction of the T-wave amplitude. No signs of arrhythmia or decompensation during exercise until exhaustion were observed. Psychomotor performance indicated dose-related sedation in the single-dose study. Only minor deviations from first order kinetics were observed. Elimination half-life was estimated at 1-2 days. Steady-state serum concentrations of GBR 12909 appeared to be attained within 1 week. Based on the results of this study, the estimated therapeutic doses are expected to be well-tolerated in patients. PMID:2150527

  16. COMPARATIVE STUDY OF EMOTIONAL DISORDERS STRUCTURE IN PATIENTS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    T. G. Mikhaylichenko

    2011-01-01

    Full Text Available Being based on a private experience, authors considered necessary to study features of emotional disorders that will allow understanding the mechanism of mental adaptation to disease at patients before and after OLT. In comparative research of structure of emotional frustration at the patients making the most numerous groups of patients before transplantation of a liver (viral hepatitis and autoimmune liver diseases, 129 persons, from them 75 before OLT are included at entering into a waiting list and 54 to through 22 ± 9 days after OLT. Distinctions in structure of emotional frustration are revealed: at patients with autoimmune liver diseases be- fore OLT and viral hepatitis after OLT the semiology combined with disturbing-depressive experiences and hypochondriac fixings is brightly expressed neurotic, them distinguishes high level of personal uneasiness. For patients with autoimmune liver diseases after OLT and viral hepatitis before OLT are characteristic moderately expressed neurotic frustration of an asthenia circle and low level of personal and situational anxiety. 

  17. Sunitinib-associated hypertension and neutropenia as efficacy biomarkers in metastatic renal cell carcinoma patients

    DEFF Research Database (Denmark)

    Donskov, Frede; Michaelson, M Dror; Puzanov, Igor;

    2015-01-01

    ), neutropenia (grade ⩾2), thrombocytopenia (grade ⩾2), hand-foot syndrome (grade >0), and asthenia/fatigue (grade >0)) were analysed in multivariate analyses of progression-free survival (PFS) and overall survival (OS) end points. RESULTS: On-treatment neutropenia and hypertension were associated with longer...... PFS (P=0.0276 and P<0.0001, respectively) and OS (P=0.0014 and P<0.0001, respectively), independent of baseline prognostic factors, including International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria. By 12-week landmark analysis, neutropenia was significantly associated with...... longer PFS and OS (P=0.013 and P=0.0122, respectively) and hypertension or hand-foot syndrome with longer OS (P=0.0036 and P=0.0218, respectively). The concordance index was 0.65 (95% CI: 0.63-0.67) for IMDC classification alone and 0.72 (95% CI: 0.70-0.74) when combined with hypertension and neutropenia...

  18. Subcutaneous Administration of Bortezomib in Combination with Thalidomide and Dexamethasone for Treatment of Newly Diagnosed Multiple Myeloma Patients

    Directory of Open Access Journals (Sweden)

    Shenghao Wu

    2015-01-01

    Full Text Available Objective. To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma (MM patients with the therapy of subcutaneous (subQ administration of bortezomib and dexamethasone plus thalidomide (VTD regimen. Methods. A total of 60 newly diagnosed MM patients were analyzed. 30 patients received improved VTD regimen (improved VTD group with the subQ injection of bortezomib and the other 30 patients received conventional VTD regimen (VTD group.The efficacy and safety of two groups were analyzed retrospectively. Results. The overall remission (OR after eight cycles of treatment was 73.3% in the VTD group and 76.7% in the improved VTD group (P>0.05. No significant differences in time to 1-year estimate of overall survival (72% versus 75%, P=0.848 and progression-free survival (median 22 months versus 25 months; P=0.725 between two groups. The main toxicities related to therapy were leukopenia, neutropenia, thrombocytopenia, asthenia, fatigue, and renal and urinary disorders. Grade 3 and higher adverse events were significantly less common in the improved VTD group (50% than VTD group (80%, P=0.015. Conclusions. The improved VTD regimen by changing bortezomib from intravenous administration to subcutaneous injection has noninferior efficacy to standard VTD regimen, with an improved safety profile and reduced adverse events.

  19. Castlemans Disease Mimetizing Pancreatic Tumor

    Directory of Open Access Journals (Sweden)

    Franz Robert Apodaca-Torrez

    2012-01-01

    Full Text Available Context Angiofollicular lymph node hyperplasia or Castleman’s disease is a rare clinical condition. Knowledge about etiology and physiopathology; and treatment management as well are yet to be defined. Unicentric presentation of this disease affecting single lymph nodes in the mediastinum seems to be the most common presentation. Castleman’s disease localized in the pancreas topographic area that mimics a pancreatic neoplasm is an even more uncommon event, with available published data of less than 15 cases until now. Case report We present a 64-year-old male patient with a six-month past history of asthenia, adynamia, and lack of general clinical conditions. Imaging studies showed a nodular hypoechoic mass in the pancreatic head. Enucleation of the lesion was performed. Histopathological study revealed unicentric form of Castleman’s Disease. Conclusions Castleman’s disease mimetizing pancreatic tumor is uncommon and it also curses with a difficult preoperative diagnosis. Surgery seems to be the best therapeutic alternative for this disease.

  20. Intensive Farmaco- Surveillance of Interferon Alpha 2b Recombinant in Multiple Sclerosis.

    Directory of Open Access Journals (Sweden)

    Leslie Pérez Ruiz

    2007-12-01

    Full Text Available Background: The interferon alpha 2b recombinant, produced in Cuba, is used in the treatment of different illnesses, such as the multiple sclerosis. For its commercialization it is needed to know its safety scope. Objective: To assess the adverse reactions of interferon alpha 2b recombinant in the treatment of multiple sclerosis. Method: During the period between 1996 and 2006, 70 clinical histories and data collection notebooks of patients included in the randomized double blind national clinical trial phase IV were revised. This trial was developed in the Clinic of Multiple Sclerosis of the Hospital "Dr. Gustavo Aldereguía Lima" in Cienfuegos. With regard to the total of manifested adverse reactions we analyzed type, length, and use of a given treatment to counteract them, intensity level (light, moderate, serious or lethal and causality level (definitive, probable, possible, conditional or not related. Results: 53 patients out of the total presented 207 adverse reactions to interferon. The most frequent were: fever, migraine, chills, arthralgia, asthenia and myalgia, being most of them moderate collateral effects of definitive character. In 197 patients the outcome was favorable. Conclusion: The use of the interferon alpha 2b recombinant was safe in the treatment of the multiple sclerosis in these patients. 

  1. Evaluation with stabilometric platform of balance disorders in osteoporosis patients. A proposal for a diagnostic protocol.

    Science.gov (United States)

    Cultrera, Pina; Pratelli, Elisa; Petrai, Veronica; Postiglione, Marco; Zambelan, Giulia; Pasquetti, Pietro

    2010-05-01

    Osteoporosis is a systemic disease with reduced bone mass and qualitative alterations of the bone, associated to increased risk of fracture. Pathogenesis of osteoporosis fractures is multifactorial. Main risk factor is falls (except for vertebral fragility fractures which occurs often in absence of trauma). Aging by itself produces physiological changes: muscular hypotrophy with asthenia, deficit of visus and hearing together with associated pathologies and multi-drug therapies. In osteoporosis patients with vertebral fractures posture change occurs which reduces balance. After clinical postural evaluation it is possible to carry out instrumental evaluation of posture with computerized methods such as stabilometry, baropodometry, dynanometry and gait analysis. Examination carried out with use of stabilometric computerized platform allows stabilometric (body sway assessment) as well as posturometric examination (center of pressure assessment during quiet standing). Fundamental parameters obtained are: position of the body center of gravity, area and shape of sway density curve and velocity variables. Protocol of evaluation includes assessment of examination in standard condition and in condition of temporary sensorial deprivation (to investigate the influence of various afferent systems on the maintenance of posture and balance). Accurate evaluation of postural control in osteoporosis patients constitutes a fundamental tool in fracture risk evaluation due to fall and in identification and correction of modifiable factors responsible for balance defect. This approach, together with adequate drug therapy, may lead to significant reduction of fractures in osteoporosis patients with subsequent reduction of hospitalization and residual consequent disabilities. PMID:22460016

  2. Development of countermeasures for medical problems encountered in space flight

    Science.gov (United States)

    Nicogossian, Arnauld E.; Rummel, John D.; Leveton, Lauren; Teeter, Ron

    1992-08-01

    By the turn of this century, long-duration space missions, either in low Earth orbit or for got early planetary missions, will become commonplace. From the physiological standpoint, exposure to the weightless environment results in changes in body function, some of which are adaptive in nature and some of which can be life threatening. Important issues such as environmental health, radiation protection, physical deconditioning, and bone and muscle loss are of concern to life scientists and mission designers. Physical conditioning techniques such as exercise are not sufficient to protect future space travellers. A review of past experience with piloted missions has shown that gradual breakdown in bone and muscle tissue, together with fluid losses, despite a vigorous exercise regimen can ultimately lead to increased evidence of renal stones, musculoskeletal injuries, and bone fractures. Biological effects of radiation can, over long periods of time increase the risk of cancer development. Today, a vigorous program of study on the means to provide a complex exercise regimen to the antigravity muscles and skeleton is under study. Additional evaluation of artificial gravity as a mechanism to counteract bone and muscle deconditioning and cardiovascular asthenia is under study. New radiation methods are being developed. This paper will deal with the results of these studies.

  3. PATIENTS’ PSYCHOSOMATIC STATUS BEFORE AND AFTER ORTHOPEDIC CORRECTION OF MAXILLOFACIAL DEFECTS

    Directory of Open Access Journals (Sweden)

    A. A. Kulakov

    2012-01-01

    Full Text Available A medicopsychological study of the time course of psychic changes was conducted in 88 cancer patients with defects of facial soft tissues (n = 38 and maxilla (n = 50. Since the patients’ visit to an oncologist, the diagnostic-stage depth of mental disorders was rather various: from mild asthenia to depression. Thus, 88 (100 % patients were found to have an anxious feeling, 16 (18.2 % had affective-shock reactions; 7 (7.9 % had reactive depression. In the postoperative period, anxiety-depressive syndrome gave way to astheno-depressive one. After hospital discharge, the reactive state became less tense during psychosocial readaptation, the characteriological personality changes were increasingly more pronounced in the forefront in the patients. They became anxious, suspicious, unconfident about themselves, sensitive, tried to avoid difficult situations in life. The circle of interests was limited to thoughts on their own health. Combination therapy with psychotropic drugs was used to correct the mental status of patients with acquired maxillary defects in the study group. The dosage of the drugs was individually adjusted according to the degree of psychopathological manifestations. 

  4. Antiproliferative effects of lanreotide autogel in patients with progressive, well-differentiated neuroendocrine tumours: a Spanish, multicentre, open-label, single arm phase II study

    International Nuclear Information System (INIS)

    Somatostatin analogues (SSAs) are indicated to relieve carcinoid syndrome but seem to have antiproliferative effects on neuroendocrine tumours (NETs). This is the first prospective study investigating tumour stabilisation with the long-acting SSA lanreotide Autogel in patients with progressive NETs. This was a multicentre, open-label, phase II trial conducted in 17 Spanish specialist centres. Patients with well-differentiated NETs and radiologically confirmed progression within the previous 6 months received lanreotide Autogel, 120 mg every 28 days over ≤92 weeks. The primary endpoint was progression-free survival (PFS). Secondary endpoints were response rate, tumour biomarkers, symptom control, quality of life (QoL), and safety. Radiographic imaging was assessed by a blinded central radiologist. Of 30 patients included in the efficacy and safety analyses, 40% had midgut tumours and 27% pancreatic tumours; 63% of tumours were functioning. Median PFS time was 12.9 (95% CI: 7.9, 16.5) months, and most patients achieved disease stabilisation (89%) or partial response (4%). No deterioration in QoL was observed. Nineteen patients (63%) experienced treatment-related adverse events, most frequently diarrhoea and asthenia; only one treatment-related adverse event (aerophagia) was severe. Lanreotide Autogel provided effective tumour stabilisation and PFS >12 months in patients with progressive NETs ineligible for surgery or chemotherapy, with a safety profile consistent with the pharmacology of the class. ClinicalTrials.gov Identifier http://clinicaltrials.gov/show/NCT00326469; EU Clinical Trial Register EudraCT no 2004-002871-18

  5. Sulbutiamine in sports.

    Science.gov (United States)

    Sobolevsky, Tim; Rodchenkov, Grigory

    2010-01-01

    Sulbutiamine (isobutyryl thiamine disulfide) is a lipophilic derivative of thiamine used for the treatment of asthenia and other related pathological conditions. It is available over-the-counter in several countries either as a component of nutritional supplements or as a pharmaceutical preparation. The presence of sulbutiamine in urinary doping control samples was monitored to evaluate the relevance of its use in sports. As one of the sulbutiamine metabolites has very close retention time and the same characteristic ion (m/z 194) as the main boldenone metabolite, the raw data files generated from the screening for anabolic steroids were automatically reprocessed to identify the samples containing sulbutiamine. It was found that of ca. 16 000 samples analyzed in the Russian laboratory during 2009, about 100 samples contained sulbutiamine. It is important to note that most of these samples were collected in-competition, and sulbutiamine concentration was estimated to be greater than 500 ng/ml. This may indicate that sulbutiamine was intentionally administered for its ergogenic and mild stimulating properties. PMID:21204296

  6. Large gangliocytic paraganglioma of the duodenum:A rare entity

    Institute of Scientific and Technical Information of China (English)

    Alejandra; Gordillo; Hernández; Eduardo; Dominguez-Adame; Lanuza; Auxiliadora; Cano; Matias; Rosario; Perez; Huertas; Katherine; Maria; Gallardo; Rodriguez; Purificacion; Gallinato; Perez; Fernando; Oliva; Mompean

    2015-01-01

    Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.

  7. Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect

    Directory of Open Access Journals (Sweden)

    Juan Lacalzada

    2010-01-01

    Full Text Available A hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE had shown a PVS and no valve vegetations were observed. Following discharge, he was readmitted with fever and blood cultures positive for Staphylococcus haemolyticus. A new TTE revealed two pulmonary valve vegetations and a previously undetected ostium secundum-type atrial septal defect (ASD, confirmed by transesophageal echocardiography. The clinical course was uneventful with intravenous antibiotic treatment and the patient was safely discharged. This is a case of pulmonary valve infective endocarditis (IE. The incidence of right-sided IE is on the rise due to the increased number of patients using central venous lines, pacing, haemodialysis and other intravascular devices. Pulmonary valve IE is extremely rare, especially in structurally normal hearts. The case reported here, presents a combination of predisposing factors, such as severe congenital PVS, the presence of a central venous catheter, and haemodialysis. The fact that it was an older patient with severe congenital PVS and associated with a previously undiagnosed ASD, is also an unusual feature of this case, making it even more interesting.

  8. Clinical and laboratory diagnosis of dengue fever in travelers

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    N. I. Khokhlova

    2015-01-01

    Full Text Available The paper presents the analysis of clinical and laboratory symptoms in 35 adult patients with denger fever, Novosibirsk residents, which travelled in endemic countries, mostly Tailand. The classic form of the disease was determined in all cases. The moderate form was in 71,5% patients, the severe form was in the rest ones. The diagnosis of dengue was verified by detection of specific immunoglobulin M and in some cases immunoglobulin G and also virus dengue NS1 antigen by immunochromatography. The dominant clinical symptoms in observed patients were fever for 3–8 days (100%, mostly high one (71,4%, asthenia (97,1%, anorexia (100%, myalgia or/and arthralgia (77,1%, exantema (60%, hepatomegaly (62,8%. The gematologic indicators were represented with thrombocytopenia in 91,4% patients (from 167 to 20×109/l и leucopenia in 85,7% patients (from 3,9 to 1,1×109/l. The cytolitic syndrom was revealed in 80% patients with predominance of aspartate aminotransferase activity in early period of the disease. 

  9. Resolution of statin-induced myalgia by correcting vitamin D deficiency: a case report

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    Luca Gallelli

    2015-03-01

    Full Text Available The onset of myalgia is a well-known side effect of cholesterol-lowering statins. Recent studiesa dvanced the hypothesis that reduced vitamin D levels may play a role in the onset of myalgia in statin users and potentially a vitamin D supplementation may be useful in these cases, as suggested by the present case report.A 52-year-old man with a history of smoke and successfully controlled hypertension presented with chest pain and asthenia. He was diagnosed with stable angina pectoris and discharged on atorvastatin. Due to the onset of myalgia, the dosage of atorvastatin was reduced (from 40 mg daily to 20 mg daily and then atorvastatin was switched to rosuvastatin without symptoms improvement. Switching from rosuvastatin to ezetimibe resulted in pain improvement, but also in plasma lipids increase beyond the normal range. Ezetimibe was switched to rosuvastatin+ analgesic; in the meanwhile a high-performance liquid chromatography (HPLC analysis showed low levels of 25-hydroxy-vitamin D and 1-25-dihydroxy-vitamin D. Therefore, vitamin D3 was added to rosuvastatin, resulting in pain improvement, decrease of plasma lipids and progressive discontinuation of analgesics. During the follow-up, rosuvastatin was switched to atorvastatin + vitamin D3, with a good control of plasma lipid levels and without the onset of myalgia.http://dx.doi.org/10.7175/cmi.v9i1.978

  10. Hematology and serum biochemistry in debilitated, free-ranging raccoon dogs (Nyctereutes procyonoides) infested with sarcoptic mange.

    Science.gov (United States)

    Kido, Nobuhide; Kamegaya, Chihiro; Omiya, Tomoko; Wada, Yuko; Takahashi, Maya; Yamamoto, Yasuhiko

    2011-12-01

    Frequent outbreaks of Sarcoptes scabiei infestation in raccoon dogs (Nyctereutes procyonoides) have been reported in Japan. Although many raccoon dogs are brought to Kanazawa Zoological Garden (Yokohama, Kanagawa, Japan) because of S. scabiei infestation and debilitation, some of them die of asthenia. The clinical status of severely debilitated raccoon dogs must be determined to save their lives. In this study, we compared hematological and serum biochemical values between severely debilitated and nondebilitated raccoon dogs infested with S. scabiei. The total protein, albumin, glucose, and calcium values of debilitated raccoon dogs were significantly lower than those of nondebilitated raccoon dogs. On the other hand, debilitated raccoon dogs had significantly higher aspartate aminotransferase, total bilirubin, blood urea nitrogen, sodium, chloride, and phosphorus values than did nondebilitated raccoon dogs. The increase in the blood urea nitrogen value was particularly dramatic. The present study revealed that debilitated raccoon dogs infested with S. scabiei exhibited abnormal hematological values compared with nondebilitated raccoon dogs infested with S. scabiei. Clinically, the raccoon dogs developed malnutrition and sepsis if the mange infestation was untreated. Moreover, dehydration associated with appetite loss may have resulted in insufficient renal perfusion. These findings suggest that chronic S. scabiei infestations debilitated the raccoon dogs and resulted in physiological changes that were detected with hematological and serum biochemical tests. PMID:21749931

  11. Pattern of relapse of glioblastoma multiforme treated with radical radio-chemotherapy: Could a margin reduction be proposed?

    Science.gov (United States)

    Buglione, Michela; Pedretti, Sara; Poliani, Pietro Luigi; Liserre, Roberto; Gipponi, Stefano; Spena, Giannantonio; Borghetti, Paolo; Pegurri, Ludovica; Saiani, Federica; Spiazzi, Luigi; Tesini, Giulia; Uccelli, Chiara; Triggiani, Luca; Magrini, Stefano Maria

    2016-06-01

    To analyse the pattern of recurrence of patients treated with Stupp protocol in relation to technique, to compare in silico plans with reduced margin (1 cm) with the original ones and to analyse toxicity. 105 patients were treated: 85 had local recurrence and 68 of them were analysed. Recurrence was considered in field, marginal and distant if >80 %, 20-80 % or silico plans were retrospectively recalculated using the same technique, fields angles and treatment planning system of the original ones. The pattern of recurrence was in field, marginal and distant in 88, 10 and 2 % respectively and was similar in in silico plans. The margin reduction appears to spare 100 cc of healthy brain by 57 Gy-volume (p = 0.02). The target coverage was worse in standard plans (pt student silico planning. A higher incidence of asthenia and leuko-encephalopathy was observed in patients with greater percentage of healthy brain included in 57 Gy-volume. No differences in the pattern of recurrence according to margins were found. The margin reduction determines sparing of healthy brain and could possibly reduce the incidence of late toxicity. Margin reduction could allow to use less sophisticated techniques, ensuring appropriate target coverage, and the choice of more costly techniques could be reserved to selected cases. PMID:27025858

  12. Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients.

    Science.gov (United States)

    Castori, Marco; Camerota, Filippo; Celletti, Claudia; Danese, Chiara; Santilli, Valter; Saraceni, Vincenzo Maria; Grammatico, Paola

    2010-03-01

    Hypermobility type Ehlers-Danlos syndrome (HT-EDS) is a relatively frequent, although commonly misdiagnosed variant of Ehlers-Danlos syndrome, mainly characterized by marked joint instability and mild cutaneous involvement. Chronic pain, asthenia, and gastrointestinal and pelvic dysfunction are characteristic additional manifestations. We report on 21 HT-EDS patients selected from a group of 40 subjects with suspected mild hereditary connective tissue disorder. General, mucocutaneous, musculoskeletal, cardiovascular, neurologic, gastrointestinal, urogynecological, and ear-nose-throat abnormalities are investigated systematically and tabulated. Six distinct clinical presentations of HT-EDS are outlined, whose tabulation is a mnemonic for the practicing clinical geneticist in an attempt to diagnose this condition accurately. With detailed clinical records and phenotype comparison among patients of different ages, the natural history of the disorder is defined. Three phases (namely, hypermobility, pain, and stiffness) are delineated based on distinguishing manifestations. A constellation of additional, apparently uncommon abnormalities is also identified, including dolichocolon, dysphonia, and Arnold-Chiari type I malformation. Their further investigation may contribute to an understanding of the pathogenesis of the protean manifestations of HT-EDS, and a more effective approach to the evaluation and management of affected individuals. PMID:20140961

  13. Characterization of reemerging chikungunya virus.

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    Marion Sourisseau

    2007-06-01

    Full Text Available An unprecedented epidemic of chikungunya virus (CHIKV infection recently started in countries of the Indian Ocean area, causing an acute and painful syndrome with strong fever, asthenia, skin rash, polyarthritis, and lethal cases of encephalitis. The basis for chikungunya disease and the tropism of CHIKV remain unknown. Here, we describe the replication characteristics of recent clinical CHIKV strains. Human epithelial and endothelial cells, primary fibroblasts and, to a lesser extent, monocyte-derived macrophages, were susceptible to infection and allowed viral production. In contrast, CHIKV did not replicate in lymphoid and monocytoid cell lines, primary lymphocytes and monocytes, or monocyte-derived dendritic cells. CHIKV replication was cytopathic and associated with an induction of apoptosis in infected cells. Chloroquine, bafilomycin-A1, and short hairpin RNAs against dynamin-2 inhibited viral production, indicating that viral entry occurs through pH-dependent endocytosis. CHIKV was highly sensitive to the antiviral activity of type I and II interferons. These results provide a general insight into the interaction between CHIKV and its mammalian host.

  14. The myelodysplastic syndromes: diagnosis, prognosis and therapy

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    Cristina Clissa

    2013-03-01

    Full Text Available The authors conducted a systematic review of the medical literature published in the past 15 years on the myelodysplastic syndromes (MDSs. The MDSs are typically seen in the elderly, and primary and secondary forms can be distinguished. This heterogeneous group of hematologic diseases is caused by clonal disorders of pluripotent hematopoietic stem cells. The pathogenesis of the syndromes appears to be multifactorial. Genetic damage, spontaneous or induced by environmental or iatrogenic factors, leads to abnormal proliferation and apoptosis of bone marrow stem cells. The most common presentation is anemia, alone or associated with thrombocytopenia and / or neutropenia, accompanied by the related symptoms and clinical signs (asthenia, fatigue, bleeding, recurrent infections. The diagnosis involves the exclusion of other causes of cytopenia and is based on well-defined, internationally recognized criteria, which are mainly morphologic and cytogenetic. Accurate diagnosis of MDS is essential for prognostic evaluation and for estimating the risk of progression to acute myeloid leukemia (AML. The risk is rated according to the International Prognostic Scoring System (IPSS, which includes 4 levels (low, intermediate-1, intermediate-2, and high. The risk class is a major determinant of the therapeutic approach. Apart from supportive care (transfusions, the main therapeutic tools are erythropoiesis-stimulating agents (ESAs, iron-chelating agents, immunomodulatory drugs, demethylating agents and, in selected cases, allogeneic bone marrow transplantation.

  15. CARACTERÍSTICAS CLÍNICO EPIDEMIOLOGICAS DE LOS PACIENTES CON LEUCEMIA AGUDA DEL SERVICIO DE HEMATOLOGIA DEL HOSPITAL ALMANZOR AGUINAGA ASENJO

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    Ana María Polo-Capuñay

    2014-01-01

    Full Text Available Objective: To identify the organisms that conform the normal flora of the external auditory canal. Material and Methods: Retrospective, transversal and descriptive. We reviewed a total of 55 medical records with a diagnosis of acute leukemia, taken from the HNAAA registration office during the period from January 2005 to March 2010. Results: During the study period, 142 cases were diagnosed with Leukemia, 105 (73.94% were acute leukemia. Of the 105 cases, 55 were evaluated. Of these 39 were males and 16 females. The most common age group was between 31-55 years (30.9% and the least frequent was 0-2 years (3.6%. 38 patients (69.1% were diagnosed as outpatients and 17 (30.9% diagnosed in emergency. Acute lymphocytic leukemia is more common in men than in women. The type of acute leukemia was undetermined for 7.27%. Within the initial manifestations collected we found more anemia, pallor, fever, body aches, and others (gingival, abdominal pain and vomiting, whereas we found fewer asthenia, fatigue, and bleeding. For laboratory data, 20 patients (69.1% had leukopenia, 33 patients (98.2% had thrombocytopenia and 48 patients (87.3% presented low hemoglobin. Conclusions: The prevalence of acute leukemia was 73.94%. The predominant age group was between 31-55 years. The most common signs and symptoms developed during the disease were, splenomegaly, hepatomegaly, anemia, bruising and petechiae. (Horiz Med 2014; 14(1: 18-23

  16. Whipple's disease: rare disorder and late diagnosis

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    Viviane Plasse Renon

    2012-10-01

    Full Text Available Whipple's disease is a rare systemic infectious disorder caused by the bacterium Tropheryma whipplei. We report the case of a 61-year-old male patient who presented to emergency room complaining of asthenia, arthralgia, anorexia, articular complaints intermittent diarrhea, and a 10-kg weight loss in one year. Laboratory tests showed the following results: Hb = 7.5 g/dL, albumin = 2.5 mg/dL, weight = 50.3 kg (BMI 17.4 kg/m². Upper gastrointestinal endoscopy revealed areas of focal enanthema in the duodenum. An endoscopic biopsy was suggestive of Whipple's disease. Diagnosis was confirmed based on a positive serum polymerase chain reaction. Treatment was initiated with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole. After one year of treatment, the patient was asymptomatic, with Hb = 13.5 g/dL, serum albumin = 5.3 mg/dL, and weight = 70 kg (BMI 24.2 kg/m². Whipple's disease should be considered a differential diagnosis in patients with prolonged constitutional and/or gastrointestinal symptoms. Appropriate antibiotic treatment improves the quality of life of patients.

  17. Multiple-System Atrophy with Cerebellar Predominance Presenting as Respiratory Insufficiency and Vocal Cords Paralysis

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    Ramon Andrade Bezerra de Mello

    2010-01-01

    Full Text Available Background. MSA (Multiple System Atrophy may be associated either with Parkinsonism or with cerebellar ataxia (MSA-c subtype. It is considered a rare disease, but many patients are misdiagnosed as suffering from idiopathic Parkinson's disease. In this paper, we report a case of a patient admitted with respiratory failure and vocal cords paralysis due to MSA-c. Case Report. A 79-year-old Caucasian woman was admitted in March 2010 with dyspnea, asthenia, stridor, and respiratory failure needing noninvasive ventilation. She had orthostatic blood pressure decline, constipation, insomnia, daytime sleepiness, and snoring. The neurologic examination revealed cerebellar ataxia. A laryngoscopy revealed vocal cord paralysis in midline position and tracheostomy was performed. The Brain Magnetic Resonance Imaging revealed atrophy of middle cerebellar peduncles and pons with the “hot cross bun sign.” Conclusion. Although Multiple-system atrophy is a rare disease, unexplained respiratory failure, bilateral vocal cord paralysis, or stridor should lead to consider MSA as diagnosis.

  18. Chronic polyarthritis in a patient affected by sarcoidosis and chronic HCV infection. Case report and review of the literature

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    A. Carcassi

    2011-09-01

    Full Text Available Sarcoidosis is a systemic granulomatous disease of unknown etiology that has a wide variety of clinical manifestation. Lung involvement may slowly undergo pulmonary fibrosis. Chronic sarcoid arthritis is a rare, usually non destructive arthropathy; may be a mono, oligo or polyarthritis. Knees, ankles, shoulders, wrists and small joint of the hands and feet may be involved. It can involve skin, eyes, exocrine glands such as salivary and lacrimal glands, and many other tissues. We describe the case of a 77 years old woman with a history of rhinopharyngitis with epistaxis and chronic laryngitis since youth; a dry mouth and throat, a erytematous, infiltrative skin lesion in the forehead and in the nape of the neck, a purple lesion of the left ear and nose, skin distrophy of the hands from 30 years before. She underwent an operation for a left femoral fracture with emotrasfusion 14 years ago. Then she developed a polyarthritis of the small joints of the hands (II, III and IV right DIP, I, III, e V left DIP; III and V bilateral PIP, knees, tarsi, toes and left elbow. An HCV chronic hepatitis was discovered 6 years before. She is affected by productive cough, dysphonia, dyspnea at rest, feveret, cephalea and asthenia for over 5 years. Laboratory examination revealed leukopenia, HCV hepatitis with anti HCV, HCV-RNA, transaminases elevated and cryoglobulinemia. HCV may be involved in the etiopathogenesis of rheumatic diseases, lung fibrosis and may moreover contribuite to the onset or progression of sarcoidosis; the possible pathogenesis is discussed.

  19. Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis

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    Mahe J

    2013-08-01

    Full Text Available Julien Mahe,1 Aurélie Meurette,2 Anne Moreau,3 Caroline Vercel,2 Pascale Jolliet1,4 1Clinical Pharmacology Department, Institute of Biology, University Hospital, Nantes, France; 2Clinical Nephrology and Immunology Department, University Hospital, Nantes, France; 3Laboratory of Pathology, University Hospital, Nantes, France; 4EA 4275 Biostatistics, Pharmacoepidemiology and Subjective Measures in Health Sciences, University of Nantes, Nantes, France Abstract: Interferon beta-1a is available as an immunomodulating agent for relapsing forms of multiple sclerosis. Common side effects include flu-like symptoms, asthenia, anorexia, and administration site reaction. Kidney disorders are rarely reported. In this study we describe the case of a woman who has been undergoing treatment with interferon beta-1a for multiple sclerosis for 5 years. She developed a hemolytic-uremic syndrome with intravascular hemolysis in a context of severe hypertension. A kidney biopsy showed a thrombotic microangiopathy. This observation highlights an uncommon side effect of long-term interferon beta-1a therapy. Pathophysiological mechanisms leading to this complication might be explained by the antiangiogenic activity of interferon. Keywords: thrombotic microangiopathy, interferon beta, hemolytic-uremic syndrome, antiangiogenic activity

  20. Rural tourism: a risk factor for schistosomiasis transmission in Brazil

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    Martin Johannes Enk

    2010-07-01

    Full Text Available This paper reports an outbreak of acute schistosomiasis among 38 tourists who rented a country house in the district of Igarapé, the metropolitan region of Belo Horizonte, Brazil, during a holiday period in 2006. A total number of 32 individuals were positive for Schistosoma mansoni. Results of stool examinations revealed individual S. mansoni egg counts per gram of faeces (epg ranging from 4-768 epg with a geometric mean egg count of 45. The most frequent clinical symptoms were abdominal pain (78.1%, headache (75%, fever (65.6%, dry cough (65.2% and both diarrhoea and asthenia (59.4%. A malacological survey of the area, where 22 specimens of Biomphalaria glabrata were collected, revealed three (13.6% specimens eliminating Schistosoma cercariae. This investigation re-confirms a recently described pattern of schistosomiasis infection, resulting in the acute form of the disease and connected to rural tourism, which contributes to the spread of the disease among the middle-class and into non-endemic areas. The lack of specific knowledge about acute schistosomiasis among health services causes an increased number of unnecessary diagnostic procedures and delays in accurate diagnosis and treatment, resulting in considerable discomfort for the patients.

  1. 腹泻型肠易激综合征影响因素与中医体质分型研究%Study on the Influential Factors of Diarrhea-Predominant Irritable Bowel Syndrome and Traditional Chinese Medicine Constitution Typing

    Institute of Scientific and Technical Information of China (English)

    龚军

    2014-01-01

    Objective:To analyze the constitution features of the patient with diarrhea-predominant irritable bowel syndrome,and investi-gate the relationship between its influential factors and traditional Chinese medicine constitution typing. Methods:Used a 1 1 matched case-control design,judged the constitution types in patients with IBS-D through the constitution of TCM scale score,compared the dis-tribution characteristics of TCM constitutional types under the influence factors of patients with IBS-D and analyzed the risk IBS-D pa-tient with different constitution types used by logistic regression analysis. Results:IBS-D patients with pathological constitution types of yang-asthenia,phlegm-dampness,qi-depression,qi-asthenia,dampness-heat significantly higher than the normal population (χ2 = - 2. 790,P < 0. 01);the IBS-D prevalence of women is higher than men(χ2 = - 7. 308,P < 0. 01),the yang-asthenia,dampness-heat,qi-asthenia,qi-depression constitution in female population suffering from IBS-D were more dangerous than gentleness populations, the risk were respectively 4. 531 times,2. 805 times,2. 574 times,and 2. 335 times;And the males with phlegm-dampness constitution suffering from IBS-D were more dangerous than gentleness populations as 1. 943 times(OR = 1. 943);And different age,duration of disease,occupation had no effect on the incidence of IBS-D. Conclusion:The incidence of IBS-D in different gender groups have the cor-relation with the TCM constitution,improving patient with IBS-D pathological constitution can be effective in preventing the occurrence and development of IBS-D.%目的:分析腹泻性肠易激综合征(IBS-D)患者的体质特点,探讨其影响因素与中医体质类型的关系。方法:采用11配对病例对照设计,通过中医体质量表得分判断 IBS-D 患者的体质类型,比较不同的 IBS-D 影响因素下患者的体质类型分布特点,并应用条件 LOgiSTiC 回归分析

  2. Combined therapy pathospermia patients after endovascular sclerotherapy of testicular veins

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    O. B. Zhukov

    2014-11-01

    Full Text Available We examined 44 patients with varicocele and pathospermia as asthenia and 30 patients experienced oligozoospermia and 14 patients in the control group. Of these, the marriage of the 21 patients (16 – experimental, 5 – control. Total of 43 patients were operated on both groups. The patients of the experimental group comprised 29 people, one patient withdrew from the trial group because of changing of place of living. There were 14 patients in the control group. Among the patients of both groups with subclinical varicocele operated 6 patients, with stage I – 10 patients, with stage II – 18, with stage III – 9. Age of the patients operated on experimental and control groups were comparable and reached 34.1 ± 7.2 years, and 31.2 ± 4.6 years, respectively. All patients underwent endovascular sclerotherapy of testicular veins, of which the 3rd patients underwent both sides. AndroDoz complex in less time helps restore semen parameters, improving the morphology, increasing the concentration and progressive motility. AndroDoz can be used in support of post-operative medical therapy in patients after varicocelectomy, especially in patients older than 35 years with bilateral varicocele.

  3. Tiagabine: efficacy and safety in partial seizures – current status

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    Jürgen Bauer

    2008-09-01

    Full Text Available Jürgen Bauer, Déirdre Cooper-MahkornDepartment of Epileptology, Bonn University Hospital, GermanyAbstract: Tiagabine hydrochloride (TGB is a selective gamma-aminobutyric acid (GABA reuptake inhibitor. TGB is effective as an add-on medication in adults and children 12 years and older in the treatment of partial seizures. Results of nonrandomized add-on trials with TGB show treatment success with seizure reduction of at least 50% in 33% to 46% of patients. In newly diagnosed patients with partial epilepsy, TGB monotherapy was as effective as carbamazepine. Comedication with TGB elevates the risk of nonconvulsive status (7.8% vs 2.7% without TGB. The most common side effects include dizziness/lightheadedness, asthenia/lack of energy and somnolence. TGB has no negative effects on cognition; it does not increase the risk of fractures or rash. TGB may interfere with color perception. TGB presents an intermediate risk for depression in patients with epilepsy (approximately 4%. Regarding the risk of overdose, 96–680 mg TGB (mean 224 mg caused seizures or coma. TGB is an antiepileptic drug exhibiting a specific anticonvulsive mechanism of action, the efficacy of which is relatively low when used in comedication. Critical side effects, such as the induction of nonconvulsive status epilepticus, further limit its use.Keywords: epilepsy, tiagabine, antiepileptic drugs, status epilepticus, pharmacotherapy

  4. Combined therapy pathospermia patients after endovascular sclerotherapy of testicular veins

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    O. B. Zhukov

    2012-01-01

    Full Text Available We examined 44 patients with varicocele and pathospermia as asthenia and 30 patients experienced oligozoospermia and 14 patients in the control group. Of these, the marriage of the 21 patients (16 – experimental, 5 – control. Total of 43 patients were operated on both groups. The patients of the experimental group comprised 29 people, one patient withdrew from the trial group because of changing of place of living. There were 14 patients in the control group. Among the patients of both groups with subclinical varicocele operated 6 patients, with stage I – 10 patients, with stage II – 18, with stage III – 9. Age of the patients operated on experimental and control groups were comparable and reached 34.1 ± 7.2 years, and 31.2 ± 4.6 years, respectively. All patients underwent endovascular sclerotherapy of testicular veins, of which the 3rd patients underwent both sides. AndroDoz complex in less time helps restore semen parameters, improving the morphology, increasing the concentration and progressive motility. AndroDoz can be used in support of post-operative medical therapy in patients after varicocelectomy, especially in patients older than 35 years with bilateral varicocele.

  5. Skin Rashes on Leg in Brucellosis: a Rare Presentation.

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    Seyed Hossein Shahcheraghi

    2015-06-01

    Full Text Available Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region.

  6. Certain aspects of lead in the biosphere

    Energy Technology Data Exchange (ETDEWEB)

    Hoell, W.; Hampp, R.

    1974-07-01

    Studies on the origin, distribution, and health effects of lead in the atmosphere are reviewed. Most of the lead present in the atmosphere originates from leaded gasoline, while the contribution by natural sources of lead and lead smelters is almost negligible. As emitted in the exhaust gases, most of the lead is in the form of its halogenides, 10 to 20 percent of which is in gaseous form, while the rest is aerosol. Once emitted, lead is present in the atmosphere for up to 30 days. Washout of the lead, especially by slow rain, and conversion of the halogenides into lead carbonate and oxides after a residence time of 18 hr in the atmosphere were observed. The distribution of lead in the year rings of trees can not be used as an indicator of the variations in the atmospheric lead concentration as relocation and migration were evidenced, while positive correlation between the lead content in leaves and the traffic density was established. The resorption of lead from the intestines was found to amount to 2.0 to 6.8 percent of the lead resorbed from the lungs. Anemia, asthenia, loss of weight, chronic renal lesion, and neurological changes due to lead were observed. Once retained in the bones, lead may be mobilized by changes in the calcium turnover. Lead interferes with the hemosynthesis, and lead acetate causes chromosomal aberrations in test animals.

  7. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

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    Fardin Faraji

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

  8. Autosomal recessive polycystic kidney disease. A case report.

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    Hernando Diocaretz V

    2015-01-01

    Full Text Available INTRODUCTION: Polycystic Kidney Disease is a genetic disorder characterized by progressive cystic dilations of the renal ducts, presenting as autosomal dominant or recessive forms with an incidence of 1 in 1.000 and 1 in 20.000 births, respectively, according to international series. The autosomal recessive variety can be lethal in the neonatal period due to respiratory failure secondary to pulmonary hypoplasia and can manifest during childhood with hypertension, short stature and complications of portal hypertension. CASE REPORT: 3 years and 11 months old preschoolar with antecedent of fetal growth restriction and oligohydramnios during prenatal period, and a history of asthenia, pallor and progressive feeding difficulty with postprandial vomiting. Physical examination shows cardiac bruit, hypertension, splenomegaly, caput medusae and short stature. Laboratory tests with peripheral pancytopenia; abdominal ultrasonography showed hepatosplenomegaly, findings consistent with autosomal recessive polycystic kidney disease and periportal fibrosis; renal scintigraphy with bilateral kidney failure; a positive fecal occult blood test; an upper endoscopy that shows small esophageal varices; a hand radiography that shows bone age delayed and an echocardiography with cardiomegaly. DISCUSSION: This infrequent disease requires a high degree of suspicion by the clinician and presents with portal hypertension, with platelet count being the best predictor of severity. This condition has no cure and will progress to end-stage renal disease in any moment, so the aim is to minimize and treat renal and hepatic complications.

  9. Unresponsiveness of Experimental Canine Leishmaniosis to a New Amphotericin B Formulation

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    Leticia Hernández

    2015-01-01

    Full Text Available This study was designed to evaluate the efficacy and safety of a novel free polyaggregated amphotericin B (FPA formulation used to treat experimental canine leishmaniosis (CanL caused by Leishmania infantum. Eight healthy beagles were intravenously challenged with 5×107 promastigotes per mL of L. infantum. One year after infection, they received an intravenous dose of FPA (5 mg/kg every 2 weeks three times. Dogs were assessed monthly for clinical signs, serology, and parasite detection during a follow-up period of 6 months. Transient adverse effects (i.e., hypotension, diarrhea, bodyweight loss, fever, and asthenia were observed within 24–48 hours after treatment in 4 animals. In three dogs mean clinical signs scores were reduced. Antibody titers measured by immunofluorescence antibody test (IFAT had significantly diminished at the end of the study, although according to bone marrow smears and cultures a high percentage of dogs tested positive for the parasite at 6 months posttreatment (PT6. Real-time quantitative PCR (rtQ-PCR on blood, bone marrow, and urine samples revealed the presence of parasitic DNA in all animals at PT6, although blood loads of the parasite were reduced. These findings indicate that FPA at the dosing regimen used did not achieve clinical or parasitological cure in dogs experimentally infected with L. infantum.

  10. Hodgkin’s Lymphoma Revealed by Hemophagocytic Lymphohistiocytosis in a Child

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    Sarra Benmiloud

    2014-01-01

    Full Text Available Hemophagocytic lymphohistiocytosis (HLH is a severe life-threatening disorder, responsible for extensive phagocytosis of hematopoietic cells and causing a multisystem organ failure. If lymphomas are common causes of HLH, the association with Hodgkin’s lymphoma is rarely described in children. We report a case of a 9-year-old boy presenting with HLH as an initial manifestation of Hodgkin’s lymphoma. He has been suffering from persistent high fever, asthenia, weight loss, and hepatosplenomegaly with no lymphadenopathy. The diagnosis of HLH secondary to infectious disease was initially worn. The patient received high-dose intravenous immunoglobulin with broad-spectrum antibiotics. However, his state got worse with the onset of dry cough and pleural effusion. Histopathologic examination of pleural fluid showed the presence of Reed-Sternberg cells. The outcome was favorable after treatment by corticosteroid and chemotherapy. Hodgkin’s lymphoma revealed by HLH is a source of delayed diagnosis and should be borne in mind in children.

  11. Caprylic triglyceride as a novel therapeutic approach to effectively improve the performance and attenuate the symptoms due to the motor neuron loss in ALS disease.

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    Wei Zhao

    Full Text Available Amyotrophic lateral sclerosis (ALS is a neurodegenerative disorder of motor neurons causing progressive muscle weakness, paralysis, and finally death. ALS patients suffer from asthenia and their progressive weakness negatively impacts quality of life, limiting their daily activities. They have impaired energy balance linked to lower activity of mitochondrial electron transport chain enzymes in ALS spinal cord, suggesting that improving mitochondrial function may present a therapeutic approach for ALS. When fed a ketogenic diet, the G93A ALS mouse shows a significant increase in serum ketones as well as a significantly slower progression of weakness and lower mortality rate. In this study, we treated SOD1-G93A mice with caprylic triglyceride, a medium chain triglyceride that is metabolized into ketone bodies and can serve as an alternate energy substrate for neuronal metabolism. Treatment with caprylic triglyceride attenuated progression of weakness and protected spinal cord motor neuron loss in SOD1-G93A transgenic animals, significantly improving their performance even though there was no significant benefit regarding the survival of the ALS transgenic animals. We found that caprylic triglyceride significantly promoted the mitochondrial oxygen consumption rate in vivo. Our results demonstrated that caprylic triglyceride alleviates ALS-type motor impairment through restoration of energy metabolism in SOD1-G93A ALS mice, especially during the overt stage of the disease. These data indicate the feasibility of using caprylic acid as an easily administered treatment with a high impact on the quality of life of ALS patients.

  12. Meningoencephalitis caused by a zygomycete fungus (Basidiobolus associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment

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    M. Auxiliadora-Martins

    2010-08-01

    Full Text Available Zygomycosis is an infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of fever (39°C lasting for 1 day, accompanied by shivering, trembling, and intense asthenia. The patient was admitted to the intensive care unit with complex partial seizures, and submitted to orotracheal intubation and mechanical ventilation under sedation with midazolam. The electroencephalogram showed evidence of non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum antibiotics. Differential diagnosis between fungal and bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus. Treatment with liposomal amphotericin B and fluconazole was initiated after diagnosis of meningoencephalitis by zygomycete, with a successful outcome.

  13. Malignant Pancreatic Extra-Gastrointestinal Stromal Tumor Diagnosed by Ultrasound Guided Fine Needle Aspiration Cytology. A Case Report with a Review of the Literature

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    Ram Nawal Rao

    2011-05-01

    Full Text Available Context Pancreatic extra-gastrointestinal stromal tumors are extremely uncommon neoplasm. To the best of our knowledge, only eleven cases have been reported in the literature. All the case reports published mostly involve diagnoses made on surgical pathology. Case report A 40-year-old male patient presented with asthenia, mild abdominal pain, severe anemia and weight loss. Contrast-enhanced computed tomography of the abdomen revealed a heterogeneously enhancing mass (6.5x6.0 cm in the body and head of the pancreas. Ultrasound-guided fine needle aspiration (US-FNA was performed on the mass of the pancreas before a pancreaticoduodenectomy. A cytological diagnosis of pancreatic malignant mesenchymal neoplasm was made. The final diagnosis of primary pancreatic extra-gastrointestinal stromal tumor was confirmed by histopathological examination and immunohistochemical findings (CD117 positivity. This case was diagnosed by percutaneous transabdominal ultrasound, rather than endoscopic ultrasound-guided fine needle aspiration (EUS-FNA which had been used in three previous cases. Conclusion We report a very unusual case of pancreatic extra-gastrointestinal stromal tumor which was diagnosed by US-FNA cytology. Although this is uncommon in the pancreas, extra-gastrointestinal stromal tumors should be considered in the differential diagnosis of solid and cystic pancreatic masses on cytology.

  14. Docetaxel plus cisplatin is effective for patients with metastatic breast cancer resistant to previous anthracycline treatment: a phase II clinical trial

    International Nuclear Information System (INIS)

    Patients with metastatic breast cancer (MBC) are frequently exposed to high cumulative doses of anthracyclines and are at risk of resistance and cardiotoxicity. This phase II trial evaluated the efficacy and toxicity of docetaxel plus cisplatin, as salvage chemotherapy in patients with MBC resistant to prior anthracyclines. Patients with MBC that had progressed after at least one prior chemotherapy regimen containing anthracyclines received docetaxel 75 mg/m2 followed by cisplatin 60 mg/m2 every 3 weeks for a maximum of 6 cycles or until disease progression. Between Jan 2000 and May 2002, 24 patients with tumors primary resistant and 15 with secondary resistant disease were accrued. All 39 patients were evaluable for safety and 36 for efficacy. The objective response rate was 31% (95% CI, 16–45%) with 3 complete responses. The median time to disease progression was 7 months, and the median overall survival was 23 months (median follow-up of 41 months). Neutropenia was the most frequently observed severe hematologic toxicity (39% of patients), whereas asthenia and nausea were the most common non-hematologic toxicities. No treatment-related death was observed. In conclusion, we found docetaxel plus cisplatin to be an active and safe chemotherapy regimen for patients with MBC resistant to anthracyclines

  15. Some clinical and laboratory variables in adult patients with chronic myeloid leukemia treated with recombinant alpha interferon + cytosine arabinoside

    International Nuclear Information System (INIS)

    Chronic myeloid leukemia is the most frequent myeloproliferative syndrome in adults. In a longitudinal retrospective study performed between January 1985 - December 2009, 46 patients in chronic phase diagnosed at the Institute of Hematology and Immunology were evaluated. They received cytoreductor agent as first treatment followed by interferon α2 + cytosar. Forty one percent showed high risk Sokal prognosis score. The most frequent clinical manifestations at diagnosis were asthenia (37 %), splenomegaly (31 %) and weigh lost (28.3 %). The partial and complete hematological response was of 26,8 % and 65.9 % after 6 months and the complete cytogenetic and molecular response was of 9.1 % and 16.3 %. The most frequent adverse reactions were: fever (34.9 %), thrombocytopenia (26.3 %) and general syndrome (23.8 %). Resistance or intolerance to INFα2 was found in 47.8 % of the patients and 90.0 % died due to progression of the disease. The 5 year overall survival was of 63.8 % and the 3 years free event survival was of 68.9 %. According to Sokal prognosis score the overall survival showed significant difference between groups (p= 0.005) but there was no significant difference for free event survival (p= 0.165). The INFα2 treatment in our patients showed better results than those obtained in different developed countries and is an effective therapeutic option in Cuba

  16. Factores asociados a la experiencia de sufrimiento en pacientes con cáncer avanzado

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    Alicia Krikorian

    2015-08-01

    Full Text Available Objective: To examine the experience of suffering and its relation with physical, psychological, social and spiritual problems in advanced cancer patients. Methods: Ninety-eight patients attending the palliative care unit of an oncologic institution participated in the study. The level of suffering and the intensity and threat perceived from symptoms and a series of physical, psychological, social and spiritual problems were examined, as well as adjustment levels, illness awareness and coping strategies. Descriptive and comparative statistics were obtained. Results: Nearly 50% of participants manifested moderate suffering. The most frequent problems encountered were: general distress, asthenia, emotional distress, loss of autonomy, sadness, concern for the family´s future and suffering. Severe suffering was associated to adjustment problems and use of wishful thinking. Lower levels of suffering were associated with cognitive restructuring and avoidance strategies. Conclusions: Results indicate the importance of focusing on the subjective aspects of the illness experience. Any symptom or problem has the potential to become a source of suffering when perceived as threatening and when the person´s regulatory processes are insufficient for adaptation.

  17. Macroglobulinemia de Waldenström - remissão completa após tratamento com rituximabe Successful outcome in Waldenström's macroglobulinemia treated with rituximab

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    Flavia C. F. Pimenta

    2008-10-01

    Full Text Available A macroglobulinemia de Waldenström (MW é uma patologia rara dos linfócitos B caracterizada pela produção monoclonal de IgM, e que pode manifestar-se clinicamente com fadiga, astenia, perda de peso, sangramento de mucosas e do trato gastrintestinal, lifonodonomegalias, hepatoesplenomegalia e alterações neurológicas. A doença é mais comum em pacientes idosos, e seus sintomas são decorrentes da hiperviscosidade sangüínea. Na MW observa-se hipergamaglobulinemia com pico monoclonal na eletroforese de proteínas séricas, níveis elevados de IgM e demais imunoglobulinas normais ou diminuídas, imunofenotipagem com linfócitos B CD19+, CD20+ e CD24+, aspirado de medula óssea hipercelular, e biópsia de medula óssea hipercelular com infiltração difusa de linfócitos, linfócitos plasmocitóides e plasmócitos. Atualmente, anticorpos monoclonais estão sendo usados na terapêutica da MW com grande sucesso. O rituximabe, anticorpo monoclonal anti -CD20, tem mostrado excelentes resultados no tratamento da MW, inclusive naqueles indivíduos que não obtiveram resposta adequada ao tratamento convencional. Nós reportamos o caso de uma mulher de 78 anos de idade com história de fadiga, astenia, anorexia, sonolência, inquietação, urticária, dificuldade para deambular e perda excessiva de peso, aproximadamente 22 kg em um período de cinco meses, cujo tratamento foi realizado com rituximabe. O objetivo deste relato é apresentar uma paciente com diagnóstico de MW e revisar aspectos clínicos e terapêutico atual da doença.Waldenström's macroglobulinemia is a rare pathology of B lymphocytes characterized by the production of monoclonal IgM, causing clinical manifestations which may include fatigue, asthenia, weight loss, bleeding of the mucosa and intestinal tract, lymphadenomegaly, hepatosplenomegaly and neurological alterations. The disease is more frequent among elderly patients and its symptoms are a result of the hyperviscosity of

  18. 副肿瘤综合征与神经系统损害的相关分析%Study on relationship between paraneoplastic syndrome and nerver system injury

    Institute of Scientific and Technical Information of China (English)

    郭晓玲; 李柱一

    2002-01-01

    Non-metastatic or invaded neoplasms sometimes produce distal effects in nervous system,nerve-muscle junction and muscle i.e paraneoplastic syndrome(PNS).PNS is diverse in clinical symptoms.Nervous system symptoms and neoplasm may occur simultaneously or months-years earlier.So,clinical diagnosis and management are very difficult.Here is our report about clinical manifestations in 23 PNS patients admitted in our department. 1 Subjects data 25 PNS patients including 18 males and 7 females,aging from 20~ 76(mean age:54.2) were included in our study.Tumors consisted of pulmonary cancer(n=16),digestive system tumor(n=3),leukemia(n=1),cervical carcinoma(n=1). All nervous system symptoms occur earlier than neoplasm esp.in cervical carcinoma patients(1 month~ 6 year,mean:10 months). Serum tumor markers was increased in 22 cases.Clinical symptoms:myasthenic syndrome was observed in 11 subjects,asthenia of extremities in 8 subjects,asthenia of bilateral lower limbs in 3 subjects,peripheral neuropathy in 9 subjects,numbness of limbs in 4 cases,brachia plexus injury in 1 subject,greater occipital nerve pain in 2 cases,ischialgia neuralgia in 1 subjects,muscle atrophy in 6 subjects,acute transverse myelophthy in 1 subject,progressive multifocal leukoencephalopathy in 1 subject. 2 Discussion Myasthenic syndrome is more common among these symptoms such as myopathy,peripheral neuropathy,spinal disease,encephalopathy.PNS is diverse in clinical manifestations.According to these symptoms,tumor is very available if diagnosis of nervous system disease could not be confirmed.Prostatic carcinoma,mammary carcinoma,digestive system tumor,cervical carcinoma,adrenal tumor esp. pulmonary carcinoma may be the causes of PNS.PNS may occur 15 years earlier than neoplasms.Once PNS is determined,disease status should be actively observed and primary lesion be surveyed.Diagnosis could be confirmed if (1)Aged over 40;(2)Existence of serum tumor markers.CEA,TPA and NSE increased in 22 subjects

  19. Diagnosis and principle of syndrome differentiation of stroke in Medical Cases of Nan Ya Tang based on multivariate correlation analysis%《南雅堂医案》中风案的诊断与辨证规律研究

    Institute of Scientific and Technical Information of China (English)

    钟名天; 杨朝阳

    2016-01-01

    对陈修园《南雅堂医案》中36个中风医案的症状、病因、病机进行整理和分析,总结陈氏对中风医案的诊断与辨证规律。陈氏认为中风的病因以六淫为主,病机主要为津液代谢失常、邪正盛衰和阴阳失调,提出中风分真中风与类中风。并提倡辨证中风应当重视病因、病机、病证,以虚实、标本、内外立论,辨闭脱当分阴阳,对中风常证、急证、变证的辨证提出了独道见解。%Through sorting and analyzing symptoms,etiology,pathogenesis of 36 stroke basis in CHEN Xiuyuan Medical Cases of Nan Ya Tang to summarize the diagnosis and the principle of syndrome differentiation. CHEN think etiology of stroke is“the six evils”,pathogenesis of stroke is qi-blood disturbance,healthy energy-evil struggle,imbal-ance of Yin and Yang,CHEN proposed the stroke can be divided into stroke with wind and analogous apoplexy. He ad-vocates to pay attention to etiology,pathogenesis and disease syndrome,to make points on asthenia and sthenia,branch and root,inside and outside. CHEN proposed to distinguish Yin and Yang of stroke prostration and stroke excess,and put forward a lot of experience of syndrome differentiation between the stroke regular case,critical case and deteriora-ted case .

  20. [Hypereosinophilic syndrome as paraneoplastic presentation in an adolescent].

    Science.gov (United States)

    Arias-Martínez, Isabel; Venancio-Hernández, Marco

    2013-01-01

    Hypereosinophilic syndrome is characterized by peripheral eosinophilia over 1,500 cell/mm3 and/or tissue eosinophilia, with dysfunction or damage to organ, once other causes were ruled out. This paper presents a case of hypereosinophilic syndrome (HS) which presented as lymphoblastic leukemia in a teenager. This is a 13 year old female, with B cell lymphoblastic leukemia at 9 years old, who received chemotherapy for 2 years achieving remission. One year after remission she presented malar rash, hair loss, arthralgias, conjuntival redness, dyspnea and thoracic oppression. The initial blood count only showed hypereosinophilia, and a bone marrow biopsy did not show blasts and had a negative immunophenotyping. Autoantibodies were negative, except for ANA (1:1,280 in one determination after one negative), complement was normal, lupic band in skin was negative for complement and immunoglobulins; serum IgG 2,195 mg/dL, IgA 231, IgM 327, IgE 109 U/mL; skin testing for aeroallergens and food allergens were negative. Prednisone was started at 1 mg/kg. Abdominal ultrasound only reported biliary sludge flow and hepatosplenomegaly; chest tomography showed centrolobullar interstitial pattern, suggesting eosinophilic pneumonitis. The patient started with a generalized dermatosis, and a biopsy reported leucocytoclastic vasculitis. Six months after the onset of symptomatology there were generalized malaise, uncontrolled fever, gingival haemorrhage, asthenia and adynamia; a blood cell count reported blasts, and bone marrow smear confirmed the diagnosis of cell B lymphoblastic leukemia. The patient deteriorated rapidly showing signs of respiratory difficulty and acute pulmonary edema, therefore chemotherapy was started without response, and finally the patient died. There are several causes of HS, yet one of the least frequent presentations in childhood is the association with neoplasms. PMID:24912912

  1. Variability of Sorafenib Toxicity and Exposure over Time: A Pharmacokinetic/Pharmacodynamic Analysis

    Science.gov (United States)

    Ropert, Stanislas; Mir, Olivier; Coriat, Romain; Billemont, Bertrand; Tod, Michel; Cabanes, Laure; Franck, Nathalie; Blanchet, Benoit; Goldwasser, François

    2012-01-01

    Background. Sorafenib displays major interpatient pharmacokinetic variability. It is unknown whether the pharmacokinetics of sorafenib influence its toxicity. Methods. We analyzed the severity and kinetics of sorafenib-induced toxicities in unselected consecutive patients with cancer, as well as their relationship with biological, clinical, and pharmacokinetic parameters. Toxicity was recorded bimonthly. Sorafenib plasma concentrations were assessed by liquid chromatography. Results. For 83 patients (median age, 62 years; range, 21–84 years), median sorafenib 12-hour area under the curve (AUC0–12) was 52.8 mg · h/L (range: 11.8–199.6). A total of 51 patients (61%) experienced grade 3–4 toxicities, including hand-foot skin reactions (23%), asthenia (18%), and diarrhea (11%). Sorafenib AUC0–12 preceding grade 3–4 toxicities was significantly higher than that observed in the remaining population (61.9 mg · h/L vs. 53 mg · h/L). In 25 patients treated with fixed doses of sorafenib for the first 4 months, median dose-normalized AUC0–12 on day 120 was significantly lower than on day 15 (63 vs. 102 mg · h/L). The incidence of hypertension and hand-foot skin reactions significantly decreased over time. Conclusion. Sorafenib AUC0–12 decreases over time, similarly to the incidence of hypertension and hand-foot skin reactions. Monitoring of sorafenib plasma concentrations may help to prevent acute severe toxicities and detect patients with suboptimal exposure at disease progression. PMID:22752067

  2. Profile of paritaprevir/ritonavir/ombitasvir plus dasabuvir in the treatment of chronic hepatitis C virus genotype 1 infection

    Directory of Open Access Journals (Sweden)

    Smith MA

    2015-11-01

    Full Text Available Michael A Smith, Alice LimDepartment of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, USAAbstract: Over the last several years, many advances have been made in the treatment of chronic hepatitis C virus (HCV infection with the development of direct-acting antivirals. Paritaprevir/ritonavir/ombitasvir with dasabuvir (PrOD is a novel combination of a nonstructural (NS 3/4A protein inhibitor boosted by ritonavir, an NS5A protein inhibitor, and an NS5B nonnucleoside polymerase inhibitor. This review aims to discuss the pharmacology, efficacy, safety, drug interactions, and viral drug resistance of PrOD in the treatment of HCV genotype 1 infections. Phase I, II, and III human and animal studies that describe the pharmacology, pharmacokinetics, efficacy, and safety of PrOD for HCV were identified and included. Studies that evaluated patients without cirrhosis (n=2,249 and with cirrhosis (n=422 demonstrated that PrOD for 12 or 24 weeks was effective at achieving sustained virologic response rates (>90% in patients with genotype 1a or 1b HCV infection. Although indicated for the treatment of HCV genotype 1 infection, PrOD is also recommended for the treatment of HCV in patients coinfected with HIV. Additionally, promising data exist for the use of PrOD in liver-transplant recipients. The most common adverse drug events associated with PrOD included nausea, pruritus, insomnia, diarrhea, asthenia, dry skin, vomiting, and anemia. The high efficacy rates seen coupled with a favorable side effect profile seen with PrOD with or without ribavirin have led to its addition as a recommended treatment regimen for HCV genotype 1 infection.Keywords: direct-acting antiviral, interferon-free, ribavirin-free

  3. Profile of paritaprevir/ritonavir/ombitasvir plus dasabuvir in the treatment of chronic hepatitis C virus genotype 1 infection.

    Science.gov (United States)

    Smith, Michael A; Lim, Alice

    2015-01-01

    Over the last several years, many advances have been made in the treatment of chronic hepatitis C virus (HCV) infection with the development of direct-acting antivirals. Paritaprevir/ritonavir/ombitasvir with dasabuvir (PrOD) is a novel combination of a nonstructural (NS) 3/4A protein inhibitor boosted by ritonavir, an NS5A protein inhibitor, and an NS5B nonnucleoside polymerase inhibitor. This review aims to discuss the pharmacology, efficacy, safety, drug interactions, and viral drug resistance of PrOD in the treatment of HCV genotype 1 infections. Phase I, II, and III human and animal studies that describe the pharmacology, pharmacokinetics, efficacy, and safety of PrOD for HCV were identified and included. Studies that evaluated patients without cirrhosis (n=2,249) and with cirrhosis (n=422) demonstrated that PrOD for 12 or 24 weeks was effective at achieving sustained virologic response rates (>90%) in patients with genotype 1a or 1b HCV infection. Although indicated for the treatment of HCV genotype 1 infection, PrOD is also recommended for the treatment of HCV in patients coinfected with HIV. Additionally, promising data exist for the use of PrOD in liver-transplant recipients. The most common adverse drug events associated with PrOD included nausea, pruritus, insomnia, diarrhea, asthenia, dry skin, vomiting, and anemia. The high efficacy rates seen coupled with a favorable side effect profile seen with PrOD with or without ribavirin have led to its addition as a recommended treatment regimen for HCV genotype 1 infection. PMID:26622169

  4. A simplified surveillance case definition of AIDS derived from empirical clinical data. The Clinical AIDS Study Group, and the Working Group on AIDS case definition.

    Science.gov (United States)

    Weniger, B G; Quinhões, E P; Sereno, A B; de Perez, M A; Krebs, J W; Ismael, C; Sion, F S; Ramos-Filho, C F; de Sá, C A; Byers, R H

    1992-12-01

    A clinical AIDS case definition is needed for surveillance in countries where the CDC case definition is not practical. To derive such a definition, we compared 110 HIV-seropositive and 135 randomly selected HIV-seronegative adult medical-ward inpatients in Brazil. Multivariate analysis of clinical signs and symptoms and simple diagnoses resulted in a discriminant function with sensitivity of 89% and specificity of 96% in predicting for AIDS. These data were the empirical basis for a clinical definition of AIDS in adults drafted in a Caracas, Venezuela, workshop sponsored by the Pan American Health Organization. The revised "Caracas" definition presented here requires a positive HIV serology, the absence of cancer or other cause of immunosuppression, plus > or = 10 cumulative points, as follows: Kaposi's sarcoma (10 points); extrapulmonary/noncavitary pulmonary tuberculosis (10); oral candidiasis or hairy leukoplakia (5); cavitary pulmonary/unspecified tuberculosis (5); herpes zoster or = 1 month (2); fever > or = 1 month (2); cachexia or > 10% weight loss (2); asthenia > or = 1 month (2); persistent dermatitis (2); anemia, lymphopenia, or thrombocytopenia (2); persistent cough or any pneumonia except TB (2); and lymphadenopathy > or = 1 cm at > or = 2 noninguinal sites for > or = 1 month (2). This definition has a sensitivity of 95% and a specificity of 100% (91% without HIV serology) when applied to the Brazilian patients in this study. The Caracas definition has been adopted by Brazil, Honduras, and Surinam, and is in validation elsewhere. The use of a reasonably sensitive and specific case definition commensurate with available diagnostic resources should facilitate AIDS surveillance in developing countries. PMID:1453332

  5. Diagnosis and multi-modality treatment of adult pulmonary plastoma:Analysis of 18 cases and review of literature

    Institute of Scientific and Technical Information of China (English)

    Yun-Xi Wang; Jing Zhang; Xiang-Yang Chu; Yi Liu; Fang Li; Zhan-Bo Wang; Li-Xin Wei

    2014-01-01

    The clinical data of18 patients withPB fromApril1989 toApril2013 was analyzed retrospectively, including11 men and7 women, aged45 and76 years old(mean53 years).There were12 cases of PB occurring in right lung and other cases in left lung.Among them,3 patients had no symptoms, and15 patients displayed symptoms of cough, chest pain, asthenia or minor haemoptysis. Overall,11 patients had a preoperative diagnosis of lung cancer,7 patients were preoperatively diagnosed as the other diseases, which included lung benign tumor(n=5) and mediastinal mass (n=2).All patients received a radical resection.Six patients received postoperative cisplatin-based chemotherapy, and two patients received postoperative irradiation with the dose of55Gy. Histologically,14 cases of18 patients had biphasic pulmonary blastoma and four cases had well differentiated fetal adenocarcinoma.A total of12 patients died in a period of6-36 months after operation, and1 case was lost after2 years of follow up.The median survival time was19 months. PB is a rare primary lung malignant embryonal neoplasm.Despite its assumed embyonal origin, the tumor has a predilection for adults.A preoperative correct diagnosis is very difficult in spite of modern diagnostic imaging and biopsy techniques.Surgical resection is the main method for diagnosis and treatment.Postoperative chemotherapy or irradiation can help eliminate tumor remnants.Its prognosis is very poor, especially for the biphasic type.

  6. Fatal cold agglutinin-induced haemolytic anaemia: a case report

    Directory of Open Access Journals (Sweden)

    Reverberi Roberto

    2010-08-01

    Full Text Available Abstract Introduction Cold agglutinin disease usually develops as a result of the production of a specific immunoglobulin M auto-antibody directed against the I/i and H antigens, precursors of the ABH and Lewis blood group substances, on red blood cells. Autoimmune and lymphoproliferative disorders, Mycoplasma pneumoniae and other infections can be associated with the production of cold agglutinins. In its classic presentation with haemolytic anaemia and Raynaud's syndrome, cold agglutinin disease is usually idiopathic. Several factors play a role in determining the ability of a cold agglutinin to induce a haemolytic anaemia such as antibody concentration and temperature range, in particular the highest temperature at which antibodies interact with red blood cells. Case presentation A 48-year-old Caucasian man presented to our hospital with symptoms of extreme asthenia caused by severe anaemia. The transfusion of red blood cells (O Rh-positive, started as prescribed by the emergency guidelines in force without pre-transfusion tests, induced fatal haemolysis because of the presence of high levels of anti-H antibodies in his blood, that reacted with the large amount of H antigen in universal (0 red blood cells. Conclusion Emergency transfusion of universal red blood cells (0 Rh-positive or negative is usually accepted by the international guidelines in force in emergency departments. In this report we describe a rare complication caused by the very high concentration in the recipient of cold agglutinins and the activation of the complement system, responsible for red blood cell lysis and consequent fatal cardiovascular shock. We conclude that emergency transfusion of universal red blood cells (0 Rh-positive or negative may be dangerous and its risk should be assessed against the risk of delaying transfusion until the pre-transfusion tests are completed.

  7. Toxic hepatitis induced by a herbal medicine: Tinospora crispa.

    Science.gov (United States)

    Langrand, J; Regnault, H; Cachet, X; Bouzidi, C; Villa, A F; Serfaty, L; Garnier, R; Michel, S

    2014-01-01

    Herbal remedies are becoming increasingly popular in many countries. Tinospora species (Menispermaceae) is commonly used as a herbal medicine in South Asia, but very few toxic effects have been described. We report a case of acute hepatitis associated with chronic use of high doses of Tinospora crispa. A 49-year-old male with chronic low back pain bought a herbal medicine at a market in Vietnam that was supposed to be Tinospora crispa, and started to take 10 pellets per day. He had no medical history and did not take any other drugs or toxins. Four weeks later; he developed dark urine and pale stools, associated with asthenia and right hypochondrial pain. Two months after starting treatment, he was referred to the hepatology department with jaundice. Blood tests showed aspartate aminotransferase: 1.169 IU/l, alanine aminotransferase: 2.029 IU/l, total bilirubin: 20.47 mg/dl, direct bilirubin: 13.29 mg/dl, and γ-glutamyltransferase: 243 IU/l. Viral and autoimmune hepatitis were eliminated. Upper abdominal ultrasound was normal. Histopathological findings were consistent with a toxic reaction. The herbal medicine was stopped on admission and the patient fully recovered without treatment, with normal liver function 2 months after the acute episode. Tinospora crispa was clearly identified in the pellets by microscopic analysis of the botanical characters combined with chromatographic fingerprints. The use of herbal medicines containing Tinospora crispa can induce toxic hepatitis. Recovery can be complete after discontinuation. This case highlights the risk associated with traditional herbal remedies. PMID:24867504

  8. Stereotactic body radiation therapy for primary and metastatic liver tumors: A single institution phase i-ii study

    Energy Technology Data Exchange (ETDEWEB)

    Mendez Romero, Alejandra; Wunderink, Wouter [Erasmus MC - Daniel den Hoed Cancer Center, Rotterdam (Netherlands). Dept. of Radiation Oncology; Hussain, Shahid M. [Univ. of Nebraska Medical Center, Omaha, NE (US). Dept. of Radiology] (and others)

    2006-09-15

    The feasibility, toxicity and tumor response of stereotactic body radiation therapy (SBRT) for treatment of primary and metastastic liver tumors was investigated. From October 2002 until June 2006, 25 patients not suitable for other local treatments were entered in the study. In total 45 lesions were treated, 34 metastases and 11 hepatocellular carcinoma (HCC). Median follow-up was 12.9 months (range 0.5-31). Median lesion size was 3.2 cm (range 0.5-7.2) and median volume 22.2 cm{sup 3} (range 1.1-322). Patients with metastases, HCC without cirrhosis, and HCC < 4 cm with cirrhosis were mostly treated with 3x12.5 Gy. Patients with HCC =4cm and cirrhosis received 5x5 Gy or 3x10 Gy. The prescription isodose was 65%. Acute toxicity was scored following the Common Toxicity Criteria and late toxicity with the SOMA/LENT classification. Local failures were observed in two HCC and two metastases. Local control rates at 1 and 2 years for the whole group were 94% and 82%. Acute toxicity grade =3 was seen in four patients; one HCC patient with Child B developed a liver failure together with an infection and died (grade 5), two metastases patients presented elevation of gamma glutamyl transferase (grade 3) and another asthenia (grade 3). Late toxicity was observed in one metastases patient who developed a portal hypertension syndrome with melena (grade 3). SBRT was feasible, with acceptable toxicity and encouraging local control. Optimal dose-fractionation schemes for HCC with cirrhosis have to be found. Extreme caution should be used for patients with Child B because of a high toxicity risk.

  9. A randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of ABT-594 in patients with diabetic peripheral neuropathic pain.

    Science.gov (United States)

    Rowbotham, Michael C; Duan, W Rachel; Thomas, James; Nothaft, Wolfram; Backonja, Misha-Miroslav

    2009-12-01

    ABT-594 is a neuronal nicotinic acetylcholine receptor (NNR) agonist that exhibits potent analgesic activity in preclinical models of acute, chronic, and neuropathic pain. The purpose of this phase 2, randomized, multicenter, double-blind, placebo-controlled study was to evaluate the safety and analgesic efficacy of ABT-594 in patients with diabetic peripheral neuropathic pain (DPNP). A total of 266 DPNP patients were randomized 1:1:1:1 to receive placebo, ABT-594 150 microg BID, ABT-594 225 microg BID, or ABT-594 300 microg BID. Patients were titrated to a fixed-dose of ABT-594 over 7 days and remained at this dose for another 6 weeks. Compared to placebo, all three ABT-594 treatment groups showed significantly greater decreases on the average diary-based 0-10 Pain Rating Scale (PRS) score from baseline to final evaluation, the primary efficacy measure (placebo, -1.1; 150 microg BID, -1.9; 225 microg BID, -1.9; 300 microg BID, -2.0). The proportion of patients achieving at least a 50% improvement in the average diary-based PRS was greater in all three ABT-594 treatment groups. However, adverse event (AE) dropout rates were significantly higher in all three ABT-594 treatment groups (28% for 150 microg BID, 46% for 225 microg BID, and 66% for 300 microg BID) than for the placebo group (9%). Consistent with the expected side-effect profile of NNR agonists, the most frequently reported AEs were nausea, dizziness, vomiting, abnormal dreams, and asthenia. This study establishes proof of concept for NNR agonists as a new class of compounds for treating neuropathic pain. PMID:19632048

  10. Efficacy, Safety, and Biomarkers of Single-Agent Bevacizumab Therapy in Patients with Advanced Hepatocellular Carcinoma

    Science.gov (United States)

    Malka, David; Bourredjem, Abderrahmane; Dromain, Clarisse; Baey, Charlotte; Jacques, Nathalie; Pignon, Jean-Pierre; Vimond, Nadege; Bouvet-Forteau, Nathalie; De Baere, Thierry; Ducreux, Michel; Farace, Françoise

    2012-01-01

    Objective. Hepatocellular carcinoma (HCC) is a highly vascularized tumor in which neoangiogenesis contributes to growth and metastasis. We assessed the safety, efficacy, and potential biomarkers of activity of bevacizumab in patients with advanced HCC. Methods. In this phase II trial, eligible patients received bevacizumab, 5 mg/kg or 10 mg/kg every 2 weeks. The disease-control rate at 16 weeks (16W-DCR) was the primary endpoint. Circulating endothelial cells (CECs) and plasma cytokines and angiogenic factors (CAFs) were measured at baseline and throughout treatment. Results. The 16W-DCR was 42% (95% confidence interval, 27%–57%). Six of the 43 patients who received bevacizumab achieved a partial response (objective response rate [ORR], 14%). Grade 3–4 asthenia, hemorrhage, and aminotransferase elevation occurred in five (12%), three (7%), and three (7%) patients, respectively. During treatment, placental growth factor markedly increased, whereas vascular endothelial growth factor (VEGF)-A dramatically decreased (p < .0001); soluble VEGF receptor-2 (p < .0001) and CECs (p = .03) transiently increased on day 3. High and increased CEC counts at day 15 were associated with the ORR (p = .04) and the 16W-DCR (p = .02), respectively. Lower interleukin (IL)-8 levels at baseline (p = .01) and throughout treatment (p ≤ .04) were associated with the 16W-DCR. High baseline IL-8 and IL-6 levels predicted shorter progression-free and overall survival times (p ≤ .04). Conclusion. Bevacizumab is active and well tolerated in patients with advanced HCC. The clinical value of CECs, IL-6, and IL-8 warrants further investigation. PMID:22707516

  11. HEREDITARY CONNECTIVE TISSUE DISORDERS: NOMENCLATURE AND DIAGNOSTIC ALGORITHM

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    A. V. Klemenov

    2015-01-01

    Full Text Available Hereditary connective tissue disorders (HCTDs are a genetically and clinically diverse group of diseases, which encompasses common congenital disorders of fibrous connective tissue structures. Out of the whole variety of the clinical manifestations of NCTDs, only differentiated monogenic syndromes with the agreed guidelines for their diagnosis have been long the focus of the medical community’s attention. Many unclassified forms of the pathology (dysplasia phenotypes have been disregarded while assessing a person’s prognosis and defining treatment policy. With no clear definition of NCTDs or their approved diagnostic algorithm, it is difficult to study their real prevalence in the population, to compare literature data, and to constructively discuss various scientific and practical aspects of this disease. Efforts to systematize individual clinical types of NCTD and to formulate their diagnostic criteria are set forth in the All-Russian Research Society Expert Committee national guidelines approved in 2009 and revised in 2012. The paper gives current views on the nomenclature of NCTDs, considers diagnostic criteria for both classified monogenic syndromes (Marfan's syndrome, Ehlers–Danlos' syndrome, MASS phenotype, primary mitral valve prolapse, joint hypermobility syndrome and unclassified dysplasia phenotypes (MASS-like phenotype, marfanoid appearance, Ehlers–Danlos-like phenotype, benign joint hypermobility syndrome, unclassified phenotype. The above abnormalities are presented as a continuous list drawn up in the decreasing order of the degree of their clinical manifestations and prognostic value (the phenotypic continuum described by M.J. Glesby and R.E. Pyentz: from monogenic syndromes through dysplasia phenotypes to an unclassified phenotype. Emphasis is laid on the clinical NCTD identification difficulties associated with the lack of specificity of external and visceral markers of connective tissue asthenia and with the certain

  12. Carcinosarcoma of the colon: report of a case with morphological, ultrastructural and molecular analysis

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    Ferrero Stefano

    2006-07-01

    Full Text Available Abstract Background Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. Case presentation An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately on the epithelial and mesenchymal components revealed the same p53 gene mutation (R282W in exon 8 and identical polymorphisms in p53 exon 4, in EGFR exons 20 and 21, and in c-kit exon 17. Microsatellite markers analysis revealed a common loss of heterozygosis on 18q. Overall, the data are consistent with a common origin of the two tumor components. The patient was treated with 8 cycles of oral capecitabine (1250 mg/m2 twice a day for 14 days repeated every 28 days and two years after surgery is alive with liver metastases. Conclusion Carcinosarcoma of the colon is a rare tumour with both epithelial and sarcomatous components. Molecular analysis of the current case suggests the histogenesis from a common cell progenitor.

  13. 小分子抑制剂瑞戈非尼的药理和临床概述%The progress on pharmacological and clinical research of small molecule inhibitors regorafenib

    Institute of Scientific and Technical Information of China (English)

    王明森; 刘正平; 侯良玉; 张菊红; 张建强

    2015-01-01

    Pharmacology,pharmacokinetics,clinical study and safety of regorafenib in the treatment of colorectal cancer and gastrointestinal stromal tumors were reviewed in the paper. The main refeience to foreign - related registration and clini-cal data of regorafenib. Clinical trials showed the Overall Survival(OS)and Progression - Free - Survival(PFS)was sig-nificantly increased in patients treated with regorafenib. The most serious adverse drug reactions in patients receiving Stivar-ga were severe liver injury,haemorrhage and gastrointestinal perforation. The most frequently observed adverse drug reactions (≥30% )in patients receiving Stivarga were asthenia/ fatigue,decreased appetite and food intake,hand foot skin reaction, diarrhoea,weight loss,hypertension and dysphonia.%本文综述了瑞戈非尼治疗结肠直肠癌和胃肠道间质瘤的药理、药动学、临床研究和安全性信息。主要参考国外有关的瑞格菲尼的注册和临床资料。临床试验表明瑞戈非尼能使患者的总生存期、无进展生存期获得明显提高。接受治疗的患者中最严重的药物不良反应是严重肝损伤、出血和胃肠道穿孔,最常见的不良反应(≥30%)为虚弱/疲乏、食欲减退、食物摄入量减少、手足皮肤反应、腹泻、消瘦、高血压和发音障碍。

  14. A case of osseous scintigraphy showing focuses of multifocal tuberculosis

    International Nuclear Information System (INIS)

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur's upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  15. Pernicious anemia: New insights from a gastroenterological point of view

    Institute of Scientific and Technical Information of China (English)

    Edith Lahner; Bruno Annibale

    2009-01-01

    Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B_(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen Ⅰ. Without performing Schilling's test,intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Longstanding Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.

  16. Stereotactic body radiation therapy for liver primary and metastases: The Lille experience

    International Nuclear Information System (INIS)

    Purpose. - The CyberKnifeR system is a recent radiation therapy technique that allows treatment of liver lesions with real-time tracking. Because of its high precision, the dose administered to the tumor can be increased. We report Oscar-Lambret Cancer Centre experience in the treatment of primary and secondary liver lesions. Patients and methods. - It is a retrospective study analyzing all the patients who have been treated for their liver lesions since July 2007. A hundred and twenty patients have been treated: 42 for hepatocellular carcinoma, 72 for liver metastases and six for cholangio-carcinoma. Gold seeds need to be implanted before the treatment and are used as markers to follow the movement of the lesion due to respiration. On average, the treatment is administered in three to four sessions over 12 days. A total dose of 40 to 45 Gy at the 80% isodose is delivered. Local control and overall survival analysis with Log-rank is performed for each type of lesion. Results. - Treatment tolerance is good. The most common toxicities are of digestive type, pain and asthenia. Six gastro-duodenal ulcers and two radiation-induced liver disease (RILD) were observed. At a median follow-up of 15 months, the local control rate is respectively of 80.4% and 72.5% at 1 and 2 years. Overall survival is 84.6 and 58.3% at 1 and 2 years. The local control is significantly better for the hepatocellular carcinoma and overall survival is significantly better for liver metastases (P R is a promising technique, well tolerated, with tumoral local control rates comparable to other techniques. Its advantage is that it is very minimally invasive delivered as an outpatient procedure in a frail population of patient (disease, age). (authors)

  17. Resposta virológica sustentada em pacientes com co-infecção pelos genótipos 1 e 2 do vírus da hepatite C, com apenas nove semanas de terapêutica antiviral: relato de caso Sustained virological response in patients with coinfection by hepatitis C virus genotypes 1 and 2, after just nine weeks of antiviral therapy: case report

    Directory of Open Access Journals (Sweden)

    Ana Ruth Araújo

    2010-10-01

    Full Text Available Relata-se um paciente do sexo masculino com 67 anos e sorologia positiva para o vírus da hepatite C (HCV. Exames moleculares revelaram a presença do RNA do HCV, com carga viral de 2.000 cópias/mL e genótipos 1 e 2. O tratamento foi com alfapeginterferon-2a, 180mcg/semana e ribavirina, 1.000mg/dia. Na quarta semana de tratamento, a carga viral para o HCV era indetectável. Na nona semana, o paciente apresentou hematêmese, piora do quadro de astenia, inapetência e comprometimento do estado geral, quando o tratamento foi descontinuado. O PCR foi negativo após 6 meses e permaneceu assim após um ano. O paciente encontra-se assintomático.A report of a 67 year-old male patient with positive serology for HCV. PCR revealed the presence of HCV RNA, viral load of 2,000 copies/mL and genotypes 1 and 2. The pacient was treated with peginterferon alfa-2a at 180mcg/week and ribavirin at 1,000mg/day. In week four of treatment, HCV viral load was undetectable. In week nine, the patient developed hematemesis, worsening of asthenia, anorexia and impaired general condition, so the treatment was discontinued. The PCR was negative six months and one year after the cessation of treatment. The patient remains asymptomatic.

  18. Cisplatin/gemcitabine or oxaliplatin/gemcitabine in the treatment of advanced biliary tract cancer: a systematic review

    International Nuclear Information System (INIS)

    Cisplatin/gemcitabine association has been a standard of care for first-line regimen in advanced biliary tract cancer nevertheless oxaliplatin/gemcitabine regimen is frequently preferred. Because comparative effectiveness in clinical outcomes of cisplatin- versus oxaliplatin-containing chemotherapy is not available, a systematic review of studies assessing cisplatin/gemcitabine or oxaliplatin/gemcitabine chemotherapies in advanced biliary tract cancer was performed. Published studies evaluating cisplatin/gemcitabine or oxaliplatin/gemcitabine in advanced biliary tract cancer were included. Each study was weighted according to the number of patients included. The primary objective was to assess weighted median of medians overall survival (mOS) reported for both regimens. Secondary goals were to assess weighted median of medians progression-free survival (mPFS) and toxic effects were pooled and compared within each arm. Thirty-three studies involving 1470 patients were analyzed. In total, 771 and 699 patients were treated by cisplatin/gemcitabine and oxaliplatin/gemcitabine, respectively. Weighted median of mOS was 9.7 months in cisplatin group and 9.5 months in oxaliplatin group. Cisplatin-based chemotherapy was significantly associated with more grade 3 and 4 asthenia, diarrhea, liver toxicity, and hematological toxicity. Sensitivity analysis including only the studies with the standard regimen of cisplatin (25–35 mg/m2 administered on days 1 and 8) showed that the weighted median of mOS increased from 9.7 to 11.7 months but Gem/CDDP regimen remained more toxic than Gemox regimen. These results suggest that the Gem/CDDP regimen with cisplatin (25–35 mg/m2) administered on days 1 and 8 is associated with survival advantage than Gemox regimen but with addition of toxicity

  19. A prospective longitudinal study of voice characteristics and health-related quality of life outcomes following laryngeal cancer treatment with radiotherapy.

    Science.gov (United States)

    Karlsson, Therese; Bergström, Liza; Ward, Elizabeth; Finizia, Caterina

    2016-06-01

    Background To investigate potential changes in perceptual, acoustic and patient-reported outcomes over 12 months for laryngeal cancer patients treated with radiotherapy. Material and methods A total of 40 patients with Tis-T3 laryngeal cancer treated with curative intent by radiotherapy were included in this prospective longitudinal descriptive study. Patients were followed pre-radiotherapy, one month, six months and 12 months post-radiotherapy, where voice recordings and patient-reported outcome instruments (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core30, Head and Neck35, Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer) were completed at each appointment. Perceptual analysis, using the Grade-Roughness-Breathiness-Asthenia-Strain scale and vocal fry parameters, and acoustic measures including harmonics-to-noise ratio (HNR), jitter, shimmer and mean spoken fundamental frequency (MSFF) were produced from voice recordings. Results All patients presented with dysphonic voices pre-radiotherapy, where 95% demonstrated some degree of vocal roughness. This variable improved significantly immediately post-radiotherapy, however, then deteriorated again between six and 12 months. Vocal fry also increased significantly at 12 months. Acoustic measures were abnormal pre- and post-treatment with no significant change noted except for MSFF, which lowered significantly by 12 months. Health-related quality of life (HRQL) deteriorated post-radiotherapy but returned to pretreatment levels by 12 months. Conclusion By 12 months, most perceptual, acoustic, patient-reported voice and HRQL outcomes for laryngeal cancer patients treated by radiotherapy had showed no significant improvements compared to pretreatment function. Further studies are required to investigate potential benefits of voice rehabilitation following radiotherapy. PMID:27056401

  20. Clinical developments in the treatment of relapsed or relapsed and refractory multiple myeloma: impact of panobinostat, the first-in-class histone deacetylase inhibitor

    Directory of Open Access Journals (Sweden)

    Redic KA

    2016-05-01

    Full Text Available Kimberly A Redic,1 Shannon M Hough,2 Erika M Price11College of Pharmacy, University of Michigan, 2Department of Pharmaceutical Services, University of Michigan Health System, Ann Arbor, MI, USABackground: Panobinostat is a new agent for the treatment of relapsed and refractory multiple myeloma (rrMM as part of a combination regimen. This article presents an overview of the mechanism of action, pharmacokinetics, safety, efficacy, patient care strategies, and role of the agent in treating rrMM patients.Results: Panobinostat belongs to the class of drugs known as histone deacetylase inhibitors, and has high activity against Class I, II, and IV nonhistone deacetylases and histone deacetylases. It represents the first of its class to receive approval for use in MM, and received priority review and orphan drug status in both US and Europe, when used in combination with bortezomib and dexamethasone in the treatment of rrMM. Approval of panobinostat was based on subgroup analysis of Phase III data obtained in the PANORAMA trial program for evaluation of the combination of panobinostat, bortezomib, and dexamethasone. Additional clinical trials have continued to explore optimal dosing regimens and novel combination regimens to further clarify the optimal role of panobinostat in the arsenal of drugs for rrMM. Panobinostat has shown a manageable safety profile characterized primarily by hematologic toxicities (thrombocytopenia, neutropenia, lymphopenia, and anemia, gastrointestinal toxicities, notably diarrhea and nausea, as well as fatigue/asthenia, electrolyte abnormalities, and less commonly cardiac toxicities.Conclusion: Panobinostat represents an important addition to the treatment armamentarium for patients with rrMM, and studies are underway evaluating its optimal dosing strategy and role in combination with other drugs used to treat this patient population. Keywords: panobinostat, multiple myeloma, LBH589, relapsed-refractory, Farydak, HDAC

  1. Clinical application of a right ventricular pressure-volume loop determined by gated blood-pool imaging and simultaneously measured right ventricular pressure

    International Nuclear Information System (INIS)

    The data obtained by ECG-gated radionuclide angiography were collected simultaneously with right ventricular pressure and thermal cardiac output (CO) obtained by a Swan-Ganz catheter in Scintipac 1200 (Shimazu Co) in order to create a right ventricular pressure-volume (RV P-V) loop. Subjects consisted of 15 patients with old myocardial infarction (MI group), seven with angina pectoris (AP group), six with congestive cardiomyopathy (CCM group) and five with neurocirculatory asthenia (NCA group). Right ventricular end-diastolic volume (RVEDV) was calculated as RVEDV = CO/(EF x HR) (CO = cardiac output; HR = heart rate). Systolic work (W sub(S)), diastolic work (W sub(D)) and net work (W sub(N)) were calculated from a RV P-V loop by Simpson's method. The measurements were performed before and 5 min after sublingual administration of nitroglycerin (NG) (0.3 mg). The results were as follows: 1. RV P-V loops shifted towards the left lower part of the P-V plane after sublingual administration of nitroglycerin, indicating the reduction of pressure and volume of the right ventricle. 2. Right ventricular ejection fraction (RVEF) in the MI, AP and CCM groups showed smaller values than that of the NCA group. 3. Right ventricular end-diastolic volume index (RVEDVI) showed a converse relation with RVEF. 4. Cardiac index in all groups decreased after NG and a statistical significance was seen in the MI, AP and NCA groups (p<0.05). 5. RV W sub(S), RV W sub(D) and RV W sub(N) showed no difference among each groups in the control state, and significantly decreased after NG. We conclude that the present method using RV P-V loop might be useful as a noninvasive bedside monitoring and permits the evaluation of RV function in a clinical setting

  2. Palatine Tonsils Asymmetry: 10 Years Experience of the Otorhinolaryngology Service of the Clinical Hospital of the Federal University of Paraná

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    Ballin, Annelyse Cristine

    2011-01-01

    Full Text Available Introduction: A few patients with asymmetric palatine tonsils have lymphoma; but most lymphomas in palatine tonsils evolve with tonsillar asymmetry. Objective: To report the profile of patients and histopathological changes in patients submitted to adenotonsillectomy/tonsillectomy with disproportional palatine tonsils. Method: Retrospective study based on data analysis from the Pathologic Anatomy Service Database and in the review of reports of patients submitted to adenotonsillectomy and tonsillectomy with palatine tonsils asymmetry during the period from October 1999 through October 2009 at the Clinical Hospital (HC of the Federal University of Paraná (UFPR. Results: 50 patients took part, aged between 3 to 53 years old, mean age of 14.05 years. The anatomopathological exam confirmed 48 patients (96% with lymphoid hyperplasia and 2 cases of lymphoma (4%. These included men aged from 40 to 53 yeas with complaint of unilateral increase of the tonsil, one of whom had other symptoms (asthenia and weight loss. Upon physical examination: tonsils disproportion without involvement of other organs or lymph nodes. Conclusion: Our study is according to the literature as regards the fact the lymphomas are more common in men, the patient is the first one to notice the increase in volume and the asymmetry is larger than 2 degrees between palatine tonsils in cases of lymphoma. Although it is rare, even in the presence of differences, there are chances for the asymmetry to evolve to a malignant profile. The need for anatomopathological evaluation of a part must be considered along with other clinical data that suggests a malignant profile.

  3. Carcinosarcoma of the colon: report of a case with morphological, ultrastructural and molecular analysis

    International Nuclear Information System (INIS)

    Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately on the epithelial and mesenchymal components revealed the same p53 gene mutation (R282W in exon 8) and identical polymorphisms in p53 exon 4, in EGFR exons 20 and 21, and in c-kit exon 17. Microsatellite markers analysis revealed a common loss of heterozygosis on 18q. Overall, the data are consistent with a common origin of the two tumor components. The patient was treated with 8 cycles of oral capecitabine (1250 mg/m2 twice a day for 14 days repeated every 28 days) and two years after surgery is alive with liver metastases. Carcinosarcoma of the colon is a rare tumour with both epithelial and sarcomatous components. Molecular analysis of the current case suggests the histogenesis from a common cell progenitor

  4. Health status of radiation workers in an institute of nuclear research

    International Nuclear Information System (INIS)

    The aim of this study was the identification of the changes in health condition of workers from an institute of nuclear research. Thirty-five workers (25 male and 10 female) radiation exposed to low doses of ionizing radiation were admitted in the Radiopathology Centre Bucharest, after a selection performed during the annual check-up. The workers have had different professions: nuclear fuel processor, engineer laboratory technician, electrician, instrument technician. The time of exposure to ionizing radiation was between 6 to 25 years. Medical specialists in occupational health, dermatology, ophthalmology, O.R.L., endocrinology, haematology, neurology and psychology investigated them. The following lab tests were performed: haematological examination, biochemical examination, immunology tests, alergology skin tests, functional lung tests and cardiogram. No special problems concerning the exposure to ionizing radiation were found, but the following diseases were detected in some extent: neurasthenia, high blood pressure, ischemic heart disease, digestive system disorders, endocrinology disorders and anaemia. High blood pressure, ischemic heart disease and digestive system disorders were related with stress or job strain. Anaemia occurred in connection with gynaecological disorders. Some thyroid dysfunction appeared because of low dietary iodine content in the Sub-Carpathian region. The focus of the psychological exam was the identification of the effect of different factors (exogenous, endogenous or multidimensional) over a person, that could influence the psychological potential. The psychological exam reveals the following disturbances: asthenia, tiredness, chronic fatigue, psycho-emotional impairment, lapses of attention, anxiety. These disturbances may be in relation both with job strain (especially a substantial stress factor for nuclear fuel processor and engineer laboratory technician) and the syndrome of workplace. (author)

  5. Clinical safety of tbo-filgrastim, a short-acting human granulocyte colony-stimulating factor.

    Science.gov (United States)

    Pettengell, Ruth; Bias, Peter; Mueller, Udo; Lang, Nicole

    2016-06-01

    The recombinant human granulocyte colony-stimulating factor (G-CSF) known as filgrastim (Tevagrastim(®), Ratiograstim(®), Biograstim(®)) in Europe (approved in 2008) and tbo-filgrastim (Granix(®)) in the USA (approved in 2012; Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel) is indicated to reduce the duration of severe neutropenia in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. This article presents pooled clinical data for tbo-filgrastim compared with Neupogen(®) (Amgen, Thousand Oaks, CA, USA) as well as tbo-filgrastim post-marketing safety data. The safety and efficacy of tbo-filgrastim were evaluated in three phase III studies in 677 patients receiving myelosuppressive chemotherapy and study drug (348 patients with breast cancer, 237 with lung cancer, 92 with non-Hodgkin lymphoma). In each study, the efficacy of tbo-filgrastim was similar to that of Neupogen. Overall, 633 (93.5 %) patients receiving the study drug experienced 6093 treatment-emergent adverse events (AEs), most of which were related to chemotherapy. Adverse events related to the study drug (tbo-filgrastim or Neupogen) were experienced by 185 (27.3 %) patients; 19 (2.8 %) had severe drug-related AEs, 5 (0.7 %) had drug-related serious AEs, and 6 (0.9 %) discontinued the study due to drug-related AEs. Overall, the most common drug-related AEs were bone pain (7.1 %), myalgia (4.0 %), and asthenia (4.4 %). The post-marketing safety profile of tbo-filgrastim was consistent with that observed during the clinical studies. The availability of tbo-filgrastim, a G-CSF with safety and efficacy comparable to those of Neupogen, provides physicians with an alternative treatment option for supportive care of patients with non-myeloid malignancies receiving myelosuppressive chemotherapy. PMID:26780505

  6. Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

    International Nuclear Information System (INIS)

    Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO2 laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option

  7. TAK-228 (formerly MLN0128), an investigational oral dual TORC1/2 inhibitor: A phase I dose escalation study in patients with relapsed or refractory multiple myeloma, non-Hodgkin lymphoma, or Waldenström's macroglobulinemia.

    Science.gov (United States)

    Ghobrial, Irene M; Siegel, David S; Vij, Ravi; Berdeja, Jesus G; Richardson, Paul G; Neuwirth, Rachel; Patel, Chirag G; Zohren, Fabian; Wolf, Jeffrey L

    2016-06-01

    The PI3K/AKT/mTOR signaling pathways are frequently dysregulated in multiple human cancers, including multiple myeloma (MM), non-Hodgkin lymphoma (NHL), and Waldenström's macroglobulinemia (WM). This was the first clinical study to evaluate the safety, tolerability, maximal-tolerated dose (MTD), dose-limiting toxicity (DLT), pharmacokinetics, and preliminary clinical activity of TAK-228, an oral TORC1/2 inhibitor, in patients with MM, NHL, or WM. Thirty-nine patients received TAK-228 once daily (QD) at 2, 4, 6, or 7 mg, or QD for 3 days on and 4 days off each week (QDx3d QW) at 9 or 12 mg, in 28-day cycles. The overall median age was 61.0 years (range 46-85); 31 patients had MM, four NHL, and four WM. Cycle 1 DLTs occurred in five QD patients (stomatitis, urticaria, blood creatinine elevation, fatigue, and nausea and vomiting) and four QDx3d QW patients (erythematous rash, fatigue, asthenia, mucosal inflammation, and thrombocytopenia). The MTDs were determined to be 4 mg QD and 9 mg QDx3d QW. Thirty-six patients (92%) reported at least one drug-related toxicity; the most common grade ≥3 drug-related toxicities were thrombocytopenia (15%), fatigue (10%), and neutropenia (5%). TAK-228 exhibited a dose-dependent increase in plasma exposure and no appreciable accumulation with repeat dosing; mean plasma elimination half-life was 6-8 hr. Of the 33 response-evaluable patients, one MM patient had a minimal response, one WM patient achieved partial response, one WM patient had a minor response, and 18 patients (14 MM, two NHL, and two WM) had stable disease. These findings encourage further studies including combination strategies. Am. J. Hematol. 91:400-405, 2016. © 2016 Wiley Periodicals, Inc. PMID:26800393

  8. [Munchhausen syndrome by proxy revealed by falsely toxic methotrexate levels].

    Science.gov (United States)

    Charfi, Rim; Trabelsi, Sameh; Salouage, Issam; Gaïes, Emna; Jebabli, Nadia; Lakhal, Mohamed; Klouz, Anis

    2012-01-01

    Methotrexate is an antifolate drug used intravenously at high-dose in acute lymphocytic leukemia (ALL). Therapeutic drug monitoring is required to identify patients at risk of developing toxicity and to control folinic acid rescue. We report a case of Münchausen syndrome by proxy revealed by high and persistent falsely toxic methotrexate plasmatic levels. A 12 year-old child was treated with chemotherapy including methotrexate every 70 days for an ALL. The last methotrexate plasmatic level was 0.15 μmol/L at the 72th hour of the infusion. Then, he was treated by oral rout low-dose methotrexate. Ten days after methotrexate infusion, the patient consulted for asthenia, vomiting and presented a mucositis. Methotrexate plasmatic level was 2323 μmol/L. Renal function was normal. All drugs' intake was stopped. Folinic acid rescue was instituted. Even though there was no clinical sign of toxicity, therapeutic drug monitoring showed persistent high methotrexate plasmatic levels. Investigations eliminated measurement errors and pharmacokinetic problems. A deliberate methotrexate addition in each child blood sample brought by the mother was highly suspected. We confirmed this hypothesis by measuring methotrexate plasmatic levels in three samples: one brought by the mother, the second brought by the child's doctor and the last collected in our laboratory. Methotrexate plasmatic levels were respectively over 10,000 μmol/L (first sample) and lower than 0.02 μmol/L (the two others). The diagnosis of Munchausen's syndrome by proxy revealed by falsely toxic methotrexate plasmatic levels was made and the mother was addressed to the psychiatric department. PMID:22484536

  9. Fasting therapy for psychosomatic diseases with special reference to its indication and therapeutic mechanism.

    Science.gov (United States)

    Suzuki, J; Yamauchi, Y; Horikawa, M; Yamagata, S

    1976-01-01

    It has been well known that the fasting therapy which was invented in Medical School of Tohoku University reveals an excellent effect upon various kinds of psychosomatic diseases, but its therapeutic mechanism and suitable indication are not yet explained completely. In order to corroborate these problems, this study was undertaken on 262 cases of psychosomatic diseases in the field of internal medicine. It is a complete fasting for 10 days with nothing by mouth except for drinking water, and 500 ml of parenteral fluid containing vitamins are administered intravenously every day. Absolute bed rest and self meditation are required in a closed individual room, and patients are not allowed to meet anyone but physicians and nurse in charge. The return to normal ordinary diet follows the order of fluid diet, soft diet and semiordinary diet during 5 days. In the period of the therapy, various clinical and laboratory examinations were carried out. Significance of these examinations consists in prediction of possible danger during the fasting period and elucidation of its therapeutic mechanism. Consequently, an outstanding efficacy rate of 87% with excellent prognosis was attained, and the following diseases were determined as suitable indication of this therapy; irritable colon, dysorexia nervosa, borderline hypertension, neurocirculatory asthenia, bronchial asthma, mild diabetes mellitus, obesity, lumbago without organic findings, conversion hysteria, various neurosis with somatic symptoms and masked depression. Possible mechanism of action of the therapy is that fasting acts as an extreme stress on the function of the autonomic nervous and endocrine systems, then it regulates the function of whole body including the brain, also it acts as one of the behaviour therapy for abnormal conditioning. PMID:964029

  10. Epidemiology, clinical manifestations, and diagnosis of chikungunya fever: Lessons learned from the re-emerging epidemic

    Directory of Open Access Journals (Sweden)

    Mohan Alladi

    2010-01-01

    Full Text Available Chikungunya fever, caused by "Chikungunya virus," is an arbovirus disease transmitted by the bite of infected mosquitoes belonging to the genus Aedes. Chikungunya fever epidemics have been reported from several countries around the world. The disease that was silent for nearly 32 years re-emerged in the October 2005 outbreak in India that is still ongoing. The incubation period ranges from 3 to 12 days. The onset is usually abrupt and the acute stage is characterized by sudden onset with high-grade fever, severe arthralgias, myalgias, and skin rash. Swollen tender joints and crippling arthritis are usually evident. In the chronic stage, relapses that include sensation of fever, asthenia, exacerbation of arthralgias, inflammatory polyarthritis, and stiffness may be evident. Neurological, ocular, and mucocutaneous manifestations have also been described. Chronic arthritis may develop in about 15% of the patients. Viral culture is the gold standard for the diagnosis of Chikungunya fever. Reverse transcription polymerase chain reaction and real-time loop-mediated isothermal amplification have also been found to be useful. Serodiagnostic methods for the detection of immunoglobulin M and immunoglobulin G antibodies against Chikungunya virus are more frequently used. Chikungunya is a self-limiting disease; however, severe manifestations such as meningoencephalitis, fulminant hepatitis, and bleeding manifestations may sometimes be life-threatening. Treatment is symptomatic and supportive. Prevention by educating the community and public health officials, vector control measures appear to be the best approach at controlling Chikungunya fever as no commercially available vaccine is available for public use in India for this condition presently.

  11. The profile of patients with obstructive uropathy in Cameroon: case of the Douala General Hospital

    Science.gov (United States)

    Halle, Marie Patrice; Toukep, Linda Njonkam; Nzuobontane, Samuel Ekane; Ebana, Hermine Fouda; Ekane, Gregory Halle; Priso, Eugene Belley

    2016-01-01

    Introduction Obstructive uropathy can lead to irreversible kidney damage. The etiology largely determined by the patient's age can be benign or malignant. This study aimed at determining the profile and outcome of patients with obstructive uropathy in Cameroon. Methods A cross sectional study carried out in the urology unit of the Douala General Hospital, including patients with a diagnosis of obstructive uropathy seen from January 2004 to December 2013. Clinical profile, treatment and outcome data were obtained from patients records. Results Of the 229 patients included 69% were men, mean age 50 ±18 years. Associated comorbidities were hypertension, diabetes, and HIV. Mean haemoglobin 8,40±2,4g/dl, mean GFR 10,3 ±10ml/min, 94 (41%) patients needed emergency dialysis. Symptoms at presentation: asthenia (57%), anorexia (55%), loin pain (37%), vomiting (28%), oedema (20%), and anuria (15%). Urinary tract infection was present in 33 patients. Main aetiologies of obstruction: urolithiasis (35%), begnin prostatic hypertrophy (27%), prostatic cancer (12%), cervical cancer (16%), and congenital malformations (5%). Drainage was effective in 102 (45%) patients, 63 (28%) recovered completely, 91 (41%) were loss to follow up, 49 (22%) died and more women (p = 0.02). Mortality was associated with prostatic cancer (p = 0.000), cervical cancer (p = 0.004) and radiotherapy (p = 0.03). Conclusion Patients with obstructive uropathy presented with significant impaired renal function. Main causes were urinary stones, prostatic hypertrophy, prostatic and cervical cancers. Renal recovery was poor, loss to follow up and mortality high. Specific strategies to target improvement in renal recovery and patient's survival are needed in this patient's group.

  12. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later.

    Science.gov (United States)

    Ryan, Aoife M; Power, Derek G; Daly, Louise; Cushen, Samantha J; Ní Bhuachalla, Ēadaoin; Prado, Carla M

    2016-05-01

    An awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50-80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20-70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40-60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms. PMID:26786393

  13. Health status of radiation workers in an institute of nuclear research

    Energy Technology Data Exchange (ETDEWEB)

    Popescu, F.; Paunescu, G.; Stroe, F. [Inst. of Public Health, Bucharest (Romania); Andrei, N.

    2000-05-01

    The aim of this study was the identification of the changes in health condition of workers from an institute of nuclear research. Thirty-five workers (25 male and 10 female) radiation exposed to low doses of ionizing radiation were admitted in the Radiopathology Centre Bucharest, after a selection performed during the annual check-up. The workers have had different professions: nuclear fuel processor, engineer laboratory technician, electrician, instrument technician. The time of exposure to ionizing radiation was between 6 to 25 years. Medical specialists in occupational health, dermatology, ophthalmology, O.R.L., endocrinology, haematology, neurology and psychology investigated them. The following lab tests were performed: haematological examination, biochemical examination, immunology tests, alergology skin tests, functional lung tests and cardiogram. No special problems concerning the exposure to ionizing radiation were found, but the following diseases were detected in some extent: neurasthenia, high blood pressure, ischemic heart disease, digestive system disorders, endocrinology disorders and anaemia. High blood pressure, ischemic heart disease and digestive system disorders were related with stress or job strain. Anaemia occurred in connection with gynaecological disorders. Some thyroid dysfunction appeared because of low dietary iodine content in the Sub-Carpathian region. The focus of the psychological exam was the identification of the effect of different factors (exogenous, endogenous or multidimensional) over a person, that could influence the psychological potential. The psychological exam reveals the following disturbances: asthenia, tiredness, chronic fatigue, psycho-emotional impairment, lapses of attention, anxiety. These disturbances may be in relation both with job strain (especially a substantial stress factor for nuclear fuel processor and engineer laboratory technician) and the syndrome of workplace. (author)

  14. A case of osseous scintigraphy showing focuses of multifocal tuberculosis; Un cas de scintigraphie osseuse montrant des foyers de tuberculose multifocale

    Energy Technology Data Exchange (ETDEWEB)

    Faurous-Vanaud, R. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Faurous, P. [CRLC, Montpellier (France); Kalfa, G.; Collet, H. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Couty, H.; Artus, J.C. [CRLC, Montpellier (France)

    1997-12-31

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur`s upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  15. Characterization of HBeAg-negative chronic hepatitis B in western Brazilian Amazonia

    Directory of Open Access Journals (Sweden)

    Flamir da Silva Victoria

    2008-02-01

    Full Text Available The present study was conducted with 55 patients native from western Brazilian Amazonia, who were HBV-DNA positive after seroconversion of HBeAg. It is a descriptive case study, with the patients separated into two groups: with hepatitis and without hepatitis on histological examination. The aim of the present study was to describe the clinical and molecular characteristics of patients who are chronic carriers of HBsAg. The prevalence of hepatitis was 63.64%, with a predominance of males (41.82% and a mean age of 42.5 years, occurring mostly in natives of the southeast sub-region (32.73%. Time was a variable proportional to the course of the disease and the most frequent symptoms were: dyspepsia, asthenia and loss of libido with the majority of the patients having history of prior contact with HBV or positive family history. Splenomegalia was the most frequent sign (40%. Among the tests, platelet count, serum albumin and prothrombin activity were significant in the diagnosis of hepatitis. Alpha-fetoprotein was greater in patients with hepatitis, and hepatocellular carcinoma was detected in 3.63% of the patients with hepatic cirrhosis. Three types of HBV genotypes were diagnosed: A, D and F in the samples amplified for gene S. Genotype A (AA was observed in 54.54% of the cases with hepatitis, in contrast to other studies showing the predominance of genotype F in this region. We observed mutations in 36.36%, with a predominance of the mutations in the core promoter region (31.81%, due to the greater prevalence of genotype A in this study.

  16. Comparing acoustic and perceptual voice parameters in female teachers based on voice complaints

    Directory of Open Access Journals (Sweden)

    Maryam Faghani Abukeili

    2014-04-01

    Full Text Available Background and Aim: Teachers are a large group of professional voice users that several risk factors and voice demands causes various voice complaints among them. As the voice is multidimensional, the aim of this study was acoustic and perceptual measurement of teachers’ voice and comparing the findings between two groups with many and few voice complaints.Methods: Sixty female teachers of high school in Sari, north of Iran, were chosen by available sampling to participate in this cross-sectional study. According to a voice complaints questionnaire, 21 subjects located in few voice complaints and 31 in many voice complaints group. After a working day, subjects completed a voice self-assessment questionnaire. Also, teachers’voice were recorded during three tasks including sustained vowels /a/ and /i/, text reading and conversational speech. Acoustic parameters were analyzed by Praat software and 2 speech-language pathalogists performed auditory-perceptual assessment by GRBAS ( Grade, Roughness, Breathiness, Asthenia, Strain scale. Results: Comparing of the voice self-assessment between the two groups demonstrated statistically significant difference (p<0.05; however results of the acoustic and auditory-perceptual measurement did not show significant diffrence.Conclusion: Despite prevalent voice problems in teachers, there are various conditions in terms of complaints and assessments methods. In this study, only a remarkable deviation documented in the client-based assessments in many voice compliants group in comparison with few voice compliants, which would be probably related to different individual’s perception of voice problem between two groups. These results support paying attention to self-assessments in clinical process of voice problems.

  17. Fiebre manchada por rickettsias en el Delta del Paraná: Una enfermedad emergente Rickettsial spotted fever in the Paraná Delta: An emerging disease

    Directory of Open Access Journals (Sweden)

    Alfredo Seijo

    2007-12-01

    Full Text Available Se comunica un caso de fiebre manchada por rickettsia autóctono del delta del Paraná correspondiente a la provincia de Buenos Aires. Luego de cinco días de haber permanecido en una región cercana a la localidad de ingeniero Otamendi, partido de Campana, el paciente presentó un síndrome febril agudo caracterizado por hipertermia con escalofríos y sudoración, mialgias, cefalea, astenia y discreta odinofagia, seguido a las 72 horas por un exantema maculopapuloso congestivo con elementos purpúricos, de distribución universal. En la región preauricular izquierda se observaba una lesión papuloerosiva, producida cinco días antes de iniciada la fiebre por una garrapata adquirida en el lugar. El cuadro clínico remitió rápidamente con la administración de doxiciclina. Por inmunofluorescencia indirecta se identificaron anticuerpos reactivos contra el grupo de rickettsias causantes de fiebres manchadas (CDC, Atlanta, EE.UU.. Se realizan consideraciones sobre la especie de rickettsia, el vector involucrado y la posibilidad que la enfermedad fuera debida a Rickettsia parkeri.We describe a case of rickettsial spotted fever in the Paraná Delta region of Buenos Aires province in Argentina. The patient developed an acute febrile syndrome characterized by myalgias, headache, asthenia and moderate odynophagia, followed by a diffuse macular, papular, and purpuric exanthema. The patient had been bitten recently by a tick on the left preauricular region and an erosive papular lesion was evident at the bite site. An indirect immunofluorescence antibody assay identified antibodies reactive with spotted fever group rickettsiae in the patient's serum. The patient improved rapidly with doxycycline. Several considerations relating to the identity of the rickettsial species and tick vector are discussed, including the possibility that this patient's illness may have been caused by Rickettsia parkeri.

  18. Human immunodeficiency virus/Leishmania infantum in the first foci of urban American visceral leishmaniasis: clinical presentation from 1994 to 2010

    Directory of Open Access Journals (Sweden)

    Iúri Paz Lima

    2013-04-01

    Full Text Available INTRODUCTION: Human immunodeficiency virus (HIV coinfection with Leishmania infantum or Leishmania donovani, the agents of visceral leishmaniasis (or kala-azar, has become a fatal public health problem in the tropics where kala-azar is endemic. METHODS: The clinical presentation of patients with HIV and L. infantum coinfection is described using two unique databases that together produce the largest case series of patients with kala-azar infected with HIV in South America. First, a retrospective study paired the list of all patients with kala-azar from 1994 to 2004 with another of all patients with HIV/AIDS from the reference hospital for both diseases in the City of Teresina, State of Piauí, Brazil. Beginning in 2005 through to 2010 this information was prospectively collected at the moment of hospitalization. RESULTS: During the study, 256 admissions related to 224 patients with HIV/L. infantum coinfection were registered and most of them were males between 20-40 years of age. Most of the 224 patients were males between 20-40 years of age. HIV contraction was principally sexual. The most common symptoms and signs were pallor, fever, asthenia and hepatosplenomegaly. 16.8% of the cohort died. The primary risk factors associated to death were kidney or respiratory failure, somnolence, hemorrhagic manifestations and a syndrome of systemic inflammation. The diagnosis of HIV and kala-azar was made simultaneously in 124 patients. CONCLUSIONS: The urban association between HIV and kala-azar coinfection in South America is worrisome due to difficulty in establishing the diagnosis and higher mortality among the coinfected then those with either disease independently. HIV/L. infantum coinfection exhibits some singular characteristics and due to its higher mortality it requires immediate assistance to patients and greater research on appropriate combination therapy.

  19. Cetuximab in combination with irinotecan/5-fluorouracil/folinic acid (FOLFIRI in the initial treatment of metastatic colorectal cancer: a multicentre two-part phase I/II study

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    Cals Laurent

    2009-04-01

    Full Text Available Abstract Background This study was designed to investigate the efficacy and safety of the epidermal growth factor receptor (EGFR inhibitor cetuximab combined with irinotecan, folinic acid (FA and two different doses of infusional 5-fluorouracil (5-FU in the first-line treatment of EGFR-detectable metastatic colorectal cancer. Methods The 5-FU dose was selected on the basis of dose-limiting toxicities (DLTs during part I of the study. Patients received cetuximab (400 mg/m2 initial dose and 250 mg/m2/week thereafter and every 2 weeks irinotecan (180 mg/m2, FA (400 mg/m2 and 5-FU (either low dose [LD], 300 mg/m2 bolus plus 2,000 mg/m2 46-hour infusion, n = 7; or, high-dose [HD], 400 mg/m2 bolus plus 2,400 mg/m2; n = 45. Results Only two DLTs occurred in the HD group, and HD 5-FU was selected for use in part II. Apart from rash, commonly observed grade 3/4 adverse events such as leucopenia, diarrhoea, vomiting and asthenia occurred within the expected range for FOLFIRI. Among 52 patients, the overall response rate was 48%. Median progression-free survival (PFS was 8.6 months (counting all reported progressions and the median overall survival was 22.4 months. Treatment facilitated the resection of initially unresectable metastases in fourteen patients (27%: of these, 10 patients (71% had no residual tumour after surgery, and these resections hindered the estimation of PFS. Conclusion The combination of cetuximab and FOLFIRI was active and well tolerated in this setting. Initially unresectable metastases became resectable in one-quarter of patients, with a high number of complete resections, and these promising results formed the basis for the investigation of FOLFIRI with and without cetuximab in the phase III CRYSTAL trial.

  20. Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Aaltonen, Leena-Maija, E-mail: leena-maija.aaltonen@hus.fi [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Rautiainen, Noora; Sellman, Jaana [Institute of Behavioural Sciences, University of Helsinki, Helsinki (Finland); Saarilahti, Kauko [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Mäkitie, Antti; Rihkanen, Heikki [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Laranne, Jussi; Kleemola, Leenamaija [Department of Otorhinolaryngology–Head and Neck Surgery, Tampere University Hospital, and University of Tampere, Tampere (Finland); Wigren, Tuija [Department of Oncology, Tampere University Hospital, and University of Tampere, Tampere (Finland); Sala, Eeva [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Lindholm, Paula [Department of Oncology, Turku University Hospital, and University of Turku, Turku (Finland); Grenman, Reidar [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Joensuu, Heikki [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland)

    2014-10-01

    Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO{sub 2} laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.

  1. Clinical application of a right ventricular pressure-volume loop determined by gated blood-pool imaging and simultaneously measured right ventricular pressure

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    Yasue, Takao; Watanabe, Sachiro; Sugishita, Nobuyoshi; Tanaka, Tsutomu; Yokoyama, Hideo (Prefectural Gifu Hospital (Japan))

    1983-09-01

    The data obtained by ECG-gated radionuclide angiography were collected simultaneously with right ventricular pressure and thermal cardiac output (CO) obtained by a Swan-Ganz catheter in Scintipac 1200 (Shimazu Co) in order to create a right ventricular pressure-volume (RV P-V) loop. Subjects consisted of 15 patients with old myocardial infarction (MI group), seven with angina pectoris (AP group), six with congestive cardiomyopathy (CCM group) and five with neurocirculatory asthenia (NCA group). Right ventricular end-diastolic volume (RVEDV) was calculated as RVEDV = CO/(EF x HR) (CO = cardiac output; HR = heart rate). Systolic work (W sub(S)), diastolic work (W sub(D)) and net work (W sub(N)) were calculated from a RV P-V loop by Simpson's method. The measurements were performed before and 5 min after sublingual administration of nitroglycerin (NG) (0.3 mg). The results were as follows: 1. RV P-V loops shifted towards the left lower part of the P-V plane after sublingual administration of nitroglycerin, indicating the reduction of pressure and volume of the right ventricle. 2. Right ventricular ejection fraction (RVEF) in the MI, AP and CCM groups showed smaller values than that of the NCA group. 3. Right ventricular end-diastolic volume index (RVEDVI) showed a converse relation with RVEF. 4. Cardiac index in all groups decreased after NG and a statistical significance was seen in the MI, AP and NCA groups (p<0.05). 5. RV W sub(S), RV W sub(D) and RV W sub(N) showed no difference among each groups in the control state, and significantly decreased after NG. We conclude that the present method using RV P-V loop might be useful as a noninvasive bedside monitoring and permits the evaluation of RV function in a clinical setting.

  2. Human immunodeficiency virus/Leishmania infantum in the first foci of urban American visceral leishmaniasis: clinical presentation from 1994 to 2010

    Directory of Open Access Journals (Sweden)

    Iúri Paz Lima

    2013-09-01

    Full Text Available INTRODUCTION: Human immunodeficiency virus (HIV coinfection with Leishmania infantum or Leishmania donovani, the agents of visceral leishmaniasis (or kala-azar, has become a fatal public health problem in the tropics where kala-azar is endemic. METHODS: The clinical presentation of patients with HIV and L. infantum coinfection is described using two unique databases that together produce the largest case series of patients with kala-azar infected with HIV in South America. First, a retrospective study paired the list of all patients with kala-azar from 1994 to 2004 with another of all patients with HIV/AIDS from the reference hospital for both diseases in the City of Teresina, State of Piauí, Brazil. Beginning in 2005 through to 2010 this information was prospectively collected at the moment of hospitalization. RESULTS: During the study, 256 admissions related to 224 patients with HIV/L. infantum coinfection were registered and most of them were males between 20-40 years of age. Most of the 224 patients were males between 20-40 years of age. HIV contraction was principally sexual. The most common symptoms and signs were pallor, fever, asthenia and hepatosplenomegaly. 16.8% of the cohort died. The primary risk factors associated to death were kidney or respiratory failure, somnolence, hemorrhagic manifestations and a syndrome of systemic inflammation. The diagnosis of HIV and kala-azar was made simultaneously in 124 patients. CONCLUSIONS: The urban association between HIV and kala-azar coinfection in South America is worrisome due to difficulty in establishing the diagnosis and higher mortality among the coinfected then those with either disease independently. HIV/L. infantum coinfection exhibits some singular characteristics and due to its higher mortality it requires immediate assistance to patients and greater research on appropriate combination therapy.

  3. Temperament and character properties of primary focal hyperhidrosis patients

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    Ak Mehmet

    2013-01-01

    Full Text Available Abstract Background Primary focal hyperhidrosis is a health problem, which has negative effects on the patient's quality of life and significantly affects the patients’ daily activities, social and business life. The aim of this study is to evaluate temperament and character properties of patients diagnosed with primary focal hyperhidrosis. Methods Fifty-six primary focal hyperhidrosis (22.42 ± 7.80 and 49 control subjects (24.48 ± 5.17 participated in the study. Patients who met the diagnostic criteria for PFH were referred to psychiatry clinic where the subjects were evaluated through Structured Clinical Interview for DSM Disorders-I and Temperament and Character Inventory. Results In order to examine the difference between the PFH and control group in terms of temperament and character properties, one-way Multivariate Analysis of Variance (MANOVA was conducted. In terms of temperament properties, PFH group took significantly higher scores than control group in Fatigability and asthenia dimension. In terms of character properties, PFH group scored significantly lower than control group in Purposefulness , Resourcefulness , Self-Directedness and scored significantly higher than control group in Self-forgetfulness and Self-Transcendence. Conclusion Temperament and character features of PFH patients were different from healthy group and it was considered that these features were affected by many factors including genetic, biological, environmental, socio-cultural elements. During the follow-up of PFH cases, psychiatric evaluation is important and interventions, especially psychotherapeutic interventions can increase the chances of success of the dermatological treatments and can have a positive impact on the quality of life and social cohesion of chronic cases.

  4. 足三里与针灸调体规律探析%The Research on Acupoint ST36 in Regulating Constitution with Acupuncture

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    张新普; 林培挺; 李敏; 薛丹; 傅杰英

    2014-01-01

    This article analyses use of acupoint ST 36 in constitution-regulating involving constitution of yin -yang harmony 、constitu-tion of qi asthenia、constitution of yang asthenia、constitution of yin asthenia 、constitution of phlegm -dampness 、constitution of damp-heat、constitution of blood stasis、constitution of qi stagnation and allergic constitution .It comes to the conclusion that constitution and syndrome are root to curing and preventing disease , while doctor's clinical idea and concrete methods are water to curing and pre-venting disease .The process of watering the root equals to treating patients with correct remedies ..Acupoints where the qi and blood spread and stop are natural entry point , and constitution-regulation using acupuncture & moxabustion could adjust our body to keep our body in balance and health as well as improve the quality of our life .%探析了足三里在平和、气虚、阳虚、阴虚、痰湿、气郁、瘀血、湿热和特禀体质针灸调理中的运用规律。总结出,体、证是治病、治未病必求之本,医者针灸临床思维和具体方法是其标,标本相得是机体状态和干预措施间的应答,是临床疗效提高的保障,具体切入点是经络气血输注、神气游行出入的腧穴。调体就是针灸调动或促使机体功能信息的自我调整来维持稳态、促进健康和提高生存质量和延年益寿。

  5. Aspergilose pulmonar necrotizante crônica Chronic necrotizing pulmonary aspergillosis

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    Eduardo Felipe Barbosa Silva

    2009-01-01

    Full Text Available A aspergilose pulmonar necrotizante crônica é uma das formas de aspergilose pulmonar usualmente encontrada em pacientes com imunossupressão leve. Apresentamos o caso de uma paciente com queixas de tosse produtiva crônica, febre e astenia. Havia utilizado corticóides. A TC do tórax evidenciava consolidação com cavitação de permeio no lobo superior direito. A fibrobroncoscopia demonstrou secreção purulenta em árvore traqueobrônquica e lesão vegetante endobrônquica. Biópsias desta lesão e biópsia transbrônquica foram compatíveis com aspergilose. Diante do quadro clínico, radiológico e histopatológico, o diagnóstico de aspergilose pulmonar necrotizante crônica foi realizado. Tratada com itraconazol, a paciente apresentou boa evolução clínico-radiológica.Chronic necrotizing pulmonary aspergillosis is one of the forms of pulmonary aspergillosis typically found in mildly immunocompromised patients. We report the case of a female patient with complaints of chronic productive cough, fever and asthenia. She reported previous corticosteroid use. A CT scan of the chest revealed consolidation with interposed cavitation in the right upper lobe. Fiberoptic bronchoscopy revealed purulent fluid within the tracheobronchial tree and an endobronchial exophytic lesion. The results of the biopsy of that lesion and the transbronchial biopsy were consistent with aspergillosis. Based on the clinical, radiological and histopathological findings, the patient was diagnosed with chronic necrotizing pulmonary aspergillosis. Treated with itraconazole, the patient presented a favorable clinical-radiological evolution.

  6. Subclinical myopathy in patients with colorectal cancer: clinical-pathological characterization and search for tissue markers

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    Massimo Vecchiato

    2012-03-01

    Full Text Available Skeletal muscle in patients with cancer undergoes many morphological changes due to immuno-inflammatory factors of tumor origin or treatment.T he latest event of these changes is cancer cachexia. Aim of the study is to identify myopathic features in skeletal muscle biopsies from weight stable patients with colorectal cancer and without cachexia or asthenia / weakness, that could possibly provide new diagnostic and prognostic cancer biomarkers. Morphometric analyses and immunohistochemical studies were performed on intraoperative muscle biopsies from patients with colorectal cancer and from weight stable patients undergoing surgery for benign non-inflammatory conditions. A rectus abdominis biopsy was taken in all patients and controls.A correlation between histopathologic findings and clinical characteristics, circulating inflammatory biomarkers and markers of muscle necrosis,surgery data and cancer phenotype were investigated.. Forty four patients (21male/23 female and 17 controls (6 male/11 female (p=NS were studied. In cancer patients’biopsies we observed asubclinical myopathy characterized by an abnormal distribution of myonuclei, which are localized inside the myofiber rather than at the periphery, and by the presence of regenerating muscle fibers. The percentage of myofibers with internalized nuclei is significantly higher in patients (median= 9%, IQR= 3.7-18.8 than in controls (median= 2.7%, IQR= 1.7-3.2 ( p=0.0002. In patients we observed an inverse correlation between the number of centronucleated fibers and the presence of node metastasis (N+(ρ=-0.64 (p=0.002. Patients affected with colorectal cancer display early sign of a myopathy, characterized by centronucleated and regenerating myofibers. This myopathy appears to be associated with an early stage of neoplasia and it could be an adaptive response of muscle to cancer. We hope a future application of these findings as a possible early diagnostic and prognostic biomarker of

  7. Social participation of women with breast cancer

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    Nikolić Snežana

    2015-01-01

    Full Text Available Background/Aim. The general problems of persons with malignant diseases (stages of asthenia, chronic fatigue and exhaustion, followed by depression and anxiety lead to a decrease in functional abilities and a declining quality of life. The aim of this study was to determine the level of difficulty, the type of required assistance and the level of satisfaction that derives from maintaining life habits. The study also examined the correlation between the level of accomplishment of life habits and the level of satisfaction with how they are maintained. Methods. The research was conducted at the Military Medical Academy in Belgrade and in the “Get Together” Association of Women with Breast Cancer from June to September 2012 on a sample of 30 women. A standardised questionnaire, Assessment of Life Habits - LIFE-H v.3.0, was administered. Results. The lowest level of maintaining normal activities was related to education, housing and recreation. The greatest need for support to maintain normal activities was in the domains of housing, interpersonal relationships and employment. The greatest satisfaction in the accomplishment of normal activities was observed in the domains of mobility, nutrition and housing, and the lowest level of satisfaction was in the domains of recreation, communication and interpersonal relationships. The correlation between the level of accomplishment of normal activities and the level of satisfaction was the highest in the domains of general physical activity, responsibility and life in a community; the lowest level was in the domains of personal hygiene, housing, mobility, employment and recreation (p < 0.001. Conclusion. The results indicate that research participants found it more difficult to maintain their social activities than their everyday activities. This clearly indicates the necessity to develop and implement special advisory and educational programs aimed at preventing social exclusion and to strengthen and

  8. Quality of Life and Hormonal, Biochemical, and Anthropometric Profile Between Olanzapine and Risperidone Users.

    Science.gov (United States)

    de Araújo, Aurigena Antunes; Ribeiro, Susana Barbosa; Dos Santos, Ana Cely Souza; Lemos, Telma Maria Araújo Moura; Medeiros, Caroline Addison Xavier; Guerra, Gerlane Coelho Bernardo; de Araújo Júnior, Raimundo Fernandes; Serrano-Blanco, Antoni; Rubio-Valera, Maria

    2016-06-01

    This cross-sectional study compared quality of life and side effects in 108 users of olanzapine or risperidone suffering schizophrenia and being attended at psychiatric ambulatory services in Rio Grande do Norte, Brazil. Economic, socio-demographic, anthropometric, biochemical, and hormonal variables were compared. The EuroQoL Five-Dimension Scale (EQ-5D) was used to evaluate quality of life, and side effects were assessed using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale and the Simpson-Angus Scale. Data were analysed using the χ(2) test and Student's t test, with a significance level of 5 %.The household incomes of approximately 80 % of patients were <2.0 minimum wages ($678). Anthropometric variables (waist circumference, hip circumference, weight, waist-to-hip ratio) and systolic and diastolic blood pressure were noted among male olanzapine users (all p < 0.05). EQ-5D scores showed that olanzapine use significantly impacted self-help ability (p < 0.001). Risperidone users had a mean quality-adjusted life year value of 1. Mean total Simpson-Angus Scale scores was 0.38 for olanzapine users and 0.11 for risperidone users (p < 0.02). Significant differences in UKU were observed for the following items: asthenia/lassitude/fatigue (higher among olanzapine users, p = 0.02), dystonia (higher among olanzapine users, p = 0.01), tremors (higher among olanzapine users, p = 0.03), gynecomastia (higher among risperidone users, p < 0.02), and ejaculatory dysfunction (higher among risperidone users, p < 0.02). Olanzapine users had impaired quality of life, which can be explained in part by adverse motor, biochemical, and hormonal effects characteristic of metabolic syndrome. PMID:26220635

  9. Syndrome Differentiation and Treatment Experience of Lichen Planus%扁平苔藓证治经验

    Institute of Scientific and Technical Information of China (English)

    周宝宽

    2011-01-01

    目的:总结周宝宽主任医师辨证论治扁平苔藓经验.方法:以医案形式阐述扁平苔藓的病因病机、证型、治法、方药.结果:病因病机为风湿热邪侵袭肌肤,阻滞经络;肝郁气滞,脾失健运,湿热火毒内生;肝肾阴虚,虚火上炎;内外因相合,蕴结肌肤;上述诸因阻于皮肤、黏膜导致肌肤失养形成风热相搏证、血虚风燥证、肝郁气滞证、阴虚内热等证.治疗原则为疏风、清热、利湿、解毒、疏肝、活血、化瘀、滋阴、降火等.常用方剂为消风散、逍遥散、当归饮子、知柏地黄汤.结论:辨证论治扁平苔藓疗效显著.%Objective: To summarize syndrome differentiation and treatment experience of lichen planus in clinic. Methods: Discuss etiopathogenisis, pathogenesis, pattern of syndrome, method of treatment, formulas and tnedicinals based on medical records. Results : Etiopathogenisis and pathogenesis of lichen planus are wind dampness and heat injury muscle and skin, blocked on meridians; stagnation of QI due to depression of the liver, dys-splenism, damp-heat and virulent fire produced from the interior; hepatic and renal yin deficiency, hyperactivity of deficient fire;coincide of exterior and interior evil, gathering on muscle and skin; those causes blocked in skin and blocked result in failure of skin and muscle to be nourished, generate syndrome of wind-heat fighting, syndrome of blood deficiency wind-dryness syndrome, syndrome of stagnation of QI due to depression of the liver, syndrome of yin asthenia generating intrinsic heat. Treatment principles of lichen planus are, eliminating wind,eliminating heat, damp elimination, neutralize poison, disperse the depressed liver-energy, promoting blood flow, resolve stasis, nourish yin, downbear fire, etc. Frequently used decoction is Xaiofeng Yin, Danggui Yinzi, Zhibai Dihaung Tang. Conclusions:Syndrome differentiation and treatment shows a better therapeutic effect for lichen planus.

  10. Pioglitazone treatment increases survival and prevents body weight loss in tumor-bearing animals: possible anti-cachectic effect.

    Science.gov (United States)

    Beluzi, Mércia; Peres, Sidney B; Henriques, Felipe S; Sertié, Rogério A L; Franco, Felipe O; Santos, Kaltinaitis B; Knobl, Pâmela; Andreotti, Sandra; Shida, Cláudio S; Neves, Rodrigo X; Farmer, Stephen R; Seelaender, Marília; Lima, Fábio B; Batista, Miguel L

    2015-01-01

    Cachexia is a multifactorial syndrome characterized by profound involuntary weight loss, fat depletion, skeletal muscle wasting, and asthenia; all symptoms are not entirely attributable to inadequate nutritional intake. Adipose tissue and skeletal muscle loss during cancer cachexia development has been described systematically. The former was proposed to precede and be more rapid than the latter, which presents a means for the early detection of cachexia in cancer patients. Recently, pioglitazone (PGZ) was proposed to exhibit anti-cancer properties, including a reduction in insulin resistance and adipose tissue loss; nevertheless, few studies have evaluated its effect on survival. For greater insight into a potential anti-cachectic effect due to PGZ, 8-week-old male Wistar rats were subcutaneously inoculated with 1 mL (2×107) of Walker 256 tumor cells. The animals were randomly assigned to two experimental groups: TC (tumor + saline-control) and TP5 (tumor + PGZ/5 mg). Body weight, food ingestion and tumor growth were measured at baseline and after removal of tumor on days 7, 14 and 26. Samples from different visceral adipose tissue (AT) depots were collected on days 7 and 14 and stored at -80o C (5 to 7 animals per day/group). The PGZ treatment showed an increase in the survival average of 27.3% (P< 0.01) when compared to TC. It was also associated with enhanced body mass preservation (40.7 and 56.3%, p< 0.01) on day 14 and 26 compared with the TC group. The treatment also reduced the final tumor mass (53.4%, p<0.05) and anorexia compared with the TC group during late-stage cachexia. The retroperitoneal AT (RPAT) mass was preserved on day 7 compared with the TC group during the same experimental period. Such effect also demonstrates inverse relationship with tumor growth, on day 14. Gene expression of PPAR-γ, adiponectin, LPL and C/EBP-α from cachectic rats was upregulated after PGZ. Glucose uptake from adipocyte cells (RPAT) was entirely re-established due to

  11. Pioglitazone treatment increases survival and prevents body weight loss in tumor-bearing animals: possible anti-cachectic effect.

    Directory of Open Access Journals (Sweden)

    Mércia Beluzi

    Full Text Available Cachexia is a multifactorial syndrome characterized by profound involuntary weight loss, fat depletion, skeletal muscle wasting, and asthenia; all symptoms are not entirely attributable to inadequate nutritional intake. Adipose tissue and skeletal muscle loss during cancer cachexia development has been described systematically. The former was proposed to precede and be more rapid than the latter, which presents a means for the early detection of cachexia in cancer patients. Recently, pioglitazone (PGZ was proposed to exhibit anti-cancer properties, including a reduction in insulin resistance and adipose tissue loss; nevertheless, few studies have evaluated its effect on survival. For greater insight into a potential anti-cachectic effect due to PGZ, 8-week-old male Wistar rats were subcutaneously inoculated with 1 mL (2×107 of Walker 256 tumor cells. The animals were randomly assigned to two experimental groups: TC (tumor + saline-control and TP5 (tumor + PGZ/5 mg. Body weight, food ingestion and tumor growth were measured at baseline and after removal of tumor on days 7, 14 and 26. Samples from different visceral adipose tissue (AT depots were collected on days 7 and 14 and stored at -80o C (5 to 7 animals per day/group. The PGZ treatment showed an increase in the survival average of 27.3% (P< 0.01 when compared to TC. It was also associated with enhanced body mass preservation (40.7 and 56.3%, p< 0.01 on day 14 and 26 compared with the TC group. The treatment also reduced the final tumor mass (53.4%, p<0.05 and anorexia compared with the TC group during late-stage cachexia. The retroperitoneal AT (RPAT mass was preserved on day 7 compared with the TC group during the same experimental period. Such effect also demonstrates inverse relationship with tumor growth, on day 14. Gene expression of PPAR-γ, adiponectin, LPL and C/EBP-α from cachectic rats was upregulated after PGZ. Glucose uptake from adipocyte cells (RPAT was entirely re

  12. Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes.

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    Thomas Kratz

    Full Text Available Data collected during the 2012 Ebola virus disease (EVD epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV, establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3% and of community EVD cases in the age group of 15-54 years (82.4%. All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay or self-reported fever (88.2% upon admission at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%, anorexia (82.4%, myalgia (70.6%, sore throat/difficulty swallowing (70.6%, arthralgia (76.5% and nausea (70.6%. Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting (76.4% as well as general pain (94.1% were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%, intestinal parasitosis (10.9%, and infectious syndrome (10.9%. There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease and emphasizes the need for improving

  13. [Clinical aspects of AIDS at the Calmette hospital in Phnom Penh, Kingdom of Cambodia A report on 356 patients hospitalized in the Medicine "B" Department of the Calmette Hospital].

    Science.gov (United States)

    Pichith, K; Chanroeun, H; Bunna, P; Nyvanny, N; Thavary, S; Kosal, S; Crepin, P

    2001-01-01

    A study on AIDS subjects carried out at the Calmette Hospital in Phnom-Penh between the 1st January 97 and the 30th December 98. The objective of this study was to describe the most frequent clinical manifestations as well as the opportunistic infections according to the 1993 CDC classification (purely clinical classification). Three hundred and fifty six AIDS patients hospitalized in medicine B were included in our study. A complete file was prepared for each subject, specifying his/her social and family situation, profession, sexual behavior and history. The clinical condition was specified and the paraclinical examinations were recorded. The average age was 35 years with 250 men and 106 women, i.e. a M/F sex ratio of 2.4. The majority of male contaminations were due to sexual relationships with multiple partners, 82%, and women with a single partner was of 78%. The use of condoms was of 60% (versus 40% occasional); the extent of drug-addiction was 1.12% (4 cases). A history of STD was found in 56% of cases. The presenting symptoms most frequently found were asthenia, anorexia, fever and weight-loss. In decreasing order, the clinical manifestations often associated were: weight-loss > 10% or a catechetic condition 58.70% (209/356), fever > 38 degrees C >1 month 53% (189/356), diarrhea (> one month) 41.60% (148/356). The most frequent opportunistic infections were: oral candidiasis 51.40% (183/356) and 40% are oro-oesophageal (oral candidiasis + dysphagia or odynphagia), pulmonary and extrapulmonary tuberculoses (TB) 43.50% (155/356) (pulmonary TB in 65.16%, TB of the lymph nodes 23.22% and disseminated TB and cerebral TB 11.61%), cryptococcal meningitis 11.80% (42/356) and pneumocystosis 6.50% (23/356), CMV retinitis 1.12% (4/356). The other opportunistic manifestations such as toxoplasmosis and Kaposis sarcoma are much more rarely encountered due to the difficulties of the paraclinical diagnosis. The mortality in the department was of 17.40% (62/356). In

  14. Distribution Characteristics of Syndrome Types in TCM in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC)%207例晚期非小细胞肺癌中医证型分布特点

    Institute of Scientific and Technical Information of China (English)

    杨小兵; 龙顺钦; 邓宏; 刘伟; 河文峰; 潘宗奇; 周宇姝; 蔡姣芝; 欧阳育树

    2013-01-01

    Objective: To investigate the distribution characteristics of TCM syndrome types in patients with advanced non-smallcell lung cancer ( NSCLC ) . Methods; Patients were selected with the inclusion criteria, retrospective method was used to observe the distribution. TCM syndromes were generalized according to pre-designed forms and diagnostic criteria for clinical syndromes, inputting the questionnaire data into database, the statistical analysis was conducted. Results : Total of 207 patients with advanced NSCLC ( stage Ⅲ B and Ⅳ ) were collected. The distribution of TCM syndromes were as follows: Qi-deficiency with damp-phlegm type was the most common type, accounted for 76.3%; Qi-yin deficiency type followed, accounted for 9.2%; Qi stagnation with blood stasis type, Yin asthenia and excess toxin and heat type and toxic heat flourishing type were 5.8%, 5.8% and 2.9%, respectively. Conclusion; The study suggests that Qi-deficiency with damp-phlegm type was the most common type in patients with advanced non-small cell lung cancer ( stage Ⅲ B and Ⅳ ) .%目的:探讨晚期(ⅢB及Ⅳ期)非小细胞肺癌的中医证型分布特点.方法:采用回顾性的研究方法,按照纳入标准筛选病例,根据预先设计的观察表和临床证型诊断标准,归纳证型,将调查表数据输入数据库,进行统计学分析.结果:共收集到207例晚期非小细胞肺癌患者,各证型构成如下:气虚痰湿型最多,占76.3%,其次为气阴两虚型,占9.2%,气滞血瘀型、阴虚毒热型及热毒炽盛型分别占5.8%、5.8%、2.9%.结论:晚期(ⅢB及Ⅳ期)非小细胞肺癌的中医证型以气虚痰湿型为主.

  15. Dengue Hemorrhagic Fever. Clinical Study of Hospitalized Adult Patients

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    Alfredo Espinosa Brito

    2014-08-01

    Full Text Available Background: the description of an epidemic is crucial from a clinical and epidemiological point of view.Objective: to identify the main clinical characteristics of hospitalized adult patients diagnosed with dengue hemorrhagic fever. Methods: a prospective case series study was conducted in 997 patients who met the diagnostic criteria for dengue hemorrhagic fever and were discharged from the Dr. Gustavo Aldereguía Lima Hospital from June 1st. to August 31, 1981. An automated database was developed based on the information collected from medical records using forms designed for the purpose. Results: forty eight point seven percent of the patients were in the third and fourth decades of life; females predominated (60.1 %. General symptoms were fever (97.4 %, asthenia (78.6 %, headache (76.4 %, anorexia (75.9 %, myalgia (62.1 % and sweating (37.2 %. The digestive symptoms included: nausea (57.8 %, vomiting (46.2 %, abdominal pain (31.6 % and diarrhea (14.1 %. The rash was developed by 32.5 % of the patients. Among the hemorrhagic manifestations were: petechiae (31.2 %, ecchymosis (11.5 %, epistaxis (7.6 %, hematemesis (6.2 %, hematuria (5.5 %, melena (3.4 %, gingival bleeding (3.4 %, enterorrhagia (2.2 %, metrorrhagia (2.1 %. The signs included: abdominal tenderness (53.6 %, tachycardia (25.9 %, lymphadenopathy (22.1 %, hypotension (12.0 %, pharyngeal redness (11.7 %, hepatomegaly (8.3 %, shock or "pre-shock" (6.9 % and splenomegaly (6.2%. Symptoms and signs were more frequent and severe among women. Eighty one point five percent of the patients were admitted one to three days after developing the symptoms. Thrombocytopenia (less than 100 000 platelets per mm3 was found in all cases and leukopenia was observed in 38.9 % of females and 20.6 % of men. Fourteen patients were admitted to intensive care, mostly due to shock; four of them with severe hemorrhagic manifestations. Only one patient died. Conclusions: the high morbidity due to dengue

  16. Evaluation of the safety and efficacy of pregabalin in older patients with neuropathic pain: results from a pooled analysis of 11 clinical studies

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    Zlateva Gergana

    2010-11-01

    Full Text Available Abstract Background Older patients are typically underrepresented in clinical trials of medications for chronic pain. A post hoc analysis of multiple clinical studies of pregabalin in patients with painful diabetic peripheral neuropathy (DPN or postherpetic neuralgia (PHN was conducted to evaluate the efficacy and safety of pregabalin in older patients. Methods Data from 11 double-blind, randomized, placebo-controlled clinical studies of pregabalin in patients with DPN or PHN were pooled. Efficacy outcomes included change in Daily Pain Rating Scale score, ≥30% and ≥50% responders, and endpoint pain score ≤3. Safety was based on adverse events (AEs. Primary efficacy was analyzed by analysis of covariance with terms for treatment, age category, protocol, baseline pain, and treatment-by-age category interaction. Results 2516 patients (white, n = 2344 [93.2%]; men, n = 1347 [53.5%]; PHN, n = 1003 [39.9%]; pregabalin, n = 1595 were included in the analysis. Patients were grouped by age: 18 to 64 years (n = 1236, 65 to 74 years (n = 766, and ≥75 years (n = 514. Baseline mean pain and sleep interference scores were comparable across treatment and age groups. Significant improvements in endpoint mean pain were observed for all pregabalin dosages versus placebo in all age groups (p ≤ 0.0009, except for the lowest dosage (150 mg/day in the youngest age group. Clinically meaningful pain relief, defined as ≥30% and ≥50% pain response, was observed in all age groups. The most common AEs were dizziness, somnolence, peripheral edema, asthenia, dry mouth, weight gain, and infections. The relative risks for these AEs increased with pregabalin dose, but did not appear related to older age or type of neuropathic pain. Conclusions Pregabalin (150-600 mg/day significantly reduced pain in older patients (age ≥65 years with neuropathic pain and improvements in pain were comparable to those observed in younger patients. Titration of pregabalin to the

  17. Monitoring the use of nifurtimox-eflornithine combination therapy (NECT in the treatment of second stage gambiense human African trypanosomiasis

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    Franco JR

    2012-08-01

    Full Text Available Jose R Franco,1 Pere P Simarro,1 Abdoulaye Diarra,2 Jose A Ruiz-Postigo,3 Mireille Samo,1 Jean G Jannin11World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland; 2World Health Organization, Regional Office for Africa, Brazzaville, Congo; 3World Health Organization, Communicable Disease Control, Control of Tropical Diseases and Zoonoses Regional Office for the Eastern Mediterranean, Cairo, EgyptAbstract: After inclusion of the nifurtimox-eflornithine combination therapy (NECT in the Model List of Essential Medicines for the treatment of second-stage gambiense human African trypanosomiasis (HAT, the World Health Organization, in collaboration with National Sleeping Sickness Control Programs and nongovernmental organizations set up a pharmacovigilance system to assess the safety and efficacy of NECT during its routine use. Data were collected for 1735 patients treated with NECT in nine disease endemic countries during 2010–2011. At least one adverse event (AE was described in 1043 patients (60.1% and a total of 3060 AE were reported. Serious adverse events (SAE were reported for 19 patients (1.1% of treated, leading to nine deaths (case fatality rate of 0.5%. The most frequent AE were gastrointestinal disorders (vomiting/nausea and abdominal pain, followed by headache, musculoskeletal pains, and vertigo. The most frequent SAE and cause of death were convulsions, fever, and coma that were considered as reactive encephalopathy. Two hundred and sixty-two children below 15 years old were treated. The characteristics of AE were similar to adults, but the major AE were less frequent in children with only one SAE and no deaths registered in this group. Gastrointestinal problems (vomiting and abdominal pain were more frequent than in adults, but musculoskeletal pains, vertigo, asthenia, neuropsychiatric troubles (headaches, seizures, tremors, hallucinations, insomnia were less

  18. Combined phase I/II study of imexon (AOP99.0001) for treatment of relapsed or refractory multiple myeloma.

    Science.gov (United States)

    Moehler, Thomas M; Feneberg, Reinhard; Ho, Anthony Dick; Golenkov, Anatoly K; Ludwig, Heinz; Kropff, Martin; Khuageva, Nuriet K; Hajda, Jacek; von Broen, Ingo; Goldschmidt, Hartmut

    2010-08-01

    Imexon [AOP99.0001 (4-imino-1,3-diazobicyclo[3. 1. 0]-hexan-2-one)] belongs to a novel class of promising anticancer agents that induce tumor apoptosis through oxidative stress. Clinical experience since the late 1960s has provided initial evidence for a clinical antitumor activity. Our open-label, multicenter phase I clinical trial was designed to further investigate the adverse event (AEs) profile and pharmacokinetics of AOP99.0001 in pretreated myeloma patients and collect initial data on the potential clinical efficacy in this indication. Thirty-six patients with relapsed or refractory myeloma, who had been pretreated with at least two lines of therapy earlier, were included. Imexon was applied intravenously on 5 consecutive days for 2 weeks (d1-5 and d8-12) for a 3-week cycle. The plasma half-life of AOP99.0001 and its active metabolite AOP99.0002 was found to be approximately 1.2 and 2.6 h, respectively. The mean duration of treatment with Imexon was 6.8 weeks in a dose range between 50 and 1000 mg/m without reaching dose-limiting toxicity. Drug-related AEs occurring with a frequency of greater than 10% were fatigue, nausea, constipation, headache, asthenia, anemia, thrombocytopenia, leukopenia and creatinine increase. A total of nine severe adverse events occurred in three patients. No mortality was encountered when patients were on treatment with Imexon. Preliminary antimyeloma efficacy of AOP99.0001 was observed with 1 minimal response, 12 (36%) stable disease responses, and all other evaluable patients had progressive disease. Remarkably, the patient with minimal response also experienced a complete clinical resolution of myeloma-associated polyneuropathy. Overall, Imexon was safe and well tolerated in the dose range investigated. Imexon showed minor clinical activity as a single agent in heavily pretreated myeloma patients. On account of its unique mechanism of action, favorable toxicity profile, initial clinical evidence for antimyeloma activity, and

  19. Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes.

    Science.gov (United States)

    Kratz, Thomas; Roddy, Paul; Tshomba Oloma, Antoine; Jeffs, Benjamin; Pou Ciruelo, Diana; de la Rosa, Olimpia; Borchert, Matthias

    2015-01-01

    Data collected during the 2012 Ebola virus disease (EVD) epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV), establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre) were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3%) and of community EVD cases in the age group of 15-54 years (82.4%). All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay) or self-reported fever (88.2% upon admission) at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%), anorexia (82.4%), myalgia (70.6%), sore throat/difficulty swallowing (70.6%), arthralgia (76.5%) and nausea (70.6%). Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting) (76.4%) as well as general pain (94.1%) were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%), intestinal parasitosis (10.9%), and infectious syndrome (10.9%). There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease) and emphasizes the need for improving

  20. Rabdomiólisis por spinning en nueve pacientes Rhabdomyolysis caused by spinning in nine patients

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    Javier Montero

    2009-02-01

    Full Text Available La rabdomiólisis es un síndrome que resulta de la destrucción del músculo esquelético. Aquella producida por ejercicio se observa luego de un esfuerzo físico intenso. Un tipo de actividad física basado en el pedaleo sobre bicicleta fija llamado spinning o indoor cycling, que trae consigo los fundamentos teóricos del ciclismo sobre una bicicleta estática, ha sido descrito excepcionalmente como factor precipitante de rabdomiólisis. Se realizó un estudio retrospectivo que evaluó la presentación clínica y complicaciones ocurridas en 9 pacientes que desarrollaron rabdomiólisis por pedaleo sobre bicicleta fija. Los síntomas predominantes fueron mialgias, astenia, eliminación de orinas oscuras e impotencia funcional de miembros inferiores. Todos presentaron elevaciones significativas de las enzimas musculares y los valores de creatinfosfoquinasa variaron entre 1.650 y 165 000 UI/l. Sólo un paciente presentó insuficiencia renal y otro hipocalcemia; ambos parámetros se normalizaron con el tratamiento instaurado. No se halló relación entre el aumento de enzimas musculares y la aparición de complicaciones. El objetivo del trabajo es presentar una serie de casos de rabdomiólisis por este deporte y alertar sobre el posible riesgo de dicha actividad.Rhabdomyolysis is a syndrome that results from the destruction of the skeletal muscle. The one produced by exercise is observed after an intense physical effort. A form of high-intensity exercise called spinning or indoor cycling that involves using a stationary bicycle, has been exceptionally reported as a generating factor of muscular damage in the medical literature. A retrospective study was performed to assess the clinical presentation and the complications shown by nine patients who experienced rhabdomyolysis caused by indoor cycling. The prevailing symptoms were myalgias, asthenia, myoglobinuria and functional impotence of the lower limbs. All the patients showed significant muscular

  1. Inhibition of the mammalian target of rapamycin (mTOR) in advanced pancreatic cancer: results of two phase II studies

    International Nuclear Information System (INIS)

    The phosphoinositide 3-kinase (PI3K)/Akt pathway is constitutively activated in pancreatic cancer and the mammalian target of rapamycin (mTOR) kinase is an important mediator for its signaling. Our recent in vitro studies suggest that prolonged exposure of pancreatic cancer cells to mTOR inhibitors can promote insulin receptor substrate-PI3K interactions and paradoxically increase Akt phosphorylation and cyclin D1 expression in pancreatic cancer cells (negative feedback loop). The addition of erlotinib to rapamycin can down-regulate rapamycin-stimulated Akt and results in synergistic antitumor activity with erlotinib in preclinical tumor models. Two studies prospectively enrolled adult patients with advanced pancreatic cancer, Eastern Cooperative Oncology Group performance status 0-1, adequate hematologic, hepatic and renal parameters and measurable disease. In Study A, temsirolimus was administered intravenously at 25 mg weekly. In Study B, everolimus was administered orally at 30 mg weekly and erlotinib was administered at 150 mg daily. The primary endpoint in both studies was overall survival at 6 months. Secondary endpoints included time to progression, progression-free survival, overall survival, response rate, safety and toxicity. Pretreatment tumor biopsies were analyzed by immunofluorescence and laser scanning cytometry for the expression of pmTOR/mTOR, pAkt/Akt, pErk/Erk, pS6, p4EBP-1 and PTEN. Five patients enrolled in Study A; Two patients died within a month (rapid disease progression and hemorrhagic stroke, respectively). One patient developed dehydration and another developed asthenia. Sixteen patients enrolled in Study B.: 12 males, all ECOG PS = 1. Median cycles = 1 (range 1-2). Grade 4 toxicity: hyponatremia (n = 1), Grade 3: diarrhea (n = 1), cholangitis (n = 3), hyperglycemia (n = 1), fatigue (n = 1). Grade 2: pneumonia (n = 2), dehydration (n = 2), nausea (n = 2), neutropenia (n = 1), mucositis (n = 2) & rash (n = 2). Four patients were

  2. Clinical Observation of Tiaojing Cupai Zhuyun Decoction in the Treatment of Ovulation Failure Infertility%调经促排助孕汤治疗排卵障碍性不孕症临床观察

    Institute of Scientific and Technical Information of China (English)

    陈芷玲

    2012-01-01

    Objective:To observe the clinical curative effect of TiaojingCupaiZhuyun decoction in the treatment of ovulation failure infertility. Methods: 142 cases with ovulation failure infertility (kidney asthenia and essence damage, insufficiency of vital energy and blood type) were given TiaojingCupaiZhuyun decoction to ovulation after 5 days in menstrual cycle,1 month as one course of treatment,continuous course treatment for 1~6 courses. Results: After treatment, 128 cases become pregnant,unfertilized but ovulation function improved in 9 cases, no change before and after treatment in 5 cases, the effective rate was 96. 5 % . Conclusion: The TiaojingCupaiZhuyun decoction has adjustment of menstrual cycle, satisfactory ovulation function and distinct curative effect on ovulation failure infertility caused by reproduction axis abnormality.%目的:观察调经促排助孕汤治疗排卵障碍性不孕症的临床疗效.方法:142例排卵障碍性不孕症患者(证属肾虚精亏、气血不足型)于月经周期第5天开始服用调经促排助孕汤直至排卵,1个月为1个疗程.连续治疗1~6个疗程.结果:142例不孕症患者经治疗后,受孕者128例,未孕但排卵功能改善者9例,治疗前后无变化者5例,有效率为96.5%.结论:调经促排助孕汤具有调整月经周期及良好的促排卵作用,对女性生殖轴紊乱引起的排卵障碍性不孕症疗效显著.

  3. Effect of Salvia Miltiorrhiza on Coagulation Parameters and Clinical Effect in Patients with Advanced Non Small Cell Lung Cancer%丹参酮对晚期非小细胞肺癌患者凝血指标与临床效果的影响研究

    Institute of Scientific and Technical Information of China (English)

    朱业靖

    2016-01-01

    Objective To investigate the effect of the improvement of the high coagulation state of the non small cell lung cancer (NSCLC). Methods 120 patients with NSCLC complicated with high blood coagulation status in Heze Municiple Hospital from January 2012 to June 2015, were randomly divided into observation group and control group, 60 cases in observation group and control group, two groups were given conventional anti tumor and symptomatic treatment. The changes of platelet, blood coagulation index, clinical symptom score and KPS score were observed before and after treatment. Result (1) plasma FBI, D-D and FDP levels in the control group were significantly higher than those before treatment, while the observation group was significantly lower than before treatment, the difference was statistically significant (P0.05); The total score of clinical symptoms were observed after the treatment group compared with those before treatment significantly improved, mainly reflected in the body tired asthenia and tongue dark ecchymosis on, the difference has statistical significance (P0.05);观察组治疗后临床症状总积分较治疗前明显改善,主要体现在体倦乏力和舌暗瘀斑方面,差异具有统计学意义(P<0.05);观察组临床症状疗效总有效率为93.33%,对照组临床症状疗效总有效率为78.33%,观察组有效率显著高于对照组,有统计学差异(P<0.05)。结论丹参酮在改善 NSCLC 患者的血液高凝状态方面效果明显,并可明显缓解临床症状,值得临床推广应用。

  4. Effects of first-dose volume and exercise on the efficacy and tolerability of bowel preparations for colonoscopy in Chinese people

    Directory of Open Access Journals (Sweden)

    Qin Y

    2016-04-01

    Full Text Available Ying Qin, Wei Liu, Songbai Lin, Xiangfeng Li International Medical Services, Peking Union Medical College Hospital, Beijing, People’s Republic of China Aim: This study was designed to compare the efficacy and tolerability of bowel preparations with and without the higher first-dose volume of polyethylene glycol (PEG solution or exercise after drinking PEG solution in Chinese people. Methods: A total of 330 participants who had a colonoscopy done in Peking Union Medical College Hospital were randomly and evenly assigned to three groups. Participants in Group A ingested 1 L PEG solution and then ingested 2 L PEG solution at a rate of 250 mL every 15 minutes. Participants in Group B ingested 3 L PEG solution at a rate of 250 mL every 15 minutes and then exercised more than 10 minutes after ingesting each liter of PEG solution. Participants in Group C ingested 3 L PEG solution at a rate of 250 mL every 15 minutes. Experienced gastrointestinal endoscopists rated the efficacy of bowel preparations based on the Boston Bowel Preparation Scale score. A questionnaire regarding participants’ symptoms associated with bowel preparations was administered to evaluate participants’ tolerability. Results: The three groups had insignificant difference in the percentages of participants’ symptoms including dizziness, nausea, stomach ache, bloating, and asthenia. However, the percentages of participants having hunger sensation, sleep disturbance, and anal discomfort were significantly higher in groups with the higher first-dose volume of PEG solution or exercise after drinking PEG solution than without them. The three groups had insignificant difference in the Boston Bowel Preparation Scale score. Conclusion: Whether to add the higher first-dose volume of PEG solution and exercise after drinking PEG solution or not, all participants achieved a similar quality of bowel preparations. Bowel preparations without the additional first-dose volume of PEG

  5. Comparação do perfil epidemiológico das hepatites B e C em um serviço público de São Paulo Comparison between hepatitis B and C epidemiological profiles at a public institution in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Camila Rodrigues Bressane Cruz

    2009-09-01

    Full Text Available CONTEXTO: As hepatites virais constituem doença de notificação compulsória e apresentam grande importância em nosso meio devido à elevada prevalência. OBJETIVO: Comparar o perfil epidemiológico dos casos confirmados de hepatites B e C notificados no Núcleo de Vigilância Epidemiológica do Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, no período entre janeiro de 2004 e abril de 2007. MATERIAL: Os resultados foram analisados através do teste do qui ao quadrado. RESULTADOS: Observou-se 112 casos confirmados de hepatite B e 651 de hepatite C. Houve predominância do sexo masculino dentre os casos de hepatite B e do sexo feminino entre os de hepatite C, com significância estatística. A faixa etária mais frequente foi de 30 a 39 anos, considerando-se hepatite B (PCONTEXT: Viral hepatitis is a disease of compulsory notification and is very important due to its high prevalence. OBJECTIVE: To analyze the epidemiological profiles of hepatitis B and C, reported through surveillance at the "Hospital do Servidor Público Estadual", São Paulo, SP, Brazil, from January 2004 to April 2007. METHODS AND RESULTS: The study revealed 112 confirmed cases of hepatitis B and 651 of hepatitis C. Male gender predominated among hepatitis B while female gender predominated among hepatitis C, statistically significant. Hepatitis B occurred mainly among patients from 30 to 39 years old (P<0.01, and hepatitis C was more frequent among patients from 40 to 49 years old (P = 0.49. Asthenia was the most frequent symptom. The main risk factors were: sexually transmitted diseases (hepatitis B; P<0.01, previous surgery and blood transfusion (hepatitis C; P<0,01. Cases were mostly confirmed through laboratory tests. Chronic hepatitis occurred in 54.5% and 81.7% cases of hepatitis B and C, respectively (P<0,01. Virus B was mostly transmitted by sexual contact (P<0,01; virus C was transmitted mainly by blood transfusion (P<0,01. CONCLUSIONS: The

  6. Fisiología de la sarcopenia: Similitudes y diferencias con la caquexia neoplásica Psysiology of sarcopenia: Similarities and differences with neoplasic cachexia (muscle impairments in cancer and aging

    Directory of Open Access Journals (Sweden)

    Josep M. Argilés

    2006-05-01

    Full Text Available Las alteraciones que acontecen durante el proceso canceroso y el envejecimiento comparten bastantes vías metabólicas así como también mediadores. Dado que afectan a gran cantidad de personas, la caquexia cancerosa y la sarcopenia del envejecimiento podrían ser dianas para futuras investigaciones clínicas. La caquexia cancerosa es un síndrome caracterizado por una gran pérdida de peso, anorexia, astenia y anemia. De hecho, muchos de los pacientes que mueren de cáncer avanzado sufren caquexia. El grado de caquexia está inversamente correlacionado con el tiempo de supervivencia de los pacientes y siempre implica una mala prognosis. En los últimos años, las enfermedades e incapacidades relacionadas con la edad han despertado un gran interés e importancia sanitaria. Concretamente, el desgaste muscular, también conocido como sarcopenia, disminuye la calidad de vida de la población geriátrica, aumentando la morbilidad y decreciendo la esperanza de vida. Deberían dedicarse más investigaciones al esclarecimiento de los factores/mediadores del proceso caquéctico (asociados a la pérdida de las reservas grasas y de tejido muscular tanto en caquexia como en sarcopenia, ya que podría ser una buena estrategia terapéutica para la prevención y el tratamiento de la pérdida de masa muscular tanto en la enfermedad como durante el envejecimiento sano.Muscle wasting during cancer and ageing share many common metabolic pathways and mediators. Due to the size of the population involved, both cancer cachexia and ageing sarcopenia may represent targets for future promising clinical investigations. Cancer cachexia is a syndrome characterized by a marked weight loss, anorexia, asthenia and anemia. In fact, many patients who die with advanced cancer suffer from cachexia. The degree of cachexia is inversely correlated with the survival time of the patient and it always implies a poor prognosis. In recent years, age-related diseases and disabilities

  7. Intradermal vaccination of adults with three low doses (2 µg of recombinant hepatitis B vaccine. I. Seroconversion rate and adverse effects

    Directory of Open Access Journals (Sweden)

    Baldy José Luís da S

    2003-01-01

    Full Text Available A total of 250 dentists (53.6% men and 46.4% women, with a mean age of 35.1 ± 9.8 years, were submitted to serological tests for the diagnosis of hepatitis B (HB - HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe - using a radioimmunoassay. One or more of these markers were detected in 78 individuals (31.2% who were excluded from the group to be vaccinated. Of the 172 HB-susceptible individuals, 135 (78.5% responded to the call and were intradermally injected with three 2 µg doses of the Belgian HB recombinant vaccine, applied at an interval of one month between the 1st and 2nd dose and of five months between the 2nd and 3rd dose. A new determination of HB markers carried out 50 days after the 3rd dose showed that 110 (81.5% individuals had become anti-HBs positive (65.5% good responders and 34.5% poor responders. Mean serum anti-HBs titer of these 110 dentists was 42.4 U S/N, similar in both sexes. The adverse effects analyzed in 106 dentists were: (a local: pain (12.3%, burning sensation (14.1%, pruritus (25.5%, erythema (28.3%, local heat (18.9%, and a hypochromic spot (32.1%; (b systemic (4.7%: discomfort in two patients, and fever, anorexia, and asthenia in one patient each. Intradermal administration of a fourth 2 µg vaccine dose to 39 dentists (poor or non-responders increased the total number of anti-HBs-positive individuals from 110 (81.5% to 114 (84.4%, with the number of good responders increasing from 72 (65.5% to 85 (74.6%. We conclude that the Belgian recombinant vaccine applied in the scheme used here induces a high rate of seroconversion and causes only mild and transitory adverse effects.

  8. Inhibition of the mammalian target of rapamycin (mTOR in advanced pancreatic cancer: results of two phase II studies

    Directory of Open Access Journals (Sweden)

    Zhang Yujian

    2010-07-01

    Full Text Available Abstract Background The phosphoinositide 3-kinase (PI3K/Akt pathway is constitutively activated in pancreatic cancer and the mammalian target of rapamycin (mTOR kinase is an important mediator for its signaling. Our recent in vitro studies suggest that prolonged exposure of pancreatic cancer cells to mTOR inhibitors can promote insulin receptor substrate-PI3K interactions and paradoxically increase Akt phosphorylation and cyclin D1 expression in pancreatic cancer cells (negative feedback loop. The addition of erlotinib to rapamycin can down-regulate rapamycin-stimulated Akt and results in synergistic antitumor activity with erlotinib in preclinical tumor models. Methods Two studies prospectively enrolled adult patients with advanced pancreatic cancer, Eastern Cooperative Oncology Group performance status 0-1, adequate hematologic, hepatic and renal parameters and measurable disease. In Study A, temsirolimus was administered intravenously at 25 mg weekly. In Study B, everolimus was administered orally at 30 mg weekly and erlotinib was administered at 150 mg daily. The primary endpoint in both studies was overall survival at 6 months. Secondary endpoints included time to progression, progression-free survival, overall survival, response rate, safety and toxicity. Pretreatment tumor biopsies were analyzed by immunofluorescence and laser scanning cytometry for the expression of pmTOR/mTOR, pAkt/Akt, pErk/Erk, pS6, p4EBP-1 and PTEN. Results Five patients enrolled in Study A; Two patients died within a month (rapid disease progression and hemorrhagic stroke, respectively. One patient developed dehydration and another developed asthenia. Sixteen patients enrolled in Study B.: 12 males, all ECOG PS = 1. Median cycles = 1 (range 1-2. Grade 4 toxicity: hyponatremia (n = 1, Grade 3: diarrhea (n = 1, cholangitis (n = 3, hyperglycemia (n = 1, fatigue (n = 1. Grade 2: pneumonia (n = 2, dehydration (n = 2, nausea (n = 2, neutropenia (n = 1, mucositis (n = 2

  9. Injectable interferon beta-1b for the treatment of relapsing forms of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Slobodan M Jankovic

    2010-03-01

    -specific reactions, insomnia, influenza-like syndrome, asthenia, headache, myalgia, hypoesthesia, nausea, paresthesia, myasthenia, chills and depression. Efficacy of IFN-β1b in  relapsing-remitting MS is higher than that of IFN-β1a, and similar to the efficacy of glatiramer acetate. These facts promote IFN-β1b as one of the most important drugs in the spectrum of immunological therapies for this debilitating disease.Keywords: multiple sclerosis, interferon beta 1b, mechanism of action, efficacy, safety

  10. Gefitinib Plus Interleukin-2 in Advanced Non-Small Cell Lung Cancer Patients Previously Treated with Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Bersanelli, Melissa, E-mail: melissa.bersanelli@alice.it; Buti, Sebastiano; Camisa, Roberta [Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (Italy); Brighenti, Matteo; Lazzarelli, Silvia [Oncology Unit, Azienda Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100 Cremona (Italy); Mazza, Giancarlo [Radiology Division, Spedali Civili di Brescia, P.le Spedali Civili,1, 25123 Brescia (Italy); Passalacqua, Rodolfo, E-mail: melissa.bersanelli@alice.it [1Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (Italy)

    2014-09-30

    The activation of lymphocytes by gefitinib treatment has been described. In this phase II pilot trial, we explored the possible synergism between IL-2 and gefitinib for non-small cell lung cancer (NSCLC) treatment. From September, 2003, to November, 2006, 70 consecutive patients with advanced, progressive NSCLC, previously treated with chemotherapy, received oral gefitinib 250 mg daily. The first 39 patients received gefitinib alone (G group). The other 31 also received subcutaneous IL-2 (GIL-2 group): 1 MIU/m{sup 2} (Million International Unit/m{sup 2})twice a day on Days 1 and 2, once a day on Days 3, 4, 5 every week for four consecutive weeks with a four-week rest period. Median follow-up was 25.2 months. Grade 3–4 toxicity of gefitinib was represented by skin rash (7%), asthenia/anorexia (6%) and diarrhea (7%); patients treated with IL-2 showed grade 2–3 fever (46%), fatigue (21%) and arthralgia (13%). In the GIL-2 group and G-group, we respectively observed: an overall response rate of 16.1% (6.4% complete response) and 5.1% (only partial response); a disease control rate of 41.9% and 41%; a median time to progression of 3.5 (CI 95% = 3.2–3.8) and 4.1 (CI 95% = 2.6–5.7) months; a median overall survival of 20.1 (CI 95% = 5.1–35.1) and 6.9 (CI 95% = 4.9–8.9) months (p = 0.002); and an actuarial one-year survival rate of 54% and 30%. Skin toxicity (p < 0.001; HR = 0.29; CI 95% = 0.16–0.54) and use of IL-2 (p < 0.001; HR = 0.33; CI 95% = 0.18–0.60) were independently associated with improvement of survival. In this consecutive, non-randomized, series of advanced NSCLC patients, the use of IL-2 increased the efficacy of gefitinib.

  11. Pemetrexed single agent chemotherapy in previously treated patients with locally advanced or metastatic non-small cell lung cancer

    International Nuclear Information System (INIS)

    The main objective of this study was to evaluate the safety of second-line pemetrexed in Stage IIIB or IV NSCLC. Overall, 95 patients received pemetrexed 500 mg/m2 i.v. over Day 1 of a 21-day cycle. Patients also received oral dexamethasone, oral folic acid and i.m. vitamin B12 supplementation to reduce toxicity. NCI CTC 2.0 was used to rate toxicity. All the adverse events were graded in terms of severity and relation to study treatment. Dose was reduced in case of toxicity and treatment was delayed for up to 42 days from Day 1 of any cycle to allow recovering from study drug-related toxicities. Tumor response was measured using the RECIST criteria. Patients received a median number of 4 cycles and 97.8% of the planned dose. Overall, 75 patients (78.9% of treated) reported at least one adverse event: 34 (35.8%) had grade 3 as worst grade and only 5 (5.2%) had grade 4. Drug-related events occurred in 57.9% of patients. Neutropenia (8.4%) and leukopenia (6.3 %) were the most common grade 3/4 hematological toxicities. Grade 3 anemia and thrombocytopenia were reported in 3.2% and 2.1% of patients, respectively. Diarrhea (6.3%), fatigue (3.2%) and dyspnea (3.2%) were the most common grade 3/4 non-hematological toxicities. The most common drug-related toxicities (any grade) were pyrexia (11.6%), vomiting, nausea, diarrhea and asthenia (9.5%) and fatigue (8.4%). Tumor Response Rate (CR/PR) in treated patients was 9.2%. The survival at 4.5 months (median follow-up) was 79% and the median PFS was 3.1 months. Twenty patients (21.1%) died mainly because of disease progression. Patients with locally advanced or metastatic NSCLC could benefit from second-line pemetrexed, with a low incidence of hematological and non-hematological toxicities

  12. Saturnismo: a propósito de un caso Lead poisoning: A case report

    Directory of Open Access Journals (Sweden)

    Pablo Honorio Labanda Urbano

    2012-06-01

    Full Text Available Profesora de pintura sobre vidrio y restauración de vidrieras de 65 años acude a la Unidad Médica de Valoración de Incapacidades del Instituto Nacional de la Seguridad Social (INSS con diagnóstico de exposición laboral a plomo. La paciente ha permanecido en Incapacidad Temporal por astenia durante varios meses, y se le detecta tras una reincorporación al trabajo plumbemia elevada, asociada a otros síntomas típicos de la intoxicación por plomo, por lo que se la separa de su ambiente de trabajo. Finalmente, el Equipo de Valoración de Incapacidades, reunido para valorar su caso resuelve Incapacidad Laboral Permanente Total derivada de enfermedad profesional para trabajos en que haya exposición a plomo y otros ototóxicos, exposición a ruidos de riesgo, y para aquellos trabajos en que sea necesaria una comunicación verbal fluida en frecuencias conversacionales normales. Con este caso clínico pretendemos revisar los síntomas del cuadro clínico de saturnismo, así como hacer una reflexión sobre los efectos de la prevención de riesgos para el trabajador.Lead poisoning is most commonly caused by occupational exposure. We report a case of a 65-year-old woman, paint teacher, which was working in reparation of stained glass window. She consults the Medical Incapacity Valoration Unit of National Institute of Social Security with diagnosis of lead occupational intoxication. The patient was not able to word for several months because of presenting asthenia. After reporting for work high lead blood levels were detected, in association with physical symptoms. She was evaluated by a tribunal which settled total long sick-leave due to occupational lead exposure and was restricted for loud works and other ones that need verbal communication in conversational frequencies. With this clinical case we try to check the symptoms of lead poisoning, as well as to think about the effects of prevention of occupational hazards.

  13. Second-line Treatment of Stage III/IV Non-Small-Cell Lung Cancer (NSCLC with pemetrexed in routine clinical practice: Evaluation of performance status and health-related quality of life

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    Schuette Wolfgang

    2012-01-01

    Full Text Available Abstract Background Second-line treatment of advanced non-small-cell lung cancer (NSCLC improves overall survival. There is a lack of data regarding the impact on patients' overall health condition. This prospective, non-interventional study evaluated performance status (PS and health-related quality of life (HR-QoL during second-line pemetrexed treatment in routine clinical practice. Methods Stage III/IV NSCLC patients who initiated second-line pemetrexed (standard vitamin and dexamethasone supplementation were observed for a maximum of 9 treatment cycles. The primary objective was to evaluate the proportion of patients achieving improvement of Karnofsky Index (KI of ≥ 10% (absolute or maintaining KI ≥ 80% after the second treatment cycle ("KI benefit response". HR-QoL was self-rated using the EuroQoL-5D questionnaire (EQ-5D. Factors potentially associated with KI benefit response were evaluated using logistic regression models. Results Of 521 eligible patients (73.5% Stage IV, median age 66.3 yrs, 36.1% ≥ 70 yrs, 62.0% with KI ≥ 80%, 471 (90.4% completed at least 2 treatment cycles. 58.0% (95%CI 53.6%;62.2% achieved KI benefit response after the second cycle. Patients with baseline KI ≥ 80%, no Grade 3/4 toxicities during the first 2 cycles, or combination regimen as prior first-line therapy were more likely to achieve a KI benefit response. EQ-5D scores improved over time. Grade 3/4 toxicities were reported in 23.8% of patients (mainly fatigue/asthenia 15.9%, neutropenia 8.7%. Conclusions In this large prospective, non-interventional study of second-line pemetrexed treatment in patients with advanced NSCLC, including 36% elderly patients ( ≥ 70 years, physician-rated PS and self-rated HR-QoL were maintained or improved in the majority of patients. Trial registration Registered on ClinicalTrials.gov (NCT00540241 on October 4, 2007

  14. Histoplasmose pulmonar aguda: relato de uma microepidemia Acute pulmonary histoplasmosis: report of an outbreak

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    Erick Malheiro Leoncio Martins

    2003-06-01

    Full Text Available Os autores relatam uma microepidemia de histoplasmose pulmonar, com cinco crianças que desenvolveram a doença em um período de 7 a 14 dias após a limpeza de um forno desativado para produção de carvão vegetal. Todas apresentaram quadro de febre alta persistente, tosse seca, astenia e anorexia, com 28 dias de evolução. Quando buscaram atendimento médico, uma delas encontrava-se taquipnéica, febril, com hepatomegalia e palidez cutânea, estando as restantes em regular estado geral e já sem febre. As radiografias de tórax demonstravam, em todos os casos, infiltrados reticulonodulares grosseiros, difusos e bilaterais, além de linfonodomegalias hilares. As tomografias computadorizadas evidenciaram pequenos nódulos difusos, com distribuição aleatória, além das linfonodomegalias. Os diagnósticos foram confirmados por meio da imunodifusão em gel para Histoplasma capsulatum, que foi positiva em todas as amostras pareadas coletadas com 15 dias de intervalo. Apenas uma criança necessitou de internação, por causa de importante queda no estado geral, sendo realizado tratamento de suporte e observação. Todas as crianças evoluíram com melhora clínica, sem o uso de antifúngicos, e foram submetidas a tomografias de controle após cerca de 50 dias, que demonstraram importante regressão das lesões.The authors report a pulmonary histoplasmosis outbreak occurring in five children after the cleaning of a deactivated coal furnace. The symptoms were high fever, dry cough, asthenia and anorexia. By the time parents seeked for medical care, only one child remained symptomatic with fever, tachypnea and hepatomegaly. All the patients had similar radiological findings. Chest films showed diffuse, bilateral, reticulonodular infiltrates and lymph node enlargement. Computed tomography showed small nodules with a random distribution and hilar and mediastinal lymph nodes. Diagnosis was confirmed by positive gel immunodiffusion for Histoplasma

  15. Perfil epidemiológico do beribéri notificado de 2006 a 2008 no Estado do Maranhão, Brasil Epidemiological profile of reported beriberi cases in Maranhão State, Brazil, 2006-2008

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    Estela Maura Padilha

    2011-03-01

    Full Text Available O objetivo do estudo foi descrever o perfil epidemiológico dos casos e óbitos de beribéri notificados de 2006-2008 no Estado do Maranhão, Brasil. Informações foram obtidas de fichas de notificação da Secretaria de Estado da Saúde do Maranhão e utilizou-se o Índice Global de Moran para avaliar autocorrelação espacial. Foram notificados 1.207 casos e 40 óbitos. Regiões oeste e central mostraram forte presença de autocorrelação espacial da incidência. Ocorrência de casos e óbitos concentrou-se de maio a agosto, em homens jovens (20-40 anos. Hábito de consumir álcool e fumar esteve presente entre os óbitos; baixa renda e ocupação com atividade pesada, entre os casos. Os sintomas mais comuns foram diminuição da força, dormência e edema das pernas, dificuldade para caminhar e dor na panturrilha. O perfil dos acometidos e os sintomas, exceto edema de membros inferiores, são característicos de beribéri seco. É pertinente que estudos sobre seu ressurgimento no país sejam aprofundados.This study aimed to describe the epidemiological profile of beriberi cases and related deaths reported from 2006 to 2008 in Maranhão State, Brazil. Data were obtained from beriberi notification forms at the State Health Department. The global Moran index was used to evaluate spatial auto-correlation. 1207 cases and 40 deaths were reported. The western and central regions of the State showed strong spatial auto-correlation of incidence rates. Cases and deaths were concentrated from May to August, in young men (20-40 years. Regular alcohol consumption and smoking were recorded among fatal cases. Low income and heavy labor were widespread among cases. Common symptoms were asthenia, numbness, and swollen legs, difficulty walking, and calf pain. The profile of cases and their symptoms (except swollen legs are characteristic of dry beriberi. We recommend further studies on the resurgence of beriberi in Brazil.

  16. Gefitinib Plus Interleukin-2 in Advanced Non-Small Cell Lung Cancer Patients Previously Treated with Chemotherapy

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    Melissa Bersanelli

    2014-09-01

    Full Text Available The activation of lymphocytes by gefitinib treatment has been described. In this phase II pilot trial, we explored the possible synergism between IL-2 and gefitinib for non-small cell lung cancer (NSCLC treatment. From September, 2003, to November, 2006, 70 consecutive patients with advanced, progressive NSCLC, previously treated with chemotherapy, received oral gefitinib 250 mg daily. The first 39 patients received gefitinib alone (G group. The other 31 also received subcutaneous IL-2 (GIL-2 group: 1 MIU/m2 (Million International Unit/m2twice a day on Days 1 and 2, once a day on Days 3, 4, 5 every week for four consecutive weeks with a four-week rest period. Median follow-up was 25.2 months. Grade 3–4 toxicity of gefitinib was represented by skin rash (7%, asthenia/anorexia (6% and diarrhea (7%; patients treated with IL-2 showed grade 2–3 fever (46%, fatigue (21% and arthralgia (13%. In the GIL-2 group and G-group, we respectively observed: an overall response rate of 16.1% (6.4% complete response and 5.1% (only partial response; a disease control rate of 41.9% and 41%; a median time to progression of 3.5 (CI 95% = 3.2–3.8 and 4.1 (CI 95% = 2.6–5.7 months; a median overall survival of 20.1 (CI 95% = 5.1–35.1 and 6.9 (CI 95% = 4.9–8.9 months (p = 0.002; and an actuarial one-year survival rate of 54% and 30%. Skin toxicity (p < 0.001; HR = 0.29; CI 95% = 0.16–0.54 and use of IL-2 (p < 0.001; HR = 0.33; CI 95% = 0.18–0.60 were independently associated with improvement of survival. In this consecutive, non-randomized, series of advanced NSCLC patients, the use of IL-2 increased the efficacy of gefitinib.

  17. Results of paclitaxel (day 1 and 8 and carboplatin given on every three weeks in advanced (stage III-IV non-small cell lung cancer

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    Salepci Taflan

    2005-01-01

    Full Text Available Abstract Background Both paclitaxel (P and carboplatin (C have significant activity in non-small cell lung cancer (NSCLC. The weekly administration of P is active, dose intense, and has a favorable toxicity profile. We retrospectively reviewed the data of 51 consecutive patients receiving C and day 1 and 8 P chemotherapy (CT regimen in advanced stage NSCLC to evaluate the efficacy and toxicity. Methods Patients treated in our institutions having pathologically proven NSCLC, no CNS metastases, adequate organ function and performance status (PS ECOG 0–2 were given P 112.5 mg/m2 intravenously (IV over 1 hour on day 1 and 8, followed by C AUC 5 IV over 1 hour, repeated in every three weeks. PC was given for maximum of 6 cycles. Results Median age was 58 (age range 39–77 and 41 patients (80% were male. PS was 0/1/2 in 29/17/5 patients and stage was IIIA/IIIB/IV in 3/14/34 patients respectively. The median number of cycles administered was 3 (1–6. Seven patients (14% did not complete the first 3 cycles either due to death, progression, grade 3 hypersensitivity reactions to P or lost to follow up. Best evaluable response was partial response (PR in 45% and stable disease (SD in 18%. Twelve patients (24% received local RT. Thirteen patients (25% received 2nd line CT at progression. At a median follow-up of 7 months (range, 1–20, 25 (49% patients died and 35 patients (69% progressed. Median overall survival (OS was 11 ± 2 months (95% CI; 6 to 16, 1-year OS ratio was 44%. Median time to progression (TTP was 6 ± 1 months (95% CI; 4 to 8, 1-year progression free survival (PFS ratio was 20%. We observed following grade 3 toxicities: asthenia (10%, neuropathy (4%, anorexia (4%, anemia (4%, hypersensitivity to P (2%, nausea/vomiting (2%, diarrhea (2% and neutropenia (2%. Two patients (4% died of febrile neutropenia. Doses of CT were reduced or delayed in 12 patients (24%. Conclusions P on day 1 and 8 and C every three weeks is practical and fairly

  18. Paniculitis mesentérica: experiencia en nuestro centro Mesenteric panniculitis: Experience in our center

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    L. Delgado Plasencia

    2007-05-01

    Full Text Available A pesar de que se han reconocido distintos factores precipitantes en la paniculitis mesentérica, su etiología en determinados casos es incierta. Presentamos un análisis retrospectivo de 8 pacientes afectados de paniculitis mesentérica en un periodo comprendido entre mayo 2000 hasta diciembre 2006. En nuestra serie la edad media de presentación fue 63 años, siendo la mayoría de pacientes varones (proporción 3:1. Las manifestaciones clínicas más frecuentes fueron el dolor abdominal (n = 4 y la astenia (n = 4. Tres casos se presentaron como cuadro de obstrucción y tres casos presentaron antecedentes de cirugía abdominal. El antecedente más común fue el tabaquismo (5 casos eran fumadores activos y 2 exfumadores y hubo un paciente que desarrolló un linfoma folicular en el seguimiento. Revisamos la literatura para analizar nuestros resultados y formular una hipótesis. En nuestra opinión, pensamos que debe ser analizada de forma más exhaustiva la relación entre el tabaco y sus componentes con la aparición de la enfermedad debido a la fuerte asociación encontrada en este estudio.Although several etiological factors have been associated with mesenteric panniculitis, the exact etiology in some cases remains unknown. Herein, we present a retrospective analysis of 8 patients affected with this disorder performed between May 2000 and December 2006. In our series the mean age at which patients presented was 63 years. The majority of the patients were male (with a male: female ratio of 3:1. The most common clinical manifestations were abdominal pain (n = 4 and asthenia (n = 4. Three cases presented with obstructive symptoms and three had a history of abdominal surgery. Notably, seven had a background of tobacco use (five smokers and two ex-smokers and one patient developed follicular lymphoma. A literature research was carried out to analyze our results and formulate a new hypothesis. In our opinion, we believe that the study of causal

  19. Meta-analysis of adjunctive levetiracetam in refractory partial sei

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    ZHANG Ying

    2012-10-01

    Full Text Available Objective To evaluate the effects and tolerability of adjunctive levetiracetam (LEV in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive LEV in refractory partial seizures from January 1998 to December 2010 were retrieved from Cochrane Library, MEDLINE, EMbase, Social Sciences Citation Index (SSCI, VIP, Chinese National Knowledge Infrastructure (CNKI database, China Biology Medicine (CBM. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted by using RevMan 5.0 software. Results According to the enrollment criteria, eleven prospective, randomized controlled clinical trials with a total of 1192 in LEV group and 789 in placebo group were finally selected. The reduction in three endpoints (a 50% or greater reduction of partial seizure frequency per week, a 75% or greater reduction of partial seizure frequency per week and seizure free was significant in LEV group than placebo group. There was no significance between LEV group and placebo group in the withdrawl rate (1000 mg/d: OR = 1.180, 95%CI: 0.690-2.010, P = 0.540; 2000 mg/d: OR = 1.530, 95%CI: 0.770-3.030, P = 0.230; 3000 mg/d: OR = 1.000, 95% CI: 0.620-1.600, P = 1.000. The following adverse events were associated with LEV: somnolence (OR = 1.720, 95%CI: 1.280-2.310, P = 0.000, dizziness (OR = 1.490, 95%CI: 1.000-2.220, P = 0.050, asthenia (OR = 1.670, 95%CI: 1.140-2.240, P = 0.008, nasopharyngitis (OR = 1.120, 95% CI: 0.710-1.760, P = 0.630, psychiatric and behavioral abnormalities (OR = 2.120, 95% CI: 1.370-3.280, P = 0.000. Conclusion LEV is effective and well tolerated when added to existing therapy in patients with refractory partial seizures compared with control drugs. Further studies are needed to identify the effects of monotherapy of LEV in partial seizures.

  20. EVEROLIMUS IN THE TREATMENT FOR METASTATIC RENAL CANCER

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    B. Ya. Alekseyev

    2014-07-01

    -IV toxicity was recorded in 5% of patients. In the everolimus-taking patients, the most common adverse reactions of all severity degrees were stomatitis (36%, eruption (28%, fatigue (23%, asthenia (22%, and diarrhea (21%. The hematological reactions included anemia (25%, hypercholesterolemia (18%, and hyperglycemia (8%. Everolimus is now the first and only registered drug to treat metastatic RCC if therapy with tyrosine kinase inhibitors is ineffective.

  1. Dalfampridine extended release tablets: 1 year of postmarketing safety experience in the US

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    Jara M

    2013-03-01

    Full Text Available Michele Jara,1 Graham Barker,2 Herbert R Henney 3rd1 1Acorda Therapeutics, Inc, Ardsley, NY, USA; 2Biogen Idec, Inc, Maidenhead, Berkshire, UK Background: Dalfampridine extended release tablets (dalfampridine-ER; prolonged-, modified, or sustained-release fampridine in some countries were approved in the US to improve walking in patients with multiple sclerosis, as demonstrated by improvement in walking speed. Postmarketing safety experience is available from exposure of approximately 46,000 patients in the US from product approval through March 2011. Objective: To provide a descriptive analysis of all spontaneously reported postmarketing adverse events (AEs for dalfampridine-ER since product launch. Methods: AE data were extracted from the safety database from product launch through March 31, 2011; AEs were classified using the Medical Dictionary for Regulatory Activities. Seizure cases were reviewed for patient demographics, time to event from treatment onset, and presence of additional risk factors. Results: The most frequently reported postmarketing AEs were similar to those reported during clinical development: dizziness, insomnia, balance disorder, headache, nausea, urinary tract infection, asthenia, and back pain (all included in US product labeling. New clinically significant findings are related to lack of efficacy and inappropriate dosing. Of the approximately 46,000 patients exposed, 85 seizures were reported (~5.4/1000 patient-years, of which 82 were reported or confirmed by a health care practitioner (~5.2/1000 patient-years. Beyond the intrinsic multiple sclerosis-related seizure risk, more than half of the 85 cases (62% had an additional potential risk factor for seizure including a previous history of convulsions, renal impairment, incorrect dosing, or use of concurrent medications with a labeled seizure risk. Duration of treatment prior to the seizure ranged from one dose to 365 days; 26/85 (31% patients suffered a seizure

  2. Connective tissue disorders in domestic animals.

    Science.gov (United States)

    Halper, Jaroslava

    2014-01-01

    Though soft tissue disorders have been recognized and described to some detail in several types of domestic animals and small mammals for some years, not much progress has been made in our understanding of the biochemical basis and pathogenesis of these diseases in animals. Ehlers-Danlos syndrome described in dogs already in 1943 and later in cats affects mainly skin in these animals. The involved skin is thin and hyperextensible with easily inflicted injuries resulting in hemorrhagic wounds and atrophic scars. Joint laxity and dislocation common in people are less frequently found in dogs. No systemic complications, such as organ rupture or cardiovascular problems which have devastating consequences in people have been described in cats and dogs. The diagnosis is based on clinical presentation and on light or electron microscopic features of disorganized and fragmented collagen fibrils. Several cases of bovine and ovine dermatosparaxis analogous to human Ehlers-Danlos syndrome type VIIC were found to be caused by mutations in the procollagen I N-proteinase (pnPI) or ADAMTS2 gene, though mutations in other sites are likely responsible for other types of dermatosparaxis. Cattle suffering from a form of Marfan syndrome were described to have aortic dilatation and aneurysm together with ocular abnormalities and skeletal involvement. As in people mutations at different sites of bovine FBN1 may be responsible for Marfan phenotype. Hereditary equine regional dermal asthenia (HERDA), or hyperelastosis cutis, has been recognized in several horse breeds as affecting primarily skin, and, occasionally, tendons. A mutation in cyclophilin B, a chaperon involved in proper folding of collagens, has been identified in some cases. Degenerative suspensory ligament desmitis (DSLD) affects primarily tendons and ligaments of certain horse breeds. New data from our laboratory showed excessive accumulation of proteoglycans in organs with high content of connective tissues. We have

  3. Diagnosis and clinical manifestations of subacute combined degeneration of the spinal cord:Analysis of 21 cases

    Institute of Scientific and Technical Information of China (English)

    Yanhong Shou; Caifeng Li; Dongsheng Fan; Yang Shen; Jun Zhang; Weizhong Xiao; Shuqing Zhao; Jinsheng Liu; Wei Sui

    2007-01-01

    BACKGROUND: Subacute combined degeneration of the spinal cord is caused by vitamin B12 deficiency and is a kind of degenerative disease owing the characteristics of nervous system diseases. In addition,different patients have variously clinical manifestations and various prognoses after vitamin B12 therapy.OBJECTIVE: To investigate and analyze diagnosis, clinical manifestations and prognosis of subacute combined degeneration of the spinal cord.DESIGN: Case analysis.SETTING: Department of Neurology, the Third Hospital of Peking University.PARTICIPANTS: A total of 21 subacute combined dcgeneration of the spinal cord patients including 14 males and 7 females aged from 33 to 82 years were selected from Department of Neurology, the Third Hospital of Peking University from January 1999 to December 2005. Duration from onset to final diagnosis lasted for 1.5 - 108 months. All patients had typically clinical manifestations; meanwhile, level of serum vitamin B12 was decreased and/or vitamin B12 therapy was effective. All patients provided the confirmed consent.METHODS: Clinical data of 21 subacute combined degeneration of the spinal cord patients were retrospectively analyzed, while general data and clinical characteristics were recorded at the same time.Levels of blood routine, serum vitamin B12 and homocysteine were measured at the phase of hospitalization.Normal value of serum vitamin B12 was 187 - 1 059 ng/L and normal value of serum homocysteine was 5 -15 μ mol/L. All patients received neuroelectrophysiological examination and 15 patients received MRI examinations of spinal cord. After final diagnosis, patients were given vitamin B12 therapy. And follow-up was performed to investigate the prognosis.prognosis.RESULTS: Clinical data of 21 patients and follow-up data of 20 patients were involved in the final analysis typically clinical manifestations. The original symptoms included numbness of lower and/or upper limbs (5 cases), unstable gait (3 cases), limb asthenia (4

  4. 接受HAART治疗的1718例HIV/AIDS患者中医证候研究%Study of TCM Syndrome in Patients with HIV/AIDS Syndrome in 1718 Cases Treated with HAART

    Institute of Scientific and Technical Information of China (English)

    段呈玉; 方路; 葛锋

    2015-01-01

    Objective:To understand the symptoms distribution of patients with HIV/AIDS treated by HAART to explore the characteris-tics of TCMsyndrome.Methods:Selected 1718 patients treated with HAART for more than 3 months to cross sectional survey.Collect four diagnostic information of TCM and modern biological information and descriptive statistics of symptoms,signs,frequency (time). Results:The most common symptoms were fatigue,anorexia,cough,headache,menstrual disorder (female),joint pain,skin itching, pain,muscle pain,fever;tongue color to red,crimson red,pale purple,fat and tooth marked tongue,a whitish fur and yellow greasy,thick and greasy fur see;pulse compound,after decomposition to fine pulse,slippery pulse,taut pulse.There are 24 kinds of TCM syndrome type,deficiency of both QI and qi-yin asthenia are the most common syndrome,followed by stagnation of QI due to depression of the liv-er.For more complex syndrome,decomposition occurred after up to 32 kinds of documents.Main deficiency,followed by empirical,defi-ciency of at least.The incidence rate of organs from high to low according to the spleen,lung,kidney,liver,heart,spleen system among the highest incidence,and is often associated with lung,liver,kidney and to a disease.The incidence of viscera number is successively from high to low:three viscera comorbidity,two viscera comorbidity,four viscera comorbidity,five viscera comorbidity.Conclusion:The clinical symptoms of patients with HIV/AIDS treated with HAART showed diverse,complex disease,asthenia-sthenia zheng complica-tions,common multi viscera disease.%目的:通过调查接受HAART治疗的HIV/AIDS患者的症状分布规律,探讨该类患者的中医证候特点。方法:选取接受HAART治疗3个月以上的HIV/AIDS患者1718例进行横断面调查,采集中医四诊信息和现代生物学信息,对这些患者进行症状、体征、证候出现频率(次)的描述性统计。结果:常见症状依次为:乏力、纳呆、

  5. 青年男性中医体质分类与生殖健康的相关性研究%The correlation study on TCM body constitution classification and the reproductive system diseases in young man

    Institute of Scientific and Technical Information of China (English)

    吉保民; 胡海翔; 罗少波

    2011-01-01

    目的 研究青年男性中医体质辨证分类与生殖健康的相关性。方法 对749例调查对象通过填写“男性体质调查表”,结合查体进行体质辨证,以期了解男性体质类型的构成及其与生殖健康的关系。结果 接受调查者年龄在18~35岁。包皮过长者中,气郁质、瘀血质明显多于平和质(P<0.01);前列腺炎患者中,湿热质、气郁质明显多于平和质(P<0.01);精索静脉曲张患者中,气虚质、瘀血质多于平和质(P<0.01);包茎患者中,阳虚质明显多于平和质(P<0.01);早泄患者中,气虚质、阴虚质、特禀质明显多于平和质(P<0.01);勃起功能障碍患者中,阴虚质、特禀质明显多于平和质(P<0.01);不育症患者中,阳虚质、阴虚质、瘀血质明显多于平和质(P<0.01)。结论 青年男性中医体质辨证类型与生殖系统健康状况有一定相关性。%Objective To study the correlation between the body constitution classifications of traditional Chinese medicine (TCM)and the reproductive system diseases in young man. Methods All 749 objects took physical examination about the reproductive system diseases, filled in the questionnaire of male body constitution, and differentiated TCM classifications of body constitution. Results The incidence rate of redundant prepuce of depressed vital energy constitution and stagnant blood constitution was obviously higher than balance constitution (P<0.01) , the incidence rate of prostatitis of dampness-heat constitution and depressed vital energy constitution was obviously higher than balance constitution (P<0.01), the incidence rate of varicocele of Qi asthonia constitution and stagnant blood constitution was obviously higher than balance constitution(P<0.01), the incidence rate of phimosis of Yang deficiency constitution was obviously higher than balance constitution (P<0.01) , the incidence rote of prospermia of Qi asthenia constitution

  6. Síndrome Poliglandular Autoinmune Tipo II: Posible Asociación con HLA DRB1*-DQB1* Possible association of Type II Autoimmune Polyendrocrine Syndrome with HLA DRB1*-DQB1*

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    M.S. Mallea Gil

    2010-12-01

    Full Text Available Los síndromes poliendocrinos autoinmunes (APS asocian enfermedades endocrinas autoinmunes con otros desórdenes autoinmunes no endocrinos. El APS tipo II se caracteriza por compromiso primario suprarrenal, tiroideo y/o DM tipo I. Presentamos un paciente masculino de 46 años que fue internado por astenia, adinamia, hiporexia, severa disminución de peso, mareos y vómitos. Antecedente de obesidad y diabetes diagnosticada 3 años antes. Presentaba hipotensión arterial, hiperpigmentación de mucosas y pliegues, anemia, hiponatremia e hipoglucemias frecuentes a pesar de la disminución de la dosis de insulina. Se diagnosticó insuficiencia suprarrenal, concomitantemente con hipotiroidismo y diabetes tipo 1, todas de origen autoinmune, iniciándose reemplazo hormonal. Se encontró una posible asociación del HLA DRB1*-DQB1* en los estudios genéticos. Conclusiones: Nuestro paciente presenta el HLA DQB1*0302 descripto en el APSII, pero el HLA DRB1 *08 encontrado no está descripto en este síndrome ni en ningún otro desorden autoinmune. En pacientes con Diabetes tipo 1 que disminuyan el requerimiento insulínico, habría que descartar insuficiencia suprarrenal, un componente del APS II, como factor etiológico, a pesar de su baja prevalencia.Autoimmune polyendocrine syndromes (APS are the association of autoimmune endocrine diseases with other non-endocrine autoimmune disorders. Type II APS is defined by occurrence of Addison´s disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. We present a 46-year-old male patient who was hospitalized because of asthenia, adynamia, hyporexia, severe loss of weight, dizziness and vomiting. Diabetes mellitus had been diagnosed 3 years earlier when he was obese. He presented arterial hypotension, anemia, darkening of the skin and oral mucosa, hyponatremia and frequent hypoglycemia although his insulin dose was decreased. Adrenal insufficiency was diagnosed together with hypothyroidism and type

  7. Ebola Virus Disease (EVD and Women's Health Care in Pregnancy

    Directory of Open Access Journals (Sweden)

    Arash Khaki

    2015-01-01

    sex or the use of condoms during sex, as well as avoidance of breastfeeding and contact with the mucous membranes of the eye for at least 3 months after recovery, are still recommended to avoid possible exposure to EBOV in the aforementioned immunologically protected sites. Male survivors may be able to transmit the disease via semen for nearly two months(2. Pregnancy The number of infected women was slightly higher than the number of infected men.In research that done by Mupapa in 2000 confirmed, Among 105 women 15% were pregnant and one of those survived. The mortality rate among pregnant woman with Ebola virus was slightly higher (93.3% than during the overall epidemic in the area (77%. The mortality rate for non-pregnant women was 70%(6-7. Pregnant women might suffer hemorrhage due to various reasons such as Placenta Previa or abortion, making it difficult to diagnose Ebola in pregnant women. During an outbreaks of Ebola each expectation mother with bleeding receives care as a suspected Ebola patient, they may need blood transfusion and/or abortion and post-abortion care(6-7. Symptoms in Pregnancy Most clinical sign of ebola disease in pregnant women are: fever, asthenia, abdominal pain, conjunctivitis, anorexia, diarrhea, hiccups, arthralgia, shock, dysphagia, nausea, vomiting, retrosternal pain, cutaneous eruptio, increased respiratory rate. All infected women had with signs of hemorrhage, including severe genital bleeding, melena, gum bleeding, ecchymosis, bleeding at injection sites, hematemesis, petechia, and hematuria, respectively(7. Neuropsychiatric symptoms in pregnant women Headache, anxiety, decreased consciousness, apathy, coma, delirium, and convulsions, respectively(7. Abortion Spontaneous abortion is frequent. A high frequency of abortion has also been observed during infection. Previous study was confirmed that (67% of the pregnancy ended with an abortion in infected women with Ebola virüs(7.

  8. Meta-analysis of EGFR tyrosine kinase inhibitors compared with chemotherapy as second-line treatment in pretreated advanced non-small cell lung cancer.

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    Ning Li

    Full Text Available Since efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs versus chemotherapy in the treatment of patients with pretreated advanced non-small cell lung cancer (NSCLC remain controversial, we performed a meta-analysis to compare them.An internet search of several databases was performed, including PubMed, Embase, and the Cochrane database. Randomized trials that compared an EGFR-TKI with chemotherapy in the second-line setting were included. The outcomes were progression-free survival (PFS, overall survival (OS, objective response rate (ORR, and grade 3-4 toxicities. The PFS, OS for the EGFR mutation-positive (EGFR M+ and EGFR mutation-negative (EGFR M- subgroups were pooled. The pooled hazard ratios (HRs and odds ratios (ORs with their corresponding confidence intervals (CIs were calculated on the STATA software.Our meta-analysis combined 3,825 patients from 10 randomized trials. Overall, EGFR-TKIs and second-line chemotherapy have equivalent efficacy in terms of PFS (HR, 1.03; 95%CI, 0.87-1.21; P = 0.73; I2 = 78.7%, Pheterogeneity<0.001, OS (HR, 1.00; 95%CI, 0.92-1.08; P = 0.90; I2 = 0.0%, Pheterogeneity = 0.88, and ORR (OR, 1.34; 95%CI, 0.86-2.08; P = 0.20; I2 = 73.1%, Pheterogeneity<0.001. However, subgroup analysis based on EGFR mutation status showed that second-line chemotherapy significantly improved PFS (HR, 1.35; 95%CI, 1.09-1.66; P = 0.01; I2 = 55.7%, Pheterogeneity = 0.046 for EGFR M- patients, whereas OS was equal (HR, 0.96; 95%CI, 0.77-1.19; P = 0.69; I2 = 0.0%, Pheterogeneity = 0.43; EGFR-TKIs significantly improved PFS (HR, 0.28; 95%CI, 0.15-0.53; P<0.001; I2 = 4.1%, Pheterogeneity = 0.35 for EGFR M+ patients, whereas OS was equal (HR, 0.86; 95%CI, 0.44-1.68; P = 0.65; I2 = 0.0%, Pheterogeneity = 0.77. Compared with chemotherapy, EGFR-TKIs led to more grade 3-4 rash, but less fatigue/asthenia disorder, leukopenia and

  9. Study on the Mechanism of BushenHuoLuofang in Ovulation promting to Rats with Polycystic ovary and insulin-like growth factor-binding proteins-1 expression in the Ovary%补肾活络方对PCOS大鼠促排卵及卵巢IGFBP-1表达影响的研究

    Institute of Scientific and Technical Information of China (English)

    王萍; 杨艳

    2011-01-01

    Obejective: To study the mechanism of BushenHuoLuofang based on the role of tonifying kidney. d issolving blood stasis treating female the sterility due to asthenia of the kidney deficiency and blood stasis and interpret the intervention role of promoting the growth of follicle ovulation.Methods:Pcos model was set up and screened by vaginal smear. The use of morphological techniques in molecular biology and microscopy, the normal group, model group, chinese medicines group,western medicine group SD female rats ovarian IGFBP-1 gene expression in cells were detected, while observing the morphological changes of ovary AMD. Results:The Chinese Medicines Board, WM group with the model group in ovarian weight and the number of follicles at all levels had a significant difference.(P<0.05)Chinese medicine with western medicine group at all levels of follicle number had a significant difference (P<0.05).Model group LHRmRNA expression in the expression of both size and intensity of expression and not on the normal group, Chinese medicine and western medicine group (P<0.05).Chinese medicine group and the normal group in the area and the expression on the expression of no difference(P>0.05). Conclusion:BushenHuoLuofang based on the role of invigorating the kidney can greatly increase the weight of ASR rats' ovary and the quantities of ovarian follicles in ovary. By affecting the expression of the IGFBP-1mRIVA in ovary, it improves the growth.%目的:探讨以补肾活络立法的"补肾活络方"对肾虚血瘀型不孕症促进卵泡发育及促排卵的可能机制.方法:建立PCOS大鼠不孕模型,运用分子生物学和显微形态学技术,对正常组、模型组、中药组、西药组SD雌大鼠卵巢细胞IGFBP-1基因表达水平进行检测,同时观察卵巢局部超微形态学的变化.结果:中药组、西药组与模型组在卵巢重量及卵泡数目上比较,差异有统计学意义(P0.05).结论:以补肾活络立法的补肾活络方可以显

  10. 贵阳市社区居民脑血管病及危险因素问卷调查%Questionnaire Survey of Cerebrovascular Disease and Risk Factors In The GUIYANG City Community

    Institute of Scientific and Technical Information of China (English)

    井绪西; 陈赞军; 付桂丽; 侯丽; 陈安强; 金建平; 刘康; 龙胜利; 梁忠明; 翁颖; 尤丛笑; 张曦

    2009-01-01

    Objective To investigate morbidity,risk factors and clinical symptom of cerebrovascular disease in the Guiyang community. Methods In the sixteen cornmunity,19715 people above 30 years-old were selected. The data of four groups(30 ~ 39,40 ~ 49,50 ~ 59, ≥60years-old) was comparatively analyzed. Results The morbidity of the cerebrovascular disease was 5.1% in last five years in the sixteen community. The incidence of smoking and drinking in 30 ~ 49 years-old two groups was the highest-level comparated other groups. The mor-bidity of the cerebrovascular disease,the hypertension, the diabetes mellitus, the coronary heart disease, and the hyperlipoidemia was raise as they continue into old age. The incidence of clinical symptom of cerebrovascular disease for instance dizzy, asthenia, Unilateral hypodynamia, unilateral neglect and simple eye blurred vision and so on was raise as they continue into old age. Conclusion In order to prevent and control the cerebrovascular disease of people in community, we should focus on its clinical features, take appropriate measures, such as quist smoking, controlling drinking and Primary Prevent in the under 49 years-old people. The above 49 years-old should take secondary and third prevention, such as pay close attention to their blood pressure, blood sugar, blood-fat and so on. We should guide their periodic physical examination, timing hospitalize, proper dose and ad-justing diet composition, strengthening physical exercise.%目的 探讨贵阳市社区居民脑血管病患病情况、危险因素、与脑血管病相关的临床症状的发生率.方法 采用采用分层整群随机方法对16个社区的30岁以上居民问卷调查,按年龄每10岁(60岁以上归入一组)一组分别统计.结果 各个年龄段5年累加的脑血管病患病率为5.1%;吸烟、饮酒率在30~49岁两个年龄段最高;脑血管病、高血压、糖尿病、冠心病、高血脂均随年龄增大而患病率增加;而与脑血管病

  11. Çanakkale Muharebelerimde Cephede ve Cephe Dışında Sağlık Hizmetleri

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    Ahmet ESENKAYA

    2011-04-01

    Full Text Available It is essential to know not only the shooting-war in the combats occurred in different fronts in the Gallipoli peninsula like Seddülbahir, Arıburnu, Anafartalar and Suvla, but also how the medical services such as hospital was operated in those fronts. With launching the Gallipoli campaign, the entente states aimed at a front which would last very shortly and bring many gains. However, their all expectations came to naught. The Gallipoli became a long-duration battle-front and resulted in more casualties than expected. On the other hand, that situation was a resurrection for Turkish people. Nevertheless, the price of the victory was very high. Due to long-term battle, there were so many injuries as much as the number of deaths. The case of injury was accompanied by pediculosis, malaria, cholera, dysentery, paratyphoid, typhus, icterus, inflammation and scorbutic. Besides, the war environment also brought about some other health problems among soldiers. These were in general insomnia, asthenia, irregular heartbeats and deafness. Despite all these problems, hygenic measures were carried out sensitively. The Turkish Medical Department averted any imminent spread of infectious disease among the army which was deployed in a narrow area. In 9 months, 110.220 injuries, 70.939 patients and those who needed sick leave were sent to the hospitals of "Menzil" and "Kızılay". In this period, 48.268 patients and 22.619 injuries were treated at hospitals. Surprisingly, the deathrate at hospitals was low. Only 11.6 per cent of patients and 2.7 per cent of injuries were lost. The hospitals of the fifth army were dominantly in østanbul. When the hospitals reached full capacity, the army and Kızılay began to use the public buildings such as schools as hospitals, just like the Balkan wars. Since most of their students were in the battle, the medical schools, Gülhane and østanbul, interrupted their education and became additional military hospitals. This

  12. Study on Chinese Syndromes of Chronic Renal Failure%基于证素辨证原理的慢性肾功能衰竭中医证候研究

    Institute of Scientific and Technical Information of China (English)

    唐娟; 魏仲南

    2014-01-01

    -cess,which mostly sign as asthenia syndrome,and locations and natures of diseases react upon each other. Pathogenesis of CRF is ac-cordant,that is:ruin of spleen and kidney,Qi Blood Yin Yang concurrent deficiency,dampness heat goes with blood stasis blocking,tox-in accumulating,and disorder of Qi movement.

  13. Avaliação acústica e perceptivo-auditiva da voz nos momentos pré e pós-operatório da cirurgia de implante de pré-fáscia do músculo temporal Acoustical analysis and perceptual ratings of voice before and after surgery for implantation of pre-fascia temporal muscle

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    Juliana de Oliveira Costa

    2008-03-01

    sulcus vocalis. Perceptual voice ratings [Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS], acoustical analysis and spectrogram analysis were analyzed. Perceptual voice ratings was carried out by three speech-language pathologists and spectrograms analysis by three speech language pathology students after three hours of training. RESULTS: perceptual ratings (GRBAS: Statistically significant improvement was found just in parameter B (Breathiness t>1.734. Analysis acoustical: The fundamental frequency decreased and the maximum phonation time increased after surgery. Spectrogram analysis: Harmonic form and periodicity remained without improvement after treatment. The noise of spectrogram decreased and harmonic definition increased after treatment. CONCLUSION: the patients who underwent pre-fascia temporal muscle implantation for sulcus vocalis showed improvement in perceptual rating of Breathiness (B, fundamental frequency, maximum phonation time and spectrograms analysis (noise decreased and harmonic definition increased.

  14. 陕西省延安地区胃黏膜异型增生证候特征及发病因素探讨%Research of gastric mucosal dysplasia syndrome characteristics and risk factors in Yan'an region of Shanxi

    Institute of Scientific and Technical Information of China (English)

    惠建萍; 沈舒文; 刘力; 刘梅君

    2012-01-01

    with insufficiency of spleen - YANG, deficiency cold of the spleen. Conclusion The syndrome characteristics of gastric mucosal dysplasia is Xu - Shi correlation syndrome, asthenia syndrome was deficiency of spleen - QI and stomach - QI, insufficiency of spleen - YANG, deficiency cold of the spleen and stomach yin deficiency. Sthenia syndrome was stagnation of liver - QI and stomach - QI and obstruction in the hepatic chollateral. The incidence of gastric mucosal dysplasia may be associated with chills, tiredness addicted to spicy food, alcohol, tobacco and other factors.

  15. AL Amyloidosis

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    Desport Estelle

    2012-08-01

    Full Text Available Abstract Definition of the disease AL amyloidosis results from extra-cellular deposition of fibril-forming monoclonal immunoglobulin (Ig light chains (LC (most commonly of lambda isotype usually secreted by a small plasma cell clone. Most patients have evidence of isolated monoclonal gammopathy or smoldering myeloma, and the occurrence of AL amyloidosis in patients with symptomatic multiple myeloma or other B-cell lymphoproliferative disorders is unusual. The key event in the development of AL amyloidosis is the change in the secondary or tertiary structure of an abnormal monoclonal LC, which results in instable conformation. This conformational change is responsible for abnormal folding of the LC, rich in β leaves, which assemble into monomers that stack together to form amyloid fibrils. Epidemiology AL amyloidosis is the most common type of systemic amyloidois in developed countries with an estimated incidence of 9 cases/million inhabitant/year. The average age of diagnosed patients is 65 years and less than 10% of patients are under 50. Clinical description The clinical presentation is protean, because of the wide number of tissues or organs that may be affected. The most common presenting symptoms are asthenia and dyspnoea, which are poorly specific and may account for delayed diagnosis. Renal manifestations are the most frequent, affecting two thirds of patients at presentation. They are characterized by heavy proteinuria, with nephrotic syndrome and impaired renal function in half of the patients. Heart involvement, which is present at diagnosis in more than 50% of patients, leading to restrictive cardiopathy, is the most serious complication and engages prognosis. Diagnostic methods The diagnosis relies on pathological examination of an involved site showing Congo red-positive amyloid deposits, with typical apple-green birefringence under polarized light, that stain positive with an anti-LC antibody by immunohistochemistry and

  16. Intensive Farmaco- Surveillance of Interferon Alpha 2b Recombinant in Multiple Sclerosis. Farmacovigilancia intensiva al interferón alfa 2b recombinante en la esclerosis múltiple.

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    Hailen Bobillo López

    Full Text Available

    Background: The interferon alpha 2b recombinant, produced in Cuba, is used in the treatment of different illnesses, such as the multiple sclerosis. For its commercialization it is needed to know its safety scope. Objective: To assess the adverse reactions of interferon alpha 2b recombinant in the treatment of multiple sclerosis. Method: During the period between 1996 and 2006, 70 clinical histories and data collection notebooks of patients included in the randomized double blind national clinical trial phase IV were revised. This trial was developed in the Clinic of Multiple Sclerosis of the Hospital "Dr. Gustavo Aldereguía Lima" in Cienfuegos. With regard to the total of manifested adverse reactions we analyzed type, length, and use of a given treatment to counteract them, intensity level (light, moderate, serious or lethal and causality level (definitive, probable, possible, conditional or not related. Results: 53 patients out of the total presented 207 adverse reactions to interferon. The most frequent were: fever, migraine, chills, arthralgia, asthenia and myalgia, being most of them moderate collateral effects of definitive character. In 197 patients the outcome was favorable. Conclusion: The use of the interferon alpha 2b

  17. 肠易激综合征中医证候与焦虑、抑郁情绪的关系研究%The Research on the Relationship Between TCM Syndrome of Irritable Bowel Syndrome and Anxiety and Depression

    Institute of Scientific and Technical Information of China (English)

    宋素华; 宋彬彬

    2015-01-01

    目的:探讨肠易激综合征(IBS )中医辨证分型与患者焦虑、抑郁情绪的关系,为 IBS 的辨证论证提供客观化依据。方法搜集114例IBS患者的四诊信息并辨证分型,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价患者的焦虑、抑郁状况,行简单对应分析。结果 IBS的不同中医证型所表现的焦虑、抑郁心理存在差异。肝郁气滞证的点集合与焦虑、抑郁点集合的距离最近,肝郁脾虚证的点集合与焦虑并抑郁点集合的距离最近,脾胃虚弱证、脾虚湿盛证和脾肾阳虚证的点集合与无焦虑抑郁点集合的距离最近。结论 IB S的肝郁气滞证和肝郁脾虚证患者具有明显的焦虑抑郁情绪,这对 IB S 中医辨证分型有一定提示作用。%Objective To investigate the relationship between TCM syndrome differentiation of irritable bowel syndrome(IBS)and patients'anxiety and depression ,and provide objective evidence for the dialectical argument on IBS.Methods The information of 114 cases of patients with IBS was collected and their TCM syndrome differenti‐ation was obtained by the four methods of diagnosis. The anxiety and depression condition of the patients was eval‐uated by using self‐rating anxiety scale(SAS)and self‐rating depression scale(SDS). The simple correspondence a‐nalysis to these two sets of data was performed.Results There were differences between the different TCM syn‐drome types of IBS in anxiety and depression. The distance between multipoint of the liver‐depression and Qi‐stag‐nation syndrome and the anxiety and depression is the nearest. T he distance betw een multipoint of the liver‐depres‐sion and spleen‐deficiency syndrome and the anxiety with depression is the nearest. Furthermore ,the distance be‐tw een multipoint of the w eakness of spleen and stomach syndrome ,damp abundance due to splenic asthenia and in‐sufficiency of both the spleen and the kidney

  18. Capítulo 4: histoplasmose Chapter 4: histoplasmosis

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    Miguel Abidon Aidé

    2009-11-01

    asymptomatic. The symptoms of acute or epidemic histoplasmosis are high fever, cough, asthenia and retrosternal pain, as well as enlargement of the cervical lymph nodes, liver and spleen. The most common radiological findings are diffuse reticulonodular infiltrates in both lungs, as well as hilar and mediastinal lymph node enlargement. In chronic pulmonary histoplasmosis, the clinical and radiological manifestations are identical to those of reinfection with pulmonary tuberculosis. Histoplasmosis is diagnosed by means of the identification or culture growth of the fungus in sputum or fiberoptic bronchoscopy specimens. Histopathological examination reveals the fungus itself within or surrounding macrophages, as well as granulomatous lesions with or without caseous necrosis. Double agar gel immunodiffusion is the most easily used and readily available serologic test for making the immunological diagnosis. Acute histoplasmosis with prolonged symptoms requires treatment, as do the disseminated or chronic pulmonary forms of the disease. The drug of choice is itraconazole.

  19. Coexistência de colonização fúngica intracavitária (bola fúngica e tuberculose ativa Coexistence of intracavitary fungal colonization (fungus ball and active tuberculosis

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    Gisela Unis

    2005-04-01

    evolution in patients with tuberculosis and fungus ball. METHOD: We reviewed, retrospectively, the records of 625 patients diagnosed with fungus ball between 1974 and 2002. All of the patients had been diagnosed through immunodiffusion or mycological study, or both. The inclusion criterion was positivity for acid-fast bacilli in sputum smear microscopy or histopathology. RESULTS: The charts of 14 patients were selected. All had presented hemoptysis, followed by productive cough, dyspnea, weight loss, fever, asthenia and chest pain. In one patient colonized by Aspergillus niger and in another colonized by Scedosporium apiospermum (Teleomorph, Pseudallescheria boydii, active tuberculosis was seen concomitant to the fungus ball. In the remaining cases, the mycobacteria were found in the adjacent parenchyma or in the contralateral lung. CONCLUSION: This study corrobates the assertion that antagonism exists between Mycobacterium tuberculosis and Aspergillus fumigatus. The potential for fungal colonization and mycobacteriosis to occur concomitantly is demonstrated in other fungal agents, S. apiospermum (P. boydii and A. niger in particular.

  20. 结肠慢传输性便秘临床路径的建立及针灸治疗的研究%Clinical pathway and acupuncture in slow-transit constipation

    Institute of Scientific and Technical Information of China (English)

    丁曙晴; 丁义江; 王小峰; 谭妍妍; 金洵; 霍雏宇; 季新涛; 丁康

    2009-01-01

    Objective To create a dinical slow-transit constipation pathway, and based on patient reported outocomes to assess the characteristic and effect of aeuptmcture. Methods After create the slow-transit constipation treatment team and database, according to Rome Ⅲ criteria and colon transit test from Feb.2007 to Aug. 30 cases,9 males and 21 females,aged 18-80(49.3± 17.6)years,duration of disease 2-40(10.9 ±9.6)years were enrolled. All of the 30 cases had depended upon irritative laxafives or glycerine enema for a long time. In 30 cases of slow transit constipation 12 cases were pancolon type,and 18 cases were decending colon type. Twelve of the 30 cases associated with psychological disorder and 15 cases with insomnia. Acoording to the classification in traditional medicine,the main types of syndrome were qi asthenia and liver depression, asthenia of both qi and yin, and spleen qi deficiency. The acupoints defined as group 1 including TIANSHU, DAHENG, FUJIE, QIHAI, GUANYUAN, ZUSANLI and SHANGJUXU, and group 2 including DACHANGSHU SHENSHU, BALIAO and SISHENODNG. Deep stab to the aeupoints on abdomen and back,and moxibustion over the SISHENCONG acupoint were performed. The assessment of effectiveness was based on patient reported outcomes. Evaluations of the Bristol score, times of defecation, sense of distention and PAC-QOL at pretreatment and 1,2 and 3 weeks after treatment were completed. Results Compared the differences in pretreatment and 1 2 and 3-week post-treatment, the number of patients using irritant laxative or glycerine enema reduced,and those with normal Bristol score rised, awareness of defecation and times of defecation ineresed, and feeling of abdominal distension lessened. (all P< 0.0001). After treatment PAC-QOL scores of malaise, psyehosocial complaint,anxiety and interest related to constipation and satisfaction were obviously reduced and the difference of total score values reduced too. The results of assessment at the end of treatment,and after

  1. Analysis on the clinical characteristics and treatment of intracranial venous and sinus thrombosis%颅内静脉系统血栓形成的临床特征与疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈书红; 周广喜

    2011-01-01

    middle-aged women. The common causes were pregnancy, infection, immunological disorder, etc. Acute or subacute clinieal characteristics were headache (71.43%, 10/14), aeizure (35.71%, 5/14), asthenia (21.43%, 3/14), and CSF pressure was aignificantly high in most patients. The imaging findings were cerebral venous and sinus occlusion and cerebral parenchymal impairment (infarction, hemorrhage, brain edema). There were 7 and 5 effective cases in argatroban group and heparin group, respectively (Z = - 0.067, P = 0.950). In both group, the neural function [National Institute of Health Stroke Scale (NIHSS) score] was significantly improved after treatment (P = 0.007). Conclusion Intracranial venoua and sinus thrombosis should be highly suspected in patients who have no common risk factors for stroke, but with acute intracranial hypertensive symptoms such as headache, vomitinS, and cortex symmetric infarction on CT scanning. AlthouSh cerebral angiography is the golden gtandard for the diagnosis of intracranial venous and sinus thrombosis, most patients can be early diagnosed by magnetic resonance imaging (MRI) and magnetic resonance venography (MRV). The difference in curative effect is not aignificant between argatroban and heparin. The patient with intracranial venous and sinus thrombosis may get more benefit when anticoagulant therapy ia given earlier and actively.

  2. Hospitalized cases of influenza A(H1N1pdm09 in the French territories of the Americas, July 2009-March 2010 Casos hospitalizados de gripe A(H1N1pdm09 en los territorios franceses de las Américas entre julio de 2009 y marzo de 2010

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    Marie Barrau

    2012-08-01

    Full Text Available OBJECTIVE: To describe the methodology used for implementing a surveillance system specifically for influenza A(H1N1pdm09 in the French West Indies and French Guiana during an outbreak of this new virus in 2009-2010, and to report its main results. METHODS: This was an observational descriptive study of confirmed and probable cases of influenza A(H1N1pdm09 hospitalized for at least 24 hours in 23 July 2009-3 March 2010. Reverse transcription polymerase chain reaction was performed on nasopharyngeal swab samples according to the Centers for Disease Control and Prevention protocol. A probable case was defined as fever > 38ºC or aches or asthenia with respiratory symptoms (cough or dyspnea. All confirmed and probable hospitalized cases were reported, along with patient's age, sex, clinical condition at admission, place and length of hospitalization, antiviral treatment, underlying conditions, complications, and clinical evolution. A case was classified as severe if respiratory assistance or intensive care was required or if death resulted. RESULTS: A total of 331 confirmed and 16 probable cases were hospitalized, with a hospitalization rate ranging from 4.3 per 1 000 clinical cases in Saint Martin to 10.3 in French Guiana. Of these, 36 were severe, and subsequently, 10 were fatal. The median length of stay was 4 days for non-severe cases and 9 days for severe (P OBJETIVO: Describir la metodología usada para implementar un sistema de vigilancia específico para la gripe A(H1N1pdm09 en las Indias Occidentales Francesas y la Guayana Francesa durante un brote ocasionado por este virus nuevo ocurrido en 20092010 y presentar sus principales resultados. MÉTODOS: Se llevó a cabo un estudio de observación descriptivo de los casos confirmados y probables de gripe por A(H1N1pdm09 hospitalizados durante al menos 24 horas entre el 23 de julio de 2009 y el 3 de marzo de 2010. De conformidad con el protocolo de los Centros para el Control y la Prevención de

  3. 卡培他滨与铂类在晚期乳腺癌一线二线治疗中的疗效对比%Comparison of the efficacy of capecitabine and platinum-based chemotherapy in first-line and second-line treatment of advanced breast cancer

    Institute of Scientific and Technical Information of China (English)

    闫石; 孟庆威; 蔡莉

    2015-01-01

    Objective To explore the efficacy of capecitabine and platinum⁃based chemotherapy in first⁃line and second⁃line treatment of advanced breast cancer. Methods From January 2010 to June 2013, 317 patients with advanced breast cancer were en⁃rolled in this study. They were treated capecitabine and platinum⁃based chemotherapy with a cycle of 3 weeks. Tumor evaluation was performed according to RECIST 1�0 criteria and toxicities were evaluated according to NCI CTC 3�0. Patients receiving different chem⁃otherapy regimes were followed up and the medium progression free survival ( PFS) were compared. Results One hundred and eight⁃een and 78 patients can be evaluated in first⁃line and second⁃line treatment, respectively. Difference in first⁃line response rate ( 53�6%vs. 63�3%) and disease control rate (81�2% vs.91�8%) of capecitabine and platinum⁃based chemotherapy has no statistical signifi⁃cance (P>0�05). Similarly, no statistical significance was observed in second⁃line response rate (42�9% vs. 47�2%) and disease control rate ( 90�5% vs. 91�7%) between capecitabine and platinum⁃based chemotherapy. In first⁃line treatment, median progression⁃free survival ( PFS) of patients receiving capecitabine and platinum⁃based chemotherapy were 15�6 and 12�4 months with statistical significance ( P0�05) . Adverse reactions mainly included hematological toxicity, nausea and vomiting, hand foot syndrome, asthenia, oral ulcers and diarrhea. Compared with platinum⁃based chemotherapy, there were lower incidence of grade 1⁃2 nausea and vomiting but higher incidence of hand⁃foot syndrome in the first⁃line capecitabine⁃based chemotherapy with statistical significance ( P<0�05) . Lower incidence of fatigue and grade 1 nausea and vomiting and higher in⁃cidence of hand⁃foot syndrome were observed in capecitabine versus platinum⁃based chemotherapy in second⁃line treatment with statisti⁃cal significance ( P<0�05

  4. Risk factors for cardiorespiratory failure in infants with hand, foot and mouth disease and establishment of risk score model%手足口病心肺衰竭危险因素分析及其风险评分模型的建立

    Institute of Scientific and Technical Information of China (English)

    付海燕; 石伟娜; 王晓明; 赵欣; 刘俊莹; 殷润开; 殷春兰; 贾彬; 李海花; 张静

    2012-01-01

    infection,rashes,drowsiness,vomiting,abnormal respiratory rhythm,limb asthenia, convulsion, the time from eruption of skin rash or oral ulcer to the appearance of central nervous system symptoms, peripheral blood leukocytes, percentage of lymphocyte, and random glucose level. Logistic regression was used to examine the relationship between risk factors and cardiorespiratory failure. A risk score model was built according to the above factors. The predictive effect of the model was evaluated by sensitivity, specificity, consistency and area under receiver operating characteristic (ROC)curve. Results In the multivariable analysis,4 variables in the risk evaluation model (the highest temperature, vomiting, random glucose level and abnormal respiratory rhythm) remained independent predictors of the outcome. The risk score model highly predicted cardiorespiratory failure. The area under the ROC curve for the evaluation model was 0.994. When the prediction was performed based on the existing date using the presut model, the sensitivity,specificity and consistency of the model were 94.12%(64/68) ,97.71%(128/132)and 94.48%( 192/199), respectively. Conclusions The risk score model was a quantitative and effective tool for predicting cardiorespiratory failure in infants with hand,foot and mouths disease.

  5. Alteração de mobilidade de prega vocal unilateral: avaliação subjetiva e objetiva da voz nos momentos pré e pós-fonoterapia Unilateral vocal fold mobility alteration: objective and subjective evaluation of voice quality on prior and post speech therapy

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    Ana Cristina Cortes Gama

    2011-08-01

    through chart review, which analyzed the recorded voices of 12 individuals with otorhinolaringology diagnosis of unilateral vocal fold paralysis. The collected material was the sustained emission of the vowel /a/, and then connected speech. The voices before and after therapy were analyzed by using GRBASI scale. The parameters for spectrographic analysis were: shape of the spectrographic tracing, degree of browning of harmonics, stability of the tracing of harmonics, presence of noise, presence of harmonics, presence of sub-harmonics and harmonics definition. The measurement of the maximum phonation time for the vowel /a/ represented the highest value among three emissions. The obtained data were submitted to statistical analysis through Wilcoxon Test Ranking. RESULTS: in the perceptual analysis, the parameter that has changed in the post-treatment was breathiness (B (p=0.003, followed by dysphonia grade (G (p=0.004 and asthenia (A (p=0,01, and those results were statistically significant. As for the spectrogram, we found an improvement of the tracing in 91% of patients, and the changed parameters were: increase in number of harmonics (32% and reduction in noise (24%. Measurement of the maximum phonation time of the vowel /a/ was higher in the post-speech therapy (p = 0.003. CONCLUSION: speech therapy treatment of unilateral vocal fold paralysis improved perceptual-hearing and spectrographic data and the maximum phonation time of voice.

  6. 慢性肾脏病患者中医证型分布与营养状态相关性分析%The Relationship between Traditional Chinese Medicine Syndromes and the Nutritional Status in Chronic Kidney Disease Patients

    Institute of Scientific and Technical Information of China (English)

    吴一帆; 卢富华; 傅立哲; 朱德礼; 刘旭生

    2012-01-01

    SPSS 17. 0. Results;In the asthenia syndromes, spleen - kidney - qi deficiency took the largest proportion ( 47. 6% ). And proportion of yin - yang deficiency was larger and larger while the proportion of liver - kidney deficiency and spleen - kidney deficiency was smaller and smaller with the progress of CKD stage. In the excess syndromes, non - syndrome took the largest proportion ( 44.4% ). And proportion of stasis syndrome, wet - muddy syndrome and wet - heat syndrome was larger and larger with the progress of CKD stage. TFS and AC of yin - yang deficiency was smallest and the difference was statistically significant. AMC was smallest, too. And Class B for SGA of yin -yang deficiency took highest percentage, but the difference was not statistically significant P>0.05 ). Class B for SGA of stasis syndrome took highest percentage and the difference was statistically significant P 0. 05 ). Conclusion; There are certain rules to follow with the traditional Chinese medicine syndromes in CKD patients and the nutritional status were certain correlation with the rules, This may help us in the clinical practice.

  7. 重组人促黄体激素释放激素-绿脓杆菌外毒素A融合蛋白Ⅰ期人体耐受性临床研究%Phase Ⅰ clinical trial of lyophilized recombinant human luteinizing hormone releasing hormone-exotoxin of pseudomonas aeruginosa fusion protein

    Institute of Scientific and Technical Information of China (English)

    周爱萍; 杜春霞; 刘鹏; 孙永琨; 吴广谋; 朱平; 王金万

    2011-01-01

    . Fourteen patients received doses ranging from 120 to 600 μg·m-2 given once a day for consecutive 14 days. Seven patients received 600 or 700 μg·m-2 once every 2 days for 14 doses. Results; The MTD of LHRH-PE40 when given once a day for 14 days was 400 μg·m -2 with the dose-limiting toxicity being grade Ⅲ asthenia, grade Ⅲ anorexia and acute renal dysfunction. The renal dysfunction was transient and reversible. The MTD of LHRH-PE40 when given once every 2 days for 14 doses was 600 μg · m-2. The common adverse events at the MTD included fatigue, anorxia, pain, fever, headache, aller-gic reaction, nausea/vomiting, and gastric mucosities. LHRH-PE40 showed no heamotologic toxicity and a mild impact on liver function. Antibodies against LHRH-PE40 were detected in patients at baseline and found to be elevated during treatment. One advanced ovarian cancer patient had a decline of CA125 by 620 U·mL-1. Conclusion; LHRH-PE40 displays mild and manageable toxicity at MTD. LHRH-PE40 might have antitumor activities in ovarian cancer which warrants further investigation. The clinical relevance of antibody needs further illustration.

  8. Tabletas bucales oravescentes de fentanilo en el dolor episódico: revisión de datos clínicos Fentanyl oravescentes buccal tablets for episodic pain: review of clinical data

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    M. Nabal

    2012-02-01

    breakthrough pain Methods: non systematic review of the literature published in Medline supplemented by manual search of related work and grey literature. Keywords: "Breakthrough pain" OR "Cancer pain" AND "Fentanyl buccal tablets" OR "Rapid onset opioids." Limits: Language: English or Spanish and studies in adults over 18 years. Inclusion criteria: clinical work with content related to the presentation of oral fentanyl "oravescente". Exclusion criteria referring to work pharmacokinetics or pharmacodynamics of the drug or its dosage, the work of general epidemiological nature and those that were not obtained in full text even though the query to several databases and national libraries. Results: from the 29 papers found, 12 studies were included following the inclusion and exclusion criteria. 4 were randomized double blind clinical trials, 1 was a multicenter open, 1 systematic review, 4 non-systematic reviews and 2 expert opinion papers. The four trials confirm that the analgesic effect is present 5 minutes after administration of the drug. There were significant differences with placebo since the 10 minutes till the 90 minutes. These differences kept stable for 2 hours. The Sum of Pain Intensity Differences (SPID is favourable to the drug compared to placebo at 60 minutes after administration (p < 0.0001. It is noted that side effects mentioned were mild nausea (32%, vomiting (24%, asthenia (18%, constipation (15% and headache (15%. No reference to neurocognitive changes at times of peak plasma concentration or behaviors of addiction or abuse were detected. The non systematic reviews offer the expert insight on the treatment of breakthrough pain with an independent position. They criticized the inclusion criteria of randomized trials for introducing significant bias in the sample selection and the lack of oral fentanyl compared with standard treatments available. Conclusions: fentanyl tablets "oravescentes" have proven more effective than placebo in the episodic pain caused

  9. Directory of Open Access Journals (Sweden)

    Frederico F. Gil

    2013-04-01

    Full Text Available Intestinal parasites are an important cause of morbidity and mortality. Immunocompromised individuals may develop more severe forms of these infections. Taking into account the immunity impairment in patients suffering from chronic renal failure (CRF, we will determine the prevalence and associated symptoms of intestinal parasites in these patients. Controls without CRF were used for comparison. Stool samples were collected and processed for microscopic identification of parasites using the Formalin-ether concentration method. For Cryptosporidium diagnosis, the ELISA technique was used. One hundred and ten fecal samples from hemodialysis patients were analyzed, as well as 86 from a community group used as control group. A result of 51.6% of intestinal parasites was observed in hemodialysis patients and 61.6% in the control group. Cryptosporidium and Blastocystis were the most common infections in patients with CRF (26.4% and 24.5%, respectively. Blastocystis was the most common infection in the control group (41.9%, however no individual was found positive for Cryptosporidium. Among the CRF patients, 73.6% were symptomatic, 54.3% of these tested positive for at least one parasite, in contrast to 44.8% in asymptomatic patients (p = 0.38. The most common symptoms in this group were flatulence (36.4%, asthenia (30.0% and weight loss (30.0%. In the control group, 91.9% were symptomatic, 60.8% of these tested positive for at least one parasite, in contrast to 71.4% in asymptomatic patients (p = 0.703. A significant difference between the two groups was observed with regard to symptoms, with bloating, postprandial fullness, and abdominal pain being more frequent in the control group than in the hemodialysis group (all p Doenças parasitárias infectam grande número de indivíduos em todo o mundo. Manifestações clínicas mais severas podem se apresentar em pacientes imunocomprometidos. Considerando o importante comprometimento imunológico observado

  10. Comparative efficacy, safety and tolerability of policosanol versus statins in patients with type II hypercholesterolemia: emphasis on muscle function indicators

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    Gladys Castaño

    2003-01-01

    statins group (120/205,58.5 % Both treatments were well tolerated. None of them affected physical safety indicators. Policosanol signi-ficantly lowered (p < 0.05 aspartate aminotransferase (AST and (p < 0.01 creatinphosphokinase (CPK values, while unchanged other blood biochemistry indicators. Statins significantly (p < 0.05 increased CPK levels. Twenty-eight (28 patients (7 policosanol, 21 statin discontinued from the study, Two policosanol patients withdrew from the trial due to AE consisting of abdominal pain and lower limb edema, respectively. Eleven (11 statin-patients discontinued the study due to a serious AE (unstable angina and other 10 non-serious AE. Three patients reported mus-cular AE (cramps and/or myalgia, 5 suffered gastrointestinal distur-bances (abdominal pain; diarrhea, nauseas, gastric discomfort and/or vomiting, 2 referred cardiovascular AE (arrythmia, uncontrolled hyper-tension and other patient reported dizziness + headache. In addition, three of these patients concomitantly reported asthenia; skin rash and uncontrolled diabetes. The fre-quency of AE in policosanol (14, 6.8% was lower (p < 0.05 than in statin group (29, 14.1 %. It is concluded that short-term efficacy of policosanol (10 mg/d to reduce LDL-C in patients with type II HC was similar to that of starting doses of statins. Effects of both treatments on TC and triglycerides were also equivalent. Policosanol, but not statins, significantly increased HDL-C. Both drugs were safe, but only statins increased CPK, an indicator of muscle function. Policosanol was better tolerated than statins as revealed AE and withdrawal analysis, including reports related with muscle-related AE. Never-theless, long-term studies invest-tigating policosanol effects on muscle function variables through specific algorithm will be needed to definitively discard its potential risk to induce such effects.

  11. Prevalência de TB ativa e TB latente em internos de um hospital penal na Bahia Prevalence of active and latent TB among inmates in a prison hospital in Bahia, Brazil

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    Antônio Carlos Moreira Lemos

    2009-01-01

    questionnaire was applied and completed by medical students. The detainees were systematically submitted to the following tests: tuberculin skin test, chest X-ray (anteroposterior, sputum smear microscopy and culture for mycobacteria. The events of interest were active TB and latent TB. RESULTS: The mean age of the participants was 36.6 years, and 89.9% were male. Smoking and alcohol consumption were reported by 70.0% and 43.9% of the inmates, respectively. A history of treatment for TB was reported by 11.3% of the inmates. Of the inmates evaluated, 36.3% reported cough and 31.4% reported expectoration. Other less common symptoms were asthenia (in 26.2%, weight loss (in 23.1%, loss of appetite (in 17.7%, fever (in 11.3% and hemoptysis (in 6.7%. Of the 86 inmates tested, none presented positive HIV serology. The prevalence of latent TB was 61.5% (96 of the 156 inmates submitted to tuberculin skin tests, whereas that of active TB was 2.5% (6 of the 237 inmates evaluated. The presence of cough was a determinant of active TB (prevalence ratio = 8.8; 95% CI: 1.04-73.9; p = 0.025. CONCLUSIONS: Active and latent TB are highly prevalent among inmates hospitalized in the Bahia State Prison Hospital. Our findings justify the need to implement public policies specifically directed towards the control of TB in this population.

  12. Patients admitted in an Intensive Care Unit with severe clinical manifestations of Influenza, october-december 2009 Pacientes ingresados con formas graves de Enfermedad Tipo Influenza en una Unidad de Cuidados Intensivos, octubre a diciembre 2009

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    Octavio Rivero Rodríguez

    2011-04-01

    Full Text Available A descriptive study of a series of cases was carried out, where 109 patients with the presumptive diagnosis of severe clinical pictures of Influenza were included, the total of them admitted in one of our Intensive Care Units (ICU, prepared for that purpose during the recent pandemic, during the period comprised between October 1 and December 31, 2009. There were 62 women (56,9%, of which 19 were pregnant or postpartum women (17,4%. The mean age of the sick persons of this serie was of 52,53 ± 22,54 years. The beginning of symptoms before the time of admission revealed an average of 4,90 ± 4,37 days. The predominant symptoms were: cough in 93 patients (85,3%, dyspnea in 86 (78,9%, fever in 76 (68,8% and general symptoms of asthenia and anorexia in 76 (68,8%. In the physical exam, the most frequent signs were: polypnea in 86 (78,9% and wet rales in 65 (59,6%. Personal antecedents were informed by patients suffering arterial hypertension in 31 (28,4%, bronchial asthma and chronic obstructive lung disease in 26 (23,9%, diabetes in 19 (17,4%, ischemic heart disease in 19 (17,4%, alcoholism in 5 (4,6% and valvulopathies in 4 (3,7%. Among the signs found in the thorax´s radiographies at the moment of admission, it prevailed the pattern of radiopacity diffuse hilar and bilateral parahilar in 31 patients (28,4%, followed by bilateral diffuse opacities toward medial and inferiors lobes in 16 (14,7%, unilateral diffuse radiopacity in 12 (11,0%, increment in the broncovascular network in 13 (11,9%, lobar consolidation in 7 (6,4% and pleural esfusion in 5 (4,6%. In 25 cases the initial X-ray films were normal. In electrocardiograms, alterations were verified of ST-T in 12 sick persons (11,0%, sinusal tachicardia in 12 (11,0%, supraventricular arrhythmias (that included acute auricular fibrillation and supraventricular paroxysmal tachicardia in 7 (6,4% and ventricular arrhythmias in 2 (1,8%. The complications verified with more frequency were the