1/101. Two separate episodes of hemophagocytic syndrome at a two-year interval in an apparently immunocompetent male.We describe two separate episodes of hemophagocytic syndrome (HPS) at an interval of two years in a seemingly immunocompetent male. This case suggests the possible existence of an inherent predisposition to HPS, in which otherwise negligible self-limited viral infection may trigger HPS. Laboratory data for a 16-year-old boy admitted with persistent high grade fever and severe thrombocytopenia disclosed coagulation abnormality, liver damage, and hypercytokinemia. A bone marrow aspiration revealed a proliferation of histiocytes with fresh hemophagocytosis. We diagnosed that he was suffering from HPS. Responding to steroid pulse therapy, he recovered completely and was discharged. After two years of healthy life, he became febrile again and was readmitted. The fever was refractory to antibiotics and was associated with a sudden drop in platelet count. Laboratory data and the bone marrow picture were consistent with those of HPS. He was again successfully treated with steroid. After the second episode, he has been healthy for more than two years.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
2/101. Heat-related illnesses and deaths--missouri, 1998, and united states, 1979-1996.Although heat-related illness and death are readily preventable, exposure to extremely high temperatures caused an annual average of 381 deaths in the United States during 1979-1996. Basic behavioral and environmental precautions are essential to preventing adverse health outcomes associated with sustained periods of hot weather (daytime heat index of > or = 105 F [> or = 40.6 C] and a nighttime minimum temperature of 80 F [26.7 C] persisting for at least 48 hours). This report describes four heat-related deaths that occurred in missouri during 1998, summarizes heat-related deaths in the united states during 1979-1996, describes risk factors associated with heat-related illness and death, especially in susceptible populations (young and elderly, chronically ill, and disabled persons), and recommends preventive measures.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
3/101. A dentoalveolar abscess in a pediatric patient with ketoacidosis caused by occult diabetes mellitus: a case report.oral health professionals are frequently asked to evaluate patients with routine odontogenic infections. These patients can sometimes present with systemic signs and symptoms, including fever, malaise, tachycardia, and dehydration. It is important for the astute clinician to understand the possible associated systemic diseases that may be contributing to odontogenic infections. We present here an interesting case of a pediatric patient with a routine canine space infection who exhibited classic clinical signs and symptoms of diabetic ketoacidosis.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
4/101. Diagnosis of tuberculous peritonitis.The diagnosis of tuberculous peritonitis may be difficult and elusive. The patient may present with non-specific symptoms of fever, general ill-health or vague abdominal pains. There may be no pulmonary symptoms and the chest X-ray may be normal. The CT scan of the abdomen is sometimes helpful in suggesting the diagnosis. We have found that laparoscopic examination of the abdominal contents and the peritoneum is an effective way to obtain a conclusive diagnosis.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
5/101. Interferon therapy in multiple myeloma.A woman with multiple myeloma relapsed after 6 years of satisfactory tumor control with melphalan therapy. When progression then occurred, she was given exogenous human leukocyte interferon, 3 x 10(6) reference units twice daily i.m., as the sole therapy. Side-effects of the interferon therapy consisted of fever reactions and thrombocytopenia. One month after the initiation of interferon therapy there was 1) improvement of general health with less pain and tiredness, 2) reduction of the M-component, IgG-lambda, in the serum, and 3) a reduced plasma cell concentration in the bone marrow. After 5 months of interferon therapy tumor progression occurred despite continuous interferon treatment. At the same time, the tumor cells were less sensitive to interferon in in vitro tests than prior to interferon therapy. It is suggested that interferon therapy should be given as initial treatment to a few patients with multiple myeloma in a phase I trial.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
6/101. Granulocytic sarcoma: report of three cases.Granulocytic sarcoma (GS) is a rare extramedullary solid tumour composed of malignant immature cells of the granulocytic series. It may herald, accompany or signal acute myeloid leukaemia (AML) or chronic granulocytic leukaemia (CGL). GS may also occur in patients with myelodysplastic syndromes (MDS) where it is a sign of imminent disease progression. Three cases of GS are presented; the first one involving the pancreas and preceding AML, the second case affecting uterine cervix in stable phase CGL and the third case is GS of the breast accompanying AML. Any site of the body may be involved by the GS, and morbidity depends on the local organ/tissue affected in addition to the attending primary leukaemia or MDS. Treatment of GS involves surgery, radiotherapy and chemotherapy. The objective of this communication is to enhance awareness in personnel providing health care. Further, early diagnosis and treatment affects overall outcome.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
7/101. Neonatal herpes simplex virus type II.This description of a tragic case of infection with neonatal herpes simplex virus type II is presented to alert professional nurses to the fact that this disease is sometimes difficult to recognize, but must be considered when a newborn has any unusual symptoms. Neonatal herpes simplex type II may have a slow and insidious onset, and be masked by many other symptoms. Even though the virus might be present in a newborn, the symptoms might not be apparent until several days after birth; this is a problem because infants are now leaving hospitals much earlier and can become ill after hospital discharge. parents, especially first-time parents, may not recognize subtle signs of illness in their child. Therefore, the onus is on the health care provider to evaluate each infant for symptomatology and provide education to parents along with instructions to obtain early follow-up care for all newborns.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
8/101. mortality from peripartum meningitis.A young primigravid parturient had an uneventful labour under epidural analgesia and delivered a healthy male infant. She returned 48 hours later with fever, vomiting and severe headache, but was misdiagnosed as having endometritis. Further signs of meningitis appeared six hours later, however she succumbed to the infection and died four weeks later despite intensive care and high-dose antibiotic management. Causes of meningitis in the peripartum period are discussed. The possibility of a causal association between the patient's epidural analgesia and her infection are considered and preventive measures discussed.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
9/101. Hemorrhagic shock and encephalopathy syndrome: neurologic features.Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe disease that affects previously healthy infants of less than 1 year of age and is associated with significant mortality and neurologic morbidity. It is characterized by sudden onset of shock, convulsions and coma, bleeding due to severe coagulopathy, fever, diarrhea, metabolic acidosis, and hepatorenal dysfunction. central nervous system involvement with recurrent seizures and brain edema is the most common cause of high mortality and neurological morbidity. In this report, we describe four patients of HSES and review the initial and follow-up neurological features, electroencephalography findings, and the results of neuroradiological examinations of this catastrophic illness.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
10/101. Fatal hyperthermia in hot baths in individuals with multiple sclerosis.The authors report the case of a 47-year-old black man with a history of multiple sclerosis who was found dead in a bathtub, head above water, with a body temperature of 105.7 F. Results of a complete autopsy and toxicologic screen were negative. Individuals with multiple sclerosis, if immersed in hot water, develop motor weakness, which may be so severe as to prevent them from getting out of the water, whether they be in a bathtub or whirlpool bath. In this case, the individual was trapped in a bathtub in which there was a continuous flow of hot water. This overwhelmed an already impaired thermoregulatory mechanism, causing hyperthermia and death.- - - - - - - - - - ranking = 0.18669845301741keywords = individual (Clic here for more details about this article) |
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