Cases reported "Acute Disease"

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21/57. Calcium-channel blocker verapamil administration in prolonged and refractory status epilepticus.

    We report on an 11-year healthy boy who presented refractory status epilepticus (SE), which was unresponsive to conventional antiepileptic drugs used in the algorithm of the treatment of SE. Based on evidence that verapamil has anticonvulsant activity in animal models and the fact that the boy had a supraventricular tachycardia (140-160 b/min), i.v. verapamil (0.034 mg/min) was administered on day 37, and after a 3.125 mg cumulative verapamil dose (1.5 hour after initiation of the infusion), the patient regained consciousness was able to breathe spontaneously and the electrical SE promptly disappeared. The apparent dramatic response to i.v. verapamil may be explained by its direct anticonvulsant action on the basis of the potential involvement of calcium channels in epileptic activity and that verapamil, a known Pgp inhibitor in the cerebrovascular endothelium in the epilepticus focus, acted by facilitating the brain penetration of the antiepileptic drugs that our patient was receiving simultaneously.
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keywords = animal
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22/57. erysipeloid--case report.

    erysipeloid is an acute, bacterial infection of traumatized skin in an individual who was in direct contact with meat or other animal products contaminated with a gram-positive bacillus erysipelothrix rhusiopathiae. We present a case of a 50-year-old housewife whose hobby was fishing, with a reddish, tender patch on the fifth finger and dorsum of the left hand, which developed a week after she had sustained an injury while boning the fish. The patient was treated with orally administered penicillin v 1,500,000 IU t.i.d. for 7 days, with complete resolution.
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23/57. The changing direction of nystagmus in acute Meniere's disease: pathophysiological implications.

    The direction(s) and pathophysiologic basis of nystagmus during an acute attack of Meniere's disease have been subject to much debate in the world literature. Clinical recordings from two patients whose nystagmus was captured near the very beginning of the acute vertiginous episode are presented. Previous clinical observations in Meniere's disease, experimental animal models concerned with initiation of peripheral nystagmus, and the phenomenon of recovery are discussed.
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keywords = animal
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24/57. Secondary myocardial disease. Virus myocarditis and cardiomyopathy.

    In an attempt to prove the hypothesis that virus myocarditis may be a cause of idiopathic cardiomyopathy, clinical and experimental studies were performed. Eleven patients with a presumptive or proven diagnosis of virus myocarditis were followed for one and a half to 13 years after the acute illness. One patient died in the acute stage, six recovered completely and one continued to have bifascicular block without subjective symptoms. Three patients had exertional dyspnea, cardiomegaly and an abnormal ECG three to 13 years after the onset, and two of them had an enlarged LV cavity with reduced EF and histological changes in myocardial biopsies. The clinical picture in these three cases was similar to that seen in congestive cardiomyopathy. Clinical observations of the heart in an epidemic of coxsackie B 3 virus infection among school children revealed that 49 (19%) of 263 infected children had abnormal chest-X ray, electrocardiographic or echocardiographic findings one to 10 months after the onset, however none of them developed cardiomyopathy. In experimental infection of weanling golden hamsters with coxsackie B 3 virus (Nancy strain), all animals developed acute and severe myocarditis, and the virus was detected in the myocardium. Hemodynamic data suggested decreased contractility of the left ventricle in the acute stage. Histologically the heart showed focal myocardial necrosis and cellular infiltration without calcification, findings which resemble those in human doxsackie B virus myocarditi. Thus, the golden hamster is a better animal model than the mouse in studies on virus myocarditis and postcarditic cardiomyopathy.
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keywords = animal
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25/57. MR imaging of acute subarachnoid hemorrhage.

    The MR appearance of acute subarachnoid hemorrhage experimentally produced in macaca monkeys and observed in patients with clinically documented acute subarachnoid hemorrhage is presented. Subarachnoid hemorrhages were produced in two macaca Nemestrema monkeys using the technique of Frazee. CT and MR imaging were performed immediately after the procedure and at frequent intervals up to two week post hemorrhage. MR including T1 and T2 weighted multiplanar spin echo images were obtained. The imaging studies were compared with clinical evaluations and pathological specimens of all animals. Findings in the experimental animals are correlated with those observed in patients with clinically documented subarachnoid hemorrhage. The results show that acute subarachnoid hemorrhage (SAH) can be detected with MRI as isointense signal replacing normally black CSF spaces on T1 weighted images. Signal changes most likely relate to protein water binding associated with the clotting mechanism rather than oxidative denaturation of hemoglobin. Imaging performed experimentally and clinically beyond four days, however, showed a marked increase in signal intensity on T1 weighted images which probably does result from methemoglobin formation within the clot matrix. Although CT remains the gold standard in detecting acute SAH, MR does provide some sensitivity to its presence.
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ranking = 2
keywords = animal
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26/57. Three-dimensional images of the temporal bone and experimental otitis media in Japanese monkeys.

    Since the middle ear structure of animals commonly used for experimental study is different from that of humans, we used the Japanese monkey (macaca fuscatus) as an animal model for otitis media with effusion (OME). The exact similarities and differences of the ear structure between humans and Japanese monkeys were studied by the use of computer-aided three-dimensional reconstruction, in addition to light and electron microscopy. otitis media with effusion was repeatedly induced by direct intratympanic inoculation of one of the following: keyhole limpet hemocyanin; following systemic immunization with keyhole limpet hemocyanin, streptococcus pneumoniae; or endotoxin. The temporal bones were serially sliced with a diamond band saw, after which the histologic findings were examined by light and electron microscopy on the basis of macroscopic observations. Each substance induced OME equally, 2 to 3 days after inoculation. Inflammatory reaction of the middle ear mucosa extended to all of the air cells; subsequently, the inflamed mucosa returned to normal in each case along with normalization of both the tympanometric and otoscopic findings. No remarkable architectural change remained, even after OME was induced repeatedly. These findings are applicable to acute otitis media and acute mastoiditis. The development of chronic middle ear effusion was not observed in this study. The usefulness of the diamond band saw and computer-aided analysis for temporal bone histologic evaluations is emphasized.
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ranking = 2
keywords = animal
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27/57. Painless acute pancreatitis subsequent to anticholinesterase insecticide (parathion) intoxication.

    Painless acute hemorrhagic pancreatitis, manifested only by an ileus, is described in two of nine patients after ingestion of parathion, a poisonous anticholinesterase insecticide. Other investigators have shown in animal experiments that parathion increases pancreatic intraductal pressure and stimulates pancreatic secretion. Such described cases may be designated pathologically as clinical examples of acute obstruction pancreatitis. hemoperfusion is usually chosen to treat parathion intoxication, but carries the risk of causing hemorrhages in acute hemorrhagic pancreatitis. Clinically, it is therefore important to determine, by way of enzyme estimations and imaging procedures, whether acute pancreatitis has occurred following parathion intoxication, so that the prognosis for the poisoned patient is comprehensive enough and the antidated measures applied do not aggravate the pancreatic condition.
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keywords = animal
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28/57. As sick as a pigeon--psittacosis myelitis.

    An association between acute transverse myelitis and psittacosis in a teenage boy is described. Closer collaboration between doctors and vets might have made the diagnosis sooner. A full paediatric history should include details of contact with pets and other animals.
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keywords = animal
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29/57. Lead-contaminated health food. association with lead poisoning and leukemia.

    A doctor prescribed a dietary supplement prepared from powdered animal bone for a young woman with dysmenorrhea. Severe lead poisoning developed while she was taking the powder, which was shown to be contaminated with lead. The diagnosis eluded more than 20 physicians and was finally made by the patient herself. The Food and Drug Administration, informed of the contamination, declined to take action, stating that a food supplement is neither a food nor a drug and, besides, there are no maximal limits for heavy-metal contamination of foods and drugs.
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keywords = animal
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30/57. Spontaneous ovarian hyperstimulation syndrome associated with hypothyroidism.

    A causal link between hypothyroidism and spontaneously occurring ovarian hyperstimulation syndrome is suggested by analysis of data from a patient with myxedema and review of data from animal research.
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keywords = animal
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