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At least 307 records · Page 17Linked to original sources
PubMed1994

[An investigation on risk factors relating to the treatment difficulty in originally treated pulmonary tuberculosis cases].

In order to investigate whether so-called risk factors relating to treatment difficulty are true risk or not, treatment results of 520 in-patients originally treated for pulmonary tuberculosis during 12 years' period from 1980 to 1991 in our hospital were analyzed. The proportion of cases with so-called risk factors among total 520 cases was as follows: Aged patients (70 years of age and over) 31.5%. Cases discharging abundant bacilli in sputum (Gaffky scale VII or above or culture, +3 positive) 29.4%. Adverse reactions to drugs 18.1%. Far advanced cavitary lesions (GAKKAI Classification I or II3) 15.6%. Relative risk of various risk factors in cases of group A (died of tuberculosis), group B (showed delay in the negative conversion of bacilli; namely, cases converted to negative only 4th month of treatment or later) and group C (cases of groups A and B) were calculated comparing with cases of the control group (pretreatment negative bacilli cases or cases converted to negative within 3 months). In cases of group A died of tuberculosis, the results were as follows; pretreatment abundant bacilli discharge 3.1, far advanced cavitary lesions 4.6, emaciation and/or malnutrition 5.1. Other risk factors identified were the following; unhealthy life style 4.0, severe gastrointestinal tract disease 3.9, impaired pulmonary function 3.3, complicated infections 3.2, cerebrovascular injuries including psychosis and nervous system diseases 2.3, diabetes mellitus 2.0, and the adverse reactions to drugs 1.9. In cases of group B showing delay in the negative conversion of bacilli, significant risk factors were pretreatment abundant bacilli discharge, far advanced cavitary lesions, emaciation and/or malnutrition and diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Suspected inherited granulocytopathy in four Holstein Friesian calves].

Five Holstein Friesian calves varying in age from 7 to 9 weeks old, were suspected of suffering from an inherited granulocytopathy known as bovine leucocyte adhesion deficiency (BLAD). Four of them were examined clinically and at necropsy. The most significant clinical findings were fever, depression, weakness, emaciation, diarrhoea, pseudomembranous gingivitis, loose teeth, respiratory infection and occult blood in the faeces. Significant clinicopathological findings were marked leucocytosis, mainly due to a neutrophilia, hypoalbuminemia, hypogammaglobulinemia, increased alpha- and beta-globulins, elevated alkaline phosphatase enzyme activity, hypoglycaemia, and decreased blood urea concentrations. The necropsy revealed emaciated carcasses, granulomatous to necrotising gingivitis, pseudomembranous to necrotising enteritis with perforations, bronchopneumonia, splenic atrophy, and hypoplasia of the thymus. Histopathological examination supported the macroscopic findings.

Animals↗
PubMed1998

Metabolic responses of chronically starved horses to refeeding with three isoenergetic diets.

OBJECTIVE: To examine metabolic responses of chronically starved horses to refeeding with 3 isoenergetic diets. DESIGN: Uncontrolled clinical trial. ANIMALS: 22 mature mixed-breed horses that were emaciated but otherwise clinically normal. PROCEDURE: Horses were fed 1 of 3 diets: alfalfa hay, oat hay, or a combination diet of half oat hay and half commercially prepared ration. Digestible energy of diets was gradually increased throughout the refeeding period. One pre- and 4 postprandial blood samples were obtained daily, and analyses included RBC count, Hct, and determination of hemoglobin, glucose, insulin, free fatty acid, total bilirubin, 2,3-diphosphoglyceric acid, phosphorus, magnesium, calcium, sodium, and potassium concentrations. Body weight, fecal output, and feed and water consumption were measured and recorded daily. Repeated-measures ANOVA was used to examine dietary and temporal (day) effects of the 3 dietary regimens during 10-day trials. RESULTS: 19 Horses survived. Three horses (2 fed alfalfa diet, 1 fed combination diet) died of metabolic or gastrointestinal problems. Increasing temporal effects in serum concentrations of glucose, insulin, magnesium, calcium, and sodium; decreasing temporal effects in serum concentrations of free fatty acid, 2,3-diphosphoglyceric acid, and phosphorus; and dietary effects in serum concentrations of glucose, insulin, magnesium, and potassium were detected in the 19 surviving horses. Serum phosphorus and free fatty acid concentrations decreased dramatically during the first 5 days of refeeding with all 3 diets. Serum magnesium concentrations increased in horses fed the alfalfa hay diet, whereas improvement was not evident in horses fed oat hay or combination diets. Horses receiving the alfalfa and oat hay diets had lower postprandial glucose and insulin concentrations than horses receiving the combination diet. Horses fed oat hay alone ate 92% of feed offered, compared with 98% feed consumption for horses fed alfalfa hay or combination diets. CLINICAL IMPLICATIONS: Clinically normal emaciated horses can be successfully rehabilitated by gradual refeeding with a high forage diet.

2,3-Diphosphoglycerate↗
PubMed1998

Malignant seminoma with metastasis and herpesvirus infection in a free-living sea otter (Enhydra lutris).

In winter 1990, an adult male sea otter (Enhydra lutris) was found dead along the eastern shore of Prince William Sound, Alaska. Necropsy findings included an enlarged retained left testicle with a twisted spermatic cord, enlarged left sublumbar lymph node, emaciation, dental attrition, oral papules and ulcers, and luminal intestinal hemorrhage associated with numerous acanthocephalids. A malignant seminoma was present in the left testicle and left sublumbar lymph node. Additionally, herpesvirus like intranuclear inclusion bodies were found in oral, esophageal, and corneal epithelial cells. Virions consistent with a herpesvirus were found in esophageal epithelium. Dental attrition, severe intestinal acanthocephaliasis, the malignant seminoma, and emaciation were considered contributing factors in causing death. The herpesviral disease was probably secondary to the debilitation and stress. This is the first report of malignant seminoma with metastasis in a sea otter.

Animals↗
PubMed1986

Anorexia nervosa. Treatment efficacy of cyproheptadine and amitriptyline.

Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an anti-depressant effect demonstrated by a significant decrease in the Hamilton depression ratings.

Adolescent↗
PubMed1997

Diencephalic syndrome and disseminated juvenile pilocytic astrocytomas of the hypothalamic-optic chiasm region.

BACKGROUND: Diencephalic syndrome (DS) is a complex of signs and symptoms related to hypothalamic dysfunction; its main features are emaciation, despite a normal or slightly diminished caloric intake, and an alert appearance. DS has been almost exclusively described in association with space-occupying lesions of the hypothalamic-optic chiasm region, mainly juvenile pilocytic astrocytoma (JPA). A systematic diagnostic approach, including contrast-enhanced magnetic resonance imaging (MRI) of the child's head, is rapidly expanding our knowledge of this syndrome. METHODS: The MRI findings for three children affected by DS associated with biopsy-proven JPA, consecutively referred to the Pediatric Neuro-Oncology Program of the Department of Pediatrics at the University of Padua between September 1991 and January 1996, are presented in this article. The children were boys, ages 6, 7, and 18 months, respectively. RESULTS: In all three patients, the initial contrast-enhancing MRIs of the head showed evidence of tumor dissemination. This finding prompted a study of the spine, which in turn showed tumor deposits in all three subjects. Among the 43 patients younger than 16 years with low grade astroctyoma who consecutively entered the Neuro-Oncology Program during the study period, these 3 patients were the only ones who had disseminated tumors. CONCLUSIONS: In this study, the hypothesis was formulated that DS and disseminated hypothalamic-optic chiasm JPA tend to be more commonly associated than previously stated. This study suggests that the initial contrast-enhanced MRI of the head of a child affected by DS and hypothalamic JPA must be looked at carefully for evidence of tumor dissemination, and that the spine must also be examined if the findings are positive.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Treatment of diencephalic syndrome with chemotherapy: growth, tumor response, and long term control.

BACKGROUND: The diencephalic syndrome (DS), which is manifested by progressive emaciation and failure to thrive in an apparently alert, cheerful infant, usually is due to a low grade hypothalamic glioma. Treatment with aggressive surgery and/or radiotherapy is variably successful in controlling disease and may result in severe neurologic sequelae. Chemotherapy recently has been shown to be effective in patients with low grade gliomas of childhood, but it is used infrequently in those with DS. METHODS: The authors evaluated the efficacy of a regimen of carboplatin and vincristine on improving weight, causing tumor shrinkage, and delaying the need for alternative therapies in seven children (ages 9-20 months; median age, 11 months) with DS. Five patients weighed less than the 5th percentile for their age at the start of the study, one weighed within the 10th percentile, and one weighed within the 25th percentile. RESULTS: At follow-up (range, 6-54 months; median, 28 months), the patients' weights had increased by 66-95% (median, 80%). On magnetic resonance imaging, four patients had a >50% reduction in tumor mass, one had a 25-50% reduction, and two had stable disease. In those patients with radiographic response to treatment, weight gain was accomplished with oral feedings in four of five patients, whereas those with stable disease required nasogastric, nasojejunal, or gastrostomy tube supplementation to maintain weight. Disease progression occurred at a median of 24 months after initiation of chemotherapy, and two patients remained free of progressive disease at last follow-up. Five patients were alive a median of 59 months from diagnosis. The need for radiation or other therapies was delayed in six of seven children. Therapy was tolerated without significant toxicities. CONCLUSION: The authors conclude that treatment of DS with a carboplatin and vincristine regimen results in demonstrable weight gain, may result in tumor shrinkage, and in some cases, significantly delays the need for alternative therapies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Accidental selenium poisoning of growing pigs.

Chronic selenium (Se) toxicosis was diagnosed in two groups of growing pigs. Emaciation, loss of hair, necrotic areas in the skin, lesions of the coronary band and hooves, postnecrotic atrophic cirrhosis of liver, and lumbal poliomyelomalacia were the principal findings. High Se concentrations were detected in blood plasma. Addition of the calculated amounts of sodium selenite directly to the feedstuff instead to mineral premix was the cause of this intoxication.

Animals↗
PubMed1994

Obturator hernia presenting as small bowel obstruction.

Obturator hernia is a rare but important cause of small bowel obstruction that is associated with difficult diagnosis and high mortality. In the past 7 years, 16 patients with small bowel obstruction due to obturator hernia diagnosed at operation were seen at the Department of Surgery, the University of Hong Kong, Queen Mary Hospital. They represented 1% (16 of 1,554) of all hernia repair performed and 1.6% (16 of 1,000) of mechanical intestinal obstruction encountered during the same period. Elderly emaciated women with chronic disease were commonly affected. All patients presented with partial or complete mechanical small bowel obstruction. Right-sided obturator hernia outnumbered left-sided hernia, and bilateral hernia was found in only one patient. The majority of patients required resection of their strangulated small bowel. Most of the hernial orifices were closed with interrupted nonabsorbable sutures. Morbidity and mortality rates were significantly high for this group of debilitated patients with chronic disease who underwent late operation for this elusive diagnosis.

Age Factors↗
PubMed2005

Experimental Trypanosoma evansi infection in the goat. I. Clinical signs and clinical pathology.

A strain of Trypanosoma evansi isolated from an equine case of surra in Mindanao, Philippines was used to infect intravenously two groups (A and B) of five male goats aged 8-10 months. Animals of groups A and B received 5000 and 50 000 trypanosomes, respectively, and five further animals (group C) served as uninfected controls. Four of the 10 infected goats died 8-78 days after inoculation. Group C goats gained weight (mean 22.8 g/day) while infected goats in groups A and B lost weight (means of 21.4 and 45.0 g/day, respectively). Parasitaemia fluctuated regularly between peaks and troughs, with repeated periods of about 6 days during which no trypanosomes were detected in the blood. Clinical signs and clinico-pathological changes in infected goats were not pathognomonic in the absence of parasites in the blood, and leucocytosis was not a reliable indicator of infection. It was concluded that in endemic areas fluctuating fever, progressive emaciation, anaemia, coughing, testicular enlargement and diarrhoea are suggestive of surra; confirmation, however, may necessitate examination of blood every few days for trypanosomes, and possibly other diagnostic tests.

Anemia↗
PubMed2005

The Shetland Islands scrapie monitoring and control programme: analysis of the clinical data collected from 772 scrapie suspects 1985-1997.

There were 574 scrapie positive suspects (histopathological scrapie lesions present) and 198 scrapie negative suspects (histopathological scrapie lesions absent). The greatest number of scrapie cases were recorded in sheep of 2, 3 and 4 years of age which represented 17%, 36% and 23% of the scrapie positive suspects, respectively. The sign sensitivities and specificities for the ten recorded signs were, respectively: pruritus (62%, 42%), ataxia (23%, 74%), hyperaesthesia (32%, 74%), wool loss (25%, 73%), fleece discolouration (29%, 85%), bruxism (23%, 69%), nibbling reflex (17%, 58%), head rubbing (47%, 78%), poll rubbing (25%, 83%). These single signs had poor discriminatory values with likelihood ratios close to one (range 0.89-1.21); combinations of the four signs, pruritus, wool loss, ataxia, hyperaesthesia and emaciation were more discriminatory (range 0.30-4.3). This study covered a time period when bovine spongiform encephalopathy (BSE) might have been introduced into the sheep population on the Shetland Islands via contaminated feed. No temporal changes could be detected in the age structure of the affected animals.

Aging↗
PubMed2004

Clinical and serological aspects of visceral leishmaniasis in northeast Brazilian dogs naturally infected with Leishmania chagasi.

Human visceral leishmaniasis is endemic in the northeast of Brazil, where the domestic dog is an important parasite reservoir in the infectious cycle of Leishmania chagasi. In this study, we evaluated the clinical signs of canine visceral leishmaniasis (CVL), serum protein profile and the antileishmanial IgG antibody production in 86 dogs living in northeast endemic areas of leishmaniasis. Thirty dogs from a leishmaniasis-free area were used as a control group. The major clinical signs of CVL seen were emaciation and skin ulcers (80%), followed by onychogryphosis and conjunctivitis (73%). Depilation was observed in 60% of animals while lymphadenomegaly, splenomegaly, liver enlargement or kidney involvement was less frequent (< or =20%). VL seropositive dogs presented with serum hyperproteinemia, hypoalbuminemia, hypergammaglobulinemia and decreased albumin/globulin ratio. A lower sensitivity and higher specificity was observed for promastigote indirect fluorescent antibody test (IFAT) (83 and 100%, respectively) compared with enzyme-linked immunosorbent assay (ELISA) (94 and 90%), which uses a crude extract of Leishmania. There was a positive correlation between IFAT and ELISA titers of antileishmanial IgG antibodies (Spearman test, P < 0.05), which was augmented in CVL dogs. This study found that the determination of serum protein, A/G ratio and the use of two different leishmanial serological tests like IFAT and ELISA are essential in CVL screening.

Animals↗
PubMed1987

Removal of a giant ovarian cyst. Anaesthetic and intensive care management.

Excision of a giant ovarian cyst may be associated with considerable mortality. Problems stem from the size of the cyst and the emaciated state of the patient. We describe a case in which the patient's pre-operative nutritional and psychological state required attention. Gradual pre-operative drainage of a cyst weighing 113 kg was carried out successfully. The main problems intra-operatively stemmed from copious blood loss and the duration of surgery. Postoperatively, ventilatory inadequacy occurred and was probably caused by altered mechanics of ventilation, postoperative pain and pulmonary oedema. We suggest ways in which the management of such cases might be improved.

Anesthesia, General↗
PubMed1991

Hypoglycaemia associated with anorexia nervosa.

A 41 year old woman with severe emaciation due to longstanding anorexia nervosa presented with recurrent hypoglycaemia. During an episode of hypoglycaemia, serum insulin and C peptide were undetectable and plasma beta hydroxybutyrate, free fatty acids and lactate were inappropriately low. Response to intravenous glucagon was poor. Muscle enzymes were grossly elevated until she gained weight. Hypoglycaemia was abolished by weight gain.

Adult↗
PubMed1993

Possible involvement of hypersecretion of ADH in hyponatremia in a diabetic patient complicated with severe neuropathy.

The present case was a 44-year-old man who had been diagnosed as having noninsulin-dependent diabetes mellitus 2 years before admission. He gradually showed severe neuropathy and emaciation because of poor control of his blood glucose levels. He was admitted to our hospital because of disturbance of consciousness with hyponatremia. The endocrinological findings including thyroid and adrenal functions revealed no abnormalities. Insufficiency of water diuresis was noted in the water loading test. Severe orthostatic hypotension was noted during the standing up test, and an excessive response in the plasma ADH level was also noted. These findings demonstrated that excessive ADH secretion occurred to compensate for the fall in blood pressure because of the breakdown of homeostatic regulation in blood pressure due to diabetic neuropathy. It is suggested that hyponatremia seemed to be subsequently induced by hypersecretion of ADH.

Adult↗
PubMed1997

Prediction of low body weight at long-term follow-up in acute anorexia nervosa by low body weight at referral.

OBJECTIVE: The authors investigated the hypothesis that in acute anorexia nervosa a low body weight predicts a poor weight prognosis for the future. METHOD: The body mass indexes at referral of 272 female patients were examined in relation to the body mass indexes of these patients after a mean follow-up of 9.5 years. RESULTS: The overall correlation between body mass indexes at referral and at follow-up was r = 0.33. Despite this low correlation, the 100 patients with body mass indexes less than 13 kg/m2 at referral had low weights at long-term follow-up. Eleven of the 12 deceased patients were among these 100 patients, as were 24 of the 46 surviving patients whose body mass indexes were 17.5 kg/m2 or less at follow-up. CONCLUSIONS: For patients with anorexia nervosa, a body mass index less than 13 kg/m2 at referral indicates a substantial risk for chronic anorexia nervosa and death related to emaciation.

Acute Disease↗
PubMed2002

An endocrinopathy characterized by dysfunction of the pituitary-adrenal axis and alopecia universalis: supporting the entity of a triple H syndrome.

We demonstrate the rare disorder of triple H syndrome in a 25-year-old man. He was pointed out as having short stature, at -5.9 s.d., and diagnosed as GH deficient at 6 years old. Approximately a year ago, he noticed systematic hair loss. He lost body weight by 7 kg during the last half year. He was admitted to Jichi Medical School Hospital because of unconsciousness. Physical findings showed disturbance of consciousness with Japan Coma Scale I-3. He had emaciation and alopecia universalis. Laboratory findings showed plasma glucose was as low as 1.11 mmol/l. GH and ACTH deficiency with hypoadrenocorticism were clarified. His intelligence was in the low normal range with a WAIS IQ of 70, and anterograde amnesia was suggested in the presence of a little, but not significant, morphological change in the hippocampus on a magnetic resonance imaging scan. Replacement by a physiological dose of hydrocortisone normalized plasma glucose, and restored body weight and growth of hair during the 7 month therapeutic period. The present finding strongly supports a clinical entity of triple H syndrome, including ACTH deficiency, alopecia universalis and anterograde amnesia, and that there may be some variation of the triad among the subjects.

Adrenal Glands↗