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At least 415 records · Page 23Linked to original sources
PubMed1986

A multicenter trial of enalapril in the treatment of essential hypertension.

The therapeutic profile of enalapril in mild to moderate uncomplicated essential hypertension was assessed in 265 patients who participated in a multicenter, open-label, prospective study lasting eight weeks. There were 54 younger (aged 39 years or less), 136 middle-aged (40 to 59 years), and 75 older patients (60 years or over). Monotherapy with enalapril in a single daily dosage regimen ranging between 5 and 40 mg resulted in normotension (in the sitting position) in 73% of the younger, 50% of the middle-aged, and 56% of the older patients. Normotension was achieved with 5 mg/day of enalapril in 41%, 18%, and 37% of the subgroups, respectively. Both systolic and diastolic pressures at the end of eight weeks of treatment were significantly lower (P less than 0.01) in the younger patients than in the other two age groups. White patients had significantly greater (P less than 0.001) response of both systolic and diastolic blood pressures than did black patients and required significantly smaller (P less than 0.01) average daily dosages of enalapril (14 mg versus 22 mg, respectively). The overall incidence of side effects was 14% among all 276 patients enrolled in the study. Most were mild and transient, but six patients discontinued enalapril during the first week of therapy because of side effects. There were no cases of rash, dysgeusia, hematological disorders, or deterioration in renal function, but there were two cases of pruritus, one of glossitis associated with an upper respiratory infection, and three of dry cough or wheezing. Angioedema was not observed. Monotherapy with enalapril, usually in a single daily dose of 10 to 20 mg, was effective in inducing normotension in approximately half of the middle-aged and older hypertensive individuals and in nearly three fourths of those below age 40. In this study it was generally well tolerated, with a relatively small incidence of side effects.

Adult↗
PubMed1988

[Clinical studies on sultamicillin fine granules in the urological field].

Clinical studies of sultamicillin (SBTPC) fine granules, an oral antibiotic with ester linked ampicillin and beta-lactamase inhibitor, sulbactam, were performed in acute uncomplicated cystitis and complicated urinary tract infections. 1. SBTPC fine granules were administrated at a dose of 187.5 mg 2-3 times daily for 5-7 days to 6 patients with acute uncomplicated cystitis. Clinical efficacies as judged according to the criteria of the UTI Committee were excellent in 5 cases and moderate in 1 case with an effectiveness rate of 100%. All of 7 identified bacteria were eradicated by the treatment. 2. SBTPC fine granules were administrated at a dose of 187.5 mg or 375 mg 3 times daily for 5-7 days to 17 patients with complicated urinary tract infections. Clinical efficacies as judged according to the criteria of the UTI Committee were excellent in 8 cases, moderate in 4 cases and poor in 5 cases with an effectiveness rate of 70.6%. Out of 17 identified bacteria, 14 (82.4%) were eradicated by the treatment. 3. As adverse reactions, glossitis, diarrhea and pharyngeal redness were observed in 1 case out of 31 cases treated with the drug. These symptoms, however, were mild and transient. No abnormal laboratory test values were observed. From the above results, it appears that SBTPC fine granules are useful in the treatment of urinary tract infections.

Administration, Oral↗
PubMed1988

Diagnosing vitamin B12 deficiency, a common geriatric disorder.

Vitamin B12 deficiency in the elderly is a common disorder associated with an increased morbidity if it goes undetected, as often happens. Its diagnosis can be enhanced if the clinician recognizes the associated clinical features of nonspecific symptoms, glossitis, and dermatologic and neuropsychiatric abnormalities, and realizes the limitations of various tests (serum B12 assay, parietal cell and intrinsic factor antibody, mean corpuscular volume, and Schilling tests). Available data indicate it is sufficient to prescribe replacement B12 injections three or four times a year.

Aged↗
PubMed1987

[Symptoms and findings of giant cell arteritis in the area of the ear, nose, and throat].

Jaw claudication (angina masticatorica) is one of the best known signs of giant cell arteritis (Horton's arteritis). Other symptoms are pain, swelling, redness and necrosis of the face, mouth, and nasal mucosa (ulcerous pharyngitis, glossitis) leading to disturbances in swallowing. In rare cases there are alterations of smelling and hearing. The knowledge of such non-characteristic symptoms can be of diagnostic importance in cases of Horton's arteritis without local signs in the temporal area, visual failure or polymalgia rheumatica.

Giant Cell Arteritis↗
PubMed1987

[Cutaneous manifestations of zinc deficiency in ethylic cirrhosis].

Thirty-three patients with alcoholic cirrhosis (AC), selected on widely recognized criteria (16, 57), were investigated prospectively for cutaneous manifestations of zinc deficiency. The patients were divided into 3 groups: group A (n = 12): AC without skin lesions; group B (n = 12): AC with skin lesions responsive to a zinc-free topical treatment or resistant to enteral zinc sulfate intake; group C (n = 9): AC with skin lesions cured by oral zinc replacement therapy alone. The lesions observed in group C were studied microscopically. Data concerning zinc metabolism (Zn concentrations in plasma, red cells, urine and hair; alkaline phosphatase values), biochemical criteria of AC (plasma serum-albumin concentration, IgA/transferrin ratio) and a malabsorption test (xylosemia 120 min after oral absorption of D-xylose 25 g) were compared by the variance analysis method. A control group (D, n = 12) was used as reference. Few cases of cutaneous manifestations of zinc deficiency in AC patients have been published. In more than one half of the 15 or so we found in the literature, an aggravating factor (total parenteral nutrition, digestive tract surgery) had to be taken into account. In this prospective study 9 new cases in which AC was the only cause of zinc deficiency are reported. A clinical picture similar to acrodermatitis enteropathica with peribuccal bullous lesions was observed in only one patient. In all other cases the patients presented with a cracked and reticulated eczema on the extensor aspect of the limbs and (often erosive) in the perianal and genital regions. The eczema was associated with cheilitis, glossitis, stomatitis, alopecia and, seldom, ungual Beau's lines. Disorders of behaviour, diarrhoea and bouts of lever regressing under zinc replacement therapy were frequent. Histology was not very specific, except for the presence of necrotic areas in the stratum germinativum, sometimes associated with small subcorneal pustules containing altered polymorphonuclears. In every case, it was the rapid regression of symptoms under zinc sulfate treatment that confirmed the diagnosis. Plasma zinc concentrations were most significantly decreased in all AC groups as compared to controls (61.2 +/- 19.4 vs 97.8 +/- 10.4 micrograms/100 ml) and also in AC patients with skin manifestations of zinc deficiency as compared to the other AC patients (44.4 +/- 9.2 vs 66.5 +/- 18.8 micrograms/100 ml) table V). Changes in serum-albumin levels and in hepatocellular function were parallel to changes in plasma zinc concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗
PubMed1986

New disorder of vitamin B12 metabolism (cobalamin F) presenting as methylmalonic aciduria.

An infant with vitamin B12-responsive methylmalonic aciduria and no homocystinuria or megaloblastic anemia presented with stomatitis, glossitis, convulsions, and developmental delay. Cultured fibroblasts showed defective incorporation of both [14C]5-methyltetrahydrofolate and [14C]propionate into protein by whole cells and a decrease of methionine synthase activity in cell extracts. Despite excessive incorporation of [57Co]cyano-B12 by fibroblasts from the patient, free vitamin B12 was unable to efflux from lysosomes, and, therefore, synthesis of both adenosyl-B12 and methyl-B12 was impaired.

5-Methyltetrahydrofolate-Homocysteine S-Methyltran↗
PubMed1985

Oral candidiasis--its pleomorphic clinical manifestations, diagnosis and treatment.

Up to 60% of the population carry Candida albicans as part of the oral flora without having evidence of candidiasis. The pleomorphic clinical manifestations of oral candidiasis viz. thrush, denture stomatitis, angular cheilitis, median rhomboid glossitis, speckled leukoplakia, and chronic mucocutaneous candidiasis and its variants are briefly discussed. Current diagnostic techniques of oral candidiasis (OC) are reviewed. A simple and quick method of helping the clinician in the diagnosis of OC by taking a direct smear of the lesion is emphasized. OC is a 'disease of the diseased'. As a routine a full blood picture, serum iron and serum folate levels should be looked at. Several predisposing causes of OC need to be investigated. An up-date on the treatment of OC with nystatin, amphotericin B lozenges, clotrimazole and miconazole is made.

Candidiasis, Oral↗
PubMed1977

[Diagnosis and therapy of megaloblastic anemias].

In most cases megaloblastic anaemias are the sequel of a deficiency of vitamin B12, more infrequently of a deficiency of folic acid of different etiology. Oriented to frequency and anamnesis the diagnostics follows the leading symptoms of pernicious anaemia (straw colour, glossitis, achlorhydria) and on the basis of special findings in the peripheral blood (hyperchromacia, megalocytosis, much decreased number of reticulocytes, increased iron and bilirubin level) it leads to the proved suspicion of a megaloblastic anaemia. This suspicion is ascertained by the investigation of the bone-marrow, with the help of aimed investigations the anaemia is further clarified differential-diagnostically. An unclear anaemia should not be treated ex juvantibus with vitamin B12 and/or folic acid. The therapy, always taking into consideration a possible basic disease, is carried out by parenteral application of vitamin B12, possibly in form of hydroxocobalamine or by folic acid. In persisting disturbance of the resorption of vitamin B12 on account of the threatening complication of a funicular spinal disease the long-term therapy must never be interrupted, unless in normal haematological findings.

Anemia, Macrocytic↗
PubMed1980

[The glucagon syndrome].

Although the features of the glucagonoma syndrome had been described in isolated reports since 1942, this potentially curable condition has only recently been adequately defined. In 1974, MALLINSON collected nine cases and described the association of a peculiar skin rash with glucagon-secreting tumors of the pancreas. The typical skin rash, necrolytic migratory erythema, is accompanied by other disturbances including weight loss, anaemia, glossitis, cheilitis angularis, psychiatric symptoms. Diabetes is not a prominent feature, and the impairment of glucose tolerance can indeed be very slight. Up to 1979, about 50 cases have been reported. More than half of these patients had malignant tumors. The authors report on a 67-year-old man in whom a glucagonoma in the tail of the pancreas has been resected with apparent cure. The almost complete disappearance of the skin rash within three weeks of extirpation of the tumor has been most impressive. In June 1979 a similar tumor has been operated by one of the authors in a 60-year-old man. In this instance the tumor was located in the pancreatic corpus and could be radically resected by left-sided pancreatectomy.

Adenoma, Islet Cell↗
PubMed1984

[Familial chronic mucocutaneous candidiasis. Study of 2 families].

Four cases of familial mucocutaneous candidiasis corresponding to two families were studied. In two of the cases (Family I), there were lesions in the mouth, vaginal mucosa, nails, palms and soles, with no other associated infections. In the other two cases (Family II) there were oral (glossitis with macroglossia), genital and inguinal folds lesions, associated to frequent bacterial infections (recurring forunculosis , pneumonia). The immunological study in the four cases showed overlapping results: anti-candida circulating antibodies at high dilutions, a negative or weakly positive candidine a negative TTL to candida in some of the cases, and not other abnormalities in T. lymphocytes. All of the cases became sensitive to DNCB. In two of them, there were low figures of ferritin (Family II); however, no improvement was obtained with an iron treatment. There were no endocrinological abnormalities in any case. All of the cases were cured with ketoconazole in a few months, and no relapse was found six months after the end of the treatment in one of them. A follow up could not be performed on the other three cases.

Adolescent↗
PubMed1983

[Case of trichinosis with a fatal outcome].

Death with trichinelliasis of a 30-year-old man who had used for food raw pork not subjected to trichinelloscopy is described. In the terminal period of the disease there was a clinical picture of ascending polyradiculoneuritis of the type of Landry syndrome which was the main clinical diagnosis. Morphological examinations revealed massive larval invasion of the voluntary muscles, trichinellous myositis, glossitis, myocarditis, meningoencephalitis, trichinellous pneumonia. The cause of death was severe toxicity, respiratory and cardiac insufficiency.

Adult↗
PubMed1983

[Clinical evaluation of cefroxadine in bacterial infections of the eye].

Cefroxadine (CXD) capsules and dry syrup, an oral cephem antibiotic, were administered into 120 cases with ocular infections and the following results were obtained: The daily dose of CXD capsule was ranged from 500 to 1,500 mg and that of CXD dry syrup from 17.9 to 85.7 mg/kg, and the duration of CXD administration was from 2 days to 14 days. Clinical response rates classified by diagnosis The clinical response rates were 77.8% (14/18) in blepharitis, 86.7% (26/30) in hordeolum, 62.5% (5/8) in meibomianitis, 74.6% (44/59) in conjunctivitis, 100% (2/2) in corneal infiltration, 100% (1/1) in cellulitis of the lid, in dacryocystitis and in corneal ulcer, respectively. Clinical response classified by isolated organisms The response rates on S. aureus were 80.0% (20/25), on S. epidermidis 75.8% (47/62) and on S. pneumoniae 66.7% (2/3), respectively. The overall clinical response rate on Gram-positive bacteria was 78.3% (94/120). The response rates on H. influenzae, Acinetobacter spp., P. mirabilis, E. coli and Moraxella spp. were ranged from 42.9 to 100%. The sensitivity distributions of clinically isolated S. aureus and S. epidermidis to CXD were ranged from 1.56 to greater than 100 micrograms/ml and from 0.39 to 12.5 micrograms/ml, respectively. The former showed a peak at 3.13 micrograms/ml and the latter in 1.56 micrograms/ml. Side effects in 3 cases (2.3%) out of 129 were observed. That is; glossitis, thirst feeling and palpitation in each case, respectively.

Administration, Oral↗
PubMed1980

Graft versus host reactions in foals with combined immunodeficiency.

Nine foals with combined immunodeficiency were given hepatic and thymus cells from 68- to 110-day-old (gestational age) fetuses or peripheral blood lymphocytes from nonrelated horses. Clinical signs and lesions consistent with graft vs host reaction were observed in eight of the foals. Diarrhea was observed in these 8 foals, and ulcerative dermatitis, stomatitis, or glossitis was detected in 6 of the 8 foals. Histopathologic changes consisting of necrosis and lymphocyte infiltration were observed in liver, skin, alimentary tract, and less frequently in lymphoid tissues. Changes in complete blood counts, plasma bilirubin concentration, and serum sorbitol dehydrogenase activity were compared with sequential histopathologic alterations in the liver of two combined immunodeficiency foals given peripheral blood lymphocytes from unrelated donor horses. Elevations of sorbitol dehydrogenase correlated with the onset and increasing severity of hepatic lesions.

Animals↗
PubMedDate not supplied

Facial swelling and giant cell arteritis.

A 62-year-old white woman presented with severe facial swelling, glossitis, and odynophagia. Giant cell arteritis (GCA) was diagnosed on the basis of temporal artery biopsy, and the patient responded to corticosteroids. GCA may rarely involve vessels of the mouth and face, resulting in unusual clinical manifestations. Early recognition and treatment are important.

Diagnosis, Differential↗
PubMed1982

[Antifungal agents in otorhinolaryngology].

Numerous progresses are realized in the chemotherapy of mycoses, particularly in the field of deep mycoses due to 3 categories of systemic antifungal agents: polyenes (oral nystatin, oral and intravenous amphotericin B), 5-fluorocytosine (oral and intravenous) and imidazole derivatives (oral and intravenous miconazole, oral ketoconazole). The old drugs as nystatin and amphotericin B per os continue to have a remarkable effect in oro-pharyngeal candidosis, chiefly after sufficient local contact with the mucos membranes; topical preparation are effective in fungal O.R.L. localizations (aspergillar or candidal otomycoses, glossitis). IV amphotericin B is indicated in naso-orbital-cerebral mucor mycosis, nasosinusal aspergillosis, candidosis, entomophthoromycoses and particularly systemic mycoses (histoplasmosis, blastomycosis, coccidioidomycosis) in spite of severe toxicity. 5-fluorocytosine (100-200 mg/kg) has a limited spectrum to Candida, Cryptococcus neoformans, Aspergillus fumigatus infections if the strains are sensitive to this agent (5% primary resistance). Among the new imidazole derivatives, ketoconazole (400 mg/day) represent a revolutionary antifungal agent due to a very large antifungal spectrum, absence of toxicity, rapid diffusion by oral way, and high therapeutic efficiency in candidosis, histoplasmosis, blastomycosis, rhino-entomophthoromycosis... Oral miconazole has a poor diffusion into the tissues and by intravenous way necessitates several injections daily to obtain therapeutic levels. Numerous imidazole derivatives (econazole, miconazole, clotrimazole etc...) can be successfully utilized by topical application, as well as numerous other local antifungal agents.

Amphotericin B↗
PubMed1980

[Treatment of chronic polyarthritis with acemetacin and indomethacin].

In a controlled double blind study the therapeutic efficacy and tolerability of equimolar doses of [1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-acetoxy] acetic acid (acemetacin, TV 1322, Rantudil) and indometacin (acemetacin: 180 mg/day, indometacin: 150 mg/day) were studied in 40 patients suffering from rheumatoid arthritis. The period of treatment lasted 42 days. With the exception of the parameter "state of the joint" a statistically confirmed improvement was detectable in the acemetacin group. The parameter "pain" was significantly improved after acemetacin as well after indometacin. With regard to the test criteria "functional disturbances" and "inflammation" only acemetacin was able to achieve a significant improvement. Neither of the antirheumatic agents had a significantly positive influence on the "state of the joint". The therapeutic effect on the course of the disease was better in the group treated with acemetacin than in the group treated with indometacin. However, the difference was not statistically significant. The number of undesired effects which occurred in the acemetacin group was smaller and less pronounced than in the indometacin group. In one instance, the therapy in the acemetacin group was discontinued because of a glossitis and stomatitis. one patient in the control group was excluded from the study owing to heamatemesis.

Adult↗
PubMed1995

[Report of a case of glucagonoma misdiagnosed as "eczema" and "hepatic angioma" for three years and review of literature].

Glucagonoma is a rare pancreatic tumor, necrolytic migratory erythema is its distinctive feature and it is often associated with diabetes mellitus, weight loss, anemia, hypoaminoacidemia, glossitis and stomatitis. We reported a case of glucagonoma misdiagnosed as "eczema" and "benign hepatic anginoma" for 3 years. His blood glucagon level was 1,758 ng/L. The results of abdominal B-mode ultrasonography and CT scan were negative, but selected arteriogram showed a tumor mass between the pancreatic body and tail. Before operation, treatment with octreotide and supply of amino acids were given with improvement of the skin lesion. After resection of the tumor from pancreas, necrolytic migratory erythema disapeared, but his blood level of glucagon and amino acids did not improve. It is suggested that any diabetic patient with chronic skin damage should be checked for blood glucagon level. In suspected cases, selected arteriogram will be helpful for location of the tumor. Vigorous resection of the pancreatic tumor should be done as soon as possible, even though there is already metastases.

Diagnostic Errors↗
PubMed1995

[Skin symptoms in disorders of vitamin and mineral metabolism].

The daily vitamin intake of the Swiss population seems to be good. In certain situations or population groups a vitamin or mineral salt deficiency is still possible. It seems more useful to show the different changes of the skin, mucous membranes, hair or nails in the various vitamin or mineral salt deficiencies than to enumerate the vitamins. In a first part, skin signs such as seborrhoic-dermatitis-like or acrodermatitis-enteropathica-like changes, perlèches, xeroderma, hyperpigmentation or less frequent skin changes e.g. edema, intertriginous or ichthyosiform lesions, are mentioned. The second portion then shows lesions of the mucous membranes which are seen in different vitamin or mineral salt deficiencies, e.g. glossitis, cheilitis, stomatitis, aphthous ulcers or gingivitis. In a third chapter the consequences on the hair as alopecias or hair shaft alterations are discussed. Finally, in the last section, the possible nail changes as dystrophies or discolorations are mentioned. A table with the functions and the daily recommended doses of the vitamins and some mineral salts is given.

Acrodermatitis↗