Biomedicine & pharmacotherapy = Biomédecine & pharmacothérapie
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The accurate diagnosis of chest pain is often difficult. We review the differential diagnosis of chest pain and the diagnostic studies used in the evaluation of chest pain syndromes. Myocardial ischemia, aortic dissection, pulmonary embolism, pericarditis, and gastroenterologic sources of chest pain are the most common. The chest X-ray, electrocardiogram, echocardiogram, heart catheterization studies, and esophageal studies are helpful diagnostically.
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Biomed. Pharmacother. · Jan 1990
Comparative StudyComparison of creatinine and inulin clearances in multiple trauma.
Creatinine clearance (Ccr) is a good predictor of renal dysfunction. However, numerous analytical interferences have been observed with the classical measurement of creatinine by Jaffé's procedure. This prospective study was conducted to compare 4 methods for determining creatinine; and also endogenous creatinine clearance with inulin clearance (Cin) to estimate the glomerular filtration rate. ⋯ The best correlations between inulin clearance and creatinine clearance were observed for Jaffé's rapid kinetics (r = 0.90) in the control group and for the enzymatic procedure in the multiple trauma group (r = 0.55). Plasma creatinine is not a useful indicator in multiple trauma. The correlation between creatinine clearance and inulin clearance is not very strong in multiple trauma, indicating that the relative evolution (not the absolute values) of creatinine clearance is of interest.
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Lyme disease is transmitted by the tick Ixodes dammini ("deer tick") or a related ixodid tick. Early diagnosis of children with Lyme disease is difficult because the bite of the ixodid tick often goes unnoticed. Furthermore, erythema chronicum migrans, the characteristic rash of the disease, occurs in less than 50% of cases. ⋯ Lyme disease shares symptoms in common with septic arthritis and juvenile rheumatoid arthritis. Whenever a distinction between Lyme arthritis and septic arthritis is difficult to make, treatment should be directed at septic arthritis while serological tests for Lyme disease are pending. The physician should consider Lyme disease to be a possible diagnosis of any patient with arthritis and a history of rash or fever, idiopathic neurological disease, or a cardiac conduction defect--especially if there is a history of possible exposure to the carrier tick.(ABSTRACT TRUNCATED AT 250 WORDS)
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Biomed. Pharmacother. · Jan 1989
Disability, physician consultation, and use of prescription medications in a population-based study of headache.
In a population-based telephone interview survey of 9,380 residents aged 12 to 29 yr in Washington County, Maryland, who reported having had a headache, 60% of females and 41% of males had had one or more headaches during the previous week; 14.4% of females and 6.0% of males in the study group had consulted a physician in the previous 12 months for a headache problem. The likelihood of consulting a physician differed according to the type of headache. Subjects with headache during the week before the interview meeting the criteria for certain migraine or certain mixed tension--migraine were twice as likely as subjects with all other types of headaches to consult a physician during the previous 12 months. ⋯ On the other hand, males with migraine headache during the previous week were more likely than females with migraine to consult a physician. Disability (defined as being absent from school or from work for all or part of the day) was relatively common among those subjects with a headache during the previous week (13.7% of females and 7.9% of males). However, even among those reporting disability as a result of their headache during the previous week, only 31% of females and 18% of males reported consulting a physician during the previous 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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Biomed. Pharmacother. · Jan 1988
Discontinuing chemoimmunotherapy in childhood acute lymphoblastic leukemia.
We examined the results of discontinuing therapy in Japanese children with acute lymphoblastic leukemia. Of the 209 patients in chemoimmunotherapy study, 120 (57.4%) had all chemotherapy stopped after 3 years of complete remission, and 72 (34.4%) reached the point of discontinuing immunotherapy after 5 years of complete remission. Of the 120 children removed from chemotherapy, 14 (11.7%) have relapsed, mainly in the extramedullary sites (5 testis, 5 bone marrow, 3 central nervous system, 1 bone); relapses occurred 1-23 months after cessation of chemotherapy (median 11 months). ⋯ None of the 72 children removed from immunotherapy have yet relapsed. Long-term remission and possibly cure can be expected in approximately one half of newly-diagnosed Japanese patients. Moreover, the active immunotherapy could be of benefit to elimination of bone marrow relapses after cessation of chemotherapy in children with acute lymphoblastic leukemia.