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Specific Infections in Children
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Neal Russell, Sarah May Johnson, Andrew Chapman, Christian Harkensee, Sylvia Garry, Bhanu Williams
Typhoid is difficult to differentiate from other causes of fever, with non-specific symptoms such as headache, dry cough and fever. If untreated it may become a prolonged illness, with abdominal pain, constipation, diarrhoea, prostration and confusion, followed by severe complications such as intestinal perforation or haemorrhage, encephalitis and myocarditis. Classic signs are bradycardia and rose spots (blanching red maculopapular lesions), although these are rarely present.15 Other signs may include splenomegaly and mild hepatomegaly. Relapse may occur after treatment and asymptomatic chronic carriage in a minority of patients can lead to ongoing transmission.
Chikungunya virus and Japanese encephalitis virus
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
The incubation period after the bite of an infected mosquito ranges from 1 to 12 days, at which point high fever sets in. This is accompanied almost invariably by debilitating arthralgias most commonly in the distal joints but possibly also in larger, more proximal joints. Symptoms tend to be more or less symmetric, and arthralgias may or may not present overtly with joint swelling, as this occurs in around half of cases [4,5,18]. A concomitant cutaneous manifestation also occurs about half the time and usually is described as a maculopapular rash. Gastrointestinal issues such as nausea, vomiting, and diarrhea, and myalgias without myositis tend to occur in up to a quarter of cases. Overall fatigue or prostration is very common. The acute phase lasts around a week, after which non-arthralgic or fatiguing symptoms begin to wane as the patient passes into the convalescent stage. Association between emergence of CHIKV IgG and improvement in symptoms has been made [19]. During the acute phase, elevation in C-reactive protein and lymphopenia are frequently seen [5].
Hypochondria
Published in Francis X. Dercum, Rest, Suggestion, 2019
It is necessary to repeat emphatically the caution that the period of absolute rest in bed should be short; say, three to six weeks. After this interval, the plan of treatment should gradually be converted into one of partial rest, exercise being instituted at a relatively early period. Full rest methods unduly prolonged are sometimes dangerous in hypochondria; indeed, if practised unwisely, they may be followed by disastrous results. The patient learns to love the coddling care of the rest treatment and insists upon its prolongation, declines to get out of bed, and resists tenaciously exercise or activity in any form. Care also should be taken that the treatment, and especially the institution of the various physiologic methods, should not serve to confirm in the patient's mind the belief that he is seriously ill. As in hysteria, the unfailing suggestion should be made to the patient both by the physician and nurse, directly and indirectly, first, that he is not seriously ill, and, secondly, that he will inevitably get entirely well. Further, the patient should never be accused of being hypochondriacal. As a rule, he does not ask for a specific diagnosis, and he is readily satisfied when he is told that he is suffering from one of the forms of "nervous prostration."
Encephalitis lethargica in Peru
Published in Journal of the History of the Neurosciences, 2021
Santiago Stucchi-Portocarrero, Miguel Humberto Tomas-Miranda
The second case was published by Max González-Olaechea, also in Anales de la Facultad de Medicina de Lima, in 1920. The case was about an 11-year-old boy who, on February 16, 1920, was “struck with a fever, general malaise, slight frontal headache, intestinal colic.” Two days later, the patient evolved with “manifest prostration, intense delirium, tremor in the upper limbs, slight ptosis, pupil dilation [and] deviation of the eyes to the right” (González-Olaechea 1920, 169–170). The next day he was “delusional and disoriented.” His temperature was 37.3°C, his heart rate was 80 beats per minute, and his respiratory rate was 26 breaths per minute. The results from the cerebrospinal fluid analysis came back normal, but no blood or urine tests were ordered. Regarding treatment, a purgative was administered the first day, and then “urotropin and [an] hydric diet” (González-Olaechea 1920, 170). Eight days later, the patient recovered.
Non-clinical toxicology evaluation of BIA 10-2474
Published in Critical Reviews in Toxicology, 2021
A. Wallace Hayes, Klaus Weber, Paul Moser, Patrício Soares-da-Silva
In the primate, there were some deaths during the MTD studies. Thus, subjects were euthanized after the fourth administration of either 125 or 250 mg/kg/day. In addition, one female was euthanized after the third administration at 60 mg/kg although the other subjects (2 males and one female) completed the study which reached doses of 110 mg/kg/day for 14 days (Weber et al. 2020). During the up-titration phase of the 4-week study one female was found dead after receiving four administrations each of 10, 25, and 50 mg/kg/day and nine at 75 mg/kg/day. This subject had shown signs of incoordination, prostration, and weakness. At lower doses, signs including tremors, weakness, and incoordination were seen with increasing frequency from 25 mg/kg/day and from 50 mg/kg/day hypothermia was also seen.
Stephanus Bisius (1724–1790) on mania and melancholy, and the disorder called plica polonica
Published in Journal of the History of the Neurosciences, 2021
Eglė Sakalauskaitė-Juodeikienė, Paul Eling, Stanley Finger
Melancholy or melancholia was, in many ways, the opposite of mania. Two of its features are decreased motility and feeling lethargic or morose; both recognized as symptoms of depression today (Berrios 1988). The label “melancholy,” however, meant more than depression in the past. It was frequently applied to any condition involving physical and mental prostration, even quartan fever (malaria). Like mania, melancholy was interpreted in terms of the humoral theory during the Greco–Roman period and for many centuries thereafter. It was supposedly caused by melaina kole—in effect, an overabundance of “black bile” produced by the spleen (Jones 1972). Some ancient Greek philosophers had already begun to maintain that men known to be outstanding in philosophy, statesmanship, poetry, or the arts had a propensity to be melancholic. During the Renaissance, Italian humanist Marsilio Ficino (1433–1499) even pointed to an astrological connection, claiming that those born under Saturn—the “gloomy” planet commonly associated with contemplative life—were prone to melancholic brilliance (Klibansky, Panofsky, and Saxl 1964; Sullivan 2008).