Liver Abscess, Pyogenic
A randomized, double-blind comparative trial evaluating the safety of liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia. L Amph/ABLC Collaborative Study Group. (1/19)In this double-blind study to compare safety of 2 lipid formulations of amphotericin B, neutropenic patients with unresolved fever after 3 days of antibacterial therapy were randomized (1:1:1) to receive amphotericin B lipid complex (ABLC) at a dose of 5 mg/kg/d (n=78), liposomal amphotericin B (L Amph) at a dose of 3 mg/kg/d (n=85), or L Amph at a dose of 5 mg/kg/d (n=81). L Amph (3 mg/kg/d and 5 mg/kg/d) had lower rates of fever (23.5% and 19.8% vs. 57.7% on day 1; P<.001), chills/rigors (18.8% and 23.5% vs. 79.5% on day 1; P<.001), nephrotoxicity (14.1% and 14.8% vs. 42.3%; P<.01), and toxicity-related discontinuations of therapy (12.9% and 12.3% vs. 32.1%; P=.004). After day 1, infusional reactions were less frequent with ABLC, but chills/rigors were still higher (21.0% and 24.3% vs. 50.7%; P<.001). Therapeutic success was similar in all 3 groups. (+info)
Rituximab dose-escalation trial in chronic lymphocytic leukemia. (2/19)PURPOSE: To conduct a dose-escalation trial of rituximab in patients with chronic lymphocytic leukemia (CLL) to define the maximum-tolerated dose (MTD), to evaluate first-dose reactions in patients with high circulating lymphocyte counts, and to assess the efficacy at higher versus lower doses. PATIENTS AND METHODS: Fifty patients with CLL (n = 40) or other mature B-cell lymphoid leukemias (n = 10) were treated with four weekly infusions of rituximab. The first dose was 375 mg/m(2) for all patients; dose- escalation began with dose 2 but was held constant for each patient. Escalated doses were from 500 to 2,250 mg/m(2). RESULTS: Toxicity with the first dose (375 mg/m(2)) was noted in 94% of patients but was grade 1 or 2 in most, predominantly fever and chills. Six patients (12%) experienced severe toxicity with the first dose, including fever, chills, dyspnea, and hypoxia in all six patients, hypotension in five, and hypertension in one. Toxicity on subsequent doses was minimal until a dose of 2,250 mg/m(2) was achieved. Eight (67%) of 12 patients had grade 2 toxicity, including fever, chills, nausea, and malaise, although no patient had grade 3 or 4 toxicity. Severe toxicity with the first dose was significantly more common in patients with other B-cell leukemias, occurring in five (50%) of 10 patients versus one (2%) of 40 patients with CLL (P <.001). The overall response rate was 40%; all responses in patients with CLL were partial remissions. Response rates were 36% in CLL and 60% in other B-cell lymphoid leukemias. Response was correlated with dose: 22% for patients treated at 500 to 825 mg/m(2), 43% for those treated at 1,000 to 1,500 mg/m(2), and 75% for those treated at the highest dose of 2,250 mg/m(2) (P =.007). The median time to disease progression was 8 months. Myelosuppression and infections were uncommon. CONCLUSION: Rituximab has significant activity in patients with CLL at the higher dose levels. Severe first-dose reactions were uncommon in patients with CLL, even with high circulating lymphocyte counts, but were frequent in patients with other mature B-cell leukemias in which CD20 surface expression is increased. Efficacy of rituximab was also significant in this group of patients. (+info)
Dacarbazine and interferon alpha with or without interleukin 2 in metastatic melanoma: a randomized phase III multicentre trial of the Dermatologic Cooperative Oncology Group (DeCOG). (3/19)In several phase II-trials encouraging tumour responses rates in advanced metastatic melanoma (stage IV; AJCC-classification) have been reported for the application of biochemotherapy containing interleukin 2. This study was designed to compare the efficacy of therapy with dacarbazine (DTIC) and interferon alpha (IFN-alpha) only to that of therapy with DTIC and IFN-alpha with the addition of interleukin 2 (IL-2) in terms of the overall survival time and rate of objective remissions and to provide an elaborated toxicity profile for both types of therapy. 290 patients were randomized to receive either DTIC (850 mg/m(2)every 28 days) plus IFN-alpha2a/b (3 MIU/m(2), twice on day 1, once daily from days 2 to 5; 5 MIU/m(2)3 times a week from week 2 to 4) with or without IL-2 (4.5 MIU/m(2)for 3 hours i.v. on day 3; 9.0 MIU/m(2) i.v. day 3/4; 4.5 MIU/m(2) s.c. days 4 to 7). The treatment plan required at least 2 treatment cycles (8 weeks of therapy) for every patient. Of 290 randomized patients 281 were eligible for an intention-to-treat analysis. There was no difference in terms of survival time from treatment onset between the two arms (median 11.0 months each). In 273 patients treated according to protocol tumour response was assessable. The response rates did not differ between both arms (P = 0.87) with 18.0% objective responses (9.7% PR; 8.3% CR) for DTIC plus IFN-alpha as compared to 16.1% (8.8% PR; 7.3% CR) for DTIC, IFN-alpha and IL-2. Treatment cessation due to adverse reactions was significantly more common in patients receiving IL-2 (13.9%) than in patients receiving DTIC/IFN-alpha only (5.6%). In conclusion, there was neither a difference in survival time nor in tumour response rates when IL-2, applied according to the combined intravenous and subcutaneous schedule used for this study, was added to DTIC and IFN-alpha. However, toxicity was increased in melanoma patients treated with IL-2. Further phase III trials with continuous infusion and higher dosages must be performed before any final conclusions can be drawn on the potential usefulness of IL-2 in biochemotherapy of advanced melanoma. (+info)
Therapeutic use of cytokines to modulate phagocyte function for the treatment of infectious diseases: current status of granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, macrophage colony-stimulating factor, and interferon-gamma. (4/19)The innate immune system represents the initial arm of host defense against pathogenic bacteria, fungi, and parasites. Neutrophils, monocytes, and tissue-based macrophages are major cellular components of this system. The potential ability to augment activity of the innate immune system has increased dramatically during the past 2 decades, with the discovery and development of cytokines. Four cytokines, namely granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), and interferon (IFN)-gamma, have received increasing attention as potential adjunctive agents for the treatment of infectious diseases. In various animal models of infection, therapeutic administration of each of the 4 cytokines has been shown to enhance pathogen eradication and to decrease morbidity and/or mortality. However, variable therapeutic efficacy has been reported in clinical trials conducted to date. This review summarizes the current status of the use of G-CSF, GM-CSF, M-CSF, and IFN-gamma in the treatment of infectious diseases. (+info)
Phase 2 study of a combined immunochemotherapy using rituximab and fludarabine in patients with chronic lymphocytic leukemia. (5/19)This multicenter phase 2 trial investigated safety and efficacy of a new immunochemotherapeutic regimen combining rituximab (R) and fludarabine (F) in patients with fludarabine- and anthracycline-naive chronic lymphocytic leukemia (CLL). The rationale for using R + F includes single-agent efficacy of both drugs, in vitro synergism of R and F, and no apparent overlapping toxicity. Of 31 eligible patients with B-CLL enrolled, 20 were previously untreated and 11 relapsed. Treatment consisted of fludarabine administered at standard doses (25 mg/m(2)/d; days 1-5, 29-33, 57-61, and 85-89) and rituximab (375 mg/m(2)/d) given on days 57, 85, 113, and 151. Side effects such as fever, chills, and exanthema were generally mild (National Cancer Institute Common Toxicity Criteria [NCI-CTC] grade 1/2 in 48% and grade 3 and/or 4 in 3% of patients). Fever and chills were mainly associated with the first rituximab infusion. Hematologic toxicity included neutropenia (grade 1 and/or 2 in 26%, grade 3 and/or 4 in 42%) and thrombocytopenia (grade 1 and/or 2 in 19%, grade 3 and/or 4 in 9%). One patient died of cerebral bleeding during prolonged thrombocytopenia after the second cycle of fludarabine. There were a total of 32 infections in 16 patients, none of which was fatal. The overall response rate (complete remission [CR] and partial remission [PR]) was 87% (27 of 31 evaluable patients). In 20 previously untreated patients, 17 (85%) responded. Ten of 31 patients achieved CR (5 of 20 untreated; 5 of 11 pretreated; 9 of 21 Binet stage B, 1 of 10 Binet stage C). The median duration of response was 75 weeks. We conclude that the combination of rituximab and fludarabine is feasible and effective in patients with B-CLL. (+info)
An overview of the current clinical use of the anti-CD20 monoclonal antibody rituximab. (6/19)The chimeric anti-CD20 monoclonal antibody rituximab has become part of the standard therapy for patients with non-Hodgkin's lymphoma (NHL). To date, more than 300 000 patients have been treated with rituximab worldwide, including patients with indolent and aggressive NHL, Hodgkin's disease and other B-cell malignancies. Combination of rituximab with cytotoxic agents or cytokines has been explored in a number of different studies. Rituximab is now also approved for patients with diffuse large B-cell lymphoma when combined with standard CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone). The monoclonal antibody is generally well tolerated. Most adverse events are infusion-associated, including chills, fever and rigor related to the release of cytokines. (+info)
A major outbreak of severe acute respiratory syndrome in Hong Kong. (7/19)BACKGROUND: There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. We report the clinical, laboratory, and radiologic features of 138 cases of suspected SARS during a hospital outbreak in Hong Kong. METHODS: From March 11 to 25, 2003, all patients with suspected SARS after exposure to an index patient or ward were admitted to the isolation wards of the Prince of Wales Hospital. Their demographic, clinical, laboratory, and radiologic characteristics were analyzed. Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed. RESULTS: There were 66 male patients and 72 female patients in this cohort, 69 of whom were health care workers. The most common symptoms included fever (in 100 percent of the patients); chills, rigors, or both (73.2 percent); and myalgia (60.9 percent). Cough and headache were also reported in more than 50 percent of the patients. Other common findings were lymphopenia (in 69.6 percent), thrombocytopenia (44.8 percent), and elevated lactate dehydrogenase and creatine kinase levels (71.0 percent and 32.1 percent, respectively). Peripheral air-space consolidation was commonly observed on thoracic computed tomographic scanning. A total of 32 patients (23.2 percent) were admitted to the intensive care unit; 5 patients died, all of whom had coexisting conditions. In a multivariate analysis, the independent predictors of an adverse outcome were advanced age (odds ratio per decade of life, 1.80; 95 percent confidence interval, 1.16 to 2.81; P=0.009), a high peak lactate dehydrogenase level (odds ratio per 100 U per liter, 2.09; 95 percent confidence interval, 1.28 to 3.42; P=0.003), and an absolute neutrophil count that exceeded the upper limit of the normal range on presentation (odds ratio, 1.60; 95 percent confidence interval, 1.03 to 2.50; P=0.04). CONCLUSIONS: SARS is a serious respiratory illness that led to significant morbidity and mortality in our cohort. (+info)
Risk of transmission of leptospirosis from infected cattle to dairy workers in southern Israel. (8/19)BACKGROUND: Leptospirosis is a zoonotic disease that occurs worldwide, found predominantly in agricultural workers, port workers and dairy workers. OBJECTIVE: To investigate the risk of disease transmission to dairy workers following an outbreak in 1999 of Leptospirosis hardjo in the dairy herds of two kibbutzim in southern Israel. METHODS: A seroepidemiologic survey of all the dairy workers from these two kibbutzim was conducted, including individual interview and examination. Data were collected on the presence of clinical symptoms of leptospirosis during the previous month. One month later the medical personnel on the two kibbutzim were contacted in order to determine if any worker had subsequently developed clinical signs or symptoms of leptospirosis. All dairy workers had blood drawn for serology. Those workers whose initial serology had been borderline for leptospirosis had a repeated serology test between 2 and 4 weeks later. Doxycycline was given prophylactically to all dairy workers on one kibbutz only. RESULTS: Either with or without chemoprophylaxis, no dairy workers exposed to herds infected with Leptospira hardjo showed evidence of seroconversion or disease. This indicated a low risk of transmission of this serovar from cows to dairy workers. CONCLUSION: Since human illness with leptospirae can cause illness associated with significant morbidity, we recommend that physicians make an informed decision regarding doxycycline prophylaxsis for dairy workers exposed to cattle herds infected with Leptospira hardjo. (+info)
1. Sudden, brief episodes of shivering or trembling, often accompanied by feelings of coldness or a raised temperature. Chills can be a symptom of infection, inflammation, or other medical conditions.
2. A feeling of intense coldness or shivering that is not related to an actual drop in body temperature. This type of chill can be caused by emotional factors, such as anxiety or fear, or by certain medications.
3. A sudden, brief episode of trembling or shaking, often accompanied by feelings of nervousness or apprehension. Chills can be a symptom of neurological conditions, such as Parkinson's disease or multiple sclerosis.
4. In medicine, chills can also refer to a type of seizure that is characterized by shivering or trembling movements. These types of seizures are often seen in people with epilepsy.
5. Chills can also be a symptom of withdrawal from certain substances, such as alcohol or drugs.
6. In some cases, chills can be a symptom of a more serious underlying medical condition, such as a severe infection, inflammatory disorder, or blood disorder. It is important to seek medical attention if you experience persistent or severe chills, especially if they are accompanied by other symptoms such as fever, pain, or difficulty breathing.
7. Chills can also be a side effect of certain medications, such as antidepressants or antipsychotics.
8. Some people may experience chills as a result of exposure to cold temperatures or changes in weather. This is usually not a cause for concern and can be treated with warm clothing, blankets, or other forms of heat therapy.
In general, chills are a symptom that can have many different causes, and it is important to seek medical attention if they persist or worsen over time.
There are different types of fever, including:
1. Pyrexia: This is the medical term for fever. It is used to describe a body temperature that is above normal, usually above 38°C (100.4°F).
2. Hyperthermia: This is a more severe form of fever, where the body temperature rises significantly above normal levels.
3. Febrile seizure: This is a seizure that occurs in children who have a high fever.
4. Remittent fever: This is a type of fever that comes and goes over a period of time.
5. Intermittent fever: This is a type of fever that recurs at regular intervals.
6. Chronic fever: This is a type of fever that persists for an extended period of time, often more than 3 weeks.
The symptoms of fever can vary depending on the underlying cause, but common symptoms include:
* Elevated body temperature
* Muscle aches
* Loss of appetite
In some cases, fever can be a sign of a serious underlying condition, such as pneumonia, meningitis, or sepsis. It is important to seek medical attention if you or someone in your care has a fever, especially if it is accompanied by other symptoms such as difficulty breathing, confusion, or chest pain.
Treatment for fever depends on the underlying cause and the severity of the symptoms. In some cases, medication such as acetaminophen (paracetamol) or ibuprofen may be prescribed to help reduce the fever. It is important to follow the recommended dosage instructions carefully and to consult with a healthcare professional before giving medication to children.
In addition to medication, there are other ways to help manage fever symptoms at home. These include:
* Drinking plenty of fluids to stay hydrated
* Taking cool baths or using a cool compress to reduce body temperature
* Resting and avoiding strenuous activities
* Using over-the-counter pain relievers, such as acetaminophen (paracetamol) or ibuprofen, to help manage headache and muscle aches.
Preventive measures for fever include:
* Practicing good hygiene, such as washing your hands frequently and avoiding close contact with people who are sick
* Staying up to date on vaccinations, which can help prevent certain infections that can cause fever.
Example of 'Liver Abscess, Pyogenic' in a sentence:
The patient was admitted to the hospital with a diagnosis of liver abscess, pyogenic, which was caused by a bacterial infection that had spread from the gut.
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- Chills are accompanied by a bad cough, shortness of breath, abdominal pain or burning, or frequent urination. (medlineplus.gov)
- Chills often predict the coming of a fever or an increase in the body's core temperature. (medlineplus.gov)
- Fever (which can accompany chills) is the body's natural response to a variety of conditions, such as infections. (medlineplus.gov)
- Cold water may increase the fever as it can trigger chills. (medlineplus.gov)
- Medicines such as acetaminophen, aspirin, or ibuprofen are helpful in fighting a fever and chills. (medlineplus.gov)
- These measures will only make the chills worse and may even cause the fever to rise. (medlineplus.gov)
- Treatment depends on how long the chills and accompanying symptoms (especially fever) have lasted. (medlineplus.gov)
- Chills and fever following oral use of procaine amide (pronestyl). (nih.gov)
- What has been the highest body temperature connected with the chills? (medlineplus.gov)
- They use high temperature chilled water for cooling, which can make for a very efficient chiller, but even if they use normal chilled water temperatures a chilled water system is much more efficient than DX. (physicsforums.com)
- The buildings then use the chilled water for climate control (both temperature and humidity) and for the cooling of equipment, equipment discharges, etc. (nih.gov)
- To understand the mitigation effects of melatonin on the chilling-induced photoinhibition in tomato , four groups of seedlings were labelled NW (normal temperature + water ), NM (normal temperature + melatonin ), CW (chilling + water ) and CM (chilling+ melatonin ). (bvsalud.org)
- Steam rises from the Xcel Energy Plant as construction workers at the Red Bull Crashed Ice 2018 venue work to assemble the stage and were seen against the rising sun in more than minus 30 below with wind chill temps Saturday, Dec. 30, 2017, in St. Paul, MN. (startribune.com)
- chillertv .com/getchiller/ Joined May 2009 165 Following 14.8K Followers Tweets Replies Media Chiller TV @ ChillerTV · Jun 28, 2017 Ready to get #babashook? (aol.com)
- Even experienced swimmers may venture out farther than they should and not be able to make it back to shore, or they may not notice how chilled they're getting and develop hypothermia. (nih.gov)
- Prefabricated, chilled water piping system with variable speed pumps and controls that provides an efficient and flexible solution for Tier II and III data center cooling. (apc.com)
- The belief that those in power in Russia will resort to murder to silence critics abroad has only been compounded by Voronenkov's brazen assassination in downtown Kiev, which is already having a chilling effect on Ukraine's community of Russian dissidents. (foreignpolicy.com)
- Retaliation can be as simple as a supervisor's words that potentially send a "chilling effect" on the participation in or use of the discrimination complaint process. (nih.gov)
- EEOC found that this statement sufficiently sends a chilling effect to others and it may discourage others from participating in the EEO process. (nih.gov)
- The Commission found that these comments could have a chilling effect on the EEO process. (nih.gov)
- Crain's Detroit Business reported that Bursch previously had told the judge that prosecuting Lyon for manslaughter and misconduct in office could create a precedent and have a "chilling effect" on state employees, whose actions could be second-guessed by a prosecutor. (medscape.com)
- So if the building is large, consistently occupied, with reasonably controlled humidity then chilled beams would work well? (physicsforums.com)
- Mitigation of exogenous melatonin on photoinhibition of tomato seedlings under chilling stress. (bvsalud.org)
- Following four simple steps at home-Clean, Separate, Cook, and Chill-can help protect you and your loved ones from food poisoning. (cdc.gov)
- Chills are caused by rapid muscle contraction and relaxation. (medlineplus.gov)
- Did the chills happen only once, or are there many separate episodes? (medlineplus.gov)
- Infants tend not to develop obvious chills. (medlineplus.gov)
- Chill until very cold, at least 3 hours to allow flavors to blend. (travelks.com)
- The thermal energy storage system will consist of a partially buried eight million-gallon storage tank that will provide 45,000-ton hours of chilled water at a discharge rate of 5,000 tons per hour. (nih.gov)
- Thermal energy storage consists of storing chilled water in a storage tank during off-peak hours. (nih.gov)
- During peak hours, when chilled water demand is highest, the storage tank will supplement the existing chillers' capacity. (nih.gov)
- Stream Chiller live online. (aol.com)
- Can somebody give me a scenario when chilled beams would be the preferred method of conditioning and ventilation as opposed to the variable refrigerant flow systems? (physicsforums.com)
- The winter chill of Geneva is warmed in the last week of January every year by the meeting of the WHO Executive Board, which gathers to follow up on decisions of the World Health Assembly and provide guidance and direction to the WHO Secretariat. (who.int)
- Does anyone have any approximations on how much energy it would take to power a 50-ton Variable Refrigerant Flow DX system, and how much it might take to run a 50-ton Chilled Beam system? (physicsforums.com)
- The Assure/Expand Chilled Water Project will increase the chilled water capacity and reliability at the Bethesda Campus. (nih.gov)
- I don't know why and I want to understand why chilled beams don't seem to be gaining as fast as VRF in the US? (physicsforums.com)
- The Chilled beam system would require a 2,000 cfm unit on the roof that can produce very dry air. (physicsforums.com)
- With a chilled-beam system, as with a fan coil unit system, you still need a centralized outside air unit. (physicsforums.com)
- The chilled water system is critical to the NIH mission and is absolutely essential for NIH's three data centers, over 1.3 million research animals, 240-bed hospital, and over 12 million square feet of sophisticated biomedical research facilities. (nih.gov)
- Chilled beam systems compete with VAV and fan coil unit systems, saving a lot on fan energy. (physicsforums.com)
- This is my understanding of the basic energy principles for the chilled beams. (physicsforums.com)
- Conservation of energy demands that the output must be equal and since chilled water systems are more efficient than DX, you almost always save on the input. (physicsforums.com)
- We concluded that exogenous melatonin application could alleviate photoinhibition in tomato seedlings under chilling by balancing the partitioning of absorption energy in PS â ¡ and by enhancing the ROS scavenging efficiency of the AsA-GSH cycle in the chloroplast . (bvsalud.org)
- Chills refers to feeling cold after being in a cold environment. (medlineplus.gov)
- It is okay to put small portions of hot food in the refrigerator since they will chill faster. (cdc.gov)