Chronic Recurrent

Ventricular tachycardia (VT) is defined by three or more repetitive PVCs occurring at a rate greater than 100 beats/min. It occurs most commonly in acute myocardial infarction (MI) other causes are severe electrolyte abnormalities (e.g., hypokalemia), hypoxemia, and digitalis toxicity. The chronic recurrent form is almost always associated with underlying organic heart disease (e.g., idiopathic dilated cardiomyopathy or remote MI with left ventricular [LV] aneurysm). 

Ulcer recurrence Duodenal ulcer is a chronic recurrent disease. While short-term treatment can completely heal the ulcer, do not expect a successful course to alter posthealing frequency or severity of duodenal ulceration. 

Uses Suppress/eluninate bacteriuria associated w/ chronic/recurrent UTI Action Converted to formaldehyde ammonia in acidic urine nonspecific bactericidal action Dose Adults. Hippurate 0.5-1 g bid. Mandelate 1 g qid PO pc hs Peds 6-12 y. Hippurate 25-50 mg/kg/d PO bid. Mandelate 50-75 mg/kg/d PO qid (take w/ food, ascorbic acid w/ adequate hydration) Caution [C, +] Contra Renal insuff, severe hepatic Dz, severe dehydration sulfonamide allergy Disp Tabs SE Rash, GI upset, dysuria, t LFTs EMS Monitor BP for hypovolemia and dehydration OD Sxs unknown symptomatic and supportive... 

In contrast, chronic recurrent headache, for which patients most often consult physicians, is associated with various medical, neurological, or psychogenic disorders. Appropriate therapy depends on an accurate diagnosis of the type of headache. 

Schopf, E., J.M. Mueller, and T. Ostermann, Value of adjuvant basic therapy in chronic recurrent skin diseases. Neurodermatitis atopica/psoriasis vulgaris. Hautarzt, 1995, 46 451-4. 

Rheumatoid arthritis is a chronic, recurrent systemic inflammatory disorder that primarily affects the joints. The incidence is typically between 1% and 3% of the UK population with a female preponderance of 3 1. Age of onset is typically between the ages of 20 and 40 years. The small joints of the hands and feet are usually affected first and presentation is usually symmetrical. Deformities may arise and the condition may progress to larger joints. In the most severe of cases, extra-articular tissues may be affected, including the lungs, muscle tissues and blood vessels. Additional complications may include Sjdgren s syndrome and Felty s syndrome. 

Norfloxacin 3h) is used for acute or chronic recurrent urinary tract infections. 

Portosystemic encephalopathy (PSE) develops in chronic liver diseases and/or in the wake of portosystemic circulation. Liver cirrhosis with its hepatofugal collateral circulatory pathway is thus the focus of interest in this clinical form of disease. The term PSE is identical to exogenous liver coma or liver cell failure coma . PSE can be further subdivided according to its symptomatology and depending on its form and degree of severity. There are three forms of portosystemic encephalopathy (1.) subclinical (or latent) PSE, (2.) acute or acute recurrent (episodic) PSE, and (i.) chronic recurrent or chronic persistent PSE. 

Reddish-brown stool is generally encountered in chronic recurrent lower gastrointestinal bleeding, mostly below the right part of the colon. 

Fig. 35.8 Biliary liver cirrhosis after long-term chronic-recurrent cholangitis...

Fig. 35.9 Liver cirrhosis due to chronic-recurrent, ascending cholangitis...

Pachori AS, Melo LG, Zhang L, Solomon SD, Dzau VJ. Chronic recurrent myocardial ischemic injury is significantly attenuated by pre-emptive adeno-associated virus heme oxygenase-1 gene dehvery. J Am Coll Cardiol 2006 47 635-643. 

Symptoms are similar to acute sinusitis but more nonspecific Rhinorrhea is associated with acute exacerbations Chronic unproductive cough, laryngitis, and headache may occur Chronic/recurrent infections occur 3 to 4 times a year and are unresponsive to steam and decongestants... 

Horowitz BJ. Topical flucytosine flier y for chronic recurrent Candida tropicalis infections. J Reprod Med 1986 31 821-824. 

Symptoms of dizziness and syncope due to postural hypotension may result from dehydration, blood loss, and myocardial disease. However, the most important cause of chronic recurrent symptomatic postural hypotension is failure of the autonomic nervous system. The drug treatment for postural hypotension is difficult because the response varies and tolerance to drugs develops. Patients with autonomic abnormalities may suffer symptoms after eating, and this further hampers treatment. 

Melasma is a chronic recurrent acquired symmetric cutaneous hypermelanosis, representing a dysfunction of the pigmentary system. Characterized by irregular brown, grayish brown, or tan macules and patches occurring on sun-exposed skin areas, it mostly involves the forehead, malar eminences, mandibular areas, and cutaneous part of the upper lip. Melasma develops slowly, can last for many years, worsens in summer and improves in colder seasons. It may be called chloasma and mask of pregnancy but the widely accepted term for this entity is melasma. 

Fig. 5.5. a Color-coded lung perfusion as a result of three-material decomposition of air, soft tissue and iodine. Note the perfusion defect caused by the embolus in the segmental vessel. b In another patient with chronic recurrent pulmonary... 

Chronic, recurrent) pancreatitis Hepatosplenomegaly Reye or "Reye-like syndromes Recurrent severe infections (Non-immune hemolytic) anemia Myeloproliferative syndrome (Cave Routine chemical abnormalities such as hypoglycemia, metabolic acidosis, lactic acidosis, hyperammonemia or ketonuria, the usual concomitants of disorders of organic acid metabolism, can be conspicuously absent in the last two categories)... 

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