Malignant clinical symptoms

There seems to be tremendous buffer and networked self-control against overshooting and attenuated immune response. Only extreme alterations appear to result in clinical symptoms as the majority of immune cells are never challenged by supposed threats, i.e., pathogens or correctly or not identified constituents of the body as malignant. We lack thresholds of adversity for immu-nomodulation, where they do not represent an increased incidence of disease when the immune response is inadequate. This would be a prerequisite for establishing any screening for immunotoxic instead of immunomodulatory properties. 

Ovarian vein thrombosis typically presents a complication in the postpartum period and is encountered most frequently after caesarean section. It is caused by venous stasis and hypercoagulability. The incidence of puerperal vein thrombosis (POVT) is approximately 1 in 2,000 deliveries [33]. Other conditions such as infection, recent surgery, malignancy, and Crohn disease increase the risk for ovarian vein thrombosis [34]. Although a rare entity, ovarian vein thrombosis presents a differential diagnostic problem because of the unspecific clinical symptoms, including fever, and the potential of fatal complications due to uterine necrosis... 

Nevertheless, chronic diarrhoea is a frequent symptom of patients with a carcinoid, a benign or malignant tumour derived from enterochromaflBn cells and producing vast amounts of S-HT. Recently, several polypeptides such as bradykinin have also been implicated as other factors responsible for the clinical symptoms of the carcinoid syndrome (Sandler in ref. 6). 

Once neuroleptic malignant syndrome (NMS) develops, signs and symptoms may escalate over 24—72 h and may have a prolonged clinical course... 

Neuroleptic malignant syndrome (NMS) A potentially fatal symptom complex sometimes referred to as NMS has been reported in association with promethazine alone or in combination with antipsychotic drugs. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability (eg, irregular pulse or blood pressure, tachycardia, diaphoresis, cardiac dysrhythmias). 

Intrathecal - Early symptoms of baclofen withdrawal may include return of baseline spasticity, pruritus, hypotension, and paresthesias. Some clinical characteristics of the advanced intrathecal baclofen withdrawal syndrome may resemble autonomic dysreflexia, infection (sepsis), malignant hyperthermia, neuroleptic-malignant syndrome, or other conditions associated with a hypermetabolic state or widespread rhabdomyolysis. 

The primary indication for ECT in adolescents is the short-term treatment of mood symptoms, depressive or manic (Walter et al., 1999). Mood symptoms in the course of major depression, psychotic depression, bipolar disorder, organic mood disorders, schizophrenia, and schizoaffective disorder respond well to ECT. Psychotic symptoms in mood disorders also respond well to ECT whereas the effectiveness of ECT in the treatment of psychotic symptoms in schizophrenia is doubtful. There are suggestions that other uncommon clinical conditions in adolescents such as catatonia and neuroleptic malignant syndrome also benefit from ECT. The effectiveness of ECT seems to lessen when there is a comorbid personality disorder or drug and/or alcohol problems. There are very few data about usefulness on prepubertal children. 

This classification allows for seronegative patients to be classified as having PNS (no. 1). In addition, the set of definitions takes into consideration that new antibody specificities are still being characterized (no. 3). Different clinical subtypes are still being described in association with well-known antibodies, and such cases are also included. Finally, a negative screening for malignancy does not exclude PNS, as spontaneous remission is known to occur. As cancer is ultimately detected in the majority of patients with symptoms and a well-characterized antibody, the number of false positives is probably low (no. 4). 

In conclusion, induced, moderate hypothermia can decrease ICP, reduce mortality, and may improve outcome in patients with severe MCA infarction with malignant postischemic brain edema. Important side effects are reduction of platelet count, increased rate of pneumonia, and elevation of serum amylase and lipase levels. The results of our own pilot trial suggest a beneficial effect of moderate hypothermia in the treatment of severe space-occupying MCA infarction. However, our data call for a randomized trial of hypothermia in the therapy of malignant MCA infarction. Whether early hypothermic therapy within the first 6 h after onset of symptoms can reduce infarct size has to be clarified in further clinical trials. 

The rationale for the need of recovery animals was frequently discussed. For drag substances which require chronic (live time) treatment (e.g. oral anti-diabetics, drags for treatment of hypertension, anti-Parkinson drugs, etc.) the question of recovery is less important than in the case of anti-infectives with, in most cases, short treatment periods where mild symptoms of intolerance, e.g. diarrhoea, are observed. However, inclusion of recovery animals is recommended in general because at the stage of development where first clinical studies are conducted, the whole set of indications is not finally known and line extensions can happen. One example is the use of quinolones and other anti-infectives for the treatment of cystic fibrosis. Another example is drugs used for chemotherapy of malignant diseases where recovery has to be studies anyway. 

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