Prodromal period

Finally, remember that the immune system is unusually sensitive to the effects of radiation exposure. Patients who have received enough radiation to cause burns or radiation sickness may suffer from suppression of their immune systems and may require medical follow-up and antibiotic support. Because there is sometimes an asymptomatic period following the prodromal period, it may be prudent to keep patients under observation for several days after treatment. 

The onset of the autoimmune disease Type-I diabetes has a protracted prodromal period. Overt symptoms such as hyperglycaemia occur only months and years after initial metabolic and immunological abnormalities such as impaired glucose tolerance, ICA and IAA are noted. 

Both medical iflnesses and medications can cause psychiatric symptoms. The rapidity of onset of psychiatric symptoms is an important clue that a medical cause may be present. Most chronic mental illnesses have a prodromal period, whereas medically based psychiatric symptoms often have a more rapid onset of symptoms. Patients over age 40 at first presentation are more likely to have a medical cause for their psychiatric symptoms because major psychiatric illnesses such as schizophrenia and bipolar disorder usually first present in adolescence or early adulthood. A family history of physical illnesses with a psychiatric component, such as Huntington s chorea or systemic lupus erythematosus, may provide an additional clue. 

Syndromic surveillance focuses on the early symptom (prodrome) period before clinical or laboratory confirmation of a particular disease and uses both clinical and alternative data sources. Strictly defined, syndromic surveillance gathers information about patients symptoms (e g., cough, fever, shortness of breath). 

PRODROMAL PERIOD A brief, symptomatic period that may immediately follow exposure to radiation. It is characterized by nausea, vomiting, and diarrhea, and lasts up to about 36 hours, depending upon dose received. 

Mesenteric venous thrombosis is rarely registered in women using oral contraceptives. A total of 14 cases have been reviewed by Milne and Thomas (91 ). They note that a long prodromal period is often present ranging from iVi days to 2 weeks in length. The condition has a high mortality 6 of the 14 patients died. 

Circulating islet cell and p-cell specific autoantibodies are characteristic of prodromal periods of insulin-dependent diabetes mellitus. Conventional quantitation of these is often prone to errors because specific and unspecific fluorescence signals are difficult to separate. The situation can be dramatically improved if the Eu chelate [Eu(NTA-terpy)] conjugated to anti-human polyclonal IgG is used as the secondary antibody in a test of 57 patients, 96.5% were detected as being positive for islet cell autoantibodies compared to only 89.5% with the conventional test [105]. 

C. Duration Continuous signs of disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet criterion A (i.e., active-phase symptoms), and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of disturbance may be manifested by only negative symptoms, or by two or more symptoms listed in category A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). 

Anthrax. A nonspecific prodrome (i.e., fever, dyspnea, cough, and chest discomfort) follows inhalation of infectious spores. Approximately 2-4 days after initial symptoms, sometimes after a brief period of improvement, respiratory failure and hemodynamic collapse ensue. Inhalational anthrax also might include thoracic edema and a widened mediastinum on chest radiograph. Gram-positive bacilli can grow on blood culture, usually 2-3 days after onset of illness. Cutaneous anthrax follows deposition of the organism onto the skin, occurring particularly on exposed areas of the hands, arms, or face. An area of local... 

Herpes lahialis (cold sores) Topical Penciclovir should be applied every 2 hours during waking hours for a period of 4 days. Treatment should be started as early as possible (i. e., during the prodrome or when lesions appear). 

The symptoms of major depression typically evolve over a period of days to weeks. Prodromal depressive and nondepressive symptoms (e.g., generalized anxiety, panic attacks, phobias), however, may be present for months to years before the onset of a full depressive syndrome. An episode may also develop in association with severe psychosocial stress (e.g., bereavement). Although some individuals have only a single episode with full return to premorbid functioning, 50% to 85% have recurrences (1). 

With regard to the time period involved in the course of a liver disease, distinction has to be made between two further groups, excluding the prodromal stage and the healing process (s. tab. 4.1) (s. p. 75) ... 

In approx. 90% of all patients, acute viral hepatitis A is subclinical, i.e. it frequently goes undetected. The end of the prodromal and the beginning of the clinical phase is indicated by a brown colouration of the urine. Urobili-nogenuria persists for a longer period of time than bili-rubinuria. Mild proteinuria and microhaematuria can develop. Stools are usually acholic. With the occurrence of jaundice (60-70% children, 80-90% adults), most of the subjective symptoms of the prodromal stage subside. 

The eruption rapidly occurs over a period of 12 to 24 hours. In about half the cases there are prodromal symptoms of an upper respiratory infection accompanied by fever, malaise, and varying degrees of muscular and joint pains. 

Acute smallpox symptoms resemble those of other acute viral infections such as influenza. After an incubation period of 12-14 days (range 7-17 days), smallpox begins with a 2-4 day nonspecific prodrome of fever, myalgias, headache, and backache. Severe abdominal pain, nausea, vomiting, prostration, and delirium may be present. Patients are not infectious until the end of the prodrome (25), when a maculopapular rash begins on the oral and pharyngeal mucosa, face and forearms, and spreads to the trunk and legs. 

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