Secondary syndrome

This book mainly considers individual syndromes, such as the syndrome of Spleen-Qi deficiency, and it discusses the composition of individualized formulas, such as a formula to tonify the Spleen-Qi. In practice, a syndrome can be much more complicated. The sections on Common accompanying symptoms and treatment offer more possibilities for herb selection in complicated situations. To treat a syndrome with different kinds of secondary syndromes, such as Spleen-Qi deficiency with dampness accumulation or food accumulation, a practitioner should consult different chapters to compose an effective formula. 

A secondary syndrome develops from the principal syndrome and manifests in a series of secondary symptoms. When the principal syndrome is treated, the secondary syndrome may disappear as well. For example, in an exterior wind-cold syndrome, since the superficial region is obstructed, the Lung-Qi is unable to disperse so the nose may be blocked and there may be shortness of breath. As soon as the wind-cold is expelled from the superficial region of the body, the Lung-Qi obstruction disappears and the secondary symptoms disappear too. 

A secondary syndrome might be a coexisting syndrome that is less important at the time of treatment. For example, in an acute condition of Liver-Yang ascending and generating Liver-wind, the patient may also have a syndrome of Spleen-Qi deficiency but this is less important for treatment in this acute condition. 

Deputy Regulate the Qi and blood, enhance the strength of the chief herbs to expel wind-cold treat the secondary syndrome and coexisting syndromes... 

These herbs can regulate the Qi, which is disturbed by the quick ascending of Liver-Yang and Liver-wind. As soon as the Qi descends or moves smoothly, Liver-wind is extinguished. For this reason, these herbs are often selected as deputies to treat the secondary syndrome. 

Sang Ye and Ju Hua are sweet, bitter and cold Bo He is pungent and cold. They all enter the Lung and Liver meridians and have light dispersing and descending abilities. As assistants in formulas, they disperse constrained Liver-Qi and clear Liver-heat to treat secondary syndromes. They are particularly effective for treating dry eyes, blurred vision and headache. 

Cruveilhier-Baumgarten syndrome This is a secondary syndrome observed in liver cirrhosis with pronounced... 

HDL deficiency may, in many cases, be a secondary syndrome, i.e. linked to hypertriglyceridemia, nicotine abuse, physical inactivity, etc. The primary deficiencies are also numerous Tangier disease, fish-eye disease, A-I-C-III deficiencies (variants I and II), some of the mutants, and HDL processing defects. 

Vital C, Tavoni A, Viegi G, et al. Lung involvement in Sjogren s syndrome a comparison between patients with primary and with secondary syndrome. Ann Rheum Dis 1985 44 455 61. 

Turner s Syndrome. Turner s syndrome is a genetic disorder of females characterized by short stature, nonfunctioning ovaries, and failure to develop secondary sexual characteristics. Several clinical trials in the United States, Europe, and Japan have demonstrated that hGH can accelerate... 

Secondary immunodeficiencies (9) are much more common than primary ones and frequently occur as a result of immaturity of the immune system in premature infants, immunosuppressive therapy, or surgery and trauma. Illnesses, particularly when prolonged and serious, have been associated with secondary immunodeficiencies, some of which may be reversible. Acquked immune deficiency syndrome (AIDS) (10—12) may be considered a secondary immunodeficiency disease caused by the human immunodeficiency vimses HIV-1 or HIV-2. Hitherto unknown, the disease began to spread in the United States during the latter part of the 1970s. The agent responsible for this infection has been isolated and identified as a retrovims. 

Hyperaldosteronism is a syndrome caused by excessive secretion of aldosterone. It is characterized by renal loss of potassium. Sodium reabsorption in the kidney is increased and accompanied by an increase in extracellular fluid. Clinically, an increased blood pressure (hypertension) is observed. Primary hyperaldosteronism is caused by aldosterone-producing, benign adrenal tumors (Conn s syndrome). Secondary hyperaldosteronism is caused by activation of the renin-angiotensin-aldosterone system. Various dtugs, in particular diuretics, cause or exaggerate secondary peadosteronism. 

Nociceptive neurons in the spinal cord as well as in higher centres such as the thalamus and cortex can also undergo alterations in activity following chronic peripheral changes and trauma (Table 1). These changes are typically long-term in nature and lead to the clinical syndromes of centrally maintained pain (secondary hyperalgesia, allodynia, spontaneous pain). Alterations... 

Signs and symptoms of sympathetic nervous system activity are invariably found in MH. Levels of catecholamines are markedly increased in MH. Whether activation of the sympathetic nervous system is a primary or a secondary response in the syndrome has not been fully elucidated. Gronert reported that stress-induced sympathetic hyperactivity can initiate a malignant hyperthermic episode in susceptible swine without a triggering agent. Stress-induced MH in humans has been inferred because susceptible families have been shown to have an increased incidence of sudden death. Gronert s reasons that activation of the sympathetic... 

Inherited defects in lipoprotein metabofism lead to the primary condition of either hypo- or hyperlipoproteinemia (Table 26-1). In addition, diseases such as diabetes mellitus, hypothyroidism, kidney disease (nephrotic syndrome), and atherosclerosis are associated with secondary abnormal hpoprotein patterns that are very similar to one or another of the primary inherited conditions. Virtually all of the primary conditions are due to a defect at a stage in hpoprotein formation, transport, or destruction (see Figures 25—, 26-5, and 26-6). Not all of the abnormafities are harmful. 

Consider large-volume paracentesis if evidence of abdominal compartment syndrome is secondary to tense ascites... 

Acute coronary syndromes is a term that includes all clinical syndromes compatible with acute myocardial ischemia resulting from an imbalance between myocardial oxygen demand and supply.3 In contrast to stable angina, an ACS results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus. Acute coronary syndromes are classified according to electrocardiogram (ECG) changes into STE ACS (STE MI) or NSTE ACS (NSTE MI and unstable angina) (Fig. 5-1). An STE MI, formerly... 

The most significant mechanism for primary dysmenorrhea is the release of prostaglandins in the menstrual fluid and possibly vasopressin-mediated vasoconstriction.5,17 Causes of secondary dysmenorrhea may include cervical stenosis, endometriosis, pelvic infections, pelvic congestion syndrome, uterine or cervical polyps, and uterine fibroids.20... 

Stenchever MA, Droegemueller W, Herbst AL, Mishell DR. Primary and secondary dysmenorrhea and premenstrual syndrome Etiology, diagnosis, and management. In Stenchever MA, ed. Comprehensive Gynecolgy. 4th ed. St. Louis Mosby 2001 1065-1078. 

Short-gut syndrome (e.g., intestinal artresia, necrotizing enterocolitis, intestinal volvulus, massive resection secondary to inflammatory bowel disease, tumors, mesenteric thrombosis)... 

Risk factors for the development of AML include exposure to environmental toxins, Hispanic ethnicity, and genetics.6 Of greater concern is the increased prevalence of AML as a secondary malignancy, resulting from chemotherapy and radiation treatment for other cancers. Alkylating agents, such as ifosfamide and cyclophosphamide, and topoisomerase inhibitors, such as etoposide, are linked to an increased risk of myelodysplastic syndrome (MDS) and AML.8... 

For patients with myelodysplastic syndrome or AML as a secondary neoplasm, there are a number of key features characteristic of the leukemia. Alkylator-related secondary leukemias after Hodgkin s disease usually have a myelodysplastic prodrome and a monosomy 5 or monosomy 7. Secondary ANLL with the use of epipodophyllotoxin (etoposide) demonstrates mainly M4 or M5 morphology and exhibits translocations within the MLL gene with 1 lq23 chromosomal alterations.8... 

In older adults, AML is either more likely to arise from a proximal bone marrow stem cell disorder, such as myelodys-plastic syndrome (MDS), or present as a secondary leukemia resulting from treatment with prior chemotherapy or radiation for an earlier malignancy. These forms of AML are notoriously less responsive to chemotherapy and thus have a lower CR rate and EFS.20... 

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