Toxic shock syndrome is a devastating and potentially lethal complication, which can occur in postoperative patients. Our experience with toxic shock syndrome after a reconstructive procedure on the hand is reported. An awareness of the clinical and laboratory manifestations of toxic shock syndrome was needed to facilitate its early recognition ...

We have presented a well-documented case of hyperkalemia in a patient known to have Wolff-Parkinson-White type preexcitation syndrome. Increased serum potassium level appears to depress or block conduction via the accessory pathway to a greater extent than in the A-V node, i.e. the accessory pathway is more sensitive to hyperkalemia ...

Reports from Europe suggest that the hemolytic-uremic syndrome is associated with an impaired ability to produce prostacyclin (prostaglandin [PG] I(2)), a potent inhibitor of platelet aggregation and thrombus formation. In comparing the production of PGI(2) by cultured endothelial cells using serum obtained from 22 children with the hemolytic-uremic syndrome with ...

In its 1982 report on toxic shock syndrome, the institute of Medicine, Washington, DC, identified population-based studies of the incidence of toxic shock syndrome over time based on hospital records as being a high priority for further research. We conducted such a study using records of hospitalizations in Northern California ...

Thirteen confirmed cases of toxic shock syndrome temporally related to use of the vaginal contraceptive sponge have been reported. The observed risk of toxic shock syndrome in sponge users may be elevated above estimated background rates, but this risk remains very low. Traumatic manipulation of the sponge, use during menstruation ...

Coagulase-negative staphylococci that produce toxic shock syndrome toxin 1 (TSST-1) or a staphylococcal enterotoxin or both were isolated from various sources. Coagulase-negative strains that produce TSST-1 alone or with enterotoxin A were the only staphylococci isolated from seven patients with toxic shock syndrome. Two other toxic shock syndrome patients had ...

Eleven patients who presented with predystonic syndrome later developed pure dystonic syndromes and later developed parkinsonism. This suggests that dystonic syndromes can be the precursor to a mixed syndrome including both dystonia and parkinsonism. While the parkinsonian features in such patients respond to either levodopa or direct-acting agonists, levodopa often ...

In order to test the diagnostic potential of phase analysis of radionuclide ventriculography (RNV) for localizing accessory bundles in Wolff-Parkinson-White (WPW) syndrome, 24 experimental runs were performed in three open chest instrumented dogs. After a baseline study, WPW syndrome was simulated by stimulation at seven different sites around the base ...

Patients with restless legs syndrome often have difficulty describing their symptoms. Three features characterize the classic syndrome: an unusual, almost indescribable sensation in the lower extremities; an irresistible urge to move the legs, and the exclusive occurrence of the symptoms at rest, with their relief by movement. Restless legs syndrome ...

Anterograde block in the accessory pathway with a short effective refractory period was observed after intravenous (IV) injection of 1 mg/kg of ajmaline in two patients with the Wolff-Parkinson-White syndrome. The possibility of a false-negative response to this test is discussed. Ajmaline is proposed as an emergency drug in the ...

Several clinical definitions of toxic shock syndrome have been proposed and used in extensive epidemiologic and clinical studies. Most of these definitions suggest (but usually do not require) that there be sufficient laboratory studies to exclude other potentially similar syndromes. Simplified definitions which broaden the spectrum of toxic shock syndrome ...

A child with 12% total body surface area superficial and partial-thickness burns was admitted to the Oregon Burn Center. Within 48 hours of admission, signs and symptoms of toxic shock syndrome (TSS) were present including high spiking fevers, vomiting, diarrhea, hypotension, conjunctival hyperemia, and a diffuse macular erythroderma. Cultures of ...

The sustained high incidence of staphylococcal toxic shock syndrome (TSS) in Utah provided an opportunity to examine changes in the epidemiology of this disease during a period of greater media attention to the syndrome and increased scientific understanding of its etiology and pathogenesis. An apparent peak in the statewide incidence ...

A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad ...

Spontaneous mutants that have pigmentation different than that of their parents were isolated from three Staphylococcus aureus strains associated with toxic shock syndrome. These mutants produced toxic shock syndrome toxin 1 in amounts varying from less than 0.05 to greater than 25 times that produced by the parents. The occurrence ...

We report the case of a patient with idiopathic aqueductal stenosis and hydrocephalus who had several episodes of akinetic mutism, each preceded by shunt malfunction, that resolved with shunt revision. She also developed a parkinson's syndrome resistant to shunt revision but responsive to antiparkinsonian medications. The parkinson's syndrome and the ...

A patient with Wolff-Parkinson-White syndrome, susceptible to tachydysrhythmias , presented for eye surgery under general anaesthesia. He developed a supraventricular tachycardia refractory to a variety of treatments. Phenylephrine consistently abolished the dysrhythmia, probably by acting directly to stimulate the arterial baroreceptors and hence vagal output. Vasopressor therapy should be considered ...

Although supraventricular tachycardia in the Wolff-Parkinson-White (WPW) syndrome is generally due to atrioventricular reentry, the presence of the accessory pathway does not preclude other mechanisms of tachycardia. We observed AV nodal reentry in three of 95 consecutive patients (3.1%) referred for assessment of arrhythmias associated with WPW syndrome. The unique ...

The surgical treatment of supraventricular tachyarrhythmias has undergone considerable evolution since its inception in 1968 with the treatment of a patient with Wolff-Parkinson-White syndrome. At present, Wolff-Parkinson-White syndrome, atrioventricular node re-entry, and ectopic atrial foci that can be localized are all amenable to surgical therapy.

Presenting features and clinical manifestations of six patients with toxic shock syndrome are reported. In four of the six cutaneous injury, sometimes trivial, occurred before the onset of symptoms and may have been a causal factor. All six children recovered. The need for early recognition and intensive management in this ...

Although toxic shock syndrome toxin-1 (TSST-1) has been proposed as the toxin responsible for toxic shock syndrome, its role in this disease has not been proved. To study this question, we examined Staphylococcus aureus strains isolated from normally sterile sites in patients with nonmenstrual toxic shock syndrome for the presence ...

Two patients with movement disorders are described and neurochemically studied. The first subject concerns a central anticholinergic syndrome in a 83 years old man treated with l-dopa and amantadine for red nucleus tremor. The second one is an association of parkinsonism and chorea in a 76 years old woman presenting ...

Fibronectin is a normal plasma glycoprotein thought to have an important role in platelet aggregation and clot formation. Because of the participation of the coagulation system in hemolytic-uremic syndrome, the present study sought to determine if fibronectin plays a role in the pathogenesis of this disease. With this purpose in ...

Abrupt onset of coma, seizures, severe shock, and hyperpyrexia occurred in two previously healthy children. Their illnesses closely resembled a clinical syndrome of uncertain cause, the hemorrhagic shock and encephalopathy syndrome. Our patients had striking similarities to as well as certain differences from reported patients. Based on the similarities, we ...

A comparison of the effects of several antiarrhythmic agents was made in a study of 70 patients - 15 with manifest Wolff-Parkinson-White (WPW) syndrome, 17 with concealed WPW syndrome, 18 with AV nodal re-entrant tachycardia, 14 with paroxysmal atrial fibrillation and 6 with paroxysmal atrial flutter - employing intracardiac stimulation ...

63% of 523 lethal cases of shock showed a DIC-syndrome. First of all the lung was affected with 69% of the cases with DIC-syndrome, followed by the pancreas with 52%. In search of disseminated intravascular coagulation, the pancreas is a very favourable organ since other acute superimposed findings normally don't ...

Staphylococci from 22 cases of toxic shock syndrome with onsets between 1981 and March 1983 have been studied. Another four cases were detected by abstract surveillance. Three of these patients died. The case histories show that the syndrome occurs in women during menstruation as well as in males and in ...

Super-absorbent tampons and an exotoxin of Staphylococcus aureus have been associated with the recent emergence of toxic shock syndrome (TSS). In the majority of cases, when a TSS strain of S. aureus was cultivated in the presence of various tampons and a contraceptive sponge, increased amounts of toxic shock syndrome ...

The association between toxic shock syndrome and the staphylococcal toxin TSST-1 is not entirely consistent. In vitro, the elaboration of the toxin occurs only under aerobic conditions, whereas the environment of the vagina is largely anaerobic. So far, moreover, the materials of which tampons are composed seem not especially to ...

From isolates of Staphylococcus aureus derived from patients suffering from toxic shock syndrome a toxin was identified by tests in monkeys and was found to be distinct from the enterotoxin responsible for staphylococcal food poisoning. When purified, this TSS toxin (TSST-1) was characterised and used to generate antibodies in rabbits. ...

Strains of Staphylococcus aureus isolated from toxic shock syndrome (TSS) produce toxic shock syndrome toxin 1 (TSST1) which causes a shock-like illness in rabbits with many features similar to TSS in humans. TSST1 is lethal per se in rabbits and also acts synergistically with endotoxin to potentiate lethality. The mode ...

Tampon usage is commonly associated with the development of transient, asymptomatic focal vaginal abnormalities such as dehydration, epithelial peeling and micro-ulceration. These abnormalities occur most commonly with superabsorbent tampons and are probably due to a fluid shift across the vaginal epithelium. Clinically apparent vaginal ulceration due to tampon usage is ...

To define the risk of having a recurrence of toxic shock syndrome, we collected information on 53 cases (42 definite and 11 probable cases) that occurred in Oregon between Jan 1, 1980, and May 30, 1982. For the 777 person-months for which follow-up information was available, only one probable recurrent ...

Three patients were recently treated for thrombotic thrombocytopenic purpura (TTP). One presented with toxic shock syndrome; TTP developed but promptly responded to a regimen of antiplatelet agents, steroids and plasma exchange. In another the manifestations of TTP developed after presentation with hypertension and abdominal pain. This patient responded to a ...

A subacute parkinsonian syndrome was seen in three patients with CT evidence of basal ganglia infarcts. The clinical picture improved spontaneously, making the diagnosis of idiopathic Parkinson's disease untenable, and other causes of parkinsonism were not detected. This extrapyramidal syndrome was therefore compatible with "vascular parkinsonism," even though it lacked ...

The Wolff-Parkinson-White syndrome can complicate the anesthetic management of the pregnant patient. These patients are prone to arrhythmia that can be accompanied by hypotension. Maintenance of a stable heart rhythm is necessary for both maternal and fetal well-being. An optimal anesthetic regimen that provides minimal cardiac and hemodynamic changes has ...

This entity represents the most common type of recurrent, regular, narrow QRS tachycardia in the absence of preexcitation syndrome. Electrophysiologic basis for the arrhythmia is reentry within the AV node resulting from dissociation between intranodal pathways. A better understanding of these intranodal pathways helps in the selection of a rational ...

The Wolff-Parkinson-White syndrome is an uncommon cardiac disorder due to the presence of an accessory atrioventricular pathway resulting in ventricular pre-excitation and supraventricular tachycardias. The recognition of the Wolff-Parkinson-White syndrome is important because of the potential for the development of extremely rapid ventricular rates during atrial fibrillation that may lead ...

We describe a case of an irregular pacemaker circus movement tachycardia in a patient with the Wolff-Parkinson-White syndrome and a normally functioning A-V universal (DDD) pacemaker (Cordis Sequicor 233 D). The mechanism of the artificial circus movement tachycardia, which uses the pacemaker as the anterograde limb and a septally located ...

A case of toxic shock syndrome in a previously-healthy man was reported. The clinical features are in accordance with the criteria of diagnosis defined by the Center for Disease Control (CDC) of USA. Phage-group-III Staphylococcus aureus, demonstrated to produce enterotoxin F, was isolated from an axillary abscess.

A pure culture of migmatoxin-producing Staphylococcus aureus was isolated from the purulent nasal packing removed from a 13-year-old premenarchal girl with toxic-shock syndrome after rhinoplasty. The similarities between this case and the tampon-associated illness are examined. An increased awareness of these similarities and the identification of predisposing factors may lead ...

Twenty-one patients with the Wolff-Parkinson-White (WPW) syndrome who underwent surgical division of the accessory conduction pathway (ACP) were studied by gated blood-pool scintigraphy. In each case, a functional image of the phase was generated, based on the fundamental frequency of the Fourier transform. The location of the ACP was confirmed ...

The classic symptoms of hypovolemic shock have probably been recognized since prehistoric times. Clear, written descriptions did not emerge until the 19th century, and the syndrome implied impending, unpreventable death until the 20th century. We now have the tools for resuscitation of the large majority of patients in shock. When ...

A case of the rare heart disease Wolf-Parkinson-White-syndrome in the dog is described. ECG-findings typical of the syndrome are shortened P-R interval, widened QRS-complex with an initial delta-wave, and supraventricular tachycardia. Pre- (Fig. 1) and post-treatment (Fig. 2) ECG's are analyzed. Different kinds of treatment are discussed.

A young woman with celiac disease presented with fever, headache, diffuse myalgia, vomiting, diarrhea and hypotension during a menstrual period in which tampons were used. The clinical picture and laboratory data were typical of toxic shock syndrome. This recently defined entity is rare outside of the United States, and has ...

A patient who developed palpitation in 1917 was later found to have the Wolff-Parkinson-White syndrome and survived to the age of 86, when he died of emphysema. Shortly before he first presented, a report of another patient had been published that can now retrospectively be recognized as containing the first ...

Over the past 3 years, toxic shock syndrome (TSS) has emerged from virtual obscurity to become a household word. The syndrome, which most commonly occurs in previously healthy women during menses, is characterized by the sudden onset of headache, malaise, high fever, myalgia, diarrhea, syncope, skin rash, and evidence of ...

A case of toxic shock syndrome (TSS) in a male continuous ambulatory peritoneal dialysis (CAPD) patient is described. The prodromal phase started with staphylococcal peritonitis and deteriorated to the malignant phase of TSS approximately 48 hours from the time he presented to the local emergency room. Desquamation first affected the ...

A 16-year-old boy had toxic shock syndrome (TSS); Staphylococcus aureus bacteremia developed 11 hours prior to his death, which was three days after onset of the illness. The isoelectric focusing pattern of the staphylococcal isolate differed from both non-TSS and classic TSS S aureus isolates. Anatomic findings suggest three pathogenetic ...

The toxic shock syndrome (TSS) is a newly-recognized entity caused by a Staphylococcal exotoxin and associated with the use of tampons for menstrual protection. Two cases are presented which demonstrate the spectrum of severity of the disease. The common nature of its early symptoms necessitates a high index of suspicion ...