According to a recent hypothesis, the restless legs syndrome is thought to be due to a caffeine-like substance produced by the human body (1). Some researchers have reported a case of familial restless legs that had high concentration of free dopamine in the cerebrospinal fluid (2). Other researchers have noticed ...

Several observations suggest that staphylococcal enterotoxins A, B and C (SEA, SEB and SEC, respectively), in addition to toxic shock syndrome toxin-1 (TSST-1), are causative exotoxins of toxic shock syndrome (TSS). Based on the view that polyclonal T cell activation with the causative exotoxins, resulting in over-production of lymphokines, is ...

Toxic shock syndrome is a rare and potentially lethal postoperative complication. The recognition of this disorder can be delayed by the fact that the offending wounds in postoperative toxic shock syndrome are classically benign in appearance. The infrequency with which this syndrome is encountered can also prolong the interval between ...

The hypothesis that toxic shock syndrome toxin 1 (TSST-1) exerts its deleterious effects in toxic shock syndrome (TSS) primarily by enhancing the lethality of small amounts of endogenous endotoxin derived from mucosal colonization with gram-negative bacteria was assessed by evaluating two means of inactivating endotoxin in rabbit models of TSS. ...

Historically, the literature suggests that staphylococcal exoproteins, including enterotoxins, are stimulated by various physicochemical ecologic factors, many of which have been shown to stimulate production of toxic shock syndrome toxin 1 (TSST-1). The propensity of different fibers and other substances to amplify TSST-1 production in toxic shock syndrome-associated strains of ...

Excess production of toxic shock syndrome toxin 1 by appropriate strains of Staphylococcus aureus occurs when the organisms are grown in an environment deficient in Mg++. Since many of the fibers previously used in tampons combine with Mg++, an explanation for the pathogenesis of menstrually related toxic shock syndrome presents ...

Toxic shock syndrome (TSS) secondary to mastitis or breast abscess is only seldom described. We report a case of definite TSS due to postpartum staphylococcal mastitis which evolved over a period of 3 weeks to a breast abscess, recurring after 2 months. Only the episode of acute mastitis was complicated ...

We detected increased concentrations of lipoperoxidation products, as malondialdehyde, in the serum of an infant with classic hemolytic-uremic syndrome. The concentrations declined when peritoneal dialysis was initiated and eventually returned to normal after clinical recovery. Our observation adds to the existing body of evidence that links the pathogenesis of hemolytic-uremic ...

Clinical observations and experimental studies have pointed to a role for leukocytes in the pathogenesis of the typical or epidemic form of the hemolytic uremic syndrome. As a result of these observations we measured serum elastase levels and the levels of two protease inhibitors, alpha-1-antitrypsin and alpha-2-macroglobulin in 12 patients ...

Three patients presented with multisystem disease that shared many of the features of toxic shock syndrome. Bacteriologic and serologic evidence strongly suggested that group A beta-hemolytic Streptococcus had caused the illnesses. Group A streptococcal infection may be an underdiagnosed cause of a toxic streptococcal syndrome, a syndrome of multisystem disease ...

Atrial fibrillation was identified as the initial arrhythmia complicating the Wolff-Parkinson-White syndrome in ten (9%) of 108 patients. Despite initially rapid ventricular responses in seven, long term survival and control of arrhythmia were excellent on medical treatment. Whereas symptom free patients with the pre-excitation syndrome who have additional underlying disease ...

A 20 year old woman with pseudohypoparathyroidism, Parkinsonism and no basal ganglia calcifications shown by computed tomography is reported. She has typical features of pseudohypoparathyroidism and biochemical evidence of end-organ resistance to parathyroid hormone. She is mentally retarded and has tremor, rigidity, bradykinesia, and stooped posture. The cause of Parkinsonism ...

A case of toxic shock syndrome (TSS) in a 6-year-old boy with a 5 per cent body surface area partial thickness scald burn is reported. Biobrane was the wound dressing used initially. The clinical and laboratory characteristics of the syndrome are listed. The syndrome is caused by an exotoxin of ...

A toxic shock syndrome isolate of Staphylococcus aureus was grown in a chemostat, in a defined synthetic medium of six amino acids, glucose, two vitamins and salts. Steady states were achieved under limiting and replete Mg2+ conditions and at a range of relative specific growth rates. The biomass and toxic ...

Toxic shock syndrome has been noted to occur with nasal surgery, both with and without packing. A new synthetic sponge, described as a nasal tampon, has become available for use as packing after surgery. Herein is reported the first case of toxic shock syndrome associated with the use of this ...

Otolaryngologists have increased their use of parenteral prophylactic antibiotics to prevent toxic shock syndrome following nasal surgery. This rare but potentially serious postoperative complication presumably requires nasal carriage of a toxigenic strain of Staphylococcus aureus by a susceptible patient. We investigated the effect of a single preoperative dose of intravenous ...

We describe a case of a 29-year-old Japanese woman with toxic shock syndrome which occurred 6 days after a normal vaginal delivery. This is the second case of postpartum toxic shock syndrome in Japan, so far as we know. Staphylococcus aureus was isolated from the uterine cavity. The isolate was ...

We report a case of nonmenstrual toxic shock syndrome. A 21-year-old man presented with severe pain in the right hand after an altercation in which he sustained a bite from a person. Physical examination revealed a small abscess on the right proximal interphalangeal joint with edema in the fourth and ...

A patient receiving the antitumor agent mitomycin C (MMC) in combination with 5-fluorouracil and adriamycin because of adenocarcinoma of Vater's papilla manifested hemolytic-uremic syndrome (HUS) after five cycles of 5-fluorouracil-adriamycin-MMC combination chemotherapy. The syndrome most likely was caused by MMC, since an association between HUS and the use of MMC ...

A commercial reversed passive latex agglutination kit (Oxoid), that detects toxic shock syndrome toxin 1 (TSST-1), was evaluated for its ability to support the clinical diagnosis of toxic shock syndrome (TSS) by detecting the presence of TSST-1 producing Staphylococcus aureus. 15/16 isolates from patients with TSS were positive, while 4/50 ...

The correlation was investigated between the frequency of attacks of vibration-induced white finger (VWF) and numbness or coldness of the fingers and legs in patients with vibration syndrome. Some 1687 patients with vibration syndrome were examined and of these 342 chain-saw operators and 277 rock-drill operators had no disease other ...

A modified ELISA for the detection of S. aureus strains producing toxic shock syndrome toxin (TSST-1) is described. Polystyrene balls are coated with specific sheep antibody and incubated with an over-night culture of suspected colonies. Biotinylated second antibody and an Avidin/biotinylated enzyme system are used to obtain an easily readable ...

First described in 1978, toxic shock syndrome (TSS) emerged as cause for public concern in 1980 as an acute multisystem disease syndrome associated with Staphylococcus aureus. Epidemiological, clinical and microbiological studies have revealed most of the pieces of the puzzle: a new toxin TSST-1, low antibodies in susceptible individuals, the ...

The rectal absorption of flecainide from an aqueous solution, a fatty suppository and a polyethyleneglycol suppository was studied in one patient with supraventricular tachycardia (Wolff-Parkinson-White syndrome) refractory for oral anti-arrhythmic treatment. Rectal absorption was found to be fast (t1/2abs = 1 h) and complete when flecainide was administered as a ...

A prospective comparison of the microbiologic safety of Merocel versus NuGauze nasal packing in 119 surgical patients is presented. Presurgical and postsurgical nasal cultures were obtained, analyzed, and compared. The importance of a preoperative nasal culture isolate of Toxic Shock Syndrome Toxin Number 1 (TSST-1) producing Staphylococcus aureus in predicting ...

Disorders of conduction occurring simultaneously in both normal and accessory pathways of patients with Wolff-Parkinson-White (WPW) syndrome have only rarely been observed. To our knowledge this is the first report of impaired conduction in both pathways in WPW syndrome due to mitral annulus calcification (MAC). This case of WPW syndrome ...

A 12-year-old girl presented with recurrent episodes of supraventricular tachycardia. A 12 lead electrocardiogram showed normal sinus rhythm with a normal PR interval and no evidence of preexcitation. A 24 h Holter monitor showed intermittent preexcitation. Both phase 3 and phase 4 block in the accessory pathway were demonstrated with ...

When used with insight, the 12-lead electrocardiogram can provide a considerable amount of useful data in patients with the Wolff-Parkinson-White syndrome. The 12-lead electrocardiogram during tachycardia usually provides excellent clues as to the mechanism of tachycardia, with the most valuable feature being the relationship of the P wave to the ...

During a 12-month period, 14 patients with the hemolytic uremic syndrome were identified in a prospective study of enteric pathogens associated with this disorder. Of the 12 patients with a diarrheal illness preceding the onset of hemolytic uremic syndrome, fecal Escherichia coli O157:H7 was detected in seven (58%), all of ...

Toxic shock syndrome is a rapidly developing disease which may be lethal if not recognized and treated early. While this disease is usually associated with menstruating females, it is being seen in both male and female patients following clean, elective surgery. Toxic shock syndrome has been reported following surgical procedures ...

Two cases of toxic shock syndrome following chemical face peel are reported. Toxic shock syndrome is a severe toxin-mediated multisystem disease. The major signs are fever, rash, desquamation, and hypotension. It can occur in males as well as females and is not necessarily related to menstruation. The surgical wound does ...

The case history is documented of a young competitive athlete known to have the electrocardiographic pattern of the Wolff-Parkinson-White syndrome, but considered asymptomatic. On that basis competitive sport was not proscribed. In retrospect, he had experienced occasional tachycardias which were of short duration and ended spontaneously. He never requested medical ...

Paroxysmal nocturnal hemoglobinuria (PNH) may present with acute anemia, thrombocytopenia and, if hemoglobin nephropathy or dehydration is present, azotemia. Thus PNH may be confused with the hemolytic uremic syndrome (HUS). Recurrent episodes, though common in PNH, are unusual in HUS. A positive acid hemolysis test can be used to differentiate ...

Accessory pathway location in the Wolff-Parkinson-White syndrome influences the success and morbidity of nonpharmacological therapies, so that an estimate of accessory pathway location is relevant to the practicing physician. We derived an algorithm for accessory pathway localization based on the surface electrocardiogram; we tested it in a population of 141 ...

The bypass tracts of the WFW syndrome may be situated anywhere along the AV ring. Accurate localization of such tracts has in the past been largely effected by electrophysiologic studies, particularly epicardial mapping. During recent years, however, criteria for localization of the bypass tracts from the conventional 12-lead ECG have ...

We report a case of toxic shock syndrome occurring after an excisional skin biopsy in an otherwise healthy woman. Her clean-appearing wound grew Staphylococcus aureus and was implicated as the source of toxin. Dermatologists should be aware that toxic shock syndrome may occur as a complication of simple dermatologic surgery.

We present the case of a 4.5-week-old boy with acute encephalopathy, shock, intestinal bleeding and disseminated intravascular coagulation. The clinical course and typical laboratory parameters were compatible with a diagnosis of haemorrhagic shock-encephalopathy syndrome (HSE). Immediate shock treatment, repeated haemodialysis and plasmapheresis did not prevent a fatal outcome 4 days ...

We have previously found transient menstruation-associated abnormalities in the in vitro bactericidal function of neutrophils from females who have recovered from toxic shock syndrome (TSS). We now report the case of a young woman who has also recovered from TSS, but who has a persistent, non-menstruation-associated defect in the ability ...

Toxic shock syndrome was first described in children in 1978. Two years later the strong connection between this disease and the colonization of vaginal tampons with certain strains of Staphylococcus aureus was noted. Even from the earliest descriptions, however, it has been clear that the same clinical picture may be ...

Sepsis and septic shock remain all too frequent syndromes in modern medicine with unacceptably high mortality rates. Physicians must be aware of the many ways in which sepsis and septic shock may present and the multiple differential diagnoses. Early recognition and prompt institution of empiric therapy are of utmost importance. ...

Coagulase-positive staphylococci have been isolated from more than 95% of cases of toxic shock syndrome (TSS). Toxic shock syndrome toxin-1 (TSST-1) is produced in more than 90% of cases. A case is described of recurrent TSS in which a coagulase-negative staphylococcus was isolated from the vagina and produced TSST-1. No ...

In five unrelated patients with the restless legs syndrome, opioid drugs relieved restlessness, dysesthesias, dyskinesias while awake, periodic movements of sleep, and sleep disturbances. When naloxone was given parenterally to two treated patients, the signs and symptoms of the restless legs syndrome reappeared. Naloxone placebo had no effect. Opioid medications ...

An 8-year-old boy with bacterial tracheitis, treated by endotracheal intubation, humidification, airway toilet and antibiotics, experienced a toxic shock syndrome on the day after his admission. The course was favourable. Staphylococcus aureus was isolated from tracheal secretions. Bacterial tracheitis is an infrequent cause of non-menstrual toxic shock syndrome. The diagnosis ...

Having been confronted with a post-operative toxic shock syndrome, we made a study of European literature and were struck by the more favorable course the disease promptly took when penicillinase-resistant antibiotics were used. We suggest that a new case, based on bacteriological analysis and phagotyping of the offending organism and ...

Two patients are reported with Ekbom's syndrome of "restless legs" occurring in association with arborizing telangiectasia of the lower limbs. Sensory complaints have previously been reported in this skin condition but not described in detail. The co-existence of the two conditions is discussed in the context of previous explanations of ...

21 patients with Wolff-Parkinson-White (WPW) syndrome were investigated through radionuclide imaging and body surface mapping. Ventricular preexcitation was localized by display of identical phase ventricular regions (phase display). In 79% of the cases radioisotope and body surface mapping methods have identical results for the site of preexcitation. In two patients ...

Toxic Shock Syndrome (TSS) is an acute multisystem disease that has been recognized to occur in a variety of clinical settings. Postoperative TSS has been described following nasal surgery associated with the use of postoperative nasal packing. We report a case of classic TSS following septoplasty where intranasal splints without ...

The importance of considering organic diseases when evaluating catatonic patients is illustrated by two cases of akinetic parkinsonism in which the patients became catatonic, with waxy flexibility. The catatonic syndrome occurs in association with a variety of lesions that may affect any level of the central nervous system from the ...

Wolff-Parkinson-White syndrome often mimics myocardial infarction. Q-wave-T-wave discordance (upright T waves in the inferior leads with inferior Q waves) is normally found in Wolff-Parkinson-White syndrome as a result of secondary repolarization changes. We evaluated Q-wave-T-wave concordance as a result of an inferoposterior infarction and documented it with electrocardiographic, enzyme, and ...

To elucidate further the etiology of toxic shock syndrome, we assessed the effects of certain contraceptive methods and recent history of vaginal infection on the incidence of toxic shock syndrome, with confounding effects of other risk factors controlled. We found a strong but imprecise positive association between toxic shock syndrome ...