Long-term changes in clinical signs and symptoms and disc position and morphology in patients with nonreducing disc displacement in the temporomandibular joint

Hypoglycemia is one of the most common clinical care issues facing the neonatal practitioner. Increasing evidence indicates that neonatal hypoglycemia may have long-term neurologic effects. Care is complicated by the lack of a clearly defined threshold for hypoglycemia in term and preterm infants, however, and by highly variable clinical signs and symptoms. Furthermore, many infants with low blood glucose measurements do not exhibit obvious signs of impairment. The complexity of neonatal glucose metabolism is illustrated by the variety of conditions producing or associated with both neonatal hypo- and hyperglycemia. Maintenance of euglycemia is especially challenging in the sick or low birth weight neonate. This article defines euglycemia by its range and reviews the differential diagnoses and etiology of hypoglycemia—as well as the principles of its management—in the neonatal period.

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Amyloid in the Lung

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-0040-1708059 ◽

2020 ◽

Vol 41 (02) ◽

pp. 299-310

Author(s):

Misbah Baqir ◽

Anja C. Roden ◽

Teng Moua

Keyword(s):

Clinical Signs ◽

Signs And Symptoms ◽

Amyloid Protein ◽

Pulmonary Manifestations ◽

Precursor Proteins ◽

Multisystemic Disease ◽

Clinical Signs And Symptoms ◽

Long Term Prognosis ◽

Secondary Diseases

AbstractAmyloidosis is the term given to abnormal deposition of misfolded precursor proteins at single or multiple sites, leading to organ dysfunction or clinical signs and symptoms. Pulmonary manifestations are nonspecific and may be associated with several amyloid protein subtypes, commonly AL (light chain) and AA (autoimmune) amyloids. Signs or symptoms of amyloid disease may often involve more of the clinical abnormalities of other affected organs than the lungs themselves. Radiologic pulmonary findings include septal and parenchymal ground glass or nodular infiltrates, multiple nodules, cysts, and focal tracheobronchial abnormalities. Lymphadenopathy with or without calcification and pleural effusions has also been reported. Directed therapy is initiated in response to clinical signs or symptoms often as a result of systemic or secondary diseases or conditions. Long-term prognosis is more dependent on the extent of organ involvement where morbidity is often the highest in those with multisystemic disease.

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MON-327 Soluble Alpha Klotho and IGF-I Before Surgery as Prognostic Factors to Acromegaly Long-term Remission

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.420 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Junia Ribeiro de Oliveira Longo Schweizer ◽

Katharina Schilbach ◽

Michael Haenelt ◽

Xiao Wang ◽

Mariana Ferreira Bizzi ◽

...

Keyword(s):

Medical Treatment ◽

Surgical Outcome ◽

Clinical Signs ◽

Signs And Symptoms ◽

Somatostatin Analogues ◽

Total N ◽

Igf I ◽

Treatment Naïve ◽

Clinical Signs And Symptoms

Abstract BACKGROUND: Transsphenoidal surgery is the cornerstone of acromegaly treatment. However, cure is obtained in only ~50% of the cases. Until today, no biochemical marker has been identified to preoperatively predict surgical outcome and long-term remission. Recently, soluble alpha klotho (αKL) was proposed as new biomarker for diagnosis and follow-up of acromegaly. Therefore, we aimed to evaluate the potential of pre-surgery αKL concentrations as a prognostic factor to predict remission by surgery alone. Methods: We measured αKL concentrations (IBL-ELISA) and classical biomarkers (IGF-I and GHrandom, both by IDS-iSYS, GHnadir measured by IDS-iSYS (n=13) or DiaSorin-Liaison® (n=7)) in samples from a prospective study in treatment-naïve patients with acromegaly (total n=25). Patients were then followed for at least 6 months after surgery (median (range) 30.1 (6–142) months). Outcome was evaluated and classified as non-remission (NR: IGF-I>1.2xULN (n=2) or continued need for medical treatment with somatostatin analogues (n=10)) or remission (R: improvement on clinical signs and symptoms and IGF-I<1.2xULN without medical treatment, n=13). Results: Before surgery, all patients had elevated IGF-I (>1.2xULN), GHnadir (>0.4 ng/mL) and GHrandom (>1.0 ng/mL). As expected, αKL (pg/mL) was also high (>1.2xULN) in 92% patients. Before surgery, αKL was significantly higher in NR compared to R [6648 (4408–13951) vs. 3389 (2132–6837); p<0.05), as was IGF-I (ng/mL) [NR: 879.7 (771.8–961.5) vs. R: 640.2 (448.6–862.6); p<0.05). There was no difference in GHnadir and GHrandom (ng/mL) [10.42 (6.35–16.40) vs. 5.19 (1.19–10.70) and 12.39 (8.24–24.87) vs. 8.94 (4.24–15.55); p>0.05 for both comparisons). ROC analysis indicated that concentrations of αKL>4470pg/mL (~3.5xULN) (75% specificity, 62% sensitivity, AUC=0.72) and IGF-I>3.8xULN (67% specificity, 85% sensitivity, AUC=0.79) indicate lack of long-term remission. Conclusion: High αKL (>4470pg/mL, ~3.5xULN) and IGF-I (>3.8xULN) concentrations before surgery are significantly associated with persistent disease activity after surgery. However, both biomarkers alone or in combination have insufficient specificity (though acceptable sensitivity) as predictors of surgical outcome.

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Does Recurrence of Carpal Tunnel Syndrome (CTS) after Complete Division of the Transverse Ligament Really Exist?

Journal of Clinical Medicine ◽

10.3390/jcm10184208 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4208

Author(s):

Fatma Kilinc ◽

Bedjan Behmanesh ◽

Volker Seifert ◽

Gerhard Marquardt

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Surgical Intervention ◽

Clinical Signs ◽

Signs And Symptoms ◽

Long Term Results ◽

Transverse Ligament ◽

Tunnel Syndrome ◽

Clinical Signs And Symptoms

The aim of this study was to evaluate whether recurrent carpal tunnel syndrome (CTS) after complete and sufficient division of the transverse ligament really exists. Another goal was to analyze the underlying reasons for recurrent CTS operated on in our department. Over an observation period of eleven years, 156 patients underwent surgical intervention due to CTS. The records of each patient were analyzed with respect to baseline data (age, gender, affected hand), as were clinical signs and symptoms pre- and postoperatively. To assess long-term results, standardized telephone interviews were performed using a structured questionnaire in which the patients were questioned about persisting symptoms, if any. Of the 156 patients, 128 underwent first surgical intervention due to CTS in our department. In long-term follow-up, two-thirds of these patients had no symptoms at all; one-third of the patients described mild persisting numbness. None of the patients experienced a recurrence of CTS. The 28 patients who received their first operation outside of our department were operated on for recurrent CTS. The cause of recurrence was incomplete division of the distal part of the transverse carpal ligament in all cases. The results suggest that recurrent CTS after complete and sufficient division of the transverse ligament is very unlikely.

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Temporomandibular Joint Monoarthritis in Rheumatoid Arthritis - A Rare Case Report

Bangladesh Medical Journal ◽

10.3329/bmj.v48i3.51797 ◽

2021 ◽

Vol 48 (3) ◽

pp. 43-45

Author(s):

Md Abu Shahin ◽

Sudhir Karmacharya ◽

Md Ariful Islam ◽

Mamun Khan ◽

Abdulla Al Morshed ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Temporomandibular Joint ◽

High Titer ◽

Clinical Signs ◽

Joint Stiffness ◽

Signs And Symptoms ◽

Joint Inflammation ◽

Joint Involvement ◽

Inflammatory Disorder ◽

Clinical Signs And Symptoms

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the rheumatologist. TMJ complaints are present in about more than 50% of patients of RA. TMJ is usually among the last joint to be involved and is associated with many clinical signs and symptoms of which pain is a major problem leading to inflammation, limited movements, swelling, joint stiffness, and muscle spasm. Here reported case is 64 years old male, ex-smoker, diagnosed case of diabetes mellitus for 7 years, hypertension for 2 years, came to hospital with the complains of pain in left jaw for 1 year. He had no history of other joint pain, morning stiffness or any deformities. The patient was diagnosed as a case of rheumatoid arthritis on the basis of inflammatory monoarthritis with high titer positive RA factor and anti CCP. The patient gradually improved after treatment with methotrexate. Inflammatory markers like ESR dropped down with the clinical improvement. TMJ is seldom joint to be affected first in the disease course. Bangladesh Med J. 2019 Sep; 48 (3): 43-45

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CHILDHOOD HYPERTHYROIDISM

Acta Endocrinologica ◽

10.1530/acta.0.0510321 ◽

1966 ◽

Vol 51 (3) ◽

pp. 321-336 ◽

Cited By ~ 9

Author(s):

J. Mäenpää ◽

H. Hiekkala ◽

B.-A. Lamberg

Keyword(s):

Surgical Approach ◽

Thyroid Nodules ◽

Radioactive Iodine ◽

Clinical Signs ◽

Signs And Symptoms ◽

Nodular Goitre ◽

Close Observation ◽

Conservative Attitude ◽

Clinical Signs And Symptoms

ABSTRACT Thirty-nine patients with childhood hyperthyroidism were treated during the period 1950-1964, most of them after 1955. The youngest patient was 3 years old. Thyroid nodules occurred in 55 per cent of the cases. In 25 patients long-term anti-thyroid treatment was instituted. This therapy was considered as successful in 7 instances (29 per cent). Four patients (17 per cent) are still under treatment, while in 13 (54 per cent) operation was later regarded as advisable owing to unsuccessful anti-thyroid treatment. The failure of thyrostatic therapy may have had some connection with the presence or appearance of thyroid nodules. In eight instances operation was carried out, primarily owing to compressive and/or nodular goitre. The results of operation (21 cases in all) are that 10 patients are euthyroid (48%) and 4 hypothyroid (19%) whilst 7 had a relapse or persistence of the disease (33%) of whom 5 are still under treatment and two have subsequently been rendered euthyroid by reoperation in one case and radioactive iodine (at the age of 19) in another case. There also seems to be a small group of patients (6 cases in this series) in whom, in spite of evident »biochemical disease« although with slight clinical signs and symptoms, the condition seems to resolve spontaneously and nothing but close observation appears to be needed. A primarily conservative attitude seems advisable. The presence of nodules in the thyroid initially, however, seems to indicate that a surgical approach will be required later on.

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Use of the Fonseca's questionnaire to assess the prevalence and severity of temporomandibular disorders in brazilian dental undergraduates

Brazilian Dental Journal ◽

10.1590/s0103-64402007000200015 ◽

2007 ◽

Vol 18 (2) ◽

pp. 163-167 ◽

Cited By ~ 51

Author(s):

Kariny Nomura ◽

Mathias Vitti ◽

Anamaria Siriani de Oliveira ◽

Thaís Cristina Chaves ◽

Marisa Semprini ◽

...

Keyword(s):

Early Diagnosis ◽

Neck Pain ◽

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Clinical Signs ◽

Signs And Symptoms ◽

Public University ◽

Men Students ◽

Young Population ◽

Clinical Signs And Symptoms

This study to assessed the prevalence of signs and symptoms of temporomandibular disorders (TMD) by means of the frequency distribution of data for 218 dentistry students from a Brazilian public university using the Fonseca's questionnaire. The group consisted of 96 men and 122 women, with an average age of 20 years. Of the students, 53.21% showed some level of TMD: 35.78% mild TMD 11.93% moderate and 5.5% severe. Women were the most affected group, with 63.11% showing some level of TMD, against 40.62% of men. When considering only severe TMD, women are approximately 9 times more affected than men. Students with any level of TMD showed marked characteristics: 76.72% considered themselves tense people; 71.55% reported to clench or grind their teeth; 65.52% reported clicking of the temporomandibular joint; 64.66% reported frequent headache and 61.21% neck pain. In conclusion, clinical signs and symptoms of TMD can occur in young population and this information is of great importance for the early diagnosis of the dysfunction.

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