scholarly journals Comparison of Clinical Symptoms of Assumed vs. Actual Uterine Fibroids – Symptoms Described by Patients and Ultrasound Findings

2019 ◽  
Vol 80 (03) ◽  
pp. 316-323
Author(s):  
Nina Isabelle Knudsen ◽  
Klaus-D. Wernecke ◽  
Heribert Kentenich ◽  
Matthias David
Keyword(s):  
Ultrasound Examination ◽  
Clinical Symptoms ◽  
Uterine Fibroids ◽  
Abdominal Ultrasound ◽  
Physical Symptoms ◽  
Bleeding Disorders ◽  
Inclusion Criteria ◽  
Significant Difference ◽  
Ultrasound Findings ◽  
Ultrasound Investigation

Abstract Purpose How many women assume that they have fibroids but are found not to have fibroids on ultrasound examination? How severe are the physical symptoms reported by these women compared to the symptoms reported by women with actual uterine fibroids? Are the symptoms more severe if the patient believes that she has at least one relatively large (dominant) fibroid or more than 3 fibroids? Material and Methods A total of 1548 patients completed an anonymous questionnaire in which they were asked about the number of their fibroids, dysmenorrhea and premenstrual symptoms, dyspareunia and bleeding disorders (using a numerical analog scale between 0 – 10). The questionnaire was administered in a hospital-based fibroid clinic. The information provided by the patients was then compared with transvaginal or abdominal ultrasound findings. The symptoms reported by women with and without fibroid(s) were compared. Results 1045 out of 1548 patients fulfilled the studyʼs inclusion criteria. Contrary to the information they provided, no fibroid(s) were detected in 6% (62 of 1045 patients) of patients on ultrasound examination. Of these women, 87% had dysmenorrhea, 79% had premenstrual pain and 57% reported dyspareunia. The severity of the symptoms was found not to be associated with the assumed size or number of fibroid(s). There was no significant difference in the pain reported by women without and by women with fibroids. Reporting a feeling of strong pressure on the bladder (OR: 1.18) or abdomen (OR: 1.12) or constipation (OR: 1.16) increased the likelihood of detecting a fibroid on ultrasound investigation. Conclusions The presence of manifest symptoms (dysmenorrhea, dyspareunia, premenstrual pain, bleeding disorders) does not allow conclusions to be made about the number or size of fibroids or about which therapy is indicated. Even an erroneous assumption about the presence of fibroids may result in patients experiencing symptoms.

Impact of tobacco and alcohol use on HRQOL in patients with advanced head and neck cancer: Results from a community oncology database.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17512-e17512
Author(s):  
Maxine D. Fisher ◽  
Ancilla Fernandes ◽  
Temitope O Olufade ◽  
Paul J. Miller ◽  
Mark Stephen Walker ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Head And Neck ◽  
Tobacco Use ◽  
Clinical Symptoms ◽  
Physical Symptoms ◽  
Community Oncology ◽  
Significant Difference ◽  
And Performance ◽  
Composite Scores ◽  
Over Time

e17512 Background:Tobacco and heavy alcohol use are important risk factors for head and neck (H&N) cancer. H&N cancer may affect activities of daily life (eg, eating, drinking, swallowing), and can be debilitating to health-related quality of life (HRQOL). This study reports HRQOL findings for patients (pts) with advanced H&N cancer eligible for systemic treatment in multimodality or palliative care. Methods:Medical records from pts diagnosed 1/1/2007–10/1/2015 with stage III–IVc H&N cancer and ≥1 disease progression were retrospectively collected from 10 US community oncology practices. We evaluated specific items and composite measures (physical symptoms, treatment effects, distress, despair, ambulation, and performance) with the Patient Care Monitor (PCM), an 86-item pt-recorded outcomes survey. Linear mixed models (LMM) assessed prespecified effects (eg smoking, alcohol use) and change over time across 2 lines of therapy. Results: The study included 462 pts (median age, 61 y; range, 26–99 y). Of these, 81% were male, 77% white, and 21% African American. The most common tumor locations were hypopharynx/larynx (31.1%) and oropharynx (30.9%). Overall, 41.8% of pts were current tobacco users and 22.3% were current or past alcohol abusers/excessive users. No significant difference was observed for receipt of surgery or radiation therapy in the first or second line for either alcohol or tobacco use. Approximately 1240 PCM surveys were collected from 146 pts. LMM showed effects for past tobacco use vs never/undocumented use for sore throat (1.31), dry mouth (1.46), and changes in taste (1.57); P< 0.05. Effects were seen for alcohol use for increased trouble swallowing (1.87; P= 0.01) among current or past abusers/excessive vs never/undocumented users. LMM showed no impacts of tumor location. Models of composite scores showed that after progression, worsening was seen over time for despair (0.57; P= 0.03), impaired ambulation (0.81; P= 0.05) and performance (0.66; P= 0.05). Conclusions: The study showed smoking and alcohol use were associated with worsening clinical symptoms in pts with advanced H&N cancer. Certain composite scores for symptom burden also worsened with progression.

Ankle Disease in Juvenile Idiopathic Arthritis: Ultrasound Findings in Clinically Swollen Ankles

2009 ◽  
Vol 36 (8) ◽  
pp. 1725-1729 ◽  
Author(s):  
MADELEINE E. ROONEY ◽  
CATHERINE McALLISTER ◽  
JAMES F.T. BURNS
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Ankle Joint ◽  
Ultrasound Examination ◽  
Frequency Of Occurrence ◽  
Lateral Ankle ◽  
Tibiotalar Joint ◽  
Systemic Jia ◽  
Significant Difference ◽  
Ultrasound Findings

Objective.The ankle joint is frequently involved in juvenile idiopathic arthritis (JIA), but it is unclear whether this is predominantly due to synovitis, tenosynovitis, or both. We performed clinic-based ultrasound examination to assess the prevalence of synovitis and tenosynovitis in children with JIA felt clinically to have active inflammatory disease of the ankle.Methods.Thirty-four patients with 49 clinically swollen ankles were studied (19 polyarticular JIA, 13 oligoarticular JIA, 1 systemic JIA, 1 psoriatic JIA). All cases had at least one clinically swollen ankle joint. The children were assessed clinically and had ultrasound examination during routine clinic appointments.Results.We found 71% of ankles had tenosynovitis and 39% had tenosynovitis alone. Only 29% of swollen ankles had a tibiotalar effusion alone. We found 33% had both tenosynovitis and a tibiotalar effusion. When results were analyzed by JIA subtype, we found 81% of oligoarticular JIA ankles had medial ankle tenosynovitis but only 19% had tibiotalar effusion alone. There was a significant difference between JIA subgroups for the frequency of occurrence of medial ankle tenosynovitis (p = 0.048) and lateral ankle tenosynovitis (p = 0.001).Conclusion.The tibiotalar joint was not involved in 39% of the swollen ankles; and tenosynovitis, sometimes in isolation, was the dominant finding. This has implications for therapeutic intervention and also for an improved classification of children with JIA, especially with ankle involvement.

Nonimmune fetal ascites: identification of ultrasound findings predictive of perinatal death

2016 ◽  
Vol 44 (2) ◽  
Author(s):  
Felipe Baccega ◽  
Maria de Lourdes Brizot ◽  
Vera Lúcia Jornada Krebs ◽  
Rossana Pulcineli Vieira Francisco ◽  
Marcelo Zugaib
Keyword(s):  
Respiratory Tract ◽  
Retrospective Cohort ◽  
Ultrasound Examination ◽  
Perinatal Death ◽  
Cystic Hygroma ◽  
Inclusion Criteria ◽  
Ultrasound Evaluation ◽  
Ultrasound Findings ◽  
Live Fetus

AbstractTo determine the ultrasonographic findings that predict death in fetal ascites.This was a retrospective cohort study involving pregnancies with ultrasonographic findings related to fetal ascites. The inclusion criteria were as follows: single pregnancy with a live fetus; ultrasound findings of ascites; ascites unrelated to maternal fetal alloimmunization; and pregnancy follow-up at our institution. TheA total of 154 pregnancies were included in the study. In 8 (5.19%) cases, ascites was an isolated finding, and in 146 cases, other alterations were observed during the ultrasound evaluation. Death before hospital discharge occurred in 117 cases (76.00%). The following ultrasonographic findings were significantly associated with death: gestational age at diagnosis <24 weeks (P<0.0001); stable/progressive ascites evolution (P=0.004); the presence of hydrops (P<0.0001); and the presence of cystic hygroma (P<0.0001). The presence of hydrops, the presence of respiratory tract malformations, and stable/progressive ascites evolution were significantly associated with the prediction of death.Based on ultrasound examination, the presence of hydrops, malformation of the respiratory tract, and stable/progressive evolution of ascites increase the chances of death in cases of fetal ascites.

APPLICATION OF PERMANENT PACEMAKERS AND OPTIMAL PROGRAMMATION IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 114-121
Author(s):  
Van Minh Huynh ◽  
Anh Tien Hoang ◽  
Khanh Hung Doan ◽  
Vu Phong Nguyen ◽  
Viet Lam Ngo ◽  
...  
Keyword(s):  
Sick Sinus Syndrome ◽  
Clinical Symptoms ◽  
Jugular Vein ◽  
Pacemaker Implantation ◽  
Heart Association ◽  
External Jugular Vein ◽  
Permanent Pacemaker ◽  
Male Gender ◽  
Inclusion Criteria ◽  
Underlying Diseases

Aim: To evaluate the application of permanent pacemaker and optimal programmation associated with Nora G. checklist in pacemaker implantation. Patients and methods: we analyse the 35 cases who were implanted the permanent pacemakers we analyse the 35 cases who were implanted the permanent pacemakers in 2017. For inclusion criteria, we used the recomendation of ACC/AHA/ HRS and Vietnam Heart Association. Apply the C arm fluoroscopy to perform the implantation of the permanent pacemaker. Most of patients were performed the subclavian vein and cephalic vein as the main way but some cases we choosed the external jugular vein as the alternative route. Results: male gender was 60%, mean age was 71.97±12.55. Mostly cardiac arrhythmia were sick sinus syndrome (42.86%), atrial fibrillation with slow rate response (17.14%), blocAVII nd degree Mobitz II (14.28%), bloc AV III rd (11.42%), the underlying diseases were arterial hypertension 42.86%, coronary disease (20%), diabetes mellitus (14.29%). The implanted pacemekers were predominantly one chamber VVIR type (47.5%). The complications was rare and there were a clear recovery of clinical symptoms and mortality death following the Nora checklist. Conclusion: VT technology is an integral part of the treatment of arrhythmias, especially the optimal combination of programming and the Nora checklist, which makes it more effective. Key words: permanent pacemaker, optimal programmation

scholarly journals The The Effectiveness of Early Mobilization Time on Balance and Functional Ability after Ischemic Stroke

2019 ◽  
Vol 7 (7) ◽  
pp. 1088-1092
Author(s):  
Umi Budi Rahayu ◽  
Samekto Wibowo ◽  
Ismail Setyopranoto
Keyword(s):  
Randomized Controlled Trial ◽  
Ischemic Stroke ◽  
Functional Ability ◽  
Controlled Trial ◽  
Early Mobilization ◽  
Berg Balance Scale ◽  
Early Mobilisation ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference

BACKGROUND: Early mobilisation (EM) after-ischemic stroke is a motor learning intervention aimed to restore nerve cells and to improve balance and functional ability. Unfortunately, the study of when this intervention began has not been widely studied. AIM: On this study was compared the effect of EM started at 24 hours and 48 hours after an ischemic stroke on balance and functional ability. MATERIAL AND METHODS: Randomized controlled trial involving 40 patients on 2 groups meeting predefined inclusion criteria. The levels of balance were measured using the Berg Balance Scale, and the functional ability was measured using the Barthel Index, at 5th and 7th day. RESULTS: A significant difference was observed in both balance (p = 0.038) and functional ability (p = 0.021) obtained on the 7th day of assessment between both groups. A significant difference on the 5th day was observed only in the functional ability (p = 0.002) and not in the balance (p = 0.147), between the groups. CONCLUSION: EM started at 24 hours after the ischemic stroke has been found to have a better impact on balance and functional ability compared to that at 48 hours.

scholarly journals Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

2021 ◽  
Vol 23 (1) ◽  
pp. 33-49 ◽  
Author(s):  
Sally Griffin
Keyword(s):  
Adrenal Glands ◽  
Ultrasound Examination ◽  
Abdominal Ultrasound ◽  
Evidence Base ◽  
Vital Role ◽  
Abdominal Ultrasonography ◽  
Operator Experience ◽  
High Resolution Images ◽  
Clinically Significant ◽  
Diagnostic Work

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the adrenal glands can provide important information pertaining to several conditions including hyperaldosteronism and hyperadrenocorticism. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as adrenal mineralisation, and clinically significant pathological changes can be challenging. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased adrenal glands. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. Equipment: Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

scholarly journals Single-bone versus both-bone plating of unstable paediatric both-bone forearm fractures. A randomized controlled clinical trial

2021 ◽  
Author(s):  
Mohamed Khaled ◽  
Amr A. Fadle ◽  
Ahmed Khalil Attia ◽  
Andrew Sami ◽  
Abdelkhalek Hafez ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Operative Time ◽  
Forearm Fractures ◽  
Inclusion Criteria ◽  
Fracture Union ◽  
Exclusion Criteria ◽  
Bone Fixation ◽  
Fixation Group ◽  
Significant Difference ◽  
Single Bone

Abstract Purpose This clinical trial compares the functional and radiological outcomes of single-bone fixation to both-bone fixation of unstable paediatric both-bone forearm fractures. Methods This individually randomized two-group parallel clinical trial was performed following the Consolidated Standards of Reporting Trials (CONSORT) statement at a single academic tertiary medical centre with an established paediatric orthopaedics unit. All children aged between nine and 15 years who presented to the emergency department at Assiut university with unstable diaphyseal, both-bone forearm fractures requiring surgical intervention between November 1, 2018, and February 28, 2020, were screened for eligibility against the inclusion and exclusion criteria. Inclusion criteria were diaphyseal unstable fractures defined as shaft fractures between the distal and proximal metaphyses with an angulation of > 10°, and/or malrotation of > 30°, and/or displacement > 10 mm after attempted closed reduction. Exclusion criteria included open fractures, Galeazzi fractures, Monteggia fractures, radial head fractures, and associated neurovascular injuries. Patients who met the inclusion criteria were randomized to either the single-bone fixation group (intervention) or the both-bone fixation group (control). Primary outcomes were forearm range of motion and fracture union, while secondary outcomes were forearm function (price criteria), radius re-angulation, wrist and elbow range of motion, and surgical time Results A total of 50 children were included. Out of these 50 children, 25 were randomized to either arm of the study. All children in either group received the treatment assigned by randomization. Fifty (100%) children were available for final follow-up at six months post-operatively. The mean age of single-bone and both-bone fixation groups was 11.48 ± 1.93 and 13 ± 1.75 years, respectively, with a statistically significant difference (p = 0.006). There were no statistically significant differences in gender, laterality, affection of the dominant hand, or mode of trauma between single-bone and both-bone fixation groups. All patients in both groups achieved fracture union. There mean radius re-angulation of the single-bone fixation groups was 5.36 ± 4.39 (0–20) degrees, while there was no radius re-angulation in the both-bone fixation group, with a statistically significant difference (p < 0.001). The time to union in the single-bone group was 6.28 ± 1.51 weeks, while the time to union in the both-bone fixation group was 6.64 ± 1.75 weeks, with no statistically significant difference (p = 0.44). There were no infections or refractures in either group. In the single-bone fixation group, 24 (96%) patients have regained their full forearm ROM (loss of ROM < 15°), while only one (4%) patient lost between 15 and 30° of ROM. In the both-bone fixation group, 23 (92%) patients have regained their full forearm ROM (loss of ROM < 15°), while only two (8%) patients lost between 15 and 30° of ROM. There was no statistically significant difference between groups in loss of forearm ROM (p = 0.55). All patients in both groups regained full ROM of their elbow and wrist joints. On price grading, 24 (96%) and 23 (92%) patients who underwent single bone fixation and both-bone fixation scored excellent, respectively. Only one (4%) patient in the single-bone fixation group and two (8%) patients in the both-bone fixation group scored good, with no statistically significant difference in price score between groups (p = 0.49). The majority of the patients from both groups had no pain on the numerical pain scale; 22 (88%) patients in the single-bone fixation group and 21 (84%) patients in the both-bone fixation groups, with no statistically significant difference between groups (p = 0.38). The single-bone fixation group had a significantly shorter mean operative time in comparison to both-bones plating (43.60 ± 6.21 vs. 88.60 ± 10.56 (min); p < 0.001). Conclusion Single-bone ulna open reduction and plate fixation and casting are safe and had a significantly shorter operative time than both-bone fixation. However, single-bone ORIF had a higher risk radius re-angulation, alas clinically acceptable. Both groups had equally excellent functional outcomes, forearm ROM, and union rates with no complications or refractures. Long-term studies are required.

scholarly journals Significance of nucleic acid positive anal swab in COVID-19 patients

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 332-337
Author(s):  
Xiaoli Li ◽  
Lei Rong ◽  
Peiyan Zhang ◽  
Jian Xu ◽  
Yan Rong
Keyword(s):  
Platelet Count ◽  
Clinical Symptoms ◽  
Influence Factors ◽  
Recovery Phase ◽  
Negative Group ◽  
Pharyngeal Swab ◽  
Positive Group ◽  
Oral Transmission ◽  
Significant Difference ◽  
Anal Swab

Abstract Aim We compared the clinical characteristics of patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) positive and negative anal swabs during coronavirus disease 2019 (COVID-19) recovery and investigated the clinical significance and influence factors of anal swab detection. Methods This study retrospectively analyzed 23 moderate COVID-19 patients in the recovery phase. They were divided into anal swab positive group (n = 13) (negative for pharyngeal swabs but positive for anal swabs) and anal swab negative group (n = 10) (negative for pharyngeal and anal swabs). The epidemiology, clinical symptoms, time of pharyngeal swabs turning negative, and laboratory results were compared. Results The time of pharyngeal swabs turning negative in the anal swab positive group was 6 (5–8.5) days, significantly longer than that in the anal swab negative group (1 (1–4.25) days), P = 0.0002). The platelet count of the anal swab positive group was significantly lower than that of the anal swab negative group (198 (135–235) × 109/L vs 240.5 (227–264.75) × 109/L, P = 0.0248). No significant difference was observed between the two groups in other variables. Conclusions The time of pharyngeal swab turning negative in anal swab positive patients is longer than that in anal swab negative patients. The platelet count can be used as an indicator for viral infection evaluation. For patients with a longer time of pharyngeal swabs turning negative, the combined testing of the anal swab and platelet counts may help to avoid pharyngeal swab false negatives, premature discharge, and the possibility of fecal-oral transmission.

scholarly journals In vitro testing of explanted shunt valves in hydrocephalic patients with suspected valve malfunction

2021 ◽  
Author(s):  
Christoph Bettag ◽  
Christian von der Brelie ◽  
Florian Baptist Freimann ◽  
Ulrich-Wilhelm Thomale ◽  
Veit Rohde ◽  
...  
Keyword(s):  
Flow Rate ◽  
Clinical Symptoms ◽  
Obstructive Hydrocephalus ◽  
Flow Characteristics ◽  
Normal Pressure ◽  
Diagnostic Tools ◽  
Programmable Valve ◽  
Significant Difference ◽  
Valve Malfunction

AbstractDiagnosis of symptomatic valve malfunction in hydrocephalic patients treated with VP-Shunt (VPS) might be difficult. Clinical symptoms such as headache or nausea are nonspecific, hence cerebrospinal fluid (CSF) over- or underdrainage can only be suspected but not proven. Knowledge concerning valve malfunction is still limited. We aim to provide data on the flow characteristics of explanted shunt valves in patients with suspected valve malfunction. An in vitro shunt laboratory setup was used to analyze the explanted valves under conditions similar to those in an implanted VPS. The differential pressure (DP) of the valve was adjusted stepwise to 20, 10, 6, and 4 cmH2O. The flow rate of the explanted and the regular flow rate of an identical reference valve were evaluated at the respective DPs. Twelve valves of different types (Codman CertasPlus valve n = 3, Miethke Shuntassistant valve n = 4, Codman Hakim programmable valve n = 3, DP component of Miethke proGAV 2.0 valve n = 2) from eight hydrocephalic patients (four male), in whom valve malfunction was assumed between 2016 and 2017, were replaced with a new valve. Four patients suffered from idiopathic normal pressure (iNPH), three patients from malresorptive and one patient from obstructive hydrocephalus. Post-hoc analysis revealed a significant difference (p < 0.001) of the flow rate between each explanted valve and their corresponding reference valve, at each DP. In all patients, significant alterations of flow rates were demonstrated, verifying a valve malfunction, which could not be objectified by the diagnostic tools used in the clinical routine. In cases with obscure clinical VPS insufficiency, valve deficiency should be considered.

scholarly journals Decision making under ambiguity and risk in adolescent-onset schizophrenia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dandan Li ◽  
Fengyan Zhang ◽  
Lu Wang ◽  
Yifan Zhang ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Decision Making ◽  
Executive Function ◽  
Iowa Gambling Task ◽  
Clinical Symptoms ◽  
Healthy Controls ◽  
Syndrome Scale ◽  
Significant Difference ◽  
Abnormal Pattern ◽  
Negative Syndrome ◽  
The Relationship

Abstract Objective Numerous studies have identified impaired decision making (DM) under both ambiguity and risk in adult patients with schizophrenia. However, the assessment of DM in patients with adolescent-onset schizophrenia (AOS) has been challenging as a result of the instability and heterogeneity of manifestations. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT), which are frequently used to evaluate DM respectively under ambiguity and risk, are sensitive to adolescents and neuropsychiatric patients. Our research intended to examine the performance of DM in a relatively large sample of patients with AOS using the above-mentioned two tasks. We also aimed to take a closer look at the relationship between DM and symptom severity of schizophrenia. Methods We compared the performance of DM in 71 patients with AOS and 53 well-matched healthy controls using IGT for DM under ambiguity and GDT for DM under risk through net scores, total scores and feedback ration. Neuropsychological tests were conducted in all participants. Clinical symptoms were evaluated by using Positive and Negative Syndrome Scale (PANSS) in 71 patients with AOS. Pearson’s correlation revealed the relationship among total score of DM and clinical and neuropsychological data. Results Compared to healthy controls, patients with AOS failed to show learning effect and had a significant difference on the 5th block in IGT and conducted more disadvantageous choices as well as exhibited worse negative feedback rate in GDT. Apart from DM impairment under risk, diminished DM abilities under ambiguity were found related to poor executive function in AOS in the present study. Conclusions Our findings unveiled the abnormal pattern of DM in AOS, mainly reflected under the risky condition, extending the knowledge on the performance of DM under ambiguity and risk in AOS. Inefficient DM under risk may account for the lagging impulse control and the combined effects of developmental disease. In addition, our study demonstrated that the performance on IGT was related to executive function in AOS.

Sign in / Sign up

Export Citation Format

Share Document