Chronic Knee Pain

2018 ◽  
Author(s):  
Randy L. Calisoff ◽  
David R. Walega
Keyword(s):  
Knee Pain ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Osteoarthritis Of The Knee ◽  
Chronic Knee Pain ◽  
History Of

Chronic knee pain affects 27 million people in the United States and is a leading cause of disability. Seventy percent of the population 65 years or older will have knee pain with radiographic evidence of osteoarthritis, and 12% will have clinical symptoms of osteoarthritis. Chronic knee pain after total knee replacement ranges from 10% to 20%. Patellofemoral pain syndrome (PFPS) refers to anterior knee pain exacerbated with knee joint loading activities (squatting, kneeling, prolonged sitting, ascending/descending stairs). PFPS is a clinical diagnosis, and treatment is directed toward pain alleviation and restoration of proper biomechanics. Pes anserine syndrome is common in runners, athletes, and individuals with osteoarthritis of the knee. Other risk factors include: female sex and a history of diabetes mellitus, obesity, or arthritis. Knowledge of the common knee pain etiologies, as well as key clinical manifestations, physical exam findings, differential diagnosis, and treatment options for each is important for pain specialists.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

Pain in dementia

2021 ◽  
Vol 26 (3) ◽  
pp. 15-22
Author(s):  
T. M. Manevich ◽  
E. A. Mkhitaryan
Keyword(s):  
Pain Relief ◽  
Life Expectancy ◽  
Elderly Patients ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Diagnosis And Treatment ◽  
Prevalence Of Pain

Increasing life expectancy of the world’s population is accompanied by increasing number of elderly patients with dementia. According to various studies, the prevalence of pain syndrome in elderly patients with dementia ranges from 35.3% to 63.5%. The review represents data on the epidemiology, clinical manifestations, methods of diagnosis and treatment of pain syndrome in patients with dementia. Medicinal and non-pharmacological methods of pain relief are discussed.

scholarly journals Chronic venous insufficiency after COVID-19: management of edema and pain syndromes

2021 ◽  
Vol 18 (2) ◽  
pp. 151-153
Author(s):  
F. Kh. Nizamov
Keyword(s):  
Chronic Diseases ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Venous Stasis ◽  
Vein Wall ◽  
Vas Scores

Introduction. COVID-19 infection raises many questions regarding the health condition of patients after they have had COVID-19. The aim of this study is to examine the characteristic symptoms of chronic venous insufficiency in the postcovid period.Materials and methods. The materials that were used for work included the results of studying the medical aid appealability, characteristic symptoms, diagnosis and treatment of symptoms of chronic venous insufficiency in persons who have had the coronavirus infection. 47 patients presented with complaints about deterioration of their condition after they had had COVID-19 over March to September 2021 period. Methods: general clinical examiniation, ultrasound angioscanning of veins of the lower extremities, laboratory coagulation tests.Results and discussion. Before deterioration, calf circumference was measured 22–24 cm at a typical measurement site in most patients (89%), after covid infection it reached 26–27 cm. Varicose veins remained soft, without intravascular formations, edema was often bilateral, asymmetric, pain was described as constant (5–6 VAS scores), patients had prominent signs of lymphostasis. 35 out of 47 people received diosmin-based venotonic drug of Russian manufacture at a dose of 1000 mg/day (one tablet twice a day), the course of treatment lasted one to two months. After that period, the edema subsided in 85% of patients, the severity of pain syndrome significantly reduced (up to 2–3 VAS scores). With regard to chronic venous insufficiency in patients with chronic diseases of lower extremity veins (mostly varicose and post-thrombotic diseases), the significant progress of disease was observed in almost 94% of follow-up cases. Diosmin is the main drug that is prescribed to treat chronic venous insufficiency. The drug has an angioprotective and venotonic effect, reduces the vein wall elasticity, increases venous tone, and decreases venous stasis, reduces capillary permeability and fragility, and increases their resistance, improves microcirculation and lymphatic drainage.Сonclusions. In the postcovid period, clinical symptoms of some chronic diseases occur/worsen, including clinical manifestations of chronic venous insufficiency. The use of Russian diosmin-based drug for the management of edema and pain syndrome is very promising.

scholarly journals Diagnosis of tarsal coalitions

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 74-78
Author(s):  
O.A. Turchin ◽  
V.M. Piatkovskiy ◽  
T.M. Omelchenko ◽  
A.P. Liabakh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Resonance Imaging ◽  
Flat Foot ◽  
Inappropriate Treatment ◽  
Lack Of Physicians ◽  
History Of

Tarsal coalitions (TC) are congenital abnormal connections of the rearfoot bones. They occur in 1 to 13 % of all population. The article deals with the features of clinical and instrumental diagnosis of TC according to the literature. The main clinical manifestations are pain syndrome in the subtalar area, rigid flat foot; peroneal spastic flat foot is possible. Radiographic imaging of TC includes direct and indirect signs. To verify bone coalition, computed tomo-graphy is indicated, in cases of cartilaginous and fibrous — magnetic resonance imaging. Despite the long history of studying the problem, the diagnosis of TC remains a live issue today. Difficulties in diagnosing this pathology are due to the lack of physicians’ awareness of the clinical and radiographic picture of TC. Classical orthopedic exa-mination and suspicion of possible TC will allow detecting pathology in time and avoiding inappropriate treatment. The use of modern imaging techniques, such as computed tomography and magnetic resonance imaging, helps increase the accuracy of TC diagnosis.

Obstructive sleep apnoea and schizophrenia: a primer for psychiatrists

2011 ◽  
Vol 23 (5) ◽  
pp. 201-209 ◽  
Author(s):  
Abdulkader Alam ◽  
Kadiamada Nanaiah Roy Chengappa
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Daytime Sleepiness ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Adverse Health Outcomes ◽  
Ovid Medline ◽  
Obstructive Sleep ◽  
Osa Treatment

Alam A, Chengappa KNR. Obstructive sleep apnoea and schizophrenia: a primer for psychiatristsObjective:The main objective of this review is to improve psychiatric clinician awareness of obstructive sleep apnoea (OSA) and its potential consequences in patients with schizophrenia. This article will also discuss the diagnosis and treatment options for OSA while considering the significant role psychiatrists can play in facilitating the diagnosis and treatment of OSA.Data sources:Ovid, Medline and PsychInfo databases were searched for articles between 1960 and 2010. Search terms used wereSleep apnoeaorapnoeaandschizophreniaorpsychosis. The number of articles retrieved was 38. Articles were carefully reviewed for any data pertinent to OSA in patients with schizophrenia.Conclusions:OSA is a common disorder that is frequently unrecognised. As a chronic breathing condition, OSA is associated with adverse health outcomes and high mortality. OSA may co-occur with schizophrenia or evolve over time, especially with weight gain. The diagnosis should be considered whenever a patient presents with risk factors or clinical manifestations that are highly suggestive of OSA. Those who report snoring, daytime sleepiness and are obese or have a large neck circumference should be considered for an OSA diagnosis. Appropriate diagnosis and treatment of OSA can reduce daytime sleepiness, improve cardiovascular and other medical conditions, as well as reduce mortality. Psychiatrists can play very important role in suspecting OSA in their patients and making the initial referral. Furthermore, behavioural management, especially promoting weight loss and smoking cessation, are effective components of OSA treatment that psychiatrists are positioned to facilitate with their patients.

scholarly journals Anti-Toxocara antibodies detected in children attending elementary school in Vitoria, State of Espírito Santo, Brazil: prevalence and associated factors

2011 ◽  
Vol 44 (4) ◽  
pp. 461-466 ◽  
Author(s):  
Roberta Paranhos Fragoso ◽  
Mariza Buriche Macedo Monteiro ◽  
Elenice Moreira Lemos ◽  
Fausto Edmundo Lima Pereira
Keyword(s):  
Elementary School ◽  
Clinical Symptoms ◽  
Past History ◽  
Clinical Manifestations ◽  
Cross Reactivity ◽  
Blood Eosinophil ◽  
Intestinal Helminths ◽  
Positive Serology ◽  
Cell Counts ◽  
History Of

INTRODUCTION: The aim of this study was to evaluate the frequency of anti-Toxocara antibodies in serum from 7-year-old children attending elementary school in Vitória-ES, Brazil and to correlate these antibodies with socio-demographic factors, the presence of intestinal helminths, blood eosinophil numbers, past history of allergy or asthma, and clinical manifestations of helminth infections. METHODS: The detection of anti-Toxocara antibodies was performed using an ELISA (Cellabs Pty Ltd)on serum from 391 children who had already been examined by fecal examination and blood cell counts. Data from clinical and physical examinations were obtained for all children. RESULTS: The prevalence of anti-Toxocara antibodies was 51.6%, with no gender differences. No significant differences were observed between positive serology and the presence or absence of intestinal worms (60.3 and 51.7%, respectively; p = 0.286). The only variables significantly related to positive serology were onycophagy and the use of unfiltered water. Although eosinophilia (blood eosinophil count higher than 600/mm³) was significantly related to the presence of a positive ELISA result, this significance disappeared when we considered only children without worms or without a past history of allergy or asthma. No clinical symptoms related to Toxocara infection were observed. CONCLUSIONS: There is a high prevalence of anti-Toxocara antibodies in children attending elementary schools in Vitória, which may be partially related to cross-reactivity with intestinal helminths or to a high frequency of infection with a small number of Toxocara eggs.

scholarly journals Chronic gastroduodenal pathology in schoolchildren: the clinical picture and features of the course

2021 ◽  
Vol 1 (1) ◽  
pp. 111-117
Author(s):  
Sh. T. Turdieva ◽  
D. K. Ganieva ◽  
Kh. B. Abdurashidova
Keyword(s):  
Helicobacter Pylori ◽  
Sleep Disturbances ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Blood Analysis ◽  
Immunochromatographic Test ◽  
Respiratory Test ◽  
Loss Of Appetite ◽  
Ph Metry

The aim of the study was to study the course and clinical manifestations of chronic gastroduodenal pathology (CGDP) in schoolchildren.Materials and methods. Clinically examined 286 children and adolescents from 6 to 15 years old with СGDP. The research methods included collection of anamnestic data, instrumental and functional (esophagogastroduodenoscopy, pH-metry), clinical and laboratory (general blood analysis, coprology), and Helicobacter pylori infection was tested by respiratory test and fecal immunochromatographic test.Result. Studies have shown that the main clinical manifestations of СGDP in children were dyspeptic syndrome, vegetovascular dysfunction, and pain syndrome, against the background of objectively visible signs of anemia. Symptoms were more characteristic in patients with СGDP from vegetovascular dysfunction: loss of appetite (83.6%), fatigue (83.2%), recurrent headaches (62.2%), and sleep disturbances (59.1%). Among dyspeptic disorders, unstable stools (85%), periodic nausea (57.7%), belching (56.6%), and a feeling of heaviness in the epigastric region after eating (56.3%) prevailed. Clinical symptoms more pronounced in children with chronic gastritis.Conclusion. For schoolchildren with CGDP, vegetovascular dysfunction (98.9%) with severe dyspeptic disorders (100%) and pain (79%), against the background of objective signs of anemia (53%), is more characteristic. In adolescents is more often a less symptomatic.

scholarly journals La terapia enzimatica sostitutiva nella malattia di Fabry

2019 ◽  
Vol 31 (3) ◽  
pp. 197-200
Author(s):  
Letizia Roggero ◽  
Sara Auricchio ◽  
Federico Pieruzzi
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Left Ventricular ◽  
Lysosomal Storage ◽  
Igg Antibody ◽  
Enzyme Replacement ◽  
Gi Symptoms ◽  
History Of ◽  
Treat All

Anderson-Fabry disease (FD) is a X-linked lysosomal storage disorder, which involves glycosphingolipids metabolism. Specific treatment for FD has been available in the last two decades, after the development and commercialization of recombinant human alfa-galactosidase A. Since then enzyme replacement therapy (ERT) has changed the natural history of the disease. Two different enzymatic formulations are available: agalsidase alfa and agalsidase beta at different dosages. The safety and efficacy profiles are similar. ERT induces Gb3 deposits reduction in renal and cardiac biopsies, improves quality of life, reduces pain and GI symptoms, decreases left ventricular mass and slows down renal function decline. In case of organ involvement, clinical evidence confirms the need to treat all patients with enzyme therapy, both male and female. In all other clinical settings, the decision to start ERT is controversial, because of the extremely variable clinical manifestations of FD. However, data suggest a greater response to ERT if started as early as possible in any patients. Timely treatment appears to be effective in stabilizing and possibly delaying FD progression. ERT infusion reactions due to allergic hypersensitivity or IgG antibody development could occur but can be easily managed. In-hospital and at home infusions are possible. The wide genetic and phenotypic heterogeneity observed in all FD patients requires a tailored approach to treatment options. Patients should be referred to an expert multidisciplinary team for the long term management of this challenging disease.

scholarly journals COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes

2020 ◽  
Author(s):  
Mohammad Ali Ashraf ◽  
Nasim Shokouhi ◽  
Elham Shirali ◽  
Fateme Davari-tanha ◽  
Omeed Memar ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Treatment Options ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Post Discharge ◽  
Reactive Protein ◽  
Presenting Symptoms ◽  
Discharged Patients ◽  
Symptom Relapse

Abstract Background There is a growing need for information regarding the recent coronavirus disease of 2019 (Covid-19). We present a comprehensive report of Covid-19 patients in Iran.Methods One hundred hospitalized patients with Covid-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and post-discharge follow-up were analyzed.Results The median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), lymphocytopenia (74.2 %) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in CT scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom relapse, (8.6%) were readmitted to the hospital, and 3 patients (4.3%) died.Conclusions This report demonstrates a heterogeneous nature of clinical manifestations in patients affected with Covid-19. The most common presenting symptoms are non-specific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom relapse.

scholarly journals COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes

2020 ◽  
Author(s):  
Mohammad Ali Ashraf ◽  
Nasim Shokouhi ◽  
Elham Shirali ◽  
Fateme Davari-tanha ◽  
Omeed Memar ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Treatment Options ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Post Discharge ◽  
Reactive Protein ◽  
Presenting Symptoms ◽  
Discharged Patients ◽  
Symptom Relapse

AbstractPurposeThere is a growing need for information regarding the recent coronavirus disease of 2019 (Covid-19). We present a comprehensive report of Covid-19 patients in Iran.MethodsOne hundred hospitalized patients with Covid-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and post-discharge follow-up were analyzed.ResultsThe median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), lymphocytopenia (74.2 %) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in CT scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom relapse, (8.6%) were readmitted to the hospital, and 3 patients (4.3%) died.ConclusionThis report demonstrates a heterogeneous nature of clinical manifestations in patients affected with Covid-19. The most common presenting symptoms are non-specific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom relapse.

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