scholarly journals Upper airway cough syndrome may be the main cause of chronic cough in Japan: a cohort study

2020 ◽  
Author(s):  
Kimihiko Yasuda
Keyword(s):  
Logistic Regression ◽  
Chronic Cough ◽  
Standard Treatment ◽  
Gastrointestinal Symptoms ◽  
Upper Airway ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Common Cause ◽  
Post Infectious ◽  
Observation Period

Abstract Background: Upper airway cough syndrome (UACS) is generally considered the main cause of chronic cough, but it is rarely recognised in Japan. This study identified the causes of chronic cough and assessed whether “UACS is the most common cause of chronic cough” in Japan, as it is in other countries. Although signs and symptoms of UACS are described as nonspecific, some items of interviews and examinations might be considered potentially useful in its diagnosis, and were evaluated for their association with it. Methods: All patients with chronic cough who visited my clinic were preliminarily diagnosed based on interviews and examinations. Bronchial asthma and UACS were preferentially diagnosed. Among the excluded cases, some patients with gastrointestinal symptoms or diet-related cough were diagnosed with gastroesophageal reflux disease, while others were diagnosed with post-infectious prolonged cough. Nasal corticosteroids were administered to the UACS group, and standard treatment to the other groups. The observation period lasted 4 weeks. Subjective cough score at first diagnosis was set at 10, and final diagnosis was made based on the treatment administered when the cough score had decreased to ≤2. The association between the presence or absence of UACS and interview and examination items was statistically evaluated using a logistic regression model. Results: Among 230 patients with chronic cough, 146 were diagnosed with UACS-only. In the UACS-only group treated with nasal corticosteroids, 110 patients showed a significant improvement in cough scores within 2 weeks. Multivariate logistic regression revealed that assessment items “awareness of mucus accumulating in the back of the throat” (odds ratio [OR]: 4.613; 95% confidence interval [CI]: 1.124–18.928; P=0.034), “presence of abnormal echography findings” (OR: 15.725; 95% CI: 1.445–171.101; P=0.024), “absence of associated coughing when exercising” (OR: 0.212; 95% CI, 0.055–0.813; P=0.024), and “presence of coughing persisting after onset” (OR: 6.470; 95% CI, 1.755–23.843; P=0.005) were significantly associated with the presence or absence of UACS. Conclusions: UACS is the most common cause of chronic cough in Japan, as in other countries, and can be effectively treated with nasal corticosteroids. Diagnosing UACS might be possible by selecting appropriate interview and examination items.

scholarly journals Upper airway cough syndrome may be the main cause of chronic cough in Japan: a cohort study

2021 ◽  
Author(s):  
Kimihiko Yasuda
Keyword(s):  
Chronic Cough ◽  
Standard Treatment ◽  
Upper Airway ◽  
Final Diagnosis ◽  
Multivariate Logistic Regression ◽  
Common Cause ◽  
Nasal Steroids ◽  
Potential Use ◽  
Post Infectious ◽  
Observation Period

Abstract BackgroundUpper airway cough syndrome (UACS) is generally considered a common cause of chronic cough but remains poorly recognised in Japan.ObjectiveThis study aimed to assess whether UACS was a common cause of chronic cough in Japan, as is true in other countries. Interview and examination items were evaluated for their potential use in UACS diagnosis.Methods All patients with chronic cough were preliminarily diagnosed with bronchial asthma, UACS, gastroesophageal reflux disease, or post-infectious prolonged cough, based on interviews and examinations. Treatment centred on nasal steroids was administered to the UACS group and standard treatment to the other groups. The observation period lasted 4 weeks. The subjective cough score at first diagnosis was set at 10, and the final diagnosis was made based on the treatment administered at the time the cough score had decreased to ≤ 2. The associations between the presence or absence of UACS and interview and examination items were statistically evaluated.Results Among 230 patients with chronic cough, 146 were diagnosed with UACS-only. Multivariate logistic regression revealed that the assessment items ‘awareness of mucus accumulating in the back of the throat’, ‘presence of abnormal echography findings’, ‘absence of associated coughing when exercising’ and ‘presence of coughing persisting after onset’ were significantly correlated with the presence or absence of UACS (p < 0.05).ConclusionsUACS may be the most common cause of chronic cough in Japan and may be effectively treated with nasal corticosteroids. Diagnosing UACS might be possible by selecting appropriate interview and examination items.

scholarly journals Endometriosis Mimicking a Cecum Mass with Complete Bowel Obstruction: An Infrequent Cause of Acute Abdomen

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Gabriel A. Molina ◽  
Darwin R. Ramos ◽  
Alberto Yu ◽  
Patricio A. Paute ◽  
Paul S. Llerena ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Preoperative Diagnosis ◽  
Malignant Tumors ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Intestinal Involvement ◽  
History Of ◽  
Ovarian Abscess ◽  
Fertile Women

Endometriosis is a common entity among fertile women which unfortunately manifests through variable symptomatology. Intestinal involvement in endometriosis is quite common and can simulate several diseases such as Crohn’s disease, appendicitis, tubo-ovarian abscess, or malignant tumors. Intestinal obstruction due to endometriosis is rare, and preoperative diagnosis is difficult because the signs and symptoms are nonspecific and can be easily confused. In the case of patients without a history of endometriosis, diagnosis is further complicated. We present a case of a 41-year-old female patient. She presented to the emergency room with complete bowel obstruction and a mass in the cecum. Surgery was decided, and the patient underwent full recovery. Endometriosis was the final diagnosis for the observed condition.

scholarly journals An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorenzo Storari ◽  
Valerio Barbari ◽  
Fabrizio Brindisino ◽  
Marco Testa ◽  
Maselli Filippo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Visceral Pain ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Outpatient Setting ◽  
Direct Access ◽  
Life Threatening ◽  
Medical Referral

Abstract Background Shoulder pain (SP) may originate from both musculoskeletal and visceral conditions. Physiotherapists (PT) may encounter patients with life-threatening pathologies that mimic musculoskeletal pain such as Acute Myocardial Infarction (AMI). A trained PT should be able to distinguish between signs and symptoms of musculoskeletal or visceral origin aimed at performing proper medical referral. Case presentation A 46-y-old male with acute SP lasting from a week was diagnosed with right painful musculoskeletal shoulder syndrome, in two successive examinations by the emergency department physicians. However, after having experienced a shift of the pain on the left side, the patient presented to a PT. The PT recognized the signs and symptoms of visceral pain and referred him to the general practitioner, which identified a cardiac disease. The final diagnosis was acute myocardial infarction. Conclusion This case report highlights the importance of a thorough patient screening examination, especially for patients treated in an outpatient setting, which allow distinguishing between signs and symptoms of musculoskeletal from visceral diseases.

scholarly journals A case of fatal disseminated strongyloidiasis accompanied with intestinal obstruction

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Peyman Heydarian ◽  
Iraj Mobedi ◽  
Mohamad Ali Mohaghegh ◽  
Abozar Hosseini ◽  
Fatemeh Goudarzvand Chegini ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Signs And Symptoms ◽  
Strongyloides Stercoralis ◽  
Final Diagnosis ◽  
High Humidity ◽  
Important Message ◽  
Disseminated Strongyloidiasis ◽  
Endemic Areas

Abstract Strongyloides stercoralis is an endemic parasite in some regions including the tropical and subtropical areas with high humidity. Most infections are asymptomatic with nonspecific signs and symptoms, making the final diagnosis complicated. Here, we report a patient referred to our hospital with signs consistent with sepsis, intestine obstruction, which finally died with the diagnosis of strongyloidiasis. The patient was from northern parts of Iran which are considered as endemic areas for S. stercoralis. In conclusion, there is an important message in this history, i.e. physicians should be aware of specific and non-specific signs of strongyloidiasis especially in people living in endemic areas to make an accurate final diagnosis by proper clinical and paraclinical examinations.

scholarly journals Efficacy and Safety of a New Formulation of Pancrelipase (Ultrase MT20) in the Treatment of Malabsorption in Exocrine Pancreatic Insufficiency in Cystic Fibrosis

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Michael W. Konstan ◽  
Theodore G. Liou ◽  
Steven D. Strausbaugh ◽  
Richard Ahrens ◽  
Jamshed F. Kanga ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Exocrine Pancreatic Insufficiency ◽  
Efficacy And Safety ◽  
Protein Nitrogen ◽  
Enzyme Replacement ◽  
New Formulation

Background. Pancreatic enzyme replacement therapy is the standard of care for treatment of malabsorption in patients with cystic fibrosis (CF) and exocrine pancreatic insufficiency (PI).Aim. To evaluate efficacy and safety of a new formulation of pancrelipase (Ultrase MT20) in patients with CF and PI. Coefficients of fat absorption (CFA%) and nitrogen absorption (CNA%) were the main efficacy parameters. Safety was evaluated by monitoring laboratory analyses, adverse events (AEs), and overall signs and symptoms.Methods. Patients (n=31) were randomized in a crossover design comparing this pancrelipase with placebo during 2 inpatient evaluation periods (6-7 days each). Fat and protein/nitrogen ingestion and excretion were measured from food diaries and 72-hour stool collections. CFA% and CNA% were calculated for each period and compared.Results. Twenty-four patients provided analyzable data. This pancrelipase increased mean CFA% and CNA% (+34.7% and +25.7%, resp.,P<.0001for both), reduced stool frequency, and improved stool consistency compared with placebo. Placebo-treated patients reported more AEs, with gastrointestinal symptoms being the most frequently reported AE.Conclusions. This pancrelipase is a safe and effective treatment for malabsorption associated with exocrine PI in patients with CF.

Correlation between Restless Leg Syndrome and Superficial Venous Reflux

2021 ◽  
Author(s):  
Aaron R. Dezube ◽  
Jake Rauh ◽  
Michael Dezube ◽  
Mark Iafrati ◽  
JoAnn Rigo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Family History ◽  
Lower Extremity ◽  
Symptom Improvement ◽  
Venous Disease ◽  
Restless Leg Syndrome ◽  
Venous Reflux ◽  
Common Cause ◽  
History Of ◽  
Prospective Trials

AbstractRestless leg syndrome (RLS) is a common cause of lower extremity discomfort. We hypothesized that patients with RLS symptoms have higher rates of deep and superficial venous reflux (SVR). Retrospective review of patients ≥18 years of age evaluated in a venous center from December 2018 to February 2019. Differences in rates of RLS symptoms, demographics, comorbidities, and clinical and radiologic presence of venous disease were analyzed. Overall, 207 patients were analyzed; 140 (67.6%) reported RLS symptoms (n = 25 with prior RLS diagnosis). RLS symptoms were more common with superficial or combined superficial and deep venous reflux (DVR) compared with those without reflux (p < 0.001). Patients with RLS symptoms as opposed to those without had similar demographics and comorbidities (all p > 0.05) but increased rates of venous pain, phlebitis, family history of venous disease, lower extremity swelling and SVR, and combined SVR and DVR (all p < 0.05). Our multivariable logistic regression found presence of SVR, and family history of venous reflux was associated with RLS symptomatology (all p < 0.001). Ninety-nine patients with RLS underwent ablation; of them, 93 had duplex-proven reflux resolution of which 81 (87%) reported RLS symptom improvement. This included 13 of 16 (81.3%) with prior RLS diagnosis. SVR is associated with increased rates of RLS symptoms in a vein center population. Therefore, RLS symptoms should trigger a targeted venous evaluation. Our results suggest that venous ablation may lead to resolution of RLS symptoms in patients with SVR, but randomized prospective trials with strict RLS definition criteria are warranted to confirm these outcomes.

scholarly journals A Patient with Typhoid Hepatitis

2021 ◽  
Vol 22 (2) ◽  
pp. 154-158
Author(s):  
M Vitanata Arfijanto ◽  
Isty Rindryastuti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
Liver Function Tests ◽  
Salmonella Typhi ◽  
Abnormal Liver Function ◽  
Grade Ii ◽  
Ig G

Typhoid hepatitis is typhoid fever accompanied by symptoms of jaundice, hepatomegaly and abnormal liver function tests. The incidence varies between 0.4% -26% of typhoid fever patients. We report a case of a 34-year-old male, presented with fever, epistaxis, gastrointestinal symptoms, thrombocytopenia and elevated AST/ ALT, thus the patient was first diagnosed as dengue hemorrhagic fever grade II. On day 9th the signs and symptoms were persisted, Ig M and Ig G Dengue was negative. Then we evaluated the virus marker for hepatitis and blood culture. The results were negative for HBsAg, anti HCV and Ig M anti HAV, but Salmonella typhi detected on blood culture. The patient was treated with ceftriaxone 1000mg bid iv and get better then discharged from hospital.

Systemic Lupus Erythematosus with Secondary Thrombotic Thrombocytopenic Purpura and Acute Parkinsonism: A Case Report

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Pooja Deepak ◽  
Roha Saeed Memon ◽  
Fizza Tariq ◽  
Hassan Ahmed ◽  
Shaheen Bhatti
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Lupus Erythematosus ◽  
Late Onset ◽  
Case Reports ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Urgent Care ◽  
Systemic Lupus ◽  
Thrombocytopenic Purpura

Systemic lupus erythematosus (SLE) is an autoimmune disease that has certain characteristic features but can also present with misleading signs and symptoms especially when it is of late-onset. Various case reports address its association with thrombotic thrombocytopenic purpura (TTP), however, its association with parkinsonism remains unclear. We present the case of a 58-year-old male who reported with acute-onset parkinsonism along with some gastrointestinal symptoms. Detailed laboratory investigations unmasked the underlying SLE with an overlapping picture of TTP. This unusual presentation in a resource-constrained setting created challenges and subsequent delays in the diagnosis and management of the patient. Despite urgent care, the patient’s age, presence of overlapping conditions, and multi-organ involvement were some of the factors due to which the treatment failed and he could not survive. We report the association of SLE with secondary TTP and parkinsonism.

Study of predictive value of serum C- reactive protein in diagnosis of acute appendicitis

2021 ◽  
Vol 19 (1) ◽  
pp. 31-34
Author(s):  
Pradeep Chandra Sharma ◽  
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Common Finding ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Female Ratio ◽  
Reactive Protein ◽  
Serum Crp

Background: Acute appendicitis is a common surgical condition and the most common cause of acute surgical abdomen. Commonly used tests for diagnosis of acute appendicitis were WBC, CRP ESR and procalcitonin (PCT) levels. In present study we correlated the serum levels of CRP with the histopathology of the removed appendix, to study predictive value of serum C- reactive protein in diagnosis of acute appendicitis. Material and Methods:Present study was conducted in patients with possibility of acute appendicitis, underwent appendicectomy. The histopathology report was considered as the final diagnosis. CRP more than 6 mg/dl was considered to be positive. Results: In present study total 88 patients were included. Male to female ratio was 1.4:1, most common age group was 21-30 years (35.23%) followed by 31-40 years (27.27%). Abdominal pain (92.05%), McBurney tenderness (80.68%), vomiting (76.14%), rebound tenderness (67.05%) and fever (55.68%) were common signs and symptoms noted in present study. On histopathology examination, inflammed appendix (51.14%) was most common finding, others were gangrenous appendix (23.86%), perforated appendix (5.68%) and normal appendix (19.32%). In present study diagnostic efficacy of serum CRP was sensitivity (80%), specificity (84.62%), positive predictive value (96.77%), negative predictive value (42.31%), diagnostic accuracy (80.68%). Conclusion. Serum CRP estimation is useful adjunct in diagnosis of acute appendicitis along with clinical diagnosis. Serum CRP value should be interpreted in combination with clinical findings.

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