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Acute Symptoms (acute + symptom)

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Medical Sciences	100%

Selected Abstracts

Acute symptoms associated with asphalt fume exposure among road pavers,

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2006
Allison L. Tepper PhD
Background Although asphalt fume is a recognized irritant, previous studies of acute symptoms during asphalt paving have produced inconsistent results. Between 1994 and 1997, the National Institute for Occupational Safety and Health (NIOSH) evaluated workers at seven sites in six states. Methods NIOSH (a) measured exposures of asphalt paving workers to total (TP) and benzene-soluble particulate (BSP), polycyclic aromatic compounds, and other substances; (b) administered symptom questionnaires pre-shift, every 2 hr during the shift, and post-shift to asphalt exposed and nonexposed workers; and (c) measured peak expiratory flow rate (PEFR) of asphalt paving workers when they completed a symptom questionnaire. Results Full-shift time-weighted average exposures to TP and BSP ranged from 0.01 to 1.30 mg/m3 and 0.01 to 0.82 mg/m3, respectively. Most BSP concentrations were <0.50 mg/m3. Asphalt workers had a higher occurrence rate of throat irritation than nonexposed workers [13% vs. 4%, odds ratio (OR),=,4.0, 95% confidence interval (CI): 1.2,13]. TP, as a continuous variable, was associated with eye (OR,=,1.34, 95% CI: 1.12,1.60) and throat (OR,=,1.40, 95% CI: 1.06,1.85) symptoms. With TP dichotomous at 0.5 mg/m3, the ORs and 95% CIs for eye and throat symptoms were 7.5 (1.1,50) and 15 (2.3,103), respectively. BSP, dichotomous at 0.3 mg/m3, was associated with irritant (eye, nose, or throat) symptoms (OR,=,11, 95% CI: 1.5,84). One worker, a smoker, had PEFR-defined bronchial lability, which did not coincide with respiratory symptoms. Conclusions Irritant symptoms were associated with TP and BSP concentrations at or below 0.5 mg/m3. Am. J. Ind. Med. 49:728,739, 2006. © 2006 Wiley-Liss, Inc. [source]

Black, Hispanic, and White Women's Knowledge of the Symptoms of Acute Myocardial Infarction

JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2005
Cynthia Arslanian-Engoren
Objective: To examine Black, Hispanic, and White women's knowledge of the symptoms of acute myocardial infarction. Design: Descriptive, nonexperimental design. Setting: Detroit, Michigan, and San Antonio, Texas, metropolitan areas. Participants: A convenience sample of 78 ethnically diverse women. Hispanics (n = 26) were recruited from San Antonio, Texas; Blacks (n = 26) were recruited from Detroit, Michigan; and Whites were recruited from San Antonio, Texas (n = 13), and Detroit, Michigan (n = 13). Main Outcome Measures: Participants ranked 10 acute symptoms they believed represented a myocardial infarction: anxiety, arms ache, change in thinking, chest pain, cough, fatigue, decreased appetite, headache, indigestion, and shortness of breath. Next, participants assigned a likelihood score for each acute symptom as representing a myocardial infarction. Results: Hispanic women were more likely than Black women to perceive the symptom of headache as indicative of a myocardial infarction. Women older than age 45 were more likely to assign a higher likelihood score to the symptom of shortness of breath than were women age 45 or younger. Conclusions: Age and ethnic differences were noted in women's perception of the signs and symptoms indicative of a myocardial infarction. [source]

Executive functioning in offspring at risk for depression and anxiety

DEPRESSION AND ANXIETY, Issue 9 2009
Jamie A. Micco Ph.D.
Abstract Background: Executive functioning deficits (EFDs) have been found in adults with major depression and some anxiety disorders, yet it is unknown whether these deficits predate onset of disorder, or whether they reflect acute symptoms. Studies of at-risk offspring can shed light on this question by examining whether EFDs characterize children at high risk for depression and anxiety who are not yet symptomatic. Methods: This study examined neuropsychological functioning in a sample of 147 children, ages 6,17 years (M age=9.16, SD=1.82), of parents with major depression (MDD) and/or panic disorder (PD) and of controls with neither disorder. Children were assessed via structured diagnostic interviews and neuropsychological measures. Results: Although parental MDD and PD were not associated with neuropsychological impairments, presence of current offspring MDD was associated with poorer performance on several executive functioning and processing speed measures. Children with current generalized anxiety showed poorer verbal memory, whereas children with social phobia had more omissions on a continuous performance task. Conclusions: Findings suggest that EFDs do not serve as trait markers for developing anxiety or depression but appear to be symptomatic of current disorder. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source]

Therapeutic targets in the management of Type 1 diabetes

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S1 2002
P. D. Home
Abstract For historical reasons, diabetes has long been linked with blood and urine glucose control, partly because these were clearly linked to acute symptoms, and partly because glucose became measurable around 200 years ago. Today it is recognized that there is far more to diabetes than simply monitoring symptoms and blood glucose. Intensive management has an impact on the quality of life. Late complications have their own risk factors and markers. Monitoring and early detection of these risk factors and markers can lead to changes in treatment before tissue damage is too severe. Accordingly, professionals now find themselves monitoring a range of adverse outcomes, markers for adverse outcomes, risk factors and risk markers for microvascular and arterial disease, acute complications of therapy, and the care structures needed to deliver this. Adverse outcomes lend themselves to targets for complication control in populations, and markers of adverse outcomes (such as retinopathy and raised albumin excretion rate) in treatment cohorts. Surveillance systems will have targets for yearly recall and review of early complications. Metabolic (surrogate) outcomes can be monitored in individual patients, but monitoring is only of value in so far as it guides interventions, and this requires comparison to some intervention level or absolute target. Even for blood glucose control this is not easy, for conventional measures such as glycated haemoglobin have their own problems, and more modern approaches such as post-prandial glucose levels are controversial and less convenient to measure. In many people with type 1 diabetes targets for blood pressure, LDL cholesterol, and serum triglycerides will also be appropriate, and need to be part of any protocol of management. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Etiology and Distribution of Headaches in Two Brazilian Primary Care Units

HEADACHE, Issue 3 2000
Marcelo E. Bigal MD
Objectives.,To determine (a) which patients seek primary care services with a complaint of headache, (b) the percentages of the various types of headache in this population, and (c) the impact of the care provided to these patients on the basic health care network. Background.,Headache is one of the most frequent symptoms reported in medical practice, resulting in significant medical services costs and loss of patient productivity, as well as reduced quality of life. Methods.,A prospective study was conducted in two towns (Ribeirão Preto and São Carlos) in the State of São Paulo, Brazil. The participants in the study consisted of 6006 patients (52.4% women) with highly varied acute symptoms. The patients ranged in age from 14 to 98 years. Results.,Headache as the main complaint was reported by 561 (9.3%) of the patients considered, with 312 (55.6%) of those patients presenting with primary headache, 221 (39.4%) with headaches secondary to systemic disorders, and 28 (5.0%) with headaches secondary to neurological disorders. Migraine, the most prevalent primary headache, accounted for 45.1% of patients reporting headache as the single symptom. The most frequent etiologies of headaches secondary to systemic disorders were fever, acute hypertension, and sinusitis. The most frequent headaches secondary to neurological disorders were posttraumatic headaches, headaches secondary to cervical disease, and expansive intracranial processes. Of the 26 cases of drug abuse, 20 were secondary to alcohol (hangover). Headaches secondary to systemic disorders were more frequent in the extreme age ranges. Conclusions.,Headache is a very frequent symptom among patients seen at primary health care units and should be considered a public health problem. The dissemination of the diagnostic criteria of the International Headache Society among primary health care physicians is urgently needed in order to avoid the repeated return of patients or their referral to more differentiated emergency units, which overburden an already insufficient health care network. [source]

Black, Hispanic, and White Women's Knowledge of the Symptoms of Acute Myocardial Infarction

Reviewing the efficacy of changing prophylactic measures for the prevention of bisphosphonate related osteonecrosis of the jaws (BRONJ) in the management of oral surgery patients

ORAL SURGERY, Issue 3 2010
C.J. Hanson
Abstract Aims:, Many papers postulate treatments for established bisphosphonate related osteonecrosis of the jaws (BRONJ) or advise on ideal long-term strategies to avoid BRONJ. This article demonstrates prophylactic regimes and compares their outcomes when patients' acute symptoms demand active treatments involving bone. It assesses the efficacy of the protocols developed at Dundee Dental Hospital for prophylaxis of BRONJ in the management of patients undergoing oral surgery. Materials and methods:, This prospective study tracked the progress of patients who were treated in the exodontia clinics and had taken, or were taking bisphosphonates. Their consequent recovery was documented over 1, 4, 12 and 24 weeks. The prophylactic protocol followed was recorded. These data were then reviewed for healing, operator, jaw predilection and co-morbidity influences. Results:, In total, 25 patients were treated over the 1 year period of the study 2008,09. This amounted to 33 oral surgery treatments involving 64 extractions. Several protocols had been followed however these were grouped into: antimicrobial or chlorhexidine based protocols. In all cases, complete healing was achieved. Concomitant steroid use and increasing age were the only associated co-morbidities that increased the length of healing time. There were no direct associations of any of the other variables with healing. No prophylactic protocol was superior to another with chlorhexidine rinses proving as efficacious as any of the antibiotic regimes. Conclusion:, For patients taking oral bisphosphonates, simple extractions carried out with minimal trauma by graduate and supervised undergraduate operators with prophylactic chlorhexidine rinses, heal as satisfactorily as those with antibiotic based protocols for prophylaxis. [source]

Assessment and validation of bronchodilation using the interrupter technique in preschool children,

PEDIATRIC PULMONOLOGY, Issue 7 2010
Laura Mele
Abstract Objective To determine and validate a cut-off value for bronchodilation using the interrupter resistance (Rint) in preschool children. Patients and Methods Rint was measured in 60 healthy children (age range 2.7,6.4 years) before and after salbutamol inhalation (200,µg). Four potential methods for assessing BDR were evaluated: percent change from baseline, percent change of predicted values, absolute change in Rint, and change in Z-score. These cut-off values, determined as the fifth percentile of the healthy group, were applied to children referred for the assessment of recurrent wheezing, classified on the basis of acute symptoms and/or abnormal chest examination into symptomatic (n,=,60, age range 2.9,6.1 years) and asymptomatic (n,=,60, age range 2.5,5.7 years) groups. Results The cut-off values for bronchodilation calculated in healthy children were: ,32% baseline; ,33% predicted; ,0.26,kPa L,1 sec; and ,1.25 Z-scores. Assessing BDR in children with a history of wheezing by either a decrease in absolute Rint or a decrease in Z-score gave sensitivity, specificity, negative predictive value, and positive predictive value all >80% for detecting children with current respiratory symptoms. Conclusions Both a decrease in Rint ,0.26,kPa L,1 sec and a decrease in Z-score of ,1.25 are appropriate for assessing BDR in preschool children with a history of recurrent wheezing. As Z-score is a more general solution, we recommend using a change in Z-score to determine BDR in preschool children. Further longitudinal studies will be required to determine the clinical utility of measuring BDR in managing lung disease in such children. Pediatr Pulmonol. 2010; 45:633,638. © 2010 Wiley-Liss, Inc. [source]

Knee pain in the ACL-deficient osteoarthritic knee and its relationship to quality of life

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2003
Michael Hartwick
Abstract Background and Purpose Pain during activities of daily living is a common presenting complaint of individuals with knee osteoarthritis and anterior cruciate ligament injury. Knee pain is also associated with a decrease in quality of life for people with osteoarthritis. The purpose of the present study was to examine the dose,response relationship between knee joint forces and painful symptoms, and whether the acute symptoms, were associated with individuals' quality of life. Method This was a cross-sectional cohort correlation study. Seventeen individuals with anterior cruciate ligament (ACL)-deficient knees diagnosed with ipsilateral knee osteoarthritis completed the ACL quality of life questionnaire (ACL-QOL). The subjects also rated pain associated with each of five incremental isometric knee extension tests, proportional to their body weight. Analysis of variance was used to assess the association between pain and normalized torque. Linear regression was used to assess the correlation between the ACL-QOL score and the total pain experienced during the graded test. Results A strong relationship was found between the level of perceived knee pain and the amount of isometric torque produced (Pearson's r = 0.98; p<0.001). There was a statistically significant relationship between pain during the graded isometric test and the ACL-QOL (Pearson's r = ,0.56; p = 0.016). Conclusions Since knee joint compression is a function of active isometric knee extension torque, increased painful symptoms were associated with increased compression forces at the knee joint for these subjects. The relationship between pain provocation and disease-specific quality of life provides evidence for the proposed joint provocation test for this subject population. Weakness caused by osteoarthritis (OA) may, in part, be a negative conditioning response that would need to be overcome in rehabilitation. Copyright © 2003 Whurr Publishers Ltd. [source]