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Distinct Clinical Features (distinct + clinical_feature)
Selected AbstractsBipolar II disorder: a reviewBIPOLAR DISORDERS, Issue 1 2005Michael Berk Objectives:, To review the current knowledge of bipolar II disorder. Methods:, Literature was reviewed after conducting a Medline search and a hand search of relevant literature. Results:, Bipolar II disorder is a common disorder, with a prevalence of approximately 3,5%. Distinct clinical features of bipolar II disorder have been described. The key to diagnosis is the recognition of past hypomania, while depression is the typical presenting feature of the illness. This is responsible for a significant rate of missed diagnosis, and consequent management according to unipolar guidelines. It is unclear if bipolar II disorder is over-represented amongst resistant depression populations and if abrupt offset of antidepressant action is a phenomenon over represented in bipolar II disorder, reflecting induction of predominantly depressive cycling. A few mood-stabilizer studies available provide provisional suggestion of utility. A supportive role for psychosocial therapies is suggested, however, there is a sparsity of published studies specific to bipolar II disorder cohorts. A small number of short-term antidepressant trials have suggested efficacy, however, compelling long-term maintenance data is absent. Conclusions:, An emerging literature on the specific clinical signature and management of the disorder exists, however, this is disproportionately small relative to the epidemiology and clinical significance of the disorder. [source] Angioleiomyoma: a clinical, pathological and radiological reviewINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2004P. Ramesh Summary Angioleiomyoma is a benign tumour arising from the vascular smooth muscle (tunica media) and presents commonly between third and fifth decades of life. Although there are sporadic reports about this tumour in the literature, none describes all the information in detail. This review is an attempt to collate all the facts in one concise article. Angioleiomyoma presents as a painful mass in approximately 60% of the cases. One of the distinct clinical feature noted is the increase in size of the swelling with physical activity of the involved part, especially in the hand. It should be considered in the differential diagnosis of painful nodular lesions of the extremity. Pre-operative diagnosis is difficult, but with a high index of suspicion and awareness, it is possible. The use of ultrasound and magnetic resonance imaging should be considered. It causes minimal morbidity and excision is usually curative. Histological examination using smooth muscle Actin stain portraits the smooth muscle bundles clearly. [source] Intrahepatic cholangiocarcinoma diagnosed preoperatively as hepatocellular carcinomaJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2004Masakazu Yamamoto MD Abstract Background Some cases of mass-forming intrahepatic cholangiocarcinoma (ICC) are diagnosed as hepatocellular carcinoma (HCC) based on preoperative imaging and clinical findings. We investigated the backgrounds of such cases. Methods Sixty-seven patients with mass-forming ICC underwent surgery from 1980 to 2002. Twenty-four of these patients received a diagnosis of HCC preoperatively. We compared the group diagnosed as HCC and that diagnosed as ICC. ICC was diagnosed histopathologically in all 67 patients. Results The specific clinical findings included high rates of associated hepatitis C virus infection, high levels of serum alpha fetoprotein, lower levels of serum CA19-9, small dimension of the tumor, hypervascular staining on angiography or computed tomography, lower rates of lymph node metastasis, and high rates of HCC occurrence in the group diagnosed as HCC. None of the patients underwent extrahepatic bile duct resection and most patients did not undergo lymph node dissection in the group diagnosed as HCC. The rates of mucus secretion and the ductal expression of mucin core protein-1 (MUC1) were significantly different between the subgroups. The cumulative survival rates were significantly better in the group diagnosed as HCC than in the group diagnosed as ICC. Conclusion Patients with ICC given a preoperative diagnosis of HCC had distinct clinical features and could be treated with the same operation as HCC patients. J. Surg. Oncol. 2004;87:80,83. © 2004 Wiley-Liss, Inc. [source] Imaging appearance of the symptomatic perforating artery in patients with lacunar infarction: Occlusion or other vascular pathology?ANNALS OF NEUROLOGY, Issue 2 2001Joanna M. Wardlaw FRCR Lacunar infarction is associated with distinct clinical features. It is thought to result from occlusion of a deep perforating artery in the basal ganglia, centrum semiovale, or brainstem. However, occluded perforating arteries have only rarely been observed at postmortem in patients with lacunar stroke and have not been noted previously on imaging despite the increasing sophistication of the techniques. We observed nine patients with lacunar stroke imaged with computed tomography and magnetic resonance imaging in whom we observed a linear structure with density or signal features consistent with an occluded (or at least abnormal) perforating artery associated with the relevant lacunar infarct. The appearance might also have been caused by a leak of blood and fluid into the perivascular space around the artery, as in several patients the width of the tubular vessel-like structure (>1mm in diameter) was greater than the expected width of a perforating artery (<0.8mm in diameter). This interpretation is supported by the fact that the area of infarction was usually around the abnormal vessel, not at the end of it. We describe the patients' clinical and imaging features, and discuss alternative explanations for the imaging appearance and the implications for gaining insights into the cause of lacunar infarction. [source] Systemic lupus erythematosus in a multiethnic US cohort: Clinical features, course, and outcome in patients with late-onset diseaseARTHRITIS & RHEUMATISM, Issue 5 2006Ana M. Bertoli Objective To examine the clinical differences and the type and extent of organ damage in late- versus early-onset systemic lupus erythematosus (SLE). Methods A nested case,control study was performed in the context of LUMINA (LUpus in MInorities, NAture versus nurture), a large, longitudinal, multiethnic cohort. Patients who developed SLE at or after the age of 50 years were considered cases. Two controls (patients who developed SLE at age ,49 years) per case, matched for sex and disease duration, were randomly chosen. Selected baseline socioeconomic/demographic, behavioral, and psychological features, self-reported quality of life, and cumulative clinical data (clinical manifestations, laboratory data, disease activity, damage, and mortality) were compared between cases and controls. Multivariable analyses with late-onset lupus, damage accrual, and mortality as dependent variables were then performed. Results Two hundred seventeen patients were studied. Of them, 73 were cases. Cases were more likely to have neurologic involvement, arterial thrombotic events, osteoporosis, and hypertriglyceridemia, while renal involvement and anti-Sm antibodies were less frequent. Disease activity at baseline was lower among cases. Cases also exhibited more cardiovascular and ocular damage. Late-onset lupus was an independent predictor of damage accrual (t -test = 2.23, P = 0.028), any damage at last visit (odds ratio [OR] 23.32, 95% confidence interval [95% CI] 3.98,141.56) (P < 0.001), and mortality (OR 10.74, 95% CI 3.07,37.56) (P < 0.001). Conclusion Patients with late-onset lupus exhibit distinct clinical features. Although disease activity tends to be lower in these patients, they tend to accrue more damage and experience higher mortality than patients with early-onset lupus. These findings probably reflect the contribution exerted by other comorbid conditions in the overall impact of lupus in these patients. [source] 1254: Diagnostic techniques for adnexal tumoursACTA OPHTHALMOLOGICA, Issue 2010S SEREGARD Purpose To outline clinical features and diagnostic techniques available for ocular adnexal tumours Methods Review of pertinent literature and personal unpublished data. Results Ocular adnexal tumours include a wide range of beningn and malignant neoplasms, some of which may be systemic. A correct pre-operative diagnosis is imperative for appropriate management of these tumours. In most cases a combination of distinct clinical features, pertinent review of the patient's history and the judicial use of salient diagnostic techniques, like exfolitaion cytology and punch biopsies will provide the clinician with an approach to manage these lesions. Conclusion The wide range of ocular adnexal tumours may cause significant clinical confusion. Recognition of distinct clinical features and judicial use of auxiliary diagnostic techniques will in most cases provide the clinician with a correct pre-operative diagnosis. [source] | ||||||||||