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Unexplained Syndromes (unexplained + syndrome)

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Medical Sciences	100%

Selected Abstracts

Clinical features associated with medically unexplained stroke-like symptoms presenting to an acute stroke unit

EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2005
F. S. Nazir
In many areas of secondary care, symptoms unexplained by disease account for around one-third of all patients seen. We sought to investigate patients presenting with medically unexplained stroke-like symptoms to identify distinguishing features which may help to identify a non-organic aetiology. Patients given a discharge diagnosis of medically unexplained stroke-like symptoms over the preceding 11 years were identified retrospectively from a prospectively completed stroke unit database. Age- and sex-matched controls with ischaemic or haemorrhagic stroke or transient ischaemic attack were also identified. Clinical features on presentation, ischaemic risk factors, alcohol history, marital status and history of depression or anxiety were examined. Previous or subsequent admissions with medically unexplained syndromes were also examined via record linkage with hospital discharge records. A medically unexplained syndrome was assumed to be present if an International Classification of Diseases 9 discharge code for one or more of the thirteen conditions forming recognized functional syndromes was given. Logistic regression was applied to determine predictors of non-organicity. One hundred and five patients and controls, 1.6% of all stroke unit admissions were identified, 62% (65 patients) were females. Mean age was 50.3 ± 14.9. Compared with age- and sex-matched controls patients with medically unexplained stroke-like symptoms were significantly more probable to have a headache at presentation (47% vs. 26%, P = 0.0004), have a diagnosis of one or more additional medically unexplained syndromes (24% vs. 11%, P = 0.007) but significantly less probable to present with symptoms of vertebrobasilar dysfunction (32% vs. 61%, P < 0.0001). A history of anxiety or depression, as recorded in the notes, was not found to be associated with a medically unexplained presentation. Medically unexplained stroke-like presentations are common (1.6% of all stroke presentations), they are most strongly predicted by the presence of other functional somatic syndromes, headache and the absence of symptoms of vertebrobasilar dysfunction. [source]

Symptoms after mould exposure including Stachybotrys chartarum, and comparison with darkroom disease

ALLERGY, Issue 2 2010
M. Al-Ahmad
To cite this article: Al-Ahmad M, Manno M, Ng V, Ribeiro M, Liss GM, Tarlo SM. Symptoms after mould exposure including Stachybotrys chartarum, and comparison with darkroom disease. Allergy 2010; 65: 245,255. Abstract Background:, Mould-attributed symptoms have included features which overlap with unexplained syndromes such as sick building syndrome. Objectives:, We describe questionnaire and chart review findings in patients following exposure to moulds which include Stachybotrys and compare responses with two control groups. Methods:, Thirty-two patients presented with symptoms attributed to mould exposures. Exposure identification for 25 patients had reported S tachybotrys chartarum as well as other mould (Aspergillus, Penicillium), 88% at work. The remaining seven had professionally visualized or self-reported/photographic exposure evidence only. A chart review was performed and a follow-up with a questionnaire, including questions on current health status, and nonspecific symptoms. Results:, Cough, shortness of breath and chest tightness (at presentation) were reported in 79%, 70% and 64%, respectively, and persisted >6 weeks in 91%. Skin test(s) were positive to fungal extract(s) in 30%. Seventeen returned questionnaires were obtained 3.1 (SD 0.5) years after the initial clinic assessment. Among this subgroup, persisting asthma-like symptoms and symptoms suggestive of sick building syndrome were frequent, and similar to a group previously assessed for darkroom disease among medical radiation technologists. The mould-exposed group more commonly reported they were bothered when walking in a room with carpets, complained of a chemical or metallic taste in their mouth, and had problems in concentration when compared with a control physiotherapist group (P < 0.005). Conclusions:, Although only a minority with health concerns from indoor mould exposure had demonstrable mould-allergy, a significant proportion had asthma-like symptoms. Other symptoms were also common and persistent after the initial implicated exposure. [source]

Work-attributed symptom clusters (darkroom disease) among radiographers versus physiotherapists: Associations between self-reported exposures and psychosocial stressors

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2004
FRCPC, Susan M. Tarlo MB
Abstract Background "Darkroom disease" (DRD) has been used to describe unexplained multiple symptoms attributed by radiographers to their work environment. This study determines the prevalence of symptom clusters similar to other unexplained syndromes among (medical radiation technologists (MRTs) as compared with physiotherapists (PTs), and identifies associated work-related (WR) factors. Methods A mail survey was undertaken of members of the professional associations of MRTs and PTs in Ontario, Canada. Questions were included to determine the prevalence and frequency of symptom clusters including abnormal tiredness as well as WR headaches, and symptoms suggestive of eye, nasal, and throat irritation. For the purpose of this study, these are considered to be DRD symptom clusters. Individuals with doctor-diagnosed asthma were excluded from our analyses. Results Overall, 63.9% of MRTs and 63.1% of PTs participated. Criteria for DRD were met by 7.8% of 1,483 MRTs and 1.8% of 1,545 PTs [odds ratio, OR 4.8 (confidence interval, CI 3.1,7.5); (P,<,0.0001)]. Both occupations showed significant associations between responses reflecting psychosocial stressors and DRD. Those with this symptom cluster were more likely to report additional symptoms than those without, and MRTs with DRD symptoms reported significantly more workplace chemical exposures. Conclusions Findings suggest excess symptoms consistent with DRD among MRTs versus PTs, and there were associations among those meeting our definition of DRD with self-reported irritant exposures and psychosocial stressors. Am. J. Ind. Med. 45:513,521, 2004. © 2004 Wiley-Liss, Inc. [source]