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Only Symptom (only + symptom)
Selected AbstractsHeadache As Only Symptom in Multiple Cervical Artery DissectionHEADACHE, Issue 5 2001Maarten Buyle MD We describe a patient with atypical headache as the only presenting symptom of spontaneous triple cervical artery dissection. As the patient suffered from arterial hypertension, a causative relation between headache and arterial hypertension was initially taken into consideration. However, four-vessel arteriography disclosed a dissection of both internal carotid arteries and the right vertebral artery. This unique case highlights the value of conventional arteriography for diagnosing cervical artery dissection. Since multiple cervical artery dissections are not rare, all cervical arteries should be examined by means of conventional arteriography when a dissection is suspected. [source] Assessing diabetic control , reliability of methods available in resource poor settingsDIABETIC MEDICINE, Issue 3 2002A. P. Rotchford Abstract Aims and methods To examine the reliability of random venous or capillary blood glucose testing, random urine glucose testing, and a current symptom history in predicting a high HbA1c in Type 2 diabetic patients taking oral hypoglycaemic agents in a poorly controlled rural African population. Results For a cut-off point for HbA1c of , 8%, for random venous plasma glucose of , 14 mmol/L (present in 47.2% of subjects), specificity was 97.1% (95% CI 85.1,99.9), sensitivity 56.8% (48.8,64.5) and positive predictive value (PPV) 98.9% (94.2,99.9). HbA1c, 8% is predicted by a random capillary blood glucose of 17 mmol/L (present in 28.4% of subjects) with specificity 100% (90.0,100.0), PPV 100% (93.7,100.0) and sensitivity of 34.3% (27.2,42.1). HbA1c, 8% is predicted by the presence of heavy glycosuria (, 55 mmol/L) (present in 35.6%) with specificity 94.1% (80.3,99.3), sensitivity of 41.9% (34.1,49.9) and PPV 97.1% (89.9,99.6). Polyuria/nocturia (present in 31.3%) was the only symptom found to be associated with poor control, with a specificity for predicting HbA1c of , 8% of 81.5% (61.9,93.7), PPV 89.1% (76.4,96.4) and sensitivity 30.6% (22.9,39.1). Conclusions Where resources are short, random glucose testing can be used to detect a significant proportion of those with the worst control with a high degree of specificity enabling primary care staff to modify treatment safely. Where facilities are limited capillary blood or urine testing with reagent strips, may be substituted for venous plasma testing in the laboratory. A symptom history was insufficient to replace biochemical testing, but where this is unavailable, urinary symptoms may be helpful. Diabet. Med. 19, 195,200 (2002) [source] Bladder pheochromocytoma encountered on sonographyJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2004M Çelikta Summary Pheochromocytomas of the bladder are rare neoplasms, constituting <0.06% of all vesical tumours. Common presenting features of this tumour include episodes of sweating, hypertension, haematuria and postmicturition syncope. We describe a case of bladder pheochromocytoma in a 66-year-old man whose only symptom of macroscopic haematuria was initially assessed with ultrasonography. Clinical presentation highlights the need for a high index of suspicion during sonographic evaluation of bladder neoplasms because such tumours might present without symptoms of adrenergic excess. [source] Late onset Wilson's disease: Therapeutic implicationsMOVEMENT DISORDERS, Issue 6 2008Anna Cz, onkowska MD Abstract The clinical symptoms of Wilson's disease (WD) usually develop between 3 and 40 years of age and include signs of liver and/or neurologic and psychiatric disease. We report on an 84-year-old woman with WD. Despite the absence of treatment, the only symptom she presented with, until the age of 74 years, was Kayser-Fleisher rings. At the age of 74, she developed slightly abnormal liver function. This case raises the following issues: (a) Should WD be considered in all patients of all ages who manifest signs related to the disease? (b) Are ATP7B mutations fully penetrant? (c) Should all patients diagnosed presymptomatically receive anticopper therapy? © 2008 Movement Disorder Society [source] Menopausal symptom perception and severity: results from a screening questionnaireJOURNAL OF CLINICAL NURSING, Issue 7 2008FAANP, Judith A Berg PhD Background., Although it is widely acknowledged women experience symptoms during their transition from reproductive to postreproductive stage, there is inconsistency as to the prevalence of symptoms as well as their severity ratings. Aim and objectives., The purpose of this study was to describe symptom perception and severity in mid-life women volunteering for an intervention study for menopause symptom management. Design., A cross-sectional descriptive design was used to provide data on presenting symptoms in a sample of women negotiating the menopausal transition. Methods., A community-based sample of Caucasian women aged 43,55 years was recruited from national nursing media, local media and a variety of local community sources. A screening questionnaire was administered to determine qualification for study entry based upon symptom severity scores from the questionnaire. This report includes results from the screening questionnaire. Results., One hundred and sixty-five women were screened to obtain 110 qualified participants with mean age of 49·3 SD 3·04 years who were 4·7 SD 7 months past their last menstrual period. Sleep difficulties, forgetfulness and irritability were perceived by the highest number of women while sleep difficulties, night sweats, irritability and forgetfulness were rated the most severe. Conclusions., Findings from this study expand understanding of the menopause symptom experience, because few reports include symptom severity reports. All aspects of the symptom experience are necessary to develop appropriate interventions and to evaluate them. Relevance to clinical practice., Providing education about menopause symptoms is central to nursing practice of mid-life women. Therefore, nurses must keep abreast of current knowledge to prepare women for their transition to postreproductive phase or to reassure women who are surprised to find hot flashes are not the only symptoms encountered. [source] Rapid and sensitive detection of mumps virus RNA directly from clinical samples by real-time PCRJOURNAL OF MEDICAL VIROLOGY, Issue 3 2005Kazue Uchida Abstract A rapid, sensitive, and specific assay to detect mumps virus RNA directly from clinical specimens using a real-time PCR assay was developed. The assay was capable of detecting five copies of standard plasmid containing cDNA from the mumps virus F gene. No cross-reactions were observed with other members of Paramyxoviridae, or with viruses or bacteria known to be meningitis pathogens. Seventy-three clinical samples consisting of throat swabs collected from patients with parotitis, and cerebrospinal fluid (CSF) collected from patients with aseptic meningitis, were examined with a real-time PCR assay developed by the authors, reverse-transcription nested-PCR (RT-n-PCR), and virus isolation using cell culture. Like the RT-n-PCR assay, the real-time PCR assay could detect mumps virus RNA in approximately 70% of both throat swabs and CSF samples, while, by tissue culture, mumps virus was isolated from only approximately 20% of CSF and 50% of throat swab samples. In addition, the real-time PCR assay could be developed easily into a quantitative assay for clinical specimens containing more than 1,800 copies of mumps virus RNA/ml by using serial dilutions of the standard plasmid. The results suggest that the real-time PCR assay is useful for identification of mumps virus infections, not only in typical cases, but also in suspected cases, which show only symptoms of meningitis or encephalitis. J. Med. Virol. 75:470,474, 2005. © 2005 Wiley-Liss, Inc. [source] | ||||||||||