Severe Symptoms (severe + symptom)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Clinical guideline for male lower urinary tract symptoms

Yukio Homma
Abstract: This article is a shortened version of the clinical guideline for lower urinary tract symptoms (LUTS), which has been developed in Japan for symptomatic men aged 50 years and over irrespective of presumed diagnoses. The guideline was formed on the PubMed database between 1995 and 2007 and other relevant sources. The causes of male LUTS are diverse and attributable to diseases/dysfunctions of the lower urinary tract, prostate, nervous system, and other organ systems, with benign prostatic hyperplasia, bladder dysfunction, polyuria, and their combination being most common. The mandatory assessment should comprise medical history, physical examination, urinalysis, and measurement of serum prostate-specific antigen. Symptom and quality of life questionnaires, bladder diary, residual urine measurement, urine cytology, urine culture, measurement of serum creatinine, and urinary tract ultrasonography would be optional tests. The Core Lower Urinary Tract Symptom Score Questionnaire may be useful in quickly capturing important symptoms. Severe symptoms, pain symptoms, and other clinical problems would indicate urological referral. One should be careful not to overlook underlying diseases such as infection or malignancy. The treatment should be initiated with conservative therapy and/or medicine such as ,1 -blockers. Treatment with anticholinergic agents should be reserved only for urologists, considering the risk of urinary retention. The present guideline should help urologists and especially non-urologists treat men with LUTS. [source]

Consequences of frequent nocturnal gastro-oesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity

Summary Background Effects of frequent nocturnal symptoms of gastro-oesophageal reflux disease (GERD-FNS) on health-related quality of life (HRQOL) and work productivity are not well documented. Aim To assess symptom severity, production loss, and HRQOL among employed adults with and without GERD-FNS. Methods Using several validated outcome measures in a web survey design, GERD was pre-specified as GERD Symptom and Medication Questionnaire score >9, and ,1 episode of heartburn or acid regurgitation during the preceding week. GERD-FNS patients were those reporting ,2 symptom-nights during the previous week; their outcomes were compared with those of patients having minimal or no nocturnal symptoms (GERD-NNS) and vs. non-GERD controls. Results Data were collected from 1002 GERD patients (476 GERD-FNS, 526 GERD-NNS) and 513 controls. Severe symptoms were more common, sleep abnormalities were more frequent (P < 0.0001) and SF-36 scores lower (P < 0.05, all scores) among GERD-FNS patients vs. GERD-NNS patients. GERD-related work loss was greater among those with GERD-FNS vs. GERD-NNS (P < 0.0001). Work loss and functional limitations were more pronounced when comparing GERD-FNS cases vs. non-GERD controls. Conclusion Employed adults with frequent nocturnal GERD report more severe symptoms, and are associated with impaired sleep, HRQOL and work productivity compared with controls and patients with minimal or no nocturnal symptoms. [source]

Today's allergic rhinitis patients are different: new factors that may play a role

ALLERGY, Issue 9 2007
R. Mösges
Most of today's patients suffering from allergic rhinitis (AR) are sensitized to more than one trigger and suffer from persistent and moderate/severe symptoms, which severely impair their quality of life (QOL). The objective of this article was to review the data on the effect of increased air pollution, changes in indoor environment/lifestyle/affluence, exposure to new allergens and psychologically stressful lifestyles, as also to explore their potential in the development of this more ,aggressive' form of disease. Increased fossil fuel-generated air pollution may increase the risk of allergic sensitization, airway responsiveness to allergens, and allergenicity and the bioavailability of airborne allergens. Changes in indoor environment/lifestyle/affluence appear to have led to more time being spent indoors and resulted in perennial exposure to indoor allergens, changes in sensitization patterns, and polysensitization to a variety of novel cross-reacting exotic food and pet allergens. Although evidence suggests an association between psychological stress and increased risk for atopy and allergic disease, further studies are required to demonstrate this unequivocally. The more persistent and moderate/severe nature of the disease suggests a need for modification of current treatment strategies and advocacy of the use from the outset of agents, which are both efficacious and safe in managing severe and persistent AR symptoms and in improving the QOL of affected individuals. [source]

Zebrafish as a model for long QT syndrome: the evidence and the means of manipulating zebrafish gene expression

I. U. S. Leong
Abstract Congenital long QT syndrome (LQT) is a group of cardiac disorders associated with the dysfunction of cardiac ion channels. It is characterized by prolongation of the QT-interval, episodes of syncope and even sudden death. Individuals may remain asymptomatic for most of their lives while others present with severe symptoms. This heterogeneity in phenotype makes diagnosis difficult with a greater emphasis on more targeted therapy. As a means of understanding the molecular mechanisms underlying LQT syndrome, evaluating the effect of modifier genes on disease severity as well as to test new therapies, the development of model systems remains an important research tool. Mice have predominantly been the animal model of choice for cardiac arrhythmia research, but there have been varying degrees of success in recapitulating the human symptoms; the mouse cardiac action potential (AP) and surface electrocardiograms exhibit major differences from those of the human heart. Against this background, the zebrafish is an emerging vertebrate disease modelling species that offers advantages in analysing LQT syndrome, not least because its cardiac AP much more closely resembles that of the human. This article highlights the use and potential of this species in LQT syndrome modelling, and as a platform for the in vivo assessment of putative disease-causing mutations in LQT genes, and of therapeutic interventions. [source]

Gaining time: early treatment of severe pediatric malaria in Tanzania

M.F. Gomes
Abstract Early effective treatment prevents death or disability from malaria. In malaria-endemic rural areas, pediatric patients who cannot take drugs orally and require injectable treatment have to be transported to the nearest facility that can give injectable malaria drugs. If time to reach the hospital is long, pre-referral treatment and effective referral can play a major positive role. We compare the clinical course of illness and time taken to reach hospital in patients from Study 13, a randomized controlled study of pre-referral rectal artesunate in which rapid referral was emphasized, with a comparator group of pediatric patients admitted at the same hospital in Tanzania whose parents' actions prior to admission at the hospital reflected routine behavior. The key difference was that parents of sick children from the intervention study rapidly transferred their children to the hospital following the advice they were given. Time gained by the referral study was 48,h and this difference was reflected in less severe symptoms at admission. Efforts to improve referral advice in the community can be a powerful complement to other malaria case management strategies. Drug Dev Res 71: 92,98, 2010. © 2009 Wiley-Liss, Inc. [source]

Hosts and symptoms of Plum pox virus: fruiting Prunus species

EPPO BULLETIN, Issue 2 2006
G. Llácer
A description of plum pox (sharka) symptoms on European and Japanese plum, apricot, peach, sweet and sour cherry and almond is presented. Plum pox is a serious disease mainly because it produces severe symptoms on fruits of numerous cultivars of Prunus species, causing fruit to fall or making them unfit for consumption. [source]

Corticosteroid side-effects and risk for bleeding in immune thrombocytopenic purpura: patient and hematologist perspectives

Jacqueline A. Guidry
Abstract Objectives:, The purpose of this study was to examine hematologist and patient perspectives about the side-effects of the corticosteroid treatment of immune thrombocytopenic purpura (ITP) and their perspectives about the patient's risk for bleeding. The specific aim was to compare patient and hematologist perspectives and, if a difference was documented, the implications of that difference. We hypothesized that patients with ITP may have more concern about corticosteroid side-effects and less concern about serious bleeding than hematologists. Methods:, We surveyed 80 patients in the Oklahoma ITP Registry and all 83 hematologists in Oklahoma about the occurrence and severity of 18 corticosteroid side-effects and risks for serious bleeding. Results:, Response rates were 80% (patients) and 71% (hematologists). Responses of patients and hematologists were significantly different from each other regarding both the frequency of severe corticosteroid side-effects and the risk of serious bleeding. For 13 of the 18 corticosteroid side-effects, patients reported more frequent occurrence of severe symptoms than hematologists (P < 0.05); physicians reported more frequent occurrence for one side-effect (P < 0.05). Conversely, 69% and 93% of hematologists reported being very worried about serious bleeding when responding to two case scenarios describing patients with platelet counts of 10 000/,L and 5000/,L (P < 0.05), compared with only 16 (31%) of 51 patients whose lowest platelet count had been <10 000/,L. Conclusion:, Awareness of the different opinions about corticosteroid side-effects and risk for bleeding between ITP patients and hematologists may improve management decisions. [source]

To tell or not to tell: Men's disclosure of their HIV-positive status to their mothers,

Constance L. Shehan
Abstract: Disclosing an HIV diagnosis to his mother may be the first step in a man's successful management of his illness, but it may also lead to added stress due to stigmatization. Analyzing data provided by 166 HIV-positive men who lived in the southeastern United States, we found that the most powerful correlate of disclosure was exposure to HIV through homosexual contact. Additionally, those who had AIDS rather than HIV and exhibited more severe symptoms were significantly more likely to have disclosed to their mothers; older and more highly educated men were significantly less likely to have done so. We discuss the implications of our findings for maternal caregiving to adult sons in middle and later life. [source]

Coherence in consciousness: Paralimbic gamma synchrony of self-reference links conscious experiences

Hans C. Lou
Abstract A coherent and meaningful percept of the world is essential for human nature. Consequently, much speculation has focused on how this is achieved in the brain. It is thought that all conscious experiences have reference to the self. Self-reference may either be minimal or extended, i.e., autonoetic. In minimal self-reference subjective experiences are self-aware in the weak sense that there is something it feels like for the subject to experience something. In autonoetic consciousness, consciousness emerges, by definition, by retrieval of memories of personally experienced events (episodic memory). It has been shown with transcranial magnetic stimulation (TMS) that a medial paralimbic circuitry is critical for self-reference. This circuitry includes anterior cingulate/medial prefrontal and posterior cingulate/medial parietal cortices, connected directly and via thalamus. We here hypothesized that interaction in the circuitry may bind conscious experiences with widely different degrees of self-reference through synchrony of high frequency oscillations as a common neural event. This hypothesis was confirmed with magneto-encephalography (MEG). The observed coupling between the neural events in conscious experience may explain the sense of unity of consciousness and the severe symptoms associated with paralimbic dysfunction. Hum Brain Mapp, 2010. © 2009 Wiley-Liss, Inc. [source]

Prevalence of lower urinary tract symptoms in a community-based survey of men in Turkey

Abstract Aim: The aim of the present study was to determine the frequency of lower urinary tract symptoms (LUTS), assess the impact of LUTS on quality of life (QOL) and compare the results with recent reports from other population-based studies. Methods: A total of 266 men participated in the study. The men were stratified into 10-year age groups between 40 and 79 years. All participants were asked to complete a questionnaire that included a Turkish translation of the International Prostate Symptom Score (IPSS) with QOL questions, and void into a uroflowmeter to obtain voided urine volume, peak and mean flow rate. Results: While 14.8% of men had no symptoms (IPSS = 0), 24.9% had moderate to severe symptoms (IPSS> 7). Severity of symptoms increased with age (P= 0.0018). There was a strong relationship between bother score and IPSS (rs= 0.79, P= 0.0001). Fifty-five percent of moderately symptomatic and 78% of severely symptomatic men reported poor QOL (QOL score , 3). The results of the survey provide a general picture of the symptomatology and urinary flow profiles of elderly men living in Turkey. Conclusion: The prevalence of LUTS in the Turkish community is fairly high, it increases with age and has an impact on QOL that is not negligible. [source]

Quality of life in partners of people with congestive heart failure: gender and involvement in care

Marie Louise Luttik
Abstract Title.,Quality of life in partners of people with congestive heart failure: gender and involvement in care. Aim., This paper is a report of a study conducted to investigate quality of life in partners of people with congestive heart failure in comparison to individuals living with a healthy partner. Background., Congestive heart failure is a chronic debilitating disease with severe symptoms and complex treatment. The support of partners is essential in the management of congestive heart failure. Living with a chronic illness generally affects the quality of life of patients and their partners. Method., Data were collected using a cross-sectional, comparative design between October 2002 and February 2005 with 303 partners of people with congestive heart failure. Reference data were collected in 304 age- and gender-matched individuals living with a healthy partner, drawn from the general population. All respondents completed questionnaires at home on quality of life and general well-being. Analysis of variance was used to analyse the data. Findings., Overall, differences in quality of life between partners of people with heart failure and matched controls were small. However, substantial variation in the quality of life of partners was found by exploring the role of gender and involvement in care. Quality of life scores varied strongly for male and female partners who had to perform caregiving tasks. The performance of these caregiving tasks was negatively associated with the quality of life of female partners but not with that of male partners. Conclusion., Female partners especially should not be overlooked when they become involved in personal care tasks. Nurses should not be reluctant to involve male partners in caring for women with heart failure. [source]

Analysis of clinical characteristics of dyspeptic symptoms in Shanghai patients

Xiao Bo LI
OBJECTIVE: To improve the management of dyspepsia by analyzing the clinical characteristics of dyspeptic symptoms in patients from Shanghai. METHODS: 782 patients with functional dyspepsia (FD) or organic dyspepsia (OD) completed a questionnaire about dyspepsia. The questionnaire asked participants to score 12 previously validated common upper abdominal symptoms. The clinical characteristics of dyspepsia including severe symptoms; and the relationship between symptoms and meals were then analyzed. RESULTS: Among the 782 dyspeptic patients, 543 cases (69.4%) were classed as FD and 239 (30.6%) OD. The proportion of males was significantly higher in the OD group. There was no difference in average dyspepsia scores between the 2 dyspeptic groups (21.5 vs 20.4, P > 0.05), but the scores of ,stomach' pain and ,stomach' pain before meals were higher in OD patients than in FD patients (2.65 ± 1.11 vs 2.16 ± 0.92, 2.26 ± 1.26 vs 1.79 ± 0.92, P < 0.05). In 45.2% of the OD patients and 47.7% of the FD patients, respectively, the severity of symptoms was not related to meals. In subgroups of ulcer-like, dysmotility-like and unspecified dyspepsia, the proportion of patients with symptoms not related to meals was 59.6%, 50.9% and 35.2%, respectively. 2.5% (6/239) of OD patients presented with progressive dysphagia, compared with 2.8% (15/543) of FD patients who presented with intermittent dysphagia. Approximately 8.8% (21/239) of OD patients reported dramatic weight loss accompanied with other severe symptoms, compared with 5.9% (32/543) of FD patients who had no other severe symptoms. A shift in symptom subtypes during the follow-up period was found in 13.8% of FD patients. The infection rate of Helicobacter pylori was higher in the OD group than in the FD group (53.1%vs 42.2%, P < 0.01), but no difference was found among the three subgroups of FD patients (P > 0.05). Halitosis was more often found in dyspeptic patients with H. pylori infection (44.9%vs 17.0% in OD, 47.3%vs 25.4% in FD, P < 0.01). CONCLUSIONS: When dyspepsia patients present with ,stomach' pain or ,stomach' pain before meals, a diagnosis of OD should be considered. Intermittent dysphagia, weight loss not accompanied with other severe symptoms, and halitosis (more often seen in patients with H. pylori infection) might be regarded as the relatively unique symptoms of dyspepsia in some FD patients. In FD, we found that the severity of dyspepsia symptoms was not related to meals in half of the patients, and symptom subtypes might shift over time, this adds difficulty to the management of FD. [source]

Quantitative evaluation of prostatectomy for benign prostatic hypertrophy under a national health insurance law: a multi-centre study

D. Pilpel PhD
Abstract Assessing regional variation between various medical centres in diagnostic and surgical processes is an approach aimed at evaluating the quality of care. This study analyses the differences between eight medical centres in Israel, where all citizens are covered by medical insurance, through the National Health Insurance Law (NHIL). The analysis refers to the diagnostic process, type of surgery and immediate post-surgical complications associated with prostatectomy for benign prostatic hypertrophy (BPH), which is the most frequent surgical procedure performed on men aged 50+. The study sample was comprized of 261 consecutive prostatectomy patients operated on in eight Israeli medical centres (MC), located in various parts of the country, between November 1996 and April 1997. Co-operation with participating directors of surgical wards was obtained after confidentiality of information had been assured. Surgeons in selected departments abstracted data routinely recorded in the patient's file and filled-out a standard one-page questionnaire. The following items were included: age, the presence of accompanying chronic diseases, preoperative tests, type of operation, and post-surgical complications. In the various MCs 32.6% of the patients underwent more than five preoperative tests ranging from 8.9% to 88.9% (<0.01). Assessment of kidney and bladder normality ranged from 75% to 100% (P < 0.01). The rate of patients whose prostatic symptoms (I-PSS) were assessed ranged from 0% to 79% (P < 0.01). There were also differences in severity of prostatism between the MCs, with severe symptoms ranging from 54.0% to 89.3% (P < 0.05), for type of operation performed (for ,open' prostatectomies, 35.4% to 68.0%, P < 0.01) and post-operative complications (19.0% to 41.6%, P = 0.07). After controlling for case-mix, type of operation was the most important predictor for post-surgical complications. MCs with low volume of surgeries had a higher rate of postoperative complications. We conclude that diagnostic and type of operation and post-surgical complications differed between various MCs. Participating surgeons were willing to fill out a one-page standard questionnaire from data routinely recorded in patients' files. [source]

Discovery of rotavirus: Implications for Child health

Ruth Bishop
Abstract For centuries, acute diarrhea has been a major worldwide cause of death in young children, and until 1973, no infectious agents could be identified in about 80% of patients admitted to hospital with severe dehydrating diarrhea. In 1973 Ruth Bishop, Geoffrey Davidson, Ian Holmes, and Brian Ruck identified abundant particles of a ,new' virus (rotavirus) in the cytoplasm of mature epithelial cells lining duodenal villi and in feces, from such children admitted to the Royal Children's Hospital, Melbourne. Rotaviruses have now been shown to cause 40,50% of severe acute diarrhea in young children worldwide in both developing and developed countries, and > 600 000 young children die annually from rotavirus disease, predominantly in South-East Asia and sub-Saharan Africa. Longitudinal surveillance studies following primary infection in young children have shown that rotavirus reinfections are common. However the immune response that develops after primary infection is protective against severe symptoms on reinfection. This observation became the basis for development of live oral rotavirus vaccines. Two safe and effective vaccines are now licensed in 100 countries and in use in 17 countries (including Australia). Rotarix (GSK) is a single attenuated human rotavirus, representative of the most common serotype identified worldwide (G1P[8]). RotaTeq (Merck) is a pentavalent mixture of naturally attenuated bovine/human rotavirus reassortants representing G1, G2, G3, G4, and P(8) serotypes. Preliminary surveillance of the numbers of children requiring hospitalization for severe diarrhea, in USA, Brazil, and Australia, after introduction of these vaccines, encourages the hope that rotavirus infection need no longer be a threat to young children worldwide. [source]

Genetically distinct strains of Candida albicans with elevated secretory proteinase production are associated with diarrhoea in hospitalized children

Leslie T Mathaba
Abstract Background: Candida albicans has been implicated as the aetiological agent in a significant percentage of children with diarrhoea. The virulence properties of C. albicans strains associated with acute and chronic diarrhoea in hospitalized children were investigated. Methods: The genotypic relationships between the isolates were determined using restriction enzyme analysis and hybridization with a C. albicans -specific DNA probe, 27A. Results and Conclusion: In patients with acute and chronic diarrhoea, there is evidence for selection of specific, genetically distinct strains of C. albicans. Higher levels of secretory Candida acid proteinase produced by isolates from patients with acute diarrhoea may account for the more severe symptoms. However, the lower adherence of these isolates may predispose to the rapid (within 2 to 4 days) resolution of the condition. In patients with chronic diarrhoea the lower levels of proteinase produced correlate with the less severe symptoms, while the increased adherence may account for the persistence of the infection. [source]

Antibacterial peptides: basic facts and emerging concepts

H. G. Boman
Abstract., Boman HG (Microbiology and Tumor Biology Center, Karolinska Institutet, Stockholm, Sweden). Antibacterial peptides: basic facts and emerging concepts (Review). J Intern Med 2003; 254: 197,215. Antibacterial peptides are the effector molecules of innate immunity. Generally they contain 15,45 amino acid residues and the net charge is positive. The cecropin type of linear peptides without cysteine were found first in insects, whilst the defensin type with three disulphide bridges were found in rabbit granulocytes. Now a database stores more than 800 sequences of antibacterial peptides and proteins from the animal and plant kingdoms. Generally, each species has 15,40 peptides made from genes, which code for only one precursor. The dominating targets are bacterial membranes and the killing reaction must be faster than the growth rate of the bacteria. Some antibacterial peptides are clearly multifunctional and an attempt to predict this property from the hydrophobicity of all amino acid side chains are given. Gene structures and biosynthesis are known both in the fruit fly Drosophila and several mammals. Humans need two classes of defensins and the cathelicidin-derived linear peptide LL-37. Clinical cases show that deficiencies in these peptides give severe symptoms. Examples given are morbus Kostmann and atopic allergy. Several antibacterial peptides are being developed as drugs. [source]

The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males

N. J. Nassif
Summary, A temporomandibular disorder (TMD) screening history and screening examination was performed on 523 young adult males. The screening forms were similar to those TMD forms developed and formulated under the auspices of the American College of Prosthodontists. In turn, the substance of the latter forms was initially derived from the recommendations of the President's TMD Conference of the American Dental Association, with 62 eminent researchers, educators and clinicians as participants. Each subject was given a TMD self-administered screening history form to complete, formatted in a check , the block format. It included all items considered to be classic TMD symptoms. The screening examination was performed extraorally and included (i) range of jaw movement, (ii) digital palpation of selected masticatory muscles and palpation over the pre-auricular temporomandibula joint (TMJ) area and (iii) digital palpation for TMJ sounds during jaw movement. The subjects were categorized into the following four categories: 0 = no symptoms/signs, 1 = insignificant moderate symptoms and/or signs, 2 = significant moderate symptoms and/or signs, and 3 = severe symptoms and/or signs. The overall results showed that 75% of the subjects had TMD symptoms and/or signs. There were 6·9% in category 1, 51·4% in category 2, and 16·7% in category 3. It was recommended that subjects in category 2 and 3 should have a comprehensive TMD evaluation, in order to further identify the recommended need for TMD Therapy. [source]

Laryngeal foreign bodies in children: First stop before the right main bronchus

PJ Robinson
Abstract: Laryngeal foreign bodies may produce either complete or incomplete airways obstruction. In complete airways obstruction the presentation is with calamitous respiratory difficulty. However incomplete laryngeal obstruction may present with less severe symptoms, resulting in possible misdiagnosis and confusion with other causes of upper airway obstruction such as infectious croup. This report describes three cases of incomplete laryngeal obstruction secondary to inhaled foreign bodies. In each case, the diagnosis of an inhaled foreign body was initially missed, resulting in delay in diagnosis and in one case prolonged recovery. The importance of considering laryngeal foreign bodies, both in cases of suspected foreign body inhalation and clinical cases of incomplete laryngeal obstruction are discussed. [source]

RT-PCR Detection of Odontoglossum ringspot virus, Cymbidium mosaic virus and Tospoviruses and Association of Infections with Leaf-Yellowing Symptoms in Phalaenopsis

K. Yamane
Abstract Leaf-yellowing symptoms in Phalaenopsis are most important effects in its commercial production in Japan and their cause has not yet been clarified. In the present study, Odontoglossum ringspot virus (ORSV), Cymbidium mosaic virus (CymMV) and tospoviruses were evaluated by reverse transcription-polymerase chain reaction (RT-PCR) in Phalaenopsis showing leaf-yellowing symptoms. Ring, spot, mosaic, necrosis and other symptom types were observed in 42%, 24%, 25%, 16% and 44% of the tested plants respectively. ORSV was detected in 55% of the plants, particularly in 35 of 42 plants with ring symptoms. CymMV was detected in 34% of the plants, particularly in 18 of 25 plants with mosaic symptoms. Plants co-infected with both viruses tended to show severe symptoms. In spite of systemic infection by inoculation of ORSV, no clear ring symptoms were observed in any plant for 6 months. Symptoms of leaf-yellowing were significantly reduced after 3 months. These results suggest that the symptoms can be associated with the viruses but occurred and alleviated over time and by changes in the environmental conditions. No tospoviruses were detected in 70 tested plants. ORSV and CymMV were simultaneously detected by RT-PCR using reported primers for ORSV and newly designed primers for CymMV using an efficient direct tube RNA extraction technique providing more cost-effective RT-PCR screening. No viruses were detected by RT-PCR in several plants showing spot or ring symptoms, suggesting the presence of other causal agents related to these symptoms. [source]

PCR-based Detection and Differentiation of Anthracnose Pathogens, Colletotrichum gloeosporioides and C. truncatum, from Vegetable Soybean in Taiwan

L. S. Chen
Abstract Anthracnose of vegetable soybean sometimes occurs in summer and causes severe symptoms and yield loss in southern Taiwan. Despite previous reports that Glomerella glycines and Colletotrichum truncatum were causal agents of soybean anthracnose, C. truncatum and C. gloeosporioides (teleomorph G. cingulata), but not G. glycines, were identified as the major pathogens causing anthracnose on the pods and stems of vegetable soybeans from 2003 to 2005. Most strains of C. truncatum and C. gloeosporioides were derived from diseased pods. Morphological formation of fruiting bodies separates the Colletotrichum isolates into two groups. Colletotrichum truncatum forms acervuli only while C. gloeosporioides produces acervuli and/or perithecia. Based on the sequence variation in the ITS1 and ITS2 regions, C. truncatum isolates were highly similar (99,100% nucleotide identity) while C. gloeosporioides isolates diverged into two separate groups that were not associated with morphotype. For early detection of C. truncatum and C. gloeosporioides infection on vegetable soybean plants, two species-specific primer pairs Colg 1/Colg 2 (expected size of 443 bp) and Colg 1/CT 2 (375 bp) were designed that allowed differentiation of C. gloeosporioides and C. truncatum in multiplex polymerase chain reaction. [source]

Molecular Analysis of Zucchini yellow mosaic virus Isolates from Hangzhou, China

M.-F. Zhao
Abstract Isolates of Zucchini yellow mosaic virus were obtained from different cucurbit crops in Hangzhou city, China. The complete nucleotide sequences of four isolates and the 3,-terminal sequences, including the coat protein coding region, of four others were determined and then compared with other available sequences. Phylogenetic analysis of the coat protein nucleotide sequences showed that these isolates fell into three significant groups, one of which (designated group III) consisted exclusively of Chinese isolates and is reported for the first time. Comparisons over the completely sequenced genomes showed that, typically for potyviruses, the 5,-end of the genome was usually the most variable but that the group III isolate differed from the others most significantly in the N-terminal part of the coat protein. Partially sequenced group III isolates also varied from other isolates in this region. Group III isolates appear to differ biologically from the other isolates because they do not cause symptoms in watermelon fruit but induce more severe symptoms on the watermelon leaves. [source]

Sequence of a Second Isolate of Chinese Wheat Mosaic Furovirus

The nucleotide sequences of the two RNAs of an isolate of Chinese wheat mosaic furovirus (CWMV) from Rongcheng, Shandong province, China, where the infected wheat crop developed particularly severe symptoms, were determined. The two RNAs consisted of 7147 and 3564 nucleotides, and shared 95.5% identity to those of the Yantai CWMV isolate previously described. Differences were greatest in the coat protein readthrough domain and the 19 kDa cysteine-rich protein (both on RNA2). A CGxxH amino acid sequence motif common to the cysteine-rich proteins of the genera Furovirus, Hordeivirus, Tobravirus and Pecluvirus was detected. Sequenz eines zweiten Isolats des Chinese wheat mosaic furovirus Bei einem Isolat des Chinese wheat mosaic furovirus (CWMV) aus Rongcheng, Provinz Shandong, China, wurden die Nucleotidsequenzen der zwei RNAs bestimmt. In Rongcheng zeigten die befallenen Weizenpflanzen besonders schwere Symptome. Die beiden RNAs bestanden aus 7147 bzw. 3564 nts und waren zu 95,5% identisch mit denjenigen des bereits beschriebenen Yantai CWMV-Isolats. Die größten Unterschiede fanden sich in der Readthrough-Domäne des Hüllproteins und im 19 kDA-cysteinreichen Protein (beide auf RNA2). Ein CGxxH-Aminosäuresequenzmotiv, das den cysteinreichen Proteinen der Gattungen Furovirus, Hordeivirus, Tobravirus und Pecluvirus gemeinsam ist, wurde detektiert. [source]

Detection of Phytoplasma Infection in Rose, with Degeneration Symptoms

M. Kami
In 1998 a severe disease was observed on rose cvs. ,Patina', ,Papillon' and ,Mercedes' cultivated in a commercial greenhouse in Poland. The symptoms included stunted growth, bud proliferation, leaf malformation and deficiency of flower buds. Sporadically some plants yielded flower buds transformed into big-bud structures and degenerated flowers. The presence of phytoplasma in roses with severe symptoms as well as in recovered plants and Catharanthus roseus experimentally infected by grafting and via dodder was demonstrated by nested polymerase chain reaction assay with primers pair R16F2/R2 or R16F1/R0 and R16(I)F1/R1 amplifying phytoplasma 16S rDNA fragment. The polymerase chain reaction products (1.1 kb) used for restriction fragment length polymorphism analysis after digestion with endonuclease enzymes AluI and MseI produced the same restriction profiles for all samples. The restriction profiles of phytoplasma DNA from these plants corresponded to those of an aster yellows phytoplasma reference strain. Electron microscope examination of the ultra-thin sections of the stem showed wall thickenings of many sieve tubes of the diseased roses and single phytoplasma cells within a sieve element of the phloem of experimentally infected periwinkles. This paper is the first report on aster yellows phytoplasma in rose identified at a molecular level. Detektion einer Phytoplasma-Infektion bei Rosen mit Degenerationserscheinungen Im Jahr 1998 wurde eine schwere Krankheit bei Rosen der Sorten ,Patina', ,Papillon' und ,Mercedes' festgestellt, die in einem polnischen Gewächshaus für kommerzielle Zwecke kultiviert wurden. Zu den Symptomen gehörten Kümmerwuchs, durchwachsene Knospen, Blattmißbildungen und ein Mangel an Blütenknospen. Einige wenige Pflanzen trugen übergroße Blütenknospen, die degenerierte Blüten hervorbrachten. Die Anwesenheit von Phytoplasmen in Rosen mit starken Symptomen, in erholten Pflanzen und in Catharanthus roseus, der durch Pfropfen und durch Teufelszwirn (Cuscuta) experimentell infiziert worden war, wurde mittels einer genesteten Polymerase-Kettenreaktion mit den Primerpaaren R16F2/R2 oder R16F1/R0 und R16(1)F1/R1 zur Amplifikation des Phytoplasma-16S rDNA-Fragments demonstriert. Die für die Analyse der Restriktionsfragmentlängenpolymorphismen nach Verdau mit den Endonucleasen AluI und MseI verwendeten PCR-Produkte (1,1 kb) produzierten bei allen Proben die gleichen Restriktionsprofile. Die Restriktionsprofile der Phytoplasma-DNA aus diesen Pflanzen entsprachen denjenigen eines Typenstamms eines Asternvergilbung auslösenden Phytoplasmas. Elektronenmikroskopische Untersuchungen ultradünner Schnitte des Stamms zeigten Wandverdickungen bei zahlreichen Siebröhren der erkrankten Rosen und einzelne Phytoplasmazellen innerhalb eines Siebelements des Phloems experimentell infizierter Immergrün-Pflanzen. Dies ist der erste Bericht über ein auf molekularer Ebene identifiziertes Asternvergilbungs-Phytoplasma bei Rosen. [source]

Promoting self-care through symptom management: A theory-based approach for nurse practitioners

ACNP (Acute Care Nurse Practitioner), Christopher Fowler RN, PhD(c)
Abstract Purpose: To present a theory of illness representation useful in clinical practice along with two case studies as examples of theory implementation. Data sources: Literature review of relevant theory and associated literature, case studies from clinical practice. Conclusions: An individual asks several questions when experiencing a physical sensation: "Am I sick, stressed, or is this a sign of aging? If I'm sick, is the symptom connected with a disease label?" After asking these questions, the individual develops a cognitive and emotional illness representation that includes the dimensions of identity, cause, consequences, control, and timeline. This representation is guided by personal, cultural, and environmental contexts and determines coping strategies. By assessing the individual's cognitive and emotional representations of the illness, the nurse practitioner (NP) can use the common sense model of illness representation (CSM) to establish interventions and action plans helpful in decreasing distress in the management of symptoms. Implications for practice: NPs frequently care for patients who present with very severe symptoms related to their health problem. This becomes a major challenge in effective disease management. Leventhal's CSM can be used as a framework to identify the cognitive and emotional illness representations individuals develop when acute and chronic symptoms are presented. By assessing the individual's cognitive and emotional representations of the illness, the NP will be able to use the CSM to establish interventions and action plans that will be helpful in decreasing the patient's distress in the management of symptoms. [source]

The Frequency Of Arterial Hypertension Versus Orthostatic Hypotension In Diabetic Patients

C Ionescu-Tîrgoviste
Aim: The aim of this study was to assess the relationship between supine high blood pressure and orthostatic hypotension both in Type 1 (T1DM) and Type 2 (T2DM) diabetic patients. Patients and Methods: Our study included 321 T2DM patients (153 M/168 F; mean age 62.3 (14.2 yr; duration of disease 12.1 (7.6 yr) and 116 T1DM patients (65 M/51 F; mean age 39.7 (9.2 yr; duration of diabetes 11.9 (8.1 yr). Patients with orthostatic hypotension were divided into 3 groups: A , without symptoms; B , mild/moderate symptoms (short and tolerable dizziness when standing); C , severe symptoms (persistent and disabling dizziness or even fainting in upright position). Results: Arterial hypertension was registered in 67.6% of T2DM patients (217 from 321 cases) and in 50.0% of T1DM patients (58 from 116 cases). Orthostatic hypotension (defined as a decrease in systolic blood pressure (30 mm Hg)) was encountered in 64.5% in T2DM patients (207 out of 321 cases) and in 60.3% of T1DM patients (70 out of 116 cases). From 207 T2DM patients with orthostatic hypotension, 105 were in Group A (50.7%), 89 in Group B (42.99%) and 13 in Group C (6.28%), while from 70 T1DM patients with orthostatic hypotension 14 were in Group A (20.0%), 51 in Group B (72.8%) and 5 in Group C (7.14%). An association of supine arterial hypertension with orthostatic hypotension was registered in 96 (29.9%) T2DM patients (68 of them receiving antihypertensive treatment) and in 25 (21.5%) T1DM patients (19 of which were on antihypertensive treatment). From the 18 patients with severe orthostatic hypotension (13 T2DM and 5 T1DM), supine arterial hypertension was registered in 5 cases (3 T2DM and 2 T1DM). In 4 of these 5 cases, patients were receiving antihypertensive treatment. Discontinuation of this treatment led to a decrease in the intensity of clinical signs of orthostatic hypotension in 4 out of 5 cases. An improvement of clinical symptoms of orthostatic hypotension was recorded in about 1/3 of hypertensive patients after discontinuation or just lowering of the dose of antihypertensive drugs (26 out of 87 cases). Conclusion: An association between hypertension and orthostatic hypotension is frequent both in T1DM and in T2DM, rising in difficulties for treatment. The treatment of hypertension in diabetic patients should take into account the possible orthostatic hypotension induced by some of the antihypertensive drugs. [source]

Symptoms in patients on long-term proton pump inhibitors: prevalence and predictors

Summary Background, Symptom control in primary care patients on long-term proton pump inhibitor (PPI) treatment is poorly understood. Aim, To explore associations between symptom control and demographics, lifestyle, PPI use, diagnosis and Helicobacter pylori status. Methods, A cross-sectional survey (n = 726) using note reviews, questionnaires and carbon-13 urea breath testing. Determinants of symptom control [Leeds Dyspepsia Questionnaire (LDQ), Carlsson and Dent Reflux Questionnaire (CDRQ), health-related quality-of-life measures (EuroQoL: EQ-5D and EQ-VAS)] were explored using stepwise linear regression. Results, Moderate or severe dyspepsia symptoms occurred in 61% of subjects (LDQ) and reflux symptoms in 59% (CDRQ). Age, gender, smoking and body mass index had little or no influence upon symptom control or PPI use. Average symptom scores and PPI use were lower in patients with non-ulcer dyspepsia and gastro-protection than gastro-oesophageal reflux disease (GERD) and uninvestigated dyspepsia. H. pylori infection was associated with lower reflux symptom scores only in patients with GERD and uninvestigated dyspepsia. EQ-5D was not able to discriminate between diagnostic groups, although the EQ-VAS performed well. Conclusions, A majority of patients suffered ongoing moderate or severe symptoms. GERD and uninvestigated dyspepsia were associated with poorer long-term symptom control; H. pylori appeared to have a protective effect on reflux symptoms in these patients. [source]

Consequences of frequent nocturnal gastro-oesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity

Summary Background Effects of frequent nocturnal symptoms of gastro-oesophageal reflux disease (GERD-FNS) on health-related quality of life (HRQOL) and work productivity are not well documented. Aim To assess symptom severity, production loss, and HRQOL among employed adults with and without GERD-FNS. Methods Using several validated outcome measures in a web survey design, GERD was pre-specified as GERD Symptom and Medication Questionnaire score >9, and ,1 episode of heartburn or acid regurgitation during the preceding week. GERD-FNS patients were those reporting ,2 symptom-nights during the previous week; their outcomes were compared with those of patients having minimal or no nocturnal symptoms (GERD-NNS) and vs. non-GERD controls. Results Data were collected from 1002 GERD patients (476 GERD-FNS, 526 GERD-NNS) and 513 controls. Severe symptoms were more common, sleep abnormalities were more frequent (P < 0.0001) and SF-36 scores lower (P < 0.05, all scores) among GERD-FNS patients vs. GERD-NNS patients. GERD-related work loss was greater among those with GERD-FNS vs. GERD-NNS (P < 0.0001). Work loss and functional limitations were more pronounced when comparing GERD-FNS cases vs. non-GERD controls. Conclusion Employed adults with frequent nocturnal GERD report more severe symptoms, and are associated with impaired sleep, HRQOL and work productivity compared with controls and patients with minimal or no nocturnal symptoms. [source]

IgE to peanut allergen components: relation to peanut symptoms and pollen sensitization in 8-year-olds

ALLERGY, Issue 9 2010
A. Asarnoj
To cite this article: Asarnoj A, Movérare R, Östblom E, Poorafshar M, Lilja G, Hedlin G, van Hage M, Ahlstedt S, Wickman M. IgE to peanut allergen components: relation to peanut symptoms and pollen sensitization in 8-year-olds. Allergy 2010; 65: 1189,1195. Abstract Background:, Allergen-specific IgE testing is often performed with crude peanut extract, but the results may be difficult to interpret because of cross-reactions between peanut and other plant allergens. The aim was to investigate IgE reactivity to peanut allergen components in children from a birch-rich region in relation to pollen sensitization and peanut symptoms. Methods:, From a birth cohort, clinical parameters were obtained through questionnaires and IgE antibody levels to peanut and birch pollen were measured. Different peanut/birch sensitization phenotypes were defined among 200 selected children. IgE reactivity to peanut and pollen allergen components was analysed using microarray technique. Results:, Peanut symptoms were reported in 87% of the children with IgE reactivity to any of the peanut allergens Ara h 1, 2 or 3 but not to Ara h 8 (n = 46) vs 17% of children with IgE reactivity to Ara h 8 but not to Ara h 1, 2 or 3 (n = 23), P < 0.001. Furthermore, symptoms were more severe in children with Ara h 1, 2 or 3 reactivity. Children with IgE reactivity both to Ara h 2 and to Ara h 1 or 3 more often reported peanut symptoms than children with IgE only to Ara h 2 (97%vs 70%, P = 0.016), particularly respiratory symptoms (50%vs 9%, P = 0.002). Conclusions:, IgE analysis to peanut allergen components may be used to distinguish between peanut-sensitized individuals at risk of severe symptoms and those likely to have milder or no symptoms to peanut if sensitized to pollen allergens and their peanut homologue allergens. [source]

Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three

ALLERGY, Issue 1 2009
N. Aït-Khaled
Background:, Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global patterns of prevalence and severity of symptoms of rhinoconjunctivitis in children in 1993,1997. Methods:, International Study of Asthma and Allergies in Childhood Phase Three was a cross-sectional survey performed 5,10 years after Phase One using the same methodology. Phase Three covered all of the major regions of the world and involved 1 059 053 children of 2 age groups from 236 centres in 98 countries. Results:, The average overall prevalence of current rhinoconjunctivitis symptoms was 14.6% for the 13- to 14-year old children (range 1.0,45%). Variation in the prevalence of severe rhinoconjunctivitis symptoms was observed between centres (range 0.0,5.1%) and regions (range 0.4% in western Europe to 2.3% in Africa), with the highest prevalence being observed mainly in the centres from middle and low income countries, particularly in Africa and Latin America. Co-morbidity with asthma and eczema varied from 1.6% in the Indian sub-continent to 4.7% in North America. For 6- to 7-year old children, the average prevalence of rhinoconjunctivitis symptoms was 8.5%, and large variations in symptom prevalence were also observed between regions, countries and centres. Discussion:, Wide global variations exist in the prevalence of current rhinoconjunctivitis symptoms, being higher in high vs low income countries, but the prevalence of severe symptoms was greater in less affluent countries. Co-morbidity with asthma is high particularly in Africa, North America and Oceania. This global map of symptom prevalence is of clinical importance for health professionals. [source]

Reported food allergy to peanut, tree nuts and fruit: comparison of clinical manifestations, prescription of medication and impact on daily life

ALLERGY, Issue 7 2008
T. M. Le
Background: Peanut (PN), tree nuts (TN) and fruits are frequent causes of food allergy (FA). Peanut and TN are believed to cause more severe reactions than fruits. However, there are no studies comparing the severity of PN, TN and fruit allergy within one patient group. Methods: Four-hundred and eleven adult patients referred to our tertiary allergy center with suspicion of FA completed a standardized questionnaire. Patients with a typical history of immunoglubulin E (IgE)-mediated allergy, e.g. oropharyngeal symptoms to PN, TN (hazelnut, walnut, cashew nut) or fruit (apple, kiwi, peach, pear and cherry) were recruited (218/411). The objective was to evaluate differences in clinical severity between PN, TN and fruit allergy and how this was reflected by prescription of emergency medication and impact on daily life. Results: Eighty-two percent of the included 218 patients were sensitized to the respective foods. The percentages of severe symptoms (i.e. respiratory or cardiovascular symptoms) in PN, TN and fruit allergic patients were respectively 47%, 39% and 31% (respiratory) and 11%, 5.0% and 3.4% (cardiovascular). Prescription and use of emergency medication (epinephrine, antihistamines and steroids) did not differ among the three groups. The majority of patients with a PN or TN allergy (72%) and fruit allergy (62%) reported that FA influences their daily life considerably. Conclusions: Fruit allergy causes less severe symptoms than TN and especially PN allergy. However, this is not reflected in the prescription or use of emergency medication. This may indicate that physicians are not fully acquainted with the guidelines for prescription of emergency medication. A high impact on daily life was found both in PN, TN and in fruit allergy. [source]