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Symptom Presentation (symptom + presentation)
Selected AbstractsSurveillance of Infectious Disease Occurrences in the Community: An Analysis of Symptom Presentation in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 7 2003Joe Suyama MD Objectives: To determine the effectiveness of a simulated emergency department (ED)-based surveillance system to detect infectious disease (ID) occurrences in the community. Methods: Medical records of patients presenting to an urban ED between January 1, 1999, and December 31, 2000, were retrospectively reviewed for ICD-9 codes related to ID symptomatology. ICD-9 codes, categorized into viral, gastrointestinal, skin, fever, central nervous system (CNS), or pulmonary symptom clusters, were correlated with reportable infectious diseases identified by the local health department (HD). These reportable infectious diseases are designated class A diseases (CADs) by the Ohio Department of Health. Cross-correlation functions (CCFs) tested the temporal relationship between ED symptom presentation and HD identification of CADs. The 95% confidence interval for lack of trend correlation was 0.0 ± 0.074; thus CCFs > 0.074 were considered significant for trend correlation. Further cross-correlation analysis was performed after chronic and non-community-acquirable infectious diseases were removed from the HD database as a model for bioterrorism surveillance. Results: Fifteen thousand five hundred sixty-nine ED patients and 6,489 HD patients were identified. Six thousand two hundred eight occurrences of true CADs were identified. Only 87 (1.33%) HD cases were processed on weekends. During the study period, increased ED symptom presentation preceded increased HD identification of respective CADs by 24 hours for all symptom clusters combined (CCF = 0.112), gastrointestinal symptoms (CCF = 0.084), pulmonary symptoms (CCF = 0.110), and CNS symptoms (CCF = 0.125). The bioterrorism surveillance model revealed increased ED symptom presentation continued to precede increased HD identification of the respective CADs by 24 hours for all symptom clusters combined (CCF = 0.080), pulmonary symptoms (CCF = 0.100), and CNS symptoms (CCF = 0.120). Conclusions: Surveillance of ED symptom presentation has the potential to identify clinically important ID occurrences in the community 24 hours prior to HD identification. Lack of weekend HD data collection suggests that the ED is a more appropriate setting for real-time ID surveillance. [source] The assessment of regional gut transit times in healthy controls and patients with gastroparesis using wireless motility technologyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010I. SAROSIEK Summary Background, Wireless pH and pressure motility capsule (wireless motility capsule) technology provides a method to assess regional gastrointestinal transit times. Aims, To analyse data from a multi-centre study of gastroparetic patients and healthy controls and to compare regional transit times measured by wireless motility capsule in healthy controls and gastroparetics (GP). Methods, A total of 66 healthy controls and 34 patients with GP (15 diabetic and 19 idiopathic) swallowed wireless motility capsule together with standardized meal (255 kcal). Gastric emptying time (GET), small bowel transit time (SBTT), colon transit time (CTT) and whole gut transit time (WGTT) were calculated using the wireless motility capsule. Results, Gastric emptying time, CTT and WGTT but not SBTT were significantly longer in GP than in controls. Eighteen percent of gastroparetic patients had delayed WGTT. Both diabetic and idiopathic aetiologies of gastroparetics had significantly slower WGTT (P < 0.0001) in addition to significantly slower GET than healthy controls. Diabetic gastroparetics additionally had significantly slower CTT than healthy controls (P = 0.0054). Conclusions, In addition to assessing gastric emptying, regional transit times can be measured using wireless motility capsule. The prolongation of CTT in gastroparetic patients indicates that dysmotility beyond the stomach in GP is present, and it could be contributing to symptom presentation. Aliment Pharmacol Ther,31, 313,322 [source] The challenge of cross-cultural, multi-national research: potential benefits in the functional gastrointestinal disordersNEUROGASTROENTEROLOGY & MOTILITY, Issue 4 2009A. D. Sperber Abstract, The increasing interest in research in irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs), taken together with the growing sophistication of communication technology, makes cross-cultural, multi-national research a feasible endeavour. The aim of this study is to encourage collaborative cross-cultural studies in FGIDs by discussing relevant methodological issues, and by suggesting potential areas in which cross-cultural research can make a significant contribution to the understanding of FGIDs and to patient care. To this end, methodological issues related to cross-cultural research and competences required for its conduct are presented together with a critique of published studies and recommendations for future research in the area. The term ,cross-cultural' research in FGIDs is usually applied to the results of prevalence studies, for example comparative studies of IBS prevalence in different countries and ethnic groups. The validity of these comparisons is impacted negatively by the lack of uniformity in research methods. In addition to prevalence studies, cross-cultural research can make a significant contribution in areas such as molecular biology, genetics, psychosocial factors, symptom presentation, extra-intestinal comorbidity, diagnosis and treatment, determinants of disease severity, healthcare utilization, and health-related quality of life, all issues that can be affected by culture, ethnicity and race. Well-designed and implemented cross-cultural studies can advance our knowledge in many FGID-related areas ranging from epidemiology through psychosocial factors, pathophysiological mechanisms and therapeutics. These studies, conducted by investigators with competence in cross-cultural research methodology, can advance our understanding of the FGIDs and contribute to improved patient care. [source] Factors influencing gender differences in the diagnosis and treatment of asthma in childhood: The Tucson Children's Respiratory StudyPEDIATRIC PULMONOLOGY, Issue 4 2006Anne L. Wright PhD Abstract Studies identified gender differences in diagnosed asthma, but the extent to which they can be attributed to differences in symptom experience and frequency rather than factors influencing diagnosis has not been established. We investigated prevalence of, and consultation for, asthma symptoms, as well as diagnosis and treatment in 533 boys and 556 girls enrolled in the Tucson Children's Respiratory Study, a population-based birth-cohort study. Questionnaires regarding respiratory symptoms and diagnoses were obtained at ages 2, 3, 6, 8, 11, 13, 16, and 18 years. Boys were significantly more likely than girls to experience both wheeze and frequent wheeze most years in the first decade of life. However, girls with symptoms were less likely than boys to see a physician (74.1% vs. 83.4%, P,<,0.001) and to be labeled as having asthma (43.3% vs. 53.8%, P,<,0.009), even after adjusting for symptom frequency. A difference in symptom presentation also appeared to influence diagnosis: nocturnal cough without frequent wheeze was more prevalent among girls, and was associated with reduced diagnosis of asthma. Among subjects who consulted a physician for wheeze, boys were significantly more likely than girls to have taken medication (81.5% vs. 73.5%, P,<,0.01). The lag time between age at first wheeze and first use of medication among those consulting a physician for wheeze or asthma was greater for girls, especially among subjects with frequent wheeze (2.8 vs. 1.6 years, P,<,0.005). These findings indicate that gender differences in the diagnosis and treatment of asthma cannot be explained completely by differences in symptom prevalence and frequency. Pediatr Pulmonol. © 2006 Wiley-Liss, Inc. [source] Self-referenced memory, social cognition, and symptom presentation in autismTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 7 2009Heather A. Henderson Background:, We examined performance on a self-referenced memory (SRM) task for higher-functioning children with autism (HFA) and a matched comparison group. SRM performance was examined in relation to symptom severity and social cognitive tests of mentalizing. Method:, Sixty-two children (31 HFA, 31 comparison; 8,16 years) completed a SRM task in which they read a list of words and decided whether the word described something about them, something about Harry Potter, or contained a certain number of letters. They then identified words that were familiar from a longer list. Dependent measures were memory performance (d,) in each of the three encoding conditions as well as a self-memory bias score (d, self,d, other). Children completed The Strange Stories Task and The Children's Eyes Test as measures of social cognition. Parents completed the SCQ and ASSQ as measures of symptom severity. Results:, Children in the comparison sample showed the standard SRM effect in which they recognized significantly more self-referenced words relative to words in the other-referenced and letter conditions. In contrast, HFA children showed comparable rates of recognition for self- and other-referenced words. For all children, SRM performance improved with age and enhanced SRM performance was related to lower levels of social problems. These associations were not accounted for by performance on the mentalizing tasks. Conclusions:, Children with HFA did not show the standard enhanced processing of self- vs. other-relevant information. Individual differences in the tendency to preferentially process self-relevant information may be associated with social cognitive processes that serve to modify the expression of social symptoms in children with autism. [source] Duplication 8q22.1-q24.1 associated with bipolar disorder and speech delayBIPOLAR DISORDERS, Issue 3 2006JF Macayran Objective:, To report a case of a child with bipolar disorder found to have an unbalanced translocation involving the long arm of chromosome 8, a region that has been previously implicated in genome-wide linkage scans. Case report:, A 7-year-old boy with a complex psychiatric symptom presentation including attention deficits, distractibility, impulsivity, pressured speech, sleep disturbance, aggressive behavior, and hypersexuality diagnosed with bipolar disorder. He also showed evidence of borderline intellectual and adaptive functioning and had mild dysmorphic features with a duplication of distal 8q that arose as an unbalanced chromosomal translocation due to a maternal 15p;8q insertion. Conclusion:, This finding of an unbalanced translocation provides further evidence to support previous linkage studies of a potential causative gene on 8q for bipolar disorder. [source] Ethnic differences in symptom presentation of youths with bipolar disorderBIPOLAR DISORDERS, Issue 1 2006Nick C Patel Objective:, To compare symptom profiles of African-American and white adolescents with a diagnosis of bipolar disorder. Method:, Adolescents, aged 12,18 years at their first psychiatric hospitalization, with a DSM-IV diagnosis of bipolar disorder, manic or mixed, were evaluated on measures of manic, depressive, and positive symptoms of psychosis. Ethnic differences in symptom profiles were examined using multivariate analysis of covariance, and specific symptoms contributing to the difference were analyzed. Results:, Ethnic differences existed in manic and positive symptom profiles, but not depressive symptoms. Compared with the white cohort, African-American youths were diagnosed more frequently as having psychotic features, and had higher ratings for auditory hallucinations. Conclusions:, Similar to adults, symptom expression in adolescent bipolar disorder may differ between ethnic groups. Future studies are needed to replicate these findings and explore possible explanations. [source] Gender differences in bipolar disorder: age of onset, course, comorbidity, and symptom presentationBIPOLAR DISORDERS, Issue 2 2005Izabela Kawa Objective:, To determine whether men and women with bipolar disorder differ in age of onset, course of illness, number of suicide attempts, comorbidity rates and symptom presentation. Method:, Data were collected from 211 (121 women; 90 men) adults using the Diagnostic Interview for Genetic Studies, medical records, and additional information gathered from relatives. Results:, Most gender comparisons showed no evidence of differences. Nonetheless, more men than women reported mania at the onset of bipolar I disorder. Men also had higher rates of comorbid alcohol abuse/dependence, cannabis abuse/dependence, pathological gambling and conduct disorder. Men were more likely to report ,behavioural problems' and ,being unable to hold a conversation' during mania. Women reported higher rates of comorbid eating disorders, and weight change, appetite change and middle insomnia during depression. Conclusions:, Men and women were generally similar in their symptom presentation, age of onset of bipolar disorder, and in the total number of mood episodes. However, they differed in the type of episode at onset and comorbidity patterns. [source] Impact of concurrent alcohol misuse on symptom presentation of acute mania at initial evaluationBIPOLAR DISORDERS, Issue 6 2002Ihsan M Salloum Objectives:, The aim of this study was to evaluate the impact of current alcohol misuse on symptom presentation of acute mania. Methods:, The impact of concurrent alcohol misuse on symptom presentation of acute mania was examined by comparing comorbid subjects with acute bipolar mania complicated by current alcohol misuse (n=60) with subjects with acute bipolar mania without current alcohol misuse (n=196). Results:, Age- and gender-controlled analysis revealed that the comorbid group presented with more severe psychopathology, as indicated by higher number of total mood-related symptoms as well as of higher total number of manic symptoms. Specifically, they presented with significantly higher rates of mood lability and impulsivity, and also demonstrated higher rates of violent behavior, and other drug use. Conclusions:, Acute mania complicated by current alcohol misuse is differentiated from acute mania without alcohol misuse by the presence of higher numbers of manic symptoms and increased high risk behavior such as mood lability, impulsivity, violence, and other drug abuse. [source] | ||||||||||