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Symptomatic Cases (symptomatic + case)
Selected AbstractsAdenovirus infections within a family cohort in Iran,PEDIATRIC PULMONOLOGY, Issue 8 2009Mohammadreza Naghipour PhD Abstract Background Adenovirus is one of the most frequent viruses associated with acute respiratory infections (ARI). There is limited information of its transmission within the community. Methods Cohorts of 50 families with ,two children were visited weekly for 2 months to ascertain the presence ARI in Rasht, Iran. Nasopharyngeal swabs were obtained from symptomatic participants and at 3,4-day intervals to assess the duration of adenovirus shedding. Adenoviruses were identified by PCR and adenovirus positive amplicons were subjected to DNA sequencing. Results Thirty-three (35%) of 94 ARI episodes in children and 8 (27%) of 30 episodes in adults were due to adenovirus (not significant, NS). 25/50 (50%) families had adenovirus infections. Children had more infections than adults, were more likely to develop symptoms if there was a symptomatic case within the household and episodes had a longer duration (P,<,0.05). Adenoviruses were recovered for a median of 11 (interquartile range 5,26) days of follow up in children and 7 (2,20) days in adults (NS). Adenovirus-7 was the most frequent serotype (12 families), followed by adenovirus-6 (5 families), adenovirus-1 and 2 (4 families each), and adenovirus-5 (3 families). Both adenovirus-5 and 7 amplicons fell into two clusters. No mutations were observed during transmission within a family. Conclusion A substantial proportion of ARI in the community are due to adenovirus with further transmission within the family. Children ,2 years experienced a higher proportion of infections than younger children and adults. Viral shedding was more prolonged in children and adenovirus-7 and 5 predominated with several clusters co-circulating in the same season. Pediatr Pulmonol. 2009; 44:749,753. © 2009 Wiley-Liss, Inc. [source] Hypocretin/orexin and narcolepsy: new basic and clinical insightsACTA PHYSIOLOGICA, Issue 3 2010S. Nishino Abstract Narcolepsy is a chronic sleep disorder, characterized by excessive daytime sleepiness (EDS), cataplexy, sleep paralysis and hypnagogic hallucinations. Both sporadic (95%) and familial (5%) forms of narcolepsy exist in humans. The major pathophysiology of human narcolepsy has been recently discovered based on the discovery of narcolepsy genes in animals; the genes involved in the pathology of the hypocretin/orexin ligand and its receptor. Mutations in hypocretin-related genes are rare in humans, but hypocretin ligand deficiency is found in a large majority of narcolepsy with cataplexy. Hypocretin ligand deficiency in human narcolepsy is probably due to the post-natal cell death of hypocretin neurones. Although a close association between human leucocyte antigen (HLA) and human narcolepsy with cataplexy suggests an involvement of autoimmune mechanisms, this has not yet been proved. Hypocretin deficiency is also found in symptomatic cases of narcolepsy and EDS with various neurological conditions, including immune-mediated neurological disorders, such as Guillain,Barre syndrome, MA2-positive paraneoplastic syndrome and neuromyelitis optica (NMO)-related disorder. The findings in symptomatic narcoleptic cases may have significant clinical relevance to the understanding of the mechanisms of hypocretin cell death and choice of treatment option. The discoveries in human cases lead to the establishment of the new diagnostic test of narcolepsy (i.e. low cerebrospinal fluid hypocretin-1 levels for ,narcolepsy with cataplexy' and ,narcolepsy due to medical condition'). As a large majority of human narcolepsy patients are ligand deficient, hypocretin replacement therapy may be a promising new therapeutic option, and animal experiments using gene therapy and cell transplantations are in progress. [source] Cervical phosphorylated insulin-like growth factor binding prote,n-1 for the prediction of preterm delivery in symptomatic cases with intact membranesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009H. Mete Tanir Abstract Aim:, This prospective, observational study was an attempt to evaluate whether a positive cervical phosphorylated insulin-like growth factor binding prote,n-1 admission test in women with signs and symptoms of preterm labor (PTL) may be useful in the prediction of women who will deliver prematurely. Methods:, Pregnant women with confirmed gestational age between 24 and 37 weeks' gestation with <3 cm cervical dilatation and intact membranes were included in the study. Prior to digital examination, a sterile speculum examination was performed using a dacron swab rotated in the external cervical os for 15 s. The test was based on immunochromatographic qualitative analysis of cervical phosphorylated insulin-like growth factor binding prote,n-1. Test (+) and (,) cases were evaluated in terms of maternal demographic characteristics and neonatal outcomes. Results:, A total of 68 cases were enrolled in the study. There were no statistically significant differences between test (+) and (,) groups, in terms of maternal characteristics or adverse neonatal outcomes. However, cases with + test had high Bishop scores on admission (P = 0.01) and gestational age at delivery (P = 0.003). For deliveries within 7 days of admission, the strongest predictors were test positivity (RR:24,%95CI:2.8,204, P < 0.0001) and Bishop score (RR:1.3, %95CI: 1.0,1.6, P = 0.03). For deliveries <34 weeks' gestation, the test had a sensitivity, specificity, positive predictive values, negative predictive values, +likelihood ratios and ,likelihood ratios of 70%, 74%, 48%, 88, 2.8 and 0.39, respectively. Conclusion:, Among women with signs and symptoms of PTL, the high negative predictive value of this test to predict the PTL <34 weeks' gestation as well as within 7 days of delivery may be of value in the reassurance of patients, avoiding unnecessary medical interventions. [source] Results of balloon valvuloplasty in 40 dogs with pulmonic stenosisJOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2004M. Stafford Johnson The records of 43 dogs presenting with severe pulmonic stenosis in which balloon valvuloplasty was attempted were reviewed. Thirty-four dogs (79 per cent) were symptomatic at initial presentation. All patients were selected for balloon valvuloplasty on the basis of a Doppler-derived trans-stenotic pressure gradient of over 80 mmHg and concurrent evidence of mild to severe right ventricular hypertrophy. Forty dogs underwent balloon valvuloplasty; the procedure was not performed in three dogs because of an aberrant coronary artery in two cases and because catheterisation of the pulmonary artery was not possible in the third. Overall, 37 out of the 40 dogs (93 per cent) were successfully ballooned, resulting in a mean reduction in the pressure gradient of 46 per cent, with a mean pressure gradient of 124 mmHg on presentation and 67 mmHg six months after the procedure. Three dogs died during balloon valvuloplasty (all of which had a concurrent defect) and three dogs showed a poor clinical response to the procedure. Thus balloon valvuloplasty was successful and resulted in a sustained clinical improvement in 80 per cent of previously symptomatic cases. This study was undertaken to document the results of balloon valvuloplasty in a larger population of dogs than has previously been published. [source] Dejerine-Sottas Neuropathy with Multiple Nerve Roots Enlargement and Hypomyelination Associated with a Missense Mutation of the Transmembrane Domain of MPZ/P0JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2003A Simonati In a patient affected with a slowly progressive, severe form of Dejerine-Sottas syndrome, symmetric enlargement of cranial nerves and focal hypertrophy of cervical and caudal roots were detected following MRI. Neuropathological features of the sural nerve disclosed a dramatic loss of myelinated fibres, with skewed-to-the-left, unimodal distribution of the few residual fibres, consistent with the diagnosis of congenital hypomyelination neuropathy. Genetic analysis revealed this condition to be associated with a heterozygous G to A transition at codon 167 in the exon 4 of the MPZ/P0 gene causing a Gly138Arg substitution in the transmembrane domain of the mature MPZ/P0 protein. Focal enlargement of the nerve trunks in demyelinating, hereditary motor and sensory neuropathies (HMSN) was previously reported in both asymptomatic and symptomatic cases with root compression, but peculiar to this case is the diffuse involvement of both cranial and spinal nerves. We believe that the relevance of nerve trunk hypertrophy in HMSN is probably underevaluated: therefore MRI investigation of the head and spine should be included in the diagnostic study of selected HMSN patients. Molecular analysis of peripheral myelin genes will help to rule out misdiagnosed cases. [source] Combined use of clinical pretest probability and D-dimer test in cancer patients with clinically suspected deep venous thrombosisJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 1 2006M. DI NISIO Summary.,Background: The value of the D-dimer (DD) test in combination with the clinical pretest probability (PTP) has not been evaluated in cancer patients with suspected deep vein thrombosis (DVT), whereas this group of patients usually accounts for 10,25% of clinically suspected DVT. Methods: A cohort of 2066 consecutive patients with clinically suspected DVT was investigated. Patients were judged to be positive or negative for DVT according to the outcomes of serial compression ultrasound and a 3-month follow-up period with imaging test verification of the symptomatic cases. Diagnostic accuracy indices of the DD test according to the PTP score were assessed in patients with and without cancer. Results: Of the cohort, 244 (11%) were known to have cancer at presentation. A venous thromboembolic event was diagnosed in 41% of the patients with cancer and in 22% of the patients without malignancy. Among the cancer patients, 17% were considered to have a low PTP, 35% a moderate and 41% a high PTP. The negative predictive value (NPV) of the DD test was 100% (95%CI, 85,100) and 97% (95% CI, 88,99) among cancer patients with low PTP or low-moderate PTP. In the absence of malignancy, the corresponding NPV were 98% and 97%, respectively. The specificity of the DD test progressively decreased moving from the low to the higher PTP. Conclusions: In cancer patients with clinically suspected DVT, a negative DD might be useful in excluding the diagnosis within the low or low-moderate PTP groups. More studies are warranted to confirm these findings. [source] Investigation of bacterial communities associated with asymptomatic and symptomatic endodontic infections by denaturing gradient gel electrophoresis fingerprinting approachMOLECULAR ORAL MICROBIOLOGY, Issue 6 2004J. F. Siqueira Jr The purpose of the present study was to investigate the bacterial communities associated with asymptomatic and symptomatic endodontic infections and to compare denaturing gradient gel electrophoresis (DGGE) fingerprinting patterns of these two clinical conditions. The root canal microbiota of teeth associated with asymptomatic or symptomatic periradicular lesions was profiled by the PCR-DGGE method and then compared, taking into consideration the banding patterns. Bacteria were present in all examined cases. Comparative analysis of the two clinical conditions revealed bands that were common to both symptomatic and asymptomatic cases, but most DGGE bands appeared to be unique for each clinical condition. No single band occurred in all profiles. The mean number of bands detected in the 16S rDNA community profiles were 12.1 ± 9.4 (range 2,29) for symptomatic samples and 6.7 ± 2.7 (range 2,11) for asymptomatic ones. Clustering methods and principal component analysis of DGGE banding pattern placed the samples according to the presence or absence of symptoms. Four intense bands that were excised from the gel and sequenced showed similarities to species of the Campylobacter genus (found in 5/12 asymptomatic and in 3/11 symptomatic cases), Fusobacterium genus (4/11 symptomatic cases), Acinetobacter genus (5/12 asymptomatic cases), and Enterobacteriaceae family (11/12 asymptomatic and 2/11 symptomatic cases). The profiles of the predominant bacterial community appeared to be unique for each individual. These findings confirm that endodontic infections are polymicrobial and showed that there are significant differences in the predominant bacterial composition between asymptomatic and symptomatic cases. [source] The Renegade in German Exile LiteratureORBIS LITERARUM, Issue 1 2001Malcolm Humble The article outlines the process by which several exile writers came to terms with the realisation that the response of the writing community to the Nazi takeover was by no means unanimous. It focuses in particular on the reactions of exiles in criticism, prose fiction and poetry to what was perceived as renegade behaviour by Gottfried Benn and Gerhart Hauptmann, before briefly considering the less well known but equally symptomatic cases of Max Barthel, Ernst Glaeser and Josef Ponten. It then looks at Paul Zech's attempt in his novel Deutschland, dein Tänzer ist der Tod (published 1980, but written during the thirties) to place Ponten and others in the context of a broader view of the literary landscape which included those who remained in Germany and made differing accommodations to the new regime, as well as those emigrants whose work had not (yet) been devoted to the anti-Fascist cause. [source] Characterization of a fatal methyl bromide exposure by analysis of the water coolerAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2009David J. Hewitt MD Abstract Background A suspected inhalation exposure to methyl bromide (MeBr) in the packaging and shipping area of a chemical manufacturer resulted in a worker fatality and several symptomatic cases. However, air testing was negative for MeBr resulting in uncertainty regarding the potential chemical exposure. Methods of quickly confirming the exposure and magnitude were sought. Methods Head space air and water samples were obtained from the breakroom water cooler in the facility and tested for MeBr. Results Increased levels of MeBr were identified in the air and water samples from the cooler and used to calculate the MeBr concentration of air entering the cooler. The MeBr air concentration within the breakroom was estimated as 1,200,2,100,ppm depending on assumptions regarding the amount of water dispensed from the cooler both before and during the incident. Conclusions Estimated MeBr air concentrations in the breakroom were consistent with those known to be associated with reported health effects among the involved workers. The water cooler analysis represented a unique method of retrospectively verifying and quantifying exposure to MeBr. Am. J. Ind. Med. 52:579,586, 2009. © 2009 Wiley-Liss, Inc. [source] Glossopharyngeal schwannomas: A 100 year review,THE LARYNGOSCOPE, Issue 1 2009Nopawan Vorasubin BS Abstract Objectives: To review the literature on glossopharyngeal schwannomas with a focus on clinical presentation, radiologic/audiologic characteristics, and management options, and to propose a mechanism explaining the nature of vestibulocochlear dysfunction seen with these tumors. Study Design: Contemporary review. Methods: English literature search for cases of primary isolated glossopharyngeal schwannomas and chart review of two new cases. Results: A total of 42 glossopharyngeal schwannoma cases between 1908,2008 were reviewed. Of these 84% presented with vestibulocochlear symptoms whereas only 30% presented with glossopharyngeal symptoms. Tumors can occur anywhere along the CNIX; however, the majority of symptomatic cases are intracranial/intraosseous, which present with vestibulocochlear dysfunction. Reviewed cases typically described the caliber of CNVII and VIII on CT/MRI as normal. We present a case where notching and displacement of CNVIII by the tumor can be appreciated on MRI, allowing for the first correlation between clinical symptoms and imaging findings. Mid frequency SNHL was prevalent in contrast to the high-frequency pattern typical of vestibular schwannomas. Tonotopic studies of CNVIII mapped low-to-mid frequency fibers along the posterior medial surface corresponding to the area of greatest compression by glossopharyngeal schwannomas. Conclusion: Glossopharyngeal schwannomas usually present with vestibulocochlear rather than glossopharyngeal symptoms, likely due to CNVIII compression and displacement by tumor, which can be better appreciated with modern imaging. The tumor's location posterior and medial to CNVIII combined with the complex CNVIII tonotopic organization may account for the preferential mid-frequency hearing loss seen in these patients. Laryngoscope, 119:26,35, 2009 [source] An in vitro study of the antimicrobial activity of some endodontic medicaments and their bases using an agar well diffusion assayAUSTRALIAN DENTAL JOURNAL, Issue 2 2009B Athanassiadis ABSTRACT Background:, The aim of this study was to determine the in vitro antimicrobial activities of various endodontic medicaments and their bases against selected organisms using an agar diffusion assay. Methods:, An agar well diffusion assay was used to test the antimicrobial action of some commonly used endodontic medicaments (Ledermix paste, Pulpdent paste, Ultracal paste, and a 50:50 mix of Ledermix and Pulpdent pastes) and their bases. Three bacterial species (E. faecalis, P. micros, P. intermedia) and one yeast (C. albicans) were selected. The diameters of growth inhibition zones and pH were assessed. Results:,P. micros demonstrated the highest level of in vitro resistance. Pulpdent and Ultracal pastes had the highest pH (12.64 and 12.53, respectively). The addition of Pulpdent to Ledermix did not increase the zone sizes significantly. Conclusions:, All the commercial products showed some in vitro antimicrobial activity. Ledermix paste and the 50:50 Ledermix/Pulpdent mixture being the most effective in this model. The known anti-inflammatory/analgesic properties of Ledermix and the results from this agar model suggest that the 50:50 Ledermix/Pulpdent combination would be the preferred medicament for clinical use in symptomatic cases, even though the addition of calcium hydroxide to Ledermix did not appear to be synergistic in terms of enhancing the antimicrobial action. [source] Progressive stridor: could it be a congenital cystic lung disease?ACTA PAEDIATRICA, Issue 9 2009M Zedan Abstract Bronchogenic cyst of the mediastinum, a cause of stridor early in life, is the result of abnormal budding of the ventral segment of the primitive foregut. Bronchogenic cysts are often asymptomatic in older children and adults. However, symptomatic cases usually manifest early in life with cough, stridor or wheezing due to airway compression. We report a female infant aged 4.5 months with a normal full-term pregnancy, who developed respiratory distress with stridor. This stridor was preceded by a history of slowly progressive noisy breathing. Physical examination revealed evidence of bilateral obstructive emphysema. Chest radiograph revealed bilateral overinflation. Fibro-optic bronchoscopy revealed posterior mediastinal compression. Possibility of congenital cystic lung disease (CCLD) was considered, emphasizing the value of computed tomography (CT) chest, which revealed a cyst probably bronchogenic. Surgical excision was performed with evident histological confirmation of bronchogenic cyst. Conclusion:, we highlight that in any infant, presented with slowly progressive noisy breathing in the first year of life, CCLD should be considered in the differential diagnosis even with normal X-ray chest. CT chest should be performed for exclusion or diagnosis of the case. [source] | ||||||||||