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Symptomatic Presentation (symptomatic + presentation)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Hepatocellular carcinoma in Sydney South West: late symptomatic presentation and poor outcome for most

INTERNAL MEDICINE JOURNAL, Issue 8 2007
L. Gellert
Abstract Background: Hepatocellular cancer (HCC) is a serious complication of cirrhosis and chronic hepatitis B infection. The aim of the study was to determine the characteristics of patients with HCC presenting within the South West Sydney area, including an analysis of the rates and benefits of hepatocellular surveillance. Methods: Data from patients with HCC presenting to Liverpool and Bankstown Hospitals from July 1993 to June 2003 were analysed retrospectively, predominantly from hospital records. Results: Of the 151 HCC patients, 41% were Asian born. Most of the patients required an interpreter. Chronic viral hepatitis infection was present in 91 patients, of whom only 7% had previously received antiviral therapy. Alcohol alone was considered responsible in 31 patients. Cirrhosis could be documented in 58% of patients. Most of the patients (75%) presented symptomatically. The median survival was 5.1 months. When HCC was detected by surveillance, the tumours were slightly but not significantly more likely to be operable and the patients tended to be offered some form of active treatment more frequently. Multivariate analysis identified detection by surveillance, lower Child,Pugh score, smaller tumour size and eligibility for some form of treatment to be associated with a more favourable outcome. Conclusion: We observed low rates of surveillance for HCC, low recognition of cirrhosis before development of HCC and low rates of prior treatment of viral hepatitis. The poor outcome of HCC in the small group who had some sort of community surveillance is also a concern requiring further investigation. [source]

Consumer attitudes towards self-referral with early signs of cancer: implications for symptom awareness campaigns

INTERNATIONAL JOURNAL OF NONPROFIT & VOLUNTARY SECTOR MARKETING, Issue 4 2007
Douglas Eadie
Traditionally, secondary prevention programmes have employed mass screening approaches to assess for asymptomatic signs of cancer. It has been suggested that early detection strategies, involving public education and self-referral may prove more cost-effective, with low-risk populations for cancers with symptomatic presentation. The success of public education approaches is dependent on careful consideration of the psycho-social factors of self-examination and referral. This paper presents the findings from an exploratory study, using qualitative methods with an at-risk population of older people living in deprived communities in west-central Scotland. The study examines consumer perceptions of the early detection of cancer and the cultural barriers to self-referral, as well as response to aspects of communication strategy. The implications for design of symptom awareness campaigns, including use of message appeals, specification of target symptoms, identification of target audience and selection of communication channels, are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Sarcoidosis in Singapore: Epidemiology, clinical presentation and ethnic differences

RESPIROLOGY, Issue 3 2007
Devanand ANANTHAM
Background and objectives: The aim of this study is to better understand the epidemiological and clinical features of patients with sarcoidosis in Singapore and to ascertain if ethnic differences exist. Methods: A review of hospital medical records from June 1998 to May 2004 to identify patients with sarcoidosis. Results: There were 59 patients with sarcoidosis identified (19 Chinese, 29 Asian Indian and 11 Malay). The estimated annual incidence of sarcoidosis in Singapore was 0.56 per 100 000. There was a significant difference between the observed and expected disease frequency in Chinese (32.2% vs 78.7%) and Indians (49.2% vs 6.0%, P < 0.005). A bimodal distribution of age at diagnosis was seen with peaks in the 30,39 years and 50,59 years age groups; 38.9% of cases were over the age of 50. Chinese patients were more likely to be asymptomatic (57.9%, P = 0.015) and less likely to have impaired spirometry (P = 0.013). Pulmonary sarcoid presented largely as stage 0 or stage 1 disease (74.4%). Overall mean spirometry was unimpaired and prognosis was good with 79.2% showing no radiological deterioration. There were no significant differences in organ involvement or treatment between ethnic groups. Conclusion: Sarcoidosis in Singapore is rare and the incidence differs between ethnic groups. Chinese appear to have a lower incidence and a less symptomatic presentation; Indians have a higher incidence and poorer clinical course. [source]

Early ostial saphenous vein graft stenosis associated with the use of Symmetry sutureless aortic proximal anastomosis device: Successful percutaneous revascularization

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2004
Sharon L. Cline MD
Abstract A recent advance in technology permits the creation of sutureless proximal aortic anastomosis during coronary artery bypass graft surgery. This new tool has significant potential benefit by minimizing aortic manipulation with subsequent reduction in neuroembolization. Implantation of a nitinol-based proximal aortic connector (Symmetry) has a potential to elicit intimal hyperplastic reaction analogous to restenosis after coronary stent placement. We report cases of early vein graft stenosis in association with the use of the Symmetry device. Three patients suffered from severe ostial stenosis within 6 months of bypass surgery with symptomatic presentation. Of these three patients, two underwent successful percutaneous revascularization. Fluoroscopic star-shaped appearance of the metallic Symmetry allows device recognition during angiography. We review current data regarding graft patency with the use of Symmetry device and discuss technical issues to address specific problems during percutaneous revascularization. Catheter Cardiovasc Interv 2004;62:203,208. © 2004 Wiley-Liss, Inc. [source]