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Sample records for asymptomatic bacteriuria escherichia

  1. Asymptomatic bacteriuria Escherichia coli strains

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Nielsen, E.M.; Klemm, Per

    2006-01-01

    Urinary tract infections (UTIs) affect millions of people each year. Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. Persons affected by ABU may carry a particular E. coli strain for extended periods of time without any symptoms. In contrast...

  2. Transcriptomics and adaptive genomics of the asymptomatic bacteriuria Escherichia coli strain 83972

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Seshasayee, Aswin S.; Ussery, David

    2008-01-01

    Escherichia coli strains are the major cause of urinary tract infections in humans. Such strains can be divided into virulent, UPEC strains causing symptomatic infections, and asymptomatic, commensal-like strains causing asymptomatic bacteriuria, ABU. The best-characterized ABU strain is strain....... Strain 83972 is a deconstructed pathogen rather than a commensal strain that has acquired fitness properties....

  3. Virulence Potential of Escherichia coli Strains Causing Asymptomatic Bacteriuria during Pregnancy ▿

    Science.gov (United States)

    Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert

    2011-01-01

    We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis. PMID:21918033

  4. Virulence potential of Escherichia coli strains causing asymptomatic bacteriuria during pregnancy.

    Science.gov (United States)

    Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert

    2011-11-01

    We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis.

  5. Virulence Potential of Escherichia coli Strains Causing Asymptomatic Bacteriuria during Pregnancy ▿

    OpenAIRE

    Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert

    2011-01-01

    We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis.

  6. Escherichia coli Isolates Causing Asymptomatic Bacteriuria in Catheterized and Noncatheterized Individuals Possess Similar Virulence Properties

    DEFF Research Database (Denmark)

    Watts, Rebecca E; Hancock, Viktoria; Ong, Cheryl-lynn Y

    2010-01-01

    Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli being responsible for >80% of all cases. Asymptomatic bacteriuria (ABU) occurs when bacteria colonize the urinary tract without causing clinical symptoms and can affect both catheterized...

  7. Asymptomatic bacteriuria among pregnant women

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    Paul Erhunmwunse Imade

    2010-06-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  8. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-01-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion : Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  9. Contribution of siderophore systems to growth and urinary tract colonization of asymptomatic bacteriuria Escherichia coli

    DEFF Research Database (Denmark)

    Watts, Rebecca E; Totsika, Makrina; Challinor, Victoria L;

    2012-01-01

    The molecular mechanisms that define asymptomatic bacteriuria (ABU) Escherichia coli colonization of the human urinary tract remain to be properly elucidated. Here, we utilize ABU E. coli strain 83972 as a model to dissect the contribution of siderophores to iron acquisition, growth, fitness, and...... receptor mutant was outcompeted by 83972 in human urine and the mouse urinary tract, indicating a role for catecholate receptors in urinary tract colonization....

  10. Molecular characterization of the Escherichia coli asymptomatic bacteriuria strain 83972

    DEFF Research Database (Denmark)

    Klemm, Per; Hancock, Viktoria; Ulett, G.C.

    2006-01-01

    Escherichia coli 83972 is a clinical asymptomatia bacteriuric isolate that is able to colonize the human urinary bladder without inducing an immune response. Here we demonstrate that one of the mechanisms by which this strain has become attenuated is through the mutation of its genes encoding type...

  11. The asymptomatic bacteriuria Escherichia coli strain 83972 outcompetes uropathogenic E. coli strains in human urine

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Ulett, G.C.; Schembri, M.A.

    2006-01-01

    Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU). In contrast to uropathogenic E. coli (UPEC), which causes symptomatic urinary tract infections (UTI), very little is known about the mechanisms by which these strains colonize the human urinary tract....... The prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. Deliberate colonization of UTI-susceptible individuals with E. coli 83972 has been used successfully as an alternative approach for the treatment of patients who are refractory...... to conventional therapy. Colonization with strain 83972 appears to prevent infection with UPEC strains in such patients despite the fact that this strain is unable to express the primary adhesins involved in UTI, viz. P and type 1 fimbriae. Here we investigated the growth characteristics of E. coli 83972 in human...

  12. Identification of Genes Important for Growth of Asymptomatic Bacteriuria Escherichia coli in Urine

    DEFF Research Database (Denmark)

    Vejborg, Rebecca Munk; de Evgrafov, Mari Cristina Rodriguez; Phan, Minh Duy;

    2012-01-01

    reduced competitive advantage in the bladder and/or kidney during coinoculation experiments with the parent strain, whereas 83972metE and 83972ilvC did not. Taken together, our data have identified several biosynthesis pathways as new important fitness factors associated with the growth of ABU E. coli......Escherichia coli is the most important etiological agent of urinary tract infections (UTIs). Unlike uropathogenic E. coli, which causes symptomatic infections, asymptomatic bacteriuria (ABU) E. coli strains typically lack essential virulence factors and colonize the bladder in the absence...... of symptoms. While ABU E. coli can persist in the bladder for long periods of time, little is known about the genetic determinants required for its growth and fitness in urine. To identify such genes, we have employed a transposon mutagenesis approach using the prototypic ABU E. coli strain 83972...

  13. Asymptomatic bacteriuria among pregnant women

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    Sudha Biradar Kerure

    2013-04-01

    Full Text Available Background: Urinary tract infections (UTIs are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens. Methods: A total of 500 pregnant women were studied over a period of one year. Clean catch midstream urine sample was collected into a sterile container & then subjected to culture method. Results: Significant bacteriuria was noted in 45 patients (9%. 3% patients had insignificant bacteriuria. Growth of contaminants was noted in 8%. 80% samples were sterile with no growth. E. coli was the most common etiological agent, followed by Staphylococcus aureus. Conclusions: Asymptomatic bacteriuria is not uncommon in antenatal patients. All pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt UTI & other complications in both mother & fetus. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 213-216

  14. Global gene expression profiling of the asymptomatic bacteriuria Escherichia coli strain 83972 in the human urinary tract

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Klemm, Per

    2006-01-01

    long-term bladder colonization. The strain has been used for prophylactic purposes in patients prone to more severe and recurrent UTIs. For this study, we used DNA microarrays to monitor the expression profile of strain 83972 in the human urinary tract. Significant differences in expression levels were......Urinary tract infections (UTIs) are an important health problem worldwide, with many million cases each year. Escherichia coli is the most common organism causing UTIs in humans. The asymptomatic bacteriuria E. coli strain 83972 is an excellent colonizer of the human urinary tract, where it causes...

  15. ASYMPTOMATIC BACTERIURIA AND PYURIA IN PREGNANCY

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    M Rahimkhani

    2008-11-01

    Full Text Available "nPregnant women are at increased risk for urinary tract infection (UTI but in many cases infection is asymptomatic. This study was performed to determine the incidence of asymptomatic bacteriuria and pyuria in pregnant women. A total of 86 pregnant women during first trimester and 56 nonpregnant women were evaluated. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine samples were collected for both groups. Urine samples were examined microscopically and were cultured. Bacteriological examination revealed asymptomatic bacteriuria in 25 (29.1% and 3 (5.4% of the study group and controls, respectively (P < 0.05. Microscopic analysis of urine revealed pyuria in 18 (20.9% and 3 (5.4% of the study group and controls, respectively (P < 0.05. In study group, Escherichia coli were found in 20%, Staphylococcus epidermidis in 36%, Staphylococcus haemolyticus in 12%, streptococcus group D in 12%, Staphylococcus saprophyticus in 12% and Proteus mirabilis in 8%. In control group, E. coli were found in 33.3% and S. epidermidis in 66.7%. Our results show that the incidence of asymptomatic bacteriuria is significantly higher in pregnant women than nonpregnant women. The main finding in the present study was that 29.1% of the pregnant women who were in first trimester had asymptomatic bacteriuria which is much higher than figures reported from other countries. The use of microscopic urinanalysis was not an effective method of detecting asymptomatic bacteriuria and urine culture is necessary for screening these pregnant women.

  16. Asymptomatic bacteriuria in antenatal women

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    Lavanya S

    2002-01-01

    Full Text Available A total of 500 antenatal women in their first or second trimesters were screened over a period of 2 years for asymptomatic bacteriuria. Out of them, 8.4% (42 were culture positive. A control group of 100 non-pregnant women, both married and unmarried, was also simultaneously screened. The control group yielded an overall culture positivity of 3% (4% in the married non-pregnant women and 2% in the unmarried women. Primigravida had highest percent culture positivity of 66.6%. The incidence was higher in less than 20 years age group i.e. 71.42%. Of the screening tests, Gram stained smear when compared with the standard loop method, showed the highest sensitivity of 95.2%. The specificity of the screening tests was high [Gram stained smear (98.6%, catalase test (97.1% and pus cell count(96.5%]. Escherichia coli was the most common organism isolated in the test and control groups. The organisms were sensitive to cephalexin, nitrofurantoin, amoxycillin and norfloxacin in decreasing order. Incidence of prematurity was 75% and that of low birth weight was 50% in untreated patients.

  17. Global gene expression profiling of asymptomatic bacteriuria Escherichia coli during biofilm growth in human urine

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Klemm, Per

    2007-01-01

    asymptomatic bacteriuria (ABU) E. coli strains 83972 and VR50 are significantly better biofilm formers in their natural growth medium, human urine, than the two uropathogenic E. coli isolates CFT073 and 536. We used DNA microarrays to monitor the expression profile during biofilm growth in urine of the two ABU...... strains 83972 and VR50. Significant differences in expression levels were seen between the biofilm expression profiles of the two strains with the corresponding planktonic expression profiles in morpholinepropanesulfonic acid minimal laboratory medium and human urine; 417 and 355 genes were up- and down...... versions of 83972 and VR50; all mutants showed reduced biofilm formation in urine by 18 to 43% compared with the wild type (P profile of strain 83972 in the human urinary tract partially overlaps with the biofilm expression profile....

  18. Biofilm-Exclusion of Uropathogenic Bacteria by Selected Asymptomatic Bacteriuria Escherichia Coli Strains

    DEFF Research Database (Denmark)

    Ferriéres, L.; Hancock, Viktoria; Klemm, Per

    2007-01-01

    . In contrast to uropathogenic E coli (UPEC), which cause symptomatic urinary tract infection, asymptomatic bacteriuria (ABU) strains are associated with essentially symptom-free infections. Here the biofilm-forming capacity on abiotic surfaces of selected E coli ABU strains and UPEC strains in human urine...... was investigated. It was found that there is a strong bias for biofilm formation by the ABU strains. Not only were the ABU strains significantly better biofilm formers than UPEC strains, they were also able to out-compete UPEC strains as well as uropathogenic strains of Klebsiella spp. during biofilm formation....... The results support the notion of bacterial prophylaxis employing selected ABU strains to eliminate UPEC strains and other pathogens in patients prone to recalcitrant infections....

  19. Asymptomatic Bacteriuria in Clinical Urological Practice

    DEFF Research Database (Denmark)

    Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo;

    2016-01-01

    Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two i...... a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis) has been isolated....

  20. PREVALENCE OF ASYMPTOMATIC BACTERIURIA IN PREGNANCY AT A TEACHING HOSPITAL

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    Indira Guntoory

    2016-07-01

    Full Text Available BACKGROUND UTI is the most frequent medical complication. It may be asymptomatic or symptomatic. Asymptomatic bacteriuria if left untreated might result in symptomatic UTI and adverse pregnancy outcomes. AIM This prospective study was aimed to determine the prevalence of Asymptomatic bacteriuria of pregnancy among antenatal women attending the antenatal clinic in the Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram District, Andhra Pradesh. MATERIAL AND METHODS After taking approval from Institutional Ethics Committee and informed written consent from patients, urine samples were collected from antenatal women in their first antenatal visit. A clean catch midstream specimen of urine was collected and inoculated on blood agar and MacConkey’s agar. It was incubated aerobically at 37 degrees centigrade overnight. Isolates were identified up to species level using standard protocol and sensitivity to different antibiotics is tested. Results were analysed statistically and a P value of less than 0.05 was taken as significant. RESULTS A total of 173 samples were screened; 154 women showed no growth on culture; 19 women had significant bacteriuria with a prevalence rate of 10.98%; 15 women in the age group of 18-25 years and 4 women in the age group of 26-35 years had significant bacteriuria; 83 women were multiparous and 11 (57.89% women in this group had significant bacteriuria, while only 8 (42.1% out of 90 women in the nulliparous group had significant bacteriuria. With respect to trimester, 10 (52.63% out of 19 culture positive cases were in second trimester. In our study, the organisms isolated were Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. The bacteria grown were most sensitive to Ampicillin+Sulbactam (68%, Nitrofurantoin (73%, Amikacin (84% and Meropenem (100%. CONCLUSION It is therefore essential to screen every antenatal women for asymptomatic

  1. PREVALENCE OF ASYMPTOMATIC BACTERIURIA IN PREGNANCY AT A TEACHING HOSPITAL

    OpenAIRE

    2016-01-01

    BACKGROUND UTI is the most frequent medical complication. It may be asymptomatic or symptomatic. Asymptomatic bacteriuria if left untreated might result in symptomatic UTI and adverse pregnancy outcomes. AIM This prospective study was aimed to determine the prevalence of Asymptomatic bacteriuria of pregnancy among antenatal women attending the antenatal clinic in the Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianag...

  2. Predictive value of Escherichia coli susceptibility in strains causing asymptomatic bacteriuria for women with recurrent symptomatic urinary tract infections receiving prophylaxis.

    Science.gov (United States)

    Beerepoot, M A J; den Heijer, C D J; Penders, J; Prins, J M; Stobberingh, E E; Geerlings, S E

    2012-04-01

    A significant proportion of women develop a recurrence following an initial urinary tract infection (UTI). In women with recurrent UTI, the predictive value of asymptomatic bacteriuria (ASB) for the development of a subsequent UTI has not yet been established and it is not known whether information from an asymptomatic sample is useful in guiding antimicrobial therapy. To address these questions, we used data that originated from the 'Non-antibiotic prophylaxis for recurrent urinary tract infections' (NAPRUTI) study: two randomized controlled trials on the prevention of recurrent UTI in non-hospitalized premenopausal and postmenopausal women (n=445). During 15months of follow-up, no difference was observed in the time to a subsequent UTI between women with and without ASB at baseline (hazard ratio: 1.07, 95% CI 0.80-1.42). The antimicrobial susceptibility and pulsed-field gel-electrophoresis (PFGE) pattern of 50 Escherichia coli strains causing a UTI were compared with those of the ASB strain isolated 1month previously. The predictive values of the susceptibility pattern of the ASB strain, based on resistance prevalence at baseline, were ≥76%, except in the case of nitrofurantoin- and amoxicillin-clavulanic acid-resistance. Asymptomatic and symptomatic isolates had similar PFGE patterns in 70% (35/50) of the patients. In the present study among women with recurrent UTI receiving prophylaxis, ASB was not predictive for the development of a UTI. However, the susceptibility pattern of E. coli strains isolated in the month before a symptomatic E. coli UTI can be used to make informed choices for empirical antibiotic treatment in this patient population.

  3. Association between Asymptomatic Bacteriuria and Pre-Eclampsia.

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    Rezavand, Negin; Veisi, Firooze; Zangane, Mrayam; Amini, Roghaye; Almasi, Afshin

    2015-12-18

    Asymptomatic bacteriuria is one of the most common and important bacterial infections during pregnancy and can result in progressive infections and endanger maternal as well as fetal health. In this study, we assessed the relationship between asymptomatic bacteriuria and pre-eclampsia. In this case-control study, pregnant women who presented to Imam Reza Hospital in Kermanshah in 2013-14 were studied. The minimum sample size was calculated as 125 pregnant women in each group with a total of 250 subjects. There were 125 women with pre-eclampsia and 125 women without pre-eclampsia (control group). Matching was done for age, gestational age, and parity between case and control groups. Matching was verified by a P value of 0.061 for maternal age and gestational age and 0.77 for parity. The statistical analyses were done by applying the chi-squared test and determining odds ratio (OR) for having bacteriuria in univariate logistic regression as well as multivariate regression with adjusting the effect of maternal age, gestational age, and parity. Pyuria and bacteriuria were significantly more common in pre-eclampsia group than in control group. The results showed that a significant association existed between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was 6.8 times higher in women with pre-eclampsia compared to those without pre-eclampsia. Further studies are required for better clarification of association between asymptomatic bacteriuria and pre-eclampsia.

  4. Urinary tract infections and asymptomatic bacteriuria in older adults.

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    Nelson, Joan M; Good, Elliot

    2015-08-15

    Overuse of urinalysis in older adults to investigate vague changes in condition such as confusion, lethargy, and anorexia, has led to overtreatment of asymptomatic bacteriuria and associated antibiotic resistance.

  5. Prevalence and outcome of asymptomatic bacteriuria in early pregnancy

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    Sreekumary Radha

    2016-12-01

    Full Text Available Background: Bacteriuria is a major risk factor for developing symptomatic urinary tract infection which is associated with significant maternal and fetal risks. Various studies have put a prevalence of asymptomatic bacteriuria between 2-10% in pregnancy. Maternal and fetal complications like gestational hypertension, anaemia, premature delivery, IUGR, and low birth weight are commonly associated with pyelonephritis which occurs as a result of undiagnosed or inadequately treated infections of the urinary tract. The primary objective was to find out the prevalence of asymptomatic bacteriuria in pregnancies less than 28 weeks gestation in our hospital and to study the various adverse pregnancy outcomes in the study group. Methods: This was a cross sectional study done over a period of 12 months at this tertiary care centre in Government sector in Trivandrum, Kerala. A sample size was calculated statistically and 400 women with gestational age less than 28 weeks attending the outpatient department were included in this study. A structured proforma, urine microscopy and urine culture and sensitivity were the study tools. Results: Prevalence of asymptomatic bacteriuria in our study population was 8.25%. Commonest pathogen isolated was E.coli in 57.14% cases. Maternal morbidity was higher in women with asymptomatic bacteriuria (24.2% than those without (12.5%. Fetal morbidity in women with asymptomatic bacteriuria was 24% whereas it was 12.5% in those without it. Preterm labour, preeclampsia and prematurity were the common morbidities noted. Conclusions: Since pregnant women with asymptomatic bacteriuria were at an increased risk of adverse maternal and fetal outcome, routine screening for asymptomatic bacteriuria preferably in the first trimester is highly recommended.

  6. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy

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    Ghafarnezhad M

    2001-07-01

    Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.

  7. Asymptomatic bacteriuria in postmenopausal women with diabetes mellitus

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    George Kasyan

    2013-05-01

    Full Text Available Introduction. An evaluation of efficacy of the management of urinary tract infections by using local forms of Estriol in postmenopausal women with type II diabetes and asymptomatic bacteriuria.Material and methods. The study was conducted in two stages. The first stage: a prospective cross–sectional study to identify patients with asymptomatic bacteriuria. During this stage, 414 postmenopausal women with type II diabetes, but without clinical symptoms of urinary tract infection, were investigated. In the second stage, women with asymptomatic bacteriuria (87 women were randomized to two groups: the first group was the main group receiving 0.5 mg of Estriol as a vaginal cream, the second group was the control group. The study lasted 12 months.Results. After 12 months of the study, asymptomatic bacteriuria was revealed in 19.4% of women in the group 1 and 68.4% of women in the group 2 (р <0.001, and symptomatic urinary tract infection in 8.3% of women in the group 1 and 18.4% of women in the group 2 (р <0.001. There was no connection revealed between asymptomatic bacteriuria and НвА1с. Using Estriol in group 1 led to an increase in VHI, the appearance of lactobacilli in the vaginal smear, and the decrease of symptom frequency in atrophic vaginitis. In group 2, there were no significant changes revealed.Conclusions. Usage of local forms of Estriol effectively prevents and decreases the frequency of asymptomatic bacteriuria and urinary tract infection in postmenopausal women suffering with diabetesmellitus.

  8. Consequences of asymptomatic bacteriuria in women with diabetes mellitus

    NARCIS (Netherlands)

    Geerlings, SE; Stolk, RP; Camps, MJL; Netten, PM; Collet, JT; Schneeberger, PM; Hoepelman, AIM

    2001-01-01

    Background: Women with diabetes mellitus (DM) have asymptomatic bacteriuria (ASB) more often than women without DM. It is unknown, however, what the consequences of ASB are in these women. Objectives: To compare women with DM with and without ASB for the development of symptomatic urinary tract infe

  9. Asymptomatic bacteriuria and antibacterial susceptibility during pregnancy

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    Anjana Verma

    2016-02-01

    Conclusions: Ectopic pregnancy can have varied presentations and misdiagnosis can be seen in Surgical, Medical and Gynaecology Universal screening of aymptomatic bacteriuria is recommended because of its high prevalence and prenatal and maternal complications, if left untreated. Nitrofurantoin can be advocated because of its low cost and high effectiveness where culture is not possible because of inadequate resources. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 407-410

  10. Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria

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    Ikefuna Anthony N

    2011-09-01

    Full Text Available Abstract Background Urinary tract infection (UTI is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Methods One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml on two consecutive cultures were regarded as having asymptomatic bacteriuria. Results Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1 when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%. All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones. Conclusion The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.

  11. ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN ATTENDING THE OUTPATIENT CLINIC OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN, NEPAL

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    Mamata Sharma Neupane

    2012-11-01

    Full Text Available Urinary Tract Infection (UTI refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobial susceptibility pattern, and also to determine the relationship between asymptomatic bacteriuria and pyuria. The total number of participants who finished the study was 392. The mean age of the participants was 29.76 ± 6.71(range, 21-37 years. Of the 392 urine specimens processed, 102 (26.0% showed significant bacteriuria. The commonest organism causing bacteriuria was Escherichia coli. The sensitivity pattern of the isolated organisms revealed that all were sensitive to ciprofloxacin and gentamicin at very high percentage. 200 (51.5% women had more than 5 pus cells in urine specimens from which 50 (12.75% had positive cultures. Women with higher number of pus cells in urine specimen had significantly higher asymptomatic bacteriuria (p < 0.0001.In conclusion, screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in Nepalese community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women.

  12. Urinary tract infections and asymptomatic bacteriuria in renal transplant recipients

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    Rabi Yacoub

    2011-01-01

    Full Text Available Asymptomatic bacteriuria and urinary tract infection are common complications after kidney transplantation. In this population, if urinary tract infection occurred in the first six months post procedure, it carries a grave impact on both graft and patient survival. Renal transplant recipients with urinary tract infection are often clinically asymptomatic as a consequence of immunosuppression. Urinary tract infection, however, may progress to acute pyelonephritis, bacteremia and the full blown picture of urosepsis. PubMed and Cochrane databases were searched. The purpose of this review is to discuss the screening and treatment of urinary tract infection and asymptomatic bacteriuria in renal transplant recipients and to evaluate the guidelines on the basis of a review of published evidence.

  13. Asymptomatic bacteriuria and urinary tract infections in women : focus on diabetes mellitus and pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline

    2014-01-01

    There is a shortage of evidence for clinical guidelines on diagnosis and management of both asymptomatic bacteriuria (the presence of bacteria in urine without symptoms of an infection) and urinary tract infections in women with diabetes and pregnant women. Asymptomatic bacteriuria and urinary tract

  14. Asymptomatic bacteriuria and symptomatic urinary tract infections during pregnancy.

    Science.gov (United States)

    Macejko, Amanda M; Schaeffer, Anthony J

    2007-02-01

    Urinary tract infections are common complications of pregnancy; upper tract infections in particular may lead to significant morbidity for both the mother and fetus. Bacteriuria is a significant risk factor for developing pyelonephritis in pregnant women. Therefore, proper screening and treatment of bacteriuria during pregnancy is necessary to prevent complications. All women should be screened for bacteriuria in the first trimester, and women with a history of recurrent urinary tract infections or anomalies should have repeat bacteriuria screening throughout pregnancy. Treatment of bacteriuria should include 3-day therapy with appropriate antimicrobials, and women should be followed closely after treatment because recurrence may occur in up to one third of patients.

  15. Etiology and resistance of asymptomatic bacteriuria isolates among school going children in Sanadaj-Iran

    Institute of Scientific and Technical Information of China (English)

    Sofei-Majidpur H; Kalantar E; Verdi F; Khaksar N; Shahsavari S; Beiranvand S

    2008-01-01

    Objective:The objective of this study was to determine the etiology and antimicrobial susceptibility patterns of asymptomatic bacteriuria pathogens isolated among school going children in Sanandaj,Iran.Methods:A total of 1 457 urine samples of 5 to 10 years children from forty different schools of Sanandaj city were screened to see asymptomatic bacteriuria during November 2007 to June 2008.Results:Bacterial colony count of over (105)colony forming units CFU /mL were found in 28 (1.90%)of total cases,with 767 (52.64%)girls and 690 (47.35%)boys.The highest class-specific prevalence was found in the fourth standard (2.8%)and the lowest in the first standard (1.0%).The dominant bacterial isolates were E.coli 20 (74.1%),followed by Klebsiella pneumoniae 04 (14.8%)and Staphylococcus aureus 04 (14.8%).Cefotaxime,Cefixime,Kana-mycin,Co-trimoxazole,nalidicxic acid,nitrofurantoin and Amoxicillin,resistance rates were above 90.0%. Ceftriaxone expressed the highest susceptibility among E.coli isolates.Surprisingly,S.aureus showed 100. 0% resistance to oxacillin.Conclusion:In the present study in which Escherichia coli is the most frequently incriminated as the causative agents.The results show a very serious antibiotic resistance of E.coli isolated. Surveillance and monitoring studies will be essential in preventing of renal scarring or other abnormalities.

  16. Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI

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    Tommaso Cai

    2016-01-01

    Full Text Available Asymptomatic bacteriuria (ABU is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs. Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis has been isolated.

  17. Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI.

    Science.gov (United States)

    Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo; Caciagli, Patrizio; Malossini, Gianni; Nesi, Gabriella; Wagenlehner, Florian M E; Köves, Bela; Pickard, Robert; Grabe, Magnus; Bjerklund Johansen, Truls E; Bartoletti, Riccardo

    2016-01-05

    Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs). Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis) has been isolated.

  18. A study on asymptomatic bacteriuria in pregnancy: prevalence, etiology and comparison of screening methods

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    Kheya Mukherjee

    2014-06-01

    Full Text Available Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. Methods: Clean catch mid-stream urine were collected from 250 pregnant women aged between 18-45 years attending antenatal clinic, for a period of one year (November 2008-2009. Screening tests such as gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test were done. Identification of organisms and antibiotic sensitivity tests were performed as per standard methods. Results: Out of the 250 pregnant women, 21 (8.4% had significant bacteriuria. High percentage of asymptomatic bacteriuria was seen in 2nd trimester (42.86% and in primigravidas (52.38%. E. coli (57.14% was the most common organism. Among screening tests gram staining of uncentrifuged urine had a sensitivity of 85.71%. Nitrite and leukocyte esterase tests alone showed sensitivity of 71.42%. However, the combination of these two tests, either tests positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively. Conclusion: Asymptomatic bacteriuria in pregnancy can be identified by simple and combined rapid screening methods and urine culture along with antibiogram so that early treatment can be started thereby preventing complications. [Int J Res Med Sci 2014; 2(3.000: 1085-1091

  19. Asymptomatic bacteriuria may be considered a complication in women with diabetes

    NARCIS (Netherlands)

    Geerlings, SE; Stolk, RP; Camps, MJL; Netten, PM; Hoekstra, JBL; Bouter, KP; Bravenboer, B; Collet, JT; Jansz, AR; Hoepelman, AIM

    2000-01-01

    OBJECTIVE - To study the prevalence of and risk factors for asymptomatic bacteriuria (ASB) in women with and without diabetes. RESEARCH DESIGN AND METHODS - A total of 636 nonpregnant women with diabetes (type 1 and type 2) who were 18-75 years of age and had no abnormalities of the urinary tract, a

  20. Screening for asymptomatic bacteriuria in adults : US preventive services task force reaffirmation recommendation statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen; Gregory, Kimberly D.; Harris, Russell; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne; Loveland-Cherry, Carol; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Yawn, Barbara P.

    2008-01-01

    Description: Reaffirmation of the 2004 U. S. Preventive Services Task Force recommendation statement about screening for asymptomatic bacteriuria in adults. Methods: The U. S. Preventive Services Task Force did a targeted literature search for evidence on the benefits and harms of screening for asym

  1. History taking and leukocyturia predict the presence of asymptomatic bacteriuria in women with diabetes mellitus

    NARCIS (Netherlands)

    Meiland, R; Geerlings, SE; Stolk, RP; Hoes, AW; Hoepelman, AIM

    2004-01-01

    Objective: To investigate the accuracy of history taking to diagnose asymptomatic bacteriuria (ASB) in diabetic women, and the added value of leukocyturia. Methods: Data were obtained from a multicenter study including 465 women with diabetes. Many patient characteristics were considered as potentia

  2. Deliberate Establishment of Asymptomatic Bacteriuria-A Novel Strategy to Prevent Recurrent UTI.

    Science.gov (United States)

    Wullt, Björn; Svanborg, Catharina

    2016-07-29

    We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.

  3. Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

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    Abirami Lakshmy Jayachandran

    2016-02-01

    Results: Out of the 120 samples 14 (11.66% were positive for asymptomatic bacteriuria. The Gram staining showed specificity and negative predictive value of 95.2% and 98.1% respectively. Pus cell count showed a specificity and negative predictive value of 96.29% and 98.11% respectively. Escherichia coli were the predominant species isolated 5 (35.7%. Among the gram negative bacteria, amikacin and nitrofurantoin showed a susceptibility of 90% and 80% each. All the staphylococcus aureus isolates showed 100% sensitivity for nitrofurantoin. Two Klebsiella spp and one Escherichia coli isolate were identified as ESBL producers. Among the S. aureus isolates 3 were identified as Methicillin resistant (MRSA. Conclusions: Urine culture should be performed for all pregnant women irrespective of the symptoms and should be treated promptly to prevent the complications arising out of ASB. [Int J Res Med Sci 2016; 4(2.000: 540-544

  4. Benefits and harms of screening for and treatment of asymptomatic bacteriuria in pregnancy: a systematic review

    OpenAIRE

    2016-01-01

    Background Most European and North American clinical practice guidelines recommend screening for asymptomatic bacteriuria (ASB) as a routine pregnancy test. Antibiotic treatment of ASB in pregnant women is supposed to reduce maternal upper urinary tract infections (upper UTIs) and preterm labour. However, most studies supporting the treatment of ASB were conducted in the 1950s to 1980s. Because of subsequent changes in treatment options for ASB and UTI, the applicability of findings from thes...

  5. The evaluation of urine pH in screening for asymptomatic bacteriuria in pregnancy.

    Science.gov (United States)

    Harlass, F F; Duff, P; Herd, M

    1990-02-01

    The purpose of this prospective investigation was to determine whether an alteration in urine pH, either by itself or in combination with other rapid screening tests, could be used to identify asymptomatic bacteriuria in pregnant women. Clean catch urine specimen was used to evaluate 510 asymptomatic obstetric patients. Urine specimens were tested for pH, leukocyte esterase activity, and the presence of nitrites. The pH, leukocyte esterase activity, and nitrite reaction were evaluated singly and in combination to determine if these variables could be used to predict significant bacteriuria. Twenty-four (4.8%) patients had positive cultures for E. coli. The mean pH of the infected population was not significantly different from that of the uninfected population. The performance parameters of pH, singly and in combination with the leukocyte esteras and nitrite status, were poor. We concluded that the identification of urine pH is not of value in detecting asymptomatic bacteriuria.

  6. The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis.

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    Mahin Ghafari

    Full Text Available Asymptomatic bacteriuria (ASB is defined as the presence of bacteria in urine without having signs and symptoms. The aim of this meta-analysis was to estimate the overall prevalence of asymptomatic bacteriuria among Iranian pregnant women.Major national and international databases were searched up to November 2015, including Scientific Information Database, MagIran, Web of Science, Medline, Scopus, Science Direct and Ovid. The checklist of the STROBE statement was used for evaluating the quality of reporting. The extracted data were analyzed and the results were reported using a random-effects model with 95% confidence interval (CI.From 3709 obtained studies, 20 included in the meta-analysis, which involved 15108 pregnant women. The overall prevalence of ASB was 0.13 (95% CI: 0.09, 0.17. The prevalence of ASB in the northern and southern regions of Iran was 0.13 (95% CI: 0.09, 0.18 and 0.11 (95% CI: 0.05, 0.16, respectively.Prevalence of ASB among Iranian pregnant women is considerable. Due to the complications of ASB for pregnant women and their children, preventative planning and control of ASB among pregnant women in Iran is necessary.

  7. Genetic variation of the human urinary tract innate immune response and asymptomatic bacteriuria in women.

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    Thomas R Hawn

    Full Text Available BACKGROUND: Although several studies suggest that genetic factors are associated with human UTI susceptibility, the role of DNA variation in regulating early in vivo urine inflammatory responses has not been fully examined. We examined whether candidate gene polymorphisms were associated with altered urine inflammatory profiles in asymptomatic women with or without bacteriuria. METHODOLOGY: We conducted a cross-sectional analysis of asymptomatic bacteriuria (ASB in 1,261 asymptomatic women ages 18-49 years originally enrolled as participants in a population-based case-control study of recurrent UTI and pyelonephritis. We genotyped polymorphisms in CXCR1, CXCR2, TLR1, TLR2, TLR4, TLR5, and TIRAP in women with and without ASB. We collected urine samples and measured levels of uropathogenic bacteria, neutrophils, and chemokines. PRINCIPAL FINDINGS: Polymorphism TLR2_G2258A, a variant associated with decreased lipopeptide-induced signaling, was associated with increased ASB risk (odds ratio 3.44, 95%CI; 1.65-7.17. Three CXCR1 polymorphisms were associated with ASB caused by gram-positive organisms. ASB was associated with urinary CXCL-8 levels, but not CXCL-5, CXCL-6, or sICAM-1 (P< or =0.0001. Urinary levels of CXCL-8 and CXCL-6, but not ICAM-1, were associated with higher neutrophil levels (P< or =0.0001. In addition, polymorphism CXCR1_G827C was associated with increased CXCL-8 levels in women with ASB (P = 0.004. CONCLUSIONS: TLR2 and CXCR1 polymorphisms were associated with ASB and a CXCR1 variant was associated with urine CXCL-8 levels. These results suggest that genetic factors are associated with early in vivo human bladder immune responses prior to the development of symptomatic UTIs.

  8. [The pertinence of microscopic analysis of the urine as a diagnostic test for asymptomatic bacteriuria in pregnancy].

    Science.gov (United States)

    Boucher, M; Leduc, L; Rinfret, D

    1989-01-01

    The genito-urinary tract is the most frequent site of infection during pregnancy. Asymptomatic bacteriuria is found in 2 to 12% of the obstetrical population. The importance of its detection is underlined by the fact that 20 to 40% of untreated cases will present acute pyelonephritis. Our study's first aim was determining the incidence of asymptomatic bacteriuria in our population. Our results show an incidence of 3.9%. Second, routine mandatory prenatal laboratory examinations include urinalysis and urine culture. Considering the fact that we already do a routine culture, we questioned the pertinence of the microscopic part of urinalysis for screening asymptomatic bacteriuria. Our study has shown that no amount of erythrocytes, leucocytes, bacteria, pus or combination thereof has sufficient sensitivity and/or specificity to be used for screening. We thus conclude that in our context of budget restrictions, the microscopic analysis of urine should be abandoned as a routine test. The biochemical part of urinalysis could be done easily with dipsticks at a lower cost. Urine culture remains the gold standard for detection of asymptomatic bacteriuria.

  9. Asymptomatic bacteriuria and urinary tract infections in special patient groups : women with diabetes mellitus and pregnant women

    NARCIS (Netherlands)

    Schneeberger, Caroline; Kazemier, Brenda M.; Geerlings, Suzanne E.

    2014-01-01

    Purpose of reviewAsymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in women with diabetes mellitus and during pregnancy are common and can have far-reaching consequences for the woman and neonate. This review describes epidemiology, risk factors, complications and treatment of UTI a

  10. Prevalence of asymptomatic bacteriuria in antenatal women attending a tertiary care hospital

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    Ananthi Kasinathan

    2014-04-01

    Methods: A total of 174 antenatal women of and #8804;28 weeks of gestation who had no clinical features of urinary tract infection were recruited for this study over a period of 6 months. Midstream urine sample was collected and sent for routine examination and culture-sensitivity testing. Results: Significant bacteriuria was detected in 22 (12.6% antenatal women. Of them 13 (59.1% belonged to the age group 26-30 years. Nearly half of the culture positive cases, that is 10 (45.5% were educated upto primary school and they belonged to socioeconomic status class 4. Majorities (68% were in the second trimester of pregnancy and the commonest organism isolated was E. coli. Conclusions: Undetected and untreated asymptomatic bacteriuria leads to chronic drug resistant infection, hypertension, anemia, etc. in the mother and prematurity, intrauterine growth restriction etc. in the fetus. Hence it is important to do urine culture for all women during antenatal check-up. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 437-441

  11. Profile and microbiological isolates of asymptomatic bacteriuria among pregnant women in Abakaliki, Nigeria

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    Onu FA

    2015-07-01

    Full Text Available Fidelis Agwu Onu,1 Leonard Ogbonna Ajah,1 Paul Olisaemeka Ezeonu,1 Odidika Ugochukwu Joannes Umeora,1 Perpetus Chudi Ibekwe,1 Monique Iheoma Ajah2 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital, 2Department of Microbiology, Ebonyi State University, Abakaliki, Nigeria Background: Detecting and treating asymptomatic bacteriuria (ASB prevents urinary tract infection and its consequences. The cost-effectiveness of routine screening for ASB in pregnancy is controversial. In populations with high prevalence, however, it is worthwhile and justifiable. Aim: To determine the profile, prevalence, microbiological isolates, and risk factors of ASB among booking antenatal clinic attendees in Abakaliki, Nigeria. Materials and methods: This was a cross-sectional study involving booking antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, who met the inclusion criteria. This study occurred between January and December, 2012. The midstream urine samples of these women were subjected to microscopy, culture, and sensitivity. Results: A total of 300 randomly selected booking antenatal clinic attendees participated in the study; 74 of them had ASB, giving a prevalence of 24.7%. With the exception of rural residence, sociodemographic and obstetric characteristics did not influence the risk of ASB among the participants in this study. Staphylococcus aureus was the commonest organism isolated. The majority of the organisms were sensitive to ofloxacin and ceftriaxone. Conclusion: There is a high prevalence of ASB among pregnant women in Abakaliki. With the exception of rural dwelling, sociodemographic and obstetric characteristics did not significantly influence the risk of ASB among these pregnant women. Therefore, routine ASB screening of pregnant women is recommended in our environment. Keywords: asymptomatic bacteriuria, pregnant women, Abakaliki

  12. Escherichia coli bacteriuria in female adults is associated with the development of hypertension

    NARCIS (Netherlands)

    Meiland, Ruby; Geerlings, Suzanne E.; Stolk, Ronald P.; Hoepelman, Andy I.; Peeters, Petra H.; Coenjaerts, Frank E.; Grobbee, Diederik E.

    2010-01-01

    Objective: To investigate whether Escherichia coli bacteriuria is associated with the development of hypertension during a long-term follow-up. Methods: A prospective cohort study was performed among the participants of two population-based studies. Between 1974 and 1986 all women aged 39 to 68 year

  13. Socio-demographic factors associated with asymptomatic bacteriuria in children with sickle cell anemia in a tertiary health facility in South eastern, Nigeria

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    B F Chukwu

    2010-01-01

    Full Text Available Background: Urinary tract infection (UTI is a common cause of chronic kidney disease in children. It is second only to respiratory tract infection in developed countries as a cause of morbidity and mortality arising from microbial infections. It is also common in a developing country like Nigeria and is the commonest cause of renal disorders in Port Harcourt, South South, Nigeria. UTI can be symptomatic or asymptomatic (asymptomatic bacteriuria. Asymptomatic bacteriuria is said to be more common in school aged girls and children of low socio-economic class. It has also been documented to be more common in children with sickle cell anaemia. Objectives:To determine the relationship between asymptomatic bacteriuria and age, sex and socio-economic status of children with sickle cell anaemia. Methods: One hundred children with sickle cell anaemia in stable state were screened for asymptomatic bacteriuria using midstream urine samples. The age, sex and social class of the children were obtained through a structured questionnaire administered to the parents/care-givers. The relationship between age, sex and social class with asymptomatic bacteriuria in these children was analyzed using SPSS software. Results: The age of the children ranged from 2-12 years. Six of the 100 children were noted to have asymptomatic bacteriuria and five of the six children were females (p=0.04.Five (83.3% of the six children were five years and above. There was a predominance of positive cases (66.7% in the higher socioeconomic class (p=0.03. Conclusion: Asymptomatic bacteriuria is commoner in school aged female sickle cell anaemia children of higher socioeconomic class. However, we suggest that further studies be done to confirm this finding especially with regards to the socioeconomic status of these children.

  14. Asymptomatic bacteriuria in sickle cell disease: a cross-sectional study

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    Roye-Green Karen

    2006-03-01

    Full Text Available Background It is known that there is significant morbidity associated with urinary tract infection and with renal dysfunction in sickle cell disease (SCD. However, it is not known if there are potential adverse outcomes associated with asymptomatic bacteriuria (ASB infections in sickle cell disease if left untreated. This study was undertaken to determine the prevalence of ASB, in a cohort of patients with SCD. Methods This is a cross-sectional study of patients in the Jamaican Sickle Cell Cohort. Aseptically collected mid-stream urine (MSU samples were obtained from 266 patients for urinalysis, culture and sensitivity analysis. Proteinuria was measured by urine dipsticks. Individuals with abnormal urine culture results had repeat urine culture. Serum creatinine was measured and steady state haematology and uric acid concentrations were obtained from clinical records. This was completed at a primary care health clinic dedicated to sickle cell diseases in Kingston, Jamaica. There were 133 males and 133 females in the sample studied. The mean age (mean ± sd of participants was 26.6 ± 2.5 years. The main outcome measures were the culture of ≥ 105 colony forming units of a urinary tract pathogen per milliliter of urine from a MSU specimen on a single occasion (probable ASB or on consecutive occasions (confirmed ASB. Results Of the 266 urines collected, 234 were sterile and 29 had significant bacteriuria yielding a prevalence of probable ASB of 10.9% (29/266. Fourteen patients had confirmed ASB (prevalence 5.3% of which 13 had pyuria. Controlling for genotype, females were 14.7 times more likely to have confirmed ASB compared to males (95%CI 1.8 to 121.0. The number of recorded visits for symptomatic UTI was increased by a factor of 2.5 (95% CI 1.4 to 4.5, p Conclusion ASB is a significant problem in individuals with SCD and may be the source of pathogens in UTI. However, further research is needed to determine the clinical significance of ASB in

  15. Asymptomatic bacteriuria: predisposing factors and correlation with preterm labor in low resource settings

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    Meenakshi Lallar

    2014-04-01

    Full Text Available Background: Infection of urinary tract occurs frequently during pregnancy ranging from Asymptomatic Bacteriuria (ASB to potentially life threatening acute pyelonephritis. The incidence varies from 5% to 20% and it is an important risk factor for preterm labor and perinatal morbidity and mortality. The present study was performed to correlate preterm labor and to define other risk factors associated with ASB like gravida status, socioeconomic status, and anaemia in pregnant women with ASB in low resource settings. Methods: A total of 1000 pregnant mothers in second and third trimester of pregnancy were screened for ASB by using two rapid reagent strip tests, namely nitrate and leukocyte esterase reagent strip tests. Out of those screened positive hundred consecutive pregnant women were taken as cases, after positive urine culture and out of those screened negative, two hundred patients were followed as controls after matching and pairing with cases. A detailed history was taken from each patient to determine all risk factors for ASB. The cases and controls were followed prospectively till delivery. Results: Mean gestational age at the time of labor in 100 cases of ASB was 35.6 +/- 2.9 weeks and in 200 controls was 37.9 +/- 0.6 weeks. The difference between mean gestational age at the time of labor in cases and controls was statistically significant (P value 0.000. The likelihood of preterm labor in the cases was 14.5 times more than the control and the difference was significant (P <0.05. Conclusions: ASB leads to a higher rate of preterm labor and is more frequently seen in population with anemia, illiteracy, rural background and low socioeconomic status. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 403-408

  16. Asymptomatic bacteriuria prevalence and its relationship with urinary tract infections in the elderly

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    Alper Şener

    2013-03-01

    Full Text Available Objective: The aim of this study was investigation of ASB prevalence and the relation for development of UTI in thepeople aged over 65 living in three nursing homes in Izmir province, Turkey.Methods: The people aged over 65 in three nursing homes in Izmir, who did not suffer from any urinary systemsymptoms, on whom no urinary catheterizations were applied within the last 15 days, and who had not received anyantibacterial treatments for the last one week for any reason, were included in the study between 2003 and 2004. Firsturine specimens were collected in the morning and the second were collected 24 to 48 hours later. ASB were includedin clinical follow-up for six months and whether or not any UTI developed was recorded at intervals. At the third month,however, it was investigated whether ASB continued in patients or not. Patients were also examined in terms of ASBfacilitating factors at same time.Results: ASB was detected in 146 (24.1% of 606 patients and more frequent in females than males (%27.8 vs. %18.6;p=0.009. The prevalence of ASB increased by age and length of stay in the nursing home. UTI was not developed andno death occurred in any of the patients during the follow-up period. At the third follow up month, it was observed thatthe ASB except Proteus spp. continued likewise.Conclusion: The ASB prevalence was found as quite high in elderly in our country. Direct or indirect relationship betweenASB and UTI has not been established. J Microbiol Infect Dis 2013; 3(1: 18-23Key words: Asymptomatic bacteriuria, nursing homes, Urinary tract infections

  17. Evaluating a Hospitalist-Based Intervention to Decrease Unnecessary Antimicrobial Use in Patients With Asymptomatic Bacteriuria.

    Science.gov (United States)

    Hartley, Sarah E; Kuhn, Latoya; Valley, Staci; Washer, Laraine L; Gandhi, Tejal; Meddings, Jennifer; Robida, Michelle; Sabnis, Salas; Chenoweth, Carol; Malani, Anurag N; Saint, Sanjay; Flanders, Scott A

    2016-09-01

    OBJECTIVE Inappropriate treatment of asymptomatic bacteriuria (ASB) in the hospital setting is common. We sought to evaluate the treatment rate of ASB at the 3 hospitals and assess the impact of a hospitalist-focused improvement intervention. DESIGN Prospective, interventional trial. SETTING Two community hospitals and a tertiary-care academic center. PATIENTS Adult patients with a positive urine culture admitted to hospitalist services were included in this study. Exclusions included pregnancy, intensive care unit admission, history of a major urinary procedure, and actively being treated for a urinary tract infection (UTI) at the time of admission or >48 hours prior to urine collection. INTERVENTIONS An educational intervention using a pocket card was implemented at all sites followed by a pharmacist-based intervention at the academic center. Medical records of the first 50 eligible patients at each site were reviewed at baseline and after each intervention for signs and symptoms of UTI, microbiological results, antimicrobials used, and duration of treatment for positive urine cultures. Diagnosis of ASB was determined through adjudication by 2 hospitalists and 2 infectious diseases physicians. RESULTS Treatment rates of ASB decreased (23.5%; P=.001) after the educational intervention. Reductions in treatment rates for ASB differed by site and were greatest in patients without classic signs and symptoms of UTI (34.1%; P<.001) or urinary catheters (31.2%; P<.001). The pharmacist-based intervention was most effective at reducing ASB treatment rates in catheterized patients. CONCLUSIONS A hospitalist-focused educational intervention significantly reduced ASB treatment rates. The impact varied across sites and by patient characteristics, suggesting that a tailored approach may be useful. Infect Control Hosp Epidemiol 2016;37:1044-1051.

  18. Discovery and Characterization of Human-Urine Utilization by Asymptomatic-Bacteriuria-Causing Streptococcus agalactiae.

    Science.gov (United States)

    Ipe, Deepak S; Ben Zakour, Nouri L; Sullivan, Matthew J; Beatson, Scott A; Ulett, Kimberly B; Benjamin, William H; Davies, Mark R; Dando, Samantha J; King, Nathan P; Cripps, Allan W; Schembri, Mark A; Dougan, Gordon; Ulett, Glen C

    2015-11-09

    Streptococcus agalactiae causes both symptomatic cystitis and asymptomatic bacteriuria (ABU); however, growth characteristics of S. agalactiae in human urine have not previously been reported. Here, we describe a phenotype of robust growth in human urine observed in ABU-causing S. agalactiae (ABSA) that was not seen among uropathogenic S. agalactiae (UPSA) strains isolated from patients with acute cystitis. In direct competition assays using pooled human urine inoculated with equal numbers of a prototype ABSA strain, designated ABSA 1014, and any one of several UPSA strains, measurement of the percentage of each strain recovered over time showed a markedly superior fitness of ABSA 1014 for urine growth. Comparative phenotype profiling of ABSA 1014 and UPSA strain 807, isolated from a patient with acute cystitis, using metabolic arrays of >2,500 substrates and conditions revealed unique and specific l-malic acid catabolism in ABSA 1014 that was absent in UPSA 807. Whole-genome sequencing also revealed divergence in malic enzyme-encoding genes between the strains predicted to impact the activity of the malate metabolic pathway. Comparative growth assays in urine comparing wild-type ABSA and gene-deficient mutants that were functionally inactivated for the malic enzyme metabolic pathway by targeted disruption of the maeE or maeK gene in ABSA demonstrated attenuated growth of the mutants in normal human urine as well as synthetic human urine containing malic acid. We conclude that some S. agalactiae strains can grow in human urine, and this relates in part to malic acid metabolism, which may affect the persistence or progression of S. agalactiae ABU.

  19. Prevalence and associate risk factors of asymptomatic bacteriuria in pregnancy with bacterial pathogens and their antimicrobial susceptibility in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Udayagiri Venkata Rohini

    2017-01-01

    Full Text Available Background: Asymptomatic bacteriuria (ASB is defined as the presence of actively multiplying bacteria, which is greater than 105/ ml of urine within the urinary tract excluding the distal urethra, at a time when the patient has no symptoms of UTI. Untreated and undiagnosed ASB is associated with adverse maternal and perinatal outcomes. The objective was to determine the profile, prevalence, microbiological isolates with susceptibility, and risk factors of ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Andhra Pradesh, India. Methods: A prospective cross sectional study with 200 pregnant women was conducted for a period of 3 months from January to March 2016. The mid- stream urine specimen was collected and processed from all the cases and social and baseline obstetric data was collected. The isolates from all the cases of ASB were identified by standard biochemical tests. Antimicrobial susceptibility was performed by Kirby- Bauer disc diffusion method and interpreted as per CLSI guidelines. Results: Prevalence of ASB in our study was 30.5%, mean age of the cases was 27.3± 2.9 years. ASB was most common in 25- 30 year’s age group, during 3rd trimester and among multiparous and multigravidae. Previous history of UTI, pre-eclampsia was having significant association among cases with ASB. Escherichia coli was the predominant isolate in the study followed by K. pneumoniae, CONS (Coagulase-Negative Staphylococci, Staphylococcus aureus, citrobacter and Enterococci. Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women during all trimesters must be considered in preventing the complications and adverse foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.

  20. Genetic control of the variable innate immune response to asymptomatic bacteriuria.

    Directory of Open Access Journals (Sweden)

    Jenny Grönberg-Hernández

    Full Text Available The severity of urinary tract infection (UTI reflects the quality and magnitude of the host response. While strong local and systemic innate immune activation occurs in patients with acute pyelonephritis, the response to asymptomatic bacteriuria (ABU is low. The immune response repertoire in ABU has not been characterized, due to the inherent problem to distinguish bacterial differences from host-determined variation. In this study, we investigated the host response to ABU and genetic variants affecting innate immune signaling and UTI susceptibility. Patients were subjected to therapeutic urinary tract inoculation with E. coli 83972 to ensure that they were exposed to the same E. coli strain. The innate immune response repertoire was characterized in urine samples, collected from each patient before and after inoculation with bacteria or PBS, if during the placebo arm of the study. Long-term E. coli 83972 ABU was established in 23 participants, who were followed for up to twelve months and the innate immune response was quantified in 233 urine samples. Neutrophil numbers increased in all but two patients and in an extended urine cytokine/chemokine analysis (31 proteins, the chemoattractants IL-8 and GRO-α, RANTES, Eotaxin-1 and MCP-1, the T cell chemoattractant and antibacterial peptide IP-10, inflammatory regulators IL-1-α and sIL-1RA and the T lymphocyte/dendritic cell product sIL-2Rα were detected and variably increased, compared to sterile samples. IL-6, which is associated with symptomatic UTI, remained low and numerous specific immune mediators were not detected. The patients were also genotyped for UTI-associated IRF3 and TLR4 promoter polymorphisms. Patients with ABU associated TLR4 polymorphisms had low neutrophil numbers, IL-6, IP-10, MCP-1 and sIL-2Rα concentrations. Patients with the ABU-associated IRF3 genotype had lower neutrophils, IL-6 and MCP-1 responses than the remaining group. The results suggest that the host

  1. Biofilm formation by asymptomatic and virulent urinary tract infectious Escherichia coli strains

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Ferrieres, Lionel; Klemm, Per

    2007-01-01

    Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. In contrast to uropathogenic E. coli (UPEC) that cause symptomatic urinary tract infection, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we...... have investigated the biofilm-forming capacity on abiotic surfaces of groups of ABU strains and UPEC strains in human urine. We found that there is a strong bias; ABU strains were significantly better biofilm formers than UPEC strains. Our data suggest that biofilm formation in urinary tract infectious...

  2. Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB study

    Directory of Open Access Journals (Sweden)

    Kazemier Brenda M

    2012-06-01

    Full Text Available Abstract Background The prevalence of asymptomatic bacteriuria (ASB in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥105 colony forming units (CFU/mL of a single microorganism or two different colonies but one ≥105 CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind. Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. Discussion This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16–22 weeks of pregnancy and subsequent nitrofurantoin treatment. Trial registration Dutch trial registry: NTR-3068

  3. Clinical analysis of asymptomatic bacteriuria for elderly people%老年人无症状性菌尿的临床分析

    Institute of Scientific and Technical Information of China (English)

    金美华; 蒋惠芳; 陈丽萍

    2015-01-01

    Objective: To further investigate asymptomatic bacteriuria in elderly people, and to take correct and effective methods of treatment. Methods:68 hospitalized elderly patients with asymptomatic bacteriuria were retrospectively analyzed. Results:①Asymptomatic bacteriuria in the elderly people had some causative factors and occurred with some complications. ②The treatment measures were mainly to eliminate the susceptible factors and handle the primary disease, rather than the anti-infection treatment. Conclusions:Asymptomatic bacteriuria in the elderly people is in a state of engraftment, and mainly treated by eliminating the suscep-tible factors and handling the primary disease;however, abuse of antibiotics cannot ease the symptoms of the patients with chronic uro-genital system, but can increase the chance of dual infection and increase adverse drug reactions.%目的::提高对老年人无症状性菌尿的认识,以采取正确有效的处理方法。方法:对68例住院老年人无症状性菌尿者进行回顾性分析。结果:①老年无症状性菌尿多存在诱发因素和合并症;②治疗措施主要是消除易患因素争及对原发病的处理,而非抗感染治疗。结论:老年人无症状性菌尿大多是处于一种定植状态,主要注重消除易患因素和原发病治疗,滥用抗生素不但不能改善患者慢性泌尿生殖系统症状,反而会增加双重感染的机会及增加药物不良反应。

  4. A Controlled Quasi-Experimental Study of an Educational Intervention to Reduce the Unnecessary Use of Antimicrobials For Asymptomatic Bacteriuria.

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    Neal Irfan

    Full Text Available Asymptomatic bacteriuria (ABU should only be treated in cases of pregnancy or in-patients undergoing urologic procedures; however, unnecessary treatment of ABU is common in clinical practice.To identify risk factors for unnecessary treatment and to assess the impact of an educational intervention focused on these risk factors on treatment of ABU.Quasi-experimental study with a control group.Two tertiary teaching adult care hospitals.Consecutive patients with positive urine cultures between January 30th and April 17th, 2012 (baseline and January 30th and April 30th, 2013 (intervention.In January 2013, a multifaceted educational intervention based on risk factors identified during the baseline period was provided to medical residents (monthly on one clinical teaching unit (CTU at one hospital site, with the CTU of the other hospital serving as the control.During the baseline period, 160/341 (46.9% positive urine cultures were obtained from asymptomatic patients at the two hospitals, and 94/160 (58.8% were inappropriately treated with antibiotics. Risk factors for inappropriate use included: female gender (OR 2.1, 95% CI 1.1-4.3, absence of a catheter (OR 2.5, 1.2-5, bacteriuria versus candiduria (OR 10.6, 3.8-29.4, pyuria (OR 2.0, 1.1-3.8, and positive nitrites (OR 2.2, 1.1-4.5. In 2013, only 2/24 (8% of ABU patients were inappropriately treated on the intervention CTU as compared to 14/29 (52% on the control CTU (OR 0.10; 95% CI 0.02-0.49. A reduction was also observed as compared to baseline on the intervention CTU (OR 0.1, 0.02-0.7 with no significant change noted on the control CTU (OR 0.47, 0.13-1.7.A multifaceted educational intervention geared towards medical residents with a focus on identified risk factors for inappropriate management of ABU was effective in reducing unnecessary antibiotic use.

  5. Asymptomatic bacteriuria in pregnancy from the perspective of public health and maternal health care: review and case report

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    Teodor Markov Garnizov

    2016-05-01

    Full Text Available The present mini-review attempts to analyse the incidence, microbial agents and complications of asymptomatic bacteriuria (ASB in pregnancy. Although there are regional differences in the incidence and microflora involved in ASB in different countries and geographical areas, the prevalence of ASB in pregnant women is generally high and its complications aggravate pregnancy outcomes and exacerbate maternal and foetal morbidity. This makes ASB in pregnancy particularly important from a public health perspective, suggesting that all pregnant women should be subject to routine ASB testing. Another aspect that is highlighted here is the need for general consensus guidelines for treatment of ASB in pregnancy: recommended duration of treatment, types of antibiotics suitable for use in pregnancy, adverse side effects, both maternal and foetal. Finally, this paper describes a case of ASB in a pregnant woman, with Klebsiella pneumoniae identified as the causative agent. The pregnant woman had typical ASB-associated complications combined with an atypical symptom: urinary retention in early postpartum period, which, to the best of our knowledge, is described here for the first time.

  6. Comparison of different antibiotic protocols for asymptomatic bacteriuria in patients with neurogenic bladder treated with botulinum toxin A

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    Ana Claudia Paradella

    Full Text Available ABSTRACT Intravesical botulinum toxin A (BoNTA injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days for the treatment of asymptomatic bacteriuria. All patients were performing self or assisted clean intermittent bladder catheterization and underwent a rigid cystoscopy, under general or regional anesthesia with sedation, and the drug used was Botox®. A total of 616 procedures were performed during the study period. There were 11 identified cases of UTI (1.8% with a trend to a higher rate in the group that used antibiotics for longer time. This report shows that a single dose of antibiotics before the detrusor BoNTA injection is enough to prevent UTI. Randomized clinical trial should be conducted for definitive conclusions.

  7. Preditores clínicos de bacteriúria assintomática na gestação Clinical predictors of asymptomatic bacteriuria during pregnancy

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    Omar Ismail Santos Pereira Darzé

    2011-08-01

    Full Text Available OBJETIVOS: Estimar a prevalência de bacteriúria assintomática (BAS entre gestantes atendidas em pré-natal de Serviço Universitário e identificar prováveis preditores clínicos. MÉTODOS: Estudo prospectivo de corte transversal, envolvendo 260 gestantes matriculadas em serviço de pré-natal de baixo risco entre agosto de 2008 e outubro de 2009, sem sintomas de infecção do trato urinário. Foram excluídas aquelas com febre, disúria, tenesmo vesical, dor lombar, presença de sangramento genital, perda de líquido amniótico, uso de antimicrobianos nos últimos 30 dias e aquelas que não desejaram participar do projeto. A presença de colonização bacteriana ≥10(5 UFC/mL de único patógeno, na amostra urinária obtida do jato médio, foi considerada como a variável dependente. As variáveis estudadas foram: idade, raça, estado civil, nível de instrução, história obstétrica, idade gestacional, anemia, traço falciforme, colpite, passado de infecção do trato urinário, polaciúria, urgência miccional e incontinência urinária. Dados do sumário de urina também foram analisados, como a presença de leucocitúria, flora bacteriana aumentada, hematúria, proteinúria e nitrito. A análise estatística foi realizada com o programa Statistical Package for the Social Sciences (SPSS 13.0 e a significância estatística foi previamente definida por valor pPURPOSE: To estimate the prevalence of asymptomatic bacteriuria among pregnant women attended at our university prenatal care clinic and to identify probable clinical predictors. METHODS: Across-sectional study was carried out from August 2008 to October 2009 at the Bahiana School of Medicine involving 260 pregnant women without symptoms of urinary tract infection. The following exclusion criteria were considered: presence of clinical signs such as fever, dysuria, vesical tenesmus, lumbar pain, history of active genital bleeding or loss of amniotic fluid, use of antimicrobial

  8. BACTERIURIA IN PREGNANCY: A REVIEW OF LITERATURE

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    S. L. B. Souza

    2015-06-01

    Full Text Available The alteration Structural and functional of the urinary system appear as a predisposing factor from pregnant population to urinary tract infections. The bacteriuria in pregnancy still be one of the principal factor of morbidity and mortality, maternal and perinatal. Thus, proposing to analyze the bibliographic production around bacteriuria in pregnancy has developed this study. Proceded to the investigation of 06 national articles, published from 2003 to 2013, on the LILACS database. Were used as descriptors: Bacteriuria and Pregnancy. Defined as bacteriuria from quantitative colony forming units per mililiter of urine (CFU / ml equal to or higher than 105. With etiology is observed Escherichia coli as a major etiologic agent and urine culture the most efficient diagnostic method. The results also attach the treatment of bacteriuria during pregnancy independently of the occurrence of symptoms and tracking of the bacteriuria from the first trimester of pregnancy to prevent maternal and fetal complications.

  9. Molecular Analysis of Asymptomatic Bacteriuria Escherichia coli Strain VR50 Reveals Adaptation to the Urinary Tract by Gene Acquisition

    DEFF Research Database (Denmark)

    Beatson, Scott A.; Ben Zakour, Nouri L.; Totsika, Makrina;

    2015-01-01

    to adhere to human bladder epithelial cells. In the mouse model of UTI, VR50afa and VR50afaE displayed reduced bladder colonization compared to wild-type VR50, similar to the colonization level of the GI-VR50-pheV mutant. Our study suggests that E. coli VR50 is a commensal-like strain that has acquired...

  10. Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI

    OpenAIRE

    2016-01-01

    We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia...

  11. Immune response in diarrheal patients and asymptomatic carrier with CS6-producing enterotoxigenic Escherichia coli infection.

    Science.gov (United States)

    Puiprom, Orapim; Chantaroj, Siriporn; Matsuda, Shigeaki; Sawanpanyalert, Pathom; Honda, Takeshi; Iida, Tetsuya; Taniguchi, Tooru

    2012-11-01

    Enterotoxigenic Escherichia coli (ETEC) is one of the major causes of diarrhea in children and travelers in developing countries. ETEC colonization factors (CFs) are virulence determinants considered as protective antigens and major targets for vaccine development against ETEC infections. One of the most prevalent CFs, coli surface antigen 6 (CS6), a non-fimbrial polymeric protein consisting of two major subunits, CssA and CssB, is produced by approximately 25-35% of ETEC worldwide. We could isolate only CS6-producing ETEC strains from two diarrheal patients and one asymptomatic carrier, but we could not detect CssA- or CssB-specific antibodies in the feces and blood of two patients convalescing from natural ETEC infection and of an asymptomatic carrier using western blotting. Therefore, in order to protect against infection with CS6-producing ETEC, protective levels of CS6 immunity should be incorporated in any future vaccines against ETEC.

  12. Prevalence of asymptomatic urinary tract infections in morbidly obese dogs

    OpenAIRE

    Wynn, Susan G.; Angela L. Witzel; Joseph W. Bartges; Tamberlyn S. Moyers; Claudia A. Kirk

    2016-01-01

    Background. Obesity has reached epidemic proportions in dogs and, as in humans, cost of care has increased due to associated comorbidities. In humans, asymptomatic urinary tract infections (UTI) may be more prevalent in the obese. Asymptomatic bacteriuria (AB) is the term used when UTI are asymptomatic. We hypothesized that morbidly obese dogs are similarly more likely to have asymptomatic bacteriuria than lean, overweight, and moderately obese dogs. Methods. A retrospective study was underta...

  13. Genomic analysis of a pathogenicity island in uropathogenic Escherichia coli CFT073: distribution of homologous sequences among isolates from patients with pyelonephritis, cystitis, and Catheter-associated bacteriuria and from fecal samples.

    Science.gov (United States)

    Guyer, D M; Kao, J S; Mobley, H L

    1998-09-01

    Urinary tract infection is the most frequently diagnosed kidney and urologic disease and Escherichia coli is by far the most common etiologic agent. Uropathogenic strains have been shown to contain blocks of DNA termed pathogenicity islands (PAIs) which contribute to their virulence. We have defined one of these regions of DNA within the chromosome of a highly virulent E. coli strain, CFT073, isolated from the blood and urine of a woman with acute pyelonephritis. The 57,988-bp stretch of DNA has characteristics which define PAIs, including a size greater than 30 kb, the presence of insertion sequences, distinct segmentation of K-12 and J96 origin, GC content (42.9%) different from that of total genomic DNA (50.8%), and the presence of virulence genes (hly and pap). Within this region, we have identified 44 open reading frames; of these 44, 10 are homologous to entries in the complete K-12 genome sequence, 4 are nearly identical to the sequences of E. coli J96 encoding the HlyA hemolysin, 11 encode P fimbriae, and 19 show no homology to J96 or K-12 entries. To determine whether sequences found within the junctions of the PAI of CFT073 were common to other uropathogenic strains of E. coli, 11 probes were isolated along the length of the PAI and were hybridized to dot blots of genomic DNA isolated from clinical isolates (67 from patients with acute pyelonephritis, 38 from patients with cystitis, 49 from patients with catheter-associated bacteriuria, and 27 from fecal samples). These sequences were found significantly more often in strains associated with the clinical syndromes of acute pyelonephritis (79%) and cystitis (82%) than in those associated with catheter-associated bacteriuria (58%) and in fecal strains (22%) (P < 0.001). From these regions, we have identified a putative iron transport system and genes other than hly and pap that may contribute to the virulent phenotype of uropathogenic E. coli strains.

  14. Prevalence of asymptomatic urinary tract infections in morbidly obese dogs

    Science.gov (United States)

    Witzel, Angela L.; Bartges, Joseph W.; Moyers, Tamberlyn S.; Kirk, Claudia A.

    2016-01-01

    Background. Obesity has reached epidemic proportions in dogs and, as in humans, cost of care has increased due to associated comorbidities. In humans, asymptomatic urinary tract infections (UTI) may be more prevalent in the obese. Asymptomatic bacteriuria (AB) is the term used when UTI are asymptomatic. We hypothesized that morbidly obese dogs are similarly more likely to have asymptomatic bacteriuria than lean, overweight, and moderately obese dogs. Methods. A retrospective study was undertaken to explore a possible association between obesity and asymptomatic bacteriuria. Records from lean, overweight, and obese dogs receiving both a dual energy absorptiometry (DXA) scan and urine culture were included. Results. Six positive urine cultures were identified among 46 dogs fulfilling search criteria. All six positive cultures were found in dogs with body fat percentage of >45%. In dogs with body fat percentage of <45%, there were no positive urine cultures. Discussion. There was an increased prevalence of asymptomatic bacteriuria in the morbidly obese dogs in this study compared to those that were lean, overweight, or moderately obese. Whether antibiotic therapy is necessary in such cases is still being debated, but because asymptomatic bacteriuria may be associated with ascending infections, uroliths, or other complications, the data reported herein support the screening of obese patients for bacteriuria. PMID:26989606

  15. Prevalence of asymptomatic urinary tract infections in morbidly obese dogs

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    Susan G. Wynn

    2016-03-01

    Full Text Available Background. Obesity has reached epidemic proportions in dogs and, as in humans, cost of care has increased due to associated comorbidities. In humans, asymptomatic urinary tract infections (UTI may be more prevalent in the obese. Asymptomatic bacteriuria (AB is the term used when UTI are asymptomatic. We hypothesized that morbidly obese dogs are similarly more likely to have asymptomatic bacteriuria than lean, overweight, and moderately obese dogs. Methods. A retrospective study was undertaken to explore a possible association between obesity and asymptomatic bacteriuria. Records from lean, overweight, and obese dogs receiving both a dual energy absorptiometry (DXA scan and urine culture were included. Results. Six positive urine cultures were identified among 46 dogs fulfilling search criteria. All six positive cultures were found in dogs with body fat percentage of >45%. In dogs with body fat percentage of <45%, there were no positive urine cultures. Discussion. There was an increased prevalence of asymptomatic bacteriuria in the morbidly obese dogs in this study compared to those that were lean, overweight, or moderately obese. Whether antibiotic therapy is necessary in such cases is still being debated, but because asymptomatic bacteriuria may be associated with ascending infections, uroliths, or other complications, the data reported herein support the screening of obese patients for bacteriuria.

  16. Asymptomatic bacteriuria Escherichia coli strain 83972 carries mutations in the foc locus and is unable to express F1C fimbriae

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Schembri, M.A.; Ulett, G.C.

    2006-01-01

    this adhesin. The data imply that E. coli 83972 has lost its ability to express this important colonization factor as a result of host-driven evolution. The ancestor of the strain seems to have been a pyelonephritis strain of phylogenetic group B2. Strain 83972 therefore represents an example of bacterial...

  17. Asymptomatic infections by diarrheagenic Escherichia coli in children from Misiones, Argentina, during the first twenty months of their lives.

    Science.gov (United States)

    Quiroga, M; Oviedo, P; Chinen, I; Pegels, E; Husulak, E; Binztein, N; Rivas, M; Schiavoni, L; Vergara, M

    2000-01-01

    Diarrheagenics Escherichia coli are the major agents involved in diarrheal disease in developing countries. The aim of this study was to evaluate the time of appearance of the first asymptomatic infection by the different categories of diarrheagenic E. coli in 44 children since their birth and during the first 20 months of their lives. In all of the children studied, we detected at least one category of diarrheagenic E. coli through the 20 months of the study. 510 diarrheagenic E. coli (33.5%) were obtained from the 1,524 samples collected from the 44 children during the time of the study (31.4% EAggEC, 28.8% EPEC, 27.1% DAEC, and 12.7% ETEC). Neither EHEC nor EIEC were identified. The median age for diarrheagenic E. coli colonization was 7.5 months. The mean weaning period was 12.8 months and the mean age for introduction of mixed feeding (breast fed supplemented) was 3.8 months. A significantly lower incidence of diarrheal disease and asymptomatic infections was recorded among the exclusively breast-fed rather than in the supplemented and non breast-fed infants. For ETEC, EPEC and EAggEC the introduction of weaning foods and complete termination of breast-feeding were associated with an increase of asymptomatic infections.

  18. Prevalence of asymptomatic urinary tract infections in morbidly obese dogs.

    Science.gov (United States)

    Wynn, Susan G; Witzel, Angela L; Bartges, Joseph W; Moyers, Tamberlyn S; Kirk, Claudia A

    2016-01-01

    Background. Obesity has reached epidemic proportions in dogs and, as in humans, cost of care has increased due to associated comorbidities. In humans, asymptomatic urinary tract infections (UTI) may be more prevalent in the obese. Asymptomatic bacteriuria (AB) is the term used when UTI are asymptomatic. We hypothesized that morbidly obese dogs are similarly more likely to have asymptomatic bacteriuria than lean, overweight, and moderately obese dogs. Methods. A retrospective study was undertaken to explore a possible association between obesity and asymptomatic bacteriuria. Records from lean, overweight, and obese dogs receiving both a dual energy absorptiometry (DXA) scan and urine culture were included. Results. Six positive urine cultures were identified among 46 dogs fulfilling search criteria. All six positive cultures were found in dogs with body fat percentage of >45%. In dogs with body fat percentage of obese dogs in this study compared to those that were lean, overweight, or moderately obese. Whether antibiotic therapy is necessary in such cases is still being debated, but because asymptomatic bacteriuria may be associated with ascending infections, uroliths, or other complications, the data reported herein support the screening of obese patients for bacteriuria.

  19. Characterization of adhesion associated surface properties of uropathogenic Escherichia coli.

    Science.gov (United States)

    Bartková, G; Ciznár, I; Lehotská, V; Kernová, T

    1994-01-01

    Escherichia coli was isolated from the urine of patients with pyelonephritis, with urinary tract infections other than pyelonephritis and with asymptomatic bacteriuria. Surface properties of the strains were analyzed by the salting-out aggregation test (SAT), hydrophobic interaction chromatography (HIC), Congo red binding (Crb), agglutination of erythrocytes (MRHA) and latex particles covered by digalactoside (PF) and by adherence to tissue culture cells. In addition, a DNA probe for the pap gene was used. The DNA probe detected the highest proportion of strains with pap gene in the group of patients with pyelonephritis, lower in the urinary tract infections other than pyelonephritis and the lowest in the group with asymptomatic bacteriuria. Tests for P-fimbriae (PF, MRHA) showed a similar distribution. Hydrophobicity measured by SAT and by HIC did not show differences among the tested groups of strains. The results suggest that factors other than the P-fimbriae and hydrophobicity may contribute to the persistence of E. coli in the urinary tract.

  20. [Onset and significance of postoperative bacteriuria].

    Science.gov (United States)

    Riss, P; Schieder, K; Bartl, W

    1984-06-01

    In 52 patients an indwelling transurethral catheter was inserted after gynaecological surgery for 5 days; no patient received antibiotics. At the time of removal of the catheter on the 6th postoperative day and 2 days later (8th postoperative day) a urine culture was set up. At the time of removal of the catheter on the 6th day, 26/52 patients (50%) had significant bacteriuria greater than or equal to 10(5)/ml. In 11 out of the 26 patients with bacteriuria the urine cleared spontaneously within 2 days; on the other hand, 10/26 patients with a negative culture at the time of removal of the catheter had significant bacteriuria 2 days later. As a group these women also had delayed spontaneous onset of voiding and persistence of residual urine. Younger patients (less than 45 years) had significantly fewer bacteriurias on the 6th day than older patients. A positive urine culture at the time of removal of the catheter should be treated with antibiotics; a negative urine culture should be repeated whenever spontaneous voiding is delayed, when there is persistent residual urine, or when the clinical signs of urinary tract infection are present.

  1. Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization

    Directory of Open Access Journals (Sweden)

    Zegers Bas SHJ

    2012-10-01

    Full Text Available Abstract Background Significant bacteriuria (SBU and urinary tract infections (UTIs are common in patients with spina bifida and neuropathic detrusor sphincter dysfunction. Laboratory agar plated culture is the gold standard to establish SBU. It has the disadvantage of diagnostic and subsequent therapeutic delay. Leukocyte esterase tests (LETs and dip slides proved to be useful in the general populations to exclude SBU and UTI. The aim of this study was to evaluate the reliability of LET and dip slide in children with spina bifida without symptoms of UTI. The reliability in children with asymptomatic SBU was not studied before. Methods In one hundred and twelve children with spina bifida on clean intermittent catheterization LETs and dip slides were compared with laboratory cultures. Both tests and agar plated cultures were performed on catheterized urine samples. The hypothesis was that the home tests are as accurate as laboratory cultures. Results A SBU was found in 45 (40% of the 112 laboratory cultures. A negative LET excluded SBU (negative predictive value 96%, while a positive LET had a positive predictive value of 72%. The false positive rate was 28%. Dip slide determination of bacterial growth had no added value, other than serving as transport medium. Conclusions In spina bifida children, leukocyte esterase testing can be used to exclude significant bacteriuria at home, while dip slide tests have no added value to diagnose or exclude significant bacteriuria.

  2. Quantitative Real-time Polymerase Chain Reaction for Enteropathogenic Escherichia coli: A Tool for Investigation of Asymptomatic Versus Symptomatic Infections

    Science.gov (United States)

    Barletta, Francesca; Mercado, Erik; Ruiz, Joaquim; Ecker, Lucie; Lopez, Giovanni; Mispireta, Monica; Gil, Ana I.; Lanata, Claudio F.; Cleary, Thomas G.

    2011-01-01

    Background. Enteropathogenic Escherichia coli (EPEC) strains are pediatric pathogens commonly isolated from both healthy and sick children with diarrhea in areas of endemicity. The aim of this study was to compare the bacterial load of EPEC isolated from stool samples from children with and without diarrhea to determine whether bacterial load might be a useful tool for further study of this phenomenon. Methods. EPEC was detected by polymerase chain reaction (PCR) of colonies isolated on MacConkey plates from 53 diarrheal and 90 healthy children aged <2 years. DNA was isolated from stool samples by cetyltrimethylammonium bromide extraction. To standardize quantification by quantitative real-time PCR (qRT-PCR), the correlation between fluorescence threshold cycle and copy number of the intimin gene of EPEC E2348/69 was determined. Results. The detection limit of qRT-PCR was 5 bacteria/mg stool. The geometric mean load in diarrhea was 299 bacteria/mg (95% confidence interval [CI], 77–1164 bacteria/mg), compared with 29 bacteria/mg (95% CI, 10–87 bacteria/mg) in control subjects (P = .016). Bacterial load was significantly higher in children with diarrhea than in control subjects among children <12 months of age (178 vs 5 bacteria/mg; P = .006) and among children with EPEC as the sole pathogen (463 vs 24 bacteria/mg; P = .006). Conclusions. EPEC load measured by qRT-PCR is higher in diarrheal than in healthy children. qRT-PCR may be useful to study the relationship between disease and colonization in settings of endemicity. PMID:22028433

  3. Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI

    Directory of Open Access Journals (Sweden)

    Björn Wullt

    2016-07-01

    Full Text Available We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI, where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.

  4. Asymptomatic dystrophinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Morrone, A. [Univ. of Pittsburgh School of Medicine, PA (United States)]|[Univ. of Florence (Italy); Hoffman, E.P.; Hoop, R.C. [Univ. of Pittsburgh School of Medicine, PA (United States)] [and others

    1997-03-31

    A 4-year-old girl was referred for evaluation for a mild but persistent serum aspartate aminotransferase (AST) elevation detected incidentally during routine blood screening for a skin infection. Serum creatine kinase activity was found to be increased. Immuno-histochemical study for dystrophin in her muscle biopsy showed results consistent with a carrier state for muscular dystrophy. Molecular work-up showed the proposita to be a carrier of a deletion mutation of exon 48 of the dystrophin gene. Four male relatives also had the deletion mutation, yet showed no clinical symptoms of muscular dystrophy (age range 8-58 yrs). Linkage analysis of the dystrophin gene in the family showed a spontaneous change of an STR45 allele, which could be due to either an intragenic double recombination event, or CA repeat length mutation leading to identical size alleles. To our knowledge, this is the first documentation of an asymptomatic dystrophinopathy in multiple males of advanced age. Based on molecular findings, this family would be given a diagnosis of Becker muscular dystrophy. This diagnosis implies the development of clinical symptoms, even though this family is clearly asymptomatic. This report underscores the caution which must be exercised when giving presymptomatic diagnoses based on molecular studies. 28 refs., 4 figs., 1 tab.

  5. Prevalence of asymptomatic urinary abnormalities among adolescents.

    Science.gov (United States)

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had adolescents from rural than urban areas (P adolescents in our population.

  6. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  7. Prevalence of Asymptomatic Carriers of Shiga Toxin-Producing Escherichia Coli (STEC in Dairy Cattle Farms in the Governorate of Blida (Algeria

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    Baazize-Ammi Djamila

    2015-04-01

    Full Text Available We investigated whether dairy beef cattle raised in Algeria are Shiga toxin-producing Escherichia coli (STEC carriers. Stx1 and stx2 genes were analysed in DNA isolated from 200 faecal samples collected from adult dairy cows from 27 randomly selected farms in Blida, North Algeria, after amplification by PCR. Samples from 61 (30.5% animals out of the 200 were positive and were located in 18 farms with a prevalence of 66.7%. Interestingly, no sample from any cow was positive for only the stx2 gene, while in contrast, samples from 51 cows were positive for the stx1 gene alone (83.6% and those from 10 other cows were positive for both stx1 and stx2 genes (16.4%. It should be noted that the faecal samples infected with pathogens carrying the two genes originated from 4 out of the 18 farms that were found to be positive, with a rate of 22.2%.

  8. Circumcision for the prevention of significant bacteriuria in boys.

    Science.gov (United States)

    Nayir, A

    2001-12-01

    The aim of this study was to determine whether circumcision affects significant bacteriuria in boys. During a 60-month prospective study, 100 boys with microbiologically confirmed symptomatic urinary tract infection (UTI) were evaluated. Twelve patients with abnormal ultrasonography findings were excluded from the study. Eighteen of the boys had not been circumcised due to parental choice. The remaining 70 boys with normal renal ultrasonography were randomly allocated into two groups. In the first group 35 boys ranging in age from 6 months to 10 years (mean 33.2+/-30.9 months) were observed for 6 months and urinary cultures were taken monthly. When they had a positive urine culture (with or without any symptoms), they received antibiotic treatment. After 6 months they were circumcised and then observed for another 6-month period. Group 2 comprised 35 boys aged from 3 months to 9 years (mean 29.1+/-36.7 months). They were circumcised immediately after the first UTI and were followed for 6 months. Urine samples were obtained by the bag technique in infants and by the mid-stream technique in older patients. In the uncircumcised group, the rate of significant bacteriuria per patient did not change in two 6-month follow-up periods (3.46+/-0.91 and 3.33+/-0.97 episodes). In group 1, the rate of positive urine cultures dropped from 3.57+/-1.11 to 0.14+/-0.35 episodes after circumcision (Pcircumcision. Among the uncircumcised patients, symptomatic UTI was observed in 6 cases (3 cases in the first period of group 1, 1 case in the first and 2 cases in the second period of the uncircumcised group), whereas after circumcision no patient had symptomatic UTI. The mean age at circumcision was 42.7+/-28.4 months. No complication due to circumcision occurred in any patient. UTI may also occur in boys after the 1st year of life. The present study indicated that circumcision in boys decreases the rate of positive urine cultures. Therefore circumcision could be considered as a part of

  9. Intestinal population dynamics of UTI-causing Escherichia coli within heterosexual couples.

    Science.gov (United States)

    Manges, Amee R; Johnson, James R; Riley, Lee W

    2004-09-01

    From October 1999 to July 2001, a prospective cohort study was conducted to assess the intestinal Escherichia coli population dynamics of 23 sexually active couples. We tested the hypothesis that intestinal persistence and predominance of specific E. coli strains, co-colonization of sex partners with the same E. coli strain, and the intestinal diversity of fecal E. coli, contribute to recurrent urinary tract infection (UTI). E. coli isolates causing UTI, asymptomatic bacteriuria (ABU), or intestinal co-colonization were evaluated by ERIC2 PCR and compared with strains recovered exclusively from stool samples with respect to intestinal persistence, predominance, and diversity. Contrary to our hypothesis, UTI-causing strains exhibited similar levels of intestinal persistence and predominance as did fecal strains, and UTI episodes were not associated with shifts in fecal E. coli diversity. In contrast, intestinal co-colonization strains exhibited greater persistence and predominance than did fecal strains and were more likely to cause ABU, and co-colonization episodes were associated with significantly increased fecal E. coli diversity. Nonetheless, intestinal co-colonization strains were not associated with UTI. These findings suggest that E. coli strains involved in co-colonization may be more important contributors to intestinal E. coli dynamics than to UTI pathogenesis.

  10. Comparison of the serum sensitivity of uropathogenic strains of Escherichia coli isolated from different diagnostic groups

    Directory of Open Access Journals (Sweden)

    J. Vraneš,

    2005-02-01

    Full Text Available The bactericidal activity of serum caused by complement system is an important defence mechanism protecting the host organism against infection. The capacity to resist bactericidal activity of normal human serum contributes to the virulence of many gram-negative pathogens. Serum resistance in bacteria has been attributed to their surface components, but exact mechanism of resistance which most likely involves multiple factors is not well understood. In this study, the capacity of Escherichia coli to resist the bactericidal action of serum was examined in 85 clinical isolates obtained from patients with acute pyelonephritis (n=23, acute cystitis (n=22, chronic pyelonephritis (n=22 and asymptomatic bacteriuria (n=18. Serum sensitivity was also examined in relation to the serogroup specificity and expression of the different adhesins of the strains.Bacterial susceptibility to serum killing was measured by assessing regrowth after incubation in serum according to Schiller and Hatch method. The adhesins of E. coli were determined by hemagglutination and inhibition of hemagglutiation, and serotyping was performed on glass slides and confirmed using a mechanized microtechnique.The significant correlation between serum resistance of uropathogenic strains of E. coli and expression of P-fimbriae and O6 serogroup was observed.Theincidence of serum-resistant E. coli strains was significantly higher in strains isolated from urine of patients with acute pyelonephritis, as compared to strains isolated in other diagnostic groups, which is in accordance with higher virulence and invasive potential of these strains.

  11. Asymptomatic infection with Borrelia burgdorferi.

    Science.gov (United States)

    Steere, Allen C; Sikand, Vijay K; Schoen, Robert T; Nowakowski, John

    2003-08-15

    The natural history of asymptomatic seroconversion to Borrelia burgdorferi has been unclear. We report here, on the basis of a post hoc assessment, the frequency and outcome of asymptomatic seroconversion to B. burgdorferi in participants of a large Lyme disease vaccine trial. We show that infection with B. burgdorferi may be asymptomatic but that asymptomatic infection is unusual in the United States.

  12. An association study of Schistosoma haematobium infection and bacteriuria in young South African females

    DEFF Research Database (Denmark)

    Kildemoes, Anna M. O.; Kjetland, Eyrun F; Taylor, Myra;

    2013-01-01

    , proteinuria and leukocytes with Neotest4 dipsticks and 10ml urine was added to 1ml 5% formalin solution and preserved for later egg count microscopy. Furthermore samples were tested for bacteriuria with Uricult dipslides (cut-off point;105CFU/ml). Results: The mean overall prevalence for S. haematobium was 18...... of leukocytes was positively associated with bacteriuria (P = 0.002) probably due to detection of neutrophils rather than eosinophils with the dipstick. As expected, intensity of S. haematobium infection was positively correlated with degree of micro-haematuria (r = 0.505; P = 0.01). Proteinuria was positively...

  13. Asymptomatic Borrelia burgdorferi infection.

    Science.gov (United States)

    Wormser, G P; Nadelman, R B; Nowakowski, J; Schwartz, I

    2001-10-01

    Little is known about the natural history of asymptomatic Borrelia burgdorferi infection. Our analysis of the asymptomatic infections diagnosed serologically in a recent OspA vaccine trial conducted in the United States (N Engl J Med 1998;339: 209-215), suggests that the natural history of this event is more benign than that reported for untreated patients with erythema migrans (Ann Intern Med 1987;107: 725-731). We hypothesize that this is due either to incorrect diagnosis since the specificity of the serologic criteria used to diagnose asymptomatic infection in the vaccine study is unknown, or to infection with non-pathogenic strains of B. burgdorferi. Increasing evidence indicates that the invasive potential of strains of B. burgdorferi varies according to the specific subtype. Theoretically, a serologic testing method could be devised which would distinguish infection with invasive versus non-invasive strains of B. burgdorferi, and allow testing of the second hypothesis.

  14. Asymptomatic infections by diarrheagenic Escherichia coli in children from Misiones, Argentina, during the first twenty months of their lives Infecções assintomáticas por Escherichia coli causadoras de diarréias em crianças de Misiones, Argentina durante os primeiros vinte meses de vida

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    Marina QUIROGA

    2000-02-01

    Full Text Available Diarrheagenics Escherichia coli are the major agents involved in diarrheal disease in developing countries. The aim of this study was to evaluate the time of appearance of the first asymptomatic infection by the different categories of diarrheagenic E. coli in 44 children since their birth and during the first 20 months of their lives. In all of the children studied, we detected at least one category of diarrheagenic E. coli through the 20 months of the study. 510 diarrheagenic E. coli (33.5% were obtained from the 1,524 samples collected from the 44 children during the time of the study (31.4% EAggEC, 28.8% EPEC, 27.1% DAEC, and 12.7% ETEC. Neither EHEC nor EIEC were identified. The median age for diarrheagenic E. coli colonization was 7.5 months. The mean weaning period was 12.8 months and the mean age for introduction of mixed feeding (breast fed supplemented was 3.8 months. A significantly lower incidence of diarrheal disease and asymptomatic infections was recorded among the exclusively breast-fed rather than in the supplemented and non breast-fed infants. For ETEC, EPEC and EAggEC the introduction of weaning foods and complete termination of breast-feeding were associated with an increase of asymptomatic infections.E. coli é o principal agente envolvido na produção de diarréias nos países em desenvolvimento. O objetivo deste estudo foi avaliar o tempo de aparição da primeira infecção assintomática pelas diferentes categorias de E. coli causadoras de diarréias em 44 crianças desde o nascimento e durante os primeiros 20 meses de vida. Em todas as crianças estudadas foram detectadas algumas categorias de E. coli causadoras de diarréia ao longo dos 20 meses do estudo. Durante o estudo foram obtidas 510 E. coli causadoras de diarréia (33,5% a partir das 1524 amostras colectadas das 44 crianças (31,4% EAggEC, 28,8% EPEC, 27,1%DAEC e 12,7% ETEC. Não foram detectadas nem EHEC e nem EIEC. A idade média para a colonização pelas E

  15. Asymptomatic ocular sarcoidosis

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    Luiz Guilherme Azevedo de Freitas

    2013-04-01

    Full Text Available Sarcoidosis is an idiopathic systemic granulomatous disease. It commonly affects the skin, lungs, kidneys, and central nervous system. In the eyes it primarily affects the uveal tract, conjunctiva, lacrimal glands and optic nerve. Here in we describe the case of a patient with systemic sarcoidosis and asymptomatic eye inflammation.

  16. Frequency of pap and pil operons in Escherichia coli strains associated with urinary infections.

    Science.gov (United States)

    Perugini, M R; Vidotto, M C

    1996-03-01

    Strains of E. coli isolated from patients with urinary tract infection were examined for P and type 1 adhesin production by colony hybridization with pap and pil operons. The P pili probe detected 45 (46.4%) of the total of 97 strains studied and the type 1 pili probe detected 83 (85.6%). The pap operon was detected in 39 (53.4%) of 73 strains isolated from urine of patients with urinary disease and in 6 (25.0%) of 24 strains isolated from feces of healthy individuals employed as controls (P = 0.029), and the pil operon was detected in 67 (91.8%) of the urinary strains and in 16 (66.6%) of the fecal strains (P = 0.007). Our data did not show significant differences in frequency of P pili among isolates from pyelonephritis (78.5%), cystitis (45.8%) and asymptomatic bacteriuria (54.5%). Type 1 pili were not associated with the different types of infection; the frequency of these pili was 100% in pyelonephritis and in asymptomatic bacteriuria, and 87.5% in cystitis. The incidence of pap operon in strains isolated from pyelonephritis and from asymptomatic bacteriuria was higher in 11- to 40-year old women. These data show a high frequency of pap and pil operons among uropathogenic strains of E. coli, which seems to be an important factor in the development of urinary infection.

  17. Staphylococcus aureus bacteriuria as a prognosticator for outcome of Staphylococcus aureus bacteremia: a case-control study

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    Weinstein Robert A

    2010-07-01

    Full Text Available Abstract Background When Staphylococcus aureus is isolated in urine, it is thought to usually represent hematogenous spread. Because such spread might have special clinical significance, we evaluated predictors and outcomes of S. aureus bacteriuria among patients with S. aureus bacteremia. Methods A case-control study was performed at John H. Stroger Jr. Hospital of Cook County among adult inpatients during January 2002-December 2006. Cases and controls had positive and negative urine cultures, respectively, for S. aureus, within 72 hours of positive blood culture for S. aureus. Controls were sampled randomly in a 1:4 ratio. Univariate and multivariable logistic regression analyses were done. Results Overall, 59% of patients were African-American, 12% died, 56% of infections had community-onset infections, and 58% were infected with methicillin-susceptible S. aureus (MSSA. Among 61 cases and 247 controls, predictors of S. aureus bacteriuria on multivariate analysis were urological surgery (OR = 3.4, p = 0.06 and genitourinary infection (OR = 9.2, p = 0.002. Among patients who died, there were significantly more patients with bacteriuria than among patients who survived (39% vs. 17%; p = 0.002. In multiple Cox regression analysis, death risks in bacteremic patients were bacteriuria (hazard ratio 2.9, CI 1.4-5.9, p = 0.004, bladder catheter use (2.0, 1.0-4.0, p = 0.06, and Charlson score (1.1, 1.1-1.3, p = 0.02. Neither length of stay nor methicillin-resistant Staphylococcus aureus (MRSA infection was a predictor of S. aureus bacteriuria or death. Conclusions Among patients with S. aureus bacteremia, those with S. aureus bacteriuria had 3-fold higher mortality than those without bacteriuria, even after adjustment for comorbidities. Bacteriuria may identify patients with more severe bacteremia, who are at risk of worse outcomes.

  18. Intramacrophage survival of uropathogenic Escherichia coli: Differences between diverse clinical isolates and between mouse and human macrophages

    DEFF Research Database (Denmark)

    Bokil, Nilesh J.; Totsika, Makrina; Carey, Alison J.;

    2011-01-01

    Uropathogenic E. coli (UPEC) are the primary cause of urinary tract infections. Recent studies have demonstrated that UPEC can invade and replicate within epithelial cells, suggesting that this bacterial pathogen may occupy an intracellular niche within the host. Given that many intracellular...... or initial uptake of bacteria. E. coli UTI89 localized to a Lamp1+ vesicular compartment within BMM. In contrast to survival within mouse BMM, intracellular bacterial loads of VR50 were low in both human monocyte-derived macrophages (HMDM) and in human T24 bladder epithelial cells. Collectively, these data......, originally isolated from patients with cystitis and asymptomatic bacteriuria respectively, showed elevated bacterial loads in BMM at 24h post-infection as compared to CFT073 and the asymptomatic bacteriuria strain 83972. These differences did not correlate with differential effects on macrophage survival...

  19. Detection by molecular hybridization of pap, afa, and sfa adherence systems in Escherichia coli strains associated with urinary and enteral infections.

    Science.gov (United States)

    Archambaud, M; Courcoux, P; Labigne-Roussel, A

    1988-01-01

    The genetic determinants responsible for the adherence of Escherichia coli to uroepithelial cells have been identified in recent years by genetic and molecular methods. Specific DNA probes for each of the three operons which have been cloned so far (pap, afa, sfa/foc operons) have been used in colony hybridization experiments to detect the presence of each of these operons in the chromosomal DNA of 443 strains of E. coli; 186 strains were from patients with urinary tract infections (pyelonephritis, 106 strains; cystitis, 59; asymptomatic bacteriuria, 21) and 257 were strains from the stools of healthy subjects (61) or from patients with various enteral infections (196). E. coli strains harbouring the pap operon were found more frequently in the urine of patients with pyelonephritis (p less than 0.001) and cystitis (p less than 0.01) than in control stools. The presence of two operons (pap + afa) or (pap + sfa/foc) was only observed in uropathogenic strains (p less than 0.02). Pap and sfa/foc operons were never found in strains causing enteral infection; however, the afa operon was found in 7.6% of the enteropathogenic E. coli.

  20. There is a low incidence of recurrent bacteriuria in painful bladder syndrome/interstitial cystitis patients followed longitudinally.

    Science.gov (United States)

    Stanford, Edward; McMurphy, Carolyn

    2007-05-01

    The objective of this paper was to establish whether patients with confirmed painful bladder syndrome/interstitial cystitis (PBS/IC) presenting with symptoms of UTI have actual bacteriuria vs a flare of their PBS/IC symptoms. One hundred and six (n = 106) consecutive female patients (mean age 39.8 +/- 14 years) with newly diagnosed IC were identified and followed longitudinally for 24 months. At the initial visit and at all subsequent visits, urinary specimens were obtained by sterile catheterization (Bard 14Fr female) and cultured for bacteria. Eight patients had an initially positive urine culture, and repeat cultures 8 weeks after treatment were all negative. Once sterile urine was established, the diagnosis of PBS/IC was confirmed. A pelvic pain/urgency/frequency (PUF) questionnaire score was obtained from 89 patients. After the diagnosis of PBS/IC, all patients received multimodal treatment. Patients were instructed to present to the office whenever they developed symptoms of UTI, at which time a sterile catheter specimen was obtained and sent for culture. Greater than 10(3) colonies were considered positive. Patients who did not report flares were contacted to establish whether unreported treatments were given. Seventy-two patients (68%) had no UTI episodes or flares. The remaining 34 patients (32%) presented with 54 flares, of which 44 were culture-negative and 10 were culture-positive. A single flare was reported by 21 patients during the 24 months, with three positive cultures (14.3%). Recurrent UTI symptoms (two to four flares) were seen in a small group (n = 13) for a total of 33 flares. Of these, seven had two flares each (12 negative, 2 positive), five had three flares each (12 negative, 3 positive), and one patient had four flares (two negative, two positive). Therefore, within the group with recurrent symptoms, seven positive cultures were obtained for a rate of recurrent bacteriuria of 6.6% (7/106). Nine of the 10 positive bacterial cultures were

  1. Effect of Cranberry Capsules on Bacteriuria Plus Pyuria among Older Women in Nursing Homes: A Randomized Clinical Trial

    Science.gov (United States)

    Juthani-Mehta, Manisha; Van Ness, Peter H.; Bianco, Luann; Rink, Andrea; Rubeck, Sabina; Ginter, Sandra; Argraves, Stephanie; Charpentier, Peter; Acampora, Denise; Trentalange, Mark; Quagliarello, Vincent; Peduzzi, Peter

    2017-01-01

    Importance Bacteriuria plus pyuria is highly prevalent among older women living in nursing homes. Cranberry capsules are an understudied, non-antimicrobial, prevention strategy used in this population. Objective To test the effect of two oral cranberry capsules once per day on presence of bacteriuria plus pyuria among women residing in nursing homes Design, Setting, and Participants This study was a double-blind, randomized, placebo-controlled efficacy trial with stratification by nursing home and surveillance of one year. 21 nursing homes with at least 90 beds and within 50 miles of New Haven, CT participated. 185 English-speaking, female, nursing home residents, age 65 or older, with or without bacteriuria and pyuria at baseline, were randomized. The study was conducted from 8/24/12-10/26/15. Intervention Two oral cranberry capsules, each capsule containing 36mg of the active ingredient proanthocyanidin (i.e., 72mg total, equivalent to 20 ounces of cranberry juice), versus placebo administered once per day in 92 treatment and 93 control group participants. Main Outcomes and Measures The primary outcome was the presence of bacteriuria (i.e., at least 105 cfu/mL of one or two microorganisms on urine culture) plus pyuria (i.e., any number of white blood cells on urinalysis) assessed every two months for a total of six assessments over the one year of surveillance; any positive finding was considered to meet the primary outcome. Secondary outcomes were symptomatic urinary tract infection (UTI), all-cause death, all-cause hospitalization, all multi-drug antibiotic resistant organisms, antibiotics administered for suspected UTI, and total antimicrobial administration. Results Among 185 women who were randomized (mean age 86.4 years [± 8.2], 90.3% white, 31.4% with bacteriuria plus pyuria at baseline), 147 completed the study. Overall adherence to capsule administration was 80.1%. Unadjusted results showed the presence of bacteriuria plus pyuria in 25.5% (95% CI 18

  2. Evaluation of Malthus 128H microbiological growth analyser for detecting significant bacteriuria.

    Science.gov (United States)

    Smith, T K; Eggington, R; Pease, A A; Harris, D M; Spencer, R C

    1985-08-01

    In a pilot study a prototype Malthus 128H microbiological growth analyser was used to study the growth of six commonly encountered urinary pathogens in a range of five different laboratory media. No single medium had been able to show acceptable conductance changes for all bacteria within five hours. Subsequently, the Malthus system, with fastidious anaerobe broth as the culture medium, was used to screen 500 consecutive clinical specimens of urine for significant bacteriuria. After two and a half hours the Malthus system detected 32 out of the 40 true positives and eight of the 44 contaminated urines. Increasing the detection time to five hours permitted the recognition of 39 true positives and 37 contaminated urines.

  3. Prevalence of bacteriuria in Jeyaseharan Hospital of South India and their antibiogram

    Institute of Scientific and Technical Information of China (English)

    Prakash S; S Anto Jeya Dayalan; Edison N

    2011-01-01

    Objective: To investigate the prevalence of bacteriologically positive urinary tract infection (UTI) among people enrolled in the hospital during January 2010 to June 2010. Methods: In the study period, a total of 1 546 patients were screened for UTI and the antibiogram was studied. Results: A total of 744 patients were positive. It revealed that females were more vulnerable to bacteriuria than males. Organisms predominantly isolated were Esherichia coli followed byKlebsiella in both males and females. Among the antibiotics tested against the isolated organisms for sensitivity test, chloramphenicol was more effective followed by amikacin and gatifloxacin for Enterobacteriaceae. For Pseudomonas aeruginosa, chloramphenicol was not effective, amikacin was effective. Amoxycillin, amoxycillin/clavulanic acid and first generation cephalosporin were least effective against Enterobacteriaceae and Pseudomonas aeruginosa. Conclusions: This study would not only help in proper treatment of patients but also discourage the indiscriminate use of antibiotics and prevent development of drug resistance.

  4. Comparative analysis of antibiotic resistance and phylogenetic group patterns in human and porcine urinary tract infectious Escherichia coli

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Nielsen, E.M.; Krag, L.

    2009-01-01

    to relatively benign asymptomatic bacteriuria strains. Here we analyse a spectrum of porcine and human UTI E. coli strains with respect to their antibiotic resistance patterns and their phylogenetic groups, determined by multiplex PCR. The clonal profiles of the strains differed profoundly; whereas human...... strains predominantly belonged to clonal types B2 and D, these were not seen among the porcine strains, which all belonged to the E. coli clonal groups A and B1. Contrary to the human strains, the majority of the porcine strains were multidrug resistant. The distinct profiles of the porcine strains...... suggest selective pressure due to extensive antibiotic use....

  5. Megalocytic interstitial nephritis following acute pyelonephritis with Escherichia coli bacteremia: a case report.

    Science.gov (United States)

    Kwon, Hee Jin; Yoo, Kwai Han; Kim, In Young; Lee, Seulkee; Jang, Hye Ryoun; Kwon, Ghee Young

    2015-01-01

    Megalocytic interstitial nephritis is a rare form of kidney disease caused by chronic inflammation. We report a case of megalocytic interstitial nephritis occurring in a 45-yrold woman who presented with oliguric acute kidney injury and acute pyelonephritis accompanied by Escherichia coli bacteremia. Her renal function was not recovered despite adequate duration of susceptible antibiotic treatment, accompanied by negative conversion of bacteremia and bacteriuria. Kidney biopsy revealed an infiltration of numerous histiocytes without Michaelis-Gutmann bodies. The patient's renal function was markedly improved after short-term treatment with high-dose steroid.

  6. Clinical isolates of uropathogenic Escherichia coli ST131 producing NDM-7 metallo-β-lactamase in China.

    Science.gov (United States)

    Wang, Lian-Hui; Liu, Pan-Pan; Wei, Dan-Dan; Liu, Yang; Wan, La-Gen; Xiang, Tian-Xin; Zhang, Yu-Juan

    2016-07-01

    Here we report five cases of NDM-7-producing Escherichia coli from patients with bacteriuria in a teaching hospital in mainland China. Two isolates belonged to sequence type 131 (ST131), simultaneously carrying blaCTX-M-15, blaSHV-11, blaTEM-1 and qnrS1. The blaNDM-7 gene was located on a conjugative IncX3-type plasmid bearing blaTEM-1 and qnrS1. These findings indicate the spread of NDM-7 metallo-β-lactamase in a highly resistant and virulent E. coli sequence type in China.

  7. Asymptomatic Esophageal Varices Should Be Endoscopically Treated

    Directory of Open Access Journals (Sweden)

    Nib Soehendra

    1998-01-01

    Full Text Available Endoscopic treatment has generally been accepted in the management of bleeding esophageal varices. Both the control of acute variceal bleeding and elective variceal eradication to prevent recurrent bleeding can be achieved via endoscopic methods. In contrast to acute and elective treatment, the role of endoscopic therapy in asymptomatic patients who have never had variceal bleeding remains controversial because of the rather disappointing results obtained from prophylactic sclerotherapy. Most published randomized controlled trials showed that prophylactic sclerotherapy had no effect on survival. In some studies, neither survival rate nor bleeding risk was improved. In this article, the author champions the view that asymptomatic esophageal varices should be endoscopically treated.

  8. Asymptomatic body packers should be treated conservatively

    DEFF Research Database (Denmark)

    Glovinski, Peter V; Lauritsen, Morten L; Bay-Nielsen, Morten

    2013-01-01

    Body packing takes advantage of the human storage capacity within the alimentary tract. Body packing is used for the smuggling of drugs such as heroin, cocaine, amphetamine, hashish and ecstasy. Most body packers are asymptomatic. However, packets may rupture or obstruct the alimentary tract...

  9. ASYMPTOMATIC ABSENT EPIGLOTTIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vaibhav Shahi

    2015-03-01

    Full Text Available Absence or hypoplasia of the epiglottis is a rare anomaly. Most patients, with absent or hypoplastic epiglottis, have presented, life-threatening symptoms of respiratory distress and severe aspiration in infancy or early childhood. We report a case of completely asymptomatic 30 year old female with absent epiglottis posted for modified radical mastoidectomy for chronic suppurative otitis media (CSOM.

  10. Multiseptate Gallbladder in an Asymptomatic Child

    Directory of Open Access Journals (Sweden)

    Dylan Wanaguru

    2011-01-01

    Full Text Available A one-year-old child being investigated for urinary tract infection was diagnosed with a multiseptate gallbladder. The patient remains asymptomatic, and investigations demonstrate no associated anomalies. Forty-three cases, including 13 cases in children were identified in the literature. Their presentation and management were reviewed.

  11. ASYMPTOMATIC ABSENT EPIGLOTTIS: A CASE REPORT

    OpenAIRE

    2015-01-01

    Absence or hypoplasia of the epiglottis is a rare anomaly. Most patients, with absent or hypoplastic epiglottis, have presented, life-threatening symptoms of respiratory distress and severe aspiration in infancy or early childhood. We report a case of completely asymptomatic 30 year old female with absent epiglottis posted for modified radical mastoidectomy for chronic suppurative otitis media (CSOM).

  12. Association of bacteriuria and urinary nitrosamine formation with Schistosoma haematobium infection in the Qalyub area of Egypt.

    Science.gov (United States)

    Hicks, R M; Ismail, M M; Walters, C L; Beecham, P T; Rabie, M F; El Alamy, M A

    1982-01-01

    In Egypt, bladder cancer incidence is high in areas where the prevalence and intensity of Schistosoma haematobium infection is also high. Experimental evidence shows bladder carcinogenesis to be a multi-stage process which can be accelerated by many factors. N-nitroso compounds, some of which are known bladder carcinogens, can be formed from amine precursors and nitrate in urine during some bacterial infections. In experimental animals the growth of nitrosamine-induced urothelial cancers is accelerated by damage to the urothelium caused by S. haematobium infections, and by analogy in man this could account for the lower peak age of incidence of this cancer in Egypt by comparison with Europe. The present study was designed to investigate whether bacterial infection of the urinary tract was common in areas of endemic schistosomiasis and whether N-nitrosamines were regularly found to be associated with bacteriuria. Urine samples from young men in the Qalyub area of Egypt and from an adjacent Delta region were analysed for S. haematobium ova, the nature and intensity of any bacterial infection, nitrate and nitrite, and total N-nitroso compounds plus volatile N-nitrosamines. A relatively high prevalence of bacteriuria was found in young men with schistosomiasis and low levels of N-nitroso compounds were present in all specimens. When the groups were sub-divided on the basis of the ability of their bacterial flora to reduce nitrate to nitrite (the latter is required for the nitrosation of amine precursors to N-nitroso compounds), significantly higher levels of N-nitroso compounds were found in S. haematobium-infected individuals also infected with nitrate-reducing bacteria by comparison either with uninfected controls (p less than 0.0005) or with those infected with non-nitrate-reducing bacteria (p less than 0.001). The results show N-nitroso compounds to be present in the urines of young men in areas of endemic S. haematobium infection in Egypt, and elevated levels of

  13. Endothelial dysfunction and inflammation in asymptomatic proteinuria

    OpenAIRE

    Paisley, K.E.; Beaman, M; Tooke, J. E.; Mohamed-Ali, V; Lowe, G. D. O.; Shore, A C

    2003-01-01

    Background. Proteinuria is associated with vascular risk and a systemic increase in vascular permeability. Endothelial dysfunction occurs early in atherosclerosis and modulates vascular permeability. Vascular risk and chronic inflammation are associated. This study investigates whether the increased vascular permeability in proteinuria reflects systemic endothelial dysfunction and chronic inflammation. Methods. Twenty-one patients with asymptomatic proteinuria (1.29 g/24 h; range 0.18 to 3.17...

  14. Asymptomatic atlantoaxial subluxation in rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Mohammadali Nazarinia

    2014-06-01

    Full Text Available This cross-sectional study is conducted to determine the prevalence of asymptomatic cervical spine subluxation in rheumatoid arthritis patients by plain radiographs and its relation to demographic and clinical characteristics, disease activity measures and medications. 100 rheumatoid arthritis patients (18 male and 82 female were selected randomly, according to the American college of Rheumatology Criteria, who were under follow up in the rheumatology clinic. A complete history was taken, and physical examination has been done with focus on the cervical spine to determine their demographic data, disease duration, age of disease onset, drug history, swollen and tender joint counts, and ESR, Hb, CRP, RF levels. The disease activity of patients with rheumatoid arthritis was measured using the disease activity score 28. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of the neck and anterioposterior and odontoid projection view. Asymptomatic cervical spine subluxation was found in 17 of the 100 patients (17%. The prevalence of, anterior atlantoaxial subluxation, atlantoaxial impaction and subaxial subluxation was 10(10%, 5(5% and 6(6%, respectively. Posterior subluxation was not detected. The only characteristic that showed meaningful relationship with cervical spine subluxation was CRP (P=0.036. Our results showed that patients with RA, who have cervical spine subluxation cannot be distinguished on the basis of symptoms. Cervical spine involvement is common and may be asymptomatic, indicating routine cervical spine imaging is needed in patients with RA.

  15. Prevalence of Bacteriuria and Antimicrobial Susceptibility Patterns among Diabetic and Nondiabetic Patients Attending at Debre Tabor Hospital, Northwest Ethiopia

    Science.gov (United States)

    Derbie, Awoke; Adem, Yesuf; Biadglegne, Fantahun

    2017-01-01

    Background. Urinary tract infection is a major health problem especially in developing countries. Information about bacterial pathogens isolated from urinary tract infection in diabetic patients and their antimicrobial susceptibility patterns is limited in Ethiopia. Therefore, this study aimed at isolating bacterial pathogens and their antimicrobial susceptibility patterns. Methods. A hospital based comparative cross-sectional study was conducted at Debre Tabor. Urine sample was inoculated onto cysteine lysine electrolyte deficient (CLED) medium. Bacterial pathogens were identified using standard bacteriological methods. The data were cleaned and entered into SPSS version 20. P value less than 0.05 is considered statistically significant. Result. A total of 384 study participants were included in the study. Of them, 21 (10.9%) were from diabetics and 9 (4.7%) of them were from nondiabetics. Large proportion of gram positive bacteria at 18 (58.1%) were isolated compared to gram negatives at 13 (41.9%). Gram positive isolates were resistant to cotrimoxazole 10 (58.8%). Conclusion. The isolation rates of bacterial pathogens were higher in diabetic than nondiabetic patients. Bacteriuria was significantly associated with sex and type of diabetes. Multidrug resistance to two or more antibiotics was observed in 56.7% of bacterial isolates. Rational use of antimicrobial agent should be thought of to prevent the emergence of multidrug resistance.

  16. Evaluation of dipstick analysis among elderly residents to detect bacteriuria: a cross-sectional study in 32 nursing homes

    Directory of Open Access Journals (Sweden)

    Sundvall Pär-Daniel

    2009-07-01

    Full Text Available Abstract Background Few studies have evaluated dipstick urinalysis for elderly and practically none present confidence intervals. Furthermore, most previous studies combine all bacteria species in a "positive culture". Thus, their evaluation may be inappropriate due to Yule-Simpson's paradox. The aim of this study was to evaluate diagnostic accuracy of dipstick urinalysis for the elderly in nursing homes. Methods In this cross-sectional study voided urine specimens were collected from 651 elderly individuals in nursing homes. Dipstick urinalysis for nitrite, leukocyte esterase and urine culture were performed. Sensitivity, specificity, positive and negative predictive values with 95% confidence intervals were calculated. Visual readings were compared to readings with a urine chemistry analyzer. Results 207/651 (32% of urine cultures showed growth of a potentially pathogenic bacterium. Combining the two dipsticks improved test characteristics slightly compared to using only one of the dipsticks. When both dipsticks are negative, presence of potentially pathogenic bacteria can be ruled out with a negative predictive value of 88 (84–92%. Visual and analyzer readings had acceptable agreement. Conclusion When investigating for bacteriuria in elderly people at nursing homes we suggest nitrite and leukocyte esterase dipstick be combined. There are no clinically relevant differences between visual and analyzer dipstick readings. When dipstick urinalysis for nitrite and leukocyte esterase are both negative it is unlikely that the urine culture will show growth of potentially pathogenic bacteria and in a patient with an uncomplicated illness further testing is unnecessary.

  17. Escherichia Coli

    Science.gov (United States)

    Goodsell, David S.

    2009-01-01

    Diverse biological data may be used to create illustrations of molecules in their cellular context. I describe the scientific results that support a recent textbook illustration of an "Escherichia coli cell". The image magnifies a portion of the bacterium at one million times, showing the location and form of individual macromolecules. Results…

  18. Intramacrophage survival of uropathogenic Escherichia coli: differences between diverse clinical isolates and between mouse and human macrophages.

    Science.gov (United States)

    Bokil, Nilesh J; Totsika, Makrina; Carey, Alison J; Stacey, Katryn J; Hancock, Viktoria; Saunders, Bernadette M; Ravasi, Timothy; Ulett, Glen C; Schembri, Mark A; Sweet, Matthew J

    2011-11-01

    Uropathogenic E. coli (UPEC) are the primary cause of urinary tract infections. Recent studies have demonstrated that UPEC can invade and replicate within epithelial cells, suggesting that this bacterial pathogen may occupy an intracellular niche within the host. Given that many intracellular pathogens target macrophages, we assessed the interactions between UPEC and macrophages. Colonization of the mouse bladder by UPEC strain CFT073 resulted in increased expression of myeloid-restricted genes, consistent with the recruitment of inflammatory macrophages to the site of infection. In in vitro assays, CFT073 was able to survive within primary mouse bone marrow-derived macrophages (BMM) up to 24h post-infection. Three additional well-characterized clinical UPEC isolates associated with distinct UTI symptomatologies displayed variable long-term survival within BMM. UPEC strains UTI89 and VR50, originally isolated from patients with cystitis and asymptomatic bacteriuria respectively, showed elevated bacterial loads in BMM at 24h post-infection as compared to CFT073 and the asymptomatic bacteriuria strain 83972. These differences did not correlate with differential effects on macrophage survival or initial uptake of bacteria. E. coli UTI89 localized to a Lamp1(+) vesicular compartment within BMM. In contrast to survival within mouse BMM, intracellular bacterial loads of VR50 were low in both human monocyte-derived macrophages (HMDM) and in human T24 bladder epithelial cells. Collectively, these data suggest that some UPEC isolates may subvert macrophage anti-microbial pathways, and that host species differences may impact on intracellular UPEC survival.

  19. Intramacrophage survival of uropathogenic Escherichia coli: Differences between diverse clinical isolates and between mouse and human macrophages

    KAUST Repository

    Bokil, Nilesh J.

    2011-11-01

    Uropathogenic E. coli (UPEC) are the primary cause of urinary tract infections. Recent studies have demonstrated that UPEC can invade and replicate within epithelial cells, suggesting that this bacterial pathogen may occupy an intracellular niche within the host. Given that many intracellular pathogens target macrophages, we assessed the interactions between UPEC and macrophages. Colonization of the mouse bladder by UPEC strain CFT073 resulted in increased expression of myeloid-restricted genes, consistent with the recruitment of inflammatory macrophages to the site of infection. In in vitro assays, CFT073 was able to survive within primary mouse bone marrow-derived macrophages (BMM) up to 24h post-infection. Three additional well-characterized clinical UPEC isolates associated with distinct UTI symptomatologies displayed variable long-term survival within BMM. UPEC strains UTI89 and VR50, originally isolated from patients with cystitis and asymptomatic bacteriuria respectively, showed elevated bacterial loads in BMM at 24h post-infection as compared to CFT073 and the asymptomatic bacteriuria strain 83972. These differences did not correlate with differential effects on macrophage survival or initial uptake of bacteria. E. coli UTI89 localized to a Lamp1 + vesicular compartment within BMM. In contrast to survival within mouse BMM, intracellular bacterial loads of VR50 were low in both human monocyte-derived macrophages (HMDM) and in human T24 bladder epithelial cells. Collectively, these data suggest that some UPEC isolates may subvert macrophage anti-microbial pathways, and that host species differences may impact on intracellular UPEC survival. © 2011 Elsevier GmbH.

  20. Five cases of asymptomatic spontaneous pneumothorax.

    Science.gov (United States)

    Kadokura, M; Nonaka, M; Yamamoto, S; Kataoka, D; Tanio, N; Iyano, K; Oki, A; Kawada, T; Takaba, T

    1999-06-01

    Asymptomatic spontaneous pneumothorax (ASPT) is an uncommon condition. Between January 1, 1989 and December 31, 1997, 269 patients were admitted to our department with spontaneous pneumothorax. Of the 269 patients, 5 had no symptoms at the time of discovery. Their ages ranged from 15 to 61 years (mean, 37.8 years), and all of them were male. Of the 5 patients with no complaints, 2 had bilateral metachronous pneumothoraces and 3 had hemilateral pneumothorax. All of these ASPTs were revealed by chest roentgenographs taken during medical examinations or follow-up studies relating to other diseases. The mean value of body mass index (BMI) was 19.96 +/- 1.4 (range 18.7 - 22.1). Two of the 5 patients underwent bilateral partial lung resection. Histopathological examination of the resected specimens showed elastofibrosis, scar formation, and an interruption of the elastic fiber of the pleura. In these 5 cases, clinical courses were uneventful, and relapse of the pneumothorax did not occur. Clinical physicians should be aware of the possibility of asymptomatic pneumothorax, as well as the optimal radiographic techniques for revealing small pneumothoraces.

  1. Asymptomatic Urolithiasis Complicated by Nephrocutaneous Fistula

    Science.gov (United States)

    Hamard, Marion; Amzalag, Gaël; Becker, Christoph D; Poletti, Pierre-Alexandre

    2017-01-01

    Asymptomatic spontaneous nephrocutaneous fistula is a rare and severe complication of chronic urolithiasis. We report a case of 56-year-old woman with a nephrocutaneous fistula (NFC) which developed from a superinfected urinoma following calyceal rupture due to an obstructing calculus in the left ureter. The patient was clinically asymptomatic and came to the emergency department for a painless left flank fluctuating mass. This urinoma was superinfected, with a delayed development of renal abscesses and perirenal phlegmon found on contrast-enhanced uro-computed tomography (CT), responsible for left renal vein thrombophlebitis and left psoas abscess. Thereafter, a 99 mTc dimercaptosuccinic acid (DMSA) scintigraphy revealed a nonfunctional left kidney, leading to the decision of left nephrectomy. Chronic urolithiasis complications are rare and only few cases are reported in medical literature. A systematic medical approach helped selecting the best imaging modality to help diagnosis and treatment. Indeed, uro-CT scan and renal scintigraphy with 99 mTc-DMSA are the most sensitive imaging modalities to investigate morphological and functional urinary tract consequences of NFC, secondary to chronic urolithiasis. PMID:28299237

  2. Multimicronutrient supplementation and asymptomatic urinary tract infections in the elderly

    Directory of Open Access Journals (Sweden)

    Paul Boekitwetan

    2016-02-01

    Full Text Available As human life expectancy continues to increase, developing countries are reporting higher percentages of elderly in their respective populations. The defense mechanisms of the elderly are reduced due to several factors, such as increased susceptibility to infection, specifically urinary tract infection (UTI. A randomised, placebo-controlled, double-blind trial was conducted to assess whether multimicronutrient supplementation is effective in reducing UTIs in older people in the community. A total of 261 elderly who lived in Mampang Prapatan district, South Jakarta, were randomised to daily multimicronutrient supplementation or control groups. The primary outcomes were the incidence of asymptomatic UTI, the organisms responsible for UTIs and the results of sensitivity tests on UTI microorganisms. UTI was defined as culture-positive urine yielding a single species of organisms in numbers greater than 104 cfu/mL urine specimen. At base-line 19.5% of the elderly had UTI, namely 23.7% patients in the MMN group and 16.7% in the control group, but the difference was not statistically significant (p=0.158. Escherichia coli was the most common microorganism, isolated in 20.7% of the MMN group and 17.5% of the control group. After six months of supplementation, UTI in the MMN group decreased by 40.6% compared with only 14.4% in the control group. The numbers of E. coli also declined by 64.3% in the MMN group compared to 37.8% in the control group. This study has confirmed the beneficial effect of multimicronutrient supplementation on UTI in the elderly.

  3. Asymptomatic brucellosis infection in humans: implications for diagnosis and prevention.

    Science.gov (United States)

    Zhen, Q; Lu, Y; Yuan, X; Qiu, Y; Xu, J; Li, W; Ke, Y; Yu, Y; Huang, L; Wang, Y; Chen, Z

    2013-09-01

    Human brucellosis is mainly caused by contact with Brucella-infected animals and their secretions and carcasses. Individuals who are continuously in contact with animals are considered to be at a high risk but only some show symptoms and are diagnosed as cases of brucellosis. Here, we showed that asymptomatic brucellosis infections occur among humans. Asymptomatic infections mainly result from less frequent contact with Brucella and/or contact with low-virulence Brucella. In our study, patients with asymptomatic infection had low antibody titres and different contact patterns. Awareness of asymptomatic infection is important for early diagnosis of brucellosis and prevention of chronic infection.

  4. Recurrent Parotid Carcinosarcoma in an Asymptomatic Patient

    Directory of Open Access Journals (Sweden)

    Joshua Mansour MD

    2016-10-01

    Full Text Available In this article, we present the case of a 52-year-old male with a history of parotid carcinosarcoma with initial diagnosis being 18 months prior. Initial treatment included a combination of gamma knife surgery coupled with high dosage chemotherapy and X-ray radiation therapy. At the time of follow-up, the patient presented with no complaints and had a nearly normal physical exam with the exception of some facial nerve weakness on the same side as the initial surgery. Despite being asymptomatic, the patient had a significant progression of disease that was manifested with intracranial lesions, multiple pathologic fractures, and a dramatic increase in overall tumor burden. Ultimately, the patient decided to pursue comfort measures only and succumbed to the disease peacefully soon thereafter.

  5. Are the Intracranial Lipomas Always Asymptomatic?

    Directory of Open Access Journals (Sweden)

    Mustafa Yilmaz

    2014-02-01

    Full Text Available Intracranial lipomas are rarely observed, and accepted as the congenital lesion of central nervous system. Intracranial lipomas are usually based centrally and have benign character. In the brain, it is mostly localized in pericallosal region, quadrigeminal system, and suprasellar region and cerebellopontine angles. As being mostly asymptomatic, the patients occasionally constitute clinical symptoms according to localization area. These symptoms are systemic symptoms such as cephalalgia, drowsiness, crisis and ataxy. In this article, we aimed to present the intracranial lipomas phenomenon which was diagnosed to have caused ptosis and upper lateral sight problem, namely causing localized neurological symptom, situated in mesencephalon and having pressure effect, regarding a 57-year old male patient brought to the emergency service with the nausea, throwing up and cephalalgia ailments.

  6. Asymptomatic young man with Danon disease.

    Science.gov (United States)

    Kim, Jiwon; Parikh, Parag; Mahboob, Mohammad; Arrighi, James A; Atalay, Michael K; Rowin, Ethan J; Maron, Martin S

    2014-06-01

    Danon disease is a rare, codominant X-linked genetic disorder characterized by the triad of left ventricular hypertrophy, mental retardation, and peripheral myopathy. This disease is caused by mutations in the gene that encodes lysosomal associated membrane protein 2 (LAMP2), a deficiency of which results in the accumulation of autophagic granular débris within the vacuoles of muscle cells. This is a report of an asymptomatic 19-year-old man with Danon disease in the absence of mental retardation or clinically significant skeletal myopathy. This case underscores the importance of accurate diagnosis of unexplained left ventricular hypertrophy, in order to establish an appropriate treatment plan and to advise genetic counseling.

  7. Asymptomatic humans transmit dengue virus to mosquitoes.

    Science.gov (United States)

    Duong, Veasna; Lambrechts, Louis; Paul, Richard E; Ly, Sowath; Lay, Rath Srey; Long, Kanya C; Huy, Rekol; Tarantola, Arnaud; Scott, Thomas W; Sakuntabhai, Anavaj; Buchy, Philippe

    2015-11-24

    Three-quarters of the estimated 390 million dengue virus (DENV) infections each year are clinically inapparent. People with inapparent dengue virus infections are generally considered dead-end hosts for transmission because they do not reach sufficiently high viremia levels to infect mosquitoes. Here, we show that, despite their lower average level of viremia, asymptomatic people can be infectious to mosquitoes. Moreover, at a given level of viremia, DENV-infected people with no detectable symptoms or before the onset of symptoms are significantly more infectious to mosquitoes than people with symptomatic infections. Because DENV viremic people without clinical symptoms may be exposed to more mosquitoes through their undisrupted daily routines than sick people and represent the bulk of DENV infections, our data indicate that they have the potential to contribute significantly more to virus transmission to mosquitoes than previously recognized.

  8. Asymptomatic post-rheumatic giant left atrium.

    Science.gov (United States)

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-06-26

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m(2) for the definition of a "giant left atrium".

  9. Asymptomatic cardiopulmonary changes caused by adenoid hypertrophy.

    Science.gov (United States)

    Abdel-Aziz, Mosaad

    2011-07-01

    Adenoid hypertrophy is the most common cause of pediatric upper airway obstruction, and it can lead to cardiopulmonary complications such as pulmonary hypertension, cor pulmonale, and even heart failure. The aim of this study was to detect the asymptomatic cardiopulmonary changes that could happen in children with adenoid hypertrophy.Eighty children with adenoid hypertrophy were included in this study. Chest x-ray was used to assess the cardiothoracic ratio, whereas echocardiography was used for measuring the pulmonary arterial pressures, right ventricular diastolic filling parameters, and right ventricular end-diastolic diameters. All patients underwent adenoidectomy with or without tonsillectomy, and they were subjected again to echocardiographic assessment 6 months after the operation. No patient showed an increase in the cardiothoracic ratio on x-ray. Preoperative echocardiography showed an increase in pulmonary artery pressure (22.7 [SD, 3.8] mm Hg), a decrease in right ventricular diastolic filling parameters (E/A = 1.03 [SD, 0.17]), and an increase in right ventricular end-diastolic diameters (1.89 [SD, 0.19] cm). Postoperatively, pulmonary artery pressure decreased to 17.2 [SD, 2.1] mm Hg, right ventricular diastolic filling (E/A) increased to 1.25 [SD, 0.11], and right ventricular end-diastolic diameters decreased to 1.68 [SD, 0.12] cm. The comparison between preoperative and postoperative results for each individual parameter was statistically significant. Clinically asymptomatic cardiopulmonary changes due to adenoid hypertrophy are not rare. Early diagnosis and treatment of upper airway obstruction can prevent these serious complications. Echocardiographic examination should be recommended for these patients as a part of preoperative preparation to avoid anesthetic complications.

  10. Enteropathogenic Escherichia coli: foe or innocent bystander?

    Science.gov (United States)

    Hu, J; Torres, A G

    2015-08-01

    Enteropathogenic Escherichia coli (EPEC) remain one the most important pathogens infecting children and they are one of the main causes of persistent diarrhoea worldwide. Historically, typical EPEC (tEPEC), defined as those isolates with the attaching and effacement (A/E) genotype (eae(+)), which possess bfpA(+) and lack the stx(-) genes are found strongly associated with diarrhoeal cases. However, occurrence of atypical EPEC (aEPEC; eae(+)bfpA(-)stx(-)) in diarrhoeal and asymptomatic hosts has made investigators question the role of these pathogens in human disease. Current epidemiological data are helping to answer the question of whether EPEC is mainly a foe or an innocent bystander during infection.

  11. Human rhinovirus infections in symptomatic and asymptomatic subjects

    Directory of Open Access Journals (Sweden)

    C.N. Camargo

    2012-12-01

    Full Text Available The role of rhinovirus asymptomatic infections in the transmission among close contacts subjects is unknown. We tested health care workers, a pair of one child and a family member and immunocompromised patients (n =191. HRV were detected on 22.9% symptomatic and 3.6% asymptomatic cases suggesting lower transmission among contacts.

  12. Asymptomatic moyamoya disease: literature review and ongoing AMORE study.

    Science.gov (United States)

    Kuroda, Satoshi

    2015-01-01

    Recent development of a non-invasive magnetic resonance examination has increased the opportunity to identify asymptomatic patients with moyamoya disease who have experienced no cerebrovascular events. However, their clinical features, prognosis, and treatment strategy are still unclear because of small number of subjects and short follow-up periods. Therefore, we have designed Asymptomatic Moyamoya Registry (AMORE) study in Japan. The objectives of this nation-wide, multi-center prospective study are to clarify long-term prognosis of asymptomatic patients with moyamoya disease and to determine the risk factors that cause ischemic and hemorrhagic stroke in them. In this article, we review the published data on asymptomatic moyamoya disease and report the on-going multi-center prospective cohort study, AMORE study. We would like to emphasize the importance to determine the clinical features, prognosis, and treatment strategies of asymptomatic moyamoya disease in very near future.

  13. Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

    Reyes, David; Locke, James

    2016-01-01

    Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain

  14. Treatment of asymptomatic catecholaminergic polymorphic ventricular tachycardia.

    Science.gov (United States)

    Obeyesekere, Manoj N; Sy, Raymond W; Leong-Sit, Peter; Gula, Lorne J; Yee, Raymond; Skanes, Allan C; Klein, George J; Krahn, Andrew D

    2012-05-01

    Catecholaminergic polymorphic ventricular tachycardia is a rare genetic disorder caused by mutations in genes involved in the intracellular calcium homeostasis of cardiac cells. Affected patients typically present with life-threatening ventricular arrhythmias precipitated by emotional/physical stress. The diagnosis is based on the demonstration of polymorphic or bidirectional ventricular tachycardia associated with adrenergic stress. Genetic testing can be confirmatory in some patients. Treatment for catecholaminergic polymorphic ventricular tachycardia includes medical and surgical efforts to suppress the effects of epinephrine at the myocardial level and/or modulation of calcium homeostasis. Mortality is high when untreated and sudden cardiac death may be the first manifestation of the disease. First-degree relatives of a proband should be offered genetic testing if the causal mutation is known. If the family mutation is not known, relatives should be clinically evaluated with provocative testing. In the absence of rigorous trials, prophylactic treatment of the asymptomatic catecholaminergic polymorphic ventricular tachycardia patient appears to reduce morbidity and mortality.

  15. Asymptomatic patients of chronic obstructive pulmonary disease in China

    Institute of Scientific and Technical Information of China (English)

    LU Ming; WANG Chang-zheng; NI Dian-tao; WANG Xiao-ping; WANG Da-li; LIU Sheng-ming; L(U) Jia-chun; SHEN Ning; DING Yan-ling; RAN Pi-xin; YAO Wan-zhen; ZHONG Nan-shan; ZHOU Yu-min; WANG Chen; CHEN Ping; KANG Jian; HUANG Shao-guang; CHEN Bao-yuan

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.Methods A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents (over 40 years old) were interviewed with a standardized questionnaire and spirometry.Post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic,personal and exposure variables were collected and analyzed.Results Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 (35.3%)were asymptomatic. The age, sex, body mass index (BMI),rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group.Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV1 (73.1% vs. 61.0%), FVC (91.9% vs. 82.0%), and a higher ratio of FEV1/FVC (62.9% vs.58.7%) (all P <0.001) than symptomatic group. More asymptomatic patients were underdiagnosed (91.9% vs.54.3%, P<0.001) than symptomatic patients.Conclusions This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

  16. Ultrasonography in the diagnosis of asymptomatic hyperuricemia and gout.

    Science.gov (United States)

    Puig, J G; Beltrán, L M; Mejía-Chew, C; Tevar, D; Torres, R J

    2016-12-01

    Sonography has detected urate deposits in 34%-42% of the patients with asymptomatic hyperuricemia. This may prompt reclassification of asymptomatic hyperuricemia into "asymptomatic gout" and consideration of urate lowering therapy (ULT) to resolve urate deposits. In patients with gout and no visible tophi, sonography has detected urate deposits in half of the patients. This may allow diagnosing "tophaceous gout" and influencing the serum urate target level, prophylaxis to avoid acute gout flares during ULT, and clinical follow-up. Current accessibility to sonography may better classify patients with hyperuricemia and gout and contribute to delineate therapeutic objectives and clinical guidance.

  17. Prognostic value of asymptomatic skin sensitization to aeroallergens

    DEFF Research Database (Denmark)

    Bødtger, Uffe

    2004-01-01

    immunological mechanisms in asymptomatic skin sensitization might provide new insights into the natural history and treatment of respiratory allergy. RECENT FINDINGS: Research on asymptomatic skin sensitization is rare, and the present review unites previous studies with recent findings. It is a common...... positive skin test must be ruled out before allergen avoidance measures are initiated. SUMMARY: Surprisingly few papers exist on asymptomatic skin sensitization epidemiology and immunology, despite the intriguing question as to why symptoms do not develop in IgE-sensitized patients. It is a common...

  18. Paper-based ELISA to rapidly detect Escherichia coli.

    Science.gov (United States)

    Shih, Cheng-Min; Chang, Chia-Ling; Hsu, Min-Yen; Lin, Jyun-Yu; Kuan, Chen-Meng; Wang, Hsi-Kai; Huang, Chun-Te; Chung, Mu-Chi; Huang, Kui-Chou; Hsu, Cheng-En; Wang, Chun-Yuan; Shen, Ying-Cheng; Cheng, Chao-Min

    2015-12-01

    Escherichia coli is a generic indicator of fecal contamination, and certain serotypes cause food- and water-borne illness such as O157:H7. In the clinic, detection of bacteriuria, which is often due to E. coli, is critical before certain surgical procedures or in cases of nosocomial infection to prevent further adverse events such as postoperative infection or sepsis. In low- and middle-income countries, where insufficient equipment and facilities preclude modern methods of detection, a simple, low-cost diagnostic device to detect E. coli in water and in the clinic will have significant impact. We have developed a simple paper-based colorimetric platform to detect E. coli contamination in 5h. On this platform, the mean color intensity for samples with 10(5)cells/mL is 0.118±0.002 (n=4), and 0.0145±0.003 (Ppaper-based ELISA is an innovative point-of-care diagnostic tool to rapidly detect E. coli, and possibly other pathogens when customized as appropriate, especially in areas that lack advanced clinical equipment.

  19. Nutritional profile of asymptomatic alcoholic patients

    Directory of Open Access Journals (Sweden)

    Maria Beatriz Sobral-Oliveira

    2011-06-01

    Full Text Available CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls. METHODS: Subjects (n = 60 were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001, with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04, but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01. CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.

  20. Cognitive Deficits in Symptomatic and Asymptomatic Carotid Endarterectomy Surgical Candidates

    Science.gov (United States)

    Jackson, Daren C.; Sandoval-Garcia, Carolina; Rocque, Brandon G.; Wilbrand, Stephanie M.; Mitchell, Carol C.; Hermann, Bruce P.; Dempsey, Robert J.

    2016-01-01

    The role played by vessel disease in stroke-related cognition dysfunction is unclear. We assessed the impact of significant atherosclerotic disease on cognition—even in patients asymptomatic for stroke. We hypothesized that patients would perform poorly relative to controls, but that symptomatic/asymptomatic status (history of stroke/transient ischemic attack) would have no effect. Fifty-two carotid endarterectomy candidates with >60% carotid stenosis and 17 controls underwent a 60-min neuropsychological test protocol. Symptomatic and asymptomatic patients showed deficits in executive function, delayed verbal recall, and general knowledge. Patients symptomatic for stroke also performed worse on tests of language and motor/visuomotor ability. Symptomatic and asymptomatic patients differed in working memory and language task performance. Although all patients showed deficits in executive function and memory, only symptomatic patients showed additional deficits in language and motor function. Cognitive abnormalities in patients viewed as “asymptomatic” for stroke underscore the need for early identification and treatment. PMID:26663810

  1. [Asymptomatic myxoma of the tricuspid valve septal leaflet].

    Science.gov (United States)

    Jedliński, Ireneusz; Jamrozek-Jedlińska, Maria; Bugajski, Paweł; Kalawski, Ryszard; Poprawski, Kajetan; Słomczyński, Marek

    2012-01-01

    We presented a case of asymptomatic myxoma of the tricuspid valve septal leaflet. The tumour was diagnosed accidentally during rutine transthoracic echocardiography and confirmed by transesophageal echocardiography. It was resected and the septal leaflet repaired during surgery.

  2. Oesophageal carcinoma presenting with a synchronous asymptomatic colon carcinoma

    OpenAIRE

    Alok Gupta; Bharat Chauhan; V Rangarajan; Saral Desai; Vanita Noronha; Kumar Prabhash

    2013-01-01

    The advancement in diagnostic techniques has resulted in increased incidence of occult second primary in cancer patients. Here, we report a case of symptomatic oesophageal carcinoma and synchronous asymptomatic colon carcinoma diagnosed through Positron Emission Tomography-Computed Tomography imaging.

  3. Clinical and angiographic comparison of asymptomatic occlusive cerebrovascular disease.

    Science.gov (United States)

    Gorelick, P B; Caplan, L R; Langenberg, P; Hier, D B; Pessin, M; Patel, D; Taber, J

    1988-06-01

    We compared clinical and arteriographic features in 106 patients with symptomatic unilateral carotid territory occlusive disease to determine the frequency and distribution of occlusive arterial lesions in asymptomatic vessels. Among black patients who were predominantly from Chicago, young, and female, there were fewer transient ischemic attacks and myocardial infarcts, less claudication, and more asymptomatic lesions of the supraclinoid internal carotid artery, anterior cerebral artery stem, and the middle cerebral artery stem. Among white patients predominantly from New England, elderly, and male, there was more frequent and severe occlusive asymptomatic disease at extracranial carotid and vertebral artery sites. Knowledge of the distribution of asymptomatic lesions will help guide evaluation and treatment strategies for patients with occlusive cerebrovascular disease.

  4. Asymptomatic infection with American cutaneous leishmaniasis: epidemiological and immunological studies

    Science.gov (United States)

    Andrade-Narvaez, Fernando J; Loría-Cervera, Elsy Nalleli; Sosa-Bibiano, Erika I; Van Wynsberghe, Nicole R

    2016-01-01

    American cutaneous leishmaniasis (ACL) is a major public health problem caused by vector-borne protozoan intracellular parasites from the genus Leishmania, subgenera Viannia and Leishmania. Asymptomatic infection is the most common outcome after Leishmania inoculation. There is incomplete knowledge of the biological processes explaining the absence of signs or symptoms in most cases while other cases present a variety of clinical findings. Most studies of asymptomatic infection have been conducted in areas of endemic visceral leishmaniasis. In contrast, asymptomatic ACL infection has been neglected. This review is focused on the following: (1) epidemiological studies supporting the existence of asymptomatic ACL infection and (2) immunological studies conducted to understand the mechanisms responsible for controlling the parasite and avoiding tissue damage. PMID:27759762

  5. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  6. Asymptomatic spontaneous rupture of suprasellar dermoid cyst : a case report.

    Directory of Open Access Journals (Sweden)

    Venkatesh S

    2002-10-01

    Full Text Available Suprasellar dermoid cysts are uncommon intracranial lesions. CT and MRI findings in a rare case of asymptomatic rupture of suprasellar dermoid cyst with subarachnoid dissemination is described.

  7. Transthoracic Repair of Asymptomatic Morgagni Hernia in an Adult

    OpenAIRE

    2011-01-01

    Morgagni hernia represents a rare type of diaphragmatic hernia which usually occurs on the right side, in the anterior mediastinum. Predisposing factors of Morgagni hernia include pregnancy, obesity or other causes of increased intraabdominal pressure, and a history of trauma. Most of adults diagnosed with a foramen of Morgagni are asymptomatic. We report a case of an overweight 23-year-old asymptomatic patient with a Morgagni hernia incidentally diagnosed on chest x-ray. There was a satisfac...

  8. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  9. [Is there a role for asymptomatic carotid artery stenosis screening?].

    Science.gov (United States)

    Heldenberg, Eitan; Bass, Arie

    2014-08-01

    Screening for asymptomatic carotid artery stenosis (CAS) is highly controversial Many surgeons routinely screen their patients for carotid disease prior to major operations, yet the benefit of such practice was never demonstrated. The treatment of symptomatic patients has not changed much during the last twenty years, since the publication of the North American Symptomatic Carotid Endarterectomy Trial (NASCET). However, in contrast, the Asymptomatic Carotid Atherosclerosis Study (ACAS) and the Asymptomatic Carotid Surgery Trial (ACST) failed to get the same acceptance among the multidisciplinary group treating CAS.The prevalence of asymptomatic 60-99% carotid artery stenosis among the general population is about 1%. Neither ACAS nor ACST showed that stenosis severity was associated with increasing stroke risk. The 'realpolitik' is that mass interventions in asymptomatic patients will probably only ever prevent about 1% of all strokes. This is even truer regarding patients scheduLed for major operation, in which the incidence of stroke is less than 1%. Moreover the current evidence in the literature suggests that the best medicaL treatment (BMT) results in 0.5% strokes per year, better than resuLts which can be offered by surgery. According to the current evidence, it seems that asymptomatic carotid artery screening should be discontinued, since it is a major waste of resources.

  10. Dynamics of collateral circulation in progressive asymptomatic carotid disease.

    Science.gov (United States)

    Moll, F L; Eikelboom, B C; Vermeulen, F E; van Lier, H J; Schulte, B P

    1986-03-01

    Inadequacy of collateral arterial flow is the major risk factor for hemispheric infarction in association with spontaneous occlusion of the ipsilateral carotid artery. This prospective study was designed to measure the adaptation of collateral cerebral circulation through the circle of Willis in patients in whom a unilateral carotid stenosis of hemodynamic consequence develops asymptomatically. The collateral cerebral potential is assessed by ocular pneumoplethysmography (OPG) during proximal common carotid artery compression, measuring the collateral ophthalmic artery pressure (COAP). During an average follow-up of almost 3 years (maximum more than 7 years), 45 patients showed asymptomatic development of a unilateral hemodynamically significant carotid stenosis according to OPG evidence. In these patients the mean index COAP/brachial artery pressure did not change on the side of stenosis progression (p greater than 0.05). The developed carotid stenosis had only reduced collateral circulation to the contralateral hemisphere. The risk of inadequate collateral cerebral circulation remained during progression of asymptomatic extracranial arterial obstructive disease.

  11. Transthoracic repair of asymptomatic morgagni hernia in an adult.

    Science.gov (United States)

    Pousios, Dimitrios; Panagiotopoulos, Nikolaos; Piyis, Anastasios; Gourgiotis, Stavros

    2012-10-01

    Morgagni hernia represents a rare type of diaphragmatic hernia which usually occurs on the right side, in the anterior mediastinum. Predisposing factors of Morgagni hernia include pregnancy, obesity or other causes of increased intraabdominal pressure, and a history of trauma. Most of adults diagnosed with a foramen of Morgagni are asymptomatic. We report a case of an overweight 23-year-old asymptomatic patient with a Morgagni hernia incidentally diagnosed on chest x-ray. There was a satisfactory result after the repair by a transthoracic approach.

  12. Spatial working memory in asymptomatic HIV-infected subjects.

    Science.gov (United States)

    Grassi, B; Garghentini, G; Campana, A; Grassi, E; Bertelli, S; Cinque, P; Epifani, M; Lazzarin, A; Scarone, S

    1999-01-01

    Many clinical and research findings converge to indicate that frontal lobe, basal ganglia, and related neuronal connections are primarily involved in human immunodeficiency virus (HIV) infection; frontal lobe, mainly the prefrontal cortex, has a specialized role in working memory processes. This study focused on neuropsychological evaluation of the spatial component of working memory in a sample of 34 asymptomatic HIV-infected subjects as compared with 34 age- and sex-matched seronegative control subjects. A computer-administered test assessing spatial working memory was used for the neuropsychological evaluation. The findings did not show any spatial working memory impairment during the asymptomatic phase of HIV infection.

  13. Asymptomatic Wolff-Parkinson-White Syndrome: Who Should Be Treated?

    Science.gov (United States)

    Obeyesekere, Manoj N; Leong-Sit, Peter; Krahn, Andrew D; Gula, Lorne J; Yee, Raymond; Skanes, Allan C; Klein, George J

    2012-09-01

    This article discusses the merits of electrophysiology study (EPS) and/or ablation for asymptomatic preexcitation Wolff-Parkinson-White (WPW) ECG pattern. Sudden deaths in asymptomatic patients are too few to merit broad screening and aggressive intervention. It also discusses the risks of ablation and the low predictive accuracy of EPS. When WPW is an incidental finding, the decision to proceed with investigation and ablation can be made considering patients' situations and preferences. An invasive strategy is targeted at patients concerned about the low risk of life-threatening arrhythmia as a first presentation after a discussion of the risks and benefits.

  14. Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Greve, Anders; Gerdts, Eva; Boman, Kurt

    2013-01-01

    BACKGROUND: The frequency and prognostic importance of atrial fibrillation (AF) in asymptomatic mild-to-moderate aortic stenosis (AS) has not been well described. METHODS: Clinical examination, electrocardiography and echocardiography were obtained in asymptomatic patients with mild......-to-moderate AS and preserved left ventricular (LV) systolic function, randomized to simvastatin/ezetimibe combination vs. placebo in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. At inclusion, AF was categorized as episodic or longstanding. Rhythm change was assessed on annual in-study electrocardiograms...

  15. Diagnosis and management of patients with asymptomatic severe aortic stenosis

    Institute of Scientific and Technical Information of China (English)

    Minako Katayama; Hari P Chaliki

    2016-01-01

    Aortic stenosis(AS) is a disease that progresses slowly for years without symptoms, so patients need to be carefully managed with appropriate follow up and referred for aortic valve replacement in a timely manner. Development of symptoms is a clear indication for aortic valve intervention in patients with severe AS. The decision for early surgery in patients with asymptomatic severe AS is more complex. In this review, we discuss how to identify high-risk patients with asymptomatic severe AS who may benefit from early surgery.

  16. Left Atrial Systolic Force in Asymptomatic Aortic Stenosis

    DEFF Research Database (Denmark)

    Cioffi, Giovanni; Cramariuc, Dana; Dalsgaard, Morten

    2011-01-01

    Background: There is a limited knowledge about left atrial (LA) systolic force (LASF) and its key determinants in patients with asymptomatic mild-moderate aortic stenosis (AS). Methods: We used baseline clinic and echocardiographic data from 1,566 patients recruited in the simvastatin ezetimibe...... in aortic stenosis study evaluating the effect of placebo-controlled combined simvastatin and ezetimibe treatment in asymptomatic AS. The LASF was calculated by Manning's method. Low and high LASF were defined as 95th percentile of the distribution within the study population, respectively. Results: Mean...

  17. Peripheral artery disease (PAD) screening in the asymptomatic population

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Falk, Erling

    2011-01-01

    and feet (lower limb), which in the Western world is caused by atherosclerosis if not previous trauma. Whereas severity of intermittent claudication is only poorly related to ABI, cardiovascular outcomes are as follows: the lower the ABI the higher the incidence of cardiovascular events and death....... Measuring ABI identifies asymptomatic persons at increased risk of cardiovascular morbidity and mortality: an ABI 25% in people between 80 and 90 years of age. The majority of persons with reduced ABI are asymptomatic and therefore unaware of the increased risk they are living with, thus, screening...

  18. Application of biotinylated and 32P probes for detection of P-fimbriae in urinary E. coli.

    Science.gov (United States)

    Jusková, E; Ciznár, I

    1993-01-01

    Escherichia coli is the common causative agent of urinary tract infections. Twenty-six strains of Escherichia coli were isolated from children with pyelonephritis, symptomatic urinary tract infections and asymptomatic bacteriuria. Biotinylated and 32P-DNA probes were prepared for detection of P-fimbriae in the isolates. Of the 13 strains isolated from patients with pyelonephritis 11 were positive for the presence of the P gene by both probes. Strains isolated from cases of symptomatic urinary tract infections revealed the presence of P gene only in three samples of the total of nine isolated. None of the isolated E. coli strains from asymptomatic bacteriuria was found positive for the presence of the P gene. The biotinylated probe was simple and easily applicable in standard laboratory conditions and therefore the authors recommend it for use in diagnostic laboratories.

  19. Acute Obstructive Suppurative Pancreatic Ductitis in an Asymptomatic Patient

    Directory of Open Access Journals (Sweden)

    Eisha Wali

    2015-01-01

    Full Text Available Acute obstructive suppurative pancreatic ductitis (AOSPD, defined as suppuration from the pancreatic duct without associated pseudocyst, abscess, or necrosis, is a rare complication of chronic pancreatitis. We present the first case of AOSPD in an asymptomatic patient with a polymicrobial infection and review the literature on this rare clinical entity.

  20. Asymptomatic malaria infections: detectability, transmissibility and public health relevance

    NARCIS (Netherlands)

    Bousema, T.; Okell, L.; Felger, I.; Drakeley, C.

    2014-01-01

    Most Plasmodium falciparum infections that are detected in community surveys are characterized by low-density parasitaemia and the absence of clinical symptoms. Molecular diagnostics have shown that this asymptomatic parasitic reservoir is more widespread than previously thought, even in low-endemic

  1. Vulvovaginal Candida: a study of (a)symptomatic women

    NARCIS (Netherlands)

    Engberts, M.K.

    2007-01-01

    The research described in this thesis concerns presence of asymptomatic vaginal Candida and vulvovaginal candidiasis. Vulvovaginal candidiasis (VVC) is an infection caused by abnormal growth of yeasts in the mucosa of the female genital tract. Acute vulvar pruritus and vaginal discharge are the usua

  2. [Screening of parasitic diseases in the asymptomatic immigrant population].

    Science.gov (United States)

    Goterris, Lidia; Bocanegra, Cristina; Serre-Delcor, Núria; Moure, Zaira; Treviño, Begoña; Zarzuela, Francesc; Espasa, Mateu; Sulleiro, Elena

    2016-07-01

    Parasitic diseases suppose an important health problem in people from high endemic areas, so these must be discarded properly. Usually, these infections develop asymptomatically but, in propitious situations, are likely to reactivate themselves and can cause clinical symptoms and/or complications in the receiving country. Moreover, in some cases it is possible local transmission. Early diagnosis of these parasitic diseases made by appropriate parasitological techniques and its specific treatment will benefit both, the individual and the community. These techniques must be selected according to geoepidemiological criteria, patient's origin, migration route or time spent outside the endemic area; but other factors must also be considered as its sensitivity and specificity, implementation experience and availability. Given the high prevalence of intestinal parasites on asymptomatic immigrants, it is recommended to conduct a study by coproparasitological techniques. Because of its potential severity, the screening of asymptomatic malaria with sensitive techniques such as PCR (polymerase chain reaction) is also advisable. Serological screening for Chagas disease should be performed on all Latin American immigrants, except for people from the Caribbean islands. Other important parasites, which should be excluded, are filariasis and urinary schistosomiasis, by using microscopic examination. The aim of this paper is to review the different techniques for the screening of parasitic diseases and its advices within the care protocols for asymptomatic immigrants.

  3. Asymptomatic brain metastases in patients with cutaneous metastatic malignant melanoma

    DEFF Research Database (Denmark)

    Zukauskaite, Ruta; Schmidt, Henrik; Asmussen, Jon T

    2013-01-01

    The aim of the study was to identify the frequency of asymptomatic brain metastases detected by computed tomography (CT) scans in patients with metastatic cutaneous melanoma referred to first-line systemic treatment. Between 1995 and 2009, 697 Danish patients were screened with a contrast...

  4. Histopathologic assessment of the entire endometrium in asymptomatic women

    NARCIS (Netherlands)

    Mingels, M.J.J.M.; Geels, Y.P.; Pijnenborg, J.M.A.; Wurff, A.A. van der; Tilborg, A.A. Van; Ham, M.A.P.C. van; Massuger, L.F.A.G.; Bulten, J.

    2013-01-01

    Knowledge on the nature of the endometrium in women without symptoms of endometrial disease is poor. Therefore, the aim of this prospective study was to describe the endometrium of a cohort of asymptomatic women. The entire endometrium of premenopausal and postmenopausal women was embedded for histo

  5. Recurrent Urinary Tract Infections due to Asymptomatic Colonic Diverticulitis

    Directory of Open Access Journals (Sweden)

    Evangelos Falidas

    2012-01-01

    Full Text Available Colovesical fistula is a common complication of diverticulitis. Pneumaturia, fecaluria, urinary tract infections, abdominal pain, and dysuria are commonly reported. The authors report a case of colovesical fistula due to asymptomatic diverticulitis, and they emphasize the importance of deeply investigate recurrent urinary tract infection without any bowel symptoms. They also briefly review the literature.

  6. Aortic coarctation, aneurysm, and ventricular dysfunction in an asymptomatic infant.

    Science.gov (United States)

    García, Ana I; Aguilar, Juan M; García, Enrique

    2016-06-01

    Aortic arch coarctation with post-coarctation aneurysm is rare in infants. We present the case of an asymptomatic 3-month-old infant with severe left ventricular dysfunction in this setting. The patient underwent surgical repair, and the left ventricular ejection fraction improved to recovery the 4th post-operative month.

  7. Asymptomatic Malaria among Blood Donors in Benin City Nigeria.

    Directory of Open Access Journals (Sweden)

    Bankole Henry Oladeinde

    2014-09-01

    Full Text Available This study aimed at determining the prevalence and associated risk factors for asymptomatic malaria parasitaemia and anemia among blood donors in a private medical laboratory in Benin City, Nigeria.Venous blood was collected from a total of 247 blood donors. Malaria status, ABO, Rhesus blood groups and hemoglobin concentration of all participants were determined using standard methods.The prevalence of asymptomatic malaria infection was higher among commercial blood donors than volunteer group (commercial vs volunteer donor: 27.5 %vs. 13.8%; OR = 2.373, 95% CI = 0.793, 7.107, P = 0.174. Asymptomatic malaria was not significantly affected by gender (P = 0.733, age (P = 0.581, ABO (P = 0.433 and rhesus blood groups (P = 0.806 of blood donors. Age was observed to significantly (P = 0.015 affect malaria parasite density with donors within the age group of 21-26 years having the highest risk. The prevalence of anemia was significantly higher among commercial donors (commercial vs volunteer donors: 23.4% vs 3.4%: OR = 8.551, 95% CI = 1.135, 64.437, P = 0.013 and donors of blood group O type (P = < 0.0001.Asymptomatic malaria parasitaemia and anemia was higher among commercial donors than voluntary donors. Mandatory screening of blood donors for malaria parasite is advocated to curb transfusion transmitted malaria and associated sequelae.

  8. Asymptomatic free-floating vitreous cyst masquerading as cysticercosis.

    Science.gov (United States)

    Ganger, Anita; Agarwal, Rinki; Kumar, Vinod

    2016-11-02

    A male patient aged 37 years, referred with the diagnosis of right eye intravitreal cysticercosis, was diagnosed as asymptomatic free-floating vitreous cyst after thorough evaluation. The patient was kept under observation, since baseline visual acuity was unaffected. No change was noted over the period of 6 months.

  9. Asymptomatic carriers contribute to nosocomial Clostridium difficile infection

    DEFF Research Database (Denmark)

    Blixt, Thomas; Gradel, Kim Oren; Homann, Christian;

    2017-01-01

    BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects of of as...

  10. Picornavirus-Induced Airway Mucosa Immune Profile in Asymptomatic Neonates

    DEFF Research Database (Denmark)

    Wolsk, Helene M.; Følsgaard, Nilofar V.; Birch, Sune;

    2016-01-01

    Bacterial airway colonization is known to alter the airway mucosa immune response in neonates whereas the impact of viruses is unknown. The objective was therefore to examine the effect of respiratory viruses on the immune signature in the airways of asymptomatic neonates. Nasal aspirates from 571...

  11. Asymptomatic skin sensitization to birch predicts later development of birch pollen allergy in adults

    DEFF Research Database (Denmark)

    Bodtger, Uffe; Poulsen, Lars K.; Malling, Hans-Jørgen

    2003-01-01

    The skin prick test is the allergologic test of choice, but asymptomatic skin sensitization to aeroallergens is common. However, no data in the literature describe the clinical phenotype of asymptomatic sensitized adults....

  12. Ileal ulcer in asymptomatic individuals. Is this Crohn?

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Marques dos Santos

    2012-06-01

    Full Text Available The endoscopic finding of ileal ulcers, alone or in small number, is not usual, but when it occurs in asymptomatic patients, an impasse may be generated regarding the action to be taken, since the medical literature is unclear as to how to proceed in this situation. OBJECTIVE: Evaluate patients with ileal ulcers, single or in a small number, asymptomatic, and their follow-up. METHODS: The author reports a series of asymptomatic cases (23 patients of ulcers - single or in small number - found in colonoscopy exams performed for other reasons than typical clinical manifestations of Crohn's disease. RESULTS: Most patients were not treated and remained asymptomatic during the follow-up period. CONCLUSIONS: The patients remained asymptomatic and without treatment in most cases, and, considering the small number of cases and the short observation time, this study does not allow to conclude that this is the best practice in case of asymptomatic patients with ileal ulcer.O achado endoscópico de úlceras ileais, isoladas ou em pequeno número, não é frequente, mas quando ocorre em pacientes assintomáticos pode gerar um impasse quanto à conduta a ser tomada, já que a literatura médica não é clara quanto a como se proceder nessa situação. OBJETIVO: Avaliar pacientes que apresentaram úlceras ileais solitárias ou em pequena quantidade, assintomáticos e a evolução clínica dos mesmos. MÉTODOS: O autor relata uma série de casos (23 pacientes assintomáticos que apresentaram úlceras ileais únicas ou em pequeno número em colonoscopias realizadas por outros motivos que não manifestações clínicas típicas de doença de Crohn. RESULTADOS: A maioria dos pacientes não foi tratada e permaneceu assintomática pelo período de acompanhamento. CONCLUSÕES: Os pacientes permaneceram assintomáticos e sem tratamento em sua maioria, salientando-se o reduzido número de casos e o curto tempo de observação, de modo a não permitirem a este estudo

  13. Should incidental asymptomatic angiographic stenoses and occlusions be treated in patients with peripheral arterial disease?

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-09-01

    The clinical importance of angiographically detected asymptomatic lower-limb stenoses and occlusions is unknown. This study aims to (i) assess the clinical outcome of asymptomatic lesions in the lower limb, (ii) identify predictors of clinical deterioration, and (iii) determine which asymptomatic lower-limb lesions should be treated at presentation.

  14. Isolated Asymptomatic Short Sternum in a Healthy Young Girl

    Directory of Open Access Journals (Sweden)

    Francesco Turturro

    2014-01-01

    Full Text Available Congenital sternal defects are rare deformities frequently associated with other anomalies of the chest wall and other organ systems. Although pectus excavatum, pectus carinatum, and cleft sternum can present as isolated deformity, in most cases they are associated with heart and inner organs anomalies and described as symptoms of syndromes like Marfan syndrome, Noonan syndrome, Poland anomaly, and Cantrell pentalogy. In contrast, the etiology of an isolated defect is not well understood. We observed a short sternum (dysmorphic manubrium, hypoplastic body, and complete absence of the xiphoid process in a completely asymptomatic 13-year-old woman. A comprehensive instrumental exams panel was performed to exclude associated anomalies of the heart and of the other organ systems. The patient was completely asymptomatic and she did not need any medical or surgical treatment. To our knowledge, this is the first case of isolated short sternum reported in literature.

  15. Advanced Asymptomatic Carotid Disease and Cognitive Impairment: An Understated Link?

    Directory of Open Access Journals (Sweden)

    Irena Martinić-Popović

    2012-01-01

    Full Text Available Advanced carotid disease is known to be associated with symptomatic cerebrovascular diseases, such as stroke or transient ischemic attack (TIA, as well as with poststroke cognitive impairment. However, cognitive decline often occurs in patients with advanced carotid stenosis without clinically evident stroke or TIA, so it is also suspected to be an independent risk factor for dementia. Neurosonological methods enable simple and noninvasive assessment of carotid stenosis in patients at risk of advanced atherosclerosis. Cognitive status in patients diagnosed with advanced carotid stenosis is routinely not taken into consideration, although if cognitive impairment is present, such patients should probably be called symptomatic. In this paper, we discuss results of some most important studies that investigated cognitive status of patients with asymptomatic advanced carotid disease and possible mechanisms involved in the causal relationship between asymptomatic advanced carotid disease and cognitive decline.

  16. A Case of Aortopulmonary Window: Asymptomatic until the First Pregnancy

    Directory of Open Access Journals (Sweden)

    Murat Kose

    2015-01-01

    Full Text Available The aortopulmonary window (APW is an abnormal communication between the ascending aorta and the pulmonary trunk in the presence of two separate semilunar valves. It is a rare congenital malformation which represents 0.1% of all congenital cardiac diseases. Herein, we report a very rare case of 27-year-old patient with unrepaired APW causing Eisenmenger syndrome and pulmonary hypertension who was asymptomatic until her first pregnancy. The median survival of uncorrected APW is 33 years. Aortopulmonary window is a very rare congenital anomaly. To our knowledge, asymptomatic adult case has not been reported until now. APW should be considered in the differential diagnosis of the severe pulmonary hypertension also in adult patients.

  17. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Simões-Silva, Liliana; Correia, Inês; Barbosa, Joana; Santos-Araujo, Carla; Sousa, Maria João; Pestana, Manuel; Soares-Silva, Isabel; Sampaio-Maia, Benedita

    Currently, chronic kidney disease (CKD) is a global health problem. Considering the impaired immunity of CKD patients, the relevance of infection in peritoneal dialysis (PD), and the increased prevalence of parasites in CKD patients, protozoa colonization was evaluated in PD effluent from CKD patients undergoing PD. Overnight PD effluent was obtained from 49 asymptomatic stable PD patients. Protozoa analysis was performed microscopically by searching cysts and trophozoites in direct wet mount of PD effluent and after staining smears. Protozoa were found in PD effluent of 10.2% of evaluated PD patients, namely Blastocystis hominis, in 2 patients, and Entamoeba sp., Giardia sp., and Endolimax nana in the other 3 patients, respectively. None of these patients presented clinical signs or symptoms of peritonitis at the time of protozoa screening. Our results demonstrate that PD effluent may be susceptible to asymptomatic protozoa colonization. The clinical impact of this finding should be further investigated.

  18. Insurability for asymptomatic hematuria or proteinuria during childhood.

    Science.gov (United States)

    Feld, L G; Stapleton, F B

    1993-08-01

    The objective of this survey was to describe life insurance underwriting practices concerning children with asymptomatic hematuria and proteinuria. A questionnaire was sent to 200 companies licensed to issue life insurance policies in the state of New York. The medical director of each company was asked to respond to the insurability of children with asymptomatic hematuria and proteinuria. Two case summaries were provided with the questionnaire. Of 97 companies, 66 would offer insurance to the patient with hematuria, although 38 (58%) would charge additional premiums. In response to the problem of proteinuria, 61 companies would offer life insurance, although 50 (82%) would require higher premium charges (P life insurance, although often at higher cost. Invasive diagnostic tests are not necessary for insurers to offer insurance.

  19. A Rare Entity: Adult Asymptomatic Giant Vallecular Cyst

    Science.gov (United States)

    Torun, Mümtaz Taner; Seçkin, Ender; Tuncel, Ümit; Kılıç, Caner; Özkan, Özalkan

    2015-01-01

    Background. Cysts in the larynx are rare and generally asymptomatic. However, large cysts in adults can be symptomatic. If they are symptomatic, they typically present with respiratory and feeding difficulties. They are usually benign in terms of pathology. Several surgical techniques may be used for treatment. Case Report. A 56-year-old man presented to our clinic with hoarseness. Routine laryngeal examination revealed a giant mass and the larynx could not be visualized. At magnetic resonance imaging (MRI), a cystic mass originating from the vallecula was detected. There was no pathology at the glottic level. We planned tracheotomy for the airway and endoscopic surgery for excision. The mass was excised using CO2 laser and was reported as benign. Conclusion. An asymptomatic vallecular cyst may cause difficult intubation in any operation. It may also cause respiratory or other complications. Airway management should be led by an ear, nose, and throat surgeon, since tracheotomy may be required. Endoscopic excision with CO2 laser is a good choice for treatment in elective cases. In this report, we discuss the diagnosis and treatment of a patient with an asymptomatic giant vallecular cyst. PMID:26688767

  20. A Rare Entity: Adult Asymptomatic Giant Vallecular Cyst

    Directory of Open Access Journals (Sweden)

    Mümtaz Taner Torun

    2015-01-01

    Full Text Available Background. Cysts in the larynx are rare and generally asymptomatic. However, large cysts in adults can be symptomatic. If they are symptomatic, they typically present with respiratory and feeding difficulties. They are usually benign in terms of pathology. Several surgical techniques may be used for treatment. Case Report. A 56-year-old man presented to our clinic with hoarseness. Routine laryngeal examination revealed a giant mass and the larynx could not be visualized. At magnetic resonance imaging (MRI, a cystic mass originating from the vallecula was detected. There was no pathology at the glottic level. We planned tracheotomy for the airway and endoscopic surgery for excision. The mass was excised using CO2 laser and was reported as benign. Conclusion. An asymptomatic vallecular cyst may cause difficult intubation in any operation. It may also cause respiratory or other complications. Airway management should be led by an ear, nose, and throat surgeon, since tracheotomy may be required. Endoscopic excision with CO2 laser is a good choice for treatment in elective cases. In this report, we discuss the diagnosis and treatment of a patient with an asymptomatic giant vallecular cyst.

  1. First metatarsophalangeal joint- MRI findings in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Dietrich, Tobias Johannes; Pfirrmann, Christian W.A. [University of Zurich, Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Figueira da Silva, Flora Luciana [University of Zurich, Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Radiology, Hospital Mae de Deus and Mae de Deus Center, Porto Alegre, RS (Brazil); Abreu, Marcelo Rodrigues de [Radiology, Hospital Mae de Deus and Mae de Deus Center, Porto Alegre, RS (Brazil); Klammer, Georg [University of Zurich, Orthopedic Surgery, Orthopedic University Hospital Balgrist, Zurich (Switzerland)

    2015-04-01

    To evaluate the spectrum and frequency of MR findings of the first metatarsophalangeal joint (MTPJ) in asymptomatic volunteers. MR imaging of 30 asymptomatic forefeet was performed with a dedicated extremity 1.5-Tesla system. Participants were between 20 and 49 years of age (mean ± SD: 35.5 ± 8.4 years). Two radiologists assessed cartilage, bone, capsuloligamentous structures, and tendons of first MTPJs on MR images. Cartilage defects were observed in 27 % (n = 8) of first MTPJs, most frequently located at the base of the proximal phalanx (23 %, n = 7), whereas cartilage defects of the metatarsal head (13 %, n = 4) and the metatarsosesamoid compartment were rare (0 %-3 %, n = 0-1). Bone marrow oedema-like signal changes were present in 37 % (n = 11) and subchondral cysts in 20 % (n = 6) of first MTPJs. Hyperintense areas on intermediate-weighted sequences (range: 30-43 %, n = 9-13) and on fluid-sensitive sequences with fat suppression (range: 33-60 %, n = 10-18) within the medial and lateral collateral ligament complex were common. Plantar recesses (77 %, n = 23) and distal dorsal recesses (87 %, n = 26) were frequently observed. Cartilage defects, bone marrow oedema-like signal changes, subchondral cysts, plantar recesses, and distal dorsal recesses were common findings on MRI of first MTPJs in asymptomatic volunteers. The collateral ligaments were often heterogeneous in structure and showed increased signal intensity. (orig.)

  2. Asymptomatic pancreatic lesions: New insights and clinical implications

    Institute of Scientific and Technical Information of China (English)

    Martin Loos; Christoph W Michalski; J(o)rg Kleeff

    2012-01-01

    Despite great efforts in experimental and clinical research,the prognosis of pancreatic cancer (PC) has not changed significantly for decades.Detection of pre-invasive lesions or early-stage PC with small resectable cancers in asymptomatic individuals remains one of the most promising approaches to substantially improve the overall outcome of PC.Therefore,screening programs have been proposed to identify curable lesions especially in individuals with a familial or genetic predisposition for PC.In this regard,Canto et al recently contributed an important article comparing computed tomography,magnetic resonance imaging,and endoscopic ultrasound for the screening of 216 asymptomatic high-risk individuals (HRI).Pancreatic lesions were detected in 92 of 216 asymptomatic HRI (42.6%).The high diagnostic yield in this study raises several questions that need to be answered of which two will be discussed in detail in this commentary:First:which imaging test should be performed? Second and most importantly:what are we doing with incidentally detected pancreatic lesions? Which ones can be observed and which ones need to be resected?

  3. Urine culture doubtful in determining etiology of diffuse symptoms among elderly individuals: a cross-sectional study of 32 nursing homes

    Directory of Open Access Journals (Sweden)

    Ulleryd Peter

    2011-05-01

    Full Text Available Abstract Background The high prevalence of bacteriuria in elderly individuals makes it difficult to know if a new symptom is related to bacteria in the urine. There are different views concerning this relationship and bacteriuria often leads to antibiotic treatments. The aim of this study was to investigate the relationship between bacteria in the urine and new or increased restlessness, fatigue, confusion, aggressiveness, not being herself/himself, dysuria, urgency and fever in individuals at nursing homes for elderly when statistically considering the high prevalence of asymptomatic bacteriuria in this population. Methods In this cross-sectional study symptoms were registered and voided urine specimens were collected for urinary cultures from 651 elderly individuals. Logistic regressions were performed to evaluate the statistical correlation between bacteriuria and presence of a symptom at group level. To estimate the clinical relevance of statistical correlations at group level positive and negative etiological predictive values (EPV were calculated. Results Logistic regression indicated some correlations at group level. Aside from Escherichia coli in the urine and not being herself/himself existing at least one month, but less than three months, EPV indicated no clinically useful correlation between any symptoms in this study and findings of bacteriuria. Conclusions Urinary cultures provide little or no useful information when evaluating diffuse symptoms among elderly residents of nursing homes. Either common urinary tract pathogens are irrelevant, or urine culture is an inappropriate test.

  4. Assessment of biological and colony hybridization assays for detection of the aerobactin system in Escherichia coli from urinary tract infections.

    Science.gov (United States)

    Orskov, I; Williams, P H; Svanborg Edén, C; Orskov, F

    1989-01-01

    A total of 466 E. coli strains from urinary tract infections (UTI) were screened for the presence and expression of the aerobactin system by a colony hybridization test and a bioassay. A probe carrying part of the genes for aerobactin synthesis was used. A total of 43.1% (201) of the strains were positive in the probe test and undoubtedly positive in the bioassay. When doubtfully positive bioassays were included, this figure rose to 49.8% (232). An additional 4.9% (23) of the strains were positive in the colony hybridization test only while 44% (205) of the strains were negative in both tests. Doubtfully positive bioassays were probably due either to a false positive reaction or to a weak expression of the aerobactin system. 01:K1:H- strains were characteristically probe positive and doubtfully positive in the bioassay. The incidence of isolates positive by both methods or by only one of them was significantly higher among isolates from cases of pyelonephritis (Py) than among those from asymptomatic bacteriuria (ABU) and normal feces (FN) (P less than 0.01).

  5. Fatores associados à bacteriúria após sondagem vesical na cirurgia ginecológica Factors associated with bacteriuria after indwelling urethral catheterization in gynecologic surgery

    Directory of Open Access Journals (Sweden)

    Sonia Cristina Araújo Hinrichsen

    2009-01-01

    Full Text Available OBJETIVOS: Determinar a frequência e os principais fatores associados à bacteriúria após a sondagem vesical em mulheres submetidas à cirurgia ginecológica eletiva. MÉTODOS: Realizou-se um estudo do tipo coorte em mulheres submetidas à cirurgia ginecológica após sondagem vesical no Instituto de Medicina Integral Prof. Fernando Figueira, no período de janeiro a maio de 2007. As uroculturas foram coletadas até 24 horas após a retirada da sonda e 7/10 dias após a sondagem vesical. A análise estatística bivariada e multivariada foi realizada calculando-se a razão de risco e os seus intervalos de confiança a 95%. RESULTADOS: Foram incluídas no estudo 249 mulheres. A frequência de uroculturas positivas até 24 horas depois da retirada da sonda foi de 23,6%, diminuindo para 11,1% 7/10 dias após a sondagem. Destas, apenas 2,4% eram sintomáticas. Verificou-se menor risco de bacteriúria com 7/10 dias após a sondagem vesical quando a paciente referiu vulvovaginite tratada nos últimos três meses, não permanecendo estatisticamente significativa após a análise multivariada. Não houve associação significativa com idade, escolaridade, número de gestações, paridade, fase da vida reprodutiva, tipo e duração da cirurgia, tipo da anestesia, uso de antibiótico profilático, profissional que colocou a sonda e o tempo de permanência da sonda vesical. CONCLUSÃO: A frequência de bacteriúria foi de 23,6% e 11,1% com 24 horas e 7/10 dias, respectivamente. Não se encontrou associação significativa das variáveis pesquisadas com a bacteriúria evidenciada na urocultura com 7/10 dias.OBJECTIVES: To determine the frequency and risk factors associated to bacteriuria after urinary catheterization in women submitted to elective gynecological surgery. METHODS: A cohort study was carried out among women submitted to gynecological surgery after urinary catheterization. This study took place at the "Instituto de Medicina Integral Professor

  6. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital

    Directory of Open Access Journals (Sweden)

    Ali Salah K

    2011-01-01

    Full Text Available Abstract Background Urinary tract infections (UTI can lead to poor maternal and perinatal outcomes. Investigating epidemiology of UTI and antibiotics sensitivity among pregnant women is fundamental for care-givers and health planners. Methods A cross sectional study has been conducted at Khartoum north teaching hospital Antenatal Care Clinic between February-June 2010, to investigate epidemiology of UTI and antibiotics resistance among pregnant women. Structured questionnaires were used to gather data from pregnant women. UTI was diagnosed using mid stream urine culture on standard culture media Results Out of 235 pregnant women included, 66 (28.0% were symptomatic and 169 (71.9% asymptomatic. the prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were (12.1%, and (14.7% respectively, with no significant difference between the two groups (P = 0.596, and the overall prevalence of UTI was (14.0%. In multivariate analyses, age, gestational age, parity, and history of UTI in index pregnancy were not associated with bacteriuria. Escherichia coli (42.4% and S. aureus (39.3% were the commonest isolated bacteria. Four, 2, 2, 3, 4, 2 and 0 out of 14 E. coli isolates, showed resistance to amoxicillin, naladixic acid, nitrofurantoin, ciprofloxacin, co-trimoxazole, amoxicillin/clavulanate and norfloxacin, respectively Conclusion Escherichia coli were the most prevalent causative organisms and showing multi drug resistance pattern, asymptomatic bacteriuria is more prevalent than symptomatic among pregnant women. Urine culture for screening and diagnosis purpose for all pregnant is recommended.

  7. Foodborne norovirus outbreak: the role of an asymptomatic food handler

    Directory of Open Access Journals (Sweden)

    Pintó Rosa

    2010-09-01

    Full Text Available Abstract Background In July 2005 an outbreak of acute gastroenteritis occurred on a residential summer camp in the province of Barcelona (northeast of Spain. Forty-four people were affected among residents and employees. All of them had in common a meal at lunch time on 13 July (paella, round of beef and fruit. The aim of this study was to investigate a foodborne norovirus outbreak that occurred in the residential summer camp and in which the implication of a food handler was demonstrated by laboratory tests. Methods A retrospective cohort study was designed. Personal or telephone interview was carried out to collect demographic, clinical and microbiological data of the exposed people, as well as food consumption in the suspected lunch. Food handlers of the mentioned summer camp were interviewed. Ten stool samples were requested from symptomatic exposed residents and the three food handlers that prepared the suspected food. Stools were tested for bacteries and noroviruses. Norovirus was detected using RT-PCR and sequence analysis. Attack rate, relative risks (RR and its 95% confidence intervals (CI were calculated to assess the association between food consumption and disease. Results The global attack rate of the outbreak was 55%. The main symptoms were abdominal pain (90%, nausea (85%, vomiting (70% and diarrhoea (42.5%. The disease remitted in 24-48 hours. Norovirus was detected in seven faecal samples, one of them was from an asymptomatic food handler who had not eaten the suspected food (round of beef, but cooked and served the lunch. Analysis of the two suspected foods isolated no pathogenic bacteria and detected no viruses. Molecular analysis showed that the viral strain was the same in ill patients and in the asymptomatic food handler (genotype GII.2 Melksham-like. Conclusions In outbreaks of foodborne disease, the search for viruses in affected patients and all food handlers, even in those that are asymptomatic, is essential. Health

  8. Education, individual time preferences, and asymptomatic disease detection.

    Science.gov (United States)

    Kim, Younoh; Radoias, Vlad

    2016-02-01

    Asymptomatic conditions such as hypertension are generally hard to diagnose, absent routine medical examinations. This is especially problematic in developing countries, where most citizens do not engage in routine examinations due to limited economic resources. We study the roles of education and individual time preferences in asymptomatic disease detection and management. Using discrete choice models on a sample of 4209 hypertensive Indonesian adults surveyed between November 2007 and April 2008, we find that both education and individual time preferences play important roles. However, the effects are different for people in good health than they are for people in bad health. Education does not seem to matter for disease detection when respondents are in good general health, and its effects on disease management vary largely in magnitudes between these groups. In terms of disease detection, more educated respondents have a higher probability of being diagnosed, but only conditional on being in poor general health. Time preferences, on the other hand, matter for respondents in good general health, but the effect is not significant for those in bad health. More impatient respondents that are in good health have a higher probability of being under-diagnosed because they are more likely to forgo routine physicals. The findings point to two distinct channels through which education can affect health, and suggest that different types of policies need to be implemented, in order to reach the entire population. Traditional programs that stimulate education and improve the socio-economic status of individuals in developing countries are helpful, but they do not address the whole problem. Besides its more usual positive effects, education can also negatively affect the health of asymptomatic patients, because it reflects a higher opportunity cost of engaging in preventative health screenings.

  9. Characterization of M2 antibodies in asymptomatic Chinese population

    Institute of Scientific and Technical Information of China (English)

    Xiao-Hua Jiang; Ren-Qian Zhong; Xiao-Yun Fan; Yin Hu; Feng An; Jian-Wen Sun; Xian-Tao Kong

    2003-01-01

    AIM: To investigate the presence of M2 antibodies specific for pdmary biliary cirrhosis (PBC) in asymptomatic Chinese and identify patients with early PBC.METHODS: Enzyme-linked immunosorbent assay (ElISA)tests for M2 antibodies to recombinant protein were performed in 5 011 subjects (age range, 26-85 years; mean age: 45.81±15.02 years) who took an annual physical examination. M2-positive subjects were further analyzed for immunoglobulin (Ig) classes and subclasses of M2 antibodies.Clinical, biochemical and immunological data were obtained for M2-positive subjects. In addition, ultrasonography (US)or endoscopic retrograde cholangio-pancreatography (ERCP)was performed to exclude any disorders other than PBC.RESULTS: M2 antibodies were detected in 8 (0.16%) of the 5 0LL subjects studied. Of the 8 subjects, 7 were female and 1 was male (age range: 40-74 years). An unexplained increase of serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (γ-GT) values, often to striking levels,was detected in 4 M2-positive subjects, 3 of them accorded with the diagnostic criteria recommended by the American Association for the Study of Liver Diseases, even though they had no symptoms of PBC (such as fatigue, pruritus or jaundice).Liver biopsy was performed in two M2-positive subjects and the histology was compatible with PBC in both cases.CONCLUSION: Our data, while not assessing the true prevalence of asymptomatic PBC in the general population,suggest that asymptomatic PBC is much more common in China than has been supposed.

  10. Coexistence of disseminated granuloma annulare and asymptomatic multiple myeloma

    Directory of Open Access Journals (Sweden)

    Şebnem Aktan

    2013-09-01

    Full Text Available Granuloma annulare (GA is a benign inflammatory dermatosis of unknown cause, characterized by necrobiotic dermal papules. Several morphologic forms of GA including localized, disseminated, linear, nodular, perforating, subcutaneous, pustular and arcuate dermal erythema have been reported in the literature. Disseminated GA, a rarely seen form, has been reported in association with some hematopoietic and solid malignancies; however, it has been suggested that the exact causative relationship between malignancy and GA is unclear. We present here a 66-year-old female patient with disseminated GA associated with asymptomatic multipl myeloma.

  11. MRI cervical spine findings in asymptomatic fighter pilots.

    Science.gov (United States)

    Petrén-Mallmin, M; Linder, J

    1999-12-01

    MRI of the cervical spine for evaluation concerning degenerative lesions was performed on asymptomatic experienced military high performance aircraft pilots (mean age 42 yr with mean accumulated flying time of 2600 h), and for comparison on age-matched controls without military flying experience. Young military high performance aircraft pilots (mean age 23 yr with 220 h of flying per person) were also examined. There were significantly more osteophytes, disk protrusions, compressions of the spinal cord and foraminal stenoses in the experienced pilots than in the age-matched controls. Low frequency of low grade degenerative lesions was found in the young and inexperienced pilots.

  12. Incidental finding of a giant asymptomatic right atrial tumor

    Science.gov (United States)

    Strecker, Thomas; Agaimy, Abbas; Zelzer, Peter; Weyand, Michael; Wachter, David Lukas

    2014-01-01

    Primary cardiac tumors are very rare, atrial myxoma being the most common benign tumor of the heart. They may present with a great variety of incidental asymptomatic masses to severe life-threatening cardiovascular complications necessitating emergency surgery. Here we report the diagnostic evaluation and successful surgical resection of such a giant cardiac tumor which was found on a routine medical check-up in a 62-year-old patient. Histology confirmed diagnosis of unusually huge myxoma. This article demonstrates it’s necessary to include cardiac tumors in the differential diagnosis of subtle and non-specific cardiothoracic symptoms. PMID:25120848

  13. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, T. [Department of Neurology, CN Centre, All India Institute of Medical Sciences, New Delhi (India); Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India); Kochar, D.K. [Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India)

    2003-10-01

    Spinal arachnoiditis is one of the common and disabling complication of tuberculous meningitis (TBM). We focused on early diagnosis of spinal arachnoiditis by spinal MRI in asymptomatic patients in whom neurological examination was normal. We studied 16 patients with a diagnosis of probable or highly probable TBM with symptoms for less than 1 month; three had radiological evidence of spinal arachnoiditis. High cerebrospinal fluid protein appeared to be a risk factor for development of spinal arachnoiditis. MRI is sensitive to detect early spinal arachnoiditis. Earlier diagnosis may be helpful in management of spinal arachnoiditis in TBM. (orig.)

  14. Asymptomatic leukemic-cell infiltration of the pancreas: US findings.

    Science.gov (United States)

    Collado, Laura; Dardanelli, Esteban; Sierre, Sergio; Moguillansky, Silvia; Lipsich, José

    2011-06-01

    Pancreatic infiltration of leukemic cells is a very rare manifestation at the onset of acute lymphoblastic leukemia (ALL) in childhood. Pancreatic enlargement in this situation is unusual and pancreatic involvement is often associated with biliary obstruction, cholestasis and pancreatitis. We report a 3-month-old girl who presented with asymptomatic leukemic infiltration of the pancreas, demonstrated by US with heterogeneous pancreatic enlargement associated with multiple hypoechogenic lesions, without cholestasis. Although these manifestations are rare, ALL should be considered a cause of pancreatic enlargement.

  15. Articulated dental cast analysis of asymptomatic and symptomatic populations

    Science.gov (United States)

    Cordray, Frank E

    2016-01-01

    Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

  16. Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy.

    Science.gov (United States)

    Sung, Jia-Ying; Tani, Jowy; Chang, Tsui-San; Lin, Cindy Shin-Yi

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (Pmotor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (Pdevelopment of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches.

  17. Management of Asymptomatic Erosive Esophagitis: An E-Mail Survey of Physician's Opinions

    OpenAIRE

    Lim, Seong Woo; Lee, Jun Haeng; Kim, Jie-Hyun; Kim, Jeong Hwan; Kim, Heung Up; Jeon, Seong Woo

    2013-01-01

    Background/Aims The management of asymptomatic erosive esophagitis is controversial. We surveyed physicians' opinions on asymptomatic erosive esophagitis using e-mail. Methods All members of the Korean Society of Neurogastro-enterology and Motility were invited to answer the questionnaire on the treatment and follow-up of patients with asymptomatic erosive esophagitis by e-mail. Results A total of 73 members answered the questionnaire (response rate, 18%). As initial management, 41% of respon...

  18. Evaluation of microalbuminuria in relation to asymptomatic bacteruria in Nigerian patients with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    B A Iwalokun

    2012-01-01

    Full Text Available Studies have identified microalbuminuria (MA and asymptomatic bacteruria (ASB as co-morbid factors in sickle cell anemia (SCA. However, the relationship between these comorbid factors remains unclear and data are lacking for Nigerian patients. This study determined the prevalence of MA and ASB in a cohort of patients with SCA in a steady state, in Lagos, Nigeria. Early morning mid-stream urine samples were collected in sterile bottles from 103 patients comprising 48 males and 55 females with a mean age of 10.4 years. Aerobic culture and colony count of organisms was done using conventional methods. Serum creatinine and hematological indices, including irreversibly sickled cells (ISC, were also assayed. Of the 103 urine samples screened, 23 (22.3% had albuminuria (ALB, and consisted of nine males and 14 females (P > 0.05; 16.5% of the cases had MA (P 0.05. The prevalence of confirmed ASB was 14.6%, with females accounting for 14 of 19 probable ASB cases (P <0.05. Univariate regression analysis demonstrated a significant (P <0.05 association between age at onset of MA, hemoglobin level, reticulocyte count, ISC and occurrence of ASB, but with only ISC evolving as an independent predictor. Twenty-eight bacterial isolates predominated by Escherichia coli (39.3%; P <0.05, of whom 89.3% were multi-drug resistant, were recovered from the ASB urine samples. In conclusion, both MA and ASB are common in Nigerian SCA patients, with the former occurring from the first decade of life.

  19. Basal longitudinal strain predicts future aortic valve replacement in asymptomatic patients with aortic stenosis

    DEFF Research Database (Denmark)

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian

    2016-01-01

    of myocardial dysfunction and predictors of outcome in asymptomatic aortic stenosis. Aortic stenosis and ischaemic heart disease share risk factors and longitudinal function can be severely reduced in both conditions, why some of the previous findings of impaired regional longitudinal function in asymptomatic...... aortic stenosis could in fact be explained by silent ischaemic heart disease. METHODS AND RESULTS: Prospective follow-up of 104 asymptomatic patients with moderate-severe aortic stenosis defined as an aortic valve area ...: In contrast to GLS, reduced BLS is a significant predictor of future AVR in asymptomatic patients with aortic stenosis, independently of clinical characteristics, conventional echocardiographic measures, and coronary pathology....

  20. Magnetic resonance imaging features of asymptomatic bipartite patella

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, J., E-mail: juliemobrien@gmail.com [Department of Radiology, Adelaide and Meath Incorporating National Children' s Hospital, Tallaght, Dublin 24 (Ireland); Murphy, C.; Halpenny, D.; McNeill, G.; Torreggiani, W.C. [Department of Radiology, Adelaide and Meath Incorporating National Children' s Hospital, Tallaght, Dublin 24 (Ireland)

    2011-06-15

    Objective: The purpose of our study was to describe the magnetic resonance imaging (MRI) features of bipartite patella in asymptomatic patients. Materials and methods: The study was prospective in type and performed following institutional ethical committees approval. In total, 25 subjects were recruited into the study and informed consent obtained in each case. The local radiology database was utilised in conjunction with a clinical questionnaire to identify patients who had asymptomatic bipartite patella. Any patient with a history of trauma or symptomatic disease was excluded from the study. MRI imaging was performed in each case on a 1.5 T system using a dedicated knee coil and a standardised knee protocol. The images obtained were then analysed by two musculoskeletal radiologists in consensus. Results: Of the 25 subjects, there were 8 females and 17 males. The mean age was 34.6 years. All but one of the bipartite fragments were located on the superolateral aspect of the patella. In 23 cases, one fragment was identified. The average transverse diameter of the fragment was 12.8 mm. The average distance between the fragment and the adjacent patella in the axial plane was 1.46 mm. In addition, the cartilage overlying the patella and accessory fragment was intact in all cases. The average thickness of the patella cartilage at its border to the fragment was 2.4 mm with an average ratio of the cartilage thickness of the fragment as compared with the cartilage thickness of the patella of 0.72. There was no evidence of high signal or bone marrow oedema on fluid sensitive sequences within either the patella or the fragment in any of the patients. Fluid was identified in the cleft between the patella and the fragment in the majority of cases. Conclusions: Asymptomatic bipartite patella is characterised by intact but thinned cartilage along the border between the patella and the fragment, fluid between the cleft and a lack of any bone marrow oedema or high signal within

  1. Cardiotoxicity in Asymptomatic Patients Receiving Adjuvant 5-fluorouracil

    DEFF Research Database (Denmark)

    Nielsen, Karin; Polk, Anne; Nielsen, Dorte Lisbet

    2014-01-01

    Evolving evidence of cardiotoxicity in cancer patients treated with 5-fluorouracil (5-FU) has been reported. We report two different clinical manifestations of asymptomatic 5-FU-associated cardiotoxicity in patients operated for colorectal cancer and treated with adjuvant chemotherapy of 5-FU...... (bolus-injection and continuous infusion for 46 hours), folinic acid and oxaliplatin (FOLFOX). For a research study evaluating cardiac events during 5-FU treatment, Holter monitoring, electrocardiogram (ECG) and echocardiography were done and cardiac markers monitored before and during the first...... and hyperlipidemia as well as an incidental finding of negative T-waves in electrocardiogram years before 5-FU treatment. No subjective cardiac symptoms were described during infusion, but approximately 12 hours after infusion she suffered from cardiac arrest but was revived. Subsequent analysis of the Holter...

  2. Genetic testing in asymptomatic minors: background considerations towards ESHG Recommendations

    DEFF Research Database (Denmark)

    Borry, Pascal; Evers-Kiebooms, Gerry; Cornel, Martina C;

    2009-01-01

    Although various guidelines and position papers have discussed, in the past, the ethical aspects of genetic testing in asymptomatic minors, the European Society of Human Genetics had not earlier endorsed any set of guidelines exclusively focused on this issue. This paper has served as a background...... document in preparation of the development of the policy recommendations of the Public and Professional Committee of the European Society of Human Genetics. This background paper first discusses some general considerations with regard to the provision of genetic tests to minors. It discusses the concept...... of best interests, participation of minors in health-care decisions, parents' responsibilities to share genetic information, the role of clinical genetics and the health-care system in communication within the family. Second, it discusses, respectively, the presymptomatic and predictive genetic testing...

  3. Colon perforation after esophagogastroduodenoscopy in an asymptomatic diverticulitis patient

    Directory of Open Access Journals (Sweden)

    Li-Wen Huang

    2016-03-01

    Full Text Available Esophagogastroduodenoscopy (EGD is regarded as a relatively safe procedure; however, it carries a very low incidence of severe adverse events. Perforation is a rare complication of EGD, and it may further lead to pneumoperitoneum or pneumoretroperitoneum. The occurrence of large bowel perforation after EGD is extremely rare, and it has never been reported in the international literature. Herein, we present a case of concurrence of pneumoperitoneum and pneumoretroperitoneum as a result of sigmoid perforation after EGD. In our case, the probable mechanism of the perforation may have stemmed from the excessive inflation of air that passed through the gastrointestinal tract to the sigmoid colon, causing the increased intraluminal pressure, and then prompting a healed asymptomatic diverticulitis leak again.

  4. Effect of occlusion on joint sounds in asymptomatic individuals.

    Science.gov (United States)

    Garcia, Alício Rosalino; Zuim, Paulo R Junqueira; Goiato, Marcelo Coelho; dos Santos, Paulo H; Ribeiro, Adriana Barbosa; Pita, Murillo Sucena; Flacón-Antenucci, Rosse M

    2008-01-01

    Occlusion is a predisposing factor for Temporomandibular Dysfunctions (TMD) of the joint, whose first sign and/or symptom is usually joint sound. To verify the effect of occlusion on joint sounds, temporomandibular joints (TMJ) were analyzed in 78 asymptomatic individuals with various dental conditions. Electrosonography was used to determine the intensity of the vibration in the temporomandibular joint (TMJ) on opening and closing the mouth. Transducers (piezoelectric accelerometer) were placed on the right and left joints. Results were tabled and analyzed using the Kruskal-Wallis test (a=0.05). It was concluded that TMJ vibration in partly edentulous individuals from Kennedy classes I, II and III is statistically higher than in dentate and fully edentulous subjects.

  5. Management of asymptomatic gene carriers of transthyretin familial amyloid polyneuropathy.

    Science.gov (United States)

    Schmidt, Hartmut H-J; Barroso, Fabio; González-Duarte, Alejandra; Conceição, Isabel; Obici, Laura; Keohane, Denis; Amass, Leslie

    2016-09-01

    Transthyretin familial amyloid polyneuropathy (TTR-FAP) is a rare, severe, and irreversible, adult-onset, hereditary disorder caused by autosomal-dominant mutations in the TTR gene that increase the intrinsic propensity of transthyretin protein to misfold and deposit systemically as insoluble amyloid fibrils in nerve tissues, the heart, and other organs. TTR-FAP is characterized by relentless, progressively debilitating polyneuropathy, and leads to death, on average, within 10 years of symptom onset without treatment. With increased availability of disease-modifying treatment options for a wider spectrum of patients with TTR-FAP, timely detection of the disease may offer substantial clinical benefits. This review discusses mutation-specific predictive genetic testing in first-degree relatives of index patients diagnosed with TTR-FAP and the structured clinical follow-up of asymptomatic gene carriers for prompt diagnosis and early therapeutic intervention before accumulation of substantial damage. Muscle Nerve 54: 353-360, 2016.

  6. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

    Directory of Open Access Journals (Sweden)

    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  7. Elevated creatine kinase and transaminases in asymptomatic SBMA.

    Science.gov (United States)

    Sorenson, Eric J; Klein, Christopher J

    2007-02-01

    X-linked spinal and bulbar muscular atrophy (SBMA or Kennedy's disease) has a variable prognosis. Most male carriers are affected by their fourth or fifth decade of life, while some remain asymptomatic lifelong. Elevations of serum creatine kinase are well known to occur in clinically manifesting SBMA patients. Elevations prior to the onset of the clinical syndrome have not been reported. Here we report two cases of SBMA presenting with 'idiopathic' elevations of serum transaminases and creatine kinase a decade in advance of their symptomatic onset. These cases emphasize the need to consider SBMA and genetic testing for the androgen receptor trinucleotide CAG expansion in males otherwise healthy with 'idiopathic' elevated creatinine kinase.

  8. Asymptomatic brain tumor detected at brain check-up

    Energy Technology Data Exchange (ETDEWEB)

    Onizuka, Masanari; Suyama, Kazuhiko; Shibayama, Akira; Hiura, Tsuyoshi; Horie, Nobutaka; Miyazaki, Hisaya [Sankoukai Miyazaki Hospital, Isahaya, Nagasaki (Japan)

    2001-09-01

    Brain check-up was performed in 4000 healthy subjects who underwent medical and radiological examinations for possible brain diseases in our hospital from April 1996 to March 2000. Magnetic resonance imaging revealed 11 brain tumors which consisted of six meningiomas, three pituitary adenomas, one astrocytoma, and one epidermoid cyst. The detection rate of incidental brain tumor in our hospital was 0.3%. Nine patients underwent surgery, with one case of morbidity due to postoperative transient oculomotor nerve paresis. The widespread use of brain check-up may increasingly detect asymptomatic brain tumors. Surgical indications for such lesions remain unclear, and the strategy for treatment should be determined with consideration of the patient's wishes. (author)

  9. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection

    DEFF Research Database (Denmark)

    Lundgren, Jens D; Babiker, Abdel G; Gordin, Fred

    2015-01-01

    BACKGROUND: Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus (HIV) infection who have a CD4+ count of more than 350 cells per cubic millimeter. METHODS: We randomly assigned HIV...... entry, the median HIV viral load was 12,759 copies per milliliter, and the median CD4+ count was 651 cells per cubic millimeter. On May 15, 2015, on the basis of an interim analysis, the data and safety monitoring board determined that the study question had been answered and recommended that patients...... per cubic millimeter provided net benefits over starting such therapy in patients after the CD4+ count had declined to 350 cells per cubic millimeter. (Funded by the National Institute of Allergy and Infectious Diseases and others; START ClinicalTrials.gov number, NCT00867048.)....

  10. Timing of testing and treatment for asymptomatic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kırkızlar, Eser [State Univ. of New York (SUNY), Plattsburgh, NY (United States); Faissol, Daniel M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Griffin, Paul M. [Pennsylvania State Univ., State College, PA (United States); Swann, Julie L. [Georgia Inst. of Technology, Atlanta, GA (United States)

    2010-07-01

    Many papers in the medical literature analyze the cost-effectiveness of screening for diseases by comparing a limited number of a priori testing policies under estimated problem parameters. However, this may be insufficient to determine the best timing of the tests or incorporate changes over time. In this paper, we develop and solve a Markov Decision Process (MDP) model for a simple class of asymptomatic diseases in order to provide the building blocks for analysis of a more general class of diseases. We provide a computationally efficient method for determining a cost-effective dynamic intervention strategy that takes into account (i) the results of the previous test for each individual and (ii) the change in the individual’s behavior based on awareness of the disease. We demonstrate the usefulness of the approach by applying the results to screening decisions for Hepatitis C (HCV) using medical data, and compare our findings to current HCV screening recommendations.

  11. Intramural leiomyomas of the bladder in asymptomatic men

    Directory of Open Access Journals (Sweden)

    Roberto I. Lopes

    2003-06-01

    Full Text Available Bladder leiomyomas are rare benign mesenchymal tumors, which account for less than 0.43% of all bladder tumors with approximately 200 cases described in the literature. These tumors may be classified into 3 different locations: endovesical, intramural and extravesical. Endovesical is the most common form, accounting for 63-86% of the cases, while intramural occurs in 3-7% and extravesical in 11-30%. The intramural form, especially small tumors, may not produce symptoms hardening detection. We report two cases of intramural bladder leiomyomas in asymptomatic men observed incidentally by transabdominal ultrasonography during the follow-up of benign prostatic hyperplasia. We discuss the diagnosis and management of these lesions.

  12. Asymptomatic giant coronary aneurysm in an adolescent with Behcet's syndrome

    Directory of Open Access Journals (Sweden)

    Kahn Philip J

    2012-01-01

    Full Text Available Abstract Objective Behcet's is an idiopathic multi-organ syndrome, which may have onset during childhood. Vascular involvement is uncommon, with rarely reported coronary aneurysm formation. We present a case report of a teenager girl who developed recalcitrant life-threatening Behcet's vasculitis, involving both small and large venous and arterial systems including a giant coronary aneurysm. Case report De-identified data were collected retrospectively in case report format. Although our sixteen year old female with Behcet's vasculitis had resolution of many arterial aneurysms, she had persistent venous thrombosis of large vessels, as well as persistent, giant arterial aneurysms requiring intra-arterial coiling of a lumbar artery and coronary bypass grafting despite intensive immunosuppression including glucocorticoids, cyclophosphamide, infliximab, methotrexate, azathioprine and intravenous immunoglobulin. Conclusions Vascular manifestations may be seen in Behcet's syndrome, including asymptomatic coronary aneurysm, which may be refractory to immunosuppression and ultimately require surgical intervention. Increased awareness is essential for prompt diagnosis and management.

  13. Asymptomatic ileal adenocarcinoma in the setting of undiagnosed Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Vikram B Reddy; Harold Aslanian; Namsoo Suh; Walter E Longo

    2008-01-01

    A 53-year old previously healthy male underwent a screening colonoscopy for detection of a potential colorectal neoplasm. The terminal ileum was intubated and a mass was noted. Examination of the colon was normal. The biopsy of the ileal mass was consistent with an adenocarcinoma arising from the terminal ileum. His father who had never been previously ill from gastrointestinal disease died of natural causes,but was found to have Crohn's disease postmortem.The patient underwent exploratory laparotomy and aright hemicolectomy with a 30 cm section of terminal ileum in continuity. Findings were consistent with ileal adenocarcinoma in the setting of Crohn's disease. Thepatient made an uneventful recovery. The pathology was stage 1 adenocarcinoma. This is a unique case in that on a screening colonoscopy, a favorable ileal adenocarcinoma was discovered in the setting of asymptomatic, undiagnosed ileal Crohn's disease in a patient whose father had Crohn's disease diagnosed postmortem.

  14. Asymptomatic Cholecystocolonic Fistula: A Diagnostic and Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Nicola Antonacci

    2013-01-01

    Full Text Available Cholecystocolonic fistulas (CCF are rare complications of gallstones with a variable clinical presentation. Despite modern diagnostic tools, cholecystocolonic fistulas are often asymptomatic and it is difficult to diagnose them preoperatively. Biliary-enteric fistulae have been found in 0.9% of patients undergoing biliary tract surgery. The most common site of communication of the fistula is the cholecystoduodenal (70%, followed by the cholecystocolic (10–20%, and the least common is the cholecystogastric fistula. Herein, we report a case of female patient with multiple episodes of acute recurrent cholangitis due to common bile duct and gallbladder stones in which preoperative imaging studies were negative for cholecystocolonic fistula that was incidentally discovered and treated during surgery and was appropriately treated. A review of the literature is reported too.

  15. Prevalence of asymptomatic coronary disease in fibrosing idiopathic interstitial pneumonias

    Energy Technology Data Exchange (ETDEWEB)

    Cassagnes, Lucie; Gaillard, Vianney [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Monge, Emmanuel [Department of Pulmonology, Center of Competence for Rare Pulmonary Diseases, Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Faivre, Jean-Baptiste [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Delhaye, Cédric [Department of Cardiology, Cardiology Hospital, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Molinari, Francesco [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Petyt, Grégory; Hossein-Foucher, Claude [Department of Nuclear Medicine, Hospital Salengro, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Wallaert, Benoit [Department of Pulmonology, Center of Competence for Rare Pulmonary Diseases, Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Duhamel, Alain [Department of Medical Statistics (EA 2694), Univ Lille Nord de France, F-59000 Lille (France); Remy, Jacques [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France); Remy-Jardin, Martine, E-mail: martine.remy@chru-lille.fr [Department of Thoracic Imaging (EA 2694), Hospital Calmette, CHRU and Univ Lille 2 Nord de France, F-59000 Lille (France)

    2015-01-15

    Background: Because of growing body of interest on the association between fibrosing idiopathic interstitial pneumonias (f-IIP) and ischaemic heart disease, we initiated this prospective study to evaluate the prevalence of asymptomatic coronary artery disease (CAD) in patients with f-IIP. Methods: Forty-two patients with f-IIP underwent noninvasive screening for CAD that included (a) a chest CT examination enabling calculation of the coronary artery calcium (CAC) score, then depiction of coronary artery stenosis; and (b) stress myocardial perfusion scintigraphy (MPS). Patients with significant coronary abnormalities, defined by a CAC score >400 or coronary artery stenosis >50% at CT and/or perfusion defect >5% at MPS, were referred to the cardiologist. Coronary angiography was indicated in presence of a perfusion defect >10% at MPS or significant left main or proximal left anterior descending stenosis whatever MPS findings. Results: Combining CT and MPS, significant abnormalities were detected in 32/42 patients (76%). The cardiologist: (a) did not consider further investigation in 21 patients (CT abnormalities but no ischaemia at MPS: 12/21; false-positive findings at MPS: 3/21; poor respiratory condition: 6/21); (b) proceeded to coronary angiography in 11 patients which confirmed significant stenoses in 5 patients (5/42; 12%). In the worst-case-scenario (i.e., inclusion of 6 patients with significant coronary artery abnormalities who were not investigated due to poor respiratory condition), the prevalence of CAD reached 26% (11/42). Conclusion: In the studied population of patients with f-IIP, asymptomatic CAD ranged between 12% and 26%.

  16. Echocardiographic findings in asymptomatic systemic lupus erythematosus patients.

    Science.gov (United States)

    Mohammed, Abdel GaffarA; Alghamdi, Abdulaziz A; ALjahlan, Mohammad A; Al-Homood, Ibrahim A

    2017-03-01

    The aim of this study is to use transthoracic echocardiographic (TTE) imaging methods to identify cardiac dysfunction in asymptomatic systemic lupus erythematosus (SLE) patients and to determine the association between echocardiographic findings and serology. This is a prospective cross-sectional study where 50 patients with confirmed diagnoses of SLE were recruited from rheumatology outpatient clinics. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. Fifty SLE patients, 46 (92%) females and 4 (8%) males, were recruited. Anti-double-stranded DNA (Anti-dsDNA), anticardiolipin, lupus anticoagulant, and anti-β2-glycoproteins were positive in 52.1, 32.6, 13.3, and 15.6%, respectively. Transthoracic echocardiogram revealed mitral regurgitation in 16 patients (32%), pericardial effusion in16 patients (32%), aortic regurgitation in five patients (10%), and tricuspid regurgitation in 10 patients (20%). Eleven patients had left ventricular hypertrophy (22%), and eight patients had ventricular systolic dysfunction (16%). Only four patients had ventricular diastolic dysfunction (8%). A significant association between mitral and tricuspid valve regurgitation and positive anti-dsDNA (p lupus anticoagulant, and anti-β 2 glycoprotein antibodies were also associated with mitral valve regurgitation (p values 0.044, 0.006, and 0.023), respectively. Active disease assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was found to be associated with increased risk of mitral valvular leaflet thickening (p value 0.028). Performing regular transthoracic echocardiogram in asymptomatic SLE patients is important for early detection and appropriate treatment of cardiac lesions. Clinically quiescent but serologically active disease and presence of antiphospholipid antibodies were associated with structural heart abnormalities.

  17. Asymptomatic Meckel′s diverticulum in adults: Is diverticulectomy indicated?

    Directory of Open Access Journals (Sweden)

    Tauro Leo

    2010-01-01

    Full Text Available Background/Aim: The objective of this study was to estimate the incidence of the Meckel′s diverticulum (MD and to study its clinical profile and surgical outcome, as well as to check whether diverticulectomy is indicated for asymptomatic MD in adults. Materials and Methods: This is a prospective study of 1332 patients who were operated upon for acute abdomen during the period August 1999 to July 2009 in a single surgical unit. Preoperative abdominal ultrasonography and plain x-ray abdomen (erect were done depending on the necessity. These patients were subjected to laparotomy/ appendicectomy depending on the case. A search for MD was done, and if found, surgical resection and analysis by histopathological confirmation of the resected MD were performed. Results: During the operation, this study detected 15 (1.13% patients with MD. In none of these cases, preoperative diagnosis of Meckel′s diverticulitis was made. The age of the patients ranged from 18 to 68 years (mean age, 32.9 years. Out of 15 patients, 9 (60% were males; 6 (40% were females. Seven (46.7% cases were symptomatic due to MD and 8 (53.3% were asymptomatic. One patient presented with hematochezia; 2, with intestinal obstruction due to gangrene of the MD; and 4, with Meckel′s diverticulitis. One patient had duplication of (double Meckel′s diverticulum without any inflammation in both the diverticulae. Histopathological examination of these specimens confirmed 4 cases with inflammation; 2, with gangrene; and 1, with ulcerated gastric mucosa in the MD. Among these, in 2 (13.3% cases there was heterotopic epithelium (ulcerated gastric mucosa- 1, colonic mucosa- 1. Conclusion: We recommend that a search for MD in every case of appendicectomy/ laparotomy done for acute abdomen should be conducted, and if found, Meckel′s diverticulectomy or resection should be performed to avoid secondary complications arising from it.

  18. Screening and Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

    Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen

    2017-01-01

    Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

  19. Nonalcoholic fatty liver disease in asymptomatic Brazilian adolescents

    Institute of Scientific and Technical Information of China (English)

    Raquel Rocha; Helma Pinchemel Cotrim; Almir Galv(a)o Vieira Bitencourt; Daniel Batista Valente Barbosa; Adméia Souza Santos; Alessandro de Moura Almeida; Bruno Cunha; Isabel Guimar(a)es

    2009-01-01

    AIM: To evaluate the prevalence and clinical characteristics of Nonalcoholic fatty liver disease (NAFLD) among asymptomatic Brazilian adolescents.METHODS: Transversal observational study included asymptomatic adolescents with central obesity from private and public schools in Salvador-Bahia, northeastern Brazil. The children answered a questionnaire that included age, gender, race, and medical history, and were submitted to a complete physical exam and abdominal ultrasound. Biochemical exams included: ALT, AST, GGT,C reactive protein (CRP), fasting glucose, insulin, cholesterol and triglycerides. Criteria for NAFLD included: the presence of steatosis in ultrasound and/or high level of ALT, negative or occasional historic of intake of alcohol (≤ 140 g/wk), negative investigation for hepatitis A, B, C,auto-immune hepatitis, Wilson disease and hemochromatosis.RESULTS: From October, 2005 to October, 2006, the study included 1801 subjects between 11 and 18 years of age and a mean age of 13.7±2.0 years.One hundred ninety-nine had central obesity. The prevalence of NAFLD was 2.3%, most of whom were male and white. Insulin resistance (IR) was observed in 22.9% of them and had positive correlations with ALT and GGT ( P < 0.05). Elevated CRP was observed in 6.9% of the cases; however, it was not associated with WC,IR or liver enzymes.CONCLUSION: The prevalence of NAFLD in Brazilian adolescents was low. The ethnicity may have influence this frequency in the population studied, which had a large proportion of African descendents.

  20. Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy

    Science.gov (United States)

    Sung, Jia-Ying; Tani, Jowy; Chang, Tsui-San; Lin, Cindy Shin-Yi

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (P<0.05), shortened strength-duration time constant (P<0.01), increased superexcitability (P<0.01), decreased subexcitability (P<0.05), decreased accommodation to depolarizing current (P<0.01), and a trend of decreased accommodation to hyperpolarizing current in threshold electrotonus. All the changes progressed into G1 (TNSr 1–8) and G2+3 (TNSr 9–24) groups. In contrast, motor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (P<0.01) in the G0 group. This study revealed that the development of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches. PMID:28182728

  1. PATHOGENIC ESCHERICHIA COLI

    Science.gov (United States)

    Escherichia coli is a bacterial species which inhabits the gastrointestinal tract of man and warm-blooded animals. Because of the ubiquity of this bacterium in the intestinal flora, it serves as an important indicator organism of fecal contamination. E. coli, aside from serving a...

  2. Escherichia coli O157:H7.

    Science.gov (United States)

    Mead, P S; Griffin, P M

    1998-10-10

    Escherichia coli O157 was first identified as a human pathogen in 1982. One of several Shiga toxin-producing serotypes known to cause human illness, the organism probably evolved through horizontal acquisition of genes for Shiga toxins and other virulence factors. E. coli O157 is found regularly in the faeces of healthy cattle, and is transmitted to humans through contaminated food, water, and direct contact with infected people or animals. Human infection is associated with a wide range of clinical illness, including asymptomatic shedding, non-bloody diarrhoea, haemorrhagic colitis, haemolytic uraemic syndrome, and death. Since laboratory practices vary, physicians need to know whether laboratories in their area routinely test for E. coli O157 in stool specimens. Treatment with antimicrobial agents remains controversial: some studies suggest that treatment may precipitate haemolytic uraemic syndrome, and other studies suggest no effect or even a protective effect. Physicians can help to prevent E. coli O157 infections by counselling patients about the hazards of consuming undercooked ground meat or unpasteurised milk products and juices, and about the importance of handwashing to prevent the spread of diarrhoeal illness, and by informing public-health authorities when they see unusual numbers of cases of bloody diarrhoea or haemolytic uraemic syndrome.

  3. Single-centre experience with mitral valve repair in asymptomatic patients with severe mitral valve regurgitation

    NARCIS (Netherlands)

    W.J. van Leeuwen (Wouter); S.J. Head (Stuart); L.E. de Groot-de Laat (Lotte); M.L. Geleijnse (Marcel); A.J.J.C. Bogers (Ad); L.A. van Herwerden (Lex); A.P. Kappetein (Arie Pieter)

    2013-01-01

    textabstractOBJECTIVES: Guidelines recommend surgical mitral valve repair in selected patients with asymptomatic severe mitral valve regurgitation (MR), but the role of repair remains a matter of debate. Survival analyses of operated asymptomatic patients have been reported, but long-term haemodynam

  4. Insight into alteration of gut microbiota in Clostridium difficile infection and asymptomatic C. difficile colonization.

    Science.gov (United States)

    Zhang, Lihua; Dong, Danfeng; Jiang, Cen; Li, Zhen; Wang, Xuefeng; Peng, Yibing

    2015-08-01

    Clostridium difficile is well recognized as the common pathogen of nosocomial diarrhea, meanwhile, asymptomatic colonization with C. difficile in part of the population has also drawn public attention. Although gut microbiota is known to play an important role in the pathogenesis of C. difficile infection (CDI), whether there is any alteration of gut microbial composition in asymptomatic C. difficile carriers hasn't been clearly described. The purpose of this study was to explore the differences in gut microbiome among CDI patients, asymptomatic C. difficile carriers and healthy individuals. We performed fecal microbiota analysis on the samples of eight CDI patients, eight asymptomatic C. difficile carriers and nine healthy subjects using 16S rRNA gene pyrosequencing. CDI patients and asymptomatic carriers showed reduced microbial richness and diversity compared with healthy subjects, accompanied with a paucity of phylum Bacteroidetes and Firmicutes as well as an overabundance of Proteobacteria. Some normally commensal bacteria, especially butyrate producers, were significantly depleted in CDI patients and asymptomatic carriers. Furthermore, the differences observed in microbial community structure between CDI patients and asymptomatic carriers suggested that the gut microbiota may be a potential factor of disease state for CDI. Our study demonstrates the characterization and diversity of gut microbiota in CDI and asymptomatic C. difficile colonization, which will provide new ideas for surveillance of the disease state and development of microbiota-targeted agents for CDI prevention and treatment.

  5. Infrequency of asymptomatic malaria in an endemic area in Amazonas, Brazil

    Directory of Open Access Journals (Sweden)

    Aluizio Prata

    1988-06-01

    Full Text Available A malaria survey was conducted in an area of high transmission (Costa Marques, Rondonia, Brazil to determine the prevalence of asymptomatic parasitemia and its clinical significance. Most of the people surveyed were immigrants who had lived in the endemic area 2 days, 4 had only gametocytes, 1 had taken inadequate anti-malarial treatment, 3 were under treatment and 2 moved. Six asymptomatic patients denied the use of anti-malarial drugs and they developed malaria 3-6 days after the initial parasitological diagnosis. The final patient remained asymptomatic during the 7 day observation period. He had a history of > 40 malaria attacks and denied the use of antimalarial treatment. With the exception of the latter all of the other asymptomatic patients, were either in the incubation period or had been treated It is concluded that asymptomatic malaria is rare in the Costa Marques area and that it is necessary to treat all individuals with plasmodial parasitemia.

  6. Canine distemper virus detection in asymptomatic and non vaccinated dogs

    Directory of Open Access Journals (Sweden)

    Helen L. Del Puerto

    2010-02-01

    Full Text Available A quantitative real time polymerase chain reaction (PCR revealed canine distemper virus presence in peripheral blood samples from asymptomatic and non vaccinated dogs. Samples from eleven domestic dogs with no signs of canine distemper and not vaccinated at the month of collection were used. Canine distemper virus vaccine samples in VERO cells were used as positive controls. RNA was isolated with Trizol®, and treated with a TURBO DNA-free kit. Primers were designed for canine distemper virus nucleocapsid protein coding region fragment amplification (84 bp. Canine b-actin (93 bp was utilized as the endogenous control for normalization. Quantitative results of real time PCR generated by ABI Prism 7000 SDS Software showed that 54.5% of dogs with asymptomatic canine distemper were positive for canine distemper virus. Dissociation curves confirmed the specificity of the real time PCR fragments. This technique could detect even a few copies of viral RNA and identificate subclinically infected dogs providing accurate diagnosis of this disease at an early stage.A reação em cadeia da polimerase (PCR em tempo real revelou a presença do vírus da cinomose canina em amostra de sangue de cães assintomáticos e não vacinados. Amostra de onze cães domésticos sem nenhum sinal clínico de cinomose e que não foram vacinados no mês da coleta de sangue foram utilizados para análise. Amostra vacinal do vírus da cinomose canina em células VERO foi utilizada como controle positivo. O RNA total foi isolado utilizando-se Trizol®, e tratadas com o Kit TURBO DNA-free. Os iniciadores foram desenhados para amplificar a região do nucleocapsídeo viral com 319pb e 84pb para a PCR convencional e PCR em tempo real, respectivamente. O fragmento alvo da b-actina canina com 93pb foi utilizado como controle endógeno e normalizador. Resultados quantitativos da PCR em tempo real gerados pelo programa ABI Prism 7000 SDS demonstraram que 54,5% dos cães assintom

  7. Atrophy rates in asymptomatic amyloidosis: implications for Alzheimer prevention trials.

    Directory of Open Access Journals (Sweden)

    K Abigail Andrews

    Full Text Available There is considerable interest in designing therapeutic studies of individuals at risk of Alzheimer disease (AD to prevent the onset of symptoms. Cortical β-amyloid plaques, the first stage of AD pathology, can be detected in vivo using positron emission tomography (PET, and several studies have shown that ~1/3 of healthy elderly have significant β-amyloid deposition. Here we assessed whether asymptomatic amyloid-PET-positive controls have increased rates of brain atrophy, which could be harnessed as an outcome measure for AD prevention trials. We assessed 66 control subjects (age = 73.5±7.3 yrs; MMSE = 29±1.3 from the Australian Imaging Biomarkers & Lifestyle study who had a baseline Pittsburgh Compound B (PiB PET scan and two 3T MRI scans ~18-months apart. We calculated PET standard uptake value ratios (SUVR, and classified individuals as amyloid-positive/negative. Baseline and 18-month MRI scans were registered, and brain, hippocampal, and ventricular volumes and annualized volume changes calculated. Increasing baseline PiB-PET measures of β-amyloid load correlated with hippocampal atrophy rate independent of age (p = 0.014. Twenty-two (1/3 were PiB-positive (SUVR>1.40, the remaining 44 PiB-negative (SUVR≤1.31. Compared to PiB-negatives, PiB-positive individuals were older (76.8±7.5 vs. 71.7±7.5, p<0.05 and more were APOE4 positive (63.6% vs. 19.2%, p<0.01 but there were no differences in baseline brain, ventricle or hippocampal volumes, either with or without correction for total intracranial volume, once age and gender were accounted for. The PiB-positive group had greater total hippocampal loss (0.06±0.08 vs. 0.02±0.05 ml/yr, p = 0.02, independent of age and gender, with non-significantly higher rates of whole brain (7.1±9.4 vs. 4.7±5.5 ml/yr and ventricular (2.0±3.0 vs. 1.1±1.0 ml/yr change. Based on the observed effect size, recruiting 384 (95%CI 195-1080 amyloid-positive subjects/arm will provide 80% power to detect 25

  8. Dynamic magnetic resonance defecography in 10 asymptomatic volunteers

    Institute of Scientific and Technical Information of China (English)

    Andreas G Schreyer; Christian Paetzel; Alois Fürst; Lena M Dendl; Elisabeth Hutzel; René Müller-Wille; Philipp Wiggermann

    2012-01-01

    AIM:Evaluation of the wide range of normal findings in asymptomatic women undergoing dynamic magnetic resonance (MR) defecography.METHODS:MR defecography of 10 healthy female volunteers (median age:31 years) without previous pregnancies or history of surgery were evaluated.The rectum was filled with 180 mL gadolinium ultrasound gel mixture.MR defecography was performed in the supine position.The pelvic floor was visualized with a dynamic T2-weighted sagittal plane where all relevant pelvic floor organs were acquired during defecation.The volunteers were instructed to relax and then to perform straining maneuvers to empty the rectum.The pubococcygeal line (PCGL) was used as the line of reference.The movement of pelvic floor organs was measured as the vertical distance to this reference line.Data were recorded in the resting position as well as during the defecation process with maximal straining.Examinations were performed and evaluated by two experienced abdominal radiologists without knowledge of patient history.RESULTS:Average position of the anorectal junction was located at-5.3 mm at rest and-29.9 mm during straining.The anorectal angle widened significantly from 93° at rest to 109° during defecation.A rectocele was diagnosed in eight out of 10 volunteers showing an average diameter of 25.9 mm.The bladder base was located at a position of +23 mm at rest and descended to-8.1 mm during defecation in relation to the PCGL.The bladder base moved below the PCGL in six out of 10 volunteers,which was formally defined as a cystocele.The uterocervical junction was located at an average level of +43.1 mm at rest and at +7.9 mm during straining.The uterocervical junction of three volunteers fell below the PCGL; described formally as uterocervical prolapse.CONCLUSION:Based on the range of standard values in asymptomatic volunteers,MR defecography values for pathological changes have to be re-evaluated.

  9. Recovery ofCyclospora cayetanensis among asymptomatic rural Thai schoolchildren

    Institute of Scientific and Technical Information of China (English)

    K Thima; H Mori; R Praevanit; S Mongkhonmu; J Waikagul; D Watthanakulpanich

    2014-01-01

    Objective:To obtain the prevalence with clinical symptoms ofCyclospora cayetanensis (C. cayetanensis), a coccidian protozoan parasite, inThailand which is the cause of an intestinal infection characterized by sporadic-to-frequent explosive diarrhea.Methods:In a field survey conducted by theFaculty ofTropicalMedicine,MahidolUniversity, as part of the existing parasite-control program, a total of2540 faecal samples from villagers inNanProvince, Thailand, were collected and examined to determine the prevalence and clinical characteristics of parasitic infections.Results:Twelve cases ofC. cayetanensis infection were found during faecal examination of schoolchildren aged5-12 years.None exhibited obvious clinical symptoms, especially evidence of diarrhea;5 of12 had loose faeces, one reported frequent symptoms of abdominal discomfort, and another had pale conjunctiva with low hematocrit.The children were generally asymptomatic.Conclusions:This finding confirms a public-health issue with potentially serious consequences whereby children can be exposed to an environment contaminated with food-and water-borne transmitted oocysts, and can hence become infected withC. cayetanensis.

  10. Brain Abscesses Associated with Asymptomatic Pulmonary Arteriovenous Fistulas

    Science.gov (United States)

    Nam, Taek-Kyun; Park, Yong-sook; Kwon, Jeong-taik

    2017-01-01

    Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source. PMID:28061502

  11. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Directory of Open Access Journals (Sweden)

    Ana Laura Calderón-Garcidueñas

    2012-01-01

    Full Text Available Breast density (BD is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate ( and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170, fibroglandular 29% (87, heterogeneously dense 5.7% (17, and dense pattern 8.6% (26. Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117 and older than 50 (68.8%, 126/183. Patterns of high breast density (BD (dense + heterogeneously dense were observed in 25.6% (30/117 of women ≤50 years and 7.1% (13/183 of women >50. Asymmetry in BD was observed in 22% (66/300. Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300 of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300 of cases, vascular calcification in 150 cases (78.9%, and fat necrosis in 38 cases (20%. Conclusions. Mexican women have a low percentage of high-density patterns.

  12. The opioid effects of gluten exorphins: asymptomatic celiac disease.

    Science.gov (United States)

    Pruimboom, Leo; de Punder, Karin

    2015-11-24

    Gluten-containing cereals are a main food staple present in the daily human diet, including wheat, barley, and rye. Gluten intake is associated with the development of celiac disease (CD) and related disorders such as diabetes mellitus type I, depression, and schizophrenia. However, until now, there is no consent about the possible deleterious effects of gluten intake because of often failing symptoms even in persons with proven CD. Asymptomatic CD (ACD) is present in the majority of affected patients and is characterized by the absence of classical gluten-intolerance signs, such as diarrhea, bloating, and abdominal pain. Nevertheless, these individuals very often develop diseases that can be related with gluten intake. Gluten can be degraded into several morphine-like substances, named gluten exorphins. These compounds have proven opioid effects and could mask the deleterious effects of gluten protein on gastrointestinal lining and function. Here we describe a putative mechanism, explaining how gluten could "mask" its own toxicity by exorphins that are produced through gluten protein digestion.

  13. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M.

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ2) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns. PMID:23346398

  14. EVALUATION OF SPINOPELVIC PARAMETERS IN ASYMPTOMATIC INDIAN POPULATION

    Directory of Open Access Journals (Sweden)

    Shiblee S

    2015-02-01

    Full Text Available BACKGROUND: The study aims at evaluation of spinopelvic parameters in an Indian population in a sample composed of asymptomatic individuals. METHODS : 84 healthy adult individuals were evaluated. The exclusion criteria included spinal deformity , spine degenerative or infective condition and improper radiograph study. In each radiograph the sagittal balance and spinopelvic parameters were evaluated , including vertical sagittal axis , sacral slope , pelvic tilt and pelvic incidence. RESULTS : Data obtained in this study were in accordance to International literatures. No significant variation between genders was obtained for various parameters. The mean values of Pelvic Incidence , Sacral Slope and Pelvic Ti lt in healthy Indian Population is 49.4°±7.6° , 37.4°±6.6° and 13.9°±5.8° respectively. CONCLUSION : There were no differences in any radiographic parameter between males and females in the present study. Further , the values obtained a re comparable with the values presented as normal in the literature. The Indian and European populations shows significance in pelvic incidence and sacral slope which were higher in European populations and Indian and Korean population showed significant difference in pelvic til t which was lower in Korean population.

  15. Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania.

    Science.gov (United States)

    Masinde, A; Gumodoka, B; Kilonzo, A; Mshana, S E

    2009-07-01

    Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women attending Bugando Medical centre (BMC) in Mwanza, Tanzania. A total of 247 pregnant women were enrolled, of these 78 (31.5%) were symptomatic and 169 (68.4%) asymptomatic. UTI was diagnosed using mid stream urine (MSU) culture on standard culture media and urinalysis was done using rapid dip stick. The prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were 17.9% and 13.0% respectively, with no significant difference between the two groups (p = 0.307). Using univariate analysis there was no association of parity (p = 0.825), gestational age (p = 0.173), education (p = 0.615), age (p = 0.211) and marital status (p = 0.949) with bacteriuria. The sensitivity and specificity of urine dipstick was 38.9% and 86.7% respectively. Escherichia coli (47.2%) and Enterococcus spp (22.2%) were the most commonly recovered pathogens. The rate of resistance of Escherichia coli to ampicillin, tetracycline, sulfamethaxazole/trimethoprim, gentamicin, ciprofloxacin, nitrofurantoin, ceftriaxone, and imipenem were 53%, 58.8%, 64.7%, 5.9%, 11.8%, 5.9%, 29.4% and 0%, respectively. In conclusion, asymptomatic bacteriuria among pregnant women is prevalent in our setting and majority of Escherichia coli are resistant to ampicillin, tetracycline, SXT and ceftriaxone. Due to low sensitivity of rapid dip stick, routine urine culture and susceptibility testing is recommended to all pregnant women at booking.

  16. Asymptomatic leishmaniasis in kala-azar endemic areas of Malda district, West Bengal, India

    Science.gov (United States)

    Saha, Pabitra; Ganguly, Swagata; Chatterjee, Moytrey; Das, Soumendu Bikash; Kundu, Pratip K.; Guha, Subhasish K.; Ghosh, Tamal K.; Bera, Dilip K.; Basu, Nandita

    2017-01-01

    Asymptomatic leishmaniasis may drive the epidemic and an important challenge to reach the goal of joint Visceral Leishmaniasis (VL) elimination initiative taken by three Asian countries. The role of these asymptomatic carriers in disease transmission, prognosis at individual level and rate of transformation to symptomatic VL/Post Kala-azar Dermal Leishmaniasis (PKDL) needs to be evaluated. Asymptomatic cases were diagnosed by active mass survey in eight tribal villages by detecting antileishmanial antibody using rK39 based rapid diagnostic kits and followed up for three years to observe the pattern of sero-conversion and disease transformation. Out of 2890 total population, 2603 were screened. Antileishmanial antibody was detected in 185 individuals of them 96 had a history of VL/PKDL and 89 without such history. Seventy nine such individuals were classified as asymptomatic leishmaniasis and ten as active VL with a ratio of 7.9:1. Out of 79 asymptomatic cases 2 were lost to follow up as they moved to other places. Amongst asymptomatically infected persons, disease transformation in 8/77 (10.39%) and sero-conversion in 62/77 (80.52%) cases were noted. Seven (9.09%) remained sero-positive even after three years. Progression to clinical disease among asymptomatic individuals was taking place at any time up to three years after the baseline survey. If there are no VL /PKDL cases for two or more years, it does not mean that the area is free from leishmaniasis as symptomatic VL or PKDL may appear even after three years, if there are such asymptomatic cases. So, asymptomatic infected individuals need much attention for VL elimination programme that has been initiated by three adjoining endemic countries. PMID:28187202

  17. Mortality in asymptomatic vs. symptomatic patients surgically treated for non-small cell lung cancer (NSCLC)

    DEFF Research Database (Denmark)

    Madsen, Kirsten Riis; Bødtger, Uffe

    , tobacco pack years, or FEV1. Former malignancy was significantly more prevalent among asymptomatic than symptomatic subjects (33 % vs. 11%), with insignificant differences in prevalence of other co-morbidities or in post-surgical TNM (82% vs 85% in stages IA-IIB). 12-months mortality was insignificantly...... higher in asymptomatic than symptomatic subjects (23% vs. 12%), and in patients with former malignancy compared to patients with no former cancer (17% vs. 16%). Discussion: Symptoms at diagnosis per se appear unrelated to mortality in patients with NSCLC referred for surgery. Asymptomatic patients were...

  18. Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, David A. [Department of Pediatric Imaging, Children' s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201 (United States); Adler, Brent H. [Department of Radiology, Children' s Radiological Institute, Columbus Children' s Hospital, Columbus, Ohio (United States); Forsythe, Robert C. [Department of Pediatrics, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States); Mutabagani, Khaled; Teich, Steven [Department of Surgery, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States)

    2003-05-01

    A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

  19. The plantar fasciotomy: MR imaging findings in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S.; Ashman, C. [Ohio State Univ. Medical Center, Department of Radiology, Columbus, OH (United States); Smith, G.; Kaeding, C. [Ohio State Univ. Medical Center, Department of Surgery, Columbus, OH (United States)

    1999-08-01

    Objective. To determine the postoperative appearance of the plantar fascia on MR imaging after a fasciotomy has been performed, and to compare the postsurgical appearance of the fascia after an open and endoscopic procedure.< rate at head-abs-p1.lf>Design and patients. Fifteen asymptomatic volunteers (12 women, 3 men; age range 22-49 years, mean age 33 years) with prior fasciotomies for treatment of longstanding plantar fasciitis were studied. Fourteen volunteers had a unilateral release and one volunteer had bilateral releases, allowing for assessment of 16 ankles. Eight fasciotomies were performed through an open incision and eight were performed endoscopically. The average time between surgery and imaging was 24 months (range 11-46 months). The site of surgery was established from the operative reports. Proton density (PD)-weighted and T2-weighted images in three orthogonal planes were obtained on a 1.5-T magnet. In eight studies, T1-weighted sagittal and STIR sagittal images were included. The fascia in each ankle was assessed for morphology and signal intensity. Perifascial soft tissues and bone marrow were assessed for edema. Preoperative MR studies were available in five volunteers.< rate at head-abs-p1.lf>Results. There was no apparent difference in the postoperative appearance of the ankle after an open or endoscopic procedure except for scar formation in the subcutaneous fat which was common after an open procedure (P<0.05). Three ankles had a gap in the fascia (one open, two endoscopic). The plantar fascia measured a mean of 7.0 mm (range 5-10 mm) at the fasciotomy, and 8.3 mm (range 6-12 mm) at the enthesis. At the fasciotomy, 11 of 13 ankles had an indistinct deep contour and 9 of 13 had an indistinct superficial contour. At the enthesis, 13 of 16 ankles had an indistinct deep contour and 6 of 16 had an indistinct superficial contour. Compared with preoperative MR studies there was an average reduction in the fascial thickness at the enthesis of 14

  20. Fenofibrate for patients with asymptomatic primary biliary cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Kazufumi Dohmen; Toshihiko Mizuta; Makoto Nakamuta; Naoya Shimohashi; Hiromi Ishibashi; Kyosuke Yamamoto

    2004-01-01

    AIM: Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology, the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (aPBC) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation. However, only 20-30% of patients respond fully to UDCA. Recently, lipoproteinlowering agents have been found to be effective for PBC. The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory activated receptor α, in patients with aPBC. METHODS: Fenofibrate was administered for twelve weeks in nine patients with aPBC who failed to respond to UDCA. UDCA was used along with fenofibrate during the study. The data from aPBC patients were analyzed to assess the biochemical effect of fenofibrate during the study. RESULTS: The serum levels of alkaline phosphatase (ALP) (285±114.8 IU/L) and immunoglobulin M (IgM) (255.8±85.9 mg/dl) significantly decreased to 186.9±76.2 IU/L and 192.9±67.5 mg/dL respectively, after fenofibrate treatment in patients with aPBC (P<0.05). Moreover, the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in any patients.CONCLUSION: Fenofibrate appears to be significantly effective in treating patients with aPBC who respond incompletely to UDCA alone. Although the mechanism of fenofibrate on aPBC has not yet been fully clarified, combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its anti inflammatory effect.

  1. Dental occlusion influences knee muscular performances in asymptomatic females.

    Science.gov (United States)

    Grosdent, Stéphanie; O'Thanh, Roseline; Domken, Olivier; Lamy, Marc; Croisier, Jean-Louis

    2014-02-01

    Some authors claim that occlusal appliances can enhance athletic performance. Therefore, this study investigated the influence of dental occlusion on knee muscle strength performance. Twelve healthy female subjects (mean age, 24.1 ± 3.1 years) without temporomandibular joint dysfunction participated in this study. Isokinetic quadriceps and hamstring strength were assessed in relation to 3 randomized jaw conditions: mouth closed in maximum intercuspidation without splint, mouth closed on a balanced splint which optimized contact over the dental arch, mouth closed on a piece of resin of 1 mm which created an imbalanced occlusion. Tests were performed at 60 and 240°·s in concentric and 30°·s in eccentric exertions. Concentric performances did not show any significant difference between the 3 jaw conditions (p > 0.05). In contrast, in the eccentric trials related to quadriceps performance, significant differences (p ≤ 0.05) were observed between the resin condition and the 2 other modalities (without splint or with a balanced splint). The imbalanced occlusion created by the resin component corresponded to an average decrease of 9% in eccentric peak torque. The eccentric hamstring peak torques also showed a significant difference (p ≤ 0.05) between measurements with splint and with resin (7% decrease when occlusion was imbalanced). In conclusion, among asymptomatic females, artificial imbalanced occlusion induces immediate and significant alteration of knee eccentric muscle performances. Therefore, occlusion examination should be undertaken on a regular and frequent basis for high-level athletes. Moreover, for athletes using mouthguards, muscular performance assessments should be planned with and without the dental protection.

  2. Cool dialysate reduces asymptomatic intradialytic hypotension and increases baroreflex variability.

    Science.gov (United States)

    Chesterton, Lindsay J; Selby, Nicholas M; Burton, James O; McIntyre, Chris W

    2009-04-01

    Intradialytic hypotension (IDH) remains an important cause of morbidity and mortality in chronic hemodialysis (HD) patients and can be ameliorated by cool temperature HD. The baroreflex arc is under autonomic control and is essential in the short-term regulation of blood pressure (BP). This study aimed to investigate if the baroreflex sensitivity (BRS) response to HD differed between standard and cool-temperature dialysate. Ten patients (mean age 67+/-2 years) prone to IDH were recruited into a randomized, crossover study to compare BRS variation at dialysate temperatures of 37 degrees C (HD(37)) and 35 degrees C (HD(35)). Each patient underwent continuous beat-to-beat BP monitoring during a dialysis session of HD(37) and HD(35). During HD(37) 2 patients developed symptomatic IDH, as opposed to 1 with HD(35). However, asymptomatic IDH occurred with a frequency of 0.4 episodes per session with HD(35) and 6.2 episodes per session during HD(37) (odds ratio15.5; 95%CI 5.6-14.2). Although absolute BRS measurements did not differ between the 2 modalities, BRS variability increased during HD(35). Our study has demonstrated that in IDH-prone patients, cool HD resulted in a reduction in heart rate and a greater reduction in cardiac output and stroke volume. Mean arterial pressure was maintained through a significantly greater increase in total peripheral resistance. Furthermore, although absolute BRS values during HD were not significantly altered by a reduction in dialysate temperature, there was a greater percentage increase in BRS values during cool HD. Understanding the varied causes of, and categorizing impaired hemodynamic responses to HD will enable further individualization of HD prescriptions according to patient need.

  3. Sorbitol-negative phenotype among enterohemorrhagic Escherichia coli strains of different serotypes and from different sources.

    Science.gov (United States)

    Ojeda, A; Prado, V; Martinez, J; Arellano, C; Borczyk, A; Johnson, W; Lior, H; Levine, M M

    1995-08-01

    Enterohemorrhagic Escherichia coli (EHEC) strains detected with DNA probes (for virulence plasmid and Shiga-like toxins) from subjects with hemolytic-uremic syndrome (n = 19) or diarrhea (n = 41) or asymptomatic carriers (n = 29) were examined for sorbitol fermentability, as were enterotoxigenic (n = 40), enteropathogenic (n = 40), and enteroinvasive (n = 40) E. coli and urinary tract infection (n = 40) strains and normal flora E. coli strains (n = 40). Sorbitol negativity was common only in EHEC, particularly among strains from severe clinical infections. All 19 EHEC strains from patients with hemolytic-uremic syndrome, irrespective of O:H serotype or Shiga-like toxin genotype, were sorbitol negative.

  4. Radiology, histology and short-term outcome of asymptomatic congenital thoracic malformations

    DEFF Research Database (Denmark)

    Kongstad, Thomas; Buchvald, Frederik; Brenøe, Jørn;

    2012-01-01

    The aim of this study was to evaluate the safety and short-term outcome of our management of asymptomatic children with antenatally diagnosed congenital thoracic malformations (CTM), compared with recommendations from a recent review and meta-analysis....

  5. Accessory wandering spleen: Report of a case of laparoscopic approach in an asymptomatic patient

    Directory of Open Access Journals (Sweden)

    Alessandro Perin

    2014-01-01

    CONCLUSION: We suggest performing surgery with a laparoscopic approach in patients with accessory wandering spleen, though asymptomatic, because of the risk of serious complications in case of accessory spleen torsion.

  6. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    P.N. Ruygrok (Peter); M.W.I. Webster (Mark); V. de Valk (Vincent); G.A. van Es (Gerrit Anne); J.A. Ormiston (John); M-A.M. Morel (Marie-Angèle); P.W.J.C. Serruys (Patrick)

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND

  7. Asymptomatic natural Chlamydia pecorum infection reduces growth rates in calves by up to 48 percent

    Science.gov (United States)

    Intracellular Chlamydia (C.) bacteria cause in cattle some acute but rare diseases such as abortion, sporadic bovine encephalomyelitis, kerato-conjunctivitis, pneumonia, enteritis and polyarthritis. Much more frequent, essentially ubiquitous worldwide, are low-level, asymptomatic chlamydial infecti...

  8. Sex differences in prevalence and risk factors of asymptomatic cholelithiasis in Korean health screening examinee

    Science.gov (United States)

    Kim, Sung Bum; Kim, Kook Hyun; Kim, Tae Nyeun; Heo, Jun; Jung, Min Kyu; Cho, Chang Min; Lee, Yoon Suk; Cho, Kwang Bum; Lee, Dong Wook; Han, Ji Min; Kim, Ho Gak; Kim, Hyun Soo

    2017-01-01

    Abstract The aim of this study was to evaluate sex difference in the prevalence and risk factors for asymptomatic cholelithiasis in Korean health screening examinees. Examinees who underwent examination through health promotion center at 5 hospitals of Daegu-Gyeongbuk province in 2014 were analyzed retrospectively. All examinees were checked for height, weight, waist circumference, and blood pressure, and underwent laboratory tests and abdominal ultrasound. Diagnosis of cholelithiasis was made by ultrasound. Of the total of 30,544 examinees, mean age was 47.3 ± 10.9 years and male to female ratio was 1.4:1. Asymptomatic cholelithiasis was diagnosed in 1268 examinees with overall prevalence of 4.2%. In age below 40 years, females showed higher prevalence of asymptomatic cholelithiasis than males (2.7% vs. 1.9%, P = 0.020), whereas prevalence of asymptomatic cholelithiasis was higher in males than females older than 50 years (6.2% vs. 5.1%, P = 0.012). Multiple logistic regression analysis revealed age (≥50 years), obesity, and high blood pressure as risk factors for asymptomatic cholelithiasis in males and age, obesity, hypertriglyceridemia, and chronic hepatitis B infection in females (P < 0.05). Overall prevalence of asymptomatic cholelithiasis was 4.2% in Korean health screening examinees. Females showed higher prevalence of asymptomatic cholelithiasis than males younger than 40 years, whereas it was higher in males older than 50 years. Age and obesity were risk factors for asymptomatic cholelithiasis in both sexes. Males had additional risk factors of high blood pressure and females had hypertriglyceridemia and chronic hepatitis B infection. PMID:28353587

  9. Risk stratification in asymptomatic and symptomatic patients with carotid artery stenosis

    OpenAIRE

    den Hartog, A.G.

    2013-01-01

    The overall aim of this thesis is to explore and assess the risks that patients with carotid artery disease, whether asymptomatic or symptomatic, are exposed to, and to explore whether patients that may be subject to relatively higher risk can be identified by imaging. Although large randomized trials have proven carotid endarterectomy (CEA) to be beneficial compared to best medical treatment alone, revascularization of patients with asymptomatic carotid artery stenosis (ACAS) remains a matte...

  10. Dengue Patients Exhibit Higher Levels of PrM and E Antibodies Than Their Asymptomatic Counterparts

    OpenAIRE

    Adeline Syin Lian Yeo; Anusyah Rathakrishnan; Seok Mui Wang; Sasheela Ponnampalavanar; Rishya Manikam; Jameela Sathar; Santha Kumari Natkunam; Shamala Devi Sekaran

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified a...

  11. An Interesting and Rare Case of Dextrocardia: Asymptomatic Left Atrial Aneurysm in an Adult.

    Directory of Open Access Journals (Sweden)

    Sravan Reddy

    2015-08-01

    Full Text Available Asymptomatic congenital intrapericardial aneurysm are extremely rare. This anomaly is usually present in second to fourth decade of life. They are usually associated with arrhythmias, embolic manifestations and heart failure. Here we present a case of LA aneurysm manifested asymptomatically. We present a 37 year old male referred to our department for pre-operative evaluation. He was diagnosed to have dextrocardia, the evaluation of which led to the diagnosis of congenital left atrial aneurysm as the cause.

  12. Effect of lipid lowering on new-onset atrial fibrillation in patients with asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Bang, Casper N; Greve, Anders M; Boman, Kurt

    2012-01-01

    Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS).......Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent atrial fibrillation (AF). This effect has not been investigated on new-onset AF in asymptomatic patients with aortic stenosis (AS)....

  13. Asymptomatic Intrahepatic Portosystemic Venous Shunt: To Treat or Not To Treat?

    Science.gov (United States)

    Palvanov, Arkadiy; Marder, Ruth Leah; Siegel, David

    2016-09-01

    Intrahepatic portosystemic venous shunts (IPSVSs) are rare vascular malformations. They can be asymptomatic or present with various symptoms including encephalopathy. We present two cases of IPSVS, one involving a patient presenting with altered mental status and the other discovered incidentally. While there is no question that patients presenting with symptomatic IPSVS should undergo definitive treatment, there is no consensus regarding elective therapy for asymptomatic lesions.

  14. High prevalence of asymptomatic malaria in apparently healthy schoolchildren in Aliero, Kebbi state, Nigeria

    Directory of Open Access Journals (Sweden)

    Rupashree Singh

    2014-04-01

    Full Text Available Background & objectives: In malaria endemic areas, continuous exposure to Plasmodium parasites leads to asymptomatic carriers that provide a reservoir, contributing to the persistence of malaria transmission. Thus, a study of the degree of prevalence of asymptomatic parasitaemias will help in assessing the level of reservoir of infection. Methods: All the consented participants without any signs and symptoms, suggestive of malaria were interviewed and thick blood smears were made to detect malaria parasites. The children presenting with malaria or any other severe illness, and those declining to give consent were excluded from the study. Results: A total of 118 (59.6% children out of 198 apparently healthy children were positive for malaria parasites while 80 (40.4% children were negative for malaria parasites. Prevalence of asymptomatic malaria was higher in males 75 (63.6% compared to females 43 (36.4%, but the difference was not statistically significant. Incidence of asymptomatic malaria was highest with 76.1% in the children aged 6– 10 yr. There was statistically significant association of the use of bednet on prevalence of asymptomatic malaria. Interpretation & conclusion: High prevalence of asymptomatic malaria detected in this study is a big challenge and can be a threat to the present malaria control programme. Thus, it should be considered in assessing and reorganising more effective malaria elimination strategies to achieve the desired goal of malaria control.

  15. An epidemiological study of asymptomatic neurocysticercosis in a pig farming community in northern India.

    Science.gov (United States)

    Prasad, Kashi N; Verma, Avantika; Srivastava, Sandeep; Gupta, Rakesh K; Pandey, Chandra M; Paliwal, Vimal K

    2011-09-01

    Neurocysticercosis (NCC) is the most frequent parasitic infection of the central nervous system caused by the larvae of Taenia solium. The prevalence of NCC is obscured due to variations in the methods used for epidemiological studies and often asymptomatic manifestation. The present study was conducted on 595 apparently healthy individuals belonging to the pig farming community of northern India to estimate the prevalence of asymptomatic NCC and to evaluate risk factors based on questionnaires. Diagnosis of NCC was based on neuroimaging, immunological and epidemiological criteria. Asymptomatic NCC was detected in 90 (15.1%) of 595 individuals. The evaluation of risk factors showed that age >15 years (P=0.001), intake of raw vegetables (P=0.025) and undercooked pork (P=0.005), lack of safe drinking water (P=0.003), inadequate drainage system (P=0.049), no separate place for pigs (P≤0.001), NCC related active epilepsy in the family (P≤0.001) were significantly associated with asymptomatic NCC. The present study shows high prevalence of asymptomatic NCC in pig farming community of northern India. Further, asymptomatic NCC is associated with most variables of poor socio-economic parameters.

  16. Asymptomatic carotid stenosis: What we can learn from the next generation of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Mark N Rubin

    2014-04-01

    Full Text Available Stroke remains an exceedingly incident and prevalent public health burden across the globe, with an estimated 16 million new strokes per annum and prevalence over 60 million, and extracranial internal carotid artery atherosclerotic disease is an important risk factor for stroke. Randomized trials of surgical treatment were conducted (North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial and demonstrated efficacy of carotid endarterectomy for secondary prevention of stroke in patients with cerebrovascular events (e.g. ipsilateral stroke, transient ischemic attack, and/or amaurosis fugax attributable to a diseased artery with 50–99% stenosis. Therapeutic clarity, however, proved elusive with asymptomatic carotid artery disease. Asymptomatic Carotid Atherosclerosis Study (ACAS, Asymptomatic Carotid Surgery Trial, and Veterans Affairs Cooperative Study (VACS suggested only modest benefit from surgical intervention for primary stroke prevention and the best medical therapy at the time of these trials is not comparable to modern medical therapy. ACT-1, Asymptomatic Carotid Surgery Trial-2, Stent-Protected Angioplasty in asymptomatic Carotid artery stenosis versus Endarterectomy Trial-2, European Carotid Surgery Trial-2, Carotid Revascularization Endarterectomy Versus Stenting Trial-2 are trials that are recent, ongoing, or in development that include diverse populations across Europe and North America, complementary trial designs, and a collaborative spirit that should provide clinicians with evidence that informs best clinical practice for asymptomatic carotid artery disease.

  17. Prevalence of advanced colonic polyps in asymptomatic Chinese

    Institute of Scientific and Technical Information of China (English)

    Hui-Hsiung Liu; Meng-Chen Wu; Yeh Peng; Ming-Shiang Wu

    2005-01-01

    AIM: To investigate the prevalence of advanced polyps in asymptomatic Chinese and to determine the risk of proximal advanced colonic polyps in subjects with and without polyps in the distal colon.METHODS: Data were collected prospectively during colonoscopic examinations performed in 5 973 subjects as part of health evaluation at our unit from December 1997 to December 2003. Polyps were considered advanced, if they were larger than 10 mm or were tubovillous, villous or malignant. Proximal colon was defined as the splenic flexure and more proximal portions of the colon.RESULTS: Colon polyps were detected in 971 (16.3%)subjects (613 males and 358 females) with their mean age being 56.6±10.7 years. Advanced polyps were noted in 199 (3.3%) individuals. Subjects were sub-classified according to the location of polyps into three groups: distal (569, 58.6%), proximal (284, 29.2%), and combined proximal and distal (118, 12.2%) groups. Subjects with advanced polyps in these three groups were 95 (9.8%),56 (5.8%), and 48 (4.9%) respectively. In the 48 subjects with advanced combined polyps, 13 advanced polyps were distributed at the distal colon, 17 at the proximal colon,and 18 at both. Eighteen colon cancers including 12 at sigmoid and 6 at ascending colon were confirmed by final pathology. The relative risk for advanced proximal polyp according to distal findings was 3.1 (95%CI: 1.3-7.4) for hyperplastic polyp, 2.7 (95%CI: 1.4-5.3) for tubular polyp and 13.5 (95%CI: 5.1-35.4) for advanced polyp as compared to that for no polyp. However, 56 (28.2%) of 199 subjects with advanced polyps had no index polyps at the distal colon and might go undetected under sigmoidoscopic screening.CONCLUSION: Although distal lesions can predict the risk of advanced proximal polyps, a substantial portion of Chinese with advanced proximal polyps is not associated with any distal sentinel lesions. These data have implications for screening policy of colon cancers in Taiwanese Chinese.

  18. Increased frequency of anti-retina antibodies in asymptomatic patients with chronic t. gondii infection

    Science.gov (United States)

    Cursino, Sylvia Regina Temer; da Costa, Thaís Boccia; Yamamoto, Joyce Hisae; Meireles, Luciana Regina; Silva, Maria Antonieta Longo Galvão; de Andrade Junior, Heitor Franco

    2010-01-01

    PURPOSE: To search for anti-retina antibodies that serve as markers for eye disease in uveitis. MATERIALS AND METHODS: Stored sera from patients with uveitis, ocular toxoplasmosis (n = 30) and non-infectious, immune-mediated uveitis (n = 50) and from asymptomatic individuals who were positive (n = 250) and negative (n = 250) for anti-Toxoplasma antibodies were tested. Serum anti-retina IgG was detected by an optimized ELISA using a solid-phase whole human retina extract, bovine S-antigen or interphotoreceptor retinoid-binding protein. RESULTS: Uveitis patients showed a higher mean reactivity to whole human retina extract, interphotoreceptor retinoid-binding protein and S-antigen in comparison to the asymptomatic population. These findings were independent of the uveitis origin and allowed the determination of the lower anti-retina antibody cut-off for the three antigens. Asymptomatic anti-Toxoplasma serum-positive individuals showed a higher frequency of anti-human whole retina extract antibodies in comparison to asymptomatic anti-Toxoplasma serum-negative patients. The bovine S-antigen and interphotoreceptor retinoid-binding protein ELISAs also showed a higher mean reactivity in the uveitis groups compared to the asymptomatic group, but the observed reactivities were lower and overlapped without discrimination. CONCLUSION: We detected higher levels of anti-retina antibodies in uveitis patients and in a small fraction of asymptomatic patients with chronic toxoplasmosis. The presence of anti-retina antibodies in sera might be a marker of eye disease in asymptomatic patients, especially when whole human retina extract is used in a solid-phase ELISA. PMID:21120306

  19. Increased frequency of anti-retina antibodies in asymptomatic patients with chronic t. gondii infection

    Directory of Open Access Journals (Sweden)

    Sylvia Regina Temer Cursino

    2010-01-01

    Full Text Available PURPOSE: To search for anti-retina antibodies that serve as markers for eye disease in uveitis. MATERIALS AND METHODS: Stored sera from patients with uveitis, ocular toxoplasmosis (n = 30 and non-infectious, immune-mediated uveitis (n = 50 and from asymptomatic individuals who were positive (n = 250 and negative (n = 250 for anti-Toxoplasma antibodies were tested. Serum anti-retina IgG was detected by an optimized ELISA using a solid-phase whole human retina extract, bovine S-antigen or interphotoreceptor retinoid-binding protein. RESULTS: Uveitis patients showed a higher mean reactivity to whole human retina extract, interphotoreceptor retinoid-binding protein and S-antigen in comparison to the asymptomatic population. These findings were independent of the uveitis origin and allowed the determination of the lower anti-retina antibody cut-off for the three antigens. Asymptomatic anti-Toxoplasma serum-positive individuals showed a higher frequency of antihuman whole retina extract antibodies in comparison to asymptomatic anti-Toxoplasma serum-negative patients. The bovine S-antigen and interphotoreceptor retinoid-binding protein ELISAs also showed a higher mean reactivity in the uveitis groups compared to the asymptomatic group, but the observed reactivities were lower and overlapped without discrimination. CONCLUSION: We detected higher levels of anti-retina antibodies in uveitis patients and in a small fraction of asymptomatic patients with chronic toxoplasmosis. The presence of anti-retina antibodies in sera might be a marker of eye disease in asymptomatic patients, especially when whole human retina extract is used in a solid-phase ELISA.

  20. Prevalence and risk factors of asymptomatic peptic ulcer disease in Taiwan

    Institute of Scientific and Technical Information of China (English)

    Fu-Wei Wang; Ming-Shium Tu; Guang-Yuan Mar; Hung-Yi Chuang; Hsien-Chung Yu; Lung-Chih Cheng; Ping-I Hsu

    2011-01-01

    AIM: To investigate the prevalence and risk factors of asymptomatic peptic ulcer disease (PUD) in a general Taiwanese population. METHODS: From January to August 2008, consecu-tive asymptomatic subjects undergoing a routine health check-up were evaluated by upper gastrointestinal en-doscopy. Gastroduodenal mucosal breaks were carefully assessed, and a complete medical history and demo-graphic data were obtained from each patient. Logistic regression analysis was conducted to identify indepen-dent risk factors for asymptomatic PUD. RESULTS: Of the 572 asymptomatic subjects, 54 (9.4%) were diagnosed as having PUD. The prevalence of gas-tric ulcer, duodenal ulcer and both gastric and duode-nal ulcers were 4.7%, 3.9%, and 0.9%, respectively. Multivariate analysis revealed that prior history of PUD [odds ratio (OR), 2.0, 95% CI: 1.3-2.9], high body mass index [body mass index (BMI) 25-30: OR, 1.5, 95% CI: 1.0-2.2; BMI > 30 kg/m2: OR, 3.6, 95% CI: 1.5-8.7] and current smoker (OR, 2.6, 95% CI: 1.6-4.4) were in-dependent predictors of asymptomatic PUD. In contrast, high education level was a negative predictor of PUD (years of education 10-12: OR, 0.5, 95% CI: 0.3-0.8; years of education > 12: OR, 0.6, 95% CI: 0.3-0.9).CONCLUSION: The prevalence of PUD in asymptom-atic subjects is 9.4% in Taiwan. Prior history of PUD, low education level, a high BMI and current smoker are independent risk factors for developing asymptomatic PUD.

  1. Diarrheagenic Escherichia coli.

    Science.gov (United States)

    Gomes, Tânia A T; Elias, Waldir P; Scaletsky, Isabel C A; Guth, Beatriz E C; Rodrigues, Juliana F; Piazza, Roxane M F; Ferreira, Luís C S; Martinez, Marina B

    2016-12-01

    Most Escherichia coli strains live harmlessly in the intestines and rarely cause disease in healthy individuals. Nonetheless, a number of pathogenic strains can cause diarrhea or extraintestinal diseases both in healthy and immunocompromised individuals. Diarrheal illnesses are a severe public health problem and a major cause of morbidity and mortality in infants and young children, especially in developing countries. E. coli strains that cause diarrhea have evolved by acquiring, through horizontal gene transfer, a particular set of characteristics that have successfully persisted in the host. According to the group of virulence determinants acquired, specific combinations were formed determining the currently known E. coli pathotypes, which are collectively known as diarrheagenic E. coli. In this review, we have gathered information on current definitions, serotypes, lineages, virulence mechanisms, epidemiology, and diagnosis of the major diarrheagenic E. coli pathotypes.

  2. Comparison of asymptomatic and symptomatic rhinovirus infections in university students: incidence, species diversity, and viral load.

    Science.gov (United States)

    Granados, Andrea; Goodall, Emma C; Luinstra, Kathy; Smieja, Marek; Mahony, James

    2015-08-01

    Human rhinovirus (HRV) infections are common but poorly characterized in university students. Thus, we characterized asymptomatic and symptomatic HRV infections by incidence, species diversity, and viral load of 502 university students during September and October of 2010 and 2011 from nasal swabs and electronically submitted symptom questionnaires. We tested all symptomatic students and randomly sampled participants who remained asymptomatic (n=25/week, over 8 weeks each study year) on a weekly basis by real-time PCR and sequenced HRV positives. HRV was identified in 33/400 (8.3%) and 85/92 (92.4%) of the asymptomatic and symptomatic students, respectively. We identified a higher than previously reported rate of HRV-B in both groups, although the distribution of HRV species was similar (P=0.37). Asymptomatic viral load averaged 1.2 log10 copies/mL lower than symptomatic HRV (P<0.001). In conclusion, asymptomatic HRV activity preceded peak symptomatic activity in September and October and was associated with lower viral load.

  3. Dengue patients exhibit higher levels of PrM and E antibodies than their asymptomatic counterparts.

    Science.gov (United States)

    Yeo, Adeline Syin Lian; Rathakrishnan, Anusyah; Wang, Seok Mui; Ponnampalavanar, Sasheela; Manikam, Rishya; Sathar, Jameela; Kumari Natkunam, Santha; Sekaran, Shamala Devi

    2015-01-01

    Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals.

  4. Temporal Cortex Morphology in Mesial Temporal Lobe Epilepsy Patients and Their Asymptomatic Siblings.

    Science.gov (United States)

    Alhusaini, Saud; Whelan, Christopher D; Doherty, Colin P; Delanty, Norman; Fitzsimons, Mary; Cavalleri, Gianpiero L

    2016-03-01

    Temporal cortex abnormalities are common in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE+HS) and believed to be relevant to the underlying mechanisms. In the present study, we set out to determine the familiarity of temporal cortex morphologic alterations in a cohort of MTLE+HS patients and their asymptomatic siblings. A surface-based morphometry (SBM) method was applied to process MRI data acquired from 140 individuals (50 patients with unilateral MTLE+HS, 50 asymptomatic siblings of patients, and 40 healthy controls). Using a region-of-interest approach, alterations in temporal cortex morphology were determined in patients and their asymptomatic siblings by comparing with the controls. Alterations in temporal cortex morphology were identified in MTLE+HS patients ipsilaterally within the anterio-medial regions, including the entorhinal cortex, parahippocampal gyrus, and temporal pole. Subtle but similar pattern of morphology changes with a medium effect size were also noted in the asymptomatic siblings. These localized alterations were related to volume loss that appeared driven by shared contractions in cerebral cortex surface area. These findings indicate that temporal cortex morphologic alterations are common to patients and their asymptomatic siblings and suggest that such localized traits are possibly heritable.

  5. Ischiofemoral space on MRI in an asymptomatic population: Normative width measurements and soft tissue signal variations

    Energy Technology Data Exchange (ETDEWEB)

    Maras Oezdemir, Zeynep; Goermeli, Cemile Ayse; Sagir Kahraman, Ayseguel [Inoenue University School of Medicine, Department of Radiology, Malatya (Turkey); Aydingoez, Uestuen [Hacettepe University School of Medicine, Department of Radiology, Ankara (Turkey)

    2015-08-15

    To make normative width measurements of the ischiofemoral (IF) space in an asymptomatic population and to record soft tissue MRI signal variations within the IF space in order to determine whether such variations are associated with IF space dimensions. Normative width measurements of the IF space were prospectively made in 418 hips on 1.5 T MR images of 209 asymptomatic volunteers. Quantitative and qualitative assessments of the IF soft tissues including the quadratus femoris (QF) muscle were also made. The mean IF space width was 2.56 ± 0.75 cm (right, 2.60 ± 0.75 cm; left, 2.53 ± 0.75 cm). Soft tissue MRI signal abnormalities were present within the IF space in 19 (9.1 %) of 209 volunteers. Soft tissue abnormalities within the IF space included oedema (3/209, 1.4 %) of the QF and/or surrounding soft tissue, and only fatty infiltration (16/209, 7.7 %) of the QF. Bilateral IF spaces are asymmetrical in asymptomatic persons. There is ≥10 % of width difference between right and left IF spaces in approximately half of asymptomatic individuals. Fatty infiltration and oedema can be present at the IF space in a small portion of the asymptomatic population, who also have narrower IF spaces than those without soft tissue MRI signal abnormalities. (orig.)

  6. A new screening pathway for identifying asymptomatic patients using dental panoramic radiographs

    Science.gov (United States)

    Hayashi, Tatsuro; Matsumoto, Takuya; Sawagashira, Tsuyoshi; Tagami, Motoki; Katsumata, Akitoshi; Hayashi, Yoshinori; Muramatsu, Chisako; Zhou, Xiangrong; Iida, Yukihiro; Matsuoka, Masato; Katagi, Kiyoji; Fujita, Hiroshi

    2012-03-01

    To identify asymptomatic patients is the challenging task and the essential first step in diagnosis. Findings of dental panoramic radiographs include not only dental conditions but also radiographic signs that are suggestive of possible systemic diseases such as osteoporosis, arteriosclerosis, and maxillary sinusitis. Detection of such signs on panoramic radiographs has a potential to provide supplemental benefits for patients. However, it is not easy for general dental practitioners to pay careful attention to such signs. We addressed the development of a computer-aided detection (CAD) system that detects radiographic signs of pathology on panoramic images, and the design of the framework of new screening pathway by cooperation of dentists and our CAD system. The performance evaluation of our CAD system showed the sensitivity and specificity in the identification of osteoporotic patients were 92.6 % and 100 %, respectively, and those of the maxillary sinus abnormality were 89.6 % and 73.6 %, respectively. The detection rate of carotid artery calcifications that suggests the need for further medical evaluation was approximately 93.6 % with 4.4 false-positives per image. To validate the utility of the new screening pathway, preliminary clinical trials by using our CAD system were conducted. To date, 223 panoramic images were processed and 4 asymptomatic patients with suspected osteoporosis, 7 asymptomatic patients with suspected calcifications, and 40 asymptomatic patients with suspected maxillary sinusitis were detected in our initial trial. It was suggested that our new screening pathway could be useful to identify asymptomatic patients with systemic diseases.

  7. Taxonomy Icon Data: Escherichia coli [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available cherichia_coli_S.png Escherichia_coli_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Escherichia+co...li&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Escherichia+coli&t=NL http://biosciencedbc.jp/taxonomy..._icon/icon.cgi?i=Escherichia+coli&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Escherichia+coli&t=NS ...

  8. Escherichia coli Uropathogenesis In Vitro

    DEFF Research Database (Denmark)

    Andersen, Thomas E; Khandige, Surabhi; Madelung, Michelle

    2012-01-01

    Uropathogenic Escherichia coli (UPEC) strains are capable of invading bladder epithelial cells (BECs) on the bladder luminal surface. Based primarily on studies in mouse models, invasion is proposed to trigger an intracellular uropathogenic cascade involving intracellular bacterial proliferation...

  9. Asymptomatic Malaria Correlates with Anaemia in Pregnant Women at Ouagadougou, Burkina Faso

    Directory of Open Access Journals (Sweden)

    Zoenabo Douamba

    2012-01-01

    Full Text Available Sub-Saharan Africa records each year about thirty-two million pregnant women living in areas of high transmission of Plasmodium falciparum causing malaria. The aim of this study was to carve out the prevalence of asymptomatic malaria among pregnant women and to emphasize its influence on haematological markers. The prevalence of Plasmodium falciparum asymptomatic infection among pregnant women was 30% and 24% with rapid detection test (RDT and microscopy, respectively. The prevalence of P. falciparum asymptomatic malaria was reduced among pregnant women using sulfadoxine-pyrimethamine's intermittent preventive treatment and 61% of them were anaemic. Anaemia was significantly more common in women infected with P. falciparum compared with the uninfected pregnant women. Most of the women had normal levels of homocysteine and low levels of folate, respectively. Therefore, the systematic diagnosis of malaria should be introduced to pregnant women as a part of the antenatal care.

  10. Hematological and biochemical parameters in symptomatic and asymptomatic leishmania-seropositive dogs

    Directory of Open Access Journals (Sweden)

    Igor Ulchar

    2015-10-01

    Full Text Available Leishmaniosis caused by Leishmania infantum is vector-born severe enzootic disease in dogs. It includes a wide spectrum of clinical symptoms, but the most characteristic are alterations in the hematopoetic system and renal failure. Also, infected animals could be asymptomatic, so the manifestation of L. infantum infection depends on many factors, including host’s immunological status. The aim of this survey was to find parameters related with hematopoetic and renal failure (hematology, biochemical parameters – urea, creatinine, serum proteins in symptomatic and asymptomatic dogs seropositive for canine leishmaniosis. Within the hematological parameters, we found signifi cant differences between symptomatic and asymptomatic dogs in the erythrogram and platelet count, but not in the leukogram. Significant differences between the two groups were found also for urea, creatinine, serum albumin and globulin, but not in serum total protein and A/G ratio. These findings indicate individual variability of the host’s response to infection with L. infantum.

  11. A reservoir of drug-resistant pathogenic bacteria in asymptomatic hosts.

    Directory of Open Access Journals (Sweden)

    Gabriel G Perron

    Full Text Available The population genetics of pathogenic bacteria has been intensively studied in order to understand the spread of disease and the evolution of virulence and drug resistance. However, much less attention has been paid to bacterial carriage populations, which inhabit hosts without producing disease. Since new virulent strains that cause disease can be recruited from the carriage population of bacteria, our understanding of infectious disease is seriously incomplete without knowledge on the population structure of pathogenic bacteria living in an asymptomatic host. We report the first extensive survey of the abundance and diversity of a human pathogen in asymptomatic animal hosts. We have found that asymptomatic swine from livestock productions frequently carry populations of Salmonella enterica with a broad range of drug-resistant strains and genetic diversity greatly exceeding that previously described. This study shows how agricultural practice and human intervention may lead and influence the evolution of a hidden reservoir of pathogens, with important implications for human health.

  12. Tissue Velocities and Myocardial Deformation in Asymptomatic and Symptomatic Aortic Stenosis

    DEFF Research Database (Denmark)

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian

    2015-01-01

    BACKGROUND: Assessment of myocardial longitudinal function has proved to be a sensitive marker of deteriorating myocardial function in aortic stenosis, demonstrated by both color Doppler tissue imaging and recently by two-dimensional speckle-tracking echocardiography. The aim of this study...... was to compare velocity (color Doppler tissue imaging) and deformation (two-dimensional speckle-tracking echocardiography) in relation to global and regional longitudinal function in asymptomatic and severe symptomatic aortic stenosis. METHODS: In a cross-sectional design, 231 patients with aortic stenosis were...... divided into four groups: asymptomatic moderate aortic stenosis (aortic valve area, 1.0-1.5 cm(2); n = 38), asymptomatic severe aortic stenosis (aortic valve area aortic stenosis with preserved (n = 68) and reduced (

  13. Is it possible that this patient is asymptomatic? The role of multidetector ct angiography in detection of ulcerated plaques in patients with asymptomatic carotid stenosis: Case report

    Directory of Open Access Journals (Sweden)

    Tanasković Slobodan

    2015-01-01

    Full Text Available Introduction. Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss treatment options in a patient with asymptomatic carotid stenosis and high embolic potential lesions of common and internal carotid artery detected by multidetector computed tomography (MDCT. Case Outline. A 78-year-old female patient was admitted to our institution for diagnostics and surgical treatment of asymptomatic high-grade carotid stenosis. Upon admission, color duplex ultrasonography of the carotid arteries revealed the left common carotid artery (CCA stenosis of 50% and the ipsilateral internal carotid artery (ICA stenosis of 60%, while the right CCA was narrowed by 60% and the ipsilateral ICA by 80%. Because of the left subclavian artery (LSA occlusion, also described by ultrasonography, MDCT angiography was performed to assess arterial morphology for possible angioplasty. In addition to LSA occlusion, MDCT angiography surprisingly revealed significant left CCA (>80% and ICA (>70% narrowing by ulcerated plaques with high embolic potential. Surgical treatment of the left CCA and ICA was indicated and Dacron® tubular graft interposition was performed. The postoperative course was uneventful and the patient was discharged from the Institute on the third postoperative day. After the six-month follow-up the patient was doing well with well-preserved graft patency. Conclusion. Although color duplex ultrasonography is reliable and safe imaging modality in carotid stenosis diagnosis, MDCT angiography plays a significant role in patients with asymptomatic carotid stenosis since plaques with high embolic potential could be detected, which, if left untreated, could have severe neurological ischemic consequences. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  14. Outcomes of asymptomatic malaria parasitaemia in neonates in a tertiary hospital, southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Matthew Igwe Nwali

    2014-01-01

    Full Text Available Background: Malaria infestation during pregnancy is mostly asymptomatic and untreated especially in unbooked pregnancies. It presents with almost all the fetal complications of overt malaria in pregnancy. The aim of this study was to determine the effect of asymptomatic malaria parasitaemia on the neonates of unbooked parturients delivered at term at the Federal Teaching Hospital, Abakaliki. Materials and Methods: This study was conducted in the labour ward complex of the Federal Teaching Hospital, Abakaliki from March to May 2012. Unbooked pregnant women who fulfilled the inclusion criteria and gave consent were consecutively recruited. Cord blood and placenta tissue were collected for haemoglobin concentration determination and histology, respectively. Birth weights were determined with an electronic weighing machine. Statistical Analysis was done with 2008 Epi Info™ software and level of significant was set at P-value <0.05. Results: A total of 250 unbooked parturients were recruited, of which 194 (77.6% had asymptomatic malaria parasitaemia while 227 (90.8% had placental parasitisation. The prevalence of low birth weight in the study was 16.4%. There was significant relationship between asymptomatic malaria parasitemia and birth weight (X [2] = 43.70, P-value < 0.001. There were no low-birth-weight deliveries among paturients without placental parasitemia. No neonate, however, had anaemia in the study. Conclusion: Asymptomatic malaria parasitemia and placental parasitisation by malaria parasites contribute to the outcome of the foetal birth weight. Asymptomatic malaria parasitaemia and placental parasitaemia did not result in a corresponding foetal anaemia on babies delivered.

  15. PART I. ESCHERICHIA COLI

    Directory of Open Access Journals (Sweden)

    Sanaa Mahdi Oraibi

    2016-11-01

    Full Text Available The presence of Escherichia coli in the air of facilities involved in management and composting of post-slaughter poultry wastes in selected plants of West Western Pomerania region was studied. Measurements were made on four dates in a variety of weather conditions during the year. The study was conducted at 5 objects that differ in the type of waste and the degree of preparation for composting. These were: chemical treatment and preliminary processing plant, liquid wastes reservoir, platform for preparation of materials for composting, storage of biological sediments, and composting facility. Measurement of bacteria count was carried out in accordance with the applicable procedures on selective chromogenic TBX medium. The assays revealed the presence of E. coli at all test objects, but not always on all measurement dates. It has been shown that the presence of E. coli was from 20 to 3047 CFU∙m-3 of air, although the largest quantities were most frequently detected in the air of the building for post-slaughter waste pre-treatment in chemical treatment plant.

  16. Zoonotic Escherichia coli

    Directory of Open Access Journals (Sweden)

    Wasteson Yngvild

    2002-03-01

    Full Text Available Escherichia coli is a normal inhabitant of the gastrointestinal tract of all warm-blooded animals, but variants of this species is also among the important etiological agents of enteritis and several extraintestinal diseases. The E. coli strains that cause diarrhoeal illness are categorised into pathogenicity groups based on virulence properties, mechanisms of pathogenicity, clinical symptoms and serology. The five main categories include enterotoxinogenic E. coli (ETEC, enteropathogenic E. coli (EPEC, enteroaggregative E. coli (EAggEC, enteroinvasive E. coli (EIEC and Shiga (Vero toxin-producing E. coli (STEC/VTEC. From a zoonotic point of view, STEC is the only E. coli pathogenicity group of major interest, as the shiga toxin-producing strains are able to cause severe disease in humans when being transmitted through the food chain from their animal reservoirs. The focus of this manuscript is therefore on STEC; pathogenicity factors, disease, the reservoirs and on-farm ecology, transmission into the food chain, growth and survival in food and in the environment, and the shiga toxin-encoding bacteriophages.

  17. Asymptomatic papillary fibroelastoma of the Aortic valve in a young woman - a case report

    Directory of Open Access Journals (Sweden)

    Pitsis Antonis

    2009-09-01

    Full Text Available Abstract Echocardiography represents an invaluable diagnostic tool for the detection of intracardiac masses while simultaneously provides information about their size, location, mobility and attachment site as well as the presence and extent of any consequent hemodynamic derangement. A 29-year-old asymptomatic young woman with incidental transthoracic echocardiographic (TTE discovery of an aortic valve mass is presented. The 2-dimensional TTE showed a mobile, pedunculated mass, attached by a thin stalk to the aortic surface of the right coronary aortic cusp at the junction of its base with the anterior aortic wall. The importance of valve sparing tumour resection even in asymptomatic patients is emphasised.

  18. Nephrocutaneous fistula as the initial manifestation of asymptomatic nephrolithiasis: A call for radical management

    Directory of Open Access Journals (Sweden)

    Raman Tanwar

    2015-01-01

    Full Text Available Renal stones are a common affliction presenting in an acute setting. We report a case of asymptomatic renal stone in an elderly gentleman presenting initially as a discharging lumbar sinus managed by subcapsular nephrectomy and radical excision of the fistula tract. Nephrocutaneous fistula is most commonly associated with tuberculosis, xanthogranulomatous pyelonephritis, and rarely with complicated calyceal stones, and its occurrence with asymptomatic pelvic stones is rare. We present the points in favor of radical open surgery in the management of such patients.

  19. Treatment of asymptomatic carriers with artemether-lumefantrine: an opportunity to reduce the burden of malaria?

    Directory of Open Access Journals (Sweden)

    Gbadoé Adama

    2010-01-01

    Full Text Available Abstract Background Increased investment and commitment to malaria prevention and treatment strategies across Africa has produced impressive reductions in the incidence of this disease. Nevertheless, it is clear that further interventions will be necessary to meet the international target of a reversal in the incidence of malaria by 2015. This article discusses the prospective role of an innovative malaria control strategy - the community-based treatment of asymptomatic carriers of Plasmodium falciparum, with artemisinin-based combination therapy (ACT. The potential of this intervention was considered by key scientists in the field at an Advisory Board meeting held in Basel, in April 2009. This article summarizes the discussions that took place among the participants. Presentation of the hypothesis Asymptomatic carriers do not seek treatment for their infection and, therefore, constitute a reservoir of parasites and thus a real public-health risk. The systematic identification and treatment of individuals with asymptomatic P. falciparum as part of a surveillance intervention strategy should reduce the parasite reservoir, and if this pool is greatly reduced, it will impact disease transmission. Testing the hypothesis This article considers the populations that could benefit from such a strategy and examines the ethical issues associated with the treatment of apparently healthy individuals, who represent a neglected public health risk. The potential for the treatment of asymptomatic carriers to impair the development of protective immunity, resulting in a 'rebound' and age escalation of malaria incidence, is also discussed. For policymakers to consider the treatment of asymptomatic carriers with ACT as a new tool in their malaria control programmes, it will be important to demonstrate that such a strategy can produce significant benefits, without having a negative impact on the efficacy of ACT and the health of the target population. Implications

  20. Asymptomatic pseudotumours after metal-on-metal hip resurfacing show little change within one year

    NARCIS (Netherlands)

    van der Weegen, W.; Brakel, K.; Horn, R. J.; Hoekstra, H. J.; Sijbesma, T.; Pilot, P.; Nelissen, R. G. H. H.

    2013-01-01

    The aim of this study was to establish the natural course of unrevised asymptomatic pseudotumours after metal-on-metal (MoM) hip resurfacing during a six- to 12-month follow-up period. We used repeated metal artefact reduction sequence (MARS)-magnetic resonance imaging (MRI), serum metal ion analysi

  1. Asymptomatic and persistent elevation of pancreatic enzymes in an ulcerative colitis patient.

    Science.gov (United States)

    Liverani, Elisa; Leonardi, Filippo; Castellani, Lucia; Cardamone, Carla; Belluzzi, Andrea

    2013-01-01

    Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as "Gullo's syndrome," but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as "benign pancreatic hyperenzymemia"?

  2. Asymptomatic and Persistent Elevation of Pancreatic Enzymes in an Ulcerative Colitis Patient

    Directory of Open Access Journals (Sweden)

    Elisa Liverani

    2013-01-01

    Full Text Available Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as “Gullo’s syndrome,” but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as “benign pancreatic hyperenzymemia”?

  3. Risk stratification in asymptomatic and symptomatic patients with carotid artery stenosis

    NARCIS (Netherlands)

    den Hartog, A.G.

    2013-01-01

    The overall aim of this thesis is to explore and assess the risks that patients with carotid artery disease, whether asymptomatic or symptomatic, are exposed to, and to explore whether patients that may be subject to relatively higher risk can be identified by imaging. Although large randomized tria

  4. Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults (Review)

    NARCIS (Netherlands)

    Mettes, Th.G.P.H.; Nienhuijs, M.E.L.; Sanden, W.J.M. van der; Verdonschot, E.H.A.M.; Plasschaert, A.J.M.

    2005-01-01

    BACKGROUND: The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth have been associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, g

  5. Anaemia caused by asymptomatic Plasmodium falciparum infection in semi-immune African schoolchildren

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Addae, M M; Akanmori, B D;

    1999-01-01

    A cohort of 250 Ghanaian schoolchildren aged 5-15 years was followed clinically and parasitologically for 4 months in 1997/98 in order to study the effect of asymptomatic Plasmodium falciparum infections on haematological indices and bone-marrow responses. Of the 250 children 65 met the predefine...

  6. Association between metabolic syndrome and subclinical coronary atherosclerosis in asymptomatic adults.

    Science.gov (United States)

    Kullo, Iftikhar J; Cassidy, Andrea E; Peyser, Patricia A; Turner, Stephen T; Sheedy, Patrick F; Bielak, Lawrence F

    2004-12-15

    Metabolic syndrome was associated with the presence and quantity of coronary artery calcium, a marker of subclinical coronary atherosclerosis, in 1,129 asymptomatic adults, ages 20 to 79 years, from a community-based study. The association was independent of 10-year risk of coronary heart disease based on the Framingham risk score.

  7. Malarial anemia leads to adequately increased erythropoiesis in asymptomatic Kenyan children

    NARCIS (Netherlands)

    Verhoef, H.; West, C.E.; Kraaijenhagen, R.; Nzyuko, S.M.; King, R.; Mbandi, M.M.; Laatum, van S.; Hogervorst, R.; Schep, C.; Kok, F.J.

    2002-01-01

    Malarial anemia is associated with a shift in iron distribution from functional to storage compartments. This suggests a relative deficit in erythropoietin production or action similar to that observed in other infections. Our study in Kenyan children with asymptomatic malaria aimed at investigating

  8. Asymptomatic Celiac Disease in Children with Trisomy 21 at 26 Months of Age or Less

    Directory of Open Access Journals (Sweden)

    Nancy J. Roizen

    2014-09-01

    Full Text Available We report three cases of asymptomatic celiac disease identified in children with Down syndrome after being screened at around twenty-four months of age.  These cases raise the question as to what age is screening for celiac disease indicated in a child with Down syndrome and no symptoms.

  9. Genome Sequence of Southern tomato virus in Asymptomatic Tomato ‘Sweet Hearts’

    Science.gov (United States)

    Alcalá-Briseño, Ricardo I.; Coşkan, Sevgi; Londoño, Maria A.

    2017-01-01

    ABSTRACT The genome sequence of Southern tomato virus in asymptomatic Solanum lycopersicum ‘Sweet Hearts’ (STV-Florida) in Florida was assembled from small RNAs sequenced by Illumina RNA-seq. The STV-Florida genome shared 99.0 to 99.9% similarity with full genome sequences from Bangladesh, China, Mexico, and the United States (Mississippi and North Carolina). PMID:28209810

  10. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    OpenAIRE

    Ruygrok, Peter; Webster, Mark; de Valk, Vincent; Es, Gerrit Anne; Ormiston, John; Morel, Marie-Angèle; Serruys, Patrick

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND RESULTS: All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariat...

  11. Active infection with Helicobacter pylori in an asymptomatic population of middle aged to elderly people

    DEFF Research Database (Denmark)

    Rothenbacher, D; Bode, G; Peschke, F

    1998-01-01

    The study objective was to investigate prevalence and determinants of current Helicobacter pylori infection in an asymptomatic population of middle-aged to elderly people. A cross-sectional study was conducted among 337 participants of a general education programme of the University of Ulm aged 50...

  12. Postoperative lumbar MR imaging with contrast enhancement. Comparison between symptomatic and asymptomatic patients

    Energy Technology Data Exchange (ETDEWEB)

    Grane, P. [Dept. of Neuroradiology, Karolinska Hospital, Stockholm (Sweden); Tullberg, T. [Dept. of Orthopaedics, St. Goeran`s Hospital, Stockholm (Sweden); Rydberg, J. [Dept. of Radiology, St. Goeran`s Hospital, Stockholm (Sweden); Lindgren, L. [Dept. of Neurosurgery, Karolinska Hospital, Stockholm (Sweden)

    1995-05-01

    Contrast-enhanced MR imaging of the spine after surgery for lumbar disk herniation almost always shows pathologic changes. To investigate to what extent these changes are correlated to patients` actual clinical symptoms, we compared the postoperative MR findings in 19 asymptomatic patients with 42 symptomatic patients (43 levels). The asymptomatic patients underwent MR examination one year after surgery. Twenty-six of the symptomatic patients underwent MR one year of less after surgery, and in 16 patients (17 levels) MR was performed more than one year after surgery. Sixteen percent of the asymptomatic and 42% of the symptomatic patients had disk herniation at the level of previous surgery. Most of the herniated disks were found in the symptomatic patients less than one year after surgery. The amount of epidural scar tissue, displacement and thickening of nerve roots, and compression of the dural sac were also studied. Disk herniation as a probable cause of recurrent sciatica was a common finding among symptomatic patients examined one year or less after surgery. In comparing asymptomatic patients and symptomatic patients with more than one year between surgery and MR examination, no significant radiologic differences, including disk herniation, were found. (orig.).

  13. Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth (Review)

    NARCIS (Netherlands)

    Mettes, T.G.; Ghaeminia, H.; Nienhuijs, M.E.L.; Perry, J.; Sanden, W.J. van der; Plasschaert, A.

    2012-01-01

    BACKGROUND: The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gum

  14. ASFV in Tanzania: Asymptomatic pigs harbor virus of molecular similarity to Georgia 2007

    DEFF Research Database (Denmark)

    Uttenthal, Åse; Braae, Uffe Christian; Ngowi, H. A.;

    2013-01-01

    In 2011 African swine fever virus (ASFV) genome was detected in asymptomatic pigs in field samples in Mbeya, Tanzania. The aim of this paper is to partly characterize the virus that was harboured in these pigs and furthermore to confirm, by a second sampling, the latest occurrence of ASFV...

  15. Asymptomatic spontaneous cerebral emboli and mood in a cohort of older people: a prospective study.

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Purandare, N.; Hardicre, J.; McCollum, C.N.; Burns, A.

    2007-01-01

    OBJECTIVE: To examine whether asymptomatic spontaneous cerebral emboli (SCE) predicts subsequent depression in older people. METHODS: Prospective cohort study with 2.5 years of follow-up including 96 nondepressed older subjects in primary care. Presence of SCE was measured at baseline by transcrania

  16. Prevalence of asymptomatic carotid artery stenosis according to age and sex systematic review and metaregression analysis

    NARCIS (Netherlands)

    de Weerd, M.; Greving, J.P.; de Jong, A.W.F.; Buskens, E.; Bots, M.L.

    2009-01-01

    Background and Purpose-In the discussion on the value of population-wide screening for asymptomatic carotid artery stenosis (ACAS), reliable prevalence estimates are crucial. We set out to provide reliable age- and sex-specific prevalence estimates of ACAS through a systematic literature review and

  17. Prevalence and genotype distribution of human papillomavirus infection in asymptomatic women in Liaoning province, China.

    Science.gov (United States)

    Xue, Hui; Lin, Xuyong; Li, Tianren; Yan, Xiaoxia; Guo, Kejun; Zhang, Yi

    2015-07-01

    Infection by human papillomavirus (HPV) is a necessary cause of cervical cancer. The purpose of this study was to investigate the prevalence and genotype distribution of HPV infection in Chinese women who were asymptomatic for cervical diseases. Cervical cytology samples were collected from 6479 asymptomatic Chinese women of Liaoning province, and tested for various HPV genotypes using a chip hybridization assay. HPV was found in 10.3% of all the asymptomatic women studied, with the prevalence of high risk HPV (HR HPV) and low risk HPV (LR HPV) being 9.5% and 1.1%, respectively. HPV genotypes 16, 52, and 58 were found the most frequently genotypes in the HR HPV positive women, and were present in 26.2%, 19.4% and 13.8%, respectively. A graph of HR HPV positive infection rates as a function of age is U-shaped, with a peak in women less than 30 years old and a second peak among women older than 50 years. Nearly half of the women infected with either HR HPV or LR HPV presented a normal looking cervix upon visual examination. The current study demonstrates that the epidemiology of HPV infection in asymptomatic Chinese women in Liaoning province is different from that in women from other regions, even from patients with cervical lesions in the same region. These findings could be used to guide the generation and design of an HPV vaccine for this population.

  18. Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls : a systematic review

    NARCIS (Netherlands)

    Weering, van Marit; Vollenbroek-Hutten, M.M.R.; Kotte, E.M.; Hermens, H.J.

    2007-01-01

    Objective: To gain an insight into the daily physical activity levels of patients with chronic pain or fatigue compared with asymptomatic controls. Data sources: MEDLINE, EMBASE, PsycINFO, Picarta, Cochrane Database of Systematic Reviews, reference tracking and a manual search of relevant journals.

  19. Resting heart rate and risk of adverse cardiovascular outcomes in asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Greve, Anders M; Bang, Casper N; Berg, Ronan M G

    2015-01-01

    BACKGROUND: An elevated resting heart rate (RHR) may be an early sign of cardiac failure, but its prognostic value during watchful waiting in asymptomatic aortic stenosis (AS) is largely unknown. METHODS: RHR was determined by annual ECGs in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS...

  20. Asymptomatic eosinophilia due to enterobiasis in a child:A case report

    Institute of Scientific and Technical Information of China (English)

    Yann A.Meunier; MD

    2008-01-01

    This paper reported the case of a 6-year old child who presented with an asymptomatic eosinophilia.The diag-nosis of enterobiasis was established by a Graham anal scotch test and he was successfully treated with flu-oromebendazole.Subsequent control exams were negative.

  1. Brain glucose metabolism in adults with ataxia-telangiectasia and their asymptomatic relatives.

    Science.gov (United States)

    Volkow, Nora D; Tomasi, Dardo; Wang, Gene-Jack; Studentsova, Yana; Margus, Brad; Crawford, Thomas O

    2014-06-01

    Ataxia-telangiectasia is a recessive genetic disorder (ATM is the mutated gene) of childhood with severe motor impairments and whereas homozygotes manifest the disorder, heterozygotes are asymptomatic. Structural brain imaging and post-mortem studies in individuals with ataxia-telangiectasia have reported cerebellar atrophy; but abnormalities of motor control characteristic of extrapyramidal dysfunction suggest impairment of broader motor networks. Here, we investigated possible dysfunction in other brain areas in individuals with ataxia-telangiectasia and tested for brain changes in asymptomatic relatives to assess if heterozygocity affects brain function. We used positron emission tomography and (18)F-fluorodeoxyglucose to measure brain glucose metabolism (quantified as µmol/100 g/min), which serves as a marker of brain function, in 10 adults with ataxia-telangiectasia, 19 non-affected adult relatives (12 siblings, seven parents) and 29 age-matched healthy controls. Statistical parametric mapping and region of interest analyses were used to compare individuals with ataxia-telangiectasia, asymptomatic relatives, and unrelated controls. We found that participants with ataxia-telangiectasia had lower metabolism in cerebellar hemispheres (14%, P brain stimulation. Our finding of decreased metabolism in vermis and hippocampus of asymptomatic relatives suggests that heterozygocity influences the function of these brain regions.

  2. A prospective, clinical study on asymptomatic sensitisation and development of allergic rhinitis

    DEFF Research Database (Denmark)

    Bodtger, Uffe; Assing, Kristian; Poulsen, Lars K

    2011-01-01

    Asymptomatic aeroallergen sensitisation affects approximately 10% of Western adolescents and is an established risk factor for the development of respiratory allergy. The reported incidence is 2-20% annually. Previous studies are based on out-seasonal symptom recollection or selected populations...

  3. Asymptomatic parental mosaicism for osteogenesis imperfect associated with a new splice site mutation in COL1A2

    DEFF Research Database (Denmark)

    Frederiksen, Anja Lisbeth; Dunø, Morten; Johnsen, Iben Birgit Gade;

    2016-01-01

    Recurrent lethal perinatal osteogenesis imperfecta may result from asymptomatic parental mosaicism. A previously unreported mutation in COL1A2 leads to recurrent cases of fetal osteogenesis imperfecta Sillence type IIA, which emphasizes the importance of clinical and genetic evaluation of mosaicism...... in asymptomatic parents as verified mosaicism highly increases recurrence risk....

  4. Asymptomatic parental mosaicism for osteogenesis imperfecta associated with a new splice site mutation in COL1A2

    OpenAIRE

    2016-01-01

    Key Clinical Message Recurrent lethal perinatal osteogenesis imperfecta may result from asymptomatic parental mosaicism. A previously unreported mutation in COL1A2 leads to recurrent cases of fetal osteogenesis imperfecta Sillence type IIA, which emphasizes the importance of clinical and genetic evaluation of mosaicism in asymptomatic parents as verified mosaicism highly increases recurrence risk.

  5. Parasite load estimation by qPCR differentiates between asymptomatic and symptomatic infection in Indian Visceral Leishmaniasis

    Science.gov (United States)

    Sudarshan, Medhavi; Sundar, Shyam

    2014-01-01

    Using quantitative PCR we differentiated asymptomatic and symptomatic Indian Leishmania donovani infection. qPCR on blood of 40 visceral leishmaniasis, 130 endemic and 40 nonendemic healthy controls showed 500 times less (p<0.0001) parasitemia in asymptomatic compared to the symptomatic ones, and threshold of 5 parasite genome/ml for the clinical disease. PMID:25023070

  6. Subclinical infection and asymptomatic carriage of gastrointestinal zoonoses: occupational exposure, environmental pathways, and the anonymous spread of disease.

    Science.gov (United States)

    Quilliam, R S; Cross, P; Williams, A Prysor; Edwards-Jones, G; Salmon, R L; Rigby, D; Chalmers, R M; Thomas, D Rh; Jones, D L

    2013-10-01

    Asymptomatic carriage of gastrointestinal zoonoses is more common in people whose profession involves them working directly with domesticated animals. Subclinical infections (defined as an infection in which symptoms are either asymptomatic or sufficiently mild to escape diagnosis) are important within a community as unknowing (asymptomatic) carriers of pathogens do not change their behaviour to prevent the spread of disease; therefore the public health significance of asymptomatic human excretion of zoonoses should not be underestimated. However, optimal strategies for managing diseases where asymptomatic carriage instigates further infection remain unresolved, and the impact on disease management is unclear. In this review we consider the environmental pathways associated with prolonged antigenic exposure and critically assess the significance of asymptomatic carriage in disease outbreaks. Although screening high-risk groups for occupationally acquired diseases would be logistically problematical, there may be an economic case for identifying and treating asymptomatic carriage if the costs of screening and treatment are less than the costs of identifying and treating those individuals infected by asymptomatic hosts.

  7. Impact of QRS duration and morphology on the risk of sudden cardiac death in asymptomatic patients with aortic stenosis

    DEFF Research Database (Denmark)

    Greve, Anders M; Gerdts, Eva; Boman, Kurt

    2012-01-01

    The aim of the study was to examine the predictive value of QRS duration and morphology during watchful waiting in asymptomatic patients with aortic stenosis (AS).......The aim of the study was to examine the predictive value of QRS duration and morphology during watchful waiting in asymptomatic patients with aortic stenosis (AS)....

  8. Grass pollen symptoms interfere with the recollection of birch pollen symptoms - a prospective study of suspected, asymptomatic skin sensitization

    DEFF Research Database (Denmark)

    Assing, K; Bodtger, U; Poulsen, Lars K.

    2007-01-01

    Asymptomatic skin sensitization (AS) is a risk factor for the development of allergic symptoms. A meticulous definition of this condition requires a systematic assessment of clinical symptoms before inclusion.......Asymptomatic skin sensitization (AS) is a risk factor for the development of allergic symptoms. A meticulous definition of this condition requires a systematic assessment of clinical symptoms before inclusion....

  9. Prevalence and risk factors of asymptomatic peripheral arterial disease in patients with COPD in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ming-Shian Lin

    Full Text Available AIM: Chronic obstructive pulmonary disease (COPD is an independent risk factor for cardiovascular morbidity and mortality. The aim of this study was to determine the prevalence of asymptomatic peripheral arterial disease (PAD and the associated risk factors for patients with COPD. METHODS: This prospective cross-sectional study enrolled 427 COPD patients (mean age: 70.0 years without PAD symptoms consecutively. Demographic data, lung function and cardiovascular risk factors were recorded. The ankle-brachial index (ABI was used to detect PAD (ABI<0.90. RESULTS: The overall prevalence of asymptomatic PAD in the COPD patients was 8% (2.5% in the younger participants (<65 years of age, n = 118 and 10% in the elderly participants (≥65 years of age, n = 309. The COPD patients with asymptomatic PAD had a significantly higher rate of hyperlipidemia (47.1% vs. 10.4% and hypertension (79.4% vs. 45.8% than those without asymptomatic PAD (p<0.05. There was no significant difference in lung function (forced vital capacity and forced expiratory volume in one second between the two groups. In multivariate logistic regression, hyperlipidemia was the strongest independent factor for PAD (odds ratio (OR: 6.89, p<0.005, followed by old age (OR: 4.80, hypertension (OR: 3.39 and smoking burden (pack-years, OR: 1.02. CONCLUSIONS: The prevalence of asymptomatic PAD among COPD patients in Taiwan is lower than in Western countries. Hyperlipidemia, old age, hypertension, and smoking burden were the associated cardiovascular risk factors. However, there was no association between lung function and PAD in the COPD patients.

  10. Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic Stenosis

    DEFF Research Database (Denmark)

    Christensen, Nicolaj Lyhne; Dahl, Jordi Sanchez; Carter-Storch, Rasmus

    2016-01-01

    BACKGROUND: Transition from an asymptomatic to symptomatic state in severe aortic stenosis is often difficult to assess. Identification of a morphological sign of increased hemodynamic load may be important in asymptomatic aortic stenosis to identify patients at risk. METHODS AND RESULTS: Thirty......-nine patients with asymptomatic severe aortic stenosis (aortic valve area 3.5 m/s) underwent exercise testing with simultaneous invasive hemodynamic monitoring and Doppler echocardiography. Cardiac index, pulmonary artery pressure, and pulmonary capillary wedge pressure (PCWP) were.......92-4.15). CONCLUSIONS: LA size reflects hemodynamic burden in patients with asymptomatic severe aortic stenosis. Quantitative measurements of LA and diastolic function are associated with left ventricular filling pressures with exercise and could be used to identify asymptomatic patients with increased hemodynamic...

  11. Role of verocytotoxigenic Escherichia coli in the swine production chain

    Directory of Open Access Journals (Sweden)

    Laura Ercoli

    2015-06-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC can cause severe clinical diseases in humans, such as haemorrhagic colitis (HC and haemolytic-uremic syndrome (HUS. Although ruminants, primarily cattle, have been suggested as typical reservoirs of STEC, many food products of other origins, including pork products, have been confirmed as vehicles for STEC transmission. Only in rare cases, pork consumption is associated with severe clinical symptoms caused by high pathogenic STEC strains. However, in these outbreaks, it is unknown whether the contamination of food products occurs during swine processing or via cross-contamination from foodstuffs of different sources. In swine, STEC plays an important role in the pathogenesis of oedema disease. In particular a Shiga toxin subtype, named stx2e, it is considered as a key factor involved in the damage of swine endothelial cells. On the contrary, stx2e-producing Escherichia coli has rarely been isolated in humans, and usually only from asymptomatic carriers or from patients with mild symptoms, such as uncomplicated diarrhoea. In fact, the presence of gene stx2e, encoding for stx2e, has rarely been reported in STEC strains that cause HUS. Moreover, stx2e-producing STEC isolated from humans and pigs were found to differ in serogroup, their virulence profile and interaction with intestinal epithelial cells. Because of the limited epidemiologic data of STEC in swine and the increasing role of non-O157 STEC in human illnesses, the relationship between swine STEC and human disease needs to be further investigated.

  12. Is asymptomatic peripheral arterial disease associated with walking endurance in patients with COPD?

    Directory of Open Access Journals (Sweden)

    Sun KS

    2015-07-01

    Full Text Available Kuo-Shao Sun,1,2* Ming-Shian Lin,1,2* Yi-Jen Chen,1,2 Yih-Yuan Chen,3 Solomon Chih-Cheng Chen,4 Wei Chen1,5,6 1Division of Pulmonary and Critical Care Medicine, 2Department of Respiratory Care, Chang Gung University of Science and Technology, 3Department of Internal Medicine, 4Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, 5College of Nursing, Dayeh University, Changhua, 6Department of Respiratory Therapy, China Medical University, Taichung, Taiwan, Republic of China *These authors contributed equally to this work Objective: Symptomatic peripheral arterial disease (PAD is associated with impaired walking endurance in patients with chronic obstructive pulmonary disease (COPD. However, it is unknown whether asymptomatic PAD is associated with impaired walking endurance in patients with COPD. Methods: This prospective cross-sectional study enrolled 200 COPD patients (mean age: 70.9 years who volunteered to perform ankle-brachial index (ABI and 6-minute walk test (6MWT consecutively. Demographic data, lung function, dyspnea scales, and cardiovascular risk factors were recorded. The ABI was used to detect PAD (ABI <0.90. All patients were free of PAD symptoms at enrollment. Results: Of the 200 COPD patients, 17 (8.5% were diagnosed with asymptomatic PAD. The COPD patients without asymptomatic PAD did not walk significantly further on the 6MWT than the COPD patients with asymptomatic PAD (439±86 m vs 408±74 m, P=0.159. The strongest correlation with the distance walked on the 6MWT was Medical Research Council dyspnea scale (r2=-0.667, P<0.001, followed by oxygen-cost diagram (r2=0.582, P<0.001 and forced expiratory volume in 1 second (r2=0.532, P<0.001. In multivariate linear regression analysis, only age, forced expiratory volume in 1 second, and baseline pulse oximetry were independently correlated with the distance covered on the 6MWT (P<0.05. However, body mass index, baseline heart rate, and

  13. Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants

    Energy Technology Data Exchange (ETDEWEB)

    Morigeri, C.; Mukhopadhyay, K.; Narang, A. [Postgraduate Institute of Medical Education and Research (PGIMER), Division of Neonatology, Department of Paediatrics, Chandigarh (India); Bhattacharya, A.; Mittal, B.R. [Postgraduate Institute of Medical Education and Research (PGIMER), Department of Nuclear Medicine, Chandigarh (India)

    2008-09-15

    Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. {sup 99m}Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p=0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p=0.449). Mean number of reflux episodes in 20 min was 4.4{+-}2.4 in symptomatic babies and 4.9 {+-}2.2 in asymptomatic babies (p=0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in

  14. Animal Reservoirs of Shiga Toxin-Producing Escherichia coli.

    Science.gov (United States)

    Persad, Anil K; LeJeune, Jefrey T

    2014-08-01

    Shiga toxin-producing Escherichia coli (STEC) strains have been detected in a wide diversity of mammals, birds, fish, and several insects. Carriage by most animals is asymptomatic, thus allowing for dissemination of the bacterium in the environment without detection. Replication of the organism may occur in the gastrointestinal tract of some animals, notably ruminants. Carriage may also be passive or transient, without significant amplification of bacterial numbers while in the animal host. Animals may be classified as reservoir species, spillover hosts, or dead-end hosts. This classification is based on the animal's ability to (i) transmit STEC to other animal species and (ii) maintain STEC infection in the absence of continuous exposure. Animal reservoirs are able to maintain STEC infections in the absence of continuous STEC exposure and transmit infection to other species. Spillover hosts, although capable of transmitting STEC to other animals, are unable to maintain infection in the absence of repeated exposure. The large diversity of reservoir and spillover host species and the survival of the organism in environmental niches result in complex pathways of transmission that are difficult to interrupt.

  15. A Critical Protection Level Derived from Dengue Infection Mathematical Model Considering Asymptomatic and Symptomatic Classes

    Science.gov (United States)

    Anggriani, N.; Supriatna, A. K.; Soewono, E.

    2013-04-01

    In this paper we formulate a model of dengue fever transmission by considering the presence of asymptomatic and symptomatic compartments. The model takes the form as a system of differential equations representing a host-vector SIR (Susceptible - Infective -Recovered) disease transmission. It is assumed that both host and vector populations are constant. It is also assumed that reinfection of recovered hosts by the disease is possible due to a wanning immunity in human body. We analyze the model to determine the qualitative behavior of the model solution and use the concept of effective basic reproduction number (fraktur Rp) as a control criteria of the disease transmission. The effect of mosquito biting protection (e.g. by using insect repellent) is also considered. We compute the long-term ratio of the asymptomatic and symptomatic classes and show a condition for which the iceberg phenomenon could appear.

  16. Uncommon Asymptomatic Unilateral Complete Duplicated Collecting System and Giant Ectopic Ureterocele in Middle-Age Patient

    Directory of Open Access Journals (Sweden)

    Halil Serin

    2014-02-01

    Full Text Available Ureterocele is a common pediatric urologic problem, but has been reported seldom in adults. Most duplex system ureteroceles existent as urinary tract infections at an early age, with adult presentation being uncommon. Urinary stasis in the dilated distal ureter often lends to urinary infection and stone formation; precluding the most common offering symptoms of dysuria, urgency, and recurrent urinary tract infections. Ižn duplex system ureteroceles to poorly or non-functioning moieties, heminephroureterectomy is an definite solution. We present a case of rarely middle-age asymptomatic obstructive giant ureterocele. We intended to emphasize that patient with obstructive, giant, ectopic ureterocele and duplicated collecting system may have asymptomatic course.

  17. Evaluation of cats (Felis catus) as possible asymptomatic carriers of dermatophytes in extreme south of Brazil

    Institute of Scientific and Technical Information of China (English)

    Tony Silveira; Renata de Faria; Mariana Remio; Camila Graeff; Fabiana Poetsch; Guilherme Azevedo; Juliane Guimares; Rafaela Bellora; Tassiane Moraes; Pedro Quevedo

    2015-01-01

    Objective: To investigate the presence of Microsporum canis in pelage of asymptomatic cats for dermatophytosis, in south region of Rio Grande do Sul, Brazil, and evaluate its importance in epidemiology of dermatophytosis in the study area. Methods: A total of 60 domestic cats were evaluated for the presence of Microsporum canis. The animals were divided into three groups of 20 felines. Each group consisted of exclusively domiciled, semi-domiciled and rural animals. Samples were collected following the carpet-square technique. The microorganisms were cultivated under laminar flow in mycosel agar and grown in a greenhouse. Results: All the cats of the three groups analysed had negative cultures for dermatophytes. In 85% of the dishes, there was a growth of environmental saprophytic fungi such as Aspergillus sp., Fusarium sp. and Penicillium sp. Conclusions: Thus, asymptomatic cats for dermatophytes did not show importance in the transmission and maintenance of the disease in southern of Rio Grande do Sul, Brazil.

  18. Soluble products of inflammatory reactions are not induced in children with asymptomatic Plasmodium falciparum infections

    DEFF Research Database (Denmark)

    Jakobsen, P H; McKay, V; N'Jie, R;

    1996-01-01

    A proportion of children with Plasmodium falciparum infection have a high parasitaemia without accompanying fever, indicative of different clinical thresholds of parasitaemia. Higher levels of IL-10, IL-1Ra and sIL-4R but not sIL-2R were found in children with P. falciparum malaria, compared...... with levels in children with asymptomatic P. falciparum infections and in healthy children. Concentrations of IL-10 and IL-1Ra were correlated with levels of parasitaemia, but the association of cytokine levels with disease was independent of the association with parasitaemia. Children may tolerate a high...... parasitaemia by neutralizing the parasite-derived toxins. When studying potential anti-toxic molecules we found that children with symptomatic infections had lower concentrations of a phospholipid-binding molecule, beta 2-glycoprotein I (beta 2-GPI), compared with children with asymptomatic infections...

  19. Asymptomatic Genital Infection of Human Papillomavirus in Pregnant Women and the Vertical Transmission Route

    Institute of Scientific and Technical Information of China (English)

    DENG Dongrui; WEN Liangzhen; CHEN Wen; LING Xiazhen

    2005-01-01

    Summary: To further investigate the vertical transmission route of human papillomavirus (HPV) and the indication for the choice of mode of delivery, the infective status of 152 asymptomatic pregnant wemen and the maternal-fetal transmission were studied. By using general primers in polymerase chain reaction (GP-PCR) combined with restriction fragment length polymorphism analysis, HPV DNA positive rate in cervical secretions and venous blood in asymptomatic pregnant women was 36.21 % and 52.78 %, respectively, and the identified genotypes were mainly HPV16 and 18. The maternal-fetal transmission rate of HPV via genital tract as well as blood was 40.91 % and 57.89 %, respectively. It was concluded that besides the transmission route of genital tract and amniotic fluid, there was also transplacental transmission of HPV in utero. Therefore,in our opinion, it is not an absolut indication to perform a cesarean delivery for the pregnant women with HPV asymtomatic genital infection.

  20. Prevalence of cystic paraurethral structures in asymptomatic women at endovaginal and perineal sonography

    Energy Technology Data Exchange (ETDEWEB)

    Cross, Justin J.L.; Fynes, Michelle; Berman, Laurence; Perera, Divaka

    2001-07-01

    AIM: To prospectively assess the prevalence of paraurethral cystic structures in asymptomatic adult women. PATIENTS AND METHODS: One hundred and forty consecutive women undergoing endovaginal sonography with no history of lower urinary tract symptoms. RESULTS: Paraurethral cystic structures were identified in 4/140 subjects (2.9%). Ultrasound assessment allowed rapid definition of the site, size and vascularity of these lesions and was well tolerated by the patient. CONCLUSION: This is the first prospective ultrasound study to determine the prevalence of paraurethral cystic structures in a large consecutive cohort of asymptomatic women. Our findings are in accordance with previously published post-mortem data and surgical series which have estimated the prevalence of paraurethral cystic structures to be between 1 and 6%. Cross, J.J.L. et al.(2001)

  1. Association of ischemic heart disease to global and regional longitudinal strain in asymptomatic aortic stenosis

    DEFF Research Database (Denmark)

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian

    2015-01-01

    Longitudinal deformation has been shown to deteriorate with progressive aortic stenosis as well as ischemic heart disease. Despite that both conditions share risk factors and are often coexisting, studies have not assessed the influence on longitudinal deformation for both conditions simultaneously....... Thus the purpose of this study was to evaluate the association between subclinical ischemic heart disease and global and regional longitudinal strain in asymptomatic patients with significant aortic stenosis. Prevalent patients with a diagnosis of aortic stenosis at six hospitals in the Greater...... Copenhagen area were screened for inclusion. A total of 104 asymptomatic patients with moderate-severe aortic stenosis (aortic valve area ≤1.5 cm(2)) fulfilled study criteria and underwent advanced echocardiographic analysis and coronary angiography by multi-detector computed tomography. Angiography revealed...

  2. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study

    Energy Technology Data Exchange (ETDEWEB)

    Schibany, N. E-mail: nadja.schibany@univie.ac.at; Zehetgruber, H.; Kainberger, F.; Wurnig, C.; Ba-Ssalamah, A.; Herneth, A.M.; Lang, T.; Gruber, D.; Breitenseher, M.J

    2004-09-01

    Objective: To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers. Materials and Methods: Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology. Results: Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P<0.01). Conclusion: There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living.

  3. Asymptomatic carotid lesions after endarterectomy of contralateral carotid artery. Five-year follow-up study and prognosis

    DEFF Research Database (Denmark)

    Schroeder, T; Helgstrand, U J; Egeblad, M R

    1987-01-01

    patients developed symptoms referable to the territory of the previously asymptomatic ICA (five strokes and eight transient ischemic attacks). Using life-table analysis, the annual stroke rate was estimated to be 1% and 2.2% considering the previously asymptomatic and symptomatic ICA, respectively......Of 185 patients who consecutively underwent carotid endarterectomy five years ago, 135 had a patent asymptomatic contralateral internal carotid artery (ICA). During follow-up (median, 59 months), 36 patients developed new neurologic symptoms (18 strokes and 18 transient ischemic attacks). Thirteen...

  4. Asymptomatic malaria, growth status, and anaemia among children in Lao People’s Democratic Republic: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Takeshi Akiyama

    2016-10-01

    Full Text Available Abstract Background Asymptomatic malaria can be observed in both stable endemic areas and unstable transmission areas. However, although much attention has been given to acute malaria infections, relatively little attention has been paid to asymptomatic malaria. Nonetheless, because the asymptomatic host serves as a reservoir for the malaria parasite, asymptomatic malaria is now recognized as an important obstacle to malaria elimination. Asymptomatic malaria is also associated with anaemia, a global public health problem with serious consequences on human health as well as social and economic development. In Lao People’s Democratic Republic (Lao PDR, malaria, anaemia, and malnutrition are serious public health concerns. However, few studies have focused on the relationship between these variables. Therefore, this study investigated the relationship between asymptomatic malaria, growth status, and the prevalence of anaemia among children aged 120 months old or younger in rural villages in Lao PDR. Methods In December 2010 and March 2011, data were collected from five villages in Savannakhet province. Anthropometric measurements, blood samples, and malaria rapid diagnostic tests were conducted. The presence of malaria was confirmed with polymerase chain reaction assays for Plasmodium falciparum. Underweight status, stunting, and anaemia were defined according to World Health Organization standards. Results The mean age of participants (n = 319 was 88.3 months old (Standard Deviation: 20.6, ranged from 30–119 months old, and 20 participants (6.3 % had an asymptomatic malaria infection, 92 (28.8 % were anaemic, 123 (38.6 % were underweight, and 137 (42.9 % were stunted. Stunted children were more likely to be infected with asymptomatic malaria [odds ratio (OR 3.34, 95 % confidence interval (CI 1.25–8.93], and asymptomatic malaria was associated with anaemia [OR 5.17, 95 % CI 1.99–13.43]. Conclusions These results suggest a

  5. Asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract.

    Science.gov (United States)

    Mustelier, Juan Valiente; Rego, Julio Oscar Cabrera; Aquiles, Eddy W Olivares; Llerena, Luis Roberto

    2010-12-01

    Coronary artery fistulas are unusual congenital or acquired coronary artery abnormalities in which blood is shunted into a cardiac chamber, great vessel or other structure, bypassing the myocardial capillary network (Jung et al. in Cardiovasc Ultrasound 5:10, 2007). We present a young adult patient with an asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract, first diagnosed by echocardiography examination and further confirmed by 128-slice computed tomography coronary angiography.

  6. Digestive fungal flora in asymptomatic subjects in Bobo-Dioulasso, Burkina Faso

    OpenAIRE

    Bamba Sanata; Ouédraogo Abdoul Salam; Sangaré Ibrahim; Zida Adama; Cissé Mamoudou; Simplice, Karou D.; Simpore Jacques; Guiguemdé T. Robert; Hennequin Christophe

    2014-01-01

    Objective: To identify Candida species in asymptomatic subjects in Bobo-Dioulasso (Burkina Faso) by the matrix-assisted laser desorption ionization-time of flight mass spectrometry. Methods: A cross-sectional study was conducted from January to February 2013 in Bobo-Dioulasso to collect fecal and urine specimens from voluntary donors. Fungal strains were isolated on Sabouraud dextrose agar and analyzed using matrix-assisted laser desorption ionisation-time-of-flight mass spectrometry. R...

  7. Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

    2013-03-15

    This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

  8. Tracking hepatitis C virus quasispecies major and minor variants in symptomatic and asymptomatic liver transplant recipients.

    OpenAIRE

    Gretch, D R; Polyak, S J; Wilson, J J; Carithers, R L; Perkins, J. D.; Corey, L

    1996-01-01

    To evaluate the possibility that distinct viral quasispecies play a role in the pathogenesis of progressive hepatitis C virus (HCV) infection, we performed a detailed evaluation of HCV quasispecies before and after liver transplantation in five patients infected with HCV genotype 1, three of whom developed severe recurrent hepatitis C and two of whom developed asymptomatic posttransplant infections with high-titered viremia. HCV quasispecies were characterized by using a combination of nucleo...

  9. Conservative management of a left ventricle cardiac fibroma in an asymptomatic child patient.

    Science.gov (United States)

    Ünsal, Handan; Ekici, Enver

    2015-07-01

    Primary cardiac tumors in infancy and childhood are rare and usually benign. Fibroma is the second most common bening cardiac tumor after rhabdomyoma. Surgery is required when fibromas cause ventricular outflow tract obstruction, ventricular dysfunction and life-threatening arrhythmia. This case report describes a 9-year-old asymptomatic male presenting with a giant left ventricular cardiac fibroma who was followed up using conservative treatment.

  10. Detection of Asymptomatic Renal Calcifications in Astronauts Using a Novel Ultrasound Protocol

    Science.gov (United States)

    Garcia, Kathleen; Sargsyan, Ashot; Reyes, David; Locke, James

    2017-01-01

    Ultrasound (US) specifically looking for asymptomatic renal calcifications that may be renal stones is typically not done in the terrestrial setting. Standard abdominal US without a renal focus may discover incidental, mineralized renal material (MRM); however punctate solid areas of MRM is less than 3 mm are usually considered subclinical. Detecting these early calcifications before they become symptomatic renal stones is critical to prevent adverse medical and mission outcomes during spaceflight.

  11. A risk score for predicting mortality in patients with asymptomatic mild to moderate aortic stenosis

    DEFF Research Database (Denmark)

    Holme, Ingar; Pedersen, Terje R; Boman, Kurt

    2012-01-01

    BackgroundPrognostic information for asymptomatic patients with aortic stenosis (AS) from prospective studies is scarce and there is no risk score available to assess mortality.ObjectivesTo develop an easily calculable score, from which clinicians could stratify patients into high and lower risk...... of mortality, using data from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study.MethodA search for significant prognostic factors (p...

  12. ECU tendon ''dislocation'' in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Petchprapa, Catherine N. [New York University Langone Medical Center, Hospital for Joint Diseases, Department of Radiology, New York, NY (United States); Meraj, Seema [Zwanger-Pesiri Radiology Group, Lindenhurst, NY (United States); Jain, Nidhi [New York University School of Medicine, New York University Langone Medical Center, Department of Radiology, New York, NY (United States)

    2016-06-15

    Assess extensor carpi ulnaris (ECU) tendon position in the ulnar groove, determine the frequency of tendon ''dislocation'' with the forearm prone, neutral, and supine, and determine if an association exists between ulnar groove morphology and tendon position in asymptomatic volunteers. Axial proton density-weighted MR was performed through the distal radioulnar joint with the forearm prone, neutral, and supine in 38 asymptomatic wrists. The percentage of the tendon located beyond the ulnar-most border of the ulnar groove was recorded. Ulnar groove depth and length was measured and ECU tendon signal was assessed. 15.8 % of tendons remained within the groove in all forearm positions. In 76.3 %, the tendon translated medially from prone to supine. The tendon ''dislocated'' in 0, 10.5, and 39.5 % with the forearm prone, neutral and supine, respectively. In 7.9 % prone, 5.3 % neutral, and 10.5 % supine exams, the tendon was 51-99 % beyond the ulnar border of the ulnar groove. Mean ulnar groove depth and length were 1.6 and 7.7 mm, respectively, with an overall trend towards greater degrees of tendon translation in shorter, shallower ulnar grooves. The ECU tendon shifts in a medial direction when the forearm is supine; however, tendon ''dislocation'' has not been previously documented in asymptomatic volunteers. The ECU tendon medially translated or frankly dislocated from the ulnar groove in the majority of our asymptomatic volunteers, particularly when the forearm is supine. Overall greater degrees of tendon translation were observed in shorter and shallower ulnar grooves. (orig.)

  13. Giant prostatic hyperplasia: report of a previously asymptomatic man presenting with gross hematuria and hypovolemic shock.

    Science.gov (United States)

    Wroclawski, Marcelo Langer; Carneiro, Ariê; Tristão, Rodrigo Alves; Sakuramoto, Paulo Kouiti; Youssef, Jorg Daoud Merched; Lopes Neto, Antonio Correa; Santiago, Lucila Heloísa Simardi; Pompeo, Antonio Carlos Lima

    2015-01-01

    Giant prostatic hyperplasia is a rare condition characterized by very high volume benign prostatic enlargement (>500g). Few cases have been reported so far and most of them are associated with severe lower urinary symptoms. We report the first case of asymptomatic giant prostatic hyperplasia in an elderly man who had a 720g prostate adenoma, sudden gross hematuria and hypovolemic shock. The patient was successfully treated with open transvesical prostatectomy and had an uneventful postoperative recovery.

  14. Frequency of Chlamydia Trachomatis in Symptomatic and Asymptomatic Non-pregnant Women in Golestan Province

    Directory of Open Access Journals (Sweden)

    Samira Okhli (MSc

    2016-06-01

    Full Text Available Background and Objective: Chlamydia trachomatis is one of the most common causes of genital infection in men and women. Genital chlamydial infections in women are clinically asymptomatic in 70-80% of the cases; therefore, the lack of timely diagnosis and treatment leads to complications such as infertility and ectopic pregnancy. The aim of this study was to evaluate the frequency of chlamydial infection in symptomatic and asymptomatic women in the Golestan province. Methods: This cross-sectional study was conducted on 150 cervical swab samples obtained from 150 women referred to the clinic, after obtaining written consent and completion of questionnaires. The swab samples were transferred to laboratory in phosphate-buffered saline solution and DNA extraction was carried out using phenol-chloroform and boiling methods. The frequency of chlamydial infection was evaluated by PCR. Results: None of the tested samples were found as Chlamydia-positive. Conclusion: The findings require that some more extensive research with larger sample sizes and dispersed population be performed to determine the true prevalence. Considering the serious complications of chlamydial infections and its asymptomatic nature, a highly sensitive and specific method such as PCR should be used to detect Chlamydia. It is suggested that this method be used along with a complementary test to obtain the results that are more accurate. Furthermore, conducting simultaneous studies on other populations at risk will be very helpful in obtaining representable national data.

  15. ADMA/SDMA in Elderly Subjects with Asymptomatic Carotid Atherosclerosis: Values and Site-Specific Association

    Directory of Open Access Journals (Sweden)

    Graziano Riccioni

    2014-04-01

    Full Text Available Asymmetric dimethylarginine (ADMA is an endogenous nitric oxide synthase (NOS inhibitor known as a mediator of endothelial dysfunction and atherosclerosis. Circulating ADMA levels are correlated with cardiovascular risk factors such as hypercholesterolemia, arterial hypertension, diabetes mellitus, hyperhomocysteinemia, age and smoking. We assessed the relationship between ADMA values and site-specific association of asymptomatic carotid atherosclerosis (intima-media thickness (CIMT and plaque in elderly subjects. One hundred and eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI. All subjects had no acute or chronic symptoms of carotid atherosclerosis. Statistical analyses showed that high plasma levels of ADMA/SDMA were positively correlated to carotid atherosclerosis (CIMT and plaque (p < 0.001, with significant site-specific association. Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p < 0.001. High serum concentrations of ADMA and SDMA were associated with carotid atherosclerotic lesions as measured by CIMT ad plaque and may represent a new marker of asymptomatic carotid atherosclerosis in elderly subjects.

  16. A novel CLCN5 mutation in a boy with asymptomatic proteinuria and focal global glomerulosclerosis.

    Science.gov (United States)

    Valina, Mary Rose; Larsen, Christopher P; Kanosky, Sherry; Suchy, Sharon F; Nield, Linda S; Onder, Ali Mirza

    2013-11-01

    Dent disease is an X-linked proximal tubulopathy that typically presents with hypercalciuria, low-molecular-weight proteinuria and slow progression to endstage renal disease. We report the case of a 5-year-old boy who presented with asymptomatic nephrotic range proteinuria and was later diagnosed with Dent disease. Absence of specific glomerular pathology in the first kidney biopsy led to erroneous treatment for presumably unsampled primary focal segmental glomerulosclerosis. Aggressive angiotensin blockade and immunosuppression resulted in significant side effects with marginal benefit. The continued nonspecific findings after a second kidney biopsy 2 years later led to the suspicion of a congenital tubulopathy. We detected a novel CLCN5 gene mutation, c.1396G > C, that creates a G466R missense change in the ClC-5 protein. Dent disease should be considered in the differential diagnosis of asymptomatic proteinuria for male patients. Profiling proteinuria in these patients by spot urine albumin/creatinine ratio may give the first clue to a tubulopathy. Determining the extent to which the clinical work-up should proceed for females with Dent phenotype or asymptomatic proteinuria remains to be a challenging clinical dilemma.

  17. MRA of the intracranial circulation in asymptomatic patients with sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Gillams, A.R. [Department of Radiology, Boston City Hospital Imaging Foundation, Boston, MA (United States)]|[Academic Department of Medical Imaging, Middlesex Hospital, London (United Kingdom); McMahon, L.; Weinberg, G. [Boston City Hospital Sickle Cell Centre, Boston, MA (United States); Carter, A.P. [Department of Radiology, Boston City Hospital Imaging Foundation, Boston, MA (United States)

    1998-05-01

    Background. MR angiography (MRA) provides a mechanism for non-invasively studying blood flow, thus providing a new opportunity to study the intracranial circulation in asymptomatic sickle cell disease (SCD) patients. Although conventional angiography is the gold standard for the depiction of vascular anatomy, this is too invasive for an asymptomatic population. Objective. To establish the range of appearances in asymptomatic SCD patients and to correlate brain MRI results (either sub-clinical abnormalities or normal brain parenchyma) with the MRA findings. Materials and methods. Brain MRI and MRA of the intracranial circulation was performed on 22 patients (13 male and 9 female, median age 7.5 years, range 1.3-20 years). Fourteen were homozygous SS and eight were SC. The median haematocrit at the time of MRI was 25.9 (range 13.8-33.3). Results. On MR imaging, four patients had infarcts in eight vascular territories (six anterior and two posterior). In 3/4 of anterior vascular territories with infarction, long ({>=} 6 mm) segments of abnormal signal were seen at the internal carotid artery bifurcation with associated reduced distal flow. Short focal areas of abnormal signal were commonly seen where vessels branched, bifurcated or curved and were not associated with infarcts. These areas probably represent turbulence-related dephasing secondary to high velocity flow found in SCD. Conclusion. Long segments ({>=} 6 mm) of abnormal signal with reduced distal flow correlated with sub-clinical infarction. (orig.) With 3 figs., 1 tab., 24 refs.

  18. Inflammatory arthritis-like and other MR findings in wrists of asymptomatic subjects

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, P.L.; Page, P.J.; McColl, G.J. [University of Melbourne, Royal Melbourne Hospital, Radiology Department, Parkville (Australia)

    2006-10-15

    To describe magnetic resonance (MR) imaging findings in the wrists of asymptomatic subjects that might be confused with pathologic findings. MR examination of the dominant wrist was performed in 30 asymptomatic volunteers aged 22-49 years using pre-contrast and post-contrast sequences in the coronal and axial planes. The bases of the metacarpals, the carpus and the distal radius and ulna were evaluated by two musculoskeletal radiologists for lesions, notches, blood vessels and synovial enhancement. There were 24 bright osseous lesions (erosions, intraosseous ganglia, oedema or cysts) in 14 subjects. Intraosseous blood vessels were seen in all but one wrist examined, most commonly in the capitate and lunate bones. Enhancement was present in 26 of 27 notches identified at the base of the second metacarpal and less commonly in the capitate, hamate and triquetral notches. A small joint effusion was present in 14 subjects. Joint or soft-tissue enhancement was identified in 16 wrists. Many MR abnormalities and variants may be detected in the wrists of asymptomatic subjects. Many of these could be confused with pathologic findings usually associated with inflammatory arthritis. (orig.)

  19. High Prevalence of Asymptomatic Sexually Transmitted Infections among Men Who Have Sex with Men

    Directory of Open Access Journals (Sweden)

    Patrick Philibert

    2014-12-01

    Full Text Available Background: Men who have sex with men (MSM are disproportionately affected by sexually transmitted infection. The aim of this cross-sectional study is to prospectively detect the prevalence of chlamydia trachomatis (CT, neisseria gonorrhoeae (NG, mycoplasma genitalium (MG, and high risk human papillomavirus (HR-HPV, and syphilis in a population of asymptomatic sexually active MSM. Methods: Rectal, pharyngeal, and urine samples for CT, NG, MG, and HR-HPV were analyzed in 116 MSM patients attending the clinic for their routine follow-up during the period the study was conducted: 99 patients were issued from the clinic routine follow-up for their HIV infection, and 17 attended the clinic because they were sexual partners of an HIV infected male. Results: An STI was found in 16% of the patients (19/116, with at least one bacterial strain (CT, NG, or MG found in one site (the pharynx, rectum, or urine. Conclusions: In this study, 16% of the MSM reporting recent RAI were asymptomatic carriers of rectal CT, NG, or MG. According to the high prevalence of asymptomatic STIs found in our MSM population and in other studies, prevention efforts in the form of counseling about the risk of STI need to be done in the population of MSM.

  20. The utility of endometrial thickness measurement in asymptomatic postmenopausal women with endometrial fluid.

    Science.gov (United States)

    Seckin, B; Ozgu-Erdinc, A S; Dogan, M; Turker, M; Cicek, M N

    2016-01-01

    The aim of this study was to assess the clinical usefulness of sonographic endometrium thickness measurement in asymptomatic postmenopausal women with endometrial fluid collection. Fifty-two asymptomatic postmenopausal women with endometrial fluid, who underwent endometrial sampling were evaluated. Histopathological findings revealed that 25 (48.1%) women had insufficient tissue, 20 (38.4%) had atrophic endometrium and 7 (13.5%) had endometrial polyps. No case of malignancy was found. There was no statistically significant difference between the various histopathological categories (insufficient tissue, atrophic endometrium and polyp) with regard to the mean single-layer endometrial thickness (1.54 ± 0.87, 2.04 ± 1.76 and 1.79 ± 0.69 mm, respectively, p = 0.436). Out of 44 patients with endometrial thickness of less than 3 mm, 38 (86.4%) had atrophic changes or insufficient tissue and 6 (13.6%) had endometrial polyps. In conclusion, if the endometrial thickness is 3 mm or less, endometrial sampling is not necessary in asymptomatic postmenopausal women with endometrial fluid.

  1. High Prevalence of Asymptomatic Sexually Transmitted Infections among Men Who Have Sex with Men

    Science.gov (United States)

    Philibert, Patrick; Khiri, Hacène; Pénaranda, Guillaume; Camus, Claire; Drogoul, Marie-Pierre; Halfon, Philippe

    2014-01-01

    Background: Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infection. The aim of this cross-sectional study is to prospectively detect the prevalence of chlamydia trachomatis (CT), neisseria gonorrhoeae (NG), mycoplasma genitalium (MG), and high risk human papillomavirus (HR-HPV), and syphilis in a population of asymptomatic sexually active MSM. Methods: Rectal, pharyngeal, and urine samples for CT, NG, MG, and HR-HPV were analyzed in 116 MSM patients attending the clinic for their routine follow-up during the period the study was conducted: 99 patients were issued from the clinic routine follow-up for their HIV infection, and 17 attended the clinic because they were sexual partners of an HIV infected male. Results: An STI was found in 16% of the patients (19/116), with at least one bacterial strain (CT, NG, or MG) found in one site (the pharynx, rectum, or urine). Conclusions: In this study, 16% of the MSM reporting recent RAI were asymptomatic carriers of rectal CT, NG, or MG. According to the high prevalence of asymptomatic STIs found in our MSM population and in other studies, prevention efforts in the form of counseling about the risk of STI need to be done in the population of MSM. PMID:26237608

  2. Cervical and lumbar MRI in asymptomatic older male lifelong athletes: Frequency of degenerative findings

    Energy Technology Data Exchange (ETDEWEB)

    Healy, J.F.; Healy, B.B.; Wong, W.H.M.; Olson, E.M. [Univ. of California, San Diego, CA (United States)

    1996-01-01

    The athletic activity of the adult U.S. population has increased markedly in the last 20 years. To evaluate the possible long-term effects of such activity on the cervical and lumbar spine, we studied a group of asymptomatic currently very active lifelong male athletes over age 40 (41-69 years old, av. age 53). Nineteen active, lifelong male athletes were studied with MRI and the results compared with previous imaging studies of other populations. An athletic history and a spine history were also taken. Evidence of asymptomatic degenerative spine disease was similar to that seen in published series of other populations. Degenerative changes including disk protrusion and herniation, spondylosis, and spinal stenosis were present and increased in incidence with increasing patient age. In this group, all MRI findings proved to be asymptomatic and did not limit athletic activity. The incidence of lumbar degenerative changes in our study population of older male athletes was similar to those seen in other populations. 14 refs., 8 figs., 1 tab.

  3. Hepatitis B virus infection and genotype in asymptomatic people from 10 ethnic groups in Yunnan, China

    Science.gov (United States)

    Shen, Yuan-Ying; Hou, Wei; Yang, Zhan-Qiu; Xiao, Wen

    2015-01-01

    AIM: To evaluate the infection and genotype distribution of hepatitis B virus (HBV) in ethnic groups in Yunnan, China. METHODS: Two thousand five hundred and eighty-four asymptomatic local people from 10 ethnic groups were investigated in Yunnan, China. Infection and genotype distribution were evaluated by serological and genetic methods. Genotyping was verified by sequencing. Ethnic genotype distribution was compared by proportion test. RESULTS: Four types of infection model based on HBV serum markers were identified, and the average HBV infection rate was 5.7% in those asymptomatic local people. The genotype prevalence was 59.6% for B, 21.1% for C and 19.3% BC; subgenotypes Ba, Cs and Ce were identified in this study. Hepatitis B surface antigen-positive rate and the proportion of genotype B were significantly lower in ethnic groups with a northern origin compared to those with a southern origin (50% vs 73.9%, P = 0.037; 4.2% vs 10.5%, P = 0.000). CONCLUSION: Genotype B is dominant and genotype BC has high occurrence in asymptomatic local ethnic groups in Yunnan. HBV infection status and genotype distribution may associate with ethnic origin. PMID:26640334

  4. Hepatitis E in blood donors: investigation of the natural course of asymptomatic infection, Germany, 2011

    Science.gov (United States)

    Vollmer, Tanja; Diekmann, Juergen; Eberhardt, Matthias; Knabbe, Cornelius; Dreier, Jens

    2016-01-01

    Asymptomatic hepatitis E virus (HEV) infections have been found in blood donors from various European countries, but the natural course is rarely specified. Here, we compared the progression of HEV viraemia, serostatus and liver-specific enzymes in 10 blood donors with clinically asymptomatic genotype 3 HEV infection, measuring HEV RNA concentrations, plasma concentrations of alanine/aspartate aminotransferase, glutamate dehydrogenase and bilirubin and anti-HEV IgA, IgM and IgG antibodies. RNA concentrations ranged from 77.2 to 2.19×105 IU/mL, with viraemia lasting from less than 10 to 52 days. Donors showed a typical progression of a recent HEV infection but differed in the first detection of anti-HEV IgA, IgM and IgG and seropositivity of the antibody classes. The diagnostic window between HEV RNA detection and first occurrence of anti-HEV antibodies ranged from eight to 48 days, depending on the serological assay used. The progression of laboratory parameters of asymptomatic HEV infection was largely comparable to the progression of symptomatic HEV infection, but only four of 10 donors showed elevated liver-specific parameters. Our results help elucidate the risk of transfusion-associated HEV infection and provide a basis for development of screening strategies. The diagnostic window illustrates that infectious blood donors can be efficiently identified only by RNA screening. PMID:27608433

  5. Prevalence of upper airway obstruction in patients with apparently asymptomatic euthyroid multi nodular goitre

    Directory of Open Access Journals (Sweden)

    Sunil K Menon

    2011-01-01

    Full Text Available Aims: To study the prevalence of upper airway obstruction (UAO in "apparently asymptomatic" patients with euthyroid multinodular goitre (MNG and find correlation between clinical features, UAO on pulmonary function test (PFT and tracheal narrowing on computerised tomography (CT. Materials and Methods: Consecutive patients with apparently asymptomatic euthyroid MNG attending thyroid clinic in a tertiary centre underwent clinical examination to elicit features of UAO, PFT, and CT of neck and chest. Statistical Analysis Used: Statistical analysis was done with SPSS version 11.5 using paired t-test, Chi square test, and Fisher′s exact test. P value of <0.05 was considered to be significant. Results: Fifty-six patients (52 females and four males were studied. The prevalence of UAO (PFT and significant tracheal narrowing (CT was 14.3%. and 9.3%, respectively. Clinical features failed to predict UAO or significant tracheal narrowing. Tracheal narrowing (CT did not correlate with UAO (PFT. Volume of goitre significantly correlated with degree of tracheal narrowing. Conclusions: Clinical features do not predict UAO on PFT or tracheal narrowing on CT in apparently asymptomatic patients with euthyroid MNG.

  6. Hepatitis E in blood donors: investigation of the natural course of asymptomatic infection, Germany, 2011.

    Science.gov (United States)

    Vollmer, Tanja; Diekmann, Juergen; Eberhardt, Matthias; Knabbe, Cornelius; Dreier, Jens

    2016-09-01

    Asymptomatic hepatitis E virus (HEV) infections have been found in blood donors from various European countries, but the natural course is rarely specified. Here, we compared the progression of HEV viraemia, serostatus and liver-specific enzymes in 10 blood donors with clinically asymptomatic genotype 3 HEV infection, measuring HEV RNA concentrations, plasma concentrations of alanine/aspartate aminotransferase, glutamate dehydrogenase and bilirubin and anti-HEV IgA, IgM and IgG antibodies. RNA concentrations ranged from 77.2 to 2.19×10(5) IU/mL, with viraemia lasting from less than 10 to 52 days. Donors showed a typical progression of a recent HEV infection but differed in the first detection of anti-HEV IgA, IgM and IgG and seropositivity of the antibody classes. The diagnostic window between HEV RNA detection and first occurrence of anti-HEV antibodies ranged from eight to 48 days, depending on the serological assay used. The progression of laboratory parameters of asymptomatic HEV infection was largely comparable to the progression of symptomatic HEV infection, but only four of 10 donors showed elevated liver-specific parameters. Our results help elucidate the risk of transfusion-associated HEV infection and provide a basis for development of screening strategies. The diagnostic window illustrates that infectious blood donors can be efficiently identified only by RNA screening.

  7. The gymnasts' hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes

    Energy Technology Data Exchange (ETDEWEB)

    Papavasiliou, A.; Sykaras, E. [Aristotle Univ., Thessaloniki (Greece). Sport Injuries Lab.; Siatras, T. [Aristotle Univ., Thessaloniki (Greece). Lab. of Excercise Physiology-Ergometry; Bintoudi, A. [Papageorgiu NHS General Hospital, Thessaloniki (Greece); Milosis, D. [Aristotle Univ., Thessaloniki (Greece). Dept. of Physical Education and Sport Sciences; Lallas, V. [Euromedica Diagnostic Centre, Thessaloniki (Greece); Karantanas, A. [University Hospital Heraklion (Greece). Dept. of Medical Imaging

    2014-08-15

    Specific patterns of developmental adaptation of the proximal femur have been recognized in some sports. Gymnastics are characterized by repetitive axial loading and hip rotations in combination with extreme hip positions. It is unknown how and if these forces can affect an immature skeleton in the long term. We sought to evaluate this, by means of magnetic resonance imaging of the hip and groin of such elite asymptomatic athletes. We performed a case-control comparative MR imaging study of both hips and groin of 12 (7 male, 5 female) skeletally mature young (mean age 18.6 years) asymptomatic international level gymnasts with a minimum of 10 years' training with age-matched non-athletes. At the time of recruitment, none of the athletes had a recorded musculoskeletal complaint or injury in the anatomical area around the hip. The study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal and are considered to be the result of adaptational changes to the specific sport: high centre-column-diaphysis angle (coxa valga140 on average), ligamentum teres hypertrophy, friction of the iliotibial band with oedema surrounding the greater trochanter, and a high incidence (62.5 %) of radiological appearances of ischiofemoral impingement. Our study showed that elite gymnasts share four common morphological characteristics on MRI that deviate from normal. These findings were in asymptomatic subjects; hence, radiologists and sports physicians should be aware of them in order to avoid unnecessary treatment. (orig.)

  8. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Glaucia Celeste Rossatto [Clinica Diagnoson and Hospital Aristides Maltez, Salvador, BA (Brazil). Servicos de Medicina Nuclear; Pavin, Elizabeth Joao; Parisi, Maria Candida R. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Endocrinology; Coelho, Otavio Rizzi; Almeida, Raitany C. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Cardiology; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario, E-mail: cdramos@unicamp.br [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Radiology. Service of Nuclear Medicine; Camargo, Edwaldo Eduardo [Hospital Sirio-Libanes, Campinas, SP (Brazil). Service of Nuclear Medicine

    2013-01-15

    Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with {sup 99m}Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

  9. Prevalence and risk factors of asymptomatic hepatitis C virus infection in Egyptian children

    Institute of Scientific and Technical Information of China (English)

    MS El-Raziky; H El-Karaksy; M El-Hawary; G Esmat; AM Abouzied; N El-Koofy; N Mohsen; S Mansour; A Shaheen; M Abdel Hamid

    2007-01-01

    AIM:To identify the prevalence,risk factors and manifestations of asymptomatic hepatitis C virus (HCV) infection in Egyptian children.METHODS:Children at the age of 1-9 years were screened for HCV antibodies and alanine aminotransferase (ALT) levels. Every child with elevated ALT and/or detectable HCV antibodies was tested for HCV RNA by RT-PCR and compared with two negative controls for risk factors and signs and symptoms of liver disease.RESULTS:We screened 1042 children,six of them had elevated ALT,negative HCV antibody and positive RNA,likely representing acute hepatitis C cases. Fifteen children were HCV seropositive,5 of them were HCV RNA positive. Asymptomatic HCV infection was present in 2.02% (positive results for either HCV antibodies or HCV-RNA or both). Symptoms such as diarrhea,abdominal pain,history of fatigue and school absence because of illness and risk factors such as dental care were significantly more common among HCV positive cases than among controls. None of the HCV positive children was diagnosed as having signs of advanced liver disease upon clinical or ultrasonographic examination.CONCLUSION:Asymptomatic HCV infection is detectable in 2.02% Egyptian children.

  10. COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY.

    Science.gov (United States)

    Carmalt, James L; Kneissl, Sibylle; Rawlinson, Jennifer E; Zwick, Timo; Zekas, Lisa; Ohlerth, Stefanie; Bienert-Zeit, Astrid

    2016-05-01

    Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology.

  11. Protease activity in Giardia duodenalis trophozoites of axenic strains isolated from symptomatic and asymptomatic patients

    Directory of Open Access Journals (Sweden)

    Guimarães Semíramis

    2003-01-01

    Full Text Available We have examined by gelatin-SDS-PAGE the protease activity in cell lysates of Giardia duodenalis trophozoites of two axenic strains isolated in Brazil from a symptomatic patient (BTU-11 and an asymptomatic carrier (BTU-10, and the reference strain Portland 1 (P1. The proteolysis band patterns showed differences among strains isolated from asymptomatic and symptomatic individuals. The lysate of the strain BTU-10, showed only five hydrolysis bands, while a greater number of bands (10-11 bands was seen in strains BTU-11 and P1. The protease activity in all lysates was inhibited by cysteine (E-64 and iodoacetamide and serine proteases (TPCK and TLCK inhibitors, but not by PMSF and EDTA. In general, the results revealed protease activities in G. duodenalis trophozoites of Brazilian axenic strains and the predominance of cysteine proteinases. It should be stressed the inter-strain difference in hydrolysis band patterns observed between strains isolated from symptomatic patients and the strain obtained from an asymptomatic carrier.

  12. White blood cell-based detection of asymptomatic scrapie infection by ex vivo assays.

    Directory of Open Access Journals (Sweden)

    Sophie Halliez

    Full Text Available Prion transmission can occur by blood transfusion in human variant Creutzfeldt-Jakob disease and in experimental animal models, including sheep. Screening of blood and its derivatives for the presence of prions became therefore a major public health issue. As infectious titer in blood is reportedly low, highly sensitive and robust methods are required to detect prions in blood and blood derived products. The objectives of this study were to compare different methods--in vitro, ex vivo and in vivo assays--to detect prion infectivity in cells prepared from blood samples obtained from scrapie infected sheep at different time points of the disease. Protein misfolding cyclic amplification (PMCA and bioassays in transgenic mice expressing the ovine prion protein were the most efficient methods to identify infected animals at any time of the disease (asymptomatic to terminally-ill stages. However scrapie cell and cerebellar organotypic slice culture assays designed to replicate ovine prions in culture also allowed detection of prion infectivity in blood cells from asymptomatic sheep. These findings confirm that white blood cells are appropriate targets for preclinical detection and introduce ex vivo tools to detect blood infectivity during the asymptomatic stage of the disease.

  13. Family planning services in developing countries: an opportunity to treat asymptomatic and unrecognised genital tract infections?

    Science.gov (United States)

    Wilkinson, D; Ndovela, N; Harrison, A; Lurie, M; Connolly, C; Sturm, A W

    1997-12-01

    This is a study of 189 women attending a family planning clinic in rural South Africa to determine the prevalence of asymptomatic and unrecognized genital tract infections. Genital samples were taken from these women to diagnose infection with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, Treponema pallidum, and HIV, and to diagnose bacterial vaginosis. Among the 189 women, 41 (22%) reported having had an STD treated in the preceding 12 months. By direct questioning, 74 women stated the following symptoms: genital itch -- 38 (20%); vaginal discharge -- 56 (30%); dysuria -- 33 (18%); dyspareunia -- 22 (12%); and genital ulcers -- 4 (2%). 45 (24%) women had more than one symptom. 119 (63%) women had at least one genital infection, and 49 (26%) had multiple infections. Most of the infections were asymptomatic; while those that were symptomatic, were unrecognized or not reported. Results showed a high prevalence of genital tract infection among the participating women, with most of their infections remaining asymptomatic or unrecognized. Thus, strategies to detect and treat genital tract infections in rural South Africa need to be developed.

  14. Asymptomatic neurocognitive disorders in patients infected by HIV: fact or fiction?

    Directory of Open Access Journals (Sweden)

    Torti Carlo

    2011-12-01

    Full Text Available Abstract Neurocognitive disorders are emerging as a possible complication in patients infected with HIV. Even if asymptomatic, neurocognitive abnormalities are frequently detected using a battery of tests. This supported the creation of asymptomatic neurocognitive impairment (ANI as a new entity. In a recent article published in BMC Infectious Diseases, Magnus Gisslén and colleagues applied a statistical approach, concluding that there is an overestimation of the actual problem. In fact, about 20% of patients are classified as neurocognitively impaired without a clear impact on daily activities. In the present commentary, we discuss the clinical implications of their findings. Although a cautious approach would indicate a stricter follow-up of patients affected by this disorder, it is premature to consider it as a proper disease. Based on a review of the data in the current literature we conclude that it is urgent to conduct more studies to estimate the overall risk of progression of the asymptomatic neurocognitive impairment. Moreover, it is important to understand whether new biomarkers or neuroimaging tools can help to identify better the most at risk population. Please see related article: http://www.biomedcentral.com/1471-2334/11/356

  15. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    Directory of Open Access Journals (Sweden)

    Ciccone M

    2011-03-01

    Full Text Available Marco Matteo Ciccone1, Artor Niccoli-Asabella2, Pietro Scicchitano1, Michele Gesualdo1, Antonio Notaristefano2, Domenico Chieppa1, Santa Carbonara1, Gabriella Ricci1, Marco Sassara1, Corinna Altini2, Giovanni Quistelli1, Mario Erminio Lepera1, Stefano Favale1, Giuseppe Rubini21Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO, 2Nuclear Medicine Unit, Department of Internal Medicine and of Public Medicine, University of Bari, Bari, ItalyIntroduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis.Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries.Results: A statistically significant relationship (P = 0.023 was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively.Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in

  16. Extended-spectrum β-lactamase-producing Escherichia coli isolated from poultry

    DEFF Research Database (Denmark)

    Olsen, Rikke Heidemann; Bisgaard, Magne; Löhren, Ulrich;

    2014-01-01

    Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli has been documented in humans as well as in food-producing birds, including chickens, and for unknown reasons the prevalence has increased significantly during the last decade. With E. coli as a major opportunistic pathogen in chickens...... and with a potential for zoonotic transfer to human beings, ESBL-producing E. coli represents a major risk both to poultry production and to human health. This review presents some of the current problems with ESBL-producing E. coli in relation to poultry production, with a focus on chickens. To illustrate issues...... in relation to screening and typing, two case studies are included where one collection of ESBL-producing E. coli isolates was obtained from asymptomatic carrier chickens while the other was obtained from lesions in chickens. Pulsed-field gel electrophoresis and multi-locus sequence typing revealed a highly...

  17. Prolonged and mixed non-O157 Escherichia coli infection in an Australian household.

    Science.gov (United States)

    Staples, M; Graham, R M A; Doyle, C J; Smith, H V; Jennison, A V

    2012-05-01

    An Australian family was identified through a Public Health follow up on a Shiga-toxigenic Escherichia coli (STEC) positive bloody diarrhoea case, with three of the four family members experiencing either symptomatic or asymptomatic STEC shedding. Bacterial isolates were submitted to stx sequence sub-typing, multi-locus variable number tandem repeat analysis (MLVA), multi-locus sequence typing (MLST) and binary typing. The analysis revealed that there were multiple strains of STEC being shed by the family members, with similar virulence gene profiles and the same serogroup but differing in their MLVA and MLST profiles. This study illustrates the potentially complicated nature of non-O157 STEC infections and the importance of molecular epidemiology in understanding disease clusters.

  18. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls

    DEFF Research Database (Denmark)

    Branci, Sonia; Thorborg, Kristian; Bech, Birthe Højlund

    2015-01-01

    BACKGROUND: Soccer players are commonly affected by long-standing adductor-related groin pain (ARGP), but the clinical significance of MRI findings in these athletes is largely unknown. Our aims were (1) to evaluate whether MRI findings are associated with long-standing ARGP in soccer players, (2......) to assess MRI findings in asymptomatic soccer players and non-soccer playing controls. METHODS: This cross-sectional study included 28 male soccer players with long-standing ARGP, 17 male asymptomatic soccer players and 20 male asymptomatic non-soccer playing athletes of matching age and athletic exposure...... soccer players displayed different positive MRI findings, and asymptomatic soccer players had significantly higher odds (OR ranging from 6.3 to 13.3) for BMO, adductor tendinopathy and degenerative changes than non-soccer players. CONCLUSIONS: ARGP in soccer players was associated with central disc...

  19. Increased platelet count and leucocyte-platelet complex formation in acute symptomatic compared with asymptomatic severe carotid stenosis.

    LENUS (Irish Health Repository)

    McCabe, D J H

    2005-09-01

    The risk of stroke in patients with recently symptomatic carotid stenosis is considerably higher than in patients with asymptomatic stenosis. In the present study it was hypothesised that excessive platelet activation might partly contribute to this difference.

  20. Medical interventions for treating anthracycline-induced symptomatic and asymptomatic cardiotoxicity during and after treatment for childhood cancer

    NARCIS (Netherlands)

    Cheuka, Daniel K. L.; Sieswerda, Elske; van Dalen, Elvira C.; Postma, Aleida; Kremer, Leontien C. M.

    2016-01-01

    Background Anthracyclines are frequently used chemotherapeutic agents for childhood cancer that can cause cardiotoxicity during and after treatment. Although several medical interventions in adults with symptomatic or asymptomatic cardiac dysfunction due to other causes are beneficial, it is not kno

  1. Is Carotid Ultrasound Necessary in the Clinical Evaluation of the Asymptomatic Hollenhorst Plaque? (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Bakri, Sophie J.; Luqman, Ashraf; Pathik, Bhupesh; Chandrasekaran, Krishnaswamy

    2013-01-01

    Purpose: To evaluate the utility of carotid ultrasound in patients with asymptomatic Hollenhorst plaques. Methods: Retrospective chart review of 237 patients diagnosed with Hollenhorst plaques between 1996 and 2004. The baseline cardiovascular risk profile, medications, and carotid ultrasound findings were documented. Retinal ischemia, myocardial ischemia, and cerebrovascular events during follow-up were noted. Results: There was no statistically significant difference in the proportion of patients with carotid stenosis >40% between symptomatic (n=60) and asymptomatic (n=177) patients (32.7% vs 22.7%; P=.192, one-way ANOVA). However, symptomatic patients were statistically more likely to have stenosis >69% (25% compared with 9.2% in the asymptomatic group; P=.008, one-way ANOVA). Among asymptomatic patients, those with carotid bruit (27.1%) were more likely to have moderate carotid stenosis >40% (55.6% vs 18.6% in patients without bruit; P=.0008, one-way ANOVA) and significant stenosis >69% (37% vs 4.3% in patients without bruit; P=.0001, one-way ANOVA). Follow-up data was obtained from 32 symptomatic patients (39.6 ± 22.9 months) and 100 asymptomatic patients (41.3 ± 21.8 months). Vascular and neurologic event rates were similar between the two groups. Conclusions: Hollenhorst plaques are a marker of significant carotid disease irrespective of retinal symptoms. Carotid auscultation remains important in the examination of patients with Hollenhorst plaques and increases the yield of asymptomatic patients diagnosed with carotid stenosis. The presence of visual symptoms on presentation did not correlate with an increased risk of death or stroke compared to asymptomatic patients during follow-up. Therefore all patients with asymptomatic plaques should have a medical workup, including carotid ultrasonography. PMID:24072943

  2. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity

    DEFF Research Database (Denmark)

    Romero, Roberto; Nicolaides, Kypros; Conde-Agudelo, Agustin;

    2012-01-01

    To determine whether the use of vaginal progesterone in asymptomatic women with a sonographic short cervix (≤ 25 mm) in the midtrimester reduces the risk of preterm birth and improves neonatal morbidity and mortality.......To determine whether the use of vaginal progesterone in asymptomatic women with a sonographic short cervix (≤ 25 mm) in the midtrimester reduces the risk of preterm birth and improves neonatal morbidity and mortality....

  3. Virulent bacteriophages can target O104:H4 enteroaggregative Escherichia coli in the mouse intestine.

    Science.gov (United States)

    Maura, Damien; Galtier, Matthieu; Le Bouguénec, Chantal; Debarbieux, Laurent

    2012-12-01

    In vivo bacteriophage targeting of enteroaggregative Escherichia coli (EAEC) was assessed using a mouse intestinal model of colonization with the O104:H4 55989Str strain and a cocktail of three virulent bacteriophages. The colonization model was shown to mimic asymptomatic intestinal carriage found in humans. The addition of the cocktail to drinking water for 24 h strongly decreased ileal and weakly decreased fecal 55989Str concentrations in a dose-dependent manner. These decreases in ileal and fecal bacterial concentrations were only transient, since 55989Str concentrations returned to their original levels 3 days later. These transient decreases were independent of the mouse microbiota, as similar results were obtained with axenic mice. We studied the infectivity of each bacteriophage in the ileal and fecal environments and found that 55989Str bacteria in the mouse ileum were permissive to all three bacteriophages, whereas those in the feces were permissive to only one bacteriophage. Our results provide the first demonstration that bacterial permissivity to infection with virulent bacteriophages is not uniform throughout the gut; this highlights the need for a detailed characterization of the interactions between bacteria and bacteriophages in vivo for the further development of phage therapy targeting intestinal pathogens found in the gut of asymptomatic human carriers.

  4. Diffusely adherent Escherichia coli strains isolated from children and adults constitute two different populations

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    Mansan-Almeida Rosane

    2013-02-01

    Full Text Available Abstract Background Diffusely adherent Escherichia coli (DAEC have been considered a diarrheagenic category of E. coli for which several potential virulence factors have been described in the last few years. Despite this, epidemiological studies involving DAEC have shown inconsistent results. In this work, two different collections of DAEC possessing Afa/Dr genes, from children and adults, were studied regarding characteristics potentially associated to virulence. Results DAEC strains were recovered in similar frequencies from diarrheic and asymptomatic children, and more frequently from adults with diarrhea (P Citrobacter freundii strain have shown an improved ability to form biofilms in relation to the monocultures. Control strains have shown a greater diversity of Afa/Dr adhesins and higher frequencies of cellulose, TTSS, biofilm formation and induction of IL-8 secretion than strains from cases of diarrhea in children. Conclusions DAEC strains possessing Afa/Dr genes isolated from children and adults represent two different bacterial populations. DAEC strains carrying genes associated to virulence can be found as part of the normal microbiota present in asymptomatic children.

  5. The impact of infant feeding patterns on infection and diarrheal disease due to enterotoxigenic Escherichia coli

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    Long Kurt

    1999-01-01

    Full Text Available OBJECTIVE. Determine the impact of dietary risk factors on patterns of infection by heat labile toxin-producing Escherichia coli (LT-ETEC. MATERIALS AND METHODS. Ninety-eight infants were followed from birth for one year in Guadalajara, Mexico, beginning in august of 1986. Stool and breast milk samples were collected weekly from infants and their mothers, respectively. Mothers were also interviewed on a weekly basis regarding the health of the infants. Parametric hazard models were fit to durations of different LTETEC disease states determined through the analysis of stools. The child's consumption of supplemental foods and liquids as well as specific levels of LT-ETEC-specific breast milk antibodies were included in each model as time-varying covariates. RESULTS. The hazard of LTETEC asymptomatic infection increased 400 percent among children who received oats gruel (hazard rate= 4.01; 95% CI 2.77-5.24. The duration of infection was reduced if the child had had a previous LT-ETEC diarrheal episode (2.12; 95% CI 1.74-2.49 but was prolonged if the child consumed herbal teas (0.53; 95% CI 0.27-0.7. Herbal teas and high LTETEC-specific breast milk antibody levels each reduced the hazard of symptomatic infection by ninety percent. Symptomatic episodes became asymptomatic more rapidly if a child was given rice water. CONCLUSIONS. Specific weaning foods increase the risk of infection. Breastmilk antibodies and liquid infusions reduce diarrheal disease and infection duration.

  6. Prevalence of asymptomatic infections in sexually transmitted diseases attendees diagnosed with bacterial vaginosis, vaginal candidiasis, and trichomoniasis

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    R Rajalakshmi

    2016-01-01

    Full Text Available Background: Sexually transmitted diseases (STD are a major health problem affecting mostly young people in both developing and developed countries. STD in women causes both acute morbidity and complications such as infertility, ectopic pregnancy, low-birth weight, and prematurity. Aims: The aim of the study is to assess the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic females attending STD outpatient department in a tertiary care hospital in South India. Materials and Methods: A retrospective analysis of data collected from clinical records of 3000 female patients of age 18 to 49 over a period of 12 months (July 2014 to June 2015 was carried out at the Institute of Venereology, Madras Medical College. Complete epidemiological, clinical, and investigational data were recorded and analyzed for the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic patients. Results: About 48.37% (228/470 of bacterial vaginosis patients were asymptomatic. Nearly 45.38% (116/235 of vaginal candidiasis patients were asymptomatic and 30.35% (26/87 of trichomoniasis patients were asymptomatic. The above infections were common in the age group 25–35. Conclusion: Holistic screening protocol was incorporated for all female patients attending STD clinic even if asymptomatic and should be treated accordingly to prevent the acquisition of other serious sexually transmitted infections.

  7. Low frequency of asymptomatic carriage of toxigenic Clostridium difficile in an acute care geriatric hospital: prospective cohort study in Switzerland

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    Daniela Pires

    2016-06-01

    Full Text Available Abstract Background The role of asymptomatic carriers of toxigenic Clostridium difficile (TCD in nosocomial cross-transmission remains debatable. Moreover, its relevance in the elderly has been sparsely studied. Objectives To assess asymptomatic TCD carriage in an acute care geriatric population. Methods We performed a prospective cohort study at the 296-bed geriatric hospital of the Geneva University Hospitals. We consecutively recruited all patients admitted to two 15-bed acute-care wards. Patients with C. difficile infection (CDI or diarrhoea at admission were excluded. First bowel movement after admission and every two weeks thereafter were sampled. C. difficile toxin B gene was identified using real-time polymerase chain-reaction (BD MAXTMCdiff. Asymptomatic TCD carriage was defined by the presence of the C. difficile toxin B gene without diarrhoea. Results A total of 102 patients were admitted between March and June 2015. Two patients were excluded. Among the 100 patients included in the study, 63 were hospitalized and 1 had CDI in the previous year, and 36 were exposed to systemic antibiotics within 90 days prior to admission. Overall, 199 stool samples were collected (median 2 per patient, IQR 1-3. Asymptomatic TCD carriage was identified in two patients (2 %. Conclusions We found a low prevalence of asymptomatic TCD carriage in a geriatric population frequently exposed to antibiotics and healthcare. Our findings suggest that asymptomatic TCD carriage might contribute only marginally to nosocomial TCD cross-transmission in our and similar healthcare settings.

  8. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD. PMID:27936193

  9. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis.

    Science.gov (United States)

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD.

  10. Diagnosis, treatment and registration of urinary tract infections in geriatric patients

    DEFF Research Database (Denmark)

    Friis-Møller, Alice; Lüneborg-Nielsen, Margrethe

    2002-01-01

    Bacteriuria (> or = 10(5) CFU/ml) is a very common phenomenon in elderly people, occurring twice as frequently in women than in men. There are symptomatic and asymptomatic types of bacteriuria. Risk factors include: a decrease in the estrogen level in women after the menopause, catheterisation, u...

  11. Asymptomatic pseudotumours after metal-on-metal hip resurfacing show little change within one year.

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    van der Weegen, W; Brakel, K; Horn, R J; Hoekstra, H J; Sijbesma, T; Pilot, P; Nelissen, R G H H

    2013-12-01

    The aim of this study was to establish the natural course of unrevised asymptomatic pseudotumours after metal-on-metal (MoM) hip resurfacing during a six- to 12-month follow-up period. We used repeated metal artefact reduction sequence (MARS)-magnetic resonance imaging (MRI), serum metal ion analysis and clinical examination to study 14 unrevised hips (mean patient age 52.7 years, 46 to 68, 5 female, 7 male) with a pseudotumour and 23 hips (mean patient age 52.8 years, 38 to 69, 7 female, 16 male) without a pseudotumour. The mean post-operative time to the first MARS-MRI scan was 4.3 years (2.2 to 8.3), and mean time between the first and second MARS-MRI scan was eight months (6 to 12). At the second MRI scan, the grade of severity of the pseudotumour had not changed in 35 hips. One new pseudotumour (Anderson C2 score, moderate) was observed, and one pseudotumour was downgraded from C2 (moderate) to C1 (mild). In general, the characteristics of the pseudotumours hardly changed. Repeated MARS-MRI scans within one year in patients with asymptomatic pseudotumours after MoM hip resurfacing showed little or no variation. In 23 patients without pseudotumour, one new asymptomatic pseudotumour was detected. This is the first longitudinal study on the natural history of pseudotumours using MARS-MRI scans in hip resurfacing, and mirrors recent results for 28 mm diameter MoM total hip replacement.

  12. Alcohol and tea consumption are associated with asymptomatic erosive esophagitis in Taiwanese men

    Science.gov (United States)

    Chang, Chung-Hsin; Wu, Cheng-Pin; Wang, Jung-Der; Lee, Shou-Wu; Chang, Chi-Sen; Yeh, Hong-Zen; Ko, Chung-Wang; Lien, Han-Chung

    2017-01-01

    Objective Asymptomatic erosive esophagitis (AEE) is commonly found in men, and might be a risk factor of developing esophageal adenocarcinoma. We aimed to determine if specific dietary habits increase the risk of AEE in asymptomatic Taiwanese men. Methods We recruited male adults undergoing upper gastrointestinal endoscopy for health check. We excluded subjects with reflux symptoms, or taking anti-reflux medications or drugs that potentially impair lower esophageal sphincter function or cause mucosal injury. The frequency of consuming reflux-provoking diets including alcohol, tea, coffee, tomato/citric juice, chocolate, sweet food, and spicy food was assessed. The erosive esophagitis was diagnosed based on the Los Angeles Classification after endoscopy. Frequent consumption of a specific diet was defined as ≥4 days/week of consuming that diet. Results A total of 1256 participants were recruited. After excluding 424 ineligible subjects, AEE was identified in 180 (22%) among 832 asymptomatic subjects. The risk of AEE increased with the number of days per week of consuming alcohol or tea: nondrinkers (19%, 17%), occasional drinkers (<1 day/week; 19%, 15%), regular drinkers (1–3 days/week; 26%, 21%), frequent drinkers (4–6 days/week; 32%, 22%), and daily drinkers (42%, 28%), respectively (trend test P < 0.001 for both). Multivariate analysis showed that hiatus hernia (adjusted odds ratio (aOR) 5.0, 95% confidence interval (CI) 2.6–9.6), drinking alcohol ≥4 days/week (aOR 2.3, 95% CI 1.3–4.0), and drinking tea ≥4 days/week (aOR 1.6, 95% CI 1.1–2.3) are independent risk factors of AEE. The risk of AEE was 3.8 times greater for those drinking both alcohol and tea ≥4 days/week than the non-drinkers. Conclusions Frequent alcohol and tea consumption increased the risk of AEE in Taiwanese men. PMID:28264069

  13. Asymptomatic malaria in refugees living in a non-endemic South African city.

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    Joyce M Tsoka-Gwegweni

    Full Text Available BACKGROUND: Asymptomatic malaria infection in refugees is both a threat to the lives of the individuals and the public in the host country. Although South Africa has been experiencing an unprecedented influx of refugees since 1994, data on malaria infection among refugees is lacking. Such information is critical since South Africa is among the countries that have planned to eliminate malaria. The objective of this study was to determine prevalence of asymptomatic malaria infection among a refugee population living in a city of KwaZulu-Natal province, South Africa. METHODS AND FINDINGS: A survey was conducted on adult refugee participants who attended a faith-based facility offering social services in a city of KwaZulu-Natal province, South Africa. The participants were screened for the presence of malaria using rapid diagnostic tests and microscopy. Demographic data for the participants were obtained using a closed ended questionnaire. Data was obtained for 303 participants consisting of 51.5% females and 47.5% males, ranging from 19 to 64 years old. More than 95% of them originated from sub-Saharan African countries. Two hundred and ninety participants provided a blood sample for screening of malaria. Of these, 3.8% tested positive for rapid diagnostic test and 5.9% for microscopy. The majority of malaria infections were due to Plasmodium falciparum. CONCLUSIONS: The study confirms the presence of asymptomatic malaria infections among a refugee population residing in a city of KwaZulu-Natal province that is not endemic for malaria. The results have important implications for both public health and malaria control in South Africa, particularly since the country has decided to eliminate malaria by 2018. To achieve this goal, South Africa needs to expand research, surveillance and elimination activities to include non-endemic areas, particularly with high refugee populations. We further recommend use of powerful diagnostic tests such as PCR for

  14. Characterization of the vaginal micro- and mycobiome in asymptomatic reproductive-age Estonian women.

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    Drell, Tiina; Lillsaar, Triin; Tummeleht, Lea; Simm, Jaak; Aaspõllu, Anu; Väin, Edda; Saarma, Ivo; Salumets, Andres; Donders, Gilbert G G; Metsis, Madis

    2013-01-01

    The application of high-throughput sequencing methods has raised doubt in the concept of the uniform healthy vaginal microbiota consisting predominantly of lactobacilli by revealing the existence of more variable bacterial community composition. As this needs to be analyzed more extensively and there is little straightforward data regarding the vaginal mycobiome of asymptomatic women we aimed to define bacterial and fungal communities in vaginal samples from 494 asymptomatic, reproductive-age Estonian women. The composition of the vaginal microbiota was determined by amplifying bacterial 16S rRNA and fungal internal transcribed spacer-1 (ITS-1) regions and subsequently sequencing them using 454 Life Sciences pyrosequencing. We delineated five major bacterial community groups with distinctive diversity and species composition. Lactobacilli were among the most abundant bacteria in all groups, but also members of genus Gardnerella had high relative abundance in some of the groups. Microbial diversity increased with higher vaginal pH values, and was also higher when a malodorous discharge was present, indicating that some of the women who consider themselves healthy may potentially have asymptomatic bacterial vaginosis (BV). Our study is the first of its kind to analyze the mycobiome that colonizes the healthy vaginal environment using barcoded pyrosequencing technology. We observed 196 fungal operational taxonomic units (OTUs), including 16 OTUs of Candida spp., which is more diverse than previously recognized. However, assessing true fungal diversity was complicated because of the problems regarding the possible air-borne contamination and bioinformatics used for identification of fungal taxons as significant proportion of fungal sequences were assigned to unspecified OTUs.

  15. Genetic characterization of Shigella spp. isolated from diarrhoeal and asymptomatic children.

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    Ghosh, Santanu; Pazhani, Gururaja P; Niyogi, Swapan Kumar; Nataro, James P; Ramamurthy, Thandavarayan

    2014-07-01

    Phenotypic and genetic characteristics of Shigella spp. isolated from diarrhoeal and asymptomatic children aged up to 5 years were analysed in this study. In total, 91 and 17 isolates were identified from diarrhoeal (case) and asymptomatic (control) children, respectively. All the isolates were tested for antimicrobial resistance, the presence of integrons, plasmid-mediated quinolone resistance (PMQR), virulence-associated genes and Shigella pathogenicity island (SH-PAI). The majority of the Shigella spp. from cases (68.1%) and controls (82.3%) were found to be resistant to fluoroquinolones. Integron carriage was detected more in cases (76.9%) than in controls (35.5%). Atypical class 1 integron was detected exclusively in Shigella flexneri from cases but not from the controls. PMQR genes such as aac(6')-Ib-cr and qnrS1 were detected in 82.4 and 14.3% of the isolates from cases and in 53 and 17.6% in controls, respectively. Shigella isolates from cases as well as from controls were positive for the invasive plasmid antigen H-encoding gene ipaH. The other virulence genes such as virF, sat, setA, setB, sen and ial were detected in Shigella isolates in 80.2, 49.4, 27.4, 27.4, 80.2 and 79.1% of cases and in 64.7, 52.9, 17.6, 17.6, 64.7 and 64.7% of controls, respectively. The entire SH-PAI was detected in S. flexneri serotype 2a from cases and controls. In an isolate from a control child, the SH-PAI was truncated. Integrons, PMQR and virulence-encoding genes were detected more frequently in cases than in controls. In diarrhoea endemic areas, asymptomatic carriers may play a crucial role in the transmission of multidrug-resistant Shigella spp. with all the putative virulence genes.

  16. Symptomatic and Asymptomatic Neurological Complications of Infective Endocarditis: Impact on Surgical Management and Prognosis

    Science.gov (United States)

    Delahaye, François; Tattevin, Pierre; Federspiel, Claire; Le Moing, Vincent; Chirouze, Catherine; Nazeyrollas, Pierre; Vernet-Garnier, Véronique; Bernard, Yvette; Chocron, Sidney; Obadia, Jean-François; Alla, François; Hoen, Bruno; Duval, Xavier

    2016-01-01

    Objectives Symptomatic neurological complications (NC) are a major cause of mortality in infective endocarditis (IE) but the impact of asymptomatic complications is unknown. We aimed to assess the impact of asymptomatic NC (AsNC) on the management and prognosis of IE. Methods From the database of cases collected for a population-based study on IE, we selected 283 patients with definite left-sided IE who had undergone at least one neuroimaging procedure (cerebral CT scan and/or MRI) performed as part of initial evaluation. Results Among those 283 patients, 100 had symptomatic neurological complications (SNC) prior to the investigation, 35 had an asymptomatic neurological complications (AsNC), and 148 had a normal cerebral imaging (NoNC). The rate of valve surgery was 43% in the 100 patients with SNC, 77% in the 35 with AsNC, and 54% in the 148 with NoNC (p<0.001). In-hospital mortality was 42% in patients with SNC, 8.6% in patients with AsNC, and 16.9% in patients with NoNC (p<0.001). Among the 135 patients with NC, 95 had an indication for valve surgery (71%), which was performed in 70 of them (mortality 20%) and not performed in 25 (mortality 68%). In a multivariate adjusted analysis of the 135 patients with NC, age, renal failure, septic shock, and IE caused by S. aureus were independently associated with in-hospital and 1-year mortality. In addition SNC was an independent predictor of 1-year mortality. Conclusions The presence of NC was associated with a poorer prognosis when symptomatic. Patients with AsNC had the highest rate of valve surgery and the lowest mortality rate, which suggests a protective role of surgery guided by systematic neuroimaging results. PMID:27400273

  17. Radiographic Analysis of the Sacropelvic Parameters of the Spine and Their Correlation in Normal Asymptomatic Subjects.

    Science.gov (United States)

    Sudhir, G; Acharya, Shankar; K L, Kalra; Chahal, Rupinder

    2016-03-01

    Study Design Cross-sectional study. Objective Sacropelvic parameters in various spine and hip disorders have been published in various studies. We aimed to study the normal sacropelvic parameters and curvatures of the spine and their correlation in asymptomatic Indian adults in relation to variations in sex and age. Methods The study included 101 asymptomatic adults (50 men and 51 women with an average age of 47.16 and 48.59 years, respectively). For each subject, the thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured from standing lateral radiographs. After stratification of the group by sex and age with a cutoff of 50 years, descriptive, correlation, and regression analysis were performed using SPSS software. Results The average PI, SS, PT, LL, and TK values were 55.48 (±5.31), 35.99 (±7.53), 17.97 (±7.16), 48.84 (±9.82), and 32.55 (±10.92), respectively. No statistically significant difference was observed in these values with regards to sex and age  50 years but the pelvic incidence was found to be higher in women. A positive correlation between the PI and SS and a negative correlation between the SS and PT was observed. A positive correlation between the TK and LL was found in subjects > 50 years. Simple and multiple regression analyses were also performed for different groups. Conclusion The current study is the first of asymptomatic Indian adults and provides invaluable information to the clinicians about the normal range of sacropelvic and spinopelvic parameters, which is useful to plan spinal deformity corrections and to evaluate pathologic conditions associated with abnormal angular values.

  18. Three-phase bone scan pattern in asymptomatic uncemented total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Rubello, D. [Nuclear Medicine-PET Center, General Hospital of Castelfranco Veneto (Italy); Caricasulo, D. [Orthopaedics Dept., General Hospital of Bassano del Grappa (Italy); Borsato, N. [Nuclear Medicine-PET Center, General Hospital of Castelfranco Veneto (Italy); Chierichetti, F. [Nuclear Medicine-PET Center, General Hospital of Castelfranco Veneto (Italy); Zanco, P. [Nuclear Medicine-PET Center, General Hospital of Castelfranco Veneto (Italy); Ferlin, G. [Nuclear Medicine-PET Center, General Hospital of Castelfranco Veneto (Italy)

    1996-10-01

    In this study we investigated the bone scan pattern in a homogeneous group of asymptomatic patients implanted with the same type of total knee arthroplasty (TKA) and with a minimum follow-up of 2 years. Twenty-nine patients (21 females, 8 males, mean age 62 years), with a total of 30 uncemented Hofmann TKAs, were entered in the study. The time interval from surgery to scintigraphic evaluation ranged from 2 to 4 years. Bone scan was performed using the three-phase technique and images were interpreted by visual analysis using a three-point scale for the dynamic and blood pool phases and a five-point scale for the bone phase. Areas of increased periprosthetic technetium-99m methylene diphosphonate (MDP) uptake were observed until 4 years after surgery. However, comparing the TKAs implanted 2, 3 and 4 years previously, a decreasing pattern in tracer uptake intensity was noted this being more evident in the femoral and lateral tibial components. In some cases, a persistently elevated tracer uptake, not exceeding a moderate grade, was found in the medial tibial component. In conclusion, increased periprosthetic {sup 99m}TC-MDP uptake is a common finding in asymptomatic uncemented Hofmann TKAs for a prolonged period after surgery, but the uptake intensity is generally mild or moderate and shows a characteristic decreasing pattern over time. Furthermore, in contrast with other types of asymptomatic knee implants previously investigated, no case of high or very high bone uptake was recorded with this type of implant. We may speculate that scintigraphic parameters of normality, and pathology, should be determined for each type of TKA. It is likely that, with the uncemented Hofmann TKA, a high or very high tracer uptake or a progressive increase in the uptake intensity is suggestive of the presence of complications. (orig.)

  19. A follow-up study of the fate of small asymptomatic deep venous thromboses

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    Persson Lena M

    2010-02-01

    Full Text Available Abstract Background Postoperative asymptomatic deep venous thromboses (ADVT can give rise to posttthrombotic syndrome (PTS, but there are still many unresolved issues in this context. For example, there is a lack of knowledge regarding the fate of small ADVT following minor orthopedic surgery. This follow-up study evaluates postthrombotic changes and clinical manifestations of PTS in a group of patients with asymptomatic calf vein DVT after surgery for Achilles tendon rupture. Methods Forty-six consecutive patients with distal ADVT were contacted and enrolled in a follow-up consisting of a single visit at the hospital at a mean time of 5 years postoperatively, including clinical examination and scoring, ultrasonography and venous plethysmography. All patients had participated in DVT-screening with colour duplex ultrasound (CDU 3 and 6 weeks postoperatively and 80% of them were treated with anticoagulation. Results With CDU postthrombotic changes and deep venous reflux were detected at follow-up in more than 50% of the patients, more commonly in somewhat larger calf DVT:s initially affecting more than one vessel. However, only about 10% of the patients had significant venous reflux according to venous plethysmography. No patient had plethysmographic evidence of remaining outflow obstruction, but presence of postthrombotic changes shown with CDU negatively influenced venous outflow capacity measured with plethysmography. A clinical entity of PTS was rarely found and occurred only in two patients (4% and then classified by Villalta scoring as of mild degree with few clinical signs of disease. Distal ADVT:s detected in the early postoperative period (3 weeks showed DVT-progression in 75% of the limbs that were still immobilized and without anticoagulation. Conclusions Asymptomatic postoperative distal DVT:s following surgery for Achilles tendon rupture have a good prognosis and a favourable clinical outcome. In our material of 46 patients the

  20. MRI findings in the lumbar spines of asymptomatic elite junior tennis players

    Energy Technology Data Exchange (ETDEWEB)

    Rajeswaran, G.; Healy, J.C. [Chelsea and Westminster Hospital NHS Foundation Trust, Department of Radiology, London, England (United Kingdom); Turner, M. [The National Tennis Centre, Lawn Tennis Association, London (United Kingdom); Gissane, C. [St Mary' s University, Twickenham, Middlesex (United Kingdom)

    2014-07-15

    To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis players. The lumbar spine MRI studies of 98 asymptomatic junior elite tennis players (51 male, 47 female) with a mean age of 18 years (age range 11.2-26.3 years; standard deviation 3.1) was reviewed by two consultant musculoskeletal radiologists using consensus opinion. Images were assessed using accepted classification systems. Four players (4 %) had no abnormality. Facet joint arthropathy occurred in 89.7 % of the players, being mild in 84.5 % of cases. There were 41 synovial cysts in 22.4 % of the cohort all occurring in the presence of facet arthropathy. Disc degeneration was noted in 62.2 % of players, being mild in 76.2 % of those affected. Disc herniation was noted in 30.6 % of players, with 86.1 % of these being broad based and 13.9 % being focal. There was nerve root compression in 2 %. There were 41 pars interarticularis abnormalities in 29.6 % of patients, 63.4 % of these being grades 1-3. There was grade 1 spondylolisthesis in 5.1 % of players. The prevalence of facet joint arthropathy, disc degeneration, disc herniation and pars interarticularis fracture was lower in female players than in male and lower in the under 16-year-olds compared with the over 20-year-olds. There is a significant amount of underlying pathology that would normally go undetected in this group of asymptomatic elite athletes. Whilst these findings cannot be detected clinically, their relevance is in facilitating appropriate prehabilitation to prevent loss of playing time and potentially career-ending injuries. (orig.)

  1. Asymptomatic T-cell large granular lymphocyte leukemia with an unusual immunophenotype

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    Panagiota K. Petsa

    2012-06-01

    Full Text Available T-cell large granular lymphocyte (T-LGL leukemia represents a clonal proliferation of cytotoxic T-cells which etiology has not been entirely elucidated. However, CD4+, CD4–,CD8–, CD4+, CD8+ cases have been described. The disease is usually characterized by cytopenias and a modest lymphocytosis. The majority of patients with T-LGL leukemia remains asymptomatic for a long period and will require treatment later during the course of their disease. Hereby we describe a case of T-LGL leukemia diagnosed by flow cytometry, which presented indolent course and required no treatment so far.

  2. Asymptomatic early acute appendicitis initiated and diagnosed during colonoscopy: A case report

    Institute of Scientific and Technical Information of China (English)

    Michelle Petro; Anil Minocha

    2005-01-01

    Colonoscopic diagnosis of asymptomatic early acute appendicitis is exceedingly rare. Although obstruction of the lumen due to various causes is believed to be the most common physiologic mechanism of acute appendicitis, all of the previously documented cases in the literature have only shown a patent appendiceal lumen with pus flowing into the cecum. We present the case of a patient undergoing colonoscopy for colorectal cancer evaluation with no abdominal symptoms. An obstructed, swollen appendix was seen. The process was probably initiated during the colonoscopy, documenting perhaps the earliest stage of acute appendicitis for the first time. Endoscopic, CT and microscopic documentation of the case is also presented.

  3. PINK DISEASE, A REVIEW OF AN ASYMPTOMATIC BACTERIAL DISEASE IN PINEAPPLE

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    VIANEY MARÍN-CEVADA

    Full Text Available ABSTRACT Pink disease is an asymptomatic pineapple disease in the field and is evidenced with a reddark coloration when the infected fruit is processed to obtain products such as juice, jam, and preservatives. Tatumella morbirosei and T. ptyseos (formerly Pantoea citrea have been demonstrated as causal agents. Although T. morbirosei and T. ptyseos have been well studied, there are currently no cost effective control methods in pineapple cultivation. The purpose of this review is to summarize the significant and updated research on the role of pink disease in pineapple.

  4. Molecular detection of Cytauxzoon spp. in asymptomatic Brazilian wild captive felids.

    Science.gov (United States)

    André, Marcos R; Adania, Cristina H; Machado, Rosangela Z; Allegretti, Silmara M; Felippe, Paulo A N; Silva, Ketty F; Nakaghi, Andréa C H; Dagnone, Ana S

    2009-01-01

    Cytauxzoon spp. DNA was detected for the first time in blood samples from asymptomatic Brazilian wild captive felids. In 2006, 72 EDTA blood samples from seven wild felids species: Puma concolor (puma), Leopardus pardalis (ocelot), Puma yagouaroundi (jaguarundi), Leopardus wiedii (margay), Leopardus tigrinus (little spotted cat), Oncifelis colocolo (pampas cat) and Panthera onca (jaguar) were analyzed using polymerase chain reaction to amplify the 18S rRNA gene segment in order to verify the presence of Cytauxzoon spp. DNA. Nine samples were positive: six ocelots, two pumas, and one jaguar. In Brazil, wild felids may be natural reservoirs for Cytauxzoon spp.

  5. Asymptomatic congenital intrapericardial diaphragmatic hernia and epigastric hernia in the adult.

    Science.gov (United States)

    La Greca, Gaetano; Sofia, Maria; Randazzo, Valentina; Barbagallo, Francesco; Lombardo, Rosario; Soma, Pierfranco; Russello, Domenico

    2007-08-01

    The congenital intrapericardial hernia is a rare kind of diaphragmatic hernia. It is due to an embryologic defect of the central tendon of the diaphragm, often accompanied by other congenital malformations. This work presents a unique case report in the literature of the congenital association between intrapericardial diaphragmatic hernia and epigastric hernia in an adult woman. In spite of herniation of the colon and omentum the patient was completely asymptomatic, requesting surgery for an epigastric hernia for aesthetic reasons. The defect of the diaphragm was sutured and the abdominal wall was repaired with a prosthetic mesh.

  6. Wilson's disease in an adult asymptomatic patient: a potential role for modifying factors of copper metabolism.

    Science.gov (United States)

    Loudianos, Georgios; Incollu, Simona; Mameli, Eva; Lepori, Maria B

    2016-01-01

    Diagnosis of Wilson's disease (WD) still remains a challenge since no single test has an accuracy of 100%. Molecular testing for ATP7B gene mutations can help reach the diagnosis when routine testing is equivocal. We herein report an asymptomatic WD patient diagnosed accidentally by genetic analysis. Th is case suggests that WD is a challenge even in particular contexts such as family screening. Genetic testing of ATP7B gene should be recommended in the family members of WD patients with minimal alterations of specific tests such as ceruloplasmin, and presence of steatosis or increased body mass index.

  7. Treatment of liver hydatidosis:How to treat an asymptomatic carrier?

    Institute of Scientific and Technical Information of China (English)

    Bernardo; Frider; Edmundo; Larrieu

    2010-01-01

    Liver hydatidosis is the most common clinical presentation of cystic echinococcosis(CE).Ultrasonographic mass surveys have demonstrated the true prevalence,including the asymptomatic characteristic of the majority of cases,providing new insight into the natural history of the disease.This raises the question of whether to treat or not to treat these patients,due to the high and unsuspected prevalence of CE.The high rate of liver/lung frequencies of cyst localization,the autopsy findings,and the involution o...

  8. The Evaluation of a Borderline Long QT Interval in an Asymptomatic Patient.

    Science.gov (United States)

    Obeyesekere, Manoj N; Leong-Sit, Peter; Gula, Lorne J; Yee, Raymond; Skanes, Allan C; Klein, George J; Krahn, Andrew D

    2012-06-01

    QT prolongation on resting electrocardiography (ECG) is common, and the clinician is often challenged by the dilemma of excluding acquired causes and recognizing potential congenital long QT syndrome (LQTS). The hallmark of LQTS is an abnormally long QT interval. However, a normal or borderline long QT interval may be observed in up to 50% of patients with LQTS because of the intermittent nature of QT prolongation. This review presents an approach to evaluating the asymptomatic patient with a borderline long QT interval, which incorporates a comprehensive clinical assessment, rest and provocative ECG testing, and genetic testing when appropriate.

  9. SuPAR Predicts Cardiovascular Events and Mortality in Patients With Asymptomatic Aortic Stenosis

    DEFF Research Database (Denmark)

    Hodges, Gethin W; Bang, Casper N; Eugen-Olsen, Jesper

    2016-01-01

    BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory marker associated with subclinical cardiovascular damage and cardiovascular events. Whether suPAR is of prognostic value in asymptomatic patients with aortic stenosis (AS) remains unknown. METHODS: Plasma su......PAR levels were measured in 1503 patients with a mean age of 68 years who were recruited in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox regression analysis was performed to evaluate associations between suPAR and the composite end points of ischemic cardiovascular events (ICEs), aortic...

  10. [A combination of diseases of the thyroid and asymptomatic adenoma of the parathyroid glands].

    Science.gov (United States)

    Romanchishen, A F; Matveeva, Z S

    2006-01-01

    The authors have analyzed the cases of diagnosis of asymptomatic tumors of the parathyroid gland made during 8814 operations on the thyroid in the period from 1995 through 2004. The probability of detecting parathyroid incidentalomas in different forms of goiter was calculated which reaches 0.4%. A precision technique of operating allows the parathyroid tumors to be detected at the preclinical stage in all patients apart from a removal of the necessary volume of the thyroid tissue, guaranteed preservation of the laryngeal nerves and parathyroid glands.

  11. Massive gastrointestinal bleeding:An unusual case of asymptomatic extrarenal,visceral,fibromuscular dysplasia

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Extrarenal fibromuscular dysplasia causing gastrointestinal bleeding without other manifestations and especially sparing renal vasculature is uncommon. The diagnosis of this entity is usually made by radiographic appearance and the treatment is controversial. To our knowledge only seven cases of visceral fibromuscular dysplasia as a primary manifestation of the disease have been described, symptoms range from abdominal pain to gangrene. This is the first case of visceral fibromuscular dysplasia presenting with otherwise asymptomatic gastrointestinal bleeding, without bowel necrosis or ischemic changes. We provide a review of the literature.

  12. Asymptomatic pontine and extra-pontine lesions in a patient with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Raj Kanwar Yadav

    2016-01-01

    Full Text Available Osmotic demyelination syndrome leading to central pontine/extra-pontine myelinolysis (CPM/EPM occurs mainly in patients with history of alcohol abuse, malnourishment, following liver transplantation and less commonly, in association with other systemic diseases. Asymptomatic CPM/EPM is rare. Patients with end-stage renal disease (ESRD who develop CPM/EPM are usually symptomatic with florid neurologic manifestations. Herein, we present a patient with ESRD on maintenance hemodialysis who was incidentally detected to have pontine and extra-pontine lesions suggestive of myelinolysis without any neurologic signs or symptoms.

  13. Detection of Chlamydia trachomatis in asymptomatic women: relationship to history, contraception, and cervicitis.

    Science.gov (United States)

    Bontis, J; Vavilis, D; Panidis, D; Theodoridis, T; Konstantinidis, T; Sidiropoulou, A

    1994-12-01

    The presence of Chlamydia trachomatis antigen was examined in 400 endocervical samples collected from an equal number of asymptomatic sexually active women. The overall prevalence was found to be 4%, using the enzyme-linked immunosorbent assay. Chlamydia infection was correlated with younger age (5.8%, p 0.05), condom (0%, p Chlamydia trachomatis infection is associated with younger age, intense sexual life, and use of oral contraceptives. Given that the majority of infected women revealed cervical pathology, the detection of chlamydia in the high-risk female population with cervical changes seems to be essential.

  14. A Rare Case of Sarcina ventriculi of the Stomach in an Asymptomatic Patient.

    Science.gov (United States)

    Haroon Al Rasheed, Mohamed Rizwan; Kim, George J; Senseng, Carmencita

    2016-04-01

    Sarcina ventriculi is a gram-positive coccus that grows in a tetrad arrangement in the stomach. In the past 35 years, less than 20 cases have been reported in the literature, and it has been associated with life-threatening complications such as emphysematous gastritis and perforation. Treatment of S ventriculi generally consists of proton pump inhibitors with or without adjuvant antibiotic therapy. We report the first ever case of S ventriculi, including the morphological and immunohistochemical features, occurring in an asymptomatic patient with a history of Helicobacter pylori gastric ulcers.

  15. Shiga Toxin Producing Escherichia coli.

    Science.gov (United States)

    Bryan, Allen; Youngster, Ilan; McAdam, Alexander J

    2015-06-01

    Shiga toxin-producing Escherichia coli (STEC) is among the common causes of foodborne gastroenteritis. STEC is defined by the production of specific toxins, but within this pathotype there is a diverse group of organisms. This diversity has important consequences for understanding the pathogenesis of the organism, as well as for selecting the optimum strategy for diagnostic testing in the clinical laboratory. This review includes discussions of the mechanisms of pathogenesis, the range of manifestations of infection, and the several different methods of laboratory detection of Shiga toxin-producing E coli.

  16. Apparent rarity of asymptomatic herpes cervicitis in a woman with intra-uterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Adeola Fowotade

    2013-12-01

    Full Text Available Infection with genital herpes simplex virus (HSV remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.

  17. Factors influencing the prophylactic removal of asymptomatic impacted lower third molars.

    Science.gov (United States)

    Almendros-Marqués, N; Alaejos-Algarra, E; Quinteros-Borgarello, M; Berini-Aytés, L; Gay-Escoda, C

    2008-01-01

    The aim of this study was to analyse factors indicating prophylactic removal of impacted lower third molars, and how they, and possibly surgeon experience, influence the therapeutic decision-making process. A descriptive observational study was made of 40 asymptomatic impacted lower third molars. Orthopantomographs were scanned and presented to four professionals with different degrees of surgical experience. The examiners received information relating to patient age and sex, molar inclination and degree of impaction, and expressed their opinion on the necessity for teeth removal. There was a statistically significant relationship between examiner decision and the estimated probability of pathology if the molars were not removed (Pmolar, age, degree of impaction and patient sex. No statistically significant differences (P>0.05) were observed between residents and trainers in terms of the decision to remove or estimated risk of complications. The management approach adopted by oral surgeons regarding the removal of asymptomatic impacted lower third molars depends upon the perceived risk of complications if such teeth are not removed, other factors being secondary. The surgical experience of the professional does not seem to influence treatment decision.

  18. A Mixed Methods Feasibility Trial of PKCι Inhibition with Auranofin in Asymptomatic Patients with Ovarian Cancer

    Science.gov (United States)

    Jatoi, Aminah; Breitkopf, Carmen Radecki; Foster, Nathan R.; Block, Matthew S.; Grudem, Megan; Hendrickson, Andrea Wahner; Carlson, Rachel E.; Barrette, Brigitte; Karlin, Nina; Fields, Alan P.

    2015-01-01

    Purpose This trial was undertaken to 1) determine the feasibility of enrolling asymptomatic ovarian cancer patients with Ca-125 elevation to a trial with the PKCι inhibitor, auranofin, and 2) understand patients’ perceptions of Ca-125 monitoring. Methods Asymptomatic ovarian cancer patients with Ca-125 elevation received auranofin 3 mg orally twice/day and were evaluated. Patients participated in interviews about Ca-125 monitoring. Results Ten patients were enrolled in slightly over 6 months, exceeding our anticipated rate. Four manifested stable Ca-125 levels for 1 month or longer. The median progression-free survival was 2.8 months (95% confidence interval: 1.3, 3.8 months); auranofin was well tolerated. One patient had baseline and monthly Ca-125 levels of 5570, 6085, 3511, and 2230 units/mL, respectively, stopped auranofin because of radiographic progression at 3 months, and manifested an increase in Ca-125 to 7168 units/mL approximately 3 months later. Patient interviews revealed: 1) the important role of Ca-125 in cancer monitoring; 2) ardent advocacy for Ca-125 testing; and 3) evolution toward the Ca-125 assuming a life of its own. Conclusions This study showed feasibility; and patients favored Ca-125 monitoring. One patient had a decline in Ca-125, suggesting that PKCι inhibition merits further study in ovarian cancer. PMID:25502607

  19. Peripheral capillary non-perfusion in asymptomatic Waldenström's macroglobulinemia

    Directory of Open Access Journals (Sweden)

    Papaconstantinou Dimitris

    2010-12-01

    Full Text Available Abstract Background To report the rare association of peripheral retinal ischemia in a patient with Waldenström's macroglobulinemia. Case Presentation A 39-year old man with a recent diagnosis of asymptomatic Waldenström's macroglobulinemia (WM was referred from his physician for ocular evaluation. The fundus examination in his right eye (RE revealed very mild central vein dilation, while retinal hemorrhages associated with microaneurismal alterations of the vascular plexus were detected at the temporal periphery. Fluoroscein angiography of his RE revealed an extended area of capillary dropout distal to the microaneurismal lesions. In our patient with WM an extensive area of capillary non-perfusion, in the absence of severe involvement of the posterior pole was documented; this association to the best of our knowledge has never been reported before. Conclusion Although the incidence of the disease is rare, meticulous examination of the retinal periphery should be performed in all patients with WM and vice versa the differential diagnosis of peripheral retinal ischemia of unknown origin should include an investigation to rule out asymptomatic Waldenström's macroglobulinemia.

  20. When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?

    Institute of Scientific and Technical Information of China (English)

    Raj P.Pal; Thivyaan Thiruudaian; Masood A.Khan

    2008-01-01

    Aims: To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer. Methods: Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value. Results: Only 1/61 men (1.6%) with a serum PSA ≤ 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups. Conclusion: Based on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA ≤ 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.

  1. Relationship between framingham risk score and coronary artery calcium score in asymptomatic Korean individuals

    Energy Technology Data Exchange (ETDEWEB)

    Heo, So Young; Park, Noh Hyuck; Park, Chan Sub; Seong, Su Ok [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of)

    2016-02-15

    We explored the association between Framingham risk score (FRS) and coronary artery calcium score (CACS) in asymptomatic Korean individuals. We retrospectively analyzed 2216 participants who underwent routine health screening and CACS using the 64-slice multidetector computed tomography between January 2010 and June 2014. Relationship between CACS and FRS, and factors associated with discrepancy between CACS and FRS were analyzed. CACS and FRS were positively correlated (p < 0.0001). However, in 3.7% of participants with low coronary event risk and high CACS, age, male gender, smoker, hypertension, total cholesterol, diabetes mellitus, and body mass index (BMI; ≥ 35) were associated with the discrepancy. In the diagnostic prediction model for discrepancy, the receiver operating characteristic curve including factors associated with FRS, diastolic blood pressure (≥ 75 mm Hg), diabetes mellitus, and BMI (≥ 35) showed that the area under the curve was 0.854 (95% confidence interval, 0.819–0.890), indicating good sensitivity. Diabetes mellitus or obesity (BMI ≥ 35) compensate for the weakness of FRS and may be potential indicators for application of CACS in asymptomatic Koreans with low coronary event risk.

  2. Varicella-Zoster Virus Keratitis with Asymptomatic Conjunctival Viral Shedding in the Contralateral Eye

    Directory of Open Access Journals (Sweden)

    Akio Miyakoshi

    2012-10-01

    Full Text Available Purpose: To report a case of varicella-zoster virus (VZV keratitis with detection of VZV DNA in the tear fluid of not only the symptomatic eye but also the contralateral asymptomatic eye by polymerase chain reaction (PCR. Methods: This is a case report. A 63-year-old otherwise healthy woman presented with circular corneal ulcer and stromal opacity with infiltration accompanied by mild conjunctival and ciliary injections in the left eye. Bacterial cultures of the corneal scrapings and virus PCR analyses of tear fluid from both eyes were performed. Results: No pathogen was found by bacterial cultures. PCR was negative for Acanthamoeba, herpes simplex virus and cytomegalovirus, but positive for VZV. VZV DNA was also detected in the unaffected eye. Based on the diagnosis of VZV keratitis, oral valacyclovir and acyclovir eye ointment were administered to the corneal infected eye. The infected eye was healed and VZV DNA turned negative in the tear fluid of the treated eye after 6 months of treatment; however, VZV DNA was still positive in the tear fluid of the contralateral eye. Conclusions: To our knowledge, this is the first case report of the detection of VZV DNA in the tear fluid of both affected and unaffected eyes in a patient with VZV keratitis. Asymptomatic conjunctival shedding of VZV may continue in the healthy unaffected eye in VZV keratitis patients.

  3. Apparent Rarity of Asymptomatic Herpes Cervicitis in a Woman with Intra-Uterine Contraceptive Device

    Science.gov (United States)

    Okolo, Abu Clement; Manga, Mohammed Mohammed; Anaedobe, Chinenye Gloria; Salami, Ayodeji Akeem; Akang, Effiong Essien Udo

    2013-01-01

    Infection with genital herpes simplex virus (HSV) remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy. PMID:28299103

  4. Diagnosis of Alzheimer’s Disease with [18F]PET in Mild and Asymptomatic Stages

    Directory of Open Access Journals (Sweden)

    Alexander Drzezga

    2009-01-01

    Full Text Available With longer life expectancy, dementia based on the age-related Alzheimers’ disease (AD has turned into one of the most prevalent disorders of older age, representing a serious medical and socio-economic issue. There has been growing interest in early diagnosis of this disease, particularly regarding the initiation of new treatment strategies ahead of the onset of irreversible neuronal damage. It is accepted that the pathologic changes underlying AD appear in the brain years to decades before the symptomatic stages. Consequently, clinical measures of cognitive impairment, as used for definition of dementia, will not allow early diagnosis of AD-pathology in the mild or asymptomatic stages. Thus, a need for complementary sensitive biomarkers is apparent. Brain imaging markers are among the most promising candidates for this diagnostic challenge. Particularly, [18F]FDG PET as a marker of regional neuronal function has been demonstrated to represent a most sensitive and specific method for early identification of AD-pathology and thus for prediction of dementia of the Alzheimer type (DAT, even in the mild and asymptomatic stages. Currently, systematic data of comparable quality are hardly available for any other imaging procedure. The purpose of this article is to describe the typical findings of [18F]FDG PET in different stages of AD and to demonstrate its value for early and reliable diagnosis of Alzheimer's disease, particularly ahead of the stage of dementia of the Alzheimer’s type.

  5. Asymptomatic Brucella bacteraemia and isolation of Brucella melitensis biovar 3 from human breast milk.

    Science.gov (United States)

    Celebi, Güven; Külah, Canan; Kiliç, Selçuk; Ustündağ, Gonca

    2007-01-01

    Brucellosis is a zoonotic disease and virtually all infections derived from exposure to animals or ingestion of unpasteurized dairy products. Brucellosis among family members has been reported. However, screening household members of an index case of acute brucellosis is not a routine procedure. A 10-y-old boy was diagnosed with acute brucellosis. Unpasteurized goat cheese commonly consumed within the family was thought to be the possible source of the bacteria. The family (parents, sister and brother) was screened with physical examination, serum tube agglutination test, blood cultures and routine laboratory tests. Three additional cases (parents and sister) of serological and culture proven brucellosis were detected. Two of them (mother and sister) were asymptomatic and had no clinical findings. Brucella melitensis biovar 3 was isolated from breast milk culture and from all blood cultures of 4 brucellosis cases. In conclusion, brucellosis, even with bacteraemia, can be completely asymptomatic. Consumption of raw milk products by household members is a common risk factor for brucellosis outbreak among family members. Thus, screening household members of an index case of brucellosis can expose new brucellosis cases.

  6. "Evaluation of Trichomonas Vaginalis Isolates from Symptomatic and Asymptomatic Patients in Mouse Model"

    Directory of Open Access Journals (Sweden)

    Z Valadkhani

    2004-07-01

    Full Text Available Trichomoniasis, a worldwide prevalent infection, is a perfect example of interplay between the infecting parasite and the host, on which the presentation of disease depends. To study the pathogenesis, animal model is required for establishment of infection. In this study, by using strains of Trichomonas vaginalis isolated from vaginal swabs and/or urine samples and maintained in axenic form from 10 symptomatic and 10 asymptomatic female patients, the infections in BALB/c mice have been evaluated. Based on parasitic load, experimental peak infection in vagina of estradiol and L. acidophilus treated female BALB/c mice was observable on 5th post infection day. This was significantly higher in mice infected with isolates from symptomatic patients in comparison to the other group. Gradual increase up to day 5 followed by decline in parasites, polymorphs and vaginal epithelial cells was observed in mice infected with isolates from symptomatic subjects in contrast to mice infected with asymptomatic patients’ isolates or control animals at all time intervals.

  7. Molecular Characterization of Trichomonas vaginalis Strains Based on Identifying Their Probable Variations in Asymptomatic Patients

    Science.gov (United States)

    SPOTIN, Adel; EGHTEDAR, Sanaz TAGHIZADEH; SHAHBAZI, Abbas; SALEHPOUR, Asghar; SARAFRAZ, Seddigheh; SHARIATZADEH, Seyyed Ali; MAHAMI-OSKOUEI, Mahmoud

    2016-01-01

    Background: The aim of this study was to identify the Trichomonas vaginalis strains/haplotypes based on identifying their probable variations in asymptomatic patients referred to Tabriz health centers, northwestern Iran. Methods: Sampling was taken from 50-suspected women to T. vaginalis in northwestern Iran. The obtained samples were smeared and cultured. Fifty DNA samples were extracted, amplified and identified by nested polymerase chain reaction and PCR-RFLP of actin gene using two endonuclease enzymes: MseI and RsaI. To reconfirm, the amplicons of actin gene were directly sequenced in order to identify the strains/haplotypes. Results: PCR-RFLP patterns, sequencing and phylogenetic analyses revealed definitely the presence of the G (n=22; 73.4%) and E (n=8; 26.6%) strains. Multiple alignments findings of genotype G showed five haplotypes and two amino acid substitutions in codons 192 and 211 although, no remarkable unique haplotype was found in genotype E. Conclusion: The accurate identification of T. vaginalis strains based on discrimination of their unknown haplotypes particularly those which are impacted on protein translation should be considered in parasite status, drug resistance, mixed infection with HIV and monitoring of asymptomatic trichomoniasis in the region. PMID:28127362

  8. Diagnosis of Alzheimer's disease with [18F]PET in mild and asymptomatic stages.

    Science.gov (United States)

    Drzezga, Alexander

    2009-01-01

    With longer life expectancy, dementia based on the age-related Alzheimers' disease (AD) has turned into one of the most prevalent disorders of older age, representing a serious medical and socio-economic issue. There has been growing interest in early diagnosis of this disease, particularly regarding the initiation of new treatment strategies ahead of the onset of irreversible neuronal damage. It is accepted that the pathologic changes underlying AD appear in the brain years to decades before the symptomatic stages. Consequently, clinical measures of cognitive impairment, as used for definition of dementia, will not allow early diagnosis of AD-pathology in the mild or asymptomatic stages. Thus, a need for complementary sensitive biomarkers is apparent. Brain imaging markers are among the most promising candidates for this diagnostic challenge. Particularly, [18F]FDG PET as a marker of regional neuronal function has been demonstrated to represent a most sensitive and specific method for early identification of AD-pathology and thus for prediction of dementia of the Alzheimer type (DAT), even in the mild and asymptomatic stages. Currently, systematic data of comparable quality are hardly available for any other imaging procedure. The purpose of this article is to describe the typical findings of [18F]FDG PET in different stages of AD and to demonstrate its value for early and reliable diagnosis of Alzheimer's disease, particularly ahead of the stage of dementia of the Alzheimer's type.

  9. Reversible and Asymptomatic Gyral and Subarachnoid Contrast Enhancement after Carotid Stenting

    Science.gov (United States)

    Vangosa, Alessandra Briatico; Tortora, Domenico; Modestino, Francesco; Cotroneo, Antonio R

    2015-01-01

    The presence of sulcal hyperdensity in patients after endovascular procedures is not necessarily attributable to hemorrhage. It may frequently indicate the absolute or concomitant extravasation of contrast material into the subarachnoid spaces. This case report describes the clinical case of an 84-year-old patient with 90% stenosis of the right internal carotid who presented with a diffuse gyral and sulcal hyperdensity in the right temporal-occipital and frontal lobes at routine post-carotid stenting (CAS) brain CT scan. The patient was asymptomatic and CT findings were interpreted as contrast enhancement hyperattenuation and no therapeutic decisions were made. A 24-hour follow-up brain CT demonstrated the complete resolution of the hyperdensity, confirming the diagnosis. In this patient we considered the concomitant presence of gyral and sulcal hyperdensity as the consequence of reversible damage to the blood-brain barrier (BBB) determining a transitory extravasation of contrast material. Asymptomatic gyral and subarachnoid contrast enhancement following CAS is generally indicative of benign and transitory damage to the BBB and is not to be misinterpreted as hemorrhage. PMID:25923674

  10. Ingestion of either scotch or vodka induces equal effects on sleep and breathing of asymptomatic subjects.

    Science.gov (United States)

    Block, A J; Hellard, D W

    1987-06-01

    Polysomnography was performed on 13 asymptomatic men and four women on three consecutive nights in our sleep laboratory. In random order, the subjects ingested either orange juice alone or the equivalent of 1 mL of 100-proof alcoholic beverage (scotch or vodka) per pound of body weight in 1.5 hours or less. All subjects ingested a different beverage on each of the three nights. Blood alcohol level in the subjects before sleep was, for vodka, 73 mg/100 mL, and, for scotch, 74 mg/100 mL. On control nights the subjects showed significantly more time in bed, sleep period time, and total sleep time, and more rapid eye movement sleep. On the scotch and vodka nights, oxygen saturation was significantly lower; there were more episodes of oxygen desaturation in which there was greater than 4% decrease in saturation, more desaturation to levels of less than 90%, and more hypopnea. Comparison of data of scotch with vodka nights showed no significant differences in any variable. Both scotch and vodka ingestion in equal dosage induced sleep-disordered breathing and nocturnal oxygen desaturation in asymptomatic volunteers, and the beverages had equal effects.

  11. Significance of microalbuminuria in relation to subclinical coronary atherosclerosis in asymptomatic nonhypertensive, nondiabetic subjects.

    Science.gov (United States)

    Park, Hyo Eun; Heo, Nam Ju; Kim, Minkyung; Choi, Su-Yeon

    2013-03-01

    We aimed to investigate the significance of microalbuminuria and its relationship with subclinical atherosclerosis in nonhypertensive and nondiabetic patients, by using coronary artery computed tomography (CT). A total of 1,318 nonhypertensive and nondiabetic subjects who had taken coronary artery CT and measured spot urine albumin to creatinine ratio (UACR) were evaluated. The atherosclerotic changes of coronary arteries were greater in subjects with microalbuminuria, reflected by coronary artery calcium score (CACS) and significant coronary artery stenosis (CACS ≥ 100 in 15.3% vs 7.6% and stenosis ≥ 50% in 11.5% vs 4.9% of patients with vs without microalbuminuria, P = 0.008 and P = 0.011, respectively). Among various parameters that are known as a risk factor or possible biomarkers of coronary artery disease, presence of microalbuminuria, age and Framingham risk score were significantly related to coronary artery stenosis. Among them the presence of microalbuminuria showed stronger correlation than others to the coronary artery stenosis detected by CT, even after adjusting confounding factors (OR 3.397, 95% confidence interval 1.138 to 10.140, P = 0.028). The presence of microalbuminuria by UACR was significantly associated with presence of coronary artery stenosis ≥ 50% in asymptomatic, nonhypertensive and nondiabetic general population. Our study suggests that the presence of microalbuminuria may imply subclinical coronary artery disease, even in asymptomatic population.

  12. Transient asymptomatic white matter lesions following Epstein-Barr virus encephalitis

    Directory of Open Access Journals (Sweden)

    Yoo Young Jang

    2011-09-01

    Full Text Available We present the case of a patient with Epstein-Barr virus (EBV encephalitis who developed abnormal white matter lesions during the chronic phases of the infection. A 2-year-old-boy was admitted for a 2 day history of decreased activity with ataxic gait. The results of the physical examination were unremarkable except for generalized lethargy and enlarged tonsils with exudates. Brain magnetic resonance imaging (MRI at admission showed multiple high signal intensities in both basal ganglia and thalami. The result of EBV polymerase chain reaction (PCR of the cerebral spinal fluid was positive, and a serological test showed acute EBV infection. The patient was diagnosed with EBV encephalitis and recovered fully without any residual neurologic complications. Subsequently, follow-up MRI at 5 weeks revealed extensive periventricular white matter lesions. Since the patient remained clinically stable and asymptomatic during the follow-up period, no additional studies were performed and no additional treatments were provided. At the 1-year follow-up, cranial MRI showed complete disappearance of the abnormal high signal intensities previously seen in the white matter. The patient continued to remain healthy with no focal neurologic deficits on examination. This is the first case of asymptomatic self-limited white matter lesions seen in serial MRI studies in a Korean boy with EBV encephalitis.

  13. Antileishmania Immunological Tests for Asymptomatic Subjects Living in a Visceral Leishmaniasis-Endemic Area in Brazil

    Science.gov (United States)

    Silva, Luciana Almeida; Romero, Héctor Dardo; Nogueira Nascentes, Gabriel Antônio; Costa, Roberto Teodoro; Rodrigues, Virmondes; Prata, Aluízio

    2011-01-01

    The objective of this study was to evaluate the behavior of different tests used for the diagnosis of visceral leishmaniasis (VL) in asymptomatic subjects living in an endemic area. No gold standard is available for the diagnosis of asymptomatic infection with Leishmania. In continuation of a previous study, 1,017 subjects living in a VL-endemic area were clinically reevaluated. Of these, 576 had at least one positive serological test in a first assessment. About 3 years after the first evaluation, none of the subjects had progressed to clinical VL. Among this group, 246 subjects were selected, and five serological tests (enzyme-linked immunosorbent assay p [ELISAp], ELISArK39, ELISArK26, indirect immunofluorescence test [IIFT] using L. amazonensis promastigote antigen, and an immunochromatographic test using rK39 antigen [TRALd]) and the Montenegro skin test (MST) were repeated. There was a significant increase in the number of subjects who tested positive in the MST, IIFT, ELISAp, and ELISArK39 in the second evaluation. For all tests, there were subjects who tested positive in the first evaluation and negative in the second evaluation. A positive result in the serological tests and MST in subjects from the endemic area studied did not indicate a risk of progression to VL and may only be temporary. PMID:21292896

  14. Asymptomatic cardiovascular manifestations in diabetes mellitus: Left ventricular diastolic dysfunction and silent myocardial ischemia

    Directory of Open Access Journals (Sweden)

    Seferović-Mitrović Jelena P.

    2011-01-01

    Full Text Available Introduction. Several cardiovascular manifestations in patients with diabetes may be asymptomatic. Left ventricular diastolic dysfunction (LVDD is considered to be the earliest metabolic myocardial lesion in these patients, and can be diagnosed with tissue Doppler echocardiography. Silent myocardial ischemia (SMI is a characteristic and frequently described form of ischemic heart disease in patients with diabetes. Objective. The aim of the study was to assess the prevalence of LVDD and SMI in patients with type 2 diabetes, as well as to compare demographic, clinical, and metabolic data among defined groups (patients with LVDD, patients with SMI and patients with type 2 diabetes, without LVDD and SMI. Methods. We investigated 104 type 2 diabetic patients (mean age 55.4±9.1 years, 64.4% males with normal blood pressure, prehypertension and arterial hypertension stage I. Study design included basic laboratory assessment and cardiological workup (transthoracic echocardiography and tissue Doppler, as well as the exercise stress echocardiography. Results. LVDD was diagnosed in twelve patients (11.5%, while SMI was revealed in six patients (5.8%. Less patients with LVDD were using metformin, in comparison to other two groups (χ2 =12.152; p=0.002. Values of HDL cholesterol (F=4.515; p=0.013 and apolipoprotein A1 (F=5.128; p= 0.008 were significantly higher in patients with LVDD. Conclusion. The study confirmed asymptomatic cardiovascular complications in 17.3% patients with type 2 diabetes.

  15. Detection of Theileria equi in spleen and blood of asymptomatic piroplasm carrier horses.

    Science.gov (United States)

    Ribeiro, Isabel B; Câmara, Antônio Carlos L; Bittencourt, Marta V; Marçola, Tatiana G; Paludo, Giane R; Soto-Blanco, Benito

    2013-06-01

    This study aimed to determine whether asymptomatic horses naturally infected with Theileria equi retain infected erythrocytes in the spleen and whether the presence of the hemoparasite in this organ is associated with parasitemia. We collected samples from 25 adult horses without clinical signs of any disease. From each animal, we collected whole blood samples from the jugular vein and a splenic puncture blood sample. All samples were submited to blood cell counts and detection of Theileria or Babesia. DNA extraction and PCR were performed in all samples for identification of piroplasm infection (T. equi and B. caballi). From the 25 horses evaluated for piroplasm detection by PCR, seven horses (28%) were positive in jugular vein blood but negative in splenic blood samples, five horses (20%) were positive in splenic blood samples but negative in jugular vein blood samples, and 13 horses (52%) were positive in both jugular vein and splenic blood samples. The hematological evaluation revealed anemia in 13 of 25 (52%) infected horses, lymphopenia in five (20%), neutrophilia in two (8%), neutropenia in one (4%), and thrombocytopenia in one (4%) infected horse. The present study demonstrated that several (20%) of the asymptomatic piroplasm carrier horses did not show parasitemia, but show infected erythrocytes in the spleen.

  16. Pulmonary Findings on Computed Tomography in Asymptomatic Total Joint Arthroplasty Patients.

    Science.gov (United States)

    Vigdorchik, Jonathan M; Riesgo, Aldo M; Lincoln, Denis; Markel, David C

    2016-08-01

    An increase in the diagnosis of pulmonary embolus (PE) in the early postoperative period has been attributed to the use of multidetector 64-slice computed tomographic (CT) scans. It was suspected that this finding was the result of marrow or fat emboli that are commonly associated with arthroplasty rather than a true venous thromboembolic phenomenon. The purpose of this study was to determine the baseline pulmonary findings in asymptomatic patients after total joint arthroplasty (TJA). Over a 1-year period, an institutional review board-approved prospective study of 20 asymptomatic patients using a multidetector 64-slice CT scanner was performed. Overall, 15 TKAs and 5 total hip arthroplasties were included for analysis. All of the CT scans were negative for PE. There were no signs of microemboli or fat emboli on any scan. No patient went on to develop a PE at 2 years postoperatively. Despite the fact that emboli are created during TJA, if emboli are seen on a CT scan postoperatively, they should be assumed to be real events with clinical sequelae. If pulmonary symptoms develop postoperatively, they should not simply be assumed to be the result of fat or marrow embolism.

  17. Comparison of clinical samples for visceral Leishmaniasis diagnosis in asymptomatic dogs by PCR hybridization

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Sidney A.; Ituassu, Leonardo T.; Melo, Maria N. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Parasitologia], e-mail: saninoalmeida@gmail.com, e-mail: Itituassu@yahoo.com.br, e-mail: melo@icb.ufmg.br; Leite, Rodrigo S.; Andrade, Antero S.R. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN-CNEN/MG), Belo Horizonte, MG (Brazil)], e-mail: rleite2005@gmail.com, e-mail: antero@cdtn.br

    2009-07-01

    The canine visceral leishmaniasis (CVL) diagnosis still represents a challenge because of complexity of this disease. The aim of present study was to compare different clinical samples for diagnosis of CVL by Polymerase Chain Reaction (PCR) combined with hybridization of {sup 32}P labeled probes. Bone marrow (BM), skin biopsy (SB), peripheral blood (PB) and conjunctival swab (CS) were used in this work. With this purpose 40 asymptomatic dogs, all positive by parasitological test, were obtained. From each animal were collected SB with sterile punches from ear internal surface, 1.0 mL of PB, BM aspirates from sternum and CS from both lower eyelid. Each clinical sample was submitted to suitable DNA purification process and PCR-hybridization assays. The positive results obtained with PCR were 55%, 25%, 30% and 22.5% for CS, BM, SB and PB respectively while the PCR followed by hybridization showed a positivity of 87.5%, 50%, 45% and 27.5% respectively. The hybridization assay was able to increase the PCR positivity in all kinds of clinical samples. The best performance was obtained using CS samples. We concluded that the PCR associated with DNA radioactive probes was a very sensitive tool for diagnosis of CVL in asymptomatic dogs and the CS has an important potential for regular screening of dogs. (author)

  18. MRI appearances of the asymptomatic patellar tendon on gradient echo imaging

    Energy Technology Data Exchange (ETDEWEB)

    Reiff, D.B. [Dept. of Diagnostic Radiology, St. George`s Hospital, London (United Kingdom); Heenan, S.D. [Dept. of Diagnostic Radiology, St. George`s Hospital, London (United Kingdom); Heron, C.W. [Dept. of Diagnostic Radiology, St. George`s Hospital, London (United Kingdom)

    1995-02-01

    Thickening of the patellar tendon and foci of increased signal intensity have been described as characteristic features of ``jumper`s knee`` (chronic patellar tendinitis) on magnetic resonance imaging (MRI). It was our impression that such appearances may be seen in the patellar tendons of patients without symptoms referable to the anterior part of the knee when using gradient echo images. The appearances of the asymptomatic patellar tendon on three-dimensional gradient echo sequences were studied by retrospectively reviewing the images of 60 patients, none of whom had symptoms related to the anterior part of the knee. The anteroposterior width of the patellar tendon was measured at three levels (superior, middle and inferior) on the central sagittal image of a gradient echo sequence. The relative signal intensities at the same levels were recorded. In 97% of subjects the superior part of the tendon was wider than the midpoint, and in 97% the inferior part was wider than the midpoint. The range of widths was wide, and there was no significant difference between sexes. Focal increased signal intensity in the superior part was shown in 75%, and in the inferior part in 43%. The asymptomatic patellar tendon shows uniform thickness throughout most of its length, but there are focal expansions at the proximal and distal ends. It usually demonstrates low signal on MRI, but may contain foci of increased signal intensity at either or both ends when imaged on gradient-echo sequences. (orig.)

  19. Asymptomatic malaria parasitemia does not induce additional oxidative stress in pregnant women of South East Nigeria

    Institute of Scientific and Technical Information of China (English)

    Uchenna Ifeanyi Nwagha; Tochukwu Christopher Okeke; Theresa Ukamaka Nwagha; FidelisEbeleEjezie; SylvesterOgbonnaOgbodo; CyrilChukwudiDim; BondUgochukwuAnyaehie

    2011-01-01

    Objective:To determine the relationship between asymptomatic malaria parasitemia and some oxidative stress parameters in pregnant Nigerian women. Methods:This is a cross-sectional study involving 130 normal pregnant women at various trimesters, who were attending antenatal clinic at the University of Nigeria Teaching Hospital (UNTH) and Kenechukwu Specialist Hospital in Enugu. A comparable group (control), made of 30 non pregnant women was also recruited. After a 24 hour dietary recall, serum levels of vitamin A, C and malondialdehyde (MDA) were determined by colorimetric method, while vitamin E was determined by absorptiometric method. Results: There were no statistically significant differences in age, parity, estimated calorie, vitamins A, C and E intake between the pregnant and non pregnant groups (P>0.05). The serum level of the vitamins (umol/L) and MDA (umol/L) in control, 1st, 2nd and 3rd trimesters respectively were:(1)Vitamin A:1.6±0.36 vs 0.6±0.26 vs 0.62±0.33 vs 0.46±0.21 (P0.05). Conclusions:Asymptomatic malaria parasitemia does not induce additional oxidative stress on pregnant women in Nigeria. The enormity of acute and complicated attack should be further investigated.

  20. Genetic Evaluation of E. coli Strains Isolated from Asymptomatic Children with Neurogenic Bladders

    Directory of Open Access Journals (Sweden)

    John Kryger

    2015-01-01

    Full Text Available This study was conducted to describe the genetic profiles of E. coli that colonize asymptomatic pediatric neurogenic bladders. E. coli was isolated from 25 of 80 urine samples. Patients were excluded if they presented with symptomatic urinary tract infection or received treatment with antibiotics in the preceding three months. Multiplex PCR was performed to determine E. coli phylotype (A, B1, B2, and D and the presence of seven pathogenicity islands (PAIs and 10 virulence factors (VFs. E. coli strains were predominantly of the B1 and B2 phylotype, with few strains in the A or D phylotype. The PAIs IV536, ICFT073, and IICFT073 had the highest prevalence: 76%, 64%, and 48%, respectively. The PAIs II536, IJ96, and IIJ96 were less prevalent: 28%, 20%, and 24%, respectively. The most prevalent VF was vat (40%, while the least prevalent VFs were sfa (8% and iha (12%. None of the strains carried the VF fyuA, which is very common in uropathogenic E. coli (UPEC. The genetic profiles of E. coli in this cohort seem to be more similar to UPEC than to commensal E. coli. However, they appear to have reduced virulence potential that allows them to colonize asymptomatically.

  1. High Prevalence of Asymptomatic Neurocysticercosis in an Endemic Rural Community in Peru

    Science.gov (United States)

    O’Neal, Seth E.; Ayvar, Viterbo; Gonzalvez, Guillermo; Gamboa, Ricardo; Vilchez, Percy; Rodriguez, Silvia; Reistetter, Joe; Tsang, Victor C. W.; Gilman, Robert H.; Gonzalez, Armando E.; Garcia, Hector H.

    2016-01-01

    Background Neurocysticercosis is a common helminthic infection of the central nervous system and an important cause of adult-onset epilepsy in endemic countries. However, few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level. Methodology We conducted a population-based study of resident’s ≥2 years old in a highly endemic village in Peru (pop. 454). We applied a 14 -question neurologic screening tool and evaluated serum for antibodies against Taenia solium cysticercosis using enzyme-linked immunoelectrotransfer blot (LLGP-EITB). We invited all residents ≥18 years old to have non-contrast computerized tomography (CT) of the head. Principal findings Of the 385 residents who provided serum samples, 142 (36.9%) were seropositive. Of the 256 residents who underwent CT scan, 48 (18.8%) had brain calcifications consistent with NCC; 8/48 (17.0%) reported a history of headache and/or seizures. Exposure to T. solium is very common in this endemic community where 1 out of 5 residents had brain calcifications. However, the vast majority of people with calcifications were asymptomatic. Conclusion This study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future. PMID:27992429

  2. Blastocystis hominis among symptomatic and asymptomatic individuals in Talkha Center, Dakahlia Governorate, Egypt.

    Science.gov (United States)

    El-Shazly, Atef M; Abdel-Magied, Aida A; El-Beshbishi, Samar N; El-Nahas, Hala A; Fouad, Mahmoud A H; Monib, Mohamed S M

    2005-08-01

    Blastocystis hominis is now getting acceptance as an agent of human intestinal disease. B. hominis in stool samples of symptomatic and asymptomatic individuals was evaluated as a possible cause of gastro-intestinal troubles. B. hominis was found in 106 (10.1%) out of 1050 individuals examined from six villages and one city in Talkha Center, Dakahlia Governorate. The highest infection rate was in Manshayt El-Badawy village (25.47%), whereas Talkha City showed the lowest rate (4.73%). Age group 10-20 years had higher infection (13.3%). In twenty-three symptomatic patients, B. hominis represented the only causative parasitic agent. The most common symptoms were diarrhoea (30.4%), abdominal pain (26.1%), flatulence (21.7%). vomiting (13.1%) and fatigue (8.7%). High concentrations of B. hominis were found in symptomatic patients than in asymptomatic ones with statistical significant difference (8.2 cells/100 x field versus 3.8 respectively). The mean number of B. hominis was significantly high in patients complaining of diarrhoea and abdominal pain.

  3. Anti - H. pylori IgG seroprevalence rates in asymptomatic children and adults from South India

    Directory of Open Access Journals (Sweden)

    Kate V

    2001-01-01

    Full Text Available This study was undertaken to determine the seroprevalence of H.pylori in asymptomatic children and compare it with that seen in the asymptomatic adult population from south India. One hundred and five children and one hundred adults admitted to the wards for conditions other than gastrointestinal disorders were included for this study. H.pylori status was determined by ELISA for IgG. The prevalence of H.pylori in children of various ages varied from 44% to 46% with an overall prevalence of H.pylori in children of 45%. 67% of adults were infected with H.pylori which was significantly higher than children (P = 0.002. The prevalence of H.pylori increased markedly with age with the maximum colonization (74% occurring in young adults (16-30 years. The antibody levels too followed a similar pattern. In conclusion, it was seen that almost half the children in south India acquire H.pylori infection early in life which increases slowly and steadily with a peak prevalence in the young adults. Gender does not affect the prevalence in children and adults. As age advances further there is a slight decline in the prevalence of H.pylori infection. The immune response reflected by the levels of the antibody levels also follows the same pattern.

  4. Mammographic density in asymptomatic menopausal women: correlation with clinical and sonographic findings

    Directory of Open Access Journals (Sweden)

    Beatriz Regina Alvares

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate mammographic breast density in asymptomatic menopausal women in correlation with clinical and sonographic findings. MATERIALS AND METHODS: Mammograms and clinical and sonographic findings of 238 asymptomatic patients were retrospectively reviewed in the period from February/2022 to June/2006. The following variables were analyzed: mammographic density patterns, sonographic findings, patients' age, parity, body mass index and use of hormone replacement therapy. RESULTS: Age, parity and body mass index showed a negative correlation with breast density pattern, while use of hormone replacement therapy showed a positive correlation. Supplementary breast ultrasonography was performed in 103 (43.2% patients. Alterations which could not be visualized at mammography were found in 34 (33% of them, most frequently in women with breast density patterns 3 and 4. CONCLUSION: The authors concluded that breast density patterns were influenced by age, parity, body mass index and time of hormone replacement therapy. Despite not having found any malignant abnormality in the studied cases, the authors have observed a predominance of benign sonographic abnormalities in women with high breast density patterns and without mammographic abnormalities, proving the relevance of supplementary ultrasonography to identify breast lesions in such patients.

  5. Classification and Prognostic Evaluation of Left Ventricular Remodeling in Patients With Asymptomatic Heart Failure.

    Science.gov (United States)

    Pugliese, Nicola Riccardo; Fabiani, Iacopo; La Carrubba, Salvatore; Conte, Lorenzo; Antonini-Canterin, Francesco; Colonna, Paolo; Caso, Pio; Benedetto, Frank; Santini, Veronica; Carerj, Scipione; Romano, Maria Francesca; Citro, Rodolfo; Di Bello, Vitantonio

    2017-01-01

    Patients with asymptomatic heart failure (HF; stage A and B) are characterized by maladaptive left ventricular (LV) remodeling. Classic 4-group classification of remodeling considers only LV mass index and relative wall thickness as variables. Complex remodeling classification (CRC) includes also LV end-diastolic volume index. Main aim was to assess the prognostic impact of CRC in stage A and B HF. A total of 1,750 asymptomatic subjects underwent echocardiographic examination as a screening evaluation in the presence of cardiovascular risk factors. LV dysfunction, both systolic (ejection fraction) and diastolic (transmitral flow velocity pattern), was evaluated, together with LV remodeling. We considered a composite end point: all-cause death, myocardial infarction, coronary revascularizations, cerebrovascular events, and acute pulmonary edema. CRC was suitable for 1,729 patients (men 53.6%; age 58.3 ± 13 years). Two hundred thirty-eight patients presented systolic dysfunction (ejection fraction remodeling, 47 eccentric remodeling, 350 concentric hypertrophy, 29 mixed hypertrophy, 86 dilated hypertrophy, and 53 eccentric hypertrophy. Age and gender distribution was noticed (p remodeling classification, systolic, and diastolic dysfunction), CRC was independent predictor of primary end point (p = 0.044, hazard ratio 1.101, 95% CI 1.003 to 1.21), confirmed in a logistic regression (p <0.03). In conclusion, CRC could help physicians in prognostic stratification of patients in stage A and B HF.

  6. 6-month evaluation of JinHuang Chinese herbal medicine study in asymptomatic HIV infected Thais.

    Science.gov (United States)

    Maek-a-nantawat, Wirach; Pitisuttithum, Punnee; Bussaratid, Valai; Chamnachanan, Supat; Naksrisook, Supa; Peonim, Wantanee; Thantamnu, Narumon; Muanaum, Rungrapat; Ngamdee, Vatcharachai

    2003-06-01

    Good results of in vitro study of anti-HIV effects of JinHuang, a Chinese herbal medicine led to in vivo study of safety and efficacy among asymptomatic HIV infected individuals. It was a prospective open study of 21 asymptomatic HIV infected Thai volunteers. Twelve and 9 were female and male, respectively, with mean age of 29.24 +/- 3.94 years. JinHuang preparation, 6 capsules and 2 bottles of liquid formula orally three times a day, was given on an outpatient basis initially for 6 months. Regular close monitoring and follow-up were done. The side effects reported included : increased bowel movements (81%), vague taste, and smell of drug after initiation (52%). No serious adverse event related to JinHuang was detected during study. No significant changes in terms of log viral load and CD4 count were observed after 6-months' duration. Most of the patients felt that the quality of life was better in terms of better appetite, good sleep and healthy during study participation, however, these were subjective.

  7. Case of granulomatosis with polyangiitis (Wegener's granulomatosis) manifested with asymptomatic intracerebral hemorrhage.

    Science.gov (United States)

    Takaoka, Hirokazu; Hashimoto, Atsushi; Nogi, Shinichi; Iwata, Kanako; Futami, Hidekazu; Arinuma, Yoshiyuki; Shimada, Kota; Nakayama, Hisanori; Komiya, Akiko; Furukawa, Hiroshi; Matsui, Toshihiro; Tohma, Shigeto

    2013-01-01

    A 46-year-old man, who had had sinusitis, developed bilateral omalgia, petechiae on his lower extremities and a congested right eye. A blood test detected elevated serum C-reactive protein level. Computed tomography incidentally found an acute lesion of thalamic hemorrhage without neurological symptoms and no specific therapy was given at the time. Thereafter, he developed vertigo, vomiting and pneumonia for which antibiotics were ineffective. He was referred and admitted to our hospital. Further, aural and renal lesions, and presence of serum proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) confirmed his diagnosis of granulomatosis with polyangiitis (Wegener's) (GPA). With corticosteroid and cyclophosphamide therapy, his symptoms disappeared in two months along with faded PR3-ANCA. Afterward he showed neither new cerebral lesion nor symptom. This is a rare case of GPA manifested with asymptomatic intracerebral hemorrhage. It should be noted that GPA could cause various manifestations in central nervous system such as a fatal or an asymptomatic hemorrhagic lesion, which might respond to immunosuppressive therapy.

  8. [Anti-neutrophil cytoplasmic antibodies (ANCA) in patients with symptomatic and asymptomatic HIV infection].

    Science.gov (United States)

    Habegger de Sorrentino, A; Motta, P; Iliovich, E; Sorrentino, A P

    1997-01-01

    The cytopathic effect of HIV on CD4 T cells, as well as the active autoimmune mechanism occurring during infection, have been documented. Of the cytokines involved in the pathogenesis of AIDS, the main one produced by the monocyte-macrophage series is tumor necrosis factor alfa (TNF alpha). This cytokine induces antigens such as proteinase 3 (Pr 3) or mieloperoxidase (MPO). Anti-neutrophil cytoplasmic antibodies (ANCA) are directed against this type of PMN antigens. In the present paper, the role of anti-neutrophil cytoplasmic antibodies (ANCA) in HIV infected patients as responsible for autoimmune phenomena in relation to opportunistic infections, was studied. A total of 88 serum samples belonging to 49 asymptomatic and 39 symptomatic HIV infected patients were tested for ANCA by an indirect immunofluorescence (IIF) test over a neutrophil substrate. ANCA were detected in 53.8% of symptomatic patients as compared to 4.1% in asymptomatic cases (p tuberculosis is a frequent finding in HIV infected patients from Northeastern Argentina. When the presence of ANCA in TB(+) HIV(+) and TB(+) HIV(-) patients was studied, it was seen that positive-ANCA significantly correlated with the first group (p pulmonar TB, could indicate that the virus may not be responsible for the induction of these antibodies.

  9. Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

    Science.gov (United States)

    Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

    2013-08-01

    Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

  10. Prevalence of signs of temporomandibular joint dysfunction in asymptomatic edentulous subjects: a cross-sectional study.

    Science.gov (United States)

    Shetty, Rajesh

    2010-06-01

    Patients having complete dentures with reduced vertical dimension generally do not manifest Temporomandibular Joint problems. It is not understood as to why the closure of jaws in dentulous individuals can predispose to Temporomandibular Joint problems, while the same etiology in edentulous subjects does not cause any concern. This study was planned to find out the prevalence of various Temporomandibular Joint dysfunction signs in subjects who were edentulous for a period of 6 months to 2 year. The various signs were obtained from a population of 100 healthy asymptomatic edentulous subjects by a questionnaire and then were clinically examined for the presence or absence of signs of Temporomandibular Joint dysfunction. 59% of the subjects exhibited one or more signs of Temporomandibular Joint dysfunction, 41% of the subjects did not show any signs of Temporomandibular Joint dysfunction. 56.6% of males reported signs of Temporomandibular Joint dysfunction when compared with females which was 62.5%. 43.3% of males did not show any signs of Temporomandibular Joint dysfunction when compared with those of the females which was 37.5%. The number of subjects who showed two signs was 29%, subjects who had only one sign was 25%. It was found that dysfunction was prevalent among both men and women in more than half of the asymptomatic subjects examined. 59% had one or as many as three signs of Temporomandibular dysfunction. The most commonly seen Joint dysfunction was the joint sounds which was 47%

  11. The Association between Myocardial Iron Load and Ventricular Repolarization Parameters in Asymptomatic Beta-Thalassemia Patients

    Directory of Open Access Journals (Sweden)

    Mehmet Kayrak

    2012-01-01

    Full Text Available Previous studies have demonstrated impaired ventricular repolarization in patients with β-TM. However, the effect of iron overload with cardiac T2* magnetic resonance imaging (MRI on cardiac repolarization remains unclear yet. We aimed to examine relationship between repolarization parameters and iron loading using cardiac T2* MRI in asymptomatic β-TM patients. Twenty-two β-TM patients and 22 age- and gender-matched healthy controls were enrolled to the study. From the 12-lead surface electrocardiography, regional and transmyocardial repolarization parameters were evaluated manually by two experienced cardiologists. All patients were also undergone MRI for cardiac T2* evaluation. Cardiac T2* score <20 msec was considered as iron overload status. Of the QT parameters, QT duration, corrected QT interval, and QT peak duration were significantly longer in the β-TM group compared to the healthy controls. Tp−Te and Tp−Te dispersions were also significantly prolonged in β-TM group compared to healthy controls. (Tp-Te/QT was similar between groups. There was no correlation between repolarization parameters and cardiac T2* MRI values. In conclusion, although repolarization parameters were prolonged in asymptomatic β-TM patients compared with control, we could not find any relation between ECG findings and cardiac iron load.

  12. Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners.

    LENUS (Irish Health Repository)

    Drummond, Frances J

    2009-01-01

    BACKGROUND: Increased use of prostate specific antigen (PSA) has been associated with increased prostate cancer incidence. Ireland is estimated to have one of the highest prostate cancer incidences in Europe and has no national guidelines for prostate cancer screening. GPs have a pivotal role in influencing PSA testing, therefore, our aim was to describe GP testing practices and to identify factors influencing these. METHODS: A postal survey, including questions on clinical practice and experience, knowledge and demographics was distributed to all GPs (n = 3,683). The main outcomes were (i) PSA testing asymptomatic men and (ii) "inappropriate" PSA testing, defined as testing asymptomatic men aged < 50 or > 75 years. Factors associated with these outcomes were identified using logistic regression. RESULTS: 1,625 GPs responded (response rate corrected for eligibility = 53%). Most respondents (79%) would PSA test asymptomatic men. Of these, 34% and 51% would test asymptomatic men < 50 and > 75 years, respectively. In multivariate analyses, GPs were more likely to test asymptomatic men if they were >or= 50 years, in practice >or= 10 years, female or less knowledgeable about PSA efficacy. Male GPs who would have a PSA test themselves were > 8-times more likely to PSA test asymptomatic men than GPs who would not have a test. GPs who had an asymptomatic patient diagnosed with prostate cancer following PSA testing, were > 3-times more likely to test asymptomatic men. Practice-related factors positively associated with testing included: running \\'well man\\' clinics, performing occupational health checks and performing other tests routinely with PSA. Factors positively associated with \\'inappropriate\\' testing included; being male and willing to have a PSA test, having worked\\/trained in the UK and supporting annual PSA testing. 91% of respondents supported the development of national PSA testing guidelines. CONCLUSION: Our findings suggest that widespread PSA testing

  13. Detection and genotype analysis of Giardia duodenalis from asymptomatic Hungarian inhabitants and comparative findings in three distinct locations.

    Science.gov (United States)

    Plutzer, Judit; Törökné, Andrea; Szénási, Zsuzsanna; Kucsera, István; Farkas, Kata; Karanis, Panagiotis

    2014-03-01

    The transmission route of giardiasis not yet understood and why some infected individuals remain asymptomatic while others become quite ill. The drinking water quality is supposedly responsible for the prevalence of asymptomatic Giardia duodenalis infections in different areas, therefore asymptomatic giardiasis has been investigated in three water supply areas of Hungary: three hundred stool samples from inhabitants of Budapest, Füzér and Mátrafüred were examined by immunological and molecular methods for the presence of G. duodenalis infections. Individuals were asked to fill out a validated questionnaire at the time of stool collection and the interview covered demographic data, family life, education and travel history.In Budapest and in Mátrafüred in one stool sample G. duodenalis Assemblage A, whereas in Füzér once G. duodenalis Assemblage A, once Assemblage B and twice mixed infection were detected. We found higher prevalence rate of 4% of G. duodenalis infections of asymptomatic people in the village Füzér, where the removal of the Giardia cysts of the drinking water treatment plant was not effective. This study throws a light the need to look into the possibility of other risks of Giardia infections such as water transmission routes. To our knowledge, this is the first study evaluating the prevalence of G. duodenalis infections in asymptomatic persons in Hungary.

  14. Evaluation of the in vitro growth of urinary tract infection-causing gram-negative and gram-positive bacteria in a proposed synthetic human urine (SHU) medium.

    Science.gov (United States)

    Ipe, Deepak S; Ulett, Glen C

    2016-08-01

    Bacteriuria is a hallmark of urinary tract infection (UTI) and asymptomatic bacteriuria (ABU), which are among the most frequent infections in humans. A variety of gram-negative and gram-positive bacteria are associated with these infections but Escherichia coli contributes up to 80% of cases. Multiple bacterial species including E. coli can grow in human urine as a means to maintain colonization during infections. In vitro bacteriuria studies aimed at modeling microbial growth in urine have utilized various compositions of synthetic human urine (SHU) and a Composite SHU formulation was recently proposed. In this study, we sought to validate the recently proposed Composite SHU as a medium that supports the growth of several bacterial species that are known to grow in normal human urine and/or artificial urine. Comparative growth assays of gram-negative and gram-positive bacteria E. coli, Pseudomonas aeruginosa, Proteus mirabilis, Streptococcus agalactiae, Staphylococcus saprophyticus and Enterococcus faecalis were undertaken using viable bacterial count and optical density measurements over a 48h culture period. Three different SHU formulations were tested in various culture vessels, shaking conditions and volumes and showed that Composite SHU can support the robust growth of gram-negative bacteria but requires supplementation with 0.2% yeast extract to support the growth of gram-positive bacteria. Experiments are also presented that show an unexpected but major influence of P. mirabilis towards the ability to measure bacterial growth in generally accepted multiwell assays using absorbance readings, predicted to have a basis in the release of volatile organic compound(s) from P. mirabilis during growth in Composite SHU medium. This study represents an essential methodological validation of a more chemically defined type of synthetic urine that can be applied to study mechanisms of bacteriuria and we conclude will offer a useful in vitro model to investigate the

  15. Disease: H01339 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available es does not always cause symptoms and tissue damage. Asymptomatic bacteriuria has been attracting attention as a model to study mecha...nisms underlying the development of commensalism. Escher

  16. Neurohormonal and circulatory effects of short-term treatment with enalapril and quinapril in dogs with asymptomatic mitral regurgitation

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Pedersen, Lotte Gam; Teerlink, Tom;

    2005-01-01

    - provided that the results seen in humans regarding improved endothelial dysfunction can be reproduced in dogs. The aim of the study was to compare the effect enalapril and quinapril on neurohormonal and circulatory parameters in CKCS with asymptomatic MR. Ten CKCS with mild to severe untreated MR completed......, there was no significant difference between the effects of the two treatments on MR. These results suggest that ACE inhibitors do not affect NOx and ADMA concentrations in asymptomatic dogs with MR, however, stress in connection with clinical examination may influence NOx concentrations in these dogs.......Mitral regurgitation (MR) is a common cause of heart failure in dogs. Cavalier King Charles Spaniels (CKCS) are predisposed to the disease and often develop asymptomatic MR at a young age, which seems to be associated with a decreased production of nitric oxide (NO) (measured as the stable...

  17. Evaluation of Asymptomatic Peripheral Arterial Disease by Ankle-brachial Index in Patients with Concomitant Coronary Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hosein Vakili

    2012-12-01

    Full Text Available Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. As such, it is found that screening for peripheral arterial disease (PAD improves risk assessment. Thus, intensive risk factor modification and medical treatment in these patients are necessary. Objectives: The purpose of this study was to determine the prevalence of asymptomatic peripheral arterial disease in patients with concomitant coronary arterial disease. Methods: Asymptomatic peripheral arterial disease was investigated in 400 patients (60% males, 40% females, aged 59.7± 11.3 with a documented coronary arterial disease. Results: Among patients with documented CAD, 12% had asymptomatic PAD with the ABI ratio of less than 0.9. Conclusions: It is advisable to screen for PAD not only as a disease but also as a risk assessment method for atherosclerosis.

  18. A prospective, clinical study on asymptomatic sensitisation and development of allergic rhinitis: high negative predictive value of allergological testing

    DEFF Research Database (Denmark)

    Bodtger, Uffe; Assing, Kristian; Poulsen, Lars K

    2011-01-01

    populations, conferring bias towards higher incidence rates. Objective: The aim was to determine the incidence of onset of symptoms among clinically well-characterised asymptomatic, sensitised subjects compared with controls, and to evaluate the predictive values of common allergological tests. Methods: We...... an annual incidence rate of 5% for the onset of symptoms in the AS group (healthy control group 0%). At baseline, the AS group displayed intermediate experimental allergen susceptibility. Subjects developing symptoms had higher levels of specific IgE and larger late-phase reaction than those persistently...... asymptomatic. However, the positive predictive values were low (14-27%) in contrast to the negative predictive values (95-100%). Conclusion: In a well-characterised young population, asymptomatic aeroallergen sensitisation conferred a low risk for onset of symptoms during the 2-year follow-up. Persistent...

  19. Clinical and Imaging Features Associated with an Increased Risk of Late Stroke in Patients with Asymptomatic Carotid Disease

    DEFF Research Database (Denmark)

    Naylor, A R; Schroeder, T V; Sillesen, H

    2014-01-01

    BACKGROUND: The 2011 American Heart Association Guidelines on the management of asymptomatic carotid disease recommends that carotid endarterectomy (CEA) (with carotid artery stenting (CAS) as an alternative) may be considered in highly selected patients with 70-99% stenoses. However, no guidance...... was provided as to what "highly selected" meant. This caveat is, however, important as up to 95% of asymptomatic individuals undergoing prophylactic CEA or CAS will ultimately undergo an unnecessary procedure. Even if the procedural risk following CEA or CAS could be reduced to 0%; 93% of patients would still....../CAS. METHODS: Review of clinical and/or imaging based scoring systems, predictive algorithms and imaging parameters that may be associated with an increased (or decreased) risk of stroke in patients with asymptomatic carotid disease. RESULTS: Parameters associated with an increased risk of late stroke include...

  20. The immunophenotypic fingerprint of patients with primary antibody deficiencies is partially present in their asymptomatic first-degree relatives.

    Science.gov (United States)

    Bogaert, Delfien J A; De Bruyne, Marieke; Debacker, Veronique; Depuydt, Pauline; De Preter, Katleen; Bonroy, Carolien; Philippé, Jan; Bordon, Victoria; Lambrecht, Bart N; Kerre, Tessa; Cerutti, Andrea; Vermaelen, Karim Y; Haerynck, Filomeen; Dullaers, Melissa

    2017-01-01

    The etiology of primary antibody deficiencies is largely unknown. Beside rare monogenic forms, the majority of cases seem to have a more complex genetic basis. Whereas common variable immunodeficiency has been investigated in depth, there are only a few reports on milder primary antibody deficiencies such as idiopathic primary hypogammaglobulinemia and IgG subclass deficiency. We performed flow cytometric immunophenotyping in 33 patients with common variable immunodeficiency, 23 with idiopathic primary hypogammaglobulinemia and 21 with IgG subclass deficiency, as well as in 47 asymptomatic first-degree family members of patients and 101 unrelated healthy controls. All three groups of patients showed decreased memory B- and naïve T-cell subsets and decreased B-cell activating factor receptor expression. In contrast, circulating follicular helper T-cell frequency and expression of inducible T-cell co-stimulator and chemokine receptors were only significantly altered in patients with common variable immunodeficiency. Asymptomatic first-degree family members of patients demonstrated similar, albeit intermediate, alterations in naïve and memory B- and T-cell subsets. About 13% of asymptomatic relatives had an abnormal peripheral B-cell composition. Furthermore, asymptomatic relatives showed decreased levels of CD4(+) recent thymic emigrants and increased central memory T cells. Serum IgG and IgM levels were also significantly lower in asymptomatic relatives than in healthy controls. We conclude that, in our cohort, the immunophenotypic landscape of primary antibody deficiencies comprises a spectrum, in which some alterations are shared between all primary antibody deficiencies whereas others are only associated with common variable immunodeficiency. Importantly, asymptomatic first-degree family members of patients were found to have an intermediate phenotype for peripheral B- and T-cell subsets.

  1. Lack of consistency in the relationship between asymptomatic DVT detected by venography and symptomatic VTE in thromboprophylaxis trials.

    Science.gov (United States)

    Chan, Noel C; Stehouwer, Alexander C; Hirsh, Jack; Ginsberg, Jeffrey S; Alazzoni, Ashraf; Coppens, Michiel; Guyatt, Gordon H; Eikelboom, John W

    2015-11-01

    Asymptomatic deep-vein thrombosis (DVT) detected by mandatory venography, a surrogate outcome, comprises most of the efficacy outcome events in recent thromboprophylaxis trials. The validity of this surrogate to estimate trade-off between thrombotic and bleeding events in these clinical trials requires a consistent relationship between asymptomatic DVT and symptomatic venous thromboembolism (VTE). In this systematic review of high quality VTE prevention trials, we examined the consistency of the ratios of asymptomatic DVT to symptomatic VTE across a broad range of indications. Studies were identified from citations listed in the chapters on VTE prevention in the antithrombotic guidelines by the American College of Chest Physicians, 2012. A study was eligible if it: 1) was a randomised trial comparing an anticoagulant with standard of care; 2) included at least 500 participants; 3) reported asymptomatic or all DVT rates; and 4) reported symptomatic VTE rates. Of the 26 eligible trials, 19 trials were conducted in orthopaedic patients, five in general surgery patients and two in general medical patients. The overall median rates (ranges) for asymptomatic DVT and symptomatic VTE were 9.11 % (0.75 to 54.87 %) and 0.49 % (0.00 to 3.10 %), respectively. The median ratio was 14.53, with a wide range (2.75 to 103.86). Wide variability in the ratios persisted despite indication- and anticoagulant-specific analyses. In VTE prevention trials of alternative anticoagulants, the wide variability in the ratios of asymptomatic DVT to symptomatic VTE precludes judging the trade-off between thrombotic and bleeding events on the basis of composite outcomes dominated by venographic DVT.

  2. Scapholunate kinematics of asymptomatic wrists in comparison with symptomatic contralateral wrists using four-dimensional CT examinations: initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Demehri, Shadpour; Hafezi-Nejad, Nima; Morelli, John N.; Thakur, Uma; Eng, John [Johns Hopkins University, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Lifchez, Scott D.; Shores, Jaimie T. [Johns Hopkins University, Department of Plastic and Reconstructive Surgery, Baltimore, MD (United States); Means, Kenneth R. [MedStar Union Memorial Hospital, The Curtis National Hand Center, Baltimore, MD (United States)

    2016-04-15

    Using four-dimensional CT scan (4DCT), we aimed at showing the kinematics of scapholunate (SL) interval in asymptomatic wrists in comparison with symptomatic contralateral wrists with inconclusive radiographic findings. This is an IRB approved, HIPPA compliant, retrospective study. Patients suspected of SL interosseous ligament (SLIL) injuries were referred for further evaluation of chronic wrist pain (>3 months). Twelve wrists (11 subjects) with chronic symptoms and inconclusive plain radiographs and 10 asymptomatic wrists (in 10 different subjects) were scanned using 4DCT. The minimum SL interval was measured during three wrist motions: relaxed-to-clenched fist, flexion-to-extension, and radial-to-ulnar-deviation. Changes were recorded using double-oblique multiplanar reformation technique. We extracted the normal limits of the SL interval as measured by dynamic CT scanning during active motion in asymptomatic wrists. In asymptomatic wrists, the average SL interval was observed to be smaller than 1 mm during all motions. In symptomatic wrists, during exams performed with clenched fist (SL interval (mean ± SD) = 2.53 ± 1.19 mm), extension (2.54 ± 1.48 mm) or ulnar deviation (2.06 ± 1.12 mm), the average SL interval was more than 2 mm. In contrast to symptomatic wrists, no significant change in SL interval measurements was detected during wrist motions in asymptomatic wrists. There was a mild to moderate correlation between SL interval change and presence/absence of symptoms (point-biserial correlation coefficients: 0.29-0.55). In patients with wrist pain suspicious for SLIL injury and inconclusive radiographs, SL interval increase can be detected with 4DCT in the symptomatic wrist compared to the asymptomatic wrist. (orig.)

  3. Surgery in asymptomatic patients with colorectal cancer and unresectable liver metastases: the authors' experience

    Directory of Open Access Journals (Sweden)

    Boselli C

    2013-03-01

    Full Text Available Carlo Boselli,1 Claudio Renzi,2 Alessandro Gemini,1 Elisa Castellani,1 Stefano Trastulli,2 Jacopo Desiderio,2 Alessia Corsi,2 Francesco Barberini,1 Roberto Cirocchi,2 Alberto Santoro,3 Amilcare Parisi,4 Adriano Redler,3 Giuseppe Noya1 1Department of General and Oncologic Surgery, University of Perugia, Perugia, 2Department of General Surgery, University of Perugia, St Maria Hospital, Terni, 3Department of Surgical Sciences, Sapienza University of Rome, Rome, 4Department of Digestive Surgery, St Maria Hospital, Terni, Italy Purpose: In asymptomatic patients with Stage IV colorectal cancer, the debate continues over the efficacy of primary resection compared to chemotherapy alone. The aim of this study was to define the optimal management for asymptomatic patients with colorectal cancer and unresectable liver metastases. Patients and methods: Patients receiving elective surgery (n = 17 were compared to patients receiving chemotherapy only (n = 31. Data concerning patients' demographics, location of primary tumor, comorbidities, performance status, Child–Pugh score, extension of liver metastases, size of primary, and other secondary locations were collected. Results: Thirty-day mortality after chemotherapy was lower than that after surgical resection (19.3% versus 29.4%; not significant. In patients with >75% hepatic involvement, mortality at 1 month was higher after receiving surgical treatment than after chemotherapy alone (50% versus 25%. In patients with <75% hepatic involvement, 30-day mortality was similar in both groups (not significant. Thirty-day mortality in patients with Stage T3 was lower in those receiving chemotherapy (16.7% versus 30%; not significant. Overall survival was similar in both groups. The risk of all-cause death after elective surgery (2.1 was significantly higher than in patients receiving chemotherapy only (P = 0.035. Conclusion: This study demonstrated that in palliative treatment of asymptomatic unresectable Stage

  4. Prediction of coronary artery calcium progression by FDG uptake of large arteries in asymptomatic individuals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang-Geon; Park, Ki Seong; Kim, Jahae; Song, Ho-Chun [Chonnam National University Hospital, Department of Nuclear Medicine, Gwang-ju (Korea, Republic of); Kang, Sae-Ryung; Kwon, Seong Young; Jabin, Zeenat; Kim, Young Jae; Jeong, Geum-Cheol; Song, Minchul; Min, Jung-Joon; Bom, Hee-Seung [Chonnam National University Hwasun Hospital, Department of Nuclear Medicine, Hwasun-gun, Jeollanam-do (Korea, Republic of); Seon, Hyun Ju [Chonnam National University Hwasun Hospital, Department of Radiology, Hwasun-gun, Jeollanam-do (Korea, Republic of)

    2017-01-15

    The purpose of this study is to evaluate whether fluorodeoxyglucose (FDG) uptake of the large arteries can predict coronary artery calcium (CAC) progression in asymptomatic individuals. Ninety-six asymptomatic individuals who underwent FDG positron emission tomography (PET) and CAC scoring on the same day for health screening and follow-up CAC scoring ≥1 year after baseline studies (mean 4.3 years) were included. Vascular FDG uptake was measured and corrected for blood pool activity to obtain peak and average target-to-blood pool ratios (TBRpeak and TBRavg, respectively) for the carotid arteries, and ascending and abdominal aorta. CAC scores at baseline and follow-up of each individual were measured and absolute CAC change (ΔCAC), annual CAC change (ΔCAC/year), and annual CAC change rate (ΔCAC%/year) were calculated. CAC progression was defined as ΔCAC >0 for individuals with negative baseline CAC; ΔCAC/year ≥10 for those with baseline CAC of 0

  5. Late gadolinium enhancement and subclinical cardiac dysfunction on cardiac MRI in asymptomatic HIV-positive men

    Directory of Open Access Journals (Sweden)

    A Loy

    2012-11-01

    Full Text Available Background: HIV is associated with an increased risk of cardiovascular disease (CVD and related clinical events. While traditional risk factors play an important role in the pathology of cardiovascular disease, HIV infection and its sequelae of immune activation and inflammation may have significant effects on the myocardium before becoming clinically evident. Cardiac MRI (CMR can be used to detect the pattern of these subclinical changes. This will lead to a better understanding of risk factors contributing to cardiovascular disease prior to it becoming clinically significant in HIV-positive patients. Methods: Prospective cohort study of 127 asymptomatic HIV-positive men on ART compared to 35 matched controls. Baseline demographics, HIV parameters, 12-lead ECG, routine biochemistry, and traditional cardiovascular risk factors were recorded. Images were acquired on a 3T Achieva Philips MRI scanner with 5 channel phase array cardiac coil and weight-based IV gadolinium was given at 0.15 mmol/kg dose with post-contrast inversion recovery imaging after 10 minutes. Results: 6/127 (4.7% of asymptomatic HIV-positive men had late gadolinium enhancement (LGE on MRI verses 1/35 (2.9% in the control group. In 3/6 (50% of cases this was in a classical infarction pattern with subendocardial involvement. 3/6 (50% were consistent with prior myocarditis. There was no significant difference in mean LVEF (66.93% vs 65.18%, LVMI (60.05g/m2 vs 55.94g/m2 or posterolateral wall thickness (8.28 mm and 8.16 mm between cases and controls respectively. There was significantly more diastolic dysfunction, E:A ratio < 1, found in the HIV-positive group, 18% vs 7% of controls (p = 0.037. Framingham risk did not predict either of these outcomes. Conclusions: There is an increased incidence of LGE detected on CMR in this asymptomatic HIV-positive cohort. Two distinct pathological processes were identifed as causing these changes, myocardial infarction and myocarditis

  6. Genomics of Escherichia and Shigella

    Science.gov (United States)

    Perna, Nicole T.

    The laboratory workhorse Escherichia coli K-12 is among the most intensively studied living organisms on earth, and this single strain serves as the model system behind much of our understanding of prokaryotic molecular biology. Dense genome sequencing and recent insightful comparative analyses are making the species E. coli, as a whole, an emerging system for studying prokaryotic population genetics and the relationship between system-scale, or genome-scale, molecular evolution and complex traits like host range and pathogenic potential. Genomic perspective has revealed a coherent but dynamic species united by intraspecific gene flow via homologous lateral or horizontal transfer and differentiated by content flux mediated by acquisition of DNA segments from interspecies transfers.

  7. Symptomatic versus asymptomatic knees after bilateral total knee arthroplasty: what is the difference in SPECT/CT?

    Energy Technology Data Exchange (ETDEWEB)

    Awengen, R.; Hirschmann, M.T. [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology, Bruderholz (Switzerland); Rasch, H. [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Institute of Radiology and Nuclear Medicine, Bruderholz (Switzerland); Amsler, F. [Amsler Consulting, Basel (Switzerland)

    2016-04-15

    The primary purpose of this retrospective study was to evaluate the differences of bone tracer uptake (BTU) in symptomatic and asymptomatic knees after bilateral total knee arthroplasty (TKA) and identify typical BTU patterns with regards to TKA component position and alignment. A consecutive number of 37 patients after bilateral TKA were retrospectively included. The knees were grouped into symptomatic (group A) and asymptomatic (group B) knees. All patients underwent 99m-Tc-HDP-SPECT/CT. Coronal, rotational, and sagittal TKA component position was analysed in 3D reconstructed CT. BTU was anatomically localised and quantified using a validated standardized localization scheme. Maximum BTU values for each area were recorded and normalized values calculated. Signed log-rank test, chi-square test, paired t-tests, and Pearson correlations were used (p <0.05). Symptomatic TKAs were significantly more flexed and had a tendency to be more internally rotated when compared to asymptomatic ones (p < 0.05). In all regions, the mean BTU in asymptomatic knees was lower than in symptomatic knees. In both groups the highest mean BTU was found around the tibial stem (symptomatic 7.30; asymptomatic 6.30, p = 0.061) and at the tip of the tibial stem (symptomatic 5.49; asymptomatic 4.74, p = 0.062). Superior patellar regions showed higher BTU than inferior regions. The highest patellar BTU was found in the superior medial patella (symptomatic 4.99; asymptomatic 3.98, p = 0.048). The lowest BTU was found in the posterior femoral regions (flatsp, flatip, fmedsp, fmedip) (Table 3). Tibial and patellar areas showed twice as high mean BTUs than femoral areas (Fig. 3). A significant correlation of TKA component position and BTU was demonstrated. Distribution and intensity of BTU in SPECT/CT depends on TKA component position and alignment. In addition, typical BTU patterns in symptomatic and asymptomatic knees were identified. A profound knowledge of BTU pattern, TKA component position

  8. Prognostic Importance of Exercise Brain Natriuretic Peptide in Asymptomatic Chronic Organic Severe Mitral Regurgitation: An Observational Study

    Science.gov (United States)

    Sinha, Santosh Kumar; Garg, Shalini; Thakur, Ramesh; Krishna, Vinay; Singh, Karandeep; Sachan, Mohit; Goel, Amit; Razi, Mahamdula; Pandey, Umeshwar; Varma, Chandra Mohan

    2016-01-01

    Background The optimal timing of surgery in patients with chronic organic severe mitral regurgitation (MR) continues to be debated, especially for those who are asymptomatic. The aim of the study was to determine independent and additive prognostic value of exercise brain natriuretic peptide (eBNP) in patients with severe asymptomatic MR and normal left ventricular ejection fraction (LVEF). Methods Two hundred twenty-three consecutive patients with severe MR defined by effective regurgitant orifice (ERO) area ≥ 40 mm2 and/or residual volume ≥ 60 mL, LVEF > 60%, and normal LV end-systolic diameter free survival and might be considered for early MVR.

  9. Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study

    DEFF Research Database (Denmark)

    Greve, Anders M; Gerdts, Eva; Boman, Kurt

    2011-01-01

    BACKGROUND: The frequency and prognostic importance of atrial fibrillation (AF) in asymptomatic mild-to-moderate aortic stenosis (AS) has not been well described. METHODS: Clinical examination, electrocardiography and echocardiography were obtained in asymptomatic patients with mild......-to-moderate AS and preserved left ventricular (LV) systolic function, randomized to simvastatin/ezetimibe combination vs. placebo in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. At inclusion, AF was categorized as episodic or longstanding. Rhythm change was assessed on annual in-study electrocardiograms...

  10. Urinary tract infection in older adults

    OpenAIRE

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-01-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based ap...

  11. Impact of asymptomatic infection on coupled disease-behavior dynamics in complex networks

    CERN Document Server

    Zhang, Hai-Feng; Chen, Han-Shuang; Liu, Can; Small, Michael

    2016-01-01

    Studies on how to model the interplay between diseases and behavioral responses (so-called coupled disease-behavior interaction) have attracted increasing attention. Owing to the lack of obvious clinical evidence of diseases, or the incomplete information related to the disease, the risks of infection cannot be perceived and may lead to inappropriate behavioral responses. Therefore, how to quantitatively analyze the impacts of asymptomatic infection on the interplay between diseases and behavioral responses is of particular importance. In this Letter, under the complex network framework, we study the coupled disease-behavior interaction model by dividing infectious individuals into two states: U-state (without evident clinical symptoms, labelled as U) and I-state (with evident clinical symptoms, labelled as I). A susceptible individual can be infected by U- or I-nodes, however, since the U-nodes cannot be easily observed, susceptible individuals take behavioral responses \\emph{only} when they contact I-nodes....

  12. The Typhoid Toxin Promotes Host Survival and the Establishment of a Persistent Asymptomatic Infection

    DEFF Research Database (Denmark)

    Del Bel Belluz, Lisa; Guidi, Riccardo; Pateras, Ioannis S.

    2016-01-01

    analysis confirmed the toxin-mediated suppression of the intestinal inflammatory response. The presence of a functional typhoid toxin further induced an increased frequency of asymptomatic carriers. Our data indicate that the typhoid toxin DNA damaging activity increases host survival and favours long...... this issue, we assessed the effects of the Salmonella enterica genotoxin, known as typhoid toxin, in in vivo models of murine infection. Immunocompetent mice were infected with isogenic S. enterica, serovar Typhimurium (S. Typhimurium) strains, encoding either a functional or an inactive typhoid toxin....... The presence of the genotoxic subunit was detected 10 days post-infection in the liver of infected mice. Unexpectedly, its expression promoted the survival of the host, and was associated with a significant reduction of severe enteritis in the early phases of infection. Immunohistochemical and transcriptomic...

  13. An audit of intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT).

    Science.gov (United States)

    Illingworth, Clare; Timmons, Stephen

    2007-11-01

    This paper reports a prospective audit, against an existing baseline standard, for intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT). This was done via a structured questionnaire, using the methodology of total population sampling, encapsulating all theatre staff within one NHS trust. With regards to the standard, performance is good, as IPC is DVT prophylaxis of choice in the perioperative area and is used frequently on most patients. The findings of the audit do, however, highlight the need for appropriate local DVT risk assessment guidelines, essential to ensure that prophylaxis is administered to the correct at risk groups, as prevention may be unjustified in low risk groups and possibly inappropriate for the same regimen to be used for all patients.

  14. [Monoclonal gammopathy of undetermined significance and asymptomatic multiple myelom in the year 2014 ].

    Science.gov (United States)

    Adam, Zdeněk; Krejčí, Marta; Pour, Luděk; Sevčíková, Eva; Křivanová, Andrea; Rehák, Zdeněk; Koukalová, Renata; Cermáková, Zdeňka; Vaníček, Jíří; Sevčíková, Sabina

    2014-10-01

    Presence of monoclonal immunoglobulin in serum or urine is a relatively common event affecting about 3.2 % of people over 50. Isolated increase of only one type of free light chain, either κ or λ, is detected in 0.7-0.8 % of people over 50. Most people with monoclonal immunoglobulin meet the criteria of the so-called "mono-clonal gammopathy of undetermined significance (MGUS)". MGUS is defined by concentration of monoclonal immunoglobulin in serum < 30 g/l, number of plasma cells in the bone marrow < 10 % and the absence of symptoms of multiple myeloma and other lymphoproliferative diseases. A proportion of people with MGUS gradually progresses from asymptomatic into symptomatic myeloma or other malignant lymphoproliferative disease requiring treatment. Therefore, MGUS is considered to be one of the most common premalignant conditions with an average risk of transformation into malignant disease of 1 % per year. Monoclonal gammopathy of IgG and IgA subtype can develop into multiple myeloma. Light chain monoclonal gammopathy can develop not only into light chain multiple myeloma but also into AL-amyloidosis and light chain deposition disease (amorphous deposits of light chains damaging organs). IgM monoclonal gammopathy may develop into Waldenstrom macroglobulinemia or other lymphoproliferative disorder, or into rare IgM subtype of multiple myeloma. Unfortunately, people with MGUS are threatened by more than an increased risk of transformation into multiple myeloma or other severe hematologic disease. Pre-malignant clone of plasma cells in the bone marrow causes changes in the bone marrow that directly affect the person. For people with MGUS, there is an increased incidence of osteoporosis and increased fracture risk when compared to the general population. People with MGUS also have an increased risk of bacterial infections and thromboembolic complications compared with the same age population without MGUS. Clonal plasma cells, which are the basis of MGUS, may in

  15. NMR-Based Metabolomic Analysis of Huanglongbing-Asymptomatic and -Symptomatic Citrus Trees.

    Science.gov (United States)

    Freitas, Deisy dos Santos; Carlos, Eduardo Fermino; Gil, Márcia Cristina Soares de Souza; Vieira, Luiz Gonzaga Esteves; Alcantara, Glaucia Braz

    2015-09-01

    Huanglongbing (HLB) is one of the most severe diseases that affects citrus trees worldwide and is associated with the yet uncultured bacteria Candidatus Liberibacter spp. To assess the metabolomic differences between HLB-asymptomatic and -symptomatic tissues, extracts from leaf and root samples taken from a uniform 6-year-old commercial orchard of Valencia trees were subjected to nuclear magnetic resonance (NMR) and chemometrics. The results show that the symptomatic trees had higher sucrose content in their leaves and no variation in their roots. In addition, proline betaine and malate were detected in smaller amounts in the HLB-affected symptomatic leaves. The changes in metabolic processes of the plant in response to HLB are corroborated by the relationship between the bacterial levels and the metabolic profiles.

  16. A case of asymptomatic fungal and bacterial colonization of an intragastric balloon

    Institute of Scientific and Technical Information of China (English)

    Halil Coskun; Suleyman Bozkurt

    2009-01-01

    Intragastric balloon therapy, as a part of a multidisciplinary weight management program, is an effective short-term intervention for weight loss. Although the insertion procedure is easy and generally well tolerated by patients, a few complications can occur. We report here a heavy smoker with intragastric balloon insertion complicated by colonization with opportunistic organisms. The 27-year-old female, body mass index 35.5 kg/m2, had a BioEnterics. Intragastric Balloon inserted under conscious sedation without any perioperative complications. Six months later, when the standard removal time arrived, the balloon was seen to be covered with a necrotic white-gray material. Microbiological examination revealed Enterobacter cloacae and Candida species yeast colonies. We recommend that asymptomatic fungal and/or bacterial colonization should be considered among the complications of the intragastric balloon procedure, despite its rarity.

  17. Plasma copeptin as marker of cardiovascular disease in asymptomatic type 2 diabetes patients

    DEFF Research Database (Denmark)

    Bar-Shalom, Dana; Poulsen, Mikael K; Rasmussen, Lars M;

    2014-01-01

    for sub-clinical CVD. A total of 302 T2DM patients referred to the Diabetes Clinic at Odense University Hospital, Denmark, entered the study. None of the patients had known or suspected CVD. As a control group, 30 healthy adults were recruited from the DanRisk study - a random sample of middle-aged Danes....... A variety of clinical investigations were performed, including blood pressure measurements, carotid intima media thickness evaluation and myocardial perfusion scintigraphy. Blood sample analyses included copeptin measurements. Median plasma copeptin concentrations were similar in the T2DM group......Recently, copeptin was found associated with cardiovascular disease (CVD) and all-cause mortality in type 2 diabetes mellitus (T2DM) patients treated in primary care. This study aimed to evaluate whether plasma copeptin correlated to CVD in asymptomatic T2DM patients intensively investigated...

  18. Exercise echocardiography in asymptomatic survivors of childhood cancer treated with anthracyclines

    DEFF Research Database (Denmark)

    Sieswerda, Elske; Kremer, Leontien C M; Vidmar, Suzanna;

    2010-01-01

    BACKGROUND: Exercise echocardiography reveals abnormalities in asymptomatic childhood cancer survivors who previously have been treated with anthracyclines. We determined the added value of monitoring childhood cancer survivors with exercise echocardiography compared to monitoring with resting...... survivors, who had undergone cardiac tests including exercise echocardiography 10.5 years earlier, for new cardiac evaluation. Each subject underwent a resting echocardiogram at both evaluations. At first evaluation a repeat echocardiogram was performed following peak exercise. Resting echocardiographic......) decreased from -0.18 to -0.93. Higher cumulative anthracycline dose was a risk factor for a lower RFSz at late follow-up (P = 0.0002). Adding exercise fractional shortening (XFS) to a model containing RFSz did not improve prediction of abnormal RFSz at late follow-up. CONCLUSIONS: Monitoring with exercise...

  19. An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body

    Science.gov (United States)

    Gundara, Justin S.; Harrison, Richard

    2010-01-01

    A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases. PMID:21113288

  20. An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body

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    Justin S. Gundara

    2010-01-01

    Full Text Available A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases.

  1. Peripartum cardiomyopathy in a previously asymptomatic carrier of Duchenne muscular dystrophy.

    Science.gov (United States)

    Cheng, Victoria E; Prior, David L

    2013-08-01

    A 40 year-old woman presented to hospital with 12h of progressive shortness of breath. She was 11 days postpartum, having delivered a full-term male infant. She was discharged on antibiotics for presumed pneumonia, but represented two days later with NYHA class IV symptoms and in acute decompensated heart failure confirmed on clinical examination and chest X-ray. Echocardiography showed a left ventricular ejection fraction (LVEF) of 20%. She was treated for peripartum cardiomyopathy (PPCM) with angiotensin converting enzyme inhibitors (ACEi), beta-blockers and diuretics with normalisation of her cardiac function within six months. Four years later, her son was diagnosed with Duchenne muscular dystrophy (DMD) and she tested positive as a carrier of the mutant gene. It is unclear whether the DMD carrier state alone is associated with increased susceptibility to PPCM or if this is merely the first expression of cardiomyopathy in a previously asymptomatic carrier.

  2. Prognostic value of multi-detector computed tomography in asymptomatic aortic valve stenosis

    DEFF Research Database (Denmark)

    Larsen, Linnea Hornbech; Kofoed, Klaus Fuglsang; Carstensen, Helle Gervig;

    2016-01-01

    was defined as indication for aortic valve replacement (AVR) determined by the treating physician or sudden cardiac death. RESULTS: The mean age was 72 (8) years, 27% were women, mean AVA by TTE was 1.01 (0.30) cm(2). Median follow up time was 27 (IQR 19-44) months. Forty seven patients (41%) developed...... indication for AVR. No patients suffered a sudden cardiac death. AVA and aortic valve calcification were significant univariable predictors of AVR when measured by both TTE and MDCT, whereas left ventricular mass was only significant measured by MDCT. Significant coronary artery disease by MDCT tended...... to predict future indication for AVR, but this did not reach statistical significance (HR: 1.79 (95% CI 0.96-3.44), p=0.08). CONCLUSION: MDCT derived AVA can be of use as an alternative to TTE derived AVA in patients with asymptomatic AS to predict future clinical indication for AVR....

  3. Subclinical Coronary Plaque Burden in Asymptomatic Relatives of Patients With Documented Premature Coronary Artery Disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh; Jensen, Jesper Møller; Bøtker, Hans Erik;

    Introduction: A family history of premature coronary artery disease (CAD) is a well-known risk factor for adverse coronary events with age of onset being inversely related to the degree of heritability. Hypothesis: We hypothesized that asymptomatic first degree relatives, of patients with premature...... CAD, suffer a high burden of subclinical coronary atherosclerosis. Methods: First degree relatives, aged 30-65 years, of patients with a documented coronary revascularization procedure before the age of 40 years, were invited to participate in the study. Participants were matched by age, sex...... and absence of a family history, with patients referred for coronary CT angiography (CTA) because of atypical angina or non-anginal chest pain. A pooled blinded analysis was performed. The main outcome measure was the number of plaque-affected coronary segments. Results: 88 relatives and 88 symptomatic...

  4. High shear stress relates to intraplaque haemorrhage in asymptomatic carotid plaques

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    Tuenter, A.; Selwaness, M.; Arias Lorza, A.

    2016-01-01

    BACKGROUND AND AIMS: Carotid artery plaques with vulnerable plaque components are related to a higher risk of cerebrovascular accidents. It is unknown which factors drive vulnerable plaque development. Shear stress, the frictional force of blood at the vessel wall, is known to influence plaque...... estimating equations analysis, adjusting for age, sex and carotid wall thickness. RESULTS: The study group consisted of 93 atherosclerotic carotid arteries of 74 participants. In plaques with higher maximum shear stresses, IPH was more often present (OR per unit increase in maximum shear stress (log...... formation. We evaluated the association between shear stress and plaque components (intraplaque haemorrhage (IPH), lipid rich necrotic core (LRNC) and/or calcifications) in relatively small carotid artery plaques in asymptomatic persons. METHODS: Participants (n = 74) from the population-based Rotterdam...

  5. Asymptomatic type B right atrial thrombus in a case with protein S deficiency

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    Rajinder Singh Rawat

    2014-01-01

    Full Text Available Thirty seven year old asymptomatic male underwent routine medical examination which revealed an abnormal mass in the right atrium. Family history was not suggestive of any cardiac or malignant disease. Detailed investigation detected deficiency of protein S, which is a vitamin K dependent protein and a cofactor for activated protein C mediated cleavage of factor Va and VIIIa. The deficiency of protein S predisposes to venous thrombosis. Further investigation revealed that it was an organized calcified thrombus in right atrium occupying almost whole of the cavity. Various approaches including surgical excision, thrombolysis and anticoagulation has been used to manage such thrombosis. However therapeutic approach is still a question of debate. Atriotomy and excision of mass was done using cardiopulmonary bypass.

  6. Does "asymptomatic" mean without symptoms for those living with HIV infection?

    Science.gov (United States)

    Willard, Suzanne; Holzemer, William L; Wantland, Dean J; Cuca, Yvette P; Kirksey, Kenn M; Portillo, Carmen J; Corless, Inge B; Rivero-Méndez, Marta; Rosa, María E; Nicholas, Patrice K; Hamilton, Mary Jane; Sefcik, Elizabeth; Kemppainen, Jeanne; Canaval, Gladys; Robinson, Linda; Moezzi, Shahnaz; Human, Sarie; Arudo, John; Eller, Lucille Sanzero; Bunch, Eli; Dole, Pamela J; Coleman, Christopher; Nokes, Kathleen; Reynolds, Nancy R; Tsai, Yun-Fang; Maryland, Mary; Voss, Joachim; Lindgren, Teri

    2009-03-01

    Throughout the history of the HIV epidemic, HIV-positive patients with relatively high CD4 counts and no clinical features of opportunistic infections have been classified as "asymptomatic" by definition and treatment guidelines. This classification, however, does not take into consideration the array of symptoms that an HIV-positive person can experience long before progressing to AIDS. This short report describes two international multi-site studies conducted in 2003-2005 and 2005-2007. The results from the studies show that HIV-positive people may experience symptoms throughout the trajectory of their disease, regardless of CD4 count or classification. Providers should discuss symptoms and symptom management with their clients at all stages of the disease.

  7. Is pre-surgical imaging required for an asymptomatic posterior vertex subcutaneous dermoid? A case report

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    Simon Ho

    2016-09-01

    Full Text Available Scalp dermoid cysts are common etiologies of subcutaneous lump and bump lesions in the pediatric population, with incidence ranging from 15 to 22% (Crawford, 1990; McAvoy & Zuckerbraun, 1976. Midline scalp dermoid cysts have high risk for intracranial extension, with incidence reported to be 39–57% of cases (Wood, Couture, & David, 2012; Posnick, Bortoluzzi, Armstrong, & Drake, 1994. The following case illustrates a healthy thirteen-year-old boy who presented with asymptomatic enlarging subcutaneous posterior scalp mass who was consented for excision of the mass without pre-operative imaging, and was found to have an intracranial dermoid sinus tract intra-operatively. Post-operative imaging found an intracranial dermoid nodule which entailed an otherwise avoidable second-stage surgery to achieve complete resection.

  8. Prevalence of Asymptomatic Neurophysiological Carpal Tunnel Syndrome in 130 Healthy Individuals

    Science.gov (United States)

    Alrawashdeh, Omar

    2016-01-01

    Diagnosis of carpal tunnel syndrome (CTS) is frequently confirmed by performing nerve conduction studies. Previous studies demonstrated that abnormal nerve conduction study (NCS) is suggestive of CTS among asymptomatic individuals. However, previous studies included individuals with risk factors for the syndrome. A NCS was performed on the median and ulnar nerves in 130 healthy individuals. About 15% of individuals in this study demonstrated electrodiagnostic evidence of carpal tunnels syndrome. Four cases have shown signs of isolated median neuropathy with normal median sensory component. Results indicated that the most widely used method for confirming diagnosis of CTS may have up to 15% of false positives. However, most of those showed changes of minimal CTS. Isolated prolongation of the median motor latency should be investigated further as they are usually classified as moderate to severe CTS and may undergo unnecessary surgeries. PMID:27994828

  9. Prevalence of asymptomatic neurophysiological carpal tunnel syndrome in 130 healthy individuals

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    Omar Alrawashdeh

    2016-11-01

    Full Text Available Diagnosis of carpal tunnel syndrome (CTS is frequently confirmed by performing nerve conduction studies. Previous studies demonstrated that abnormal nerve conduction study (NCS is suggestive of CTS among asymptomatic individuals. However, previous studies included individuals with risk factors for the syndrome. A NCS was performed on the median and ulnar nerves in 130 healthy individuals. About 15% of individuals in this study demonstrated electrodiagnostic evidence of carpal tunnels syndrome. Four cases have shown signs of isolated median neuropathy with normal median sensory component. Results indicated that the most widely used method for confirming diagnosis of CTS may have up to 15% of false positives. However, most of those showed changes of minimal CTS. Isolated prolongation of the median motor latency should be investigated further as they are usually classified as moderate to severe CTS and may undergo unnecessary surgeries.

  10. Social factors and coping status in asymptomatic middle-aged Danes

    DEFF Research Database (Denmark)

    Mols, Rikke Elmose; Sand, Niels Peter; Jensen, Jesper Møller;

    2013-01-01

    by the general self-efficacy (GES) scale. Coronary artery calcification (CAC) was assessed by computed tomography using the Agatston score (AS). Conventional clinical risk factors included sex, family history of CAD, BMI > 25, smoking, hypercholesterolaemia and hypertension. Results: In 568 individuals...... the prevalence of subjects with CAC was 267 (45%). Independent predictors of CAC in males were age (OR = 1.10, 95% CI = 1.04–1.16, p ... = 1.67, 95% CI = 1.02–1.12, p = 0.006), and smoking (OR = 1.71, 95% CI = 1.06–2.78, p = 0.029). Higher AS was associated to lower employment level in females (p = 0.001) but not in males (p = 0.833). Conclusions: Social factors are associated to the prevalence and severity of CAC in asymptomatic...

  11. Restrictive pattern on spirometry: association with cardiovascular risk and level of physical activity in asymptomatic adults

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    Evandro Fornias Sperandio

    2016-02-01

    Full Text Available Objective : To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL, as well as with cardiovascular disease (CVD risk factors, in asymptomatic adults. Methods : A total of 374 participants (mean age, 41 ± 14 years underwent spirometry, which included the determination of FVC and FEV1. A restrictive pattern on spirometry was defined as an FEV1/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer. Results : A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness, the following variables retained significance (OR; 95% CI as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8, smoking (11.6; 1.56-87.5, physical inactivity (8.1; 1.43-46.4, larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71; and dyslipidemia (1.89; 1.12-1.98. Conclusions : A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies.

  12. New insights of Microsporidial infection among asymptomatic aboriginal population in Malaysia.

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    Tengku Shahrul Anuar

    Full Text Available BACKGROUND: Studies on microsporidial infection mostly focus on immunodeficiency or immunosuppressive individuals. Therefore, this cross-sectional study describes the prevalence and risk factors of microsporidiosis among asymptomatic individuals in Malaysia. METHODS/FINDINGS: Four hundred and forty seven stool samples were collected and examined for microsporidia after staining with Gram-chromotrope Kinyoun. Demographic, socioeconomic, environmental, and behavioral information were collected by using a pre-tested questionnaire. Overall, 67 (15% samples were positive for microsporidia. The prevalence of infection was significantly higher among individuals aged more than 15 years compared to those aged <15 years (OR = 1.97, 95% CI = 1.08, 3.62; P = 0.028. Furthermore, logistic regression analysis confirmed that the presence of other family members infected with microsporidia (OR = 8.45; 95% CI = 4.30, 16.62; P<0.001 and being a consumer of raw vegetables (OR = 2.05; 95% CI = 1.15, 3.66; P = 0.016 were the significant risk factors of this infection. CONCLUSIONS: These findings clearly show that exposure to microsporidia is common among Aboriginal population. Further studies using molecular approach on microsporidia isolates from asymptomatic individuals is needed to determine species-specific. The risk factors associated with microsporidiosis will help in identifying more clearly the sources of the infection in the environment that pose a risk for transmission so that preventive strategies can be implemented.

  13. Excessive interatrial adiposity is associated with left atrial remodeling, augmented contractile performance in asymptomatic population

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    Yau-Huei Lai

    2016-05-01

    Full Text Available Purpose: Pericardial adipose tissue had been shown to exert local effects on adjacent cardiac structures. Data regarding the mechanistic link between such measures and left atrial (LA structural/functional remodeling, a clinical hallmark of early stage heart failure (HF and atrial fibrillation (AF incidence, in asymptomatic population remain largely unexplored. Methods: This retrospective analysis includes 356 subjects free from significant valvular disorders, atrial fibrillation, or clinical HF. Regional adipose tissue including pericardial and periaortic fat volumes, interatrial septal (IAS, and left atrioventricular groove (AVG fat thickness were all measured by multidetector computed tomography (MDCT (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA. We measured LA volumes, booster performance, reservoir capacity as well as conduit function, and analyzed their association with adiposity measures. Results: All four adiposity measures were positively associated with greater LA volumes (all P < 0.05, while IAS and AVG fat were also related to larger LA kinetic energy and worse reservoir capacity (both P < 0.01. In multivariate models, IAS fat thickness remained independently associated with larger LA volumes, increased LA kinetic energy and ejection force (β-coef: 0.17 & 0.15, both P < 0.05, and impaired LA reservoir and conduit function (β-coef: −0.20 & −0.12, both P < 0.05 after adjusting for clinical variables. Conclusion: Accumulated visceral adiposity, especially interatrial fat depots, was associated with certain LA structural/functional remodeling characterized by impaired LA reservoir and conduit function though augmented kinetic energy and ejection performance. Our data suggested that interatrial fat burden may be associated with certain detrimental LA functions with compensatory LA adaptation in an asymptomatic population.

  14. Markers of inflammation are inversely associated with VO2 max in asymptomatic men.

    Science.gov (United States)

    Kullo, Iftikhar J; Khaleghi, Mahyar; Hensrud, Donald D

    2007-04-01

    We investigated whether markers of inflammation, including a cytokine (IL-6), acute-phase reactants [C-reactive protein (CRP) and fibrinogen], and white blood cell (WBC) count are associated with maximal O(2) consumption (Vo(2 max)) in men without coronary heart disease (CHD). In asymptomatic men (n = 172, 51 +/- 9.3 yr old), Vo(2 max) was measured during a symptom-limited graded treadmill exercise test. Physical activity level was assessed by a standardized questionnaire. IL-6 and CRP were measured by immunoassays, fibrinogen by the Clauss method, and WBC count with a Coulter counter. IL-6 and CRP were logarithmically transformed to reduce skewness. Multivariable regression was used to assess whether markers of inflammation were associated with Vo(2 max) after adjustment for age, body mass index, CHD risk factors, and lifestyle variables (physical activity level, percent body fat, and alcohol intake). Vo(2 max) was 34.5 ml.kg(-1).min(-1) (SD 6.1). Log IL-6 (r = -0.38, P max). In separate multivariable linear regression models that adjusted for age, body mass index, CHD risk factors, and lifestyle variables, log IL-6 [beta-coeff = -1.66 +/- 0.63 (SE), P = 0.010], log CRP [beta-coeff = -0.99 +/- 0.33 (SE), P = 0.003], fibrinogen [beta-coeff = -1.51 +/- 0.44 (SE), P = 0.001], and WBC count [beta-coeff = -0.52 +/- 0.30 (SE), P = 0.088] were each inversely associated with Vo(2 max). In conclusion, higher circulating levels of IL-6, CRP, and fibrinogen are independently associated with lower Vo(2 max) in asymptomatic men.

  15. Determination of Asymptomatic Chlamydia Trachomatis Infections by Omp1 Gene Based -PCR

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    Masoumeh Nazer

    2008-01-01

    Full Text Available Objective: The objective of this research was to determine the prevalenceof genital C. trachomatis infection in asymptomatic women by using highlysensitive nested-polymerase chain reaction (PCR in urine sample.Materials and Methods: One hundred-forty asymptomatic women wererandomly selected from those who attended gynecology out patient departmentof Hazraat e Rasool Hospital in Tehran. First catch urine specimen were collectedfrom all the participants. DNA extraction was performed by means of HighPure PCR Template Preparation Kit (HPPTP according to the manufacture’sinstructions. Extracted DNA was tested by omp1 gene based nested-PCR,using sets of primers to amplify C. trachomatis omp1 gene. Visualizationof a 1027 bp fragment from omp1 gene in agarose gel electrophoresis wasconsidered as a positive result.Results: In total, 140 urines were tested for determination of C. trachomatisinfection. C. trachomatis omp-1 was detected in 22.1% of cases (31/140. Theoverall prevalence rates of C. trachomatis in the urine sample as determined byomp1 based nested-PCR were 4.3% in group I (age, 44 years. The highest prevalence of C. trachomatis infection (12.1% wasseen in women aged 25-34 years. This finding was not statistically significant(p=0.710. Also, there was not relation between C. trachomatis infection andsome probable risk factors such as young age (<25 years, STD history andmissing use of barrier contraceptive in this study.Conclusion: The prevalence of C.trachomatis infection in the women notseeking health care warrants more comprehensive study using high sensitiveomp1 based nested- PCR to identify and treat a large number of infectedwomen in Iran.

  16. Relationship between active cervical range of motion and flexion-relaxation ratio in asymptomatic computer workers.

    Science.gov (United States)

    Yoo, Won-Gyu; Park, Se-Yeon; Lee, Mi-Ra

    2011-01-01

    A high prevalence and incidence of neck and shoulder pain is present in the working population, especially sedentary workers. Recent findings have indicated that the flexion-relaxation (FR) ratio in the cervical erector spinae (CES) muscles might be a significant criteria of neuromuscular impairment and function. Additionally, the active cervical range of motion (ROM) is frequently used for discriminating between individuals with pain and those who are asymptomatic. The purpose of the present study was to examine the relationship between the active cervical ROM and the FR ratio in a sample of regular visual display terminal (VDT) workers. In total, 20 asymptomatic male VDT workers were recruited. Active cervical ROM was measured by a cervical ROM (CROM) instrument. Surface electromyography (EMG) was used to collect myoelectrical signals from the CES muscles, and the FR ratio was calculated for statistical analysis. Pearson correlation coefficients were used to quantify the linear relationship between the active cervical ROM and the FR ratio. The values obtained for the FR ratio in the right CES muscles correlated significantly with the active cervical ROM measured in flexion (r=0.73, pcervical FR ratio had a positive correlation with cervical movements, and that changes of the activation patterns in CES demonstrated as cervical FR ratio are associated with reduction of the cervical range of motion including flexion and lateral flexion. In addition, muscular dysfunction of the CES could occur in regular computer workers prior to occurrence of pain; this means that the FR ratio could be used to evaluate the potential risk of neck discomfort in computer workers.

  17. Asymptomatic pulmonary cryptococcosis in solid organ transplantation: report of four cases and review of the literature.

    Science.gov (United States)

    Mueller, N J; Fishman, J A

    2003-09-01

    Cryptococcus neoformans is the third most common cause of invasive fungal infections in solid organ transplantation. The infection generally presents as disseminated disease, involving multiple sites including the central nervous system, lungs, and skin. An increase in the incidence of primary pulmonary cryptococcal infections has been reported recently in solid organ recipients; these infections were generally symptomatic with an accelerated clinical course. We report four cases of asymptomatic pulmonary cryptococcosis in solid organ recipients (kidney, n=2, heart, n=2). In each case, an incidental finding on a routine chest radiograph led to the microbiological or histopathological diagnosis of invasive pulmonary C. neoformans infection. In these patients, cryptococcosis occurred a median of 25 months (range 7-36 months) after organ transplantation. All patients had a calcineurin inhibitor, prednisone, and azathioprine or mycophenolate mofetil as part of their immunosuppressive therapy at the time of diagnosis. Serum cryptococcal antigen was available and positive in the three patients studied; assessment of cerebrospinal fluid (CSF) of all four patients revealed no organisms by smear or culture. Therapy consisted of oral fluconazole in all cases, with flucytosine in one case, combined with resection of lung tissue in two individuals. All patients have remained free of cryptococcal disease (follow-up median 42 months, from 18 to 88 months). Cryptococcal disease in solid organ recipients may present as asymptomatic, localized pulmonary disease. The natural history of such infections is unknown. New pulmonary radiographic findings should prompt an aggressive diagnostic evaluation including serum and CSF cryptococcal antigen assays, and a biopsy of pulmonary lesions. Prolonged therapy may be used to reduce the risk of progression and dissemination during periods of intensified immune suppression.

  18. Measurement of the aortic diameter in the asymptomatic Korean population: Assessment with multidetector CT

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    Lee, Sang Hwan; Lee, Whal; Choi, Hyuck Jae; Kim, Dae Jin; Park, Eun Ah; Chung, Jin Wook; Park, Jae Hyung [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-08-15

    To determine normal reference values for aortic diameters in asymptomatic Korean adults. Three hundred adults without signs or symptoms of cardiovascular diseases were enrolled in this study. Aortic diameters were measured at nine predetermined levels on CT images. Aortic diameter measurements were adjusted for body surface area. Analysis of data was performed with regard to age, sex, weight, height and hypertension. Aortic diameters were 2.99 ± 0.57 cm at the ascending aorta, 2.54 ± 0.35 cm at the transverse aortic arch, 2.36 ± 0.35 cm at the proximal descending thoracic aorta (DTA), 2.23 ± 0.37 cm at the mid DTA, 2.17 ± 0.38 cm at the distal DTA, 2.16 ± 0.37 cm at the thoracoabdominal junction, 2.10, 00B1, 0.35 cm at the level of the celiac axis, 1.94, 00B1, 0.36 cm at the suprarenal aorta, 1.58 ± 0.24 cm at the aortic bifurcation. Men had slightly larger diameters than women (p < 0.05). All diameters increased with age and hypertension, with statistical significance (p < 0.01). And all aortic diameters increased with height (p < 0.05) except at the level of the aortic arch (p = 0.056), and increased with weight (p < 0.05) except at the level of the suprarenal aorta (p = 0.067). Male sex, higher weight and height, age and hypertension are associated with larger aortic diameters in asymptomatic Korean adults.

  19. VARIATION IN PRACTICE OF THE DIAGNOSTIC WORKUP OF ASYMPTOMATIC PATIENTS DIAGNOSED WITH INVASIVE BREAST CANCER

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    Anees eChagpar

    2016-03-01

    Full Text Available Introduction:Breast cancer is frequently diagnosed, yet variation remains in terms of practice patterns in presurgical workup. We sought to determine factors associated with this variation.Methods:An anonymous web-based survey was distributed to surgeons regarding their practices. Statistical analyses were conducted using SPSS.Results:253 surgeons responded to the survey. 17.0% were in academic practice, 37.5%% were hospital employed, and 41.5% were in private practice. 53.3% claimed that > 50% of their practice was breast-related. Surgeons were asked how often they would use various tests in the workup of an otherwise healthy asymptomatic patients, presenting with a non-palpable mammographic abnormality and a core needle biopsy showing invasive breast cancer. 23.5% stated they always would obtain a breast ultrasound, 17.2% stated they never would. 12.8% stated they never order a breast MRI; 4.1% always would. Workup of patients did not vary significantly based on number of years in practice nor practice setting. However, those whose practice was >50% breast were more likely to state that they would always order a breast ultrasound (32.5% vs. 12.9%, p<0.001, and less likely to state they would never order a breast MRI (3.4% vs. 25.8%, p<0.001. However, the proportions of surgeons who would always order a breast MRI was similar in the two groups (3.4% and 3.2%, respectively. Conclusions:These data highlight the lack of uniformity in the workup of asymptomatic patients presenting with non-palpable breast cancers, pointing to potential areas for improving value by minimizing variability.

  20. Distribution of Blood Groups(ABO between Symptomatic & Asymptomatic Human Leishmania Infantum Infection in Human

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    S Molaie

    2013-09-01

    Full Text Available Abstract Background & aim: According to the hypothesis that leishmania parasites can be escaped from immune system covered by blood group antigens (ABO to prevent its recognition by the immune system. The aim of this study was to show the associated blood groups with symptomatic or asymptomatic visceral leishmaniasis due to Leishmania infantum in human. Methods: In this cross-sectional study the population was divided into two groups. The first group included 54 patients with kala-azar (antibody against Leishmania titers ≥1:3200 by TDA with clinical specificity and the second group consisted of 45 subjects infected with Leishmania infantum (Leishmania antibody titers of1: 800 and 1:1600 by DAT method and non-specific symptoms. The distribution of the 4 main blood groups ABO type, sex, age, presence or absence of symptoms, clinical signs, and response to Glucantim therapy and DAT results were evaluated. Data were analyzed by chi-square test. Results: Most of the patients in group 1 were blood group A (37% and the lowest number of blood group were B (12.8%. In the second group, most of the ABO blood group A (42.2% and lowest in the ABO blood group AB (8.9%.There was no significant association between blood groups and clinical symptoms (p>0.05. Conclusion: This study showed that there is no association between blood group and incidence of symptomatic and asymptomatic kala-azar. Key words: Leishmania Infantum, Kala-azar, Blood Group, Human

  1. Incidence of cardiac arrhythmias in asymptomatic hereditary hemochromatosis subjects with C282Y homozygosity.

    Science.gov (United States)

    Shizukuda, Yukitaka; Tripodi, Dorothy J; Zalos, Gloria; Bolan, Charles D; Yau, Yu-Ying; Leitman, Susan F; Waclawiw, Myron A; Rosing, Douglas R

    2012-03-15

    It is not well known whether systemic iron overload per se in hereditary hemochromatosis (HH) is associated with cardiac arrhythmias before other signs and symptoms of cardiovascular disease occur. In the present study, we examined the incidence of cardiac arrhythmia in cardiac asymptomatic subjects with HH (New York Heart Association functional class I) and compared it to that in age- and gender-matched normal volunteers. The 42 subjects with HH and the 19 normal control subjects were recruited through the National Heart, Lung, and Blood Institute-sponsored "Heart Study of Hemochromatosis." They completed 48-hour Holter electrocardiography ambulatory monitoring at the baseline evaluation. The subjects with HH were classified as newly diagnosed (group A) and chronically treated (group B) subjects. All subjects with HH had C282Y homozygosity, and the normal volunteers lacked any HFE gene mutations known to cause HH. Although statistically insignificant, the incidence of ventricular and supraventricular ectopy tended to be greater in the combined HH groups than in the controls. Supraventricular ectopy was more frequently noted in group B compared to in the controls (ectopy rate per hour 11.1 ± 29.9 vs 1.5 ± 3.5, p arrhythmias was not significantly reduced after 6 months of intensive iron removal therapy in the group A subjects. No life-threatening arrhythmias were observed in our subjects with HH. In conclusion, our data suggest that the incidence of cardiac arrhythmias is, at most, marginally increased in asymptomatic subjects with HH. A larger clinical study is warranted to further clarify our observation.

  2. Open and hidden agendas of "asymptomatic" patients who request check-up exams

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    Nüesch Reto

    2011-04-01

    Full Text Available Abstract Background Current guidelines for a check-up recommend routine screening not triggered by specific symptoms for some known risk factors and diseases in the general population. Patients' perceptions and expectations regarding a check-up exam may differ from these principles. However, quantitative and qualitative data about the discrepancy between patient- and provider expectations for this type of clinic consultation is lacking. Methods For a year, we prospectively enrolled 66 patients who explicitly requested a "check-up" at our medical outpatient division. All patients actively denied upon prompting having any symptoms or specific health concerns at the time they made their appointment. All consultations were videotaped and analysed for information about spontaneously mentioned symptoms and reasons for the clinic consultation ("open agendas" and for cues to hidden patient agendas using the Roter interaction analysis system (RIAS. Results All patients initially declared to be asymptomatic but this was ultimately the case in only 7 out of 66 patients. The remaining 59 patients spontaneously mentioned a mean of 4.2 ± 3.3 symptoms during their first consultation. In 23 patients a total of 31 hidden agendas were revealed. The primary categories for hidden agendas were health concerns, psychosocial concerns and the patient's concept of disease. Conclusions The majority of patients requesting a general check-up tend to be motivated by specific symptoms and health concerns and are not "asymptomatic" patients who primarily come for preventive issues. Furthermore, physicians must be alert for possible hidden agendas, as one in three patients have one or more hidden reasons for requesting a check-up.

  3. Insulin resistance is associated with higher cerebrospinal fluid tau levels in asymptomatic APOE ε4 carriers

    Science.gov (United States)

    Starks, Erika J.; O'Grady, J. Patrick; Hoscheidt, Siobhan M.; Racine, Annie M.; Carlsson, Cindy M.; Zetterberg, Henrik; Blennow, Kaj; Okonkwo, Ozioma C.; Puglielli, Luigi; Asthana, Sanjay; Dowling, N. Maritza; Gleason, Carey E.; Anderson, Rozalyn M.; Davenport-Sis, Nancy J.; DeRungs, LeAnn M.; Sager, Mark A.; Johnson, Sterling C.; Bendlin, Barbara B.

    2015-01-01

    Background Insulin resistance (IR) is linked with the occurrence of pathological features observed in Alzheimer's disease (AD), including neurofibrillary tangles and amyloid plaques. However, the extent to which IR is associated with AD pathology in the cognitively asymptomatic stages of preclinical AD remains unclear. Objective To determine the extent to which IR is linked with amyloid and tau pathology in late-middle-age. Method Cerebrospinal fluid (CSF) samples collected from 113 participants enrolled in the Wisconsin Registry for Alzheimer's Prevention study (mean age = 60.6 years), were assayed for AD-related markers of interest: Aβ42, P-Tau181, and T-Tau. IR was determined using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Linear regression was used to test the effect of IR, and APOE ε4, on tau and amyloid pathology. We hypothesized that greater IR would be associated with higher CSF P-Tau181 and T-Tau, and lower CSF Aβ42. Results No significant main effects of HOMA-IR on P-Tau181, T-Tau, or Aβ42 were observed; however, significant interactions were observed between HOMA-IR and APOE ε4 on CSF markers related to tau. Among APOE ε4 carriers, higher HOMA-IR was associated with higher P-Tau181 and T-Tau. Among APOE ε4 non-carriers, HOMA-IR was negatively associated with P-Tau181 and T-Tau. We found no effects of IR on Aβ42 levels in CSF. Conclusion IR among asymptomatic APOE ε4 carriers was associated with higher P-Tau181 and T-Tau in late-middle age. The results suggest that IR may contribute to tau-related neurodegeneration in preclinical AD. The findings may have implications for developing prevention strategies aimed at modifying IR in mid-life. PMID:25812851

  4. Dysregulation of coronary microvascular reactivity in asymptomatic patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Neverve, Jodi; Nekolla, Stephan G.; Schwaiger, Markus; Bengel, Frank M. [Nuklearmedizinische Klinik und Poliklinik der Technischen Universitaet Muenchen, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675 Munich (Germany); Abletshauser, Claudia [Department of Medicine, Novartis Pharma GmbH, Nuernberg (Germany); Schnell, Oliver; Standl, Eberhard [Institut fuer Diabetesforschung, Munich (Germany)

    2002-12-01

    In diabetic patients, a number of studies have suggested an impairment of vascular reactivity in response to vasodilatory stimuli. The pattern of dysregulation at the coronary microcirculatory level, however, has not been clearly defined. Thus, it was the aim of this study to characterise coronary microvascular function non-invasively in a homogeneous group of asymptomatic type 2 diabetic patients. In 46 patients with type 2 diabetes, myocardial blood flow (MBF) was quantified at baseline, in response to cold pressor test (CPT) and during adenosine-mediated vasodilation using positron emission tomography and nitrogen-13 ammonia. None of the patients had been treated with insulin, and none had symptoms of cardiac disease. Decreased MBF during CPT, indicating microvascular dysregulation, was observed in 16 patients (CPT-), while 30 patients demonstrated increased MBF during CPT (CPT+). Response to CPT was mildly, but significantly correlated with response to adenosine (r=0.44, P=0.0035). There was no difference in HbA1c, serum lipid levels or serum endothelial markers between the groups. Microvascular dysregulation in the CPT- group was associated with elevated baseline MBF (P<0.0001), reduced baseline vascular resistance (P=0.0026) and an abnormal increase in resistance during CPT (P=0.0002). In conclusion, coronary microvascular dysregulation is present in approximately one-third of asymptomatic, non-insulin-treated type 2 diabetic patients. Elevated baseline blood flow and reduced microvascular resistance at rest are characteristics of this dysregulation. These data suggest a state of activation of endothelial-dependent vasodilation at baseline which appears to limit the flow response to stress conditions. (orig.)

  5. Detectability of the emerald ash borer (Coleoptera: Buprestidae) in asymptomatic urban trees by using branch samples.

    Science.gov (United States)

    Ryall, Krista L; Fidgen, Jeffrey G; Turgeon, Jean J

    2011-06-01

    The emerald ash borer, Agrilus planipennis Fairmaire, is an exotic invasive insect causing extensive mortality to ash trees, Fraxinus spp., in Canada and the United States. Detection of incipient populations of this pest is difficult because of its cryptic life stages and a multiyear time lag between initial attack and the appearance of signs or symptoms of infestation. We sampled branches from open-grown urban ash trees to develop a sample unit suitable for detecting low density A. planipennis infestation before any signs or symptoms are evident. The sample unit that maximized detection rates consisted of one 50-cm-long piece from the base of a branch ≥6 cm diameter in the midcrown. The optimal sample size was two such branches per tree. This sampling method detected ≈75% of asymptomatic trees known to be infested by using more intensive sampling and ≈3 times more trees than sampling one-fourth of the circumference of the trunk at breast height. The method is less conspicuous and esthetically damaging to a tree than the removal of bark from the main stem or the use of trap trees, and could be incorporated into routine sanitation or maintenance of city-owned trees to identify and delineate infested areas. This research indicates that branch sampling greatly reduces false negatives associated with visual surveys and window sampling at breast height. Detection of A. planipennis-infested asymptomatic trees through branch sampling in urban centers would provide landowners and urban foresters with more time to develop and implement management tactics.

  6. Asymptomatic endemic Chlamydia pecorum infections reduce growth rates in calves by up to 48 percent.

    Directory of Open Access Journals (Sweden)

    Anil Poudel

    Full Text Available Intracellular Chlamydia (C. bacteria cause in cattle some acute but rare diseases such as abortion, sporadic bovine encephalomyelitis, kerato-conjunctivitis, pneumonia, enteritis and polyarthritis. More frequent, essentially ubiquitous worldwide, are low-level, asymptomatic chlamydial infections in cattle. We investigated the impact of these naturally acquired infections in a cohort of 51 female Holstein and Jersey calves from birth to 15 weeks of age. In biweekly sampling, we measured blood/plasma markers of health and infection and analyzed their association with clinical appearance and growth in dependence of chlamydial infection intensity as determined by mucosal chlamydial burden or contemporaneous anti-chlamydial plasma IgM. Chlamydia 23S rRNA gene PCR and ompA genotyping identified only C. pecorum (strains 1710S, Maeda, and novel strain Smith3v8 in conjunctival and vaginal swabs. All calves acquired the infection but remained clinically asymptomatic. High chlamydial infection associated with reduction of body weight gains by up to 48% and increased conjunctival reddening (P<10(-4. Simultaneously decreased plasma albumin and increased globulin (P<10(-4 suggested liver injury by inflammatory mediators as mechanisms for the growth inhibition. This was confirmed by the reduction of plasma insulin like growth factor-1 at high chlamydial infection intensity (P<10(-4. High anti-C. pecorum IgM associated eight weeks later with 66% increased growth (P = 0.027, indicating a potential for immune protection from C. pecorum-mediated growth depression. The worldwide prevalence of chlamydiae in livestock and their high susceptibility to common feed-additive antibiotics suggests the possibility that suppression of chlamydial infections may be a major contributor to the growth promoting effect of feed-additive antibiotics.

  7. Urinary tract infection and antibiotic sensitivity pattern among diabetics.

    Science.gov (United States)

    Simkhada, R

    2013-03-01

    Diabetes Mellitus is a major health problem of today's world. Urinary tract infection is its common complication. A descriptive, cross sectional study was designed to know the prevalence of culture positive Urinary Tract Infection in diabetic patients, to know their common clinical features and to find out the proportion of asymptomatic bacteriuria, to know the causative organisms and pattern of antibiotic sensitivity. Mid stream urine sample was collected using full aseptic precaution. Among 100 patients included, 53 were female and 47 were male. In total, 21% of them had culture positive Urinary Tract Infection. Urinary Tract Infection was more in female (P = 0.047). Asymptomatic bacteriuria was found more common in female as compared to male. Common clinical features in symptomatic were burning micturation (90%), frequency of micturation (80%), suprapubic pain (60%), urgency (70%), loin pain (30%), and fever and vomiting (20%). Urinary Tract Infection was common among those who had prolong duration of diabetes (P = 0.039) and among those receiving insulin as compared to those under oral medications (P = 0.08). Escherichia-coli was most common organism followed by klebsiella, proteus and pseudomonas. Most of the urinary isolates were sensitive to ciprofloxacin, cotrimoxazole and ceftriaxone, where as resistance was high for ampicillin.

  8. Risk of thyroid cancer in euthyroid asymptomatic patients with thyroid nodules with an emphasis on family history of thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    JHwang, Shin Hye; Kim, Eun Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    To determine the factors associated with thyroid cancer, focusing on first-degree family history and ultrasonography (US) features, in euthyroid asymptomatic patients with thyroid nodules. This retrospective study included 1310 thyroid nodules of 1254 euthyroid asymptomatic patients who underwent US-guided fine-needle aspiration biopsy between November 2012 and August 2013. Nodule size and clinical risk factors- such as patient age, gender, first-degree family history of thyroid cancer, multiplicity on US and serum thyroid stimulating hormone (TSH) levels - were considered together with US features to compare benign and malignant nodules. Multiple logistic regression analysis was performed to assess the risk of thyroid malignancy according to clinical and US characteristics. Although all of the clinical factors and US findings were significantly different between patients with benign and malignant nodules, a solitary lesion on US (p = 0.041–0.043), US features and male gender (p < 0.001) were significant independent risk factors for thyroid malignancy in a multivariate analysis. Patient age, a first-degree family history of thyroid cancer and high normal serum TSH levels did not independently significantly increase the risk of thyroid cancer. However, multicollinearity existed between US assessment and patient age, first-degree family history of thyroid cancer and serum TSH values. Ultrasonography findings should be the primary criterion used to decide the management of euthyroid asymptomatic patients with thyroid nodules. The concept of first-degree family history as a risk factor for thyroid malignancy should be further studied in asymptomatic patients.

  9. Bacterial colonization of disposable soft contact lenses is greater during corneal infiltrative events than during asymptomatic extended lens wear.

    Science.gov (United States)

    Sankaridurg, P R; Sharma, S; Willcox, M; Naduvilath, T J; Sweeney, D F; Holden, B A; Rao, G N

    2000-12-01

    Microorganisms, especially gram-negative bacteria, are considered to play a role in the etiology of certain corneal infiltrative events (CIEs) observed during soft contact lens wear. This study explored the possibility of microbial colonization of soft contact lenses as a risk factor leading to CIEs. In a clinical trial conducted from March 1993 to January 1996, 330 subjects wore disposable soft contact lenses on a 6-night extended-wear and disposal schedule. During this period, 4,321 lenses (118 during CIEs; 4,203 during asymptomatic lens wear) were recovered aseptically and analyzed for microbial colonization. A greater percentage of lenses were free from microbial colonization during asymptomatic wear than during CIEs (42 versus 23%; P ocular microbiota. Of the gram-positive bacteria, the incidence of Streptococcus pneumoniae was greater during CIE than during asymptomatic wear (7.6 versus 0.6%; P contact lens acute red eye, and asymptomatic infiltrative keratitis were associated with lens colonization with gram-negative bacteria or S. pneumoniae. Colonization of soft contact lenses with pathogenic bacteria, especially gram-negative bacteria and S. pneumoniae, appears to be a significant risk factor leading to CIE.

  10. Towards a Rational Design of an Asymptomatic Clinical Herpes Vaccine: The Old, the New, and the Unknown

    Directory of Open Access Journals (Sweden)

    Aziz Alami Chentoufi

    2012-01-01

    Full Text Available The best hope of controlling the herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2 pandemic is the development of an effective vaccine. However, in spite of several clinical trials, starting as early as 1920s, no vaccine has been proven sufficiently safe and efficient to warrant commercial development. In recent years, great strides in cellular and molecular immunology have stimulated creative efforts in controlling herpes infection and disease. However, before moving towards new vaccine strategy, it is necessary to answer two fundamental questions: (i why past herpes vaccines have failed? (ii Why the majority of HSV seropositive individuals (i.e., asymptomatic individuals are naturally “protected” exhibiting few or no recurrent clinical disease, while other HSV seropositive individuals (i.e., symptomatic individuals have frequent ocular, orofacial, and/or genital herpes clinical episodes? We recently discovered several discrete sets of HSV-1 symptomatic and asymptomatic epitopes recognized by CD4+ and CD8+ T cells from seropositive symptomatic versus asymptomatic individuals. These asymptomatic epitopes will provide a solid foundation for the development of novel herpes epitope-based vaccine strategy. Here we provide a brief overview of past clinical vaccine trials, outline current progress towards developing a new generation “asymptomatic” clinical herpes vaccines, and discuss future mucosal “asymptomatic” prime-boost vaccines that could optimize local protective immunity.

  11. Middle-aged to elderly women have a higher asymptomatic infection rate with Mycobacterium avium complex, regardless of body habitus.

    Science.gov (United States)

    Nishimura, Tomoyasu; Fujita-Suzuki, Yukiko; Mori, Masaaki; Carpenter, Stephen M; Fujiwara, Hiroshi; Uwamino, Yoshifumi; Tamizu, Eiko; Yano, Ikuya; Kawabe, Hiroshi; Hasegawa, Naoki

    2016-04-01

    Mycobacterium avium complex (MAC) pulmonary disease is prevalent in middle-aged to elderly women with a thin body habitus. By comparing the rate of serologically diagnosed asymptomatic MAC infection and body mass index among 1033 healthy subjects, we find that middle-aged to elderly women became infected with MAC, regardless of their body habitus.

  12. Lack of consistency in the relationship between asymptomatic DVT detected by venography and symptomatic VTE in thromboprophylaxis trials

    NARCIS (Netherlands)

    Chan, Noel C.; Stehouwer, Alexander C.; Hirsh, Jack; Ginsberg, Jeffrey S.; Alazzoni, Ashraf; Coppens, Michiel; Guyatt, Gordon H.; Eikelboom, John W.

    2015-01-01

    Asymptomatic deep-vein thrombosis (DVT) detected by mandatory venography, a surrogate outcome, comprises most of the efficacy outcome events in recent thromboprophylaxis trials. The validity of this surrogate to estimate trade-off between thrombotic and bleeding events in these clinical trials requi

  13. Tinea capitis: study of asymptomatic carriers and sick adolescents, adults and elderly who live with children with the disease

    Directory of Open Access Journals (Sweden)

    BERGSON Christiane Loureiro

    2001-01-01

    Full Text Available Tinea capitis is a dermatophyte infection that occurs mainly in childhood; there are few reports, in Brazil, in adolescents and adults. The detection of asymptomatic carriers is of great importance in the disease control. From February 1998 to February 1999, a study was performed at the outpatient Dermatologic Unit of Instituto de Puericultura e Pediatria Martagão Gesteira (Universidade Federal do Rio de Janeiro, Brasil to verify the frequency of asymptomatic carriers and tinea capitis between 79 adolescents, adults and elderly who lived in the same household of 56 children (0-12 years with tinea capitis. Of these, one female and one male adults (2.5% were asymptomatic carriers and the cultures revealed Trichophyton tonsurans and Microsporum canis respectively. One female adolescent and two female adults (3.8% had tinea capitis and all cultures revealed Trichophyton tonsurans. The study has shown that adolescents and adults who live in the same household of children with tinea capitis may be sick or asymptomatic carriers.

  14. Myocardial strain and strain rate in monitoring subclinical heart failure in asymptomatic long-term survivors of childhood cancer.

    NARCIS (Netherlands)

    Mavinkurve-Groothuis, A.M.C.; Groot-Loonen, J.J.; Marcus, K.A.; Bellersen, L.; Feuth, T.; Bokkerink, J.P.M.; Hoogerbrugge, P.M.; Korte, C.L. de; Kapusta, L.

    2010-01-01

    We studied the role of global myocardial strain and strain rate in monitoring subclinical heart failure in a large group of asymptomatic long-term survivors of childhood cancer. Global strain (rate) parameters of survivors were compared with those in healthy controls and were related to conventional

  15. Sipuleucel-T: Autologous Cellular Immunotherapy for Men with Asymptomatic or Minimally Symptomatic Metastatic Castrate Resistant Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Robert B. Sims

    2011-01-01

    Full Text Available Sipuleucel T is an autologous cellular immunotherapy designed to stimulate an immune response in men diagnosed with asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory prostate cancer. Sipuleucel T improves overall survival and provides an additional treatment option for this patient population.

  16. Are basophil histamine release and high affinity IgE receptor expression involved in asymptomatic skin sensitization?

    DEFF Research Database (Denmark)

    Jensen, Bettina Margrethe; Assing, K; Jensen, Lone Hummelshøj;

    2006-01-01

    Immunoglobulin (Ig)E-sensitized persons with positive skin prick test, but no allergy symptoms, are classified as being asymptomatic skin sensitized (AS). The allergic type 1 disease is dependant on IgE binding to the high affinity IgE-receptor (FcepsilonRI) expressed on basophils and mast cells...

  17. Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Breijer, M. C.; Peeters, J. A. H.; Opmeer, B. C.; Clark, T. J.; Verheijen, R. H. M.; Mol, B. W. J.; Timmermans, A.

    2012-01-01

    Objectives Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding, but the role of endometrial thickness measurement by ultrasound in asymptomatic women is unclear. The aims of this study were to determine: (1) the normal endometrial thickne

  18. Sipuleucel-T: autologous cellular immunotherapy for men with asymptomatic or minimally symptomatic metastatic castrate resistant prostate cancer.

    Science.gov (United States)

    Sims, Robert B

    2011-01-01

    Sipuleucel T is an autologous cellular immunotherapy designed to stimulate an immune response in men diagnosed with asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer. Sipuleucel T improves overall survival and provides an additional treatment option for this patient population.

  19. Sipuleucel-T: Autologous Cellular Immunotherapy for Men with Asymptomatic or Minimally Symptomatic Metastatic Castrate Resistant Prostate Cancer

    OpenAIRE

    Sims, Robert B.

    2011-01-01

    Sipuleucel T is an autologous cellular immunotherapy designed to stimulate an immune response in men diagnosed with asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer. Sipuleucel T improves overall survival and provides an additional treatment option for this patient population.

  20. Left Atrial Volume as Predictor of Valve Replacement and Cardiovascular Events in Patients with Asymptomatic Mild to Moderate Aortic Stenosis

    DEFF Research Database (Denmark)

    Dalsgaard, Morten; Egstrup, Kenneth; Wachtell, Kristian

    2013-01-01

    Left atrial (LA) size is known to increase with chronically increased left ventricular (LV) filling pressure. We hypothesized that LA volume was predictive of aortic valve replacement (AVR) and cardiovascular events in a large cohort of patients with asymptomatic mild to moderate aortic valve...... stenosis....