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Sample records for asymptomatic patients correlation

  1. Increased Levels of Human Carotid Lesion Linoleic Acid Hydroperoxide in Symptomatic and Asymptomatic Patients Is Inversely Correlated with Serum HDL and Paraoxonase 1 Activity

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    Elad Cohen

    2012-01-01

    Full Text Available Human carotid plaque components interact directly with circulating blood elements and thus they might affect each other. We determined plaque paraoxonase1 (PON1 hydrolytic-catalytic activity and compared plaque and blood levels of lipids, HDL, PON1, and HbA1c, as well as plaque-oxidized lipids in symptomatic and asymptomatic patients. Human carotid plaques were obtained from symptomatic and asymptomatic patients undergoing routine endarterectomy, and the lesions were ground and extracted for PON activity and lipid content determinations. Plaque PONs preserved paraoxonase, arylesterase, and lactonase activities. The PON1-specific inhibitor 2-hydroxyquinoline almost completely inhibited paraoxonase and lactonase activities, while only moderately inhibiting arylesterase activity. Oxysterol and triglyceride levels in plaques from symptomatic and asymptomatic patients did not differ significantly, but plaques from symptomatic patients had significantly higher (135% linoleic acid hydroperoxide (LA-13OOH levels. Their serum PON1 activity, cholesterol and triglyceride levels did not differ significantly, but symptomatic patients had significantly lower (28% serum HDL levels and higher (18% HbA1c levels. Thus LA-13OOH, a major atherogenic plaque element, showed significant negative correlations with serum PON1 activity and HDL levels, and a positive correlation with the prodiabetic atherogenic HbA1c. Plaque PON1 retains its activity and may decrease plaque atherogenicity by reducing specific oxidized lipids (e.g., LA-13OOH. The inverse correlation between plaque LA-13OOH level and serum HDL level and PON1 activity suggests a role for serum HDL and PON1 in LA-13OOH accumulation.

  2. Nutritional profile of asymptomatic alcoholic patients

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    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.

  3. A Patient With an Asymptomatic Atrial Fibrillation

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    Ewa Majos, MD; Rafal Dabrowski MD, PhD

    2015-02-01

    Full Text Available Atrial fibrillation (AF is a common and refractory arrhythmia. Prevalence of AF increases with age. Asymptomatic AF is a state of asymptomatic episodes of arrhythmia and its exact prevalence remains unknown. Ablation and therapy with antiarrhythmic agents may predispose to asymptomatic AF. Detection of silent AF is crucial for prevention of ischaemic stroke. Progress in continuous ECG monitoring by Holter ECG, telemetry methods or implantable devices can provide a useful tools for identifying silent AF. Simple screening procedures like pulse examination and ambulatory ECG may be helpful in arrhythmia detection and logically – ischemic stroke prevention.

  4. Asymptomatic patients of chronic obstructive pulmonary disease in China

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    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.

  5. Clinical Experience with Flexible Sigmoidoscopy in Asymptomatic and Symptomatic Patients

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    Meyer, Christopher T.; McBride, William; Goldblatt, Robert S.; Borak, Jonathan; Marignani, Pierluigi; Black, Henry R.; McCallum, Richard W.

    1980-01-01

    The purpose of this study was to evaluate the diagnostic yield of flexible sigmoidoscopy when performed as a routine procedure in asymptomatic patients over the age of 40 being referred for a complete physical examination. The preliminary results of this ongoing program are presented together with the diagnostic yield in 408 patients with symptoms and signs suggestive of colorectal disease who were of similar age (56.6 vs. 56.5 years) and sex distribution (79 percent male) to the asymptomatic...

  6. Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

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    Chauhan, V S; Suprakash Chaudhury; Sudarsanan, S.; Kalpana Srivastava

    2013-01-01

    Background: Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. Aim: The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. Materials and Methods: A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consec...

  7. Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

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    V S Chauhan

    2013-01-01

    Full Text Available Background: Psychiatric morbidity in human immunodeficiency virus (HIV patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. Aim: The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. Materials and Methods: A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ, mini mental status examination, hospital anxiety and depression scale (HADS and sensation seeking scale (SSS and the scores were analyzed statistically. Results: Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. Conclusion: Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.

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

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    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-enhance...

  9. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

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    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. PMID:27659930

  10. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

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    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.

  11. Mammographic density in asymptomatic menopausal women: correlation with clinical and sonographic findings

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    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.

  12. Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

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    Reneta Yovcheva Koycheva

    2015-12-01

    Full Text Available BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT, precursor of B-natriuretic peptide (NT-proBNP and high sensitivity C-reactive protein (hs CRP and their relation to the presence of left ventricular hypertrophy (LVH in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure. MATERIAL AND METHODS: Were studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH, and gr B - 8 patients (without LVH. RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05 after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47 and weaker with hs CRP (r = 0.163. Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966, for NT-proBNP (r = 0.918 and for hs CRP (r = 0.859. It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng /mL, p < 0.05 and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg /mL, p < 0.05. Not find a significant difference in hs CRP in both groups. CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

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

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    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

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

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    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.

  15. Role of myocardial perfusion SPECT in asymptomatic diabetic patients

    International Nuclear Information System (INIS)

    Purpose: It is important that early diagnosis and treatment of coronary artery disease in diabetic patients, but there are few reports on the prevalence of stress-induced myocardial perfusion abnormalities and the rates of cardiac event in patients with type 2 diabetes. We evaluated the scan findings on gated myocardial perfusion SPECT in asymptomatic diabetic patients. Methods: We performed pharmacological stress test and gated perfusion SPECT in 69 diabetic patients without cardiovascular symptom (mean age: 65 year, male 31 and female 38). Patients underwent two-day imaging protocol and stress study was performed injection of Tc-99m MIBI during adenosine infusion. We followed up these patients by reviewing medical records. Results: Fifty-two of 69 patients (74.5%) showed normal scan findings and 17 patients (24.6%) showed reversible or fixed perfusion defects. Three of 52 patients with normal scan findings showed decreased LV ejection fraction and decreased wall motion. Twenty-three patients with normal scan findings were possible to follow up for more than 1yr (mean time: 18.3±3.3 mo.) and they all had no cardiac event. Three patients with reversible perfusion defects were performed coronary angioplasty. Conclusion: Myocardial perfusion SPECT is a noninvasive method and maybe useful in early diagnosis and predicting prognosis in diabetic patients

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

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    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.

  17. A STUDY ON ASYMPTOMATIC CARDIAC CHANGES IN TYPE 2 DIABETES PATIENTS

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    Ramchandra Rao

    2015-06-01

    Full Text Available INTRODUCTION: Majority of the time the patient of Diabetes presents with complications like Myocardial infarction, heart failure, being end stages of cardiovascular 2 disease associated with other macro and microvascular complications. If patients are screened at an early stage of Diabetes before the onset of symptoms the cardiovascular complications can be delayed and mortality can be reduced . There are only few studies in India done to screen asymptomatic diabetic individuals for cardiovascular compli cations. This study is done in view of screening the asymptomatic individuals in our area to prevent complications. With the available infrastructure, ECG, 2D ECHO were done in 50 patients who met inclusion, exclusion criterias, the changes were noted and the cardiac status was evaluated. AIM AND OBJECTIVES : “To study the asymptomatic cardiac changes in type2 Diabetes patients”. To observe the ECG changes in patients of type2 Diabetes without any symptoms of cardiac disease. To evaluate the ECG changes along with 2DECHO findings in asymptomatic cardiac patients of type 2 Diabetes. To study the correlation between these two investigations and evaluate the cardiac status of the individual. CONCLUSIONS : M ost of the patients in study group belong to 5 th decade , Males with Diabetes were almost double that of females , Most of the patients had duration of Diabetes as 5yrs , Less than half of patients had family history of Diabetes , Half of the group had alcohol, smoking habits , More than half of patients were overweight , Only 20% had good control of Diabetes , Total cholesterol is above normal in almost all of the patients, LDL is elevated in half of the patients, triglycerides in most of them, there is significant dyslipidemia in patients of Diabetes , Only 6 had normal ECG. Rest of them have LVH, ischemia , 18 patients had changes in echo including LVD, regional and global hypokinesias , t hus the present study shows patients with type 2

  18. ACR appropriateness criteria asymptomatic patient at risk for coronary artery disease.

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    Earls, James P; Woodard, Pamela K; Abbara, Suhny; Akers, Scott R; Araoz, Philip A; Cummings, Kristopher; Cury, Ricardo C; Dorbala, Sharmila; Hoffmann, Udo; Hsu, Joe Y; Jacobs, Jill E; Min, James K

    2014-01-01

    Atherosclerotic cardiovascular disease is the leading cause of death for both men and women in the United States. Coronary artery disease has a long asymptomatic latent period and early targeted preventive measures can reduce mortality and morbidity. It is important to accurately classify individuals at elevated risk in order to identify those who might benefit from early intervention. Imaging advances have made it possible to detect subclinical coronary atherosclerosis. Coronary artery calcium score correlates closely with overall atherosclerotic burden and provides useful prognostic information for patient management. Our purpose is to discuss use of diagnostic imaging in asymptomatic patients at elevated risk for future cardiovascular events. The goal for these patients is to further refine targeted preventative efforts based on risk. The following imaging modalities are available for evaluating asymptomatic patients at elevated risk: radiography, fluoroscopy, multidetector CT, ultrasound, MRI, cardiac perfusion scintigraphy, echocardiography, and PET. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:24316232

  19. Early detection of asymptomatic carotid disease in patients with arteriosclerotic occlusive disease of the lower extremities

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    Rančić Zoran S.

    2002-01-01

    Full Text Available Prevalence of asymptomatic carotid artery stenosis in patients with lower extremities atherosclerosis is relatively high. Limiting screening of specific subgroups for any demographic or medical characteristics is ineffective. Screening for asymptomatic carotid artery stenosis is indicated in all patients with lower extremities atherosclerosis except in whom prophylactic carotid endarterectomy is not recommended because of comorbid disease or extreme age.

  20. 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

  1. The Association between Myocardial Iron Load and Ventricular Repolarization Parameters in Asymptomatic Beta-Thalassemia Patients

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    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.

  2. Plasma copeptin as marker of cardiovascular disease in asymptomatic type 2 diabetes patients

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    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...

  3. Prognostic value of myocardial sympathetic activity in patients with asymptomatic myocardial infarction

    International Nuclear Information System (INIS)

    To clarify the significance of myocardial sympathetic activity in patients with asymptomatic myocardial infarction (MI), we performed 123I-metaiodobenzyl-guanidine (MIBG) and 201Tl imaging at rest. We calculated the ratio of cardiac uptake of the isotope to the total injected dose (%Uptake), percent washout of MIBG over 3 hours and the Uptake Ratio (UR, %Uptake of MIBG divided by %Uptake of 201Tl). We compared these indices with clinical findings, exercise stress-rest myocardial perfusion imaging with 99Tc-methoxy-2-isobutyl isonitrile, coronary angiography, echocardiography and neurohumoral findings. During the follow-up period of 19.9±10.3 months in 32 patients, events (heart failure or cardiac death) developed in 10 (31%). In univariate analysis, diabetes mellitus, atrial fibrillation, left ventricular end-diastolic dimension (LVDd) greater than 54 mm, and the %Uptake of MIBG and UR differed significantly between event and event-free groups. Cox proportional hazard model showed that the UR was a predictor of events (p=0.0007). In patients with UR less than 0.58, the relative risk of events was 19.1 times greater than in patients with an UR greater than 0.58. UR was closely correlated to LVDd (r=-0.578, p=0.01) suggesting that myocardial sympathetic activity is related to LV remodeling after MI. MIBG imaging provides important information regarding the prognosis and the pathophysiologic process of asymptomatic MI. (author)

  4. Prognostic value of myocardial sympathetic activity in patients with asymptomatic myocardial infarction

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    Narita, Michihiro; Kurihara, Tadashi; Sindoh, Takashi; Sawada, Yoshihiro [Sumitomo Hospital, Osaka (Japan)

    1999-04-01

    To clarify the significance of myocardial sympathetic activity in patients with asymptomatic myocardial infarction (MI), we performed {sup 123}I-metaiodobenzyl-guanidine (MIBG) and {sup 201}Tl imaging at rest. We calculated the ratio of cardiac uptake of the isotope to the total injected dose (%Uptake), percent washout of MIBG over 3 hours and the Uptake Ratio (UR, %Uptake of MIBG divided by %Uptake of {sup 201}Tl). We compared these indices with clinical findings, exercise stress-rest myocardial perfusion imaging with {sup 99}Tc-methoxy-2-isobutyl isonitrile, coronary angiography, echocardiography and neurohumoral findings. During the follow-up period of 19.9{+-}10.3 months in 32 patients, events (heart failure or cardiac death) developed in 10 (31%). In univariate analysis, diabetes mellitus, atrial fibrillation, left ventricular end-diastolic dimension (LVDd) greater than 54 mm, and the %Uptake of MIBG and UR differed significantly between event and event-free groups. Cox proportional hazard model showed that the UR was a predictor of events (p=0.0007). In patients with UR less than 0.58, the relative risk of events was 19.1 times greater than in patients with an UR greater than 0.58. UR was closely correlated to LVDd (r=-0.578, p=0.01) suggesting that myocardial sympathetic activity is related to LV remodeling after MI. MIBG imaging provides important information regarding the prognosis and the pathophysiologic process of asymptomatic MI. (author)

  5. Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined

  6. 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.

  7. Asymptomatic Atherosclerosis in Egyptian Rheumatoid Arthritis Patients and Its Relation to Disease Activity

    Directory of Open Access Journals (Sweden)

    Rawhya R. Elshereef

    2015-01-01

    Full Text Available Aim. To detect the frequency of subclinical atherosclerosis in rheumatoid arthritis patients without clinically evident atherosclerosis and to correlate its presence with the disease activity. Patients and Methods. Our study includes 112 RA patients (group 1 and 40 healthy controls (group 11. All patients and controls were subjected to full history taking, clinical examination, and laboratory investigations. Carotid intima media wall thickness (IMT and carotid plaques were measured in both groups by B-mode ultrasonography; also color duplex Doppler ultrasound of the brachial artery was done to detect endothelial function. Results. There is atherosclerosis in 31.3% of asymptomatic RA patients compared with only 5% in controls P=0.003**. A significant difference was detected in patients with and without atherosclerosis regarding duration of the disease P=0.0001*** and patient’s age P=0.01*. There is highly statistical significant correlation between atherosclerosis and disease activity index. Conclusion. The frequency of subclinical atherosclerosis was high in long-term active RA patients.

  8. 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.)

  9. Dysregulation of coronary microvascular reactivity in asymptomatic patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    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.)

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

    DEFF Research Database (Denmark)

    Bang, Casper N; Greve, Anders; 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)....

  11. Effects of asymptomatic hyperuricemia on vascular endothelial cells and vascularsmoothmuscle cells in patients with primary chronic glomerulonephritis

    Institute of Scientific and Technical Information of China (English)

    连希艳

    2012-01-01

    Objective To explore the effects of asymptomatic hyperuricemia on the function of glomerular endothelial cells and vascular smooth muscle cell proliferation in patients with primary chronic glomerulonephritis and to determine if asymptomatic hyperuricemia could lead to kidney

  12. End plate marrow changes in the asymptomatic lumbosacral spine: frequency, distribution and correlation with age and degenerative changes

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Christine B. [Department of Radiology, VA Healthcare System, 3350 La Jolla Village Drive, CA 92161, La Jolla (United States); Vande Berg, Bruno C.; Malghem, Jacques [Department of Radiology, Cliniques Universitaires St Luc Universite Catholique de Louvain, 10 av Hippocrate, 1200, Brussels (Belgium); Tavernier, Thierry [Service de Radiologie, Clinique de la Sauvegarde, Av David Ben Gourion, 69009, Lyon (France); Cotten, Anne [Service de Radiologie Osteoarticulaire, Hopital R Salengro, 59037, Lille Cedex (France); Laredo, Jean-Denis [Service de Radiologie Osteo-articulaire, Hopital Lariboisiere, 2 rue Ambroise Pare, 75475, Paris Cedex 10 (France); Vallee, Christian [Service d' imagerie medicale, Hopital Raymond Poincare, 104 Boulevard R.Poincare, 92380, Garches (France)

    2004-07-01

    To investigate the frequency and distribution of end plate marrow signal intensity changes in an asymptomatic population and to correlate these findings with patient age and degenerative findings in the spine. MR imaging studies of the lumbosacral (LS) spine in 59 asymptomatic subjects were retrospectively reviewed by 2 musculoskeletal radiologists to determine the presence and location of fat-like and edema-like marrow signal changes about the end plates of the L1-2 through L5-S1 levels. The presence of degenerative changes in the spine was recorded as was patient age. Descriptive statistics were utilized to determine the frequency and associations of end plate findings and degenerative changes in the spine. Interobserver variability was determined by a kappa score. Binomial probability was used to predict the prevalence of the end plate changes in a similar subject population. The Fisher exact test was performed to determine statistical significance of the relationship of end plate changes with degenerative changes in the spine, superior versus inferior location about the disc and age of the patient population. Focal fat-like signal intensity adjacent to the vertebral end-plate was noted in 15 out of 59 subjects by both readers, and involved 38 and 36 out of 590 end plates by readers 1 and 2, respectively. Focal edema-like signal intensity adjacent to the vertebral end plate was noted in 8 out of 59 subjects by both readers and involved 11 and 10 out of 590 end plates by readers 1 and 2, respectively. Either fat or edema signal intensity occurred most often at the anterior (p<.05) aspects of the mid-lumbar spine and was seen in an older sub-population of the study (p<.05). End plate marrow signal intensity changes are present in the lumbar spine of some asymptomatic subjects with a characteristic location along the spine and in vertebral end plates. (orig.)

  13. The measurement of 99mTc-DTPA pulmonary clearance in normals, asymptomatic smokers and diabetic patients

    International Nuclear Information System (INIS)

    We measured pulmonary epithelial permeability by 99mTc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate 99mTc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. We performed 99mTc-DTPA radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). 99mTc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiophaty were significantly older (p1/2 of normal subjects and asymptomatic smokers were significantly different (65.2±23.7 min vs 39.6±9.8 min, p1/2 was 90.5±46.5 min and significantly delayed when compared with those of normals and asymptomatic smokers (p1/2 of diabetic patients without microangiopathy, 70.0±12.7 min, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the T1/2 and spirometric parameters including DLco, FVC, FEV1, FEV1/FVC (%) and FEF25-75% in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. Eventhough the influence of age can't be excluded, delayed 99mTc-DTPA clearance half-time (T1/2) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy

  14. Cervical Disc Deformation During Flexion–Extension in Asymptomatic Controls and Single-Level Arthrodesis Patients

    OpenAIRE

    Anderst, William; Donaldson, William; Lee, Joon; Kang, James

    2013-01-01

    The aim of this study was to characterize cervical disc deformation in asymptomatic subjects and single-level arthrodesis patients during in vivo functional motion. A validated model-based tracking technique determined vertebral motion from biplane radiographs collected during dynamic flexion–extension. Level-dependent differences in disc compression–distraction and shear deformation were identified within the anterior and posterior annulus (PA) and the nucleus of 20 asymptomatic subjects and...

  15. 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.

  16. 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. PMID:25576532

  17. 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.

  18. No evidence of asymptomatic variant CJD infection in immunodeficiency patients treated with UK-sourced immunoglobulin.

    Science.gov (United States)

    Helbert, M R; Bangs, C; Bishop, M; Molesworth, A; Ironside, J

    2016-04-01

    Surveillance of 75 immunodeficiency patients exposed to UK-sourced immunoglobulin, including batches derived from donors who went on to develop vCJD, has not detected any clinical cases of vCJD, or of asymptomatic infection in 15 patients with available tissue samples of sufficient quality for testing. PMID:26529032

  19. Diagnosis of pulmonary tuberculosis among asymptomatic HIV+ patients in Guangxi, China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yao; ZHANG Fu-jie; YU Lan; TANG Zhi-rong; HUANG Shao-biao; ZHENG Yuan-jia; MENG Zhi-hao; SUN Kai; WANG Li-ming; Ray Y.CHEN

    2010-01-01

    Background Pulmonary tuberculosis (PTB) among asymptomatic Chinese patients with HIV infection has not been investigated despite high tuberculosis burden in China. This study was aimed to evaluate the prevalence, risk factors and clinical outcomes of PTB among asymptomatic patients with HIV/AIDS in Guangxi to facilitate the development of diagnostic and treatment strategies.Methods All asymptomatic adult HIV-infected patients with CD4 <350 cells/μl who attended four HIV clinics in Guangxi between August 2006 and March 2008 were evaluated for active PTB with physical examination, chest X-ray (CXR),sputum smear and/or sputum liquid culture. Data were described using median (interquartile range, IQR) and frequencies.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with PTB.Results Among 340 asymptomatic subjects, 15 (4%) were diagnosed with PTB, with 4 (27%) sputum smear positive and 8 (53%) sputum culture positive. CXR has higher diagnostic sensitivity (87%) than sputum smear (25%) and sputum culture (67%), but lower specificity (56%) compared with sputum smear (99%) and culture (100%). In univariate analysis,injection drug user, body mass index (BMI) <18 kg/m2, CD4 <50 cells/μl and presence of peripheral lymphadenopathy were associated with an increased risk of asymptomatic PTB, while in multivariate analysis only peripheral lymphadenopathy maintained statistical significance (OR=7.6, 95% CI 1.4-40). Patients with negative smear and minor or no abnormalities on CXR had longer interval between screening and TB treatment.Conclusions PTB was relatively common in this group of HIV+ asymptomatic Chinese patients. Diagnosis is challenging especially where sputum culture is unavailable. These findings suggest that an enhanced evaluation for PTB needs to be integrated with HIV care in China and transmission prevention in China to control at both households and health care facilities, especially for patients

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

    Directory of Open Access Journals (Sweden)

    Adeline Syin Lian Yeo

    2015-01-01

    Full Text Available 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.

  1. Asymptomatic carotid artery stenosis in patients with severe peripheral vascular diseases

    Directory of Open Access Journals (Sweden)

    Rasoul Mirsharifi

    2009-04-01

    Full Text Available

    • BACKGROUND: The prevalence of carotid artery stenosis (CAS in the  eneral population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS among patients with severe peripheral vascular disease (PVD.
    • METHODS: Between March 2005 and February 2006, 54 consecutive  atients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A  uestionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater.
    • RESULTS: The mean age was 62.5 years (51-72. Out of 54 patients, 2 (3.7% had an occluded internal carotid artery. Significant CAS was found in 9 (16.7% and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, ankle-brachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence.
    • CONCLUSION: The prevalence of significant ACAS is higher among  atients with severe PVD. This patient population may indicate a  uitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.
    • KEYWORDS: Carotid artery stenosis, duplex ultrasound scanning, peripheral vascular disease, carotid endarterectomy,
    • cerebrovascular accident.

  2. The role of TNF-α, Fas/Fas ligand system and NT-proBNP in the early detection of asymptomatic left ventricular dysfunction in cancer patients treated with anthracyclines

    Directory of Open Access Journals (Sweden)

    Alexandros Kouloubinis

    2015-03-01

    Conclusion: SFas, sFas-L and NT-proBNP correlate with reductions in LVEF and could be used as sensitive biochemical indices for the detection of asymptomatic left ventricular dysfunction in cancer patients under cardiotoxic chemotherapy.

  3. The impact of asymptomatic helminth co-infection in patients with newly diagnosed tuberculosis in north-west Ethiopia.

    Directory of Open Access Journals (Sweden)

    Ebba Abate

    Full Text Available BACKGROUND: Areas endemic of helminth infection, tuberculosis (TB and HIV are to a large extent overlapping. The aim of this study was to assess the impact of asymptomatic helminth infection on the immunological response among TB patients with and without HIV, their house hold contacts and community controls. METHODOLOGY: Consecutive smear positive TB patients (n = 112, their household contacts (n = 71 and community controls (n = 112 were recruited in Gondar town, Ethiopia. Stool microscopy, HIV serology, serum IgE level, eosinophil and CD4 counts were performed and tuberculosis patients were followed up for 3 months after initiation of anti-TB treatment. RESULTS: Helminth co-infection rate was 29% in TB patients and 21% in both community control and household contacts (p = 0.3 where Ascaris lumbricoides was the most prevalent parasite. In TB patients the seroprevalence of HIV was 47% (53/112. Eosinophilia and elevated IgE level were significantly associated with asymptomatic helminth infection. During TB treatment, the worm infection rate of HIV+/TB patients declined from 31% (10/32 at week 0 to 9% (3/32 at week 2 of TB treatment, whereas HIV-/TB patients showed no change from baseline to week 2, 29% (13/45 vs. 22.2% (10/45. This trend was stable at week 8 and 12 as well. CONCLUSION: One third of smear positive TB patients were infected with helminths. Eosinophilia and elevated IgE level correlated with asymptomatic worm infection, indicating an effect on host immunity. The rate of worm infection declined during TB treatment in HIV+/TB co-infected patients whereas no decline was seen in HIV-/TB group.

  4. 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.

  5. Concomitant Cryptococcosis and Burkholderia Infection in an Asymptomatic Lung Transplant Patient with Cystic Fibrosis

    OpenAIRE

    2010-01-01

    Concomitant pulmonary infections with Cryptococcus neoformans and Burkholderia cepacia in lung transplant recipients are very rare and create unique diagnostic and therapeutic dilemmas. Herein, we present a double lung transplant patient with cystic fibrosis who was found to have coinfection with these two rare organisms, though he was completely asymptomatic.

  6. Asymptomatic Herpes Simplex Virus Shedding in STI Patients

    Institute of Scientific and Technical Information of China (English)

    叶兴东; 颜景兰; 朱慧兰; 张莉; 佟菊贞

    2002-01-01

    Objective: This study examined Herpes Simplex Virus(HSV) subclinical shedding in the genital tract of patients withgenital herpes (GH) or non-gonoccal urethritis (NGU). Method: Swabs were collected after exposure to rash andgenital tract during GH relapse or remission on a weekly basisfor four to six weeks. NGU patients with negative chlamydiaand mycoplasma tests were also swabbed for a similarduration. All swabs underwent HSV DNA detection withquantitative PCR. Result: There was a significant difference in the rate ofasymptomatic HSV shedding in urinary tracts comparing GHand the control group and comparing NGU and the controlgroup (P<0.05). The rate of HSV shedding was 22%, 9.8%and 3.3% for GH, NGU and control groups respectively. Therate of HSV shedding was 21.7% (20/92) for patients withactive GH and 23% for those in remission. The HSV positiverate was significantly higher in the group with patients whohad more than six relapses within one year compared to thegroup of patients with less than six GH relapses. Conclusion: There is HSV subclinical shedding in theirgenital tract during active GH and remission. SubclinicalHSV shedding is more common in patients with more than sixGH relapses per year compared to GH patients with fewerrelapses. Approximately 9.9% of NGU patients with negativechlamydia, mycoplasma testing was found to have subclinicalHSV infection.

  7. 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.

  8. Role of coronary CT angiography in asymptomatic patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Diabetic patients with coronary artery disease are often asymptomatic, making appropriate care of such patients difficult. The purpose of this study was to investigate the prevalence of coronary lesions in asymptomatic diabetic patients. Coronary computed tomography (CT) angiography was performed in 120 consecutive diabetic patients (90 of whom were men, mean age 65, mean HbA1c 7.2%). Images from patients whose coronary artery calcium scores (CAC scores) were less than 400 were subjected to stenosis and plaque analysis. Significant stenosis was defined as coronary artery stenosis >70%. High-risk plaque was defined as plaque having both a CT density <30 Hounsfield Units (HU) and showing positive remodeling. Significant stenoses were identified in 30.5% of the patients. High-risk plaques were identified in 17.1% of the patients. Less than half of the high-risk plaques were obstructive plaques. There was a statistically significant association between significant stenosis and high-risk plaque by chi-square test (P=0.022). We found significant stenosis even in patients whose CAC score =0 at a rate of 5.0%. Using univariate logistic-regression analysis, we found that coronary risk factors associated with significant stenosis and high-risk plaque were dyslipidemia (P=0.033) and current smoking (P=0.030), respectively. We report for the first time, the prevalence of high-risk plaques in the arteries of patients with asymptomatic diabetes, as assessed by coronary CT angiography. (author)

  9. 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)....

  10. Risk factors for asymptomatic ventricular dysfunction in rheumatoid arthritis patients.

    Science.gov (United States)

    Garza-García, Carlos; Rocío, Sánchez-Santillán; Orea-Tejeda, Arturo; Castillo-Martínez, Lilia; Eduardo, Canseco; López-Campos, José Luis; Keirns-Davis, Candace

    2013-01-01

    Objective. The aim of the study was to describe echocardiographic abnormalities in patients with rheumatoid arthritis, concurrent systemic comorbidities, rheumatologic clinical activity, serologic markers of rheumatoid arthritis, and inflammatory activity. Methods. In an observational, cross-sectional study, rheumatoid arthritis outpatients were included (n = 105). Conventional transthoracic echocardiographic variables were compared between patients with arthritis and non-RA controls (n = 41). For rheumatoid arthritis patients, articular activity and rheumatologic and inflammatory markers were obtained. Results. Ventricular dysfunction was found in 54.3% of the population: systolic (18.1%), diastolic (32.4%), and/or right (24.8%), with lower ejection fraction (P Pulmonary hypertension was found in 46.9%. Other echocardiographic findings included increased left atrial diameter (P = 0.01), aortic diameter (P = 0.01), ventricular septum (P = 0.01), left ventricular posterior wall (P = 0.013), and right ventricular (P = 0.01) and atrial diameters compared to control subjects. Rheumatoid factor and anti-CCP antibodies levels were significantly elevated in cases with ventricular dysfunction. Angina and myocardial infarction, diabetes, and dyslipidemia were the main risk factors for ventricular dysfunction. Conclusions. Ventricular dysfunction is common in rheumatoid arthritis and associated with longer disease duration and increased serologic markers of rheumatoid arthritis. Screening for cardiac abnormalities should be considered in this kind of patients.

  11. Management of asymptomatic carotid stenosis in patients undergoing general and vascular surgical procedures

    OpenAIRE

    Paciaroni, M; Caso, V; Acciarresi, M; Baumgartner, R.; Agnelli, G.

    2005-01-01

    Current available data do not seem to support the strategy for carotid endarterectomy prior to surgical intervention in patients with asymptomatic carotid stenosis. However, in patients with coronary artery disease, synchronous carotid endarterectomy and coronary artery bypass grafting should be considered where there is a proven surgical risk of 60% or bilateral carotid stenosis >75% on the same side as the most severe stenosis. Clarification of the optimal strategy requires an adequately po...

  12. 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”?

  13. 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)

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

    International Nuclear Information System (INIS)

    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 99mTc-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)

  15. ECHOCARDIOGRAPHIC EVALUATION OF DIASTOLIC DYSFUNCTION IN ASYMPTOMATIC TYPE 2 DIABETES MELLITUS PATIENTS

    Directory of Open Access Journals (Sweden)

    Madhumathi

    2014-01-01

    % was used as echo diagnostic criteria for LV diastolic dysfunction. RESULTS : Our study consisted of 50 patients with type 2 DM, 30(60% were females and 20(40% males. Majority of patients were in the age group of 40 – 70 years. Diastolic dysfuncti on was present in 24(48% patients out of whom 8 were males and 16 females. The maximum number of patients with LV diastolic dysfunction was in age group 50 – 59 years. There was a linear increase in prevalence of diastolic dysfunction with increasing age, increased duration of diabetes mellitus and increasing HbA1c levels. There was also significant correlation between LV diastolic dysfunction (LVDD and microangiopathy. Out of 13 patients who had diabetic retinopathy, 8 patients had LVDD and out of 11 pati ents with microalbuminuria, 9 patients had LVDD. CONCLUSION : LV diastolic dysfunction is an early manifestation of diabetic cardiomyopathy. Its prevalence correlates with duration of diabetes, HbA1c values and presence of microangiopathy. LVDD contributes s ignificantly to morbidity of congestive heart failure in diabetic patients. Echocardiography is a very useful noninvasive tool in detecting LVDD in asymptomatic type 2 DM patients.

  16. 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

    AIMS: To evaluate the prognostic value of global longitudinal strain (GLS) and basal longitudinal strain (BLS) with the knowledge of coexisting coronary pathology evaluated by multi-detector computed tomography (MDCT) coronary angiography. BACKGROUND: GLS and BLS are both sensitive markers of myo......: 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....

  17. The Role of Gratitude in Well-being in Asymptomatic Heart Failure Patients

    OpenAIRE

    Mills, Paul J.; Wilson, Kathleen; Punga, Meredith A.; Chinh, Kelly; Pruitt, Chris; Greenberg, Barry; Lunde, Ottar; Wood, Alex.; Redwine, Laura; Chopra, Deepak

    2015-01-01

    Spirituality and gratitude are associated with well-being. Few if any studies have examined the role of gratitude in heart failure (HF) patients or whether it is a mechanism through which spirituality may exert its beneficial effects on physical and mental health in this clinical population. This study examined associations between gratitude, spiritual well-being, sleep, mood, fatigue, cardiac-specific self-efficacy, and inflammation in 186 men and women with stage B asymptomatic HF (age 66.5...

  18. Prevalence and prognosis of asymptomatic coronary artery disease in patients with abdominal aortic aneurysm and minor or no perioperative risks

    International Nuclear Information System (INIS)

    According to the American Heart Association (AHA)/ American College of Cardiology (ACC) guideline 2002, patients with abdominal aortic aneurysm (AAA) with minor or no clinical risk for perioperative cardiovascular events require no preoperative coronary assessment if they have functional capacity greater than 4 METS. Further coronary assessment is not often performed, even after the operation, because of absence of symptoms. The aim of this study was to clarify the prevalence, and prognosis of asymptomatic coronary artery disease (CAD) in such AAA patients. From 2002 to 2006, 201 patients (161 men; mean age 73.1±7.7 years) were classified as minor or no clinical risk for perioperative cardiovascular events. Medical history, and physical, laboratory, plus imaging examinations were evaluated. Prognosis was assessed by telephone canvass. Asymptomatic CAD was found in 59 patients (29.4%). By multivariate analysis, advanced age (≥75 years: odds ratio (OR) 2.43, P=0.018) and family history of CAD (OR 5.27, P=0.001) independently predicted asymptomatic CAD. Asymptomatic CAD did not significantly affect death or cardiac events when treated appropriately. A high prevalence of asymptomatic CAD requiring treatment was shown in these AAA patients. Under appropriate therapies, prognosis was as well preserved as in patients without asymptomatic CAD, which underscored the importance of appropriate assessment and management of asymptomatic CAD. (author)

  19. 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

  20. 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.

  1. 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.

  2. Hepatic and pancreatic involvement in hereditary hemorrhagic telangiectasia: quantitative and qualitative evaluation with 64-section CT in asymptomatic adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Barral, Matthias; Sirol, Marc; Hamzi, Lounis; Gayat, Etienne; Boudiaf, Mourad [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Place, Vinciane [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Universite Diderot-Paris 7, UFR de Medecine, Paris (France); Borsik, Michel [Hopital Lariboisiere-APHP, Deparment of Ear, Nose and Throat, Paris (France); Soyer, Philippe [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Universite Diderot-Paris 7, UFR de Medecine, Paris (France); Unite 965 INSERM/Paris7, Hopital Lariboisiere-APHP, Paris (France)

    2012-01-15

    To analyse quantitatively and qualitatively asymptomatic hepatic and pancreatic involvement in hereditary haemorrhagic telangiectasia (HHT) using 64-section helical CT. The 64-section helical CT examinations of 19 patients with HHT (8 men, 11 women; mean age, 58.6 years) were quantitatively and qualitatively analysed and compared to those of 19 control subjects who were matched for age and sex. Comparisons were made using univariate analysis. Dilated and tortuous intrahepatic arterial branches was the most discriminating independent variable (P < 0.0001) and had the highest specificity (100%; 19/19; 95%CI: 82%-100%) and accuracy (97%; 37/38; 95%CI: 86%-100%) for the diagnosis of HHT. Heterogeneous enhancement of hepatic parenchyma, intrahepatic telangiectases, hepatic artery to hepatic vein shunting, hepatic artery enlargement (i.e. diameter > 6.5 mm) and portal vein enlargement (i.e. diameter > 13 mm) were other variables that strongly correlated with the presence of HHT. Intrapancreatic telangiectases and arteriovenous malformations were found in 42% and 16% of patients with HHT, respectively. Liver and pancreatic involvement in asymptomatic HHT patients is associated with myriad suggestive findings on 64-section helical CT. It can be anticipated that familiarity with these findings would result in more confident diagnosis of HHT. (orig.)

  3. [Prevention of ischemic stroke in patients with asymptomatic lesions of carotid arteries].

    Science.gov (United States)

    Gavrilenko, A V; Guzenko, A S; Kuklin, A V; Kochetkov, V A

    2012-01-01

    Based on the data from both Russian and foreign literature, analysed herein are the methods of surgical and medicamentous prevention of ischaemic stroke in patients presenting with asymptomatic lesions of carotid arteries. This is followed by discussing haemodynamic parameters of the blood flow in the carotid arteries and their effect on cerebrovascular symptomatology. Also presented herein are the data concerning efficacy of different modalities of antithrombocytic therapy, followed by presenting own results regarding surgical management for stenoses and pathological kinking of carotid arteries in the patient cohort concerned. PMID:22929668

  4. 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.

  5. Risk Factors for Periacetabular Osteolysis and Wear in Asymptomatic Patients with Uncemented Total Hip Arthroplasties

    OpenAIRE

    Buster Sandgren; Joakim Crafoord; Henrik Olivecrona; Göran Garellick; Lars Weidenhielm

    2014-01-01

    Osteolysis is a silent disease leading to aseptic loosening. This has not been studied in a cohort of asymptomatic patients. The aim of this study was to detect factors that might be associated with the development of periacetabular osteolysis and wear around an uncemented cup. We assessed 206 patients with an uncemented cup, measuring wear and periacetabular osteolysis using computed tomography with a median follow-up of 10 years after surgery (range 7–14 years). EQ5D, pain from the hip, and...

  6. 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.

  7. Open and hidden agendas of "asymptomatic" patients who request check-up exams

    Directory of Open Access Journals (Sweden)

    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.

  8. Potential association between coronary artery disease and the inflammatory biomarker YKL-40 in asymptomatic patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kim Hyun

    2012-07-01

    Full Text Available Abstract Background Inflammation plays an important role in coronary artery disease from the initiation of endothelial dysfunction to plaque formation to final rupture of the plaque. In this study, we investigated the potential pathophysiological and clinical relevance of novel cytokines secreted from various cells including adipocytes, endothelial cells, and inflammatory cells, in predicting coronary artery disease (CAD in asymptomatic subjects with type 2 diabetes mellitus. Methods We enrolled a total of 70 asymptomatic type 2 diabetic patients without a documented history of cardiovascular disease, and determined serum levels of chemerin, omentin-1, YKL-40, and sCD26. We performed coronary computed tomographic angiography (cCTA in all subjects, and defined coronary artery stenosis ≥ 50 % as significant CAD in this study. Results Subjects were classified into two groups: patients with suspected coronary artery stenosis on cCTA (group I, n = 41 and patients without any evidence of stenosis on cCTA (group II, n = 29. Group I showed significantly higher YLK-40 levels and lower HDL-C levels than group II (p = 0.038, 0.036, respectively. Levels of chemerin, omentin-1, and sCD26 were not significantly different between the two groups. Serum YKL-40 levels were positively correlated with systolic/diastolic BP, fasting/postprandial triglyceride levels, and Framingham risk score. Furthermore, YKL-40 levels showed moderate correlation with the degree of coronary artery stenosis and the coronary artery calcium score determined from cCTA. In multivariate logistic analysis, after adjusting for age, gender, smoking history, hypertension, and LDL-cholesterol, YLK-40 levels showed only borderline significance. Conclusions YKL-40, which is secreted primarily from inflammatory cells, was associated with several CVD risk factors and was elevated in type 2 diabetic patients with suspected coronary artery stensosis on cCTA. These results suggest

  9. 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

  10. 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.

  11. High cardiovascular event rates in patients with asymptomatic carotid stenosis: the REACH Registry

    DEFF Research Database (Denmark)

    Aichner, F T; Topakian, R; Alberts, M J;

    2009-01-01

    BACKGROUND AND PURPOSE: Data on current cardiovascular event rates in patients with asymptomatic carotid artery stenosis (ACAS) are sparse. We compared the 1-year outcomes of patients with ACAS > or =70% versus patients without ACAS in an international, prospective cohort of outpatients.......26%, P = 0.04), cardiovascular death (2.29% vs. 1.52%, P = 0.002), the composite end-point cardiovascular death/myocardial infarction/stroke (6.03% vs. 4.29%, P events (1.41% vs. 0.81%, P = 0.002). In patients with ACAS, Cox regression analyses identified history of cerebrovascular...... ischaemic events as most important predictor of future stroke (HR 3.21, 95% CI 1.82-5.65, P events. Stroke was powerfully predicted by prior cerebrovascular...

  12. 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.

  13. Prevalence of nerve-vessel contact at cisternal segments of the oculomotor nerve in asymptomatic patients evaluated with magnetic resonance images

    Institute of Scientific and Technical Information of China (English)

    WANG Jin; GONG Xiang-yang; SUN Yi; HU Xing-yue

    2010-01-01

    Background Some studies indicated that cases of idiopathic oculomotor nerve palsy can be explained by vascular compression of the oculomotor nerve. Vascular contact with or compression to the cisternal segment of the oculomotor nerve has been reported frequently in asymptomatic individuals. In this study, we retrospectively analyzed the relationship between the oculomotor nerve's cisternal segment and adjacent arteries in asymptomatic patients and the prevalence of this occurrence via magnetic resonance imaging (MRI).Method MRI of bilateral oculomotor nerves in 93 asymptomatic patients were reviewed. The oculomotor nerve-artery relationship was evaluated and classified from levels 1 to 3, representing the degrees of contact on oblique transverse and oblique sagittal reconstructed MRI. Prevalence of the nerve-artery relationship at each level was described. The correlation between the nerve-vessel relationship (levels) and the age was analyzed by Spearman's rank correlation analysis.Results Cisternal segment of the oculomotor nerve did not have contact with any artery (level 1) in 27.4% (51/186) nerves. One hundred nerves made contact with at least one artery (level 2), but their shapes or configurations were not changed; 35 nerves (18.8%) were displaced or distorted due to artery compression (level 3). The posterior cerebral artery had the greatest incidence of making contact with or compressing the cisternal segment of the oculomotor nerve (58.1%). No significant correlation between nerve-vessel relationship (levels) and the age was found in this study. Conclusions Whether oculomotor nerve contact with or compression by one or more arteries is of high prevalence in asymptomatic individuals as evidenced by MRI examination. There is no correlation with individual age. Discretion should be used when making an etiological diagnosis of vascular compression for patients with oculomotor nerve palsy. Further investigation of other causes is warranted.

  14. 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...

  15. "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.

  16. 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.

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

    DEFF Research Database (Denmark)

    Madsen, Kirsten Riis; Bødtger, Uffe

    Introduction: Compared to incidentally found lung cancer, the presence of symptoms (eg. cough, haemoptysis, pain, weight loss) at diagnosis is associated with a 50% reduction in median survival. In surgically treated patients, it is unknown whether presence of symptoms has prognostic significance....... Aim: We wanted to ascertain if symptoms at time of NSCLC diagnosis lowered 12-months mortality after surgery. Methods: Retrospective analysis of all patients with localised NSCLC referred from our department between 2009-2011 for intended curative surgery Data on age, sex, tobacco pack years, Charlson......, 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...

  19. 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.

  20. The impact of HIV infection on blood leukocyte responsiveness to bacterial stimulation in asymptomatic patients and patients with bloodstream infection

    Science.gov (United States)

    Huson, Michaëla A M; Hoogendijk, Arie J; de Vos, Alex F; Grobusch, Martin P; van der Poll, Tom

    2016-01-01

    Introduction HIV-induced changes in cytokine responses to bacteria may influence susceptibility to bacterial infections and the consequent inflammatory response. Methods We examined the impact of HIV on whole blood responsiveness to bacterial stimulation in asymptomatic subjects and patients with bacterial bloodstream infection (BSI). Whole blood was stimulated ex vivo with two bacterial Toll-like receptor agonists (lipopolysaccharide and lipoteichoic acid) and two pathogens (Streptococcus pneumoniae and non-typhoidal Salmonella), which are relevant in HIV-positive patients. Production of interferon-γ, tumour necrosis factor-α, interleukin-1β and interleukin-6 was used as a read-out. Results In asymptomatic subjects, HIV infection was associated with reduced interferon-γ, release after stimulation and priming of the pro-inflammatory cytokine response to non-typhoidal Salmonella. In patients with BSI, we found no such priming effect, nor was there evidence for more profound sepsis-induced immunosuppression in BSI patients with HIV co-infection. Conclusions These results suggest a complex effect of HIV on leukocyte responses to bacteria. However, in patients with sepsis, leukocyte responses were equally blunted in patients with and without HIV infection. PMID:27189532

  1. 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

    target CEA/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......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...... randomized trials in order to identify a "high risk for stroke" cohort in whom CEA/CAS could be prioritized....

  2. Cerebral Lesions in Patients Undergoing Coronary Artery Bypass Grafting in Relation to Asymptomatic Carotid and Vertebral Artery Stenosis

    DEFF Research Database (Denmark)

    Wiberg, Sebastian; Schoos, Mikkel; Sillesen, Henrik;

    2015-01-01

    OBJECTIVES: Carotid artery stenosis (CAS) and vertebral artery stenosis (VAS) are associated with cerebral infarction after coronary artery bypass graft surgery (CABG). It remains unclear whether this association is causal. We investigated the associations between neurologically asymptomatic CAS...... association between the presence of cerebral vessel stenosis and acute cerebral infarction (67% vs. 27%, p = 0.047). However none of the patients with stenosis had isolated cerebral lesions in the ipsilateral vascular territory. CONCLUSION: Asymptomatic CAS and VAS is common in CABG patients and is associated...

  3. Endothelial Progenitor Cells in Long-Standing Asymptomatic Type 1 Diabetic Patients with or without Diabetic Nephropathy

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Jacobsen, Peter Karl; Lajer, Maria;

    2011-01-01

    A decrease in the number and dysfunction of endothelial progenitor cells (EPC) may increase the risk for progression of cardiovascular disease (CVD) in type 1 diabetic patients with diabetic nephropathy (DN). Our aim was to evaluate EPC numbers in asymptomatic CVD type 1 diabetic patients with or...... patients with DN had EPC numbers similar to normoalbuminuric patients, which was related to aggressive CVD intervention therapy. This may have contributed to the low prevalence of CVD....

  4. Prognostic Value Of Normal Myocardial Perfusion Imaging In Asymptomatic Diabetic Patients With Moderate And High Calcium Scores

    Directory of Open Access Journals (Sweden)

    Mitevska Irena Peovska

    2015-06-01

    Full Text Available The purpose of this study was to evaluate the intermediate prognostic value of normal myocardial perfusion imaging (MPI in asymptomatic diabetic patients with intermediate and high coronary artery calcium (CAC scores. Methods: A total of 115 asymptomatic diabetic patients with no known coronary artery disease (CAD underwent MPI after multi-slice computed tomography CAC assessment for the detection of suspected CAD. The study included 75 patients with normal MPI results. A 17-segment model for myocardial perfusion and function analysis was used. Patients were divided into three groups: I gr-20 patients with a diabetes duration between 1-5 years; II gr-24 patients with a diabetes duration 5-10 years; and III gr-31 patients with a diabetes duration >10 years. End points (cardiac death, non-fatal myocardial infarction, heart failure, new angina, revascularization were assessed at 6, 12 and 24 months.

  5. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    LENUS (Irish Health Repository)

    Phelan, Dermot

    2012-11-01

    In asymptomatic subjects B-type natriuretic peptide (BNP) is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM) alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS) and peripheral serum from patients with low (n = 14) and high BNP (n = 27). Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001). CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008), CITP (r = 0.35, p = 0.03) and PIIINP (r = 0.35, p = 0.001), and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002), IL-6 (r = 0.35, p = 0.04), and IL-8 (r = 0.54, p<0.001). The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007), TNF-α (3.2±0.5 versus 3.7±1.1, p = 003), IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02) and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04), and greater left ventricular mass index (97±20 versus 118±26 g\\/m(2), p = 0.03) and left atrial volume index (18±2 versus 21±4, p = 0.008). Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  6. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    Directory of Open Access Journals (Sweden)

    Dermot Phelan

    Full Text Available In asymptomatic subjects B-type natriuretic peptide (BNP is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS and peripheral serum from patients with low (n = 14 and high BNP (n = 27. Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001. CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008, CITP (r = 0.35, p = 0.03 and PIIINP (r = 0.35, p = 0.001, and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002, IL-6 (r = 0.35, p = 0.04, and IL-8 (r = 0.54, p<0.001. The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007, TNF-α (3.2±0.5 versus 3.7±1.1, p = 003, IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02 and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04, and greater left ventricular mass index (97±20 versus 118±26 g/m(2, p = 0.03 and left atrial volume index (18±2 versus 21±4, p = 0.008. Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  7. Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

    Directory of Open Access Journals (Sweden)

    Poll Ludger W

    2010-04-01

    Full Text Available Abstract Background Imaging studies of bones in patients with sensory deficits are scarce. Aim To investigate bone MR images of the lower limb in diabetic patients with severe sensory polyneuropathy, and in control subjects without sensory deficits. Methods Routine T1 weighted and T2-fat-suppressed-STIR-sequences without contrast media were performed of the asymptomatic foot in 10 diabetic patients with polyneuropathy and unilateral inactive Charcot foot, and in 10 matched and 10 younger, non-obese unmatched control subjects. Simultaneously, a Gadolinium containing phantom was also assessed for reference. T1 weighted signal intensity (SI was recorded at representative regions of interest at the peritendineal soft tissue, the tibia, the calcaneus, and at the phantom. Any abnormal skeletal morphology was also recorded. Results Mean SI at the soft tissue, the calcaneus, and the tibia, respectively, was 105%, 105% and 84% of that at the phantom in the matched and unmatched control subjects, compared to 102% (soft tissue, 112% (calcaneus and 64% (tibia in the patients; differences of tibia vs. calcaneus or soft tissue were highly significant (p Conclusion MR imaging did not reveal grossly abnormal bone marrow signalling in the limbs with severe sensory polyneuropathy, but occult sequelae of previous traumatic injuries.

  8. Usefulness of body surface mapping to differentiate patients with Brugada syndrome from patients with asymptomatic Brugada syndrome.

    Directory of Open Access Journals (Sweden)

    Hisamatsu K

    2004-02-01

    Full Text Available We attempted to determine the usefulness of body surface mapping (BSM for differentiating patients with Brugada syndrome (BS from patients with asymptomatic Brugada syndrome (ABS. Electrocardiograms (ECG and BSM were recorded in 7 patients with BS and 35 patients with ABS. Following the administration of Ic antiarrhythmic drugs, BSM was recorded in 5 patients with BS and 16 patients with ABS. The maximum amplitudes at J0, J20, J40 and J60 were compared between the 2 groups, as were 3-dimensional maps. The maximum amplitudes at J0, J20 and J60 under control conditions were larger in patients with BS than in patients with ABS (P < 0.05. A three-dimensional map of the ST segments under control conditions in patients with BS showed a higher peak of ST elevation in the median precordium compared to that for patients with ABS. Increases in ST elevation at J20, J40 and J60 following drug administration were greater in patients with BS than in patients with ABS (P < 0.05. Evaluation of the change in amplitude of the ST segment at E5 caused by Ic drug administration was also useful for differentiating between the 2 groups. In conclusion, BSM was useful for differentiating patients with BS from those with ABS.

  9. Similar Neutrophil-Driven Inflammatory and Antibacterial Responses in Elderly Patients with Symptomatic and Asymptomatic Bacteriuria.

    Science.gov (United States)

    Yu, Yanbao; Zielinski, Martin D; Rolfe, Melanie A; Kuntz, Melissa M; Nelson, Heidi; Nelson, Karen E; Pieper, Rembert

    2015-10-01

    Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (≥38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified. PMID:26238715

  10. EP Testing in Asymptomatic Brugada Patients with Recurrent Palpitations. Just do it!

    Directory of Open Access Journals (Sweden)

    Filippo Maria Cauti

    2016-09-01

    Full Text Available Brugada syndrome is a rare heritable arrhythmogenic disease characterized by a coved ST segment elevation in the right precordial leads and by an increased risk of sudden cardiac arrest as a result of polymorphic ventricular tachyarrhythmias or ventricular fibrillation (1. Although implantable cardioverter defibrillators are considered to be the main therapy in patients with a history of ventricular arrhythmias or syncope, risk stratification in cases without these symptoms remains controversial. Patients with confirmed Brugada pattern and a history of palpitations without major events should be scheduled for risk stratification. Even though its value has been questioned, inducibility of VTs/VF at programmed electric stimulation is widely used to select candidates to receive a prophylactic implantable cardiac defibrillator in these categories. Herein, we report a patient with type I Electrocardiogram (ECG pattern induced at the Ajmaline test and a family history of sudden cardiac death who had episodes of palpitations. We describe and discuss our management proving the importance of complete electrophysiological testing in the setting of Brugada asymptomatic patients’ risk stratification.

  11. AIDS Cholangiopathy in an Asymptomatic, Previously Undiagnosed Late-Stage HIV-Positive Patient from Kenya

    Directory of Open Access Journals (Sweden)

    Yiming Gao

    2011-01-01

    Full Text Available AIDS-associated cholangiopathy is a form of biliary tract inflammation with stricture formation seen in AIDS patients who are severely immunosuppressed. It is no longer common in countries in which HAART therapy is widely employed but is still seen in underdeveloped countries. The majority of patients are symptomatic at the time of presentation. Herein, we describe a seventy-four-year-old woman who presented with unilateral leg swelling after a prolonged airplane flight. She was otherwise entirely asymptomatic. Routine laboratory testing was notable for a hypochromic microcytic anemia, slight leukopenia, and mild hypoalbuminemia. Liver enzymes were all elevated. Deep venous thrombosis was confirmed, and a CT scan of the chest disclosed no pulmonary emboli. However, the visualized portion of the abdomen showed dilatation of the common bile and pancreatic ducts. This was confirmed on ultrasonography and MRCP, and no obstructive lesions were noted. An ERCP revealed a dilated common bile duct without filling defects or strictures. A balloon occlusion cholangiogram showed strictures and beading of the intrahepatic ducts. Shortly thereafter, serology for HIV returned positive along with a depressed CD4 cell count, and the patient was diagnosed with AIDS-associated cholangiography.

  12. Current strategy for treatment of patients with Wolff-Parkinson-White syndrome and asymptomatic preexcitation in Europe

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Dagres, Nikolaos; Dobreanu, Dan;

    2013-01-01

    The aims of this survey was to provide insight into treatment activity, the strategy of treatment, and risk stratification of patients with asymptomatic and symptomatic ventricular pre-excitation across Europe. Fifty-eight centres, members of the European Heart Rhythm Association EP research...

  13. 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 ste...

  14. Impairment of myocardial blood flow reserve in patients with asymptomatic left ventricular dysfunction : Effects of ACE-inhibition with perindopril

    NARCIS (Netherlands)

    van den Heuvel, AFM; Blanksma, PK; Siebelink, HMJ; van Wijk, LM; Boomsma, F; Vaalburg, W; Crijns, HJGM; van Veldhuisen, DJ

    2001-01-01

    Myocardial blood flow (MBF) reserve is impaired in patients with symptomatic chronic heart failure. Whether this is already present in asymptomatic left ventricular (LV) dysfunction, and whether it is affected by angiotensin converting enzyme (ACE) inhibition, is unknown. We examined MBF in 20 patie

  15. Low-flow aortic stenosis in asymptomatic patients: valvular-arterial impedance and systolic function from the SEAS Substudy

    DEFF Research Database (Denmark)

    Cramariuc, Dana; Cioffi, Giovanni; Rieck, Ashild E;

    2009-01-01

    OBJECTIVES: This study sought to assess the impact of valvuloarterial impedance on left ventricular (LV) myocardial systolic function in asymptomatic aortic valve stenosis (AS). BACKGROUND: In atherosclerotic AS, LV global load consists of combined valvular and arterial resistance to LV ejection....... preserved. (An Investigational Drug on Clinical Outcomes in Patients With Aortic Stenosis [Narrowing of the Major Blood Vessel of the Heart]; NCT00092677)....

  16. The impact of asymptomatic helminth co-infection in patients with newly diagnosed tuberculosis in north-west Ethiopia

    DEFF Research Database (Denmark)

    Abate, Ebba; Belayneh, Meseret; Gelaw, Aschalew;

    2012-01-01

    Areas endemic of helminth infection, tuberculosis (TB) and HIV are to a large extent overlapping. The aim of this study was to assess the impact of asymptomatic helminth infection on the immunological response among TB patients with and without HIV, their house hold contacts and community controls....

  17. Vitamin D Levels and Asymptomatic Coronary Artery Disease in Type 2 Diabetic Patients With Elevated Urinary Albumin Excretion Rate

    OpenAIRE

    Joergensen, Christel; Reinhard, Henrik; Schmedes, Anne; Hansen, Peter R; Wiinberg, Niels; Petersen, Claus L; Winther, Kaj; Parving, Hans-Henrik; Jacobsen, Peter K; Rossing, Peter

    2011-01-01

    OBJECTIVE Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients. RESEARCH DESIGN AND METHODS We investigated the association among severe vitamin D deficiency, coronary calcium score (CCS), and asymptomatic CAD in type 2 diabetic patients with elevated urinary albumin excretion rate (UAER) >30 mg/24 h. This was a cross-sectional study in...

  18. Plasmodium falciparum Merozoite Surface Protein-1 Polymorphisms among Asymptomatic Sickle Cell Anemia Patients in Nigeria.

    Science.gov (United States)

    Bamidele Abiodun, Iwalokun; Oluwadun, Afolabi; Olugbenga Ayoola, Aina; Senapon Olusola, Iwalokun

    2016-01-01

    Asymptomatic malaria (ASM) has been implicated in the development of hemolytic crisis in infected sickle cell anemia (SCA) patients worldwide. This study surveyed steady state SCA Nigerian patients for ASM to investigate the influence of malaria prevention behaviors and age on parasitaemia and multiplicity of infection (MOI). A total of 78 steady SCA patients aged 5 - 27 years on routine care at three health facilities in Lagos were investigated for ASM by light microscopy and PCR with a multiplicity of infection determined by genotyping block 2 of merozoite surface protein 1 (msp1) gene of Plasmodium falciparum (P. falciparum). Use of malaria prevention measures was captured using a semi-structured questionnaire. The prevalence rates of ASM (due to Pf only) by microscopy and PCR were found to be 27.3% and 47.4% respectively (P < 0.05) with a Mean + SEM parasite density of 2238.4 + 464.3 parasites/uL. Five distinct msp1 genotypes [K1 (2), MAD20 (2), RO33 (1)] were detected and significant (P<0.05) disparity in allele frequencies (K1, 91.8%, MAD20, 32.4%; RO33, 18.9%) was found. The overall MOI was 1.43 and 37.8% of infections were polyclonal (P<0.05). ASM was associated with non-use of preventive measures and occurred in 62.1% of SCA patients aged < 10y with lower MOI of 1.3 compared to 38.1% in older patients with a higher MOI of 1.5 (P<0.05). We conclude that PCR improved the diagnosis of ASM among Nigerian SCA patients with infections being of low complexity and associated with non-use of preventive interventions and R033 msp1 allele selection. PMID:26853290

  19. Plasmodium falciparum Merozoite Surface Protein-1 Polymorphisms among Asymptomatic Sickle Cell Anemia Patients in Nigeria

    Directory of Open Access Journals (Sweden)

    Iwalokun Bamidele Abiodun

    2016-01-01

    Full Text Available Asymptomatic malaria (ASM has been implicated in the development of hemolytic crisis in infected sickle cell anemia (SCA patients worldwide. This study surveyed steady state SCA Nigerian patients for ASM to investigate the influence of malaria prevention behaviors and age on parasitaemia and multiplicity of infection (MOI. A total of 78 steady SCA patients aged 5 – 27 years on routine care at three health facilities in Lagos were investigated for ASM by light microscopy and PCR with a multiplicity of infection determined by genotyping block 2 of merozoite surface protein 1 (msp1 gene of Plasmodium falciparum (P. falciparum. Use of malaria prevention measures was captured using a semi-structured questionnaire. The prevalence rates of ASM (due to Pf only by microscopy and PCR were found to be 27.3% and 47.4% respectively (P < 0.05 with a Mean + SEM parasite density of 2238.4 + 464.3 parasites/uL. Five distinct msp1 genotypes [K1 (2, MAD20 (2, RO33 (1] were detected and significant (P<0.05 disparity in allele frequencies (K1, 91.8%, MAD20, 32.4%; RO33, 18.9% was found. The overall MOI was 1.43 and 37.8% of infections were polyclonal (P<0.05. ASM was associated with non-use of preventive measures and occurred in 62.1% of SCA patients aged < 10y with lower MOI of 1.3 compared to 38.1% in older patients with a higher MOI of 1.5 (P<0.05. We conclude that PCR improved the diagnosis of ASM among Nigerian SCA patients with infections being of low complexity and associated with non-use of preventive interventions and R033 msp1 allele selection.

  20. CT measurement of changes in cerebral perfusion in patients with asymptomatic carotid artery stenosis undergoing carotid stenting prior to cardiac surgery: "proof of principle"

    NARCIS (Netherlands)

    Heyden, J. Van der; Waaijer, A.; Wouter, E.S. Van; Neerven, D. van; Sonker, U.; Suttorp, M.J.; Bal, E.T.; Prokop, M.

    2011-01-01

    AIMS: To identify asymptomatic patients with impaired cerebral perfusion using CT perfusion (CTP) technique during staged carotid stenting (CAS) and cardiac surgery. METHODS AND RESULTS: This is a prospective, non-randomised study in 16 neurologically asymptomatic patients designed to analyse cerebr

  1. Cold pressor test myocardial perfusion SPECT as a predictor of the development of ischemia at exercise in the follow up of asymptomatic patients with moderate cardiovascular risk

    International Nuclear Information System (INIS)

    Introduction: Previous studies have published the correlation between myocardial perfusion SPECT (MP) during cold pressor test (CPT) and intracoronary acetylcholine and its usefulness as independent marker of endothelial dysfunction (ED). Objective: To analyze the incidence of positivization of MP exercise studies in the follow up of asymptomatic patients with moderate cardiovascular risk (CV) and ED detected by PF. Material and Methods: Of 301 patients of the PARADIGMA Registry (normal exercise MP SPECT and clinical probability < 20% of events at 10 years [moderate risk by Framingham index]) 55 had positive PF (+) (18.3%). Prospectively and consecutively, 15 asymptomatic patients with PF (+), and a control group (CG) of 15 patients with negative PF, with paired sex, age and coronary risk factors (CRF), that accomplished a 12 ± 2 months follow up, and that underwent a new exercise and resting MP SPECT were analyzed. An MP extension score was used in a model of 17 segments. The CRF and the incidence of ischemia during follow up exercise MP of each group were assessed. Results: Age: PF (-) 57.3 ± 8.9 versus TF (+) 52.5 ± 7.5 (p = 0,09). Positivized the exercise MP: PF group (+) 5/15: 33.3% and 0 in the CG (p=0.04). No statistically significant differences between CRF in both groups. Conclusions: An abnormal MP SPECT during PF in asymptomatic patients with moderate CV risk differentiated those patients who positivized exercise MP studies at one year follow up and there were no abnormal studies in the control group. (author)

  2. 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.

  3. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients

    Directory of Open Access Journals (Sweden)

    Rege Inara Carneiro

    2012-08-01

    Full Text Available Abstract Background Although cone beam computed tomography (CBCT images of the maxillofacial region allow the inspection of the entire volume of the maxillary sinus (MS, identifying anatomic variations and abnormalities in the image volume, this is frequently neglected by oral radiologists when interpreting images of areas at a distance from the dentoalveolar region, such as the full anatomical aspect of the MS. The aim of this study was to investigate maxillary sinus abnormalities in asymptomatic patients by using CBCT. Methods 1113 CBCT were evaluated by two examiners and identification of abnormalities, the presence of periapical lesions and proximity to the lower sinus wall were recorded. Data were analyzed using descriptive statistics, chi-square tests and Kappa statistics. Results Abnormalities were diagnosed in 68.2% of cases (kappa = 0.83. There was a significant difference between genders (p Conclusions Abnormalities in maxillary sinus emphasizes how important it is for the dentomaxillofacial radiologist to undertake an interpretation of the whole volume of CBCT images.

  4. Tax secretion from peripheral blood mononuclear cells and Tax detection in plasma of patients with human T-lymphotropic virus-type 1-associated myelopathy/tropical spastic paraparesis and asymptomatic carriers.

    Science.gov (United States)

    Medina, Fernando; Quintremil, Sebastián; Alberti, Carolina; Godoy, Fabián; Pando, María E; Bustamante, Andrés; Barriga, Andrés; Cartier, Luis; Puente, Javier; Tanaka, Yuetsu; Valenzuela, María A; Ramírez, Eugenio

    2016-03-01

    Human T-lymphotropic virus-type 1 (HTLV-1) is the etiologic agent of the neurologic disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Tax viral protein plays a critical role in viral pathogenesis. Previous studies suggested that extracellular Tax might involve cytokine-like extracellular effects. We evaluated Tax secretion in 18 h-ex vivo peripheral blood mononuclear cells (PBMCs) cultures from 15 HAM/TSP patients and 15 asymptomatic carriers. Futhermore, Tax plasma level was evaluated from other 12 HAM/TSP patients and 10 asymptomatic carriers. Proviral load and mRNA encoding Tax were quantified by PCR and real-time RT-PCR, respectively. Intracellular Tax in CD4(+)CD25(+) cells occurred in 100% and 86.7% of HAM/TSP patients and asymptomatic carriers, respectively. Percentage of CD4(+)CD25(+) Tax+, proviral load and mRNA encoding Tax were significantly higher in HAM/TSP patients. Western blot analyses showed higher secretion levels of ubiquitinated Tax in HAM/TSP patients than in asymptomatic carriers. In HTLV-1-infected subjects, Western blot of plasma Tax showed higher levels in HAM/TSP patients than in asymptomatic carriers, whereas no Tax was found in non-infected subjects. Immunoprecipitated plasma Tax resolved on SDS-PAGE gave two major bands of 57 and 48 kDa allowing identification of Tax and Ubiquitin peptides by mass spectrometry. Relative percentage of either CD4(+)CD25(+) Tax+ cells, or Tax protein released from PBMCs, or plasma Tax, correlates neither with tax mRNA nor with proviral load. This fact could be explained by a complex regulation of Tax expression. Tax secreted from PBMCs or present in plasma could potentially become a biomarker to distinguish between HAM/TSP patients and asymptomatic carriers.

  5. Tax secretion from peripheral blood mononuclear cells and Tax detection in plasma of patients with human T-lymphotropic virus-type 1-associated myelopathy/tropical spastic paraparesis and asymptomatic carriers.

    Science.gov (United States)

    Medina, Fernando; Quintremil, Sebastián; Alberti, Carolina; Godoy, Fabián; Pando, María E; Bustamante, Andrés; Barriga, Andrés; Cartier, Luis; Puente, Javier; Tanaka, Yuetsu; Valenzuela, María A; Ramírez, Eugenio

    2016-03-01

    Human T-lymphotropic virus-type 1 (HTLV-1) is the etiologic agent of the neurologic disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Tax viral protein plays a critical role in viral pathogenesis. Previous studies suggested that extracellular Tax might involve cytokine-like extracellular effects. We evaluated Tax secretion in 18 h-ex vivo peripheral blood mononuclear cells (PBMCs) cultures from 15 HAM/TSP patients and 15 asymptomatic carriers. Futhermore, Tax plasma level was evaluated from other 12 HAM/TSP patients and 10 asymptomatic carriers. Proviral load and mRNA encoding Tax were quantified by PCR and real-time RT-PCR, respectively. Intracellular Tax in CD4(+)CD25(+) cells occurred in 100% and 86.7% of HAM/TSP patients and asymptomatic carriers, respectively. Percentage of CD4(+)CD25(+) Tax+, proviral load and mRNA encoding Tax were significantly higher in HAM/TSP patients. Western blot analyses showed higher secretion levels of ubiquitinated Tax in HAM/TSP patients than in asymptomatic carriers. In HTLV-1-infected subjects, Western blot of plasma Tax showed higher levels in HAM/TSP patients than in asymptomatic carriers, whereas no Tax was found in non-infected subjects. Immunoprecipitated plasma Tax resolved on SDS-PAGE gave two major bands of 57 and 48 kDa allowing identification of Tax and Ubiquitin peptides by mass spectrometry. Relative percentage of either CD4(+)CD25(+) Tax+ cells, or Tax protein released from PBMCs, or plasma Tax, correlates neither with tax mRNA nor with proviral load. This fact could be explained by a complex regulation of Tax expression. Tax secreted from PBMCs or present in plasma could potentially become a biomarker to distinguish between HAM/TSP patients and asymptomatic carriers. PMID:26241614

  6. Frequency of asymptomatic choroidal metastasis in patients with disseminated breast cancer: results of a prospective screening programme

    OpenAIRE

    Wiegel, T.; Kreusel, K. M.; Bornfeld, N; Bottke, D.; M. Stange; Foerster, M.; Hinkelbein, W.

    1998-01-01

    AIM—To determine the frequency of visually asymptomatic choroidal metastasis in patients with disseminated breast cancer and its dependence on the incidence of metastasis by number and site of other organ metastases.
METHODS—From January 1995 until April 1997 120 patients irradiated for disseminated breast cancer underwent ophthalmological screening for choroidal metastasis. No patient was symptomatic for ocular disease. 68 out of 120 patients were found to have metastases in one organ and 52...

  7. Elevated basal intestinal mucosal cytokine levels in asymptomatic first-degree relatives of patients with Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Anant VK Indaram; Santa Nandi; Sam Weissman; Sing Lam; Beverly Bailey; Meyer Blumstein; Ronald Greenberg; Simmy Bank

    2000-01-01

    AIM To determine levels of cytokines in colonic mucosa of asymptomatic first degree relatives of Crohn's disease patients.METHODS Cytokines (Interleukin (IL) 1-Beta,IL-2, IL-6 and IL-8) were measured using ELISA in biopsy samples of normal looking colonic mucosa of first degree relatives of Crohn's disease patients (n = 9) and from normal controls (n=10) with no family history of Crohn's disease.RESULTS Asymptomatic first degree relatives of patients with Crohn's disease had significantly higher levels of basal intestinal mucosal cytokines (IL-2, IL-6 and IL-8) than normal controls. Whether these increased cytokine levels serve as phenotypic markers for a genetic predisposition to developing Crohn's disease later on, or whether they indicate early (preclinical) damage has yet to be further defined.CONCLUSION Asymptomatic first degree relatives of Crohn's disease patients have higher levels of cytokines in their normal-looking intestinal mucosa compared to normal controls.This supports the hypothesis that increased cytokines may be a cause or an early event in the inflammatory cascade of Crohn's disease and are not merely a result of the inflammatory process.

  8. Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Reiss, T.F.; Golden, J. (Univ. of California, San Francisco (USA))

    1990-05-01

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population.

  9. Comparison of erlotinib and pemetrexed as second-/third-line treatment for lung adenocarcinoma patients with asymptomatic brain metastases

    Directory of Open Access Journals (Sweden)

    He YY

    2016-04-01

    Full Text Available Yayi He,1,* Wenwen Sun,2,* Yan Wang,3,* Shengxiang Ren,1 Xuefei Li,3 Jiayu Li,3 Christopher J Rivard,4 Caicun Zhou,1 Fred R Hirsch4 1Department of Oncology, Shanghai Pulmonary Hospital, 2Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, 3Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, People’s Republic of China; 4Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, CO, USA *These authors contributed equally to this work Objective: Brain metastases occur in one-third of all non-small-cell lung cancer patients. Due to restrictive transport at the blood–brain barrier, many drugs provide poor control of metastases in the brain. The aim of this study was to compare erlotinib with pemetrexed as second-/third-line treatment in patients with lung adenocarcinoma with asymptomatic brain metastases.Methods: From January 2012 to June 2014, all lung adenocarcinoma patients with asymptomatic brain metastases who received treatment with erlotinib or pemetrexed as second-/third-line treatment were retrospectively reviewed. Chi-square and log-rank tests were used to perform statistical analysis.Results: The study enrolled 99 patients, of which 44 were positive for EGFR mutation. Median progression-free survival (PFS in months was not significantly different between the erlotinib- and pemetrexed-treated groups (4.2 vs 3.4 months; 95% confidence interval [CI]: 2.01–6.40 vs 2.80–5.00, respectively; P=0.635. Median PFS was found to be significantly longer in EGFR mutation–positive patients in the erlotinib-treated group (8.0 months; 95% CI 5.85–10.15 compared to the pemetrexed group (3.9 months; 95% CI: 1.25–6.55; P=0.032. The most common treatment-related side effect was mild-to-moderate rash and the most common drug-related side

  10. Differences in Surface-Exposed Antigen Expression between Helicobacter pylori Strains Isolated from Duodenal Ulcer Patients and from Asymptomatic Subjects

    OpenAIRE

    Thoreson, Ann-Catrin E.; Hamlet, Annika; Çelik, Janet; Byström, Mona; Nyström, Susanne; Olbe, Lars; Svennerholm, Ann-Mari

    2000-01-01

    We have analyzed possible qualitative and quantitative differences in antigen expression between Helicobacter pylori strains isolated from the antrum and different locations in the duodenum of 21 duodenal ulcer (DU) patients and 20 asymptomatic subjects (AS) by enzyme-linked immunosorbent assay (ELISA) and inhibition ELISA. Almost all antral and duodenal strains grown in vitro expressed the N-acetyl-neuroaminyllactose-binding hemagglutinin, flagellins (subunits FlaA and FlaB), urease, a 26-kD...

  11. Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia

    Energy Technology Data Exchange (ETDEWEB)

    Donati, Francescamaria, E-mail: fra.donati@katamail.co [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy); Boraschi, Piero; Gigoni, Roberto; Salemi, Simonetta [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy); Faggioni, Lorenzo; Bertucci, Cristina; Cecchi, Claudia; Bartolozzi, Carlo [Diagnostic and Interventional Radiology, University of Pisa, Via Rome 67, I-56126 Pisa (Italy); Falaschi, Fabio [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy)

    2010-08-15

    Purpose: To assess the diagnostic value of secretin-stimulated MRCP (SS-MRCP) compared with conventional MRCP in asymptomatic patients with mild elevations of pancreatic enzymes. Materials and methods: Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5 T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequence, repeated every 30 s up to 15 min following intravenous injection of secretin (Secrelux, Sanochemia). Results: On the basis of the standards of reference, our final diagnoses were: negative findings (n = 23), pancreas divisum (n = 22), mild chronic pancreatitis (n = 14), inflammatory ampullary stenosis (n = 3), juxtapapillary duodenal diverticulum (n = 1), small cystic lesions (<1 cm) (n = 22; 5/22 cases associated with pancreas divisum). The image quality of SS-MRCP was significantly higher than that of conventional MRCP (p < 0.0001). Standards of reference did not differ significantly from of SS-MRCP findings (p = 0.5), while was statistically different from those of conventional MRCP (p < 0.0001). A significant difference was found between conventional MRCP and SS-MRCP findings (p < 0.0001). Conclusion: In asymptomatic patients with non-specific pancreatic hyperenzymemia SS-MRCP may represent the best non-invasive diagnostic technique, since it gives morphological and functional information.

  12. Asymptomatic hyperamylasemia and hyperlipasemia in pediatric patients with toxic epidermal necrolysis.

    Science.gov (United States)

    Dylewski, Maggie L; Prelack, Kathy; Keaney, Timothy; Sheridan, Robert L

    2010-01-01

    Although pancreatitis is rare in pediatric burn patients, elevated pancreatic enzymes have been recently observed among toxic epidermal necrolysis (TEN) patients. This clinical phenomenon has implications particularly for the nutritional management of patients involved. The objective of this study was to assess the frequency of sustained, elevated amylase, and lipase enzymes among children with TEN or Stevens Johnson Syndrome (SJS) and to evaluate the utilization of enteral nutrition support in this population. Medical records of 24 patients admitted to our hospital between January 1994 and October 2008 with TEN or SJS were retrospectively reviewed. Only patients with > or =4 consecutive measures for both amylase and lipase were included in this study (n = 10). Serial laboratory values were collected during the first 30 days of disease. Four patients (40%) had elevated amylase and lipase values, whereas six patients had values within normal limits. Patients with elevated pancreatic enzymes were significantly younger in age (4.7 +/- 1.7 years) than patients without elevated enzymes (11 +/- 5.9 years) and also had a higher incidence of sepsis. All other characteristics were similar between the groups. Enteral nutrition support was initiated within 4 days of admission in all 10 patients and did not correlate with elevated enzymes. Our findings suggest that hyperlipasemia and hyperamylasemia can occur in the pediatric population with TEN or SJS. Although the sample size in this study makes it difficult to determine the cause, sepsis may have been a contributing factor. In the absence of symptomatic pancreatitis, patients with TEN can safely meet nutritional goals orally or with standard enteral nutrition support.

  13. Proton 1H- and Phosphorus 31P-MR spectroscopy (MRS in asymptomatic HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Gundolf Schuettfort

    2014-11-01

    Full Text Available Introduction: HIV infection is accompanied by a variety of neurological disorders. Depression of cell-mediated immunity is followed by the development of central nervous system opportunistic infections/tumours, and frequently by the occurrence of the AIDS dementia complex (ADC. However, the pathophysiology of the emergence of neuro-AIDS is still unknown. Despite the development of cognitive impairments, the early diagnosis, objectification and quantification of the existence and extent of this impairment during infection are difficult to recognize in each individual case. To support the early diagnosis of ADC, there is a need for additional, non-invasive diagnostic methods. In this study, it is of interest to answer the clinically relevant question of whether magnetic resonance spectroscopy can detect changes in the cerebral metabolism of asymptomatic HIV-positive patients and is possibly suitable for the early diagnosis and prevention of HIV encephalopathy. Methods: A group of 13 asymptomatic, HIV-positive patients with combined antiretroviral therapy (cART and 13 healthy controls were examined with 2D 1H-MRS and 3D 31P-MRS at 3T. The patients were treated with cART for at least 12 months. Changes in the absolute concentrations of phosphorylated metabolites (ATP, N-acetyl-aspartate, creatine, myo-Isonitol, glutamate/glutamine and choline-containing compounds were compared with that of control subjects. Results: Asymptomatic HIV-positive patients had significantly lower N-acetyl-aspartate in the white matter in a frontal and parietal target region. The other evaluated metabolites in the 1H MRS showed no significant difference between the HIV-positive patients and healthy controls. The 31P-MRS detected significant elevated values regarding the choline-containing compounds PEth, GPE and PCho. Conclusions: This spectroscopic study revealed a significantly lower N-acetyl-aspartate in the white matter in a frontal and parietal cerebral target region

  14. Examine the patient not the hernia: identification of an asymptomatic giant primary retroperitoneal pseudocyst. A case report and literature review

    Science.gov (United States)

    Karim, Lawen; Larkin, David; Sadat, Mohamed

    2016-01-01

    We present the case of a 70-year-old man with a giant right-sided retroperitoneal pseudocyst, confirmed histologically after resection to be benign with appearances dissimilar to pancreatic and adrenal tissue. The cyst was noted incidentally on table at the time of laparoscopic surgery. Retroperitoneal pseudocysts most commonly arise from the pancreas and adrenal glands occurring as a result of an inflammatory process. Primary retroperitoneal pseudocysts are a rare entity. This case highlights the importance of examining the patient thoroughly and not focusing on the obvious. The mass was not palpated on initial review prior to listing for surgery, and the patient was asymptomatic from the mass. PMID:27190202

  15. Examine the patient not the hernia: identification of an asymptomatic giant primary retroperitoneal pseudocyst. A case report and literature review.

    Science.gov (United States)

    Karim, Lawen; Larkin, David; Sadat, Mohamed

    2016-01-01

    We present the case of a 70-year-old man with a giant right-sided retroperitoneal pseudocyst, confirmed histologically after resection to be benign with appearances dissimilar to pancreatic and adrenal tissue. The cyst was noted incidentally on table at the time of laparoscopic surgery. Retroperitoneal pseudocysts most commonly arise from the pancreas and adrenal glands occurring as a result of an inflammatory process. Primary retroperitoneal pseudocysts are a rare entity. This case highlights the importance of examining the patient thoroughly and not focusing on the obvious. The mass was not palpated on initial review prior to listing for surgery, and the patient was asymptomatic from the mass.

  16. Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Kumiko; Yamano, Shigeru; Ikeda, Yukiko [Nara Medical Univ., Kashihara (Japan)] (and others)

    1999-10-01

    To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

  17. Can fish oil supplementation improve endothelial function in asymptomatic offspring of patients with peripheral arterial disease?

    Directory of Open Access Journals (Sweden)

    Spark JI

    2013-07-01

    maintain a diary of fish oil consumption on a daily basis, and fish oil returned will be measured to confirm adherence. Participants will complete validated surveys to determine background diet and physical activity levels.Discussion: This study will examine the effectiveness of a moderate-dose fish oil intervention in reversing endothelial dysfunction in asymptomatic offspring of patients with peripheral arterial disease. It provides the opportunity to delay the progression of peripheral arterial disease using a cheap and readily available dietary supplement that has minimal side effects compared with synthetic vasoactive pharmacological medications.Keywords: omega 3 fatty acids, endothelial function, peripheral arterial disease

  18. MRI plaque imaging detects carotid plaques with a high risk for future cerebrovascular events in asymptomatic patients.

    Directory of Open Access Journals (Sweden)

    Lorena Esposito-Bauer

    Full Text Available PURPOSE: The aim of this study was to investigate prospectively whether MRI plaque imaging can identify patients with asymptomatic carotid artery stenosis who have an increased risk for future cerebral events. MRI plaque imaging allows categorization of carotid stenosis into different lesion types (I-VIII. Within these lesion types, lesion types IV-V and VI are regarded as rupture-prone plaques, whereas the other lesion types represent stable ones. METHODS: Eighty-three consecutive patients (45 male (54.2%; age 54-88 years (mean 73.2 years presenting with an asymptomatic carotid stenosis of 50-99% according to ECST-criteria were recruited. Patients were imaged with a 1.5-T scanner. T1-, T2-, time-of-flight-, and proton-density weighted studies were performed. The carotid plaques were classified as lesion type I-VIII. Clinical endpoints were ischemic stroke, TIA or amaurosis fugax. Survival analysis and log rank test were used to ascertain statistical significance. RESULTS: Six out of 83 patients (7.2% were excluded: 4 patients had insufficient MR image quality; 1 patient was lost-to-follow-up; 1 patient died shortly after the baseline MRI plaque imaging. The following results were obtained by analyzing the remaining 77 patients. The mean time of follow-up was 41.1 months. During follow-up, n = 9 (11.7% ipsilateral ischemic cerebrovascular events occurred. Only patients presenting with the high-risk lesion types IV-V and VI developed an ipsilateral cerebrovascular event versus none of the patients presenting with the stable lesion types III, VII, and VIII (n = 9 (11.7% vs. n = 0 (0% during follow-up. Event-free survival was higher among patients with the MRI-defined stable lesion types (III, VII, and VIII than in patients with the high-risk lesion types (IV-V and VI (log rank test P<0.0001. CONCLUSIONS: MRI plaque imaging has the potential to identify patients with asymptomatic carotid stenosis who are particularly at risk of

  19. The relationship between brain atrophy and asymptomatic cerebral lesions

    International Nuclear Information System (INIS)

    In order to clarify the relationship between brain atrophy and asymptomatic cerebral lesions, total of 235 subjects (130 males and 105 females), who had neither neurologic deficits nor organic lesions on cerebral computed tomography, were studied. The subjects' ages ranged from 40 to 86 years (mean 66). They were divided into two groups: 90 controls without hypertension or diabetes mellitus (Group C), and 145 patients with essential hypertension (Group H). Brain atrophy was diagnosed using the caudate head index (CHI). Asymptomatic cerebral lesions on magnetic resonance imaging were defined as asymptomatic lacunae and white matter lesions. Caudate head index was higher in Group H than it was in Group C, and CHI in both groups was significantly correlated with the number of asymptomatic lacunae and the severity of white matter lesions on magnetic resonance imaging. These results indicate that brain atrophy may progress along with asymptomatic cerebral lesions. (author)

  20. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection

    International Nuclear Information System (INIS)

    The present study evaluated the diagnostic performance of 2-[18F] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection. We retrospectively recruited 190 gastric cancer patients (115 early gastric cancer patients and 75 advanced gastric cancer patients) who underwent 1-year (91 patients) or 2-year (99 patients) postoperative FDG PET/CT surveillance, along with a routine follow-up program, after curative surgical resection. All enrolled patients were asymptomatic and showed no recurrence on follow-up examinations performed before PET/CT surveillance. All PET/CT images were visually assessed and all abnormal findings on follow-up examinations including FDG PET/CT were confirmed with histopathological diagnosis or clinical follow-up. During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients. Post-operative FDG PET/CT surveillance showed good diagnostic ability for detecting recurrence in gastric cancer patients. FDG PET/CT could be a useful follow-up modality for gastric cancer patients, especially those with advanced gastric cancer

  1. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Lee, Sang Mi [Soonchunhyang University Hospital, Department of Nuclear Medicine, 23-20 Byeongmyeong-dong, Dongnam-gu, Chungcheongnam-do, Cheonan (Korea, Republic of); Son, Myoung Won; Lee, Moon-Soo [Soonchunhyang University Hospital, Department of Surgery, Cheonan (Korea, Republic of)

    2016-05-15

    The present study evaluated the diagnostic performance of 2-[{sup 18}F] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection. We retrospectively recruited 190 gastric cancer patients (115 early gastric cancer patients and 75 advanced gastric cancer patients) who underwent 1-year (91 patients) or 2-year (99 patients) postoperative FDG PET/CT surveillance, along with a routine follow-up program, after curative surgical resection. All enrolled patients were asymptomatic and showed no recurrence on follow-up examinations performed before PET/CT surveillance. All PET/CT images were visually assessed and all abnormal findings on follow-up examinations including FDG PET/CT were confirmed with histopathological diagnosis or clinical follow-up. During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients. Post-operative FDG PET/CT surveillance showed good diagnostic ability for detecting recurrence in gastric cancer patients. FDG PET/CT could be a useful follow-up modality for gastric cancer patients, especially those with advanced gastric cancer

  2. Prevalence and risk factors of asymptomatic bronchiectasis in patients with rheumatoid arthritis at a tertiary care center in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Suzan Mansour Attar

    2015-01-01

    Full Text Available Introduction and Objectives: Bronchiectasis is a pulmonary manifestation that often occurs in individuals with rheumatoid arthritis (RA. Nevertheless, the prevalence of bronchiectasis in RA patients and predictors of its development/progression remain ill-defined. Our objective was to investigate the prevalence of bronchiectasis in a group of RA patients and examine possible clinical or biochemical risk factors that might contribute to its development. Methods: This was an observational study analyzing 100 RA patients with no pulmonary symptoms selected from King Abdulaziz University Hospital in the Western region of Saudi Arabia from October 2013 to 2014. Demographic, clinical and laboratory information were collected for all patients. Diagnosis was based on the 2010 American College of Rheumatology (ACR/European League Against Rheumatism (EULAR classification system, and disease activity was assessed using the 28-Joint Disease Activity Score Index with C-reactive protein; high-resolution computed tomography chest scans were performed. The prevalence of bronchiectasis was recorded and its association with different risk factors was examined using standard statistical methods. Results: All 100 patients fulfilled the ACR and EULAR classification criteria for RA diagnosis. Their mean age was 51.05 ± 13.5 years, disease duration was 6.19 ± 6.4 years and disease activity index was 4 ± 1.3 (moderate activity. A total of 35 (35% patients developed bronchiectasis. Notably, we observed significant positive associations of bronchiectasis with age, disease duration and male gender (P < 0.001, P = 0.006, P = 0.028, respectively. Conclusions: Asymptomatic bronchiectasis represents a common complication in moderately active RA patients within the Western Region of Saudi Arabia. Furthermore, several predictors of bronchiectasis development were identified, which can contribute to effective risk stratification in RA patients. Further prospective studies are

  3. Arm exercise testing with myocardial scintigraphy in asymptomatic patients with peripheral vascular disease

    International Nuclear Information System (INIS)

    Arm exercise with myocardial scintigraphy and oxygen consumption determinations was performed by 33 men with peripheral vascular disease, 40 to 74 years of age (group 2). None had evidence of coronary disease. Nineteen age-matched male control subjects (group 1) were also tested to determine the normal endurance and oxygen consumption during arm exercise in their age group and to compare the results with those obtained during a standard treadmill performance. The maximal heart rate, systolic blood pressure, pressure rate product, and oxygen consumption were all significantly lower for arm than for leg exercise. However, there was good correlation between all these parameters for both types of exertion. The maximal heart rate, work load and oxygen consumption were greater for group 1 subjects than in patients with peripheral vascular disease despite similar activity status. None of the group 1 subjects had abnormal arm exercise ECGs, while six members of group 2 had ST segment changes. Thallium-201 scintigraphy performed in the latter group demonstrated perfusion defects in 25 patients. After nine to 29 months of follow-up, three patients who had abnormal tests developed angina and one of them required coronary bypass surgery. Arm exercise with myocardial scintigraphy may be an effective method of detecting occult ischemia in patients with peripheral vascular disease. Those with good exercise tolerance and no electrocardiographic changes or 201T1 defects are probably at lower risk for the development of cardiac complications, while those who develop abnormalities at low exercise levels may be candidates for invasive studies

  4. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    International Nuclear Information System (INIS)

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation

  5. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Girinsky, Theodore, E-mail: girinsky.theodore@orange.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); M’Kacher, Radhia [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Lessard, Nathalie [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Koscielny, Serge [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Elfassy, Eric; Raoux, François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France); Carde, Patrice [Department of Hematology, Institut Gustave Roussy, Villejuif (France); Santos, Marcos Dos [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Margainaud, Jean-Pierre [Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif (France); Sabatier, Laure [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Ghalibafian, Mithra [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Paul, Jean-François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France)

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  6. Evidence for a Specific Diabetic Cardiomyopathy: An Observational Retrospective Echocardiographic Study in 656 Asymptomatic Type 2 Diabetic Patients.

    Science.gov (United States)

    Pham, Isabelle; Cosson, Emmanuel; Nguyen, Minh Tuan; Banu, Isabela; Genevois, Isabelle; Poignard, Patricia; Valensi, Paul

    2015-01-01

    Aim. Our aim was to assess the prevalence of subclinical diabetic cardiomyopathy, occurring among diabetic patients without hypertension or coronary artery disease (CAD). Methods. 656 asymptomatic patients with type 2 diabetes for 14 ± 8 years (359 men, 59.7 ± 8.7 years old, HbA1c 8.7 ± 2.1%) and at least one cardiovascular risk factor had a cardiac echography at rest, a stress cardiac scintigraphy to screen for silent myocardial ischemia (SMI), and, in case of SMI, a coronary angiography to screen for silent CAD. Results. SMI was diagnosed in 206 patients, and 71 of them had CAD. In the 157 patients without hypertension or CAD, left ventricular hypertrophy (LVH: 24.1%) was the most frequent abnormality, followed by left ventricular dilation (8.6%), hypokinesia (5.3%), and systolic dysfunction (3.8%). SMI was independently associated with hypokinesia (odds ratio 14.7 [2.7-81.7], p < 0.01) and systolic dysfunction (OR 114.6 [1.7-7907], p < 0.01), while HbA1c (OR 1.9 [1.1-3.2], p < 0.05) and body mass index (OR 1.6 [1.1-2.4], p < 0.05) were associated with systolic dysfunction. LVH was more prevalent among hypertensive patients and hypokinesia in the patients with CAD. Conclusion. In asymptomatic type 2 diabetic patients, diabetic cardiomyopathy is highly prevalent and is predominantly characterized by LVH. SMI, obesity, and poor glycemic control contribute to structural and functional LV abnormalities. PMID:26074964

  7. Evidence for a Specific Diabetic Cardiomyopathy: An Observational Retrospective Echocardiographic Study in 656 Asymptomatic Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Isabelle Pham

    2015-01-01

    Full Text Available Aim. Our aim was to assess the prevalence of subclinical diabetic cardiomyopathy, occurring among diabetic patients without hypertension or coronary artery disease (CAD. Methods. 656 asymptomatic patients with type 2 diabetes for 14 ± 8 years (359 men, 59.7 ± 8.7 years old, HbA1c 8.7 ± 2.1% and at least one cardiovascular risk factor had a cardiac echography at rest, a stress cardiac scintigraphy to screen for silent myocardial ischemia (SMI, and, in case of SMI, a coronary angiography to screen for silent CAD. Results. SMI was diagnosed in 206 patients, and 71 of them had CAD. In the 157 patients without hypertension or CAD, left ventricular hypertrophy (LVH: 24.1% was the most frequent abnormality, followed by left ventricular dilation (8.6%, hypokinesia (5.3%, and systolic dysfunction (3.8%. SMI was independently associated with hypokinesia (odds ratio 14.7 [2.7–81.7], p<0.01 and systolic dysfunction (OR 114.6 [1.7–7907], p<0.01, while HbA1c (OR 1.9 [1.1–3.2], p<0.05 and body mass index (OR 1.6 [1.1–2.4], p<0.05 were associated with systolic dysfunction. LVH was more prevalent among hypertensive patients and hypokinesia in the patients with CAD. Conclusion. In asymptomatic type 2 diabetic patients, diabetic cardiomyopathy is highly prevalent and is predominantly characterized by LVH. SMI, obesity, and poor glycemic control contribute to structural and functional LV abnormalities.

  8. Asymptomatic ocular sarcoidosis

    Directory of Open Access Journals (Sweden)

    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.

  9. Allopurinol inappropriate use in case of asymptomatic hyperuricemic patient causes fatal Allopurinol hypersensitive syndrome: lesson to all

    Directory of Open Access Journals (Sweden)

    Arvind Kumar

    2015-12-01

    Full Text Available Allopurinol is used to treat hyperuricemia (HU in a patient of gout. It is also used to prevent HU in a patient of hematological malignancies who are about to undergo chemotherapy. Allopurinol is usually well-tolerated but it occasionally induces hypersensitivity reactions that manifest after few months of therapy. Cutaneous reactions are pruritic, erythematous, or maculopapular eruptions. Rarely fatal toxic epidermal necrolysis or Stevens-Johnson syndrome may occur. Transient leukopenia or leukocytosis, eosinophilia and elevated transaminases may also occur. HU is not a disease in itself. Its level is highly variable in the general population. Uric acid level is influenced by many factors such as dietary intake of proteins, hypertension, and obesity. Only very rarely patients of AHU may progress to gout and renal stones. Not much data is available that support HU alone in an asymptomatic patient in later life shows the diseases which are associated with HU. Sometimes only lifestyle changes, diet restrictions, alcohol restrictions, and treatment of underlying acquired cause may correct HU. Here, we are presenting a rare case of allopurinol hypersensitivity syndrome in an AHU patient. Our aim is to raise awareness among physicians so that they avoid using unnecessarily allopurinol in AHU patients and also titrate the dose of allopurinol in patients of renal failure. Risk-benefit ratio must be considered in these patients before starting allopurinol. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1302-1304

  10. Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Portopulmonary hypertension (PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension, with or without advanced hepatic disease. Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state. Similar signs of advanced liver disease can be observed in severe PPH, with ascites and lower extremity edema. Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation (LT). We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis. Since this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years, it was necessary to send him to the intensive care unit after operation. Further study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

  11. Prevalence and predictors of an abnormal stress myocardial perfusion study in asymptomatic patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Scholte, Arthur J.H.A.; Schuijf, Joanne D.; Wall, Ernst E. van der; Bax, Jeroen J. [Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Kharagjitsingh, Antje V. [Medisch Centrum Haaglanden, Department of Internal Medicine, The Hague (Netherlands); Dibbets-Schneider, Petra; Stokkel, Marcel P. [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands)

    2009-04-15

    The purpose of this study was to evaluate the prevalence of an abnormal stress myocardial perfusion study in a cohort of truly asymptomatic patients with type 2 diabetes mellitus using myocardial perfusion imaging by means of single photon emission computed tomography (SPECT). Secondly, we determined which clinical characteristics may predict an abnormal stress myocardial perfusion study in this population. A total of 120 asymptomatic patients (mean age 53{+-}10 years) with type 2 diabetes mellitus and one or more risk factors for coronary artery disease were prospectively recruited from an outpatient diabetes clinic. All patients underwent myocardial perfusion imaging by means of adenosine {sup 99m}Tc sestamibi SPECT. Images were evaluated for the presence of perfusion abnormalities as well as other nonperfusion abnormalities that may indicate extensive ischaemia, including left ventricular dysfunction (defined as a left ventricular ejection fraction <45%), transient ischaemic dilatation and adenosine-induced ST segment depression. Multivariable analysis was performed using a backward selection strategy to identify potential predictors for an abnormal stress myocardial perfusion study. Finally, all patients were followed up for 12 months to determine the occurrence of cardiovascular events: (1) cardiac death, (2) nonfatal myocardial infarction, (3) unstable angina requiring hospitalization, (4) revascularization, or (5) stroke. Of the 120 patients, 40 (33%) had an abnormal stress study, including myocardial perfusion abnormalities in 30 patients (25%). In 10 patients (8%), indicators of extensive (possibly balanced ischaemia) were observed in the absence of abnormal perfusion. The multivariable analysis identified current smoking, duration of diabetes and the cholesterol/high-density lipoprotein (HDL) ratio as independent predictors of an abnormal stress study. During a follow-up period of 12 months six patients (5%) had a cardiovascular event. The current study

  12. 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.

  13. Value of perfusion-weighted MR imaging in the assessment of early cerebral alterations in neurologically asymptomatic HIV-1-positive and HCV-positive patients.

    Directory of Open Access Journals (Sweden)

    Joanna Bladowska

    Full Text Available BACKGROUND AND PURPOSE: Asymptomatic central nervous system (CNS involvement occurs in the early stage of the human immunodeficiency virus (HIV infection. It has been documented that the hepatitis C virus (HCV can replicate in the CNS. The aim of the study was to evaluate early disturbances in cerebral microcirculation using magnetic resonance (MR perfusion-weighted imaging (PWI in asymptomatic HIV-1-positive and HCV-positive patients, as well as to assess the correlation between PWI measurements and the clinical data. MATERIALS AND METHODS: Fifty-six patients: 17 HIV-1-positive non-treated, 18 HIV-1-positive treated with combination antiretroviral therapy (cART, 7 HIV-1/HCV-positive non-treated, 14 HCV-positive before antiviral therapy and 18 control subjects were enrolled in the study. PWI was performed with a 1.5T MR unit using dynamic susceptibility contrast (DSC method. Cerebral blood volume (CBV measurements relative to cerebellum (rCBV were evaluated in the posterior cingulated region (PCG, basal ganglia (BG, temporoparietal (TPC and frontal cortices (FC, as well as in white matter of frontoparietal areas. Correlations of rCBV values with immunologic data and liver histology activity index (HAI were analyzed. RESULTS: Significantly lower rCBV values were found in the right TPC and left FC as well as in PCG in HIV-1-positive naïve (p = 0.009; p = 0.020; p = 0.012, HIV-1 cART treated (p = 0.007; p = 0.009; p = 0.033, HIV-1/HCV-positive (p = 0.007; p = 0.027; p = 0.045 and HCV-positive patients (p = 0.010; p = 0.005; p = 0.045 compared to controls. HIV-1-positive cART treated and HIV-1/HCV-positive patients demonstrated lower rCBV values in the right FC (p = 0.009; p = 0.032, respectively and the left TPC (p = 0.036; p = 0.005, respectively, while HCV-positive subjects revealed lower rCBV values in the left TPC region (p = 0.003. We found significantly elevated rCBV values in BG in HCV-positive patients (p = 0.0002; p<0.0001 compared to

  14. Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient: The Imaging Council of the American College of Cardiology.

    Science.gov (United States)

    Budoff, Matthew J; Raggi, Paolo; Beller, George A; Berman, Daniel S; Druz, Regina S; Malik, Shaista; Rigolin, Vera H; Weigold, Wm Guy; Soman, Prem

    2016-02-01

    Increased cardiovascular morbidity and mortality in patients with type 2 diabetes is well established; diabetes is associated with at least a 2-fold increased risk of coronary heart disease. Approximately two-thirds of deaths among persons with diabetes are related to cardiovascular disease. Previously, diabetes was regarded as a "coronary risk equivalent," implying a high 10-year cardiovascular risk for every diabetes patient. Following the original study by Haffner et al., multiple studies from different cohorts provided varying conclusions on the validity of the concept of coronary risk equivalency in patients with diabetes. New guidelines have started to acknowledge the heterogeneity in risk and include different treatment recommendations for diabetic patients without other risk factors who are considered to be at lower risk. Furthermore, guidelines have suggested that further risk stratification in patients with diabetes is warranted before universal treatment. The Imaging Council of the American College of Cardiology systematically reviewed all modalities commonly used for risk stratification in persons with diabetes mellitus and summarized the data and recommendations. This document reviews the evidence regarding the use of noninvasive testing to stratify asymptomatic patients with diabetes with regard to coronary heart disease risk and develops an algorithm for screening based on available data. PMID:26846937

  15. Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.

    Science.gov (United States)

    Blaha, Michael J; Silverman, Michael G; Budoff, Matthew J

    2014-03-01

    Although risk factors have proven to be useful therapeutic targets, they are poor predictors of risk. Traditional risk scores are moderately successful in predicting future CHD events and can be a starting place for general risk categorization. However, there is substantial heterogeneity between traditional risk and actual atherosclerosis burden, with event rates predominantly driven by burden of atherosclerosis. Serum biomarkers have yet to show any clinically significant incremental value to the FRS and even when combined cannot match the predictive value of atherosclerosis imaging. As clinicians, are we willing to base therapy decisions on risk models that lack optimum-achievable accuracy and limit personalization? The decision to treat a patient in primary prevention must be a careful one because the benefit of therapy in an asymptomatic patient must clearly outweigh the potential risk. CAC, in particular, provides a personalized assessment of risk and may identify patients who will be expected to derive the most, and the least, net absolute benefit from treatment. Emerging evidence hints that CAC may also promote long-term adherence to aspirin, exercise, diet, and statin therapy. When potentially lifelong treatment decisions are on the line, clinicians must arm their patients with the most accurate risk prediction tools, and subclinical atherosclerosis testing with CAC is, at the present time, superior to any combination of risk factors and serum biomarkers.

  16. Design and development of a decision aid to enhance shared decision making by patients with an asymptomatic abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Dirk T Ubbink

    2008-11-01

    Full Text Available Dirk T Ubbink1,2, Anouk M Knops1, Sjaak Molenaar1, Astrid Goossens11Department of Quality Assurance and Process Innovation and 2Department of Surgery, Academic Medical Center, Amsterdam, The NetherlandsObjective: To design, develop, and evaluate an evidence-based decision aid (DA for patients with an asymptomatic abdominal aortic aneurysm (AAA to inform them about the pros and cons of their treatment options (ie, surgery or watchful observation and to help them make a shared decision.Methods: A multidisciplinary team defined criteria for the desired DA as to design, medical content and functionality, particularly for elderly users. Development was according to the international standard (IPDAS. Fifteen patients with an AAA, who were either treated or not yet treated, evaluated the tool.Results: A DA was developed to offer information about the disease, the risks and benefits of surgical treatment and watchful observation, and the individual possibilities and threats based on the patient’s aneurysm diameter and risk profile. The DA was improved and judged favorably by physicians and patients.Conclusion: This evidence-based DA for AAA patients, developed according to IPDAS criteria, is likely to be a simple, user-friendly tool to offer patients evidence-based information about the pros and cons of treatment options for AAA, to improve patients’ understanding of the disease and treatment options, and may support decision making based on individual values.Keywords: decision support techniques, research design, program development, abdominal aortic aneurysm, decision making

  17. Is carotid artery evaluation necessary for primary prevention in asymptomatic high-risk patients without atherosclerotic cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Kim GH

    2015-07-01

    Full Text Available GeeHee Kim,1 Ho-Joong Youn,2 Yun-Seok Choi,2 Hae Ok Jung,2 Wook Sung Chung,2 Chul-Min Kim1 1Department of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, 2Division of Cardiology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Objective: Routine measurement of the carotid intima–media thickness is not recommended in recent clinical practice guidelines for risk assessment of the first atherosclerotic cardiovascular disease (ASCVD event (the definition of which includes acute coronary syndromes, a history of myocardial infarction, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease presumed to be of atherosclerotic origin. The aim of the present study was to elucidate the role of carotid artery evaluation for primary prevention of ASCVD in asymptomatic high-risk patients visiting a teaching hospital.Methods: Eight hundred seventy-three patients (487 male [55.8%], mean age 59.4±11.5 years who were statin-naive and without ASCVD, which was proven by coronary angiography or coronary CT angiography, were enrolled in this study. The patients underwent carotid scanning in the Medical Department of St Mary’s Hospital from September 2003 to March 2009. ASCVD outcomes were evaluated for median follow-up of 1,402 days.Results: A total of 119 participants experienced ASCVD events. In multivariate Cox regression analysis, age (hazard ratio [HR] =1.026, 95% confidence interval [CI] =1.002–1.050, P=0.033, history of smoking (HR =1.751, 95% CI =1.089–2.815, P=0.021, statin therapy (HR =0.388, 95% CI =0.205–0.734, P=0.004, and carotid plaques (HR =1.556, 95% CI =1.009–2.400, P=0.045 were associated with ASCVD events. In middle-aged group (45≤ age <65, n=473, history of smoking (HR =1.995, 95% CI =1.142–3.485, P=0.015, statin therapy (HR =0.320, 95% CI =0.131

  18. Clinical Implications of Electrocardiographic Left Ventricular Strain and Hypertrophy in Asymptomatic Patients with Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study

    DEFF Research Database (Denmark)

    Greve, Anders M; Boman, Kurt; Gohlke-Baerwolf, Christa;

    2012-01-01

    in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Primary endpoint was the first of myocardial infarction, non-hemorrhagic stroke, heart failure, aortic valve replacement (AVR) or cardiovascular death. Predictive value of electrocardiographic LV strain (defined as T-wave inversion in leads V(4.......1, both p=0.001) and 2.5-fold higher risk of a combined endpoint of myocardial infarction, heart failure or cardiovascular death (95% CI, 1.3 to 4.9, p=0.008). CONCLUSIONS: Electrocardiographic LV strain and LVH were independently predictive of poor prognosis in asymptomatic AS. CLINICAL TRIAL......BACKGROUND: The prognostic impact of electrocardiographic left ventricular (LV) strain and hypertrophy (LVH) in asymptomatic aortic stenosis (AS) is not well described. METHODS AND RESULTS: Data were obtained in asymptomatic patients randomized to simvastatin/ezetimibe combination vs. placebo...

  19. Evaluation of cardiac ischaemia in cardiac asymptomatic newly diagnosed untreated patients with primary hypothyroidism

    NARCIS (Netherlands)

    A. Roos; S.K. Zoet-Nugteren; A. Berghout (Arie)

    2005-01-01

    textabstractBACKGROUND: Hypothyroidism is regarded as a risk factor for coronary artery disease. Possible factors involved in this association are hyperlipidaemia and hypertension, both occurring with increased frequency in hypothyroid patients. The aim of our study was to evaluate

  20. Subclinical coronary atherosclerosis identified by coronary computed tomographic angiography in asymptomatic morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Peter A. McCullough

    2010-09-01

    Full Text Available Obesity is a common public health problem and obese individuals in particular have a disproportionate incidence of acute coronary events. This study was undertaken to identify coronary artery lesions as well as associated clinical features, risk factors and demographics in patients with a body mass index (BMI >40 kg/m2 without known coronary artery disease (CAD. Morbidly obese subjects were prospectively recruited to undergo coronary computed tomographic angiography (CCTA using a dual-source computed tomography (CT system. CAD was defined as the presence of any atherosclerotic lesion in any one coronary artery segment. The presence, location, and severity of atherosclerosis were related to patient characteristics. Forty-one patients (28 women, mean age, 50.4±10.0 years, mean BMI, 43.8±4.8 kg/m2 served as the study population. Of these, 25 patients (61% had at least one coronary stenosis. All but 2 patients within the CAD cohort had coronary artery calcium (CAC scores >0, and most plaques identified (75.4% were non-calcified. There was a predilection of calcified and non-calcified atherosclerosis involving the left anterior descending (LAD coronary artery compared with other coronary segments. Univariate predictors of CAD included older age, dyslipidemia, and diabetes. In this preliminary study of young morbidly obese patients, CCTA detected a high prevalence of calcified and non-calcified CAD, although the later predominated.

  1. Candida colonisation in asymptomatic HIV patients attending a tertiary hospital in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Newton O. Esebelahie

    2013-03-01

    Full Text Available Background: Candidiasis is the commonest opportunistic fungal infection in patients infected with human immunodeficiency virus (HIV. CD4+ lymphocyte counts have been found to be a marker of HIV disease progression. Aim: This study focused on determining the spectrum of Candida isolates in urine, stool, and oral specimens among HIV patients in a tertiary hospital. Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV subjects were used for this study. Three samples (urine, stool, and oral swab were collected from each subject. Each specimen was processed using standard microbiological techniques and emergent Candida isolates were identified with CHROMagar™ Candida and sugar fermentation tests. Results: The overall prevalence of Candida colonisation among HIV patients was 52.5%. HAART-naive patients had a significantly higher prevalence (OR = 3.65; 95% CI = 2.03–6.56; p<0.0001 than their counterpart on highly active antiretroviral therapy (HAART (OR = 1.99; 95% CI = 1.13–3.50; p=0.0232. Female gender was a significant risk factor for acquiring Candida infection (OR = 3.40; 95% CI = 1.14–10.13; p=0.0289. The effect of age on prevalence of candidiasis was observed among HIV patients on HAART (p=0.0161. A CD4+ count <200 cells/µl was a significant risk factor for acquiring candidal infection only among HAART-naive patients (OR = 4.37; 95% CI = 1.60–11.95; p=0.0042. The five species of Candida recovered from this study were C. albicans, C. krusei, C. parapsilosis, C. tropicalis, and C. glabrata. Conclusion: There is a significant relationship between antiretroviral therapy, CD4+ counts, and the prevalence of candidiasis.

  2. Double Coronary Artery Anomaly in an Elderly Asymptomatic Patient with Positive Electrocardiogram Stress Test

    Directory of Open Access Journals (Sweden)

    Giuseppe Cannavale

    2013-01-01

    Full Text Available Malignant coronary artery anomalies and myocardial bridging are more common findings in young patients with cardiac symptoms, but these two associated yet different types of anomalies in an elderly patient has been rarely described. The following case describes the diagnostic use of 128-slice coronary-computed tomography images of an 82-year-old male, former professional soccer player, who reached the age of 82 years without any symptoms of coronary heart disease. In this patient, an association of a malignant coronary artery anomaly of origin and course (left descending coronary artery originating from the right sinus of valsalva running between the aorta and the right ventricular outflow tract, together with a long myocardial bridging over the obtuse marginal branch was diagnosed by multi-slice computed tomography thanks to an initial positive electrocardiogram screening stress test.

  3. Asymptomatic cryptococcal antigenemia is associated with mortality among HIV-positive patients in Indonesia

    Directory of Open Access Journals (Sweden)

    Ahmad Rizal Ganiem

    2014-01-01

    Full Text Available Introduction: Previous studies, mostly from Africa, have shown that serum cryptococcal antigenemia may precede the development of cryptococcal meningitis and early death among patients with advanced HIV infection. We examined cryptococcal antigenemia as a risk factor for HIV-associated mortality in Indonesia, which is experiencing a rapidly growing HIV epidemic. Methods: We included ART-naïve HIV patients with a CD4 cell count below 100 cells/μL and no signs of meningitis in an outpatient HIV clinic in Bandung, West Java, Indonesia. Baseline clinical data and follow-up were retrieved from a prospective database, and cryptococcal antigen was measured in stored serum samples using a semiquantitative lateral flow assay. Cox regression analysis was used to identify factors related to mortality. Results: Among 810 patients (median CD4 cell count 22, 58 (7.1% had a positive cryptococcal antigen test with a median titre of 1:80 (range: 1:1 to 1:2560. Cryptococcal antigenemia at baseline was strongly associated with the development of cryptococcal meningitis and early death and loss to follow-up. After one year, both death (22.4% vs. 11.6%; p=0.016; adjusted HR 2.19; 95% CI 1.78–4.06 and the combined endpoint of death or loss to follow-up (67.2% vs. 40.4%; p<0.001; adjusted HR 1.57; 95% CI 1.12–2.20 were significantly higher among patients with a positive cryptococcal antigen test. Conclusions: Cryptococcal antigenemia is common and clinically relevant among patients with advanced HIV in this setting. Routine screening for cryptococcal antigen followed by lumbar puncture and pre-emptive antifungal treatment for those who are positive may help in reducing early mortality.

  4. Asymptomatic "placental prolapse" with cervical funneling in a patient with complete placenta previa.

    Science.gov (United States)

    Adekola, Henry; Lam-Rachlin, Jennifer; Bronshtein, Elena; Abramowicz, Jacques S

    2015-02-01

    We describe the transvaginal sonographic findings in a patient with complete placenta previa and increased risk of preterm birth owing to a prior history of mid-trimester pregnancy loss in whom we observed a short cervix and prolapse of the placenta and fetal membranes into the endocervical canal. We believe that this could lead to antepartum hemorrhage and mandate close observation when diagnosed. We introduced the term "placental prolapse" to describe our finding.

  5. A bipolar disorder patient becoming asymptomatic after adjunctive anti-filiarasis treatment: a case report

    OpenAIRE

    Hamdani, Nora; Doukhan, Raphaël; Picard, Aline; Tamouza, Ryad; Leboyer, Marion

    2013-01-01

    International audience; BACKGROUND: Evidence suggests that neurotropic infectious agents might be involved in bipolar disorder. So far, few have been written for the association between parasitic infection and bipolar disorder. Filariasis is a parasitic disease acting ruthlessly via mosquitos and affecting more than 120 million people worldwide. We present here, to our knowledge, the first description of a filariasis infected manic bipolar disorder patient fully improved in terms of psychiatr...

  6. The Role of Gratitude in Spiritual Well-being in Asymptomatic Heart Failure Patients

    OpenAIRE

    Mills, Paul J.; Redwine, Laura; Wilson, Kathleen; Pung, Meredith A.; Chinh, Kelly; Greenberg, Barry H.; Lunde, Ottar; Maisel, Alan; Raisinghani, Ajit; Wood, Alex.; Chopra, Deepak

    2015-01-01

    Spirituality and gratitude are associated with wellbeing. Few if any studies have examined the role of gratitude in heart failure (HF) patients or whether it is a mechanism through which spirituality may exert its beneficial effects on physical and mental health in this clinical population. This study examined associations bet ween gratitude, spiritual wellbeing, sleep, mood, fatigue, cardiac-specific self-efficacy, and inflammation in 186 men and women with Stage B asymptom...

  7. Increasing severity of cardiovascular risk factors with increasing middle cerebral artery stenotic involvement in type 2 diabetic Chinese patients with asymptomatic cerebrovascular disease

    OpenAIRE

    Thomas, GN; Lin, JW; Lam, WWM; Tomlinson, B; Yeung, V; Chan, JCN; Liu, R; Wong, KS

    2004-01-01

    OBJECTIVE: To identify determinants associated with increasing severity of middle cerebral artery (MCA) stenosis in asymptomatic Chinese type 2 diabetic patients with and without MCA stenosis determined using transcranial Doppler. Conventional risk factors contribute to the pathogenesis of ischemic stroke, and differences in the pattern of these may explain the heterogeneity of disease presentation in different populations. In Chinese patients, MCA stenosis is the most commonly identified int...

  8. Single Nodula opacity of granulomatous Pneumocystis jirovecii pneumoniain an asymptomatic lymphoma patient

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Shin, Kyung Eun; Lee, Ju Hie [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2015-04-15

    The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.

  9. Cauda equina syndrome after spinal anaesthesia in a patient with asymptomatic tubercular arachnoiditis

    Directory of Open Access Journals (Sweden)

    Divya Sethi

    2011-01-01

    Full Text Available A 14-year-old boy underwent emergency debridement surgery of right foot under spinal anaesthesia. Four hours after the surgery, the patient developed symptoms of cauda equina syndrome (CES. Postoperative magnetic resonance imaging of the patient′s spine suggested underlying tubercular arachnoiditis. The boy was started on intravenous methylprednisolone and antitubercular therapy. He responded to the therapy and recovered completely in 2 weeks without any residual neurological deficits. We suggest that underlying pathological changes in the subarachnoid space due to tubercular arachnoiditis contributed to maldistribution of the local anaesthetic drug leading to CES.

  10. Esophageal Perforation: A Rare Complication of Transesophageal Echocardiography in a Patient with Asymptomatic Esophagitis

    Directory of Open Access Journals (Sweden)

    Kabir Ahmed

    2012-12-01

    Full Text Available Transesophageal echocardiography (TEE is a commonly used procedure in patients with suspected endocarditis. A rare but dreadful complication of this procedure is perforation of the esophagus. We report the case of an elderly female with multiple comorbidities, who presented with polyarticular septic arthritis. TEE was performed to rule out endocarditis. Though the standard procedure protocol was followed, she developed esophageal perforation. It was managed with esophageal stenting but she developed multiorgan failure and did not survive. This case highlights the potential of severe morbidity and mortality associated with TEE. Appropriate screening must be done and high-risk individuals must be identified before such procedures are attempted.

  11. Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients.

    Science.gov (United States)

    Friedman, Joseph I; Tang, Cheuk Y; de Haas, Hans J; Changchien, Lisa; Goliasch, Georg; Dabas, Puneet; Wang, Victoria; Fayad, Zahi A; Fuster, Valentin; Narula, Jagat

    2014-10-01

    Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course.

  12. Indicators of inflammation and cellular damage in chronic asymptomatic or oligosymptomatic alcoholics: correlation with alteration of bilirubin and hepatic and pancreatic enzymes

    Directory of Open Access Journals (Sweden)

    Borini Paulo

    1999-01-01

    Full Text Available Biochemical and hematimetric indicators of inflammation and cell damage were correlated with bilirubin and hepatic and pancreatic enzymes in 30 chronic male alcoholics admitted into psychiatric hospital for detoxification and treatment of alcoholism. Aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, and total bilirubin were altered, respectively, in 90%, 63%, 87%, 23% and 23% of the cases. None of the indicators of inflammation (lactic dehydrogenase, altered in 16% of the cases; alpha-1 globulin, 24%; alpha-2 globulin, 88%; leucocyte counts, 28% was correlated with alterations of bilirubin or liver enzymes. Lactic dehydrogenase was poorly sensitive for detection of hepatocytic or muscular damage. Alterations of alpha-globulins seemed to have been due more to alcohol metabolism-induced increase of lipoproteins than to inflammation. Among indicators of cell damage, serum iron, increased in 40% of the cases, seemed to be related to liver damage while creatine phosphokinase, increased in 84% of the cases, related to muscle damage. Hyperamylasemia was found in 20% of the cases and significantly correlated with levels of bilirubin, alkaline phosphatase and gamma-glutamyltransferase. It was indicated that injuries of liver, pancreas, salivary glands, and muscle occurred in asymptomatic or oligosymptomatic chronic alcoholics.

  13. Frequency of coronary artery stenosis in patients with asymptomatic familial hypercholesterolemia and its association with carotid intimal thickness and cardio-ankle vascular index

    Directory of Open Access Journals (Sweden)

    Suzuki M

    2016-06-01

    Full Text Available Masayo Suzuki,1 Mao Takahashi,1 Takuo Iizuka,1 Hitoshi Terada,2 Hirohumi Noike,1 Kohji Shirai3 1Cardiovascular Center, Internal Medicine, 2Department of Radiology, 3Department of Vascular Function, Sakura Hospital, Medical Center, Toho University, Sakura City, Chiba Prefecture, Japan Background: Familial hypercholesterolemia (FH is associated with premature coronary arterial disease. We aimed to determine the incidence of coronary artery stenosis (CAS in asymptomatic FH patients using coronary computed tomography angiography (CCTA. To investigate the association between CAS and atherosclerosis of carotid arteries, we performed ultrasonography to measure the mean intima-media thickness (IMT, maximum IMT, and plaque score. We also aimed to examine the significance of the cardio-ankle vascular index (CAVI and its association with the incidence of CAS in asymptomatic FH patients. Patients and methods: We enrolled consecutively, 31 FH patients without symptoms of coronary artery disease. Based on the CCTA findings, we divided the patients into two groups, those with and without CAS, and compared various parameters and risk factors of the two groups. Results: Of 31 FH patients, seven patients (22.6% had CAS. The proportion of male patients and mean low-density lipoprotein-cholesterol level were higher in patients with CAS than in those without CAS (P<0.05. All carotid ultrasonography parameters (ie, mean IMT, maximum IMT, and plaque score were significantly higher in patients with CAS than in those without CAS (P<0.01, whereas no significant difference was found in CAVI between the two groups. Conclusion: CAS was identified in >22.6% of the asymptomatic FH patients. Patients with CAS tended to have enhanced levels of carotid plaque markers, but no increase was noted in CAVI. FH patients should be continuously monitored using CCTA and ultrasonography. Keywords: CAVI, coronary artery stenosis, heterozygous familial hypercholesterolemia, CCTA, ultrasound

  14. Thrombospondin-1 serum levels do not correlate with pelvic pain in patients with ovarian endometriosis

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    Manero Manuel

    2009-11-01

    Full Text Available Abstract Objetive Thrombospondin-1 serum levels is correlate with pelvic pain in patients with ovarian endometriosis. Patients Thrombospondin-1 serum levels were prospectively analysed in 51 patients (group A asymptomatic patients or patients presenting mild dysmenorrhea and women comprised group B severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia who underwent surgery for cystic ovarian endometriosis to asses whether a correlation exists among thrombospondin-1 serum levels and pelvic pain. Results From 56 patients, five cases were ultimateley excluded, because the histological diagnosis was other than cystic ovarian endometriosis (2 teratomas and 3 haemorragic cysts. The mean thrombospondin-1 serum levels in group A was 256,69 pg/ml_+37,07 and in group B was 291,41 pg/ml + 35,59. Conclusion Pain symptoms in ovarian endometriosis is not correlated with thrombospondin-1 serum levels.

  15. Incremental prognostic utility of coronary CT angiography for asymptomatic patients based upon extent and severity of coronary artery calcium: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study

    NARCIS (Netherlands)

    I. Cho (Iksung); H.-J. Chang (Hyuk-Jae); B.T. Hartaigh (Bríain ó); S. Shin (Sanghoon); J.M. Sung (Ji Min); F.Y. Lin (Fay); S. Achenbach (Stephan); R. Heo (Ran); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); T.Q. Callister (Tracy); M. Al-Mallah (Mouaz); F. Cademartiri (Filippo); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); A.M. Dunning (Allison M.); A. Delago (Augustin); T.C. Villines (Todd); M. Hadamitzky (Martin); J. Hausleiter (Jörg); J. Leipsic (Jonathon); L.J. Shaw (Leslee); P.A. Kaufmann (Philipp A.); R.C. Cury (Ricardo); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); E. Maffei (Erica); G.L. Raff (Gilbert); G. Pontone (Gianluca); D. Andreini (Daniele); J.K. Min (James K.)

    2015-01-01

    textabstractAim Prior evidence observed no predictive utility of coronary CT angiography (CCTA) over the coronary artery calcium score (CACS) and the Framingham risk score (FRS), among asymptomatic individuals. Whether the prognostic value of CCTA differs for asymptomatic patients, when stratified b

  16. Myocardial scarring on cardiovascular magnetic resonance in asymptomatic or minimally symptomatic patients with “pure” apical hypertrophic cardiomyopathy

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    Kim Kyung-Hee

    2012-07-01

    Full Text Available Abstract Background Late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR enables state-of-the-art in vivo evaluations of myocardial fibrosis. Although LGE patterns have been well described in asymmetrical septal hypertrophy, conflicting results have been reported regarding the characteristics of LGE in apical hypertrophic cardiomyopathy (ApHCM. This study was undertaken to determine 1 the frequency and distribution of LGE and 2 its prognostic implication in ApHCM. Methods Forty patients with asymptomatic or minimally symptomatic pure ApHCM (age, 60.2 ± 10.4 years, 31 men were prospectively enrolled. LGE images were acquired using the inversion recovery segmented spoiled-gradient echo and phase-sensitive inversion recovery sequence, and analyzed using a 17-segment model. Summing the planimetered LGE areas in all short axis slices yielded the total volume of late enhancement, which was subsequently presented as a proportion of total LV myocardium (% LGE. Results Mean maximal apical wall thickness was 17.9±2.3mm, and mean left ventricular (LV ejection fraction was 67.7 ± 8.0%. All but one patient presented with electrocardiographic negative T wave inversion in anterolateral leads, with a mean maximum negative T wave of 7.2 ± 4.7mm. Nine patients (22.5% had giant negative T waves, defined as the amplitude of ≥10mm, in electrocardiogram. LGE was detected in 130 segments of 30 patients (75.0%, occupying 4.9 ± 5.5% of LV myocardium. LGE was mainly detected at the junction between left and right ventricles in 12 (30% and at the apex in 28 (70%, although LGE-positive areas were widely distributed, and not limited to the apex. Focal LGE at the non-hypertrophic LV segments was found in some ApHCM patients, even without LGE of hypertrophied apical segments. Over the 2-year follow-up, there was no one achieving the study end-point, defined as all-cause death, sudden cardiac death and hospitalization for heart failure

  17. Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.

    LENUS (Irish Health Repository)

    Radeljic, Vjekoslav

    2012-01-31

    AIM: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. METHODS: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Among those 81 (78%) were evaluated. Eighty one (78%) patients were evaluated. Follow-up time ranged from 12 to 33 months (average +\\/-standard deviation 23 +\\/- 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results. The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. CONCLUSION: In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and

  18. Asymptomatic ischemic cerebral lesions

    International Nuclear Information System (INIS)

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)

  19. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...... levels are associated with low frequency of coronary artery disease (CAD) and good prognosis. The underlying causes of poor prognosis in patients with elevated NT-proBNP are not known; thus, we investigated the role of putative asymptomatic CAD in type 2 diabetic patients with UAER >30 mg/24 h and...... elevated P-NT-proBNP and/or CCS....

  20. Elevated NT-proBNP and coronary calcium score in relation to coronary artery disease in asymptomatic type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Persson, Frederik;

    2011-01-01

    Elevated plasma N-terminal (NT)-proBNP levels and coronary calcium score (CCS) not only predicts myocardial ischaemia and coronary artery stenosis but also adverse cardiovascular events and mortality in type 2 diabetic patients with an increased urinary albumin excretion rate (UAER), whereas low...... levels are associated with low frequency of coronary artery disease (CAD) and good prognosis. The underlying causes of poor prognosis in patients with elevated NT-proBNP are not known; thus, we investigated the role of putative asymptomatic CAD in type 2 diabetic patients with UAER >30 mg/24 h...... and elevated P-NT-proBNP and/or CCS....

  1. Avaliação ecocardiográfica em obesos graves assintomáticos Echocardiography evaluation for asymptomatic patients with severe obesity

    Directory of Open Access Journals (Sweden)

    Isaura Elaine Gonçalves Moreira Rocha

    2007-01-01

    ventricular mass to height resulted in a significantly higher number of diagnoses for hypertrophy than indexation to body surface area (p = 0.0053, demonstrating that this index is more appropriate to determine ventricular hypertrophy in obese people. Correlations between left ventricular hypertrophy with obesity duration and pressure levels were positive as well as correlations between body mass index and diastolic dysfunction indicators. CONCLUSION: This study demonstrated that echocardiograms performed on asymptomatic severely obese patients can detect alterations in the cardiac structure that are common in cases of obesity cardiomyopathy and can be associated with the development of heart failure, arrhythmias and sudden death, enabling the identification of patients with greater cardiovascular risk.

  2. Cardiovascular events in Japanese asymptomatic patients with type 2 diabetes: a 1-year interim report of a J-ACCESS 2 investigation using myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kenichi [Kanazawa University Hospital, Department of Nuclear Medicine, Kanazawa (Japan); Yamasaki, Yoshimitsu [Osaka University, Center for Advanced Science and Innovation, Osaka (Japan); Kusuoka, Hideo [National Hospital Organization Osaka National Hospital, Osaka (Japan); Izumi, Tohru [Kitasato University, Department of Cardiology and Internal Medicine, Sagamihara (Japan); Kashiwagi, Atsunori [Shiga University of Medical Science, Department of Medicine, Ohtsu (Japan); Kawamori, Ryuzo [Juntendo University, Department of Medicine, Metabolism and Endocrinology, School of Medicine, Tokyo (Japan); Shimamoto, Kazuaki [Sapporo Medical University School of Medicine, Second Department of Internal Medicine, Sapporo (Japan); Yamada, Nobuhiro [University of Tsukuba, Division of Metabolism and Endocrinology, Department of Internal Medicine, Faculty of Medicine, Tsukuba (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, 465 Kajii-cho, Kawara-machi, Hirokoji, Kamigyo-ku, Kyoto (Japan)

    2009-12-15

    Diabetic patients have a high risk for cardiovascular events. The role of myocardial perfusion imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population. A total of 506 asymptomatic patients {>=}50 years of age who had carotid artery maximum intima-media thickness {>=}1.1 mm, urinary albumin excretion of {>=}30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed. Myocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0-3, 4-8, 9-13, and {>=}14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest. The 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients. (orig.)

  3. Cardiovascular events in Japanese asymptomatic patients with type 2 diabetes: a 1-year interim report of a J-ACCESS 2 investigation using myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Diabetic patients have a high risk for cardiovascular events. The role of myocardial perfusion imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population. A total of 506 asymptomatic patients ≥50 years of age who had carotid artery maximum intima-media thickness ≥1.1 mm, urinary albumin excretion of ≥30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed. Myocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0-3, 4-8, 9-13, and ≥14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest. The 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients. (orig.)

  4. Asymptomatic coronary artery disease in Type-2 diabetes

    International Nuclear Information System (INIS)

    Objective: To select a subgroup of type-2 diabetics with two additional pre specified risk factors to see that whether there is any benefit of screening such patients. Methodology: Five hundred twenty six patients were sent for treadmill stress test or thallium scan. Those who had abnormal results were advised coronary angiography. The angiographically proven CAD was correlated with various risk factors to find the relationship between the disease and variables. Results: Two hundred thirty five (48%) patients had abnormal results and among them 158 (67%)underwent coronary angiography. Among these 21% had evidence of CAD. Coronary artery bypass grafting (CABG) was performed in 35(33%) patients, catheter based intervention (PCI) in 44(40%) patients and 30(27%) patients were not suitable for intervention. Duration of diabetes, smoking, diabetic retinopathy, albuminuria, and peripheral vascular disease were significant predictor of asymptomatic CAD. Conclusion: This study has demonstrated strong relationship between risk factors and asymptomatic CAD in type 2 diabetics. (author)

  5. The Correlation Between the Six Minute Walk Test and Spirometric Parameters in Patients with Systemic Lupus Erythematosus

    OpenAIRE

    Zahra Mirfeizi; Leila Ghofraniha; Seyyedeh Fatemeh Seyyedi Khabbaz

    2015-01-01

    Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease affect nearly every organ system. Pulmonary involvement, which is a common manifestation of SLE, can remain undiagnosed if asymptomatic. This study aimed to evaluate the efficiency of spirometric findings in early detection of silent pulmonary involvement and examine its correlation with the six minute walk test in SLE patients. Materials and Methods: In this cross-sectional study fifty patients, who met the American Co...

  6. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy1

    Directory of Open Access Journals (Sweden)

    Ghafarnezhad M

    2000-07-01

    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. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy

    Directory of Open Access Journals (Sweden)

    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.

  8. Long-Term Risk of Cardiovascular Disease among Type 2 Diabetic Patients with Asymptomatic Intracranial Atherosclerosis: A Prospective Cohort Study

    Science.gov (United States)

    Duan, Jian Gang; Chen, Xiang Yan; Lau, Alex; Wong, Adrian; Thomas, G. Neil; Tomlinson, Brian; Liu, Roxanna; Chan, Juliana C. N.; Leung, Thomas W.; Mok, Vincent; Wong, Ka Sing

    2014-01-01

    Objective To investigate whether asymptomatic middle cerebral artery (MCA) stenosis is associated with risk of cardiovascular disease (CVD) in Chinese with type 2 diabetes. Methods In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes and without history of stroke or atrial fibrillation were recruited in 1994–1996 and followed up for a median of 14.51 years. Participants were assessed at baseline for MCA stenosis using transcranial Doppler. We performed survival analysis to assess the association between asymptomatic MCA stenosis and first CVD event, defined as ischemic stroke, acute coronary syndrome (ACS) or cardiovascular death. Results Of the 2,144 subjects, MCA stenosis at baseline was detected in 264 (12.3%). Rates of stroke, ACS and cardiovascular death per 100 were, respectively, 2.24, 2.92 and 1.11 among participants with stenosis, higher than among those without stenosis. Ten-year cumulative occurrence of stroke, ACS and cardiovascular death in subjects with MCA stenosis was 20%, 24% and 10%, respectively, higher than the corresponding values for subjects without stenosis(all P<0.001). After adjusting for covariates, MCA stenosis was found to be an independent predictor of stroke [hazard ratio (HR) 1.40, 95%CI 1.05–1.86; P = 0.02], ACS (HR 1.35, 95%CI 1.04–1.75; P = 0.02) and cardiovascular death(HR 1.56, 95%CI 1.04–2.33; P = 0.03). Conclusions Asymptomatic MCA stenosis is a risk factor for CVD in Chinese with type 2 diabetes, and detection of asymptomatic MCA stenosis by transcranial Doppler can identify diabetic individuals at high risk of future CVD. This finding is particularly important for diabetic individuals in Asia, where intracranial atherosclerosis is common. PMID:25192283

  9. Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Jian Gang Duan

    Full Text Available To investigate whether asymptomatic middle cerebral artery (MCA stenosis is associated with risk of cardiovascular disease (CVD in Chinese with type 2 diabetes.In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes and without history of stroke or atrial fibrillation were recruited in 1994-1996 and followed up for a median of 14.51 years. Participants were assessed at baseline for MCA stenosis using transcranial Doppler. We performed survival analysis to assess the association between asymptomatic MCA stenosis and first CVD event, defined as ischemic stroke, acute coronary syndrome (ACS or cardiovascular death.Of the 2,144 subjects, MCA stenosis at baseline was detected in 264 (12.3%. Rates of stroke, ACS and cardiovascular death per 100 were, respectively, 2.24, 2.92 and 1.11 among participants with stenosis, higher than among those without stenosis. Ten-year cumulative occurrence of stroke, ACS and cardiovascular death in subjects with MCA stenosis was 20%, 24% and 10%, respectively, higher than the corresponding values for subjects without stenosis(all P<0.001. After adjusting for covariates, MCA stenosis was found to be an independent predictor of stroke [hazard ratio (HR 1.40, 95%CI 1.05-1.86; P = 0.02], ACS (HR 1.35, 95%CI 1.04-1.75; P = 0.02 and cardiovascular death(HR 1.56, 95%CI 1.04-2.33; P = 0.03.Asymptomatic MCA stenosis is a risk factor for CVD in Chinese with type 2 diabetes, and detection of asymptomatic MCA stenosis by transcranial Doppler can identify diabetic individuals at high risk of future CVD. This finding is particularly important for diabetic individuals in Asia, where intracranial atherosclerosis is common.

  10. A clinicopathologic study of 24 cases of systemic mastocytosis involving the gastrointestinal tract and assessment of mucosal mast cell density in irritable bowel syndrome and asymptomatic patients.

    Science.gov (United States)

    Doyle, Leona A; Sepehr, Golrokh J; Hamilton, Matthew J; Akin, Cem; Castells, Mariana C; Hornick, Jason L

    2014-06-01

    Counting mast cells in gastrointestinal (GI) mucosal biopsies is becoming an increasingly common practice. The primary reason for this exercise is to evaluate for possible involvement by systemic mastocytosis (SM). However, the features of mastocytosis in GI biopsies are not well described. In addition, recent studies have suggested that increased mast cells may be involved in the pathogenesis of some cases of diarrhea-predominant irritable bowel syndrome (IBS); the term "mastocytic enterocolitis" has been proposed for such cases. As the baseline mast cell density in colonic biopsies from normal patients has not been established in large cohorts, there is no widely accepted threshold for what constitutes increased mucosal mast cells. The aims of this study were (1) to determine the utility of GI biopsies for the diagnosis of SM, (2) to characterize the clinical, histologic, and immunohistochemical features of mastocytosis in the GI tract, (3) to determine mast cell density in normal colonic mucosa from a large cohort of asymptomatic patients, and (4) to compare these findings with those from patients with diarrhea-predominant IBS. Twenty-four patients with SM involving the GI tract, 100 asymptomatic patients, and 100 patients with IBS (the latter 2 groups with histologically normal colonic biopsies) were included. For the mastocytosis group, 107 biopsies (70 involved by mastocytosis; 67 mucosal, 3 liver) from 20 women and 4 men were evaluated (median age 59 y). The most commonly involved site was the colon (19 patients, 95%), followed by ileum (86%), duodenum (80%), and stomach (54%). In 16 cases (67%), the first diagnosis of SM was made on the basis of GI biopsies. Seventeen patients had documented cutaneous mastocytosis. Fifteen of 17 patients who underwent bone marrow biopsy had marrow involvement by SM. Eighteen patients had indolent disease, and 6 had aggressive disease (including all 3 with liver involvement). The most common GI symptom was diarrhea, followed

  11. Role of temporary pacing at the right ventricular outflow tract in anesthetic management of a patient with asymptomatic sick sinus syndrome.

    Science.gov (United States)

    Nag, Kusha; Nagella, Amrutha Bindu; Kumar, V R Hemanth; Singh, Dewan Roshan; Ravishankar, M

    2015-01-01

    A 60-year-old woman posted for percutaneous nephrolithotomy with ureterolithotripsy was found to have a history of hypertension and ischemic heart disease from past 6 months on regular treatment. Pulse rate was irregularly irregular in a range of 56-60/min, unresponsive to atropine, with a sinus pause on the electrocardiogram. Although the patient was asymptomatic, anticipating unmasking of the sick sinus syndrome during general anesthesia in the prone position, a temporary pacemaker was implanted at right ventricular outflow tract (RVOT) septum before the scheduled surgery. A balanced anesthesia technique with endotracheal intubation was administered. There were several episodes of continuous pacing by the temporary pacemaker intraoperatively, which may be attributed to unmasking of the sinus node dysfunction due to general anesthesia. At the end of surgery, patient was extubated after adequate reversal from neuromuscular blockade. Postoperative period remained uneventful, and the pacemaker wires were removed on the 2(nd) postoperative day. With this case report, we highlight the importance of inserting a temporary pacemaker prior to anesthesia even in an asymptomatic patient if a sinus node dysfunction is suspected preoperatively and if intraoperative access to transvenous pacing is difficult such as in prone position. Pacing at RVOT septum minimizes ventricular dyssynchrony and improves hemodynamic parameters.

  12. Surgical results in patients with unruptured asymptomatic cerebral aneurysms. Significance of evaluation of neuropsychological function, magnetic resonance images and cerebral blood flow

    International Nuclear Information System (INIS)

    We evaluated neuropsychological function, magnetic resonance (MR) images and cerebral blood flow (CBF) in patients with unruptured asymptomatic cerebral aneurysms. Among consecutive operations (n=73) on 70 patients since 2000, direct surgery was performed in 53 operations on 50 patients, and intravascular surgery was performed in 20 operations on 20 patients. Surgical results of direct surgery were studied. Direct surgery was selected mainly for patients with small and anterior circulation aneurysms. MR imaging was conducted 1 week after surgery, and Wechsler Adult Intelligence Scale-Revised (WAIS-R) examination and CBF measurement using 133Xe-SPECT were done before and 1 month after surgery. Abnormal neurological findings were recognized postoperatively in 26% of surgeries. Among them, visual disturbance was permanent in 4% of surgeries, all of which were surgeries for paraclinoid internal carotid artery aneurysms. WAIS-R results deteriorated in 26% of surgeries at 1 month and at least in 5% of surgeries at 1 year after surgery. MR images at 1 week after surgery revealed brain damage in 30% of surgeries and subdural fluid collection in 19% of surgeries. Patients with large brain damage or thick subdural fluid collection frequently showed neurological deficits and/or WAISR deterioration. These complications were recognized frequently in patients with ACoA aneurysms. Resting CBF decreased significantly in the area supplied by the anterior cerebral artery and anterior border zone on the operated side postoperatively. The brain damage and subdural fluid collection were observed frequently and caused neurological deficits and neuropsychological dysfunction, although these were usually transient. It may be necessary to evaluate neuropsychological function, MRI and CBF in patients with unruptured asymptomatic cerebral aneurysms to improve surgical results. (author)

  13. Productive human immunodeficiency virus infection levels correlate with AIDS-related manifestations in the patient

    International Nuclear Information System (INIS)

    Mononuclear cells were obtained from 71 human immunodeficiency virus type 1 (HIV-1) seropositive subjects presenting and first visit either as asymptomatic or with minor symptoms and with CD4 lymphocytes greater than 550 per mm3 (group A, 35 patients) or as patients with AIDS, AIDS-related illnesses, or CD4 lymphocytes less than 400 per mm3 (group B, 36 patients). After 1-5 years of follow-up, 13 patients of group A had essentially retained their initial status (asymptomatics); the 22 others had suffered clinical or immunological deterioration (progressors). Frozen cells were thawed and submitted to lethal gamma-irradiation in vitro (4500 rads; 1 rad = 0.01 Gy) before they were cultured with normal phytohemagglutinin-stimulated lymphocytes to determine radiation-resistant HIV expression ex vivo (R-HEV). HIV antigenemia correlated with R-HEV values in 142 samples (r = 0.92, P less than 0.001) but was a less sensitive predictor of disease than R-HEV. R-HEV was detected in all specimens from patients with major AIDS-related illnesses or HIV-associated CD4 lymphopenia. In 77% of the progressors from group A, R-HEV detection preceded the onset of AIDS-associated disease or CD4 lymphopenia by 1 year (average). Conversely, R-HEV was low or was not detected in 36 sequential specimens from the 13 patients who remained asymptomatic over the following 2-5 years. Thus, persistently low HIV expression in vivo predicted a nondiseased state, whereas higher HIV expression levels seemed necessary for disease to occur. These data indicate that R-HEV is related to productive HIV infection in vivo, the latter acting as a determinant of AIDS-related illnesses. In view of this, measurement of HIV expression levels in the patient should be useful in antiviral efficacy trials

  14. 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

  15. Prognostic significance of stress myocardial ECG-gated perfusion imaging in asymptomatic patients with diabetic chronic kidney disease on initiation of haemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Kondo, Chisato; Kobayashi, Hideki; Kusakabe, Kiyoko [Tokyo Women' s Medical University, School of Medicine, Department of Radiology, Shinjuku-ku, Tokyo (Japan); Babazono, Tetsuya [Tokyo Women' s Medical University, School of Medicine, Diabetes Centre, Shinjuku-ku, Tokyo (Japan); Nakajima, Takatomo [Tokyo Women' s Medical University, School of Medicine, Department of Cardiology, Shinjuku-ku, Tokyo (Japan)

    2009-08-15

    Diabetic patients with chronic kidney disease (CKD) frequently develop cardiac events within several years of the initiation of haemodialysis. The present study assesses the prognostic significance of stress myocardial ECG-gated perfusion imaging (MPI) in patients with diabetic CKD requiring haemodialysis. Fifty-five asymptomatic patients with diabetic stage V CKD and no history of heart disease scheduled to start haemodialysis were enrolled in this study (56{+-}11 years old; 49 with type 2 diabetes mellitus). All patients underwent {sup 201}Tl stress ECG-gated MPI 1 month before or after the initiation of haemodialysis to assess myocardial involvement. We evaluated SPECT images using 17-segment defect scores graded on a 5-point scale, summed stress score (SSS) and summed difference scores (SDS). The patients were followed up for at least 2 years (42{+-}15 months) to determine coronary intervention (CI) and heart failure (HF) as soft events and acute myocardial infarction (AMI) and all causes of deaths as hard events. The frequencies of myocardial ischaemia, resting perfusion defects, low ejection fraction and left ventricular (LV) dilatation were 24,20,29 and 49%, respectively. Ten events (18%) developed during the follow-up period including four CI, one HF, one AMI and four sudden deaths. Multivariate Cox analysis selected SDS (p=0.0011) and haemoglobin A{sub 1c} (HbA{sub 1c}) (p=0.0076) as independent prognostic indicators for all events. Myocardial ischaemia, in addition to glycaemic control, is a strong prognostic marker for asymptomatic patients with diabetic CKD who are scheduled to start haemodialysis. Stress MPI is highly recommended for the management and therapeutic stratification of such patients. (orig.)

  16. Left atrial volume in patients with asymptomatic aortic valve stenosis (the Simvastatin and Ezetimibe in Aortic Stenosis study)

    DEFF Research Database (Denmark)

    Dalsgaard, Morten; Egstrup, K.; Wachtell, K.;

    2008-01-01

    AS (transaortic Doppler velocity > or =2.5 and AVA) was estimated by the continuity equation and indexed by body surface...... area. Mean values for age and AVA were 67 +/- 10 years and 1.27 +/- 0.5 cm2, respectively, and 574 were women (38%). Mean value for LA volume indexed (LAVI) was 36 +/- 13 ml/m2. Enlargement of LA volume (> or =32 ml/m2) was found in 57% of patients. AVA indexed was significantly correlated to LAVI (r...... = -0.1, p = 0.0002). Multivariate analysis showed that LAVI was significantly related to AVA indexed (beta = -4.1, p = 0.007) in a model that also included mitral regurgitation (beta = 2.8, p

  17. Regadenoson-Stress Dynamic Myocardial Perfusion Improves Diagnostic Performance of CT Angiography in Assessment of Intermediate Coronary Artery Stenosis in Asymptomatic Patients

    Directory of Open Access Journals (Sweden)

    Jan Baxa

    2015-01-01

    Full Text Available The prospective study included 54 asymptomatic high-risk patients who underwent coronary CT angiography (CTA and regadenoson-induced stress CT perfusion (rsCTP. Diagnostic accuracy of significant stenosis (≥50% determination was evaluated for CTA alone and CTA + rsCTP in 27 patients referred to ICA due to the positive rsCTP findings. Combined evaluation of CTA + rsCTP had higher diagnostic accuracy over CTA alone (per-segment: specificity 96 versus 68%, p=0.002; per-vessel: specificity 95 versus 75%, p=0.012 and high overruling rate of rsCTP was proved in intermediate stenosis (40–70%. Results demonstrate a significant additional value of rsCTP in the assessment of intermediate coronary artery stenosis found with CTA.

  18. Comparison of in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and matched asymptomatic control subjects.

    Science.gov (United States)

    Rao, Smita; Baumhauer, Judith F; Tome, Josh; Nawoczenski, Deborah A

    2009-05-29

    The purpose of this study was to compare in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and asymptomatic control subjects. Segmental foot motion during walking and step descent was assessed using a multi-segment foot model in 30 patients with midfoot arthritis and 20 age, gender and BMI matched controls. Peak and total range of motion (ROM), referenced to subtalar neutral, were examined for each of the following dependent variables: 1st metatarso-phalangeal (MTP1) dorsiflexion, 1st metatarsal (MT1) plantarflexion, ankle dorsiflexion, calcaneal eversion and forefoot abduction. The results showed that, compared to level walking, step descent required greater MTP1 dorsiflexion (pwalking. Patients with midfoot arthritis responded differently to the step task compared to control subjects in terms of MT1 and calcaneus eversion excursion. During walking, patients with midfoot arthritis showed significantly less MT1 plantarflexion excursion compared to control subjects (p=0.03). However, during step descent, both groups showed similar MT1 plantarflexion excursion. During walking, patients with midfoot arthritis showed similar calcaneus eversion excursion compared to control subjects. However, during step descent, patients with midfoot arthritis showed significantly greater calcaneus eversion excursion compared to control subjects (p=0.03). Independently or in combination, these motions may contribute to articular stress and consequently to symptoms in patients with midfoot arthritis.

  19. Relationship of peripheral blood T cell subset levels and PD-1/PD-L1 expression levels with viral load in patients with asymptomatic HIV infection

    Institute of Scientific and Technical Information of China (English)

    Xi-Li Miao; Si-Qing Mei; Gui-Min Gao

    2016-01-01

    Objective:To study the relationship of different T cell subset levels and PD-1/PD-L1 expression levels in peripheral blood with viral load in patients with asymptomatic HIV infection.Methods:Patients with asymptomatic HIV infection treated in our hospital from April 2012 to October 2015 were selected as the HIV group of the study, healthy subjects during the same period were selected as the control group, and peripheral blood was collected to detect CD3+CD4+CD8-, CD3+CD4-CD8+, CD4+CD25+Foxp3+ and CD4+CD25+CD127low/-cell levels as well as PD-1/PD-L1 expression levels.Results:The number and percentage of CD3+CD4+CD8- cells as well as the number of CD4+CD25+Foxp3+ and CD4+CD25+CD127low/-cells in peripheral blood of HIV group were significantly lower than those of control group, the number and percentage of CD3+CD4-CD8+ cells, the percentage of CD4+CD25+Foxp3+and CD4+CD25+CD127low/- cells as well as the expression levels of PD-L1 and PD-1 on CD4+T cell surface were significantly higher than those of control group, and the expression levels of PD-L1 and PD-1 on CD8+T cell surface were not significantly different from those of control group; the greater the viral load in HIV group, the lower the percentage of CD3+CD4+CD8-, and the higher the percentage of CD3+CD4-CD8+, CD4+CD25+Foxp3+ and CD4+CD25+CD127low/-cells as well the PD-1/PD-L1 positive percentage on CD4+T cell surface in peripheral blood. Conclusions:The immune characteristics of patients with asymptomatic HIV infection are the decreased number of CD4+T cells and the increased number of CD8+T cells as well as the decreased absolute content and increased relative content of CD4+CD25+Treg cells, and PD-1/PD-L1 pathway is the molecular mechanism of HIV to act on CD4+T cells.

  20. Normal kidney size and its influencing factors - a 64-slice MDCT study of 1.040 asymptomatic patients

    Directory of Open Access Journals (Sweden)

    Rehder Peter

    2009-12-01

    Full Text Available Abstract Background Normal ultrasound values for pole-to-pole kidney length (LPP are well established for children, but very little is known about normal kidney size and its influencing factors in adults. The objectives of this study were thus to establish normal CT values for kidney dimensions from a group of unselected patients, identify potential influencing factors, and to estimate their significance. Methods In multiphase thin-slice MDCTs of 2.068 kidneys in 1.040 adults, the kidney length pole to pole (LPP, parenchymal (PW and cortical width (CW, position and rotation status of the kidneys, number of renal arteries, pyelon width and possible influencing factors that can be visualized, were recorded from a volume data set. For length measurements, axes were adjusted individually in double oblique planes using a 3D-software. Analyses of distribution, T-tests, ANOVA, correlation and multivariate regression analyses were performed. Results LPP was 108.5 ± 12.2 mm for the right, and 111.3 ± 12.6 mm for the left kidney (p Conclusions Due to the complex influences on kidney size, assessment should be made individually. The most important influencing factors are BMI, height, gender, age, position of the kidneys, stenoses and number of renal arteries.

  1. Asymptomatic cerebral hemorrhage detected by MRI

    International Nuclear Information System (INIS)

    Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author)

  2. Asymptomatic cerebral hemorrhage detected by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Yumi; Ohsuga, Hitoshi; Yamamoto, Masahiro; Shinohara, Yukito (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1991-03-01

    Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author).

  3. Blastocystis Isolates from Patients with Irritable Bowel Syndrome and from Asymptomatic Carriers Exhibit Similar Parasitological Loads, but Significantly Different Generation Times and Genetic Variability across Multiple Subtypes.

    Directory of Open Access Journals (Sweden)

    Gie-Bele Vargas-Sanchez

    Full Text Available Blastocystis spp is a common intestinal parasite of humans and animals that has been associated to the etiology of irritable bowel syndrome (IBS; however, some studies have not found this association. Furthermore, many biological features of Blastocystis are little known. The objective of present study was to assess the generation times of Blastocystis cultures, from IBS patients and from asymptomatic carriers. A total of 100 isolates were obtained from 50 IBS patients and from 50 asymptomatic carriers. Up to 50 mg of feces from each participant were cultured in Barret's and in Pavlova's media during 48 h. Initial and final parasitological load were measured by microscopy and by quantitative PCR. Amplicons were purified, sequenced and submitted to GenBank; sequences were analysed for genetic diversity and a Bayesian inference allowed identifying genetic subtypes (ST. Generation times for Blastocystis isolates in both media, based on microscopic measures and molecular assays, were calculated. The clinical symptoms of IBS patients and distribution of Blastocystis ST 1, 2 and 3 in both groups was comparable to previous reports. Interestingly, the group of cases showed scarce mean nucleotide diversity (π as compared to the control group (0.011±0.016 and 0.118±0.177, respectively, whilst high gene flow and small genetic differentiation indexes between different ST were found. Besides, Tajima's D test showed negative values for ST1-ST3. No statistical differences regarding parasitological load between cases and controls in both media, as searched by microscopy and by qPCR, were detected except that parasites grew faster in Barret's than in Pavlova's medium. Interestingly, slow growth of isolates recovered from cases in comparison to those of controls was observed (p<0.05. We propose that generation times of Blastocystis might be easily affected by intestinal environmental changes due to IBS probably because virulent strains with slow growth may be

  4. Retrospective analysis of the prevalence of asymptomatic cerebral aneurysm in 4518 patients undergoing magnetic resonance angiography. When does cerebral aneurysm develop?

    Energy Technology Data Exchange (ETDEWEB)

    Horikoshi, Toru; Yamagata, Zentaro; Nukui, Hideaki [Yamanashi Medical Univ., Tamaho (Japan); Akiyama, Iwao [Akiyama Neurosurgical Clinic, Nirasaki, Yamanashi (Japan)

    2002-03-01

    The natural history of cerebral aneurysms was investigated by measuring the prevalence of incidentally found unruptured aneurysms in the general population and evaluating the characteristics including risk factors. 'De novo' formation of aneurysm was also demographically estimated. The prevalence of incidental aneurysm was evaluated among 4518 patients who underwent magnetic resonance (MR) angiography for various reasons in a neurosurgical institute. Double the number of patients were randomly selected from the remaining patients without aneurysm as the Control group so that sex and age group were matched to the Aneurysm group. One hundred twenty seven patients (2.8%) had diagnoses of aneurysm. The prevalence of asymptomatic aneurysm among middle-aged and elderly patients were predominant in women and increased with age in both sexes. Patients with aneurysms had significantly more hypertension and family history of subarachnoid hemorrhage compared to the controls. The prevalence was markedly increased in the 8th decade in men and the 7th decade in women, and new aneurysms seemed to develop predominantly around these decades. Cerebral aneurysms become detectable on MR angiography in the middle or later decades, and women tend to develop aneurysm earlier than men. Hypertension and family history of subarachnoid hemorrhage are probably risk factors for the development of aneurysm. (author)

  5. The Paradigm Shift to Non-Treatment of Asymptomatic Bacteriuria

    Science.gov (United States)

    Nicolle, Lindsay E.

    2016-01-01

    Asymptomatic bacteriuria, also called asymptomatic urinary infection, is a common finding in healthy women, and in women and men with abnormalities of the genitourinary tract. The characterization and introduction of the quantitative urine culture in the 1950s first allowed the reliable recognition of asymptomatic bacteriuria. The observations that a substantial proportion of patients with chronic pyelonephritis at autopsy had no history of symptomatic urinary infection, and the high frequency of pyelonephritis observed in pregnant women with untreated asymptomatic bacteriuria, supported a conclusion that asymptomatic bacteriuria was harmful. Subsequent screening and long term follow-up programs for asymptomatic bacteriuria in schoolgirls and women reported an increased frequency of symptomatic urinary tract infection for subjects with asymptomatic bacteriuria, but no increased morbidity from renal failure or hypertension, or increased mortality. Treatment of asymptomatic bacteriuria did not decrease the frequency of symptomatic infection. Prospective, randomized, comparative trials enrolling premenopausal women, children, elderly populations, patients with long term catheters, and diabetic patients consistently report no benefits with antimicrobial treatment of asymptomatic bacteriuria, and some evidence of harm. Several studies have also reported that antimicrobial treatment of asymptomatic bacteriuria increases the short term risk of pyelonephritis. Current investigations are exploring the potential therapeutic intervention of establishing asymptomatic bacteriuria with an avirulent Escherichia coli strain to prevent symptomatic urinary tract infection for selected patients. PMID:27104571

  6. Left ventricular systolic dysfunction in asymptomatic Marfan syndrome patients is related to the severity of gene mutation: insights from the novel three dimensional speckle tracking echocardiography.

    Directory of Open Access Journals (Sweden)

    Mohamed Abd El Rahman

    Full Text Available In asymptomatic Marfan syndrome (MFS patients we evaluated the relationship between the types of fibrillin-1 (FBN1 gene mutation and possible altered left ventricular (LV function as assessed by three-dimensional speckle tracking echocardiography (3D-STE.Forty-five MFS patients (mean age 24 ± 15 years and 40 age-matched healthy controls were studied. Genetic evaluation for the FBN1 gene was carried on 32 MFS patients. Gene mutation (n = 15, 47% was classified as mild when the mutation resulted in nearly normally functioning protein, while mutations resulting in abnormally function protein were considered to be severe (n = 17, 53%. All patients and controls underwent 3D-STE for evaluation of LV function by an echocardiographer blinded to the results of the genetic testing. Compared to controls, MFS patients had significantly lower 3D-STE derived LV ejection fraction (EF, 57.43 ± 7.51 vs. 62.69 ± 4.76%, p = 0.0001, global LV longitudinal strain (LS, 14.85 ± 2.89 vs. 17.90 ± 2.01%, p = 0.0001, global LV circumferential strain (CS, 13.93 ± 2.81 vs. 16.82 ± 2.17%, p = 0.0001 and global LV area strain (AS, 25.76 ± 4.43 vs. 30.51 ± 2.61%, p = 0.0001. Apart from the global LV LS all these parameters were significantly lower in patients with severe gene mutation than in those with mild mutation (p < 0.05. In the multivariate linear regression analysis only the type of mutation had a significant influence on the 3D-STE derived LVEF (p = 0.017, global CS (p = 0.005 and global AS (p = 0.03.In asymptomatic MFS patients latent LV dysfunction can be detected using 3D STE. The LV dysfunction is mainly related to the severity of gene mutation, suggesting possible primary cardiomyopathy in MFS patients.

  7. [Asymptomatic kidney stones: active surveillance vs. treatment].

    Science.gov (United States)

    Neisius, A; Thomas, C; Roos, F C; Hampel, C; Fritsche, H-M; Bach, T; Thüroff, J W; Knoll, T

    2015-09-01

    The prevalence of kidney stones is increasing worldwide. Asymptomatic non-obstructing kidney stones are increasingly detected as an incidental finding on radiologic imaging, which has been performed more frequently over the last decades. Beside the current interventional treatment modalities such as extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL), active surveillance of asymptomatic kidney stones has been a focus of discussion lately, not only for attending physicians, but even more so for patients. The current German and European guidelines recommend active surveillance for patients with asymptomatic kidney stones if no interventional therapy is mandatory because of pain or medical factors. Herein we review the current literature on risks and benefits of active surveillance of asymptomatic non-obstructing kidney stones. PMID:26378390

  8. Asymptomatic Disseminated Cysticercosis

    OpenAIRE

    Vaidya, Ashima; Singhal, Suman; Dhall, Sonia; Manohar, Ashish; Mahajan, Harsh

    2013-01-01

    Cysticercosis is a common problem world wide. However, disseminated cysticercosis is rare. Still rarer is asymptomatic disseminated cysticercosis. We are reporting here a rare case of asymptomatic disseminated cysticercosis which involved brain, face, orbit, lungs, heart, pancreas and spleen in a young Nigerian male, who sought medical attention for dysphagia which was diagnosed as achalasia cardia. Despite widespread dissemination of cysticercosis which involves multiple organs, the individu...

  9. Vitamin D levels and asymptomatic coronary artery disease in type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Joergensen, Christel; Reinhard, Henrik; Schmedes, Anne;

    2012-01-01

    Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients.......Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients....

  10. Effect of amiodarone therapy on mortality in patients with left ventricular dysfunction and asymptomatic complex ventricular arrhythmias: Argentine Pilot Study of Sudden Death and Amiodarone (EPAMSA).

    Science.gov (United States)

    Garguichevich, J J; Ramos, J L; Gambarte, A; Gentile, A; Hauad, S; Scapin, O; Sirena, J; Tibaldi, M; Toplikar, J

    1995-09-01

    The efficiency of prophylactic antiarrhythmic treatment with amiodarone in reducing 1-year mortality in patients with reduced left ventricular ejection fraction ( < 35%) and asymptomatic ventricular arrhythmias (Lown classes 2 and 4) was investigated in a prospective, multicenter, randomized, controlled study. Among 127 patients who entered the study, 61 were assigned to no antiarrhythmic therapy (control group [CG] and 66 to amiodarone treatment (amiodarone group [AG]). Amiodarone was administered at a dosage of 800 mg/day for 2 weeks followed by 400 mg/day thereafter. A 12-month follow-up was completed for 106 patients (57 in the AG and 49 in the CG). Amiodarone reduced the overall mortality rate, which was 10.5% in the AG versus 28.6% in the CG (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.10 to 0.84; log-rank test 0.02) and sudden death rate, which was 7.0% in the AG versus 20.4% in the CG (OR 0.29; 95% CI 0.08 to 1.00; log-rank test 0.04). Side effects were rare, and in only three patients did amiodarone treatment have to be discontinued.

  11. Clinical features of asymptomatic pulmonary carcinoma: An analysis of 91 patients%91例无症状肺癌的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    高俊珍; 李国华; 付秀华; 王立红; 徐长丽

    2012-01-01

    目的 分析无症状肺癌患者的临床特点,评价体检对肺癌早期诊断的临床意义,探讨早期诊断肺癌的策略.方法 对近6年在本院发现的91例无症状肺癌患者的临床资料进行回顾性分析.结果 无症状肺癌中男性好发,男女比例2∶1,平均年龄(56.63±0.67)岁,在老年与非老年中的分布相近;腺癌最多见,以周围型为主,好发于右肺上叶;主要确诊方法首先是手术,其次是支气管镜检查;非小细胞肺癌早期48例(60.0%)多于晚期的32例(40.0%);12例发生2个部位以上的转移.结论 无症状肺癌起病隐匿,被发现时并非完全是早期,应提倡定期体检和早期及时手术.%Objective To analyze the clinical features of patients with asymptomatic pulmonary carcinoma, evaluate the clinical significance of health check- up in early discovery of pulmonary carcinoma and investigate the way to discover the pulmonary carcinoma in its early stages. Methods The clinical data of 91 cases with asymptomatic pulmonary carcinoma in recent 6 years were retrospectively analyzed. Results The majority was men in asymptomatic lung'cancer, and male/female ratio was 2:1. Average age was (56.63±0.67) years. The distribution in the elderly and non -elderly was similar. Adenocarcinoma with peripheral type of lung cancer was most common. Furthermore, the diseased were mainly located in superior lobe of right lung. The major diagnosis method was surgery while the secondary method was bronchoscopy. There were 48 (60.0% ) non - small cell lung cancer patients in early stages and 32 (40.0%) in advanced stages. There was a significant difference between two groups. Twelve cases had more than two metastatic sites. Conclusion The outbreak of asymptomatic pulmonary carcinoma is insidious of its onset. It will not be in its early stage once it is confirmed. Accordingly, regular health check - up and timely surgical treatment should be recommended.

  12. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  13. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    International Nuclear Information System (INIS)

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  14. 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.

  15. A prospective cohort study on the absolute risks of venous thromboembolism and predictive value of screening asymptomatic relatives of patients with hereditary deficiencies of protein S, protein C or antithrombin

    NARCIS (Netherlands)

    Mahmoodi, B. K.; Brouwer, J-L P.; Ten Kate, M. K.; Lijfering, W. M.; Veeger, N. J. G. M.; Mulder, A. B.; Kluin-Nelemans, H. C.; van der Meer, J.

    2010-01-01

    Background: Absolute risks of venous thromboembolism (VTE) in protein S-, protein C-, or antithrombin-deficient subjects are mainly based on retrospective data. Screening asymptomatic relatives of these patients is disputed, though studies addressing this issue have yet to be conducted. Methods: We

  16. A prospective cohort study on the absolute risks of venous thromboembolism and predictive value of screening asymptomatic relatives of patients with hereditary deficiencies of protein S, protein C or antithrombin.

    NARCIS (Netherlands)

    Mahmoodi, B.K.; Brouwer, J.L.P.; Kate, M.K. Ten; Lijfering, W.M.; Veeger, N.J.; Mulder, A.B.; Kluin-Nelemans, H.C.; Meer, J. van der

    2010-01-01

    BACKGROUND: Absolute risks of venous thromboembolism (VTE) in protein S-, protein C-, or antithrombin-deficient subjects are mainly based on retrospective data. Screening asymptomatic relatives of these patients is disputed, though studies addressing this issue have yet to be conducted. METHODS: We

  17. Morphologic Analysis of the Temporomandibular Joint Between Patients With Facial Asymmetry and Asymptomatic Subjects by 2D and 3D Evaluation: A Preliminary Study.

    Science.gov (United States)

    Zhang, Yuan-Li; Song, Jin-Lin; Xu, Xian-Chao; Zheng, Lei-Lei; Wang, Qing-Yuan; Fan, Yu-Bo; Liu, Zhan

    2016-03-01

    Signs and symptoms of temporomandibular joint (TMJ) dysfunction are commonly found in patients with facial asymmetry. Previous studies on the TMJ position have been limited to 2-dimensional (2D) radiographs, computed tomography (CT), or cone-beam computed tomography (CBCT). The purpose of this study was to compare the differences of TMJ position by using 2D CBCT and 3D model measurement methods. In addition, the differences of TMJ positions between patients with facial asymmetry and asymptomatic subjects were investigated. We prospectively recruited 5 patients (cases, mean age, 24.8 ± 2.9 years) diagnosed with facial asymmetry and 5 asymptomatic subjects (controls, mean age, 26 ± 1.2 years). The TMJ spaces, condylar and ramus angles were assessed by using 2D and 3D methods. The 3D models of mandible, maxilla, and teeth were reconstructed with the 3D image software. The variables in each group were assessed by t-test and the level of significance was 0.05. There was a significant difference in the horizontal condylar angle (HCA), coronal condylar angle (CCA), sagittal ramus angle (SRA), medial joint space (MJS), lateral joint space (LJS), superior joint space (SJS), and anterior joint space (AJS) measured in the 2D CBCT and in the 3D models (P < 0.05). The case group had significantly smaller SJS compared to the controls on both nondeviation side (P = 0.009) and deviation side (P = 0.004). In the case group, the nondeviation SRA was significantly larger than the deviation side (P = 0.009). There was no significant difference in the coronal condylar width (CCW) in either group. In addition, the anterior disc displacement (ADD) was more likely to occur on the deviated side in the case group. In conclusion, the 3D measurement method is more accurate and effective for clinicians to investigate the morphology of TMJ than the 2D method. PMID:27043669

  18. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R;

    2011-01-01

    Intensive multifactorial treatment aimed at cardiovascular (CV) risk factor reduction in type 2 diabetic patients with microalbuminuria can diminish fatal and non-fatal CV. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the utility of P-NT-proBNP in screening...... for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score≥400, carotid intima...

  19. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R;

    2011-01-01

    Intensive multifactorial treatment aimed at cardiovascular (CV) risk factor reduction in type 2 diabetic patients with microalbuminuria can diminish fatal and non-fatal CV. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the utility of P-NT-proBNP in screening...... for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score=400, carotid intima...

  20. 心房颤动导管消融相关无症状脑梗塞发生率Meta分析%Meta-analysis for the Incidence Rate of Asymptomatic Cerebral Embolism in Patients With Atrial Fibrillation After Catheter Ablation

    Institute of Scientific and Technical Information of China (English)

    韩全乐; 王桂苹; 刘书旺; 刘晓堃; 张琦; 张华; 王晓晓

    2015-01-01

      结论:房颤导管消融相关无症状脑梗塞发生率处在一个较高水平,是房颤导管消融以降低栓塞事件过程中必须面对的一个严峻问题,应得到更多关注,并采取相应的干预措施。%Objective: To generally assess the incidence rate of asymptomatic cerebral embolism in patients with atrial ifbrillation (AF) after catheter ablation by Meta-analysis in order to provide the basic information for cerebral embolism prevention. Methods: We systemically searched the publications of PubMed, Springer, Elsevier-SDOL, EMbase, SSCI, VIP, Chinese biomedical literature database (CBM), Chinese journal full-text database (CNKI), Wanfang data resource, Chinese outstanding master’s degree thesis database and Chinese important articles published in full-text database from 2006 to 2014 for the literatures regarding the asymptomatic cerebral embolism in AF patients after catheter ablation. The literature quality was evaluated by Loney criteria, Meta-analysis was conducted by R software to assess the incidence rate of asymptomatic cerebral embolism after ablation, the impact of type and quality for research were estimated by sensitivity analysis. Results: A total of 16 qualiifed literatures were enrolled in our research with 1258 patients. The incidence rate of asymptomatic cerebral embolism in AF patients after ablation was 17.46% (95% CI 13.13% - 22.84%). The sensitivity analysis indicated that excluding the literature at the lowest quality and the literature only with the part of age group, the Meta-analysis result had no obvious changes. Conclusion: The asymptomatic cerebral embolism in AF patients after ablation is at a relatively high prevalence condition, it should be seriously emphasized and with the active intervention in clinical practice.

  1. Optimized data preprocessing for multivariate analysis applied to 99mTc-ECD SPECT data sets of Alzheimer's patients and asymptomatic controls.

    Science.gov (United States)

    Merhof, Dorit; Markiewicz, Pawel J; Platsch, Günther; Declerck, Jerome; Weih, Markus; Kornhuber, Johannes; Kuwert, Torsten; Matthews, Julian C; Herholz, Karl

    2011-01-01

    Multivariate image analysis has shown potential for classification between Alzheimer's disease (AD) patients and healthy controls with a high-diagnostic performance. As image analysis of positron emission tomography (PET) and single photon emission computed tomography (SPECT) data critically depends on appropriate data preprocessing, the focus of this work is to investigate the impact of data preprocessing on the outcome of the analysis, and to identify an optimal data preprocessing method. In this work, technetium-99methylcysteinatedimer ((99m)Tc-ECD) SPECT data sets of 28 AD patients and 28 asymptomatic controls were used for the analysis. For a series of different data preprocessing methods, which includes methods for spatial normalization, smoothing, and intensity normalization, multivariate image analysis based on principal component analysis (PCA) and Fisher discriminant analysis (FDA) was applied. Bootstrap resampling was used to investigate the robustness of the analysis and the classification accuracy, depending on the data preprocessing method. Depending on the combination of preprocessing methods, significant differences regarding the classification accuracy were observed. For (99m)Tc-ECD SPECT data, the optimal data preprocessing method in terms of robustness and classification accuracy is based on affine registration, smoothing with a Gaussian of 12 mm full width half maximum, and intensity normalization based on the 25% brightest voxels within the whole-brain region.

  2. Differences in cardiovascular risk profile between electrocardiographic hypertrophy versus strain in asymptomatic patients with aortic stenosis (from SEAS data)

    DEFF Research Database (Denmark)

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

    2011-01-01

    and diastolic blood pressures, blood glucose, digoxin, antiarrhythmic drugs, drugs acting on the renin-angiotensin system, diuretics, ß blockers and calcium receptor blockers; peak aortic jet velocity was significantly greater in patients with electrocardiographic strain (mean difference 0.13 m/s, p...

  3. Differences in cardiovascular risk profile between electrocardiographic hypertrophy versus strain in asymptomatic patients with aortic stenosis (from SEAS data)

    DEFF Research Database (Denmark)

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

    2011-01-01

    and diastolic blood pressures, blood glucose, digoxin, antiarrhythmic drugs, drugs acting on the renin-angiotensin system, diuretics, β blockers and calcium receptor blockers; peak aortic jet velocity was significantly greater in patients with electrocardiographic strain (mean difference 0.13 m/s, p...

  4. Effect of fosinopril on progression of the asymptomatic carotid atherosclerosis and left ventricular hypertrophy in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Tasić Ivan

    2006-01-01

    Full Text Available INTRODUCTION The cardiovascular changes (vascular structure changes, hypertrophy of the left ventricle contribute to both the increased cardiovascular morbidity and the mortality of essential hypertension. Therefore, modern treatment strategies should not only target blood pressure (BP reduction but also normalize cardiovascular structure and function. OBJECTIVE Aim of the study was to determine the effect of the ACE inhibitor Fosinopril on the Intima-media thickness of the common carotid artery and on the left ventricle mass after 9-month treatment of hypertensive patients. METHOD The study included 40 patients with the arterial hypertension and the left ventricle hypertrophy verified by echocardiography. The patients were randomized on A ACE-inhibitor - Fosinopril and 6 without ACE inhibitor - atenolol, and they were followed up 9 months. The groups were not different by age, sex, and metabolic status. Color Duplex ultrasonography of the carotid arteries was performed by Acuson Sequia C236 with high-frequency linear probe of 8 MHz. The Intima-media thickness of the common carotids on the left and the right was measured in diastole at 1.5. cm from the highest point of bifurcation under maximal magnification. Using the same device, the left ventricle mass and other parameters of the left ventricle were determined in M-mode and by means of 2D image. RESULTS After 9 months, BP In both groups Was reduced In similar range (group A: systolic BP from 158 to 137 mmHg, and diastolic BP from 94 to 85 mmHg, and group B; systolic BP from 164 to 137 mmHg, and diastolic BP from 87 to 84 mmHg. The thickness of the intimomedial complex in patients using Fosinopril was decreased by 0.0278 ± 0.03 mm, while in the group of patients that did not use the ACE-inhibitor, it was increased by 0.078 ±0.13 mm. The left ventricle mass in patients using Fosinopril was decreased by 5 grams (312 ± 72 g vs. 307 ± 77 g, while in group B patients, it was increased by 15

  5. Usefulness of growth differentiation factor-15 levels to predict diabetic cardiomyopathy in asymptomatic patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Dominguez-Rodriguez, Alberto; Abreu-Gonzalez, Pedro; Avanzas, Pablo

    2014-09-15

    Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine that increased in patients with established type 2 diabetes mellitus (DM). Diabetic cardiomyopathy (DC), defined as left ventricular diastolic dysfunction (LVDD) in patients with type 2 DM in the absence of arterial hypertension, heart disease, or other heart disease, was assessed by GDF-15 levels in type 2 DM patients with and without DC. A total of 213 DM outpatients had blood samples drawn and on the same day (basal) underwent echocardiography and treadmill exercise testing. Plasma GDF-15 concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) at baseline. DC was diagnosed in the presence of LVDD, defined when early mitral valve flow velocity (E) and early diastolic lengthening velocity (E') ratio was E/E' ≥ 15. The prevalence of DC was 21.13%. GDF-15 levels were higher in patients with DC compared with those without DC (5,273 [8,708.4] vs 2,812.66 [7,662.1] pg/ml, respectively, p <0.001). We assessed predictors of DC using multivariate regression analysis. GDF-15 (odds ratio 9.9; 95% confidence interval [3.9 to 24.5], p <0.001) was the unique independent predictor of DC. The results of receiver operating characteristic curve show that the cut-off point of 3,812 pg/ml of GDF-15 was indicative for DC (AUC = 0.83, sensitivity = 82.2% and specificity = 70.2%, p <0.0001). In conclusion, GDF-15 represents a useful and novel tool to screen DC in patients with type 2 DM. PMID:25073564

  6. Correlation between aromatase expression in the eutopic endometrium of symptomatic patients and the presence of endometriosis

    Directory of Open Access Journals (Sweden)

    Maia Jr H

    2012-02-01

    Full Text Available Hugo Maia Jr1,2, Clarice Haddad1,2, Julio Casoy11CEPARH, 2Itaigara Memorial Day Hospital, Salvador, Bahia, BrazilObjective: To investigate whether aromatase expression in the eutopic endometrium correlates with the presence and severity of endometriosis in patients with infertility and/or dysmenorrhea undergoing laparoscopy and hysteroscopy.Patients: The study involved 106 patients of reproductive age with symptoms of dysmenorrhea and infertility. Sixteen endometriosis-free asymptomatic patients were used as a control group.Methods: Concomitant laparoscopy and hysteroscopy was carried out in all cases. An endometrial biopsy was taken to determine aromatase p450 expression by immunohistochemistry. Endometriosis was staged according to the American Society of Reproductive Medicine classification.Results: Endometriosis was diagnosed by laparoscopy in 92/106 symptomatic patients. In this group, aromatase expression was detected in the eutopic endometrium of 66/92 patients with endometriosis (72% and in 13/14 (95% patients in the symptomatic, endometriosis-free group (P = 0.09. Aromatase expression was not detected in any patients from the control group. In the endometriosis group, aromatase expression was detected in the eutopic endometrium of 28/45 patients (62% with American Society of Reproductive Medicine classification stage 1 of the disease, in 11/14 patients (78% with stage II, 14/20 patients (70% with stage III, and in 12/13 patients (92% with stage IV; however, the difference was only statistically significant between stages I and IV (P = 0.04.Conclusion: Aromatase expression in the endometrium was associated with the presence of dysmenorrhea and infertility irrespective of the presence of endometriosis. When endometriosis was present, however, there was a tendency for aromatase expression to be positively correlated with dysmenorrhea severity.Keywords: aromatase, endometrium, endometriosis, Cox-2, dysmenorrhea

  7. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers

    OpenAIRE

    Okada, Eijiro; Matsumoto, Morio; Fujiwara, Hirokazu; Toyama, Yoshiaki

    2010-01-01

    An association between progression of cervical disc degeneration and that of lumbar disc degeneration has been considered to exist. To date, however, this association has not yet been adequately studied. Age-related changes in the cervical intervertebral discs were evaluated by magnetic resonance imaging (MRI) in patients with lumbar disc herniation, and compared with the MRI findings of healthy volunteers without lower back pain. The purpose of this study was to clarify whether the prevalenc...

  8. High bacterial load in asymptomatic diabetic patients with neurotrophic ulcers retards wound healing after application of Dermagraft.

    Science.gov (United States)

    Browne, A C; Vearncombe, M; Sibbald, R G

    2001-10-01

    Diabetic neuropathic foot ulcers are a major healthcare burden. These chronic wounds always have a bacterial load, and although normal flora is not harmful, increased tissue burden may impede healing before clinical signs of infection are evident. In this study, chronic noninfected diabetic neuropathic foot ulcers (those with adequate blood supply and pressure offloading) were assessed for bacterial burden immediately before the application of a skin substitute. Eight patients with diabetic neuropathic foot ulcers greater than 1 cm2 and free of necrotic tissue had 3-mm tissue biopsies taken from the ulcer base for quantitative bacteriology. Five of the eight patients (75%) had greater or equal to 10(5) colony forming units/gram organisms present despite the absence of clinical signs of infection. Wound healing rates were linked to bacterial load as determined from quantitative biopsy--no growth was associated with a wound healing rate of 0.2 cm per week, 10(5) to 10(6) colony forming units/gram was associated with a healing rate of 0.15 cm per week, and greater than 10(6) colony forming units/gram was associated with 0.05 cm/per week healing rate. High bacterial burden impeded healing both before and after the application of the skin substitute. The authors will change their clinical practice to assess all diabetic neuropathic foot ulcers using quantitative skin biopsies before applying skin substitutes. All patients will be treated with combination antibiotics and repeat biopsies obtained with decreased bacterial burden (< 10(6) colony forming units/gram) prior to using any bioengineered skin substitute or growth factor treatment.

  9. Current imaging follow-up of non-Hodgkin lymphoma exposes patients to significant radiation but does not detect asymptomatic relapses.

    Science.gov (United States)

    Riva, Eloisa; Oliver, Carolina; Pérez, Maria Del Carmen; Telis, Osmar; Díaz, Lilian; Mikhael, Joseph R

    2016-06-01

    The standard approach to the follow-up of lymphoma includes computed tomography (CT) every 6-12 months for the first 2 years and, then, as clinically indicated. Recent evidence suggests that most relapses are detected clinically, outside scheduled CT which, on the other hand, increases risk of second malignancies and cost. In early-stage lymphomas, involved site CT instead of full body CT may be a reasonable alternative to reduce radiation dose. We analyzed whether regular CT surveillance detects asymptomatic relapses in a single-center Uruguayan early stage non-Hodgkin lymphoma (NHL) population. We evaluated utility of full body CT halfway and at the end-of-treatment evaluation and calculated the radiation exposure. In our study, CT surveillance added nothing to clinical follow-up. Moreover, 44% of our patients received a cumulative effective dose that doubles the risk of malignancies. Involved-site CT scan would be enough to monitor response during treatment in early stage NHL. PMID:26374395

  10. NEPHRITOGENIC ACTIVITY OF STREPTOCOCCUS PYOGENES emm1 AND emm12 GENOTYPES ISOLATED FROM PATIENTS AND ASYMPTOMATIC CARRIERS

    Directory of Open Access Journals (Sweden)

    L. A. Burova

    2015-01-01

    Full Text Available In this paper the nephritogenic activity of Streptococcus pyogenes genotype emm1 and emm12 clinical isolates from scarlet fever patients and healthy children was considered. As earlier established, strains of these types differ in Fc-binding profile, interacting with native IgG and immune complexes (IC, respectively. As expected, all the type emm1 strains bound native IgG; besides, ICs interacted only with strains from patients but not with those from carriers. In contrast, all type emm12 strains appeared to be negative for native IgG, whereas ICs were bound by strains from patients exclusively. None of the tested strains bound IgG3. By immunization of rabbits, binding of native IgG as well as ICs was associated with increasing of anti-IgG antibodies titer, formation of ICs, «crescent» deposition of IgG and C3-complement, local production of the proinflammatory cytokine TNFα, аnd also with accumulation of lymphocytes in kidney tissue. These signs indicated immune inflammation, leading to experimental membrane-proliferative glomerulonephritis (PSGN. It is known that PSGN development depends on IC-binding by tissue FcγR, on complement activation as well as on tissue infiltration by macrophages/monocytes. According to the data of morphometric evaluation the nephritogenic activity of the type emm12 strains exceeded those of type emm1. On testing of three IC-binding emm12 strains in six rabbits, typical PSGN developed in 5 of them and an abortive process in 1 animal. In case of five IgG-binding type emm1 strains, out of ten rabbits full-blown PSGN was observed only in 3 of them, but abortive changes in 5 and negative result in 2 animals. No pathologic changes were elicited by the «carrier» strains of either genotype; the inability of these to bind ICs, according to literature data, could be explained by mutation in the Mga-regulator gene thereby impeding M-proteins synthesis. We conclude that isolation of type emm12 IC-binding strains at acute

  11. Asymptomatic uterine fibroids.

    Science.gov (United States)

    Divakar, Hema

    2008-08-01

    It is estimated that at least 50% of fibroids are asymptomatic, but this figure is likely to be an underestimate as it is based on women in whom fibroids are found incidentally during another procedure (e.g. cervical screening), and there is little, if any, data from population studies on the true incidence of fibroids. If a prevalence of 50% by 50 years of age is accepted, a large number of women have asymptomatic fibroids. Working on the cliché, 'if it ain't broken, don't fix it', it may seem surprising that there should be a chapter dedicated to the issue of asymptomatic fibroids, since the simplistic approach might be to leave the asymptomatic fibroids well alone. However, asymptomatic fibroids may become symptomatic in the future, so it may be wiser to treat fibroids before they grow to a size when they become symptomatic, or treatment becomes more challenging, especially in young women who may desire fertility at a later stage, and in view of the fact that many women are starting their families in their mid-thirties when they have a 30% chance of having a fibroid(s). Despite their common occurrence, fibroids are still poorly understood. It is not known why they form in the first place, what determines their number and ultimate size, the best treatment approaches, or the factors that determine which women develop symptoms. Even when women present with disorders such as infertility, pelvic pain and abnormal bleeding, it is not always possible to be certain that a given myoma is not simply an innocent bystander rather than the cause of the symptom. This chapter addresses the challenging issue of what to do when fibroids are diagnosed incidentally. Firstly, there is the need to ascertain that the pelvic mass palpated is indeed a fibroid, and not an early, more sinister tumour, especially if conservative management is adopted. In addition, there is the issue of size, position and potential for becoming symptomatic at a later date. With the availability of uterine

  12. Vibrio cholerae Serogroup O139: Isolation from Cholera Patients and Asymptomatic Household Family Members in Bangladesh between 2013 and 2014.

    Directory of Open Access Journals (Sweden)

    Fahima Chowdhury

    2015-11-01

    Full Text Available Cholera is endemic in Bangladesh, with outbreaks reported annually. Currently, the majority of epidemic cholera reported globally is El Tor biotype Vibrio cholerae isolates of the serogroup O1. However, in Bangladesh, outbreaks attributed to V. cholerae serogroup O139 isolates, which fall within the same phylogenetic lineage as the O1 serogroup isolates, were seen between 1992 and 1993 and in 2002 to 2005. Since then, V. cholerae serogroup O139 has only been sporadically isolated in Bangladesh and is now rarely isolated elsewhere.Here, we present case histories of four cholera patients infected with V. cholerae serogroup O139 in 2013 and 2014 in Bangladesh. We comprehensively typed these isolates using conventional approaches, as well as by whole genome sequencing. Phenotypic typing and PCR confirmed all four isolates belonging to the O139 serogroup.Whole genome sequencing revealed that three of the isolates were phylogenetically closely related to previously sequenced El Tor biotype, pandemic 7, toxigenic V. cholerae O139 isolates originating from Bangladesh and elsewhere. The fourth isolate was a non-toxigenic V. cholerae that, by conventional approaches, typed as O139 serogroup but was genetically divergent from previously sequenced pandemic 7 V. cholerae lineages belonging to the O139 or O1 serogroups.These results suggest that previously observed lineages of V. cholerae O139 persist in Bangladesh and can cause clinical disease and that a novel disease-causing non-toxigenic O139 isolate also occurs.

  13. Urogenital Tract Infection in Asymptomatic Male Patients with Infertility in University of Benin Teaching Hospital, Benin City, Edo State

    Directory of Open Access Journals (Sweden)

    Ibadin, K. O.

    2012-01-01

    Full Text Available Aims: Urogenital tract infection (UTI contributes to the commonest single defined cause of infertility worldwide. To evaluate the role of urogenital tract infection in male with infertility and its association with sperm quality. Methodology and Results: Three hundred and twenty three (323 samples from infertile male subject were screened microbiologically for microorganisms associated with urogenital tract infection with seventy-two (72 age-matched male as controls using microbiological standard procedure. 164 (50.8% infection rate was recorded. The dorminant uropathogen detected or isolated were Staphylococcus aureus (14.0%, Chlamydia trachomatis (11.4%, Escherichia coli (4.3%, Micoplasma genitalium (4.0% Klebsielli aerogenes (4.0%. Others were Staphylococus saprophyticus, Pseudomonas aeruginosa, Protein mirabilis with 2.7% each respectively, Protein vulgaria treponema pallidum (2.1%, Schistosoma haematobium (0.9% Wulchereria Bancrofti (0.3%, Human immune virus (2.7%. Semen profile of the male patients with urogenital tract infection had abnormal semen quality in this study P<0.05. Conclusion, significance and impact of study: Oligospermic infertile male subjects should be screened for urogenital tract infection to further enhance good quality sperms and functions.

  14. No Difference in Transverse Abdominis Activation Ratio between Healthy and Asymptomatic Low Back Pain Patients during Therapeutic Exercise

    Directory of Open Access Journals (Sweden)

    Nathaniel Gorbet

    2010-01-01

    Full Text Available Dysfunction of the transverse abdominis (TrA has been associated with LBP. Several therapeutic exercises are prescribed to help target the TrA. Rehabilitative ultrasound imaging (RUSI is used to capture activation of the TrA during exercise. The purpose was to examine TrA activation during the ADIM and quadruped exercises between healthy and nonsymptomatic LBP patients. We instructed the subjects how to perform the exercises and measured muscle thickness of the TrA at rest and during the exercises using RUSI. This allowed us to calculate TrA activation ratio during these exercises. We found no significant differences between activation ratios of the two groups during either exercise; however TrA activation during the ADIM was higher than the quadruped exercise. These exercises were capable of activating the TrA, which may be in part due to the verbal instruction they received. These exercises could be used during prevention or rehabilitation programs, since the TrA is activated.

  15. Prevalence of radiographic markers of femoroacetabular impingement in asymptomatic adults

    Directory of Open Access Journals (Sweden)

    Rodrigo Benedet Scheidt

    2014-01-01

    Full Text Available OBJECTIVE: to determine the prevalence of radiographic signs of femoroacetabular impingement (FAI in asymptomatic adults and correlate them with data from physical examinations. METHODS: We conducted a cross-sectional study with 82 asymptomatic volunteers, 164 hips, between 40 and 60 years of age, selected by convenience. They were submitted to anamnesis and clinical examination of the hip, anteroposterior (AP pelvis radiographs with three incidences, Dunn 45° and Lequesne false profile of each hip, to measure the variables. We measured the alpha angle, anterior offset of the femoral neck, cervical diaphyseal angle, CE angle of Wiberg, acetabular index, Sharp angle, and the crossing, ischial spine and posterior wall signs. RESULTS: our sample consisted of 66% women, mean age of 50.4 years. The average alpha angle was 45.10°, SD=8.6. One quarter of the hips showed alpha angle greater than or equal to 50°; among men the prevalence was 34%, and among women, 11%. We found indicative radiographic signs of femoroacetabular impingement in 42.6% of hips, whether femoral or acetabular, and the increased alpha angle was related to the decrease in hip internal rotation (p<0.001. CONCLUSION: the radiographic findings of femoroacetabular impingement in asymptomatic patients were frequent in the studied sample. The increase in alpha angle was associated with decreased internal rotation.

  16. Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients

    Science.gov (United States)

    Wang, Yan; Zhang, Jin; Qian, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

    2016-01-01

    Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24–3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309–3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study. PMID:27412818

  17. Detection of group A Streptococcus in tonsils from pediatric patients reveals high rate of asymptomatic streptococcal carriage

    Directory of Open Access Journals (Sweden)

    Roberts Amity L

    2012-01-01

    Full Text Available Abstract Background Group A Streptococcus (GAS causes acute tonsillopharyngitis in children, and approximately 20% of this population are chronic carriers of GAS. Antibacterial therapy has previously been shown to be insufficient at clearing GAS carriage. Bacterial biofilms are a surface-attached bacterial community that is encased in a matrix of extracellular polymeric substances. Biofilms have been shown to provide a protective niche against the immune response and antibiotic treatments, and are often associated with recurrent or chronic bacterial infections. The objective of this study was to test the hypothesis that GAS is present within tonsil tissue at the time of tonsillectomy. Methods Blinded immunofluorescent and histological methods were employed to evaluate palatine tonsils from children undergoing routine tonsillectomy for adenotonsillar hypertrophy or recurrent GAS tonsillopharyngitis. Results Immunofluorescence analysis using anti-GAS antibody was positive in 11/30 (37% children who had tonsillectomy for adenotonsillar hypertrophy and in 10/30 (33% children who had tonsillectomy for recurrent GAS pharyngitis. Fluorescent microscopy with anti-GAS and anti-cytokeratin 8 & 18 antibodies revealed GAS was localized to the tonsillar reticulated crypts. Scanning electron microscopy identified 3-dimensional communities of cocci similar in size and morphology to GAS. The characteristics of these communities are similar to GAS biofilms from in vivo animal models. Conclusion Our study revealed the presence of GAS within the tonsillar reticulated crypts of approximately one-third of children who underwent tonsillectomy for either adenotonsillar hypertrophy or recurrent GAS tonsillopharyngitis at the Wake Forest School of Medicine. Trial Registration The tissue collected was normally discarded tissue and no patient identifiers were collected. Thus, no subjects were formally enrolled.

  18. 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.

  19. Multidimensional fatigue and its correlates in hospitalised advanced cancer patients.

    NARCIS (Netherlands)

    Echteld, M.A.; Passchier, J.; Teunissen, S.; Claessen, S.; Wit, R. de; Rijt, C.C.D. van der

    2007-01-01

    Although fatigue is a multidimensional concept, multidimensional fatigue is rarely investigated in hospitalised cancer patients. We determined the levels and correlates of multidimensional fatigue in 100 advanced cancer patients admitted for symptom control. Fatigue dimensions were general fatigue (

  20. 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.

  1. Asymptomatic Graves' disease during lithium therapy.

    OpenAIRE

    Thompson, C J; Baylis, P. H.

    1986-01-01

    Lithium salts are widely recognized to cause biochemical hypothyroidism and have been used to treat thyrotoxicosis. We present a case of Graves' disease which developed during lithium therapy. The patient was asymptomatic until the lithium was discontinued; she subsequently developed florid symptoms of thyrotoxicosis.

  2. 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.

  3. Enhancement of human immunodeficiency virus (HIV)-specific CD4+ and CD8+ cytotoxic T-lymphocyte activities in HIV-infected asymptomatic patients given recombinant gp160 vaccine.

    OpenAIRE

    Kundu, S K; Katzenstein, D; Moses, L E; Merigan, T C

    1992-01-01

    Twenty-six human immunodeficiency virus (HIV)-infected asymptomatic patients with CD4+ lymphocytes > 400 per mm3 were randomly allocated to a range of doses of recombinant gp160 or a control (recombinant hepatitis B vaccine) on a double-blind basis. Each patient received an injection at 0, 4, 12, 24, 36, and 48 weeks. Treatment assignments were decoded when all patients reached 28 weeks of the study period. HIV-1-specific CD4+ and CD8+ cytotoxic T lymphocyte (CTL) activities were assessed in ...

  4. Treatment approaches to asymptomatic follicular lymphoma.

    Science.gov (United States)

    Sarkozy, Clémentine; Salles, Gilles

    2013-12-01

    Follicular lymphoma is a heterogeneous disease in which some patients present an indolent evolution for decades and others, a rather aggressive form of the disease requiring immediate therapy. While immunochemotherapy has emerged as a standard of care for symptomatic patients, treatment of the asymptomatic population remains controversial. Since the disease is still considered incurable, delayed initiation of therapy is an acceptable option. However, four single injections of rituximab can result in an acceptable clinical response and can improve the duration of the interval without cytotoxic therapy. With recent therapeutic approaches that enable substantial improvements in life expectancy for follicular lymphoma patients, limiting short- or long-term treatment toxicities appears as a new concern in the asymptomatic population. Based on these options, the challenge is to preserve patient quality of life and prolong survival: from the patient's perspective, his/her opinion is therefore of significant importance. PMID:24219551

  5. New Insights into Genotype-phenotype Correlations in Chinese Facioscapulohumeral Muscular Dystrophy: A Retrospective Analysis of 178 Patients

    Institute of Scientific and Technical Information of China (English)

    Feng Lin; Zhi-Qiang Wang; Min-Ting Lin; Shen-Xing Murong; Ning Wang

    2015-01-01

    Background:Facioscapulohumeral muscular dystrophy (FSHD),a common autosomal dominant muscular disorder,is caused by contraction of the D4Z4 repeats on 4q35.The complicated genotype-phenotype correlation among different ethnic population remains a controversial subject.We aimed to refine this correlation in order to provide new information for genetic counseling.Methods:Here,a cohort of 136 Chinese families including 178 affected individuals and 137 unaffected members were investigated.Genetic analyses were performed using the pl3E-11,4qA and 4qB probes after pulsed field gel electrophoresis separation and southern blotting.A 10-grade FSHD clinical severity scale was adopted for clinical assessment.The genotype-phenotype correlation was established by linear regression analyses.Results:We observed a roughly inversed correlation between the short EcoRI fragment size and age-corrected clinical severity score in 154 symptomatic patients (P < 0.05).Compared to male patients,a significant higher proportion of females in both asymptomatic carriers and severe patients showed larger variation in the size of short EcoRI fragment.A high incidence (19/42,45.2%) of asymptomatic (or minimally affected) carriers was found in familial members.Conclusions:Although the number of D4Z4 repeats is known as one of the critical influences on genotype-phenotype correlation,a majority of phenotypic spectrum was still incompatible with their heterozygous contraction of the D4Z4 repeat,especial in female cases.Our results suggest that there are multi-factors synergistically modulating the phenotypic expression.

  6. Asymptomatic cerebral infarction examined by magnetic resonance imaging (MRI)

    International Nuclear Information System (INIS)

    To find the real incidence and risk factors in asymptomatic cerebral infarction, a retrospective review was made on magnetic resonance (MR) images, which were obtained from 713 outpatients seen at the Geriatrics Research Institute Hospital between March and November of 1990. The criteria for asymptomatic cerebral infarction are: high signal intensity areas larger than 3 mm in diameter on T2-weighted image; no history of stroke; no neurological and psychological signs or symptoms with or without subjective symptoms. Symptomatic cerebral stroke was defined as stroke episodes associated with neurological signs and infarction lesions on CT or MR imaging. Of a total of 713 patients, 215 (30.2%) had symtomatic cerebral infarction and 384 (53.9%) had no cerebral lesions. The incidence of asymptomatic cerebral infarction increased with aging. Cerebral risk factors, i.e. hypertension, atrial fibrillation, and diabetes mellitus, were more significantly common in both symptomatic and asymptomatic groups than the normal control group. In the group of asymptomatic patients, T2-weighted images showed hyperintensity in the corona radiata in 60.9%, in the frontal lobe in 32.1%, in the semioval center in 28.8%, and in the basal ganglia in 23.7%. Periventricular hyperintensity was present in 124 of all 713 patients (17.4%). Common complaints in asymptomatic patients were headache (40.0%), dizziness (14.4%), and neck muscle contraction (9.8%). In conclusion, MR imaging may contribute to manage asymptomatic patients. (N.K.)

  7. Correlations of estradiol and testosterone in hyperuricemia patients

    Institute of Scientific and Technical Information of China (English)

    曹永彤

    2014-01-01

    Objective To evaluate the serum concentrations of estradiol and testosterone in hyperuricemia patients and possible correlations of the two factors and uric acid(UA)in hyperuricemia(HUA)patients.Methods This was a case control study,which involved 90 hyperuricemia patients,103 healthy controls.Estradiol,testosterone,UA,serum

  8. 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.

  9. Cerebral blood flow in asymptomatic individuals

    International Nuclear Information System (INIS)

    We studied the relationship between cortical grey matter flow (CBF) and age, cerebrovascular risk factors and the severity of subcortical hypersignals (HS, hyperintensity score in MRI) in 47 asymptomatic subjects with cerebrovascular risk factors. Multiple regression analysis revealed that HS was most strongly related to CBF, and that hematocrit, age and evidence of ischemic change detected in the electrocardiogram also appeared to be independent determinants of CBF. Both the severity and location of hypersignals were correlated with CBF. The most significant negative correlation observed was that between CBF and HS in the basal ganglia-thalamic region, where the degree of signal abnormality was modest. Decreased CBF in asymptomatic subjects with cerebrovascular risk factors may be related to microcirculatory disturbance associated with elevated hematocrit and an increase in the number of risk factors, and functional suppression of cerebral cortex due to the neuronal disconnection associated with subcortical lesions. In addition, impaired cerebral circulation may be related to MRI signal abnormalities. (author)

  10. Correlation between asymptomatic hyperuricemia and number of carotid plaques%无症状高尿酸血症与颈动脉斑块数量的相关性研究

    Institute of Scientific and Technical Information of China (English)

    宋长曌; 邓汝荣; 程遥; 徐显林; 陈三民; 王道伟

    2014-01-01

    目的:探讨无症状高尿酸血症患者血尿酸水平与颈动脉斑块数量的关系。方法选择2009年1月至2013年12月间在广东省惠州市惠阳三和医院进行健康查体人员72例,依据入选对象血尿酸水平分为高尿酸组(n=39)与正常尿酸组(n=33),随访5年血尿酸水平变化,并检测颈动脉斑块数量,对血尿酸水平与颈动脉斑块数量进行相关性分析。结果纳入患者5年随访期间,高尿酸组与正常尿酸组中男性人群血尿酸水平均高于女性人群,差异均有统计学意义(P<0.05)。高尿酸组男性及女性血尿酸水平均高于正常尿酸组男性及女性尿酸水平,差异均有统计学意义(P<0.05)。两组人群5年随访期间男性及女性血尿酸水平变化不明显,年度之间血尿酸水平无统计学差异(P>0.05)。高尿酸组男性和女性颈动脉斑块数量平均为(1.9±0.5)个、(1.2±0.3)个,正常尿酸组男性和女性颈动脉斑块数量平均为(0.8±0.3)个、(0.4±0.2)个;高尿酸组男性和女性颈动脉斑块数量显著高于正常尿酸组,差异有统计学意义(P<0.05)。颈动脉斑块数量与血尿酸水平呈正相关,男性r=0.768,女性r=0.721,均有统计学意义(P<0.05)。结论血尿酸水平升高与颈动脉斑块增加明显正相关。%Objective To investigate the relationship between level of blood uric acid (BUA) and number of carotid plaques in patients with asymptomatic hyperuricemia. Methods The health persons (n=72) with physical examinations were chosen from the Huiyang Sanhe Hospital of Huizhou City of Guangdong Province from Jan. 2009 to Dec. 2013, and divided into high-BUA group (n=39) and normal-BUA group (n=33) according to their BUA level. The changes of BUA level were followed up for 5 years, and number of carotid plaques was detected. A correlation analysis on relationship between BUA level and number of carotid plaques

  11. Percutaneous ultrasound-guided renal biopsy in children: The need for renal biopsy in pediatric patients with persistent asymptomatic microscopic hematuria

    Directory of Open Access Journals (Sweden)

    Mei-Ching Yu

    2014-12-01

    Full Text Available Background: Percutaneous renal biopsy (PRB is essential for the diagnosis, prognosis, and management of children with unknown kidney disease. In this study, the safety and efficacy of PRB is investigated, and also the common etiologies of childhood kidney disease, based on histological findings. In addition, we explored the role of PRBs in the diagnosis of children who presented with persistent asymptomatic hematuria. Methods: By chart review, from July 2005 to July 2009, a total of 99 PRBs were performed on 91 children (43 girls and 48 boys; mean age, 10.9 ± 4.4 years under ultrasound (US guidance, by a doctor, using an automated 18-gauge biopsy needle following the same protocol, at a medical center in northern Taiwan. Results: The accuracy of the histological diagnosis was excellent. The most common post-biopsy complications were perirenal hematoma (11.1% and asymptomatic gross hematuria (3.0%, respectively. Nevertheless, these complications resolved spontaneously, and none had major bleeding episodes. Histological results showed that lupus nephritis, minimal change disease, and IgA nephropathy (IgAN could be the current leading causes of childhood kidney diseases in Taiwan. Conclusions: Automated ultrasound (US-guided PRB is a safe and reliable method of assessing childhood renal disease. A recent study shows that the presence of persistent asymptomatic isolated microhematuria in adolescents is a predictive marker of future end-stage renal disease. Hence, the emphasis of renal biopsy on children with persistent asymptomatic hematuria is beneficial for the early diagnosis of IgAN or other glomerulonephritis (GN, which tends toward progressive kidney disease in adulthood without prompt therapeutic intervention.

  12. 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....

  13. Clinical and radiological correlations in patients with gestational trophoblastic disease*

    Science.gov (United States)

    Lima, Lana de Lourdes Aguiar; Parente, Raphael Câmara Medeiros; Maestá, Izildinha; Amim Junior, Joffre; de Rezende Filho, Jorge Fonte; Montenegro, Carlos Antonio Barbosa; Braga, Antônio

    2016-01-01

    Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence. In the past, it was common for patients with molar pregnancy to present with marked symptoms: copious bleeding; theca lutein cysts; uterus larger than appropriate for gestational age; early preeclampsia; hyperemesis gravidarum; and hyperthyroidism. Currently, with early diagnosis made by ultrasound, most patients are diagnosed while the disease is still in the asymptomatic phase. In cases of progression to trophoblastic neoplasia, staging-typically with Doppler flow studies of the pelvis and chest X-ray, although occasionally with computed tomography or magnetic resonance imaging-is critical to the choice of an appropriate antineoplastic therapy regimen. Because it is an unusual and serious disease that affects women of reproductive age, as well as because its appropriate treatment results in high cure rates, it is crucial that radiologists be familiar with gestational trophoblastic disease, in order to facilitate its early diagnosis and to ensure appropriate follow-up imaging. PMID:27777478

  14. 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....

  15. Noninvasive Detection of Endothelial Function in Normal Subjects,Asymptomatic Patients at Risk of Atherosclerosis and Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    F. Rajabzadeh

    2005-06-01

    Full Text Available Background/Objective: The endothelial dysfunction is associated with atherosclerosis. The dilatory reaction of atherosclerotic vessels in response to occlusion is reduced. This reduction could be of value in atherosclerosis determination. This study aimed at comparing brachial artery response to occlusion and administration of nitroglycerine in three groups: coronary artery disease patients, individuals with corona ry disease risk factors but no coronary disease,and normal subjects. Patients and Methods: The participants included 23 healthy individuals, 22 subjects with cardiovascular risk factors (diabetes mellitus, smoking, hyperte nsion or hypercholesterolemia ,and 57 angiographically proven coronary pati ents. The brachial artery diameter was measured by color Doppler ultrasound at rest, 5 min utes after inflation of the cuff, and 5 minutes after sublingual administration of nitroglycerine pearl. Results: The vessel’s diameter increased the least in the coronary artery disease and coronary risk factor groups in comparison to nor mal subjects (p=0.003 and 0.048, respectively. Vessel dilatation in response to nitroglycerine did not differ in healthy individuals from the coronary patients or the risk factor group (p=0.96 and 0.77, respectively. Conclusion: Doppler ultrasound may be used as a noninvasive method to identify subjects with endothelial dysfunction at high risk of coronary artery disease who need intervention or more invasive procedures.

  16. Preliminary study on serum paraoxonase-1 status and chemokine (C-C motif) ligand 2 in hospitalized elderly patients with catheter-associated asymptomatic bacteriuria.

    Science.gov (United States)

    Iftimie, S; García-Heredia, A; Pujol, I; Ballester, F; Fort-Gallifa, I; Simó, J M; Joven, J; Camps, J; Castro, A

    2016-09-01

    Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient's immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection. PMID:27334497

  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. 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.)

  19. Scapholunate kinematics of asymptomatic wrists in comparison with symptomatic contralateral wrists using four-dimensional CT examinations: initial clinical experience

    International Nuclear Information System (INIS)

    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.)

  20. Prevention of disease progression by cardiac resynchronization therapy in patients with asymptomatic or mildly symptomatic left ventricular dysfunction: insights from the European cohort of the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial

    DEFF Research Database (Denmark)

    Daubert, Claude; Gold, Michael R; Abraham, William T;

    2009-01-01

    that CRT slows disease progression and improves the outcomes of asymptomatic or mildly symptomatic patients with left ventricular (LV) dysfunction and a wide QRS complex. METHODS: We randomly assigned 262 recipients of CRT pacemakers or defibrillators, with QRS > or =120 ms and LV ejection fraction......OBJECTIVES: The aim of this study was to determine the long-term effects of cardiac resynchronization therapy (CRT) in the European cohort of patients enrolled in the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial. BACKGROUND: Previous data suggest...... composite response. The main secondary study end point was left ventricular end-systolic volume index (LVESVi). RESULTS: In the CRT ON group, 19% of patients were worsened versus 34% in the CRT OFF group (p = 0.01). The LVESVi decreased by a mean of 27.5 +/- 31.8 ml/m(2) in the CRT ON group versus 2...

  1. Correlation between the Lactate Dehydrogenase Levels with Laboratory Variables in the Clinical Severity of Sickle Cell Anemia in Congolese Patients.

    Directory of Open Access Journals (Sweden)

    Tite Minga Mikobi

    Full Text Available Sickle cell anemia is an inflammatory disease and is characterized by chronic hemolysis. We sought to evaluate the association of lactate dehydrogenase levels with specific clinical phenotypes and laboratory variables in patients with sickle cell anemia.The present cross-sectional study was conducted in Sickle Cell Centre of Yolo in Kinshasa, the Democratic Republic of Congo. Two hundred and eleven patients with Sickle Cell Anemia in steady state were recruited. Seventy-four participants with normal Hb (Hb-AA were selected as a control group.The average rates of hemoglobin, hematocrit, and red blood cells tended to be significantly lower in subjects with Hb-SS (p<0.001. The average rates of white blood cells, platelets, reticulocytes and serum LDH were significantly higher in subjects with Hb-SS (p<0.001. The average rates of Hb, HbF, hematocrit and red blood cells of Hb-SS patients with asymptomatic clinical phenotype were significantly higher than those of the two other phenotypes. However, the average rates of white blood cells, platelets, reticulocytes, and LDH of Hb-SS patients with the severe clinical phenotype are higher than those of two other clinical phenotypes. Significant correlations were observed between Hb and white blood cell in severe clinical phenotype (r3 = -0.37 * between Hb and red blood cells in the three phenotypes (r1 = 0.69 * r2 * = 0.69, r3 = 0.83 *, and finally between Hb and reticulocytes in the asymptomatic clinical phenotype and severe clinical phenotype (r1 = -0.50 * r3 = 0.45 *. A significant increase in LDH was observed in patients with leg ulcer, cholelithiasis and aseptic necrosis of the femoral head.The increase in serum LDH is accompanied by changes in hematological parameters. In our midst, serum LDH may be considered as an indicator of the severity of the disease.

  2. Correlation between the Lactate Dehydrogenase Levels with Laboratory Variables in the Clinical Severity of Sickle Cell Anemia in Congolese Patients

    Science.gov (United States)

    Mikobi, Tite Minga; Lukusa Tshilobo, Prosper; Aloni, Michel Ntetani; Mvumbi Lelo, Georges; Akilimali, Pierre Zalagile; Muyembe-Tamfum, Jean Jacques; Race, Valérie; Matthijs, Gert; Mbuyi Mwamba, Jean Marie

    2015-01-01

    Background Sickle cell anemia is an inflammatory disease and is characterized by chronic hemolysis. We sought to evaluate the association of lactate dehydrogenase levels with specific clinical phenotypes and laboratory variables in patients with sickle cell anemia. Methods The present cross-sectional study was conducted in Sickle Cell Centre of Yolo in Kinshasa, the Democratic Republic of Congo. Two hundred and eleven patients with Sickle Cell Anemia in steady state were recruited. Seventy-four participants with normal Hb (Hb-AA) were selected as a control group. Results The average rates of hemoglobin, hematocrit, and red blood cells tended to be significantly lower in subjects with Hb-SS (p<0.001). The average rates of white blood cells, platelets, reticulocytes and serum LDH were significantly higher in subjects with Hb-SS (p<0.001). The average rates of Hb, HbF, hematocrit and red blood cells of Hb-SS patients with asymptomatic clinical phenotype were significantly higher than those of the two other phenotypes. However, the average rates of white blood cells, platelets, reticulocytes, and LDH of Hb-SS patients with the severe clinical phenotype are higher than those of two other clinical phenotypes. Significant correlations were observed between Hb and white blood cell in severe clinical phenotype (r3 = -0.37 *) between Hb and red blood cells in the three phenotypes (r1 = 0.69 * r2 * = 0.69, r3 = 0.83 *), and finally between Hb and reticulocytes in the asymptomatic clinical phenotype and severe clinical phenotype (r1 = -0.50 * r3 = 0.45 *). A significant increase in LDH was observed in patients with leg ulcer, cholelithiasis and aseptic necrosis of the femoral head. Conclusion The increase in serum LDH is accompanied by changes in hematological parameters. In our midst, serum LDH may be considered as an indicator of the severity of the disease. PMID:25946088

  3. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    Zhang Qiujuan; Yao Xiaoxin; Guo Youmin; Zhang Gejuan; Yang Junle

    2007-01-01

    Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).

  4. Asymptomatic severe aortic stenosis: challenges in diagnosis and management.

    Science.gov (United States)

    Izumi, Chisato

    2016-08-01

    Optimal management for asymptomatic severe aortic stenosis (AS) remains controversial. Considering the increase in elderly patients, improved surgical outcomes and the introduction of transcatheter aortic valve implantation, we must reconsider the optimal management of asymptomatic severe AS. In this article, previous studies regarding the natural history of asymptomatic severe AS were reviewed to obtain a clinical perspective of AS in the growing elderly patient population. The incidence of sudden death in asymptomatic severe AS varies among studies from 0.25% to 1.7% per year, with differences related to study design and patient background. Except for very severe AS, sudden death or AS-related cardiac death without preceding symptoms is uncommon if 'watchful' waiting strategy is possible. Therefore, early operation is reasonable in very severe AS, but it is not recommended for all patients with severe AS. Using exercise tests, plasma levels of natriuretic peptides and other parameters, risk stratification of asymptomatic severe AS is needed to select patients who may have greater benefit following early operation. On the other hand, 'watchful' waiting is not always possible in real world of our practice. Patient education and periodic echocardiography are essential in 'watchful' waiting, which is not simply waiting strategy without careful monitoring. Individualised discussion regarding the indication for early operation is necessary, considering age, clinical background, predicted natural history and operative risk in each patient. PMID:27091844

  5. Symptomatic versus asymptomatic knees after bilateral total knee arthroplasty: what is the difference in SPECT/CT?

    International Nuclear Information System (INIS)

    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

  6. 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

  7. Neuropsychological and MMPI correlates of patients' future employment characteristics.

    Science.gov (United States)

    Newnan, O S; Heaton, R K; Lehman, R A

    1978-04-01

    Previous research has suggested that patients' neuropsychological test scores correlate not only with neurologic status but also with their success in coping with some of the demands of daily living. This study investigated the utility of such laboratory test scores in predicting several vocational variables. Patients who had recieved neuropsychological evaluations were recontacted and questioned about their employment over the previous 6 mo. Of the 78 individuals who participated, 25 had been chronically unemployed. The remaining 53 were asked about job stability, hours worked, and wages earned, and were administered the Minnsota Job Requirements Questionnaire. Patients' scores on the Halstead-Reitan Battery, the WAIS and the MMPI were highly correlated with employment status (employed or chronically unemployed), income, and skills required on the jobs held. The results suggest that these tests may have clinical utility in assessing patients' employability, as well as the types of jobs for which they are suited. PMID:662567

  8. Neuropsychological and MMPI correlates of patients' future employment characteristics.

    Science.gov (United States)

    Newnan, O S; Heaton, R K; Lehman, R A

    1978-04-01

    Previous research has suggested that patients' neuropsychological test scores correlate not only with neurologic status but also with their success in coping with some of the demands of daily living. This study investigated the utility of such laboratory test scores in predicting several vocational variables. Patients who had recieved neuropsychological evaluations were recontacted and questioned about their employment over the previous 6 mo. Of the 78 individuals who participated, 25 had been chronically unemployed. The remaining 53 were asked about job stability, hours worked, and wages earned, and were administered the Minnsota Job Requirements Questionnaire. Patients' scores on the Halstead-Reitan Battery, the WAIS and the MMPI were highly correlated with employment status (employed or chronically unemployed), income, and skills required on the jobs held. The results suggest that these tests may have clinical utility in assessing patients' employability, as well as the types of jobs for which they are suited.

  9. Sporadic meningioangiomatosis: imaging findings with histopathologic correlations in seven patients

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Yeon; Kim, Ji Hye; Yoo, So-Young; Eo, Hong [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Suh, Yeon-Lim; Ahn, Soomin [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of)

    2013-12-15

    Meningioangiomatosis (MA) is a rare benign cerebral lesion. We aimed to evaluate the CT and MR features of sporadic MA, with a focus on the correlation between imaging and histopathologic findings. CT (n = 7) and MR (n = 8) images of eight patients (6 men and 2 women; mean age, 12.8 years; range, 4-22 years) with pathologically proven MA were retrospectively reviewed. After dividing the MA lesions according to their distribution into cortical and subcortical white matter components, the morphologic characteristics were analyzed and correlated with histopathologic findings in seven patients. CT and MR images showed cortical (n = 4, 50 %) and subcortical white matter (n = 7, 88 %) components of MA. All four cortical components revealed hyperattenuation on CT scan and T1 isointensity/T2 hypointensity on MR images, whereas subcortical white matter components showed hypoattenuation on CT scan and T1 hypointensity/T2 hyperintensity on MR images. Two cortical components (25 %) demonstrated enhancement and one subcortical white matter component demonstrated cystic change. Seven cases were available for imaging-histopathologic correlation. In all seven cases, the cortex was involved by MA and six patients (86 %) showed subcortical white matter involvement by MA. There were excellent correlations between the imaging and histopathologic findings in subcortical white matter components, and the accuracy was 100 % (seven of seven); whereas there were poor correlations in cortical components, and the accuracy was 43 % (three of seven). The cerebral cortex and subcortical white matter were concomitantly involved by MA. Subcortical white matter components of MA were more apparent than cortical components on CT and MR imaging. (orig.)

  10. Vaginal flora in asymptomatic women.

    Science.gov (United States)

    Tashjian, J H; Coulam, C B; Washington, J A

    1976-09-01

    Four groups of 25 asymptomatic women--pregnant, premenopausal and taking oral contraceptives, premenopausal and not taking oral contraceptives, and postmenopausal--were studied for the presence in vaginal specimens of aerobic bacteria, anaerobic bacteria, fungi, Mycoplasma, Chlamydia, herpes simplex virus, mycobacteria, and Trichomonas. No significant differences in microbial flora were found among the groups. PMID:957791

  11. Liver synthesis function in chronic asymptomatic or oligosymptomatic alcoholics: correlation with other liver tests A função de síntese hepática em alcoolistas crônicos assintomáticos ou oligossintomáticos. Correlações com outros testes hepáticos

    Directory of Open Access Journals (Sweden)

    Paulo Borini

    1999-06-01

    Full Text Available Liver function and its correlation with bilirubin and hepatic enzymes were evaluated in 30 male chronic asymptomatic or oligosymptomatic alcoholics admitted into the psychiatric hospital for detoxification and treatment of alcoholism. Hypoalbuminemia, lowered prothrombin activity, hypotransferrinemia and hypofibrinogenemia were detected in 32 %, 32 %, 28 %, and 24 % of patients, respectively. Transferrin was elevated in 8 %. Greater prevalence of hyperbilirubinemia was found in patients with lowered prothrombin activity, hypofibrinogenemia, or hypotransferrinemia. No correlation was found between serum bilirubin or aminotransferase levels and normal or elevated albumin levels, time or activity of prothrombin, and fibrinogen levels. Serum alkaline phosphatase was elevated in normoalbuminemics and gamma-glutamyltransferase in patients with lowered prothrombin activity. Hypoalbuminemia was associated with hypofibrinogenemia, hypotransferrinemia with elevated aspartate aminotransferase or gamma-glutamyltransferase, and hypertransferrinemia with elevation of alanine aminotransferase. These data indicated the occurrence of hepatic dysfunction due to liver damage caused directly by alcohol or by alcoholism-associated nutritional deficiencies.A função hepática e suas correlações com a bilirrubina e as enzimas hepáticas foram avaliados em 30 alcoolistas crônicos do sexo masculino, assintomáticos ou oligossintomáticos, internados em hospital psiquiátrico para desintoxicação e tratamento do alcoolismo. Hipoalbuminemia, hipoatividade da protrombina, hipofibrinogenemia e hipotransferrinemia ocorreram em 32%, 32%, 24% e 28% dos pacientes, respectivamente. A transferrina estava elevada em 8%. Maior prevalência de hiperbilirrubinemia foi encontrada em pacientes com hipoatividade da protrombina, hipofibrinogemia e hipotransferrinemia. Não observou-se correlações entre os níveis séricos da bilirrubina e das aminotransferases e os níveis normais

  12. Neuropsychological correlates of decision making in patients with bulimia nervosa.

    Science.gov (United States)

    Brand, Matthias; Franke-Sievert, Christiane; Jacoby, Georg E; Markowitsch, Hans J; Tuschen-Caffier, Brunna

    2007-11-01

    In addition to the core psychopathology of bulimia nervosa (BN), patients with BN often show impulsive behavior that has been related to decision making deficits in other patient groups, such as individuals with anorexia nervosa and pathological gamblers. However, it remains unclear whether BN patients also show difficulties in decision making. In this study, 14 patients with BN and 14 healthy comparison subjects, matched for age, gender, education, body mass index, and intelligence, were examined with the Game of Dice Task (M. Brand, E. Fujiwara, et al., 2005), a gambling task that has fixed winning probabilities and explicit rules for gains and losses, as well as with a neuropsychological test battery and personality questionnaires. On the task, the patients with BN chose the disadvantageous alternatives more frequently than did the comparison subjects. Performance on the Game of Dice Task was related to executive functioning but not to other neuropsychological functions, personality, or disease-specific variables in the BN group. Thus, in patients with BN, decision making abnormalities and executive reductions can be demonstrated and might be neuropsychological correlates of the patients' dysfunctional everyday-life decision making behavior. Neurocognitive functions should be considered in the treatment of BN.

  13. Clinicopathological and Prognostic Analysis of Patients Presented with Asymptomatic Urinary Abnormalities%无症状尿检异常患者的临床病理和预后分析

    Institute of Scientific and Technical Information of China (English)

    陈蕊; 刘昌华; 高波

    2012-01-01

    Objective To study the renal clinicopathological and prognostic analysis of the patients with asymptomatic urinary abnormalities, so that more aggressive intervention therapy to the severe pathological type cases can be made to postpone the progression of kidney disease. Methods A retrospective investigation was made in the 60 patients with asymptomatic urinary abnormalities in a routine urinary examination. All the patients underwent a renal biopsy for the pathological classifications. Results Clinically,proteinuria with hematuria was the most common manifestation pattern 63. 3% (38/60) ,hematuria for 11.7% (7/60) and proteinuria for 25% ( 15/60) . The renal insufficiency was 13. 3% ( 8/60) . IgA nephropathy accounted for 48. 3% , non-IgA mesangial proliferative glomerulonephritis for 13. 3% ,glomerular minor lesion for 11. 7% ,membranous nephropathy for 6. 7% ,focal glomerulonephritis for 6. 7% , focal segmental glomerulosclerosis for 5% , minimal change glomerulopathy for 3. 3% , mem-branoproliferative glomerulonephritis for 1.7% ,lupus nephritis for 3. 3% . After an follow-up of 18. 8 ± 11. 3( 14 —24) months,2 of the patients experienced a course of progressive deterioration of renal function. Conclusion The patients with asymptomatic u-rinary abnormalities,without any clinical symptoms,are easy to be ignored and delayed in the treatment. Renal biopsy is indicated in most of the patients for a pathological investigation of the underlining disease. Early treatment and long term follow-up is important for those patients who follow a course of chronic progressive renal disease.%目的 观察体检发现尿检异常患者的肾脏临床和病理情况,并对病理类型较重者给予积极的干预治疗,以延缓肾脏病的进展.方法 选取体检发现尿检异常患者共60例,进行肾活检检查,其中定期随访的患者20例.结果 临床表现为血尿合并蛋白尿者多见38例,占63.3%;单纯血尿7例,占11.7%;单纯蛋白尿15例,占25

  14. 尿毒症患者血清肌钙蛋白T测定的临床意义%Study of Cardiac Troponin T Assay in Asymptomatic Patients with Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    陈向东; 彭立人; 刘平

    2001-01-01

    To identify the clinical significance of cardiac troponin T (cTnT) in asymptomatic patients with chronic renal failure (CRF), vein blood was drawn from patients with CRF of no hemodialysis (HD), maintenance HD, the skeletomuscular damage, the acute myocardial infarction and CRF with heart failure patients in proper order. Fullautomatic ELISA assay was used to determine cTnT serum levels, assay serum cretinine (Cr), creatine phosphate kinase-MB (CK-MB), lactic dehydrogenase (LDH) and hydroxybutyric acid dehydrogenase (HBD). The results is that during acute myocardial infarction, the mass density of cTnT increased significantly as a result of myocardial infarction. Blood cTnT was elevated in patients of CRF with heart failure. Blood cTnT fell to normal as soon as the heart failure was cured. But cTnT was not significantly elevated in asymptomatic patients with CRF. There was no clinical specificity for cTnT assay in asymptomatic patients with CRF.%为探讨血清肌钙蛋白T(cTnT)在无症状尿毒症患者中的临床意义,分别抽取尿毒症非血液透析组、血液透析组透析前和透析后、骨骼肌损伤组、急性心肌梗死组和尿毒症合并心功能不全组病人的静脉血,以双抗体夹心法测定cTnT值,同时检测各组血肌酐(Cr)、肌酸磷酸激酶-MB同工酶(CK-MB)、乳酸脱氢酶(LDH)及羟丁酸脱氢酶(HBD)。结果显示:心肌梗死时,由于心肌大面积坏死致cTnT质量浓度明显升高;尿毒症合并心功能不全时cTnT质量浓度升高,但随心功能不全缓解,cTnT质量浓度恢复正常。而尿毒症非透析组、血透组透析前和透析后病人cTnT质量浓度与肾病对照组比较无显著性差异(P>0.01)。提示:测定无症状尿毒症患者的cTnT对判断心肌受损无特殊临床意义。

  15. The Correlation Between the Six Minute Walk Test and Spirometric Parameters in Patients with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Zahra Mirfeizi

    2015-11-01

    Full Text Available Introduction: Systemic Lupus Erythematosus (SLE is an autoimmune disease affect nearly every organ system. Pulmonary involvement, which is a common manifestation of SLE, can remain undiagnosed if asymptomatic. This study aimed to evaluate the efficiency of spirometric findings in early detection of silent pulmonary involvement and examine its correlation with the six minute walk test in SLE patients. Materials and Methods: In this cross-sectional study fifty patients, who met the American College of Rheumatology criteria for SLE, were recruited from the outpatient rheumatology clinic at the Imam Reza Hospital of Mashhad between July 2013 and September 2014. First, a checklist including demographic information and previous medical documents was completed. Then, spirometry and 6MWT was performed to evaluate subclinical pulmonary involvement and assess patients’ exercise capacity. Results: Based on the results of pulmonary function tests, patients were divided into two groups. A total of 40 patients with normal pattern were placed in one group and 10 patients with restrictive pattern in the other. The difference between SLE patients with and without abnormal spirometry were statistically significant in regard to anti-RNP positivity but total distance walked in six minute, was not significantly different between two groups (p=0.356. Additionally, there were no significant correlations between 6MWD and FVC in SLE patients in the either group as determined by Pearson’s correlation coefficient testing. (R=0.439,P=0.205 in SLE patients with normal spirometry and R=0.191,P=0.237 in those with abnormal pattern Conclusion: Considering the impact of anti-U1RNP positivity with restrictive pattern on spirometry, it can be deemed as a pulmonary involvement predictor in SLE patients. However, lack of correlation between 6MWT and spirometric parameters is suggestive of restrictive lung involvement, which in turn, demonstrates a multifactorial basis for

  16. Correlations between Lifestyle and Ischemic Heart Disease in Young Patient

    Directory of Open Access Journals (Sweden)

    Raluca IANULA

    2015-12-01

    Full Text Available Myocardial infarction in young adults, an important public health issue, is a controversial topic with many issues left unknown. Although its prevalence is low, its consequences are disastrous, as it affects apparently healthy subjects who afterwards suffer important lifestyle changes with profound social, professional and medical implications. In this perspective, the thesis aims to analyze epidemiologic aspects regarding incidence, morbidity of myocardial infarction in young people (patients under 45 years and correlation with traditional cardiovascular risk factors: tobacco use, effort, diet, dyslipidemia, obesity, hypertension, diabetes mellitus. The present study is descriptive, longitudinal, ambispective: retrospective until 2004 and prospective for next 10 years, including all of the 122 patients consecutively admitted to the Cardiology Department of Bagdasar-Arseni Hospital, aged under 45 and diagnosed with AMI. These represented 9% of all patients with this diagnosis. Considering the time evolution, we can notice an alarming increase in incidence, statistically significant, (p<0,05, for the second half of the analysed time interval. The most common cardiovascular risk factors are: smoking, dyslipidemia, obesity. Diabetes mellitus and hypertension remain risk factors specific for patients over 45 years. A significant number of young patients fulfilled the diagnostic criteria of metabolic syndrome . Cigarette smoking is the dominant risk factor found in 88 % of patients. An increase in the incidence of smoking during the study is noticed. Dyslipidemia and obesity show a linear increase in the last decade. A statistically significant association between obesity – dyslipidemia – HTN- diabetes among young men with AMI is described . In correlation with these data, 70 % of patients enrolled in the study presented a high-calorie diet in the moment of enrollment, respectively, over 3000 kcal/day, and 63 % of the patients did not practice

  17. Extent of silent cerebral infarcts in adult sickle-cell disease patients on magnetic resonance imaging: is there a correlation with the clinical severity of disease?

    Directory of Open Access Journals (Sweden)

    Ekaterini Solomou

    2013-02-01

    Full Text Available The aim of this paper is to correlate the extent of silent cerebral infarcts (SCIs on magnetic resonance imaging (MRI with the clinical severity of sickle cell disease (SCD in adult patients. Twenty-four consecutive adult asymptomatic SCD patients (11 male and 13 female with a mean age of 38.4 years (range 20-59 were submitted to brain MRI on a 1 Tesla Gyroscan Intera, Philips MR scanner with a dedicated head coil. The protocol consisted of TSE T2-weighted and FLAIR images on the axial and coronal planes. MRI readings were undertaken by two radiologists and consensus readings. Patients were compound heterozygotes (HbS/β-thal. The extent of SCIs was classified from 0-2 with 0 designating no lesions. Clinical severity was graded as 0-2 by the hematologist, according to the frequency and severity of vaso-occlusive crises. There was no statistically significant correlation between the severity of clinical disease and the extent of SCIs on MR imaging. The extent of SCI lesions did not differ statistically between younger and older patients. Patients receiving hydroxyurea had no statistically significant difference in the extent of SCI lesions. The extent of SCIs in heterozygous (HbS/β-thal SCD patients is not age related and may be quite severe even in younger (<38.4 years patients. However the extent of SCIs is not correlated with the severity of clinical disease.

  18. Management of asymptomatic silicone-injected breast with reduction mammoplasty

    Directory of Open Access Journals (Sweden)

    Theddeus Octavianus Hari Prasetyono

    2015-01-01

    Full Text Available Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic. Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics.

  19. Coronary calcification among 3477 asymptomatic and symptomatic individuals

    DEFF Research Database (Denmark)

    Øvrehus, Kristian A; Jasinskiene, Jurgita; Sand, Niels P;

    2015-01-01

    BACKGROUND: Coronary artery calcification (CAC) can be detected by cardiac computed tomography (CT), is associated to cardiovascular risk, and common in asymptomatic individuals and patients referred for cardiac CT. DESIGN: CAC was evaluated in asymptomatic individuals and symptomatic patients.......001), hyperlipidaemia (42% vs. 12%, p  0; 45% vs. 45%, p = 0.94) or severe calcifications (Agatston > 400; 6% vs. 5%, p = 0.36). In multivariate analyses age (odds ratio (OR) 1.......71-1.02)), moderate (Agatston ≥ 100; OR 0.99 (0.79-1.24)) or severe calcifications (Agatston ≥ 400; OR 0.93 (0.65-1.33)). CONCLUSION: No difference in the presence or severity of coronary calcifications was observed between asymptomatic and symptomatic middle-aged individuals. After adjusting for cardiovascular risk...

  20. Management of asymptomatic silicone-injected breast with reduction mammoplasty.

    Science.gov (United States)

    Prasetyono, Theddeus Octavianus Hari; Sadikin, Patricia Marcellina

    2015-01-01

    Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic). Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics. PMID:26933290

  1. Development and pilot feasibility study of a health information technology tool to calculate mortality risk for patients with asymptomatic carotid stenosis: the Carotid Risk Assessment Tool (CARAT)

    OpenAIRE

    Faerber, Adrienne E.; Horvath, Rebecca; Stillman, Carey; O’Connell, Melissa L; Hamilton, Amy L; Newhall, Karina A; Likosky, Donald S.; Goodney, Philip P.

    2015-01-01

    Background Patients with no history of stroke but with stenosis of the carotid arteries can reduce the risk of future stroke with surgery or stenting. At present, a physicians’ ability to recommend optimal treatments based on an individual’s risk profile requires estimating the likelihood that a patient will have a poor peri-operative outcomes and the likelihood that the patient will survive long enough to gain benefit from the procedure. We describe the development of the CArotid Risk Assess...

  2. Utility of USPIO-enhanced MR imaging to identify inflammation and the fibrous cap: A comparison of symptomatic and asymptomatic individuals

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, S.P.S. [University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ (United Kingdom); Tang, T.Y. [University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ (United Kingdom); Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Trivedi, R.; Weerakkody, R.; U-King-Im, J. [University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ (United Kingdom); Gaunt, M.E.; Boyle, J.R. [Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Li, Z.Y. [University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ (United Kingdom); Miller, S.R. [Biostatistics and Data Sciences, GlaxoSmithKline, Harlow (United Kingdom); Graves, M.J. [University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ (United Kingdom); Gillard, J.H. [University Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ (United Kingdom)], E-mail: jhg21@cam.ac.uk

    2009-06-15

    Background and purpose: Inflammation is a risk factor the vulnerable atheromatous plaque. This can be detected in vivo on high-resolution magnetic resonance (MR) imaging using a contrast agent, Sinerem{sup TM}, an ultra-small super-paramagnetic iron oxide (USPIO). The aim of this study was to explore whether there is a difference in the degree of MR defined inflammation using USPIO particles, between symptomatic and asymptomatic carotid plaques. We report further on its T{sub 1} effect of enhancing the fibrous cap, which may allow dual contrast resolution of carotid atheroma. Methods: Twenty patients with carotid stenosis (10 symptomatic and 10 asymptomatic) underwent multi-sequence MR imaging before and 36 h post-USPIO infusion. Images were manually segmented into quadrants and signal change in each quadrant was calculated following USPIO administration. Mean signal change across all quadrants were compared between the two groups. Results: Symptomatic patients had significantly more quadrants with a signal drop than asymptomatic individuals (75% vs. 32%, p < 0.01). Asymptomatic plaques had more quadrants with signal enhancement than symptomatic ones (68% vs. 25%, p < 0.05); their mean signal change was also higher (46% vs. 15%, p < 0.01) and this appeared to correlate with a thicker fibrous cap on histology. Conclusions: Symptomatic patients had more quadrants with signal drop suggesting larger inflammatory infiltrates. Asymptomatic individuals showed significantly more enhancement possibly suggesting greater stability as a result of thicker fibrous caps. However, some asymptomatic plaques also had focal areas of signal drop, suggesting an occult macrophage burden. If validated by larger studies, USPIO may be a useful dual contrast agent able to improve risk stratification of patients with carotid stenosis and inform selection for intervention.

  3. 培哚普利与美托洛尔治疗糖尿病无症状心功能不全的疗效比较%Comparison of the effect of perindopril and metoprolol in the treatment of diabetic patients with asymptomat-ic cardiac insufficiency

    Institute of Scientific and Technical Information of China (English)

    叶仕锋; 陈日来; 杨泽民; 刘徽; 黄李斐

    2015-01-01

    Objective To compare the curative effect of perindopril and metoprolol in the treatment of diabetic patients with asymptomatic cardiac insufficiency.Methods According to the method of random numbers, 152 diabetic patients with asymptomatic cardiac insufficiency were divided into the observation group and control group,with 76 cases in each group.The observation group was given with perindopril treatment,while control group was given with metoprolol treatment.The cardiac function index,glycosylated hemoglobin,BNP levels,the incidence of cardiac insufficiency and the occurrence of adverse drug reactions before and after treatment were compared.Results There were no significant differences in LVEF,Tei index and E/A between two groups before treatment (all P >0.05 ).Compared with before treatment,the cardiac function indexes of the two groups were significantly improved after treatment(t=5.96,4.83,4.91,10.22,5.68,5.18,all P0.05),and the difference between the two groups was not statistically significant(all P>0.05).The BNP levels of the observation group before and after the treatment were (515.43 ± 58.85)pg/mL and (214.43 ±32.42)pg/mL respectively,of which the control group were (513.94 ±59.11)pg/mL and (263.32 ±43.31)pg/mL respectively,and after treatment,the BNP levels of the two groups were significantly decreased(t=23.45,17.68,all P0.05).Conclusion Using perindopril in treatment of diabetic patients with asymptomatic heart function can obviously improve cardiac function,reduce the incidence of BNP and cardiac insuffi-ciency.It has the clinical curative effect and high safety.%目的:比较培哚普利与美托洛尔治疗糖尿病无症状心功能不全的临床疗效。方法将52例糖尿病无症状心功能不全患者按随机数字表法分为观察组和对照组,各76例。观察组给予培哚普利治疗,对照组予美托洛尔治疗,比较两组治疗前后的心功能指标、糖化血红蛋白水平、BNP水平、心功能不全发生

  4. Study on the Correlation between Chronic Asymptomatic HBV Carriers of Yin Asthenia Constitution and Genotypes of HLA-DRB1and HLA DQA1Alleles%慢性无症状HBV携带者阴虚体质与人类白细胞抗原-DRB1、DQA1基因多态性的联系

    Institute of Scientific and Technical Information of China (English)

    过建春; 肖丽娜; 荀运浩; 王宇芳; 李春青; 石伟珍; 施军平

    2012-01-01

    目的 探讨慢性无症状HBV携带者(chronic asymptomatic HBV carrier,ASC)阴虚体质与人类白细胞抗原(human leukocyte antigen,HLA) -DRB1、HLA-DQA1基因多态性的内在联系.方法 将105例ASC患者进行中医体质分型及分组:阴虚质组47例和非阴虚质组58例.采用聚合酶链反应-序列特异性引物(PCR-SSP)技术测定HLA-DRB1、HLA-DQA1等位基因型.结果 阴虚质组HLA-DRB1*09、HLA-DQA1*0301的基因频率明显低于非阴虚质组(分别为12.1% vs 27.8%,19.1% vs 39.7%),差异有统计学意义(P<0.01);HLA-DRB1*11、HLA-DQA1*0501的基因频率明显高于非阴虚质组(分别为12.1% vs 4.3%,28.7%vs9.5%),差异有统计学意义(P<0.05,P<0.01).结论 HLA-DRB1*09和HLA-DQA1*0301可能是ASC非阴虚体质患者的分子基础;HLA-DRB1*11和HLA-DQA1* 0501可能是ASC阴虚体质患者的分子基础.%Objective To study on the correlation between chronic asymptomatic HBV carriers (ASC) of yin asthenia constitution and genotypes of HLA-DRB1 and HLA DQAt alleles. Methods Totally 105 ASC were assigned to two groups according to their constitutions, i. e. , the yin asthenia group (47 cases) and the non-yin asthenia group (58 cases). The genotypes of HLA-DRB1 and HLA DQA1 alleles were determined using PCR-SSP. Results The gene frequency of HLA-DRB1 * 09 allele and HLA-DQA1 * 0301 aliele (being 12. 1 % and 19. 1%) were obviously lower in the yin asthenia group than in the non-yin asthenia group (being 27. 8% and 39. 7%, P<0. 05). The gene frequency of HLA-DRB1 * 11 allele and HLA-DQA1 * 0501 allele were obviously higher in the yin asthenia group (being 12. 1% and 28. 7%) than in the non-yin asthenia group (4. 3% and 9. 5%), showing statistical difference ( P < 0. 05, P < 0. 01 ). Conclusions HLA-DRB1 * 09 allele and HLA-DQA1 *0301 allele might be the molecular bases for non-yin asthenia patients with ASC. HLA-DRB1 * 11 allele and HLA-DQA1 * 0501 allele might be the molecular bases tor yin asthenia

  5. 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.

  6. Pacientes assintomáticos apresentam infecção relacionada ao cateter venoso utilizado para terapia nutricional parenteral Asymptomatic patients present infection related to the central venous catheter used for total parenteral nutrition

    Directory of Open Access Journals (Sweden)

    Juliana Deh Carvalho Machado

    2009-12-01

    . Sixty-eight percent of the catheters were infected: 72% of them were from Group 1 and 28% from Group 2 (asymptomatic patients. Systemic infection was diagnosed in 70% of the patients from Group 1. Positive blood culture was found in 17% of the patients from Group 2. The microorganisms found were: Staphylococcus sp. (48%, Candida sp. (21%, Enterococcus faecalis (16%, Pseudomonas aerurginosa (10% and Proteus sp. (5%. CONCLUSION: Central venous catheter infection is common in hospitalized asymptomatic patients. Patients receiving total parenteral nutrition are most frequently infected with Candida sp. Therefore, the creation of barriers that block colonization in the central venous catheter is essential to decrease the morbidity and mortality among patients that depend on total parenteral nutrition.

  7. CORRELATIVE STUDY OF ECG AND ECHOCARDIOGRAPHIC FINDINGS IN COPD PATIENTS

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    Anil Kumar

    2016-03-01

    Full Text Available OBJECTIVES Chronic Obstructive Pulmonary Disease (COPD is one of the commonest causes of mortality and morbidity in our country. The habit of smoking, increasing air pollution and other environmental factors facilitate the occurrence of this condition. COPD causes pulmonary hypertension through several inter-related mechanisms including hypoventilation, hypoxemia from ventilation perfusion mismatch and destruction of perfused surface area. The altered haematological and hemo-rheological factors also contribute to the development of pulmonary hypertension in COPD. Our study aims at correlating ECG and Echocardiographic findings with the severity of COPD. METHODS Our study was conducted at a tertiary hospital in Bangalore. We studied 61 patients, among them 21 were mild COPD, 20 were moderate COPD and 20 patients belonged to severe COPD patients. Patients with COPD as defined by ATS (American Thoracic Society were studied. The lung function parameters were assessed by Spiroanalyser (Vitalograph. They were categorised into mild, moderate and severe COPD based on the percentage of predicted FEV1. All of them underwent detailed clinical examination, ECG, Echocardiography and routine investigations. RESULTS The mean age of all patients was 61.11±10.51 years and majority 85.25% were males. The most common ECG finding observed in all the groups was ‘P’ pulmonale [28.57%, 40%, 45% in mild, moderate and severe COPD respectively]. The mean RV area, RA area, RVAWT were 14.26±4.82cm2, 7.98±1.97cm2 and 0.61±0.18cms; 19.19±6.02cm2, 10.68±3.45cm2 and 0.83±0.17cms; and 23.43±5.83cm2, 13.58±3.18cm2 and 0.91±0.18cms in mild, moderate and severe COPD patients respectively.

  8. Are the Intracranial Lipomas Always Asymptomatic?

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    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.

  9. Prevalence and correlates of functional dependence among maintenance dialysis patients.

    Science.gov (United States)

    Kavanagh, Niall T; Schiller, Brigitte; Saxena, Anjali B; Thomas, I-Chun; Kurella Tamura, Manjula

    2015-10-01

    Functional dependence is an important determinant of longevity and quality of life. The purpose of the current study was to determine the prevalence and correlates of functional dependence among patients with end-stage renal disease (ESRD) receiving maintenance dialysis. We enrolled 148 participants with ESRD from five clinics. Functional status, as measured by basic and instrumental activities of daily living (ADL, IADL), was ascertained by validated questionnaires. Functional dependence was defined as needing assistance in at least one of seven IADLs or at least one of four ADLs. Demographic characteristics, chronic health conditions, anthropometric measurements, and laboratories were assessed by a combination of self-report and chart review. Cognitive function was assessed with a neurocognitive battery, and depressive symptoms were assessed by questionnaire. Mean age of the sample was 56.2 ± 14.6 years. Eighty-seven participants (58.8%) demonstrated dependence in ADLs or IADLs, 70 (47.2%) exhibited IADL dependence alone, and 17 (11.5%) exhibited combined IADL and ADL dependence. In a multivariable-adjusted model, stroke, cognitive impairment, and higher systolic blood pressure were independent correlates of functional dependence. We found no significant association between demographic characteristics, chronic health conditions, depressive symptoms or laboratory measurements, and functional dependence. Impairment in executive function was more strongly associated with functional dependence than memory impairment. Functional dependence is common among ESRD patients and independently associated with stroke, systolic blood pressure, and executive function impairment. PMID:25731070

  10. Identification of asymptomatic type 2 diabetes mellitus patients with a low, intermediate and high risk of ischaemic heart disease: is there an algorithm?

    DEFF Research Database (Denmark)

    Poulsen, Mikael Kjær; Henriksen, Jan Erik; Vach, W;

    2010-01-01

    diabetes patients who had no known or suspected CVD, and had been referred consecutively to a diabetes clinic for the first time (n=305; age 58.6+/-11.3 years; diabetes duration 4.5+/-5.3 years) were screened for myocardial ischaemia using myocardial perfusion scintigraphy (MPS). RESULTS: The univariate...... the number of patients referred to MPS from 305 to 144.However, the sensitivity and specificity of the algorithm was just 68% and 62%, respectively.CONCLUSIONS/INTERPRETATION: Our algorithm was able to stratify which patients had a low, intermediate or high risk of myocardial ischaemia based on MPS. However......, the algorithm had low sensitivity and specificity, combined with high cost and time requirements.Trial registration: clinicaltrials.gov NCT00298844 Funding: The study was funded by the Danish Cardio vascular Research Academy (DaCRA), The Danish Diabetes Association and The Danish Heart Foundation....

  11. Anatomical Correlates of Non-Verbal Perception in Dementia Patients

    Science.gov (United States)

    Lin, Pin-Hsuan; Chen, Hsiu-Hui; Chen, Nai-Ching; Chang, Wen-Neng; Huang, Chi-Wei; Chang, Ya-Ting; Hsu, Shih-Wei; Hsu, Che-Wei; Chang, Chiung-Chih

    2016-01-01

    Purpose: Patients with dementia who have dissociations in verbal and non-verbal sound processing may offer insights into the anatomic basis for highly related auditory modes. Methods: To determine the neuronal networks on non-verbal perception, 16 patients with Alzheimer’s dementia (AD), 15 with behavior variant fronto-temporal dementia (bv-FTD), 14 with semantic dementia (SD) were evaluated and compared with 15 age-matched controls. Neuropsychological and auditory perceptive tasks were included to test the ability to compare pitch changes, scale-violated melody and for naming and associating with environmental sound. The brain 3D T1 images were acquired and voxel-based morphometry (VBM) was used to compare and correlated the volumetric measures with task scores. Results: The SD group scored the lowest among 3 groups in pitch or scale-violated melody tasks. In the environmental sound test, the SD group also showed impairment in naming and also in associating sound with pictures. The AD and bv-FTD groups, compared with the controls, showed no differences in all tests. VBM with task score correlation showed that atrophy in the right supra-marginal and superior temporal gyri was strongly related to deficits in detecting violated scales, while atrophy in the bilateral anterior temporal poles and left medial temporal structures was related to deficits in environmental sound recognition. Conclusions: Auditory perception of pitch, scale-violated melody or environmental sound reflects anatomical degeneration in dementia patients and the processing of non-verbal sounds are mediated by distinct neural circuits.

  12. Anatomical Correlates of Non-Verbal Perception in Dementia Patients

    Science.gov (United States)

    Lin, Pin-Hsuan; Chen, Hsiu-Hui; Chen, Nai-Ching; Chang, Wen-Neng; Huang, Chi-Wei; Chang, Ya-Ting; Hsu, Shih-Wei; Hsu, Che-Wei; Chang, Chiung-Chih

    2016-01-01

    Purpose: Patients with dementia who have dissociations in verbal and non-verbal sound processing may offer insights into the anatomic basis for highly related auditory modes. Methods: To determine the neuronal networks on non-verbal perception, 16 patients with Alzheimer’s dementia (AD), 15 with behavior variant fronto-temporal dementia (bv-FTD), 14 with semantic dementia (SD) were evaluated and compared with 15 age-matched controls. Neuropsychological and auditory perceptive tasks were included to test the ability to compare pitch changes, scale-violated melody and for naming and associating with environmental sound. The brain 3D T1 images were acquired and voxel-based morphometry (VBM) was used to compare and correlated the volumetric measures with task scores. Results: The SD group scored the lowest among 3 groups in pitch or scale-violated melody tasks. In the environmental sound test, the SD group also showed impairment in naming and also in associating sound with pictures. The AD and bv-FTD groups, compared with the controls, showed no differences in all tests. VBM with task score correlation showed that atrophy in the right supra-marginal and superior temporal gyri was strongly related to deficits in detecting violated scales, while atrophy in the bilateral anterior temporal poles and left medial temporal structures was related to deficits in environmental sound recognition. Conclusions: Auditory perception of pitch, scale-violated melody or environmental sound reflects anatomical degeneration in dementia patients and the processing of non-verbal sounds are mediated by distinct neural circuits. PMID:27630558

  13. Anatomical Correlates of Non-Verbal Perception in Dementia Patients

    Directory of Open Access Journals (Sweden)

    Pin-Hsuan Lin

    2016-08-01

    Full Text Available Purpose: Patients with dementia who have dissociations in verbal and non-verbal sound processing may offer insights into the anatomic basis for highly related auditory modes. Methods: To determine the neuronal networks on non-verbal perception, 16 patients with Alzheimer’s dementia (AD, 15 with behavior variant fronto-temporal dementia (bv-FTD, 14 with semantic dementia (SD were evaluated and compared with 15 age-matched controls. Neuropsychological and auditory perceptive tasks were included to test the ability to compare pitch changes, scale-violated melody and for naming and associating with environmental sound. The brain 3D T1 images were acquired and voxel-based morphometry (VBM was used to compare and correlated the volumetric measures with task scores. Results: The SD group scored the lowest among 3 groups in pitch or scale-violated melody tasks. In the environmental sound test, the SD group also showed impairment in naming and also in associating sound with pictures. The AD and bv-FTD groups, compared with the controls, showed no differences in all tests. VBM with task score correlation showed that atrophy in the right supra-marginal and superior temporal gyri was strongly related to deficits in detecting violated scales, while atrophy in the bilateral anterior temporal poles and left medial temporal structures was related to deficits in environmental sound recognition. Conclusions: Auditory perception of pitch, scale-violated melody or environmental sound reflects anatomical degeneration in dementia patients and the processing of non-verbal sounds is mediated by distinct neural circuits.

  14. No effects of high-dose omeprazole in patients with severe airway hyperresponsiveness and (a)symptomatic gastro-oesophageal reflux

    NARCIS (Netherlands)

    Boeree, MJ; Peters, FTM; Postma, DS; Kleibeuker, JH

    1998-01-01

    Acid gastro-oesophageal reflux may aggravate respiratory symptoms in patients with asthma and chronic obstructive pulmonary disease (COPD) by increasing airway hyperresponsiveness through vagally-mediated pathways. We wanted to determine whether elimination of acid reflux could improve symptoms in s

  15. Baseline and ongoing PET-derived factors predict detrimental effect or potential utility of 18F-FDG PET/CT (FDG-PET/CT) performed for surveillance in asymptomatic lymphoma patients in first remission

    Energy Technology Data Exchange (ETDEWEB)

    Morbelli, Silvia; Capitanio, Selene; Bongioanni, Francesca; Verardi, Maria Teresa; Buschiazzo, Ambra; Fiz, Francesco; Pomposelli, Elena; Sambuceti, Gianmario [IRCCS AOU San Martino - IST, Nuclear Medicine Unit, Genoa (Italy); De Carli, Fabrizio; Marini, Cecilia [Institute of Molecular Bioimaging and Physiology, CNR, Genoa-Milan (Italy); De Astis, Enrico; Miglino, Maurizio [IRCCS AOU San Martino-IST, Department of Hematology and Oncology, Genoa (Italy)

    2016-02-15

    To identify both clinical and FDG PET/CT-derived factors predicting the occurrence of relapse, or conversely, the likelihood of false positive findings in surveillance FDG-PET/CT studies (PETsv). The study included 149 asymptomatic patients with Hodgkin's lymphoma (HL) (n = 55) or diffuse large B cell lymphoma (DLBCL) (n = 94) in first remission. PETSv studies were performed 12, 18, 24 and 36 months thereafter. Logistic regression analysis was performed to identify clinical and imaging-derived predictors of either PET-detected relapse or false-positive (FP) results. Tested clinical variables were:(1) age, (2) HL vs. DLBCL, (3) stage of disease, (4) bulky disease, (5) previous radiotherapy. PET/CT-derived variables were: (1) maximum standardized uptake value at baseline, (2) size-incorporated maximum standardized uptake value (SIMaxSUV) at baseline, (3) positive interim PET(PET-2), (4) presence of hot spots likely to be unrelated to the disease in final PET, (5) residual non-FDG avid mass. Accuracy was 88 % for PETsv1, 95 % for PETsv2, 95 % for PETsv3 and 91 % for PETsv4. However, PPV was relatively low in all PETsv. Best predictors of relapse were result of interim PET, HL versus NHL type, SIMaxSUV, age ≥ 60. Best predictors of FP were previous radiotherapy and hot spots unrelated to the disease in final PET. The present study confirms the need of restricting the use of surveillance PET/CT to patients at high risk of relapse. Information derived from PET/CT performed at baseline (metabolic disease burden), in the course (PET2) and at the end of therapy (unrelated hot spots) can help to select high-risk patients and also to identify patients more likely to present equivocal findings at PETsv. (orig.)

  16. Asymptomatic Pellet Migration to the Heart: Report of a Case and Update on Proper Management

    Directory of Open Access Journals (Sweden)

    George Galyfos

    2014-01-01

    Full Text Available We report a case of a 42-year-old male patient who was transferred to our emergency department suffering from a gunshot wound in his left lateral thigh. The patient was haemodynamically stable, and the physical examination of the abdomen and thorax was unremarkable. There was no obvious exit point and there were no other injuries. The radiologic control of the left thigh showed an intact femur and multiple pellets within the adjacent soft tissues. Routine X-ray evaluation of the thorax revealed a small-sized round object of metal density—possibly a migrated pellet—in the proximity of the right heart atrium. Computed tomography imaging confirmed this finding and showed no other cardiac or mediastinal injury. Ultrasonography of the heart was unremarkable as well. The patient was managed conservatively for the discovered pellet, and remained asymptomatic throughout the entire hospital stay, and 6 months after the discharge. Pellet migration or embolism should be suspected in any gunshot victim without a corresponding exit wound or when the signs and symptoms do not correlate with the suspected course of the missile. Conservative management remains the first choice in asymptomatic patients, although close monitoring at first and regular observation after discharge are indicated.

  17. 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.

  18. The role of radionuclide bone scanning in follow-up of asymptomatic patients with early breast cancer (stage TIa-c)and bone marrow micro metastases

    International Nuclear Information System (INIS)

    Purpose: The presence of bone marrow micro metastases (MM-BM) in women with early breast cancer is a significant biological factor for the survival of patients (pts) with this oncological disease. The study was designed to investigate the role of radionuclide bone scanning as a highly sensitive staging procedure for detection of bone metastases in pts with MM-BM and breast cancer, stage TIa-c. Methods: Whole-body scintigraphy was carried out in 100 pts with breast cancer, stage Ia-c (aged 26-76 years, median 56) according to the clinical protocol for the 5-year postoperative follow-up. Occult tumor cells in bone marrow aspirates, taken during the surgery, were detected by cytologic and cytochemical techniques in 28 of the cases. Tumoral size (TIa,b,c), axillary lymph node status, histological type, tumor grade and SR/PR receptor status were scored for all pts. CHI-SQUARE TEST x2 was used to evaluate statistical significance of these factors for developing of bone metastases in studied women. Results: Multiple bone metastases were found on bone scans in 13 of 28 pts with MM-BM (46.4%) and in 3 of 72 pts without MM-BM(4.1%). On statistical analysis of all studied pts with early breast cancer, tumoral size, clinical N-stage, histological type, tumor grade and ER/PR receptor status were not significant (p>0.05), whereas the presence of MM-BM was significant (p<0.001) bone marrow for the development of osseous metastases in early breast cancer. Conclusion: Early identification of MM-BM and bone scintigraphy regularly performed in these pts, may have a role as factors for preventive therapy with biphosphonates in early breast cancer patients. Recent studies have supported their potential clinical application to stratify patients for adjuvant therapy

  19. Increased circulating VCAM-1 correlates with advanced disease and poor survival in patients with multiple myeloma: reduction by post-bortezomib and lenalidomide treatment.

    Science.gov (United States)

    Terpos, E; Migkou, M; Christoulas, D; Gavriatopoulou, M; Eleutherakis-Papaiakovou, E; Kanellias, N; Iakovaki, M; Panagiotidis, I; Ziogas, D C; Fotiou, D; Kastritis, E; Dimopoulos, M A

    2016-01-01

    Circulating vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and selectins were prospectively measured in 145 newly-diagnosed patients with symptomatic myeloma (NDMM), 61 patients with asymptomatic/smoldering myeloma (SMM), 47 with monoclonal gammopathy of undetermined significance (MGUS) and 87 multiple myeloma (MM) patients at first relapse who received lenalidomide- or bortezomib-based treatment (RD, n=47; or VD, n=40). Patients with NDMM had increased VCAM-1 and ICAM-1 compared with MGUS and SMM patients. Elevated VCAM-1 correlated with ISS-3 and was independently associated with inferior overall survival (OS) (45 months for patients with VCAM-1 >median vs 75 months, P=0.001). MM patients at first relapse had increased levels of ICAM-1 and L-selectin, even compared with NDMM patients and had increased levels of VCAM-1 compared with MGUS and SMM. Both VD and RD reduced dramatically serum VCAM-1 after four cycles of therapy, but only VD reduced serum ICAM-1, irrespective of response to therapy. The reduction of VCAM-1 was more pronounced after RD than after VD. Our study provides evidence for the prognostic value of VCAM-1 in myeloma patients, suggesting that VCAM-1 could be a suitable target for the development of anti-myeloma therapies. Furthermore, the reduction of VCAM-1 and ICAM-1 by RD and VD supports the inhibitory effect of these drugs on the adhesion of MM cells to stromal cells. PMID:27232930

  20. Using Electronic Patient Records to Discover Disease Correlations and Stratify Patient Cohorts

    DEFF Research Database (Denmark)

    Roque, Francisco S.; Jensen, Peter B.; Schmock, Henriette;

    2011-01-01

    phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International......Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting...

  1. Coronariopatia assintomática em chagásicos com insuficiência cardíaca: prevalência e fatores de risco Asymptomatic coronary artery disease in chagasic patients

    Directory of Open Access Journals (Sweden)

    Gustavo Carvalho

    2011-11-01

    Full Text Available FUNDAMENTO: A concomitância de doença arterial coronária assintomática em pacientes com cardiomiopatia chagásica em IC é controversa na literatura médica, pois ambas as doenças se mostram prevalentes em algumas regiões do Brasil. Objetivo: Determinar a prevalência da coronariopatia (lesões > 50% em uma população específica de pacientes com cardiomiopatia chagásica em IC classes funcionais III e IV, que não apresentavam eventos coronarianos prévios. OBJETIVO: Determinar a prevalência da coronariopatia (lesões > 50% em uma população específica de pacientes com cardiomiopatia chagásica em IC classes funcionais III e IV, que não apresentavam eventos coronarianos prévios. MÉTODOS: Realizou-se cineangiocoronariografia em 61 pacientes consecutivos, portadores de cardiomiopatia chagásica, em IC classes funcionais III e IV, para se excluir coronariopatia. Esses pacientes faziam parte do protocolo do Estudo de Terapia Celular em Cardiopatias, o qual exigia a realização de cineangiocoronariografia antes de se injetarem células-tronco. Os fatores de risco para aterosclerose também analisados nessa população foram: idade, hipertensão arterial, diabetes, dislipidemia, tabagismo e sobrepeso. RESULTADOS: Idade média 51,6 + 9,6 anos, 65,5% (n = 40 homens. A prevalência de coronariopatia encontrada nessa população foi de 1,6% (1. As prevalências dos fatores de risco foram: hipertensão arterial 18% (11, tabagismo 59% (36, diabetes 1,6% (1 e dislipidemia 6,5% (4. CONCLUSÃO: A prevalência da coronariopatia assintomática em pacientes com IC grave de etiologia chagásica é baixa e, entre os fatores de risco para doença coronária, o tabagismo foi o mais prevalente.BACKGROUND: Concomitant asymptomatic coronary artery disease in patients with Chagas cardiomyopathy in heart failure is controversial in the medical literature, as both diseases are prevalent in some regions of Brazil. OBJECTIVE: To determine the prevalence of

  2. Rare synchronous association of vestibular schwannoma and indolent insular oligodendroglioma in a patient without neurofibromatosis: controversial issue of timing for surgical treatment of asymptomatic low-grade gliomas.

    Science.gov (United States)

    Iacoangeli, Maurizio; Di Rienzo, Alessandro; Colasanti, Roberto; Alvaro, Lorenzo; Nocchi, Niccolò; Polonara, Gabriele; Di Somma, Lucia Giovanna Maria; Zizzi, Antonio; Scarpelli, Marina; Scerrati, Massimo

    2012-01-01

    The co-occurrence of a vestibular schwannoma and a low-grade glioma is rare, and even rarer is the association with an oligodendroglioma. Although various authors have addressed the problem of treating patients with incidentally discovered indolent low-grade gliomas, an established protocol does not exist to date. The common approach is to reserve surgery until there is radiological evidence of tumor growth or high-grade transformation. However, because incidental low-grade glioma may represent the first stage of unavoidable pathological progression towards high-grade glioma, early and radical surgical resection should be advocated in order to increase the chance of a "cure" and prolonged survival. This case report supports this view, and suggests reflection on a possible change from a conservative philosophy to preventative surgical treatment.

  3. Rare synchronous association of vestibular schwannoma and indolent insular oligodendroglioma in a patient without neurofibromatosis: controversial issue of timing for surgical treatment of asymptomatic low-grade gliomas

    Directory of Open Access Journals (Sweden)

    Zizzi A

    2012-11-01

    Full Text Available Maurizio Iacoangeli,1 Alessandro Di Rienzo,1 Roberto Colasanti,1 Lorenzo Alvaro,1 Niccolò Nocchi,1 Gabriele Polonara,2 Lucia Giovanna Maria Di Somma,1 Antonio Zizzi,3 Marina Scarpelli,3 Massimo Scerrati11Department of Neurosurgery, 2Department of Radiology, Section of Neuroradiology, 3Department of Pathology, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: The co-occurrence of a vestibular schwannoma and a low-grade glioma is rare, and even rarer is the association with an oligodendroglioma. Although various authors have addressed the problem of treating patients with incidentally discovered indolent low-grade gliomas, an established protocol does not exist to date. The common approach is to reserve surgery until there is radiological evidence of tumor growth or high-grade transformation. However, because incidental low-grade glioma may represent the first stage of unavoidable pathological progression towards high-grade glioma, early and radical surgical resection should be advocated in order to increase the chance of a "cure" and prolonged survival. This case report supports this view, and suggests reflection on a possible change from a conservative philosophy to preventative surgical treatment.Keywords: multiple primary intracranial tumors, vestibular schwannoma, oligodendroglioma, indolent low grade gliomas, incidentaloma, surgery

  4. Symptomatic and asymptomatic candidiasis in a pediatric intensive care unit

    OpenAIRE

    Arslankoylu Ali Ertug; Kuyucu Necdet; Yilmaz Berna; Erdogan Semra

    2011-01-01

    Abstract Introduction This study aimed to examine the incidence, epidemiology, and clinical characteristics of symptomatic and asymptomatic candidiasis in a pediatric intensive care unit (PICU), and to determine the risk factors associated with symptomatic candidiasis. Methods This retrospective study included 67 patients from a 7-bed PICU in a tertiary care hospital that had Candida-positive cultures between April 2007 and July 2009. Demographic and clinical characteristics of the patients, ...

  5. Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection

    Directory of Open Access Journals (Sweden)

    Bremell Daniel

    2013-01-01

    Full Text Available Abstract Background It has been suggested that cerebrospinal fluid (CSF CXCL13 is a diagnostic marker of Lyme neuroborreliosis (LNB, as its levels have been shown to be significantly higher in LNB than in several other CNS infections. Levels have also been shown to decline after treatment with intravenous ceftriaxone, but levels after treatment with oral doxycycline have previously not been studied. Like Borrelia burgdorferi, HIV also has neurotropic properties. Elevated serum CXCL13 concentrations have been reported in HIV patients, but data on CSF levels are limited. Methods We longitudinally analysed CSF CXCL13 concentrations in 25 LNB patients before and after oral doxycycline treatment. Furthermore, we analysed CSF CXCL13 concentrations in 16 untreated LNB patients, 27 asymptomatic untreated HIV-1 infected patients and 39 controls with no signs of infectious or inflammatory disease. Results In the longitudinal LNB study, initially high CSF CXCL13 levels declined significantly after doxycycline treatment, which correlated to a decreased CSF mononuclear cell count. In the cross-sectional study, all the LNB patients had CSF CXCL13 levels elevated above the lowest standard point of the assay (7.8 pg/mL, with a median concentration of 500 pg/mL (range 34–11,678. Of the HIV patients, 52% had elevated CSF CXCL13 levels (median 10 pg/mL, range 0–498. There was a clear overlap in CSF CXCL13 concentrations between LNB patients and asymptomatic HIV patients. All but one of the 39 controls had CSF CXCL13 levels below 7.8 pg/mL. Conclusions We confirm previous reports of highly elevated CSF CXCL13 levels in LNB patients and that these levels decline after oral doxycycline treatment. The same pattern is seen for CSF mononuclear cells. CSF CXCL13 levels are elevated in neurologically asymptomatic HIV patients and the levels overlap those of LNB patients. The diagnostic value of CSF CXCL13 in LNB remains to be established.

  6. PREVALENCE AND RISK FACTORS OF ASYMPTOMATIC CEREBRAL INFARCTION

    Directory of Open Access Journals (Sweden)

    R. R. Zhetishev

    2015-05-01

    Full Text Available Acute stroke manifesting as focal neurological deficit is a leading cause of death and disability. Of interest is the problem of asymptomatic cerebral infarctions (AСI, in which there is focal medullary involvement unaccompanied by the development of focal symptoms. The role of AСI as a marker for the progression of vascular dementia and for the further development of symptomatic stroke has not been adequately explored. There are current instrumental (neuroimaging criteria for diagnosing AСI. An update on the risk factors of AСI and their association with the further course of cerebrovascular involvement is analyzed. The results of a number of prospective studies conducted in the countries of Asia and Europe to investigate risk factors for AСI and their prognostic value are considered in detail. There is a relationship between hypertension, blood pressure instability, type 2 diabetes mellitus, some other factors, and a significantly increased risk for AСI. Based on the results of analyzing the data available in the literature, the authors demonstrate the association of prior AСI with the higher rates of progressive vascular cognitive impairments. A correlation is shown between prior AСI and an increased risk for further development of ischemic stroke accompanied by its clinical symptoms, which leads to disability. It is suggested that it is advisable to implement measures for secondary cardiovascular disease prevention, including the administration of antiaggregatory and antihypertensive agents, in patients with AСI. 

  7. Imaging in children with asymptomatic hypercalciuria and hematuria

    International Nuclear Information System (INIS)

    Fourteen children presenting with asymptomatic hematuria and hypercalciuria were evaluated with abdominal radiography, renal US, and CT of the kidneys. US and radiographic findings were negative in all patients, while CT demonstrated diffuse calcification in the medullary pyramids in eight of 14 patients (57%). Discrete foci of calcification in or adjacent to the medullary pyramids were identified in four of the eight patients (50%); one later developed overt nephrolithiasis. CT establishes that patients with hypercalciuria and hematuria are at risk for nephrocalcinosis and nephrolithiasis, suggesting that small calcifications may be important in the pathogenesis of hematuria in such patients

  8. Compariosn of the symptomatic and asymptomatic neurosyphilis patients for clinical and laboratory features%有症状与无症状神经梅毒患者临床及实验室特征的比较

    Institute of Scientific and Technical Information of China (English)

    魏春波; 伦文辉; 万钢; 徐克沂; 荣在丽

    2013-01-01

    Objective To analyze the clinical and laboratory characteristics in symptomatic neurosyphilis and asymptomatic neurosyphilis patients. Methods Total of 33 patients diagnosed as neurosyphilis received blood tests with treponema pallidum particle agglutination (TPPA), rapid plasma reagin circle card test (RPR) and cerebrospinal lfuid (CSF) examination in 2008-2012. Clinical and laboratory features of patients were ananlyzed, retrospectively. Results There were 22 cases with symptomatic neurosyphilis excluded HIV infection, with the cerebrospinal lfuid leukocyte as (25.18 ± 25.47) × 106/L and the abnormal rate as 68.2%(15/22). While for 11 cases with asymptomatic neurosyphilis, the cerebrospinal lfuid leukocyte was (21.09 ± 21.49) × 106/L and the abnormal rate was 81.8%(9/11). The cerebrospinal lfuid leukocyte count and its abnormal rate in two groups had no signiifcant differences (F=0.2432, P=0.6808). The cerebrospinal lfuid protein concentrations and abnormal rates between symptomatic neurosyphilis patients and asymptomatic neurosyphilis patients were (69.84 ± 28.83) mg/dl vs. (43.75 ± 19.6) mg/dl and 72.7%(16/22) vs. 18.2%(2/11), with signiifcant differences (F=0.0040, P=0.0078). Conclusions Abnormal CSF protein may be associated with the development and symptoms of neurosyphilis. While abnormal white blood cells in CSF may play a continuing role in the neurosyphilis progression.%目的分析有症状与无症状神经梅毒患者的临床及实验室特征。方法对33例确诊为神经梅毒的患者进行血液梅毒螺旋体明胶凝集试验(TPPA)、快速血浆反应素环状卡片试验(RPR)检测及脑脊液检测,对其临床及实验室特征进行回顾性分析。结果33例神经梅毒患者抗-HIV均为阴性,其中有症状神经梅毒患者22例(66.7%),无症状神经梅毒患者11例(33.3%);有症状神经梅毒组脑脊液白细胞计数为(25.18±25.47)×106/L,异常率为68.2%(15/22),无症状神经

  9. [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. PMID:27474244

  10. Heart rate changes during the Valsalva maneuver in patients with isolated aortic insufficiency

    Directory of Open Access Journals (Sweden)

    Navarro A.E.

    1997-01-01

    Full Text Available To determine the possible relationship between left ventricular dilatation and heart rate changes provoked by the Valsalva maneuver (Valsalva ratio, we studied 9 patients with isolated chronic aortic insufficiency. Left ventricular systolic function was assessed by two-dimensional echocardiography and cardiac catheterization. All patients were asymptomatic (functional class I of the New York Heart Association. The left ventricular internal diameters and volumes were significantly increased in all patients. The asymptomatic patients had either normal or slightly depressed ejection fraction (EF>0.40. The Valsalva ratio of these asymptomatic patients showed no significant correlation with the left ventricular volumes or with the left ventricular ejection fraction. In other words, parasympathetic heart rate control, as expressed by the Valsalva ratio, was normal in the asymptomatic patients with left ventricular dilatation and preserved left ventricular ejection fraction. Therefore, left ventricular dilatation may not be the major mechanism responsible for the abnormal parasympathetic heart rate control of patients with acquired heart disease

  11. 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.

  12. Coronary heart disease risk assessment and characterization of coronary artery disease using coronary CT angiography: comparison of asymptomatic and symptomatic groups

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Y. [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Kim, Y., E-mail: yookkim@ewha.ac.k [Department of Radiology, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Chung, I.-M. [Division of Cardiology in Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of); Ryu, J.; Park, H. [Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2010-08-15

    Aim: To evaluate the prevalence of coronary artery disease (CAD) in relation to risk of coronary heart disease (CHD) and assess plaque characteristics from coronary computed tomography (CT) angiography in asymptomatic and symptomatic patients. Materials and methods: Three hundred and ninety consecutive patients [asymptomatic group, n = 138; symptomatic group (atypical or non-anginal chest pain), n = 252] were retrospectively enrolled. They were subsequently classified into three CHD risk categories, based on the National Cholesterol Education Program guidelines, and 10 year risks of coronary events were calculated using Framingham risk score. CT was evaluated for stenosis, plaque composition, and coronary calcium scores. Results: CAD was observed in 42% of the asymptomatic group and 62% of the symptomatic group. In the former, the prevalence of CAD in low-, moderate- and high-risk subgroups was 21.4, 47.4 and 65%, respectively, and was 33.3, 74.4, and 72.4% in the symptomatic group. Framingham 10-year risks of coronary events were significantly higher in patients with CAD than in normal participants, and receiver operating characteristics curves showed that discriminatory power was poor in the asymptomatic group and symptomatic men, and good in symptomatic women. Of the participants in the asymptomatic group, 12% exhibited only non-calcified plaques and of the symptomatic group, 7% exhibited only non-calcified plaques. The coronary calcium score was significantly higher for significant stenosis than for non-significant stenosis in both groups. Conclusions: The prevalence of CAD was not negligible even in subgroups with low-to-moderate CHD risk. Additionally, the Framingham risk score was effective for predicting CAD only in symptomatic women. Coronary calcium scores correlated with significant stenosis; however, a sizeable percentage of both groups had only non-calcified plaques.

  13. Cerebral vasomotor reactivity and apnea test in symptomatic and asymptomatic high-grade carotid stenosis

    Directory of Open Access Journals (Sweden)

    Lučić-Prokin Aleksandra

    2015-01-01

    Full Text Available Introduction. Cerebral vasomotor reactivity (VMR represents an autoregulatory response of the arterial trunks on the specific vasoactive stimuli, most commonly CO2. Objective. The aim of this retrospective study was to compare VMR in high-grade symptomatic (SCAS and asymptomatic carotid stenosis (ACAS, using the apnea test to evaluate the hemodynamic status. Methods. The study included 50 patients who were hospitalized at the neurology and vascular surgery departments as part of preparation for carotid endarterectomy. We evaluated VMR by calculating the breath holding index (BHI in 34 patients with SCAS and 16 patients with ACAS, with isolated high-grade carotid stenosis. We evaluated the impact of risk factors and collateral circulation on BHI, as well as the correlation between the degree of carotid stenosis and BHI. Results. A pathological BHI was more frequent in the SCAS group (p<0.01. There was no difference in the range of BHI values between the groups, both ipsilaterally and contralaterally. Only male gender was associated with pathological BHI in both groups (p<0.05. Collateral circulation did not exist in over 60% of all subjects. We confirmed a negative correlation between the degree of carotid stenosis and BHI. Conclusion. SCAS and ACAS patients present with different hemodynamics. While ACAS patients have stable hemodynamics, combination of hemodynamic and thromboembolic effects is characteristic of SCAS patients.

  14. Is surgery necessary for 'mild' or 'asymptomatic' hyperparathyroidism?

    Science.gov (United States)

    Niederle, Bruno; Wémeau, Jean-Louis

    2015-09-01

    A large majority of the currently diagnosed patients with hyperparathyroidism (PHPT) are mild or asymptomatic, mainly women after menopause. Following the debate held at the 16th European Congress of Endocrinology in Wroclaw (Poland) from May 3-7, 2014, arguments are here presented by a surgeon and a medical practitioner considering these situations rather have to profit from surgery, or simply from survey. For the trained endocrine surgeon, it is evident that parathyroidectomy confirms the diagnosis and undoubtedly reduces the discomfort felt by certain patients, prevents all risks of complications, removes patients and medical teams from the monitoring and represents a real individual financial benefit. On the other hand, the medical practitioner considers that mild or asymptomatic PHPT is commonly stable, and very rare are the subjects at risk of complications, particularly of fractures; prevention of vascular and metabolic disorders, nephrolithiasis and bone rarefaction justify regular physical exercise, a safe alimentation, a sufficient calcium and high water intake, the correction of the frequent deficit in vitamin D; finally has also to be considered the impossibility to refer to specialized (endocrine) surgeons, the enormous cohort of subjects more than 50 years with 'mild' or 'asymptomatic' PHPT. The surgeon and the medical practitioner agree to consider that in patients with 'mild' or 'asymptomatic' disease, there is no place for medical treatments, in particular calcimimetics and bisphophonates. Both agree that further studies are needed to clarify the long-term prognosis of operated and non-operated PHPT in term of fractures, cardiovascular risk and mortality. Individual and collective cost/benefit ratios of surgery or survey are also still imperfectly evaluated. PMID:26101370

  15. Prevalence and Risk Factors for Asymptomatic Clostridium difficile Carriage

    Science.gov (United States)

    Alasmari, Faisal; Seiler, Sondra M.; Hink, Tiffany; Burnham, Carey-Ann D.; Dubberke, Erik R.

    2014-01-01

    Background. Clostridium difficile infection (CDI) incidence has increased dramatically over the last decade. Recent studies suggest that asymptomatic carriers may be an important reservoir of C. difficile in healthcare settings. We sought to identify the prevalence and risk factors for asymptomatic C. difficile carriage on admission to the hospital. Methods. Patients admitted to Barnes-Jewish Hospital without diarrhea were enrolled from June 2010 through October 2011. Demographic information and healthcare and medication exposures 90 days prior to admission were collected. Stool specimens or rectal swabs were collected within 48 hours of admission and stored at −30°C until cultured. Clostridium difficile isolates were typed and compared with isolates from patients with CDI. Results. A stool/swab specimen was obtained for 259 enrolled subjects on admission. Two hundred four (79%) were not colonized, 40 (15%) had toxigenic C. difficile (TCD), and 15 (6%) had nontoxigenic C. difficile. There were no differences between TCD-colonized and -uncolonized subjects for age (mean, 56 vs 58 years; P = .46), comorbidities, admission from another healthcare facility (33% vs 24%; P = .23), or recent hospitalization (50% vs 50%; P = .43). There were no differences in antimicrobial exposures in the 90 days prior to admission (55% vs 56%; P = .91). Asymptomatic carriers were colonized with strains similar to strains from patients with CDI, but the relative proportions were different. Conclusions. There was a high prevalence of TCD colonization on admission. In contrast to past studies, TCD colonization was not associated with recent antimicrobial or healthcare exposures. Additional investigation is needed to determine the role of asymptomatic TCD carriers on hospital-onset CDI incidence. PMID:24755858

  16. Decision logic for retreatment of asymptomatic lung cancer recurrence based on positron emission tomography findings

    International Nuclear Information System (INIS)

    Purpose: The purpose of the study was to determine if Positron emission tomography (PET) 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) imaging could detect subclinical local lung cancer recurrence and whether retreatment of such recurrence was feasible and beneficial. Methods and Materials: Twenty patients with biopsy proven lung cancer were studied with Positron emission tomography for the purpose of detecting subclinical lung cancer recurrence over a period of 4.25 years. All patients were treated with external radiation as part or all of their therapy. Twenty patients had baseline PET and computed tomography (CT) studies for comparison with later studies. Surviving patients had a total of 40 sequential PET scans and 35 CT scans. The follow-up interval ranged from 5 to 40 months posttreatment. The differential uptake ratio (DUR) was determined for regions of interest of increased FDG uptake. Results: The median DUR value of the 20 baseline PET studies was 5.59. The DUR value of greater than 3 was empirically selected as being positive for tumor detection. On baseline studies, PET had a 100% correlation with the CT findings in regard to detection of the site of primary tumor involvement. Four of 20 patients showed areas of discordance in the mediastinal and hilar areas on initial PET and CT studies. Seven of 17 patients showed discordant posttreatment PET-CT findings. Two false positive PET studies were due to radiation pneumonitis and one to macrophage glycolysis in tumor necrosis. For detection of asymptomatic tumor recurrence, analysis of sequential PET and CT studies, biopsy results, and the patient's clinical course suggested that PET had a sensitivity of 100%, specificity of 89.3%, and accuracy of 92.5%. Computerized Tomography was found to have a sensitivity of 67%, specificity of 85%, and accuracy of 82% for detection of such early-stage recurrence. Five patients went on to have retreatment with external irradiation based upon the PET evidence. Four retreated

  17. 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.

  18. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

    1998-01-01

    Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

  19. Characteristics, Correlates and Outcomes of Perceived Stigmatization in Bipolar Disorder Patients

    DEFF Research Database (Denmark)

    Nilsson, Kristine Kahr; Kugathasan, Pirathiv; Nielsen Straarup, Krista

    2016-01-01

    The aim of this study was to elucidate the characteristics, correlates and outcomes of perceived stigmatization in patients with Bipolar Disorder (BD).......The aim of this study was to elucidate the characteristics, correlates and outcomes of perceived stigmatization in patients with Bipolar Disorder (BD)....

  20. 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.

  1. 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.

  2. Headache in the paediatrics patients, clinical-EEG Correlation.

    Directory of Open Access Journals (Sweden)

    Marcelino Lizano Rabelo

    2011-12-01

    Full Text Available A descriptive study was made, with the objective to describe to a clinical group of variables epidemiologists and of laboratory of 108 patients to whom it was made to them and EEG and whose fundamental symptom was the headache; in the period January to December of 2009. The data was taken from the registry of patients of the neurophysiology department of Paediatric Hospital. The variables of the study were: age, sex, type of headache, results of the EEG, and characteristics of pathological EEG activity. The results were expressed in graphical and analyzed tables and of percentage form. The patients of 14 to 16 years predominated (40,7%, female patient (53,7%, clinically the observed recurrent acute migraine in 60 cases was the one that prevailed, as well as normality in the EEG (81,5%, the pathological cases we observed focal paroxysms in 15 patients (75% and focal alterations in 80% of the pathological EEG. Conclusions: In our environment the migraine in the paediatric patient is a frequent pathology that motivates the accomplishment of diverse studies among them the EEG, being this normal one in most of the cases and the non-specific alterations, the recurrent acute migraine and female patients prevailed.

  3. The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

    OpenAIRE

    Milošević Đorđe; Pasternak Janko; Popović Vladan; Nikolić Dragan; Milošević Pavle; Manojlović Vladimir

    2013-01-01

    Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the man...

  4. 无症状性脑梗死患者血清同型半胱胺酸水平与P300的关系%Serum level of homocysteine in the asymptomatic cerebral infarction and its correlation with P300

    Institute of Scientific and Technical Information of China (English)

    张岚; 杨涛; 熊勋波; 邓刚; 可成名; 陈燕; 向明清; 成详林

    2012-01-01

    Objective To explore the correlations among the serum level of homocysteine. P300 and symptoms. Methods P300 were obtained from 68 first — episode asymptomatic cerebral infarction (ACI) and 62 health controls (HO, the serum level of homocysteine was measured by enzyme—linked immunosorbent assay, and Clinical symptoms were assessed with Montreal Cognitive Assessment (Mo* CA) Scale and Mini —Mental State Examination(MMSE) at the same time. Results The serum level of homocysteine was significantly higher in ACI group than in HC group (P 0. 05). Conclusions The serum level of homocysteine in the first—episode ACI was increased, and cognitive dysfunctions may be related to high serum level of homocysteine. The treatment with Folic acid and Vitamin B12 might improve cognitive function in ACI patients. P300 and MoCA Scale were sensitive index for evaluation of cognitive function.%目的 研究无症状性脑梗死(ACI)患者血清同型半胱胺酸(Hcy)与事件相关电位P300及临床症状之间的关系,探讨叶酸治疗与认知功能改变的关系.方法 采用丹麦KeyPoint型肌电/诱发点位仪对68名首发ACI患者及62名正常对照进行P300测查,酶联免疫吸附法测定血清同型半胱氨酸浓度,蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)评定患者临床症状.结果 与健康对照组相比,患者组血清Hcy水平明显增高,差异有统计学意义(P<0.01),患者组P300潜伏期明显延长,波幅明显降低,差异有统计学意义(P<0.01).相关分析显示,患者血清Hcy水平与P300波幅负相关,与P300潜伏期正相关,与MoCA量表评分负相关,未发现与MMSE评分存在相关性;MoCA量表评分与P300波幅负相关,与P300潜伏期正相关,未发现与MMSE评分存在相关性;患者组经过8周叶酸和维生素岛B12治疗,血清Hcy水平明显降低(P<0.01),P300潜伏期和波幅及MoCA评分均无明显变化;经过12周的治疗,P300波幅明显增加(P<0.01),P

  5. Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

    International Nuclear Information System (INIS)

    The clinical pattern, central hemodynamics and roentgenologic data are studied in 34 patients with artificial cardiac pacemaker (ACP) to solve the problem on adequate medicamental therapy of heart failure (HF). Heart sizes and the state of a pulmonary image are estimated roentgenologically. Two types of cardiac-vessel system reactions on physical load: adequate and nonadequate - are detected. Implantation of ACP in patients with the nonadequate reaction does not lead to total liquidation of HF

  6. Taste dissatisfaction correlated factors in elderly patients with complete dentures

    OpenAIRE

    Zlatanovska, Katerina; Zarkova, Julija; Radeska, Ana; Dimova, Cena; Papakoca, Kiro

    2015-01-01

    Background: The aim of this study was to investigate taste sensation in elderly patients with complete dentures and to assign the relationship among subjective dissatisfaction with taste ability and factors such as age, gender and oral status. Methods and materials: The study comprised of 110 elderly patients with complete dentures, 61 males and 49 females, ranging in age from 52 to 80 who attended two dental offices in Shtip, Macedonia. A self-administered structured questionnaire was giv...

  7. High ERK Protein Expression Levels Correlate with Shorter Survival in Triple-Negative Breast Cancer Patients

    OpenAIRE

    Bartholomeusz, Chandra; Gonzalez-Angulo, Ana M.; Liu, Ping; Hayashi, Naoki; Lluch, Ana; Ferrer-Lozano, Jaime; Hortobágyi, Gabriel N.

    2012-01-01

    The clinical significance of extracellular signal–related kinase (ERK) was assessed in patients with triple-negative breast cancer versus patients with non–triple negative breast cancer. High ERK-2 levels were correlated with a lower overall survival rate and high phosphorylated mitogen-activated protein kinase levels were correlated with a higher relapse-free survival rate in triple-negative breast cancer patients.

  8. A Case of Asymptomatic Bezoar Incidentally Found on Intravenous Pyelogram

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    Büyükkaya R et al.

    2009-09-01

    Full Text Available Bezoars are intraluminal masses in the gastrointestinal tract that develop by collection of undigested materials. Though bezoars are usually located in the stomach, they also develop in the small intestines and cause mechanical intestinal obstructions there. Patients with bezoars usually present with intestinal obstruction. According to present literature data patients are asymptomatic and there is no bezoar case reported that was incidentally discovered. The bezoar of the present case was diagnosed with sonography and computed tomography, after a non-homogenous radioopacity was discovered in the right lower quadrant by an IVP investigation that was done due to recurrent urinary tract infection.

  9. 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...... LASF in the total study population was 21 ± 14 kdynes/cm(2) . The determinants of LASF were higher age, heart rate, body mass index, systolic blood pressure, left ventricular (LV) mass, mitral peak early velocity, maximal LA volume, and longer mitral deceleration time (multiple R(2) = 0.37, P

  10. Fear and difficulty perceived when visualizing therapeutic exercise in patients with chronic low back pain: A cross-sectional study

    OpenAIRE

    Pérez-Fernández, Marcos; Lerma-Lara, Sergio; Ferrer-Peña, Raúl; Gil-Martínez, Alfonso; López-de-Uralde-Villanueva, Ibai; Paris-Alemany, Alba; Beltrán-Alacreu, Héctor; La Touche, Roy

    2015-01-01

    The main aim of this study was to evaluate the perceived level of difficulty and fear of movement among patients with chronic low back pain (CLBP) compared with asymptomatic subjects when they visualized motor control therapeutic exercises (MCTEs) commonly used in physiotherapy. Our secondary objective was to analyse the correlation between fear of MCTEs and other psychological and disability variables. Thirty patients with CLBP comprised the treatment group, and 30 asymptomatic subjects comp...

  11. Clinical tomographic correlations of 220 patients with neurocisticercosis, Bahia, Brazil.

    Science.gov (United States)

    Andrade-Filho, Antônio de Souza; Figuerôa, Luiz Frederico da Silva; Andrade-Souza, Victor Mascarenhas

    2007-02-01

    Neurocysticercosis (NCC) is a common parasitic disease in our region, presenting diversity of neurological symptoms and signs. The present study has as primary objective an evaluation of the NCC's clinical and epidemiological profile within Bahia State, by means of a prospective study of 220 patients diagnosed from March 1988 to March 1999, with a follow-up of six months. Exams, such as Computed Cranial Tomography Scan (CT), Cerebral Spine Fluid (CSF) and Electroencephalogram (EEG), were accomplished in three distinct moments of these patients' evolution: at starting or diagnostic point (zero time), at after-intervention period (one month after treatment), and at control period (six months after treatment).

  12. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Patients with lacunar infarcts are thought tohave an increased risk of cognitive i mpair ment anddementia[1].Cognitive i mpair ment is a predictor ofpoor functional outcome in stroke survivors[2].However,in patients with lacunar infarcts,thepathway leading to cognitive i mpair ment is notclear.According to the lacunar hypothesis,cogni-tive i mpair ment results fromincreased number andvolume of lacunes,especially whenlocated strategi-cally within frontal subcortical loops[3];while Feinet al[4]found that cogn...

  13. Clinical tomographic correlations of 220 patients with neurocisticercosis, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Antônio de Souza Andrade-Filho

    2007-02-01

    Full Text Available Neurocysticercosis (NCC is a common parasitic disease in our region, presenting diversity of neurological symptoms and signs. The present study has as primary objective an evaluation of the NCC's clinical and epidemiological profile within Bahia State, by means of a prospective study of 220 patients diagnosed from March 1988 to March 1999, with a follow-up of six months. Exams, such as Computed Cranial Tomography Scan (CT, Cerebral Spine Fluid (CSF and Electroencephalogram (EEG, were accomplished in three distinct moments of these patients' evolution: at starting or diagnostic point (zero time, at after-intervention period (one month after treatment, and at control period (six months after treatment.

  14. Clinical tomographic correlations of 220 patients with neurocisticercosis, Bahia, Brazil.

    Science.gov (United States)

    Andrade-Filho, Antônio de Souza; Figuerôa, Luiz Frederico da Silva; Andrade-Souza, Victor Mascarenhas

    2007-02-01

    Neurocysticercosis (NCC) is a common parasitic disease in our region, presenting diversity of neurological symptoms and signs. The present study has as primary objective an evaluation of the NCC's clinical and epidemiological profile within Bahia State, by means of a prospective study of 220 patients diagnosed from March 1988 to March 1999, with a follow-up of six months. Exams, such as Computed Cranial Tomography Scan (CT), Cerebral Spine Fluid (CSF) and Electroencephalogram (EEG), were accomplished in three distinct moments of these patients' evolution: at starting or diagnostic point (zero time), at after-intervention period (one month after treatment), and at control period (six months after treatment). PMID:17625739

  15. Anatomical correlates of cognitive functions in early Parkinson's disease patients.

    Directory of Open Access Journals (Sweden)

    Roberta Biundo

    Full Text Available BACKGROUND: Cognitive deficits may occur early in Parkinson's disease (PD but the extent of cortical involvement associated with cognitive dysfunction needs additional investigations. The aim of our study is to identify the anatomical pattern of cortical thickness alterations in patients with early stage PD and its relationship with cognitive disability. METHODS: We recruited 29 PD patients and 21 healthy controls. All PD patients performed an extensive neuropsychological examination and 14 were diagnosed with mild cognitive impairment (PD-MCI. Surface-based cortical thickness analysis was applied to investigate the topographical distribution of cortical and subcortical alterations in early PD compared with controls and to assess the relationship between cognition and regional cortical changes in PD-MCI. RESULTS: Overall PD patients showed focal cortical (occipital-parietal areas, orbito-frontal and olfactory areas and subcortical thinning when compared with controls. PD-MCI showed a wide spectrum of cognitive deficits and related significant regional thickening in the right parietal-frontal as well as in the left temporal-occipital areas. CONCLUSION: Our results confirm the presence of changes in grey matter thickness at relatively early PD stage and support previous studies showing thinning and atrophy in the neocortex and subcortical regions. Relative cortical thickening in PD-MCI may instead express compensatory neuroplasticity. Brain reserve mechanisms might first modulate cognitive decline during the initial stages of PD.

  16. 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...... in 55 (3.5%) and no AF in 1,421 (90.9%). Incidence of new-onset AF was 1.2%/year; highest in those with impaired LV function. In multivariable analysis, longstanding AF was compared to no AF at baseline, associated with a 4.1-fold higher risk of heart failure (CI 1.2 to 13.8, p=0.02) and a 4.8-fold...... higher risk of non-hemorrhagic stroke (CI 1.7 to 13.6, p=0.003). CONCLUSION: Rate of AF is moderate in asymptomatic AS. Longstanding but not episodic AF was, independently predictive of increased risk of heart failure and non-hemorrhagic stroke. New-onset AF was associated with cardiac decompensation....

  17. A Rare Entity: Adult Asymptomatic Giant Vallecular Cyst

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    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.

  18. Phenotype-genotype correlations in patients with Wilson's disease.

    Science.gov (United States)

    Ferenci, Peter

    2014-05-01

    There is considerable phenotypic variation in Wilson's disease (WD). Some patients present with hepatic disease during the first decade of life and some with neurological degeneration in adolescence or adult life, with or without overt liver disease. Although the absence of neurologic disease in patients with liver disease in childhood or adolescence can be explained by the limited time exposure of the central nervous system to copper toxicity, it is surprising that late-onset neurologic WD can occur without any evidence of liver involvement. This huge variability in the clinical presentation of WD in general reflects our limited knowledge on the natural history of WD. Genetic association studies require the phenotype to be defined as accurately as possible.

  19. Clinical tomographic correlations of 220 patients with neurocisticercosis, Bahia, Brazil

    OpenAIRE

    Antônio de Souza Andrade-Filho; Luiz Frederico da Silva Figuerôa; Victor Mascarenhas Andrade-Souza

    2007-01-01

    Neurocysticercosis (NCC) is a common parasitic disease in our region, presenting diversity of neurological symptoms and signs. The present study has as primary objective an evaluation of the NCC's clinical and epidemiological profile within Bahia State, by means of a prospective study of 220 patients diagnosed from March 1988 to March 1999, with a follow-up of six months. Exams, such as Computed Cranial Tomography Scan (CT), Cerebral Spine Fluid (CSF) and Electroencephalogram (EEG), were acco...

  20. Phenotypic correlations in a patient with ring chromosome 22

    Directory of Open Access Journals (Sweden)

    Demirhan Osman

    2010-01-01

    Full Text Available Ring chromosome 22, a rare cytogenetic anomaly, has been described in over 60 cases in the medical literature. The aim of this report was to present a case carrying ring chromosome 22, and her family. It is a case report of a patient presented at Medical Faculty of Ηukurova University in Turkey. An 8-year-old girl with ring chromosome 22 and her family were evaluated cytogenetically and clinically. A chromosome analysis of the proband revealed a de novo 46,XX,r(22(p11.2;q13 karyotype. Our subject demonstrated the prominent features of this syndrome including profound mental retardation, language impairment, dysmorphic features, lack of speech, hyperactivity, and behavioral disorders. There is lack of consistency between the physical abnormalities that we observed in our subject and those observed for such patients in the literature. The wide range of manifestations observed in patients with this cytogenetic alteration is probably due to size differences in the deleted region.

  1. Vascular Effects of Advanced Glycation End-Products: Content of Immunohistochemically Detected AGEs in Radial Artery Samples as a Predictor for Arterial Calcification and Cardiovascular Risk in Asymptomatic Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Katarzyna Janda

    2015-01-01

    Full Text Available Objectives. Our aim was to determine whether vascular deposition of advanced glycation end-products (AGEs is associated with arterial calcification and cardiovascular mortality in chronic kidney disease (CKD patients and to assess the relationships between vascular content of AGEs and selected clinical and biochemical parameters. Materials and Methods. The study comprised 54 CKD patients (33 hemodialyzed, 21 predialyzed. Examined parameters included BMI, incidence of diabetes, plasma fasting glucose, AGEs, soluble receptor for AGEs and 2,2-diphenyl-1-picrylhydrazyl (DPPH scavenging, serum C-reactive protein (hsCRP, plasminogen activator inhibitor-1 (PAI-1, and fetuin-A. Fragments of radial artery obtained during creation of hemodialysis access were stained for calcifications using alizarin red. AGEs deposits were identified immunohistochemically and their relative content was quantified. Results. Vascular content of AGEs was positively correlated with BMI, hsCRP, fetuin-A, PAI-1, and DPPH scavenging in simple regression; only fetuin-A was an independent predictor in multiple regression. There was a significant positive trend in the intensity of AGEs immunostaining among patients with grades 1, 2, and 3 calcifications. AGEs immunostaining intensity predicted 3-year cardiovascular mortality irrespective of patient’s age. Conclusions. The present study demonstrates an involvement of AGEs in the development of medial arterial calcification and the impact of arterial AGE deposition on cardiovascular mortality in CKD patients.

  2. Correlates of 25-hydroxyvitamin D among Chinese breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Liang Shi

    Full Text Available BACKGROUND: Few studies have investigated vitamin D status in association with modifiable lifestyle factors and clinical characteristics among breast cancer patients, with no studies among Chinese women, who may be at higher risk of vitamin D deficiency. We aimed to evaluate circulating 25-hydroxyvitamin D (25(OHD levels in association with clinical and lifestyle factors among 1,940 Chinese breast cancer patients. METHODS: Participants included breast cancer cases aged 22-77 from a population-based case-control study conducted in Shanghai, China during 1996-1998 (n = 1,044 and 2002-2005 (n = 896. Circulating 25(OHD levels were measured in plasma samples (95% collected ≤6 months post-diagnosis. Prevalence ORs and 95% CIs were derived from multinomial logistic regression models, adjusting for age, season, and other factors. RESULTS: About 23% and 48% of women were vitamin D deficient (<30 nmol/L or insufficient (30-50 nmol/L, respectively. Tumor characteristics were not associated with vitamin D status. Higher BMI was associated with increased odds of vitamin D deficiency (ORs (95% CIs: 1 (reference, 1.12 (0.85,1.47, and 1.57 (1.02,2.42, for <23, 23-<27.5, and ≥27.5 kg/m(2, respectively, Ptrend <0.06. Total physical activity was associated with reduced odds of vitamin D deficiency (ORs (95% CIs:1 (reference, 0.84 (0.59,1.20, 0.65 (0.45,0.93, and 0.69 (0.48,1.00, for <7.65, 7.65-<10.6, 10.6-<13.5, ≥13.5 MET-hours/day, respectively, Ptrend <0.02. Smoking was associated with vitamin D insufficiency and deficiency (ORs (95% CIs: 2.50 (1.07,5.84 and 2.78 (1.11,6.95, respectively. CONCLUSIONS: In the largest study to date, the prevalence of low vitamin D status was high among Chinese breast cancer patients and associated with higher BMI, smoking, and lower physical activity. Our findings support careful monitoring of vitamin D status and recommendations for supplementation and other lifestyle modifications that may improve vitamin D status

  3. Identification of Human T-lymphotropic Virus Type I (HTLV-I Subtypes Using Restrited Fragment Length Polymorphism in a Cohort of Asymptomatic Carriers and Patients with HTLV-I-associated Myelopathy/tropical Spastic Paraparesis from São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Aluisio AC Segurado

    2002-04-01

    Full Text Available Although human T-lymphotropic virus type I (HTLV-I exhibits high genetic stability, as compared to other RNA viruses and particularly to human immunodeficiency virus (HIV, genotypic subtypes of this human retrovirus have been characterized in isolates from diverse geographical areas. These are currently believed not to be associated with different pathogenetic outcomes of infection. The present study aimed at characterizing genotypic subtypes of viral isolates from 70 HTLV-I-infected individuals from São Paulo, Brazil, including 42 asymptomatic carriers and 28 patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP, using restricted fragment length polymorphism (RFLP analysis of long terminal repeat (LTR HTLV-I proviral DNA sequences. Peripheral blood mononuclear cell lysates were amplified by nested polymerase chain reaction (PCR and amplicons submitted to enzymatic digestion using a panel of endonucleases. Among HTLV-I asymptomatic carriers, viral cosmopolitan subtypes A, B, C and E were identified in 73.8%, 7.1%, 7.1% and 12% of tested samples, respectively, whereas among HAM/TSP patients, cosmopolitan A (89.3%, cosmopolitan C (7.1% and cosmopolitan E (3.6% subtypes were detected. HTLV-I subtypes were not statistically significant associated with patients' clinical status. We also conclude that RFLP analysis is a suitable tool for descriptive studies on the molecular epidemiology of HTLV-I infections in our environment.

  4. ASYMPTOMATIC BACTERIURIA AND PYURIA IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    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.

  5. Asymptomatic bacteriuria Escherichia coli strains

    DEFF Research Database (Denmark)

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

    2006-01-01

    to uropathogenic E. coli (UPEC) that cause symptomatic UTI, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we have investigated the growth characteristics in human urine as well as adhesin repertoire of nine ABU strains; the ability of ABU strains to compete...... against the UPEC strain CFT073 was also studied. The different ABU strains displayed a wide variety of the measured characteristics. Half of the ABU strains displayed functional type 1 fimbriae while only one expressed functional P fimbriae. A good correlation between the growth rate of a particular...

  6. Decreased salivary sulphotransferase activity correlated with inflammation and autoimmunity parameters in Sjogren's syndrome patients

    DEFF Research Database (Denmark)

    Castro, Isabel; Aguilera, Sergio; Brockhausen, Inka;

    2012-01-01

    To determine the expression and enzymatic activities of sulphotransferases involved in mucin hyposulphation in labial salivary glands (LSGs) from SS patients and to correlate sulphotransferase activity with clinical parameters such as secretion, inflammation and serology....

  7. Correlation between bullying and clinical depression in adolescent patients

    Directory of Open Access Journals (Sweden)

    Kaltiala-Heino R

    2011-03-01

    Full Text Available Riittakerttu Kaltiala-Heino1, Sari Fröjd21University of Tampere Medical School, Tampere, Finland; 2Tampere School of Public Health, University of Tampere, FinlandAbstract: A literature review of the associations between involvement in bullying and depression is presented. Many studies have demonstrated a concurrent association between involvement in bullying and depression in adolescent population samples. Not only victims but also bullies display increased risk of depression, although not all studies have confirmed this for the bullies. Retrospective studies among adults support the notion that victimization is followed by depression. Prospective follow-up studies have suggested both that victimization from bullying may be a risk factor for depression and that depression may predispose adolescents to bullying. Research among clinically referred adolescents is scarce but suggests that correlations between victimization from bullying and depression are likely to be similar in clinical and population samples. Adolescents who bully present with elevated numbers of psychiatric symptoms and psychiatric and social welfare treatment contacts.Keywords: depression, bullying, adolescence 

  8. Correlation between obstructive coronary artery disease and electron beam tomography coronary artery calcium scan

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hoon; Hong, Yong Kook; Park, Sung Il; Lee, Hyang Mee; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-08-01

    To determine the correlation between obstructive coronary artery disease and electron beam tomography coronary artery calcium(EBT CAC) scan and to measure the difference in calcium score according to symptoms. Materials and Methods : Fifty-six patients underwent EBT CAC scanning and either coronary angiography or stress thallium 201 scanning or the treadmill test. When the results were positive, coronary artery obstructive disease(CAOD) was assumed to be present. The patients were divided into three groups : symptomatic CAOD,asymptomatic CAOD, and asymptomatic non- CAOD; those with a previous history of myocardial ischemia or who showed positive results in any of the three tests relating to typical symptoms of angina were assigned to the symptomatic group. Results : The number of cases assigned to group to group 1,2 and 3 was 19, 16 and 21, respectively; total CAC scores were 571 {+-} 751, 600 {+-} 726 293{+-} 401, respectively. The difference in CAC score between asymptomatic CAOD and asymptomatic non- CAOD was not statistically significant(p=0.079) but in asymptomatic CAOD, the score tended to be higher. The CAC score was not different between symptomatic and asymptomatic CAOD(p>0.1). When the CAC threshold was 1, sensitivity was 89% and specificity was 14%;when the threshold was 200, sensitivity was 60% and specificity was 67%. Conclusion : When the EBT CAC score is high, further evaluation provides early evidence of coronary artery obstructive disease.

  9. Surveillance study for creating the national clinical database relating to ECG-gated myocardial perfusion SPECT of asymptomatic ischemic heart disease in patients with type-2 diabetes mellitus. J-ACCESS 2 study design

    International Nuclear Information System (INIS)

    used by the largest number (83.2%), followed by hypotensive (66.7%), hypolipidemic (40.7%), and antiplatelet drugs (27.7%), vasodilators (5.5%), and antioxidants and others (2.3%). This study was designed to clarify the correlation between coronary artery disease and diabetes mellitus as its risk factor based on the clinical and imaging findings. Patient enrollment was closed on September 30, 2005, and follow-up is now under way. (author)

  10. Sex Differences and Correlates of Pain in Patients with Comorbid Obesity and Binge Eating Disorder

    OpenAIRE

    Masheb, Robin M.; White, Marney A.; Grilo, Carlos M.

    2016-01-01

    Sex differences and correlates of pain were examined in a sample of patients with comorbid binge eating disorder (BED) and obesity. One hundred fifty-two treatment-seeking patients with BED completed the Brief Pain Inventory. Analysis of covariance was utilized to compare women and men on pain, and correlational analysis, overall and by sex, was performed to examine relationships among pain, eating behaviour and metabolic risk factors. Women reported significantly greater pain severity and pa...

  11. [Applying method of correlative adaptometry for evaluating of treatment efficiency of obese patients].

    Science.gov (United States)

    Vasil'ev, A V; Mal'tsev, G Iu; Khrushcheva, Iu V; Razzhevaĭkin, V N; Shpitonkov, M I

    2007-01-01

    By the method of correlative adaptometry was perfomed a treatment of many physiological and biochemical data from patients with different degree of obese and in during dietotherapy treatment. It was shown that weight of correlative graphs of more informative parameters was originally high and parallel with the heave of disease and was decreases during a dietotherapy. It was concluded, that correlative adaptometry is the promising method of evaluation nutrition status and quality of dietotherapy. PMID:17561653

  12. Correlation between vitamin D and lipid profile in patients with ischemic stroke

    Directory of Open Access Journals (Sweden)

    Richa Giri

    2016-06-01

    Results: A positive correlation was seen between vitamin D and serum cholesterol, VLDL, LDL, triglycerides, cholesterol/HDL ratio and LDL/HDL ratio but inverse correlation between vitamin D and HDL. Conclusions: In ischemic stroke patients increase in vitamin D is associated with increase in atherogenic lipids. [Int J Res Med Sci 2016; 4(6.000: 2309-2312

  13. 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%.

  14. 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.

  15. 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.

  16. The histopathological features of asymptomatic hepatitis C virus-antibody positive blood donors.

    Science.gov (United States)

    McMahon, R F; Yates, A J; McLindon, J; Babbs, C; Love, E M; Warnes, T W

    1994-06-01

    Since the introduction of screening for hepatitis C virus (HCV) in donated blood, the risk of contracting posttransfusion hepatitis has been greatly reduced and the test has led to the recognition of asymptomatic blood donors positive for anti-HCV antibodies. Following confirmation of the HCV status with second generation RIBA testing followed by counselling, 55 patients had full investigations, including liver biopsy. These were classified by the traditional chronic hepatitis system and were graded according to the Knodell and Scheuer histological activity indices. Seven of the biopsies were normal (12%), apart from minor degrees of steatosis in two. Eleven cases (20%) were in the chronic lobular hepatitis category without portal inflammation, while 37 cases showed portal inflammation, including 20 (36%) cases where chronic persistent hepatitis was the predominant feature and 17 cases (31%) where there was chronic active hepatitis with piecemeal necrosis. Features which have previously been described in chronic HCV-associated hepatitis were noted: portal lymphoid aggregates (58%), lymphoid follicles with germinal centres (15%), bile duct damage (11%), lobular inflammation (80%), sinusoidal mononuclear cell infiltration (26%), acidophil body formation (11%), and steatosis (47%). Fibrosis was present in 46% of cases but was generally of mild degree; 9% of biopsies demonstrated bridging fibrosis but no cases of cirrhosis were present. Even though serum transaminase levels correlated well with the presence of chronic hepatitis and with the Scheuer and Knodell activity indices, a proportion of patients with significant liver damage had normal transaminase levels, and this study suggests the need for liver biopsy in the evaluation of asymptomatic HCV-positive blood donors. PMID:7520412

  17. 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...

  18. Correlation between erosive esophagitis and low-dose aspirin in elderly patients

    Institute of Scientific and Technical Information of China (English)

    于雪

    2013-01-01

    Objective To investigate the correlation between erosive esophagitis (EE) and low dose aspirin in elderly patients.Methods From January 2009 to August 2012,a total of 304 patients to undergo upper gastrointestinal endoscopy in our hospital without history of upper gastrointestinal operation,malignant tumor,liver cirrhosis and

  19. Correlation between serum osteocalcin and type 2 diabetes mellitus in elderly patients

    Institute of Scientific and Technical Information of China (English)

    邓捷

    2013-01-01

    Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged≥60 years were enrolled in this study.The

  20. The analysis of correlation between serum procalcitonin concentration and microbial infectionsin patients with sepsis

    Institute of Scientific and Technical Information of China (English)

    孙胜男

    2013-01-01

    Objective To investigate the diagnostic and predict value of procalcitonin (PCT) in ICU patients with sepsis and the correlation between PCT concentration and positive results of bacterial culture.Methods A total of 278patients with sepsis were admitted into emergency ICU,general ICU and respiratory ICU from October 2011 to September 2012.Of them,193 patients had definite microbial infection evidence.Serum PCT levels among groups of different pathogens were compared.The analysis of correlation between the PCT concentration of the

  1. Correlation between leptin level with lipid profile and free fatty acid in liver cirrhosis patients

    OpenAIRE

    Siti Maryani; Neneng Ratnasari; Siti Nurdjanah

    2015-01-01

    Malnutrition is a common condition in liver cirrhotic patients. Leptin regulates body weightphysiologically by suppressing appetite and increasing energy expenditure. Leptin is higher in femalethan male. Studies have shown correlation between leptin with metabolic factors like body massindex (BMI) and lipid profile in cirrhotic patients. This study was conducted to investigate thecorrelation between serum leptin levels with lipid profile and free fatty acid in male patients with livercirrhosi...

  2. Correlative study between neuron-specific enolase and blood sugar level in ischemic stroke patients

    OpenAIRE

    Aparna Pandey; Kiran Saxena; Meena Verma; Anuradha Bharosay

    2011-01-01

    Background: A study to investigate the level of the neurobiochemical marker, Neuron-Specific Enolase (NSE), at the time of admission and its correlation with the blood sugar level in ischemic stroke patients. Patients and Methods: We investigated 90 patients with complete stroke who were admitted to the Stroke Unit of the Department of Neurology at Sri Aurobindo Institute of Medical Sciences. NSE was measured with commercially available quantitative ‘sandwich’ enzyme-linked immunosorbent assa...

  3. Fear of Falling in Subacute Hemiplegic Stroke Patients: Associating Factors and Correlations with Quality of Life

    OpenAIRE

    Kim, Eun Joo; Kim, Doo Young; Kim, Wan Ho; Lee, Kwang Lae; Yoon, Yong Hoon; Park, Jeong Mi; Shin, Jung In; Kim, Seong Kyu; Kim, Dong Goo

    2012-01-01

    Objective To determine the associating factors of fear of falling (FOF) and the correlations between FOF and quality of life (QOL) on subacute stroke patients in Korea. Method Fifty hemiplegic subacute stroke patients in our clinic were recruited. We directly asked patients with their fear of falling and interviewed them with the Korean version of falls efficacy scale-international (KFES-I). We divided the participants into two groups; with FOF and without FOF. We compared these groups with t...

  4. Correlation between quality of life assessment and a personality neurobiologic model in dialyzed patients.

    Science.gov (United States)

    Buemi, Michele; Caccamo, Chiara; Floccari, Fulvio; Coppolino, Giuseppe; Tripodo, Donatella; Giacobbe, Maria Stella; Senatore, Massimino; Aloisi, Carmela; Ruello, Antonella; Sturiale, Alessio; Ientile, Riccardo; Crisafulli, Giuseppe; Coppolino, Salvatore; Villari, Antonino; Frisina, Nicola

    2003-01-01

    The Short Form 36 Health Survey (SF-36) is a self-administered scoring system that has been widely used and validated as a quality of life (QOL) assessment tool. In our study, a cluster analysis of SF-36 scores was performed in 50 healthy volunteers (controls) and 50 neurobiologically asymptomatic patients on maintenance hemodialysis (MHD). Firstly, we assayed the tendency to form clusters from each of the investigated dimensions. Statistic analysis was performed using the Student's t-test for independent measurements and multiple regression analysis. Secondly, we attempted to evaluate if the MHD to apply to both groups a general psychobiological personality model developed by Cloninger in 1987. Cloninger describes three independent personality dimensions: novelty seeking (NS), harm avoidance (HA)and reward dependence (RD). Each personality dimension would be the expression of hereditary variations integrating the three main brain systems, respectively: dopaminergic, serotoninergic and noradrenergic. Finally, we then aimed to investigate possible interferences among the seric concentrations of the neuromodulators and SF-36 scores, in the attempt to identify, using a simple approach, the complex personality structure of MHD patients. QOL self-assessment and seric neuromodulators were measured in both groups, choosing an interdialytic day for MHD patients. We found that MHD patients perceived a significant worsening in their QOL in all investigated dimensions with respect to the controls. In addition, they showed significantly lower dopamine and serotonine concentrations and significantly higher noradrenaline concentrations. Therefore, our study, confirmed data reported previously in the literature, that cluster analysis of SF-36 scores provides different results in the MHD population in comparison to normal subjects. In fact, comparing the hierarchical trees of both groups, it appeared evident that in MHD patients, cluster dimensions were greater than in the

  5. Microflora of urogenital tract in pregnancy with asymptomatic bacterium

    International Nuclear Information System (INIS)

    The article contains results of research interrelationship from colonization of vagina and urinary tract diseases. E.coli one of the main factors in development asymptomatic bacterium. Presented high effects of penicillin medicaments and nitrofurans in treatment of asymptomatic bacterium

  6. Increased platelet activation in early symptomatic versus asymptomatic carotid stenosis and relationship with microembolic status: Results from the Platelets And Carotid Stenosis (PACS) Study.

    LENUS (Irish Health Repository)

    Kinsella, Ja

    2013-04-26

    BACKGROUND: Cerebral microembolic signals (MES) may predict increased stroke risk in carotid stenosis. However, the relationship between platelet counts or platelet activation status and MES in symptomatic versus asymptomatic carotid stenosis has not been comprehensively assessed. SETTING: University teaching hospitals. METHODS: This prospective, pilot observational study assessed platelet counts and platelet activation status, and the relationship between platelet activation and MES in asymptomatic versus early (≤4 weeks after TIA\\/stroke) and late phase (≥3 months) symptomatic moderate or severe (≥50%) carotid stenosis patients. Full blood count measurements were performed, and whole blood flow cytometry was used to quantify platelet surface activation marker expression (CD62P and CD63) and circulating leucocyte-platelet complexes. Bilateral simultaneous transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed for 1 hour to classify patients as MES-positive or MES-negative. RESULTS: Data from 31 asymptomatic patients were compared with 46 symptomatic patients in the early phase, and 35 of these patients followed up to the late phase after symptom onset. The median platelet count (211 vs. 200 x 10(9) \\/L; p=0.03) and the median% lymphocyte-platelet complexes were higher in early symptomatic than asymptomatic patients (2.8 vs. 2.4%, p=0.001). The% lymphocyte-platelet complexes was higher in early symptomatic than asymptomatic patients with ≥70% carotid stenosis (p=0.0005), and in symptomatic patients recruited within 7 days of symptom onset (p=0.028). Complete TCD data were available in 25 asymptomatic and 31 early phase symptomatic, and 27 late phase symptomatic patients. 12% of asymptomatic versus 32% of early phase symptomatic (p=0.02) and 19% of late phase symptomatic patients (p=0.2) were MES-positive. Early symptomatic MES-negative patients had a higher% lymphocyte-platelet complexes than asymptomatic MES

  7. 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...... in patients with a CD4+ count of more than 500 cells per cubic millimeter. The risks of a grade 4 event were similar in the two groups, as were the risks of unscheduled hospital admissions. CONCLUSIONS: The initiation of antiretroviral therapy in HIV-positive adults with a CD4+ count of more than 500 cells...

  8. CORRELATION BETWEEN SERUM HER-2 ONCOPROTEIN AND PATIENTS WITH BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    Peng Yuan; Bing-he Xu; Da-tong Chu

    2004-01-01

    Objective To detect serum HER-2 oncoprotein levels in patients with operable and metastatic breast cancers, and to study the correlations between serum HER-2 level and lymph node status as well as other clinical parameters.Methods A total of 120 women were studied consisting of 10 healthy volunteers, 31 benign breast disease, 53 operable breast cancer, and 26 metastatic breast cancer patients. The levels of serum HER-2 were measured using an enzyme-liked immunosorbent assay (ELISA).Results The mean serum HER-2 levels were 9.6 + 1.5 ng/mL in healthy volunteers, 11.9 + 1.6 ng/mL in benign breast disease, 13.2 + 4.2 ng/mL in operable breast cancer, and 30.5 + 30.8 ng/mL in metastatic breast cancer patients. The former is much lower than the latter three (P=0.02, 0.001, 0.03, respectively). If using 15 ng/mL as a normal baseline, elevated serum HER-2 levels were observed in none of the healthy volunteers as well as patients with benign disease, but in 18.9% (10/53)operable breast cancer patients and 61.5% (16/26) metastatic patients. In patients with operable breast cancer, there was a positive correlation between serum concentrations of HER-2 and the size of primary rumor (P < 0.05), whereas there was no correlation between serum concentration and axillary lymph node or estrogen receptor status. In patients with metastatic disease, there was no correlation with site of metastases (P > 0.05).Conclusion Serum HER-2 level was strongly correlated with rumor loads and clinical stages, thus acting as a promising predictor of cancer recurrence in breast cancer patients.

  9. Decreased serum hepcidin concentration correlates with brain iron deposition in patients with HBV-related cirrhosis.

    Directory of Open Access Journals (Sweden)

    Dong Lin

    Full Text Available PURPOSE: Excessive brain iron accumulation contributes to cognitive impairments in hepatitis B virus (HBV-related cirrhotic patients. The underlying mechanism remains unclear. Hepcidin, a liver-produced, 25-aminoacid peptide, is the major regulator of systemic iron metabolism. Abnormal hepcidin level is a key factor in some body iron accumulation or deficiency disorders, especially in those associated with liver diseases. Our study was aimed to explore the relationship between brain iron content in patients with HBV-related cirrhosis and serum hepcidin level. METHODS: Seventy HBV-related cirrhotic patients and forty age- sex-matched healthy controls were enrolled. Brain iron content was quantified by susceptibility weighted phase imaging technique. Serum hepcidin as well as serum iron, serum transferrin, ferritin, soluble transferrin receptor, total iron binding capacity, and transferrin saturation were tested in thirty cirrhotic patients and nineteen healthy controls. Pearson correlation analysis was performed to investigate correlation between brain iron concentrations and serum hepcidin, or other iron parameters. RESULTS: Cirrhotic patients had increased brain iron accumulation compared to controls in the left red nuclear, the bilateral substantia nigra, the bilateral thalamus, the right caudate, and the right putamen. Cirrhotic patients had significantly decreased serum hepcidin concentration, as well as lower serum transferring level, lower total iron binding capacity and higher transferrin saturation, compared to controls. Serum hepcidin level negatively correlated with the iron content in the right caudate, while serum ferritin level positively correlated with the iron content in the bilateral putamen in cirrhotic patients. CONCLUSIONS: Decreased serum hepcidin level correlated with excessive iron accumulation in the basal ganglia in HBV-related cirrhotic patients. Our results indicated that systemic iron overload underlined regional

  10. Correlation between motor performance scales, body composition, and anthropometry in patients with Duchenne muscular dystrophy.

    Science.gov (United States)

    Bayram, Erhan; Topcu, Yasemin; Karakaya, Pakize; Bayram, Meral Torun; Sahin, Ebru; Gunduz, Nihan; Yis, Uluc; Peker, Ozlen; Kurul, Semra Hiz

    2013-06-01

    The aim of this study is to investigate the relationship between body composition, anthropometry, and motor scales in patients with Duchenne muscular dystrophy (DMD). Twenty six patients with DMD were evaluated by Expanded Hammersmith Functional Motor Scale (HFMSE), gross motor function classification system (GMFCS), multifrequency bioelectrical impedance analysis, and anthropometric measurements. Seventeen healthy children served as control group. There were 26 patients with a mean age of 9.5 ± 4.8 years. Ages and anthropometric measurements did not differ between groups. Of the 26 patients, nine were level I, seven were level II, two were level III, seven were level IV, and one was level V, according to the GMFCS. Despite the similar percentage of total body water, extracellular water/intracellular water ratio was significantly elevated in DMD patients (p = 0.001). Increased values of fat percentage and body fat mass index (BFMI) correlated positively with elevated GMFCS levels (r = 0.785 and 0.719 respectively). Increased fat-free mass index (FFMI) correlated negatively with elevated GMFCS levels (r = -0.401). Increased fat percentage and BFMI correlated negatively with HFMSE scores (r = -0.779 and -0.698, respectively). Increased values of FFMI correlated positively with HFMSE scores. There was also a negative correlation between increased skin fold measurements from triceps and scapula and HFMSE scores (r = -0.618 and -0.683, respectively). Increased skin fold values from the same regions correlated positively with elevated GMFCS levels (r = 0.643 and 0.712, respectively). Significant body composition changes occur in patients with DMD. Anthropometric and multifrequency bioelectrical impedance analyses measurements show good correlation between motor function scales. These results may also be helpful to evaluate the effects of new treatment strategies. PMID:22975832

  11. Heparanase Localization and Expression by Head and Neck Cancer: Correlation with Tumor Progression and Patient Survival

    Directory of Open Access Journals (Sweden)

    Ilana Doweck

    2006-12-01

    Full Text Available Heparanase is an endoglycosidase that specifically cleaves heparan sulfate (HS side chains of HS proteoglycans, the major proteoglycans in the extracellular matrix and cell surfaces. Traditionally, heparanase activity was implicated in cellular invasion associated with angiogenesis, inflammation, and cancer metastasis. More recently, heparanase upregulation was documented in an increasing number of primary human tumors, correlating with reduced postoperative survival rate and enhanced tumor angiogenesis. In the present study, we examined the expression of heparanase in squamous cell carcinoma of the head and neck by means of immunostaining, and we correlated expression levels with patient outcome. The intensity and extent of heparanase staining correlated with tumor stage (P = .049 and P = .027, respectively, and the extent of staining further correlated with tumor grade (P = .047. Moreover, heparanase expression inversely correlated with patient status at the end of the study (P = .012. Notably, heparanase localization was found to be an important parameter for patient status. Thus, 63% of patients with nuclear staining, compared to 19% of patients with cytoplasmic staining (P=.0043, were alive, indicating that nuclear localization of the enzyme predicts a favorable outcome.

  12. Personality Style in Patients Looking for Tooth Bleaching and Its Correlation with Treatment Satisfaction.

    Science.gov (United States)

    Martin, Javier; Rivas, Vanessa; Vildósola, Patricio; Moncada, Laura; Oliveira Junior, Osmir B; Saad, José Roberto C; Fernandez, Eduardo; Moncada, Gustavo

    2016-01-01

    In the last years the focus in dentistry has shifted to an "esthetic dentistry" approach, where patients are concerned about reaching a better look of their teeth. Vital tooth bleaching is a technique with immediate results, which improves the appearance and patient's self-esteem. The aim of this study was to recognize personality characteristics determined by the Millon Index of Personality Styles of participants looking for tooth bleaching and to correlate them to satisfaction with the treatment. Forty participants were included and filled out the Millon Index of Personality Styles form before treatment. Expectation about tooth bleaching was quantified from 1 to 5. Patients were treated with bleaching agent according to manufacturer's directions. One week after treatment, the patient's satisfaction was quantified from 1 to 5. Prevailing personality characteristics were determined. Expectations and satisfaction values of all patients were correlated with each of the presented personality scales by Spearman Rho test. Ten scales prevailed over their counterpart. Median of patient's expectation was 2 and satisfaction 4. Only the score of a single characteristic (extraversing) showed statistically significant correlation with patient satisfaction. Patients looking for tooth bleaching treatment seem to have common personality characteristics. Almost all of them wanted to achieve a moderate change in teeth color and the result of the treatment was usually satisfactory. PMID:27007348

  13. 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. PMID:26722984

  14. 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.

  15. Motor slowing in asymptomatic HIV infection.

    Science.gov (United States)

    Fitzgibbon, M L; Cella, D F; Humfleet, G; Griffin, E; Sheridan, K

    1989-06-01

    To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample. PMID:2762096

  16. Correlation between MRI findings and long-term outcome in patients with severe brain trauma

    Energy Technology Data Exchange (ETDEWEB)

    Pierallini, A.; Pantano, P.; Fantozzi, L.M.; Bonamini, M. [Dept. of Neurological Sciences, Univ. di Roma (Italy); Vichi, R.; Zylberman, R.; Pisarri, F. [Hospital San Giovanni Battista, SMOM, Roma (Italy); Colonnese, C. [IRCCS Neuromed, Pozzilli (Italy); Bozzao, L. [Dept. of Neurological Sciences, Univ. di Roma (Italy); IRCCS Neuromed, Pozzilli (Italy)

    2000-12-01

    Our aim was to relate MRI findings in patients with severe traumatic brain injury (TBI) to clinical severity and long-term outcome. We studied 37 patients with severe TBI, who were submitted to clinical assessment for disability and cognition and to MRI 60-90 days after trauma. Clinical assessment was also performed 3, 6 and 12 months later. The number and volume of lesions in various cerebral structures were calculated semiautomatically from FLAIR and fast field-echo images. Possible correlations between total and regional lesion volume and clinical deficits were then investigated. The frontal and temporal lobes were most frequently involved. Total lesion volume on FLAIR images correlated significantly with clinical outcome, whereas that on FFE images did not. Regional analysis showed that FLAIR lesion volume in the corpus callosum correlated significantly with scores on disability and cognition scales at the first clinical assessment. FLAIR lesion volume in the frontal lobes correlated significantly with clinical scores 1 year later. (orig.)

  17. Ecocardiograma sob estresse com dobutamina em pacientes assintomáticos com regurgitação aórtica Ecocardiografía bajo estrés con dobutamina en pacientes asintomáticos con regurgitación aórtica Dobutamine-stress echocardiography in asymptomatic patients with aortic regurgitation

    Directory of Open Access Journals (Sweden)

    Marcia M. Barbosa

    2009-07-01

    Full Text Available FUNDAMENTO: A reserva contrátil diminuída pode já estar presente em pacientes portadores de regurgitação aórtica, assintomáticos com fração de ejeção (FE normal, indicando a necessidade de avaliações frequentes e acuradas da função ventricular esquerda para detectar disfunção sistólica incipiente. OBJETIVO: Analisar se incrementos na FE em doses baixas de dobutamina podem predizer cirugia e/ou morte em pacientes com regurgitação aórtica. MÉTODOS: Eco de estresse com dobutamina foi realizado em 24 pacientes portadores de regurgitação aórtica para verificar se incrementos da FE em doses baixas de dobutamina seriam capazes de predizer a necessidade de cirurgia e/ou morte nesse grupo de pacientes. RESULTADOS: A idade média foi de 37,8±16,8 anos, e 16 (66% eram homens. A FE aumentou de um valor basal médio de 62,3±7,9% para 71,5±10,5%, na dose de 20 µg/kg/min de dobutamina (p FUNDAMENTO: La reserva contráctil disminuida puede ya estar presente en pacientes portadores de regurgitación aórtica, asintomáticos con fracción de eyección (FE normal, indicando la necesidad de evaluaciones frecuentes y cuidadosas de la función ventricular izquierda para detectar disfunción sistólica incipiente. OBJETIVO: Analizar se incrementos en la FE en dosis bajas de dobutamina pueden predecir cirugía y/o muerte en pacientes con regurgitación aórtica. MÉTODOS: Eco de estrés con dobutamina se realizó en 24 pacientes portadores de regurgitación aórtica para verificar se incrementos de la FE en dosis bajas de dobutamina serían capaces de predecir la necesidad de cirugía y/o muerte en ese grupo de pacientes. RESULTADOS: La edad promedio fue de 37,8±16,8, y 16 (66% eran varones. La FE aumentó de un valor basal promedio de 62,3±7,9% para 71,5±10,5%, en la dosis de 20 µg/kg/min de dobutamina (p BACKGROUND: Decreased contractile reserve may already be present in asymptomatic patients with aortic regurgitation and normal

  18. Correlation between subtalar varus angle and disability in patients with patellofemoral arthritis

    Directory of Open Access Journals (Sweden)

    Patel Birenkumar Jagdishbhai

    2009-11-01

    Full Text Available Aim: To find the correlation between subtalar varus angle & disability in patients with patellofemoral arthritis. Methods: A total of 30 subjects aged (48.86±5.74 referred to the department of physiotherapy, with patellofemoral arthritis and fulfilling the criteria of inclusion were recruited for the study, sampling method being convenient sampling. Disability score was measured of each patient by WOMAC index (Western Ontario and McMaster Universities Index of Osteoarthritis disability questionnaire and subtalar varus angle was measured in non weight bearing position in prone lying. Results: Pearson’s correlation coefficient test showed a highly significant (p=0.000 positive correlation (r=0.821 between disability scores and subtalar varus angle. Conclusion: There is a highly significant relation between disabilities due to patellofemoral pain in patellofemoral arthritis patients and sub talar varus angle

  19. CORRELATIONS BETWEEN FINDINGS OF OCCLUSAL AND MANUAL ANALYSIS IN TMD-PATIENTS

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    Mariana Dimova

    2016-08-01

    Full Text Available The aim of this study was to investigate and analyze the possible correlations between findings by manual functional analysis and clinical occlusal analysis in TMD-patients. Material and methods: Material of this study are 111 TMD-patients selected after visual diagnostics, functional brief review under Ahlers Jakstatt, intraoral examination and taking periodontal status. In the period September 2014 - March 2016 all patients were subjected to manual functional analysis and clinical occlusal analysis. 17 people (10 women and 7 men underwent imaging with cone-beam computed tomography. Results: There were found many statistically significant correlations between tests of the structural analysis that indicate the relationships between findings. Conclusion: The presence of statistically significant correlations between occlusal relationships, freedom in the centric and condition of the muscle complex of masticatory system and TMJ confirm the relationship between the state of occlusal components and TMD.

  20. Asymptomatic torsion of intra-abdominal testis

    OpenAIRE

    M. Amin El-Gohary

    2015-01-01

    We report a case of intra-abdominal testicular torsion, of eight years old boy who presented with asymptomatic left impalpable testis. Diagnostic laparoscopy revealed a twisted small intra-abdominal testis in which the spermatic cord twisted 3 times over a band attached to the internal ring. The cord was long enough to bring the small testis into the scrotal sac. This case highlights the pole of laparoscopy in the management of impalpable testes.

  1. CORRELATIONS BETWEEN THE FIBRINOGEN’S VALUES AND THE GODAL TEST AT PATIENTS WITH HEMATOLOGICAL DISORDERS

    Directory of Open Access Journals (Sweden)

    Violeta-Alina Duma

    2005-01-01

    Full Text Available The aim of our study is to present the correlations between the fibrinogen’s values and the Godal test on a lot of 57 patients admitted in the Municipal Clinical Hospital of Timişoara for haematological disorders. We found that low values of fibrinogen correlate to a negative FMT in 82% of cases, while the high values of fibrinogen are accompanied by a positive FMT in 90.9% of the cases studied.

  2. CORRELATION OF INFLAMMATION BIOMARKERS WITH THE TRADITIONAL RISK FACTORS IN PATIENTS WITH ACUTE CORONARY SYNDROME

    OpenAIRE

    I. S. Skopec; N N Vezikova; I M Marusenko; O. Yu. Barysheva; A. V. Malafeev; A. N. Malygin

    2016-01-01

    Actuality of cardiovascular diseases today determines the high interest to study pathogenesis of atherosclerosis and to searching new risk factors which could help to optimize primary and secondary prevention. Study the correlation between biomarkers of inflammation and traditional risk factors (TRF) in patients with different forms of ischemic heart disease is really important today.Aim. To determine the correlation between TRF and the level of biomarkers of the inflammation and endothelial ...

  3. 颈动脉支架置入术对无症状重度颈动脉狭窄患者认知功能的影响%Effect of carotid artery stenting on cognitive function in patients with asymptomatic severe carotid artery stenosis

    Institute of Scientific and Technical Information of China (English)

    赵启媛; 金平; 吴章松; 张钧; 陈生; 汪凯

    2014-01-01

    Objective To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with asymptomatic severe carotid artery stenosis.Methods The patients with asymptomatic severe carotid stenosis (stenosis ≥ 70%) were enrolled in the study.The cognitive function evaluation was performed before CAS,1 and 3 months after procedure respectively with mini-mental status scale (MMSE),digital span (DS),Chinese auditory learning test (CALT),judgment of line orientation test (JLOT),and verbal fluency test (VFT),including attention,memory,visual spatial function,and frontal fluency function.Results A total of 26 patients with asymptomatic severe carotid artery stenosis who performed CAS were enrolled,18 were males and 8 were females (aged 52 to 79 years,mean 64.19 ±6.76 years),and the years of education was 9.84 ± 3.29 years.Eighteen patients had left carotid artery stenosis and 8 had contralateral carotid artery stenosis.CAS was performed successfully in all patients,and no complications occurred.Compared with the CAS before procedure,all the cognitive functions were improved significantly at 1 and 3 months after procedure (all P <0.01),however,there was no significant difference between 1 and 3 months after procedure (all P> 0.05).Conclusions CAS may improve cognitive function in patients with asymptomatic severe carotid artery stenosis,and it was more obvious in the early postoperative period.%目的 探讨颈动脉支架置入术(carotid artery stenosis,CAS)对无症状重度颈动脉狭窄患者认知功能的影响.方法 纳入行CAS的无症状重度颈动脉狭窄(狭窄程度≥70%)患者,分别于CAS术前、术后1个月和3个月采用简易智能状态检测量表(Mini-Mental Status Examination,MMSE)、数字广度测验(Digital Span,DS)、中文听觉词汇学习测验(Chinese Auditory Learning Test,CALT)、线段方向判定测验(Judgment of Line Orientation Test,JLOT)和语言流畅性测验(Verbal Fluency Test,VFT)进行认

  4. Analysis of CTA imaging feature for the neck vascular plagues in elderly patients with senile asymptomatic cerebral infarction%老年无症状脑梗死患者颈部血管斑块CTA影像学特点分析

    Institute of Scientific and Technical Information of China (English)

    赵红英; 杨国涛

    2014-01-01

    Objective Using MDCTA(multi slice spiral CT angiography)analyzed the characteristics of senile asymptomatic cerebral infarction patients with neck vascular plaque and plaque and the relationship between symptoms of cerebral infarction and distribution characteristics. Methods a retrospective analysis of 294 cases of senile cerebral infarction patients without symptoms of head and neck CTA findings and clinical data was done, with comparative analysis on the relationship between parts and the cerebral infarction of different properties of vascular plaques prone. Results The occurrence probability of patients with cerebral infarction of senile asymptomatic neck vascular calcification plaque and non calcified plaque had no statistical significance. Calcified plaque appeared more common in the intracranial segment of internal carotid artery, and non calcified plaques appeared more common in carotid artery. Conclusion The incidence of calcified plaque and non calcified plaques had an important role in asymptomatic cerebral infarction of the elderly.%目的:应用MDCTA(多排螺旋CT血管成像)检查分析老年无症状脑梗死患者颈部血管斑块性质及分布特点以及斑块分布特点与老年无症状脑梗死之间的关系。方法回顾性分析294例老年无症状脑梗死患者头颈部CTA结果和临床资料,比较分析不同性质的血管斑块容易发生的部位与脑梗死之间的关系。结果老年无症状脑梗死患者颈部血管钙化斑块与非钙化斑块发生概率差异无统计学意义,钙化斑块出现在颈内动脉颅内段较多,而非钙化斑块出现在颈总动脉较多。钙化斑块及非钙化斑块均对老年人无症状脑梗死的发病起重要作用。结论老年无症状脑梗死患者积极行头颈部CTA检查可以及时、详尽的了解颈部血管斑块病变,分析患者梗死灶出现的致病机理,对临床治疗起到重要的指导作用。

  5. MRI-identified abnormalities and wrist range of motion in asymptomatic versus symptomatic computer users

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    Pavlosky William F

    2010-11-01

    Full Text Available Abstract Background Previous work has shown an association between restricted wrist range of motion (ROM and upper extremity musculoskeletal disorders in computer users. We compared the prevalence of MRI-identified wrist abnormalities and wrist ROM between asymptomatic and symptomatic computer users. Methods MR images at 1.5 T of both wrists were obtained from 10 asymptomatic controls (8 F, 2 M and 14 computer users (10 F, 4 M with chronic wrist pain (10 bilateral; 4 right-side. Maximum wrist range of motion in flexion and radioulnar deviation was measured with an electrogoniometer. Results Extraosseous ganglia were identified in 66.6% of asymptomatic wrists and in 75% of symptomatic wrists. Intraosseous ganglia were identified in 45.8% of asymptomatic wrists and in 75% of symptomatic wrists, and were significantly (p p Conclusions This appears to be the first MRI study of wrist abnormalities in computer users. This study demonstrates that a variety of wrist abnormalities are common in computer users and that only intraosseous ganglia prevalence and size differed between asymptomatic and symptomatic wrists. Flexion was restricted in the dominant wrist of the symptomatic group, but the correlation between wrist flexion and intraosseous ganglion burden did not reach significance. Flexion restriction may be an indicator of increased joint loading, and identifying the cause may help to guide preventive and therapeutic interventions.

  6. Outcome after neoadjuvant chemoradiation and correlation with nutritional status in patients with locally advanced pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Naumann, P.; Habermehl, D.; Welzel, T.; Combs, S.E. [University Clinic Heidelberg (Germany). Dept. of Radiation Oncology; Debus, J. [University Clinic Heidelberg (Germany). Dept. of Radiation Oncology; Deutsches Krebsforschungszentrum, Heidelberg (Germany)

    2013-09-15

    Background: Cancer patients commonly suffer from weight loss since rapid tumor growth can cause catabolic metabolism and depletion of energy stores such as abdominal fat. In locally advanced pancreatic cancer this is even more pronounced due to abdominal pain, fatigue, nausea or malnutrition. In the present article, we quantify this frequently observed weight loss and assess its impact on outcome and survival. Methods: Data on demographics, biometrics, toxicity and survival were collected for the last 100 patients treated with neoadjuvant chemoradiation for locally advanced pancreatic cancer at our department (45.0 Gy and boost up to 54.0 Gy plus concurrent and subsequent gemcitabine), and the subcutaneous fat area at the umbilicus level was measured by computer tomography before and after chemoradiation. Results: After chemoradiation, patients showed a highly statistically significant weight loss and reduction of the subcutaneous fat area. We could determine a very strong correlation of subcutaneous fat area to patient BMI. By categorizing patients according to their BMI based on the WHO classification as slender, normal, overweight and obese, we found improved but not statistically significant survival among obese patients. Accordingly, patients who showed less weight loss tended to survive longer. Conclusions: In this study, patients with pancreatic cancer lost weight during chemoradiation and their subcutaneous fat diminished. Changes in subcutaneous fat area were highly correlated with patients' BMI. Moreover, obese patients and patients who lost less weight had an improved outcome after treatment. Although the extent of weight loss was not significantly correlated with survival, the observed trend warrants greater attention to nutritional status in the future. (orig.)

  7. Outcome after neoadjuvant chemoradiation and correlation with nutritional status in patients with locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Background: Cancer patients commonly suffer from weight loss since rapid tumor growth can cause catabolic metabolism and depletion of energy stores such as abdominal fat. In locally advanced pancreatic cancer this is even more pronounced due to abdominal pain, fatigue, nausea or malnutrition. In the present article, we quantify this frequently observed weight loss and assess its impact on outcome and survival. Methods: Data on demographics, biometrics, toxicity and survival were collected for the last 100 patients treated with neoadjuvant chemoradiation for locally advanced pancreatic cancer at our department (45.0 Gy and boost up to 54.0 Gy plus concurrent and subsequent gemcitabine), and the subcutaneous fat area at the umbilicus level was measured by computer tomography before and after chemoradiation. Results: After chemoradiation, patients showed a highly statistically significant weight loss and reduction of the subcutaneous fat area. We could determine a very strong correlation of subcutaneous fat area to patient BMI. By categorizing patients according to their BMI based on the WHO classification as slender, normal, overweight and obese, we found improved but not statistically significant survival among obese patients. Accordingly, patients who showed less weight loss tended to survive longer. Conclusions: In this study, patients with pancreatic cancer lost weight during chemoradiation and their subcutaneous fat diminished. Changes in subcutaneous fat area were highly correlated with patients' BMI. Moreover, obese patients and patients who lost less weight had an improved outcome after treatment. Although the extent of weight loss was not significantly correlated with survival, the observed trend warrants greater attention to nutritional status in the future. (orig.)

  8. Correlation between the levels of circulating adhesion molecules and atherosclerosis in type-2 diabetic normotensive patients

    Science.gov (United States)

    Vargas-Robles, Hilda; Serrano, Alberto Maceda; Lozano-Nuevo, Jose Juan; Escalante-Acosta, Bruno Alfonso

    2009-01-01

    Endothelial dysfunction is a common feature in type-2 diabetic patients and is associated with inflammation, increased levels of circulating soluble adhesion molecules and atherosclerosis. The aim of this study was to evaluate the relationship between the levels of circulating soluble adhesion molecules and the degree of atherosclerosis in normotensive type-2 diabetic patients. Results: We found significant correlations between ICAM-1 (r = 0.69, p < 0.001 95% IC 0.65 to 0.82) and VCAM-1 (r = 0.4, p < 0.03, 95% IC 0.65 to 0.82) levels and maximal carotid artery intimal-medial thickness, whereas no correlation was observed with E-selectin. Methods: We studied 30 normotensive type-2 diabetic patients in whom VCAM-1, ICAM-1 and E-selectin were measured by ELISA. Additionally, the intimal-medial thickness of both the common and internal carotid arteries was measured (B-mode ultrasound). The levels of circulating adhesion molecules and maximal carotid artery intimal-medial thicknesses were correlated using the Spearman correlation coefficient test. Statistical analysis was performed with ANOVA. Conclusion: Our results suggest that ICAM-1 and VCAM-1 are markers associated, and correlated with the degree of atherosclerosis in normotensive type-2 diabetic patients. PMID:19717975

  9. Correlations between choroidal abnormalities, Lisch nodules, and age in patients with neurofibromatosis type 1

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    Makino S

    2014-01-01

    Full Text Available Shinji Makino, Hironobu Tampo, Yusuke Arai, Hiroto ObataDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanAbstract: To evaluate correlations between choroidal abnormalities, Lisch nodules, and age in patients with neurofibromatosis type 1 (NF1, we examined ten cases with NF1 using near-infrared reflectance imaging. Patients ranged in age from 4 to 39 years. The angle used for near-infrared reflectance imaging was 55°. We counted the total number of choroidal abnormalities in an area within a 55° angle centered on the fovea and the total number of Lisch nodules on the iris by slit-lamp examination. No positive correlation was found between the number of Lisch nodules and patient age (Spearman's rank correlation coefficient ρ=0.117, P=0.7414. Choroidal abnormalities tended to increase with age (ρ=0.6150, but this difference was not statistically significant (P=0.0650. A positive correlation was found between the number of choroidal abnormalities and Lisch nodules (ρ=0.783, P=0.0267. In conclusion, choroidal abnormalities tend to increase with patient age and are correlated with the number of Lisch nodules.Keywords: neurofibromatosis type 1, near-infrared reflectance, choroidal abnormality, Lisch nodule, age

  10. The Correlation of Serum Growth Differentiation Factor-15 Level in Patients with Obstructive Sleep Apnea

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    Kamran Sari

    2015-01-01

    Full Text Available Purpose. Growth differentiation factor-(GDF- is a prognostic biomarker in cardiovascular disorders (CVD. GDF-15 level was not studied in patients with obstructive sleep apnea syndrome (OSAS before. In this study, we investigated serum GDF-15 levels in OSAS patients and compared them with healthy controls. Material and Methods. Polysomnographically, confirmed forty consecutive OSAS patients (20 men and 20 women and forty consecutive healthy controls (23 men and 17 women were enrolled in the study. The samples in each group had similar demographic characteristics and body mass index (BMI values. Results. In the study, no significant correlation was found about GDF-15 levels of OSAS group and healthy controls. However, there was a significant statistical correlation between age and GDF-15 level. In correlation analysis, there was not any significant correlation between age and BMI. Conclusion. Although various developing biomarkers have been studied in cardiovascular disorders, GDF-15 levels have attracted a widespread interest as predictors of cardiovascular risk. GDF-15 level has not been evaluated previously in patients with OSAS. A significant statistical correlation was found between age and GDF-15 level. To reveal close relation between OSAS and GDF-15, further studies are needed with combination of GDF-15 and other biomarkers in OSAS.

  11. Correlation of tomographic findings with pulmonary function parameters in nonsmoking patients with idiopathic pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Agnaldo Jose; Capone, Domenico; Mogami, Roberto; Jansen, Jose Manoel [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). School of Medical Sciences].E mail: phel.lop@uol.com.br; Cunha, Daniel Leme da [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Pedro Ernesto University Hospital. Dept. of Radiology and Diagnostic Imaging; Melo, Pedro Lopes de [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. of Biology

    2007-11-15

    Objective: To correlate tomographic findings with pulmonary function parameters in patients with idiopathic pulmonary fibrosis (IPF). Methods: A cross-sectional study was carried out, in which 30 nonsmoking patients with IPF were evaluated. Using a semiquantitative scoring system, the following high-resolution computerized tomography findings were quantified: total interstitial disease (TID), reticular abnormality/honeycombing, and ground-glass opacity (GGO). The functional variables were measured by spirometry, forced oscillation technique (FOT), helium dilution method, as well as the single-breath method of measuring diffusion capacity of the lung for carbon monoxide (DLCO). Results: Of the 30 patients studied, 18 were female, and 12 were male, with a mean age of 70.9 years. We found that TID and reticular abnormality and honeycombing correlated significantly (negative correlations) with the measurements of forced vital capacity (FVC), total lung capacity (TLC), DLCO, and dynamic respiratory compliance were found, as well as that GGO correlated significantly (and positively) with residual volume/TLC. The ratio of forced expiratory flow between 25 and 75% of FVC to FVC (FEF25-75%/FVC) correlated positively with TID, reticular abnormality/honeycombing, and GGO. Conclusion: In IPF patients, the measurements of volume, diffusion, and dynamic compliance are the physiological variables which best reflect the extent of the interstitial disease on HRCT scans. (author)

  12. Correlation of tomographic findings with pulmonary function parameters in nonsmoking patients with idiopathic pulmonary fibrosis

    International Nuclear Information System (INIS)

    Objective: To correlate tomographic findings with pulmonary function parameters in patients with idiopathic pulmonary fibrosis (IPF). Methods: A cross-sectional study was carried out, in which 30 nonsmoking patients with IPF were evaluated. Using a semiquantitative scoring system, the following high-resolution computerized tomography findings were quantified: total interstitial disease (TID), reticular abnormality/honeycombing, and ground-glass opacity (GGO). The functional variables were measured by spirometry, forced oscillation technique (FOT), helium dilution method, as well as the single-breath method of measuring diffusion capacity of the lung for carbon monoxide (DLCO). Results: Of the 30 patients studied, 18 were female, and 12 were male, with a mean age of 70.9 years. We found that TID and reticular abnormality and honeycombing correlated significantly (negative correlations) with the measurements of forced vital capacity (FVC), total lung capacity (TLC), DLCO, and dynamic respiratory compliance were found, as well as that GGO correlated significantly (and positively) with residual volume/TLC. The ratio of forced expiratory flow between 25 and 75% of FVC to FVC (FEF25-75%/FVC) correlated positively with TID, reticular abnormality/honeycombing, and GGO. Conclusion: In IPF patients, the measurements of volume, diffusion, and dynamic compliance are the physiological variables which best reflect the extent of the interstitial disease on HRCT scans. (author)

  13. Surgical risk for patients with Chagasic achalasia and its correlation with the degree of esophageal dilation

    Institute of Scientific and Technical Information of China (English)

    José Garcia Neto; Roberto de Cleva; Bruno Zilberstein; Joaquim José Gama-Rodrigues

    2005-01-01

    AIM: To analyze the risk of cardiovascular complications in patients with indication for surgical treatment of Chagasic esophageal achalasia and to correlate the surgical risks with the degree of esophageal dilation,thereby proposing a risk scale index.METHODS: One hundred and twenty-four patients with Chagasic esophageal achalasia, who received surgical treatment at the Hospital das Clinicas of the Federal patients were mostly related to the postoperative complications due to the cardiovascular system. All the patients were submitted to: (1) clinical history to define the cardiac functional class (New York Heart Association);(2) conventional 12-lead electrocardiogram at rest; and (3) contrast imaging of the esophagus to determine esophageal dilatation according to Rezende's classification of Chagasic megaesophagus.RESULTS: An assessment of the functional classification (FC) of heart failure during the preoperative period determined that 67 patients (54.03%) were assigned functional class Ⅰ (FC Ⅰ), 46 patients (37.09%) were assigned functional class Ⅱ (FC Ⅱ), and 11 patients (8.87%) were assigned functional class Ⅲ (FC Ⅲ). None of the patients were assigned to functional class Ⅳ (FC Ⅳ). There was a positive correlation between the functional class and the postoperative complications (FC ⅠxFC Ⅱ: P<0.001; FC ⅠxFC Ⅲ: P<0.001). The ECG was normal in 44 patients (35.48%) and presented abnormalities in 80 patients (64.52%). There was a significant statistical correlation between abnormal ECG (arrhythmias and primary change in ventricular repolarization) and postoperative complications (P<0.001).With regard to the classification of the Chagasic esophageal achalasia, the following distribution was observed: group Ⅱ, 53 patients (42.74%); group Ⅲ, 37 patients (29.83%);and group Ⅳ, 34 patients (27.41%). There was a positive correlation between the degree of esophageal dilation and the increase in postoperative complications (grade

  14. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients

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    Richard Prazeres Canella

    2016-04-01

    Full Text Available OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI, using computed tomography (CT. METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third, femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. RESULTS: There were inverse correlations between the following angles: (1 acetabular coverage versus alpha angle (p = 0.019; (2 acetabular version (supraequatorial versus alpha angle (p = 0.049. For patients with femoral anteversion lower than 15 degrees: (1 acetabular version (supraequatorial versus alpha angle (p = 0.026; (2 acetabular version (middle third versus alpha angle (p = 0.02. For patients with acetabular version (supraequatorial lower than 10 degrees: (1 acetabular version (supraequatorial versus alpha angle (p = 0.004; (2 acetabular version (middle third versus alpha angle (p = 0.009. CONCLUSION: There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases.

  15. A study of correlation between transhilar diameter and P pulmonale in COPD patients

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    Ravindran C

    2008-01-01

    Full Text Available Background: Early diagnosis and therapy of Pulmonary hypertension in COPD patients may help in retardation of progression and amelioration of symptoms. This is an attempt to diagnose the disease from X-ray chest of COPD patients, so that invasive in-vestigations can be avoided. Objectives: (1 Measurement of transhilar diameter in Chest X-ray PA view of COPD patients and its importance in detection of pulmonary hyper-tension. (2 To study correlation between P pulmonale and transhilar diameter / hilar thoracic ratio. Design: Prospective Clinical study. Setting: Institute of Chest Diseases, Medical College, Calicut. Period of study: One year from September 2002 to August 2003. Materials and Methods: 100 patients admitted to Institute of Chest Diseases with COPD and ECG evidence of P pulmonale and/or RVH were included. Chest X-rays was taken and the following diameters were measured. Transhilar diameter, hilar thoracic ratio, width of descending branch of (Rt pulmonary artery and cardiothoracic ratio. Conclu-sions: Chest X-ray can be used for identification of pulmonary hypertension in COPD patients. Positive correlation was seen between P pulmonale and hilar thoracic ratio. Posi-tive correlation was also seen between P pulmonale and other parameters like smoking status, symptom duration, ECG evidence of RVH and negative correlation was seen with % predicted FEV1.

  16. Sonoclot Signature Analysis in Patients with Liver Disease and Its Correlation with Conventional Coagulation Studies

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    Priyanka Saxena

    2013-01-01

    Full Text Available Introduction. Liver disease patients have complex hemostatic defects leading to a delicate, unstable balance between bleeding and thrombosis. Conventional tests such as PT and APTT are unable to depict these defects completely. Aims. This study aimed at analyzing the abnormal effects of liver disease on sonoclot signature by using sonoclot analyzer (which depicts the entire hemostatic pathway and assessing the correlations between sonoclot variables and conventional coagulation tests. Material and Methods. Clinical and laboratory data from fifty inpatients of four subgroups of liver disease, including decompensated cirrhosis, chronic hepatitis, cirrhosis with HCC and acute-on-chronic liver failure were analyzed. All patients and controls were subjected to sonoclot analysis and correlated with routine coagulation parameters including platelet count, PT, APTT, fibrinogen, and D-dimer. Results. The sonoclot signatures demonstrated statistically significant abnormalities in patients with liver disease as compared to healthy controls. PT and APTT correlated positively with SONACT (P<0.008 and <0.0015, resp. while platelet count and fibrinogen levels depicted significant positive and negative correlations with clot rate and SONACT respectively. Conclusion. Sonoclot analysis may prove to be an efficient tool to assess coagulopathies in liver disease patients. Clot rate could emerge as a potential predictor of hypercoagulability in these patients.

  17. Correlation between clinical syndromes and neuropsychological tasks in unmedicated patients with recent onset schizophrenia.

    Science.gov (United States)

    Daban, Claire; Amado, Isabelle; Baylé, Franck; Gut, Anne; Willard, Dominique; Bourdel, Marie-Chantal; Loo, Henri; Olié, Jean-Pierre; Millet, Bruno; Krebs, Marie-Odile; Poirier, Marie-France

    2002-12-15

    The aim of this study is to circumscribe the cognitive deficits according to schizophrenic syndromes in a population of sub-acute untreated patients. We have studied the cross-sectional correlation between cognitive deficits and schizophrenic symptoms, in a group of 24 untreated patients (including 17 neuroleptic-naive patients) with recent onset of the disease. A task of alertness, a working memory (WM) test (including two levels of difficulty) and an abbreviated version of the Wisconsin Card Sorting Test (WCST) were selected. WM deficits and poor performance on the WCST were highly correlated with disorganized symptoms, modestly with the positive syndrome and not with the negative syndrome. Thus, disorganized symptoms, more than any other, appear to be related to the impairment of executive function and WM in recent onset unmedicated patients with schizophrenia. PMID:12467948

  18. Correlates of anxiety and depression among patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Yatan Pal Singh Balhara

    2011-01-01

    Full Text Available Context: Research has established the relation between diabetes and depression. Both diabetes and anxiety/depression are independently associated with increased morbidity and mortality. Aims: The present study aims at assessing the prevalence of anxiety/depression among outpatients receiving treatment for type 2 diabetes. Settings and Design: The study was conducted in the endocrinology outpatient department of an urban tertiary care center. Materials and Methods: The instruments used included a semi-structured questionnaire, HbA1c levels, fasting blood glucose and postprandial blood glucose, Brief Patient Health Questionnaire, and Hospital Anxiety and Depression Scale (HADS. Statistical Analysis Used: Analysis was carried out using the SPSS version 16.0. Pearson′s correlation coefficient was calculated to find out the correlations. ANOVA was carried out for the in between group comparisons. Results: There was a significant correlation between the HADS-Anxiety scale and Body Mass Index (BMI with a correlation coefficient of 0.34 (P = 0.008. Also, a significant correlation existed between HADS-Depression scale and BMI (correlation coefficient, 0.36; P = 0.004. Significant correlation were observed between the duration of daily physical exercise and HADS-Anxiety (coefficient of correlation, -0.25; P = 0.04 scores. HADS-Anxiety scores were found to be related to HbA1c levels (correlation-coefficient, 0.41; P = 0.03 and postprandial blood glucose levels (correlation-coefficient, 0.51; P = 0.02. Conclusions: Monitoring of biochemical parameters like HbA1c and postprandial blood glucose levels and BMI could be a guide to development of anxiety in these patients. Also, physical exercise seems to have a protective effect on anxiety in those with type 2 diabetes mellitus.

  19. 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.

  20. 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)

  1. 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.

  2. 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.

  3. Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis

    OpenAIRE

    Appel, Heiner; Loddenkemper, Christoph; Grozdanovic, Zarko; Ebhardt, Harald; Dreimann, Marc; Hempfing, Axel; Stein, Harald; Metz-Stavenhagen, Peter; Rudwaleit, Martin; Sieper, Joachim

    2006-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease which affects primarily the sacroiliac joints and the spine. In patients with active disease, magnetic resonance imaging (MRI) of the spine shows areas of bone marrow edema, the histopathological equivalent of which is unknown. In this study we correlate inflammation in the spine of patients with AS as revealed by histological examination with bone marrow edema as detected by MRI. We have compared the histopathological findings of ...

  4. Parathyroid scintigraphy, histopathology correlation in patients with tropical pancreatitis and coexisting primary hyperparathyroidism

    OpenAIRE

    Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga

    2013-01-01

    Purpose: Tropical pancreatitis (TP) is a juvenile, non-alcoholic type of chronic pancreatitis and is highly prevalent in Kerala, India. Increasing prevalence of TP and its varied manifestations prompted us to undertake this retrospective analysis. We attempted to study the incidence of TP in patients with primary hyperparathyroidism (PHPT) and correlate with calcium levels, scintigraphy and histopathology findings. Materials and Methods: Records of 44 hypercalcemic patients with raised parath...

  5. Pancreatic cancer patient survival correlates with DNA methylation of pancreas development genes.

    Science.gov (United States)

    Thompson, Michael J; Rubbi, Liudmilla; Dawson, David W; Donahue, Timothy R; Pellegrini, Matteo

    2015-01-01

    DNA methylation is an epigenetic mark associated with regulation of transcription and genome structure. These markers have been investigated in a variety of cancer settings for their utility in differentiating normal tissue from tumor tissue. Here, we examine the direct correlation between DNA methylation and patient survival. We find that changes in the DNA methylation of key pancreatic developmental genes are strongly associated with patient survival.

  6. Frequency, Clinical Correlates, and Ratings of Behavioral Changes in Primary Brain Tumor Patients: A Preliminary Investigation

    OpenAIRE

    Grahame K Simpson; Koh, Eng-Siew; Whiting, Diane; Wright, Kylie M.; Simpson, Teresa; Firth, Rochelle; Gillett, Lauren; Younan, Kathryn

    2015-01-01

    Purpose Few studies have addressed the specific behavioral changes associated with primary brain tumor (PBT). This paper will report on the frequency and demographic/clinical correlates of such behaviors, and the reliability of rating such behaviors among people with PBT, family informants, and clinicians. The association of behavioral changes and patient functional status will also be discussed. Methods A total of 57 patients with 37 family informants were recruited from two large...

  7. Correlative research between homocysteine,cystatin C and patients with essential hypertension and hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙屿

    2014-01-01

    Objective To investigate the correlation between homocysteine(Hcy),cystatin C(Cys C)and patients with essential hypertension and hypertensive intracerebral hemorrhage.Methods Subjects were divided into hypertensive intracerebral hemorrhage group(108 cases),essential hypertension group(100 cases)and control group(100 cases),and their cystatin C,homocysteine and total cholesterol(TC)and triglycerides(TG)were surveyed.Results The patients with hypertensive intracerebral hemorrhage and essential hypertension had higher

  8. Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients

    OpenAIRE

    Richard Prazeres Canella; Guilherme Pradi Adam; Roberto André Ulhôa de Castillo; Daniel Codonho; Gerson Gandhi Ganev; Luiz Fernando de Vicenzi

    2016-01-01

    OBJECTIVE: To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). METHODS: We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used...

  9. Correlation of Computed Tomography findings with Glasgow Coma Scale in patients with acute traumatic brain injury

    OpenAIRE

    SK Sah; ND Subedi; K. Poudel; Mallik, M

    2015-01-01

    OBJECTIVE To correlate Computed Tomography (CT) findings with Glasgow Coma Scale (GCS) in patients with acute traumatic brain injury attending in Chitwan Medical College teaching hospital Chitwan, Nepal. MATERIALS AND METHODS A cross-sectional study was performed among 50 patients of acute (less than24 hours) cases of craniocerebral trauma over a period of four months. The patient’s level of consciousness (GCS) was determined and a brain CT scan without contrast media was performed. A s...

  10. Oxidative Damage to DNA and Lipids: Correlation with Protein Glycation in Patients with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    M.T. Goodarzi

    2008-01-01

    Full Text Available Introduction & Objective: Diabetic hyperglycemia is associated with increased production of Reactive Oxygen Species (ROS. ROS reacts with DNA results in products such as 8-hydroxydeoxyguanosine that excrete in urine due to DNA repair processes. This study aims to evaluate correlation between oxidative damage of DNA and protein glycation in patients with Type 1 diabetes. We measured urinary 8-OHdG level in diabetic and control group and evaluated its correlation to glycated hemoglobin (HbA1c and glycated serum protein (GSP levels. Furthermore plasma malondialdehyde (MDA level was measured as an important indicator of lipid peroxidation in diabetes.Materials & Methods: We studied 32 patients with diabetes mellitus Type 1 and compared them with 48 sex and age-matched non-diabetic controls. GSP and MDA measurement were made by colorimetric assay. Hemoglobin A1c measured by ion-exchange chromatography method and urinary 8-OHdG measurement was made by competitive in vitro enzyme-linked immunosorbent assay (ELISA.Results: In the present study urinary 8-OHdG, blood HbA1c, plasma MDA and GSP levels were significantly higher in diabetics comparing to the control subjects (P<0.05. Furthermore, we found significant correlation between urinary 8-OHdG and HbA1c (P<0.05 in diabetic group. In addition, fasting blood sugar showed significant correlation with GSP and MDA (P<0.05. However the correlation of MDA with HbA1c was not significant in diabetic patients.Conclusion: This case-control study in young diabetic patients showed that increased blood glucose and related metabolic disorders result in oxidative stress and oxidative damage to DNA and lipids. Furthermore oxidative damage to DNA correlated to glycemic control, while there was no significant correlation between lipid peroxidation and the level of HbA1c.

  11. Correlation of Sleep Disturbance and Cognitive Impairment in Patients with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Eun Ja Kim

    2014-04-01

    Full Text Available Objective Cognitive impairment is a common nonmotor symptom of Parkinson’s disease (PD and is associated with high mortality, caregiver distress, and nursing home placement. The risk factors for cognitive decline in PD patients include advanced age, longer disease duration, rapid eye movement sleep behavior disorder, hallucinations, excessive daytime sleepiness, and nontremor symptoms including bradykinesia, rigidity, postural instability, and gait disturbance. We conducted a cross-sectional study to determine which types of sleep disturbances are related to cognitive function in PD patients. Methods A total of 71 PD patients (29 males, mean age 66.46 ± 8.87 years were recruited. All patients underwent the Mini- Mental State Examination (MMSE and the Korean Version of the Montreal Cognitive Assessments (MoCA-K to assess global cognitive function. Sleep disorders were evaluated with the Stanford Sleepiness Scale, Epworth Sleepiness Scale, Insomnia Severity Index (ISI, Pittsburg Sleep Quality Index, and Parkinson’s Disease Sleep Scale in Korea (PDSS. Results The ISI was correlated with the MMSE, and total PDSS scores were correlated with the MMSE and the MoCA-K. In each item of the PDSS, nocturnal restlessness, vivid dreams, hallucinations, and nocturnal motor symptoms were positively correlated with the MMSE, and nocturnal restlessness and vivid dreams were significantly related to the MoCA-K. Vivid dreams and nocturnal restlessness are considered the most powerful correlation factors with global cognitive function, because they commonly had significant correlation to cognition assessed with both the MMSE and the MoCA-K. Conclusions We found a correlation between global cognitive function and sleep disturbances, including vivid dreams and nocturnal restlessness, in PD patients.

  12. Dupplex doppler sonography in patients with medical renal diseases: correlation with clinical and histopathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Song, Soon Young; Koh, Byung Hee; Lee, Seung Chul; Bae, Jae Ik; Kim, Yong Soo; Rhim, Hyun Chul; Cho, On Koo; Park, Chan Hyun; Park, Moon Hyang [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    To compare the RI (resistive index) of renal artery with serum creatinine level and histological change in 50 patients with renal parenchymal disease. To measure RI in each patient, Doppler studies were performed three times in each kidney at the level of the interlobar arteries, and the average value of RI was taken. The study was performed 1 -3 days after renal biopsy and the time interval between blood sampling for serum creatinine and duplex study was also 1 - 3 days. The RI of patients with renal disease was also correlated with patient's age, sex and serum creatinine level, and RI was also correlated with the degree of severity of glomerular, interstitial, and vascular change in the kidneys. Statistical analysis was performed using Student's t test and Pearson's correlation method. The RI of the normal control and renal disease group was 0.566{+-}0.037 and 0.584{+-}0.038, respectively with no statistical significance(p=0.444). In the group with renal disease, there was no significant correlation between RI and a patient's age, sex, and serum creatinine level(p>0.05). RI was not significantly different between predominantly glomerular disease (n=45) and nonglomerular or mixed disease(n=5)(p=0.558), and did not correlate with the severity of glomerular sclerosis, interstitial fibrosis, or atherosclerosis(p>0.05). The authors conclude that RI is not helpful for the diagnosis and differential diagnosis of renal parenchymal diseases and does not correlate with serum creatinine levels. In order to define the role of the RI, further clinical experience with more cases is required.

  13. Correlation between Pulmonary Function Indexes and Survival Time 
in Patients with Advanced Lung Cancer

    Directory of Open Access Journals (Sweden)

    Hui GE

    2013-07-01

    Full Text Available Background and objective To those patients with advanced lung cancer, the ultimate objective is to improve the curative effect and quality of life, lung function indexes are an important factor. We investigate the change of lung function and the relationship between pulmonary function indexs and survival time in patients with advanced lung cancer. Methods Lung function was detected in 59 cases with lung cancer and 63 normal controls. The relationship between pulmonary function indexs and survival time was analyzed. Results There was significant difference in ventilation function and diffusing capacity between in lung cancer group and control group. Vital capacity (VC, forced expiratory volume in one second (FEV1, forced vital capacity (FVC, peak expiratory flow (PEF, peak expiratory flow% (PEF%, maximal ventilatory volume (MVV were positively correlated with survival time in patients with advanced lung cancer (r=0.29, 0.28, 0.28, 0.27, 0.26, 0.28, P<0.05, residual volume/total lung capacity was negatively correlated with survival time (r=-0.31, P<0.05. Conclusion The lung function decreases in the patients with lung cancer. VC, FEV1, FVC, PEF, PEF%, MVV, residual volume/total lung capacity were correlated with survival time in patients with advanced lung cancer. The pulmonary function indexs were important marker of prognosis in patients with lung cancer.

  14. Heart Rate Variability Correlates to Functional Aerobic Impairment in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Maria Angela Magalhães de Queiroz Carreira

    2015-06-01

    Full Text Available Background: Autonomic dysfunction (AD is highly prevalent in hemodialysis (HD patients and has been implicated in their increased risk of cardiovascular mortality. Objective: To correlate heart rate variability (HRV during exercise treadmill test (ETT with the values obtained when measuring functional aerobic impairment (FAI in HD patients and controls. Methods: Cross-sectional study involving HD patients and a control group. Clinical examination, blood sampling, transthoracic echocardiogram, 24-hour Holter, and ETT were performed. A symptom-limited ramp treadmill protocol with active recovery was employed. Heart rate variability was evaluated in time domain at exercise and recovery periods. Results: Forty-one HD patients and 41 controls concluded the study. HD patients had higher FAI and lower HRV than controls (p<0.001 for both. A correlation was found between exercise HRV (SDNN and FAI in both groups. This association was independent of age, sex, smoking, body mass index, diabetes, and clonidine or beta-blocker use, but not of hemoglobin levels. Conclusion: No association was found between FAI and HRV on 24-hour Holter or at the recovery period of ETT. Of note, exercise HRV was inversely correlated with FAI in HD patients and controls. (Arq Bras Cardiol. 2015; [online]. ahead print, PP.0-0

  15. Correlation between serum albumin, prealbumin and ventilator dependence in patients with COPD

    Institute of Scientific and Technical Information of China (English)

    Shu-Miao Wu; Dan-Dan Chen

    2016-01-01

    Objective:To investigate the correlation between the serum albumin, prealbumin and ventilator dependence in patients with COPD.Methods: Serum albumin and prealbumin of 44 COPD patients using breathing machine>48 h were tested at admission, 1 week, 2 weeks treatment. According to the existence of ventilator dependence, divided the patients into the ventilator dependence group and the ventilator independence group, compare the albumin, prealbumin average of two groups, evaluate the correlation between the serum albumin, prealbumin and ventilator dependence in patients with COPD.Results: Albumin levels reduced in both groups after 1 week treatment, but there was no statistically significant difference. Albumin levels reduced in both groups after 2 weeks treatment, but more significantly in the ventilator dependence group, the difference had statistical significance. Prealbumin levels in the ventilator independence group after 1 week treatment didn’t reduced, but reduced in the ventilator dependence group, the difference was statistically significant. Prealbumin levels reduced in both groups after 2 weeks treatment, but more significant in the ventilator dependence group, the difference had statistical significance.Conclusion:Serum albumin and prealbumin levels were correlation with the ventilator dependence in patients with COPD. But prealbumin can more sensitively and more early predict the ventilator dependence in patients with COPD suffered from malnutrition.

  16. Psychosocial and sociodemographic correlates of life satisfaction among patients diagnosed with cancer in Jordan.

    Science.gov (United States)

    Hamdan-Mansour, Ayman M; Al Abeiat, Dana D; Alzoghaibi, Ibrahim N; Ghannam, Bushra M; Hanouneh, Salah I

    2015-03-01

    Cancer is a worldwide disease, and the psychosocial concerns are nearly universal among patients with cancer. The purpose of this study is to investigate the psychosocial correlates of life satisfaction among patients diagnosed with cancer in Jordan. A cross-sectional survey using 92 patients diagnosed with cancer used to collect data in regard to life satisfaction, depressive symptoms, psychological distress, coping, and perceived social support. In general, about 50% of patients reported high level of life satisfaction and 50% of the patients reported moderate levels of ability to effectively cope with life situations. Moreover, 78% of patients reported that they had depressive symptoms and 45.3% of them reported that they had moderate to severe depressive symptoms. Depressive symptoms had significant and negative correlation with life satisfaction (r = -0.50, p life satisfaction (r = 0.05, p > 0.05). On the other hand, social support from others has positive and significant correlation with life satisfaction (r = 0.32, p life satisfaction. Health professionals need to integrate their medical care with psychosocial intervention early at admission and during follow-up care, so early detection of psychological disturbances will help to implement effective treatment plans.

  17. CORRELATION OF INFLAMMATION BIOMARKERS WITH THE TRADITIONAL RISK FACTORS IN PATIENTS WITH ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    I. S. Skopec

    2016-05-01

    Full Text Available Actuality of cardiovascular diseases today determines the high interest to study pathogenesis of atherosclerosis and to searching new risk factors which could help to optimize primary and secondary prevention. Study the correlation between biomarkers of inflammation and traditional risk factors (TRF in patients with different forms of ischemic heart disease is really important today.Aim. To determine the correlation between TRF and the level of biomarkers of the inflammation and endothelial dysfunction in patients with acute coronary syndrome (ACS. Material and methods. Patients (n=62 aged from 24 to 50 years (mean age 43.98±4.73, who were admitted to the hospital due to ACS, were included into the study. Correlations between TRF and the levels of biomarkers of the inflammation and endothelial dysfunction were assessed. The following biomarkers levels were determined: high-sensitivity C-reactive protein (hsCRP, homocysteine, soluble vascular cell (sVCAM-1 and intracellular (sICAM-1 adhesion molecule type 1, soluble E-selectin (sE-selectin, nitrate, neopterin, matrix metalloproteinase type 3 (MMP-3.Results. TRF, including modifiable ones, were often revealed in patients of the studied group. Some correlations between TRF and high concentrations of inflammatory biomarkers were determined. Patients with the family history of early cardiovascular diseases had higher concentration of sVCAM-1 (1047.78±516.98 ng/ml in comparison with the patients without this TRF (705.57±239.28 ng/ml, p=0.017. Patients with arterial hypertension had higher level of MMP-3 (9.31±3.63 ng/ml versus patients without hypertension (5.02±3.66 ng/ml, р=0.011. Patients with abdominal obesity compared with patients without this TRF demonstrated higher concentration of nitrate in acute (208.45±91.85 ng/ml vs 154.53 ng/ml, р=0.028 and long-term (193.53±40.02 ng/ml vs 173.48 ng/ml, р=0.028 periods of ASC.Conclusion. The study showed the significant correlation between

  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. A new challenge for malaria control in Brazil: asymptomatic Plasmodium infection--a review.

    Science.gov (United States)

    Coura, José Rodrigues; Suárez-Mutis, Martha; Ladeia-Andrade, Simone

    2006-05-01

    The evolution of malaria in Brazil, its morbidity, the malaria control programs, and the new challenges for these programs in the light of the emergence of asymptomatic infection in the Amazon region of Brazil were reviewed. At least six Brazilian research groups have demonstrated that asymptomatic infection by Plasmodium is an important impediment to malaria control, among mineral prospectors in Mato Grosso and riverside communities in Rondônia and, in our group, in the middle and upper reaches of the Negro river, in the state of Amazonas. Likewise, other researchers have studied the problem among indigenous communities in the Colombian, Peruvian, and Venezuelan parts of the Amazon basin, adjacent to Brazil. The frequency of positive results from the polymerase chain reaction (PCR) among asymptomatic individuals has ranged from 20.4 to 49.5%, and the presence of Plasmodium in the thick blood smears, from 4.2 to 38.5%. Infection with Anopheles darlingi has also been demonstrated by xenodiagnosis among asymptomatic patients with positive PCR results. If a mean of 25% is taken for the asymptomatic infection caused by Plasmodium sp. in the Amazon region of Brazil, malaria control will be difficult to achieve in that region with the measures currently utilized for such control. PMID:16862314

  20. Enhanced HBsAg synthesis correlates with increased severity of fibrosis in chronic hepatitis B patients.

    Directory of Open Access Journals (Sweden)

    Mei-Zhu Hong

    Full Text Available BACKGROUND AND AIMS: Little is known about whether low serum HBsAg levels result from impaired HBsAg synthesis or a reduced number of hepatocytes caused by advanced liver fibrosis. Therefore, we investigated the capacity for HBsAg synthesis in a cross-sectional cohort of treatment-naïve chronic hepatitis B patients. METHODS: Chronic hepatitis B patients (n = 362 were enrolled; liver biopsies were performed and liver histology was scored, and serum HBsAg and HBV DNA levels were investigated. In the enrolled patients, 183 out of 362 have quantitative serum HBsAg levels. Tissue HBsAg was determined by immunohistochemistry. RESULTS: A positive correlation between serum HBsAg and HBV DNA levels was revealed in HBeAg(+ patients (r = 0.2613, p = 0.0050. In HBeAg(+ patients, serum HBsAg and severity of fibrosis were inversely correlated (p = 0.0094, whereas tissue HBsAg levels correlated positively with the stage of fibrosis (p = 0.0280. After applying the mean aminopyrine breath test as a correction factor, adjusted serum HBsAg showed a strong positive correlation with fibrosis severity in HBeAg(+ patients (r = 0.5655, p<0.0001. The adjusted serum HBsAg values predicted 'moderate to severe' fibrosis with nearly perfect performance in both HBeAg(+ patients (area under the curve: 0.994, 95% CI: 0.983-1.000 and HBeAg(- patients (area under the curve: 1.000, 95% CI: 1.000-1.000. CONCLUSIONS: Although serum HBsAg levels were negatively correlated with fibrosis severity in HBeAg(+ patients, aminopyrine breath test-adjusted serum HBsAg and tissue HBsAg, two indices that are unaffected by the number of residual hepatocytes, were positively correlated with fibrosis severity. Furthermore, adjusted serum HBsAg has an accurate prediction capability.

  1. CORRELATION BETWEEN CAROTID INTIMA MEDIA THICKNESS AND NEWLY DIAGNOSED HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    Rupak

    2015-09-01

    Full Text Available BACKGROUND: Hypertension is one of the leading causes of the global burden of disease and carotid intima - media thickness (IMT increases with hypertension. Various studies have proved that IMT measurements correlated with pathologic measurements. So the study has been done to find the correlation between carotid intima media thickness and hypertension in newly diagnosed cases. METHODS: 52 newly diagnosed hypertensive subjects ( A ge>18yrs were taken along with matched controls. Known hypertensive cases and secondary hypertension cases were excluded from the study. cIMT measurement was taken in all patients. RESULTS: mean age of cases was 42.8years and BMI was 26.3kg/m 2 . For all of the subjects combined (n=104, cIMT correlated with office systolic blood pressure (SBP (r = 0.48; p<0.001 but no correlation was found between diastolic blood pressure and cIMT(r=0.15, p=0.11. Among hypertensive subjects (n=52, there was a significant positive correlation between cIMT and SBP (r=0.59, p<0.001 but no correlation was found between DBP and cIMT (r = 0.202; p = 0.15 in the hypertensive subjects. No correlation was found between BMI and smoking with cIMT. CONCLUSION: Increase in blood pressure correlates with increase in carotid intima media thickness, particularly with systolic blood pressure.

  2. Correlation of ATP7B genotype with phenotype in Chinese patients with Wilson disease

    Institute of Scientific and Technical Information of China (English)

    Xiao-Qing Liu; Ya-Fen Zhang; Tze-Tze Liu; Kwang-Jen Hsiao; Jian-Ming Zhang; Xue-Fan Gu; Ke-Rong Bao; Li-Hua Yu; Mei-Xian Wang

    2004-01-01

    AIM: To determine the mutational characterization of Ptype ATP7B gene and to explore the correlation of ATP7B genotype to phenotype in Chinese patients with Wilson disease (WD).METHODS: Seventy-five patients with WD from 72 no-kinship families, 44 males and 31 females, were enrolled in this study.The age of onset ranged from 4 to 39 years, ≤18 years in 72 patients. Some exons of ATP7B gene mutations were analyzed in patients with WD by using biochemical methods,polymerase chain reaction-single strand configuration polymorphism (PCR-SSCP) and DNA sequence analysis. A total of 778 coding regions were identified with restriction enzyme Msp I. The activity of Cu-ATPase was assessed by measuring inorganic phosphorus.RESULTS: Sixty-six of 75 patients (88%) had with hepatic manifestations, 39 of them had only hepatic manifestations,27 patients had hepatic and neurological manifestations or other symptoms at the same time (16 patients had associated neurological manifestation, 3 patients had osteopathy, 8patients had other symptoms). Eight of the 75 patients (10.7%) had only neurological symptoms, one patient (5 years old) had no symptom. Twelve changing patterns were detected in ATP7B gene by DNA sequencing, including seven mutations (R778L, C656X, G943D, V1140A, V1106I V1216M and 1384del17), six polymorphisms (IVS4-5t/c, A2495G, C2310G,IVS18+6c/t and IVS20+5a/g). R778L occurred in 49/66patients (74%) with hepatic manifestations, homozygosis of R778L in 16 patients, heterozygosity of R778L in 33 patients. V1106I mutation of ATP7B gene occurred in 2 patients with delaying onset of clinical symptoms. Cu-ATPase activity of three patients with known mutations (R778L/ V1106I/A2495G, R778L/V1216M and R778L/R778L) were determined; and the activity of Cu-ATPase was decreased by 44.55%, 88.23% and 69.49% respectively.CONCLUSION: 1384del17bp is a novel mutation found in WD patients. R778L is the most common mutation of ATP7B gene. There is a correlation between R778L and hepatic

  3. Depression and sleep disturbances in patients with multiple sclerosis and correlation with associated fatigue

    Science.gov (United States)

    Nagaraj, Karthik; Taly, Arun B.; Gupta, Anupama; Prasad, Chandrajit; Christopher, Rita

    2013-01-01

    Objective: To observe prevalence of depression and sleep disturbances in multiple sclerosis (MS) patients and their correlation with associated fatigue. Study Design and Setting: Prospective observation study in a university tertiary research hospital in India. Materials and Methods: Thirty-one patients (6 male and 25 female) with definite MS (McDonald's criteria) presented in out-patient/admitted in the department of neurology (between February 2010 and December 2011) were included in the study. Depression was assessed using Beck's Depression Inventory (BDI). Sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI). Disease severity was evaluated using the Kurtzke's expanded disability status scale (EDSS). Fatigue was assessed using Krupp's fatigue severity scale (FSS). We tried to observe correlation of depression and sleep disturbance with associated fatigue in MS patients. Results: The age of patients varied between 16 and 50 years (30.1 ± 9.1). The mean age at first symptom was 25.2 ± 6.4 years (range 14-39 years). The prevalence of sleep disturbance and depression was 51.6% (16/31) each and fatigue 58.1% (18/31) in the study group. The PSQI scores were significantly greater in the patients with fatigue as compared with those without fatigue indicating poorer sleep quality is associated with fatigue in MS (P = 0.005). The BDI scores were also significantly higher in the fatigue group showing that severity of depression also strongly correlated with fatigue (P = 0.001). Conclusions: Depression and sleep disturbance in patients with MS is significantly correlated with associated fatigue. PMID:24347942

  4. Biomarker Correlates of Survival in Pediatric Patients with Ebola Virus Disease

    Centers for Disease Control (CDC) Podcasts

    2014-08-19

    Dr. Mike Miller reads an abridged version of the article, Biomarker Correlates of Survival in Pediatric Patients with Ebola Virus Disease.  Created: 8/19/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/19/2014.

  5. Prevalence and correlates of eating disorders in 875 patients with bipolar disorder

    NARCIS (Netherlands)

    McElroy, Susan L.; Frye, Mark A.; Hellemann, Gerhard; Altshuler, Lori; Leverich, Gabriele S.; Suppes, Trisha; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph; Post, Robert M.

    2011-01-01

    Objective: Relatively little is known about the co-occurrence of bipolar and eating disorders. We therefore assessed the prevalence and clinical correlates of eating disorders in 875 patients with bipolar disorder. Method: 875 outpatients with DSM-IV bipolar I or II disorder were evaluated with stru

  6. Accelerated cognitive decline in patients with type 2 diabetes : MRI correlates and risk factors

    NARCIS (Netherlands)

    Reijmer, Yael D.; van den Berg, Esther; de Bresser, Jeroen; Kessels, Roy P. C.; Kappelle, L. Jaap; Algra, Ale; Biessels, Geert Jan

    2011-01-01

    Background Type 2 diabetes mellitus is associated with an increased risk of cognitive decline and dementia. We examined brain imaging correlates and vascular and metabolic risk factors of accelerated cognitive decline in patients with type 2 diabetes. Methods Cognitive functioning and brain volume a

  7. Neuronal correlates of maladaptive coping: an EEG-study in tinnitus patients.

    Directory of Open Access Journals (Sweden)

    Sven Vanneste

    Full Text Available Here we aimed to investigate the neuronal correlates of different coping styles in patients suffering from chronic tinnitus. Adaptive and maladaptive coping styles were determined in 85 tinnitus patients. Based on resting state EEG recordings, coping related differences in brain activity and connectivity were found. Maladaptive coping behavior was related to increases in subjective tinnitus loudness and distress, higher tinnitus severity and higher depression scores. EEG recordings demonstrated increased alpha activity over the left dorsolateral prefrontal cortex (DLPFC and subgenual anterior cingulate cortex (sgACC as well as increased connectivity in the default (i.e. resting state network in tinnitus patients with a maladaptive coping style. Correlation analysis revealed that the changes in the DLPFC correlate primarily with maladaptive coping behavior, whereas the changes in the sgACC correlate with tinnitus severity and depression. Our findings are in line with previous research in the field of depression that during resting state a alpha band hyperconnectivity exists within the default network for patients who use a maladaptive coping style, with the sgACC as the dysfunctional node and that the strength of the connectivity is related to focusing on negative mood and catastrophizing about the consequences of tinnitus.

  8. Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients

    NARCIS (Netherlands)

    D.A. Paesani; F. Lobbezoo; C. Gelos; L. Guarda-Nardini; J. Ahlberg; D. Manfredini

    2013-01-01

    The present investigation was performed in a population of patients with temporomandibular disorders (TMD), and it was designed to assess the correlation between self-reported questionnaire-based bruxism diagnosis and a diagnosis based on history taking plus clinical examination. One-hundred-fifty-n

  9. Correlates of outcome and response to IVIg in 88 patients with multifocal motor neuropathy

    NARCIS (Netherlands)

    Cats, E. A.; van der Pol, W. -L.; Piepers, S.; Franssen, H.; Jacobs, B. C.; van den Berg-Vos, R. M.; Kuks, J. B.; van Doorn, P. A.; van Engelen, B. G.; Verschuuren, J. J.; Wokke, J. H.; Veldink, J. H.; van den Berg, L. H.

    2010-01-01

    Objective: Identification and examination of all patients with multifocal motor neuropathy (MMN) in the Netherlands to document the clinical spectrum and response to IV immunoglobulin (IVIg) and to determine correlates of outcome. Methods: A national cross-sectional descriptive study was performed.

  10. Correlates of outcome and response to IVIg in 88 patients with multifocal motor neuropathy

    NARCIS (Netherlands)

    Cats, E.A.; Pol, W.L. van der; Piepers, S.; Franssen, H.; Jacobs, B.C.; Berg-Vos, R.M. van den; Kuks, J.B.M.; Doorn, P.A. van; Engelen, B.G.M. van; Verschuuren, J.J.; Wokke, J.H.J.; Veldink, J.H.; Berg, L.H. van den

    2010-01-01

    OBJECTIVE: Identification and examination of all patients with multifocal motor neuropathy (MMN) in the Netherlands to document the clinical spectrum and response to IV immunoglobulin (IVIg) and to determine correlates of outcome. METHODS: A national cross-sectional descriptive study was performed.

  11. Correlations between Plasma Levels of Anionic Uremic Toxins and Clinical Parameters in Hemodialysis Patients.

    Science.gov (United States)

    Ichimura, Yuichi; Takamatsu, Hiroyuki; Ideuchi, Hideki; Oda, Masako; Takeda, Kiyotaka; Saitoh, Hiroshi

    2016-01-01

    When the kidney is seriously impaired, various uremic toxins (UTs) accumulate in the body, often exerting unfavorable effects on physiological functions and drug pharmacokinetics. To prevent this, it is important to determine plasma UT levels accurately in chronic kidney disease patients. Although attempts to predict plasma UT levels using biomarkers have been made, the correlation between UT levels and the markers is not yet fully understood. In this study, we assessed the correlations among plasma levels of indoxyl sulfate (IS), indoleacetic acid (IA), and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF) in 20 hemodialysis patients and evaluated the relationship between the plasma levels of UTs and clinical parameters, such as serum creatinine (Scr), blood urea nitrogen, and estimated glomerular filtration rate (eGFR), with special focus on IS. There were no correlations among the plasma levels of the three UTs before and immediately after hemodialysis. However, a significant correlation was observed between plasma IS levels and Scr before hemodialysis (r=0.643, p=0.002), with the correlation becoming much stronger when using the data obtained immediately after hemodialysis (r=0.744, pScr values, although the precise mechanism behind the correlation remains to be clarified. PMID:27477735

  12. Valoración del estado nutricional y de la absorción intestinal en pacientes asintomáticos infectados por el virus de la inmunodeficiencia humana (VIH con y sin hepatitis C crónica Assessment of nutritional status and of intestinal absorption in asymptomatic patients infected with the human immunodeficiency virus (HIV with ans without chronic hepatitis

    Directory of Open Access Journals (Sweden)

    M.ª P. Ortega García

    2006-08-01

    posibles efectos clínicos.Objective: To compare nutritional status and intestinal absorption in asymptomatics HIV patients co-infected or not with hepatitis C virus. Material and methods: 15 patients (9 men and 6 women HIV seropositive in A1-A2 stage were classified in two groups, A were asymptomatics HIV patients and B were asymptomatic HIV patients with chronic hepatitis C. Nutritional status was determined by weight, height,% ideal weight, body mass index, triceps skinfold, midarm muscle circumference, grip dynamometry and body composition measured by bioelectrical impedance. Intestinal absorption was assesses with D-xilosa test in urine collected over 5 hours after fasting ingestion of 5 grams of D-xylosa. Statistical analysis was made with SPSS (v.11.0. Results: Not statistically significative differences were found in the nutritional status between the two groups of patients. Asymptomatics HIV patients with chronic hepatitis C eliminate less D-xylosa in urine than patients without chronic hepatitis C, being this difference statistically significative. Three out of the eight patients (37,5% of group B presented malabsorption (< 1,2 grams of D-xylosa in urine. In group A any patient had malabsorption. Discusion: In our study, asymptomatic HIV patients have a good nutritional status, without differences between patients co-infected or not with hepatitis C virus. Intestinal absorption is altered in patients co-infected and this should be considered because of its potential clinical consequences.

  13. Correlation between automated writing movements and striatal dopaminergic innervation in patients with Wilson's disease.

    Science.gov (United States)

    Hermann, Wieland; Eggers, Birk; Barthel, Henryk; Clark, Daniel; Villmann, Thomas; Hesse, Swen; Grahmann, Friedrich; Kühn, Hans-Jürgen; Sabri, Osama; Wagner, Armin

    2002-08-01

    Handwriting defects are an early sign of motor impairment in patients with Wilson's disease. The basal ganglia being the primary site of copper accumulation in the brain suggests a correlation with lesions in the nigrostiatal dopaminergic system. We have analysed and correlated striatal dopaminergic innervation using [(123)I]beta-CIT-SPECT and automated handwriting movements in 37 patients with Wilson's disease. There was a significant correlation of putaminal dopaminergic innervation with fine motor ability (p < 0,05 for NIV [number of inversion in velocity], NIA [number of inversion in acceleration], frequency). These data suggest that loss of dorsolateral striatal dopaminergic innervation has a pathophysiological function for decreased automated motor control in Wilson's disease. Furthermore analysis of automated handwriting movements could be useful for therapy monitoring and evaluation of striatal dopaminergic innervation. PMID:12195459

  14. Copper, zinc and selenium imbalance in Moroccan haemodialysis patients and its correlation to lipid peroxidation

    Directory of Open Access Journals (Sweden)

    Rachid Eljaoudi

    2015-08-01

    Results: The study showed that, plasma Zn and Se concentrations were lower in haemodialysis patients compared to that of healthy controls, while plasma Cu, MDA and Cu/Zn ratio were higher. Plasma Cu/Zn ratios were positively correlated to MDA and weakly correlated to hs-CRP levels whereas plasma Se concentrations were inversely correlated to MDA. In addition, MDA levels increased after haemodialysis session. Conclusions: Based on the results of the present study regarding the imbalance of trace elements in haemodialysis patients, it seems reasonable to periodically assess the trace elements status and consider possible correctional therapy in case of deficiency. [Int J Res Med Sci 2015; 3(8.000: 2079-2085

  15. The correlation between free fatty acid and insulin resistance in ischemic stroke patients

    Institute of Scientific and Technical Information of China (English)

    刘怀平

    2013-01-01

    Objective To explore the level of free fatty acid (FFA) in ischemic stroke (IS) patients and its correlation with insulin resistance (IR) .Methods This study was case-control study.Patients who were diagnosed with IS were followed up from June,2011 to September,2012in Tianjin Third Central Hospital.The 180 IS patients were divied into large infarct (57) ,middle infarct (63) and small infarct (60) according to the area of infarct.At the same time,60 healthy persons were selected as con-

  16. Positive correlation of serum leptin with estradiol levels in patients with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Mendonça H.C.

    2004-01-01

    Full Text Available Patients with polycystic ovary syndrome (PCOS usually are obese, insulin resistant and hyperinsulinemic. The known association between leptin, obesity andinsulin action suggests that leptin may have a role in PCOS but this has only been addressed peripherally. This study was designed to assess the relationship between serum leptin and the anthropometric, metabolic and endocrine variables of obese (body mass index, BMI ³30 kg/m² and non-obese (BMI <30 kg/m² PCOS patients. Twenty-eight PCOS patients and 24 control women subdivided into obese and non-obese groups were evaluated. Leptin, androgens, lipids, gonadotrophins and insulin-glucose response to the oral glucose tolerance test were measured by radioimmunoassay in all participants. The assays were done all in one time. The areas under the insulin curve (AUC-I and the glycemia curve were calculated to identify patients with insulin resistance. Mean leptin levels were not significantly higher in patients with PCOS compared to the control group (21.2 ± 10.2 vs 27.3 ± 12.4 ng/ml. Leptin levels were found to be significantly higher in the obese subgroups both in patients with PCOS (26.9 ± 9.3 vs 14.1 ± 7.0 ng/ml and in the control group (37.3 ± 15.5 vs 12.9 ± 5.8 ng/ml. The leptin of the PCOS group was correlated with BMI (r = 0.74; P < 0.0001 and estradiol (r = 0.48; P < 0.008 and tended to be correlated with the AUC-I (r = 0.36; P = 0.05. Of the parameters which showed a correlation with leptin in PCOS, only estradiol and probably insulinemia (AUC-I did not show a significant correlation with BMI, suggesting that the other parameters were correlated with leptin due to their correlation with BMI. Estradiol correlated with leptin in PCOS patients regardless of their weight.

  17. Correlative study between neuron-specific enolase and blood sugar level in ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Aparna Pandey

    2011-01-01

    Full Text Available Background: A study to investigate the level of the neurobiochemical marker, Neuron-Specific Enolase (NSE, at the time of admission and its correlation with the blood sugar level in ischemic stroke patients. Patients and Methods: We investigated 90 patients with complete stroke who were admitted to the Stroke Unit of the Department of Neurology at Sri Aurobindo Institute of Medical Sciences. NSE was measured with commercially available quantitative ′sandwich′ enzyme-linked immunosorbent assay kits obtained from R and D Systems. Hyperglycemia was defined as blood glucose concentration ≥ 7 mmol / L, and measured using the glucose oxidase method immediately. Results: Significantly increased NSE and lipid profile levels were found in ischemic stroke patients as compared to the control. Hyperglycemic ischemic stroke patients had increased levels of NSE, lipid profile, and National Institute of Health stroke scale scores (NIHSS score compared to normoglycemic ischemic stroke patients. In addition the serum NSE level of hyperglycemic stroke patients was also positively correlated with the blood sugar level (r = 0.734 P < 0.001. Conclusions: Hyperglycemia predicts an increased risk of poor outcome after ischemic stroke and it is reflected by a significantly increased level of Neuron-Specific Enolase.

  18. Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients

    Directory of Open Access Journals (Sweden)

    S. Arsic

    2015-01-01

    Full Text Available It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE for cognitive status; Functional Ambulation Category (FAC test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

  19. Atrophy of the corpus callosum correlates with white matter lesions in patients with cerebral ischaemia

    International Nuclear Information System (INIS)

    Many studies of white matter high signal (WMHS) on T2-weighted MRI have disclosed that it is related to cerebral ischaemia and to brain atrophy. Atrophy of the corpus callosum (CC) has also been studied in relation to ischaemia. Our objective was to test the hypothesis that CC atrophy could be due to ischaemia. We therefore assessed CC, WMHS and brain atrophy in patients with risk factors without strokes (the risk factor group) and in those with infarcts (the infarct group), to investigate the relationships between these factors. We studied 30 patients in the infarct group, 14 in the risk factor group, and 29 normal subjects. Using axial T1-weighted MRI, cortical atrophy and ventricular enlargement (brain atrophy) were visually rated. Using axial T2-weighted MRI, WMHS was assessed in three categories: periventricular symmetrical, periventricular asymmetrical and subcortical. Using the mid-sagittal T1-weighted image, the CC was measured in its anterior, posterior, midanterior and midposterior portions. In the normal group, no correlations were noted between parameters. In the infarct group, there were significant correlations between CC and brain atrophy, and between CC atrophy and WMHS. After removing the effects of age, gender and brain atrophy, significant correlations were noted between some CC measures and subcortical WMHS. In the risk factor group, there were significant correlations between CC and brain atrophy and between CC atrophy and WMHS. After allowance for age, gender and brain atrophy, significant correlations between some CC measures and periventricular WMHS remained. The hypothesis that CC atrophy could be due to cerebral ischaemia was supported by other analyses. Namely, for correlations between the extent of infarcts and partial CC atrophy in patients with anterior middle cerebral artery (MCA) and with posterior MCA infarcts, there were significant correlations between the extent of infarct and midanterior CC atrophy in the former, and posterior

  20. Atrophy of the corpus callosum correlates with white matter lesions in patients with cerebral ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Meguro, K.; Yamadori, A. [Section of Neuropsychology, Division of Disability Science, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, 980-8575 Sendai (Japan); Constans, J.M.; Courtheoux, P.; Theron, J. [MR Unit, University of Caen School of Medicine, Caen (France); Viader, F. [Department of Neuroradiology, University of Caen School of Medicine, Caen (France)

    2000-06-01

    Many studies of white matter high signal (WMHS) on T2-weighted MRI have disclosed that it is related to cerebral ischaemia and to brain atrophy. Atrophy of the corpus callosum (CC) has also been studied in relation to ischaemia. Our objective was to test the hypothesis that CC atrophy could be due to ischaemia. We therefore assessed CC, WMHS and brain atrophy in patients with risk factors without strokes (the risk factor group) and in those with infarcts (the infarct group), to investigate the relationships between these factors. We studied 30 patients in the infarct group, 14 in the risk factor group, and 29 normal subjects. Using axial T1-weighted MRI, cortical atrophy and ventricular enlargement (brain atrophy) were visually rated. Using axial T2-weighted MRI, WMHS was assessed in three categories: periventricular symmetrical, periventricular asymmetrical and subcortical. Using the mid-sagittal T1-weighted image, the CC was measured in its anterior, posterior, midanterior and midposterior portions. In the normal group, no correlations were noted between parameters. In the infarct group, there were significant correlations between CC and brain atrophy, and between CC atrophy and WMHS. After removing the effects of age, gender and brain atrophy, significant correlations were noted between some CC measures and subcortical WMHS. In the risk factor group, there were significant correlations between CC and brain atrophy and between CC atrophy and WMHS. After allowance for age, gender and brain atrophy, significant correlations between some CC measures and periventricular WMHS remained. The hypothesis that CC atrophy could be due to cerebral ischaemia was supported by other analyses. Namely, for correlations between the extent of infarcts and partial CC atrophy in patients with anterior middle cerebral artery (MCA) and with posterior MCA infarcts, there were significant correlations between the extent of infarct and midanterior CC atrophy in the former, and posterior

  1. Wilson disease: Identification of two novel mutations and clinical correlation in Eastern Chinese patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To study mutations in the P-type ATPase (ATP7B)gene responsible for Wilson disease (WD) in the Eastern Chinese population, and the possible correlation of specific mutations with clinical characteristics.METHODS: Mutations of the ATP7B gene were sought by means of direct sequencing in 50 Eastern Chinese WD patients of Han ethnic origin.RESULTS: Two novel mutations, Asp96Gly and Asp196Glu, were first identified. We also compared the characterization of mutations in ATP7B with the clinical findings, and a significant correlation with hepatic manifestations between patients carrying the Arg778Leu mutation and those without was found.CONCLUSION: Gene sequencing analysis was shown to have a high detection rate and accuracy. It may become the first priority in screening of WD patients.

  2. Preoperative diffusion-weighted imaging of single brain metastases correlates with patient survival times.

    Directory of Open Access Journals (Sweden)

    Anna Sophie Berghoff

    Full Text Available BACKGROUND: MRI-based diffusion-weighted imaging (DWI visualizes the local differences in water diffusion in vivo. The prognostic value of DWI signal intensities on the source images and apparent diffusion coefficient (ADC maps respectively has not yet been studied in brain metastases (BM. METHODS: We included into this retrospective analysis all patients operated for single BM at our institution between 2002 and 2010, in whom presurgical DWI and BM tissue samples were available. We recorded relevant clinical data, assessed DWI signal intensity and apparent diffusion coefficient (ADC values and performed histopathological analysis of BM tissues. Statistical analyses including uni- and multivariate survival analyses were performed. RESULTS: 65 patients (34 female, 31 male with a median overall survival time (OS of 15 months (range 0-99 months were available for this study. 19 (29.2% patients presented with hyper-, 3 (4.6% with iso-, and 43 (66.2% with hypointense DWI. ADCmean values could be determined in 32 (49.2% patients, ranged from 456.4 to 1691.8*10⁻⁶ mm²/s (median 969.5 and showed a highly significant correlation with DWI signal intensity. DWI hyperintensity correlated significantly with high amount of interstitial reticulin deposition. In univariate analysis, patients with hyperintense DWI (5 months and low ADCmean values (7 months had significantly worse OS than patients with iso/hypointense DWI (16 months and high ADCmean values (30 months, respectively. In multivariate survival analysis, high ADCmean values retained independent statistical significance. CONCLUSIONS: Preoperative DWI findings strongly and independently correlate with OS in patients operated for single BM and are related to interstitial fibrosis. Inclusion of DWI parameters into established risk stratification scores for BM patients should be considered.

  3. Correlation of platelets count with endoscopic findings in a cohort of Egyptian patients with liver cirrhosis.

    Science.gov (United States)

    Abd-Elsalam, Sherief; Habba, Eslam; Elkhalawany, Walaa; Tawfeek, Salwa; Elbatea, Hassan; El-Kalla, Ferial; Soliman, Hanan; Soliman, Samah; Yousef, Mohamed; Kobtan, Abdelrahman; El Nawasany, Sally; Awny, Sheren; Amer, Ibrahim; Mansour, Loai; Rizk, Fatma

    2016-06-01

    Screening endoscopy is recommended for early detection of esophageal varices (EVs) in cirrhotic patients with portal hypertension. However, this approach is limited by its invasiveness and cost. The aim of the study was to determine if platelet count can predict the presence of EVs, especially large (grade III, IV) EVs in need of prophylactic therapy, in a cohort of Egyptian patients with liver cirrhosis. In all, 110 patients with cirrhosis were prospectively analyzed. The presence of medium or large EVs was correlated with patients' platelet count and FIB-4. Esophageal varices were present in 87 (79.09%) patients. Among those with thrombocytopenia (platelet level below 150,000), 25.97% (20 patients) and 27.27% (21 patients) had EV grade II and EV grade III or IV, respectively. Whereas in patients in whom the platelet count was above 150,000, only 21.21% (7 patients) and 9.09% (3 patients) of patients had grade II EV and EV grade III or IV, respectively. A platelet count cut-off value of 149,000 was found to have specificity of 82% and sensitivity 39% for detection of presence of varices. A FIB-4 cut-off value of 3.175 was found to have an 83.3% sensitivity and 39.5% specificity in detecting large (grade III, IV) EVs. Platelet count is a noninvasive parameter with high accuracy for prediction of EVs. Cirrhotic patients with normal platelet counts (above 150,000), especially in financially deprived developing countries, can avoid screening endoscopy as they are at a low risk for variceal bleeding, and presence of large EVs in these patients is much less common than in those with thrombocytopenia. A 3.175 cut-off value of FIB-4 could be useful as a noninvasive predictor of large varices requiring prophylactic banding in cirrhotic patients. PMID:27281094

  4. 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.

  5. The correlation between motor impairments and event-related desynchronization during motor imagery in ALS patients

    Directory of Open Access Journals (Sweden)

    Kasahara Takashi

    2012-06-01

    Full Text Available Abstract Background The event-related desynchronization (ERD in EEG is known to appear during motor imagery, and is thought to reflect cortical processing for motor preparation. The aim of this study is to examine the modulation of ERD with motor impairment in ALS patients. ERD during hand motor imagery was obtained from 8 ALS patients with a variety of motor impairments. ERD was also obtained from age-matched 11 healthy control subjects with the same motor task. The magnitude and frequency of ERD were compared between groups for characterization of ALS specific changes. Results The ERD of ALS patients were significantly smaller than those of control subjects. Bulbar function and ERD were negatively correlated in ALS patients. Motor function of the upper extremities did was uncorrelated with ERD. Conclusions ALS patients with worsened bulbar scales may show smaller ERD. Motor function of the upper extremities did was uncorrelated with ERD.

  6. Asymptomatic neonatal colonisation by Clostridium difficile.

    OpenAIRE

    Bolton, R P; Tait, S K; Dear, P R; Losowsky, M. S.

    1984-01-01

    In a prospective survey of infants born in a single maternity unit, asymptomatic faecal colonisation by Clostridium difficile occurred in 31 (47%) of 66 babies who provided a faecal sample during week one of life and at age 14 and 28 days, and in 46 (30.7%) of the total of 150 babies for whom at least one faecal sample was obtained during the month of study. There was no evidence for acquisition of the organism from the mother during delivery and colonisation was unrelated to the means of del...

  7. Neurosyphilis Presenting as Asymptomatic Optic Perineuritis

    OpenAIRE

    Parker, Sarah E.; Pula, John H.

    2012-01-01

    Introduction. Syphilis is a sexually transmitted disease that is known as “the great imitator” due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS) syphilis. Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was ...

  8. The correlation between lacunes and microbleeds on magnetic resonance imaging in consecutive 180 patients

    International Nuclear Information System (INIS)

    Microbleeds on T2*-weighted magnetic resonance imaging (MRI) represent a hemorrhagic type of small vessel disease. Small vessel disease causes both intracerebral hemorrhages and lacunar infarctions. We studied clinical background and MRI findings of the patients to clarify the correlation between microbleeds and lacunes. This study consisted of 180 consecutive patients who underwent brain MRI using 1.5T system in our hospital for a year. We obtained T2*-weighted gradient-echo imaging as well as T1 and T2-weighted images. We statistically identified the factors related to the presence of microbleeds in all patients. The distribution of lacunes and microbleeds on MRI was compared to clarify the correlation of the lesions in the patients who had both lesions. The overall prevalence of microbleeds was 41.1% (74 of 180 patients). Logistic regression analysis indicated that previous stroke, leukoaraiosis and lacunes were significantly correlated with microbleeds. In the patients who have both microbleeds and lacunes, lesions are tended to locate in thalamus and basal ganglia, especially incidence of lacunes are significantly greater compared with other regions. Thirty-six of 398 lesions (9.05%) diagnosed as lacunes with T1- and T2-weighted imaging were demonstrated as microbleeds with T2*-weighted gradient-echo imaging. Lacunes, leukoaraiosis as a hypertensive change on MRI had statistically significant correlation with the presence of microbleeds. T2*-weighted gradient-echo imaging should be included in the imaging protocol for cerebrovascular disease, because T1- and T2-weighted imaging recognizing some of the microbleeds as lacunar infarction. (author)

  9. Structural and Functional Brain Correlates of Cognitive Impairment in Euthymic Patients with Bipolar Disorder

    Science.gov (United States)

    Goikolea, José M.; Bonnin, Caterina M.; Sarró, Salvador; Segura, Barbara; Amann, Benedikt L.; Monté, Gemma C.; Moro, Noemi; Fernandez-Corcuera, Paloma; Maristany, Teresa; Salvador, Raymond; Vieta, Eduard; Pomarol-Clotet, Edith; McKenna, Peter J.

    2016-01-01

    Introduction Cognitive impairment in the euthymic phase is a well-established finding in bipolar disorder. However, its brain structural and/or functional correlates are uncertain. Methods Thirty-three euthymic bipolar patients with preserved memory and executive function and 28 euthymic bipolar patients with significant memory and/or executive impairment, as defined using two test batteries, the Rivermead Behavioural Memory Test (RBMT) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS), plus 28 healthy controls underwent structural MRI using voxel-based morphometry (VBM). Twenty-seven of the cognitively preserved patients, 23 of the cognitively impaired patients and 28 controls also underwent fMRI during performance of the n-back working memory task. Results No clusters of grey or white matter volume difference were found between the two patient groups. During n-back performance, the cognitively impaired patients showed hypoactivation compared to the cognitively preserved patients in a circumscribed region in the right dorsolateral prefrontal cortex. Both patient groups showed failure of de-activation in the medial frontal cortex compared to the healthy controls. Conclusions Cognitive impairment in euthymic bipolar patients appears from this study to be unrelated to structural brain abnormality, but there was some evidence for an association with altered prefrontal function. PMID:27448153

  10. TRAUMATIC INTRACRANIAL HAEMORRHAGE: A CORRELATION WITH GLASGOW COMA SCALE, HAEMATOMA VOLUME AND PATIENT PROGNOSIS

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    Srinivasa Babu

    2016-05-01

    Full Text Available BACKGROUND AND PURPOSE To describe the role of Glasgow Coma Scale (GCS as an initial and simple tool of neurological assessment and also haematoma volume in selection of patient for surgery. MATERIALS AND METHODS After an initial GCS assessment, 50 patients with a history of head trauma were referred for a head CT which was done with a GE Bright Speed Elite 16 slice CT scanner. RESULTS 42 patients (84% were males and 8 (16% were females. The mean age was 33.54 years and the maximum numbers of patients affected belonged to the age group of 21 to 30 years. The most common mode of injury in this study was road traffic accident (RTA accounting for 86%. 42% of patients presented with a GCS of patients had more than one type of extraaxial haemorrhage. 20 patients in this study were operated, the indication being either SDH or EDH with a volume more than 20 mL and 30 mL respectively. Among intra-axial haemorrhages, cerebral contusions were the commonest type encountered with 34 out of 50 patients that is 68%. DAI was the other less common type of intra-axial haemorrhage accounting for 6%. Patients were selected for surgery based on the admission GCS and haematoma volume as determined using Petersen and Esperson formula on the CT images. Both GCS score and haematoma volume assessment were most crucial indicators for the surgical management of the patients in this study. Immediate surgery for patients with large haematomas was associated with positive outcome. CONCLUSIONS It was concluded that the initial GCS score played a major role in quick and reliable assessment of neurological status of the patient. The GCS score also correlated with the haematoma volume as seen on the CT. Both GCS score and haematoma volume assessment were most crucial indicators for the surgical management of the patients in this study.

  11. Correlation between relaxometry and diffusion tensor imaging in the globus pallidus of Huntington's disease patients.

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    Michael Syka

    Full Text Available Huntington's disease (HD is an inherited neurodegenerative disorder with progressive impairment of motor, behavioral and cognitive functions. The clinical features of HD are closely related to the degeneration of the basal ganglia, predominantly the striatum. The main striatal output structure, the globus pallidus, strongly accumulates metalloprotein-bound iron, which was recently shown to influence the diffusion tensor scalar values. To test the hypothesis that this effect dominates in the iron-rich basal ganglia of HD patients, we examined the globus pallidus using DTI and T2 relaxometry sequences. Quantitative magnetic resonance (MR, clinical and genetic data (number of CAG repeats were obtained from 14 HD patients. MR parameters such as the T2 relaxation rate (RR, fractional anisotropy (FA and mean diffusivity (MD were analysed. A positive correlation was found between RR and FA (R2=0.84, between CAG and RR (R2=0.59 and between CAG and FA (R2=0.44. A negative correlation was observed between RR and MD (R2=0.66. A trend towards correlation between CAG and MD was noted. No correlation between MR and clinical parameters was found. Our results indicate that especially magnetic resonance FA measurements in the globus pallidus of HD patients may be strongly affected by metalloprotein-bound iron accumulation.

  12. Adipokines in psoriatic arthritis patients: the correlations with osteoclast precursors and bone erosions.

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    Yu Xue

    Full Text Available Significant bone remodeling with disordered osteoclastogenesis has been implicated in the pathogenesis of psoriatic arthritis (PsA. And there is a high prevalence of the metabolic syndrome (MS in PsA patients. Adipokines, especially leptin and adiponectin, have recently been reported to be involved in the development and regulation of some autoimmune diseases. In this study, we examined the alternation of circulating osteoclastogenesis related cytokines [tumor necrosis factor-α (TNF-α, osteoprotegerin (OPG and receptor activator of nuclear factor-κB ligand (RANKL] and adipokines (leptin, adiponectin, resistin, chemerin, omentin in PsA patients, and analysed the correlations between these factors and osteoclast precursors numbers, radiographic damage scores, and disease activity index. 41 PsA patients, 20 psoriasis patients, and 24 healthy controls were recruited. Blood samples were obtained for detecting the levels of TNF-α, OPG, RANKL and the adipokines. The numbers of osteoclast precursors (OCs in peripheral blood were assessed. Radiographs of affected joints in PsA patients were scored for erosion, joint-space narrowing, osteolysis, and new bone formation. Compared with healthy controls, patients with PsA had higher TNF-α, RANKL, OCs, leptin and omentin but lower adiponectin and chemerin. Increased serum levels of TNF-α, RANKL, leptin, and omentin were positively correlated with OCs numbers. In contrast, serum adiponectin levels were decreased in PsA patients and negatively correlated with OCs numbers. TNF-α, RANKL and leptin were positively correlated with Psoriatic Arthritis Joint Activity Index (PsAJAI. Only TNF-α was positively correlated with radiographic damage scores. Our data demonstrated that systemic expression of soluble mediators of osteoclastogenesis and adipokines were disordered in PsA. Certain adipokines were elevated in the circulation of patients with PsA and might contribute to pathogenesis of arthritis. Prospective

  13. Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables

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    Laura MUNTEAN

    2009-12-01

    Full Text Available Objective: To evaluate bone mineral density (BMD in patients with ankylosing spondylitis (AS and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA. Using the modified Schober’s test we assessed spine mobility. We examined the sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

  14. Correlation between leptin level with lipid profile and free fatty acid in liver cirrhosis patients

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    Siti Maryani

    2015-09-01

    Full Text Available Malnutrition is a common condition in liver cirrhotic patients. Leptin regulates body weightphysiologically by suppressing appetite and increasing energy expenditure. Leptin is higher in femalethan male. Studies have shown correlation between leptin with metabolic factors like body massindex (BMI and lipid profile in cirrhotic patients. This study was conducted to investigate thecorrelation between serum leptin levels with lipid profile and free fatty acid in male patients with livercirrhosis. This was a cross sectional study that conducted at Gastroentero-Hepatology Clinic andInternal Ward at Dr. Sardjito General Hospital, Yogyakarta. The inclusion criteria were patients withliver cirrhosis > 18 years old, male, with Child-Pugh classification B and C, and provided informedconsent. The exclusion criteria were liver cirrhotic patients with comorbidity chronic kidney disease,chronic heart failure, diabetic, cancer, infection/septic, pregnancy, breast feeding, and steroid use.Data collecting was performed by anamnesis, physical examination, abdominal ultrasonographyexamination, and blood chemistry test. Pearson test was used to evaluate the correlation betweenthe serum leptin level with the lipid profile and free fatty acid. The results showed that no significantnegative correlation was observed between the serum leptin level with the total cholesterol (r= -0.052; p=0.766, high-density lipoprotein/HDL (r= -0.078; p=0.658 and triglyceride (r= -0.170; p=0.328 in male patients with liver cirrhosis. Furthermore, no significant positive correlationwas observed between the serum leptin levels with the low-density lipoprotein/LDL (r= -0.013; p=0.942 and free fatty acid/FFA (r= 0.007; p=0.968. In conclusion, there was no correlationbetween serum leptin levels with lipid profile and FFA in male patients with liver cirrhosis.

  15. Exercise testing in asymptomatic or minimally symptomatic aortic regurgitation: relationship of left ventricular ejection fraction to left ventricular filling pressure during exercise

    International Nuclear Information System (INIS)

    Exercise radionuclide angiography is being used to evaluate left ventricular function in patients with aortic regurgitation. Ejection fraction is the most common variable analyzed. To better understand the rest and exercise ejection fraction in this setting, 20 patients with asymptomatic or minimally symptomatic severe aortic regurgitation were studied. All underwent simultaneous supine exercise radionuclide angiography and pulmonary gas exchange measurement and underwent rest and exercise measurement of pulmonary artery wedge pressure (PAWP) during cardiac catheterization. Eight patients had a peak exercise PAWP less than 15 mm Hg (group 1) and 12 had a peak exercise PAWP greater than or equal to 15 mm Hg (group 2). Group 1 patients were younger and more were in New York Heart Association class I. The two groups had similar cardiothoracic ratios, changes in ejection fractions with exercise, and rest and exercise regurgitant indexes. Using multiple regression analysis, the best correlate of the exercise PAWP was peak oxygen uptake (r . -0.78, p less than 0.01). No other measurement added significantly to the regression. When peak oxygen uptake was excluded, rest and exercise ejection fraction also correlated significantly (r . -0.62 and r . -0.60, respectively, p less than 0.01). Patients with asymptomatic or minimally symptomatic severe aortic regurgitation have a wide spectrum of cardiac performance in terms of the PAWP during exercise. The absolute rest and exercise ejection fraction and the level of exercise achieved are noninvasive variables that correlate with exercise PAWP in aortic regurgitation, but the change in ejection fraction with exercise by itself is not

  16. Differences in toileting habits between children with chronic encopresis, asymptomatic siblings, and asymptomatic nonsiblings.

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    Borowitz, S M; Cox, D J; Sutphen, J L

    1999-06-01

    No studies have compared toileting-specific behaviors of encopretic children with those of asymptomatic children and have controlled for environmental factors such as parental attitudes, parenting styles, and bathroom facilities. This study prospectively examined the toileting habits of 86 chronically encopretic children compared with those of 27 asymptomatic siblings and 35 asymptomatic nonsiblings. Although encopretic children experienced significantly more soiling than did controls, the total number of daily bowel movements passed in the toilet (+/-SD) was comparable in the three groups (.92 +/- .76 in encopretic children compared with 1.14 +/- .43 and 1.08 +/- .47 in siblings and nonsiblings, respectively). Encopretic children experienced pain with defecation more often than did controls. During the 14-day study period, encopretic children complained of pain on 2.75 +/- 4.03 days compared with .58 +/- 1.84 days among sibling controls and 2.31 +/- 3.21 days among nonsibling controls. The mean pain score in encopretic children was .76 +/- 1.00 compared with .05 +/- .15 and .26 +/- .38 among siblings and nonsiblings, respectively. All three groups of children sat on the toilet without parental prompting the same number of times each day. In summary, children with chronic encopresis do not seem to avoid toileting, and they exhibit toileting behaviors that are very similar to those of asymptomatic siblings as well as to those of nonsibling controls. PMID:10393070

  17. Homocysteine and carotid intima-media thickness in ischemic stroke patients are not correlated

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    George Ntaios

    2008-04-01

    Full Text Available George Ntaios1, Christos Savopoulos1, Apostolos Hatzitolios1, Ippoliti Ekonomou2, Evangelos Destanis2, Ioannis Chryssogonidis2, Anastasia Chatzinikolaou3, Ifigenia Pidonia3, Dimitrios Karamitsos11First Propedeutic Department of Internal Medicine; 2Department of Radiology; 3Department of Biochemistry, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceIntroduction: Hyperhomocysteinemia has been linked to cardiovascular morbidity and mortality by numerous authors. Whether this association is causal or not remains uncertain. The aim of the study was to investigate the association of hyperhomocysteinemia with the degree of carotid atherosclerosis in stroke patients.Methods: We studied 97 Greek patients in our stroke unit who were hospitalized as a result of ischemic stroke between March 2006 and May 2007. The patients were divided into two groups: the first (52 patients included stroke patients with serum levels of homocysteine below 15 µmol/L, but in the second group (45 patients serum homocysteine exceeded this value. We measured carotid intima-media thickness (cIMT in all patients and correlated it with serum homocysteine.Results: The mean homocysteine concentration was 11.5 µmol/L in the first group and 21.5 µmol/L in the second group. Carotid IMT was 1.012 mm in the first group, and 1.015 mm in the second group, an insignificant difference. On the contrary, serum folate concentration was 21.3 nmol/L in the first group compared with 16.7 nmol/L in the second group (p < 0.001. VitB12 was 401 pmol/L in the first group and 340 pmol/L in the second group, a statistically significant difference (p < 0.001.Conclusions: Serum levels of homocysteine were not correlated with cIMT in ischemic stroke patients. Both folate and vitB12 were decreased in hyperhomocysteinemic ischemic stroke patients.Keywords: homocysteine, carotid intima-media thickness, ischemic stroke

  18. Random number generation deficits in patients with multiple sclerosis: Characteristics and neural correlates.

    Science.gov (United States)

    Geisseler, Olivia; Pflugshaupt, Tobias; Buchmann, Andreas; Bezzola, Ladina; Reuter, Katja; Schuknecht, Bernhard; Weller, David; Linnebank, Michael; Brugger, Peter

    2016-09-01

    Human subjects typically deviate systematically from randomness when attempting to produce a sequence of random numbers. Despite an increasing number of behavioral and functional neuroimaging studies on random number generation (RNG), its structural correlates have never been investigated. We set out to fill this gap in 44 patients with multiple sclerosis (MS), a disease whose impact on RNG has never been studied. The RNG task required the paced (1 Hz) generation of the numbers from 1 to 6 in a sequence as random as possible. The same task was administered in 39 matched healthy controls. To assess neuroanatomical correlates such as cortical thickness, lesion load and third ventricle width, all subjects underwent high-resolution structural MRI. Compared to controls, MS patients exhibited an enhanced tendency to arrange consecutive numbers in an ascending order ("forward counting"). Furthermore, patients showed a higher susceptibility to rule breaks (producing out-of-category digits like 7) and to skip beats of the metronome. Clinico-anatomical correlation analyses revealed two main findings: First, increased counting in MS patients was associated with higher cortical lesion load. Second, increased number of skipped beats was related to widespread cortical thinning. In conclusion, our test results illustrate a loss of behavioral complexity in the course of MS, while the imaging results suggest an association between this loss and cortical pathology. PMID:27403852

  19. Dietary intake of nutrients and its correlation with fatigue in multiple sclerosis patients.

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    Sama Bitarafan

    2014-03-01

    Full Text Available The role of nutrition in the progression of multiple sclerosis (MS and related complications such as fatigue has been reported by several studies. The aim of this study is the assessment of nutritional status and its relationship with fatigue in multiple sclerosis patients.This is a cross-sectional study, in which 101 relapsing-remitting MS patients were enrolled. The fatigue status was determined using the validated Persian version of of the Modified Fatigue Impact Scale (MFIS. Dietary intake was assessed using a 3-day food record questionnaire and compared to dietary reference intake (DRI values. Association between variables was determined using Pearson Correlation Coefficient.In the preset study, 25 men and 76 women (total = 101 were enrolled. Analysis of dietary intake showed that daily intake of vitamin D, folate, calcium, and magnesium were significantly lower than DRI in all of patients. In men, zinc intake was significantly lower than DRI; while, in women, iron was significantly below the DRI level. After adjusting for energy, MFIS and its physical subscale were highly correlated with intake of folate and magnesium.Our findings support that lower magnesium and folate diets are correlated with higher fatigue scores in MS patients.

  20. Serum cytokine contents in schizophrenia patient with metabolic syndrome and their correlation with nerve electrophysiology

    Institute of Scientific and Technical Information of China (English)

    Li-Yong Chen; Zhong Chen; Xue-Jing Li

    2016-01-01

    Objective:To analyze serum cytokine contents in schizophrenia patient with metabolic syndrome (MS) and their correlation with nerve electrophysiology.Methods:A total of 90 chizophrenia patient with MS, including 41 cases with simple schizophrenia and 39 cases with simple metabolic syndrome were included for study. The values of nerve electrophysiology indexes and serum illness-related indexes were compared among included patients, and the correlation between the two was further analyzed.Results:Compared with simple schizophrenia group and simple MS group, P300 latency of schizophrenia with MS group was longer, and the amplitude was shorter; N2-P3 latency and amplitude were shorter (P<0.05); serum SOD, S100b, BDNF, ABAb, PAI-1,α-HBDH, AST, cystatin c, TG, FBG and 2hPG values of schizophrenia with MS group were higher, IGF1, HMW-APN and HDL-C levels were lower, and compared with simple schizophrenia group and simple MS group, differences were significant (P<0.05); P300 latency, P300 amplitude, N2-P3 latency and N2-P3 amplitude of schizophrenia with MS group were directly correlated with serum cytokine contents (P<0.05).Conclusions:There are significantly abnormal serum cytokines and nerve electrophysiology indexes in schizophrenia patient with MS, and nerve electrophysiology detection can be used as the means to judge disease and guide treatment.

  1. Tract-Specific Correlates of Neuropsychological Deficits in Patients with Subcortical Vascular Cognitive Impairment.

    Science.gov (United States)

    Jung, Na-Yeon; Han, Cheol E; Kim, Hee Jin; Yoo, Sang Wook; Kim, Hee-Jong; Kim, Eun-Joo; Na, Duk L; Lockhart, Samuel N; Jagust, William J; Seong, Joon-Kyung; Seo, Sang Won

    2016-01-01

    The white matter tract-specific correlates of neuropsychological deficits are not fully established in patients with subcortical vascular cognitive impairment (SVCI), where white matter tract damage may be a critical factor in cognitive impairment. The purpose of this study is to investigate the tract-specific correlates of neuropsychological deficits in SVCI patients using tract-specific statistical analysis (TSSA). We prospectively recruited 114 SVCI patients, and 55 age-, gender-, and education-matched individuals with normal cognition (NC). All participants underwent diffusion weighted imaging and neuropsychological testing. We classified tractography results into fourteen major fiber tracts and analyzed group comparison and correlation with cognitive impairments. Relative to NC subjects, SVCI patients showed decreased fractional anisotropy values in bilateral anterior-thalamic radiation, cingulum, superior-longitudinal fasciculus, uncinate fasciculus, corticospinal tract, and left inferior-longitudinal fasciculus. Focal disruptions in specific tracts were associated with specific cognitive impairments. Our findings suggest that disconnection of specific white matter tracts, especially those neighboring and providing connections between gray matter regions important to certain cognitive functions, may contribute to specific cognitive impairments in SVCI. PMID:26836179

  2. Random number generation deficits in patients with multiple sclerosis: Characteristics and neural correlates.

    Science.gov (United States)

    Geisseler, Olivia; Pflugshaupt, Tobias; Buchmann, Andreas; Bezzola, Ladina; Reuter, Katja; Schuknecht, Bernhard; Weller, David; Linnebank, Michael; Brugger, Peter

    2016-09-01

    Human subjects typically deviate systematically from randomness when attempting to produce a sequence of random numbers. Despite an increasing number of behavioral and functional neuroimaging studies on random number generation (RNG), its structural correlates have never been investigated. We set out to fill this gap in 44 patients with multiple sclerosis (MS), a disease whose impact on RNG has never been studied. The RNG task required the paced (1 Hz) generation of the numbers from 1 to 6 in a sequence as random as possible. The same task was administered in 39 matched healthy controls. To assess neuroanatomical correlates such as cortical thickness, lesion load and third ventricle width, all subjects underwent high-resolution structural MRI. Compared to controls, MS patients exhibited an enhanced tendency to arrange consecutive numbers in an ascending order ("forward counting"). Furthermore, patients showed a higher susceptibility to rule breaks (producing out-of-category digits like 7) and to skip beats of the metronome. Clinico-anatomical correlation analyses revealed two main findings: First, increased counting in MS patients was associated with higher cortical lesion load. Second, increased number of skipped beats was related to widespread cortical thinning. In conclusion, our test results illustrate a loss of behavioral complexity in the course of MS, while the imaging results suggest an association between this loss and cortical pathology.

  3. 无症状高尿酸血症患者及痛风患者四肢关节尿酸盐结晶的双源CT对比分析%Analysis of urate crystal deposition us ing dual-source CT in asymptomatic hyperuricaemia and symptomatic gout patients

    Institute of Scientific and Technical Information of China (English)

    程留慧; 王道清; 张保朋; 王锁刚; 周舟; 温泽迎

    2015-01-01

    Objective Retrospectively analyze of urate crystal deposition using dual-source CT in asymptomatic hyperuricaemia and symptomatic gout patients.Methods Sixty patients with asymptomatic hyperuricemia (uric acid ≥540 μmol/L) and 48 patients with gout (without any change in the appearance of the limbs and obvious gout nodules) were selected.All patients underwent dual-energy CT imaging.The location number and size were analyzed using CT gout software.Results Eighteen patients with asymptomatic hyperuricemia with urate crystal deposition in limb joints (13 in foot and ankle, 7 in the hand and wrist, 2 in knee), the average size of crystal was (0.12±0.04) cm3.Forty-eight gout patients (28 cases of early gout and 20 cases of late gout and 20 gout cases) had urate crystal deposition (48 in foot and ankle, 39 in hand and wrist, 27 in knee), the average size of crystal was (1.7±0.7) cm3.The number and size of urate crystals deposited in the joints, tendons and ligaments was higher in patients with gout than asymptomatic hyperuricemia (x2=52.076, P<0.001;t=44.834, P<0.001).There was no difference between the early gout and late gout in the size of urate crystals (t=0.163, P>0.05).Conclusion Urate crystals can deposite in asymptomatic hyperuricemia.However, more and larger urate crystals appear in gout patients, there is no difference in size and number of urate crystals between the course duration of gout.%目的 利用双源CT(DSCT)双能成像技术对无症状高尿酸血症患者及痛风患者体内尿酸盐结晶沉积进行对比分析.方法 选择60例无症状高尿酸血症(尿酸值≥540 μmol/L)患者及48例经临床确诊且具有临床症状的痛风患者(四肢外观无任何改变和触摸不到明显痛风结节).对所有患者四肢关节进行DSCT双能成像检查,利用痛风分析软件对2组患者尿酸盐结晶沉积部位、数目及大小进行对比分析.统计学处理采用t检验、x2检验.结果 18例无症状高尿酸血症

  4. 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.

  5. Neurosyphilis Presenting as Asymptomatic Optic Perineuritis

    Directory of Open Access Journals (Sweden)

    Sarah E. Parker

    2012-01-01

    Full Text Available Introduction. Syphilis is a sexually transmitted disease that is known as “the great imitator” due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS syphilis. Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was unremarkable, and lumbar puncture revealed a normal opening pressure, with an elevated cerebrospinal fluid white cell count. Orbit MRI showed optic nerve sheath expansion and enhancement, consistent with optic perineuritis. He tested positive for syphilis based on serum RPR and FTA-ABS. Conclusion. Ophthalmologic findings, including disc edema, may be the presenting features of CNS syphilis. Even in asymptomatic persons, perineuritis should be considered early, as diagnosis and treatment are imperative given the progressive nature of the disease.

  6. [Correlations between the patient's genotype and the course of the disease in hereditary cancer diseases].

    Science.gov (United States)

    Bisgaard, Marie Luise

    2006-06-12

    The majority of hereditary cancers demonstrate extended variation of phenotype, not only between families, but also within a particular family, who supposedly have inherited the same pathogenic mutation. The present paper reviews genotype-phenotype correlations with examples mainly from the two largest hereditary cancer groups, namely hereditary colorectal cancer and hereditary breast (and ovarian) cancer. It is concluded that knowledge about genotype-phenotype correlations is essential in the cancer genetic clinic; otherwise, the patient tends to base decisions on personal experience, not realising that the course of disease might be different in other family members. PMID:16822416

  7. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Papakonstantinou, Olympia [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); Mohana-Borges, Aurea V.R.; Campell, Loretta; Trudell, Debra; Resnick, Donald [Veterans Affairs Medical Center, University of California, Department of Radiology, San Diego (United States); Haghighi, Parviz [Veterans Affairs Medical Center, University of California, Department of Pathology, San Diego, California (United States)

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  8. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation.

    Science.gov (United States)

    Papakonstantinou, Olympia; Mohana-Borges, Aurea V R; Campell, Loretta; Trudell, Debra; Haghighi, Parviz; Resnick, Donald

    2005-03-01

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. PMID:15316682

  9. Hip arthropathy in a patient with primary hemochromatosis: MR imaging findings with pathologic correlation

    International Nuclear Information System (INIS)

    Arthropathy is a major clinical manifestation in primary hemochromatosis, typically affecting the metacarpophalangeal joints. Hip arthropathy is not uncommon, with radiologic features resembling osteoarthritis or calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. We describe the MR imaging findings of the hip in a patient with severe hip arthropathy and primary hemochromatosis and correlate them with the histopathologic findings. MR imaging showed severe degenerative changes, with large subchondral cysts and subchondral sclerosis in the femoral head and acetabulum. There was conspicuous correlation between MR imaging and pathologic findings of the resected femoral head. However, MR imaging failed to reveal intra-articular iron. (orig.)

  10. Correlations Between Echocardiographic Systolic and Diastolic Function with Cardiac Catheterization in Biventricular Congenital Heart Patients.

    Science.gov (United States)

    Nadorlik, H; Stiver, C; Khan, S; Miao, Y; Holzer, R; Cheatham, J P; Cua, C L

    2016-04-01

    Newer echocardiographic techniques may allow for more accurate assessment of left ventricular (LV) function. Adult studies have correlated these echocardiographic measurements with invasive data, but minimal data exist in the pediatric congenital heart population. Purpose of this study was to evaluate which echocardiographic measurements correlated best with LV systolic and diastolic catheterization parameters. Patients with two-ventricle physiology who underwent simultaneous echocardiogram and cardiac catheterization were included. Images were obtained in the four-chamber view. LV systolic echocardiographic data included ejection fraction, displacement, tissue Doppler imaging (TDI) s' wave, global longitudinal strain, and strain rate (SR) s' wave. Diastolic echocardiographic data included mitral E and A waves, TDI e' and a' waves, and SRe' and SRa' waves. E/TDI e', TDI e'/TDI a', E/SRe', and SRe'/SRa' ratios were also calculated. Catheterization dP/dt was used as a marker for systolic function, and LV end-diastolic pressure (EDP) was used as a marker for diastolic function. Correlations of the echocardiographic and catheterization values were performed using Pearson correlation. Twenty-nine patients were included (14 females, 15 males). Median age at catheterization was 3.4 years (0.04-17.4 years). dP/dt was 1258 ± 353 mmHg/s, and LVEDP was 10.8 ± 2.4 mmHg. There were no significant correlations between catheterization dP/dt and systolic echocardiographic parameters. LVEDP correlated significantly with SRe' (r = -0.4, p = 0.03), SRa' (r = -0.4, p = 0.03), and E/SRe' (r = 0.5, p = 0.004). In pediatric congenital heart patients, catheterization dP/dt did not correlate with echocardiographic measurements of LV systolic function. Further studies are needed to determine which echocardiographic parameter best describes LV systolic function in this population. Strain rate analysis significantly correlated with LVEDP. Strain rate analysis should be considered as an

  11. Correlation between 1,5-anhydroglucitol and glycemic excursions in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    SUN Jie; DOU Jing-tao; WANG Xian-ling; YANG Guo-qing; L(U) Zhao-hui; ZHENG Hua; MA Fang-ling; LU Ju-ming; MU Yi-ming

    2011-01-01

    Background The accurate and comprehensive assessment of glycemic control in patients with diabetes is important for optimizing glycemic management and for formulating personalized diabetic treatment schemes.This study aimed to analyze the correlation between 1,5-anhydroglucitol (1,5-AG) and glycemic excursions in type 2 diabetic patients.Methods Seventy-one outpatients with type 2 diabetes mellitus were randomly recruited from Chinese People's Liberation Army General Hospital.Using a continuous glucose monitoring system (CGMS),these patients' blood glucose levels were monitored for three consecutive days to obtain mean blood glucose (MBG) data.Intraday glycemic excursions were evaluated using the mean amplitude of glycemic excursions (MAGE),the largest amplitude of glycemic excursions (LAGE),standard deviation of blood glucose (SDBG) and the M-value.Interday glycemic excursion was assessed by absolute mean of daily difference (MODD).Postprandial glycemic fluctuations were evaluated using postprandial glucose excursions (PPGE) and postprandial incremental area under the curve (iAUC).Fasting venous blood samples were collected to measure serum 1,5-AG,whole-blood hemoglobin A1c (HbA1c) and serum glycated albumin (GA).Clinical markers of glycemia and parameters of glycemic excursions from CGMS were analyzed using the Pearson correlation coefficient and multivariate stepwise regression.Results Pearson correlation analysis revealed that 1,5-AG was significantly correlated with MAGE,SDBG,M-value,LAGE,PPGE and iAUC (r values were -0.509,-0.430,-0.530,-0.462,-0.416 and -0.435,respectively,P <0.01),especially in moderately and well-controlled patients,based on defined HbA1c levels.Multivariate stepwise regression analysis revealed a negative correlation between 1,5-AG and the above parameters,but not HbA1c and GA.Finally,HbA1c and GA were positively correlated with MBG and fasting blood glucose (FBG).Conclusions 1,5-AG was much better than HbA1c and GA as a marker of

  12. Correlation Factor Analysis of Retinal Microvascular Changes in Patients With Essential Hypertension

    Institute of Scientific and Technical Information of China (English)

    Huang Duru; Huang Zhongning

    2006-01-01

    Objectives To investigate correlation between retinal microvascular signs and essential hypertension classification. Methods The retinal microvascular signs in patients with essential hypertension were assessed with the indirect biomicroscopy lens, the direct and the indirect ophthalmoscopes were used to determine the hypertensive retinopathy grades and retinal arteriosclerosis grades.The rank correlation analysis was used to analysis the correlation these grades with the risk factors concerned with hypertension. Results Of 72 cases with essential hypertension, 28 cases complicated with coronary disease, 20 cases diabetes, 41 cases stroke,17 cases renal malfunction. Varying extent retinal arterioscleroses were found in 71 cases, 1 case with retinal hemorrhage, 2 cases with retina edema, 4 cases with retinal hard exudation, 5 cases with retinal hemorrhage complicated by hard exudation, 2 cases with retinal hemorrhage complicated by hard exudation and cotton wool spot, 1 case with retinal hemorrhage complicated by hard exudation and microaneurysms,1 case with retinal edema and hard exudation, 1 case with retinal microaneurysms, 1 case with branch retinal vein occlusion. The rank correlation analysis showed that either hypertensive retinopathy grades or retinal arteriosclerosis grades were correlated with risk factor lamination of hypertension (r=0.25 or 0.31, P<0.05), other correlation factors included age and blood high density lipoprotein concerned about hypertensive retinopathy grades or retinal arteriosclerosis grades, but other parameters, namely systolic or diastolic pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting blood glucose,blood urea nitrogen and blood creatinine were not confirmed in this correlation analysis (P > 0.05).Conclusions Either hypertensive retinopathy grade or retinal arteriosclerosis grade is close with the hypertension risk factor lamination, suggesting that the fundus examination of patients with

  13. Correlation of condylar mobility and arthrotomography in patients with internal derangements of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Sook; You, Dong Soo; Park, Tae Won; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1994-08-15

    Arthrography of the temporomandibular joint is a useful method of demonstrating the tissue abnormalities related to disc dysfunction. In this study, 19 asymptomatic joints, 31 joints with anterior disc displacement with reduction, 31 joints with anterior disc displacement without reduction which were classified by arthrotomography under fluoroscopy were evaluated to determine the linear measurement of anterior recess of inferior joint space and the relationship between the condylar anterior translation and the severity of the internal derangements. Their fluoroscopic images were also evaluated to describe the characteristics of condylar paths in internal derangements of the temporomandibular joints. The results were as follows; 1. The mean lengths of the anterior recess in asymptomatic group, reduction group, and non-reduction group were 8.7 {+-} 1.6 mm, 11.2 {+-} 1.7 mm, 12.8 {+-} 1.7 mm respectively. The length of the anterior recess was increased according to the severity of the internal derangements (P<0.05). 2. Linear measurements if anterior movement of condyle on maximum mouth opening were 13.1 {+-} 4,2 mm, 15.9 {+-} 4,1 mm, 5.0 {+-} 3.7 mm in asymptomatic group, reduction group, and non-reduction group respectively. Compared with asymptomatic group, reduction group showed hypermobility of the condyle and not-reduction group showed hypomobility. 3. Condyles moved beyond the crest of articular eminence in 80% of reduction group and did not it in 70% of not-reduction group. 4. The condyle moved mainly superiorly in reduction group (66%)and horizontally in asymptomatic group (47%). There were no cases to move superiorly in not-reduction group.

  14. 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.

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

    International Nuclear Information System (INIS)

    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

  16. Patients Prefer Boarding in Inpatient Hallways: Correlation with the National Emergency Department Overcrowding Score

    Directory of Open Access Journals (Sweden)

    John R. Richards

    2011-01-01

    Full Text Available Objective. The boarding of patients in Emergency Department (ED hallways when no inpatient beds are available is a major cause of ED crowding. One solution is to board admitted patients in an inpatient rather than ED hallway. We surveyed patients to determine their preference and correlated their responses to real-time National Emergency Department Overcrowding Score (NEDOCS. Methods. This was a survey of admitted patients in the ED of an urban university level I trauma center serving a community of 5 million about their personal preferences regarding boarding. Real-time NEDOCS was calculated at the time each survey was conducted. Results. 99 total surveys were completed during October 2010, 42 (42% patients preferred to be boarded in an inpatient hallway, 33 (33% preferred the ED hallway, and 24 (24% had no preference. Mean (±SD NEDOCS (range 0–200 was 136±46 for patients preferring inpatient boarding, 112±39 for ED boarding, and 119±43 without preference. Male patients preferred inpatient hallway boarding significantly more than females. Preference for inpatient boarding was associated with a significantly higher NEDOCS. Conclusions. In this survey study, patients prefer inpatient hallway boarding when the hospital is at or above capacity. Males prefer inpatient hallway boarding more than females. The preference for inpatient hallway boarding increases as the ED becomes more crowded.

  17. Correlates of depression and burden for informal caregivers of patients in a geriatrics referral clinic.

    Science.gov (United States)

    Drinka, T J; Smith, J C; Drinka, P J

    1987-06-01

    Caregiver burden has been associated with patient dementia. In this study we tested the hypothesis that caregiver burden and depression are related to patient cognitive impairment. We analyzed records of 127 elderly male patients from a Veterans hospital geriatrics referral clinic. The patients and their informal caregivers had been referred to the clinic because the complexity and multiplicity of their problems were beyond the treatment capability of other clinics. There was a high prevalence of dementia (73%) and depression (69%) in these patients according to Diagnostic and Statistical Manual (DSM-III) criteria. Quantitative measures of patient dementia and dependency in activities of daily living were not statistically associated with measures of caregiver depression or burden. In contrast, measures of patient depression were significantly correlated with measures of caregiver depression and burden. We hypothesize that caregivers of chronically ill, elderly men cope better with physical and cognitive incapacity than with affective symptoms. Because caregiver support is the most important factor in maintaining a disabled elder in the community, we suggest evaluating patients and caregivers for depression as part of standard practice in geriatric clinical settings. PMID:3553288

  18. Correlation between metabolic controls and changes in retina in patients having diabetes

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana A.

    2014-01-01

    Full Text Available Introduction. Diabetes mellitus is as old as the human race. Retinopathy, being one of complications of diabetes mellitus, is the most common cause of blindness. This study was aimed at analyzing the correlation between retinopathy and duration of disease, metabolic control, and obesity. Material and Methods. The study sample consisted of 135 patients divided into the experimental group of 90 patients with retinopathy and the control group of 45 patients without retinopathy. The patients were examined according to standard protocols: anamneses, endocrinology, ophthalmology exams, biochemical analyses, and anthropometric measurements. Results. The average age of patients was 60.13 ± 9.29 in the experimental group, while it was 57.55 ± 4.85 in the control group. The average duration of disease was 11.71 ± 5.8 and 14.40 ± 7.68 in the control group experimental group, respectively. The following statistically essential differences between the control and experimental group were found: in duration of disease (11.71 ± 5.85; 14.40 ± 7.68; r = 0.000, in glycemia (7.02 ± 2.20; 8.34 ± 3.18; p = 0.000, in glycosylated hemoglobin A1C (HbA1C (7.16 ± 1.37; 8.22 ± 2.05; r = 0.000, in triglycerides (1.92 ± 0.72; 2.63 ± 1.60; r = 0.001, and in body mass index (23.94 ± 2.65; 27.66 ± 15.13; r = 0.000. Conclusion. There is a positive correlation between duration of disease, glycosylated hemoglobin A1C, triglycerides, body mass index - obesity and retinopathy. A significant statistical correlation among those parameters has been found in patients with diabetic retinopathy.

  19. Early smoking-induced lung lesions in asymptomatic subjects. Correlations between high resolution dynamic CT and pulmonary function testing; Danno polmonare precoce da fumo in soggetti asintomatici. Studio correlativo con TC dinamica ad elevata risoluzione e test di funzionalita' respiratoria

    Energy Technology Data Exchange (ETDEWEB)

    Spaggiari, Enrica; Zompadori, Maurizio; Bna' , Claudio; Ormitti, Francesca; Svaerzellati, Nicola; Rabaiotti, Enrico [Parma Univ., Parma (Italy). Sezione di Diagnostica per Immagini e UO di Scienze Radiologiche Dipartimento di Scienze Cliniche; Verduri, Alessia; Chetta, Alfredo [Parma Univ., Parma (Italy). Sezione Clinica Pneumologica

    2005-02-01

    smokers' group was 13.94%. Pulmonary emphysema was found in 34.6% of cases in the smokers' group: 33.3% former-smokers and 35.2% current-smokers. Emphysema was prevalent in the upper lobes (88.8%). Mean extension was 8.76% in the former smokers group and 18.81% in current-smokers, with a total mean extension of 15.47% in the smokers' group. Statistically, there was a significant difference between non-smokers and smokers as regards emphysema extension and expiratory air trapping (p=0.0034 and p=0.050 respectively). The smokers' group had a significantly wider diameter of the apical segmental bronchus of the right upper lobe than the controls. There was no significant statistical correlation between this dilatation and the emphysema score (r=0.051); p=0.81). The entity of smoking history did not correlate with emphysema extension or air trapping or with the size of the apical segmental bronchus of the right upper lobe. Conclusions: Our study demonstrates that HRCT is more sensitive and specific than commonly-used functional tests for the evaluation of initial emphysema in asymptomatic smokers. We observed expiratory air trapping only in the smokers' group, and only of the lobular type, without evidence of disease in inspiratory scans. Among the smokers and former-smokers, air trapping was found in 30.7% of subjects, with a mean extension lower than 10%. Our results therefore suggest that, even in asymptomatic subjects, expiratory air trapping is probably pathological and, once, bronchial asthma has been excluded, it may be related to cigarette smoking and indicate early inflammatory bronchiolar damage. HRCT may therefore be regarded as a useful tool in the early diagnosis of smoking-related lung disease. [Italian] Scopo: Valutare la prevalenza ed il significato degli effetti patologici del fumo di sigaretta sul polmone e la sensibilita' della HRCT nella individuazione del danno polmonare in fumatori o ex-fumatori asintomatici. Materiale e

  20. The neural correlates of motor intentional disorders in patients with subcortical vascular cognitive impairment.

    Science.gov (United States)

    Kim, Geon Ha; Seo, Sang Won; Jung, Kihyo; Kwon, Oh-Hun; Kwon, Hunki; Kim, Jong Hun; Roh, Jee Hoon; Kim, Min-Jeong; Lee, Byung Hwa; Yoon, Doo Sang; Hwang, Jung Won; Lee, Jong Min; Jeong, Jee Hyang; You, Heecheon; Heilman, Kenneth M; Na, Duk L

    2016-01-01

    Subcortical vascular cognitive impairment (SVCI) refers to cognitive impairment associated with small vessel disease. Motor intentional disorders (MID) have been reported in patients with SVCI. However, there are no studies exploring the neuroanatomical regions related to MID in SVCI patients. The aim of this study, therefore, was to investigate the neural correlates of MID in SVCI patients. Thirty-one patients with SVCI as well as 10 healthy match control participants were included. A "Pinch-Grip" apparatus was used to quantify the force control capabilities of the index finger in four different movement phases including initiation, development, maintenance, and termination. All participants underwent magnetic resonance imaging (MRI). Topographical cortical areas and white matter tracts correlated with the performances of the four different movement phases were assessed by the surface-based morphometry and tract-based spatial statistics analyses. Poorer performance in the maintenance task was related to cortical thinning in bilateral dorsolateral prefrontal, orbitofrontal and parietal cortices, while poorer performance in the termination task was associated with the disruption of fronto-parietal cortical areas as well as the white matter tracts including splenium and association fibers such as superior longitudinal fasciculus. Our study demonstrates that cortical areas and underlying white matter tracts associated with fronto-parietal attentional system play an important role in motor impersistence and perseveration in SVCI patients. PMID:26514838

  1. Novel approach to improve molecular imaging research: Correlation between macroscopic and molecular pathological findings in patients

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, Ingrid, E-mail: i.boehm@uni-bonn.de [Department of Diagnostic Radiology, ZARF Project, Center for Molecular Imaging Research MBMB, Philipps University of Marburg, Baldingerstrasse, 35039 Marburg (Germany)

    2011-09-15

    Purpose: Currently, clinical research approaches are sparse in molecular imaging studies. Moreover, possible links between imaging features and pathological laboratory parameters are unknown, so far. Therefore, the goal was to find a possible relationship between imaging features and peripheral blood cell apoptosis, and thereby to present a novel way to complement molecular imaging research. Materials and methods: The investigation has been done in systemic lupus erythematosus (SLE), a prototype of an autoimmune disease characterized by multiorgan involvement, autoantibody production, and disturbed apoptosis. Retrospectively, radiological findings have been compared to both autoantibody findings and percentage apoptotic blood cells. Results: Two SLE groups could be identified: patients with normal (annexin V binding < 20%), and with increased apoptosis (annexin V binding > 20%) of peripheral blood cells. The frequency of radiological examinations in SLE patients significantly correlated with an increased percentage of apoptotic cells (p < 0.005). In patients with characteristic imaging findings (e.g. lymph node swelling, pleural effusion) an elevated percentage of apoptotic cells was present. In contrast SLE-patients with normal imaging findings or uncharacteristic results of minimal severity had normal percentages of apoptotic blood cells. Conclusion: This correlation between radiographic findings and percentage of apoptotic blood cells provides (1) further insight into pathological mechanisms of SLE, (2) will offer the possibility to introduce apoptotic biomarkers as molecular probes for clinical molecular imaging approaches in future to early diagnose organ complaints in patients with SLE, and (3) is a plea to complement molecular imaging research by this clinical approach.

  2. MR Imaging of Knee Osteoarthritis and Correlation of Findings with Reported Patient Pain

    Institute of Scientific and Technical Information of China (English)

    艾飞; 余铖; 张炜; John; N; Morelli; Kacher; D; 李小明

    2010-01-01

    To evaluate lesion detection of MRI in knee joint osteoarthritis in patients with symptoms of pain,the correlation between MRI findings and varying degrees of reported pain was assessed.Twenty-eight patients(31 knees) with osteoarthritis were recruited for this study.The degree of knee pain was assessed by VRS scores.The knees were evaluated by plain film radiograph utilizing Kellgren-Lawrence scores.Multiple MR sequences were performed on a 1.5T MR-system,including sagittal and coronal dual fast spin echo(...

  3. Silent cerebrovascular damage and its early correlates in essential hypertensive patients.

    Science.gov (United States)

    Paglieri, Cristina; Rabbia, Franco; Bergui, Mauro; Genesia, Maria Luisa; Canadè, Antonella; Berra, Elena; Fulcheri, Chiara; Covella, Michele; Di Stefano, Cristina; Cerrato, Paolo; Veglio, Franco

    2012-01-01

    This study tested the association between cognitive functions, cerebrovascular damage, and cerebrovascular reactivity in 71 essential young hypertensives (age matched) and 22 normotensives (age matched). They underwent ambulatory blood pressure monitoring, neurocognitive tests, cerebral magnetic resonance, and transcranial Doppler. Twenty-three percent of patients showed more than 10 white matter lesions and 8% showed none. No control subjects showed more than 10 white matter lesions and 90% of normal controls showed no lesions. Patients with more than 10 white matter alterations had longer hypertensive story and showed significant lower nocturnal blood pressure fall. Pulsatility index was correlated with the number of white matter lesions. PMID:22574940

  4. Correlation of thrombocytopenia with grading of esophageal varices in chronic liver disease patients

    International Nuclear Information System (INIS)

    To determine the severity of thrombocytopenia in different grades of esophageal varices. Study Design: Cross-sectional analytical study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from January to December 2008. Methodology: Subjects were eligible if they had a diagnosis of cirrhosis. Patient with advanced cirrhosis (Child-Pugh class C), human immunodeficiency virus (HIV) infection, hepatocellular carcinoma, portal vein thrombosis, parenteral drug addiction, current alcohol abuse and previous or current treatment with b-blockers, diuretics and other vasoactive drugs were excluded from the study. All patients under went upper gastrointestinal endoscopy after consent. On the basis of platelet count patients were divided into four groups. Group I with platelets greater or equal to 20000/mm/sup 3/, Group II with values of 21000- 50000/mm/sup 3/, Group III with count of 51000-99000/mm/sup 3/ and Group IV with count of 100000-150000/mm/sup 3/. Correlation of severity of thrombocytopenia with the grading of esophageal varices was assessed using Spearman's correlation with r-values of 0.01 considered significant. Results: One hundred and two patients with thrombocytopenia and esophageal varices were included in the study. There were 62 (60.8%) males and 40 (39.2%) females. The mean age of onset of the disease in these patients was 49.49 +- 14.3 years with range of 11-85 years. Major causes of cirrhosis were hepatitis C (n=79, 77.5%), hepatitis B (n=12, 11.8%), mixed hepatitis B and C infection (n=8, 7.8%) and Wilson's disease (n=3,2.9%). Seven patients had esophageal grade I, 24 had grade II, 35 had grade III, and 36 had grade IV. Gastric varices were detected in 2 patients. Portal hypertensive gastropathy were detected in 87 patients. There was an inverse correlation of platelet count with grading of esophageal varices (r=-0.321, p < 0.001). Conclusion: The severity of thrombocytopenia increased as the grading of

  5. Increased number of Tc17 and correlation with Th17 cells in patients with immune thrombocytopenia.

    Directory of Open Access Journals (Sweden)

    Yu Hu

    Full Text Available BACKGROUND: IL-17-secreting CD8+ T cells (Tc17 subset have recently been defined as a subpopulation of effector T cells implicated in the pathogenesis of autoimmune diseases. The role of Tc17 and correlation with Th17 cells in the pathophysiology of immune thrombocytopenia (ITP remain unsettled. DESIGN AND METHODS: We studied 47 ITP patients (20 newly-diagnosed and 27 with complete response and 34 healthy controls. IL-17-producing CD3+CD8+ cells (Tc17 and IL-17-producing CD3+CD8- cells (Th17 were evaluated by flow cytometry and expressed as a percentage of the total number of CD3+ cells. Specific anti-platelet glycoprotein (GP GPIIb/IIIa and/or GPIb/IX autoantibodies were measured by modified monoclonal antibody specific immobilization of platelet antigens. Peripheral blood mononuclear cells of ITP patients were isolated, incubated in the presence of 0, 0.25, 0.5, or 1 µmol/L of dexamethasone for 72 h, and collected to detect Tc17 and Th17 cells by flow cytometric analysis. RESULTS: IL-17 was expressed on CD3+CD8- and CD3+CD8+ T cells. The percentages of Tc17 and Th17 cells in newly-diagnosed patients were significantly elevated compared to controls, and Tc17 was decreased after clinical treatment. The Th17∶Tc17 ratio was significantly lower in newly-diagnosed patients compared with controls, and was increased in patients who had complete response. There was a significantly positive correlation between Tc17 and Th17 cells in the control group, but not in the ITP patients. A positive correlation existed between Tc17 and the CD8∶CD4 ratio, as well as CD8+ cells in patients with ITP. The frequencies of Tc17 were marginally higher in autoantibody-negative patients than autoantibody-positive patients. Moreover, both Tc17 and Th17 cell percentages decreased as the concentration of dexamethasone in the culture media increased in ITP patients. CONCLUSIONS: Tc17 and the Th17 subset are involved in the immunopathology of ITP. Blocking the abnormally

  6. Correlation of NLRP3 with severity and prognosis of coronary atherosclerosis in acute coronary syndrome patients.

    Science.gov (United States)

    Afrasyab, Altaf; Qu, Peng; Zhao, Yang; Peng, Kuang; Wang, Hongyan; Lou, Dayuan; Niu, Nan; Yuan, Dajun

    2016-08-01

    We decided to assess the prognostic value of NLRP3 inflammasome level in acute coronary syndrome (ACS) patients and whether it was related to coronary atherosclerotic severity. Study population included one-hundred and twenty-three (123) subjects. Peripheral blood monocyte NLRP3 protein level was correlated with clinical presentation, angiographic characteristics and its scoring systems as well as GRACE and TIMI risk scores. Follow-up for major adverse cardiac events (MACE) was carried out at 180 days. Peripheral blood monocyte NLRP3 was found to be elevated in ACS patients (P operating characteristic curves for NLRP3 showed good predictive value for MACE. There is a positive correlation of NLRP3 level with severity of coronary atherosclerosis. NLRP3 level is a promising prognostic utility and is efficient in event prediction for MACE. PMID:26290166

  7. Sex Differences and Correlates of Pain in Patients with Comorbid Obesity and Binge Eating Disorder

    Science.gov (United States)

    Masheb, Robin M.; White, Marney A.; Grilo, Carlos M.

    2016-01-01

    Sex differences and correlates of pain were examined in a sample of patients with comorbid binge eating disorder (BED) and obesity. One hundred fifty-two treatment-seeking patients with BED completed the Brief Pain Inventory. Analysis of covariance was utilized to compare women and men on pain, and correlational analysis, overall and by sex, was performed to examine relationships among pain, eating behaviour and metabolic risk factors. Women reported significantly greater pain severity and pain interference than men. Among women, eating behaviour and metabolic markers were not associated with pain. Among men, however, binge frequency was significantly associated with pain, as was high-density lipoprotein cholesterol and fasting glucose. In sum, while women in this sample had more pain than men, the presence of pain in men was associated with increased behavioural and metabolic risk factors. Findings have clinical implications for the assessment of comorbid pain and obesity-related health risks among individuals with BED. PMID:26841114

  8. Correlation of Tc-99m GSA hepatic studies with biopsies in patients with chronic active hepatitis.

    Science.gov (United States)

    Tomiguchi, S; Kira, T; Oyama, Y; Nabeshima, M; Nakashima, R; Tsuji, A; Kojima, A; Takahashi, M; Yoshimatsu, S; Sagara, K

    1995-08-01

    To determine whether scintigraphic findings of Tc-99m DTPA-galactosyl-HSA (GSA) correspond to histopathologic findings, Tc-99m GSA hepatic scintigraphy and biopsy were compared in 65 patients with chronic active hepatitis. After injecting 185 MBq of Tc-99m GSA, anterior images were obtained at 5 minutes and 15 minutes. Scintigrams were classified into three grades according to the extent of visualization of the cardiac blood pool on 5 minute and 15 minute images. Biopsies were subjectively graded for findings of necrosis and fibrosis. Scintigraphic grades on 5 minute images were correlated with hepatic necrosis and fibrosis and those on 15-minute images with hepatic fibrosis. Scintigraphic abnormalities of Tc-99m GSA correlated well with histopathologic abnormalities, especially with hepatic fibrosis and necrosis in patients with chronic active hepatitis. PMID:7586877

  9. Correlation of CT perfusion and CT volumetry in patients with Alzheimers disease

    International Nuclear Information System (INIS)

    Background: Both brain atrophy and decrease of perfusion are observed in dementive diseases. The aim of the study was to correlate the results of brain perfusion CT (pCT) and CT volumetry in patients with Alzheimers disease (AD). Material/Methods: Forty-eight patients with AD (mean age of 71.3 years) underwent brain pCT and CT volumetry. The pCT was performed at the level of basal ganglia after the injection of contrast medium (50 ml, 4 ml/sec.) with serial scanning (delay 7 sec, 50 scans, 1 scan/sec). Volumetric measurements were carried out on the basis of source images, with the use of a dedicated CT software combined with manual outlining of the regions of interest in extracerebral and intraventricular CSF spaces. Perfusion parameters of the cerebral blood flow (CBF) and cerebral blood volume (CBV) from the grey matter of frontal and temporal as well as basal ganglia were compared statistically with the volumetric measurements of frontal and temporal cortical atrophy as well as subcortical atrophy. Results: A statistically significant positive correlation was found between the values of CBF and CBV in the basal ganglia and the volumes of the lateral and third ventricles. The comparison of CBF and CBV results with the volumetric measurements in the areas of the frontal and temporal lobes showed mostly negative correlations, but none of them was of statistical significance. Conclusions: In patients with AD, the degree of cortical atrophy is not correlated with the decrease of perfusion in the grey matter and subcortical atrophy is not correlated with the decrease of perfusion in the basal ganglia region. It suggests that functional and structural changes in AD are not related to each other. (authors)

  10. Correlation of CT perfusion and CT volumetry in patients with Alzheimer’s disease

    Science.gov (United States)

    Czarnecka, Anna; Zimny, Anna; Sąsiadek, Marek

    2010-01-01

    Summary Background: Both brain atrophy and decrease of perfusion are observed in dementive diseases. The aim of the study was to correlate the results of brain perfusion CT (pCT) and CT volumetry in patients with Alzheimer’s disease (AD). Material/Methods: Forty-eight patients with AD (mean age of 71.3 years) underwent brain pCT and CT volumetry. The pCT was performed at the level of basal ganglia after the injection of contrast medium (50 ml, 4 ml/sec.) with serial scanning (delay 7 sec, 50 scans, 1 scan/sec). Volumetric measurements were carried out on the basis of source images, with the use of a dedicated CT software combined with manual outlining of the regions of interest in extracerebral and intraventricular CSF spaces. Perfusion parameters of the cerebral blood flow (CBF) and cerebral blood volume (CBV) from the grey matter of frontal and temporal as well as basal ganglia were compared statistically with the volumetric measurements of frontal and temporal cortical atrophy as well as subcortical atrophy. Results: A statistically significant positive correlation was found between the values of CBF and CBV in the basal ganglia and the volumes of the lateral and third ventricles. The comparison of CBF and CBV results with the volumetric measurements in the areas of the frontal and temporal lobes showed mostly negative correlations, but none of them was of statistical significance. Conclusions: In patients with AD, the degree of cortical atrophy is not correlated with the decrease of perfusion in the grey matter and subcortical atrophy is not correlated with the decrease of perfusion in the basal ganglia region. It suggests that functional and structural changes in AD are not related to each other. PMID:22802771

  11. 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.

  12. Additive prognostic value of plasma N-terminal pro-brain natriuretic peptide and coronary artery calcification for cardiovascular events and mortality in asymptomatic patients with type 2 diabetes

    DEFF Research Database (Denmark)

    von Scholten, Bernt Johan; Reinhard, Henrik; Hansen, Tine Willum;

    2015-01-01

    BACKGROUND: In patients with type 2 diabetes, cardiovascular disease (CVD) is the major cause of morbidity and mortality. We evaluated the combination of NT-proBNP and coronary artery calcium score (CAC) for prediction of combined fatal and non-fatal CVD and mortality in patients with type 2 diab...

  13. Correlation between Endosonographic and Doppler Ultrasound Features of Portal Hypertension in Patients with Cirrhosis

    OpenAIRE

    Milkiewicz, P.; M. Milkiewicz; A. Wiechowska-Kozłowska; Zasada, K.

    2011-01-01

    Purpose. Endoscopic ultrasound (EUS) permits the detailed visualization of clinically significant features of portal hypertension; however, it is an invasive procedure that is not widely available. The aim of this cross-sectional study was to determine whether a correlation exists between the features of portal hypertension detected using both Doppler ultrasound and EUS in subjects with liver cirrhosis. Materials and Methods. Analyzed cohort included 42 patients who underwent a detailed Doppl...

  14. Correlates of recovery of social functioning in type I and II bipolar disorder patients

    OpenAIRE

    Wingo, Aliza P.; Baldessarini, Ross J.; Compton, Michael T.; Harvey, Philip D.

    2010-01-01

    Since bipolar disorder (BPD) patients are often functionally impaired, and factors associated with recovery from disability are largely unknown, we investigated demographic, clinical, and neurocognitive correlates of current social functional recovery in 65 stable participants diagnosed with DSM-IV type I (n=42) or II (n=23) BPD. Regaining highest previous levels of social functioning was rated with the Interpersonal Relationships Questionnaire. We also considered neuropsychological test find...

  15. Correlation between Endosonographic and Doppler Ultrasound Features of Portal Hypertension in Patients with Cirrhosis

    Directory of Open Access Journals (Sweden)

    A. Wiechowska-Kozłowska

    2012-01-01

    Full Text Available Purpose. Endoscopic ultrasound (EUS permits the detailed visualization of clinically significant features of portal hypertension; however, it is an invasive procedure that is not widely available. The aim of this cross-sectional study was to determine whether a correlation exists between the features of portal hypertension detected using both Doppler ultrasound and EUS in subjects with liver cirrhosis. Materials and Methods. Analyzed cohort included 42 patients who underwent a detailed Doppler ultrasound focusing on the parameters of blood flow in the portal/splenic vein as well as an endoscopic/EUS procedure that included the assessment of the size and localization of “deep” varices. Results. The size of “deep” oesophageal varices detected with EUS exhibited no correlation with the parameters assessed by Doppler ultrasound. However, the size of the “deep” gastric varices detected using EUS correlated with the time averaged maximum velocity (Tmax as well as Vmin, Vmax for the portal vein using Doppler ultrasound and exhibited a correlation with the Vmax and Tmax for the splenic vein. No significant correlation was determined between the diameter of the azygous vein and the thickness of the gastric wall when seen on EUS versus the parameters measured with Doppler ultrasound. Conclusion. EUS provides important information regarding the features of portal hypertension, and in the case of “deep” oesophageal varices exhibits a limited correlation with the parameters detected by Doppler ultrasound. Thus, despite its invasiveness, EUS is a method that provides a reliable and unique assessment of the features of portal hypertension in patients with liver cirrhosis.

  16. 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.

  17. Doppler study of hepatic vein in cirrhotic patients: Correlation with liver dysfunction and hepatic hemodynamics

    Institute of Scientific and Technical Information of China (English)

    KC Sudhamshu; Shoiichi Matsutani; Hitoshi Maruyama; Taro Akiike; Hiromitsu Saisho

    2006-01-01

    AIM: To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with liver dysfunction and hepatic hemodynamics.METHODS: One hundred patients with liver cirrhosis and 60 non-cirrhotic controls were studied. Doppler waveforms were obtained from right hepatic vein and flow velocity measured during quiet respiration. Doppler measurements were also obtained from portal trunk,right portal vein and proper hepatic artery.RESULTS: Hepatic vein waveforms were classified into three classical patterns. Flat waveform was uncommon.Mean hepatic vein velocity was significantly higher in cirrhotic patients (12.7 ± 6.4 vs 5.1 ± 2.1 and 6.2 ± 3.2 cm/s; P < 0.0001). The poorer the grade of cirrhosis,the higher was the mean velocity. Maximum forward velocity was never greater than 40 cm/s in controls.Degree of ascites was found to be highly correlated with mean velocity. "Very high" group (≥ 20 cm/s) presented clinically with moderate to massive ascites. Correlations between right portal flow and mean velocity was significant (P < 0.0001, r = 0.687).CONCLUSION: Doppler waveforms of hepatic vein,which is independent of liver dysfunction, should be obtained during normal respiration. Mean hepatic vein velocity reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of liver cirrhosis.

  18. Correlation of crossed cerebellar diaschisis with motor impairment of the hemiplegic upper extremity in stroke patients

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Chun; Choi, In Sung; Heo, Young Jun; Min, Jeong Jun; Lee, Sam Gyu; Bom, Hee Seung [School of Medicine, Chonnam National University, Gwangju (Korea, Republic of)

    2004-07-01

    The aim of this study was to investigate the correlation between crossed cerebellar diaschisis (CCD) and motor evoked potentials (MEPs) and to study the relationship between CCD and the severity and prognosis of stroke. Twenty-eight patients with first-ever unilateral stroke underwent brain perfusion SPECT with Tc-99m ECD. The existence of CCD was evaluated by visual inspection on SPECT images. The central motor conduction times were obtained from Abductor pollicis brevis and Abductor hallucis by recording MEPs. The National Institutes of Health stroke scale, the motricity Index (MI), and the functional outcome scales were measured. Fifteen of 28 patients (53.6%) had CCD. The presence of CCD was significantly correlated with 'not evoked' MEPs in the upper extremity (p<0.01). The existence of CCD was not associated with locations (p>0.05) and volume of brain lesion (p>0.05). There was a significant correlation between the presence of CCD and lower MI score of upper extremity (p<0.05). The presence of CCD would indicate the damage on the descending motor pathways and be associated with the severe motor impairment of the upper extremity in stroke patients.

  19. The correlation between lung sound distribution and pulmonary function in COPD patients.

    Directory of Open Access Journals (Sweden)

    Masamichi Mineshita

    Full Text Available BACKGROUND: Regional lung sound intensity in chronic obstructive pulmonary disease (COPD patients is influenced by the severity and distribution of emphysema, obstructed peripheral airways, and altered ribcage and diaphragm configurations and movements due to hyperinflation. Changes in the lung sound distribution accompanied by pulmonary function improvements in COPD patients were observed after bronchodilator inhalation. We investigated the association of lung sound distribution with pulmonary functions, and the effects of emphysematous lesions on this association. These studies were designed to acquire the basic knowledge necessary for the application of lung sound analysis in the physiological evaluation of COPD patients. METHODS: Pulmonary function tests and the percentage of upper- and lower-lung sound intensity (quantitative lung data [QLD] were evaluated in 47 stable male COPD patients (54 - 82 years of age. In 39 patients, computed tomography taken within 6 months of the study was available and analyzed. RESULTS: The ratio of lower QLD to upper QLD showed significant positive co