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Sample records for asymptomatic population undergoing

  1. A Model for Predicting the Future Risk of Incident Erosive Esophagitis in an Asymptomatic Population Undergoing Regular Check-ups.

    Science.gov (United States)

    Kang, Soo Hoon; Lim, Yaeji; Lee, Hyuk; Kim, Joungyoun; Chi, Sangah; Min, Yang Won; Min, Byung-Hoon; Lee, Jun Haeng; Son, Hee Jung; Ryu, Seungho; Rhee, Poong-Lyul; Kim, Jae J

    2016-01-01

    incidence of developing erosive esophagitis in asymptomatic populations.

  2. Asymptomatic carotid arterial stenosis - population based screening

    NARCIS (Netherlands)

    2010-01-01

    Screening for asymptomatic carotid artery stenosis in the general population is discussed in many countries because of the benefits of carotid endarterectomy in the three trials. Many factors influence the cost-effectiveness of screening. These factors are the prevalence of carotid stenosis, the

  3. pulmonary performance in asymptomatic young nigerian population

    African Journals Online (AJOL)

    Bioline

    1. PULMONARY PERFORMANCE IN ASYMPTOMATIC YOUNG NIGERIAN. POPULATION FOLLOWING THE ADMINISTRATION OF ASCORBIC. ACID AND SALBUTAMOL. S. O. ODEH1, I. E. AGABA2, A. M. SABO 1, and R. A. ODANAOGUN 1. 1 Department of Human Physiology, 2 Department of Medicine and Radiology,.

  4. Asymptomatic bacteriuria among an obstetric population in Ibadan.

    Science.gov (United States)

    Awonuga, D O; Dada-Adegbola, H O; Fawole, A O; Olala, F A; Onimisi-Smith, H O

    2011-01-01

    Asymptomatic bacteriuria in pregnancy is the major risk factor for symptomatic urinary tract infection during pregnancy. Screening and identification of bacteriuria during pregnancy have been recommended. To determine the prevalence and pattern of asymptomatic bacteriuria associated with pregnancy. The study was a descriptive, cross sectional survey of pattern of asymptomatic bacteriuria among consecutive patients presenting for the first antenatal visit at a University College Hospital, during a period of two months. Relevant information obtained from all the patients recruited for the study included age, parity, educational level, gestational age and occupation of participant. Haemoglobin electrophoresis patterns were also retrieved and recorded. Main outcome measures were prevalence of asymptomatic bacteriuria, bacterial isolates and their antibiotic sensitivities. There were 205 eligible participants with a mean age of 30.6 ± 4.3 years and a mean gestational age at booking of 20.9 ±7.0 weeks. The prevalence of asymptomatic bacteriuria was 22(10.7%). The isolated pathogens were predominantly coliforms (Klebsiella and E. coli) accounting for 45.5% and Staphylococcus saprophyticus (27.3%). Only gentamycin, nitrofurantoin and ofloxacin demonstrated high efficacy against these uropathogens with antibiotic sensitivity rates of 72.7%-81.8%. Prevalence of asymptomatic bacteriuria in this centre is relatively high. This underscores the need for routine screening of pregnant women for bacteriuria.

  5. Multislice computed tomography in an asymptomatic high-risk population.

    Science.gov (United States)

    Romeo, Francesco; Leo, Roberto; Clementi, Fabrizio; Razzini, Cinzia; Borzi, Mauro; Martuscelli, Eugenio; Pizzuto, Francesco; Chiricolo, Gaetano; Mehta, Jawahar L

    2007-02-01

    Approximately 50% of all acute coronary syndromes occur in previously asymptomatic patients. This study evaluated the value of multislice computed tomography for early detection of significant coronary artery disease (CAD) in high-risk asymptomatic subjects. One hundred sixty-eight asymptomatic subjects with >or=1 major risk factor (hypertension, diabetes, hypercholesterolemia, family history, or smoking) and an inconclusive or unfeasible noninvasive stress test result (stress electrocardiography, echocardiography, or nuclear scintigraphy) were evaluated in an outpatient setting. After clinical examination and laboratory risk analysis, all patients underwent multislice computed tomographic (MSCT) coronary angiography within 1 week. In all subjects, conventional coronary angiography was also carried out. Multislice computed tomography displayed single-vessel CAD in 16% of patients, 2-vessel CAD in 7%, and 3-vessel CAD in 4%. Selective coronary angiography confirmed the results of multislice computed tomography in 99% of all patients. Sensitivity and specificity of MSCT coronary angiography were 100% and 98%, respectively, with a positive predictive value of 95% and a negative predictive value of 100%. In conclusion, MSCT coronary angiography is an excellent noninvasive technique for early identification of significant CAD in high-risk asymptomatic patients with inconclusive or unfeasible noninvasive stress test results.

  6. [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. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. Ischiofemoral Space on MRI in an Asymptomatic Population: Normative Width Measurements and Soft Tissue Signal Variations.

    Science.gov (United States)

    Maraş Özdemir, Zeynep; Aydıngöz, Üstün; Görmeli, Cemile Ayşe; Sağır Kahraman, Ayşegül

    2015-08-01

    To make normative width measurements of the ischiofemoral (IF) space in an asymptomatic population and to record soft tissue MRI signal variations within the IF space in order to determine whether such variations are associated with IF space dimensions. Normative width measurements of the IF space were prospectively made in 418 hips on 1.5 T MR images of 209 asymptomatic volunteers. Quantitative and qualitative assessments of the IF soft tissues including the quadratus femoris (QF) muscle were also made. The mean IF space width was 2.56 ± 0.75 cm (right, 2.60 ± 0.75 cm; left, 2.53 ± 0.75 cm). Soft tissue MRI signal abnormalities were present within the IF space in 19 (9.1 %) of 209 volunteers. Soft tissue abnormalities within the IF space included oedema (3/209, 1.4 %) of the QF and/or surrounding soft tissue, and only fatty infiltration (16/209, 7.7 %) of the QF. Bilateral IF spaces are asymmetrical in asymptomatic persons. There is ≥10 % of width difference between right and left IF spaces in approximately half of asymptomatic individuals. Fatty infiltration and oedema can be present at the IF space in a small portion of the asymptomatic population, who also have narrower IF spaces than those without soft tissue MRI signal abnormalities. • Bilateral IF spaces are commonly asymmetrical in asymptomatic individuals. • MRI signal abnormalities can be observed within IF space in asymptomatic people. • Abnormal quantitative/qualitative MRI findings are not necessarily related to IF impingement.

  8. Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain.

    Science.gov (United States)

    Viso, Eloy; Rodríguez-Ares, María Teresa; Abelenda, Dolores; Oubiña, Benjamín; Gude, Francisco

    2012-05-04

    To describe epidemiologic characteristics of asymptomatic and symptomatic meibomian gland dysfunction (MGD) in a general adult population in northwestern Spain. A total of 1155 subjects aged 40 years and older were selected by an age-stratified random sample procedure in O Salnés, Spain. A standardized symptoms questionnaire was administered and a comprehensive ophthalmic evaluation, which included ocular surface tests, was carried out. Absent, viscous, or waxy white secretion upon digital expression, lid margin telangiectasia or plugging of the meibomian gland orifices was considered evidence of MGD. The prevalence and associations of asymptomatic and symptomatic MGD, and their effects on the ocular surface, were investigated. From 937 eligible subjects, 619 (66.1%) participated (mean age [SD], 63.4 [14.5] years; range, 40-96; 37.0% males). The prevalence of asymptomatic MGD was 21.9% (95% confidence interval [CI], 18.8-25.3). This prevalence increased with age (P = 0.000) and was higher in males than in females (P = 0.003). The prevalence of symptomatic MGD was 8.6% (95% CI, 6.7-10.9). This prevalence also increased with age (P = 0.000) but was not associated with sex. Abnormal tear breakup time and fluorescein staining prevalence estimates were higher among asymptomatic subjects. After controlling for age and sex, asymptomatic MGD was associated with diabetes (adjusted odds ratio [OR(a)] 2.23) and cardiovascular disease (OR(a) 1.80), and symptomatic MGD with rosacea (OR(a) 3.50) and rheumatoid arthritis (OR(a) 16.50). Asymptomatic MGD is more common than symptomatic MGD. Symptomatology is not associated with secondary damage to the ocular surface. Some systemic diseases may lower whereas others may raise the risk of developing symptoms. Symptom-based approaches do not seem appropriate for MGD estimation.

  9. Prevalence and characteristics of nonpolypoid colorectal neoplasm in an asymptomatic and average-risk Chinese population.

    Science.gov (United States)

    Chiu, Han-Mo; Lin, Jaw-Town; Chen, Chien-Chuan; Lee, Yi-Chia; Liao, Wei-Chih; Liang, Jin-Tung; Shun, Chia-Tung; Wang, Hsiu-Po; Wu, Ming-Shiang

    2009-04-01

    Evidence from Japanese studies suggests that nonpolypoid colorectal neoplasia (NP-CRN) tends to be more pathologically advanced than polypoid neoplasia. However, data are limited regarding the prevalence of NP-CRN in an average-risk population. In addition, the diagnostic yield of the fecal occult blood test (FOBT) in relation to different types of colorectal neoplasms remains unclear. We prospectively investigated the prevalence and characteristics of polypoid and nonpolypoid colorectal lesions in an asymptomatic and average-risk Chinese population. The study included 12,731 asymptomatic Chinese subjects (8372 of whom were average-risk subjects) who underwent screening colonoscopy. The prevalence, histopathologic findings, and topographic distribution of polypoid and nonpolypoid colorectal lesions were determined and analyzed. The diagnostic yield of FOBT, in relation to lesion morphology, also was assessed. NP-CRN was detected in 552 (4.3%) asymptomatic and 348 (4.2%) average-risk subjects. The prevalence of depressed NP-CRN was 0.18% in both asymptomatic and average-risk subjects. A higher proportion of smaller-sized but high-grade dysplasia and invasive carcinoma beyond the submucosal layer was noted for depressed NP-CRN compared with flat NP-CRN or polypoid neoplasia. The diagnostic yield of FOBT was comparable in depressed lesions and their polypoid counterparts. The prevalence of NP-CRN is substantial in both asymptomatic and average-risk Chinese individuals. Some subcategories of NP-CRN in this population tend to have more advanced pathologic characteristics. These findings may lead to modification of screening and prevention strategies for colorectal cancer.

  10. The range of the Oxford Shoulder Score in the asymptomatic population: a marker for post-operative improvement.

    Science.gov (United States)

    Younis, F; Sultan, J; Dix, S; Hughes, P J

    2011-11-01

    The Oxford Shoulder Score (OSS) is a validated scoring system used to assess the degree of pain and disability caused by shoulder pathology. To date there is no knowledge of the range of the OSS in the healthy adult population. This study aimed to establish the range in asymptomatic individuals. The OSS of 100 asymptomatic volunteers was compared with the pre-operative OSS of 100 symptomatic individuals who had had elective shoulder surgery performed at the Royal Preston hospital. The difference in mean scores in the operated group (36.7) and the asymptomatic group (15.3) was statistically significant (pSymptom scores can only be used effectively when the range in the asymptomatic population is known. This is so that disease severity can be gauged in the context of the normal population and post-operative improvements can be forecast more accurately.

  11. Evaluation of the Anterior Talofibular Ligament via Stress Sonography in Asymptomatic and Symptomatic Populations.

    Science.gov (United States)

    Mizrahi, Daniel J; Nazarian, Levon N; Parker, Laurence

    2018-01-24

    Sonography during externally applied stress has the potential to identify ligamentous instability, but diagnostic parameters for the most commonly sprained ankle ligament, the anterior talofibular ligament (ATFL), have not yet been established. The purpose of this study was to determine normative values of the change in the length of the ATFL in an asymptomatic population during manual stress sonography and to compare these values to those in patients with clinical findings of anterolateral ankle instability. Sonography of the ATFL at rest and with maximally applied manual stress was performed bilaterally in 20 asymptomatic volunteers from each of three 10-year age groups from 20 to 50 years. Data were compared to those for 34 patients retrospectively identified who underwent stress sonography of the ATFL for clinical signs and symptoms of chronic anterolateral ankle instability. In the asymptomatic population (10 men and 10 women), for men, the mean change in ATFL length between stress and neutral positions was 0.44 mm (95% confidence interval [CI], 0.32-0.57 mm). For women, it was 0.43 mm (95% CI, 0.31-0.55 mm). The difference in laxity between sexes was not significant (P = .85). In the symptomatic population, the mean ATFL length difference between stress and neutral positions was 1.26 mm (95% CI, 0.97-1.55 mm). A t test comparing the mean change in ATFL length showed a statistically significant increase in laxity in the symptomatic group (P < .0001). The normal ATFL shows minimal laxity in both men and women on stress sonography, with significantly greater laxity among patients with ankle instability. Given these findings, stress sonography may have an important role in the imaging diagnosis of anterolateral ankle instability. © 2018 by the American Institute of Ultrasound in Medicine.

  12. Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,745 individuals

    Science.gov (United States)

    Chang, Ye Rim; Park, Joo Kyung; Jang, Jin-Young; Kwon, Wooil; Yoon, Jeong Hee; Kim, Sun-Whe

    2016-01-01

    Abstract Although incidental pancreatic cystic neoplasms are being diagnosed with increasing frequency, little is known about the accurate prevalence of pancreatic cysts in the general population. The aims of this study were to evaluate the crude prevalence rate of pancreatic cystic neoplasms in asymptomatic healthy adults, and calculate the age- and sex-adjusted nationwide prevalence rate. A total of 21,745 asymptomatic individuals who underwent abdominal computed tomography (CT) as a health screening examination were enrolled between 2003 and 2013 at the Seoul National University Hospital Healthcare System Gangnam Center. Nationwide population data of 2010 were collected from the National Statistical Office, Korea. Incidental pancreatic cystic neoplasms were found in 457 individuals whose mean age was 58.7 years. The types of neoplasms were reviewed by 2 separate designated radiologists and the final diagnosis was made as follows: intraductal papillary mucinous neoplasm: 376 (82%), serous cystic neoplasm: 19 (4%), mucinous cystic neoplasm: 7 (2%), and indeterminate cysts: 55 (12%). Eight cases underwent operation. The crude prevalence rate was 2.1% and the age- and sex-adjusted expected nationwide prevalence was 2.2%. The prevalence increased with age. Here, we reported the first large-scale study among the healthy population to find out the prevalence rate of pancreatic cystic neoplasms; the age- and sex-adjusted prevalence was 2.2%, and increased with age. Further investigations regarding the clinical implications of incidental pancreatic neoplasms are necessary. PMID:28002329

  13. Prediction of calculated future cardiovascular disease by monocyte count in an asymptomatic population

    Directory of Open Access Journals (Sweden)

    Deirdre F Waterhouse

    2008-02-01

    , monocyte, cardiovascular risk, asymptomatic population

  14. High prevalence of asymptomatic carriers of Tropheryma whipplei in different populations from the North of Spain.

    Science.gov (United States)

    García-Álvarez, Lara; Pérez-Matute, Patricia; Blanco, José Ramón; Ibarra, Valvanera; Oteo, José Antonio

    2016-01-01

    Tropheryma whipplei is the causative agent of Whipple disease. T. whipplei has also been detected in asymptomatic carriers with a very different prevalence. To date, in Spain, there are no data regarding the prevalence of T. whipplei in a healthy population or in HIV-positive patients, or in chronic fatigue syndrome (CFS). Therefore, the aim of this work was to assess the prevalence of T. whipplei in stools in those populations. Stools from 21 HIV-negative subjects, 65 HIV-infected, and 12 CFS patients were analysed using real time-PCR. HIV-negative and positive subjects were divided into two groups, depending on the presence/absence of metabolic syndrome (MS). Positive samples were sequenced. The prevalence of T. whipplei was 25.51% in 98 stool samples analysed. Prevalence in HIV-positive patients was significantly higher than in HIV-negative (33.8% vs. 9.09%, p=0.008). Prevalence in the control group with no associated diseases was 20%, whereas no positive samples were observed in HIV-negative patients with MS, or in those diagnosed with CFS. The prevalence observed in HIV-positive patients without MS was 30.35%, and with MS it was 55.5%. The number of positive samples varies depending on the primers used, although no statistically significant differences were observed. There is a high prevalence of asymptomatic carriers of T. whipplei among healthy and in HIV-infected people from Spain. The role of T. whipplei in HIV patients with MS is unclear, but the prevalence is higher than in other populations. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Assessing Cardiovascular Health Using Life′s Simple 7 in a Chinese Population Undergoing Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Qiong Yang

    2015-01-01

    Conclusions: Few Chinese patients undergoing stroke prevention had optimal CVH (determined using LS7. Additionally, fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention. In particular, physical activity and diet status in this population require improvement.

  16. The change of cervical spine alignment along with aging in asymptomatic population: a preliminary analysis.

    Science.gov (United States)

    Chen, Yiwei; Luo, Jiaquan; Pan, Zhimin; Yu, Limin; Pang, Long; Zhong, Junlong; Li, Zhiyun; Han, Zhimin; Cao, Kai

    2017-07-06

    A cross-sectional study. To investigate the correlation of cervical spine alignment changes with aging in asymptomatic population. Previous studies demonstrated the influence of lumbar and thoracic spine on cervical spine alignment, but few has reported the cervical spine alignment change along with aging in asymptomatic population. Asymptomatic population were divided into four groups according to different ages (Group A: ≤20 years; Group B: 21-40 years; Group C: 41-60 years; Group D: ≥61 years). Each group was composed of 30 subjects. The following parameters were measured: C0-1 Cobb angle, C1-2 Cobb angle, C2-7 Cobb angle, C1-7 sagittal vertical axis (C1-7 SVA), C2-7 SVA, central of gravity to C7 sagittal vertical axis (CG-C7 SVA), Thoracic Inlet Angle (TIA), Neck Tilt (NT), cervical tilt, cranial tilt, T1 slope (TS), TS-CL, and ANOVA statistical method was used to analyze the differences among four groups, and then, linear regression analysis was performed to analyze correlation of the cervical spine alignment with the aging. C1-7 SVA, C2-7 SVA, CG-C7 SVA, TIA, NT, TS, and cranial tilt were found statistically different among four groups (P SVA were 30.7, 26.0, 21.8, and 36.9 mm, the mean C2-7 SVA were 18.7, 14.7, 11.9, and 24.7 mm, and the mean CG-C7 SVA were 19.6, 16.6, 9.4, and 26.7 mm. The mean TIA were 62.4°, 65.0°, 71.8°, and 76.9°, the mean NT were 39.4°, 43.8°, 46.3°, and 48.2°, the mean TS were 23.0°, 21.1°, 25.5°, and 28.7°, and the mean cranial tilt were 5.7°, 4.8°, 3.0°, and 9.5°. Further linear regression indicated that TIA (r = 0.472; P < 0.0001), NT (r = 0.337; P = 0.0006), and TS (r = 0.299; P = 0.0025) were positively correlated with aging. A gradual increase of TIA, NT, and TS, accompanied with an increased CL, is found along with aging in asymptomatic population, among which TIA, NT, and TS are significantly correlated with physiological nature of aging.

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

    DEFF Research Database (Denmark)

    Rothenbacher, D; Bode, G; Peschke, F

    1998-01-01

    The study objective was to investigate prevalence and determinants of current Helicobacter pylori infection in an asymptomatic population of middle-aged to elderly people. A cross-sectional study was conducted among 337 participants of a general education programme of the University of Ulm aged 50......-85 years. Prevalence of infection as determined by means of the [13C]urea breath test was 34.8% (95% CI 29.6-40.3%); overall, 33.8% (95% CI 23.0-46.0) in the age group 50-59 years, 32.4% (95% CI 25.4-39.9) in the age group 60-69 years and 41.0% (95% CI 30.0-52.7) in the age group 70-85 years. Duration...... subjects may not be as high as seroprevalence studies have suggested. Socioeconomic characteristics of childhood living conditions appear to be important determinants of infection status even at older age....

  18. Excessive interatrial adiposity is associated with left atrial remodeling, augmented contractile performance in asymptomatic population

    Directory of Open Access Journals (Sweden)

    Yau-Huei Lai

    2016-05-01

    Full Text Available Purpose: Pericardial adipose tissue had been shown to exert local effects on adjacent cardiac structures. Data regarding the mechanistic link between such measures and left atrial (LA structural/functional remodeling, a clinical hallmark of early stage heart failure (HF and atrial fibrillation (AF incidence, in asymptomatic population remain largely unexplored. Methods: This retrospective analysis includes 356 subjects free from significant valvular disorders, atrial fibrillation, or clinical HF. Regional adipose tissue including pericardial and periaortic fat volumes, interatrial septal (IAS, and left atrioventricular groove (AVG fat thickness were all measured by multidetector computed tomography (MDCT (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA. We measured LA volumes, booster performance, reservoir capacity as well as conduit function, and analyzed their association with adiposity measures. Results: All four adiposity measures were positively associated with greater LA volumes (all P < 0.05, while IAS and AVG fat were also related to larger LA kinetic energy and worse reservoir capacity (both P < 0.01. In multivariate models, IAS fat thickness remained independently associated with larger LA volumes, increased LA kinetic energy and ejection force (β-coef: 0.17 & 0.15, both P < 0.05, and impaired LA reservoir and conduit function (β-coef: −0.20 & −0.12, both P < 0.05 after adjusting for clinical variables. Conclusion: Accumulated visceral adiposity, especially interatrial fat depots, was associated with certain LA structural/functional remodeling characterized by impaired LA reservoir and conduit function though augmented kinetic energy and ejection performance. Our data suggested that interatrial fat burden may be associated with certain detrimental LA functions with compensatory LA adaptation in an asymptomatic population.

  19. 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...... and VAS and the occurrence of subclinical cerebral lesions after CABG verified by magnetic resonance imaging. METHODS: CABG patients were included and CAS and VAS were identified by magnetic resonance angiography. Cerebral magnetic resonance imaging was performed to identify new post-operative subclinical...... cerebral lesions. The associations between CAS/VAS post-operative cerebral lesions were investigated. RESULTS: Forty-six patients were included in the study. 13% had significant CAS and 11% had significant VAS. Thirty-five percent had new cerebral infarction postoperatively. We found a significant...

  20. New insights of Microsporidial infection among asymptomatic aboriginal population in Malaysia.

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    Tengku Shahrul Anuar

    Full Text Available BACKGROUND: Studies on microsporidial infection mostly focus on immunodeficiency or immunosuppressive individuals. Therefore, this cross-sectional study describes the prevalence and risk factors of microsporidiosis among asymptomatic individuals in Malaysia. METHODS/FINDINGS: Four hundred and forty seven stool samples were collected and examined for microsporidia after staining with Gram-chromotrope Kinyoun. Demographic, socioeconomic, environmental, and behavioral information were collected by using a pre-tested questionnaire. Overall, 67 (15% samples were positive for microsporidia. The prevalence of infection was significantly higher among individuals aged more than 15 years compared to those aged <15 years (OR = 1.97, 95% CI = 1.08, 3.62; P = 0.028. Furthermore, logistic regression analysis confirmed that the presence of other family members infected with microsporidia (OR = 8.45; 95% CI = 4.30, 16.62; P<0.001 and being a consumer of raw vegetables (OR = 2.05; 95% CI = 1.15, 3.66; P = 0.016 were the significant risk factors of this infection. CONCLUSIONS: These findings clearly show that exposure to microsporidia is common among Aboriginal population. Further studies using molecular approach on microsporidia isolates from asymptomatic individuals is needed to determine species-specific. The risk factors associated with microsporidiosis will help in identifying more clearly the sources of the infection in the environment that pose a risk for transmission so that preventive strategies can be implemented.

  1. Association of Metabolic Syndrome with the Cardioankle Vascular Index in Asymptomatic Korean Population

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    Su-Hyun Nam

    2015-01-01

    Full Text Available Aim. Metabolic syndrome is characterized by a cluster of atherosclerotic cardiovascular risk factors. The cardioankle vascular index (CAVI reflects arterial stiffness and may be used as an indicator of atherosclerotic cardiovascular disease. In this study, we investigated the association of CAVI with metabolic syndrome. Methods. A total of 1,144 adults were included in this study. We measured CAVIs and examined blood samples to identify metabolic syndrome according to WHO Asia Pacific criteria and NCEP-ATPIII criteria. AST, ALT, r-GTP, BUN, creatinine, high sensitivity C-reactive protein, and uric acid were also measured. Results. CAVI values were significantly higher in subjects with metabolic syndrome than those without metabolic syndrome and increased according to the number of metabolic syndrome components present. Subjects with high fasting blood sugar levels or high blood pressure showed high CAVI values. Multiple regression analysis showed that age, sex, diastolic blood pressure, and uric acid were independent predictors of CAVI. Conclusion. Subjects with metabolic syndrome had high CAVIs, which indicated arterial stiffness, and were closely associated with an increase in the number of metabolic risk factors. The individual risk factors for metabolic syndrome have the synergistic effect of elevating arterial stiffness in asymptomatic Korean population.

  2. Prevalence of human papillomavirus cervical infection in an Italian asymptomatic population

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    Sirito Rodolfo

    2005-09-01

    Full Text Available Abstract Background In the last decade many studies have definitely shown that human papillomaviruses (HPVs are the major cause of cervical carcinogenesis and, in the last few years, HPV testing has been proposed as a new and more powerful tool for cervical cancer screening. This issue is now receiving considerable attention in scientific and non scientific press and HPV testing could be considered the most important change in this field since the introduction of cervical cytology. This paper reports our prevalence data of HPV infection collected in the '90s, while a follow up of these patients is ongoing. Methods For this study we used polymerase chain reaction (PCR to search HPV DNA sequences in cervical cell scrapings obtained from 503 asymptomatic women attending regular cervical cancer screening program in the city of Genova, Italy. All patients were also submitted to a self-administered, standardized, questionnaire regarding their life style and sexual activity. On the basis of the presence of HPV DNA sequences women were separated into two groups: "infected" and "non infected" and a statistical analysis of the factors potentially associated with the infection group membership was carried out. Results The infection rate was 15.9% and the most frequent viral type was HPV 16. Conclusion Our HPV positivity rate (15.9% was consistent to that reported by other studies on European populations.

  3. Short-term results of a randomized trial examining timing of carotid endarterectomy in patients with severe asymptomatic unilateral carotid stenosis undergoing coronary artery bypass grafting.

    Science.gov (United States)

    Illuminati, Giulio; Ricco, Jean-Baptiste; Caliò, Francesco; Pacilè, Maria Antonietta; Miraldi, Fabio; Frati, Giacomo; Macrina, Francesco; Toscano, Michele

    2011-10-01

    stroke or death at 90 days. This study suggests that previous or simultaneous CEA in patients with unilateral severe asymptomatic carotid stenosis undergoing CABG could prevent stroke better than delayed CEA, without increasing the overall surgical risk. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  4. Associations between elevated resting heart rate and subclinical atherosclerosis in asymptomatic Korean adults undergoing coronary artery calcium scoring.

    Science.gov (United States)

    Han, Donghee; Lee, Ji Hyun; Rizvi, Asim; Baskaran, Lohendran; Park, Hyo Eun; Choi, Su-Yeon; Chun, Eun Ju; Sung, Jidong; Park, Sung Hak; Han, Hae-Won; Min, James K; Chang, Hyuk-Jae; Ó Hartaigh, Bríain

    2016-10-01

    Elevated resting heart rate (RHR) and the presence of coronary artery calcium (CAC) are closely related with inflammatory activity and cardiovascular disease outcomes. To date, however, the relationship between a high RHR and CAC has not been well studied, especially in non-western populations. We therefore aimed to examine the cross-sectional relationship between high RHR and the burden of subclinical atherosclerosis as measured by CAC score in a large sample of Korean adults. A total 26,018 subjects were enrolled and underwent CAC screening as part of a broader general health examination. RHR was categorized into four groups as: 0, >100, or >400 based on RHR. Mean age of the study population was 53.9 ± 8.2 years, and 79.7 % were male. After adjustment, each 10 beat per minute increment in RHR was associated with greater odds of having a CAC score above 100 (OR 1.13, 95 % CI 1.08-1.18) or 400 (OR 1.22, 95 % CI 1.13-1.31). Likewise, following adjustment, the odds of having a CAC >100 or >400 for those with a RHR ≥80 beats per minute were 1.42 (95 % CI 1.19-1.69) and 1.86 (95 % CI 1.42-2.47), respectively, compared with those who had a RHR <60 beats per minute. In a large cohort of Korean adults, elevations in the RHR, particularly above 80 beats per minute, were found to be independently associated with the presence of subclinical atherosclerosis as measured by CAC scoring.

  5. Characteristics and significant predictors of detecting underlying diseases in adults with asymptomatic microscopic hematuria: a large case series of a Korean population.

    Science.gov (United States)

    Kang, Minyong; Lee, Sangchul; Jeong, Seong Jin; Hong, Sung Kyu; Byun, Seok-Soo; Lee, Sang Eun; Jeong, Chang Wook

    2015-04-01

    To provide detailed characteristics of asymptomatic microscopic hematuria, as well as to identify the significant predictors of detecting underlying diseases of asymptomatic microscopic hematuria, by evaluating a large Korean population. We obtained data from healthy adults over the age of 20 years who underwent the health-screening program from 2005 to 2010 at Seoul National University Bundang Hospital, resulting in 56,632 participants included in the analysis. Patients who had microscopic hematuria (five red blood cells/high-power field) were referred to a urological outpatient clinic for further urological evaluation. An underlying disease of asymptomatic microscopic hematuria was predefined as a urinary stone, renal mass, urothelial cancer or other relevant lesions. At the initial urinalysis, 6.2% (3517/56,632) were diagnosed with asymptomatic microscopic hematuria. Of these, 1619 participants underwent repeat urinalysis within 1 year after screening, and 911 (56.3%) participants were detected with microscopic hematuria again. We identified 131 lesions (3.7%) as underlying diseases for asymptomatic microscopic hematuria, with urinary stone as the most common cause. Just six lesions were malignant: three renal cell carcinomas and three bladder cancers. Male sex and diabetes mellitus were significant predictors for detection of underlying diseases of asymptomatic microscopic hematuria. Herein we report the largest screening case series of asymptomatic microscopic hematuria including approximately 60,000 asymptomatic participants studied at a single institution. These findings provide clinical practice information for the management of asymptomatic microscopic hematuria in adults. © 2015 The Japanese Urological Association.

  6. Smears and cultures for diagnosis of pulmonary tuberculosis in an asymptomatic immigrant population

    Directory of Open Access Journals (Sweden)

    Assael R

    2013-09-01

    Full Text Available Roberto Assael, Joaquin Cervantes, Gerardo Barrera Clinica Medica Internacional, Ciudad Juarez, Mexico Background: The World Health Organization estimated in 2010 that 8.8 million new tuberculosis (TB cases. About one-third of the world's population is infected and 10% will develop active TB disease. While cultures remain the international gold standard for diagnosing TB disease, in many other low-income countries, sputum smears remain the only and most accessible tool with which to diagnose active TB disease. As a consequence, in patients with TB who have negative smears, their TB remains undetected. Aim: The objective of the study reported here was to demonstrate the proportion of smear-positive/culture-positive cases compared with smear-negative/culture-positive TB cases in Mexican immigrants bound for the USA. Methods: A retrospective study was undertaken of the medical records of 122 active TB cases diagnosed at a clinic in Ciudad Juarez, Mexico, from 2009 to 2012. All cases were confirmed by culture, regardless of the sputum smear results. Results: Of the cases, 80% (97 active TB cases had negative sputum smears, while only 25 cases (20% had at least one positive smear. All of the cultures were confirmed as positive for Mycobacterium tuberculosis complex. Conclusion: The fact that 80% of the TB cases were smear negative and 20% smear positive shows that there is a clear gap between the actual state of active TB disease within patients under screening conditions, meaning that eight out of ten actual cases are being missed when sputum smear is the only diagnostic tool in asymptomatic patients with abnormal chest X-rays. Based on these results, it is highly recommended that countries that have not standardized culturing as the gold standard for the diagnosis of active TB do so, so that TB cases – which may endanger global public health – are not missed. It is also recommended that further studies be undertaken to determine the clinical

  7. A prediction model for advanced colorectal neoplasia in an asymptomatic screening population.

    Science.gov (United States)

    Hong, Sung Noh; Son, Hee Jung; Choi, Sun Kyu; Chang, Dong Kyung; Kim, Young-Ho; Jung, Sin-Ho; Rhee, Poong-Lyul

    2017-01-01

    An electronic medical record (EMR) database of a large unselected population who received screening colonoscopies may minimize sampling error and represent real-world estimates of risk for screening target lesions of advanced colorectal neoplasia (CRN). Our aim was to develop and validate a prediction model for assessing the probability of advanced CRN using a clinical data warehouse. A total of 49,450 screenees underwent their first colonoscopy as part of a health check-up from 2002 to 2012 at Samsung Medical Center, and the dataset was constructed by means of natural language processing from the computerized EMR system. The screenees were randomized into training and validation sets. The prediction model was developed using logistic regression. The model performance was validated and compared with existing models using area under receiver operating curve (AUC) analysis. In the training set, age, gender, smoking duration, drinking frequency, and aspirin use were identified as independent predictors for advanced CRN (adjusted P < .01). The developed model had good discrimination (AUC = 0.726) and was internally validated (AUC = 0.713). The high-risk group had a 3.7-fold increased risk of advanced CRN compared to the low-risk group (1.1% vs. 4.0%, P < .001). The discrimination performance of the present model for high-risk patients with advanced CRN was better than that of the Asia-Pacific Colorectal Screening score (AUC = 0.678, P < .001) and Schroy's CAN index (AUC = 0.672, P < .001). The present 5-item risk model can be calculated readily using a simple questionnaire and can identify the low- and high-risk groups of advanced CRN at the first screening colonoscopy. This model may increase colorectal cancer risk awareness and assist healthcare providers in encouraging the high-risk group to undergo a colonoscopy.

  8. Prevalence and MDCT characteristics of asymptomatic Bochdalek hernia in adult population.

    Science.gov (United States)

    Temizöz, Osman; Gençhellaç, Hakan; Yekeler, Ensar; Umit, Hasan; Unlü, Ercüment; Ozdemir, Hüseyin; Demir, M Kemal

    2010-03-01

    To determine the frequency of asymptomatic incidental Bochdalek hernias in adults, using multidetector computed tomography (MDCT), and to ascertain any possible relationship between Bochdalek hernia and age, gender, or body mass index (BMI). Seven hundred and forty-eight abdominal, and 602 chest MDCT scans, which had been performed for a variety of reasons on 1350 adults, were investigated retrospectively. Location and size of Bochdalek hernias seen on these scans were correlated with age, gender, and BMI. On the basis of BMI, patients with Bochdalek hernia were classified as group A (BMI or =25). A total of 171 Bochdalek hernias were identified in 142 of 1350 patients, ranging in age from 25 to 90 years (median age, 57.2), representing a prevalence of 10.5%. Sixty leftsided unilateral Bochdalek hernias (42.2%), 53 (37.4%) rightsided unilateral Bochdalek hernias, and 29 (20.4%) bilateral Bochdalek hernias were detected. Forty-five (31.6%) were categorized as small, 82 (57.8%) were medium-sized, and 15 (10.5%) were large. BMI was or =25 in 80 patients (56.3%). Fourteen patients (9.9%) were young adults, while 86 (60.6%) were middle aged, and 42 (29.6%) were elderly. No statistically significant relationship was found between dimensions or hernia locations and age, gender, or BMI of patients with Bochdalek hernia. In view of the high prevalence of Bochdalek hernia in our study (10.5%), the multiplanar and reconstruction features of MDCT seem to facilitate the diagnosis of asymptomatic incidental Bochdalek hernia. No relationship was found between asymptomatic incidental Bochdalek hernia and age, gender, or BMI in adults.

  9. 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)

  10. Consistent prevalence of asymptomatic infections in malaria endemic populations in Colombia over time.

    Science.gov (United States)

    Vásquez-Jiménez, Juan M; Arévalo-Herrera, Myriam; Henao-Giraldo, Juliana; Molina-Gómez, Karen; Arce-Plata, María; Vallejo, Andrés F; Herrera, Sócrates

    2016-02-06

    Malaria control programmes rely on confirmation of parasite presence in patients' blood prior to treatment administration. Plasmodium parasites are detected mostly by microscopy or rapid diagnostic test (RDT). Although these methods contribute significantly to malaria control/elimination, they are not suitable for detecting the significant proportion of asymptomatic subjects harbouring low levels of parasitaemia, which endure untreated as potential reservoirs for transmission. Malaria prevalence was assessed in endemic regions of Colombia over a 4-year follow-up. A series of cross-sectional surveys were conducted between 2011 and 2014 in low to moderate malaria transmission sentinel sites (SS) of Tumaco, Buenaventura and Tierralta municipalities of Colombia. A census was performed and a random sample of houses was selected from each SS prior to each survey. Inhabitants were asked to answer a questionnaire on clinical, epidemiological and demographic aspects, and to provide a blood sample for malaria diagnosis using microscopy and quantitative real time polymerase chain reaction (qPCR). A total of 3059 blood samples were obtained from all SS, 58.5 % of which were from women and displayed a malaria prevalence ranging from 4 % (95 % CI 3-5 %) to 10 % (95 % CI 8-12 %) in the 4 years' study period. Almost all malaria cases (n = 220, 97 %) were sub-microscopic and only detectable by qPCR; 90 % of the cases were asymptomatic at the time of blood collection. While Buenaventura and Tierralta had a decreasing tendency during the follow-up, Tumaco had a rise in 2013 and then a decrease in 2014. Plasmodium vivax accounted for the majority (66-100 %) of cases in Tierralta and Buenaventura and for 25-50 % of the cases in Tumaco. This study demonstrates an important prevalence of asymptomatic malaria cases not detectable by microscopy, which therefore remain untreated representing a parasite pool for malaria transmission. This demands the introduction of alternative strategies

  11. Measurement of the aortic diameter in the asymptomatic Korean population: Assessment with multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hwan; Lee, Whal; Choi, Hyuck Jae; Kim, Dae Jin; Park, Eun Ah; Chung, Jin Wook; Park, Jae Hyung [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-08-15

    To determine normal reference values for aortic diameters in asymptomatic Korean adults. Three hundred adults without signs or symptoms of cardiovascular diseases were enrolled in this study. Aortic diameters were measured at nine predetermined levels on CT images. Aortic diameter measurements were adjusted for body surface area. Analysis of data was performed with regard to age, sex, weight, height and hypertension. Aortic diameters were 2.99 ± 0.57 cm at the ascending aorta, 2.54 ± 0.35 cm at the transverse aortic arch, 2.36 ± 0.35 cm at the proximal descending thoracic aorta (DTA), 2.23 ± 0.37 cm at the mid DTA, 2.17 ± 0.38 cm at the distal DTA, 2.16 ± 0.37 cm at the thoracoabdominal junction, 2.10, 00B1, 0.35 cm at the level of the celiac axis, 1.94, 00B1, 0.36 cm at the suprarenal aorta, 1.58 ± 0.24 cm at the aortic bifurcation. Men had slightly larger diameters than women (p < 0.05). All diameters increased with age and hypertension, with statistical significance (p < 0.01). And all aortic diameters increased with height (p < 0.05) except at the level of the aortic arch (p = 0.056), and increased with weight (p < 0.05) except at the level of the suprarenal aorta (p = 0.067). Male sex, higher weight and height, age and hypertension are associated with larger aortic diameters in asymptomatic Korean adults.

  12. High-resolution intracranial vessel wall MRI in an elderly asymptomatic population: comparison of 3T and 7T

    Energy Technology Data Exchange (ETDEWEB)

    Harteveld, Anita A.; Kolk, Anja G. van der; Dieleman, Nikki; Siero, Jeroen C.W.; Luijten, Peter R.; Zwanenburg, Jaco J.M.; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Postbox 85500, Utrecht (Netherlands); Worp, H.B. van der; Frijns, Catharina J.M. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Kuijf, Hugo J. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2017-04-15

    Several intracranial vessel wall sequences have been described in recent literature, with either 3-T or 7-T magnetic resonance imaging (MRI). In the current study, we compared 3-T and 7-T MRI in visualising both the intracranial arterial vessel wall and vessel wall lesions. Twenty-one elderly asymptomatic volunteers were scanned by 3-T and 7-T MRI with an intracranial vessel wall sequence, both before and after contrast administration. Two raters scored image quality, and presence and characteristics of vessel wall lesions. Vessel wall visibility was equal or significantly better at 7 T for the studied arterial segments, even though there were more artefacts hampering assessment. The better visualisation of the vessel wall at 7 T was most prominent in the proximal anterior cerebral circulation and the posterior cerebral artery. In the studied elderly asymptomatic population, 48 vessel-wall lesions were identified at 3 T, of which 7 showed enhancement. At 7 T, 79 lesions were identified, of which 29 showed enhancement. Seventy-one percent of all 3-T lesions and 59 % of all 7-T lesions were also seen at the other field strength. Despite the large variability in detected lesions at both field strengths, we believe 7-T MRI has the highest potential to identify the total burden of intracranial vessel wall lesions. (orig.)

  13. Population pharmacokinetics of daptomycin in adult patients undergoing continuous renal replacement therapy

    OpenAIRE

    Xu, Xiaoying; Khadzhynov, Dmytro; Peters, Harm; Chaves, Ricardo L.; Hamed, Kamal; Levi, Micha; Corti, Natascia

    2016-01-01

    Aim The objective of this population pharmacokinetic (PK) analysis was to provide guidance for the dosing interval of daptomycin in patients undergoing continuous renal replacement therapy (CRRT). Methods A previously published population PK model for daptomycin was updated with data from patients undergoing continuous veno?venous haemodialysis (CVVHD; n?=?9) and continuous veno?venous haemodiafiltration (CVVHDF; n?=?8). Model?based simulations were performed to compare the 24?h AUC, C max an...

  14. Prevalence of myocardial hypertrophy in a population of asymptomatic Swedish Maine coon cats

    Directory of Open Access Journals (Sweden)

    Häggström Jens

    2008-06-01

    Full Text Available Abstract Background Maine coon cats have a familial disposition for developing hypertrophic cardiomyopathy (HCM with evidence of an autosomal dominant mode of inheritance 1. The current mode to diagnose HCM is by use of echocardiography. However, definite reference criteria have not been established. The objective of the study was to determine the prevalence of echocardigraphic changes consistent with hypertrophic cardiomyopathy in Swedish Maine coon cats, and to compare echocardiographic measurements with previously published reference values. Methods All cats over the age of 8 months owned by breeders living in Stockholm, listed on the website of the Maine Coon breeders in Sweden by February 2001, were invited to participate in the study. Physical examination and M-mode and 2D echocardiographic examinations were performed in all cats. Results Examinations of 42 asymptomatic Maine coon cats (10 males and 32 females were performed. The age of the cats ranged from 0,7 to 9,3 years with a mean of 4,8 ± 2,3 years. Four cats (9,5% had a diastolic interventricular septal (IVSd or left ventricular free wall (LVPWd thickness exceeding 6,0 mm. In 3 of these cats the hypertrophy was segmental. Two cats (4,8% had systolic anterior motion (SAM of the mitral valve without concomitant hypertrophy. Five cats (11,9% had IVSd or LVPWd exceeding 5,0 mm but less than 6,0 mm. Conclusion Depending on the reference values used, the prevalence of HCM in this study varied from 9,5% to 26,2%. Our study suggests that the left ventricular wall thickness of a normal cat is 5,0 mm or less, rather than 6,0 mm, previously used by most cardiologists. Appropriate echocardiographic reference values for Maine coon cats, and diagnostic criteria for HCM need to be further investigated.

  15. [Geometrical and mechanical analysis of lumbar lordosis in an asymptomatic population: proposed classification].

    Science.gov (United States)

    Roussouly, P; Berthonnaud, E; Dimnet, J

    2003-11-01

    The main objective of this study was to describe the morphology and the mechanism underlying the organization of lumbar lordosis in terms of position and shape of the pelvis. A classification of lumbar lordosis was proposed based on the orientation of the sacral plane. One hundred sixty asymptomatic young adult volunteers were x-rayed in a standardized standing position. A dedicated software was used for analysis of the spine and pelvis. The pelvic parameters were: pelvic incidence, sacral slope, pelvic tilt. The point separating thoracic kyphosis and lumbar lordosis was called the inflexion point. Lumbar lordosis was bounded by the sacral plate and the inflexion point. At the apex, the lumbar curve was divided into two tangent arcs of circle, quantified by an angle and the number of included vertebrae. The lower arc was geometrically equal to the sacral slope. Regarding the vertical line, a lordosis tilt angle was drawn between the inflexion point and the frontal limit of the sacral plate. The value of the lumbar lordosis was very variable. The best correlation was between lumbar lordosis and sacral slope, then between sacral slope and pelvic incidence. The upper arc of a circle remained constant while the lower arc changed with sacral slope. Good correlations were found between the sacral slope and the position of the apex and between sacral slope and lordosis tilt angle. Regarding sacral slope, lumbar lordosis can be classified into four types. When the sacral slope is low, lumbar lordosis can either be both short and curved with a low apex and a backward tilt (type 1) or both long and flat with a higher position of the apex (type 2). When the sacral slope increases, lumbar lordosis increases in angle and number of vertebrae with an upper apex, with a progressively forward tilt (types 3 and 4). Depending on the shape and position of the pelvis, and because of the relation between sacral slope and pelvic tilt, the morphology of lumbar lordosis could be the main

  16. Serosurvey Reveals Exposure to West Nile Virus in Asymptomatic Horse Populations in Central Spain Prior to Recent Disease Foci.

    Science.gov (United States)

    Abad-Cobo, A; Llorente, F; Barbero, M Del Carmen; Cruz-López, F; Forés, P; Jiménez-Clavero, M Á

    2017-10-01

    West Nile fever/encephalitis (WNF) is an infectious disease affecting horses, birds and humans, with a cycle involving birds as natural reservoirs and mosquitoes as transmission vectors. It is a notifiable disease, re-emerging in Europe. In Spain, it first appeared in horses in the south (Andalusia) in 2010, where outbreaks occur every year since. However, in 2014, an outbreak was declared in horses in central Spain, approximately 200 km away from the closest foci in Andalusia. Before that, evidence of West Nile virus (WNV) circulation in central Spain had been obtained only from wildlife, but never in horses. The purpose of this work was to perform a serosurvey to retrospectively detect West Nile virus infections in asymptomatic horses in central Spain from 2011 to 2013, that is before the occurrence of the first outbreaks in the area. For that, serum samples from 369 horses, collected between September 2011 and November 2013 in central Spain, were analysed by ELISA (blocking and IgM) and confirmed by virus neutralization, proving its specificity using parallel titration with another flavivirus (Usutu virus). As a result, 10 of 369 horse serum samples analysed gave positive results by competitive ELISA, 5 of which were confirmed as positive to WNV by virus neutralization (seropositivity rate: 1.35%). One of these WNV seropositive samples was IgM-positive. Chronologically, the first positive samples, including the IgM-positive, corresponded to sera collected in 2012 in Madrid province. From these results, we concluded that WNV circulated in asymptomatic equine populations of central Spain at least since 2012, before the first disease outbreak reported in this area. © 2016 Blackwell Verlag GmbH.

  17. Prevalence and Predictors of Metabolic Syndrome in Young Asymptomatic Gujarati Population

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    Sharad R. Jain

    2015-01-01

    Full Text Available Background. Metabolic syndrome is a cluster of risk factors leading to the development of atherosclerotic cardiovascular diseases. We aimed to evaluate the prevalence of metabolic syndrome (MS and its predictors in young and apparently healthy Gujarati individuals. Methods. This population based cross-sectional study involved a total of 1500 healthy adults of 20–40 years of age. Demographic details and clinical data such as body mass index (BMI, waist circumference (WC, and blood pressure were measured along with the estimations of lipoprotein (a, total cholesterol (TC, triglyceride (TG, total lipid, LDL/HDL ratio, TC/HDL ratio, and fasting blood glucose (FBS. Results. Overall in young Gujarati population (20–40 years prevalence rates of MS were 16.0% (male: 21.5%; female: 10.8% where the metabolic abnormalities increased with advanced age as 9.56% of the young population (20–30 years had MS, in contrast to the 24.57% in the old (31–40 years. Odds ratio analysis had indicated BMI (1.120; 95% CI: 1.077–1.163; P<0.0001 as the strongest risk factor for MS closely followed by advancing age (1.100; 95% CI: 1.061–1.139; P<0.0001 levels. Conclusion. Prevalence of metabolic syndrome in young Gujarati population reinforces the need for early life style intervention and awareness programs in this ethnic group.

  18. Prevalence and Predictors of Metabolic Syndrome in Young Asymptomatic Gujarati Population.

    Science.gov (United States)

    Jain, Sharad R; Shah, Komal H; Acharya, Himanshu N; Barot, Kaushik; Sharma, Kamal H

    2015-01-01

    Background. Metabolic syndrome is a cluster of risk factors leading to the development of atherosclerotic cardiovascular diseases. We aimed to evaluate the prevalence of metabolic syndrome (MS) and its predictors in young and apparently healthy Gujarati individuals. Methods. This population based cross-sectional study involved a total of 1500 healthy adults of 20-40 years of age. Demographic details and clinical data such as body mass index (BMI), waist circumference (WC), and blood pressure were measured along with the estimations of lipoprotein (a), total cholesterol (TC), triglyceride (TG), total lipid, LDL/HDL ratio, TC/HDL ratio, and fasting blood glucose (FBS). Results. Overall in young Gujarati population (20-40 years) prevalence rates of MS were 16.0% (male: 21.5%; female: 10.8%) where the metabolic abnormalities increased with advanced age as 9.56% of the young population (20-30 years) had MS, in contrast to the 24.57% in the old (31-40 years). Odds ratio analysis had indicated BMI (1.120; 95% CI: 1.077-1.163; P Gujarati population reinforces the need for early life style intervention and awareness programs in this ethnic group.

  19. The association among age, early mitral leaflet closure, cardiac structure, diastolic indices and NT-proBNP in an asymptomatic Taiwanese population

    Directory of Open Access Journals (Sweden)

    Chi Chen

    2015-09-01

    Conclusions: EF-slope reduction in the asymptomatic Taiwanese population was correlated with age, several unfavorable LV remodeling, and impaired diastolic function parameters, and EF-slope can be an effective clinical diagnostic tool for identifying poor E′ and elevated LV filling pressure. In addition, our data provided reference values for EF-slope in various age groups.

  20. Cost effectiveness analysis of a population based screening programme for asymptomatic Chlamydia trachomatis infections in women by means of home obtained urine specimens

    NARCIS (Netherlands)

    van Valkengoed, I.G.M.; Postma, M.J.; Morre, S.A.; van den Brule, A.J.C.; Meijer, C.J.L.M.; Bouter, L.M.; Boeke, A.J.P.

    2001-01-01

    Objectives: To evaluate the cost effectiveness of a systematic screening programme for asymptomatic Chlamydia trachomatis infections in a female inner city population. To determine the sensitivity of the cost effectiveness analysis to variation in the probability of developing sequelae. Methods: A

  1. [Prevalence and extent of coronary artery calcification in an asymptomatic cardiovascular Mexican population: Genetics of Atherosclerotic Disease study].

    Science.gov (United States)

    Posadas-Romero, Carlos; López-Bautista, Fabiola; Rodas-Díaz, Marco A; Posadas-Sánchez, Rosalinda; Kimura-Hayama, Eric; Juárez-Rojas, Juan G; Medina-Urrutia, Aida X; Cardoso-Saldaña, Guillermo C; Vargas-Alarcón, Gilberto; Jorge-Galarza, Esteban

    The prevalence of coronary artery calcification (CAC), a specific marker of atherosclerosis, is unknown in Mexico. Our aim was to investigate the prevalence and quantity of CAC and their association with cardiovascular risk factors in a Mexican population. CAC was measured by multidetector computed tomography in asymptomatic subjects who participated in the Genetics of Atherosclerotic Disease study. Cardiovascular risk factors and medication were recorded. The sample included 1,423 individuals (49.5% men), aged 53.7±8.4 years. Those with CAC showed a higher prevalence of dyslipidaemia, diabetes, hypertension, and other risk factors. The prevalence of CAC>0 Agatston units was significantly higher among men (40%) than among women (13%). Mean values of CAC score increased consistently with increasing age and were higher in men than women in each age group. Age and high low density lipoprotein cholesterol were independently associated with prevalence of CAC>0 in men and women, while increasing systolic blood pressure in women and age in both genders showed an independent association with CAC extension. In the Mexican population the prevalence and extent of CAC were much higher in men than in women, and strongly increased with age. Independent predictors of CAC prevalence were age and low density lipoprotein cholesterol (LDL-C). Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  2. KCNQ1 Gene Variants in Large Asymptomatic Populations: Considerations for Genomic Screening of Military Cohorts.

    Science.gov (United States)

    Kruszka, Paul; Weiss, Karin; Hadley, Donald W

    2017-03-01

    The advances in genomic technology of large populations make the potential for genomic screening of military cohorts and recruits feasible, affording the potential to identify at-risk individuals before occurrence of potentially life-threatening events. Exploring sudden cardiac death, known to cause significant morbidity and mortality in young military service members, we focused on the most common gene associated with long QT syndrome (LQTS), KCNQ1. Using the publicly available database Exome Aggregation Consortium as a surrogate for a military population, variants in KCNQ1 were filtered on the basis of population prevalence, classification as a disease mutation in the Human Gene Mutation database, and classification as pathogenic or likely pathogenic in the ClinVar database. Variant prevalence and penetrance estimates were derived using reports from the medical literature. We showed that in a population of over 60,000 individuals, at least 97 (0.2%) individuals would harbor a potentially pathogenic mutation in KCNQ1, which is more prevalent than expected on the basis of current medical literature (p = 0.0004). KCNQ1 variant penetrance was estimated to be only 9% to 17%. Identifying the importance of large genomic studies, our study demonstrates that 46% of pathogenic mutations in KCNQ1 had a population frequency of less than 1:50,000. Screening a large database with genomic screening for a condition that is relevant to active duty service members results in the identification of many individuals with potentially pathogenic mutations in the KCNQ1 gene, which has profound implications for screening military or other adult cohorts in terms of over diagnosis, overtreatment, and increased medical resource usage. This study of KCNQ1 provides a platform for consideration of other genes that cause sudden cardiac death as well as other medically actionable hereditary disorders for which genomic screening is available. We review the potential benefits of genomic screening

  3. Cervical spine alignment in the pediatric population: a radiographic normative study of 150 asymptomatic patients.

    Science.gov (United States)

    Abelin-Genevois, K; Idjerouidene, A; Roussouly, P; Vital, J M; Garin, C

    2014-07-01

    To describe the normal cervical sagittal alignment of the pediatric spine in a normal population and to identify the changes during growth period. We randomly selected in PACS database 150 full-spine standing views. Exclusion criteria were: age >18 years, spinal deformity and any disease affecting the spine (medical charts reviewing). For cervical alignment we measured: OC-angle according to Mc Gregor, C1C7 angle, upper cervical angle, inferior cervical angle and C7 tilt. Spino pelvic parameters were analyzed: T1 tilt, thoracic kyphosis, lumbar lordosis, pelvic incidence, sacral slope and pelvic tilt. We compared two age subgroups (juvenile and adolescent). Differences between age groups and gender were tested using Student's t test. Correlations between sagittal spinal parameters were evaluated using Pearson's test. Cervical spine shape was correlated to cranio cervical orientation to maintain horizontal gaze (r = 0.60) and to thoracic kyphosis (r = -0.46). Cervical spine alignment was significantly different between the two age groups except for the global C1C7 cervical lordosis, which remained stable. A significant gender difference was found for all the cervical sagittal angles (p < 0.01) whereas no differences were demonstrated for the spino pelvic parameters, except the lumbar lordosis (p = 0.047). This study is the first to report the cervical spinal alignment in a normal pediatric Caucasian population. Even though cervical lordosis is the common shape, our results showed variability in cervical sagittal alignment. Cervical spine is a junctional area that adjusts its alignment to the head position and to the underlying spinal alignment.

  4. Asymptomatic hyperuricemia is a strong risk factor for resistant hypertension in elderly subjects from general population.

    Science.gov (United States)

    Mazza, Alberto; Lenti, Salvatore; Schiavon, Laura; Monte, Alvise Del; Townsend, Danyelle M; Ramazzina, Emilio; Rubello, Domenico; Casiglia, Edoardo

    2017-02-01

    In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140mmHg (systolic) and 90mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis. The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, phypertension in women (odds ratio 3.11, 95% confidence intervals 1.06-9.1, p=0.03) but not in men. In elderly women from the general population, an SUA value of ≥6.8mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Asymptomatic bacteriuria is an independent predictor of urinary tract infections in an ambulatory cirrhotic population: a prospective evaluation.

    Science.gov (United States)

    Ye, Carrie; Kumar, Deepali; Carbonneau, Michelle; Keough, Adam; Ma, Mang; Tandon, Puneeta

    2014-07-01

    Asymptomatic bacteriuria (ASB) is a risk factor for urinary tract infections (UTIs) in many patients without liver disease. It remains unclear whether a diagnosis of ASB in an outpatient with cirrhosis could be utilized to predict the subsequent development of a UTI. We undertook this study to determine the prevalence and incidence of ASB in an outpatient population and its association with UTI. We prospectively evaluated 108 adult outpatients with cirrhosis over a 6-month period. Monthly midstream urines (MSU) were performed to detect the occurrence of UTI and ASB (culture of ≥10(8) CFU/L of a urinary pathogen in the absence of UTI symptoms). Of 108 patients enrolled, 99 completed at least one MSU, for a total of 489 MSUs. Total follow-up was 44 person-years. The incidences of ASB and UTI were 181 and 250 per 1000 person-years, respectively. The prevalences of ASB and UTI on the first MSU were 5 and 1%, respectively. In total, 8% of patients developed an episode of ASB and 11% developed a UTI during the study period. Univariate predictors of UTI were female gender, primary biliary cirrhosis, number of previous UTIs and preceding ASB. Preceding ASB was the only independent predictor of UTI on multivariate analysis, with an odds ratio of 6.2 (1.1-34.3), P = 0.04. Cirrhotic patients have higher rates of ASB and UTI than reported in the general population. ASB is an independent predictor of UTI. Further studies are necessary to determine whether routine screening and antimicrobial treatment of ASB is warranted. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Evaluation of an Exercise Field Test Using Heart Rate Monitors to Assess Cardiorespiratory Fitness and Heart Rate Recovery in an Asymptomatic Population

    OpenAIRE

    Coolbaugh, Crystal L; Anderson, Ivan B.; Wilson, Machelle D.; David A Hawkins; Amsterdam, Ezra A.

    2014-01-01

    PURPOSE: Measures of cardiorespiratory fitness (CRF) and heart rate recovery (HRR) can improve risk stratification for cardiovascular disease, but these measurements are rarely made in asymptomatic individuals due to cost. An exercise field test (EFT) to assess CRF and HRR would be an inexpensive method for cardiovascular disease risk assessment in large populations. This study assessed 1) the predictive accuracy of a 12-minute run/walk EFT for estimating CRF ([Formula: see text]) and 2) the ...

  7. Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex with Men

    Science.gov (United States)

    Pinsky, Laura; Chiarilli, Daniel B.; Klausner, Jeffrey D.; Kull, Ryan M.; O'Keefe, Richard; Heffer, Calley; Seward, Samuel L., Jr.

    2012-01-01

    Objectives: The study determined prevalence of asymptomatic nonurethral gonorrhea and chlamydia in men who have sex with men (MSM) seen at the Columbia University Health Service for routine care. Participants: The study enrolled 200 participants from March 2007 to May 2010. Results: Specimens were tested using culture and nucleic acid…

  8. Burden of asymptomatic malaria among a tribal population in a forested village of central India: a hidden challenge for malaria control in India.

    Science.gov (United States)

    Chourasia, M K; Raghavendra, K; Bhatt, R M; Swain, D K; Valecha, N; Kleinschmidt, I

    2017-06-01

    Chhattisgarh in India is a malaria-endemic state with seven southern districts that contributes approximately 50-60% of the reported malaria cases in the state every year. The problem is further complicated due to asymptomatic malaria cases which are largely responsible for persistent transmission. This study was undertaken in one of the forested villages of the Keshkal subdistrict in Kondagaon district to ascertain the proportion of the population harbouring subclinical malarial infections. Community-based cross-sectional study. Mass blood surveys were undertaken of the entire population of the village in the post-monsoon seasons of 2013 and 2014. Fingerprick blood smears were prepared from individuals of all ages to detect malaria infections in their blood. Individuals with fever at the time of the survey were tested with rapid diagnostic tests, and parasitaemia in thick blood smears was confirmed by microscopy. Malaria-positive cases were treated with anti-malarials in accordance with the national drug policy. Peripheral blood smears of 134 and 159 individuals, including children, were screened for malaria infection in 2013 and 2014, respectively. Overall, the malaria slide positivity rates were 27.6% and 27.7% in 2013 and 2014, respectively, and the prevalence rates of asymptomatic malaria were 20% and 22.8%. This study showed that, for two consecutive years, the prevalence of asymptomatic malaria infection was significantly higher among children aged ≤14 years (34.4% and 34.1% for 2013 and 2014, respectively) compared with adults (15.2% and 18.2% for 2013 and 2014, respectively; P = 0.023 and 0.04, respectively). The number of asymptomatic malaria cases, especially Plasmodium falciparum, is significant, reinforcing the underlying challenge facing the malaria elimination programme in India. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. 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.

  10. Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,745 individuals: Large-scale, single-center cohort study.

    Science.gov (United States)

    Chang, Ye Rim; Park, Joo Kyung; Jang, Jin-Young; Kwon, Wooil; Yoon, Jeong Hee; Kim, Sun-Whe

    2016-12-01

    Although incidental pancreatic cystic neoplasms are being diagnosed with increasing frequency, little is known about the accurate prevalence of pancreatic cysts in the general population. The aims of this study were to evaluate the crude prevalence rate of pancreatic cystic neoplasms in asymptomatic healthy adults, and calculate the age- and sex-adjusted nationwide prevalence rate.A total of 21,745 asymptomatic individuals who underwent abdominal computed tomography (CT) as a health screening examination were enrolled between 2003 and 2013 at the Seoul National University Hospital Healthcare System Gangnam Center. Nationwide population data of 2010 were collected from the National Statistical Office, Korea.Incidental pancreatic cystic neoplasms were found in 457 individuals whose mean age was 58.7 years. The types of neoplasms were reviewed by 2 separate designated radiologists and the final diagnosis was made as follows: intraductal papillary mucinous neoplasm: 376 (82%), serous cystic neoplasm: 19 (4%), mucinous cystic neoplasm: 7 (2%), and indeterminate cysts: 55 (12%). Eight cases underwent operation. The crude prevalence rate was 2.1% and the age- and sex-adjusted expected nationwide prevalence was 2.2%. The prevalence increased with age.Here, we reported the first large-scale study among the healthy population to find out the prevalence rate of pancreatic cystic neoplasms; the age- and sex-adjusted prevalence was 2.2%, and increased with age. Further investigations regarding the clinical implications of incidental pancreatic neoplasms are necessary.

  11. Associations between measures of adiposity over 10 years and patella cartilage in population-based asymptomatic women.

    Science.gov (United States)

    Gunardi, A J; Brennan, S L; Wang, Y; Cicuttini, F M; Pasco, J A; Kotowicz, M A; Nicholson, G C; Wluka, A E

    2013-12-01

    Osteoarthritis (OA) most commonly affects the patellofemoral compartment of the knee, and is a major cause of pain and disability. Structural changes that evolve prior to the onset of symptoms can be visualised using magnetic resonance imaging (MRI). There is little known information about the role of adiposity on the early structural changes in the patella cartilage in younger, asymptomatic adult females. One hundred and sixty asymptomatic women (20-49 years) participating in the Geelong Osteoporosis Study underwent knee MRI (2006-8). Weight and body mass index (BMI) were measured 10 years prior (1994-7, baseline) and at the time of MRI (current), with change over the period calculated (current-baseline). Relationships between measures of adiposity and patella cartilage volume and defects were examined. After adjustment for age and patella bone volume, there was a reduction of 13 ml (95% confidence interval (95% CI), -25.7, -0.55) in patella cartilage volume for every 1 unit increase in current BMI, and a reduction of 27 ml (95% CI -52.6, -1.5) per BMI unit increase over 10 years (P=0.04 for both). No significant association was observed between baseline BMI and patella cartilage volume (P=0.16). Increased baseline and current weight and BMI were associated with increased prevalence of patella cartilage defects (all Ppatella in young to middle-aged healthy non-osteoarthritic women. Maintaining a healthy weight and avoiding weight gain in younger asymptomatic women may be important in the prevention of patellofemoral OA.

  12. Comparison of T1rho and T2 mapping of knee articular cartilage in an asymptomatic population

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Min A; Hong, Suk Joo; Im, A Lan [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kang, Chang Ho [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Baek Hyun [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Kim, In Seong [Siemens Healthcare, Seoul (Korea, Republic of)

    2016-11-15

    To analyze subregional differences in T1rho (T1ρ) and T2 values and their correlation in asymptomatic knee cartilage, and to evaluate angular dependence with magic angles. Six asymptomatic volunteers underwent knee MRI with T1ρ and T2 mapping. T1ρ and T2 values were measured by two radiologists independently, at nine subregions in the medial femoral condyle (MFC) cartilage, at angles of ± 0°, 15°, 35°, 55°, 75° respective to a vertical line (B0) bisecting the width of the distal femur, and at two locations in the patella. Subregional values of T1ρ and T2 were analyzed and significant differences in three divided portions of the MFC (anterior, central, and posterior) were statistically evaluated. Correlation between T1ρ and T2 and angular dependence with magic angles were also assessed for statistical significance. T1ρ values were lowest at +15° and highest at -55°. T2 values were lowest at +75° and highest at +35°. Both T1ρ and T2 were higher in superior patella than inferior patella. T1ρ showed significant differences in the three divided portions of the MFC, while T2 showed significant differences only between central and posterior portions. There was a weak correlation between T1ρ and T2 (r = 0.217, p = 0.127). T1ρ showed more angular dependence than T2. T1ρ and T2 showed different subregional values and angular dependence in asymptomatic knee cartilage with a weak correlation. Awareness of these differences will aid in assessment of cartilage in a specific subregion of the knee.

  13. Analysis of Factors Associated With Sagittal Balance in Normal Asymptomatic Individuals: A Retrospective Study in a Population of East China.

    Science.gov (United States)

    Yang, Mingyuan; Yang, Changwei; Zhai, Xiao; Zhao, Jian; Zhu, Xiaodong; Li, Ming

    2017-02-15

    A retrospective study. To determine primary contributors to sagittal balance and establish a predictive equation of sagittal balance in normal asymptomatic subjects. Sagittal balance has been verified to be associated with health-related quality of life. Although many studies have been performed to explore factors contributing to sagittal balance in various disease states, no study has been conducted in normal asymptomatic subjects in East China. Medical records of 340 asymptomatic healthy volunteers were reviewed from January 2014 to August 2015, including 311 for exploring the risk factors and predictive equation, and 29 for validation. Demographic and radiological parameters were evaluated. Correlation analysis between spinopelvic parameters was pursued. Regression analyses were performed to establish predictive radiographic parameters for sagittal balance. Paired t test was conducted to test the regression equation. There was a very good correlation between T1 sagittal angle and maxTK, maxLL and SS, SS and PI, and PT and PI; a moderate correlation between maxTK and maxLL, and maxLL and PI; a weak correlation between T1 sagittal angle and age, age and maxTK, age and SS, age and PT, age and SVA, T1 sagittal angel and SVA, SVA and PT, and SVA and PI; and very weak correlation between T1 sagittal angle and maxLL, maxLL and PT, SVA and LL, and PT and SS. Age, T1 sagittal angle, maxLL, PT, and PI were primary contributors to sagittal balance, which could be predicted by the regression equation: SVA = 0.294 × age + 0.367 × T1 sagittal angle - 1.149 × maxLL-0.704 × PT + 1.378 × PI - 34.164. No significant difference was found between actual SVA and predicted SVA using our equation (P = 0.307). Age, T1 sagittal angle, maxLL, PT, and PI were primary contributors to maintaining sagittal balance in normal asymptomatic subjects, and sagittal balance could be predicted by calculation using the equation derived in this study. 2.

  14. Population pharmacokinetics of daptomycin in adult patients undergoing continuous renal replacement therapy.

    Science.gov (United States)

    Xu, Xiaoying; Khadzhynov, Dmytro; Peters, Harm; Chaves, Ricardo L; Hamed, Kamal; Levi, Micha; Corti, Natascia

    2017-03-01

    The objective of this population pharmacokinetic (PK) analysis was to provide guidance for the dosing interval of daptomycin in patients undergoing continuous renal replacement therapy (CRRT). A previously published population PK model for daptomycin was updated with data from patients undergoing continuous veno-venous haemodialysis (CVVHD; n = 9) and continuous veno-venous haemodiafiltration (CVVHDF; n = 8). Model-based simulations were performed to compare the 24 h AUC, Cmax and Cmin of daptomycin following various dosing regimens (4, 6, 8, 10, and 12 mg kg-1 every [Q] 24 h and Q48 h), with the safety and efficacy exposure references for Staphylococcus aureus bacteraemia/right-sided infective endocarditis. The previously developed daptomycin structural population PK model could reasonably describe data from the patients on CRRT. The clearance in patients undergoing CVVHDF and CVVHD was estimated at 0.53 and 0.94 l h-1 , respectively, as compared with 0.75 l h-1 in patients with creatinine clearance (CrCl) ≥ 30 ml min-1 . Daptomycin Q24 h dosing in patients undergoing CRRT resulted in optimal exposure for efficacy, with AUC comparable to that in patients with CrCl ≥ 30 ml min-1 . In contrast, Q48 h dosing was associated with considerably lower AUC24-48h in all patients for doses up to 12 mg kg-1 and is therefore inappropriate. Q24 h dosing of daptomycin up to 12 mg kg-1 provides comparable drug exposure in patients on CVVHD and in those with CrCl ≥ 30 ml min-1 . Daily daptomycin use up to 8 mg kg-1 doses are appropriate for patients on CVVHDF, but higher doses may increase the risk of toxicity. © 2016 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

  15. The association among age, early mitral leaflet closure, cardiac structure, diastolic indices and NT-proBNP in an asymptomatic Taiwanese population.

    Science.gov (United States)

    Chen, Chi; Chen, Yung-Tzi; Wang, Kuang-Te; Shih, Shou-Chuan; Liu, Chuan-Chuan; Kuo, Jen-Yuan; Hou, Charles Jia-Yin; Wu, Yih-Jer; Hung, Chung-Lieh; Yeh, Hung-I

    2015-09-01

    Advanced age is associated with left ventricular (LV) remodeling and impaired diastole. The association among aging, mitral leaflet closure (EF slope), cardiac structures, and diastolic indices in an asymptomatic Taiwanese population is largely unknown. We studied 8103 asymptomatic participants (49.5 ± 11.6 years, 38.2% women) from a health evaluation cohort (2004-2012) in a tertiary center in Taiwan. Echo-derived LV structure/function, and M-mode based EF slope (mm/s) and serum NT-proBNP level were obtained. The association between EF slope and the other clinical or echo-based parameters was investigated. Average values for EF slope among various age groups in the Taiwanese population were determined for both genders. Advanced age was associated with reductions in EF slope (adjusted estimate: - 0.35/per decade). Reduced EF slope was associated with older age, higher blood pressure and greater body mass index in multivariate models (all p cardiac concentricity, abnormal E' and E/E' (AUROC: 0.74 and 0.77, respectively, both p parameters, and EF-slope can be an effective clinical diagnostic tool for identifying poor E' and elevated LV filling pressure. In addition, our data provided reference values for EF-slope in various age groups.

  16. Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre-participation cardiovascular screening.

    Science.gov (United States)

    Pelliccia, Antonio; Culasso, Franco; Di Paolo, Fernando M; Accettura, Domenico; Cantore, Rocco; Castagna, Walter; Ciacciarelli, Alberto; Costini, Gioberto; Cuffari, Biagio; Drago, Enrico; Federici, Vittorio; Gribaudo, Carlo Gabriele; Iacovelli, Giancarlo; Landolfi, Luigi; Menichetti, Giuseppe; Atzeni, Umberto Olla; Parisi, Attilio; Pizzi, Angelo R; Rosa, Michele; Santelli, Fabio; Santilio, Franco; Vagnini, Alberto; Casasco, Maurizio; Di Luigi, Luigi

    2007-08-01

    The implementation of 12-lead ECG in the pre-participation screening of young athletes is still controversial and number of issues are largely debated, including the prevalence and spectrum of ECG abnormalities found in individuals undergoing pre-participation screening. We assessed a large, unselected population of 32,652 subjects [26 050 (80%) males], prospectively examined in 19 clinics associated to Italian Sports Medicine Federation. Most were young amateur athletes, aged 8-78 years (median 17), predominantly students (68%), engaged predominantly in soccer (39%), volleyball or basketball (8% each), athletics (6%), cycling (5%), swimming (4%). The ECG patterns were evaluated according to commonly used clinical criteria. The 12-lead ECG patterns were considered normal in 28 799 of the 32 652 athletes (88.2%) and abnormal in 3853 (11.8%). The most frequent abnormalities included prolonged PR interval, incomplete right bundle branch block (RBBB) and early repolarization pattern (total 2280, 7.0%). Distinct ECG abnormalities included deeply inverted T-waves in > 2 precordial and/or standard leads (751, 2.3%), increased R/S wave voltages suggestive of LV hypertrophy (247, 0.8%), conduction disorders, i.e. RBBB (351, 1.0%), left anterior fascicular block (162, 0.5%), and left bundle branch block (19, 0.1%). Rarely, cardiac pre-excitation pattern (42, 0.1%) and prolonged QTc interval (1, 0.03%) were found. In a large, unselected population of young athletes undergoing pre-participation screening, the prevalence of markedly abnormal ECG patterns, suggestive for structural cardiac disease, is low (<5% of the overall population) and should not represent obstacle for implementation of 12-lead ECG in the pre-participation screening program.

  17. Population pharmacokinetics of ϵ-aminocaproic acid in adolescents undergoing posterior spinal fusion surgery.

    Science.gov (United States)

    Stricker, P A; Gastonguay, M R; Singh, D; Fiadjoe, J E; Sussman, E M; Pruitt, E Y; Goebel, T K; Zuppa, A F

    2015-04-01

    Despite demonstrated efficacy of ϵ-aminocaproic acid (EACA) in reducing blood loss in adolescents undergoing spinal fusion, there are no population-specific pharmacokinetic data to guide dosing. The aim of this study was to determine the pharmacokinetics of EACA in adolescents undergoing spinal fusion surgery and make dosing recommendations. Twenty children ages 12-17 years were enrolled, with 10 children in each of two groups based on diagnosis (idiopathic scoliosis or non-idiopathic scoliosis). Previously reported data from infants undergoing craniofacial surgery were included in the model to enable dosing recommendations over a wide range of weights, ages, and diagnoses. A population non-linear mixed effects modelling approach was used to characterize EACA pharmacokinetics. Population pharmacokinetic parameters were estimated using a two-compartment disposition model with allometrically scaled weight and an age effect on clearance. Pharmacokinetic parameters for the typical patient were a plasma clearance of 153 ml min(-1) 70 kg(-1) (6.32 ml min(-1) kg(-0.75)), intercompartmental clearance of 200 ml min(-1) 70 kg(-1) (8.26 ml min(-1) kg(-0.75)), central volume of distribution of 8.78 litre 70 kg(-1) (0.13 litre kg(-1)), and peripheral volume of distribution of 15.8 litre 70 kg(-1) (0.23 litre kg(-1)). Scoliosis aetiology did not have a clinically significant effect on drug pharmacokinetics. The following dosing schemes are recommended according to patient weight: weight <25 kg, 100 mg kg(-1) loading dose and 40 mg kg(-1) h(-1) infusion; weight ≤25 kg-<50 kg, 100 mg kg(-1) loading dose and 35 mg kg(-1) h(-1) infusion; and weight ≥50 kg, 100 mg kg(-1) loading dose and 30 mg kg(-1) h(-1) infusion. An efficacy trial employing this dosing strategy is warranted. NCT01408823. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Population pharmacokinetics of epsilon-aminocaproic acid in infants undergoing craniofacial reconstruction surgery.

    Science.gov (United States)

    Stricker, P A; Zuppa, A F; Fiadjoe, J E; Maxwell, L G; Sussman, E M; Pruitt, E Y; Goebel, T K; Gastonguay, M R; Taylor, J A; Bartlett, S P; Schreiner, M S

    2013-05-01

    Understanding the clinical pharmacology of the antifibrinolytic epsilon-aminocaproic acid (EACA) is necessary for rational drug administration in children. The aim of this study is to determine the pharmacokinetics (PKs) of EACA in infants aged 6-24 months undergoing craniofacial reconstruction surgery. Cohorts of six infants were enrolled sequentially to one of the three escalating loading dose-continuous i.v. infusion (CIVI) regimens: 25 mg kg(-1), 10 mg kg(-1) h(-1); 50 mg kg(-1), 20 mg kg(-1) h(-1); 100 mg kg(-1), 40 mg kg(-1) h(-1). Plasma EACA concentrations were determined using a validated high-performance liquid chromatography-tandem mass spectrometry assay. A population non-linear mixed effects modelling approach was used to characterize EACA PKs. Population PK parameters of EACA were estimated using a two-compartment disposition model with weight expressed as an allometric covariate and an age effect. The typical patient in this study had an age of 38.71 weeks and a weight of 8.82 kg. PK parameters for this typical patient were: pre-/postoperative plasma drug clearance of 32 ml min(-1) (3.6 ml kg(-1) min(-1)), inter-compartmental clearance of 42.4 ml min(-1) (4.8 ml min(-1) kg(-1)), central volume of distribution of 1.27 litre (0.14 litre kg(-1)), and peripheral volume of distribution of 2.53 litre (0.29 litre kg(-1)). Intra-operative clearance and central volume of distribution were 89% and 80% of the pre-/postoperative value, respectively. EACA clearance increased with weight and age. The dependence of clearance on body weight supports weight-based dosing. Based on this study, a loading dose of 100 mg kg(-1) followed by a CIVI of 40 mg kg(-1) h(-1) is appropriate to maintain target plasma EACA concentrations in children aged 6-24 months undergoing these procedures.

  19. Feasibility of a three-step magnetic resonance imaging approach for the assessment of hepatic steatosis in an asymptomatic study population

    Energy Technology Data Exchange (ETDEWEB)

    Hetterich, Holger; Bayerl, Christian; Auweter, Sigrid; Ertl-Wagner, Birgit [Ludwig-Maximilian University Hospital, Institute of Clinical Radiology, Munich (Germany); Peters, Annette; Linkohr, Birgit [German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum Muenchen, Neuherberg (Germany); Heier, Margit; Meisinger, Christa [German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum Muenchen, Neuherberg (Germany); Central Hospital of Augsburg, KORA Myocardial Infarction Registry, Augsburg (Germany); Kannengiesser, Stephan A.R. [Siemens Healthcare, Erlangen (Germany); Kramer, Harald [Ludwig-Maximilian University Hospital, Institute of Clinical Radiology, Munich (Germany); University of Wisconsin - Madison, Department of Radiology, Madison, WI (United States); Bamberg, Fabian [Ludwig-Maximilian University Hospital, Institute of Clinical Radiology, Munich (Germany); University Hospital Tuebingen, Department of Radiology, Tuebingen (Germany)

    2016-06-15

    To determine the feasibility of a multi-step magnetic resonance imaging (MRI) approach for comprehensive assessment of hepatic steatosis defined as liver fat content of ≥5 % in an asymptomatic population. The study was approved by the institutional review board and written informed consent of all participants was obtained. Participants of a population-based study cohort underwent a three-step 3-T MRI-based assessment of liver fat. A dual-echo Dixon sequence was performed to identify subjects with hepatic steatosis, followed by a multi-echo Dixon sequence with proton density fat fraction estimation. Finally, single-voxel T2-corrected multi-echo spectroscopy was performed. A total of 215 participants completed the MRI protocol (56.3 % male, average age 57.2 ± 9.4 years). The prevalence of hepatic steatosis was 55 %. Mean liver proton density fat fraction was 9.2 ± 8.5 % by multi-echo Dixon and 9.3 ± 8.6 % by multi-echo spectroscopy (p = 0.51). Dual-echo Dixon overestimated liver fat fraction by 1.4 ± 2.0 % (p < 0.0001). All measurements showed excellent correlations (r ≥ 0.9, p < 0.001). Dual-echo Dixon was highly sensitive for the detection of hepatic steatosis (sensitivity 0.97, NPV 0.96) with good specificity and PPV (0.75 and 0.81, respectively). A multi-step MRI approach may enable rapid and accurate identification of subjects with hepatic steatosis in an asymptomatic population. (orig.)

  20. Novel Cross-Border Approaches to Optimise Identification of Asymptomatic and Artemisinin-Resistant Plasmodium Infection in Mobile Populations Crossing Cambodian Borders.

    Directory of Open Access Journals (Sweden)

    Hannah M Edwards

    Full Text Available Human population movement across country borders presents a real challenge for malaria control and elimination efforts in Cambodia and its neighbouring countries. To quantify Plasmodium infection among the border-crossing population, including asymptomatic and artemisinin resistant (AR parasites, three official border crossing points, one from each of Cambodia's borders with Thailand, Laos and Vietnam, were selected for sampling.A total of 3206 participants (of 4110 approached were recruited as they crossed the border, tested for malaria and interviewed. By real-time polymerase chain reaction (RT-PCR, 5.4% of all screened individuals were found to harbour Plasmodium parasites. The proportion was highest at the Laos border (11.5%. Overall there were 97 P. vivax (55.7%, 55 P. falciparum (31.6%, two P. malariae (1.1% and 20 mixed infections (11.5%. Of identified infections, only 20% were febrile at the time of screening. Of the 24 P. falciparum samples where a further PCR was possible to assess AR, 15 (62.5% had mutations in the K13 propeller domain gene, all from participants at the Laos border point. Malaria rapid diagnostic test (RDT pLDH/HRP-2 identified a positivity rate of 3.2% overall and sensitivity compared to RT-PCR was very low (43.1%. Main individual risk factors for infection included sex, fever, being a forest-goer, poor knowledge of malaria prevention methods and previous malaria infection. Occupation, day of the week and time of crossing (morning vs. afternoon also appeared to play an important role in predicting positive cases.This study offers a novel approach to identify asymptomatic infections and monitor AR parasite flow among mobile and migrant populations crossing the borders. Similar screening activities are recommended to identify other hot borders and characterise potential hot spots of AR. Targeted "customised" interventions and surveillance activities should be implemented in these sites to accelerate elimination efforts

  1. Novel Cross-Border Approaches to Optimise Identification of Asymptomatic and Artemisinin-Resistant Plasmodium Infection in Mobile Populations Crossing Cambodian Borders.

    Science.gov (United States)

    Edwards, Hannah M; Canavati, Sara E; Rang, Chandary; Ly, Po; Sovannaroth, Siv; Canier, Lydie; Khim, Nimol; Menard, Didier; Ashton, Ruth A; Meek, Sylvia R; Roca-Feltrer, Arantxa

    2015-01-01

    Human population movement across country borders presents a real challenge for malaria control and elimination efforts in Cambodia and its neighbouring countries. To quantify Plasmodium infection among the border-crossing population, including asymptomatic and artemisinin resistant (AR) parasites, three official border crossing points, one from each of Cambodia's borders with Thailand, Laos and Vietnam, were selected for sampling. A total of 3206 participants (of 4110 approached) were recruited as they crossed the border, tested for malaria and interviewed. By real-time polymerase chain reaction (RT-PCR), 5.4% of all screened individuals were found to harbour Plasmodium parasites. The proportion was highest at the Laos border (11.5%). Overall there were 97 P. vivax (55.7%), 55 P. falciparum (31.6%), two P. malariae (1.1%) and 20 mixed infections (11.5%). Of identified infections, only 20% were febrile at the time of screening. Of the 24 P. falciparum samples where a further PCR was possible to assess AR, 15 (62.5%) had mutations in the K13 propeller domain gene, all from participants at the Laos border point. Malaria rapid diagnostic test (RDT) pLDH/HRP-2 identified a positivity rate of 3.2% overall and sensitivity compared to RT-PCR was very low (43.1%). Main individual risk factors for infection included sex, fever, being a forest-goer, poor knowledge of malaria prevention methods and previous malaria infection. Occupation, day of the week and time of crossing (morning vs. afternoon) also appeared to play an important role in predicting positive cases. This study offers a novel approach to identify asymptomatic infections and monitor AR parasite flow among mobile and migrant populations crossing the borders. Similar screening activities are recommended to identify other hot borders and characterise potential hot spots of AR. Targeted "customised" interventions and surveillance activities should be implemented in these sites to accelerate elimination efforts in

  2. Comparison of rates of adverse events in adolescent and adult women undergoing medical abortion: population register based study

    OpenAIRE

    Niinimäki, Maarit; Suhonen, Satu; Mentula, Maarit; Hemminki, Elina; Heikinheimo, Oskari; Gissler, Mika

    2011-01-01

    Objective To determine the risks of short term adverse events in adolescent and older women undergoing medical abortion. Design Population based retrospective cohort study. Setting Finnish abortion register 2000-6. Participants All women (n=27 030) undergoing medical abortion during 2000-6, with only the first induced abortion analysed for each woman. Main outcome measures Incidence of adverse events (haemorrhage, infection, incomplete abortion, surgical evacuation, psychiatric morbidity, inj...

  3. Caspofungin Population Pharmacokinetics in Critically Ill Patients Undergoing Continuous Veno-Venous Haemofiltration or Haemodiafiltration.

    Science.gov (United States)

    Roger, Claire; Wallis, Steven C; Muller, Laurent; Saissi, Gilbert; Lipman, Jeffrey; Brüggemann, Roger J; Lefrant, Jean-Yves; Roberts, Jason A

    2017-09-01

    Sepsis and continuous renal replacement therapy (CRRT) can both significantly affect antifungal pharmacokinetics. This study aimed to describe the pharmacokinetics of caspofungin in critically ill patients during different CRRT modes. Patients receiving caspofungin and undergoing continuous veno-venous haemofiltration (CVVH) or haemodiafiltration (CVVHDF) were eligible to take part in the study. Blood samples were collected at seven sampling times during a dosing interval. Demographics and clinical data were recorded. Population pharmacokinetic analysis and Monte-Carlo simulation were undertaken using Pmetrics. Twelve pharmacokinetic profiles from nine patients were analysed. The caspofungin CRRT clearance (CL) was 0.048 ± 0.12 L/h for CVVH and 0.042 ± 0.042 L/h for CVVHDF. A two-compartment linear model best described the data. Patient weight was the only covariate affecting drug CL and central volume. The mean (standard deviation) parameter estimates were 0.64 ± 0.12 L/h for CL, 9.35 ± 3.56 L for central volume, 0.25 ± 0.19 per h for the rate constant for drug distribution from central to peripheral compartments and 0.19 ± 0.10 per h from peripheral to central compartments. Based on simulation results, a caspofungin 100 mg loading dose followed by a 50 mg maintenance dose for patients with a total body weight of ≤80 kg best achieved the pharmacokinetic/PD targets whilst a 70 mg maintenance dose was required for patients with a weight of >80 kg. No caspofungin dosing adjustment is necessary for patients undergoing either form of CRRT. However, higher than recommended loading doses of caspofungin are required to achieve pharmacokinetic/pharmacodynamic targets in critically ill patients. Registration: ClinicalTrials.gov Identifier NCT01403220.

  4. Measurement of the Aortic Diameter in the Asymptomatic Thai Population in Siriraj Hospital: Assessment with Multidetector CT

    Directory of Open Access Journals (Sweden)

    Krisdee Prabhasavat

    2016-07-01

    Full Text Available Objective: The purpose of this study was to determine normal reference values of intra-thoracic and abdominal aortic diameters of asymptomatic Thai adults obtained by multidetector computed tomography. Secondary end points were evaluation of relationships between aortic diameters and patients’ demographic data or potential risk factors of cardiovascular disease. Methods: Three hundred and ten Thai adults in Siriraj Hospital who had no any signs or symptoms of cardio- vascular disease that examined with computed tomography (CT of chest and whole abdomen were investigated in this study. Aortic diameters were measured at eight predefined intra-thoracic and abdominal levels on CT images, including ascending aorta, proximal transverse aortic arch, distal transverse aortic arch, aortic isthmus, thoracoabdominal junction, celiac axis, suprarenal aorta and aortic bifurcation. Analysis of data was performed with regard to patients’ demographic data (age, sex, weight, and height and three potential risk factors of cardio- vascular disease (hypertension, dyslipidemia and diabetes mellitus. Furthermore, we also recorded the co-morbid non-cardiovascular underlying diseases which were classified into seven groups, including tumors (malignant and benign tumors, infectious diseases, inflammatory diseases, autoimmune diseases, degenerative diseases, psychiatric diseases and others. Results: Aortic diameters were 3.14±0.40 cm. at the ascending aorta, 2.88 ± 0.34 cm. at proximal transverse aortic arch, 2.65±0.30 cm. at distal transverse aortic arch, 2.46 ± 0.31cm. at aortic isthmus, 2.10± 0.27 cm. at thoracoab- dominal junction, 1.99 ± 0.26 cm. at celiac axis, 1.81 ±0.25 cm. at suprarenal aorta, and 1.47±0.21 cm. at aortic bifurcation. Overall aortic diameters tend to continuously significantly decrease aortic diameters from proximal to distal direction from ascending aorta to aortic bifurcation. Men had slightly more enlarged aortic diameters in all

  5. Comparison of selective genotyping strategies for prediction of breeding values in a population undergoing selection.

    Science.gov (United States)

    Boligon, A A; Long, N; Albuquerque, L G; Weigel, K A; Gianola, D; Rosa, G J M

    2012-12-01

    Genomewide marker information can improve the reliability of breeding value predictions for young selection candidates in genomic selection. However, the cost of genotyping limits its use to elite animals, and how such selective genotyping affects predictive ability of genomic selection models is an open question. We performed a simulation study to evaluate the quality of breeding value predictions for selection candidates based on different selective genotyping strategies in a population undergoing selection. The genome consisted of 10 chromosomes of 100 cM each. After 5,000 generations of random mating with a population size of 100 (50 males and 50 females), generation G(0) (reference population) was produced via a full factorial mating between the 50 males and 50 females from generation 5,000. Different levels of selection intensities (animals with the largest yield deviation value) in G(0) or random sampling (no selection) were used to produce offspring of G(0) generation (G(1)). Five genotyping strategies were used to choose 500 animals in G(0) to be genotyped: 1) Random: randomly selected animals, 2) Top: animals with largest yield deviation values, 3) Bottom: animals with lowest yield deviations values, 4) Extreme: animals with the 250 largest and the 250 lowest yield deviations values, and 5) Less Related: less genetically related animals. The number of individuals in G(0) and G(1) was fixed at 2,500 each, and different levels of heritability were considered (0.10, 0.25, and 0.50). Additionally, all 5 selective genotyping strategies (Random, Top, Bottom, Extreme, and Less Related) were applied to an indicator trait in generation G(0,) and the results were evaluated for the target trait in generation G(1), with the genetic correlation between the 2 traits set to 0.50. The 5 genotyping strategies applied to individuals in G(0) (reference population) were compared in terms of their ability to predict the genetic values of the animals in G(1) (selection

  6. Prevalence and risk factors of asymptomatic colorectal diverticulosis in Taiwan.

    Science.gov (United States)

    Wang, Fu-Wei; Chuang, Hung-Yi; Tu, Ming-Shium; King, Tai-Ming; Wang, Jui-Ho; Hsu, Chao-Wen; Hsu, Ping-I; Chen, Wen-Chi

    2015-04-01

    To investigate the prevalence and risk factors of asymptomatic colorectal diverticulosis in Taiwanese general population. From January 2009 to December 2011, consecutive asymptomatic subjects undergoing a health check-up were evaluated by colonoscopy. The colorectal diverticulosis was assessed, and a medical history and demographic data were obtained from each subject. Logistic regression analysis was conducted to search the risk factors of colorectal diverticulosis. Of the 1899 asymptomatic subjects, the prevalence of colorectal diverticulosis was 13.5%. On univariate logistic regression analysis, age over 60 years old, male, adenomatous polyp, current smoking and heavy alcohol consumption were significantly associated with diverticulosis. Multivariate logistic regression analysis revealed that age over 60 years old (relative risk [RR], 2.57; 95% confidence interval [CI], 1.64-6.47), adenomatous polyps (RR, 2.18; 95% CI, 1.18-4.61) and heavy alcohol consumption (RR, 1.82; 95% CI, 1.04-3.08) were independent predictors for colorectal diverticulosis. The prevalence of asymptomatic colorectal diverticulosis was 13.5% in Taiwan. Age over 60 years old, adenomatous polyp and heavy alcohol consumption may affect the risk of development of the disease.

  7. Asymptomatic HIV infection

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000682.htm Asymptomatic HIV infection To use the sharing features on this page, please enable JavaScript. Asymptomatic HIV infection is a phase of HIV/AIDS during which ...

  8. TAPP or TEP? Population-based analysis of prospective data on 4,552 patients undergoing endoscopic inguinal hernia repair.

    Science.gov (United States)

    Gass, Markus; Banz, Vanessa M; Rosella, Laura; Adamina, Michel; Candinas, Daniel; Güller, Ulrich

    2012-12-01

    Whether total extraperitoneal inguinal hernia repair (TEP) is associated with worse outcomes than transabdominal preperitoneal inguinal hernia repair (TAPP) continues to be a matter of debate. The objective of this large cohort study is to compare outcomes between patients undergoing TEP or TAPP. Based on prospective data of the Swiss association of laparoscopic and thoracoscopic surgery, all patients undergoing unilateral TEP or TAPP between 1995 and 2006 were included. The following outcomes were compared: conversion rates, intraoperative and postoperative complications, duration of operation. Data on 4,552 patients undergoing TEP (n=3,457) and TAPP (n=1,095) were collected prospectively. Average age and American Society of Anesthesiologists score were similar in the two groups. Patients undergoing TEP had a significantly higher rate of intraoperative complications (TEP 1.9% vs. TAPP 0.9%, p=0.029) and surgical postoperative complications (TEP: 2.3% vs. TAPP: 0.8%, p=0.003). The postoperative length of stay was longer for patients undergoing TAPP (2.9 vs. 2.3 days, p=0.002), whereas the duration of the operation was longer for TEP (66.6 vs. 59.0 min, pTEP 1.0% vs. TAPP 0.2%, p=0.011). This study is one of the first population-based analyses comparing TEP and TAPP in a prospective cohort of more than 4,500 patients. Intraoperative and surgical postoperative complications were significantly higher in patients undergoing TEP. TEP is also associated with longer operating times and higher conversion rates. Therefore, on a population-based level, the TAPP technique appears to be superior to the TEP repair in patients undergoing unilateral inguinal hernia repair.

  9. Reliability of the spin-T cervical goniometer in measuring cervical range of motion in an asymptomatic Indian population.

    Science.gov (United States)

    Agarwal, Shabnam; Allison, Garry T; Singer, Kevin P

    2005-09-01

    To examine the intratester reliability of the Spin-T goniometer, a cervical range of motion device, in a normal Indian population. Subjects comprised 30 healthy adults with mean age of 34 years (range, 18-65 years). The subjects were stabilized in the sitting position and the Spin-T goniometer mounted on the head of the subject. The study design was a within-subject repeated intratester reliability trial conducted for cervical range of motion in 6 directions of movement. Three measurements were taken in each direction (flexion, extension lateral flexion, and lateral rotation) per participant. Reliability coefficients, intraclass correlation coefficients, and 95% confidence interval were derived from repeated-measures analysis of variance (ANOVA). Where differences in ANOVA were detected, a paired t test was conducted and the typical error values and coefficient of variance were calculated. All repeated measures showed high intraclass correlation coefficients (all >0.96, P goniometer proved to be a reliable measuring instrument for cervical range of movement in an Indian population. The use of a laser pointer fixed to the instrument ensured a consistent neutral start position.

  10. Warfarin Use in Patients With Atrial Fibrillation Undergoing Hemodialysis: A Nationwide Population-Based Study.

    Science.gov (United States)

    Yoon, Chang-Yun; Noh, Juhwan; Jhee, Jong Hyun; Chang, Tae Ik; Kang, Ea Wha; Kee, Youn Kyung; Kim, Hyoungnae; Park, Seohyun; Yun, Hae-Ryong; Jung, Su-Young; Oh, Hyung Jung; Park, Jung Tak; Han, Seung Hyeok; Kang, Shin-Wook; Kim, Changsoo; Yoo, Tae-Hyun

    2017-09-01

    The aim of this study is to elucidate the effects of warfarin use in patients with atrial fibrillation undergoing dialysis using a population-based Korean registry. Data were extracted from the Health Insurance Review and Assessment Service, which is a nationwide, mandatory social insurance database of all Korean citizens enrolled in the National Health Information Service between 2009 and 2013. Thromboembolic and hemorrhagic outcomes were analyzed according to warfarin use. Overall and propensity score-matched cohorts were analyzed by Cox proportional hazards models. Among 9974 hemodialysis patients with atrial fibrillation, the mean age was 66.6±12.2 years, 5806 (58.2%) were men, and 2921 (29.3%) used warfarin. After propensity score matching to adjust for all described baseline differences, 5548 subjects remained, and differences in baseline variables were distributed equally between warfarin users and nonusers. During a mean follow-up duration of 15.9±11.1 months, ischemic and hemorrhagic stroke occurred in 678 (6.8%) and 227 (2.3%) patients, respectively. In a multiple Cox model, warfarin use was significantly associated with an increased risk of hemorrhagic stroke (hazard ratio, 1.44; 95% confidence interval, 1.09-1.91; P =0.010) in the overall cohort. Furthermore, a significant relationship between warfarin use and hemorrhagic stroke was found in propensity-matched subjects (hazard ratio, 1.56; 95% confidence interval, 1.10-2.22; P =0.013). However, the ratios for ischemic stroke were not significantly different in either the propensity-matched (hazard ratio, 0.95; 95% confidence interval, 0.78-1.15; P =0.569) or overall cohort (hazard ratio, 1.06; 95% confidence interval, 0.90-1.26; P =0.470). Our findings suggest that warfarin should be used carefully in hemodialysis patients, given the higher risk of hemorrhagic events and the lack of ability to prevent thromboembolic complications. © 2017 American Heart Association, Inc.

  11. Comparison of gastric emptying parameters between asymptomatic volunteers and patients with functional dyspepsia in Middle Eastern population.

    Science.gov (United States)

    Alsharif, Abedallatif A; Abu-Sneineh, Awni T; Tarawneh, Emad S; Khatib, Mohammad Amer M; Salah, Mohammad S; Shennak, Mustafa M

    2010-03-01

    To derive the normal reference values for Middle East population using a standard method, and to validate its performance in functional dyspepsia. A prospective study was designed to derive gastric emptying parameters in 36 healthy control subjects. We measured the lag phase, half time, and gastric retention at the first, second, and third hours. Values were compared to 49 patients with functional dyspepsia. This study was carried out between July 2005 and August 2009 at Jordan University Hospital, Amman, Jordan. There were no statistically significant differences between the 2 groups at lag phase. Dyspeptic patients had significantly higher gastric retention at the first, second, and third hours (p=0.045, p=0.003, p=0.002). Gastric retention at the third hour was the most sensitive parameter detecting 16 patients (32.6%). Only 3 patients (6.1%) had increased gastric retention at the first hour and normal retention at the third hour. Twelve patients (24.5%) had delayed half time; these patients had increased gastric retention either at the first or third hour. Measurement of gastric retention at the first, second, and third hour is enough to identify delayed-early and late phases of gastric emptying in functional dyspepsia patients.

  12. p.Q192R SNP of PON1 seems not to be Associated with Carotid Atherosclerosis Risk Factors in an Asymptomatic and Normolipidemic Brazilian Population Sample

    Directory of Open Access Journals (Sweden)

    Daniel Zanetti Scherrer

    2015-07-01

    Full Text Available Background:Evidences suggest that paraoxonase 1 (PON1 confers important antioxidant and anti-inflammatory properties when associated with high-density lipoprotein (HDL.Objective:To investigate the relationships between p.Q192R SNP of PON1, biochemical parameters and carotid atherosclerosis in an asymptomatic, normolipidemic Brazilian population sample.Methods:We studied 584 volunteers (females n = 326, males n = 258; 19-75 years of age. Total genomic DNA was extracted and SNP was detected in the TaqMan® SNP OpenArray® genotyping platform (Applied Biosystems, Foster City, CA. Plasma lipoproteins and apolipoproteins were determined and PON1 activity was measured using paraoxon as a substrate. High-resolution β-mode ultrasonography was used to measure cIMT and the presence of carotid atherosclerotic plaques in a subgroup of individuals (n = 317.Results:The presence of p.192Q was associated with a significant increase in PON1 activity (RR = 12.30 (11.38; RQ = 46.96 (22.35; QQ = 85.35 (24.83 μmol/min; p Conclusion:In low-risk individuals, the presence of the p.192Q variant of PON1 is associated with a beneficial plasma lipid profile but not with carotid atherosclerosis.

  13. Asymptomatic gonorrhoea and chlamydial infection in a population-based and work-site based sample of men in Kilimanjaro, Tanzania.

    Science.gov (United States)

    Klouman, E; Masenga, E J; Sam, N E; Klepp, K I

    2000-10-01

    The aim of this study was to screen healthy rural and urban Tanzanian men for chlamydial infection and gonorrhoea, and determine the prevalence and the predictive value of urethral symptoms, signs and pyuria. In 2 cross-sectional surveys, 796 men were interviewed regarding symptoms and examined for signs of urethritis. Gonorrhoea was detected by culture/gram-stained smears, Chlamydia trachomatis by antigen immunoassay, and pyuria by leukocyte esterase dipstick test. The prevalence of chlamydial infection, gonorrhoea and pyuria among rural men was 9.6%, 0.4%, and 12.7%, and among urban bar workers 7.4%, 8.1% and 6.3% respectively. Among all, 0.6% had urethral discharge confirmed by examination, while 2.6% reported urethral discharge and 7.4% dysuria. Among chlamydia-infected men, 59 (89%) of the 66 cases did not have urethritis symptoms or signs. Similarly, 24 (88%) of 28 men with gonorrhoea were asymptomatic. Treatment based on the urethral discharge sign, would have detected only one out of 92 cases with gonorrhoea and/or chlamydia in these populations.

  14. Assessment of Liver and Renal Functions of Asymptomatic Human ...

    African Journals Online (AJOL)

    Winniecure), used in our institute for the treatment of Human Immuno Deficiency Virus (HIV) infection, on liver and renal functions of individuals undergoing therapy. A total of 100 asymptomatic Human Immuno Deficiency Virus (HIV) seropositive ...

  15. Factors associated with mortality in a population with acute kidney injury undergoing hemodialysis in Peru

    Directory of Open Access Journals (Sweden)

    Percy Herrera-Añazco

    Full Text Available Abstract Introduction: Patients with acute kidney injury (AKI in developing countries are described in a profile of young age, with less comorbidities, with unifactorial, and with a lower mortality compared to patients in developed countries. Objective: To assess mortality in patients with acute kidney injury undergoing hemodialysis (HD and its associated factors in a developing country setting. Methods: Retrospective study. Demographic, clinical, and mortality variables were collected from patients who presented AKI and underwent HD between January 2014 and December 2015 at a national reference hospital in Lima, Peru. Risk ratios (RR and 95% confidence intervals (95%CI were estimated through Poisson regressions. Results: Data from 72 patients with AKI that underwent HD were analyzed, 66.7% of them were 8.9 mg/dL. The adjusted analysis showed that having had a creatinine level of > 8.9 mg/dL, compared to a creatinine level of < 5.2 mg/dL at the time of initiating HD, was associated with 74% less probability of death. Conclusion: Four out of every ten AKI patients undergoing HD die. Higher levels of creatinine were associated with lower probability of mortality.

  16. Patients undergoing radical prostatectomy have a better survival than the background population

    DEFF Research Database (Denmark)

    Andreas Røder, Martin; Brasso, Klaus; Drimer Berg, Kasper

    2013-01-01

    -matched Danish population using the methods and macros described by Dickmann. The country-specific population mortality rates used for calculation of the expected survival were based on data from The Human Mortality Database. RESULTS: The median follow-up was 3.4 years (range: 0-14.3 years). A total of 59 (4...... better than expected in the age-matched background population. This finding is likely explained by selection bias. Although the results indicate an excellent outcome in terms of cancer control, the efficacy of prostatectomy for localized prostate cancer remains at debate....

  17. Asymptomatic Primary Hyperparathyroidism

    Science.gov (United States)

    Silverberg, Shonni J.; Walker, Marcella D.; Bilezikian, John P.

    2014-01-01

    The clinical profile of primary hyperparathyroidism (PHPT) as it is seen in the United States and most Western countries has evolved significantly over the past half century. The introduction of the multichannel serum autoanalyzer in the 1970s led to the recognition of a cohort of individuals with asymptomatic hypercalcemia, in whom evaluation led to the diagnosis of PHPT. The term “asymptomatic primary hyperparathyroidism” was introduced to describe patients who lack obvious signs and symptoms referable to either excess calcium or parathyroid hormone. Although it was expected that asymptomatic patients would eventually develop classical symptoms of PHPT, observational data suggest that most patients do not evolve over time to become overtly symptomatic. In most parts of the world, the asymptomatic phenotype of PHPT has replaced classical PHPT. This report is a selective review of data on asymptomatic PHPT: its demographic features, presentation and natural history, as well as biochemical, skeletal, neuromuscular, psychological, and cardiovascular manifestations. In addition, we will summarize available information on treatment indications and options for those with asymptomatic disease. PMID:23374736

  18. Asymptomatic Plasmodium spp. infection in Tierralta, Colombia.

    Science.gov (United States)

    Cucunubá, Zulma Milena; Guerra, Angela Patricia; Rahirant, Sonia Judith; Rivera, Jorge Alonso; Cortés, Liliana Jazmín; Nicholls, Rubén Santiago

    2008-11-01

    With the aim of determining the prevalence of asymptomatic Plasmodium spp. infection by thick smear and PCR and its association with demographic and epidemiological characteristics in the village of Nuevo Tay, Tierralta, Córdoba, Colombia, a cross-sectional population study was carried out, using random probabilistic sampling. Venous blood samples were taken from 212 people on day 0 for thick smear and PCR. Clinical follow-up and thick smears were carried out on days 14 and 28. The prevalence of Plasmodium spp. infection was 17.9% (38/212; 95% CI: 12.5-23.3%) and the prevalence of asymptomatic Plasmodiumspp. infection was 14.6% (31/212; 95% CI: 9.6-19.6%). Plasmodium vivax was found more frequently (20/31; 64.5%) than Plasmodium falciparum (9/31; 29%) and mixed infections (2/31; 6.5%). A significantly higher prevalence of asymptomatic infection was found in men (19.30%) than in women (9.18%) (prevalence ratio: 2.10; 95% CI: 1.01-4.34%; p = 0.02). People who developed symptoms had a significantly higher parasitemia on day 0 than those who remained asymptomatic, of 1,881.5 +/- 3,759 versus 79 +/- 106.9 (p = 0.008). PCR detected 50% more infections than the thick smears. The presence of asymptomatic Plasmodium spp. infection highlights the importance of carrying out active searches amongst asymptomatic populations residing in endemic areas.

  19. Thromboelastographic reference ranges for a cirrhotic patient population undergoing liver transplantation.

    Science.gov (United States)

    De Pietri, Lesley; Bianchini, Marcello; Rompianesi, Gianluca; Bertellini, Elisabetta; Begliomini, Bruno

    2016-09-24

    To describe the thromboelastography (TEG) "reference" values within a population of liver transplant (LT) candidates that underline the differences from healthy patients. Between 2000 and 2013, 261 liver transplant patients with a model for end-stage liver disease (MELD) score between 15 and 40 were studied. In particular the adult patients (aged 18-70 years) underwent to a first LT with a MELD score between 15 and 40 were included, while all patients with acute liver failure, congenital bleeding disorders, and anticoagulant and/or antiplatelet drug use were excluded. In this population of cirrhotic patients, preoperative haematological and coagulation laboratory tests were collected, and the pretransplant thromboelastographic parameters were studied and compared with the parameters measured in a previously studied population of 40 healthy subjects. The basal TEG parameters analysed in the cirrhotic population of liver candidates were as follows: Reaction time (r), coagulation time (k), Angle-Rate of polymerization of clot (α Angle), Maximum strenght of clot (MA), Amplitudes of the TEG tracing at 30 min and 60 min after MA is measured (A30 and A60), and Fibrinolysis at 30 and 60 min after MA (Ly30 and Ly60). The possible correlation between the distribution of the reference range and the gender, age, MELD score (higher or lower than 20) and indications for transplantation (liver pathology) were also investigated. In particular, a MELD cut-off value of 20 was chosen to verify the possible correlation between the thromboelastographic reference range and MELD score. Most of the TEG reference values from patients with end-stage liver disease were significantly different from those measured in the healthy population and were outside the suggested normal ranges in up to 79.3% of subjects. Wide differences were found among all TEG variables, including r (41.5% of the values), k (48.6%), α (43.7%), MA (79.3%), A30 (74.4%) and A60 (80.9%), indicating a prevailing trend to

  20. A population based study of the changing demographics of patients undergoing definitive treatment for kidney stone disease.

    Science.gov (United States)

    Ordon, Michael; Urbach, David; Mamdani, Muhammad; Saskin, Refik; Honey, R John D'A; Pace, Kenneth T

    2015-03-01

    We examined temporal changes in the demographics of patients undergoing definitive treatment for kidney stones during a 20-year period in Ontario, Canada. Using the Ontario Health Insurance Plan physician claims database and the Canadian Institute for Health Information Discharge Abstract Database we performed a population based cross-sectional time series analysis by identifying all kidney stone treatments done between July 1, 1991 and December 31, 2010. The demographics assessed were patient gender, age and socioeconomic status. The rate and/or proportion of kidney stone treatments per strata of these demographics were calculated for each 1-year block of the study period. We used time series analysis with exponential smoothing and autoregressive integrated moving average models to assess for trends with time. We identified 116,115 patients who underwent treatment for kidney stones during the study period. The rate of stone procedures performed per year increased steadily from 85/100,000 to 126/100,000 population. With time the rate of females who were treated increased significantly from 40/100,000 to 53/100,000 (p <0.0001). In contrast, the rate of males who were treated remained stable, increasing from 82/100,000 to 83/100,000 (p = 0.11). In regard to age the rate of patients older than 64 years increased significantly with time from 67/100,000 to 89/100,000 (p <0.0001). In regard to socioeconomic status approximately 20% of the patients were in each of the 5 income quintiles during the entire study period. Our population based study shows an increased rate of females and of patients older than 64 years undergoing definitive treatment for kidney stones with time. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. Comparison of rates of adverse events in adolescent and adult women undergoing medical abortion: population register based study.

    Science.gov (United States)

    Niinimäki, Maarit; Suhonen, Satu; Mentula, Maarit; Hemminki, Elina; Heikinheimo, Oskari; Gissler, Mika

    2011-04-19

    To determine the risks of short term adverse events in adolescent and older women undergoing medical abortion. Population based retrospective cohort study. Finnish abortion register 2000-6. All women (n = 27,030) undergoing medical abortion during 2000-6, with only the first induced abortion analysed for each woman. Incidence of adverse events (haemorrhage, infection, incomplete abortion, surgical evacuation, psychiatric morbidity, injury, thromboembolic disease, and death) among adolescent (abortion and linked with data from the abortion register for 2004-6. During 2000-6, 3024 adolescents and 24,006 adults underwent at least one medical abortion. The rate of chlamydia infections was higher in the adolescent cohort (5.7% v 3.7%, P abortion (0.69, 0.59 to 0.82), and surgical evacuation (0.78, 0.67 to 0.90) were lower in the adolescent cohort. In subgroup analysis of primigravid women, the risks of incomplete abortion (0.68, 0.56 to 0.81) and surgical evacuation (0.75, 0.64 to 0.88) were lower in the adolescent cohort. In logistic regression, duration of gestation was the most important risk factor for infection, incomplete abortion, and surgical evacuation. The incidence of adverse events after medical abortion was similar or lower among adolescents than among older women. Thus, medical abortion seems to be at least as safe in adolescents as it is in adults.

  2. Asymptomatic inhaled foreign body

    Science.gov (United States)

    Salim, Muhammad U.; Asghar, Asif; Tareen, Irum; Azhar, Muhammad

    2016-01-01

    It is very rare to have a big foreign body in the lungs without any complications or symptoms for 2 years. A 14-year-old male with episodes of minor hemoptysis for 4 weeks had a history of inhalation of a bullet 2 years earlier. He had asymptomatic for lung complications for 2 years. The bullet was removed by right thoracotomy and non-anatomical wedge stapled resection, and he followed an uneventful recovery. An aspirated foreign body although big can remain asymptomatic for a long time, especially if it has migrated to the periphery. PMID:27652366

  3. 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.

  4. Serum triglyceride, high-density lipoprotein cholesterol, apolipoprotein B, and coronary heart disease in a Chinese population undergoing coronary angiography.

    Science.gov (United States)

    Ling, Yan; Jiang, Jingjing; Wu, Bingjie; Gao, Xin

    Increased serum triglyceride and apolipoprotein B (apoB) levels and decreased high-density lipoprotein cholesterol (HDL-C) levels are risk factors for cardiovascular diseases. The major types of dyslipidemia in Chinese population are hypertriglyceridemia and low HDL-C. This study aimed to evaluate the effect of HDL-C, triglyceride, and apoB levels on the risk of coronary heart disease (CHD) in a Chinese population undergoing coronary angiography. This was a cross-sectional study. A total of 1941 consecutive patients who were referred to coronary angiography for the evaluation of suspected CHD were recruited. Lipid parameters were measured after an overnight fast. Patients were diagnosed with CHD and without CHD based on the findings of the coronary angiography. There were 1363 angiography confirmed CHD patients and 578 non-CHD patients. In nonstatin users, the major types of dyslipidemia were hypertriglyceridemia combined with low HDL-C, isolated low HDL-C, and isolated hypertriglyceridemia, accounting for 21.60%, 19.70%, and 14.99%, respectively. In statin users, a low to moderate-intensity statin was effective in lowering low-density lipoprotein cholesterol (LDL-C). The proportion of reaching an LDL-C goal coronary angiography with a relatively low level of LDL-C and a high prevalence of hypertriglyceridemia and low HDL-C. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  5. Pulmonary Performance In Asymptomatic Young Nigerian ...

    African Journals Online (AJOL)

    Pulmonary Performance In Asymptomatic Young Nigerian Population Following The Administration Of Ascorbic Acid And Salbutamol. ... Ascorbic acid was given orally at a dose of 1.50 mg /kg body weight; and salbutamol at a dose of 70 μg/kg body weight, orally. Measurements ... http://dx.doi.org/10.4314/njps.v19i1.32635.

  6. A small population of liver endothelial cells undergoes endothelial-to-mesenchymal transition in response to chronic liver injury.

    Science.gov (United States)

    Ribera, Jordi; Pauta, Montse; Melgar-Lesmes, Pedro; Córdoba, Bernat; Bosch, Anna; Calvo, Maria; Rodrigo-Torres, Daniel; Sancho-Bru, Pau; Mira, Aurea; Jiménez, Wladimiro; Morales-Ruiz, Manuel

    2017-11-01

    Rising evidence points to endothelial-to-mesenchymal transition (EndMT) as a significant source of the mesenchymal cell population in fibrotic diseases. In this context, we hypothesized that liver endothelial cells undergo EndMT during fibrosis progression. Cirrhosis in mice was induced by CCl 4 A transgenic mouse expressing a red fluorescent protein reporter under the control of Tie2 promoter (Tie2-tdTomato) was used to trace the acquisition of EndMT. Sinusoidal vascular connectivity was evaluated by intravital microscopy and high-resolution three-dimensional confocal microscopy. A modest but significant fraction of liver endothelial cells from both cirrhotic patients and CCl 4 -treated Tie2-tdTomato mice acquired an EndMT phenotype characterized by the coexpression of CD31 and α-smooth muscle actin, compared with noncirrhotic livers. Bone morphogenetic protein-7 (BMP-7) inhibited the acquisition of EndMT induced by transforming growth factor-β1 (TGF-β1) treatment in cultured primary mouse liver endothelial cells from control mice. EndMT was also reduced significantly in vivo in cirrhotic Tie2-tdTomato mice treated intraperitoneally with BMP-7 compared with untreated mice (1.9 ± 0.2 vs. 3.8 ± 0.3%, respectively; P livers correlated with a significant decrease in liver fibrosis ( P livers in both animal models and patients. BMP-7 treatment decreases the occurrence of the EndMT phenotype and has a positive impact on the severity of disease by reducing fibrosis and sinusoidal vascular disorganization. NEW & NOTEWORTHY A subpopulation of liver endothelial cells from cirrhotic patients and mice with liver fibrosis undergoes endothelial-to-mesenchymal transition. Liver endothelial cells from healthy mice could transition into a mesenchymal phenotype in culture in response to TGF-β1 treatment. Fibrotic livers treated chronically with BMP-7 showed lower EndMT acquisition, reduced fibrosis, and improved vascular organization. Copyright © 2017 the American

  7. Three-dimensional analysis of models articulated in the seated condylar position from a deprogrammed asymptomatic population: a prospective study. Part 1.

    Science.gov (United States)

    Cordray, Frank E

    2006-05-01

    The seated condylar position (SCP), also known as centric relation (CR), is considered the most reliable and reproducible reference point for accurately recording the relationship of the mandible to the maxilla. Therefore, a determination of the SCP/CR is a prerequisite for the analyses of the dental interarch, condylar position, and skeletal relationships. The purpose of this prospective study was to statistically evaluate the 3-dimensional nature of dental interarch displacement and condylar displacement between the SCP/CR and maximum intercuspation or centric occlusion (MIC/CO). The records of 596 consecutive asymptomatic patients having routine orthodontic treatment in a private practice were used. The initial premature occlusal contact and 3-dimensional dental interarch displacement were measured by the analysis of models, mounted on an articulator (Panadent, Grand Terrrace, Calif) in the SCP/CR, by using the modified (nonmanipulated) 2-piece wax SCP/CR recording method with deprogramming. Three-dimensional condylar displacement was measured by analysis of the graphic registrations, produced by condylar position instrumentation, and evaluated for frequency, direction, and magnitude of displacement. The dental interarch discrepancy in the SCP/CR was significantly different from that observed in MIC/CO, with posterior premature contacts (94.0%), increased overjet, decreased overbite, midline differences, and Angle classification changes. A difference in condylar position between the SCP/CR and MIC/CO in at least 1 plane was detected for every asymptomatic patient and every condyle. The most prevalent types of directional change in condylar position were inferior (down) (97.0%) and distal (posterior) (66.7%) when the teeth were brought into MIC/CO. The mean difference in condylar position between the SCP/CR and MIC/CO was .86 mm in the horizontal plane, 1.80 mm in the vertical plane, and .26 mm in the transverse plane. No correlation was found between a patient

  8. The use of indium-111 labeled platelet scanning for the detection of asymptomatic deep venous thrombosis in a high risk population

    Energy Technology Data Exchange (ETDEWEB)

    Siegel, R.S.; Rae, J.L.; Ryan, N.L.; Edwards, C.; Fortune, W.P.; Lewis, R.J.; Reba, R.C. (George Washington Univ. Medical Center, Washington, DC (USA))

    1989-11-01

    Five hundred indium-111 labeled platelet imaging studies (387 donor and 113 autologous) were performed postoperatively in 473 patients who had undergone total hip replacement, total knee replacement, or internal fixation of a hip fracture to detect occult deep venous thrombosis. All patients had been anticoagulated prophylactically with aspirin, warfarin sodium (Coumadin), or dextran. Thirty-four possible cases of proximal deep venous thrombosis were identified in 28 asymptomatic patients. To verify the scan results, 31 venograms were performed in 25 patients (three refused). In 21 of 31 cases, totally occlusive thrombi were detected; in 5 cases, partially occlusive thrombi were detected; in 5 cases, no thrombus was seen. No patient who had a negative scan nor any patient who had a verified positive scan (and received appropriate heparin therapy) subsequently developed symptoms or signs of pulmonary embolism. One hundred forty-one indium study patients also underwent Doppler ultrasonography/impedance plethysmography (Doppler/IPG) as a comparative non-invasive technique. In 137 cases, the results of the indium study and Doppler/IPG studies were congruent. The indium study had no false negative results that were detected by Doppler/IPG. No patient had any clinically evident toxicity. These results suggest that indium-111 labeled platelet scanning is a safe, noninvasive means for identifying DVT in high risk patients.

  9. Long-term results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population.

    Science.gov (United States)

    Miki, Kazumasa; Fujishiro, Mitsuhiro; Kodashima, Shinya; Yahagi, Naohisa

    2009-04-01

    In order to reduce gastric cancer death, mass screening for gastric cancer has been established in Japan for several decades. Only photofluorography is considered to be an acceptable screening method so far, but recent evidence may show the usefulness of serum pepsinogen (PG) measurement for gastric cancer screening. The aim of the present study was to elucidate the feasibility of measuring serum PG levels for detection of gastric cancers. Serum PG levels (PGI/PGII) were measured in asymptomatic middle-aged Japanese between 1991 and 2005. Those with a PGI gastric cancers were detected, which corresponded to 0.12% of all participants and to 0.91% of those with gastroendoscopy. Early-stage cancers and intestinal-type intramucosal cancers accounted for 80% and 39% of all the detected cancers, respectively. Serum PG measurement for mass screening of gastric cancer enabled us to achieve high recruitment for gastroendoscopy in intended individuals, a favorable detection rate of gastric cancer and, in particular, an extremely high proportion of early-stage gastric cancer in all the detected cancers.

  10. The association of colonoscopy quality indicators with the detection of screen-relevant lesions, adverse events, and postcolonoscopy cancers in an asymptomatic Canadian colorectal cancer screening population.

    Science.gov (United States)

    Hilsden, Robert J; Dube, Catherine; Heitman, Steven J; Bridges, Ronald; McGregor, S Elizabeth; Rostom, Alaa

    2015-11-01

    Although several quality indicators of colonoscopy have been defined, quality assurance activities should be directed at the measurement of quality indicators that are predictive of key screening colonoscopy outcomes. The goal of this study was to examine the association among established quality indicators and the detection of screen-relevant lesions (SRLs), adverse events, and postcolonoscopy cancers. Historical cohort study. Canadian colorectal cancer screening center. A total of 18,456 asymptomatic men and women ages 40 to 74, at either average risk or increased risk for colorectal cancer because of a family history, who underwent a screening colonoscopy from 2008 to 2010. Using univariate and multivariate analyses, we explored the association among procedural quality indicators and 3 colonoscopy outcomes: detection of SRLs, adverse events, and postcolonoscopy cancers. The crude rates of SRLs, adverse events, and postcolonoscopy cancers were 240, 6.44, and .54 per 1000 colonoscopies, respectively. Several indicators, including endoscopist withdrawal time (OR, 1.3; 95% CI, 1.2-1.4) and cecal intubation rate (OR, 13.9; 95% CI, 1.9-96.9), were associated with the detection of SRLs. No quality indicator was associated with the risk of adverse events. Endoscopist average withdrawal time over 6 minutes (OR, .12; 95% CI, .002-.85) and SRL detection rate over 20% (OR, .17; 95% CI, .03-.74) were associated with a reduced risk of postcolonoscopy cancers. Single-center study. Quality assurance programs should prioritize the measurement of endoscopist average withdrawal time and adenoma (SRL) detection rate. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  11. [An asymptomatic chronic hypokalaemia].

    Science.gov (United States)

    Otto, Marie-Pierre; Cheminel, Valérie; Crevon, Lionel; Dubourg, Laurence; Hadj-Aissa, Aoumeur; Mounier, Chantal; Prevosto, Jean-Michel

    2011-01-01

    We report the case of an asymptomatic patient presenting a severe chronic renal hypokalaemia. Once being sure of no diuretics use, two hypothesis can be mentioned for a normotensive patient presenting an hypokalaemia associated with a metabolic alcalosis: Bartter syndrome or Gitelman syndrome. The highlighting of low magnesaemia and hypocalciuria strongly concentrates the diagnosis on Gitelman syndrome. First, this has been strengthened by the results of renal function tests and later it has confirmed by molecular diagnosis with the identification of a known homozygous mutation on SLC12A3 gene. In the patient family, the same chromosomal abnormality has been found in the young sister. For these two patients the treatment ordered is an antikaliuretic diuretic, magnesium and potassium supplements. This case shows the difficulty to diagnose Gitelman syndrome: it is frequently mistaken for Bartter syndrome. The main differences between these two syndromes are magnesaemia and calciuria. Furthemore , patients with Gitelman syndrome are often asymptomatic, this explains why prevalence of this illness is probably underestimated.

  12. Asymptomatic deer excrete infectious prions in feces

    OpenAIRE

    Tamg?ney, G?ltekin; Miller, Michael W.; Wolfe, Lisa L.; Sirochman, Tracey M.; Glidden, David V.; Palmer, Christina; Lemus, Azucena; DeArmond, Stephen J.; Prusiner, Stanley B.

    2009-01-01

    Infectious prion diseases 1 ? scrapie of sheep 2 and chronic wasting disease (CWD) of several species in the deer family 3,4 ? are transmitted naturally within affected host populations. Although several possible sources of contagion have been identified in excretions and secretions from symptomatic animals 5?8 , the biological importance of these sources in sustaining epidemics remains unclear. Here we show that asymptomatic CWD-infected mule deer (Odocoileus hemionus) excrete CWD prions in ...

  13. Asymptomatic deer excrete infectious prions in faeces

    OpenAIRE

    Tamgüney, G; Miller, MW; Wolfe, LL; Sirochman, TM; Glidden, DV; Palmer, C; Lemus, A; Dearmond, SJ; Prusiner, SB

    2009-01-01

    Infectious prion diseasesĝ€"scrapie of sheep and chronic wasting disease (CWD) of several species in the deer familyĝ€" are transmitted naturally within affected host populations. Although several possible sources of contagion have been identified in excretions and secretions from symptomatic animals, the biological importance of these sources in sustaining epidemics remains unclear. Here we show that asymptomatic CWD-infected mule deer (Odocoileus hemionus) excrete CWD prions in their faeces...

  14. 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.

  15. TAPP or TEP for Recurrent Inguinal Hernia? Population-Based Analysis of Prospective Data on 1309 Patients Undergoing Endoscopic Repair for Recurrent Inguinal Hernia.

    Science.gov (United States)

    Gass, M; Scheiwiller, A; Sykora, M; Metzger, J

    2016-10-01

    Whether total extraperitoneal inguinal hernia repair (TEP) is associated with worse outcomes compared to transabdominal preperitoneal inguinal hernia repair (TAPP) for the treatment of recurrent inguinal hernia continues to be a matter of debate. The objective of this large cohort study is to compare complications, conversion rates and postoperative length of hospital stay between patients undergoing TEP or TAPP for unilateral recurrent inguinal hernia repair. Based on prospective data of the Swiss Association of Laparoscopic and Thoracoscopic Surgery, all patients who underwent elective TEP or TAPP for unilateral recurrent inguinal hernia between 1995 and 2006 were included. The following outcomes were compared: conversion rates, intraoperative complications, surgical postoperative complications and duration of operation. Data on 1309 patients undergoing TEP (n = 1022) and TAPP (n = 287) for recurrent inguinal hernia were prospectively collected. Average age, BMI and ASA score were similar in both groups. Patients undergoing TEP had a significantly increased rate of intraoperative complications (TEP 6.3 % vs. TAPP 2.8 %, p = 0.0225). Duration of operation was longer for patients undergoing TEP (TEP 80.3 vs. TAPP 73.0 min, p TEP 2.6 vs. TAPP 3.1 day, p = 0.0145). Surgical postoperative complications (TEP 3.52 % vs. TAPP 2.09 %, p = 0.2239), general postoperative complications (TEP 1.47 % vs. TAPP 0.7 %, p = 0.3081) and conversion rates (TEP 2.15 % vs. TAPP 1.39 %, p = 0.4155) were not significantly different. This study is the first population-based analysis comparing outcomes of patients with recurrent inguinal hernia undergoing TEP versus TAPP in a prospective cohort of over 1300 patients. Intraoperative complications were significantly higher in patients undergoing TEP. The TEP technique was associated with longer operating times, but a shorter postoperative length of hospital stay. Nonetheless, the absolute outcome differences are small

  16. Evaluation of reactivation of HSV1, HHV6, CMV and EBV in a population of patients undergoing allogeneic bone marrow transplantation

    Directory of Open Access Journals (Sweden)

    Caterina Matinato

    2011-06-01

    Full Text Available Herpes viruses are recognized as important pathogens as a result of viral reactivation in immunocompromised hosts, especially in patients undergoing bone marrow transplantation. Objectives of this study were the assessment of the reactivation of herpes virus HSV1, HHV6, CMV and EBV and the correlation between viral reactivation and progression of transplantation in a population of patients undergoing allogeneic bone marrow transplantation at Fondazione IRCCS Ospedale Maggiore Ca’ Granda Policlinico, Milan. Viral DNA was detected and quantified by Real Time PCR in a population of 35 patients undergoing allogeneic bone marrow transplantation. The viral reactivation was observed in 7 patients for HSV1 (20%, 6 patients for HHV6 (17.1%, 11 patients for CMV (31.4% and 4 patients for EBV (11.4%. Difference in the incidence of aGVDH between patients with viral reactivation versus those for which there was no reactivation was statistically significant. These data confirm the importance of monitoring viral load for the management of antiviral therapy in order to prevent CMV disease and complications related to herpes viruses reactivation.

  17. Prevalence of coronary artery calcium scores and silent myocardial ischaemia was similar in Indian Asians and European whites in a cross-sectional study of asymptomatic subjects from a U.K. population (LOLIPOP-IPC).

    Science.gov (United States)

    Jain, Piyush; Kooner, Jaspal S; Raval, Usha; Lahiri, Avijit

    2011-05-01

    Coronary heart disease (CHD) mortality is 70% higher among Indian Asians (IA) than European whites (EW), the reasons for this excess remain unexplained. Coronary artery calcification (CAC) is highly correlated with coronary plaque burden and silent myocardial ischaemia in EW; but fails to identify excess risk in IA. We hypothesised that IA have a higher prevalence of silent myocardial ischaemia compared to EW, despite similar CAC, and this may explain their excess CHD mortality. CAC was measured for 2,369 asymptomatic men and women, aged 35 to 75 years, as part of the London Life Sciences Population (LOLIPOP) study. 518 subjects had CAC scores >100 Agatston units and of these 256 (49%) patients underwent myocardial perfusion scintigraphy (MPS). CAC scores were similar among IA and EW, after adjustment for conventional risk factors. MPS abnormalities were seen in 56 (22%) subjects. Presence of diabetes (P = .03) and increasing CAC (P < .001) were independent predictors for severity of silent myocardial ischaemia. Ethnicity did not influence the prevalence or the extent of silent myocardial ischaemia. MPS did not identify greater ischaemia among IA compared with EW. This appears incongruent with almost 2-fold higher risk of CHD mortality observed in IA.

  18. Asymptomatic bacteriuria among pregnant women

    OpenAIRE

    Sudha Biradar Kerure; Rajeshwari Surpur; Sheela S. Sagarad; Sneha Hegadi

    2013-01-01

    Background: Urinary tract infections (UTIs) are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB) is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB) in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens....

  19. Ocularhaemodynamics parameters of asymptomatic HAART ...

    African Journals Online (AJOL)

    Results: Vmax of blood flow in central retinal artery (CRA) of asymptomatic HAART - experienced HIV infected children was 12.2cm/s while that of seronegative children was 13.4 cm/s. The PI and RI of blood flow in CRA of asymptomatic HAARTexperienced HIV-infected children were 0.8 and 0.5 respectively while those of ...

  20. Comparison of four risk scores for in-hospital mortality in patients undergoing heart valve surgery: A multicenter study in a Chinese population.

    Science.gov (United States)

    Wang, Chong; Tang, Yang-Feng; Zhang, Jia-Jun; Bai, Yi-Fan; Yu, Yong-Chao; Zhang, Guan-Xin; Han, Lin

    2016-01-01

    To compare four risk scores with regard to their validity to predict in-hospital mortality after heart valve surgery in a multicenter patient population of China. From January 2009 to December 2012, data from 12,412 consecutive patients older than 16 years who underwent heart valve surgery at four cardiac surgical centers were collected and scored according to the EuroSCORE II, Ambler risk score, NYC risk score, and STS risk score. The patients were divided into two subgroups according to the types of valve procedures, and the performance of the four risk scores for each group was assessed. Calibration was assessed by the Hosmer-Lemeshow (H-L) test. Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve. Observed mortality was 2.09% overall. The EuroSCORE II, Ambler score, and NYC score overpredicted observed mortality (Hosmer-Lemeshow: P = 0.002, P surgery compared with the Ambler score and NYC score. However, all four risk scores give an imprecise prediction in patients undergoing multiple valve surgery. Both the STS score and Euroscore II, especially the STS score, were suitable for individual operative risk in Chinese patients undergoing single valve surgery compared with the Ambler score and NYC score, however, all four risk scores were not suitable for prediction in Chinese patients undergoing multiple valve surgery. Therefore, the creation of a new model which accurately predicts outcomes in patients undergoing multiple valve surgery is possibly required in China. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  1. Demographic characteristics of the population undergoing cine coronary angiography at the Instituto do Coração of the Medical School of USP from 1986 to 1995

    Directory of Open Access Journals (Sweden)

    Bruno Caramelli

    2003-09-01

    Full Text Available OBJECTIVE: To obtain information about the profile and behavior of a population with ischemic heart disease undergoing cine coronary angiography and to determine disease severity. METHODS: Retrospective study assessing patients hospitalized at InCor from 1986 to 1995, in which the variables age, sex, and number of major coronary arteries with obstruction degree > 40% were analyzed. RESULTS: We studied 18,221 patients and observed a significant increase in the number of females (22.8% to 25.2%, P=0.001 and an increase in age (57.1±29.3 to 60.4±10.7 years, P=0.0001. A significant increase in the incidence of multivessel disease was observed, which was more frequent among males (69.2% and 64.5% and among the older patients (59.8±9.8 and 56.8±10.7 years, P=0.0001. A reduction in the incidence of single-vessel disease was also observed (66.2% vs 69.2% and 33.8% vs 30.5%, respectively, P<0.0001. CONCLUSION: A change in the profile of the population studied was observed as follows: patients undergoing cine coronary angiography at InCor were older, had a greater number of impaired major coronary arteries, and the number of females affected increased, leading to indices suggestive of a poorer prognosis.

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

    Science.gov (United States)

    Heldenberg, Eitan; Bass, Arie

    2014-08-01

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

  3. Usefulness of the hepatitis C virus core antigen assay for screening of a population undergoing routine medical checkup.

    Science.gov (United States)

    Gaudy, Catherine; Thevenas, Catherine; Tichet, Jean; Mariotte, Nicole; Goudeau, Alain; Dubois, Frédéric

    2005-04-01

    We studied the usefulness of the recently designed Trak-C assay for the detection and quantification of the hepatitis C virus (HCV) core antigen (Ag) for the screening of HCV infection in 4,201 subjects selected from 74,150 consecutive volunteers undergoing routine medical checkups. Subjects were selected for screening because they had risk factors (group II, n = 321) and/or elevated alanine transaminase activity (group I, n = 3847). Initially, the anti-HCV antibody assay and the Trak-C assay were performed on each patient. Subsequently, the Trak-C assay was performed only when the anti-HCV enzyme immune assay (EIA) was positive. Positive samples were further evaluated for anti-HCV antibodies by a third-generation strip immunoblot assay and for HCV RNA. Four samples (1.2%) from group II and 113 (2.9%) from group I were anti-HCV EIA positive. We also tested 33 subjects who previously tested positive for anti-HCV in our medical center. Among the 150 anti-HCV EIA-positive samples, the HCV core Ag result was in accord with the HCV RNA result in 146 cases (97.3%). When the EIA result was positive, the HCV core Ag concentration and the HCV RNA load were correlated (r(2) = 0.78; P < 0.001). Four samples with low viral loads were Trak-C negative but HCV RNA positive. Among the 2,395 anti-HCV EIA-negative serum samples collected during the first part of the study, 17 (0.7%) were found to contain very low levels of HCV core Ag (<8.5 pg/ml, the cutoff value being 1.5 pg/ml). All these samples were HCV RNA negative and considered to be false positives. This was confirmed by HCV core Ag neutralization analysis. The HCV core Ag assay is a useful method in the screening strategy of HCV infection and provides a reliable means of distinguishing between current and cleared HCV infections that is well correlated with HCV RNA testing.

  4. Estimating temporal trend in the presence of spatial complexity: a Bayesian hierarchical model for a wetland plant population undergoing restoration.

    Directory of Open Access Journals (Sweden)

    Thomas J Rodhouse

    Full Text Available Monitoring programs that evaluate restoration and inform adaptive management are important for addressing environmental degradation. These efforts may be well served by spatially explicit hierarchical approaches to modeling because of unavoidable spatial structure inherited from past land use patterns and other factors. We developed bayesian hierarchical models to estimate trends from annual density counts observed in a spatially structured wetland forb (Camassia quamash [camas] population following the cessation of grazing and mowing on the study area, and in a separate reference population of camas. The restoration site was bisected by roads and drainage ditches, resulting in distinct subpopulations ("zones" with different land use histories. We modeled this spatial structure by fitting zone-specific intercepts and slopes. We allowed spatial covariance parameters in the model to vary by zone, as in stratified kriging, accommodating anisotropy and improving computation and biological interpretation. Trend estimates provided evidence of a positive effect of passive restoration, and the strength of evidence was influenced by the amount of spatial structure in the model. Allowing trends to vary among zones and accounting for topographic heterogeneity increased precision of trend estimates. Accounting for spatial autocorrelation shifted parameter coefficients in ways that varied among zones depending on strength of statistical shrinkage, autocorrelation and topographic heterogeneity--a phenomenon not widely described. Spatially explicit estimates of trend from hierarchical models will generally be more useful to land managers than pooled regional estimates and provide more realistic assessments of uncertainty. The ability to grapple with historical contingency is an appealing benefit of this approach.

  5. Population pharmacokinetics of piperacillin and tazobactam in critically ill patients undergoing continuous renal replacement therapy: application to pharmacokinetic/pharmacodynamic analysis.

    Science.gov (United States)

    Asín-Prieto, Eduardo; Rodríguez-Gascón, Alicia; Trocóniz, Iñaki F; Soraluce, Amaia; Maynar, Javier; Sánchez-Izquierdo, José Ángel; Isla, Arantxazu

    2014-01-01

    To evaluate the pharmacokinetics of piperacillin/tazobactam in critically ill patients undergoing continuous renal replacement therapy (CRRT) and to assess the success of the therapy against susceptible bacteria. Sixteen patients undergoing CRRT with different degrees of renal function were included in the study. Blood and ultrafiltrate samples were drawn after administration of piperacillin/tazobactam (4/0.5 g) every 4, 6 or 8 h. The data were analysed by a population approach using NONMEM 7.2. The probability of target attainment (PTA) of maintaining free piperacillin levels above the MIC during the entire dosing interval was estimated by simulation of intermittent and continuous infusions. The pharmacokinetics of piperacillin and tazobactam were best described by two-compartment models where the elimination of both drugs was conditioned by renal [dependent on creatinine clearance (CLCR)], non-renal and extracorporeal clearances. A 20 min infusion of piperacillin/tazobactam administered every 6 h provided high PTAs against MICs ≤ 32 mg/L in patients with severe renal failure. In patients with normal or moderate renal function PTAs ≥ 90% were only obtained up to MICs ≤ 8 mg/L with short infusions. However, simulating continuous infusion, higher probabilities of success were obtained against MICs of 32 and 16 mg/L when CLCR was 50 and 100 mL/min, respectively. Population pharmacokinetic models have been developed and validated for piperacillin and tazobactam. Based on the pharmacokinetic/pharmacodynamic analysis, dosing recommendations are given considering the residual renal function of the patient and the MIC for the isolated bacteria.

  6. Committee Opinion No.703: Asymptomatic Microscopic Hematuria in Women.

    Science.gov (United States)

    2017-06-01

    Asymptomatic microscopic hematuria is an important clinical sign of urinary tract malignancy. Asymptomatic microscopic hematuria has been variably defined over the years. In addition, the evidence primarily is based on data from male patients. However, whether the patient is a man or a woman influences the differential diagnosis of asymptomatic microscopic hematuria, and the risk of urinary tract malignancy (bladder, ureter, and kidney) is significantly less in women than in men. Among women, being older than 60 years, having a history of smoking, and having gross hematuria are the strongest predictors of urologic cancer. In low-risk, never-smoking women younger than 50 years without gross hematuria and with fewer than 25 red blood cells per high-power field, the risk of urinary tract malignancy is less than or equal to 0.5%. Furthermore, the evaluation may result in more harm than benefit and is unlikely to be cost effective. Thus, data support changing current hematuria recommendations in this low-risk group. The American College of Obstetricians and Gynecologists and the American Urogynecologic Society encourage organizations producing future guidelines on the evaluation of microscopic hematuria to perform sex-specific analysis of the data and produce practical sex-specific recommendations. In the meantime, the American College of Obstetricians and Gynecologists and the American Urogynecologic Society recommend that asymptomatic, low-risk, never-smoking women aged 35-50 years undergo evaluation only if they have more than 25 red blood cells per high-power field.

  7. Committee Opinion No. 703 Summary: Asymptomatic Microscopic Hematuria in Women.

    Science.gov (United States)

    2017-06-01

    Asymptomatic microscopic hematuria is an important clinical sign of urinary tract malignancy. Asymptomatic microscopic hematuria has been variably defined over the years. In addition, the evidence primarily is based on data from male patients. However, whether the patient is a man or a woman influences the differential diagnosis of asymptomatic microscopic hematuria, and the risk of urinary tract malignancy (bladder, ureter, and kidney) is significantly less in women than in men. Among women, being older than 60 years, having a history of smoking, and having gross hematuria are the strongest predictors of urologic cancer. In low-risk, never-smoking women younger than 50 years without gross hematuria and with fewer than 25 red blood cells per high-power field, the risk of urinary tract malignancy is less than or equal to 0.5%. Furthermore, the evaluation may result in more harm than benefit and is unlikely to be cost effective. Thus, data support changing current hematuria recommendations in this low-risk group. The American College of Obstetricians and Gynecologists and the American Urogynecologic Society encourage organizations producing future guidelines on the evaluation of microscopic hematuria to perform sex-specific analysis of the data and produce practical sex-specific recommendations. In the meantime, the American College of Obstetricians and Gynecologists and the American Urogynecologic Society recommend that asymptomatic, low-risk, never-smoking women aged 35-50 years undergo evaluation only if they have more than 25 red blood cells per high-power field.

  8. Prevalence and pattern of asymptomatic bacteriuria among ...

    African Journals Online (AJOL)

    Most of the cultured organism (89%) were sensitive to Nitrofurantoin. Conclusion: The prevalence of asymptomatic bacteriuria among pregnant women at the UPTH is high. The most prevalent organism was Klebsiella. Keywords: Asymptomatic bacteriuria, Prevalence, Pattern, Klebsiella, Nitrofurantion, Morbidity ...

  9. 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.

  10. [Asymptomatic severe aortic stenosis: a reopened debate].

    Science.gov (United States)

    Urso, Stefano; Sadaba, Rafael; de la Cruz, Elena

    2014-05-06

    Aortic stenosis is a complex disease. About 2-7% of the population over 65 years of age is affected by its degenerative form. In patients with severe aortic stenosis presenting with symptoms or left ventricle ejection fraction (LVEF)debate. Recent published data show that about one third of these patients present with low left ventricle stroke volume, which may affect survival. For this reason, and considering that aortic valve replacement is in most cases a low risk procedure, early surgery in this subgroup is a strategy that deserves to be taken into account. In this review we report on these recent findings, which allow understanding why patients with asymptomatic severe aortic stenosis should not be considered and treated as a homogenous population. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. Asymptomatic schwannoma of the heart

    Directory of Open Access Journals (Sweden)

    Kennedy Maria

    2007-01-01

    Full Text Available Abstract We present a case of an asymptomatic right atrial mass detected on a screening ECHO. Pre-operative imaging and intraoperative frozen section suggested an atrial myxoma, but the extracardiac nature of the mass and its adherence to the right superior pulmonary vein and interatrial septum were inconsistent with this. Detailed histological assessment confirmed the diagnosis of atrial schwannoma. Limited case reports have shown complete resection is curative.

  12. Functional impairment of Tax-specific but not cytomegalovirus-specific CD8+ T lymphocytes in a minor population of asymptomatic human T-cell leukemia virus type 1-carriers

    Directory of Open Access Journals (Sweden)

    Takamori Ayako

    2011-12-01

    Full Text Available Abstract Background Human T-cell leukemia virus type 1 (HTLV-1 causes adult T-cell leukemia (ATL and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP in a small percentage of infected individuals. ATL is often associated with general immune suppression and an impaired HTLV-1-specific T-cell response, an important host defense system. We previously found that a small fraction of asymptomatic HTLV-1-carriers (AC already showed impaired T-cell responses against the major target antigen, Tax. However, it is unclear whether the impaired HTLV-1 Tax-specific T-cell response in these individuals is an HTLV-1-specific phenomenon, or merely reflects general immune suppression. In this study, in order to characterize the impaired HTLV-1-specific T-cell response, we investigated the function of Tax-specific CD8+ T-cells in various clinical status of HTLV-1 infection. Results By using tetramers consisting of HLA-A*0201, -A*2402, or -A*1101, and corresponding Tax epitope peptides, we detected Tax-specific CD8+ T-cells in the peripheral blood from 87.0% of ACs (n = 20/23 and 100% of HAM/TSP patients (n = 18/18 tested. We also detected Tax-specific CD8+ T-cells in 38.1% of chronic type ATL (cATL patients (n = 8/21, although its frequencies in peripheral blood CD8+ T cells were significantly lower than those of ACs or HAM/TSP patients. Tax-specific CD8+ T-cells detected in HAM/TSP patients proliferated well in culture and produced IFN-γ when stimulated with Tax peptides. However, such functions were severely impaired in the Tax-specific CD8+ T-cells detected in cATL patients. In ACs, the responses of Tax-specific CD8+ T-cells were retained in most cases. However, we found one AC sample whose Tax-specific CD8+ T-cells hardly produced IFN-γ, and failed to proliferate and express activation (CD69 and degranulation (CD107a markers in response to Tax peptide. Importantly, the same AC sample contained cytomegalovirus (CMV pp65-specific CD8+ T

  13. Population Pharmacokinetics and Optimal Sampling Strategy for Model-Based Precision Dosing of Melphalan in Patients Undergoing Hematopoietic Stem Cell Transplantation.

    Science.gov (United States)

    Mizuno, Kana; Dong, Min; Fukuda, Tsuyoshi; Chandra, Sharat; Mehta, Parinda A; McConnell, Scott; Anaissie, Elias J; Vinks, Alexander A

    2017-09-16

    High-dose melphalan is an important component of conditioning regimens for patients undergoing hematopoietic stem cell transplantation. The current dosing strategy based on body surface area results in a high incidence of oral mucositis and gastrointestinal and liver toxicity. Pharmacokinetically guided dosing will individualize exposure and help minimize overexposure-related toxicity. The purpose of this study was to develop a population pharmacokinetic model and optimal sampling strategy. A population pharmacokinetic model was developed with NONMEM using 98 observations collected from 15 adult patients given the standard dose of 140 or 200 mg/m2 by intravenous infusion. The determinant-optimal sampling strategy was explored with PopED software. Individual area under the curve estimates were generated by Bayesian estimation using full and the proposed sparse sampling data. The predictive performance of the optimal sampling strategy was evaluated based on bias and precision estimates. The feasibility of the optimal sampling strategy was tested using pharmacokinetic data from five pediatric patients. A two-compartment model best described the data. The final model included body weight and creatinine clearance as predictors of clearance. The determinant-optimal sampling strategies (and windows) were identified at 0.08 (0.08-0.19), 0.61 (0.33-0.90), 2.0 (1.3-2.7), and 4.0 (3.6-4.0) h post-infusion. An excellent correlation was observed between area under the curve estimates obtained with the full and the proposed four-sample strategy (R 2 = 0.98; p developed pharmacokinetic model-based sparse sampling strategy promises to achieve the target area under the curve as part of precision dosing.

  14. Asymptomatic bacteriuria Escherichia coli strains

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  15. Asymptomatic Left Atrial Myxoma in Elderly Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyhan Yilmaz

    2013-08-01

    Full Text Available Approximately 75% of cardiac tumors are benign and approximately 50% are constituted of myxomas. Myxomas are more common among women, and generally appear between the third and sixth decade of life. The most common symptom of myxomas is respiratory distress associated with obstruction. The main goal in the surgery of cardiac myxomas is the full excision of the tumor with minimal manipulation and disruption/fragmentation together with the aid of a cardiopulmonary bypass. This case report is reported a seventy years old patient with asymptomatic cardiac myxoma whom undergoing surgery with general anesthesia twice at different times and undiagnosed cardiac myxoma in past seven years.

  16. Interaction of Microbiology and Pathology in Women Undergoing Investigations for Infertility

    Directory of Open Access Journals (Sweden)

    Joseph Debattista

    2004-01-01

    asymptomatic women undergoing investigation of infertility were correlated with the outcomes of microbiological screening for Chlamydia trachomatis, Mycoplasma pneumoniae, Mycoplasma hominis, ureaplasma species, Neisseria gonorrhoeae, Neisseria meningitidis and Chlamydia pneumoniae.

  17. Self-esteem, Self-efficacy, and Appearance Assessment of Young Female Patients Undergoing Facial Cosmetic Surgery: A Comparative Study of the Chinese Population.

    Science.gov (United States)

    Yin, Zhuming; Wang, Dafang; Ma, Yan; Hao, Shuwei; Ren, Huiwen; Zhang, Tingting; Chen, Wenlin; Fan, Jincai

    2016-01-01

    The psychological traits of cosmetic surgery patients (CSP) are important for selecting patients and postoperative patient satisfaction. A patient's self-esteem, self-efficacy, and self-assessment affect his or her motivation for cosmetic surgery, but the association among these traits remains unclear, especially in the Asian population. To clarify the association of a patient's psychological traits, decision to undergo cosmetic surgery, and the effectiveness of facial cosmetic surgery on the psychological conditions of young, female Chinese patients. Three different groups of young women (aged 18-30 years) from the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and 7 universities were enrolled from January 1, 2012, through December 31, 2014: CSPs (n = 161), general population controls (GPCs) (n = 355), and facial appearance raters (FARs) (n = 268). The last date of follow-up was January 20, 2015. Patient data from questionnaires were obtained preoperatively and 6 months postoperatively, and the data from the control groups were obtained immediately after enrollment. Front-view facial images of the study participants were taken and then shown to independent raters to assess the participants' facial appearances on a rating scale. Evaluation of self-esteem and self-efficacy, subjective and objective assessment of facial appearance, and structural equation models. A total of 163 CSPs and 387 GPCs were recruited for the study, and complete and valid data were obtained from 161 CSPs and 355 GPCs. All responses from the 268 FARs met the criteria for subsequent analysis. Of the questionnaires issued to the CSPs 6 months postoperatively, 126 valid responses were returned (response rate, 78.3%). Self-esteem and self-efficacy decreased significantly in preoperative patients compared with controls (P self-esteem and 21.50 [2.40] for CSPs and 28.59 [4.23] for GPCs for self-efficacy) and were found to be at nearly normal levels 6 months postoperatively (mean [SD

  18. Acetabular Wall Indices Help to Distinguish Acetabular Coverage in Asymptomatic Adults With Varying Morphologies.

    Science.gov (United States)

    Anderson, Lucas A; Anderson, Mike B; Erickson, Jill A; Chrastil, Jesse; Peters, Christopher L

    2017-04-01

    The anterior wall index (AWI) and posterior wall index (PWI) have been proposed to quantify anterior and posterior acetabular coverage using AP pelvic radiographs. However, these indices have only been reported in symptomatic patients with apparent pathomorphologies (dysplasia, overcoverage, and retroversion) undergoing osteochondroplasty or reorientation osteotomy. (1) What are the ranges for AWI and PWI from measurements obtained on AP pelvic radiographs of asymptomatic senior athletes with well-functioning hips? (2) Is there a difference between the AWI and PWI in asymptomatic athletes with acetabular morphology consistent with acetabular dysplasia, overcoverage, and retroversion when compared with asymptomatic hips that do not meet the radiographic definitions for those morphologies (controls)? Five hundred five athletes (998 asymptomatic native hips) were independently evaluated by two readers on AP pelvic radiographs for AWI and the PWI after excluding hips with prior surgery, inadequate radiographs, or poor function (modified Harris hip score  38°. The mean age of the athletes was 67 years (range, 50-91 years) and 55% were men. Linear generalized estimating equation regression was used to compare each individual diagnosis (DDH, retroversion, overcoverage) with the controls for both AWI and PWI adjusting for age and sex. The mean AWI in the study population was 0.36 (range, -0.02 to 0.91). The mean PWI was 1.13 (range, 0.12-1.74). The mean AWI and PWI in controls (n = 740) was 0.35 (range, -0.02 to 0.91) and 1.13 (range, 0.64-1.70), respectively. There were 25 (3%) with DDH in whom the mean AWI was 0.26 (range, 0.05-0.5) and the mean PWI was 1.03 (range, 0.71-1.3). There were 112 (11%) retroverted hips in whom the mean AWI was 0.42 (range, 0.1-0.89) and PWI was 1.02 (range, 0.61-1.5). There were 121 (12%) overcovered hips in whom the mean AWI was 0.43 (range, -0.18 to 0.85) and PWI was 1.22 (0.12-1.74). The AWI in the control hips was no different than

  19. The international normalized ratio (INR as seen in a population of patients with atrial fibrillation and cerebral infarction undergoing long-term treatment with vitamin K antagonists

    Directory of Open Access Journals (Sweden)

    Szczepańska-Szerej Anna

    2015-12-01

    Full Text Available It is estimated that nearly 20% of all cerebral infarctions in the total population are the result of a complication of atrial fibrillation (AF. While oral anticoagulation with vitamin K antagonists (AVKs substantially reduces this risk, this requires regular monitoring of the international normalized ratio (INR in order to achieve therapeutic levels (2,0-3,0. The aim of this study was to evaluate a group at high risk of cerebral infarction, among patients with AF undergoing long-term treatment with VKAs, taking into account the significance of therapeutic INR values. The analysed group consisted of 90 acute ischaemic stroke patients with paroxysmal or chronic “non-valvular” AF, receiving treatment with VKAs. As a result of the study, therapeutic INR values (≥ 2 were seen in thirty-five of these individuals (38,8%, while 55 (61,2% showed non-therapeutic INR values. Moreover, there were no differences in demographics, vascular risk factors, biochemical and morphological blood parameters, mean CHA2DS2-VASc score and TOAST classification between either of the two groups. Furthermore, no additional factor that would increase their risk of cerebral infarction during the adequate treatment with VKAs was found. However, patients with non-therapeutic INR values had a statistically significantly higher frequency of concomitant moderate pathology of the bicuspid valve, p<0.05. Hence, a lack of proper control of INR can proved to be particularly dangerous for this subgroup of patients. Hence, this is a group with an elevated risk of cerebral infarction and therefore requires special oversight of VKA treatment or NOA treatment.

  20. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Asymptomatic Proteinuria and Hematuria in School Going Children

    Directory of Open Access Journals (Sweden)

    Vijaya M. Sorangavi

    2013-01-01

    Full Text Available Background: This study was undertaken because many cases of asymptomatic proteinuria and hematuria are present in school children.Aims and Objectives:The study was under taken to evaluate asymptomatic proteinuria and hematuria in 100 school children of both sexes from 6 to 15 years of age. Material and Methods: Samples were collected randomly from students of different classes at the Government Kannada Primary School, K H B Colony,Bijapur, Karnataka (India. The midstream urine sample was collected in a clean wide mouth jar,examined by dipsticks for proteinuria and hematuria by microscopy. Results:We found that asymptomatic proteinuria and hematuria was more prevalent amongst the children between 10 to 13 years of age group with female predominance i.e.16% proteinuria and 5% of microscopic hematuria respectively. Conclusion:By this study we conclude that it would be possible to screen a large population of children for asymptomatic proteinuria and hematuria at a relatively low cost.

  2. Human giardiasis in Serbia: asymptomatic vs symptomatic infection*

    Science.gov (United States)

    Nikolić, A.; Klun, I.; Bobić, B.; Ivović, V.; Vujanić, M.; Živković, T.; Djurković-Djaković, O.

    2011-01-01

    Despite the public health importance of giardiasis in all of Europe, reliable data on the incidence and prevalence in Western Balkan Countries (Serbia, Bosnia and Herzegovina, Croatia, Montenegro and FYR Macedonia) are scarce, and the relative contribution of waterborne and food-borne, or person-to-person and/or animalto- person, transmission of human giardiasis is not yet clear. To provide baseline data for the estimation of the public health risk caused by Giardia, we here review the information available on the epidemiological characteristics of asymptomatic and symptomatic human infection in Serbia. Although asymptomatic cases of Giardia represent a major proportion of the total cases of infection, high rates of Giardia infection were found in both asymptomatic and symptomatic populations. No waterborne outbreaks of giardiasis have been reported, and it thus seems that giardiasis mostly occurs sporadically in our milieu. Under such circumstances, control measures to reduce the high prevalence of giardiasis in Serbia have focused on person-to-person transmission, encouraging proper hygiene, but for more targeted intervention measures, studies to identify other risk factors for asymptomatic and symptomatic infections are needed. PMID:21678797

  3. Epidemiological Study Of Asymptomatic Bacteriuria Among Nursery ...

    African Journals Online (AJOL)

    This study was undertaken to determine the prevalence of asymptomatic bateriuria in preschool children of different age and sex groups and to isolate the organisms responsible for asymptomatic bacteriuria and determine their antimicrobial susceptibility pattern. A total of 475 children from 17 nurseries in Ahvaz city, Iran ...

  4. Asymptomatic Wolff-Parkinson-White Pattern ECG in USAF Aviators.

    Science.gov (United States)

    Davenport, Eddie D; Rupp, Karen A N; Palileo, Edwin; Haynes, Jared

    2017-01-01

    Wolff-Parkinson-White (WPW) pattern is occasionally found in asymptomatic aviators during routine ECGs. Aeromedical concerns regarding WPW pattern include risk of dysrhythmia or sudden cardiac death (SCD), thus affecting the safety of flight. The purpose of this study was to determine the prevalence and outcomes of aviators with asymptomatic WPW pattern and assess for risk factors that contribute to progression to dysrhythmia or symptoms. The U.S. Air Force (USAF) ECG library database containing over 1.2 million ECGs collected over the past 68 yr was used to identify 638 individual aviators with WPW pattern. Demographic, medical history, and outcome data were obtained by medical record review. Aviators who developed high risk features defined as symptoms, arrhythmia, or ablation of a high risk pathway, were compared to those who remained asymptomatic. Prevalence of WPW pattern was 0.30% among all USAF aviators. Of the 638 individuals, 64 (10%) progressed to the combined endpoint of SCD, arrhythmia, and/or ablation of a high risk pathway over 6868 patient years, with average follow-up of 10.5 yr. There were two sudden cardiac deaths (0.3%). Annual risk of possible sudden incapacitation was 0.95% and of SCD 0.03%. Those that progressed to high risk were significantly younger, had lower diastolic blood pressure, lower total cholesterol, and better physical fitness testing scores. WPW pattern on ECG found in asymptomatic aviators confers fit populations.Davenport ED, Rupp KAN, Palileo E, Haynes J. Asymptomatic Wolff-Parkinson-White pattern ECG in USAF aviators. Aerosp Med Hum Perform. 2017; 88(1):56-60.

  5. Postepizootic Persistence of Asymptomatic Mycoplasma conjunctivae Infection in Iberian Ibex

    Science.gov (United States)

    Cabezón, Oscar; Granados, José Enrique; Frey, Joachim; Serrano, Emmanuel; Velarde, Roser; Cano-Manuel, Francisco Javier; Mentaberre, Gregorio; Ráez-Bravo, Arián; Fandos, Paulino

    2017-01-01

    ABSTRACT The susceptibility of the Iberian ibex (Capra pyrenaica) to Mycoplasma conjunctivae ocular infection and the changes in their interaction over time were studied in terms of clinical outcome, molecular detection, and IgG immune response in a captive population that underwent a severe infectious keratoconjunctivitis (IKC) outbreak. Mycoplasma conjunctivae was detected in the Iberian ibex, coinciding with the IKC outbreak. Its prevalence had a decreasing trend in 2013 that was consistent with the clinical resolution (August, 35.4%; September, 8.7%; November, 4.3%). Infections without clinical outcome were, however, still detected in the last handling in November. Sequencing and cluster analyses of the M. conjunctivae strains found 1 year later in the ibex population confirmed the persistence of the same strain lineage that caused the IKC outbreak but with a high prevalence (75.3%) of mostly asymptomatic infections and with lower DNA load of M. conjunctivae in the eyes (mean quantitative PCR [qPCR] cycle threshold [CT], 36.1 versus 20.3 in severe IKC). Significant age-related differences of M. conjunctivae prevalence were observed only under IKC epizootic conditions. No substantial effect of systemic IgG on M. conjunctivae DNA in the eye was evidenced with a linear mixed-models selection, which indicated that systemic IgG does not necessarily drive the resolution of M. conjunctivae infection and does not explain the epidemiological changes observed. The results show how both epidemiological scenarios, i.e., severe IKC outbreak and mostly asymptomatic infections, can consecutively occur by entailing mycoplasma persistence. IMPORTANCE Mycoplasma infections are reported in a wide range of epidemiological scenarios that involve severe disease to asymptomatic infections. This study allows a better understanding of the transition between two different Mycoplasma conjunctivae epidemiological scenarios described in wild host populations and highlights the ability of M

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

    Directory of Open Access Journals (Sweden)

    Gabriel G Perron

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

  7. Asymptomatic carriers contribute to nosocomial Clostridium difficile infection

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects...... of of asymptomatic carriers on nosocomial C difficile infections. METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results...... were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission. RESULTS: C difficile...

  8. Depressive symptoms and spiritual wellbeing in asymptomatic heart failure patients.

    Science.gov (United States)

    Mills, Paul J; Wilson, Kathleen; Iqbal, Navaid; Iqbal, Fatima; Alvarez, Milagros; Pung, Meredith A; Wachmann, Katherine; Rutledge, Thomas; Maglione, Jeanne; Zisook, Sid; Dimsdale, Joel E; Lunde, Ottar; Greenberg, Barry H; Maisel, Alan; Raisinghani, Ajit; Natarajan, Loki; Jain, Shamini; Hufford, David J; Redwine, Laura

    2015-06-01

    Depression adversely predicts prognosis in individuals with symptomatic heart failure. In some clinical populations, spiritual wellness is considered to be a protective factor against depressive symptoms. This study examined associations among depressive symptoms, spiritual wellbeing, sleep, fatigue, functional capacity, and inflammatory biomarkers in 132 men and women with asymptomatic stage B heart failure (age 66.5 years ± 10.5). Approximately 32 % of the patients scored ≥10 on the Beck Depression Inventory, indicating potentially clinically relevant depressive symptoms. Multiple regression analysis predicting fewer depressive symptoms included the following significant variables: a lower inflammatory score comprised of disease-relevant biomarkers (p meaning (p peace (p meaning and peace, may be a potential treatment target for depressive symptoms asymptomatic heart failure.

  9. Asymptomatic deer excrete infectious prions in faeces.

    Science.gov (United States)

    Tamgüney, Gültekin; Miller, Michael W; Wolfe, Lisa L; Sirochman, Tracey M; Glidden, David V; Palmer, Christina; Lemus, Azucena; DeArmond, Stephen J; Prusiner, Stanley B

    2009-09-24

    Infectious prion diseases-scrapie of sheep and chronic wasting disease (CWD) of several species in the deer family-are transmitted naturally within affected host populations. Although several possible sources of contagion have been identified in excretions and secretions from symptomatic animals, the biological importance of these sources in sustaining epidemics remains unclear. Here we show that asymptomatic CWD-infected mule deer (Odocoileus hemionus) excrete CWD prions in their faeces long before they develop clinical signs of prion disease. Intracerebral inoculation of irradiated deer faeces into transgenic mice overexpressing cervid prion protein (PrP) revealed infectivity in 14 of 15 faecal samples collected from five deer at 7-11 months before the onset of neurological disease. Although prion concentrations in deer faeces were considerably lower than in brain tissue from the same deer collected at the end of the disease, the estimated total infectious dose excreted in faeces by an infected deer over the disease course may approximate the total contained in a brain. Prolonged faecal prion excretion by infected deer provides a plausible natural mechanism that might explain the high incidence and efficient horizontal transmission of CWD within deer herds, as well as prion transmission among other susceptible cervids.

  10. Asymptomatic deer excrete infectious prions in feces

    Science.gov (United States)

    Tamgüney, Gültekin; Miller, Michael W.; Wolfe, Lisa L.; Sirochman, Tracey M.; Glidden, David V.; Palmer, Christina; Lemus, Azucena; DeArmond, Stephen J.; Prusiner, Stanley B.

    2011-01-01

    Infectious prion diseases 1 – scrapie of sheep 2 and chronic wasting disease (CWD) of several species in the deer family 3,4 – are transmitted naturally within affected host populations. Although several possible sources of contagion have been identified in excretions and secretions from symptomatic animals 5–8, the biological importance of these sources in sustaining epidemics remains unclear. Here we show that asymptomatic CWD-infected mule deer (Odocoileus hemionus) excrete CWD prions in their feces long before they develop clinical signs of prion disease. Intracerebral (i.c.) inoculation of irradiated deer feces into transgenic (Tg) mice overexpressing cervid PrP revealed infectivity in 14 of 15 fecal samples collected from 5 deer at 7–11 months before the onset of neurological disease. Although prion concentrations in deer feces were considerably lower than in brain tissue from the same deer collected at the disease terminus, the estimated total infectious dose excreted in feces by an infected deer over the disease course may approximate the total contained in brain tissue. Prolonged fecal prion excretion by infected deer provides a plausible natural mechanism that might explain the high incidence and efficient horizontal transmission of CWD within deer herds 3,4,9, as well as prion transmission between susceptible deer species. PMID:19741608

  11. Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

    Reyes, David; Locke, James

    2016-01-01

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

  12. [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. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Accurate Risk Assessment of Patients with Asymptomatic Hematuria for the Presence of Bladder Cancer

    Science.gov (United States)

    Cha, Eugene K.; Tirsar, Lenuta-Ancuta; Schwentner, Christian; Hennenlotter, Joerg; Christos, Paul J.; Stenzl, Arnulf; Mian, Christine; Martini, Thomas; Pycha, Armin; Shariat, Shahrokh F.; Schmitz-Dräger, Bernd J.

    2014-01-01

    Purpose Bladder cancer is frequently diagnosed during a workup for hematuria. However, most patients with microscopic hematuria and many with gross hematuria are not appropriately referred to urologists. We hypothesized that in patients presenting with asymptomatic hematuria, the risk of having bladder cancer can be predicted with high accuracy. Towards this end, we analyzed risk factors in patients with asymptomatic hematuria and developed a nomogram for the prediction of bladder cancer presence. Methods Data from 1,182 consecutive subjects without a history of bladder cancer undergoing initial evaluation for asymptomatic hematuria were collected at three centers. Clinical risk factors including age, gender, smoking status, and degree of hematuria were recorded. All subjects underwent standard workup including voided cytology, upper tract imaging, and cystourethroscopy. Factors associated with the presence of bladder cancer were evaluated by univariable and multivariable logistic regression analyses. The multivariable analysis was used to construct a nomogram. Internal validation was performed using 200 bootstrap samples. Results Of the 1,182 subjects who presented with asymptomatic hematuria, 245 (20.7%) had bladder cancer. Increasing age (OR=1.03, phematuria (OR=1.71, p=0.002), and positive cytology (OR=14.71, phematuria. We developed a nomogram to help optimize referral patterns (i.e., timing and prioritization) of patients with asymptomatic hematuria. PMID:23124847

  14. Asymptomatic Cholecystocolonic Fistula: A Diagnostic and Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Nicola Antonacci

    2013-01-01

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

  15. Visual outcomes of age-related macular degeneration patients undergoing intravitreal ranibizumab monotherapy in an urban population: letter to the editor

    Directory of Open Access Journals (Sweden)

    Stewart MW

    2015-09-01

    Full Text Available Michael W Stewart Department of Ophthalmology, Mayo Clinic Florida, Jacksonville, FL, USA In their recently published manuscript entitled “Visual outcomes of age-related macular degeneration patients undergoing intravitreal ranibizumab monotherapy in an urban population” Basheer et al1 reported on the prospectively acquired results of 123 eyes (106 patients treated for 2 years with ranibizumab as needed. Visual acuity (VA outcomes from this series were summarized by the following statement: “Although our results, and those from other clinical settings, do not quite match the degree of vision preservation and gain as the large clinical trials, they are not dramatically dissimilar”.1 Unfortunately, the authors provide no statistical analysis to support this statement.View original paper by Basheer and colleagues.

  16. Analysis of Global Sagittal Postural Patterns in Asymptomatic Chinese Adults.

    Science.gov (United States)

    Hu, Panpan; Yu, Miao; Sun, Zhuoran; Li, Weishi; Jiang, Liang; Wei, Feng; Liu, Xiaoguang; Chen, Zhongqiang; Liu, Zhongjun

    2016-04-01

    A prospective imaging study. To characterize the distribution of the global sagittal postural patterns in asymptomatic Chinese adults using Roussouly classification. The norms of sagittal parameters in asymptomatic Chinese population have been previously described, but no report described their global sagittal postural patterns as characterized by Roussouly classification. A cohort of 272 asymptomatic Chinese adults was recruited. Data was assimilated by reviewing the films for each subject. Sagittal parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. The pattern distributions were compared across genders within the study cohort. We also compared the data across different ethnicities from our study and a previous study to further characterize Chinese sagittal postures. The cohort included 161 males and 111 females, with mean age of 23.2±4.4 years. The average descriptive results were as below: pelvic incidence (PI) 46.4°±9.6°, thoracic kyphosis (TK) 24.2°±9.0°, lumbar lordosis (LL) 50.6°±10.6°, sacral slope (SS) 37.2°±7.6°, pelvic tilt (PT) 9.4°±6.8°, spinosacral angle (SSA) 131.1°±7.5° and sagittal vertical axis (SVA) 17.24±32.36 mm. Despite a significant difference between two genders in LL, PI, SSA, and SVA, no difference was found in the distribution of Roussouly types among them. 47.8% of our cohort belonged to Roussouly type 3, while type 1, 2 and 4 comprised 23.2%, 14.0% and 15.1% of the subjects, respectively. Roussouly classification was capable of categorizing sagittal parameters except for the PT. This study also found that 4.4% of the recruited subjects belonged to the C7-anterior subgroup. From a characterization of the sagittal postural patterns of asymptomatic Chinese adults using Roussouly classification, the distribution was similar between Chinese males and females; however, from a cross-study comparison, it was different between asymptomatic Chinese and Caucasian

  17. Impact of Beta-Blocker Initiation Timing on Mortality Risk in Patients With Diabetes Mellitus Undergoing Noncardiac Surgery: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Chen, Ray-Jade; Chu, Hsi; Tsai, Lung-Wen

    2017-01-10

    Relevant clinical studies have been small and have not convincingly demonstrated whether the perioperative initiation of beta-blockers should be considered in patients with diabetes mellitus undergoing noncardiac surgery. In this nationwide propensity score-matched study, we included patients with diabetes mellitus undergoing noncardiac surgery between 2000 and 2011 from Taiwan's National Health Insurance Research Database. Patients were classified as beta-blocker and non-beta-blocker cohorts. We further stratified beta-blocker users into cardioprotective beta-blocker (atenolol, bisoprolol, metoprolol, or carvedilol) and other beta-blocker users. To investigate time of initiation of beta-blocker use, initiation time was stratified into 2 periods (>30 and ≤30 days preoperatively). The outcomes of interest were in-hospital and 30-day mortality. After propensity score matching, we identified 50 952 beta-blocker users and 50 952 matched controls. Compared with non-beta-blocker users, cardioprotective beta-blocker users were associated with lower risks of in-hospital (odds ratio 0.75, 95% CI 0.68-0.82) and 30-day (odds ratio 0.75, 95% CI 0.70-0.81) mortality. Among initiation times, only the use of cardioprotective beta-blockers for >30 days was associated with decreased risk of in-hospital (odds ratio 0.72, 95% CI 0.65-0.78) and 30-day (odds ratio 0.72, 95% CI 0.66-0.78) mortality. Of note, use of other beta-blockers for ≤30 days before surgery was associated with increased risk of both in-hospital and 30-day mortality. The use of cardioprotective beta-blockers for >30 days before surgery was associated with reduced mortality risk, whereas short-term use of beta-blockers was not associated with differences in mortality in patients with diabetes mellitus. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. Carcinoid Tumor in Accidental, Asymptomatic Meckel's Diverticulum ...

    African Journals Online (AJOL)

    Although Meckel's diverticulum is the most common congenital gastrointestinal disorder, it is controversial whether asymptomatic diverticula in adults should be respected. The authors report the case of a patient who was operated due to ileus caused by adhesions and a Meckel's diverticulum without any sign of ...

  19. Microbial aetiology and sensitivity of asymptomatic bacteriuria ...

    African Journals Online (AJOL)

    Results: Twenty nine (13.3%) of the samples had significant bacterial growth and E.coli was the commonest isolate (51.2%). There was a high level (20- 62%) of anti-bacterial resistance to the commonly used antibiotics. Conclusion: Asymptomatic bacteriuria is common among ante-natal mothers in Mulago. E. Coli that is ...

  20. Prevalence of Asymptomatic Genital Infection among Pregnant ...

    African Journals Online (AJOL)

    All the isolates except Streptococcus faecalis were resistant to ampicillin. These results show a high rate of asymptomatic genital tract infections among pregnant women in Benin City, which have implications for adverse maternal and neonatal outcomes. (Afr J Reprod Health 2002; 6[3]: 93-97) Résumé Prévalence de ...

  1. Detecting asymptomatic coronary artery disease using routine ...

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... ECG-monitored exercise testing has been proposed as a relatively inexpensive and effective means of screening for asymptomatic coronary artery disease in patients presenting for peripheral vascular surgery. Despite the fact that exercise thallium scintigraphy is also dependent on the patient's ability.

  2. Detecting asymptomatic coronary artery disease using routine ...

    African Journals Online (AJOL)

    ECG-monitored exercise testing has been proposed as a relatively inexpensive and effective means of screening for asymptomatic coronary artery disease in patients presenting for peripheral vascular surgery. Despite the fact that exercise thallium scintigraphy is also dependent on the patient's ability to exercise, using this ...

  3. Prevalence of malaria parasitaemia amongst asymptomatic ...

    African Journals Online (AJOL)

    Statistical analysis was done using IBM-SPSS Windows version 20. Results: The mean age of study participants was 26.7 ± 5.1 years and the age range was 17- 42 years. The prevalence of asymptomatic malaria parasitaemia was 49.6%. Nulliparity and anaemia (PCV <30%) were associated with increased prevalence of ...

  4. Asymptomatic Bacteriuria in pregnant women attending antenatal ...

    African Journals Online (AJOL)

    The susceptibility rate of bacterial isolate was highest for levofloxacin (83.6%), followed by nalidixic acid (64.2%) and nitrofurantoin (62.7%). The pathogens were least susceptible to co-trimoxazole (8.3%), ampilcillin (8.8%) and amoxicillin (10.4%) Conclusion: The prevalence of asymptomatic bacteria among the pregnant ...

  5. Tetanus toxoid antibody level in asymptomatic Plasmodium ...

    African Journals Online (AJOL)

    The present study was designed to investigate if the presence of asymptomatic malaria parasiteamia in pregnant women will compromise their ability to respond to full dose of tetanus toxoid immunization during their antenatal clinic visits. Hence, 90 apparently healthy pregnant women who had completed the tetanus toxoid ...

  6. Asymptomatic Bacteriuria among Pregnant Women Attending ...

    African Journals Online (AJOL)

    The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective ...

  7. 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...

  8. Asymptomatic Bacteriuria in HIV Positive Nigerian Children ...

    African Journals Online (AJOL)

    This study was carried out to determine the prevalence of asymptomatic bacteriuria in HIV positive children and to identify the causative organisms. We studied 155 Human Immunodeficiency Virus (HIV) infected children aged 10 months to 17 years attending the Paediatric HIV clinics of the University of Benin Teaching ...

  9. Prevalence and Parasite Density of Asymptomatic Malaria ...

    African Journals Online (AJOL)

    Background: Malaria in pregnancy has contributed significantly to maternal morbidity and mortality in our environment. Aim: This study was aimed at determining the prevalence, and parasite density of asymptomatic malaria parasitemia among unbooked paturients at Federal Teaching Hospital Abakaliki. Subjects and ...

  10. asymptomatic bacteriuria in hiv positive nigerian children

    African Journals Online (AJOL)

    FinePrint

    children with sickle cell anemia in steady state, overall prevalence of asymptomatic bacteriuria in children aged 2 ... continued depletion of CD4 cells. This immune deficient state predisposes to a wide variety of infections, ... DNA PCR in the children younger than. 18months and by serology for children older than 18 months.

  11. Prevalence and Parasite Density of Asymptomatic Malaria ...

    African Journals Online (AJOL)

    effective use of insecticide treated nets and intermittent prophylaxis therapy for malaria during pregnancy. KEY WORDS: Asymptomatic malaria parasitemia, Nigeria, prevalence, unbooked paturients. INTRODUCTION. Malaria is a parasitic disease of humans especially in the sub‑Saharan Africa, where about 90% of deaths ...

  12. Asymptomatic cervical spine fractures: Current guidelines can fail older patients.

    Science.gov (United States)

    Healey, Christopher D; Spilman, Sarah K; King, Bradley D; Sherrill, Joseph E; Pelaez, Carlos A

    2017-07-01

    Older adults represent a growing proportion of trauma patients treated in the United States, and cervical spine (c-spine) fracture is an injury that is increasingly common in this population. Neck pain is a major component of current clinical clearance guidelines, but some older adults with c-spine fractures report no neck pain after injury. The objective of this study was to investigate the frequency at which c-spine fractures were unassociated with neck pain in an aging population. A retrospective review was performed for patients 55 years or older with a c-spine fracture during a 4-year study period. All patients had a Glasgow Coma Scale score of 15 and were considered asymptomatic if they did not complain of neck pain on initial presentation, denied tenderness to palpation of the c-spine on examination, and were without neurologic deficit. Differences between groups were assessed with Kruskal-Wallis and χ tests. Of 173 patients with c-spine fractures, 36 (21%) were asymptomatic and reported no neck pain on presentation or on examination. The group without neck pain had higher median injury severity scores (15 vs 10; p guidelines, denial of pain may lead to missed injury. We recommend liberal c-spine imaging for older trauma patients with significant mechanism of trauma. Therapeutic study, level III.

  13. Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Karp Kjell

    2011-07-01

    Full Text Available Abstract Background Directed ultrasonic screening for carotid stenosis is cost-effective in populations with > 5% prevalence of the diagnosis. Occasionally, calcifications in the area of the carotid arteries are incidentally detected on odontological panoramic radiographs. We aimed to determine if directed screening for carotid stenosis with ultrasound is indicated in individuals with such calcifications. Methods This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy. Results Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5% had a carotid stenosis - not significant over the 5% pre-specified threshold (p = 0.232, Binomial test. However, there was a significant sex difference (p = 0.008, as all stenoses were found in men. Among men, 12.5% (95%CI 4.2-20.8% had carotid stenosis - significantly over the 5% pre-specified threshold (p = 0.014, Binomial test. Conclusions The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy. Trial Registration The study was registered at http://www.clinicaltrials.gov; NCT00514644

  14. Left Atrial Systolic Force in Asymptomatic Aortic Stenosis

    DEFF Research Database (Denmark)

    Cioffi, Giovanni; Cramariuc, Dana; Dalsgaard, Morten

    2011-01-01

    in aortic stenosis study evaluating the effect of placebo-controlled combined simvastatin and ezetimibe treatment in asymptomatic AS. The LASF was calculated by Manning's method. Low and high LASF were defined as 95th percentile of the distribution within the study population, respectively. Results: Mean...... 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 ....01). High LASF (78 patients) was characterized by abnormal LV relaxation in 90% of the cases. Low LASF (82 patients) was associated with restrictive LV filling pattern, absence of abnormal relaxation pattern, smaller maximal LA volume, and lower body mass index. In 40% of the patients with low LASF...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

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

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

    Directory of Open Access Journals (Sweden)

    Sylvia Regina Temer Cursino

    2010-01-01

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

  18. Detection of an autoreactive T-cell population within the polyclonal repertoire that undergoes distinct autoimmune regulator (Aire)-mediated selection.

    Science.gov (United States)

    Taniguchi, Ruth T; DeVoss, Jason J; Moon, James J; Sidney, John; Sette, Alessandro; Jenkins, Marc K; Anderson, Mark S

    2012-05-15

    The autoimmune regulator (Aire) plays a critical role in central tolerance by promoting the display of tissue-specific antigens in the thymus. To study the influence of Aire on thymic selection in a physiological setting, we used tetramer reagents to detect autoreactive T cells specific for the Aire-dependent tissue-specific antigen interphotoreceptor retinoid-binding protein (IRBP), in the polyclonal repertoire. Two class II tetramer reagents were designed to identify T cells specific for two different peptide epitopes of IRBP. Analyses of the polyclonal T-cell repertoire showed a high frequency of activated T cells specific for both IRBP tetramers in Aire(-/-) mice, but not in Aire(+/+) mice. Surprisingly, although one tetramer-binding T-cell population was efficiently deleted in the thymus in an Aire-dependent manner, the second tetramer-binding population was not deleted and could be detected in both the Aire(-/-) and Aire(+/+) T-cell repertoires. We found that Aire-dependent thymic deletion of IRBP-specific T cells relies on intercellular transfer of IRBP between thymic stroma and bone marrow-derived antigen-presenting cells. Furthermore, our data suggest that Aire-mediated deletion relies not only on thymic expression of IRBP, but also on proper antigen processing and presentation of IRBP by thymic antigen-presenting cells.

  19. [Predictive tools of preterm birth in asymptomatic high-risk pregnancy].

    Science.gov (United States)

    Blanc, J; Bretelle, F

    2016-12-01

    Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3). The literature data are insufficient to recommend systematic cervical examination at each prenatal visit in asymptomatic high-risk pregnancy (multiple pregnancy, uterine malformations, history of spontaneous preterm birth, excisional cervical procedure or at least two voluntary first trimester abortion) (professional consensus). Regular recording of uterine activity and home visits for asymptomatic high-risk pregnancy did not predict nor reduce the risk of preterm birth (LE2) and are not recommended (grade B). In asymptomatic high-risk pregnancy, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). Shorter is the cervical length higher is the risk of preterm birth (LE3). In asymptomatic patient with prior preterm birth, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). The strategy of ultrasound indicated cerclage are discussed in dedicated chapter. The measurement of cervical length by transvaginal ultrasonography in asymptomatic pregnancy with uterine malformation, a history of cervical treatment, at least two voluntary abortions or having a multiple pregnancy would estimate the risk of preterm birth (LE3). A shortening of more than 10% of the cervical length at 3-week interval is associated with an increased risk of preterm birth (LE3). Systematic detection of fetal fibronectin is not recommended in

  20. [Asymptomatic classical hereditary xanthinuria type 1].

    Science.gov (United States)

    Yakubov, Renata; Nir, Vered; Kassem, Eiass; Klein-Kremer, Adi

    2012-06-01

    We report on a girl who was diagnosed with classical hereditary xanthinuria due to an incidental finding of extremely low Levels of uric acid in the blood. The girl is compLetely asymptomatic. Hereditary xanthinuria is a rare autosomal recessive disease that usually causes early urolithiasis but may cause rheumatoid arthritis-like disease and even be associated with defects in the formation of bone, hair and teeth. In Israel it has mostly been described in patients of Bedouin origin. Throughout the world, only about 150 cases have been described; about two thirds of these patients were asymptomatic. Since the clinical presentation and age of symptom appearance are diverse, the case raises questions as to the required follow-up of these patients and as to whether a low oxalate diet should be initiated.

  1. 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.

  2. Metformin-Associated Lactic Acidosis Undergoing Renal Replacement Therapy in Intensive Care Units: A Five-Million Population-Based Study in the North-West of Italy.

    Science.gov (United States)

    Mariano, Filippo; Pozzato, Marco; Inguaggiato, Paola; Guarena, Cesare; Turello, Ernesto; Manes, Massimo; David, Paola; Berutti, Silvia; Consiglio, Valentina; Amore, Alessandro; Campo, Andrea; Marino, Angela; Berto, Mauro; Carpani, Paola; Calabrese, Giovanni; Gherzi, Maurizio; Stramignoni, Emanuele; Martina, Guido; Serra, Andrea; Comune, Luciano; Roscini, Elisabetta; Marciello, Antonio; Todini, Vincenzo; Vio, Patrizia; Filiberti, Oliviero; Boero, Roberto; Cantaluppi, Vincenzo

    2017-07-01

    Metformin-associated lactic acidosis (MALA) is a severe complication of drug administration with significant morbidity and mortality. So far no study in large population areas have examined the incidence, clinical profile and outcome of acute kidney injury (AKI)-MALA patients admitted in intensive care units (ICUs) and treated by renal replacement therapy (MALA-RRT). Retrospective analysis over a 6-year period (2010-2015) in Piedmont and Aosta Valley regions (5,305,940 inhabitants, 141,174 diabetics treated with metformin) of all MALA-RRT cases. One hundred and seventeen cases of AKI-MALA-RRT were observed (12.04/100,000 metformin treated diabetics, 1.45% of all RRT-ICU patients). Survival rate was 78.3%. The average duration of RRT was 4.0 days at mean dialysis effluent of 977 mL/kg/day. At admission most patients were dehydrated, and experienced shock and oliguria. Our data showed that MALA-RRT is a common complication, needing more prevention. Adopted policy of early, extended, continuous and high efficiency dialysis could contribute to an observed high survival rate. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=471917. © 2017 S. Karger AG, Basel.

  3. Eating habits of a population undergoing a rapid dietary transition: portion sizes of traditional and non-traditional foods and beverages consumed by Inuit adults in Nunavut, Canada.

    Science.gov (United States)

    Sheehy, Tony; Roache, Cindy; Sharma, Sangita

    2013-06-02

    To determine the portion sizes of traditional and non-traditional foods being consumed by Inuit adults in three remote communities in Nunavut, Canada. A cross-sectional study was carried out between June and October, 2008. Trained field workers collected dietary data using a culturally appropriate, validated quantitative food frequency questionnaire (QFFQ) developed specifically for the study population. Caribou, muktuk (whale blubber and skin) and Arctic char (salmon family), were the most commonly consumed traditional foods; mean portion sizes for traditional foods ranged from 10 g for fermented seal fat to 424 g for fried caribou. Fried bannock and white bread were consumed by >85% of participants; mean portion sizes for these foods were 189 g and 70 g, respectively. Sugar-sweetened beverages and energy-dense, nutrient-poor foods were also widely consumed. Mean portion sizes for regular pop and sweetened juices with added sugar were 663 g and 572 g, respectively. Mean portion sizes for potato chips, pilot biscuits, cakes, chocolate and cookies were 59 g, 59 g, 106 g, 59 g, and 46 g, respectively. The present study provides further evidence of the nutrition transition that is occurring among Inuit in the Canadian Arctic. It also highlights a number of foods and beverages that could be targeted in future nutritional intervention programs aimed at obesity and diet-related chronic disease prevention in these and other Inuit communities.

  4. Eating habits of a population undergoing a rapid dietary transition: portion sizes of traditional and non-traditional foods and beverages consumed by Inuit adults in Nunavut, Canada

    Science.gov (United States)

    2013-01-01

    Background To determine the portion sizes of traditional and non-traditional foods being consumed by Inuit adults in three remote communities in Nunavut, Canada. Methods A cross-sectional study was carried out between June and October, 2008. Trained field workers collected dietary data using a culturally appropriate, validated quantitative food frequency questionnaire (QFFQ) developed specifically for the study population. Results Caribou, muktuk (whale blubber and skin) and Arctic char (salmon family), were the most commonly consumed traditional foods; mean portion sizes for traditional foods ranged from 10 g for fermented seal fat to 424 g for fried caribou. Fried bannock and white bread were consumed by >85% of participants; mean portion sizes for these foods were 189 g and 70 g, respectively. Sugar-sweetened beverages and energy-dense, nutrient-poor foods were also widely consumed. Mean portion sizes for regular pop and sweetened juices with added sugar were 663 g and 572 g, respectively. Mean portion sizes for potato chips, pilot biscuits, cakes, chocolate and cookies were 59 g, 59 g, 106 g, 59 g, and 46 g, respectively. Conclusions The present study provides further evidence of the nutrition transition that is occurring among Inuit in the Canadian Arctic. It also highlights a number of foods and beverages that could be targeted in future nutritional intervention programs aimed at obesity and diet-related chronic disease prevention in these and other Inuit communities. PMID:23724920

  5. Asymptomatic carotid plaque and pro-inflammatory genetic profile in the elderly.

    Science.gov (United States)

    Annoni, Giorgio; Annoni, Federico; Arosio, Beatrice; Viazzoli, Chiara; Segato, Elena; Lucchi, Tiziano; Vergani, Carlo

    2009-12-01

    Several indices of subclinical atherosclerosis (ATS), including ultrasound (US) scan of carotid vessels, have received attention in clinical studies of the general population. Since inflammation takes part in the development of ATS, we studied the relationship between US imaging of carotid vessels and genetic predisposition to inflammation, in both elderly subjects without acknowledged CV risk factors and elderly subjects with acknowledged CV risk factors undergoing primary prevention. Seventy-two elderly subjects (aged between 65-84) were divided into three groups on the basis of cardiovascular (CV) risk (G0: 0-9%, G1: 10-20% and G2: >20%) according to the NCEP Adult Panel III Report. They underwent US evaluation of carotid arteries and were analyzed for single nucleotide polymorphisms in the genes of a number of cytokines: TNF-alpha, TGF-beta1, IL-10, IL-6 and IFN-gamma. Asymptomatic carotid plaque (ACP) was detected in 19 subjects, not only in those belonging to the major risk group (36.8%) but also in those at lower risk (63.2%). In these subjects, we found a different genotype distribution in the polymorphisms of IFN-gamma (+874), IL-6 (-174) and IL- 10 (-1082). The TT +874 IFN-gamma and GG -174 IL-6 high producer-genotypes and the AA IL-10 low producergenotype were indeed more frequent in the ACP group (IFN-gamma: p=0.000 and IL-6: p=0.004). We found no correlation between genotype and carotid intima-media thickening. Our data suggest that, in the elderly, inflammation-associated polymorphisms are related to atherogenesis and that the finding of ACP on US scan can be valuable in identifying subjects at risk for CV events, even if they lack traditional cardiovascular risk factors such as an increase in IMT.

  6. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

    Directory of Open Access Journals (Sweden)

    Salini Vincenzo

    2010-12-01

    Full Text Available Abstract Background The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. Methods The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively, who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Results Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p vs 3.2 ± 0.4 mm, p vs 20.3%, p vs 7.8%, p Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8% vs 2 (3.1%, p vs 5 (7.8%, p = ns, but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p vs 10.9%, p In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found. Conclusions Our results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics. Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.

  7. Monitoring compliance to an experimental treatment in an asymptomatic population

    Directory of Open Access Journals (Sweden)

    Durval Rosa Borges

    2008-09-01

    Full Text Available Objective: To develop strategies and to monitor patient’s adherence to the follow up of the experimental treatment of secondary cholestasis in its isolate chronic form with portal hypertension. Methods: Experimental study made with 11 patients. Ursodeoxycholic acid was administered in the dosage of 15 mg/kg/day twice a day for 45 days. Evaluation of adherence was performed using pill count strategy and interviews. Rresults: The variation during pill count had no influence on the patient’s laboratory results. Serum activity of γGT normalized during treatment, returning to increased levels after interruption of medication. Cconclusions: The strategies developed were effective presenting a significant laboratory result regarding the decrease of γGT serum activity.

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

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Falk, Erling

    2011-01-01

    Measurement of ankle-brachial index (ABI) was developed to assess peripheral artery disease (PAD) in patients with symptoms of peripheral ischemia being present at rest or only functionally dependent (intermittent claudication). Reduced ABI is caused by arterial obstruction between the aortic arch...

  9. Screening for thyroid disorders in asymptomatic adults from Brazilian populations

    Directory of Open Access Journals (Sweden)

    Isabela Benseñor

    Full Text Available Advances in thyroid disorder diagnosis have created new thyroid disorder categories such as subclinical hyperthyroidism and subclinical hypothyroidism. In the 1980s, immunometric assaying for thyroid stimulating hormone (TSH emerged and became defined as the most cost-effective test in thyroid disorder screening. The second step in the screening of thyroid disorders is to determine free thyroxine (FT4, and cost-effective methods for its detection are now available. Using TSH and FT4, it is possible to determine four situations: clinical hyperthyroidism, clinical hypothyroidism, subclinical hyperthyroidism and subclinical hypothyroidism. Subclinical hypothyroidism can be a strong indicator of risk for atherosclerosis and myocardial infarction in elderly women. Cardiovascular mortality among Brazilian women is one of the highest in the Western world. The best-known risk factors for cardiovascular diseases are high blood pressure, smoking, diabetes, and hypercholesterolemia. Although these are recognized as primary risk factors, there are other risk factors that could be identified as primordial risk factors. This may be the case for subclinical hypothyroidism. Early detection of thyroid disorders in women over fifty could be a highly cost-effective option in the prevention of cardiovascular disorders among Brazilian women.

  10. Asymptomatic and Submicroscopic Carriage of Plasmodium knowlesi Malaria in Household and Community Members of Clinical Cases in Sabah, Malaysia.

    Science.gov (United States)

    Fornace, Kimberly M; Nuin, Nor Afizah; Betson, Martha; Grigg, Matthew J; William, Timothy; Anstey, Nicholas M; Yeo, Tsin W; Cox, Jonathan; Ying, Lau Tiek; Drakeley, Chris J

    2016-03-01

    Although asymptomatic carriage of human malaria species has been widely reported, the extent of asymptomatic, submicroscopic Plasmodium knowlesi parasitemia is unknown. In this study, samples were obtained from individuals residing in households or villages of symptomatic malaria cases with the aim of detecting submicroscopic P. knowlesi in this population. Four published molecular assays were used to confirm the presence of P. knowlesi. Latent class analysis revealed that the estimated proportion of asymptomatic individuals was 6.9% (95% confidence interval, 5.6%-8.4%). This study confirms the presence of a substantial number of asymptomatic monoinfections across all age groups; further work is needed to estimate prevalence in the wider community. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

  11. Low frequency of asymptomatic carriage of toxigenic Clostridium difficile in an acute care geriatric hospital: prospective cohort study in Switzerland

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    Daniela Pires

    2016-06-01

    Full Text Available Abstract Background The role of asymptomatic carriers of toxigenic Clostridium difficile (TCD in nosocomial cross-transmission remains debatable. Moreover, its relevance in the elderly has been sparsely studied. Objectives To assess asymptomatic TCD carriage in an acute care geriatric population. Methods We performed a prospective cohort study at the 296-bed geriatric hospital of the Geneva University Hospitals. We consecutively recruited all patients admitted to two 15-bed acute-care wards. Patients with C. difficile infection (CDI or diarrhoea at admission were excluded. First bowel movement after admission and every two weeks thereafter were sampled. C. difficile toxin B gene was identified using real-time polymerase chain-reaction (BD MAXTMCdiff. Asymptomatic TCD carriage was defined by the presence of the C. difficile toxin B gene without diarrhoea. Results A total of 102 patients were admitted between March and June 2015. Two patients were excluded. Among the 100 patients included in the study, 63 were hospitalized and 1 had CDI in the previous year, and 36 were exposed to systemic antibiotics within 90 days prior to admission. Overall, 199 stool samples were collected (median 2 per patient, IQR 1-3. Asymptomatic TCD carriage was identified in two patients (2 %. Conclusions We found a low prevalence of asymptomatic TCD carriage in a geriatric population frequently exposed to antibiotics and healthcare. Our findings suggest that asymptomatic TCD carriage might contribute only marginally to nosocomial TCD cross-transmission in our and similar healthcare settings.

  12. Intravenous urography in evaluation of asymptomatic microscopic hematuria.

    Science.gov (United States)

    Dikranian, Armen H; Petitti, Diana B; Shapiro, Charles E; Kosco, Anne F

    2005-06-01

    In 2001, the American Urologic Association Best Practice Policy Panel recommended CT or intravenous urography (IVU) over ultrasonography as the initial imaging modality in patients with asymptomatic microhematuria. We here present results of a study initiated many years ago and completed prior to 2001 that provides information pertinent to the use of IVU as the initial imaging modality for such patients. This study compared the results of IVU and ultrasonography in patients 40+ years of age who were referred to a single urology department for evaluation of microscopic hematuria between 1994 and 2000. There were 290 patients who agreed to participate by undergoing ultrasonography in addition to IVU; 247 completed both tests. There were 81 men and 166 women with a mean age of 56.4 years (range 40-86 years). Thirty patients (12%) were smokers. A renal lesion or mass suggestive of tumor was found in 8 patients (3.2%); 3 patients had this finding on the IVU examination and 5 on ultrasonography. None of the patients had such a lesion/mass on both examinations. Two patients with suspect lesions were ultimately found to have renal-cell carcinoma. Both of the patients with renal cancer had a suspect lesion on the ultrasound examination but not on the contemporaneous IVU. Intravenous urography may miss lesions/masses that lead to a diagnosis of upper-tract neoplasia.

  13. Vitamin B12 deficiency in patients undergoing bariatric surgery: preventive strategies and key recommendations.

    Science.gov (United States)

    Majumder, Shounak; Soriano, Jose; Louie Cruz, Allan; Dasanu, Constantin A

    2013-01-01

    Advances in bariatric surgery have brought about a paradigm shift in the management of obesity, with benefits extending beyond weight loss. However, nutritional deficiencies are an inherent problem in the postoperative period and often require lifelong supplementation. Vitamin B12, also referred to as cobalamin, is one of the most common micronutrient deficiencies affecting this population. This review explores the pathophysiology of cobalamin deficiency in patients undergoing bariatric surgery and provides an overview of the effectiveness of various available vitamin B12 formulations. To identify the relevant literature, a systematic review of MEDLINE was conducted from the earliest dates through September 2012 for English-language articles describing the prevention and management of vitamin B12 deficiency in patients undergoing bariatric surgery. Intramuscular vitamin B12 continues to be the gold standard of therapy for vitamin B12 deficiency, especially in symptomatic patients. In select patients with asymptomatic vitamin B12 deficiency after Roux-en-Y gastric bypass (RYGB), high-dose oral cyanocobalamin should be given a consideration, especially when there are concerns with the adherence to intramuscular therapy or if compliance comes into question. Unlike patients post-RYGB, those undergoing restrictive procedures such as gastric banding and sleeve gastrectomy may be maintained postoperatively on a lower-dose daily vitamin B12 supplementation. Efficacy data of nasal and sublingual routes for maintenance therapy is currently awaited. Patients undergoing bariatric surgery must be continuously educated on proper nutrition, the risk of developing significant vitamin B12 deficiency, and the role of supplements in avoiding catastrophic consequences. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  14. Comparative Study on the Vaginal Flora and Incidence of Asymptomatic Vaginosis among Healthy Women and in Women with Infertility Problems of Reproductive Age.

    Science.gov (United States)

    Babu, Geethavani; Singaravelu, Balamuru Ganvelu; Srikumar, R; Reddy, Sreenivasalu V; Kokan, Afraa

    2017-08-01

    The normal vaginal flora is highly complex, dominated by lactobacilli of doderlein that plays a vital role in maintaining the women's health and inhibits other pathogenic microorganisms. Fluctuation in local environment or exposure to any exogenous and endogenous sources changes the vaginal flora over a period of time. Disruption of the vaginal ecosystem changes the microflora of the healthy vagina, altering the pH and predisposing to lower reproductive tract infections. The change in the microflora of the female genital tract by pathogenic organisms may ascend from vagina to upper genital tract and may cause infertility. Although several studies demonstrate a higher prevalence of bacterial vaginosis in infertile population. The role of vaginal microbiome in infertility is not clear and need to be explored further. To compare the vaginal flora and analyse the incidence of asymptomatic vaginosis among healthy women and in women with infertility problems. A cross-sectional study was conducted over a period of six months at Sri Lakshmi Narayana Medical College and Hospital Puducherry, India. A total of 200 high vaginal swabs were collected from Group 1 which included 84 healthy women with regular menstrual cycles without any gynaecological disorder and from Group 2, 116 women with infertility problems attending fertility clinic within the age group of 18 to 45 years. All swabs were subjected to routine aerobic, anaerobic and fungal culture. Saline wet mount was performed for the detection of clue cells and Trichomonas vaginalis, 10% KOH was performed for demonstration of budding yeast cells and pseudo hyphae, Gram's staining to determine the presence of yeast cells, leucocytes and bacterial morphotypes. The smear was also graded using Nugent scoring system. The vaginal flora of Group 1 was dominated by Lactobacillus (40, 27.8 %) followed by Micrococcus (22, 15.3 %), Enterococcus (16, 11.1%), Coagulase negative Staphylococcus spp. (12, 8.3%). Whereas in Group 2, the

  15. Asymptomatic Central Pontine Myelinolysis: A Case Report

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    Syed Omar Shah

    2012-11-01

    Full Text Available Introduction: Central pontine myelinolysis (CPM is an acquired demyelinating lesion of the basis pontis that typically occurs after rapid correction of hyponatremia. There are only a few reported cases of patients without symptoms that have demonstrated CPM on imaging. Case Presentation: We report the case of a 26-year-old Hispanic male with history of alcohol abuse who was transferred to our medical center for acute onset diffuse abdominal pain. During his work up, a computed tomography scan demonstrated a large pancreatic mass. He underwent an endoscopic guided biopsy which demonstrated a rare and aggressive natural killer T cell lymphoma. His laboratory values were consistent with hyponatremia, which the medical team gently corrected. An MRI was performed for staging purposes which revealed findings consistent with CPM. A full neurological exam demonstrated no deficits. Materials and Methods: We conducted a PubMed search using the following keywords: asymptomatic, central, pontine, and myelinolysis in order to find other case reports of asymptomatic CPM. Results: Of the 29 results, only 6 previous case reports with English language abstracts of asymptomatic CPM were present since 1995. Conclusion: Despite slow correction of hyponatremia, CPM can be an important consequence, especially in patients with chronic alcoholism. Although this patient did not demonstrate any neurological deficits, the fact that there were changes seen on MRI should caution physicians in aggressively treating hyponatremia. Furthermore, if there is a decision to treat, then fluid restriction and reversal of precipitating factors (i.e. diuretics should be used initially, unless there is concern for hypovolemia.

  16. Absence of Asymptomatic Malaria Infection in Endemic Area of Bashagard District, Hormozgan Province, Iran

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    H Khazan

    2012-02-01

    Full Text Available Background: A successful malaria elimination program calls for enough attention to parasite carri­ers, especially asymptomatic malaria, as well as the diagnosis and treatment of clinical cases. Asymptomatic malaria is an infection that patients do not show any symptom; thus, these patients play critical role in the concept of an elimination program. The current investigation was con­ducted to evaluate the presence of these cases in Bashagard District, formerly a high malaria transmis­sion area in Hormozgan Province, Iran.Methods: Blood samples (n=500 were collected from symptomless individuals residing in Basha­gard to evaluate Plasmodium infection by using microscopic, serological and nested-PCR techniques.Results: Regarding the microscopic and nested-PCR analysis, no asymptomatic infection was detected among studied individuals. Totally, 1% of the studied population (5 of 500 had anti PvMSP-119-specific IgG antibody; however, only 0.2% (1 of 500 of the individuals was seroposi­tive to recombinant PfMSP-119, using ELISA.Conclusion: This study showed no asymptomatic malaria infection in the studied population; hence malaria elimination is feasible and can be successfully carried out in this region.

  17. Populism

    OpenAIRE

    Abts, Koenraad; Van Kessel, Stijn

    2015-01-01

    Populism is a concept applied to a wide range of political movements and actors across the globe. There is, at the same time, considerable confusion about the attributes and manifestation of populism, as well as its impact on democracy. This contribution identifies the defining elements of the populist ideology and discusses the varieties in which populism manifests itself, for instance as a component of certain party families. We finally discuss various normative interpretations of populism,...

  18. The asymptomatic teenager with an abnormal electrocardiogram.

    Science.gov (United States)

    Singh, Harinder R

    2014-02-01

    Use of medications for attention-deficit hyperkinetic disorder and preparticipation sports physical examination has led to an increase in number of electrocardiograms (ECG) performed during adolescence. Interpreting ECGs in children and young adults must take into account the evolutionary changes with age and the benign variants, which are usually not associated with heart disease. It is crucial for primary-care providers to recognize the changes on ECG associated with heart disease and risk of sudden death. In this article, the significance, sensitivity, specificity, and the diagnostic workup of these findings in the asymptomatic teenager are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Sports Eligibility After Risk Assessment and Treatment in Children with Asymptomatic Ventricular Pre-excitation.

    Science.gov (United States)

    Di Mambro, Corrado; Drago, F; Milioni, M; Russo, M S; Righi, D; Placidi, S; Remoli, R; Palmieri, R; Gimigliano, F; Santucci, L M; Silvetti, M S; Prosperi, M

    2016-08-01

    Many studies concern the management of young patients with symptomatic Wolff-Parkinson-White (WPW) syndrome, but little information exists on the significance and prognosis of ventricular pre-excitation (VPE) in asymptomatic children. The aim of the study was to evaluate the risk of sudden death in young athletes with asymptomatic VPE by transesophageal electrophysiological study (TEEPS) and their sports eligibility after the risk assessment and/or ablative treatment. Ninety-one asymptomatic children and adolescents underwent TEEPS both at rest and during adrenergic stress (exercise testing or isoproterenol infusion). After electrophysiological testing, patients were assessed in the 36 months of follow-up. Thirty-three patients (36.3 %) had a benign form of VPE and were allowed to participate in competitions. Ten patients (11 %) were at borderline risk; thus, sport eligibility was evaluated individually. Forty-eight patients (52.7 %) showed inducible sustained atrioventricular reentrant tachycardia and/or atrial fibrillation (AF), 11 of whom (12.1 % of total population) had a potential risk of sudden cardiac death due to AF inducibility during physical stress. Forty-five young athletes underwent transcatheter ablation (TCA). TCA was interrupted in 12 patients (26.7 %) because of the high procedural risk linked to septal accessory pathway (AP) location. There were no TCA-related complications, and all patients remained asymptomatic during follow-up. Most of the young athletes with asymptomatic VPE may be allowed to participate in competitive sports after an adequate risk assessment and/or ablative treatment. However, in our opinion, special care should be taken to avoid procedural complications, which are unacceptable in asymptomatic patients.

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

    Science.gov (United States)

    Sun, Kuo-Shao; Lin, Ming-Shian; Chen, Yi-Jen; Chen, Yih-Yuan; Chen, Solomon Chih-Cheng; Chen, Wei

    2015-01-01

    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. 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. 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 (r (2)=-0.667, P<0.001), followed by oxygen-cost diagram (r (2)=0.582, P<0.001) and forced expiratory volume in 1 second (r (2)=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 ABI were not correlated with the distance covered on the 6MWT. Asymptomatic PAD is not associated with walking endurance in patients with COPD. Therefore, it is important to detect and treat asymptomatic PAD early so that COPD patients do not progress to become exercise intolerant. Limited by the small sample size and predominantly male (99%) population in the study, further large-scale prospective studies are needed to verify the results.

  1. The auto-amputated adnexa: a review of findings in a pediatric population.

    Science.gov (United States)

    Focseneanu, Mariel A; Omurtag, Kenan; Ratts, Valerie S; Merritt, Diane F

    2013-12-01

    To quantify our experience and that of the literature with diagnosis and management of the auto-amputated adnexa in a pediatric population. Case series and literature review. Tertiary care medical center. Case series of pediatric patients (auto-amputation collected from our medical center and the literature. None. Auto-amputated adnexa. In addition to the 3 cases discussed from our institution, 91 cases of auto-amputated adnexa were identified in the literature dating back to 1943, for a total of 94 cases. Forty-nine percent (46/94) of the cases involved girls in a pediatric population (auto-amputated adnexa. 34 out of 46 cases were analyzed in detail. The right adnexa were involved in 56% of the cases. The most common presenting complaint verbalized by the older girls was pain; however, 8 cases were identified in asymptomatic girls undergoing unrelated diagnostic testing. The auto-amputated adnexa is a rare finding in the pediatric population, but it must be considered as a possible explanation for the incidental finding of absence of the fallopian tube or ovary in the subgroup of patients who undergo surgery for any reason. Patients with an antecedent history of pelvic pain either chronic or intermittent in nature may be diagnosed with torsion or less frequently auto-amputation of the adnexa. A fetal "pelvic mass" or "ovarian cyst" may predispose the adnexa to torsion and subsequent auto-amputation either in-utero or post-delivery. Many of these antenatally diagnosed cysts and even subsequent auto-amputations are completely asymptomatic, however, and do not compromise fertility assuming the contralateral adnexa are normal. Thus expectant management is appropriate for small (less than 4 cm), asymptomatic simple cysts and even suspected auto-amputated adnexa in an asymptomatic patient. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-01-01

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

  3. Accuracy of tests used to detect infection with Chlamydia trachomatis in asymptomatic pregnant women: a systematic review.

    Science.gov (United States)

    Sahi, Siew-Veena; Rogozińska, Ewelina; Sobhy, Soha; Khan, Khalid S

    2017-12-01

    Infection with Chlamydia trachomatis in pregnancy is linked to increased risk of miscarriage, stillbirth, and preterm birth. Currently, PCR or DNA-based tests are the gold standard when detecting the infection; however, they are costly and require access to specialist equipment. The aim of this systematic review was to assess the accuracy of available tests to detect infection in an asymptomatic pregnant population. There was evidence of the superior accuracy of nucleic acid amplification tests to cell culture in nonpregnant asymptomatic women; however, there are multiple commercial nucleic acid amplification tests with varying sensitivities and specificities. There is a gap in current literature on accuracy studies in an asymptomatic pregnant population, particularly within routine antenatal settings. There is a need for a point-of-care test for Chlamydia in pregnancy. Future test accuracy studies for this population should aim to use a universally established reference standard. Further research should provide relevant evidence to guide practice.

  4. Coronary risk variables in young asymptomatic smokers.

    Science.gov (United States)

    Sharma, S B; Dwivedi, S; Prabhu, K M; Singh, G; Kumar, N; Lal, M K

    2005-09-01

    Smoking plays a dominant role in premature atherosclerosis particularly among males in South Asian countries. It initiates and promotes atherosclerosis by altering cardiac haemodynamics, causing dyslipidaemia and producing oxidative damage. Not much information is available from our country. We therefore undertook this study to see the effect of smoking on electrocardiogram (ECG), blood pressure, lipids, apolipoprotein B level and free radical activity in young asymptomatic male smokers. The study included 100 consecutive male subjects (50 smokers and 50 non smokers) aged 30-40 yr. Smoking profile, detailed cardiovascular assessment including ECG and lipid profile were evaluated in each subject. Of the 50 smokers, 22 (44%) had grade I hypertension as against 5 of 50 non smokers. Sinus tachycardia (10%) and P-pulmonale (8%) were the only notable ECG abnormalities. Dyslipidaemia was detected in 92 per cent smokers and 48 per cent non smokers (Plevels were significantly higher (Psmokers compared to non smokers. LDL-cholesterol was > or =135 mg/dl in 94 per cent dyslipidaemic smokers. However, no significant difference was found in high density lipoprotein (HDL)-cholesterol. Smokers had significantly higher serum malondialdehyde levels (Pnon smokers. Our data indicate that young asymptomatic male smokers tend to have hypertension, dyslipidaemia and increased production of free oxygen radicals, perhaps by attenuation of oxidative stress by cigarette smoking. This makes them prone for premature coronary artery disease. However, the findings need to be confirmed on a larger sample.

  5. Aortic bypass surgery for asymptomatic patients awaiting a kidney transplant: a word of caution.

    Science.gov (United States)

    Franquet, Q; Terrier, N; Pirvu, A; Rambeaud, J-J; Long, J-A; Janbon, B; Tetaz, R; Malvezzi, P; Jouve, T; Descotes, J-L; Fiard, G

    2018-02-02

    In the presence of severe aorto-iliac calcification, aortic bypass surgery can be mandatory to allow kidney transplantation. The aim of our study was to evaluate the safety and outcomes of this strategy among asymptomatic patients. We retrospectively reviewed the files of all patients that had undergone vascular bypass surgery prior to kidney transplantation between November 2004 and March 2016. All patients undergoing aortic bypass surgery prior to kidney transplantation without any vascular-related symptoms were included. Twenty-one asymptomatic patients were included. Ten patients (48%) have not received a kidney transplant. Four patients died before kidney transplantation, including two deaths related to the bypass surgery (9.5%). Early post-operative morbidity involved 11 cases. Eleven patients (52%) were transplanted. Transplanted patients were significantly younger (median age 60 (56-61) versus 67 (60-72) years, p=0 .04) at the time of bypass and were less frequently treated for coronary heart disease (9% versus 50%, p=0.06). Aortic bypass surgery performed prior to kidney transplantation among asymptomatic patients has significant mortality and morbidity rates. When transplantation is possible, the results are satisfying. Larger studies are required to define the selection criteria, such as age and coronary heart disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. The outcome of cervical exploration for asymptomatic and symptomatic patients with primary hyperparathyroidism.

    Science.gov (United States)

    Abbas, Jaber S; Hashem, Suzan I; Faraj, Walid G; Khalifeh, Mohammad J; Horani, Mukbil H; Salti, Ibrahim S

    2006-01-01

    This study examined the success and safety of cervical exploration in patients with primary hyperparathyroidism (HPT). The presentation, pathologic findings, and outcome of patients with asymptomatic primary HPT were compared with those with symptomatic disease. Records of patients undergoing cervical exploration for primary HPT from January 1993 until December 31, 2003, were reviewed. Information collected consisted of preoperative symptoms, calcium and parathormone (PTH) levels, imaging studies, operative findings, pathology, and outcome of the patients. The groups with asymptomatic and symptomatic primary HPT were compared. In all, 139 patients were studied; 31 (22.3%) were asymptomatic (group I), and 108 (77.7%) had symptoms (group II). The two groups were also comparable regarding mean age, sex, and the yield of the imaging studies. The mean preoperative serum calcium level was comparable in the two groups (11.1 mg/dl versus 11.3 mg/dl). However, PTH levels were significantly lower in group I than in group II (142 pg/dl versus 283 pg/dl, P = 0.01). The weight of the adenoma was also significantly less in group I than in group II (1082 mg versus 1679 mg P = 0.079). The outcome of the surgical exploration was comparable in the two groups with an immediate success rate close to 98% and a long-term success rate of 95.4%. Cervical exploration and parathyroidectomy in patients with primary HPT is a safe procedure with a high success rate and favorable outcome.

  7. Numerical Distributions of Parasite Densities During Asymptomatic Malaria.

    Science.gov (United States)

    Imwong, Mallika; Stepniewska, Kasia; Tripura, Rupam; Peto, Thomas J; Lwin, Khin Maung; Vihokhern, Benchawan; Wongsaen, Klanarong; von Seidlein, Lorenz; Dhorda, Mehul; Snounou, Georges; Keereecharoen, Lilly; Singhasivanon, Pratap; Sirithiranont, Pasathorn; Chalk, Jem; Nguon, Chea; Day, Nicholas P J; Nosten, Francois; Dondorp, Arjen; White, Nicholas J

    2016-04-15

    Asymptomatic parasitemia is common even in areas of low seasonal malaria transmission, but the true proportion of the population infected has not been estimated previously because of the limited sensitivity of available detection methods. Cross-sectional malaria surveys were conducted in areas of low seasonal transmission along the border between eastern Myanmar and northwestern Thailand and in western Cambodia. DNA was quantitated by an ultrasensitive polymerase chain reaction (uPCR) assay (limit of accurate detection, 22 parasites/mL) to characterize parasite density distributions for Plasmodium falciparum and Plasmodium vivax, and the proportions of undetected infections were imputed. The prevalence of asymptomatic malaria as determined by uPCR was 27.5% (1303 of 4740 people tested). Both P. vivax and P. falciparum density distributions were unimodal and log normal, with modal values well within the quantifiable range. The estimated proportions of all parasitemic individuals identified by uPCR were >70% among individuals infected with P. falciparum and >85% among those infected with P. vivax. Overall, 83% of infections were predicted to be P. vivax infections, 13% were predicted to be P. falciparum infections, and 4% were predicted to be mixed infections. Geometric mean parasite densities were similar; 5601 P. vivax parasites/mL and 5158 P. falciparum parasites/mL. This uPCR method identified most infected individuals in malaria-endemic areas. Malaria parasitemia persists in humans at levels that optimize the probability of generating transmissible gametocyte densities without causing illness. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

  8. 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%.

  9. The prevalence and social patterning of chronic diseases among older people in a population undergoing health transition. A 10/66 Group cross-sectional population-based survey in the Dominican Republic

    Directory of Open Access Journals (Sweden)

    Ortiz Maria del C

    2010-06-01

    , as observed in other settings undergoing the epidemiologic transition, the burden of risk factors shifts towards the less affluent. Monitoring future trends in the prevalence and social patterning of chronic diseases may help to assess the effectiveness and equity of primary and secondary prevention strategies. Specific recommendations from our research include identifying and targeting the causes of anaemia among older people, and addressing women's health disadvantages.

  10. Current management of asymptomatic carotid stenosis.

    Science.gov (United States)

    Castilla-Guerra, L; Fernández-Moreno, M C; Serrano-Rodríguez, L

    2015-05-01

    Asymptomatic carotid stenosis (ACS) is a common problem in daily clinical practice, and its management is still the subject of controversy. In contrast to symptomatic carotid disease, the main studies on surgical treatment of patients with ACS have shown only a modest benefit in the primary prevention of stroke. In addition, current medical treatment has drastically decreased the risk of stroke in patients with ACS. Selecting patients amenable to endovascular treatment and determining how and when to conduct the ultrasound follow-up of these patients are issues that still need resolving. This article analyzes two new studies underway that provide evidence for better management of ACS in daily clinical practice. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  11. Recurrent Parotid Carcinosarcoma in an Asymptomatic Patient

    Directory of Open Access Journals (Sweden)

    Joshua Mansour MD

    2016-10-01

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

  12. Surgery for small asymptomatic abdominal aortic aneurysms.

    Science.gov (United States)

    Filardo, Giovanni; Powell, Janet T; Martinez, Melissa Ashley-Marie; Ballard, David J

    2015-02-08

    An abdominal aortic aneurysm (AAA) is an abnormal ballooning of the major abdominal artery. Some AAAs present as emergencies and require surgery; others remain asymptomatic. Treatment of asymptomatic AAAs depends on many factors, but an important one is the size of the aneurysm, as risk of rupture increases with aneurysm size. Large asymptomatic AAAs (greater than 5.5 cm in diameter) are usually repaired surgically; very small AAAs (less than 4.0 cm diameter) are monitored with ultrasonography. Debate continues over the appropriate roles of immediate repair and surveillance with repair on subsequent enlargement in people presenting with asymptomatic AAAs of 4.0 cm to 5.5 cm diameter. This is the third update of the review first published in 1999. To compare mortality, quality of life, and cost effectiveness of immediate surgical repair versus routine ultrasound surveillance in people with asymptomatic AAAs between 4.0 cm and 5.5 cm in diameter. For this update, the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (February 2014) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 1). We checked reference lists of relevant articles for additional studies. Randomised controlled trials in which men and women with asymptomatic AAAs of diameter 4.0 cm to 5.5 cm were randomly allocated to immediate repair or imaging-based surveillance at least every six months. Outcomes had to include mortality or survival. Three members of the review team independently extracted the data, which were cross-checked by other team members. Risk ratios (RR) (endovascular aneurysm repair only), hazard ratios (HR) (open repair only), and 95% confidence intervals based on Mantel-Haenszel Chi(2) statistic were estimated at one and six years (open repair only) following randomisation. We included all relevant published studies in this review. For this update, four trials with a combined total of 3314 participants

  13. Myocardial perfusion abnormalities in asymptomatic type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Ghada Al-Humaidi

    2018-01-01

    Conclusions: We found a high prevalence of myocardial perfusion abnormalities in asymptomatic type 2 diabetic patients. Perfusion abnormalities on myocardial perfusion SPECT images were associated with disease duration, insulin use, nephropathy, and neuropathy. Asymptomatic diabetic patients might be candidates with CAD abnormalities that can be studied using myocardial perfusion SPECT.

  14. Asymptomatic proteinuria in children in Calabar | Etuk | Global ...

    African Journals Online (AJOL)

    The urine samples of pupils from 4 Primary schools in Calabar were studied for asymptomatic proteinuria. The aim was to determine the prevalence of asymptomatic proteinuria in children in calabar. For each pupil, two urine samples were tested for proteinuria using the dipstick. The first urine sample was collected at ...

  15. Unholy Screening for Detection of Asymptomatic Haematwria and ...

    African Journals Online (AJOL)

    Ikimalo FE, Elm FU, Nkanginieme KEO, Ikinialo J. Urinary Screening for Detection of. Asymptomatic Haematurla and Pmteinuria in Children in Urban and Periurbaa Schools in Port Harcourt. Nfgeriarrjomalaf Paediatriam 30:1. In order to determine the prevalence of asymptomatic haematuria and proteinuria, a survey was ...

  16. Asymptomatic Bacteriuria among Patients with Type 2 Diabetes ...

    African Journals Online (AJOL)

    Introduction: The global increase in the prevalence of both type 1 and type 2 diabetes has brought asymptomatic bacteriuria, one of its complications to the fore. This study was designed to determine the prevalence of asymptomatic bacteriuria in patients with type 2 diabetes, identify the bacterial pathogens and their ...

  17. Asymptomatic rheumatic heart disease in South African schoolchildren

    African Journals Online (AJOL)

    adulthood with good health and no impact on their schooling. The study team also recognised the controversies that exist around: (i) the method of screening for asymptomatic RHD; (ii) the borderline disease entity; and (iii) the prognostic impact of asymptomatic. RHD. [8] The WHF criteria, which represent the only evidence- ...

  18. Prevalence and association of asymptomatic prostatitis with urinary ...

    African Journals Online (AJOL)

    The link between prostatitis and urinary tract infections (UTIs) has been acknowledged but documented incidences of asymptomatic prostatitis remains a course for concern. This study therefore, assesses the prevalence and association of asymptomatic prostatitis with urinary tract infections among apparently healthy men in ...

  19. 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 A...

  20. Asymptomatic bacteriuria in pregnancy in osogbo with special ...

    African Journals Online (AJOL)

    Asymptomatic bacteriuria is a common clinical entity in pregnancy but the prevalence due to S. saprophyticus, an established uro-pathogen in sexually active women, remained largely unknown in Nigeria. The prevalence of asymptomatic significant bacteriuria due to S. saprophyticus was therefore determined among 431 ...

  1. Human rhinovirus infections in symptomatic and asymptomatic subjects

    Directory of Open Access Journals (Sweden)

    C.N. Camargo

    2012-12-01

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

  2. Ultrasound study of the asymptomatic shoulder in patients with a ...

    African Journals Online (AJOL)

    Objective. To document the incidence of asymptomatic rotator cuff tears in patients with a confirmed symptomatic tear in the opposite shoulder, and to identify ultrasound findings that may distinguish symptomatic from asymptomatic tears. Design. When patients are referred for an ultrasound examination for the confirmation ...

  3. An Appraisal of Asymptomatic Bacteriuria in Pregnancy-The Lagos ...

    African Journals Online (AJOL)

    Background Obstetric care aims at reducing maternal (and perinatal) mortality and morbidity making the identification and management of related risk factors, such as asymptomatic bacteriuria in pregnancy of paramount importance. This study aimed at determining the prevalence of asymptomatic bacteriuria in the booking ...

  4. Alpha-Fetoprotein in Asymptomatic Hepatitis B Virus Infected Subjects

    African Journals Online (AJOL)

    The prevalence of hepatitis B virus (HBV) infection is high in sub-Saharan Africa. A great number of the infected individuals are asymptomatic and are commonly diagnosed by chance. Alpha-fetoprotein and liver function tests were evaluated in asymptomatic hepatitis B surface antigen (HBsAg) positive subjects to ascertain ...

  5. Prevalence of asymptomatic bacteriuria among pregnant women in ...

    African Journals Online (AJOL)

    Asymptomatic bacteriuria (ASB) in pregnancy is associated with obstetric complications including preeclampsia, pyelonephritis, preterm labour, low birth weight and prematurity. Determining the prevalence of asymptomatic bacteriuria among pregnant women locally is needed to justify routine screening for ASB in ...

  6. Influence of urbanisation on asymptomatic malaria in school ...

    African Journals Online (AJOL)

    Influence of urbanisation on asymptomatic malaria in school children in Molyko, South Western Cameroon. ... Objective: To determine the impact of urbanisation on the prevalence of asymptomatic malaria in. Molyko ... Results: There was a significant association between axillary temperature and malaria parasitaemia

  7. MRI in clinically asymptomatic neuropathic leprosy feet: a baseline study

    NARCIS (Netherlands)

    Maas, M.; Slim, E. J.; Akkerman, E. M.; Faber, W. R.

    2001-01-01

    This study was undertaken to analyze the magnetic resonance imaging (MRI) findings in the clinically asymptomatic neuropathic feet of leprosy patients. Since in the literature no MRI data are available concerning the asymptomatic neuropathic foot in leprosy, the interpretation of MRI examinations in

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

    Directory of Open Access Journals (Sweden)

    Patrick Philibert

    2014-12-01

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

  9. Asymptomatic Moyamoya Disease: Literature Review and Ongoing AMORE Study

    Science.gov (United States)

    KURODA, Satoshi

    2015-01-01

    Recent development of a non-invasive magnetic resonance examination has increased the opportunity to identify asymptomatic patients with moyamoya disease who have experienced no cerebrovascular events. However, their clinical features, prognosis, and treatment strategy are still unclear because of small number of subjects and short follow-up periods. Therefore, we have designed Asymptomatic Moyamoya Registry (AMORE) study in Japan. The objectives of this nation-wide, multi-center prospective study are to clarify long-term prognosis of asymptomatic patients with moyamoya disease and to determine the risk factors that cause ischemic and hemorrhagic stroke in them. In this article, we review the published data on asymptomatic moyamoya disease and report the on-going multi-center prospective cohort study, AMORE study. We would like to emphasize the importance to determine the clinical features, prognosis, and treatment strategies of asymptomatic moyamoya disease in very near future. PMID:25739434

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

    Science.gov (United States)

    Kuroda, Satoshi

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Recognition of asymptomatic hypertension in an urban emergency department: where are we now?

    Science.gov (United States)

    Souffront, Kimberly; Gestal, Christina; Melkus, Gail D’Eramo; Richardson, Lynne

    2016-01-01

    Persistently elevated blood pressure (hypertension) occurs at higher rates in the emergency department (ED) (44%) than the general population (27%) and disproportionately affecting blacks and older adults. The American College of Emergency Physicians (ACEP) recommends referral to primary care for hypertension (HTN) confirmation and management when patients are asymptomatic and their blood pressure (BP) is persistently elevated (Decker, Godwin, Hess, Lenamond, & Jagoda, 2006); however, adherence to this clinical policy is suboptimal. The purpose of this study was to examine the prevalence of asymptomatic HTN; rates of blood pressure (BP) reassessment and referral, and factors associated with it among adult patients who visit the ED and who were discharged, a decade after this policy was disseminated. A retrospective chart analysis of adults with an initial BP 140/90 mmHg or greater and who were discharged were included in the sampling frame. Appropriate bivariate analysis followed by multivariate regression was conducted. There were 2,367 patients who met inclusion criteria, of which 1,184 patients had asymptomatic HTN. A greater proportion of the sample was male (51.3%), black (43.2%; p<0.000), middle aged (μ 50.2 ± 16), and covered by Medicaid (39.8%). Mean initial BP was 170/88 mmHg. A large proportion of patients with asymptomatic HTN (94.2%) had no previously diagnosed cardiovascular disease (CVD). BP reassessment rate was 49% (μ 158/88) and these patients were more likely to have no previously diagnosed CVDs (p = 0.02). Only 4.6% (n=28) of patients with asymptomatic HTN were referred and these patients were more likely to have no previously diagnosed CVDs (p=0.000) and be middle aged (p=0.008). Adherence to follow-up was 100%. PMID:27792074

  13. Adenoma, advanced adenoma and colorectal cancer prevalence in asymptomatic 40- to 49-year-old subjects with a first-degree family history of colorectal cancer.

    Science.gov (United States)

    Del Vecchio Blanco, G; Cretella, M; Paoluzi, O A; Caruso, A; Mannisi, E; Servadei, F; Romeo, S; Grasso, E; Sileri, P; Giannelli, M; Biancone, L; Palmieri, G; Pallone, F

    2013-09-01

    First-degree relatives (FDRs) of patients with colorectal cancer (CRC) have an increased CRC risk. Few studies have addressed if adenoma and advanced adenoma risk is increased among individuals, 40-49 years of age, with a family history of CRC. Therefore, the aim of the study was to define the prevalence and location of adenoma, advanced adenoma and CRC, according to age, in asymptomatic individuals with a family history of CRC. Retrospective study of asymptomatic FDRs, 40 to ≥70 years of age undergoing first screening colonoscopy over a 3-year period, of CRC patients. Among 464 individuals studied, the prevalence of adenoma and advanced adenoma was 18.1% and 6.4%, respectively. According to age intervals, the prevalences of adenoma and advanced adenoma were 14% and 3.5%, respectively, in subjects 40-49 years of age; 14.4% and 6.3%, respectively, in subjects 50-59 years of age; 27% and 8%, respectively, in subjects 60-69 years of age; and 25% and 14%, respectively, in subjects ≥70 years of age; no significant difference was found among the four groups. No difference in lesion location was found, with similar numbers of preneoplastic lesions being present in the right colon and the left colon. CRC was diagnosed in three (0.64%) subjects, one of whom was in the 40-49 years age group. In our population of FDRs of CRC patients, 40-49 years of age, the prevalences of adenoma and advanced adenoma were similar to those observed in older subjects with the same CRC risk. Our data support the current indication to perform screening colonoscopy earlier than 45 years of age in subjects at high CRC risk. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  14. Effect of postprocedural full-dose infusion of bivalirudin on acute stent thrombosis in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: Outcomes in a large real-world population.

    Science.gov (United States)

    Wang, Heyang; Liang, Zhenyang; Li, Yi; Li, Bin; Liu, Junming; Hong, Xueyi; Lu, Xin; Wu, Jiansheng; Zhao, Wei; Liu, Qiang; An, Jian; Li, Linfeng; Pu, Fanli; Ming, Qiang; Han, Yaling

    2017-06-01

    This study aimed to evaluate the effect of prolonged full-dose bivalirudin infusion in real-world population with ST-elevation myocardial infarction (STEMI). Subgroup data as well as meta-analysis from randomized clinical trials have shown the potency of postprocedural full-dose infusion (1.75 mg/kg/h) of bivalirudin on attenuating acute stent thrombosis (ST) after primary percutaneous coronary intervention (PCI). In this multicenter retrospective observational study, 2047 consecutive STEMI patients treated with bivalirudin during primary PCI were enrolled in 65 Chinese centers between July 2013 and May 2016. The primary outcome was acute ST defined as ARC definite/probable within 24 hours after the index procedure, and the secondary endpoints included total ST, major adverse cardiac or cerebral events (MACCE, defined as death, reinfarction, stroke, and target vessel revascularization), and any bleeding at 30 days. Among 2047 STEMI patients, 1123 (54.9%) were treated with postprocedural bivalirudin full-dose infusion (median 120 minutes) while the other 924 (45.1%) received low-dose (0.25 mg/kg/h) or null postprocedural infusion. A total of three acute ST (0.3%) occurred in STEMI patients with none or low-dose prolonged infusion of bivalirudin, but none was observed in those treated with post-PCI full-dose infusion (0.3% vs 0.0%, P=.092). Outcomes on MACCE (2.1% vs 2.7%, P=.402) and total bleeding (2.1% vs 1.4%, P=.217) at 30 days showed no significant difference between the two groups, and no subacute ST was observed. Post-PCI full-dose bivalirudin infusion is safe and has a trend to protect against acute ST in STEMI patients undergoing primary PCI in real-world settings. © 2017 John Wiley & Sons Ltd.

  15. The impact of chronic obstructive pulmonary disease on intensive care unit admission and 30-day mortality in patients undergoing colorectal cancer surgery: a Danish population-based cohort study.

    Science.gov (United States)

    Platon, Anna Maria; Erichsen, Rune; Christiansen, Christian Fynbo; Andersen, Lea Kjær; Sværke, Claus; Montomoli, Jonathan; Sørensen, Henrik Toft

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) may increase the risk of postoperative complications and thus mortality after colorectal cancer (CRC) surgery, but the evidence is sparse. We conducted this nationwide population-based cohort study in Denmark, including all patients undergoing CRC surgery in the period 2005-2011, identified through medical databases. We categorised the patients according to the history of COPD. We assessed the rate of complications within 30 days. We computed 30-day mortality among patients with/without COPD using the Kaplan-Meier method. We used Cox regression to compute HRs for death, controlling for age, gender, type of admission, cancer stage, hospital volume, alcohol-related diseases, obesity and Charlson comorbidity score. We identified 18 302 CRC surgery patients. Of these, 7.9% had a prior diagnosis of COPD. Among patients with COPD, 16.1% were admitted postoperatively to the intensive care unit, 1.9% were treated with mechanical ventilation, and 3.6% were treated with non-invasive ventilation. In patients without COPD, the corresponding proportions were 9.7%, 1.1% and 1.1%. The reoperation rate was 10.6% among patients with COPD and 8% among patients with cancer without COPD. 30-day mortality was 13% (95% CI 11.4% to 14.9%) among patients with COPD and 5.3% (95% CI 5.0% to 5.7%) among patients without COPD, corresponding to an adjusted HR of 1.7 (95% CI 1.5 to 2.0). COPD is a strong predictor for intensive care unit admission and mortality after CRC surgery.

  16. Pre-procedural antibiotics for endoscopic urological procedures: Initial experience in individuals with spinal cord injury and asymptomatic bacteriuria.

    Science.gov (United States)

    Chong, Julio T; Klausner, Adam P; Petrossian, Albert; Byrne, Michael D; Moore, Jewel R; Goetz, Lance L; Gater, David R; Grob, B Mayer

    2015-03-01

    The objective of this study was to compare the safety, efficacy, quality-of-life impact, and costs of a single dose or a longer course of pre-procedural antibiotics prior to elective endoscopic urological procedures in individuals with spinal cord injury and disorders (SCI/D) and asymptomatic bacteriuria. A prospective observational study. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA. Sixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo elective endoscopic urological procedures. A single pre-procedural dose of antibiotics vs. a 3-5-day course of pre-procedural antibiotics. Objective and subjective measures of health, costs, and quality of life. There were no significant differences in vital signs, leukocytosis, adverse events, and overall satisfaction in individuals who received short-course vs. long-course antibiotics. There was a significant decrease in antibiotic cost (33.1 ± 47.6 vs. 3.6 ± 6.1 US$, P = 0.01) for individuals in the short-course group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P antibiotics. SCI/D individuals with asymptomatic bacteriuria may be able to safely undergo most endoscopic urological procedures with a single dose of pre-procedural antibiotics. However, further research is required and even appropriate pre-procedural antibiotics may not prevent severe infections.

  17. Characteristics of Patients Undergoing Cardiac Catheterization Before Noncardiac Surgery: A Report From the National Cardiovascular Data Registry CathPCI Registry.

    Science.gov (United States)

    Schulman-Marcus, Joshua; Feldman, Dmitriy N; Rao, Sunil V; Prasad, Abhiram; McCoy, Lisa; Garratt, Kirk; Kim, Luke K; Minutello, Robert M; Wong, Shing-Chiu; Vora, Amit N; Singh, Harsimran S; Wojdyla, Daniel; Mohsen, Amr; Bergman, Geoffrey; Swaminathan, Rajesh V

    2016-05-01

    disease (48.3%). In the 27 191 patients undergoing PCI, 367 treated lesions (1.3%) were in the left main artery and 3831 (13.8%) in the proximal left anterior descending artery. A total of 11 366 patients (40.8%) received drug-eluting stents. Complications occurred in a few patients, with a catheterization-related mortality rate of 0.05%. In the largest contemporary US cohort reported to date, most patients undergoing diagnostic catheterization before noncardiac surgery are asymptomatic. The discovery of obstructive coronary artery disease is common, and although randomized clinical trials have found no benefit in outcomes, revascularization is recommended in nearly half of these patients. The overall findings highlight management patterns in this population and the need for greater evidence-based guidelines and practices.

  18. Sipuleucel-T: Autologous Cellular Immunotherapy for Men with Asymptomatic or Minimally Symptomatic Metastatic Castrate Resistant Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Robert B. Sims

    2011-01-01

    Full Text Available Sipuleucel T is an autologous cellular immunotherapy designed to stimulate an immune response in men diagnosed with asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory prostate cancer. Sipuleucel T improves overall survival and provides an additional treatment option for this patient population.

  19. Gastroesophageal reflux in asymptomatic obese subjects: An esophageal impedance-pH study.

    Science.gov (United States)

    Akyüz, Filiz; Uyanıkoglu, Ahmet; Ermis, Fatih; Arıcı, Serpil; Akyüz, Ümit; Baran, Bülent; Pinarbasi, Binnur; Gul, Nurdan

    2015-03-14

    To investigate the relationship between reflux and body mass index (BMI) in the asymptomatic obese population using the impedance-pH technique. Gastroesophageal reflux is frequent in the obese population. However, the relationship between acid reflux and BMI in asymptomatic obese people is unclear. Forty-six obese (BMI > 25 kg/m(2)) people were enrolled in this prospective study. We evaluated the demographic findings and 24-h impedance pH values of the whole group. Gas, acid (pH 30 kg/m(2)). Demographic and endoscopic findings, and impedance results were similar in these two groups. However, there was a positive correlation between BMI and total and supine pH < 4 episodes (P = 0.002, r = 0.414; P = 0.000, r = 0.542), pH < 4 reflux time (P = 0.015, r = 0.319; P = 0.003, r = 0.403), and DeMeester score (P = 0.012, r = 0.333). Acid reflux is correlated with BMI in asymptomatic obese individuals.

  20. An anthropologically based model of the impact of asymptomatic cases on the spread of Neisseria gonorrhoeae.

    Science.gov (United States)

    Hazel, Ashley; Marino, Simeone; Simon, Carl

    2015-05-06

    Neisseria gonorrhoeae (GC) remains a serious burden in many high-sexual-activity, undertreated populations. Using empirical data from a 2009 study of GC burden among pastoralists in Kaokoveld, Namibia, we expand the standard gonorrhoea transmission model by using locally derived sexual contact data to explore transmission dynamics in a population with high rates of partner exchange and low treatment-seeking behaviour. We use the model to generate ball-park estimates for transmission probabilities and other parameter values for low-level (i.e. less than approx. 1200 copies/20 µl PCR reaction) asymptomatic infections, which account for 74% of all GC infections found in Kaokoveld in 2009, and to describe the impact of asymptomatic, low-level infections on overall prevalence patterns. Our results suggest that GC transmission probabilities are higher than previously estimated, that untreated infections take longer to clear than previously estimated and that a high prevalence of low-level infections is partially due to larger numbers of untreated, asymptomatic infections. These results provide new insights into the natural history of GC and the challenge of syndromic management programmes for the eradication of endemic gonorrhoea. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  1. High prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic Hispanics.

    Science.gov (United States)

    Dehesa, M; Dooley, C P; Cohen, H; Fitzgibbons, P L; Perez-Perez, G I; Blaser, M J

    1991-06-01

    In this study, we estimated the prevalence of Helicobacter pylori infection and histologic gastritis in 58 asymptomatic Hispanic adult volunteers (mean age, 41 years; 59% male) by endoscopic biopsy of the upper gastrointestinal tract. Forty-six subjects (79%) were found to harbor H. pylori in gastric biopsies, and all had histologic gastritis. Four other subjects were found to have gastritis in the absence of H. pylori. Similar prevalences of H. pylori and gastritis were noted in all age groups and also in American-born and immigrant Hispanics. Biopsy data and serologic studies of H. pylori antibodies correlated well. We conclude that H. pylori infection is an almost universal finding in the gastric mucosa of asymptomatic adult Hispanics, regardless of age. The clinical significance of these findings is unknown, but we speculate that H. pylori and its associated gastritis could have a role in the high incidence of gastric carcinoma in Hispanic populations.

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

    Directory of Open Access Journals (Sweden)

    Ramchandra Rao

    2015-06-01

    Diabetes particularly of longer duration in 4 th - 5 th decade are recommended to undergo evaluation for cardiovascular changes even though they are asymptomatic

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

    Science.gov (United States)

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

    2016-12-01

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

  4. Metabolic risk factors in children with asymptomatic hematuria.

    Science.gov (United States)

    Spivacow, Francisco Rodolfo; Del Valle, Elisa Elena; Rey, Paula Gabriela

    2016-07-01

    Idiopathic or benign hematuria is diagnosed in children after all other possible causes have been ruled out and test results for renal or urologic pathologies are negative. To identify possible urinary risk factors for hematuria in children, we retrospectively evaluated clinical onset, family history, and metabolic risk factors of 60 children with idiopathic hematuria but without renal stones or other pathologic conditions that could explain the hematuria. All patients followed the same ambulatory protocol at that used to evaluate kidney stone-formers. Seven patients had microhematuria, three patients each had microhematuria and gross hematuria, and the remaining 50 patients had gross hematuria onset. A family history of stone disease was found in 63 % of the children. At least one urinary metabolic abnormality was present in 49 patients, while 11 patients had no metabolic abnormality. The most common urinary risk factor was idiopathic hypercalciuria (single or associated), which was found in 43.5 % of patients, followed by hypocitraturia (single or associated), present in 31.7 %. Unduly acidic urine pH as a single abnormality was found in 10 % of this pediatric patient population. We also found hyperoxaluria and, less frequently, hypomagnesuria, and hyperuricosuria. Asymptomatic idiopathic hematuria in pediatric patients may often be associated to different urinary biochemical abnormalities, similar to what is observed in pediatric kidney stone-formers.

  5. Utility of Exercise Electrocardiography in Pre-participation Screening in Asymptomatic Athletes: A Systematic Review.

    Science.gov (United States)

    van de Sande, Danny A J P; Breuer, Michelle A W; Kemps, Hareld M C

    2016-08-01

    Although test characteristics of exercise electrocardiography are well established in symptomatic patients, data on healthy athletes are scarce. This systematic review focuses on the diagnostic utility of exercise electrocardiography for the detection of coronary heart disease in athletes during pre-participation screening. This systematic review evaluated the prevalence of an abnormal exercise test result and the positive predictive value of exercise electrocardiography in asymptomatic athletes. In addition, the long-term prognosis of a false-positive test result was evaluated. An electronic search was performed using the Cochrane Library, PubMed, and MEDLINE. Only studies using exercise electrocardiography in an unselected population of asymptomatic athletes were included. Data on population characteristics, cardiovascular risk factors, exercise test parameters, left ventricular hypertrophy, and morbidity/mortality were extracted and analyzed. The mean prevalence of an abnormal exercise test result was 0.6 % (range 0-29 %), with a positive predictive value of 9 % (range 0-55 %). Left ventricular hypertrophy was observed in 57 % of the athletes with an abnormal exercise test result, in 50 % of the athletes with a false-positive exercise test result, and in 24 % of the athletes with a normal exercise test. Among athletes with a false-positive test, only one athlete (3 %) experienced a possible cardiac event. This systematic review revealed a relatively low prevalence of positive exercise test results in asymptomatic athletes, but a very poor positive predictive value. There were insufficient data available to determine the prognostic implications of false-positive test results in asymptomatic athletes.

  6. Chalmydia trachomatis infection among asymptomatic males in an infertility clinic

    Directory of Open Access Journals (Sweden)

    Mania - Pramanik J

    2001-09-01

    Full Text Available Chlamydia trachomatis can lead to a variety of complications including tubal infertility. Similarly asymptomatic infection in male partner can also hinder conception. The prevalence of this infection among the infertile female in the Institute′s Infertility Clinic was observed to be 34%. Hence the present study was undertaken to find out these infection among the asymptomatic male partners of these infected women. Fifteen asymptomatic males who were not treated with any antibiotics in recent past were enrolled. First voided urine, semen and blood were collected from each individual for diagnosis of this infection. Chlamydia antigen was detected in 33.3% while Chlamydia antibody was detected in seven (46.7% of these cases. Of these seven, three cases were positive for antigen. This preliminary observation suggests that amongst the infertile couple a sizable percentage (60% of asymptomatic male partners remain infected with Chlamydia trachomatis.

  7. MOLECULAR DIAGNOSIS OF Guignardia citricarpa IN ASYMPTOMATIC SWEET ORANGE TISSUE

    Directory of Open Access Journals (Sweden)

    FERNANDA DE SILLOS FAGANELLO

    2017-10-01

    Full Text Available ABSTRACT Citrus black spot, a fungal disease caused by the quarantine fungus Guignardia citricarpa, restricts the exportation of fresh fruit to countries in the European Union. The occurrence of latent infections and the time required for diagnosis using conventional methods have brought about the need to validate fast, efficient and reproducible molecular techniques to detect the pathogen in asymptomatic tissue. As such, this study aims to detect G. citricarpa in the symptomatic fruit and asymptomatic leaf tissue of sweet oranges by conventional and real-time polymerase chain reaction (PCR. Specificity and limit of detection (LOD were assessed in tissue samples of fruit lesions and asymptomatic leaves. Low concentrations of the fungus were found in asymptomatic leaves. Under these conditions, real-time PCR proved to be viable, reproducible and highly sensitive to detection of the pathogen.

  8. Clinical characteristics of potential kidney donors with asymptomatic kidney stones

    OpenAIRE

    Lorenz, Elizabeth C.; Lieske, John C.; Vrtiska, Terri J.; Krambeck, Amy E.; Li, Xujian; Bergstralh, Eric J.; Melton, L. Joseph; Rule, Andrew D.

    2011-01-01

    Background. Patients with symptomatic kidney stones are characterized by older age, male gender, white race, hypertension, obesity, metabolic syndrome and chronic kidney disease. Whether these characteristics differ in patients with asymptomatic kidney stones is unknown.

  9. Dextrocardia with asymptomatic right atrial appendage aneurysm: a case report

    National Research Council Canada - National Science Library

    Sate, Hossein; Reshadati, Najmeh; Aliakbarzadeh, Parvaneh; Molazadeh, Negin

    2017-01-01

    .... We report a case of asymptomatic RAAA in a patient with dextrocardia and anomalous origin of RCA from left coronary sinus which was treated successfully by CABG and the aneurysm was completely excised...

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

    OpenAIRE

    Rodrigo Benedet Scheidt; Carlos Roberto Galia; Cristiano Valter Diesel; Ricardo Rosito; Carlos Alberto de Souza Macedo

    2014-01-01

    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 o...

  11. 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....

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

    Directory of Open Access Journals (Sweden)

    Sun KS

    2015-07-01

    ABI were not correlated with the distance covered on the 6MWT. Conclusion: Asymptomatic PAD is not associated with walking endurance in patients with COPD. Therefore, it is important to detect and treat asymptomatic PAD early so that COPD patients do not progress to become exercise intolerant. Limited by the small sample size and predominantly male (99% population in the study, further large-scale prospective studies are needed to verify the results. Keywords: peripheral arterial disease, COPD, ankle-brachial index, 6-minute walk tests 

  13. Bacteriological findings in radicular cyst and keratocystic odontogenic tumour fluids from asymptomatic patients.

    Science.gov (United States)

    Scalas, Daniela; Roana, Janira; Boffano, Paolo; Mandras, Narcisa; Gallesio, Cesare; Amasio, Mario; Banche, Giuliana; Allizond, Valeria; Cuffini, Anna Maria

    2013-11-01

    In this study the potential presence of bacteria in radicular cyst (RC) and keratocystic odontogenic tumour(KCOT) fluids from clinically asymptomatic patients was investigated. Cyst fluids were collected by needle aspiration from 16 patients with asymptomatic osteolytic lesions (10 RCs and 6 KCOTs) undergoing surgery. All samples were transferred into tubes containing pre-reduced transport medium, delivered to the microbiology laboratory and processed within 1h. The cysts, surgically enucleated, were sent for standard histopathological examination. Cyst fluid samples were cultured on selective and differential media in anaerobic (for about 2 weeks) and aerobic (for 24-48 h) conditions to detect viable microorganisms. After incubation, the colonies were counted, Gram-stained and identified by biochemical tests. Cultures were positive for the presence of bacteria in 15 (9 RCs, 6 KCOTs) out of 16 cases. RCs and KCOTs generally yielded low bacterial counts (10(2)-10(4) CFU/ml) and were predominantly colonized by obligate anaerobes (64%), whereas less commonly by facultative anaerobes (36%). No significant differences in the detection frequencies of obligate and facultative anaerobes were evidenced between RCs and KCOTs. Propionibacterium acnes was the most common obligate anaerobe recovered both in RC and KCOT fluids. Among facultative anaerobes, Gemella morbillorum was more frequently isolated in KCOTs, whereas Staphylococcus spp. in RCs. Bacteria may be present and persist within fluids of clinically asymptomatic jaw cystic lesions. The influence of bacteria and latent bacterial infection within cystic jaw lesions should be reconsidered in odontogenic cyst progression. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Mosaicism of an ELANE mutation in an asymptomatic mother in a familial case of cyclic neutropenia.

    Science.gov (United States)

    Hirata, Osamu; Okada, Satoshi; Tsumura, Miyuki; Karakawa, Shuhei; Matsumura, Itaru; Kimura, Yujiro; Maihara, Toshiro; Yasunaga, Shin'ichiro; Takihara, Yoshihiro; Ohara, Osamu; Kobayashi, Masao

    2015-07-01

    To confirm and characterize mosaicism of the cyclic neutropenia (CyN)-related mutation in the ELANE gene identified in the asymptomatic mother of patients with CyN. We identified sibling cases with CyN due to a novel heterozygous splicing site mutation, IVS4 +5SD G>T, in the ELANE gene, resulting in an internal in-frame deletion of 30 nucleotides (corresponding to a ten amino acid deletion, V161-F170). The mutated allele was also detected in their asymptomatic mother but at low frequency. We measured the frequency of the mutant allele from peripheral blood leukocytes (PBLs) by subcloning, and confirmed the allelic frequency of mosaicism in various cell types by massively parallel DNA sequencing (MPS) analysis. In the subcloning analysis, the mutant allele was identified in 21.36 % of PBLs from the asymptomatic mother, compared with 54.72 % of PBLs from the CyN patient. In the MPS analysis, the mutant allele was observed in approximately 30 % of mononuclear cells, CD3(+) T cells, CD14(+) monocytes and the buccal mucosa. Conversely, it was detected in low frequency in polymorphonuclear leukocytes (PLMLs) (3-4 %) and CD16(+) granulocytes (2-3 %). Mosaicism of the ELANE mutation has only previously been identified in one confirmed and one unconfirmed case of SCN. This is the first report of mosaicism of the ELANE mutation in a case of CyN. The MPS results suggest that this de novo mutation occurred during the two-cell stage of embryogenesis. PLMLs expressing the ELANE mutation were found to be actively undergoing apoptosis.

  15. [Xanthoma disseminatum with asymptomatic multisystem involvement].

    Science.gov (United States)

    Zinoun, M; Hali, F; Marnissi, F; Lazaar, S; Benchikhi, H

    2015-04-01

    Xanthogranulomas belong to non-Langerhans histiocytosis of the second group in the Histiocyte Society classification. They comprise a heterogeneous group of rare entities frequently involving cutaneous tropism. Xanthoma disseminatum belongs to this group of non-Langerhans histiocytosis. We report a case of xanthoma disseminatum (XD) in which localized skin and mucous impairment revealed multisystem involvement. A 28-year-old man presented with a two-year history of progressive yellow-orange and infiltrated xanthomatous papulonodular lesions of the face. Lesions of the oral mucosa and genital region were seen, with no functional repercussions. No ophthalmic or other complications were found. Histopathology showed a dense histiocytic infiltrate within the dermis with Touton giant cells, foamy multinucleated giant cells and inflammatory cells, without necrobiosis. Histiocytes were positive for CD68 but negative for CD1a. Gastric and lung involvement was seen and was confirmed at histology. Bone scintigraphy showed suspicious left ulnar hyperfixation suggesting bone involvement. No monoclonal gammopathy or diabetes insipidus was seen. Our patient was treated with corticosteroids 1mg/kg/day and thalidomide 100 mg/day. The outcome was marked by regression and exfiltration of the cutaneous lesions from the second week of treatment, with subsidence continuing at 3 months. This case involves a very rare form of xanthoma disseminatum. The localized facial skin lesions revealed multifocal non-Langerhans histiocytosis that was in fact asymptomatic. The diagnosis of XD was based on clinical, histological and immunohistochemical criteria. Xanthoma disseminatum is a non-Langerhans histiocytic proliferation first described by Montgomery in 1938. This rare entity is characterized by skin and mucous membrane xanthomatosis in which the facial involvement is common, together with diabetes insipidus and normal lipid metabolism. The prognosis is determined by the presence of mucosal

  16. The Prevalence of Mixed Helicobacter pylori Infections in Symptomatic and Asymptomatic Subjects in Dhaka, Bangladesh.

    Science.gov (United States)

    Kibria, Khandoker Mohammad K; Hossain, Md Enayet; Sultana, Jinath; Sarker, Shafiqul A; Bardhan, Pradip Kumar; Rahman, Motiur; Nahar, Shamsun

    2015-10-01

    Helicobacter pylori is a highly genetically diverse bacterial species, which can persist in the gastric environment for decades. Recent studies have shown that single infections predominate in developed countries, whereas mixed infections are more prevalent in developing countries. Mixed infections of this bacterium may be important for adaptation to the hostile gastric environment and may facilitate dyspeptic symptoms. To calculate the prevalence of mixed infections in symptomatic and asymptomatic subjects, 2010 H. pylori isolates collected from 83 symptomatic and 91 asymptomatic subjects from Dhaka, Bangladesh, were analyzed by (i) random amplified polymorphic DNA fingerprinting (RAPD) and (ii) multiplex PCR amplification for cagA and vacA virulence gene alleles. The overall prevalence of mixed H. pylori infection was 60.15% (77/128), indicating substantial co-colonization in this population. We additionally found that symptomatic subjects (53%) had a significantly higher rate of mixed infection than asymptomatic individuals (36.3%) (p = .016) and that the prevalence of the cagA and vacA and vacA m1/s1 and vacA m2/s1 alleles were higher in subjects with mixed infection. Our findings suggest that an increased diversity of the H. pylori strains in the gastric environment may contribute to the development of disease symptoms. © 2015 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2016-05-01

    Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology. © 2016 American College of Veterinary Radiology.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-05-01

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

  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. Sensory Neuropeptides and Endogenous Opioids Expression in Human Dental Pulp with Asymptomatic Inflammation: In Vivo Study

    Directory of Open Access Journals (Sweden)

    Daniel Chavarria-Bolaños

    2015-01-01

    Full Text Available Purpose. This study quantified the expression of substance P (SP, calcitonin gene-related peptide (CGRP, β-endorphins (β-End, and methionine-enkephalin (Met-Enk in human dental pulp following orthodontic intrusion. Methods. Eight patients were selected according to preestablished inclusion criteria. From each patient, two premolars (indicated for extraction due to orthodontic reasons were randomly assigned to two different groups: the asymptomatic inflammation group (EXPg, which would undergo controlled intrusive force for seven days, and the control group (CTRg, which was used to determine the basal levels of each substance. Once extracted, dental pulp tissue was prepared to determine the expression levels of both neuropeptides and endogenous opioids by radioimmunoassay (RIA. Results. All samples from the CTRg exhibited basal levels of both neuropeptides and endogenous opioids. By day seven, all patients were asymptomatic, even when all orthodontic-intrusive devices were still active. In the EXPg, the SP and CGRP exhibited statistically significant different levels. Although none of the endogenous opioids showed statistically significant differences, they all expressed increasing trends in the EXPg. Conclusions. SP and CGRP were identified in dental pulp after seven days of controlled orthodontic intrusion movement, even in the absence of pain.

  1. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia.

    Science.gov (United States)

    Bezold, Guntram; Politch, Joseph A; Kiviat, Nancy B; Kuypers, Jane M; Wolff, Hans; Anderson, Deborah J

    2007-05-01

    To determine the prevalence of pathogens that cause sexually transmitted infections (STIs) in semen from asymptomatic male infertility patients with and without leukocytospermia (LCS), and associations between STIs, inflammatory markers, and other semen variables. Retrospective, controlled study. Academic Medical Center. Two hundred and forty-one male infertility patients undergoing routine semen analysis: 132 with LCS, and 109 without LCS. None. The DNA from STI pathogens (human papillomavirus [HPV], cytomegalovirus [CMV], herpes simplex virus [HSV], human herpesvirus type 6 [HHV-6], Epstein-Barr virus [EBV], hepatitis B virus [HBV], and Chlamydia trachomatis [CT]), routine semen parameters, and markers of accessory gland and epididymal function and inflammation. The DNA from STI pathogens was detected in 45/241 (18.7%) of the samples (CMV, 8.7%; HPV, 4.5%; HHV-6, 3.7%; HSV, 3.7%; CT, 2.5%; EBV, 0.4%; and HBV, 0%), with no difference in prevalence between the LCS and non-LCS groups. The DNA of STI pathogens in semen was associated with a decrease in sperm concentration, motile sperm concentration, total sperm count, and neutral alpha-glucosidase concentration, whereas LCS was associated with a decrease in total sperm count, percent normal forms, and fructose concentration. The DNA of STI pathogens was detected in semen from a high percentage of asymptomatic male infertility patients, and was associated with poor semen quality. Efforts to diagnose and treat subclinical genital-tract infections should be intensified.

  2. Asymptomatic malaria in children under 5 years old in Benin City ...

    African Journals Online (AJOL)

    ... not affect significantly the prevalence of asymptomatic malaria. Age, gender and anaemia were significantly associated with asymptomatic malaria. Conclusion: Interventions to reduce asymptomatic malaria are advocated. Keywords: Asymptomatic malaria, Benin City, Children under 5 years. An Erratum was published for ...

  3. Asymptomatic malaria in refugees living in a non-endemic South African city.

    Science.gov (United States)

    Tsoka-Gwegweni, Joyce M; Okafor, Uchenna

    2014-01-01

    Asymptomatic malaria infection in refugees is both a threat to the lives of the individuals and the public in the host country. Although South Africa has been experiencing an unprecedented influx of refugees since 1994, data on malaria infection among refugees is lacking. Such information is critical since South Africa is among the countries that have planned to eliminate malaria. The objective of this study was to determine prevalence of asymptomatic malaria infection among a refugee population living in a city of KwaZulu-Natal province, South Africa. A survey was conducted on adult refugee participants who attended a faith-based facility offering social services in a city of KwaZulu-Natal province, South Africa. The participants were screened for the presence of malaria using rapid diagnostic tests and microscopy. Demographic data for the participants were obtained using a closed ended questionnaire. Data was obtained for 303 participants consisting of 51.5% females and 47.5% males, ranging from 19 to 64 years old. More than 95% of them originated from sub-Saharan African countries. Two hundred and ninety participants provided a blood sample for screening of malaria. Of these, 3.8% tested positive for rapid diagnostic test and 5.9% for microscopy. The majority of malaria infections were due to Plasmodium falciparum. The study confirms the presence of asymptomatic malaria infections among a refugee population residing in a city of KwaZulu-Natal province that is not endemic for malaria. The results have important implications for both public health and malaria control in South Africa, particularly since the country has decided to eliminate malaria by 2018. To achieve this goal, South Africa needs to expand research, surveillance and elimination activities to include non-endemic areas, particularly with high refugee populations. We further recommend use of powerful diagnostic tests such as PCR for these interventions.

  4. Asymptomatic malaria in refugees living in a non-endemic South African city.

    Directory of Open Access Journals (Sweden)

    Joyce M Tsoka-Gwegweni

    Full Text Available Asymptomatic malaria infection in refugees is both a threat to the lives of the individuals and the public in the host country. Although South Africa has been experiencing an unprecedented influx of refugees since 1994, data on malaria infection among refugees is lacking. Such information is critical since South Africa is among the countries that have planned to eliminate malaria. The objective of this study was to determine prevalence of asymptomatic malaria infection among a refugee population living in a city of KwaZulu-Natal province, South Africa.A survey was conducted on adult refugee participants who attended a faith-based facility offering social services in a city of KwaZulu-Natal province, South Africa. The participants were screened for the presence of malaria using rapid diagnostic tests and microscopy. Demographic data for the participants were obtained using a closed ended questionnaire. Data was obtained for 303 participants consisting of 51.5% females and 47.5% males, ranging from 19 to 64 years old. More than 95% of them originated from sub-Saharan African countries. Two hundred and ninety participants provided a blood sample for screening of malaria. Of these, 3.8% tested positive for rapid diagnostic test and 5.9% for microscopy. The majority of malaria infections were due to Plasmodium falciparum.The study confirms the presence of asymptomatic malaria infections among a refugee population residing in a city of KwaZulu-Natal province that is not endemic for malaria. The results have important implications for both public health and malaria control in South Africa, particularly since the country has decided to eliminate malaria by 2018. To achieve this goal, South Africa needs to expand research, surveillance and elimination activities to include non-endemic areas, particularly with high refugee populations. We further recommend use of powerful diagnostic tests such as PCR for these interventions.

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

    Science.gov (United States)

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

    2011-11-21

    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. 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, Candida isolates, antimicrobial and antifungal treatments, and previously identified risk factors for symptomatic candidiasis were recorded, and symptomatic and asymptomatic patients were compared. In all, 36 (53.7%) of the patients with Candida-positive cultures had asymptomatic candidiasis and 31 (46.3%) had symptomatic candidiasis. Candida albicans was the most common Candida sp. in the asymptomatic patients (n = 20, 55.6%), versus Candida parapsilosis in the symptomatic patients (n = 15, 48.4%). The incidence of central venous catheter indwelling, blood transfusion, parenteral nutrition, and surgery was higher in the symptomatic patient group than in the asymptomatic patient group (P candidiasis according to forward stepwise multivariate logistic regression analysis (OR: 6.1; 95% CI: 1.798-20.692). Surgery was the only risk factor significantly associated with symptomatic candidiasis and non-albicans Candida species were more common among the patients with symptomatic candidiasis. While treating symptomatic candidiasis in any PICU an increase in the incidence of non-albicans candidiasis should be considered.

  6. Clinical characteristics of potential kidney donors with asymptomatic kidney stones.

    Science.gov (United States)

    Lorenz, Elizabeth C; Lieske, John C; Vrtiska, Terri J; Krambeck, Amy E; Li, Xujian; Bergstralh, Eric J; Melton, L Joseph; Rule, Andrew D

    2011-08-01

    Patients with symptomatic kidney stones are characterized by older age, male gender, white race, hypertension, obesity, metabolic syndrome and chronic kidney disease. Whether these characteristics differ in patients with asymptomatic kidney stones is unknown. All potential kidney donors who underwent protocol computed tomography angiograms/urograms (2000-08) at the Mayo Clinic were identified. Renal abnormalities, including kidney stones, were assessed radiographically. Comorbidities, including past symptomatic kidney stones, were abstracted from the medical record. Characteristics of persons with and without radiographic stones were compared. Stone burden among persons with and without past symptomatic stones was compared. Among 1957 potential kidney donors, 3% had past symptomatic stones and 11% had radiographic stones (10% had only asymptomatic radiographic stones). Asymptomatic stone formers were more likely to be of white race, have low urine volumes and have radiographic findings of renal parenchymal thinning, focal renal scarring, medullary sponge kidney and polycystic kidney disease. Asymptomatic stone formers were not characterized by older age, male gender, hypertension, obesity, metabolic syndrome, abnormal kidney function, hyperuricemia, hypercalcemia or hypophosphatemia. Among persons with radiographic stones, those with past symptomatic stones had a slightly higher number of stones (mean 2.7 versus 2.4; P = 0.04), but a much greater diameter for the largest stone (mean 4.8 versus 1.6 mm; P kidney stones. These findings suggest that different pathophysiologic mechanisms could be involved in asymptomatic stone formation versus symptomatic stone passage.

  7. Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults

    DEFF Research Database (Denmark)

    Baber, Usman; Mehran, Roxana; Sartori, Samantha

    2015-01-01

    performed in a single cohort. OBJECTIVES: The BioImage Study (A Clinical Study of Burden of Atherosclerotic Disease in an At-Risk Population) sought to identify imaging biomarkers that predict near-term (3-year) atherothrombotic events. METHODS: The BioImage Study enrolled 5,808 asymptomatic U.S. adults......PB). The primary endpoint was the composite of major adverse cardiac events (MACE) (cardiovascular death, myocardial infarction, and ischemic stroke). A broader secondary MACE endpoint also included all-cause death, unstable angina, and coronary revascularization. RESULTS: Over a median follow-up of 2.7 years...

  8. Spirometry screening for airway obstruction in asymptomatic smokers.

    Science.gov (United States)

    Wisnivesky, Juan; Skloot, Gwen; Rundle, Andrew; Revenson, Tracey A; Neugut, Alfred

    2014-07-01

    Screening spirometry might help identify patients with chronic obstructive pulmonary disease (COPD) at an earlier stage. In this study, we evaluated the prevalence of airway obstruction in a cohort of asymptomatic smokers who underwent spirometry as part of a routine health maintenance examination. The study cohort consisted of a consecutive sample of 386 asymptomatic smokers (≥5 pack-years) without a history of COPD or asthma, who completed spirometry testing as part of a routine health maintenance examination. Overall, 9 study subjects (2.3%, 95% confidence interval: 1.1-4.4%) had evidence of airway obstruction on spirometry. Univariate and multiple regression analyses showed that the risk of airway obstruction was not significantly associated with age, sex, race, smoking history or past history of respiratory symptoms. Spirometry screening of asymptomatic smokers may help detect a small number of patients with airway obstruction who are at high risk for COPD.

  9. Coronary calcification among 3477 asymptomatic and symptomatic individuals

    DEFF Research Database (Denmark)

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

    2015-01-01

    referred for cardiac CT, to assess whether differences in CAC may be explained by symptoms or traditional cardiovascular risk factors. METHODS: The presence and extent of CAC, gender, family history of coronary artery disease, hypertension, hyperlipidaemia, diabetes and tobacco were compared in 1220......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...... asymptomatic individuals aged 49-61 years and 2257 age-matched symptomatic patients referred for cardiac CT with suspected coronary artery disease. RESULTS: Symptomatic individuals had a higher frequency of a family history of coronary artery disease (46% vs. 23%, p 

  10. 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.

  11. Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

    Directory of Open Access Journals (Sweden)

    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.

  12. Factors that affect the likelihood of undergoing cosmetic surgery.

    Science.gov (United States)

    Brown, Amy; Furnham, Adrian; Glanville, Louise; Swami, Viren

    2007-01-01

    With the rise in popularity of plastic surgery, it is useful to consider those factors that may increase the likelihood of undergoing cosmetic surgery in a nonpatient population. A study was conducted to determine those factors that might motivate a nonclinical, nonpatient population to undergo cosmetic surgery. A sample of 119 women and 89 men, ages 18 to 59, was recruited from public spaces and asked to complete a questionnaire measuring how likely they were to consider undergoing the most common cosmetic procedures. Women reported greater likelihood of undergoing cosmetic surgery than men, older men expressed less desire to undergo cosmetic surgery than younger men, and lower self-ratings of physical attractiveness predicted higher likelihood of undergoing cosmetic surgery. The vicarious experience of cosmetic surgery (via family and friends) increased the likelihood of undergoing cosmetic surgery for women, but not for men. Media exposure did not influence likelihood for either sex. Factors that affect the likelihood of undergoing cosmetic surgery vary with procedure; thus it would be valuable for future studies to use a scale that measures responses separately for different procedures. Lower self-ratings of physical attractiveness lead to consideration of cosmetic surgery; future studies may explore satisfaction levels of those who have undergone surgery.

  13. ASTRONAUT ALDRIN UNDERGOES SPACESUIT CHECKS

    Science.gov (United States)

    1969-01-01

    ASTRONAUT ALDRIN UNDERGOES SPACESUIT CHECKS KSC-69PC-0374 69-HC-742,S-266,ARCHIVE-00337 White undergoing spacesuit checks, Apollo 11 lunar module pilot Edwin E. Aldrin, Jr., watches Astronauts Neil A. Armstrong and Michael Collins suit up for launch.

  14. Intranasal sufentanil/midazolam versus ketamine/midazolam for analgesia/sedation in the pediatric population prior to undergoing multiple dental extractions under general anesthesia: a prospective, double-blind, randomized comparison.

    OpenAIRE

    Roelofse, J. A.; Shipton, E. A.; de la Harpe, C. J.; Blignaut, R. J.

    2004-01-01

    This article details a double-blind, randomized study evaluating the efficacy and safety of intranasal sufentanil and intranasal midazolam (S/M) when compared with intranasal ketamine and intranasal midazolam (K/M) for sedation and analgesia in pediatric patients undergoing dental surgery. Fifty healthy ASA status 1 children aged 5-7 years, weighing 15-20 kg, and having 6 or more teeth extracted, were randomly allocated to 2 groups of 25 patients each (n = 50). In the S/M group, 25 children r...

  15. Relationships between 2-Year Survival, Costs, and Outcomes following Carotid Endarterectomy in Asymptomatic Patients in the Vascular Quality Initiative.

    Science.gov (United States)

    Wallaert, Jessica B; Newhall, Karina A; Suckow, Bjoern D; Brooke, Benjamin S; Zhang, Min; Farber, Adrienne E; Likosky, Donald; Goodney, Philip P

    2016-08-01

    Carotid endarterectomy (CEA) for asymptomatic patients with limited life expectancy may not be beneficial or cost-effective. The purpose of this study was to examine relationships among survival, outcomes, and costs within 2 years following CEA among asymptomatic patients. Prospectively collected data from 3097 patients undergoing CEA for asymptomatic disease from Vascular Quality Initiative VQI registry were linked to Medicare. Models were used to identify predictors of 2-year mortality following CEA. Patients were classified as low, medium, or high risk of death based on this model. Next, we examined costs related to cerebrovascular care, occurrence of stroke, rehospitalization, and reintervention within 2 years following CEA across risk strata. Overall, 2-year mortality was 6.7%. Age, diabetes, smoking, congestive heart failure (CHF), chronic obstructive pulmonary disease, renal insufficiency, absence of statin use, and contralateral internal carotid artery (ICA) stenosis were independently associated with a higher risk of death following CEA. In-hospital costs averaged $7500 among patients defined as low risk for death, and exceeded $10,800 among high risk patients. Although long-term costs related to cerebrovascular disease were 2 times higher in patients deemed high risk for death compared with low risk patents ($17,800 vs. $8800, P = 0.001), high risk of death was not independently associated with a high probability of high cost. Predictors of high cost at 2 years were severe contralateral ICA stenosis, dialysis dependence, and American Society for Anesthesia Class 4. Both statin use and CHF were protective of high cost. Greater than 90% of patients undergoing CEA live long enough to realize the benefits of their procedure. Moreover, the long-term costs are supported by the effectiveness of this procedure at all levels of patient risk. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The relation between coronary artery calcification in asymptomatic subjects and both traditional risk factors and living in the city centre

    DEFF Research Database (Denmark)

    Lambrechtsen, J; Gerke, Oke; Egstrup, Kenneth

    2012-01-01

    Objective:  To evaluate the association between the risk factor of living in the city centre as a surrogate for air pollution and the presence of coronary artery calcification (CAC) in a population of asymptomatic Danish subjects. Design and subjects:  A random sample of 1825 men and women...... the greatest association with the presence of CAC: the odds ratio (OR) for men compared with women was 3.2 (95% confidence interval [CI] 2.5-4.2; P...

  17. Consequences of asymptomatic bacteriuria in women with diabetes mellitus

    NARCIS (Netherlands)

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

    2001-01-01

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

  18. Lorenzo’s Oil in Treatment of Asymptomatic ALD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-08-01

    Full Text Available The effect of 4:1 glyceryl trioleate-glyceryl trierucate (Lorenzo’s oil on disease progression in 89 asymptomatic boys (mean age 4.7+/-4.1 years; range 0.2-15 years with X-linked adrenoleukodystrophy (ALD and normal brain MRI was studied at Johns Hopkins University, Baltimore, MD, and other centers.

  19. Urinary Screening for Detection of Asymptomatic Haematuria and ...

    African Journals Online (AJOL)

    , a survey was carried out among pupils of two primary schools; one located in the urban area and the other in the periurban area of Port Harcourt Local Government Area. The prevalence rate of significant asymptomatic proteinuria was one ...

  20. High prevalence of asymptomatic plasmodium infection in a suburb ...

    African Journals Online (AJOL)

    Background: Malaria is endemic in many parts of the world. Various strategies have been planned to control malaria from time to time in many places. Whatever may be the strategy the prevalence of symptomatic and asymptomatic plasmodium parasitaemics has been of prime importance as useful parameter for its control.

  1. The Prevalence and Outcome of Asymptomatic Chlamydial Infection ...

    African Journals Online (AJOL)

    Of those with HSG result (64), the accuracy of the test kit showed low sensitivity - 44.2% (19/43) and negative predictive value 40.0% (16/40) (but, high specificity - 76.2%(16/21), and positive predictive value - 79.2% (19/24). Conclusion: Asymptomatic Chlamydial infection is common among infertile women and it positively ...

  2. Ultrasound study of the asymptomatic shoulder in patients with a ...

    African Journals Online (AJOL)

    2. Department of Orthopaedics, University of Pretoria. 3. Department of Statistics, University of Pretoria ... The asymptomatic shoulder had no history of problems severe enough to have required medical ... is little published on the natural history of small rotator cuff tears, and the answer to whether small tears progress to.

  3. Pregnancy outcome in asymptomatic women with abnormal vaginal ...

    African Journals Online (AJOL)

    tract can result in deciduitis, chorioamnionitis, amniotic fluid infection, fetal sepsis and intrauterine death. Intrauterine infection may occur early in pregnancy and remain asymptomatic and undetected for months until preterm labour or premature rupture of the membranes (PROM) occur.[3]. Abnormal genital tract colonisation ...

  4. Profile of Hepatitis B and Hepatitis C Markers in Asymptomatic ...

    African Journals Online (AJOL)

    ... was to determine the profile of viral markers of HBV and HCV among asymptomatic individuals with chronic hepatitis B surface antigen (HBsAg). Methods: Seventy one subjects who were chronic HBsAg positive were recruited as cases and thirty three apparently normal individuals who were negative for HBsAg served as ...

  5. Endarterectomy or Stenting in Severe Asymptomatic Carotid Stenosis.

    Science.gov (United States)

    Mannheim, Dallit; Falah, Batla; Karmeli, Ron

    2017-05-01

    Stroke is a major cause of death in the western world, and carotid endarterectomy has been shown to be effective in treating both symptomatic and asymptomatic carotid stenosis. Carotid stenting is a relatively new form of treatment for carotid stenosis and few studies have looked specifically at asymptomatic patients. To retrospectively examine short- and long-term results in the treatment of asymptomatic carotid artery stenosis with surgery or stenting. We retrospectively collected data of all patients with asymptomatic carotid stenosis treated by carotid artery stenting or carotid endarterectomy in our department from 2006-2007. The primary endpoints were stroke, myocardial infarction, or death during the periprocedural period; or any ipsilateral stroke, restenosis, or death within 4 years after the procedure. The study comprised 409 patients who were treated by either stenting or surgery. There was a low morbidity rate in both treatment groups with no significant difference in morbidity or mortality between the treatment groups in both in the short-term as well as long-term. Both treatment methods have a low morbidity and mortality rate and should be considered for patients with few risk factors and a long life expectancy. Treatment method should be selected according to the patient's individual risk factors and imaging data.

  6. Cardiovascular risk factors in patients with asymptomatic primary hyperparathyroidism.

    Science.gov (United States)

    García-Martín, Antonia; Reyes-García, Rebeca; García-Castro, José Miguel; Quesada-Charneco, Miguel; Escobar-Jiménez, Fernando; Muñoz-Torres, Manuel

    2014-12-01

    Patients with primary hyperparathyroidism (PHP), even asymptomatic, have an increased cardiovascular risk. However, data on reversibility or improvement of cardiovascular disorders with surgery are controversial. Our aims were to assess the prevalence of classic cardiovascular risk factors in patients with asymptomatic PHP, to explore their relationship with calcium and PTH levels, and analyze the effect of parathyroidectomy on those cardiovascular risk factors. A retrospective, observational study of two groups of patients with asymptomatic PHP: 40 patients on observation and 33 patients who underwent surgery. Clinical and biochemical data related to PHP and various cardiovascular risk factors were collected from all patients at baseline and one year after surgery in the operated patients. A high prevalence of obesity (59.9%), type 2 diabetes mellitus (25%), high blood pressure (47.2%), and dyslipidemia (44.4%) was found in the total sample, with no difference between the study groups. Serum calcium and PTH levels positively correlated with BMI (r=.568, P=.011, and r=.509, P=.026 respectively) in non-operated patients. One year after parathyroidectomy, no improvement occurred in the cardiovascular risk factors considered. Our results confirm the high prevalence of obesity, type 2 diabetes mellitus, high blood pressure, and dyslipidemia in patients with asymptomatic PHP. However, parathyroidectomy did not improve these cardiovascular risk factors. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  7. Asymptomatic intestinal protozoa in school age children in Pategi ...

    African Journals Online (AJOL)

    African Journal of Infectious Diseases ... The prevalence of intestinal asymptomatic protozoan infection was assessed (November, 2012 through May, 2013) among school age children in Pategi, Pategi Local Government ... The distribution of the parasites was E. histolytica/dispar (75.1), E. coli (18.8) and G. lamblia (6.1%).

  8. Neutrophils ingestion rate of nitroblue tetrazolium in asymptomatic ...

    African Journals Online (AJOL)

    This study suggests that the presence of E. coli endotoxin could trigger aggressive antigen phagocytosis in pregnant women with asymptomatic malaria parasiteamia. This could have far reaching consequences in pregnancy. The possibility of co-morbidity of E. coli infection in malaria parasiteamia pregnant women in ...

  9. Pattern of asymptomatic sexually transmitted infections in women ...

    African Journals Online (AJOL)

    The roles of gonorrhea and non-gonococcal urethritis due to Chlamydia trachomatis in the etiology of infertility due to tubal occlusion have been established by various studies. Hysterosalphingography (HSG) is done to investigate tubal patency. This study was aimed at finding the prevalence of asymptomatic sexually ...

  10. Prevalence of asymptomatic bacteriuria among pre-school children ...

    African Journals Online (AJOL)

    owner

    2013-01-08

    Jan 8, 2013 ... Department of Medicine,. University of Nigeria Teaching ... fore escape diagnosis by the primary care physician. Asymptomatic .... Urine microscopy. Ten milliliters of urine specimen from each participant was centrifuged in a test tube at 3,000 revolutions per minute (rpm) for five minutes. The supernatant ...

  11. Large presacral epidermoid cyst in an asymptomatic woman

    Directory of Open Access Journals (Sweden)

    Kyosuke Izumi, MD

    2017-12-01

    Full Text Available An epidermoid cyst is an infrequent entity among cysts found in the presacral region, frequently coexistent with a meningocele. Diffusion-weighted imaging is known to be a useful diagnostic measure for differentiating presacral epidermoid cysts. Here, we present a large but asymptomatic case found in the presacral region. Epidermoid cysts should be considered in patients with presacral cysts.

  12. A family study of asymptomatic small bowel Crohn's disease.

    Science.gov (United States)

    Biancone, Livia; Calabrese, Emma; Petruzziello, Carmelina; Capanna, Alessandra; Zorzi, Francesca; Onali, Sara; Condino, Giovanna; Lolli, Elisabetta; Ciccacci, Cinzia; Borgiani, Paola; Pallone, Francesco

    2014-03-01

    Discrepancies between severity of lesions and symptoms may be observed in Crohn's disease. We prospectively assessed whether Crohn's disease may be diagnosed among asymptomatic relatives of patients, using Small Bowel Contrast Ultrasonography. Diagnosis of asymptomatic Crohn's disease relatives was defined ultrasonographically as: bowel wall thickness >3mm, bowel dilation/stricture, lumen diameter >2.5 cm. Diagnosis was confirmed by ileocolonoscopy. Subjects were also screened for the Leu3020insC mutation. Consent was given by 35 asymptomatic first-degree relatives of 18 Crohn's disease patients. Ultrasonography indicated increased bowel wall thickness (5mm) compatible with ileal Crohn's disease in 1 relative (2.8%), a 42 year-old male. Ileocolonoscopy, histology, and radiology confirmed the diagnosis of stricturing ileal Crohn's disease. Gallbladder stones were detected in 7/35 (20%) relatives and Leu3020insC mutation in 3/35 (8.5%). Small Bowel Contrast Ultrasonography may be a useful tool to diagnose asymptomatic small bowel Crohn's disease among first-degree relatives of patients. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    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...

  14. Sonographic evaluation of the plantar fascia in asymptomatic subjects.

    Science.gov (United States)

    Gadalla, N; Kichouh, M; Boulet, C; Machiels, F; De Mey, J; De Maeseneer, M

    2014-01-01

    To evaluate the appearance of the plantar fascia in asymptomatic subjects. Thirty-one asymptomatic subjects were examined by 2 musculoskeletal radiologists. The plantar fascia was evaluated for thickness, echogenicity, vascularity on power Doppler, rupture, fluid adjacent to the fascia, andcalcifications. The study included 14 men and 17 women (age, 17-79 years; mean, 45 years). The mean thickness of the plantar fascia in men was 3.7 mm (range 2.5-7 mm), and in women 3.5 mm (range, 1.7-5.1 mm). The thickness was greater than 4 mm in 4 men (bilateral in 2). The mean thickness of fascias thicker than 4 mm in men was 5.4 mm (range, 4.3-7 mm). The thickness was greater than 4 mm in 5 women ( bilateral in 4). The mean thickness of fascias thicker than 4 mm in women was 4.7 mm (range, 4.2-5.1 mm). There was no statistically significant difference between men and women and between both heels. Hypoechogenicity was observed in 3 men (bilateral in 2), and in 5 women (bilateral in 6). Hypervascularity, rupture, fluid adjacent to the fascia, and calcifications were not observed. A thickness greater than 4 mm and hypoechogenicity, are common in the plantar fascia of asymptomatic subjects. Findings that were not seen in asymptomatic subjects include a thickness greater than 7 mm, hypervascularity on power Doppler, rupture, fluid adjacent to the fascia, and calcifications.

  15. Asymptomatic genital infection among pregnant women in Sagamu ...

    African Journals Online (AJOL)

    Background: Untreated genital tract infections in pregnancy may be associated with adverse effects on foetal and maternal health leading to poor pregnancy outcome. Aim: The aim of this study is to determine the prevalence and microbial isolates associated with asymptomatic genital infectionsin pregnancy. Methodology: ...

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

    NARCIS (Netherlands)

    Engberts, M.K.

    2007-01-01

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

  17. Asymptomatic malaria and associated factors among blood donors ...

    African Journals Online (AJOL)

    Background: Blood transfusion saves life of patients with severe anaemia. However, blood transfusion can transmit blood-borne parasites. Despite malaria being endemic in Tanzania, there is limited information on asymptomatic malaria among blood donors. This study determined the prevalence and associated factors of ...

  18. Studies On the Incidence of Asymptomatic Plasmodium Infection ...

    African Journals Online (AJOL)

    The incidence of asymptomatic Plasmodium falciparum infection among orphans between age groups, gender and blood groups was investigated. Standard microscopic methods were used to screen for malaria parasites in the blood specimens obtained from eighty-five (85) subjects in three orphanages in Kaduna and ...

  19. Evidence-based treatments for the asymptomatic HIV- positive ...

    African Journals Online (AJOL)

    banzi

    Preventing opportunistic infections in the asymptomatic. HIV-positive patient. Is antituberculosis prophylaxis beneficial? There is grade-A evidence from two SRs4,5 and several well-con- ducted RCTs6-9 that shows that in people who are both HIV- and tuberculin-positive, prophylactic anti-TB drugs significantly reduce.

  20. Asymptomatic Bacteriuria in Pregnancy: Much Ado about Nothing ...

    African Journals Online (AJOL)

    Chi-square test and analysis for linear trend in proportions were used to determine association between qualitative variables, and a P-value of less than 0.05 was considered significant. Results: The incidence of asymptomatic bacteriuria among the recruited pregnant women was 8.0%. Escherichia coli (E coli) and ...

  1. Estimation of spinopelvic muscles' volumes in young asymptomatic subjects: a quantitative analysis.

    Science.gov (United States)

    Amabile, Celia; Moal, Bertrand; Chtara, Oussama Arous; Pillet, Helene; Raya, Jose G; Iannessi, Antoine; Skalli, Wafa; Lafage, Virginie; Bronsard, Nicolas

    2017-04-01

    Muscles have been proved to be a major component in postural regulation during pathological evolution or aging. Particularly, spinopelvic muscles are recruited for compensatory mechanisms such as pelvic retroversion, or knee flexion. Change in muscles' volume could, therefore, be a marker of greater postural degradation. Yet, it is difficult to interpret spinopelvic muscular degradation as there are few reported values for young asymptomatic adults to compare to. The objective was to provide such reference values on spinopelvic muscles. A model predicting the muscular volume from reduced set of MRI segmented images was investigated. A total of 23 asymptomatic subjects younger than 24 years old underwent an MRI acquisition from T12 to the knee. Spinopelvic muscles were segmented to obtain an accurate 3D reconstruction, allowing precise computation of muscle's volume. A model computing the volume of muscular groups from less than six MRI segmented slices was investigated. Baseline values have been reported in tables. For all muscles, invariance was found for the shape factor [ratio of volume over (area times length): SD muscles' values for a reference population have been reported. A new model predicting the muscles' volumes from a reduced set of MRI slices is proposed. While this model still needs to be validated on other populations, the current study appears promising for clinical use to determine, quantitatively, the muscular degradation.

  2. Profile of newborns undergoing early stimulation in a neonatal intensive care unit

    National Research Council Canada - National Science Library

    Karla Camila Lima de Souza; Nataly Gurgel Campos; Francisco Fleury Uchoa Santos Júnior

    2014-01-01

    Objective: To describe the profile of newborns undergoing early stimulation in a neonatal intensive care unit, characterizing the study population according to their neonatal variables and risk factors...

  3. Profile of newborns undergoing early stimulation in a neonatal intensive care unit

    National Research Council Canada - National Science Library

    Karla Camila Lima de Souza; Nataly Gurgel Campos; Francisco Fleury Uchoa Santos Júnior

    2013-01-01

    Objective: To describe the profile of newborns undergoing early stimulation in a neonatal intensive care unit, characterizing the study population according to their neonatal variables and risk factors...

  4. The nutritional status of asymptomatic HIV-infected Africans: directions for dietary intervention?

    Science.gov (United States)

    Vorster, Hester H; Kruger, Annamarie; Margetts, Barrie M; Venter, Christina S; Kruger, H Salomé; Veldman, Frederick J; Macintyre, Una E

    2004-12-01

    To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIV-uninfected subjects, to gain more information on the appropriate diet for HIV-infected persons at an early stage of infection. Cross-sectional population-based survey. North West Province, South Africa. Two hundred and sixteen asymptomatic HIV-infected and 1550 HIV-uninfected men and women volunteers aged 15 years and older, recruited as 'apparently healthy' subjects from 37 randomly selected sites. Food and nutrient intakes, measured with a validated food-frequency questionnaire, and nutritional status indicated by anthropometric and biochemical variables, measured by a standardised methodology. The prevalence of HIV infection in the study population was 11.9%. The anthropometric indices and nutrient intakes of HIV-infected and uninfected subjects did not differ significantly, indicating that these 216 HIV-infected subjects were at an early stage of infection. Of the biochemical nutritional status variables, high-density lipoprotein cholesterol and total cholesterol, haemoglobin, albumin and triglycerides were significantly lower in infected subjects. They also had higher globulin and liver enzyme levels than uninfected subjects. In infected subjects, serum albumin correlated significantly with serum lipids, serum vitamin A, serum vitamin E, serum iron, total iron-binding capacity and haemoglobin. The significant positive correlations of the liver enzymes with serum lipids, albumin, vitamin A and iron, observed in HIV-uninfected subjects, disappeared in the infected subjects. Polyunsaturated fat intake showed significant positive correlations with the increased liver enzymes in infected subjects. A principal components analysis indicated that, in infected subjects, increased liver enzymes correlated with higher consumption of maize meal and lower consumption of meat and vegetables. This survey indicated that asymptomatic

  5. A biological model for influenza transmission: pandemic planning implications of asymptomatic infection and immunity.

    Directory of Open Access Journals (Sweden)

    John D Mathews

    Full Text Available BACKGROUND: The clinical attack rate of influenza is influenced by prior immunity and mixing patterns in the host population, and also by the proportion of infections that are asymptomatic. This complexity makes it difficult to directly estimate R(0 from the attack rate, contributing to uncertainty in epidemiological models to guide pandemic planning. We have modelled multiple wave outbreaks of influenza from different populations to allow for changing immunity and asymptomatic infection and to make inferences about R(0. DATA AND METHODS: On the island of Tristan da Cunha (TdC, 96% of residents reported illness during an H3N2 outbreak in 1971, compared with only 25% of RAF personnel in military camps during the 1918 H1N1 pandemic. Monte Carlo Markov Chain (MCMC methods were used to estimate model parameter distributions. FINDINGS: We estimated that most islanders on TdC were non-immune (susceptible before the first wave, and that almost all exposures of susceptible persons caused symptoms. The median R(0 of 6.4 (95% credibility interval 3.7-10.7 implied that most islanders were exposed twice, although only a minority became ill in the second wave because of temporary protection following the first wave. In contrast, only 51% of RAF personnel were susceptible before the first wave, and only 38% of exposed susceptibles reported symptoms. R(0 in this population was also lower [2.9 (2.3-4.3], suggesting reduced viral transmission in a partially immune population. INTERPRETATION: Our model implies that the RAF population was partially protected before the summer pandemic wave of 1918, arguably because of prior exposure to interpandemic influenza. Without such protection, each symptomatic case of influenza would transmit to between 2 and 10 new cases, with incidence initially doubling every 1-2 days. Containment of a novel virus could be more difficult than hitherto supposed.

  6. Pattern of Electrocardiographic Changes in Pre-operative check-up in Patients Undergoing ENT Surgery

    Directory of Open Access Journals (Sweden)

    Partha Pratim Das

    2011-09-01

    Full Text Available Background: The 12-lead ECG is the primary clinical tool for non-invasive assessment of cardiac electrical function. Before any surgery, ECG is commonly used in pre-operative check-up. Therefore pre-operative check-up of large number of people can be a valuable tool for accurate estimates of the prevalence of ECG abnormalities of general population. Objectives: To observe the extent of ECG changes in a group of population undergoing ENT surgery and to describe the prevalence of changes in relation to age and sex. Methods: 704 consecutive adult stable patients were included between age of 20 – 60 years without previously diagnosed case of any other systemic diseases who came to this hospital for elective surgical procedures and were investigated with new ECG for pre-operative check-up in private Hospital between January 201 to December 2010. Results: Total number of ECG recordings were 704; out of them 479 were male & 225 were female. Among 704 ECG recording 486(69.03% were normal. The number of old myocardial infarction (MI was in 36 cases (5.11%. Cardiac Ischaemia observed by ST depressions/T inversion was present in 15 cases (2.13%. Conclusion: The observation of the study is concludes that nearly 70% of all asymptomatic people (between 20 – 60 years possessing normal ECG but Ischaemic changes (like Q wave/ST depression & T inversion/ LBBB was present in about 8% cases. ECG changes of IHD (Ischaemic Heart Disease increases with age and male groups at higher risk of developing IHD. Key Words: ECG; Pre-operative Check-up; Myocardial Infarction (MI. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8630 BSMMU J 2011; 4(2:56-59

  7. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group

    NARCIS (Netherlands)

    Geerlings, S. E.; Stolk, R. P.; Camps, M. J.; Netten, P. M.; Hoekstra, J. B.; Bouter, K. P.; Bravenboer, B.; Collet, J. T.; Jansz, A. R.; Hoepelman, A. I.

    2000-01-01

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

  8. Effect of heavy training in contact sports on MRI findings in the pubic region of asymptomatic competitive athletes compared with non-athlete controls

    Energy Technology Data Exchange (ETDEWEB)

    Paajanen, Hannu [Kuopio University Hospital, Department of Surgery, Kuopio (Finland); Hermunen, Heikki; Karonen, Jari [Central Hospital of Mikkeli, Department of Radiology, Mikkeli (Finland)

    2011-01-15

    Bone marrow edema (BME) at the pubic symphysis on magnetic resonance imaging (MRI) is usually associated with groin pain and stress injury of the pubic bone. Little is known of the pubic MR imaging findings of asymptomatic heavy training athletes in contact sports. Pelvic MRI of male asymptomatic soccer (n = 10), ice hockey (n = 10), bandy (n = 10) and female floor-ball players (n = 10) were compared with non-athlete controls (10 males, 10 females) without groin pain to analyse the presence of BME (on a four-point scale). To study the possible changes of BME directly following heavy physical activity, 10 bandy players underwent MRI before and immediately after a 2-h training session. Magnetic resonance imaging showed minimal BME (grade 1) at the pubic symphysis in 19 of the 40 athletes (48%). Two soccer and 2 ice hockey players (20%) had moderate grade 2 pubic edema, but severe grade 3 BME findings were not found. Also 10 out of 20 (50%) of controls had grade 1 BME. The extent of increased signal was equally distributed in the asymptomatic athletes of different contact sports and controls. A heavy 2-h training session did not cause any enhanced signal at the pubic symphysis. This study indicates that the presence of grade 1 pubic BME was a frequent finding in contact sports and comparable to that in non-athletes. Grade 2 BME was found only in asymptomatic athletes undergoing heavy training. (orig.)

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

    DEFF Research Database (Denmark)

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

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Thomas R Hawn

    2009-12-01

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

  11. Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Roussouly, P; Berthonnaud, E; Guigui, P

    2011-09-01

    Many studies suggest the importance of the sagittal sacropelvic balance and morphology in spinal and hip disorders. This study describes the normal age- and sex-related changes in sacropelvic morphology and balance in a prospective cohort of asymptomatic adults without spinal disorder. A prospective cohort of 709 asymptomatic adults without spinal pathology was recruited. There were 354 males and 355 females aged 37.9 ± 14.7 and 35.7 ± 13.9 years, respectively. For each subjects, pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured from standing lateral radiographs. Ratios of SS to PI (SS/PI), PT to PI (PT/PI), and PT to SS (PT/SS) were also calculated. There was no significant difference in PI (pelvic incidence), SS (sacral slope), PT (pelvic tilt), PT/PI, SS/PI, or PT/SS between males and females. The mean ± 2 standard deviations (SD) range was 32°-74°, 0°-27°, and 24°-55° for PI, PT and SS, respectively. The mean ± 2 SD range was greater than 0.5 for SS/PI and less than 0.5 for PT/PI. PI was not related to age in either sex group. PT, SS, PT/PI, SS/PI, and PT/SS presented only weak correlation coefficients (r ≤ 0.21) with respect to age. The current study presents the largest cohort of asymptomatic adults in the literature dedicated to the evaluation of sagittal sacropelvic morphology and balance. The range of values corresponding to the mean ± 2 SD can provide invaluable information to clinicians about the normal range of values expected in 95% of the normal population.

  12. GLENOHUMERAL INTERNAL ROTATION DEFICIT IN THE ASYMPTOMATIC PROFESSIONAL PITCHER AND ITS RELATIONSHIP TO HUMERAL RETROVERSION

    Directory of Open Access Journals (Sweden)

    John M. Tokish

    2008-03-01

    Full Text Available The purpose of this study was to determine if glenohumeral internal rotation deficits (GIRD exist in an asymptomatic population of professional pitchers, and to assess whether these changes are primarily a bony or soft tissue adaptation. Twenty three, active, asymptomatic professional (Major League Baseball pitchers volunteered for the study. Clinical measures of glenohumeral ranges of motion, laxity, GIRD, as well as radiographic measures of humeral retroversion were taken by two independent orthopaedic surgeons. Data comparing side to side differences in range of motion, laxity, and humeral retroversion were analyzed for statistical significance using a paired t-test for continuous data and a Chi-squared test for ordinal data, with a significance set at 0.05. Evaluations of statistical correlations between different measurement parameters were accomplished using a Pearson product moment correlation. We hypothesized GIRD will be positively correlated with humeral retroversion (HR in the pitching arm. All clinical and radiographic measures were made in the field, at spring training, by physicians of both private and institutional based sports medicine practices. For the entire group, significant differences were exhibited for HR, external rotation at 90° and internal rotation at 90°, for dominant vs. non-dominant arms. GIRD of greater than 25° was noted in 10/23 of pitchers. In this group, HR was significantly increased and correlated to GIRD. No such increase or correlation was noted for the non-GIRD group. GIRD is a common finding in asymptomatic professional pitchers, and is related to humeral retroversion. Thus internal rotation deficits should not be used as the sole screening tool to diagnose the disabled throwing shoulder

  13. Canine parvovirus in asymptomatic feline carriers.

    Science.gov (United States)

    Clegg, S R; Coyne, K P; Dawson, S; Spibey, N; Gaskell, R M; Radford, A D

    2012-05-25

    population. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. 7. Prevalence of CAD in asymptomatic type II diabetics, using MPI as screening tool. Single center cross sectional study from KSA

    Directory of Open Access Journals (Sweden)

    Anwar Jelani

    2017-10-01

    Conclusion: Despite higher rate of diabetes in Saudi Arabia, asymptomatic Diabetics have a lower than expected incidence of active CAD. There would be a need to test this notion further. This would require more studies to confirm our findings in Saudi population.

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

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Marques dos Santos

    2012-06-01

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

  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. Correlation between lumbar intervertebral disc height and lumbar spine sagittal alignment among asymptomatic Asian young adults.

    Science.gov (United States)

    Zhang, Feng; Zhang, Kai; Tian, Hai-Jun; Wu, Ai-Min; Cheng, Xiao-Fei; Zhou, Tang-Jun; Zhao, Jie

    2018-02-12

    To investigate the distribution and characteristics of the lumbar intervertebral disc height (IDH) in asymptomatic Asian population and to determine whether the lumbar IDH is related to the lumbar spine sagittal alignment. A cohort of 169 cases of asymptomatic volunteers was enrolled from January 2014 to July 2016. All participants underwent magnetic resonance imaging of the lumbar spine and panoramic radiography of the spine. Panoramic radiographs of the spine were taken to evaluate pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) using Surgimap® software. Roussouly classification was utilized to categorize all subjects according to the four subtypes of sagittal alignment. The IDH was measured on the MRI mid-saggital section of the vertebral body. The relationships between lumbar IDH and spine-pelvic parameters were also assessed using the Spearman correlation analysis. The reference value ranges of IDH in asymptomatic Asian volunteers between L1/2, L2/3, L3/4, L4/5, and L5/S1 were (6.25, 10.99), (6.97, 12.08), (7.42, 13.3), (7.76, 14.57),and (7.11, 13.12) mm, respectively. Based on the above reference value, the high lumbar intervertebral space is defined as more than 14 mm. According to the Roussouly Classification, there are 33 cases in type I, 48 in type II, 66 in type III, and 22 in type IV. According to the definition of the high IDH, there are two cases in type I, three in type II, nine in type III, and eight in type IV. The results indicated that people in the Roussouly III and IV subtypes had greater values for IDH compared to those of Roussouly I and II subtypes, and the spinopelvic parameters were partly correlated with IDH in different subtypes. In addition, levels L4-L5 showed the highest IDH for all four groups followed by the L3-L4 and L5-S1 levels, and the value of L3-L4 is equivalent to that of L5-S1. All type groups showed moderate and positive correlations between the PI and IDH except the level of L1-L2 in type IV. The IDH may

  18. The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2017-08-01

    Full Text Available Background and purposeAsymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial spin labeling (pASL MRI and resting-state functional MRI (R-fMRI have been employed in cognitive impairment studies. For the present study, cognition is evaluated in severe asymptomatic carotid artery stenosis patients undergoing CAS, and the mechanisms underlying the cognitive change are explored by pASL MRI and R-fMRI.Materials and methodsWe prospectively enrolled 24 asymptomatic, severe (≥70%, unilateral internal carotid artery stenosis patients, who were expecting the intervention of CAS. Cognition assessment (including the Montreal Cognitive Assessment Beijing Version, the Minimum Mental State Examination, the Digit Symbol Test, the Rey Auditory Verbal Learning Test, and the Verbal Memory Test and an integrated MRI program (pASL MRI, and R-fMRI were administered 7 days before and 3 months after CAS.Results16 subjects completed the follow-up study. After stenting, significant improvement in the scores of the MMSE, the Verbal Memory test, and the delayed recall was found. No significant difference was found in the scores of the Montreal Cognitive Assessment Beijing Version, the Digit Symbol Test, and the immediate recall. After CAS treatment, asymptomatic carotid artery stenosis patients showed increased perfusion in the left frontal gyrus, increased amplitude of low-frequency fluctuation (ALFF in the right precentral gyrus, and increased connectivity to the posterior cingulate cortex (PCC in the right supra frontal gyrus. However, no significant correlations were found between these imaging changes and cognition assessments.ConclusionSuccessful CAS can partly improve cognition in asymptomatic carotid artery stenosis patients. The cognition

  19. Asymptomatic portal vein aneurysms: To treat, or not to treat?

    Science.gov (United States)

    Hirji, Sameer A; Robertson, Faith C; Casillas, Sergio; McPhee, James T; Gupta, Naren; Martin, Michelle C; Raffetto, Joseph D

    2017-01-01

    Background Portal vein aneurysms are rare dilations in the portal venous system, for which the etiology and pathophysiological consequences are poorly understood. Method We reviewed the existing literature as well as present a unique anecdotal case of a patient presenting with a very large portal vein aneurysm that was successfully managed conservatively and non-operatively without anticoagulation, with close follow-up and routine surveillance. Result The rising prevalence of abdominal imaging in clinical practice has increased rates of portal vein aneurysm detection. While asymptomatic aneurysms less than 3 cm can be clinically observed, surgical intervention may be necessary in large asymptomatic aneurysms (>3 cm) with or without thrombus, or small aneurysms with evidence of evolving mural thrombus formation on imaging. Conclusion Portal vein aneurysms present a diagnostic challenge for any surgeon, and the goal for surgical therapy is based on repairing the portal vein aneurysm, and if portal hypertension is present decompressing via surgically constructed shunts.

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

    Directory of Open Access Journals (Sweden)

    Murat Kose

    2015-01-01

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

  2. Epidermolysis bullosa pruriginosa: A rare presentation with asymptomatic lesions

    Directory of Open Access Journals (Sweden)

    Sangita Ghosh

    2013-01-01

    Full Text Available Epidermolysis bullosa pruriginosa (EBP is a subtype of dominant dystrophic epidermolysis bullosa (DDEB and is clinically characterized by pruritic lichenified plaques or prurigo-like lesions with violaceous linear scarring. Pruritus has always been described as one of the most striking features in EBP. Mutations in COL7A gene, especially in the glycine residue, have been shown to cause this form of DDEB. In this report, we describe a north Indian familial clustering of three cases of EBP, spread across two generations, presenting with hypertrophic lichenoid cutaneous lesions, which were completely asymptomatic. Clinical and histopathological analysis favored the diagnosis of EBP in all three cases. They are being reported for their unusual asymptomatic presentation.

  3. Imaging markers of stroke risk in asymptomatic carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Shyam Prabhakaran

    2015-01-01

    Full Text Available Carotid stenosis is a major cause of ischemic stroke. While symptomatic carotid stenosis requires prompt revascularization, there is significant debate about the management of asymptomatic carotid stenosis (ACS, especially in light of recent advances in medical therapy. As a result, there is an even greater need for reliable predictors of stroke risk in asymptomatic patients. Besides clinical factors and stenosis grade, plaque morphology and cerebral hemodynamics may be suitable prognostic tools. High-risk features, using Doppler and magnetic resonance imaging (MRI suggest that subpopulations at sufficiently high risk (10% annually can be identified and in whom revascularization would be most beneficial. In this review, imaging tools to aid in stroke risk stratification in patients with ACS are discussed.

  4. High Prevalence of Asymptomatic Neurocysticercosis in an Endemic Rural Community in Peru.

    Directory of Open Access Journals (Sweden)

    Luz M Moyano

    2016-12-01

    Full Text Available Neurocysticercosis is a common helminthic infection of the central nervous system and an important cause of adult-onset epilepsy in endemic countries. However, few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level.We conducted a population-based study of resident's ≥2 years old in a highly endemic village in Peru (pop. 454. We applied a 14 -question neurologic screening tool and evaluated serum for antibodies against Taenia solium cysticercosis using enzyme-linked immunoelectrotransfer blot (LLGP-EITB. We invited all residents ≥18 years old to have non-contrast computerized tomography (CT of the head.Of the 385 residents who provided serum samples, 142 (36.9% were seropositive. Of the 256 residents who underwent CT scan, 48 (18.8% had brain calcifications consistent with NCC; 8/48 (17.0% reported a history of headache and/or seizures. Exposure to T. solium is very common in this endemic community where 1 out of 5 residents had brain calcifications. However, the vast majority of people with calcifications were asymptomatic.This study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future.

  5. Relationship between active cervical range of motion and flexion-relaxation ratio in asymptomatic computer workers.

    Science.gov (United States)

    Yoo, Won-Gyu; Park, Se-Yeon; Lee, Mi-Ra

    2011-01-01

    A high prevalence and incidence of neck and shoulder pain is present in the working population, especially sedentary workers. Recent findings have indicated that the flexion-relaxation (FR) ratio in the cervical erector spinae (CES) muscles might be a significant criteria of neuromuscular impairment and function. Additionally, the active cervical range of motion (ROM) is frequently used for discriminating between individuals with pain and those who are asymptomatic. The purpose of the present study was to examine the relationship between the active cervical ROM and the FR ratio in a sample of regular visual display terminal (VDT) workers. In total, 20 asymptomatic male VDT workers were recruited. Active cervical ROM was measured by a cervical ROM (CROM) instrument. Surface electromyography (EMG) was used to collect myoelectrical signals from the CES muscles, and the FR ratio was calculated for statistical analysis. Pearson correlation coefficients were used to quantify the linear relationship between the active cervical ROM and the FR ratio. The values obtained for the FR ratio in the right CES muscles correlated significantly with the active cervical ROM measured in flexion (r=0.73, pflexion (r=0.64, pFlexion (r=0.74, pflexion (r=0.61, pflexion and lateral flexion. In addition, muscular dysfunction of the CES could occur in regular computer workers prior to occurrence of pain; this means that the FR ratio could be used to evaluate the potential risk of neck discomfort in computer workers.

  6. High Prevalence of Asymptomatic Neurocysticercosis in an Endemic Rural Community in Peru.

    Science.gov (United States)

    Moyano, Luz M; O'Neal, Seth E; Ayvar, Viterbo; Gonzalvez, Guillermo; Gamboa, Ricardo; Vilchez, Percy; Rodriguez, Silvia; Reistetter, Joe; Tsang, Victor C W; Gilman, Robert H; Gonzalez, Armando E; Garcia, Hector H

    2016-12-01

    Neurocysticercosis is a common helminthic infection of the central nervous system and an important cause of adult-onset epilepsy in endemic countries. However, few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level. We conducted a population-based study of resident's ≥2 years old in a highly endemic village in Peru (pop. 454). We applied a 14 -question neurologic screening tool and evaluated serum for antibodies against Taenia solium cysticercosis using enzyme-linked immunoelectrotransfer blot (LLGP-EITB). We invited all residents ≥18 years old to have non-contrast computerized tomography (CT) of the head. Of the 385 residents who provided serum samples, 142 (36.9%) were seropositive. Of the 256 residents who underwent CT scan, 48 (18.8%) had brain calcifications consistent with NCC; 8/48 (17.0%) reported a history of headache and/or seizures. Exposure to T. solium is very common in this endemic community where 1 out of 5 residents had brain calcifications. However, the vast majority of people with calcifications were asymptomatic. This study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future.

  7. Myocardial perfusion single photon emission computed tomography in asymptomatic diabetics.

    Science.gov (United States)

    Harshad, K; Sathyamurthy, I; Ashish, G; Padma, D; Shelley, S; Indirani, M; Subramanian, K

    2010-01-01

    Coronary artery disease (CAD) is the most important cause of mortality in diabetic patients. Diabetes mellitus (DM) due to autonomic neuropathy leads to asymptomatic CAD. Hence, it is important to screen the patients with DM for CAD. To study the prevalence of asymptomatic CAD by Myocardial Perfuision SPECT (Single Photon Emission Computed Tomography) (MPS) in diabetics. This prospective study included 88 asymptomatic patients (58 males and 30 females) of Type 2 DM of more than 5 years duration in the age group of 40-65 years. Risk factors like hypertension, dyslipidemia, smoking, family history of CAD and Body Mass Index > or = 25 kg/sq.m were assessed. All these patients underwent MPS study as two day standard protocol. Thirty eight patients underwent invasive Coronary Angiography (CAG) and stenosis greater than 50% was considered significant. Abnormal perfusion was detected in 38 (43%) diabetics and 4 (11%) controls. A total of 81 perfusion defects were identified (19 fired and 62 reversible). CAG showed significant coronary stenosis in 26 (68.4%), insignificant in 8 (21%) and no stenosis in 4 (10.6%) patients. A total of 114 coronaries were analysed, significant stenosis in 67 (58.8%) coronaries, 21 (18.4%) had insignificant lesions and 26(22.8%) were normal. In comparison to CAG, MPS had sensitivity of 86.6% and specificity of 51%. The Myocardial Perfusion SPECT is a sensitive diagnostic tool to identify ischemia in asymptomatic diabetics. MPS can be used as screening test for risk stratification. It has a prognostic value in predicting the outcome of CAD and can be useful for long-term follow up too.

  8. Asymptomatic Presentation of Bochdalek’s Hernia in an Adult

    OpenAIRE

    Venkatesh, S. P.; Ravi, M. J.; Thrishuli, P. B.; Sharath Chandra, B. J.

    2011-01-01

    Bochdalek hernia, a type of congenital diaphragmatic hernia usually presents in the immediate neonatal period with respiratory distress. Presentation in an adult is rare and asymptomatic. We report one such case of Bochdalek hernia, in a 35 year old male, who presented only with mild chest discomfort on left side. Radiological investigations were suggestive of a huge left side Bochdalek hernia with stomach and intestines in the left thorax. This case emphasizes the rarity of presentation of B...

  9. The Prevalence and Outcome of Asymptomatic Chlamydial Infection ...

    African Journals Online (AJOL)

    Of those with HSG result (64), the accuracy of the test kit showed low sensitivity ‑ 44.2% (19/43) and negative predictive value 40.0% (16/40) (but, high specificity. ‑ 76.2%(16/21), and positive predictive value ‑ 79.2% (19/24). Conclusion: Asymptomatic. Chlamydial infection is common among infertile women and it positively ...

  10. 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. © 2015 European Society of Endocrinology.

  11. Asymptomatic vertebral fractures in patients with low bone mineral density

    Directory of Open Access Journals (Sweden)

    Caio Cesar Leite de Negreiros

    2016-04-01

    Full Text Available Summary Objective: Vertebral fracture assessment (VFA is a test technique that can be used to detect asymptomatic vertebral fractures (AVF. It uses dual energy X-ray bsorptiometry (DXA and can be performed concurrently with bone densitometry. This study aims to assess the prevalence of AVF in patients with low bone mass. Methods: Cross-sectional study including 135 individuals with low bone mineral density (BMD with a T-score 61 years.

  12. A Rare Entity: Adult Asymptomatic Giant Vallecular Cyst

    Directory of Open Access Journals (Sweden)

    Mümtaz Taner Torun

    2015-01-01

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

  13. Tuberculosis in children undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Gargah Tahar

    2010-04-01

    Full Text Available Gargah Tahar1, Goucha-Louzir Rim2, Lakhoua Mohamed Rachid11Department of Pediatric Nephrology, 2Department of Nephrology, Charles Nicolle Hospital, Tunis, TunisiaAbstract: Tuberculosis (TB remains a public health problem in Tunisia. Its incidence is higher in immunocompromised hosts than in the general population. In children and during hemodialysis, TB is characterized by the frequency of extrapulmonary localizations and diagnostic difficulties. The aim of this retrospective study is to evaluate the incidence of TB in Tunisian children undergoing hemodialysis and to determine its clinical features as well as the results of chemotherapy.Method: This retrospective study includes seven TB children among 112 children on hemodialysis at the pediatric nephrology department in Charles Nicolle Hospital from 2002 to 2008. The diagnosis of TB was established by a combination of clinical, radiological, biochemical, microbiological, and histological examinations. Treatment with anti-TB drugs, the results of therapy, and the outcome of patients were noted.Results: There were four girls and three boys aged 10 to 16 years (mean, 13 years. They had been on hemodialysis for 2 to 5 years (mean, 3 years. Noted clinical features were weight loss and fever in five cases, chest pain in one case, cervical lymph node in one case, and spinal pain in one case. The organ systems involved were pleural in two cases, pulmonary in one case, peritoneal in one case, cervical lymphatic in one case, and spinal in one case. One patient was treated empirically with a good response. Diagnosis was made by isolation of mycobacterium TB in three cases, by specific histological signs observed in a lymph node biopsy in one case, in peritoneal biopsy in one case, and in discovertebral biopsy in one case. In the remaining patient, the clinical and radiological presentations were compatible with pulmonary TB. All patients received four anti-TB drugs: isoniazid, rifampicin, pyrazinamide

  14. Asymptomatic polyvascular abnormalities in community (APAC study in China: objectives, design and baseline characteristics.

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    Yong Zhou

    Full Text Available OBJECTIVE: The population-based "Asymptomatic Polyvascular Abnormalities in Community (APAC Study was designed to examine prevalence and associations of asymptomatic polyvascular abnormalities (APA in a general population. In this report, the objectives, design and baseline data of the APAC study are described. METHODS: The study included 5,440 participants (40.1% women with an age of 40+ years who were randomly selected from the population of the Kailuan Study which included 101,510 employees and retirees of the Kailuan Co. Ltd, a large coal mine industry located in Tangshan, Hebei, China. Exclusion criteria were previous cerebral stroke, transient ischemic attacks and coronary heart disease. In 2010 and 2011, information on potential cardiovascular risk factors was collected and all participants underwent transcranial Doppler sonography, measurement of the ankle brachial index, and bilateral carotid duplex sonography. In a first follow-up examination in 2012/2013, retinal photography and spectral-domain optical coherence tomography were additionally performed. In a planned long-term follow-up, data from clinical examinations and laboratory tests and the occurrence of cardiovascular or cerebrovascular events will be collected to build up a predicting model for the risk of ischemic events. RESULTS: At baseline, mean age of the participants was 55.2 ± 11.8 years, and men showed a significantly (P<0.001 higher prevalence of arterial hypertension (55.5% vs. 36.5% and hyperlipidemia (50.7% vs. 46.0% and a higher blood homocysteine concentration (18.68 ± 10.28 µmol/L versus 11.69 ± 6.40 µmol/L. CONCLUSIONS: The APAC is the first study to prospectively evaluate the relationship between intracranial arterial stenosis, retinal nerve fiber layer changes, retinal microvascular signs, and the eventual development of cerebrovascular or cardiovascular events.

  15. Glycemic and lipidic profile in diabetic patients undergoing dialysis.

    Science.gov (United States)

    Fortes, Paulo Cezar; Mendes, Jamille Godoy; Sesiuk, Karoline; Marcondes, Letícia Barros; Aita, Carlos Alberto Mayora; Riella, Miguel Carlos; Pecoits-Filho, Roberto

    2010-12-01

    The aim of this study is to assess the clinical care pattern and to compare the lipid and glycemic profile in a group of diabetic patients undergoing both hemodialysis (HD) and peritoneal dialysis (PD) and to correlate these data using biomarkers of cardiovascular risk. The first phase consisted in performing a survey on demographic data, questions about the medical team and glycemic control. In the second phase, patients were assessed through laboratorial data on their glycemic and lipid profile at a single center for HD and PD. 91 patients was the total population; 70 patients (77%) answered the survey; 66 patients (94%) considered the nephrologist the physician responsible for caring for their glycemic control. Second phase: 59 patients were assessed, 29 undergoing HD and 30 undergoing PD. Fifty-seven percent of the patients had HbA1c above 7%; the level of glycemic markers in patients undergoing peritoneal dialysis was significantly higher than in patients undergoing hemodialysis: HbA1c (9.37 ± 0.5) vs. (7.37 ± 0.49) p patients undergoing renal replacement therapy (RRT) is neglected. Peritoneal dialysis is related to the worst level of glycemic markers, possibly due to the glucose content in the dialysis solution, and higher levels from HbA1c have a positive correlation with hyperfibrinogenesis in this population.

  16. An audit of intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT).

    Science.gov (United States)

    Illingworth, Clare; Timmons, Stephen

    2007-11-01

    This paper reports a prospective audit, against an existing baseline standard, for intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT). This was done via a structured questionnaire, using the methodology of total population sampling, encapsulating all theatre staff within one NHS trust. With regards to the standard, performance is good, as IPC is DVT prophylaxis of choice in the perioperative area and is used frequently on most patients. The findings of the audit do, however, highlight the need for appropriate local DVT risk assessment guidelines, essential to ensure that prophylaxis is administered to the correct at risk groups, as prevention may be unjustified in low risk groups and possibly inappropriate for the same regimen to be used for all patients.

  17. Is pre-surgical imaging required for an asymptomatic posterior vertex subcutaneous dermoid? A case report

    Directory of Open Access Journals (Sweden)

    Simon Ho

    2016-09-01

    Full Text Available Scalp dermoid cysts are common etiologies of subcutaneous lump and bump lesions in the pediatric population, with incidence ranging from 15 to 22% (Crawford, 1990; McAvoy & Zuckerbraun, 1976. Midline scalp dermoid cysts have high risk for intracranial extension, with incidence reported to be 39–57% of cases (Wood, Couture, & David, 2012; Posnick, Bortoluzzi, Armstrong, & Drake, 1994. The following case illustrates a healthy thirteen-year-old boy who presented with asymptomatic enlarging subcutaneous posterior scalp mass who was consented for excision of the mass without pre-operative imaging, and was found to have an intracranial dermoid sinus tract intra-operatively. Post-operative imaging found an intracranial dermoid nodule which entailed an otherwise avoidable second-stage surgery to achieve complete resection.

  18. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes.

    Science.gov (United States)

    Abate, Michele; Schiavone, Cosima; Salini, Vincenzo

    2010-12-07

    The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively), who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p shoulder symptomatic pathologies.

  19. COMPARATIVE STUDY BETWEEN THE PUBIS OF ASYMPTOMATIC ATHLETES AND NON-ATHLETES WITH MRI.

    Science.gov (United States)

    Branco, Rodrigo Castelo; da Costa Fontenelle, César Rubens; Miranda, Leandro Marques; Junior, Yonder Archanjo Ching San; Vianna, Evandro Miguelote

    2010-01-01

    To compare the magnetic resonance imaging findings from the pubis of professional soccer players without any history or clinical findings of groin pain, and from sedentary individuals, also without symptoms, and to determine the prevalence of changes compatible with pubic overload. Nineteen professional soccer players without complaints of groin pain and seventeen sedentary individuals, also asymptomatic, underwent magnetic resonance imaging of the pubis. The results from the examinations were analyzed regarding the presence of degenerative changes, boned medullary edema and tendinopathy, and the two study groups were compared. High prevalence of bone edema, tendinopathy and degenerative findings in the pubic symphysis was seen in the athletes, with statistically significant higher odds ratios and relative risk in the population studied. Professional soccer players are at a higher risk of developing changes in the pubic region, shown in magnetic resonance images, compared with sedentary individuals. These findings are not necessarily caused by groin pain, and are probably related to intense exertion.

  20. 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.)

  1. Comparative immunohistochemical and quantitative analysis of inflammatory cells in symptomatic and asymptomatic chronic periapical lesions

    Directory of Open Access Journals (Sweden)

    Lukić Aleksandra

    2008-01-01

    Full Text Available Background/Aim. It has been demonstrated that lymphocytes, plasma cells, macrophages and neutrophil granulocytes represent the predominant cells of the inflammatory lesion of the dental granulomas. Other cells, such as mast cells, eosinophils, dendritic cells comprise minor, but functionally important cell populations. Most of the data considering cells that take part in these processes have been derived from immunohistological studies. This study was undertaken with the aim to determine the phenotype profile of inflammatory cells of dental granulomas using immunohistochemical method in order to study the differences of their quantitative properties and distribution between symptomatic and asymptomatic lesions. Methods. The material for the analysis originated from 42 individuals with clinic and radiographic diagnosis of chronic periapical lesions. The tissue was take either during the periradicular surgery, or tooth extraction. Cryostat tissue sections were stained using the alkaline phosphatase-antialkaline phosphatase assay (APAAP. This method is highly valid and sensitive using a panel of specific monoclonal antibodies: CD3, CD4, CD8, CD19, CD38, CD14, CD1a, CD83, CD80, CD86, CD45 and CD123. Results. The composition of the cell population revealed that there was no homogenous and site-specific pattern of the distribution of inflammatory cells. The results of our investigation revealed that the majority of inflammatory cells comprised lymphocytes and plasma cells, followed by subpopulations CD4+, CD8+ and CD14+ cells. Much lower in number were CD80+, CD86+ and CD83+ and CD1a+ cells. There were no statistically significant differences in mean values of inflammatory cells number between symptomatic and asymptomatic lesions, with the exception of CD86+ cells, the number of which was statistically higher in symptomatic lesions. Conclusion. Inflammatory infiltrate cells in dental granulomas are dominated by T- and Blymphocytes. It points out the

  2. T cell subtypes and reciprocal inflammatory mediator expression differentiate P. falciparum memory recall responses in asymptomatic and symptomatic malaria patients in southeastern Haiti.

    Science.gov (United States)

    Lehmann, Jason S; Campo, Joseph J; Cicéron, Micheline; Raccurt, Christian P; Boncy, Jacques; Beau De Rochars, Valery E M; Cannella, Anthony P

    2017-01-01

    Asymptomatic Plasmodium falciparum infection is responsible for maintaining malarial disease within human populations in low transmission countries such as Haiti. Investigating differential host immune responses to the parasite as a potential underlying mechanism could help provide insight into this highly complex phenomenon and possibly identify asymptomatic individuals. We performed a cross-sectional analysis of individuals who were diagnosed with malaria in Sud-Est, Haiti by comparing the cellular and humoral responses of both symptomatic and asymptomatic subjects. Plasma samples were analyzed with a P. falciparum protein microarray, which demonstrated serologic reactivity to 3,877 P. falciparum proteins of known serologic reactivity; however, no antigen-antibody reactions delineating asymptomatics from symptomatics were identified. In contrast, differences in cellular responses were observed. Flow cytometric analysis of patient peripheral blood mononuclear cells co-cultured with P. falciparum infected erythrocytes demonstrated a statistically significant increase in the proportion of T regulatory cells (CD4+ CD25+ CD127-), and increases in unique populations of both NKT-like cells (CD3+ CD8+ CD56+) and CD8mid T cells in asymptomatics compared to symptomatics. Also, CD38+/HLA-DR+ expression on γδ T cells, CD8mid (CD56-) T cells, and CD8mid CD56+ NKT-like cells decreased upon exposure to infected erythrocytes in both groups. Cytometric bead analysis of the co-culture supernatants demonstrated an upregulation of monocyte-activating chemokines/cytokines in asymptomatics, while immunomodulatory soluble factors were elevated in symptomatics. Principal component analysis of these expression values revealed a distinct clustering of individual responses within their respective phenotypic groups. This is the first comprehensive investigation of immune responses to P. falciparum in Haiti, and describes unique cell-mediated immune repertoires that delineate individuals

  3. Factors affecting patients undergoing cosmetic surgery in bushehr, southern iran.

    Science.gov (United States)

    Salehahmadi, Zeinab; Rafie, Seyyed Reza

    2012-07-01

    Although, there have been extensive research on the motivations driving patient to undergo cosmetic procedures, there is still a big question mark on the persuasive factors which may lead individuals to undergo cosmetic surgery. The present study evaluated various factors affecting patients undergoing cosmetic surgery in Bushehr, Southern Iran. From 24th March 2011 to 24th March 2012, eighty-one women and 20 men who wished to be operated in Fatemeh Zahra Hospital in Bushehr, Southern Iran and Pars Clinic, Iran were enrolled by a simple random sampling method. They all completed a questionnaire to consider reasons for cosmetic procedures. The collected data were statistically analyzed. Demographical, sociological and psychological factors such as age, gender, educational level, marital status, media, perceived risks, output quality, depression and self-improvement were determined as factors affecting tendency of individuals to undergo cosmetic surgery in this region. Trend to undergo cosmetic surgery was more prevalent in educational below bachelor degree, married subjects, women population of 30-45 years age group. Education level, age, marital status and gender were respectively the influential factors in deciding to undergo cosmetic surgery. Among the socio-psychological factors, self-improvement, finding a better job opportunity, rivalry, media, health status as well as depression were the most persuasive factors to encourage people to undergo cosmetic surgery too. Cost risk was not important for our samples in decision making to undergo cosmetic surgery. We need to fully understand the way in which the combination of demographic, social and psychological factors influence decision-making to undergo cosmetic surgery.

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

    Science.gov (United States)

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

    2016-01-05

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

  5. Progressive loss of vision caused by asymptomatic pituitary macroadenoma: role of OCT.

    Science.gov (United States)

    Asensio-Sánchez, Víctor Manuel; Foncubierta, Javier

    2016-01-01

    Most pituitary adenomas are clinically inactive. In patients with long-standing compression of the optic chiasm, ganglion cells may undergo axonal degeneration. Spectral domain optical coherence tomography (SD-OCT) is able to identify retinal nerve fiber layer (RNFL) and ganglion cell loss in the retina. We present a case in which SD-OCT was used to diagnose an asymptomatic pituitary macroadenoma. A 48-year-old female presented with progressive vision loss in both eyes. SD-OCT identified atrophy of the ganglion cell and nerve layers, with preservation of outer layers bilaterally. Magnetic resonance imaging of the brain showed a pituitary macroadenoma. The pathological diagnosis was nonfunctioning adenoma. As macroadenomas enlarge, they can induce uncrossed axon loss, resulting in nasal field defects and reduced visual acuity. In these cases, there is atrophy of the nasal and temporal portions of the optic disc, thus occupying a horizontal band across the disc. SD-OCT is able to identify RNFL loss in eyes with band atrophy of the optic nerve, which correlates with visual field defects found in perimetry. SD-OCT is a useful tool to assess the structural and functional damage of ganglion cells. In our case the SD-OCT demonstrated a symmetrical loss of the RNFL and the ganglion cell layer in both eyes, indicating important optic nerve damage.

  6. Left atrial phasic function and heart rate variability in asymptomatic diabetic patients.

    Science.gov (United States)

    Tadic, Marijana; Vukomanovic, Vladan; Cuspidi, Cesare; Suzic-Lazic, Jelena; Stanisavljevic, Dejana; Celic, Vera

    2017-03-01

    We evaluated left atrial (LA) phasic function and heart rate variability (HRV) in asymptomatic diabetic patients, and the relationship between HRV indices and LA phasic function assessed by volumes and speckle tracking imaging. This cross-sectional study included 55 asymptomatic patients with type 2 diabetes and 50 healthy controls without cardiovascular risk factors. All study subjects underwent laboratory analyses, complete two-dimensional echocardiography examination (2DE) and 24-h Holter monitoring. Maximum, minimum LA and pre-A LA volumes and volume indexes are significantly higher in diabetic patients. Total and passive LA emptying fractions (EF), representing the LA reservoir and conduit function, are significantly lower in diabetic subjects. Active LA EF, the parameter of the LA booster pump function, is compensatory increased in diabetic patients. Similar results were obtained by 2DE strain analysis. Cardiac autonomic function, assessed by HRV, is significantly deteriorated in diabetic patients. Time and frequency-domain HRV measures are significantly lower in diabetic subjects than in controls. HbA1c, LV mass index and HRV are associated with total LA EF and longitudinal LA strain independently of age, body mass index and LV diastolic function in the whole study population. LA phasic function and cardiac autonomic nervous system assessed by HRV are impacted by diabetes. HbA1c and HRV are independently associated with LA reservoir function evaluated by volumetric and strain methods in the whole study population. This study emphasizes the importance of determination of LA function and HRV as important markers of preclinical cardiac damage and autonomic function impairment in diabetic patients.

  7. Cost-effectiveness of microscopy of urethral smears for asymptomatic Mycoplasma genitalium urethritis in men in England.

    Science.gov (United States)

    Sutton, Andrew J; Roberts, Tracy E; Jackson, Louise; Saunders, John; White, Peter J; Birger, Ruthie; Estcourt, Claudia

    2018-01-01

    The objective was to determine whether or not the limited use of urethral microscopy to diagnose asymptomatic and symptomatic non-chlamydial, non-gonococcal urethritis (NCNGU) in men is a cost-effective strategy to avert pelvic inflammatory disease (PID), ectopic pregnancy or infertility in female partners. Outputs from a transmission dynamic model of NCNGU in a population of 16-30 year olds in England simulating the number of consultations, PID cases and patients treated over time amongst others, were used along with secondary data to undertake a cost-effectiveness analysis carried out from a health care provider perspective. The main outcome measure was cost per case of PID averted. A secondary outcome measure was cost per major outcome averted, where a major outcome is a case of symptomatic PID, ectopic pregnancy, or infertility. Offering a limited number of asymptomatic men urethral microscopy was more effective than the current practice of no microscopy in terms of reducing the number of cases of PID with an incremental cost-effectiveness ratio of £15,700, meaning that an investment of £15,800 is required to avert one case of PID. For major outcomes averted, offering some asymptomatic men urethral microscopy was again found to be more effective than no microscopy, but here an investment of £49,900 is required to avert one major outcome. Testing asymptomatic men for NCNGU in a small number of genitourinary medicine settings in England is not cost-effective, and thus by maintaining the current practice of not offering this patient group microscopy, this continues to make savings for the health care provider.

  8. Direct detection of incidental asymptomatic aneurysm by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Asari, S.; Sakurai, M.; Yamamoto, Y.; Suzuki, K. (Matsuyama Shimin Hospital, Ehime (Japan)); Sadamoto, K.

    1981-02-01

    Incidental asymptomatic aneurysms were found in 9 of 52 patients with intracranial aneurysms from February, 1978 to March, 1980. They had only mild initial symptoms, namely, headache, dysarthria, aphasis, light hemiparesis and others. No patients had severe neurological deficits. In eight of 9 patients with asymptomatic aneurysm, except one case of hypertensive intracerebral hematoma, 9 aneurysms (8 patients) were directly detected by high resolution CT (GE CT/T 8800) and confirmed by angiography. Location of these aneurysms as follows: three at the middle cerebral artery trifurcation, two at the internal carotisposterior communicans junction, one at anterior communication artery, one at the basilar top, one at the basilaris artery-superior cerebelli artery junction and one at the posterior cerebral artery. The smallest aneurysm detected by CT as 5 x 4 x 4 mm in size on angiography. The aneurysm may be suggested by small round or oval defect in the Sylvian fissure or suprasellar cistern, defect of the edge of the so called ''pentagon'' in the plain CT and then if its density is highly and homogeneously increased after contrast-enhanced (CE) scan. As the circle of Willis and other major cerebral arteries can often be demonstrated on CE.CT images, the aneurysm is frequently seen on these cerebral arteries. Limiting factors to direct CT detection of intracranial aneurysms are seemed to be size and location of aneurysm, anatomic location of circle of Willis and motion of patients etc. It may be considered, in our experiences, that the CT is useful in diagnosis of asymptomatic aneurysm and the higher direct CT detection rate to aneurysms, small or medium sized as well as giant aneurysms, will be obtained by devising scanning method, namely, multiprojection scans, multiple overlapping method and improvement of enhanced method.

  9. Semi-quantitative measurement of asymptomatic L. infantum infection and symptomatic visceral leishmaniasis in dogs using Dual-Path Platform® CVL.

    Science.gov (United States)

    Larson, Mandy; Toepp, Angela; Scott, Benjamin; Kurtz, Melissa; Fowler, Hailie; Esfandiari, Javan; Howard, Randall F; Vallur, Aarthy C; Duthie, Malcolm S; Petersen, Christine

    2017-01-01

    Infection with Leishmania causes diseases with variable presentation. The most severe form is visceral leishmaniasis (VL), caused by either L. donovani or L. infantum. Despite efforts to eliminate VL, to date, molecular detection in resource-poor settings have lacked the accuracy and rapidity that would enable widespread field use and the need for accurate, sensitive assays to detect asymptomatic Leishmania infection has become apparent. The domestic dog serves as the primary reservoir host of L. infantum. Study of this reservoir population provides an opportunity to evaluate the sensitivity and specificity of diagnostics for well-defined, symptomatic, canine visceral leishmaniasis (CVL) and asymptomatic L. infantum infection. Blood samples from an L. infantum-endemic population of US hunting dogs were evaluated with Dual-Path Platform (DPP®) CVL compared to those obtained via direct detection methods (culture- and Leishmania-specific quantitative polymerase chain reaction, qPCR) and immunofluorescence anti-Leishmania antibody test (IFAT). Statistically significant correlations were found between DPP® CVL development time and clinical status, culture status, circulating DNA levels, and IFAT titer. DPP® CVL results correlated with both clinical severity of disease and serological evidence of asymptomatic L. infantum infection. By precisely documenting the minimum time required for the development of a clear positive result in DPP® CVL, this test could be used in a rapid, semi-quantitative manner for the evaluation of asymptomatic and symptomatic CVL. Our results also indicate that a similar test could be used to improve our understanding of human VL.

  10. Prevalence of coronary artery calcium among asymptomatic men and women in a developing country: comparison with the USA data.

    Science.gov (United States)

    Dakik, Habib A; Skouri, Hadi N; Mehio-Sibai, Abla; Sibai, Tarek; Alam, Samir; Sawaya, Jaber; Nasrallah, Antoine; Wehbeh, Chadi; Ayach, Kamal; Abchee, Antoine B

    2005-11-01

    Coronary artery calcium score (CACS) correlates with atherosclerotic burden and predicts cardiac events. Most of the published data have been derived from the USA population. To study the prevalence of coronary calcium in an asymptomatic population from the eastern Mediterranean region and compare it to data obtained from a large population study in the USA. A total of 1154 asymptomatic men and women from Lebanon underwent EBCT screening because of the presence of one or more CAD risk factors. Mean CACS as well as the percentile cut-points increased consistently with increasing age and, except for those above 74 years of age, were higher in men than women in each age stratum. Age, hypercholesterolemia, diabetes and smoking showed significant associations with CACS in men, while only age and hypercholesterolemia were significantly associated with CACS in women. Among men, the 75th and 90th percentile distributions were comparable to what is observed in developed countries such as the USA. Findings, from this first study in the region, suggest that despite a higher rate of diabetes and smokers in our study population, the CACS distribution in Lebanon is similar to that observed in the USA.

  11. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-10-01

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

  12. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis.

    Science.gov (United States)

    Srivastava, T; Kochar, D K

    2003-10-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    Although various guidelines and position papers have discussed, in the past, the ethical aspects of genetic testing in asymptomatic minors, the European Society of Human Genetics had not earlier endorsed any set of guidelines exclusively focused on this issue. This paper has served as a background...... of best interests, participation of minors in health-care decisions, parents' responsibilities to share genetic information, the role of clinical genetics and the health-care system in communication within the family. Second, it discusses, respectively, the presymptomatic and predictive genetic testing...

  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. The relationship between Plasmodium infection, anaemia and nutritional status in asymptomatic children aged under five years living in stable transmission zones in Kinshasa, Democratic Republic of Congo.

    Science.gov (United States)

    Maketa, Vivi; Mavoko, Hypolite Muhindo; da Luz, Raquel Inocêncio; Zanga, Josué; Lubiba, Joachim; Kalonji, Albert; Lutumba, Pascal; Van Geertruyden, Jean-Pierre

    2015-02-18

    Malaria is preventable and treatable when recommended interventions are properly implemented. Thus, diagnosis and treatment focus on symptomatic individuals while asymptomatic Plasmodium infection (PI) plays a role in the sustainability of the transmission and may also have an impact on the morbidity of the disease in terms of anaemia, nutritional status and even cognitive development of children. The objective of this study was to assess PI prevalence and its relationship with known morbidity factors in a vulnerable but asymptomatic stratum of the population. A simple random sample, household survey in asymptomatic children under the age of five was conducted from April to September 2012 in two health areas of the health zone of Mont Ngafula 1, Kinshasa, Democratic Republic of Congo. The PI prevalence were 30.9% (95% CI: 26.5-35.9) and 14.3% (95% CI: 10.5-18.1) in Cité Pumbu and Kindele health areas, respectively, (OR: 2.7; p anaemia (haemoglobin anaemia (aOR: 3.5, p =0.01) and within infected children, there was an inverse relationship between parasite density and haemoglobin level (β = -5*10(-5), p anaemia (aOR: 3.4, p =0.001), chronic malnutrition (aOR: 1.8, p = 0.01), having a single parent/guardian (aOR: 1.6, p =0.04), and the non-use of insecticide-treated nets (aOR: 1.7, p = 0.04) were all predictors for PI in the overall population. PI in asymptomatic children was correlated with anaemia and chronic malnutrition and was thus a harmful condition in the study population. Malaria control initiatives should not only focus on treatment of symptomatic infections but also take into consideration asymptomatic but infected children.

  16. Parasitological Confirmation and Analysis of Leishmania Diversity in Asymptomatic and Subclinical Infection following Resolution of Cutaneous Leishmaniasis.

    Science.gov (United States)

    Rosales-Chilama, Mariana; Gongora, Rafael E; Valderrama, Liliana; Jojoa, Jimena; Alexander, Neal; Rubiano, Luisa C; Cossio, Alexandra; Adams, Emily R; Saravia, Nancy G; Gomez, María Adelaida

    2015-12-01

    The contribution of individuals with subclinical infection to the transmission and endemicity of cutaneous leishmaniasis (CL) is unknown. Immunological evidence of exposure to Leishmania in residents of endemic areas has been the basis for defining the human population with asymptomatic infection. However, parasitological confirmation of subclinical infection is lacking. We investigated the presence and viability of Leishmania in blood and non-invasive mucosal tissue samples from individuals with immunological evidence of subclinical infection in endemic areas for CL caused by Leishmania (Viannia) in Colombia. Detection of Leishmania kDNA was conducted by PCR-Southern Blot, and parasite viability was confirmed by amplification of parasite 7SLRNA gene transcripts. A molecular tool for genetic diversity analysis of parasite populations causing persistent subclinical infection based on PCR amplification and sequence analysis of an 82bp region between kDNA conserved blocks 1 and 2 was developed. Persistent Leishmania infection was demonstrated in 40% (46 of 114) of leishmanin skin test (LST) positive individuals without active disease; parasite viability was established in 59% of these (27 of 46; 24% of total). Parasite burden quantified from circulating blood monocytes, nasal, conjunctival or tonsil mucosal swab samples was comparable, and ranged between 0.2 to 22 parasites per reaction. kDNA sequences were obtained from samples from 2 individuals with asymptomatic infection and from 26 with history of CL, allowing genetic distance analysis that revealed diversity among sequences and clustering within the L. (Viannia) subgenus. Our results provide parasitological confirmation of persistent infection among residents of endemic areas of L. (Viannia) transmission who have experienced asymptomatic infection or recovered from CL, revealing a reservoir of infection that potentially contributes to the endemicity and transmission of disease. kDNA genotyping establishes proof

  17. Incremental benefit of coronary artery calcium score above traditional risk factors for all-cause mortality in asymptomatic Korean adults.

    Science.gov (United States)

    Han, Donghee; Ó Hartaigh, Bríain; Gransar, Heidi; Yoon, Ji Hyun; Kim, Kwang-Joon; Kim, Min-Kyoung; Choi, Su-Yeon; Sung, Jidong; Chang, Hyuk-Jae

    2015-01-01

    Coronary artery calcium score (CACS) is a well-recognized marker for subclinical coronary atherosclerosis, particularly in asymptomatic populations. To date, however, the added prognostic benefit of CACS compared with traditional risk factors in an Asian population remains unknown. This study therefore investigated the benefit of CACS over traditional risk factors for all-cause mortality in a large multicenter registry of asymptomatic Korean adults. A total of 34,386 individuals were retrospectively enrolled to participate in a general health examination. The Framingham 10-year risk score (FRS) was calculated according to the traditional risk stratification algorithm and CACS was calculated in log(CACS+1) for continuous data and categorized as 0, 1-100, 101-400 and >400. During a median follow-up of 4.9 years (IQR, 3.0-7.1), there were 303 all-cause deaths (0.9%). Following adjustment, CACS was independently associated with all-cause death (hazard ratio, 1.10; 95% confidence interval (CI): 1.05-1.17; P<0.001). Notably, CACS added further prognostic value above and beyond FRS (likelihood ratio, χ(2)=75.42, P<0.001; continuous net reclassification improvement=0.40, 95% CI: 0.29-0.51, P≤0.001; improving C-statistic from 0.64, 95% CI: 0.61-0.67 to 0.68, 95% CI: 0.64-0.71; ∆C=0.04, 95% CI: 0.01-0.06, P=0.002). In an asymptomatic Korean population, CACS improved prediction of all-cause mortality over and above that of a conventional risk tool.

  18. Pulmonary and cardiac function in asymptomatic obese subjects and changes following a structured weight reduction program: a prospective observational study.

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    Matthias Held

    Full Text Available BACKGROUND: The prevalence of obesity is rising. Obesity can lead to cardiovascular and ventilatory complications through multiple mechanisms. Cardiac and pulmonary function in asymptomatic subjects and the effect of structured dietary programs on cardiac and pulmonary function is unclear. OBJECTIVE: To determine lung and cardiac function in asymptomatic obese adults and to evaluate whether weight loss positively affects functional parameters. METHODS: We prospectively evaluated bodyplethysmographic and echocardiographic data in asymptomatic subjects undergoing a structured one-year weight reduction program. RESULTS: 74 subjects (32 male, 42 female; mean age 42±12 years with an average BMI 42.5±7.9, body weight 123.7±24.9 kg were enrolled. Body weight correlated negatively with vital capacity (R = -0.42, p<0.001, FEV1 (R = -0.497, p<0.001 and positively with P 0.1 (R = 0.32, p = 0.02 and myocardial mass (R = 0.419, p = 0.002. After 4 months the study subjects had significantly reduced their body weight (-26.0±11.8 kg and BMI (-8.9±3.8 associated with a significant improvement of lung function (absolute changes: vital capacity +5.5±7.5% pred., p<0.001; FEV1+9.8±8.3% pred., p<0.001, ITGV+16.4±16.0% pred., p<0.001, SR tot -17.4±41.5% pred., p<0.01. Moreover, P0.1/Pimax decreased to 47.7% (p<0.01 indicating a decreased respiratory load. The change of FEV1 correlated significantly with the change of body weight (R = -0.31, p = 0.03. Echocardiography demonstrated reduced myocardial wall thickness (-0.08±0.2 cm, p = 0.02 and improved left ventricular myocardial performance index (-0.16±0.35, p = 0.02. Mitral annular plane systolic excursion (+0.14, p = 0.03 and pulmonary outflow acceleration time (AT +26.65±41.3 ms, p = 0.001 increased. CONCLUSION: Even in asymptomatic individuals obesity is associated with abnormalities in pulmonary and cardiac function and increased myocardial mass. All the

  19. Intelligence and Academic Achievement With Asymptomatic Congenital Cytomegalovirus Infection.

    Science.gov (United States)

    Lopez, Adriana S; Lanzieri, Tatiana M; Claussen, Angelika H; Vinson, Sherry S; Turcich, Marie R; Iovino, Isabella R; Voigt, Robert G; Caviness, A Chantal; Miller, Jerry A; Williamson, W Daniel; Hales, Craig M; Bialek, Stephanie R; Demmler-Harrison, Gail

    2017-11-01

    To examine intelligence, language, and academic achievement through 18 years of age among children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected infants. We used growth curve modeling to analyze trends in IQ (full-scale, verbal, and nonverbal intelligence), receptive and expressive vocabulary, and academic achievement in math and reading. Separate models were fit for each outcome, modeling the change in overall scores with increasing age for patients with normal hearing ( n = 78) or with sensorineural hearing loss (SNHL) diagnosed by 2 years of age ( n = 11) and controls ( n = 40). Patients with SNHL had full-scale intelligence and receptive vocabulary scores that were 7.0 and 13.1 points lower, respectively, compared with controls, but no significant differences were noted in these scores among patients with normal hearing and controls. No significant differences were noted in scores for verbal and nonverbal intelligence, expressive vocabulary, and academic achievement in math and reading among patients with normal hearing or with SNHL and controls. Infants with asymptomatic congenital cytomegalovirus infection identified through newborn screening with normal hearing by age 2 years do not appear to have differences in IQ, vocabulary or academic achievement scores during childhood, or adolescence compared with uninfected children. Copyright © 2017 by the American Academy of Pediatrics.

  20. HEPATITIS B, HIV AND SYPHILIS INFECTION IN ASYMPTOMATIC PREGNANT WOMEN

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    Karuna Yadav

    2016-10-01

    Full Text Available BACKGROUND This study to determine the prevalence of and identify factors associated with Hepatitis b, HIV and Syphilis positivity among asymptomatic pregnant women. We also assessed maternal and fetal outcome in HBsAg, HIV and Syphilis pregnant women. MATERIALS AND METHODS This is a prospective study of 1000 consecutive apparently healthy asymptomatic pregnant women, who are attending the antenatal clinic of AVBRH Hospital Sawangi (Meghe during September 2014 To August 2016. The blood samples was collected after obtaining their informed written consent from those who were tested for HIV antibodies (NACO guidelines, HBsAg (ELISA test, and Syphilis (RPR SPANCARD latex kit. RESULTS The prevalence of HBsAg (1.7%, HIV (1.0%, Syphilis (0.1%. All the infection was more common in illiterate, multigravida, monogamous women of low socio-economic status, History of blood transfusion, IV/IM drug users and common in multiple sexual partner. CONCLUSION This present study clearly documented a relatively declined prevalence of HBsAg, HIV and Syphilis in pregnant women. The data reinforces the need for establishing effective preventive programs, which could lead to reduction in the prevalence of these infections.

  1. Growth curve analysis of asymptomatic and symptomatic meningiomas.

    Science.gov (United States)

    Nakasu, Satoshi; Nakasu, Yoko; Fukami, Tadateru; Jito, Junya; Nozaki, Kazuhiko

    2011-04-01

    Meningiomas sometimes appear to stop growing after attaining a large size. Commonly used exponential growth models do not reflect this phenomenon. We attempted to find the best curve to simulate their growth. Fifty-two patients with meningioma were followed up for 3.1-21.7 years (mean 7.5 years) with four or more imaging studies each. Thirty-one patients had asymptomatic tumors. The other 21 patients with residual or recurrent tumor were followed up after surgery. Time-volume curves for each tumor were plotted. Nonlinear regression analyses were performed against power, exponential, logistic, and Gompertzian curves. Time-volume curves corresponded to the Gompertzian and logistic growth curves better than to power or exponential curves. When simulating time-volume curves with Gompertzian curves, the majority of benign meningiomas began to slow their growth before patient age of 80 years. Twenty-three of 31 asymptomatic meningiomas had already passed the inflection point before diagnosis. In contrast, this happened less frequently in symptomatic tumors. Especially, all six atypical meningiomas continued to grow quasi-exponentially. Sigmoid curves that approach a plateau were better descriptors of the growth of benign meningiomas than were curves of unlimited growth. However, atypical meningiomas were unlikely to slow their growth.

  2. Asymptomatic vertebral fractures in patients with low bone mineral density.

    Science.gov (United States)

    Negreiros, Caio Cesar Leite de; Berigo, Marina Guareschi; Dominoni, Robson Luiz; Vargas, Deisi Maria

    2016-04-01

    Vertebral fracture assessment (VFA) is a test technique that can be used to detect asymptomatic vertebral fractures (AVF). It uses dual energy X-ray bsorptiometry (DXA) and can be performed concurrently with bone densitometry. This study aims to assess the prevalence of AVF in patients with low bone mass. Cross-sectional study including 135 individuals with low bone mineral density (BMD) with a T-score physical examination. Densitometric variables were obtained by bone mineral densitometry and VFA (Explorer, Hollogic®). Vertebral fractures were classified according to the Genant criteria. Student's t, chi-square and logistic regression were performed for statistical analysis. AVFs occurred in 24.4% of the subjects. They were older compared to those without AVF (65±9.25 versus 60.1±8.66; p=0.005), and had a history of lowimpact fractures (38.24% versus 19.8%; OR 2.5; p=0.03). Half of the patients that reported steroid therapy had AVFs, compared to one fifth of those who did not use steroids (50% versus 21.49%; OR 3.6; p=0.01). Asymptomatic vertebral fractures were present in approximately one fourth of patients. The risk factors associated were history of low-impact fracture, use of steroids and age > 61 years.

  3. Unusual asymptomatic presentation of bladder cancer metastatic to the penis.

    Science.gov (United States)

    Giunchi, Francesca; Vasuri, Francesco; Valerio, Vagnoni; Montagnani, Ilaria; Nelli, Federico; Fiorentino, Michelangelo; Raspollini, Maria Rosaria

    2017-06-01

    Penile metastasis is an extremely rare event and mainly originate from primary pelvic tumor sites such us urinary bladder, gastro-intestinal tract and prostate and more rarely from respiratory system, bone tumors and melanoma. Here we describe the unusual presentation of two bladder urothelial cancer metastatic to the penis with no relevant clinical symptoms. Namely, a 69 years-old man with a warthy lesions of the foreskin and the glans misunderstood for a condylomata that at histological and immunohistochemical analysis showed a bladder urothelial carcinoma; and a 71 years-old man with reddish skin lesion of the glans, a previous history of bladder and urethral carcinoma and histological pagetoid spread of urothelial cancer to the glans. Recurrent bladder urothelial carcinoma is usually a visceral disease that rarely presents as a superficial asymptomatic skin lesion. The two reported cases were asymptomatic superficial penis metastases with a relatively slow growth and a fairy good prognosis after conservative surgical approach. Accurate clinical examination of the penis is mandatory for males with history of bladder cancer. Copyright © 2016 Elsevier GmbH. All rights reserved.

  4. Faecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae and Shiga toxin-producing Escherichia coli in asymptomatic nursery children in Lower Saxony (Germany), 2014.

    Science.gov (United States)

    Harries, M; Dreesman, J; Rettenbacher-Riefler, S; Mertens, E

    2016-09-09

    Children may be at higher risk for carriage of antimicrobial-resistant bacteria because of higher usage of antimicrobials. They also have higher rates of Shiga toxin-producing Escherichia coli (STEC) infections than other population groups. Some infections, particularly in children, are asymptomatic, but still lead to the excretion of large numbers of bacteria and viruses that may cause clinical disease in other individuals. That is one reason why, in Lower Saxony as in other German federal states - asymptomatic carriers of STEC are excluded from nurseries and schools until three consecutive stool samples test negative in order to prevent secondary cases. The prevalence of children who are asymptomatic STEC carriers is unknown. But if it is high, this measure would have substantial socioeconomic effects on families. Infections with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are an increasing problem for public health, especially for hospitals. However, there are no reliable estimates of the prevalence of asymptomatic ESBL-E carriers in Lower Saxony, as there is no mandatory requirement to report these carriers. In order to discuss the exclusion policies for children attending nurseries and ascertain a baseline of ESBL-E carriers, we conducted a cross-sectional study. The aim was to determine the prevalence of ESBL-E and STEC and identify risk factors for carriage in nursery children without diarrhoea (asymptomatic) aged 0-6 years in four selected districts in Northern Germany. During April-September 2014, we collected stool specimens with the support of voluntarily participating nurseries. We tested for STEC by PCR and for ESBL-E on chromogenic agar. Questionnaires answered by parents contained data on eating and drinking habits, outdoor activities, prior antibiotic treatment and animal contact for each participating child. We compared the epidemiological characteristics of ESBL-E carriers vs. non-carriers by using univariable analysis (P

  5. Identification of Blastocystis hominis isolates from asymptomatic and symptomatic patients by PCR.

    Science.gov (United States)

    Eroglu, Fadime; Genc, Ahmet; Elgun, Gullu; Koltas, Ismail Soner

    2009-11-01

    Despite years of study, the pathogenic role of Blastocytis hominis is still controversial. Genotypic differences between the asymptomatic and symptomatic isolates should assist in determining the pathogenicity of Blastocystis. In this study, we genotyped 32 Blastocystis isolates obtained from 12 asymptomatic healthy individuals and 20 symptomatic patients pain by polymerase chain reaction using known seven kinds of sequence tagged site primers in this study. When we compared genotype of Blastocystis isolates between the symptomatic and asymptomatic patient group, we found that subtype3 is the most dominant genotype in asymptomatic individual (9/12) and subtype1 determined all of symptomatic patients (20/20).

  6. High-sensitivity Troponin T Assay in Asymptomatic High Cardiovascular Risk Patients. The TUSARC Registry.

    Science.gov (United States)

    Álvarez, Isabel; Hernández, Luis; García, Héctor; Villamandos, Vicente; López, María Gracia; Palazuelos Molinero, Jorge; Martín Raymondi, Diego

    2017-04-01

    High-sensitivity troponin T assays (Hs-TnT) have been carried out in selected populations in clinical trials and in registries of the general population with low cardiovascular risk (CVR). The aim of this study was to determine the proportion of individuals with detectable Hs-TnT and the proportion of individuals with elevated Hs-TnT in a Spanish population of asymptomatic individuals with very high CVR, as well as the parameters associated with Hs-TnT elevation. The study included 690 patients. Hs-TnT detection and Hs-TnT elevation (≥99th percentile value), as well the association of elevated Hs-TnT and clinical, analytical, and treatment data were analyzed. Hs-TnT was analyzed in 646 patients and was detected in 645. Elevated TnT was detected in 212 patients (32.9%). On multivariate analysis, elevated TnT was independently associated with male sex (OR, 2.81; 95%CI, 1.67-4.73; P < .001), older age (OR, 1.06; 95%CI, 1.04-1.09; P < .001), a higher body mass index (OR, 1.07; 95%CI, 1.02-1.12; P < .002), insulin therapy (OR, 1.99; 95%CI, 1.15-3.46; P = .01), history of heart failure (OR, 3.92; 95%CI, 1.24-12.39; P = .02), and estimated glomerular filtration rate calculated by CKD-EPI (OR, 0.96; 95%CI, 0.95-0.97; P < .001). In a Spanish population of asymptomatic individuals at very high CVR, Hs-TnT was associated with older age, male sex, higher body mass index, insulin therapy, history of heart failure, and lower glomerular filtration rate. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Prevalence of coronary atherosclerosis in asymptomatic healthy subjects: an intravascular ultrasound study of donor hearts.

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    Kim, Min-Seok; Kang, Soo-Jin; Lee, Cheol-Whan; Han, Seungbong; Park, Duk-Woo; Lee, Seung-Whan; Kim, Young-Hak; Park, Seong-Wook; Park, Seung-Jung; Kim, Jae-Joong

    2013-01-01

    At present, limited in vivo information is available on the prevalence and severity of coronary atherosclerosis in asymptomatic healthy subjects. The aim of this study was to examine the prevalence, extent and severity of coronary atherosclerosis in healthy individuals. We performed an intravascular ultrasound (IVUS) examination on 198 heart transplant recipients 4 weeks after transplantation. The donor population consisted of 147 men and 51 women (31.4±11.0 years). The left anterior descending coronary artery was imaged in all patients, and 3 vessel images were obtained for 99 patients. Angiographic appearance was completely normal in 177 of the 198 subjects (89.4%), while atherosclerotic luminal irregularities were observed in the remaining individuals. IVUS revealed that atherosclerotic lesions (defined as intimal thickness ≥0.5 mm at any site) were present in 96 patients (48.5%). The prevalence of coronary atherosclerosis rapidly increased with age (10-19 years, 5.9%; 20-29 years, 31.1%; 30-39 years, 59.0%; 40-49 years, 78.4%). In the diseased subgroup, atherosclerotic lesions were mostly eccentric (92.7%), with maximal intimal thickness of 0.99±0.42 mm (area stenosis, 32.2±11.7%). All coronary arteries were predominantly located in the proximal third of each vessel. Donor age, male sex, and hypertension were the determinants of coronary atherosclerosis measured by IVUS examination. As more risk factors were present, the risk of atherosclerosis increased. Coronary atherosclerosis is common in asymptomatic young healthy adults, supporting the need for preventive cardiology in the early stages of life.

  8. Increased variability and abnormalities in pancreatic enzyme concentrations in otherwise asymptomatic subjects with type 2 diabetes

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    Malloy J

    2012-12-01

    Full Text Available Jaret Malloy, Kate Gurney, Kevin Shan, Ping Yan, Steve ChenAmylin Pharmaceuticals LLC, San Diego, CABackground: Recent studies have demonstrated an increased incidence of pancreatitis in patients with type 2 diabetes compared with obese nondiabetic individuals. Serum lipase and pancreatic amylase concentrations are used in conjunction with clinical findings to diagnose pancreatitis.Methods: In two large clinical trials of overweight/obese nondiabetic and type 2 diabetic subjects, lipase and pancreatic amylase were measured at screening and 2–5 weeks later at baseline (prior to treatment with study medication.Results: Lipase and pancreatic amylase concentrations were above the upper limit of normal (ULN in 13% and 6% of type 2 diabetic subjects, respectively, and were approximately three-fold (3 × higher than the proportion of nondiabetic subjects with levels above ULN. Elevations exceeding ULN were seen in many subjects asymptomatic for pancreatitis; however, elevations >2 × ULN and >3 × ULN were uncommon, and elevations >3 × ULN were often associated with a history of dyslipidemia, hyperlipidemia, and gastrointestinal disorders. Additionally, enzyme concentrations varied within this 2–5-week screening period, including shifts between elevated and normal levels.Conclusion: Results from this post hoc analysis suggest that, although pancreatic enzymes can be a useful marker for pancreatitis within the proper clinical context, diagnosis of pancreatitis may be confounded in populations known to have asymptomatic elevations associated with disease, such as type 2 diabetes. Further effort is needed to clarify the etiology and epidemiology of pancreatic enzyme elevations in type 2 diabetes.Keywords: diabetes, pancreatitis, amylase, lipase

  9. EFFECT OF POSTURAL DRAINAGE POSITIONS ON VITAL PARAMETERS IN ASYMPTOMATIC HEALTHY INDIVIDUALS

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    Animesh Hazari

    2017-09-01

    Full Text Available Background: Postural drainage is used exclusively or in combination with other airway clearance techniques in the management of chronic pulmonary diseases. Postural drainage therapy helps to prevent accumulation of secretions in patients who are at high risk for pulmonary complications. It also helps to remove accumulated secretions from the lungs.The role of body positioning on lung function and the clinical implications of postural drainage has been identified in a variety of settings including intensive care units. There is dearth in literature on effects on postural drainage on vital parameters. Thus the objective of the study was to measure the vital parameters at different postural drainage positions in healthy asymptomatic adults. Methods: Twenty healthy subjects participated in the study. The instruments used in the current study included a Pulse oximeter, Sphygmomanometer, Stethoscope, Postural drainage table.The outcome measures of interest were heart rate, respiratoryrate, oxygen saturation, blood pressure and Borg’s scale of rate of perceived exertion. The changes in the vital signs were recorded at different head down titling position of 0°, 15° & 30° in both supine and prone lying positions Results: Statistical significant difference was found for Systolic Blood Pressure in prone lying at different degrees of tilt (p=0.001 and Diastolic Blood Pressure in prone lying (p=0.000. Conclusion: Postural drainage positioning should be given with caution and under proper monitoring as there is a risk of change in the blood pressure even in asymptomatic elderly population. The monitoring of vital signs should be done during the therapy to decrease the risk of complications.

  10. Asymptomatic cervicocerebral atherosclerosis, intracranial vascular resistance and cognition: the AsIA-neuropsychology study.

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    López-Olóriz, Jorge; López-Cancio, Elena; Arenillas, Juan F; Hernández, María; Jiménez, Marta; Dorado, Laura; Barrios, Maite; Soriano-Raya, Juan José; Miralbell, Júlia; Cáceres, Cynthia; Forés, Rosa; Pera, Guillem; Dávalos, Antoni; Mataró, Maria

    2013-10-01

    Carotid atherosclerosis has emerged as a relevant contributor to cognitive impairment and dementia whereas the role of intracranial stenosis and vascular resistance in cognition remains unknown. This study aims to assess the association of asymptomatic cervicocerebral atherosclerosis and intracranial vascular resistance with cognitive performance in a large dementia-free population. The Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) Neuropsychology Study included 747 Caucasian subjects older than 50 with a moderate-high vascular risk (assessed by REGICOR score) and without history of neither symptomatic vascular disease nor dementia. Extracranial and transcranial color-coded duplex ultrasound examination was performed to assess carotid intima-media thickness (IMT), presence of carotid plaques (ECAD group), intracranial stenosis (ICAD group), and middle cerebral artery pulsatility index (MCA-PI) as a measure of intracranial vascular resistance. Neuropsychological assessment included tests in three cognitive domains: visuospatial skills and speed, verbal memory and verbal fluency. In univariate analyses, carotid IMT, ECAD and MCA-PI were associated with lower performance in almost all cognitive domains, and ICAD was associated with poor performance in some visuospatial and verbal cognitive tests. After adjustment for age, sex, vascular risk score, years of education and depressive symptoms, ECAD remained associated with poor performance in the three cognitive domains and elevated MCA-PI with worse performance in visuospatial skills and speed. Carotid plaques and increased intracranial vascular resistance are independently associated with low cognitive functioning in Caucasian stroke and dementia-free subjects. We failed to find an independent association of intracranial large vessel stenosis with cognitive performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

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    Onu FA

    2015-07-01

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

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

    Science.gov (United States)

    Hunziker, Sabina; Schläpfer, Martin; Langewitz, Wolf; Kaufmann, Gilbert; Nüesch, Reto; Battegay, Edouard; Zimmerli, Lukas U

    2011-04-19

    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. 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). 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. 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.

  13. Distribution of Blood Groups(ABO between Symptomatic & Asymptomatic Human Leishmania Infantum Infection in Human

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    S Molaie

    2013-09-01

    Full Text Available Abstract Background & aim: According to the hypothesis that leishmania parasites can be escaped from immune system covered by blood group antigens (ABO to prevent its recognition by the immune system. The aim of this study was to show the associated blood groups with symptomatic or asymptomatic visceral leishmaniasis due to Leishmania infantum in human. Methods: In this cross-sectional study the population was divided into two groups. The first group included 54 patients with kala-azar (antibody against Leishmania titers ≥1:3200 by TDA with clinical specificity and the second group consisted of 45 subjects infected with Leishmania infantum (Leishmania antibody titers of1: 800 and 1:1600 by DAT method and non-specific symptoms. The distribution of the 4 main blood groups ABO type, sex, age, presence or absence of symptoms, clinical signs, and response to Glucantim therapy and DAT results were evaluated. Data were analyzed by chi-square test. Results: Most of the patients in group 1 were blood group A (37% and the lowest number of blood group were B (12.8%. In the second group, most of the ABO blood group A (42.2% and lowest in the ABO blood group AB (8.9%.There was no significant association between blood groups and clinical symptoms (p>0.05. Conclusion: This study showed that there is no association between blood group and incidence of symptomatic and asymptomatic kala-azar. Key words: Leishmania Infantum, Kala-azar, Blood Group, Human

  14. Magnetic resonance imaging features of asymptomatic bipartite patella

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

    2011-06-15

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

  15. High prevalence of asymptomatic malaria in south-eastern Bangladesh

    Science.gov (United States)

    2014-01-01

    Background The WHO has reported that RDT and microscopy-confirmed malaria cases have declined in recent years. However, it is still unclear if this reflects a real decrease in incidence in Bangladesh, as particularly the hilly and forested areas of the Chittagong Hill Tract (CHT) Districts report more than 80% of all cases and deaths. surveillance and epidemiological data on malaria from the CHT are limited; existing data report Plasmodium falciparum and Plasmodium vivax as the dominant species. Methods A cross-sectional survey was conducted in the District of Bandarban, the southernmost of the three Hill Tracts Districts, to collect district-wide malaria prevalence data from one of the regions with the highest malaria endemicity in Bangladesh. A multistage cluster sampling technique was used to collect blood samples from febrile and afebrile participants and malaria microscopy and standardized nested PCR for diagnosis were performed. Demographic data, vital signs and splenomegaly were recorded. Results Malaria prevalence across all subdistricts in the monsoon season was 30.7% (95% CI: 28.3-33.2) and 14.2% (95% CI: 12.5-16.2) by PCR and microscopy, respectively. Plasmodium falciparum mono-infections accounted for 58.9%, P. vivax mono-infections for 13.6%, Plasmodium malariae for 1.8%, and Plasmodium ovale for 1.4% of all positive cases. In 24.4% of all cases mixed infections were identified by PCR. The proportion of asymptomatic infections among PCR-confirmed cases was 77.0%, oligosymptomatic and symptomatic cases accounted for only 19.8 and 3.2%, respectively. Significantly (p malaria prevalence in two to nine year olds were 18.6 and 34.6%, respectively. No significant difference in malaria prevalence and parasite density was observed between dry and rainy season. Conclusions A large proportion of asymptomatic plasmodial infections was found which likely act as a reservoir of transmission. This has major implications for ongoing malaria control programmes that

  16. Sagittal parameters of global cervical balance using EOS imaging: normative values from a prospective cohort of asymptomatic volunteers.

    Science.gov (United States)

    Le Huec, J C; Demezon, H; Aunoble, S

    2015-01-01

    To define reference parameters for analyzing sagittal balance of the cervical spine in asymptomatic volunteers. Prospective study after Bioethics Committee approval. Imaging performed using a low-dose radiographic system (EOS Imaging, Paris, France). The absence of pain was assessed using the Oswestry Questionnaire and VAS. 106 subjects were included of whom 55.66 % were men. The parameters measured were: pelvic incidence, pelvic tilt, sacral slope, thoracic and lumbar curvature, C7 plumb line position and the spino-sacral angle. The C7 slope and new parameters were measured: cranial incidence, defined in relation to the McGregor line and the sella turcica allowing to define cranial slope and tilt, and the spino-cranial angle (SCA). This study demonstrated a close correlation between the C7 slope and the cranio-cervical system. Economic sagittal balance in the asymptomatic population was defined by a constant SCA angle of 83° ± 9°. To maintain this balance, a spine with a marked C7 slope will present lordosis and vice versa. Cranial incidence is an anatomical parameter characteristic of the cranio-cervical system which makes it possible to analyze the spatial positioning of the head and to predict the desired value of cervical lordosis which is closely correlated to cranial slope. The C7 slope has a predictive value of the shape of the cervical spine in the sagittal plane. One-third of the asymptomatic population had cervical kyphosis. Our results could be used to study sagittal balance before and after arthrodesis, or cervical prosthesis.

  17. Systematic review of the accuracy of antibody tests used to screen asymptomatic adults for hepatitis C infection.

    Science.gov (United States)

    Cadieux, Geneviève; Campbell, Jennifer; Dendukuri, Nandini

    2016-01-01

    Several expert groups, including the United States Preventive Services Task Force and the Canadian Task Force on Preventive Health Care, have recently examined or are currently examining whether primary care physicians should screen asymptomatic adults for hepatitis C virus (HCV) infection. To inform decision-making on HCV screening, we performed a systematic review of the accuracy of antibody tests compared with other immunoassays and RNA detection for screening asymptomatic adults for HCV infection in Canada. MEDLINE and Embase databases were searched from 1990 to 2016; resulting citations were uploaded into DistillerSR and independently screened by 2 reviewers. Original research studies, systematic reviews and meta-analyses were eligible for inclusion. At least 80% of the study population had to be asymptomatic, nonpregnant, treatment-naïve adults with unknown liver enzyme values and unknown HCV status. Risk of bias was assessed with the use of the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2) tool; the quality of the body of evidence was assessed by means of GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Of 1537 articles identified, 81 underwent full-text review, and 9 studies met the inclusion criteria. Compared with RNA detection, the sensitivity of the third-generation enzyme-linked immunosorbent assay was variable (61.0%-81.8%), and its specificity was high (97.5%-99.7%). As expected, there were more false-positive results when comparing antibody tests to RNA detection than to other immunoassays. Our GRADE assessment suggested that there was a high concern for risk of bias, particularly verification bias, and substantial inconsistency between studies in terms of their design. More research is needed to better characterize the accuracy of antibody tests used to screen for HCV infection in the general population. Jurisdictions that recently adopted birth cohort screening for HCV infection are

  18. Asymptomatic Bilateral Ureteropelvic Junction Obstruction due to Supernumerary Renal Arteries

    Directory of Open Access Journals (Sweden)

    Shoja Mohammadali

    2008-01-01

    Full Text Available A supernumerary renal artery is a common arterial variation, which warrants consi-derations in a variety of urologic and retroperitoneal operations. Supernumerary renal arteries can be associated with other uro-vascular variations and anomalies such as duplicated renal veins and ureters, aberrant origin of the gonadal arteries, persistence of fetal renal lobulation, and kidney malrotation. The role of crossing supernumerary renal arteries in ureteropelvic junction obstruc-tion (UPJO is controversial. We report a healthy potential renal transplant donor with bilateral UPJO, which appeared to be secondary to supernumerary renal (inferior polar arteries. We believe that the bilateral occurrence of asymptomatic UPJO associated with supernumerary renal arteries has not been previously reported.

  19. Pregnancy complicated by asymptomatic uterine arteriovenous malformation: a case report.

    Science.gov (United States)

    Nasu, Kaei; Yamaguchi, Mina; Yoshimatsu, Jun; Miyakawa, Isao

    2007-04-01

    Uterine arteriovenous malformation (AVM) is a rare disease. Percutaneous arterial embolization has been performed for patients who wish to preserve their ability to conceive. A 27-year-old primigravida was admitted for treatment of threatened premature labor at 21 weeks of gestation. She had been diagnosed with asymptomatic uterine AVM 2 years previously. She had not received any treatment before conception. At 41 weeks of gestation she spontaneously delivered a healthy infant weighting 3,154 g. and the Excessive bleeding (1,600 mL) occurred, probably due to eruption of the AVM vessel at the time of parturition. At 3 months postpartum, the patient underwent arterial embolization of AVM. The management of uterine AVM should be individualized, taking into account the patient's desire to maintain her fertility and the symptoms.

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

    Science.gov (United States)

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

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (Pdiabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches. PMID:28182728

  1. Detection of Tumorigenic Rhizobia in Asymptomatic Peach Plants by PCR

    Directory of Open Access Journals (Sweden)

    A. Raio

    2004-08-01

    Full Text Available At present the only method for the detection of Rhizobium radiobacter and R. rhizogenes (ex Agrobacterium tumefaciens in plants is by isolating the bacteria on selective medium and testing them in vivo for pathogenicity. This procedure is time-consuming and not appropriate for detecting low concentrations of these agrobacteria. In this study a protocol was developed for detecting tumorigenic agrobacteria in the stem and root tissues of artificially inoculated peach plants. DNA was extracted from the plant tissues by a rapid procedure and then a 246 bp sequence of the vir region of the pTi was amplified by PCR. The target sequence was found in all stem and root samples of asymptomatic peach plants, and was evidenced in all the samples analyzed showing the effectiveness and reliability of the method.

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

    Directory of Open Access Journals (Sweden)

    Siddiq S

    2010-05-01

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

  3. Asymptomatic colonization of upper respiratory tract by potential bacterial pathogens.

    Science.gov (United States)

    Dhakal, Rupak; Sujatha, S; Parija, S C; Bhat, B V

    2010-07-01

    To screen for asymptomatic respiratory carriage of S. pneumoniae, H. influenzae and Group A Streptococcus (GAS) in children attending JIPMER, correlate carriage rate with different socio-demographic factors and to detect antimicrobial resistance among the isolates. Throat swabs were collected from both in patients and out patients (1 organism. Antibiotic resistance was highest in S. pneumoniae with 66.7% of strains resistant to penicillin. MDR strains were also encountered. Erythromycin resistance was observed in both H. influenzae (28.4%) and GAS (22%). No statistically significant association was found between the carriage rate of these organisms and different socio-demographic factors. S. pneumoniae carriage rate was comparatively higher in the Community and its antimicrobial resistance is an issue to address.

  4. 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...

  5. Timing of testing and treatment for asymptomatic diseases

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-01

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

  6. 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.

  7. FDG/PET uptake in asymptomatic multilobar Chlamydia pneumoniae pneumonia.

    Science.gov (United States)

    Bianco, Andrea; Mazzarella, Gennaro; Rocco, Danilo; Gasperi, Maurizio; Di Marco, Roberto; Brunese, Luca

    2010-06-01

    FDG-PET is a diagnostic imaging procedure effective in staging primary and recurrent cancer. False-positive uptake already has been described in both inflammatory and infectious respiratory diseases, although no reports associate Chlamydia pneumoniae infection to FDG uptake. An incidental diagnosis of asymptomatic multilobar pneumonia during screening for thyroid malignancy is reported. Three areas of pulmonary consolidation strongly positive on PET/CT scan, mimicking pulmonary malignancy were identified. Both radiologic features and serum IgM antibodies for Chlamydia pneumoniae suggested the diagnosis of an unusual presentation of a Chlamydia pneumoniae respiratory infection. Specific antibiotic therapy induced a complete resolution of the areas of pulmonary consolidation. This case suggests that positive PET is not an absolute indicator for malignancy. Chlamydia pneumoniae respiratory infections can exhibit positive uptake on FDG-PET.

  8. [Current indications for surgical treatment of asymptomatic primary hyperparathyroidism].

    Science.gov (United States)

    Luisetto, G; Camozzi, V

    2003-01-01

    The clinical picture of hyperparathyroidism has gone toward deep modifications in the last few decades, and currently this disease is more frequently asymptomatic. So, the question is raising concerning which patients have to be operated, due to the substantial benignity of the disease and the lack of well defined symptoms. Classical indications for surgery have been formulated more than a decade ago and are as follows: calcemia higher than 3 mmol/L, previous episode of life threatening hypercalcaemia, reduced creatinine clearance, nephrolithiasis, hypercalciuria, osteoporosis. In the last years other indications have been added, on the basis of clinical and epidemiological studies that have contributed to broaden our knowledgement on the evolution and compliances of the disease. Among these, the following data have to been kept in mind: history of previous atraumatic fractures, vertebral osteopenia (Z-score < -2), vitamin D deficiency, perimenopausal status, neuromuscular or psychical disturbances.

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

    Directory of Open Access Journals (Sweden)

    Kahn Philip J

    2012-01-01

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

  10. Practical guidelines for examination of adults with asymptomatic hypertransaminasaemia.

    Science.gov (United States)

    Bruguera, Miguel

    2017-02-01

    The causes of sustained elevation of serum transaminases in asymptomatic adults, both hepatic and extrahepatic, are varied. In order to reach an aetiological diagnosis, a standardized protocol should be applied, aimed firstly at ruling out the most common causes, such as chronic hepatitis (viral or autoimmune), metabolic diseases, and toxic liver diseases. Several biochemical patterns, which take into account transaminase, cholestatic enzyme, muscle enzyme, ferritin and ceruloplasmin levels, as well protein electrophoresis and autoantibody measurement, will identify most causes. In cases in which a diagnosis cannot be reached with the use of these non-invasive methods, a needle liver biopsy will be justified. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  11. Ultrasound in the diagnosis of asymptomatic hyperuricaemia and gout.

    Science.gov (United States)

    García Puig, J; Beltrán, L; Mejía Chew, C; Torres, R; Tebar Márquez, D; Pose Reino, A

    2016-11-01

    The increase in serum urate concentrations (hyperuricaemia, ≥7.0mg/dL) creates crystals, which promote inflammation and joint lesions. Ultrasonography can reveal these urate deposits. The presence of crystals suggests that a patient with hyperuricaemia is actually experiencing asymptomatic gout, and that a patient with gout without subcutaneous tophi could experience tophaceous gout. The information offered by ultrasound (double contour sign and hyperechoic concretions mimicking clouds) enables a more specific classification of hyperuricaemia and gout. Additionally, this information can lead to relevant changes in terms of the diagnosis and therapeutic approach for patients with hyperuricaemia and gout. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  12. The safety of intrauterine contraception initiation among women with current asymptomatic cervical infections or at increased risk of sexually transmitted infections.

    Science.gov (United States)

    Jatlaoui, Tara C; Simmons, Katharine B; Curtis, Kathryn M

    2016-12-01

    The objective was to assess risk of pelvic inflammatory disease (PID) among women with current asymptomatic undiagnosed cervical infection or who are at high risk of sexually transmitted infections (STIs), comparing those who have a copper-bearing (Cu-) or levonorgestrel (LNG-) intrauterine device (IUD) placed with women who do not. We searched PubMed and Cochrane Library for articles from January 1984 through January 2016 addressing our objective. We assessed study quality using the United States Preventive Services Task Force evidence grading system. Our search strategy yielded 2220 articles, of which 10 met inclusion criteria. Two studies provided direct evidence of PID rates in women with undiagnosed gonococcal or chlamydial (GC/CT) infection or at high risk for STIs initiating IUDs versus other contraceptive methods (level II-2, fair to poor), and neither study found a difference. Eight studies provided indirect evidence (II-2 to II-3, fair to poor). One study found no difference in PID rates between initiators of Cu- versus LNG-IUDs. Five studies compared algorithms based on patient factors with laboratory GC/CT screening to predict cervical infection. Based on likelihood ratios, none of these algorithms adequately identified women at high risk of asymptomatic cervical infection who should not undergo IUD placement. Two studies compared IUD placement on the same day as STI screening with delayed placement after screening and found no difference in PID rates. Limited evidence suggests that IUD placement does not increase the risk of PID compared with no IUD placement among women with asymptomatic undiagnosed cervical infection or at high risk of STIs. Algorithms based on patient characteristics to identify women with asymptomatic GC/CT may be overly restrictive, leading to missed opportunities for IUD initiation. Historical concerns about higher PID risk among women at risk for STIs who use IUDs may not be relevant with modern devices and STI screening and

  13. Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection.

    Science.gov (United States)

    Lanzieri, Tatiana M; Chung, Winnie; Flores, Marily; Blum, Peggy; Caviness, A Chantal; Bialek, Stephanie R; Grosse, Scott D; Miller, Jerry A; Demmler-Harrison, Gail

    2017-03-01

    To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) in children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected children. We included 92 case-patients and 51 controls assessed by using auditory brainstem response and behavioral audiometry. We used Kaplan-Meier survival analysis to estimate the prevalence of SNHL, defined as ≥25 dB hearing level at any frequency and Cox proportional hazards regression analyses to compare SNHL risk between groups. At age 18 years, SNHL prevalence was 25% (95% confidence interval [CI]: 17%-36%) among case-patients and 8% (95% CI: 3%-22%) in controls (hazard ratio [HR]: 4.0; 95% CI: 1.2-14.5; P = .02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4-6.1; P = .5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset hearing loss than those without (HR: 6.9; 95% CI: 2.5-19.1; P < .01). The prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1%-9%). Delayed-onset and progression of SNHL among children with asymptomatic congenital cytomegalovirus infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. Overall, 2% of case-patients developed SNHL that was severe enough for them to be candidates for cochlear implantation. Copyright © 2017 by the American Academy of Pediatrics.

  14. Extraction of Asymptomatic Tooth With And Without Antibiotic Therapy

    Directory of Open Access Journals (Sweden)

    Manish Agrawal

    2012-06-01

    Full Text Available Background: Extraction of asymptomatic tooth constitutes a large proportion of maxillofacial surgery procedure and antibiotics are indiscriminately prescribed before and after tooth extraction in Bangladesh. Objectives: This cross sectional study was designed to evaluate the efficacy of postoperative antibiotic therapy in reducing postoperative morbidity in two groups following extraction of asymptomatic tooth. Methods: A total of 112 patients, 54 Female and 58 Male, aged 16 to 35 years comprised the study materials. Diagnosis was made by accurate history, clinical examination and radiographs. Clinical examination was done to assess the presence or absence of local infection, pain, swelling and mucosal coverage whereas Orthopantomogram (OPG and Intraoral Periapical (IOPA radiographs were taken to assess the angulations, position and bony coverage. Tooth extraction was performed with buccal guttering technique after adequate elevation and reflection of full thickness mucoperiosteal flap. The Control Group was given Cap. Amoxicillin 500mg, orally daily for 5 days postoperatively. The Study Group was not given antibiotics. Pain, swelling and trismus were evaluated preoperatively and on 2nd, 7th and 14th postoperative day. Data was processed and analyzed using SPSS version 16.0 for windows and was compiled and test of significance was done using Chi square (x² test and unpaired‘t’ test. Results: Statistical analysis of the data indicated that pain and swelling was significantly reduced and significant maximum mouth opening was achieved, when preoperative and postoperative results were compared, in both the groups P > 0.05, statistically not significant. Conclusion: There were no significant differences among the groups in the incidence of postoperative morbidity (pain, swelling and trismus.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10996 BSMMU J 2012; 5(1:24-28

  15. Asymptomatic celiac sprue in juvenile rheumatic diseases children.

    Science.gov (United States)

    Gheita, Tamer A; Fawzy, Samar M; Nour El-Din, Abeer M; Gomaa, Howaida E

    2012-04-01

    Celiac disease (CD) is the most frequent enteropathy in adults and its coexistence with other autoimmune diseases is frequent. To detect asymptomatic CD in children with rheumatic diseases by measuring tissue transglutaminase (tTG) antibodies and finding any relation to disease activity. Setting and study design: The study included 60 children with juvenile rheumatic diseases consecutively from those attending the Rheumatology Clinics of Cairo University Hospitals: 30 juvenile rheumatoid arthritis (JRA), 10 juvenile systemic lupus erythematosus (SLE), 12 juvenile seronegative spondyloarthropathy and eight juvenile systemic sclerosis/polymyositis (SSc/PM) overlap syndrome were recruited during 2010. There were 22 male and 38 female patients. Thirty matched healthy controls were included. All children were subjected to thorough history taking, clinical examination and laboratory investigations. The body mass index (BMI) for age was used. All subjects had no gastrointestinal tract symptoms suggestive of CD and the tTG antibodies (IgA and IgG) were assessed. The mean age of patients was 12.03 ± 3.3 years and disease duration 4.18 ± 3.24 years. The demographic, clinical and laboratory features of the children were studied and compared. The tTG was positive in 32 (53.3%) patients compared to 20% of the controls (P = 0.03), being higher in females. In tTG-positive patients, the BMI was significantly lower, while white blood cell count, erythrocyte sedimentation rate and disease activity were significantly higher. tTG antibodies may be used as a screening test to identify asymptomatic CD associated with juvenile rheumatic diseases, especially those with active JRA or marked reduction in BMI. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

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

    Directory of Open Access Journals (Sweden)

    Jia-Ying Sung

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

  17. Screening and Management of Asymptomatic Renal Stones in Astronauts

    Science.gov (United States)

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

    2017-01-01

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

  18. Unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse

    Directory of Open Access Journals (Sweden)

    Assem A.M. Elbiaa

    2015-09-01

    Full Text Available Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. Material and methods : Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biopsy and trans-vaginal ultrasound. Surgically removed uteri and ovaries were sent for histopathological examination. Results of histopathological examination as gold standard were compared with conventional gynecological screening methods. Results : Histopathological examination of surgically removed uteri and ovaries after vaginal hysterectomy for uterovaginal prolapse showed abnormal findings in 61.25% (49/80 of studied cases (10 chronic cervicitis; 20 cervical intra-epithelial neoplasia-1 [CIN-1]; 5 CIN-2; 2 CIN-3; 10 simple endometrial hyperplasia without atypia and 2 simple serous ovarian cyst. Also, histopathological examination showed premalignant changes in 33.75% (27/80 of studied cases (20 CIN-1; 5 CIN-2 and 2 CIN-3, which mean 50% sensitivity of pre-operative Pap smear to detect premalignant cervical changes. Conclusions : Asymptomatic women with utero-vaginal prolapse may have associated premalignant lesions which may not be detected by conventional screening methods, and this should be explained preoperatively for women undergoing surgery, especially if conservative management was considered.

  19. Assessing Optimal Blood Pressure in Patients With Asymptomatic Aortic Valve Stenosis

    DEFF Research Database (Denmark)

    Nielsen, Olav W; Sajadieh, Ahmad; Sabbah, Muhammad

    2016-01-01

    BACKGROUND: Evidence for treating hypertension in patients with asymptomatic aortic valve stenosis is scarce. We used data from the SEAS trial (Simvastatin Ezetimibe in Aortic Stenosis) to assess what blood pressure (BP) would be optimal. METHODS: A total of 1767 patients with asymptomatic aortic...

  20. 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.

  1. Autoimmune haemolytic anaemia in an asymptomatic carrier of hepatitis B virus.

    OpenAIRE

    Yoshioka, K; Miyata, H.

    1980-01-01

    A patient with 'warm type' autoimmune haemolytic anaemia (AIHA) was also an asymptomatic carrier of hepatitis B virus (HBV). Although the direct antiglobulin test became negative after the anaemia had recovered spontaneously, antigenaemia of HBV persisted and the serum transaminase level remained normal or borderline. AIHA has not previously been described in association with the asymptomatic carrier state of HBV.

  2. Systematic review of guidelines on imaging of asymptomatic coronary artery disease

    NARCIS (Netherlands)

    Ferket, Bart S.; Genders, Tessa S. S.; Colkesen, Ersen B.; Visser, Jacob J.; Spronk, Sandra; Steyerberg, Ewout W.; Hunink, M. G. Myriam

    2011-01-01

    The purpose of this study was to critically appraise guidelines on imaging of asymptomatic coronary artery disease (CAD). Various imaging tests exist to detect CAD in asymptomatic persons. Because randomized controlled trials are lacking, guidelines that address the use of CAD imaging tests may

  3. Profiles of enteropathogens in asymptomatic children from indigenous communities of Mérida, Venezuela.

    Science.gov (United States)

    Velasco, Judith; González, Fanny; Díaz, Tulia; Peña-Guillén, Jesús; Araque, María

    2011-04-26

    In Latin America, gastrointestinal infections represent one of the main causes of death among indigenous groups, with a mortality rate three times greater than in the general population. In this study, the carrier state of enteropathogens and the epidemiological risk factor in asymptomatic children from indigenous communities of Mérida, Venezuela, were determined. Fifty-eight healthy children, 5 years of age and under, were clinically and epidemiologically evaluated. Fecal samples were tested for a range of classic enteropathogens. Antimicrobial susceptibility tests (AST) were performed by dilution methods. Of the specimens studied, there were 34 (58.6%) positive samples, and a single enteropathogen was detected in 22 (64.6%) of these. Associations of two and three enteropathogens were observed in 10 (29.3%) and two (5.8%) cases, respectively. Blastocystis hominis (16; 47.0%) and Salmonella spp. (15; 43.9%) were the most frequently detected enteropathogens. Carriage of enteropathogens was most frequent in children older than two years. The variety of food in the daily diet was the risk factor strongly associated with the presence of parasites and/or enteric bacteria (p = 0.024 indigenous communities; this result is statistically related to the consumption of food. These findings stress the need of continuous epidemiological surveillance in vulnerable populations, as an important step to prevent the morbidity and mortality due to gastrointestinal infections.

  4. Clinical spectrum of uncomplicated malaria in semi-immune Amazonians: beyond the " symptomatic " vs " asymptomatic " dichotomy

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    Mônica da Silva-Nunes

    2007-06-01

    Full Text Available We analyzed prospectively 326 laboratory-confirmed, uncomplicated malarial infections (46.3% due to Plasmodium vivax, 35.3% due to P. falciparum, and 18.4% mixed-species infections diagnosed in 162 rural Amazonians aged 5-73 years. Thirteen symptoms (fever, chills, sweating, headache, myalgia, arthralgia, abdominal pain, nausea, vomiting, dizziness, cough, dyspnea, and diarrhea were scored using a structured questionnaire. Headache (59.8%, fever (57.1%, and myalgia (48.4% were the most frequent symptoms. Ninety-six (29.4% episodes, all of them diagnosed during cross-sectional surveys of the whole study population (96.9% by molecular technique only, were asymptomatic. Of 93 symptom-less infections left untreated, only 10 became symptomatic over the next two months following diagnosis. Fever was perceived as " intense " in 52.6% of 230 symptomatic malaria episodes, with no fever reported in 19.1% episodes although other symptoms were present. We found significant differences in the prevalence and perceived intensity of fever and other clinical symptoms in relation to parasite load at the time of diagnosis and patient's age, cumulative exposure to malaria, recent malaria morbidity, and species of malaria parasite. These factors are all likely to affect the effectiveness of malaria control strategies based on active or passive detection of febrile subjects in semi-immune populations.

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

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    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.

  6. Measurement precision and normal range of endometrial thickness in a postmenopausal population by transvaginal ultrasound

    DEFF Research Database (Denmark)

    Warming, L; Ravn, Pernille; Skouby, Sven O.

    2002-01-01

    OBJECTIVES: The aim of this study was to examine the endometrial thickness (ET) in an asymptomatic postmenopausal population, and to assess the long-term variability. DESIGN: A total of 1182 asymptomatic generally healthy postmenopausal women were enrolled into this cross-sectional evaluation...

  7. Is it time for preemptive drug treatment of asymptomatic (smoldering) multiple myeloma?

    Science.gov (United States)

    Fawole, Adewale; Abonour, Rafat; Stender, Michael; Shatavi, Seerin; Gaikazian, Susanna; Anderson, Joseph; Jaiyesimi, Ishmael

    2015-01-01

    Asymptomatic (smoldering) multiple myeloma is a heterogeneous plasma cell proliferative disorder with a variable rate of progression to active multiple myeloma or related disorders. Hypercalcemia, renal insufficiency, anemia, bone lesions or recurrent bacterial infections characterize active multiple myeloma. Some patients with asymptomatic myeloma develop active disease rapidly, and others can stay asymptomatic for many years. Those who are likely to progress within the first 2 years of diagnosis have been categorized as having high-risk disease. The availability of novel agents in the treatment of active multiple myeloma and our better understanding of the heterogeneity of asymptomatic multiple myeloma have spurred interest in the early treatment of these patients. We have reviewed the current proposed definitions of high-risk asymptomatic multiple myeloma, the concerns about future therapy in view of the transient nature, remissions and toxicities of the therapies, and the eventual relapses that characterize this incurable disease.

  8. Progressive loss of vision caused by asymptomatic pituitary macroadenoma: role of OCT

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    Asensio-Sánchez VM

    2016-09-01

    Full Text Available Víctor Manuel Asensio-Sánchez, Javier Foncubierta Ophthalmology Department, Clinical University Hospital of Valladolid, Valladolid, Spain Introduction: Most pituitary adenomas are clinically inactive. In patients with long-standing compression of the optic chiasm, ganglion cells may undergo axonal degeneration. Spectral domain optical coherence tomography (SD-OCT is able to identify retinal nerve fiber layer (RNFL and ganglion cell loss in the retina. We present a case in which SD-OCT was used to diagnose an asymptomatic pituitary macroadenoma.Clinical case: A 48-year-old female presented with progressive vision loss in both eyes. SD-OCT identified atrophy of the ganglion cell and nerve layers, with preservation of outer layers bilaterally. Magnetic resonance imaging of the brain showed a pituitary macroadenoma. The pathological diagnosis was nonfunctioning adenoma.Discussion: As macroadenomas enlarge, they can induce uncrossed axon loss, resulting in nasal field defects and reduced visual acuity. In these cases, there is atrophy of the nasal and temporal portions of the optic disc, thus occupying a horizontal band across the disc. SD-OCT is able to identify RNFL loss in eyes with band atrophy of the optic nerve, which correlates with visual field defects found in perimetry. SD-OCT is a useful tool to assess the structural and functional damage of ganglion cells. In our case the SD-OCT demonstrated a symmetrical loss of the RNFL and the ganglion cell layer in both eyes, indicating important optic nerve damage. Keywords: OCT, pituitary, adenoma, RNFL, ganglion cell layer

  9. Exploring the relationship between chronic undernutrition and asymptomatic malaria in Ghanaian children

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    Hale DeVon C

    2010-02-01

    Full Text Available Abstract Background A moderate association has been found between asymptomatic parasitaemia and undernutrition. However, additional investigation using the gold standard for asymptomatic parasitaemia confirmation, polymerase chain reaction (PCR, is needed to validate this association. Anthropometric measurements and blood samples from children less than five years of age in a rural Ghanaian community were used to determine if an association exists between chronic undernutrition and PCR-confirmed cases of asymptomatic malaria. Methods This was a descriptive cross-sectional study of 214 children less than five years of age from a community near Kumasi, Ghana. Blood samples and anthropometric measurements from these children were collected during physical examinations conducted in January 2007 by partners of the Barekuma Collaborative Community Development Programme. Results Findings from the logistic model predicting the odds of asymptomatic malaria indicate that children who experienced mild, moderate or severe stunting were not more likely to have asymptomatic malaria than children who were not stunted. Children experiencing anaemia had an increased likelihood (OR = 4.15; 95% CI: 1.92, 8.98 of asymptomatic malaria. Similarly, increased spleen size, which was measured by ultrasound, was also associated with asymptomatic malaria (OR = 2.17; 95% CI: 1.44, 3.28. Fast breathing, sex of the child, and age of the child were not significantly associated with the asymptomatic malaria. Conclusions No significant association between chronic undernutrition and presence of asymptomatic malaria was found. Children who experience anaemia and children who have splenomegaly are more likely to present asymptomatic malaria. Programmes aimed at addressing malaria should continue to include nutritional components, especially components that address anaemia.

  10. Significance of CT findings and catecholamine determination in peripheral blood of asymptomatic pheochromocytoma and paraganglioma

    Energy Technology Data Exchange (ETDEWEB)

    Saginoya, Toshiyuki; Miyake, Hidetoshi; Kiyosue, Hiro; Okahara, Mika; Hori, Yuko; Hata, Hiroyuki; Mori, Hiromu [Oita Medical Univ., Hasama (Japan)

    2001-01-01

    The purpose of this study was to assess the CT findings and significance of hormone determination in the peripheral blood of asymptomatic patients with pheochromocytoma and paraganglioma. CT findings in 29 patients with surgically proven pheochromocytoma (n=19) and paraganglioma (n=10) were reviewed. Nine patients (31%) were symptomatic and 20 (69%) were asymptomatic. Tumor size ranged from 39 mm to 114 mm (mean: 60 mm) in symptomatic patients and 11 mm to 100 mm (mean: 50 mm) in asymptomatic ones. Of the 9 symptomatic patients and 18 asymptomatic patients, a homogeneous solid pattern was seen in 4 and 4, mixed pattern in 2 and 6, and massive necrotic pattern in 3 and 8 patients, respectively, on CT scans. The CT attenuation values in symptomatic cases ranged from 30 HU to 50 HU (mean: 41 HU) on precontrast CT scans and 60 HU to 111 HU (mean: 77 HU) on postcontrast CT scans, while those in asymptomatic cases ranged from 15 HU to 48 HU (mean: 33 HU) on precontrast CT scans and 66 HU to 133 HU (mean: 95 HU) on postcontrast CT scans. There were no statistically significant differences in tumor size, homogeneity, or CT attenuation values between symptomatic and asymptomatic patients. All symptomatic patients and 17 (89%) of 19 asymptomatic cases showed elevated levels of catecholamine (epinephrine) or norepinephrine in the peripheral blood. Our study showed that the CT findings in asymptomatic patients were similar to those in symptomatic patients, and 89% of asymptomatic patients showed elevation of catecholamine in the peripheral blood. Determination of catecholamine level in the peripheral blood is recommended for preoperative diagnosis in patients suspected of having asymptomatic phenochromocytoma or paraganglioma on CT scans. (author)

  11. Pycnogenol® and Centella Asiatica for asymptomatic atherosclerosis progression.

    Science.gov (United States)

    Belcaro, G; Dugall, M; Hosoi, M; Ippolito, E; Cesarone, M; Luzzi, R; Cornelli, U; Ledda, A

    2014-02-01

    The aim of the study was to evaluate the effect of the nutritional supplements Pycnogenol and TECA (total triterpenic fraction of Centella Asiatica) on atherosclerosis progression in low-risk asymptomatic subjects with carotid or femoral non-stenosing plaques. This was an observational pilot substudy of the San Valentino epidemiological cardiovascular study. The study included 1363 subjects aged 45-60 without any conventional risk factors who had non stenosing atherosclerotic plaques (Centella Asiatica) 100 mg/day. There was a six monthly follow-up up to 30 months. Plaque progression was assessed using the ultrasonic arterial score based on the arterial wall morphology and the number of plaques that progressed from the non-stenotic to the stenotic group. A secondary endpoint was to evaluate the changes in oxidative stress at baseline and at 30 months. The ultrasonic score increased significantly in groups 1, 2 and 4 but not in groups 3, 5 and 6 suggesting a beneficial effect of Pycnogenol 100 mg. The percentage of plaques that progressed from class IV to class V was 8.4% in group 2, 5.3% in group 3, 4% in group 5 and 1.1% in group 6 (P<0.0001) compared with 16.6% in group 4 (aspirin) and 21.3% in the control group suggesting a beneficial effect of Pycnogenol. The lowest rate of progression was in group 6 (Pycnogenol plus TECA). At 30 months, the oxidative stress in all the Pycnogenol groups was less than in the control group. The oxidative stress was lower in the Pycnogenol 100 mg group than the Pycnogenol 50 mg group (P<0.0001). In the combined group of Pycnogenol and TECA the oxidative stress was less than the Pycnogenol alone (P<0.001). Pycnogenol and the combination of Pycnogenol+TECA appear to reduce the progression of subclinical arterial lesions in low-risk asymptomatic subjects. The reduction in plaque progression was associated with a reduction in oxidative stress. The results justify a large randomized controlled study to demonstrate the efficacy of the

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

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    Helen L. Del Puerto

    2010-02-01

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

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

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    K Abigail Andrews

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

  14. Urogenital Chlamydia trachomatis serovars in men and women with a symptomatic or asymptomatic infection : an association with clinical manifestations?

    NARCIS (Netherlands)

    Morre, SA; Rozendaal, L; van Valkengoed, IGM; Boeke, AJP; Vader, PCV; Schirm, J; de Blok, S; van den Hoek, JAR; van Doornum, GJJ; Meijer, CJLM; van den Brule, AJC

    To determine whether certain Chlamydia trachomatis serovars are preferentially associated with a symptomatic or an asymptomatic course of infection, C. trachomatis serovar distributions were analyzed in symptomatically and asymptomatically infected persons. Furthermore, a possible association

  15. Urogenital Chlamydia trachomatis serovars in men and women with a symptomatic or asymptomatic infection: an association with clinical manifestations?

    NARCIS (Netherlands)

    Morré, S. A.; Rozendaal, L.; van Valkengoed, I. G.; Boeke, A. J.; van Voorst Vader, P. C.; Schirm, J.; de Blok, S.; van den Hoek, J. A.; van Doornum, G. J.; Meijer, C. J.; van den Brule, A. J.

    2000-01-01

    To determine whether certain Chlamydia trachomatis serovars are preferentially associated with a symptomatic or an asymptomatic course of infection, C. trachomatis serovar distributions were analyzed in symptomatically and asymptomatically infected persons. Furthermore, a possible association

  16. Increased serum hepcidin and alterations in blood iron parameters associated with asymptomatic P. falciparum and P. vivax malaria.

    NARCIS (Netherlands)

    Mast, Q. de; Syafruddin, D.; Keijmel, S.; Riekerink, T.O.; Deky, O.; Asih, P.B.; Swinkels, D.W.; Ven, A.J.A.M. van der

    2010-01-01

    BACKGROUND: Asymptomatic Plasmodium spp. infections and anemia are highly prevalent conditions in tropical regions. We studied whether asymptomatic parasitemia induces hepcidin- and/or cytokine-mediated iron maldistribution and anemia. DESIGN AND METHODS: A group of 1197 Indonesian schoolchildren,

  17. Three types of sagittal alignment regarding compensation in asymptomatic adults: the contribution of the spine and lower limbs.

    Science.gov (United States)

    Bao, Hongda; Lafage, Renaud; Liabaud, Barthelemy; Elysée, Jonathan; Diebo, Bassel G; Poorman, Gregory; Jalai, Cyrus; Passias, Peter; Buckland, Aaron; Bess, Shay; Errico, Thomas; Lenke, Lawrence G; Gupta, Munish; Kim, Han Jo; Schwab, Frank; Lafage, Virginie

    2017-06-06

    A comprehensive understanding of normative sagittal profile is necessary for adult spinal deformity. Roussouly described four sagittal alignment types based on sacral slope, lumbar lordosis, and location of lumbar apex. However, the lower limb, a newly described component of spinal malalignment compensation, is missing from this classification. This study aims to propose a full-body sagittal profile classification in an asymptomatic population based on full-body imaging. This is a retrospective analysis of a prospective single-center study of 116 asymptomatic volunteers. Cluster analysis including all sagittal parameters was first performed, and then ANOVA was performed between sub-clusters to eliminate the non-significantly different parameters. This loop was repeated until all parameters were significantly different between each sub-cluster. Three types of full-body sagittal profiles were finalized according to cluster analysis with ten radiographic parameters: hyperlordosis type (77 subjects), neutral type (28 subjects), and compensated type (11 subjects). Radiographic parameters included knee angle, pelvic shift, pelvic angle, PT, PI-LL, C7-S1 SVA, TPA, T1 slope, C2-C7 angle, and C2-C7 SVA. Age was significantly different across compensation types, while BMI and gender were comparable. Age-matched subjects were randomly selected with 11 subjects in each type. ANOVA analysis revealed that all parameters but PT and C2-C7 angle remained significantly different. The current three compensation types of full-body sagittal profiles in asymptomatic adults included significant changes from cervical region to knee, indicating that subjects should be evaluated with full-length imaging. All three types exist regardless of age, but the distribution may vary.

  18. THE SHORT-TERM EFFECT OF A HOME-BASED PROGRAM TO CORRECT FORWARD HEAD POSTURE IN ASYMPTOMATIC SUBJECTS

    Directory of Open Access Journals (Sweden)

    Ahmed Omar Abdelnaeem

    2015-08-01

    Full Text Available Background: Neck pain and dysfunction may be the consequence of adopting sustained non-neutral spinal postures. Such postures are associated with increased activation of the neck-shoulder stabilizer muscles, which eventually increase the loading of cervical spine. Forward head posture is a common postural dysfunction that has been associated with many musculoskeletal disorders. The purpose of the study was to investigate the effects of deep cervical flexor muscles training on the severity of forward head posture in asymptomatic subjects. Methods: Forty-one asymptomatic subjects volunteered in this study. Participants were randomly assigned into an intervention group (n= 20that received a home-based training of deep cervical flexor muscles for 6-weeks, and a control group(n= 21 that received only the assessment procedure. Subjects were assessed at baseline and 6weeks later with regards to the severity of forward head as indicated by the cranio-vertebral angle. Also, the strength and endurance of the deep flexor muscles were assessed. Results: After six weeks, participants in the intervention group showed significant improvement in all measured variables compared to the control group. Furthermore, participants in the intervention group showed significant difference in all measured variables after 6-weeks of training compared to baseline, whereas those in the control group remained the same. Conclusion: Six-weeks of deep cervical training improves forward head posture and deep flexors strength and endurance in asymptomatic subjects. Thus, this exercise could be used as a preventive measure against the development of neck dysfunction in at risk population even before the onset of any symptoms.

  19. Carotid stenosis: what is the high-risk population?

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    Jong Hun Park

    Full Text Available OBJECTIVE: Prevention is the best treatment for cerebrovascular disease, which is why early diagnosis and the immediate treatment of carotid stenosis contribute significantly to reducing the incidence of stroke. Given its silent nature, 80% of stroke cases occur in asymptomatic individuals, emphasizing the importance of screening individuals with carotid stenosis and identifying high-risk groups for the disease. The aim of this study was to determine the prevalence and the most frequent risk factors for carotid stenosis. METHODS: A transversal study was conducted in the form of a stroke prevention campaign held on three nonconsecutive Saturdays. During the sessions, carotid stenosis diagnostic procedures were performed for 500 individuals aged 60 years or older who had systemic arterial hypertension and/or diabetes mellitus and/or coronary heart disease and/or a family history of stroke. RESULTS: The prevalence of carotid stenosis in the population studied was 7.4%, and the most frequent risk factors identified were mean age of 70 years, carotid bruit, peripheral obstructive arterial disease, coronary insufficiency and smoking. Independent predictive factors of carotid stenosis include the presence of carotid bruit or peripheral obstructive heart disease and/or coronary insufficiency. CONCLUSIONS: The population with peripheral obstructive heart disease and carotid bruit should undergo routine screening for carotid stenosis.

  20. Tracheal diverticulum in an asymptomatic male: a case report

    Science.gov (United States)

    Kokkonouzis, Ioannis; Haramis, Dimitrios; Kornezos, Ioannis; Moschouris, Hippocrates; Katsenos, Stamatis; Bouchara, Stauroula

    2008-01-01

    Introduction An air filled lesion can be a diagnostic dilemma and a careful investigation must be following to clarity any underlining pathology. Case presentation A 62-year old male, ex smoker, with a history of chronic cough was examined with helical CT tomography and an air filled lesion was demonstrated at the right paratracheal region at the thoracic inlet. A narrow connection to trachea lumen was also visible, a critical element to establish the diagnosis of ttracheal diverticulosis. Conclusion This malformation is a rare anomaly with two types, the congenital and the acquired one. It must be included into the differential diagnosis of any air filled lesion at the thoracic inlet. Computed tomography scans (with thin section and reconstructed images) seem the proper imagine. Bronchoscopy can also visualize the diverticulum although sometimes the connection with trachea can't be detected. In most cases is asymptomatic and needs no special treatment. A possible danger of repeated respiratory infections and insufficient intubation and/or ventilation must be in mind. PMID:18816406

  1. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Science.gov (United States)

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

    2012-01-01

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

  2. Evaluation of the patient with asymptomatic microscopic hematuria.

    Science.gov (United States)

    Ziemba, Justin; Guzzo, Thomas J; Ramchandani, Parvati

    2015-08-01

    Asymptomatic microscopic hematuria (AMH) is relatively common in clinical practice but the etiology remains unclear in the majority of patients; it is rarely related to genitourinary malignancies. The 2012 guidelines of the American Urological Association recommend an evaluation after a single positive urinalysis with mandatory upper tract evaluation in all patients, preferably with CT urography (CTU). The likelihood of detecting significant upper track abnormalities, particularly malignancies is low with CTU, while incidental extraurinary abnormalities are often found, the majority of which are not clinically significant. The workup for these incidental findings has significant financial and clinical implications. Primary care physicians, who are most apt to encounter patients with AMH, have a low rate of adherence to the AUA guidelines, possibly as a result of the broadening of criteria for AMH evaluation by the AUA, with resultant uncertainty amongst primary care physicians about the appropriate candidates for such evaluation. Selection of subgroups of patients with risk factors for GU malignancies who may benefit from a complete evaluation is essential, as opposed to evaluation of all patients classified as having AMH. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  3. COMPARISON OF METHODS TO IDENTIFY Neisseria meningitidis IN ASYMPTOMATIC CARRIERS

    Science.gov (United States)

    RIZEK, Camila F.; LUIZ, André Machado; de ASSIS, Gracilene Ramos; COSTA, Silvia Figueiredo; LEVIN, Anna Sara; LOPES, Marta Heloisa

    2016-01-01

    SUMMARY Neisseria meningitidis is a cause of several life-threatening diseases and can be a normal commensal in the upper respiratory tract of healthy carriers. The carrier rate is not well established especially because there is no standard method for the isolation of N. meningitidis. Therefore, the aim of this study was to compare identification methods for the carrier state. Two swabs were collected from 190 volunteers: one was cultured and the other had DNA extracted directly from the sample. The Polymerase Chain Reaction (PCR) was performed to determine species and serogroups and compared the results between the methods. PCR for species determination used two pairs of primers and when there was only one amplicon, it was sequenced. The culture technique was positive in 23 (12.1%) subjects while the direct extraction method was positive in 132 (69.5%), p < 0.001. Among the 135 subjects with positive N. meningitides tests, 88 (65.2%) were serogroup C; 3 (2.2%) serogroup B; 5 (3.7%) were positive for both serogroup B and C, and 39 (28.9%) did not belong to any of the tested serogroups. In this study, PCR from DNA extracted directly from swabs identified more N. meningitidis asymptomatic carriers than the culture technique. PMID:27680165

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

    Science.gov (United States)

    Pruimboom, Leo; de Punder, Karin

    2015-11-24

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

  5. Visual fatigue effects on vergence dynamics in asymptomatic individuals.

    Science.gov (United States)

    Thiagarajan, Preethi; Ciuffreda, Kenneth J

    2013-11-01

    To evaluate objectively changes in vergence dynamics following intentional visual fatiguing tasks using congruent (C) and non-congruent (NC) vergence stimulus demands. Pre- and post-task vergence dynamics to a 10.3° disparity stimulus were recorded objectively in 12 adult, asymptomatic individuals for both convergence and divergence. There were two fatigue-inducing tasks: Congruent or C-task: Subjects altered bifixation (50 cycles) between reduced Snellen charts at 2 m and at 20 cm every 3 s. Non-congruent or NC task: Subjects performed 50 cycles of vergence flipper (7Δ BO/BI), while bifixating a reduced Snellen chart at 40 cm. Pre- and post-task mean amplitude, time constant, peak velocity, and steady-state response variability were compared. There was a significant increase in mean post-task, steady-state response variability for both the C and NC tasks. However, there were no significant group differences for either convergence or divergence between the pre- and post-mean amplitude, time constant, and peak velocity parameters for both the C and NC tasks, although post-task peak velocity was consistently reduced. Steady-state vergence response variability was found to be the critical objective parameter to demonstrate significant fatigue effects in the group. Peak velocity was also consistently reduced to a small extent in the NC task. We speculate that these fatigue effects are of a central, and not of peripheral, origin. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  6. [Asymptomatic skull base metastases: clinical course and therapeutic alternatives].

    Science.gov (United States)

    Vargas, A; Paulazo, C; Oleaga, L; Verger, E

    2017-03-01

    Skull base metastases (SBM) are an infrequent and late type of cancer progression that are associated to poor prognosis. Its clinical manifestations may be grouped in five clinical syndromes and radiotherapy is its more frequent treatment. Because of the improvement in imaging tests and the close follow up of cancer patients, SBM can be diagnosed incidentally. In this group the best option of treatment has not been established. To analyze the clinical features and outcomes of patients with SBM diagnosed incidentally. Between January 2012 and December 2015, 31 patients with diagnoses of SBM from solid primary tumor were reviewed. SBM were diagnosed due to skull base syndromes (n = 24) or incidentally (n = 7). Symptomatic patients were treated with radiotherapy. Patients diagnosed incidentally remained without symptoms of craneal base involvement during the follow up, although they frequently had other types of intracranial progression. A statistically significant difference in survival was observed between symptomatic and asymptomatic patients (p = 0.001). The incidentally diagnosed SBM were frequently associated to other types of intracranial progression, limiting the options of treatment.

  7. Asymptomatic bacteriuria Escherichia coli are live biotherapeutics for UTI.

    Directory of Open Access Journals (Sweden)

    Charles N Rudick

    Full Text Available Urinary tract infections (UTI account for approximately 8 million clinic visits annually with symptoms that include acute pelvic pain, dysuria, and irritative voiding. Empiric UTI management with antimicrobials is complicated by increasing antimicrobial resistance among uropathogens, but live biotherapeutics products (LBPs, such as asymptomatic bacteriuria (ASB strains of E. coli, offer the potential to circumvent antimicrobial resistance. Here we evaluated ASB E. coli as LBPs, relative to ciprofloxacin, for efficacy against infection and visceral pain in a murine UTI model. Visceral pain was quantified as tactile allodynia of the pelvic region in response to mechanical stimulation with von Frey filaments. Whereas ciprofloxacin promoted clearance of uropathogenic E. coli (UPEC, it did not reduce pelvic tactile allodynia, a measure of visceral pain. In contrast, ASB E. coli administered intravesically or intravaginally provided comparable reduction of allodynia similar to intravesical lidocaine. Moreover, ASB E. coli were similarly effective against UTI allodynia induced by Proteus mirabilis, Enterococccus faecalis and Klebsiella pneumoniae. Therefore, ASB E. coli have anti-infective activity comparable to the current standard of care yet also provide superior analgesia. These studies suggest that ASB E. coli represent novel LBPs for UTI symptoms.

  8. PREVALENCE AND RISK FACTORS OF ASYMPTOMATIC CEREBRAL INFARCTION

    Directory of Open Access Journals (Sweden)

    R. R. Zhetishev

    2015-01-01

    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. 

  9. Subendocardial Systolic Dysfunction in Asymptomatic Normotensive Diabetic Patients.

    Science.gov (United States)

    Enomoto, Mami; Ishizu, Tomoko; Seo, Yoshihiro; Yamamoto, Masayoshi; Suzuki, Hiroaki; Shimano, Hitoshi; Kawakami, Yasushi; Aonuma, Kazutaka

    2015-01-01

    It remains uncertain whether diabetes itself causes specific echocardiographic features of myocardial morphology and function in the absence of hypertension or ischemic heart disease. The purpose of the present study was to determine the characteristics of pure diabetic cardiomyopathy-related echocardiographic morphology and function using layer-by-layer evaluation with myocardial strain echocardiography. We enrolled 104 patients with poorly controlled type 2 diabetes mellitus (mean HbA1c level, 10%) with (n=74) or without (n=40) hypertension and 24 age- and sex-matched healthy volunteers. Patients with coronary artery stenosis or structural heart disease were excluded. Myocardial layer-specific strain was analyzed by speckle tracking echocardiography. Compared with the healthy control group, the normotensive diabetes group showed no significant difference in ejection fraction, left ventricular mass index, diastolic properties, left atrial volume index, or B-type natriuretic protein (BNP) level, but global longitudinal strain and subendocardial radial strain were significantly deteriorated. The deterioration of longitudinal strain correlated with body mass index (R=0.49, Psubendocardial wall thickening are the characteristic functional abnormalities of diabetic cardiomyopathy in patients without hypertrophy, diastolic dysfunction, or elevated BNP. Obesity and blood pressure may also play important roles in this strain abnormality in asymptomatic patients with type 2 diabetes.

  10. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Directory of Open Access Journals (Sweden)

    Ana Laura Calderón-Garcidueñas

    2012-01-01

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

  11. Chorioamnionitis and Management of Asymptomatic Infants ≥35 Weeks Without Empiric Antibiotics.

    Science.gov (United States)

    Jan, Amanda I; Ramanathan, Rangasamy; Cayabyab, Rowena G

    2017-07-01

    Management of asymptomatic infants ≥35 weeks' gestation born to mothers with chorioamnionitis remains controversial, with many clinicians considering the need for changes to the current guidelines. The study objective was to evaluate the outcomes of asymptomatic chorioamnionitis-exposed neonates without the use of immediate empirical antibiotics. A retrospective data review was conducted from May 2008 to December 2014, including asymptomatic infants ≥35 weeks' gestation with a maternal diagnosis of clinical chorioamnionitis. A total of 240 asymptomatic infants with chorioamnionitis exposure were identified. The majority of asymptomatic chorioamnionitis-exposed infants, 162 (67.5%), remained well in the mother-infant unit with a median stay of 2 days. There were 78 (32.5%) infants admitted to the NICU and exposed to antibiotics due to abnormal laboratory data or development of clinical symptoms. Of those infants admitted to the NICU, 19 (24%) received antibiotics for antibiotics in asymptomatic newborns ≥35 weeks' gestation with maternal chorioamninonitis prevented NICU admission in two-thirds of these infants. This prevented unnecessary antibiotic exposure, increased hospitalization costs, and disruption of mother-infant bonding and breastfeeding. Laboratory evaluation and clinical observation without immediate antibiotic administration may be incorporated into a management approach in asymptomatic chorioamnionitis-exposed neonates. Additional studies are needed to establish the safety of this approach. Copyright © 2017 by the American Academy of Pediatrics.

  12. Protocol for a randomised controlled trial of treatment of asymptomatic candidiasis for the prevention of preterm birth [ACTRN12610000607077

    Directory of Open Access Journals (Sweden)

    Rickard Kristen R

    2011-03-01

    Full Text Available Abstract Background Prevention of preterm birth remains one of the most important challenges in maternity care. We propose a randomised trial with: a simple Candida testing protocol that can be easily incorporated into usual antenatal care; a simple, well accepted, treatment intervention; and assessment of outcomes from validated, routinely-collected, computerised databases. Methods/Design Using a prospective, randomised, open-label, blinded-endpoint (PROBE study design, we aim to evaluate whether treating women with asymptomatic vaginal candidiasis early in pregnancy is effective in preventing spontaneous preterm birth. Pregnant women presenting for antenatal care The study protocol draws on the usual antenatal care schedule, has been pilot-tested and the intervention involves only a minor modification of current practice. Women who agree to participate will self-collect a vaginal swab and those who are culture positive for Candida will be randomised (central, telephone to open-label treatment or usual care (screening result is not revealed, no treatment, routine antenatal care. Outcomes will be obtained from population databases. A sample size of 3,208 women with Candida colonisation (1,604 per arm is required to detect a 40% reduction in the spontaneous preterm birth rate among women with asymptomatic candidiasis from 5.0% in the control group to 3.0% in women treated with clotrimazole (significance 0.05, power 0.8. Analyses will be by intention to treat. Discussion For our hypothesis, a placebo-controlled trial had major disadvantages: a placebo arm would not represent current clinical practice; knowledge of vaginal colonisation with Candida may change participants' behaviour; and a placebo with an alcohol preservative may have an independent affect on vaginal flora. These disadvantages can be overcome by the PROBE study design. This trial will provide definitive evidence on whether screening for and treating asymptomatic candidiasis in

  13. Clinical risk assessment for gastric cancer in asymptomatic population after a health check-up

    OpenAIRE

    Park, Yoo Mi; Kim, Jie-Hyun; Baik, Su Jung; Park, Jae Jun; Youn, Young Hoon; Park, Hyojin

    2016-01-01

    Abstract For the prevention of gastric cancer, the detection of risk factors associated with precancerous conditions may be more informative. The aim of this study was to identify the risk factors of gastric cancer, including precancerous conditions: atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia. The clinical and endoscopic findings of 60,261 adults who underwent gastroduodenoscopy as part of a health check-up were reviewed retrospectively. Subgroup analysis was conducted...

  14. Effect of Age on Left Ventricular Global Dyssynchrony in Asymptomatic Individuals: A Population Study.

    Science.gov (United States)

    Vancheri, Federico; Vancheri, Sergio; Henein, Michael Y

    2016-07-01

    Left ventricular (LV) segmental dyssynchrony is common in patients with heart failure or myocardial activation abnormalities and is associated with increased cardiovascular risk. Total isovolumic time (t-IVT) and Tei index are sensitive indexes of global ventricular dyssynchrony. The aim of this study was to investigate the effect of age on t-IVT and Tei index. We evaluated 410 individuals with no evidence for coronary heart disease or activation abnormalities. T-IVT was calculated as 60 - (total ejection time + total filling time) and Tei index as t-IVT/total ejection time. The relationship between age, LV systolic and diastolic function parameters as well as t-IVT and Tei index was studied. Ejection fraction and stroke volume did not change with age, whereas early diastolic filling velocity fell and atrial systolic velocity increased, reducing the E/A ratio. Isovolumic contraction time (IVCT) and isovolumic relaxation time (IVRT) lengthened. With every 10 years of age, total LV ejection time shortened by 1.5 sec/min and total filling time by 2.1 sec/min. T-IVT and Tei index increased with age and strongly correlated with IVCT and E/A, but not with ejection fraction or QRS duration. Normal aging is associated with worsening of LV global dyssynchrony shown by prolongation of isovolumic times resulting in shortening of filling and ejection times. Age also affects diastolic function as shown by E/A but not systolic function parameters, ejection fraction or stroke volume. Worsening of global dyssynchrony correlates with that of diastolic function but not with QRS duration. © 2016, Wiley Periodicals, Inc.

  15. Clinical risk assessment for gastric cancer in asymptomatic population after a health check-up

    Science.gov (United States)

    Park, Yoo Mi; Kim, Jie-Hyun; Baik, Su Jung; Park, Jae Jun; Youn, Young Hoon; Park, Hyojin

    2016-01-01

    Abstract For the prevention of gastric cancer, the detection of risk factors associated with precancerous conditions may be more informative. The aim of this study was to identify the risk factors of gastric cancer, including precancerous conditions: atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia. The clinical and endoscopic findings of 60,261 adults who underwent gastroduodenoscopy as part of a health check-up were reviewed retrospectively. Subgroup analysis was conducted according to age, sex, cancer stage, and histology based on Lauren classification. Gastric cancer was diagnosed in 75 patients (0.12%). Both IM and AG were independent risk factors for gastric cancer in all subgroups. Male, older age, obesity, diabetes mellitus (DM), a salty and spicy diet, and Helicobacter pylori (H. pylori) were significantly associated with precancerous conditions. However, risk factors related to precancerous conditions were different according to age and sex. In risk factor related to precancerous conditions, whereas DM with a salty and spicy diet were additional risk factors in ≥40 years. In female individuals, obesity was significant risk factor for precancerous conditions as well as H. pylori infection. AG and IM are independent risk factors for gastric cancer. To prevent gastric cancer, H. pylori eradication may be more useful in obesity, salty and spicy diet may be important in female or ≥40 years. PMID:27858920

  16. Prognosis of asymptomatic and symptomatic, undiagnosed COPD in the general population in Denmark

    DEFF Research Database (Denmark)

    Çolak, Yunus; Afzal, Shoaib; Nordestgaard, Børge G

    2017-01-01

    individuals at high risk of having COPD, including 152 deaths due to respiratory disease. Compared with individuals without COPD, the age and sex adjusted hazard ratio (HR) was 5·0 (95% CI 2·8-8·9) for exacerbations, 1·7 (1·3-2·2) for pneumonia, 0·7 (0·2-3·0) for death from respiratory causes, and 1·3 (1...... of COPD are needed. FUNDING: The Danish Lung Association, the Danish Cancer Society, Herlev and Gentofte Hospital, Copenhagen University Hospital, and University of Copenhagen....

  17. Clinical Impact of Asymptomatic Presentation Status in Patients with Paroxysmal and Sustained Atrial Fibrillation

    DEFF Research Database (Denmark)

    Esato, Masahiro; Chun, Yeung-Hwa; An, Yoshimori

    2017-01-01

    BACKGROUND: The clinical characteristics and outcomes of asymptomatic patients with paroxysmal or persistent/permanent atrial fibrillation (AF) are largely unknown. METHODS: The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical...... institutions in Fushimi-ku, Japan. We investigated the clinical characteristics and outcomes of asymptomatic versus symptomatic patients in the paroxysmal (n=1,837) and persistent/permanent (as sustained: n=1,912) AF subgroups. RESULTS: In the paroxysmal AF (PAF) group, asymptomatic patients were older...

  18. Schistosoma haematobium infection and asymptomatic bacteriuria in young South African females

    DEFF Research Database (Denmark)

    Kildemoes, Anna M. O.; Kjetland, Eyrun Floerecke; Zulu, Siphosenkosi Gift

    2015-01-01

    infection and asymptomatic bacteriuria can both portray haematuria, proteinuria and leukocyturia. This shared set of proxy diagnostic markers could fuel routine misdiagnosis in S. haematobium endemic areas. Furthermore, S. haematobium infected individuals might be at a higher risk of contracting bacterial...... by microscopy of urine samples. Furthermore, urine samples were tested with dipslides for asymptomatic bacteriuria and with dipsticks for haematuria, proteinuria and leukocytes. We found no association between asymptomatic bacteriuria and S. haematobium infection in a sample of 1040 female primary and high...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-05-01

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

  20. Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar

    Directory of Open Access Journals (Sweden)

    Janet Douglass

    2017-09-01

    Full Text Available When normal lymphatic function is hampered, imperceptible subcutaneous edema can develop and progress to overt lymphedema. Low-cost reliable devices for objective assessment of lymphedema are well accepted in clinical practice and research on breast-cancer related lymphedema but are untested in populations with lymphatic filariasis (LF. This is a cross-sectional analysis of baseline data in a longitudinal study on asymptomatic, LF antigen-positive and -negative young people in Myanmar. Rapid field screening was used to identify antigen-positive cases and a group of antigen-negative controls of similar age and gender were invited to continue in the study. Tissue compressibility was assessed with three tissue tonometers, and free fluids were assessed using bio-impedance spectroscopy (BIS. Infection status was confirmed by Og4C3 antigen assay. At baseline (n = 98, antigen-positive cases had clinically relevant increases in tissue compressibility at the calf using a digital Indurometer (11.1%, p = 0.021, and in whole-leg free fluid using BIS (9.2%, p = 0.053. Regression analysis for moderating factors (age, gender, hydration reinforced the between-infection group differences. Results demonstrate that sub-clinical changes associated with infection can be detected in asymptomatic cases. Further exploration of these low-cost devices in clinical and research settings on filariasis-related lymphedema are warranted.

  1. Acupuncture for serum uric acid in patients with asymptomatic hyperuricemia: A randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Huang, Yingjuan; Meng, Jun; Sun, Baoguo; Xiang, Ting; Zhou, Xin; Xu, Biyu; Wu, Yingzi; Chen, Zexiong; Zhang, Shijun

    2017-04-01

    Hyperuricemia (HUA) is the most common disease associated with cardiovascular disease, metabolic syndrome, hypertension, and kidney disease. The objective of the current study was to evaluate the preliminary efficacy, mechanism, and safety of acupuncture on serum uric acid in patients with asymptomatic HUA. A randomized, placebo-controlled trial among 123 patients with asymptomatic HUA was conducted. The acupoints used in the acupuncture group were bilateral Five Shu in Spleen Meridian. Each participant received the intervention once daily for 10 consecutive days. The sham group received the same treatment duration on the same acupoints by the Park Sham Device. All patients underwent measurements of serum or urine creatinine, uric acid, serum lipid profiles, fasting plasma glucose, HbA1c, xanthine oxidase (XOD) and urate-anion exchanger (URAT-1). At the end of the intervention, the individuals in the acupuncture group were found to have significantly less levels of serum uric acid than those in the sham group [(453±65 vs. 528±81) μmol/L, puric acid level, urine pH value and 24-hour urine volume than the sham treatment (puric acid in a Chinese HUA patient population. The mechanism might be associated with the decrease level of enzyme URAT-1. ChiCTR-TRC-13004122. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Coronary Artery Disease in Asymptomatic Young Adults: Its Prevalence According to Coronary Artery Disease Risk Stratification and the CT Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Eun Ju; Kim, Yoo Kyung; Cheung, Joo Yeon; Shim, Sung Shine [Ewha Womans University Mokdong Hospital, Seoul (Korea, Republic of)

    2010-08-15

    We aimed at evaluating the prevalence and CT characteristics of occult coronary artery disease (CAD) in young Korean adults under 40 years of age by performing coronary CT angiography (CCTA). We retrospectively enrolled 112 consecutive asymptomatic subjects (90 men, mean age: 35.6 {+-} 3.7 years) who underwent CCTA as part of a general health evaluation. We classified the subjects into three National Cholesterol Education Program risk categories and we assessed the plaque characteristics on CCTA according to the number of involved vessels, the location and type of plaques and vascular remodeling. Twelve individuals had CAD (11%, 11 men). The prevalence of CAD was significantly higher in the subgroups with moderate (22%) or high (25%) risk than that in the low risk subgroup (5%) (p < 0.05). Nine patients had single-vessel disease and three patients had two-vessel disease. The most common location for plaque was the proximal left anterior descending coronary artery (60%). All the patients had non-significant stenosis and plaque, including the non-calcified (27%), mixed (47%) and calcified (27%) types. Positive vascular remodeling was identified in all the patients with non-calcified or mixed plaques. The prevalence of occult CAD was not negligible in the asymptomatic young adults with moderate to high risk, and this suggests the importance of management and risk factor modification in this population. All the patients had non-significant stenosis, and one fourth of the plaques did not show calcification

  3. Peak expiratory flow rate in asymptomatic male workers exposed to chemical fumes, in various industries of Hyderabad

    Directory of Open Access Journals (Sweden)

    Padaki Samata K, Dambal Amrut , Kokiwar Prashant

    2014-11-01

    Full Text Available Context: The prevalence of occupational health hazards and mortality has been reported to be unusually high among people of India. Although developed countries are very much careful about the health in occupations it is quite neglected in the developing countries like India. Aims: To record PEFR in asymptomatic male workers exposed to chemical fumes for more than 2 years and compare the results with age matched unexposed, healthy male controls. Methods and Material: This was a comparative study between 50 asymptomatic male workers exposed to chemical fumes for more than 2 years in various industries located at Jeedimetla Industrial Area and 50 unexposed healthy male individuals from general population. The sampling was done by simple random sampling (lottery method. The data was collected in the Research Laboratory of Physiology. Anthropometry like weight, height, was measured and the PEFR test was performed in the standing position by taking a deep inspiration and then blowing out as hard and as quickly as possible with their nose closed. Data was analyzed by using SPSS package and was expressed in terms of mean ± SD. Results: It was observed that mean PEFR was statistically highly significant in cases (p = 0.0001, and PEFR decreased with increase in duration of exposure. Conclusions: Thus, it can be concluded that apparently healthy individuals may also have abnormal PEFR findings. Hence, a regular check on these parameters will help them in reducing the chances of its manifestation at a future date.

  4. Camellia sinensis in asymptomatic hyperuricemia: A meta-analysis of tea or tea extract effects on uric acid levels.

    Science.gov (United States)

    Peluso, Ilaria; Teichner, Alessia; Manafikhi, Husseen; Palmery, Maura

    2017-01-22

    Flavanols of Camellia sinensis exhibit uric acid (UA) lowering effect, through the modulation of both xanthine oxidase and urate excretion. In order to investigate the potential benefit of Camellia Sinenis products in asymptomatic hyperuricemia, a meta-analysis of long-term Randomized Controlled Trials (RCT) with tea or tea extract has been conducted. From 20 human intervention studies selected only 5 RCT (13 interventions) were suitable for meta-analysis (n = 472). The current "normal" range set for hyperuricemia fails to identify patients with potential metabolic disorders. Therefore on the basis of the literature data, we fixed cut-off limits for UA baseline levels of 4.5 mg/dl for women, 6.1 mg/dl for men, and 5.5 mg/dl for studies involving mixed populations. Statistically significant effects were not found, but subgroup analysis revealed that the Pooled Estimate effect was different in subjects with baseline levels under [MD (95% CI): 0.1078 (-0.0528 to 0.2684)] and over the cut-off [MD (95% CI): -0.0239 (0.3311 to 0.2833)]. However, due to the low number of RCT and to the lack of data on bioavailability, it is difficult to draw any firm conclusion and more studies are needed to establish if tea flavanols could be useful in asymptomatic hyperuricemia treatment.

  5. Incidence of symptomatic and asymptomatic Leishmania donovani infections in high-endemic foci in India and Nepal: a prospective study.

    Directory of Open Access Journals (Sweden)

    Bart Ostyn

    2011-10-01

    Full Text Available Incidence of Leishmania donovani infection and Visceral Leishmaniasis (VL was assessed in a prospective study in Indian and Nepalese high-endemic villages. DAT-seroconversion was used as marker of incident infection in 3 yearly surveys. The study population was followed up to month 30 to identify incident clinical cases. In a cohort of 9034 DAT-negative individuals with neither active signs nor history of VL at baseline, 42 VL cases and 375 asymptomatic seroconversions were recorded in the first year, giving an infection:disease ratio of 8.9 to 1. In the 18 months' follow-up, 7 extra cases of VL were observed in the seroconverters group (N=375, against 14 VL cases among the individuals who had not seroconverted in the first year (N=8570 (RR=11.5(4.5asymptomatic L. donovani infection in VL high-endemic foci in India and Nepal is nine times more frequent than incident VL disease. About 1 in 50 of these new but latent infections led to VL within the next 18 months.

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

    Science.gov (United States)

    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

    2015-03-01

    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 asymptomatic HF (age 66.5 years ±10). In correlational analysis, gratitude was associated with better sleep (r=-.25, pgratitude also had lower levels of inflammatory biomarkers (r=-.17, pgratitude. We found that gratitude fully mediated the relationship between spiritual wellbeing and sleep quality (z=-2.35, SE=.03, p=.02) and also the relationship between spiritual wellbeing and depressed mood (z=-4.00, SE=.075, pGratitude also partially mediated the relationships between spiritual wellbeing and fatigue (z=-3.85, SE=.18, pgratitude and spiritual wellbeing are related to better mood and sleep, less fatigue, and more self-efficacy, and that gratitude fully or partially mediates the beneficial effects of spiritual wellbeing on these endpoints. Efforts to increase gratitude may be a treatment for improving wellbeing in HF patients' lives and be of potential clinical value.

  7. Detection and identification of Chlamydophila psittaci in asymptomatic parrots in Poland.

    Science.gov (United States)

    Piasecki, Tomasz; Chrząstek, Klaudia; Wieliczko, Alina

    2012-12-04

    Psittacosis, an avian disease caused by Chlamydophila psittaci, can manifest as an acute, protracted, or chronic illness, but can also be asymptomatic. C. psittaci can persist in the host for months to years, often without causing obvious illness, and therefore poses a threat for zoonotic outbreak. We investigated the prevalence of C. psittaci from 156 tracheal swab samples from 34 different species of parrots in Poland, and determined the genotype of strains from the positive samples. An overall prevalence of 10.3% was observed using two different PCR assays, both providing similar results. Thirteen of the PCR-positive samples were genotype A, two were genotype B, and one could not be classified. These results indicate widespread dissemination of C. psittaci in Polish psittacine populations, without any clinical signs of chlamydiosis, and hence could pose a zoonotic hazard. PCR screening provided a definitive diagnosis of psittacosis, and subsequent ompA gene analysis could be helpful for better understanding the epidemiology of the C. psittaci genotypes. To the best of our knowledge, this is the first report of the incidence of C. psittaci in parrots in Poland.

  8. Risk of Asymptomatic Bacteriuria among People with Sickle Cell Disease in Accra, Ghana

    Directory of Open Access Journals (Sweden)

    Eric S. Donkor

    2017-02-01

    Full Text Available Asymptomatic bacteriuria (ASB is benign except in certain medical conditions such as pregnancy and immunosuppression. In Ghana, there are hardly any studies on urinary infections among sickle cell disease (SCD patients, and the few studies carried out in Africa focused on pediatric SCD populations. The current study aimed to investigate the risk of ASB among SCD patients at a tertiary hospital in Ghana. This was a cross-sectional study involving 110 SCD patients and 110 age and sex matched healthy controls. Urine specimens were collected from all the study subjects and analyzed by standard microbiological methods. Demographic information were also collected from the study subjects. The overall ASB prevalence was significantly higher among SCD patients (17.2% than among the control group (8.2%, and the relative risk was 2.11 (p = 0.0431; CI = 1.00–4.45. Being female was as a predictor of ASB among the SCD patients (OR = 14.76; CI = 11.23–18.29; p = 0.0103. The most common organism isolated from the study participants was coagulase negative Staphylococcus species (4.1%, followed by Escherichia coli (2.7%; etiology of ASB in the SCD patients was more diverse compared to healthy people. All the E. coli isolates were susceptible to amikacin, sparfloxacin and norfloxacin but resistant to ampicillin.

  9. Association of Brachial-Ankle Pulse Wave Velocity with Asymptomatic Intracranial Arterial Stenosis in Hypertension Patients.

    Science.gov (United States)

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

    2016-08-01

    Intracranial arterial stenosis is a common cause of ischemic stroke in Asians. We therefore sought to explore the relationship of brachial-ankle pulse wave velocity and intracranial arterial stenosis in 834 stroke-free hypertensive patients. Intracranial arterial stenosis was evaluated through computerized tomographic angiography. Brachial-ankle pulse wave velocity was measured by an automated cuff device. The top decile of brachial-ankle pulse wave velocity was significantly associated with intracranial arterial stenosis (P = .027, odds ratio = 1.82; 95% confidence interval: 1.07-3.10). The patients with the top decile of brachial-ankle pulse wave velocity showed 56% higher risk for the presence of intracranial arterial stenosis to the whole population, which was more significant in patients younger than 65 years old. We also found that brachial-ankle pulse wave velocity related to both intracranial arterial stenosis and homocysteine. Our study showed the association of brachial-ankle pulse wave velocity with asymptomatic intracranial arterial stenosis in hypertension patients, especially in relative younger subjects. Brachial-ankle pulse wave velocity might be a relatively simple and repeatable measurement to detect hypertension patients in high risk of intracranial arterial stenosis. Copyright © 2016. Published by Elsevier Inc.

  10. The diagnostic accuracy of exercise electrocardiography in asymptomatic recreational and competitive athletes.

    Science.gov (United States)

    van de Sande, D A J P; Hoogeveen, A; Hoogsteen, J; Kemps, H M C

    2016-02-01

    The goals of this study were to determine the prevalence and determinants of false-positive exercise tests in athletes. Data from all athletes who visited the Department of Sport Medicine for assessment of sports eligibility during a 1.5-year period were reviewed retrospectively. Potential determinants of (false) positive test results that were evaluated included demographics, cardiovascular risk factors, sports characteristics, resting electrocardiogram (ECG) abnormalities, and exercise capacity. Data from 1298 athletes were included. In 53 athletes (4.1%), the exercise ECG was classified as positive. Among 38 athletes who were referred to a sports cardiologist for further diagnostic evaluation, 36 (95%) were classified as having a false-positive test result and 2 athletes (5%) required coronary revascularization. Athletes with a false-positive test were older than athletes with a negative test (53 ± 8 vs 45 ± 13 years, P = 0.03). In conclusion, exercise electrocardiography has a low positive predictive value in asymptomatic recreational and competitive athletes, with a false-positive test result being associated with higher age. Given the relatively high prevalence of false-positive test results in this population, efforts should be made to develop strategies aimed at identifying false-positive test results in a simple noninvasive manner. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. [Risk stratification of asymptomatic subjects using resting ECG and stress ECG].

    Science.gov (United States)

    Möhlenkamp, Stefan; Wieneke, Heinrich; Sack, Stefan; Erbel, Raimund

    2007-08-01

    The resting electrocardiogram (ECG) and stress ECG are established tests in the array of cardiovascular diagnostic modalities. In addition to their diagnostic value for structural heart disease and rhythm disorders, ECGs at rest or during stress also contain prognostically relevant information. Several ECG abnormalities, e.g., left ventricular hypertrophy (LVH), Q waves, ST segment changes, left bundle branch block, atrial fibrillation or QT interval prolongation, were shown to be associated with cardiovascular events. Differences in study design, the cohorts of investigation and morphological definitions of ECG abnormalities may in part be responsible for the abnormalities not being implemented in risk stratification algorithms. The non-ST-segment-related variables in stress testing, e.g., functional capacity, chronotropic (in)competence, heart rate (HR) recovery, and the HR/ST index and slope, could be identified as prognostically relevant markers in population-based studies. For many of these resting and stress ECG-based abnormalities, associations with the extent of subclinical atherosclerosis in persons without established coronary heart disease were observed, indicating a preclinical relationship between epicardial atherosclerosis and myocardial pathology. The resting and the stress ECG provide a number of prognostically relevant indices that can easily be obtained in routine clinical practice, but have thus far found little acceptance for risk stratification of asymptomatic individuals.

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

    Science.gov (United States)

    Onu, Fidelis Agwu; Ajah, Leonard Ogbonna; Ezeonu, Paul Olisaemeka; Umeora, Odidika Ugochukwu Joannes; Ibekwe, Perpetus Chudi; Ajah, Monique Iheoma

    2015-01-01

    Detecting and treating asymptomatic bacteriuria (ASB) prevents urinary tract infection and its consequences. The cost-effectiveness of routine screening for ASB in pregnancy is controversial. In populations with high prevalence, however, it is worthwhile and justifiable. To determine the profile, prevalence, microbiological isolates, and risk factors of ASB among booking antenatal clinic attendees in Abakaliki, Nigeria. This was a cross-sectional study involving booking antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, who met the inclusion criteria. This study occurred between January and December, 2012. The midstream urine samples of these women were subjected to microscopy, culture, and sensitivity. A total of 300 randomly selected booking antenatal clinic attendees participated in the study; 74 of them had ASB, giving a prevalence of 24.7%. With the exception of rural residence, sociodemographic and obstetric characteristics did not influence the risk of ASB among the participants in this study. Staphylococcus aureus was the commonest organism isolated. The majority of the organisms were sensitive to ofloxacin and ceftriaxone. There is a high prevalence of ASB among pregnant women in Abakaliki. With the exception of rural dwelling, sociodemographic and obstetric characteristics did not significantly influence the risk of ASB among these pregnant women. Therefore, routine ASB screening of pregnant women is recommended in our environment.

  13. Frequency of Temporomandibular Disorders in Asymptomatic Removable Partial and Complete Denture Wearers

    Directory of Open Access Journals (Sweden)

    N. Dulčić

    2006-01-01

    Full Text Available A dogmatic view on occlusion as the main aetiological factor for temporomandibular disorder (TMD has been present in the literature for a long time, but a direct scientific correlation between occlusal disorders and TMD has never been proven. The purpose of this study was to determine the frequency of TMD signs and tissue-specific diagnoses in a population of 164 asymptomatic participants, 70 removable partial denture wearers and 94 complete denture wearers of an average age of 61.3 years, by means of clinical manual functional analysis. TMD was found in 42.1% of the participants. No statistically significant difference in the occurrence of TMD was found between removable partial and complete denture wearers and between genders (P > 0.05. The most frequent tissue-specific diagnoses were osteoarthrosis (11%, total anterior disc displacement (9.1% and partial anterolateral disc displacement (8.5%. The frequency of tissue-specific diagnoses was also not influenced by the type of prosthetic replacements.

  14. Impact of Stress Testing for Coronary Artery Disease Screening in Asymptomatic Patients With Diabetes Mellitus: A Community-Based Study in Olmsted County, Minnesota.

    Science.gov (United States)

    Bates, Ruth E; Omer, Mohamed; Abdelmoneim, Sahar S; Arruda-Olson, Adelaide M; Scott, Christopher G; Bailey, Kent R; McCully, Robert B; Pellikka, Patricia A

    2016-11-01

    To evaluate the impact of screening stress testing for coronary artery disease in asymptomatic patients with diabetes in a community-based population. This observational study included 3146 patients from Olmsted County, Minnesota, with no history of coronary artery disease or cardiac symptoms in whom diabetes was newly diagnosed from January 1, 1992, through December 31, 2008. With combined all-cause mortality and myocardial infarction as the primary outcome, weighted Cox proportional hazards regression was performed with screening stress testing within 2 years of diabetes diagnosis as the time-dependent covariate. For descriptive analysis, participants were classified by their clinical experience during the first 2 years postdiagnosis as screened (asymptomatic, underwent stress test), unscreened (asymptomatic, no stress test), or symptomatic (experienced symptoms or event). Among the screened and unscreened participants, 54% (1358 of 2538) were men; the mean (SD) age at diabetes diagnosis was 55 years (13.8 years), and 97% (2442 of 2520) had type 2 diabetes. In event-free survival analysis, 292 patients comprised the screened cohort and 2246 patients comprised the unscreened cohort. Death or myocardial infarction occurred in 454 patients (32 patients in the screened cohort and 422 in the unscreened cohort [5-year rate, 1.9% and 5.3%, respectively]) during median (interquartile range) follow-up of 9.1 years (5.3-12.5 years). Screening stress testing was associated with improved event-free survival (hazard ratio, 0.61; P=.004), independent of cardiac risk factors. However, while stress test results were abnormal in 47 of the 292 screened patients (16%), only 6 (2%) underwent coronary revascularization. Although screening cardiac stress testing in asymptomatic patients with diabetes in this community-based population was associated with improvement in long-term event-free survival, this result does not appear to occur by coronary revascularization alone. Copyright

  15. Association Between a Social-Business Eating Pattern and Early Asymptomatic Atherosclerosis.

    Science.gov (United States)

    Peñalvo, José L; Fernández-Friera, Leticia; López-Melgar, Beatriz; Uzhova, Irina; Oliva, Belén; Fernández-Alvira, Juan Miguel; Laclaustra, Martín; Pocock, Stuart; Mocoroa, Agustín; Mendiguren, José M; Sanz, Ginés; Guallar, Eliseo; Bansilal, Sameer; Vedanthan, Rajesh; Jiménez-Borreguero, Luis Jesús; Ibañez, Borja; Ordovás, José M; Fernández-Ortiz, Antonio; Bueno, Héctor; Fuster, Valentin

    2016-08-23

    The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would contribute greatly to inform effective primary prevention strategies. This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults. The PESA (Progression of Early Subclinical Atherosclerosis) study enrolled 4,082 asymptomatic participants 40 to 54 years of age (mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis in multiple vascular territories. A fundamental objective of this cohort study was to evaluate the life-style-related determinants, including diet, on atherosclerosis onset and development. We conducted a cross-sectional analysis of baseline data, including detailed information on dietary habits obtained as part of the overall life-style and risk factor assessment, as well as a complete vascular imaging study that was performed blinded to the clinical information. Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern, characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, and sugar-sweetened beverages and frequent eating-out behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile and, after adjustment for risk factors, increased odds of presenting subclinical atherosclerosis (odds ratio: 1.31; 95% confidence interval: 1.06 to 1.63) compared with participants following a Mediterranean diet. A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy

  16. Household clustering of asymptomatic malaria infections in Xepon district, Savannakhet province, Lao PDR.

    Science.gov (United States)

    Pongvongsa, Tiengkham; Nonaka, Daisuke; Iwagami, Moritoshi; Nakatsu, Masami; Phongmany, Panom; Nishimoto, Futoshi; Kobayashi, Jun; Hongvanthon, Bouasy; Brey, Paul T; Moji, Kazuhiko; Mita, Toshihiro; Kano, Shigeyuki

    2016-10-18

    In the Lao PDR, malaria morbidity and mortality have remarkably decreased over the past decade. However, asymptomatic infections in rural villages contribute to the on-going local transmission. The primary objective of this study was to explore the characteristics of infections in a malaria-endemic district of the Lao PDR. The specific objectives were to investigate the prevalence and species of malaria parasites using molecular methods and to assess individual and household parasite levels and the characteristics associated with malaria infection. The study population included 870 participants from 236 households in 10 villages of the Xepon district. Interviews, blood examinations and body temperature measurements were conducted between August and September 2013. A multilevel logistic regression model, with adjustment for clustering effects, was used to assess the association between predictor variables and an outcome variable (malaria infection status as principally determined by PCR). The predictive factors included individual-level factors (age, gender, past fever episode, and forest activity during night time) and household-level factors (household member size, household bed net usage/density and a household with one other malaria-infected member). Fifty-two participants (including 26 children) tested positive (positive rate: 6.0 %): Plasmodium falciparum mono-infection was the most common infection (n = 41, 78.8 %), followed by P. falciparum and Plasmodium vivax mixed infections (n = 9, 17.3 %). The majority of infected participants (n = 42, 80.8 %) had no fever episodes in the two previous weeks or a measurable fever (>37 °C) at the time of survey. Living in a household with one other malaria-infected member significantly increased the odds of infection (odds ratio 24.33, 95 % confidence interval 10.15-58.32). Among the 40 households that had at least one infected member, nine households were responsible for 40.4 % of the total infections

  17. HTLV-1 proviral integration sites differ between asymptomatic carriers and patients with HAM/TSP.

    Science.gov (United States)

    Niederer, Heather A; Laydon, Daniel J; Melamed, Anat; Elemans, Marjet; Asquith, Becca; Matsuoka, Masao; Bangham, Charles R M

    2014-09-30

    HTLV-1 causes proliferation of clonal populations of infected T cells in vivo, each clone defined by a unique proviral integration site in the host genome. The proviral load is strongly correlated with odds of the inflammatory disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). There is evidence that asymptomatic HTLV-1 carriers (ACs) have a more effective CD8 + T cell response, including a higher frequency of HLA class I alleles able to present peptides from a regulatory protein of HTLV-1, HBZ. We have previously shown that specific features of the host genome flanking the proviral integration site favour clone survival and spontaneous expression of the viral transactivator protein Tax in naturally infected PBMCs ex vivo. However, the previous studies were not designed or powered to detect differences in integration site characteristics between ACs and HAM/TSP patients. Here, we tested the hypothesis that the genomic environment of the provirus differs systematically between ACs and HAM/TSP patients, and between individuals with strong or weak HBZ presentation. We used our recently described high-throughput protocol to map and quantify integration sites in 95 HAM/TSP patients and 68 ACs from Kagoshima, Japan, and 75 ACs from Kumamoto, Japan. Individuals with 2 or more HLA class I alleles predicted to bind HBZ peptides were classified 'strong' HBZ binders; the remainder were classified 'weak binders'. The abundance of HTLV-1-infected T cell clones in vivo was correlated with proviral integration in genes and in areas with epigenetic marks associated with active regulatory elements. In clones of equivalent abundance, integration sites in genes and active regions were significantly more frequent in ACs than patients with HAM/TSP, irrespective of HBZ binding and proviral load. Integration sites in genes were also more frequent in strong HBZ binders than weak HBZ binders. Clonal abundance is correlated with integration in a

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-08-01

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

  19. Determinants of radial artery pulse wave analysis in asymptomatic individuals.

    Science.gov (United States)

    Duprez, Daniel A; Kaiser, Daniel R; Whitwam, Wayne; Finkelstein, Stanley; Belalcazar, Andres; Patterson, Robert; Glasser, Stephen; Cohn, Jay N

    2004-08-01

    Noninvasive techniques to evaluate arterial stiffness include noninvasive radial artery pulse contour analysis. Diastolic pulse contour analysis provides a separate assessment of large (C1) and small artery (C2) elasticity. Analysis of the systolic pulse contour identifies two pressure peaks (P1 and P2) that relate to incident and reflected waves. This study aimed to compare indices from systolic and diastolic pulse contour analysis from the radial pressure waveform and to correlate these indices with traditional risk factors in asymptomatic individuals screened for cardiovascular disease. In 298 consecutive subjects (206 male and 92 female healthy subjects with a mean age of 50 +/- 12 years), noninvasive radial artery pressure waveforms were acquired with a piezoelectric transducer and analyzed for 1) diastolic indices of C1 and C2 from the CR-2000 CVProfiler, and 2) systolic indices of augmentation as defined by augmentation pressure (AP), augmentation index (AIx), and systolic reflective index (SRI = P2/P1). These indices were then correlated to each other as well as to individual traditional risk factors and the Framingham Risk Score. Diastolic indices were significantly and inversely correlated to systolic indices with C2 showing a stronger inverse association than C1. C2 and Alx were significantly correlated with height, weight, and body mass index in men but not in women. All indices correlated better to blood pressure in women than men. In women, only systolic indices were significantly correlated to HDL cholesterol and only diastolic indices were significantly correlated to LDL cholesterol. All indices were significantly correlated to the Framingham Risk Score, which was stronger in women then men, but when adjusted for age only diastolic indices remained significant in women. Diastolic and systolic indices of pulse contour analysis correlate differently with traditional risk factors in men and women. Copyright 2004 American Journal of Hypertension, Ltd.

  20. Asymptomatic bacteriuria in Nigerian children with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    S A Adegoke

    2013-01-01

    Full Text Available Urinary tract infections (UTI in children with sickle cell anemia (SCA may result in long term renal dysfunction. The prevalence, potential risk factors, and clinical significance of asymptomatic bacteriuria (ASB were investigated in 196 Nigerian children with SCA in stable state. These children had clinical evaluation and assessment of their mid-stream urine (MSU for pyuria, culture, and sensitivity tests; urinalysis for proteinuria, and estimated glomerular filtration rate (eGFR, hematocrit, serum creatinine and uric acid estimation. Children with confirmed ASB were compared with those without ASB. Those with confirmed ASB were monitored for 6 months for persistence of significant growth, development of symptomatic UTI, and evaluation of renal functions. The prevalence of probable and confirmed ASB in this cohort of SCA children were 12.2% and 6.6%, respectively. Confirmed ASB was more prevalent among older ( P = 0.046 and female ( P = 0.003 SCA children, particularly those with pyuria (odd Ratio, OR = 5.4, 95% confidence interval, CI = 2.7-11.0, P 0.05. At the end of 6 month follow-up, two (15.4% of the 13 children with ASB had persistence of significant growth, but none develop symptomatic UTI. Also, none of the two with persistent ASB had hypertension or deranged renal function. ASB is a significant problem in older age female SCA children, although renal functions were not different among those with and without ASB. A large scale randomized placebo-controlled trial of conventional treatment for ASB in SCA is advocated to define its long-term clinical significance.

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

    Science.gov (United States)

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

    2014-02-01

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

  2. Symptomatic and asymptomatic interphalageal osteoarthritis: An ultrasonographic study.

    Science.gov (United States)

    Usón, Jacqueline; Fernández-Espartero, Cruz; Villaverde, Virginia; Condés, Emilia; Godo, Javier; Martínez-Blasco, Maria Jesus; Miguélez, Roberto

    2014-01-01

    To date few studies have examined whether ultrasonography can depict morphologic differences in painful and painless osteoarthritis (OA). This study describes and compares the clinical, radiographic and ultrasonographic findings of patients with both painful and painless proximal interphalgeal (PIP) and/or distal interphalgeal (DIP) OA. Patients with PIP and/or DIP OA (ACR criteria) were prospectively recruited. The clinical rheumatologist chose up to 3 painful joints and up to 3 painless symmetric joints in each patient to define 2 cohorts of OA: symptomatic (SG) and asymptomatic (ASG). A conventional postero-anterior hand x ray was performed and read by one rheumatologist following the OARSI atlas, blinded to clinical and sonographic data. Ultrasound (US) was performed by an experienced rheumatologist, blinded to both clinical and radiographic data in joints previously selected by the clinical rheumatologist. US-pathology was assessed as present or absent as defined in previous reports: osteophytes, joint space narrowing, synovitis, intra-articular power doppler signal, intra-articular bony erosion, and visualization of cartilage. Radiographic and ultrasonographic intrareader reliability test was performed. A total of 50 joints in the SG and ASG were included from 20 right handed women aged 61.85 (46-73) years with PIP and DIP OA diagnosed 6.8 (1-17) years ago. 70% SG joints and ASG were right and left sided respectively. The SG showed significantly more osteophytes, synovitis and non-visualization of joint cartilage. Intrareader radiographic and ultrasonographic agreement was excellent. This study demonstrates that painful PIP and/or DIP OA have more ultrasonographic structural changes and synovitis. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  3. Biomechanical differences between cases with chronic exertional compartment syndrome and asymptomatic controls during walking and marching gait.

    Science.gov (United States)

    Roberts, Andrew; Roscoe, David; Hulse, David; Bennett, Alexander N; Dixon, Sharon

    2017-10-01

    Chronic exertional compartment syndrome is a significant problem in military populations that may be caused by specific military activities. This study aimed to investigate the kinematic and kinetic differences in military cases with chronic exertional compartment syndrome and asymptomatic controls. 20 males with symptoms of chronic exertional compartment syndrome of the anterior compartment and 20 asymptomatic controls were studied. Three-dimensional lower limb kinematics and kinetics were compared during walking and marching. Cases were significantly shorter in stature and took a relatively longer stride in relation to leg length than controls. All kinematic differences identified were at the ankle. Cases demonstrated increased ankle plantarflexion from mid-stance to toe-off. Cases also demonstrated less ankle inversion at the end of stance and early swing phases. Lower ankle inversion moments were observed during mid-stance. The anthropometric and biomechanical differences demonstrated provide a plausible mechanism for the development of chronic exertional compartment syndrome in this population. The shorter stature in combination with the relatively longer stride length observed in cases may result in an increased demand on the anterior compartment musculature during ambulation. The results of this study, together with clinical insights and the literature suggest that the suppression of the walk-to-run stimulus during group marches may play a significant role in the development of chronic exertional compartment syndrome within a military population. The differences in joint angles and moments also suggest an impairment of the muscular control of ankle joint function, such as a reduced effectiveness of tibialis anterior. It is unclear whether this is a cause or consequence of chronic exertional compartment syndrome. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  4. Prevalence of and risk factors for asymptomatic inflammatory (NIH-IV prostatitis in Chinese men.

    Directory of Open Access Journals (Sweden)

    Chunlei Wu

    Full Text Available BACKGROUND: While many investigators have studied symptomatic prostatitis, little research has been done with regard to asymptomatic (NIH-IV prostatitis. PURPOSE: To describe the prevalence of and risk factors for NIH-IV prostatitis among a large male population. METHODS: The study population was comprised of 1,868 men at the second phase recruitment of a population-based cohort in China. Asymptomatic and symptomatic men were defined by the National Institutes of Health Chronic Prostatitis (CP Symptom Index. Meanwhile, EPS specimens and their leukocyte count were collected. Lifestyle and demographic characteristics were obtained through a questionnaire. RESULTS: Prevalence of NIH-IV prostatitis was 21.1% among 1,868 asymptomatic men aged 19-78 years and increased with age. After adjusteing for potential confounding variables (age, smoking habits, alcohol drinking habits, education, physical activity, hypertension, dyslipidemia, obesity and diabetes, age remained a significant factor for NIH-IV prostatitis (OR = 1.35; 95% CI = 1.06-1.71; P = 0.01 and the risk of NIH-IV prostatitis was significantly higher in smokers≧15 pack/years than non-smokers (OR = 1.33; 95% CI = 1.01-1.75; P = 0.03. In addition, compared with non-drinkers, the OR of NIH-IV prostatitis in drinkers ≧1 drinks/week was 1.35 (95% CI = 1.03, 1.77, p = 0.02 after adjusting for the other variables above. In addition, having less than a college education may be a risk factor for NIH-IV prostatitis, although a statistically significant difference did not exist in our data (OR = 1.22; 95% CI = 0.97-1.52; P = 0.08. CONCLUSIONS: Our findings suggest that NIH-IV prostatitis is prevalent in China. Age, smoking, drinking and lower education levels were associated with an increased risk of NIH-IV prostatitis. The prevalence of NIH-IV prostatitis should be taken into account when estimating the total prevalence of CP in future studies.

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

    DEFF Research Database (Denmark)

    Kongstad, Thomas; Buchvald, Frederik; Brenøe, Jørn

    2012-01-01

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

  6. Exercise echocardiography in asymptomatic survivors of childhood cancer treated with anthracyclines

    DEFF Research Database (Denmark)

    Sieswerda, Elske; Kremer, Leontien C M; Vidmar, Suzanna

    2010-01-01

    echocardiography has no added value to monitoring with resting echocardiography alone in predicting late anthracycline-induced cardiotoxicity in childhood cancer survivors. RFSz deteriorates over time, even in originally asymptomatic patients. Previous treatment with higher cumulative anthracycline dose...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

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

  9. [Screening strategies for the diagnosis of asymptomatic arterial lesions in patients with atherothrombosis].

    Science.gov (United States)

    Varenne, O; Touzé, E; Collet, J P; Raoux, F; Boissier, C; Carpentier, P H; Alpérovitch, A; Mas, J L; Montalescot, G

    2005-10-01

    Atherosclerosis is a ubiquitous inflammatory disease. Patients presenting an acute atherothrombotic event (acute coronary syndrom, stroke, aortic aneurysm, ...) have an increased risk of events in remote arterial territories affected by atherosclerosis. These patients could benefit from systematic screening of asymptomatic atherosclerotic lesions to avoid these complications. For each atherosclerotic territory (coronary artery, carotid artery, aorta, peripheral arteries including renal arteries), we review the methods for screening asymptomatic atherothrombotic lesions which could justify specific treatments: coronary artery stenosis > or = 50%, carotid artery stenosis > or = 60%, renal artery stenosis > or = 50%, and abdominal aortic aneurysm > or = 30 mm. This review shows that non invasive methods (ie, echography, tomodensitometry) are widely available for diagnosis of asymptomatic lesions in carotid and renal arteries, and in the aorta. Despite its invasive caracteristic, coronarory angiography remains the gold-standard for the diagnosis of coronary artery disease. However, cardiac multi-slices CT-scan appears a promising technique for asymptomatic patients.

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  11. Rhinovirus detection in symptomatic and asymptomatic children value of host transcriptome analysis

    National Research Council Canada - National Science Library

    Heinonen, Santtu; Jartti, Tuomas; Garcia, Carla; Oliva, Silvia; Smitherman, Cynthia; Anguiano, Esperanza; De Steenhuijsen Piters, Wouter A A; Vuorinen, Tytti; Ruuskanen, Olli; Dimo, Blerta; Suarez, Nicolas M; Pascual, Virginia; Ramilo, Octavio; Mejias, Asuncion

    2016-01-01

    .... However, RVs can frequently be detected in asymptomatic individuals. Objectives: To evaluate the ability of host transcriptional profiling to differentiate between symptomatic RV infection and incidental detection in children. Methods...

  12. [The health of adults undergoing an eviction process].

    Science.gov (United States)

    Bolívar Muñoz, Julia; Bernal Solano, Mariola; Mateo Rodríguez, Inmaculada; Daponte Codina, Antonio; Escudero Espinosa, Cecilia; Sánchez Cantalejo, Carmen; González Usera, Isis; Robles Ortega, Humbelina; Mata Martín, José Luis; Fernández Santaella, M Carmen; Vila Castellar, Jaime

    2016-01-01

    To analyze perceived health status and other health-related indicators in the adult population in Granada (Spain) undergoing an eviction process from their homes, whether rented or owned, in comparison with health indicators in the general adult population in Andalusia. A cross-sectional survey was administered by trained staff. The survey included instruments from the Andalusian Health Survey 2011 for measuring variables related to physical and mental health, as well as health-related habits. We compared the results with those obtained from the Andalusian general population through the Andalusian Health Survey. A bivariate analysis using the χ2 test and a multivariate logistic regression analysis were conducted. We obtained a total sample of 205 people in the process of eviction. A total of 59.5% (n=122) were women, and 40.5% (n=83) were men. Participants were more likely to have poor health (odds ratio [OR]: 12.63, 95% confidence interval [95%CI]: 8.74-18.27), have cardiovascular diseases (OR: 3.08; 95%CI: 1.54- 6.16), or to smoke (OR: 1.68; 95% CI: 1.21-2.33) compared with the Andalusian general population. Most of the health indicators analyzed showed a worse outcome for women undergoing an eviction process. Our results suggest that, in the current context of economic crisis, people undergoing a process of eviction in Granada and its metropolitan area show poorer health than the Andalusian general population. Further research is needed on health and evictions from different methodological approaches, for a better understanding of the topic. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic family planning patients in rural New Mexico.

    OpenAIRE

    Bell, T. A.; Ebenezer, M R

    1989-01-01

    We tested 98 asymptomatic women seen in state-funded contraception clinics in rural New Mexico. A fluorescein-conjugated monoclonal antibody stain revealed Chlamydia trachomatis infection in 25% of asymptomatic unmarried women and 3% of married women (P = .03). Neisseria gonorrhoeae was detected in only one woman. As in urban clinics providing contraception, the prevalence of gonorrhea is rare in rural New Mexico, but chlamydial infections are common in young unmarried women.

  14. Presence of highly oncogenic human papillomavirus in the oral mucosa of asymptomatic men

    OpenAIRE

    Machado, Ana Paula; Gatto de Almeida, Flávia; Bonin, Camila Mareti; Martins Prata, Thiago Theodoro; Sobrinho Ávilla, Leandro; Junqueira Padovani, Cacilda Tezelli; Teixeira Ferreira, Alda Maria; dos Santos Fernandes, Carlos Eurico; Tozetti,Inês Aparecida

    2014-01-01

    OBJECTIVES: The aim of this study was to identify highly oncogenic forms of human papillomavirus in the oral mucosa of asymptomatic men. METHODS: In this study, we analyzed samples of exfoliated cells from the oral cavity of 559 asymptomatic men. DNA-human papillomavirus was detected using the consensus primers PGMY09/11; viral genotyping was performed using type-specific PCR and restriction fragment length polymorphism. RESULTS: DNA-human papillomavirus was detected in 1.3% of the s...

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

    OpenAIRE

    Rupashree Singh; Igboanua Ifeanyic Godson; Sanjay Singh; Rajendra Bahadur Singh; Nike Tawakaltu Isyaku; Ukatu Victoria Ebere

    2014-01-01

    Background & objectives: In malaria endemic areas, continuous exposure to Plasmodium parasites leads to asymptomatic carriers that provide a reservoir, contributing to the persistence of malaria transmission. Thus, a study of the degree of prevalence of asymptomatic parasitaemias will help in assessing the level of reservoir of infection. Methods: All the consented participants without any signs and symptoms, suggestive of malaria were interviewed and thick blood smears were made to detect...

  16. Screening for subclinical atherosclerosis by noninvasive methods in asymptomatic patients with risk factors

    Directory of Open Access Journals (Sweden)

    Castellon X

    2013-05-01

    Full Text Available Xavier Castellon, Vera BogdanovaDepartment of Cardiology, Private Hospital Athis Mons, Paris, FranceAbstract: Atherosclerosis is a leading cause of cardiovascular death due to the increasing prevalence of the disease and the impact of risk factors such as diabetes, obesity or smoking. Sudden cardiac death is the primary consequence of coronary artery disease in 50% of men and 64% of women. Currently the only available strategy to reduce mortality in the at-risk population is primary prevention; the target population must receive screening for atherosclerosis. The value of screening for subclinical atherosclerosis is still relevant, it has become standard clinical practice with the emergence of new noninvasive techniques (radio frequency [RF] measurement of intima-media thickness [RFQIMT] and arterial stiffness [RFQAS], and flow-mediated vasodilatation [FMV], which have been used by our team since 2007 and are based on detection marker integrators which reflect the deleterious effect of risk factors on arterial remodeling before the onset of clinical events. These techniques allow the study of values according to age and diagnosis of the pathological value, the thickness of the intima media (RFQIMT, the speed of the pulse wave (RFQAS, and the degree of endothelial dysfunction (FMV. This screening is justified in asymptomatic patients with cardiovascular risk factors (hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking. Studies conducted by RF coupled with two-dimensional echo since 2007 have led to a more detailed analysis of the state of the arterial wall. The various examinations allow an assessment of the degree of subclinical atherosclerosis and its impact on arterial remodeling and endothelial function. The use of noninvasive imaging in screening and early detection of subclinical atherosclerosis is reliable and reproducible and allows us to assess the susceptibility of our patients with risk factors and ensures better

  17. Less small airway dysfunction in asymptomatic bronchial hyperresponsiveness than in asthma.

    Science.gov (United States)

    Boudewijn, I M; Telenga, E D; van der Wiel, E; van der Molen, T; Schiphof, L; Ten Hacken, N H T; Postma, D S; van den Berge, M

    2013-11-01

    Bronchial hyperresponsiveness (BHR) can be present in subjects without any respiratory symptoms. Little is known about the role of the small airways in asymptomatic subjects with BHR. We investigated small airway function assessed by spirometry and impulse oscillometry, as well as Borg dyspnea scores at baseline and during a methacholine provocation test in 15 subjects with asymptomatic BHR, 15 asthma patients, and 15 healthy controls. At baseline, small airway function (R5 -R20 and X5 ) was comparable between subjects with asymptomatic BHR and healthy controls, whereas asthma patients showed small airway dysfunction as reflected by higher R5 -R20 and lower X5 values. During methacholine provocation, small airway dysfunction was more severe in asthma patients than in subjects with asymptomatic BHR. Interestingly, a higher increase in small airway dysfunction during methacholine provocation was associated with a higher increase in Borg dyspnea scores in subjects with asymptomatic BHR, but not in asthma patients. Subjects with asymptomatic BHR may experience fewer symptoms in daily life because they have less small airway dysfunction. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hosenpud, J.D.; Montanaro, A.; Hart, M.V.; Haines, J.E.; Specht, H.D.; Bennett, R.M.; Kloster, F.E.

    1984-08-01

    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.

  20. Predictive value of coronary calcifications for future cardiac events in asymptomatic patients with diabetes mellitus: A prospective study in 716 patients over 8 years

    Directory of Open Access Journals (Sweden)

    Tittus Janine

    2008-10-01

    Full Text Available Abstract Background To establish an efficient prophylaxis of coronary artery disease reliable risk stratification is crucial, especially in the high risk population of patients suffering from diabetes mellitus. This prospective study determined the predictive value of coronary calcifications for future cardiovascular events in asymptomatic patients with diabetes mellitus. Methods We included 716 patients suffering from diabetes mellitus (430 men, 286 women, age 55.2 ± 15.2 years in this study. On study entry all patients were asymptomatic and had no history of coronary artery disease. In addition, all patients showed no signs of coronary artery disease in ECG, stress ECG or echocardiography. Coronary calcifications were determined with the Imatron C 150 XP electron beam computed tomograph. For quantification of coronary calcifications we calculated the Agatston score. After a mean observation period of 8.1 ± 1.1 years patients were contacted and the event rate of cardiac death (CD and myocardial infarction (MI was determined. Results During the observation period 40 patients suffered from MI, 36 patients died from acute CD. The initial Agatston score in patients that suffered from MI or died from CD (475 ± 208 was significantly higher compared to those without cardiac events (236 ± 199, p Conclusion By determination of coronary calcifications patients at risk for future MI and CD could be identified within an asymptomatic high risk group of patients suffering from diabetes mellitus. On the other hand future events could be excluded in patients without coronary calcifications.

  1. Additional burden of asymptomatic and sub-patent malaria infections during low transmission season in forested tribal villages in Chhattisgarh, India.

    Science.gov (United States)

    Chourasia, Mehul Kumar; Raghavendra, Kamaraju; Bhatt, Rajendra M; Swain, Dipak Kumar; Meshram, Hemraj M; Meshram, Jayant K; Suman, Shrity; Dubey, Vinita; Singh, Gyanendra; Prasad, Kona Madhavinadha; Kleinschmidt, Immo

    2017-08-08

    The burden of sub-patent malaria is difficult to recognize in low endemic areas due to limitation of diagnostic tools, and techniques. Polymerase chain reaction (PCR), a molecular based technique, is one of the key methods for detection of low parasite density infections. The study objective was to assess the additional burden of asymptomatic and sub-patent malaria infection among tribal populations inhabiting three endemic villages in Keshkal sub-district, Chhattisgarh, India. A cross-sectional survey was conducted in March-June 2016, during the low transmission season, to measure and compare prevalence of malaria infection using three diagnostics: rapid diagnostic test, microscopy and nested-PCR. Out of 437 individuals enrolled in the study, 103 (23.6%) were malaria positive by PCR and/or microscopy of whom 89.3% were Plasmodium falciparum cases, 77.7% were afebrile and 35.9% had sub-patent infections. A substantial number of asymptomatic and sub-patent malaria infections were identified in the survey. Hence, strategies for identifying and reducing the hidden burden of asymptomatic and sub-patent infections should focus on forest rural tribal areas using more sensitive molecular diagnostic methods to curtail malaria transmission.

  2. Does asymptomatic carriage of FV Leiden and FII prothrombin mutations in heterozygous configuration pose an increased risk of thrombembolic complications in the course of pregnancy, labor and puerperium?

    Science.gov (United States)

    Vavrinkova, Blanka; Binder, Tomas; Hadacova, Ivana; Hrachovinova, Ingrid; Salaj, Peter; Hruda, Martin

    2014-06-01

    To evaluate the course of pregnancy and puerperium in asymptomatic carriers of FV Leiden and FII prothrombin mutation in heterozygous configuration in terms of risk of thrombembolic disease (TED) and late pregnancy complications. To evaluate whether global prophylactic LMWH administration during pregnancy benefits these women. We monitored the incidence of thrombembolic events and severe late pregnancy complications in 473 asymptomatic carriers of FV Leiden and FII prothrombin mutation in heterozygous configuration. In 253 women, preventive LMWH application was introduced already during pregnancy. In 220 women, the application of LMWH was commenced as late as on the delivery day. In both groups application of LMWH continued during the puerperium. The incidence of TED in the whole group of carriers of thrombophylic mutations accounted for 0.19%. The incidence of severe late pregnancy complications was low - 2.5% compared with general population of pregnant women (6.4%). No direct causal relationship was established between asymptomatic carriage of Leiden and prothrombin mutation in heterozygous configuration and the occurrence of severe late pregnancy complications. There was no benefit from general LMWH prophylaxis started as early as pregnancy in these women and thus we consider it unnecessary.

  3. Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Roussouly, Pierre; Berthonnaud, Eric; Guigui, Pierre

    2010-10-15

    Prospective study of normal sagittal global spinal balance in the Caucasian adult population. To document values for parameters of global spinal balance in 709 asymptomatic adults without spinal pathology. Previous studies have investigated sagittal spinal balance in the normal population, but there is still a need for a large prospective database with normative values on the basis of gender and age. Spinosacral angle (SSA), spinal tilt (ST), and C7 translation ratio were evaluated in 709 asymptomatic adults (354 males and 355 females). Position of C7 plumbline relative to sacrum and hip axis (HA) was also assessed. Comparisons on the basis of gender were performed using analyses of covariance with age as covariate. Relationships between parameters and age were assessed using Spearman's coefficients. Mean SSA, ST, and C7 translation ratio were respectively 130.4° ± 8.1°, 90.8° ± 3.4°, and 0.1° ± 1.9°. Mean ± 2 standard deviations were respectively 110° to 150° for SSA and 85° to 100° for ST. Mean SSA and ST were higher in females but by less than 2°. C7 plumbline was behind the HA in 86% of subjects. Correlations between global balance and age were small (-0.1 ≤ r ≤ 0.1), with only 1 correlation reaching statistical significance (SSA vs. age; r = -0.1), reflecting a slight tendency for SSA to decrease with age. There was no relationship between ST and age. Asymptomatic adults tend to stand with a stable global balance and it is expected that 95% of normal adults have an SSA and ST between 110° to 150° and 85° to 100°, respectively. C7 plumbline in front of the HA is not necessarily associated with a spinal pathology. Results suggest that in adults, anterior displacement of C7 plumbline with respect to sacrum cannot be attributed solely to aging and should raise a suspicion for the risk of developing spinal pathology.

  4. Prevalence of femoroacetabular impingement morphology in asymptomatic youth soccer players: magnetic resonance imaging study with clinical correlation

    Directory of Open Access Journals (Sweden)

    Anthony Kerbes Yépez

    Full Text Available Abstract Objective To determine the prevalence of femoroacetabular impingement morphology (FAIM, cam- or pincer-type, by magnetic resonance imaging (MRI in asymptomatic adolescent soccer players, and to evaluate the possible correlation between alterations on MRI and clinical examination findings. Methods A cross-sectional study was conducted to determine the prevalence of FAIM in asymptomatic youth soccer players aged 13-18 years. A total of 112 hips in 56 players (mean age 15.3 years were evaluated by MRI. Images were examined by two musculoskeletal radiologists for signs of FAIM. Cam-type (impingement deformity was diagnosed by alpha angle ≥55° or head-neck offset <7 mm. Pincer-type (impingement deformity was diagnosed by center-edge angle (CEA ≥35° or acetabular index ≤0°. Other MRI changes, characteristic of FAIM, were observed. Clinical examination was performed to determine the range of motion (ROM of the hips. In addition, specific tests for anterolateral and posteroinferior impingement were performed. Results The prevalence of MRI findings consistent with FAIM among this young population was 84.8% (95/112. The alpha angle was ≥55° in 77.7% (87/112 of hips, while the CEA was altered in 10.7% (12/112 of hips. Qualitative MRI findings consistent with FAIM were highly prevalent, and included loss of sphericity of the femoral head (77%, osseous bump (44%, femoral neck edema (21%, and acetabular osteitis (9%. The anterior impingement test was positive in 15% of the hips evaluated. Conclusion Youth soccer players have a high prevalence of FAIM as diagnosed by MRI. There is no correlation between physical examination findings and MRI evidence of FAIM in this population.

  5. Incidence of bacteremia in cirrhotic patients undergoing upper endoscopic ultrasonography.

    Science.gov (United States)

    Fernández-Esparrach, Gloria; Sendino, Oriol; Araujo, Isis; Pellisé, Maria; Almela, Manel; González-Suárez, Begoña; López-Cerón, María; Córdova, Henry; Sanabria, Erwin; Uchima, Hugo; Llach, Josep; Ginès, Àngels

    2014-01-01

    The incidence of bacteremia after endoscopic ultrasonography (EUS) or EUS-guided fine-needle aspiration (EUS-FNA) is between 0% and 4%, but there are no data on this topic in cirrhotic patients. To prospectively assess the incidence of bacteremia in cirrhotic patients undergoing EUS and EUS-FNA. We enrolled 41 cirrhotic patients. Of these, 16 (39%) also underwent EUS-FNA. Blood cultures were obtained before and at 5 and 30 min after the procedure. When EUS-FNA was used, an extra blood culture was obtained after the conclusion of radial EUS and before the introduction of the sectorial echoendoscope. All patients were clinically followed up for 7 days for signs of infection. Blood cultures were positive in 16 patients. In 10 patients, blood cultures grew coagulase-negative Staphylococcus, Corynebacterium species, Propionibacterium species or Acinetobacterium Lwoffii, which were considered contaminants (contamination rate 9.8%, 95% CI: 5.7-16%). The remaining 6 patients had true positive blood cultures and were considered to have had true bacteremia (15%, 95% CI: 4-26%). Blood cultures were positive after diagnostic EUS in five patients but were positive after EUS-FNA in only one patient. Thus, the frequency of bacteremia after EUS and EUS-FNA was 12% and 6%, respectively (95% CI: 2-22% and 0.2-30%, respectively). Only one of the patients who developed bacteremia after EUS had a self-limiting fever with no other signs of infection. Asymptomatic Gram-positive bacteremia developed in cirrhotic patients after EUS and EUS-FNA at a rate higher than in non-cirrhotic patients. However, this finding was not associated with any clinically significant infections. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  6. Normal parenchymal enhancement patterns in women undergoing MR screening of the breast.

    Science.gov (United States)

    Jansen, Sanaz A; Lin, Vicky C; Giger, Maryellen L; Li, Hui; Karczmar, Gregory S; Newstead, Gillian M

    2011-07-01

    To characterize the kinetic and morphological presentation of normal breast tissue on DCE-MRI in a large cohort of asymptomatic women, and to relate these characteristics to breast tissue density. 335 consecutive breast MR examinations in 229 asymptomatic women undergoing high-risk screening evaluations based on recommendations from the American Cancer Society including strong family history and genetic predisposition were selected for IRB-approved review (average age 49.2 ± 10.5 years). Breast tissue density was assessed on precontrast T₂-weighted images. Parenchymal enhancement pattern (PEP) was qualitatively classified as minimal, homogeneous, heterogeneous or nodular. Quantitative analysis of parenchymal enhancement kinetics (PEK) was performed, including calculation of initial and peak enhancement percentages (E₁, E(peak)), the time to peak enhancement (T ( peak )) and the signal enhancement ratio (SER). 41.8% of examinations were classified as minimal, 13.7% homogeneous, 23.9% heterogeneous and 21.2% nodular PEP. Women with heterogeneously or extremely dense breasts exhibited a higher proportion of nodular PEP (44.2% (27/61)) and significantly higher E₁, and E(peak) (p breasts. Qualitative and quantitative parenchymal enhancement characteristics vary by breast tissue density. In future work, the association between image-derived MR features of the normal breast and breast cancer risk should be explored.

  7. Normal parenchymal enhancement patterns in women undergoing MR screening of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, Sanaz A.; Lin, Vicky C.; Giger, Maryellen L.; Li, Hui; Karczmar, Gregory S.; Newstead, Gillian M. [University of Chicago, Department of Radiology, Chicago, IL (United States)

    2011-07-15

    To characterize the kinetic and morphological presentation of normal breast tissue on DCE-MRI in a large cohort of asymptomatic women, and to relate these characteristics to breast tissue density. 335 consecutive breast MR examinations in 229 asymptomatic women undergoing high-risk screening evaluations based on recommendations from the American Cancer Society including strong family history and genetic predisposition were selected for IRB-approved review (average age 49.2 {+-} 10.5 years). Breast tissue density was assessed on precontrast T{sub 2}-weighted images. Parenchymal enhancement pattern (PEP) was qualitatively classified as minimal, homogeneous, heterogeneous or nodular. Quantitative analysis of parenchymal enhancement kinetics (PEK) was performed, including calculation of initial and peak enhancement percentages (E{sub 1}, E{sub peak}), the time to peak enhancement (T{sub peak}) and the signal enhancement ratio (SER). 41.8% of examinations were classified as minimal, 13.7% homogeneous, 23.9% heterogeneous and 21.2% nodular PEP. Women with heterogeneously or extremely dense breasts exhibited a higher proportion of nodular PEP (44.2% (27/61)) and significantly higher E{sub 1}, and E{sub peak} (p < 0.003) compared with those with less dense breasts. Qualitative and quantitative parenchymal enhancement characteristics vary by breast tissue density. In future work, the association between image-derived MR features of the normal breast and breast cancer risk should be explored. (orig.)

  8. Evaluation of the rupture of silicone breast implants by mammography, ultrasonography and magnetic resonance imaging in asymptomatic patients: correlation with surgical findings

    Directory of Open Access Journals (Sweden)

    Anabel Medeiros Scaranelo

    Full Text Available CONTEXT: Different imaging methods can identify the integrity of breast implants and also the extent of possible silicone leakage. Mammography, ultrasonography and magnetic resonance imaging are often used to evaluate the integrity of breast implants, usually in patients that are symptomatic for rupture. A group of clinically asymptomatic patients was taken as a sample. These patients wanted to remove or change their breast implants for psychological or cosmetic reasons. OBJECTIVE: The purpose of this study was to compare the efficacy of mammography, sonography and magnetic resonance imaging in the detection of breast implant rupture in an asymptomatic population. TYPE OF STUDY: Prospective study. SETTING: Department of Diagnostic Imaging, Universidade de São Paulo, São Paulo, Brazil. METHODS: The participants were 44 asymptomatic patients who subsequently had implants surgically removed. Eighty-three implants were evaluated by both film-screen mammography and high-resolution sonography and 77 implants were evaluated by magnetic resonance imaging. The sensitivity and specificity of mammography, ultrasonography and magnetic resonance imaging were assessed using predetermined diagnostic criteria for implant rupture. All radiological signs were discussed and false positives and false negatives were retrospectively evaluated to identify the pitfalls in the investigations. RESULTS: The respective sensitivity and specificity of mammography were 20% and 89%; sonography, 30% and 81%; and magnetic resonance imaging, 64% and 77%. The differences between patients with breast implants for cosmetic and oncological reasons were discussed. CONCLUSIONS: Our experience suggests that magnetic resonance imaging seems to be the best imaging method on its own for the evaluation of rupturing among asymptomatic patients.

  9. Adapting immunisation schedules for children undergoing chemotherapy.

    Science.gov (United States)

    Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen

    2018-02-01

    Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  10. OCT findings in young asymptomatic subjects carrying familial BEST1 gene mutations.

    Science.gov (United States)

    Chacon-Camacho, Oscar F; Camarillo-Blancarte, Leyla; Zenteno, Juan C

    2011-03-01

    Best disease is an autosomal dominant retinal degeneration characterized by the presence of yellow lesions in the macula causing decreased central visual acuity at later stages. Best disease is caused by heterozygous mutations in BEST1, a gene located at chromosome 11q13. In the present study, we describe the clinical and molecular analysis of two multigenerational families with Best disease and correlate the optical coherence tomography (OCT) findings in asymptomatic and symptomatic subjects carrying BEST1 mutations. Two Mexican families with 3 affected generations each were studied. Probands underwent full ophthalmologic examination including fundus examination, fluorescent angiography (FAG), and electro-oculogram (EOG). Fourier-domain 3D OCT was performed in a number of symptomatic and asymptomatic subjects from these two pedigrees. PCR amplification and automated nucleotide sequencing of the 11 exons of the BEST1 gene in genomic DNA were also performed. Eighteen members of family 1 were molecularly tested. Seven subjects, including 4 young asymptomatic patients, carried a W24C heterozygous mutation in BEST1. OCT imaging in a 6-year-old asymptomatic patient carrying this mutation did not demonstrate retinal lesions. Fifteen subjects from family 2 were molecularly tested. Four patients, including 2 asymptomatic subjects, carried a heterozygous Q293K BEST1 mutation. OCT imaging in an asymptomatic 8-year-old individual with the Q293K mutation demonstrated bilateral subfoveal lesions and unilateral serous retinal detachment. Symptomatic patients showed severe retinal lesions by OCT. Our results add to the clinical, imaging, and molecular knowledge of Best disease and suggest that OCT can recognize retinal lesions in some asymptomatic carriers of BEST1 mutations as early as 8 years of age.

  11. Effects of symptomatic and asymptomatic isolates of Blastocystis hominis on colorectal cancer cell line, HCT116.

    Science.gov (United States)

    Chan, Kok Hoe; Chandramathi, Samudi; Suresh, Kumar; Chua, Kek Heng; Kuppusamy, Umah Rani

    2012-06-01

    The pathogenesis of Blastocystis hominis in human hosts has always been a matter of debate as it is present in both symptomatic and asymptomatic individuals. A recent report showed that B. hominis isolated from an asymptomatic individual could facilitate the proliferation and growth of existing cancer cells while having the potential to downregulate the host immune response. The present study investigated the differences between the effects of symptomatic and asymptomatic derived solubilized antigen of B. hominis (Blasto-Ag) on the cell viability and proliferation of colorectal cancer cells. Besides that, the gene expression of cytokine and nuclear transcriptional factors in response to the symptomatic and asymptomatic B. hominis antigen in HCT116 was also compared. In the current study, an increase in cell proliferation was observed in HCT116 cells which led to the speculation that B. hominis infection could facilitate the growth of colorectal cancer cells. In addition, a more significant upregulation of Th2 cytokines observed in HCT116 may lead to the postulation that symptomatic Blasto-Ag may have the potential in weakening the cellular immune response, allowing the progression of existing tumor cells. The upregulation of nuclear factor kappa light chain enhancer of activated B cells (NF-κB) was observed in HCT116 exposed to symptomatic Blasto-Ag, while asymptomatic Blasto-Ag exhibited an insignificant effect on NF-κB gene expression in HCT116. HCT116 cells exposed to symptomatic and asymptomatic Blasto-Ag caused a significant upregulation of CTSB which lead to the postulation that the Blasto-Ag may enhance the invasive and metastasis properties of colorectal cancer. In conclusion, antigen isolated from a symptomatic individual is more pathogenic as compared to asymptomatic isolates as it caused a more extensive inflammatory reaction as well as more enhanced proliferation of cancer cells.

  12. Evaluation of spinopelvic balance among patients undergoing surgical treatment for lumbar disk hernia

    Directory of Open Access Journals (Sweden)

    Rafael de Paiva Oliveira

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate spinopelvic balance using the pelvic incidence, sacral slope and pelvic tilt among patients with lumbar disk hernias who underwent surgical treatment.METHODS: thirty patients at the spinal services of Hospital Santa Casa de Misericórdia de Vitória and Hospital Vila Velha were evaluated by measuring their spinopelvic balance from the angles of pelvic tilt, sacral slope and pelvic incidence, with their respective means, on simple lateral-view lumbopelvic radiographs that needed to encompass the lumbar spine, sacrum and proximal third of the femur.RESULTS: the spinopelvic balance measurements obtained from the mean angles of the population studied, for pelvic incidence, sacral slope and pelvic tilt, were 45◦ , 36.9◦ and 8.1◦ , respectively. The confidence interval for the mean pelvic incidence was from 41.9 to 48.1 (95% CI, thus including a reference value that characterized it as low, for an asymptomatic population, thus confirming that the sample was extracted from a population with this characteristic.CONCLUSION: among these patients with lumbar disk hernias who underwent surgical treatment, the average spinopelvic balance was found to have pelvic incidence lower than what has been reported in the literature for an asymptomatic population.

  13. Effects of Muscle Relaxation on Anxiety of Parents Who Have Children with Leukaemia Undergoing Chemotherapy

    OpenAIRE

    Zaynab Poodineh

    2017-01-01

    This research intended to determine the effects of the muscle relaxation techniques on anxiety of parents having children with leukaemia who were undergoing chemotherapy at teaching hospitals of Zahedan in 2015.This was a randomized case-control intervention study. The study population consisted of 120 parents of children with leukaemia referred to teaching hospitals in Zahedan and undergoing chemotherapy. These parents were divided into the intervention and control groups, and th...

  14. Specialised care in patients undergoing pancreatoduodenectomy

    NARCIS (Netherlands)

    Tol, J.A.M.G.

    2014-01-01

    This thesis studies the controversies in the management of patients with pancreatic cancer undergoing pancreatoduodenectomy and determines different factors that will improve this management and thereby the postoperative outcomes. The studies were performed in both the pre-, peri- and postoperative

  15. Severe asymptomatic coronary obstruction in chronic hemodialysed patient - a case report.

    Science.gov (United States)

    Voiculeț, C; Zara, O; Văcăroiu, I; Bogeanu, C; Tiron, T; Turcu, F; Aron, G; Ciocâlteu, A

    2016-01-01

    Introduction. Arterial stiffness and vascular calcifications are independent predictors of cardiovascular morbidity and mortality in the chronic kidney disease (CKD) stage 5D population. According to the guidelines, patients on renal replacement therapy represent a very high cardiovascular risk class. Case report. We report the case of a 67-year-old hypertensive male patient, known with CKD stage 5D on hemodialysis (three times per week), secondary bone mineral disease, admitted for progressive right leg pain. The physical examination detected right dorsalis pedis artery pulse absence. Blood biochemistry emphasized hypercalcemia, hyperphosphatemia, increased alkaline phosphatase, metabolic acidosis, hypoalbuminemia, iPTH values above upper limits. The X-ray of right shin highlighted a vascular calcification with a "train track" aspect on the tibial-peroneal artery trunk and the thoracic X-ray (performed with low ray regime) showed calcium deposits in coronary arteries walls. Legs arteriography and coronary angiography were performed revealing multiple lesions on investigated vessels with an 80% narrowing of right coronary artery. The particularity of the case lies in the absence of angina in a chronic hemodialysis patient in whom multiple significant angiographically stenosis of the coronary arteries were found and successful endovascular therapy was performed. Conclusion. The broadening of the indication for coronary angiography should be considered in certain asymptomatic CKD stage 5D patients based on a risk score involving calcium, phosphate, PTH and acid-base imbalances, while considering their major influence on the structure and tone of vascular walls thus on cardiovascular morbidity and mortality rates. Abbreviations. ABI = ankle-brachial index,CAD = coronary artery disease,CKD = chronic kidney disease,CT = computed tomography, EBCT = electron-beam computed tomography,ESRD = end-stage renal disease,GFR = glomerular filtration rate,iPTH = intact parathormon

  16. High frequency of asymptomatic hyperparathyroidism in patients with fibromyalgia: random association or misdiagnosis?

    Science.gov (United States)

    Costa, Juliana Maria de Freitas Trindade; Ranzolin, Aline; Neto, Cláudio Antônio da Costa; Marques, Claudia Diniz Lopes; Duarte, Angela Luzia Branco Pinto

    2016-03-22

    Fibromyalgia (FM) and hyperparathyroidism may present similar symptoms (musculoskeletal pain, cognitive disorders, insomnia, depression and anxiety), causing diagnostic confusion. To determine the frequency of asymptomatic hyperparathyroidism in a sample of patients with FM and to evaluate the association of laboratory abnormalities to clinical symptoms. Cross-sectional study with 100 women with FM and 57 healthy women (control group). Parathyroid hormone (PTH), calcium and albumin levels were accessed, as well as symptoms in the FM group. In FM group, mean serum calcium (9.6±0.98mg/dL) and PTH (57.06±68,98 pg/mL) values were considered normal, although PTH levels had been significantly higher than in the control group (37.12±19.02 pg/mL; p=0.001). Hypercalcemic hyperparathyroidism was diagnosed in 6% of patients with FM, and 17% of these women exhibited only high levels of PTH, featuring a normocalcemic hyperparathyroidism, with higher frequencies than those expected for their age. There was no significant association between hyperparathyroidism and FM symptoms, except for epigastric pain, which was more frequent in the group of patients concomitantly with both diseases (p=0.012). A high frequency of hyperparathyroidism was noted in women with FM versus the general population. Normocalcemic hyperparathyroidism was also more frequent in patients with FM. Longitudinal studies with greater number of patients are needed to assess whether this is an association by chance only, if the increased serum levels of PTH are part of FM pathophysiology, or even if these would not be cases of FM, but of hyperparathyroidism. Copyright © 2015. Published by Elsevier Editora Ltda.

  17. High frequency of asymptomatic hyperparathyroidism in patients with fibromyalgia: random association or misdiagnosis?

    Directory of Open Access Journals (Sweden)

    Juliana Maria de Freitas Trindade Costa

    Full Text Available ABSTRACT Fibromyalgia (FM and hyperparathyroidism may present similar symptoms (musculoskeletal pain, cognitive disorders, insomnia, depression and anxiety, causing diagnostic confusion. Objectives: To determine the frequency of asymptomatic hyperparathyroidism in a sample of patients with FM and to evaluate the association of laboratory abnormalities to clinical symptoms. Methods: Cross-sectional study with 100 women with FM and 57 healthy women (comparison group. Parathyroid hormone (PTH, calcium and albumin levels were accessed, as well as symptoms in the FM group. Results: In FM group, mean serum calcium (9.6 ± 0.98 mg/dL and PTH (57.06 ± 68.98 pg/mL values were considered normal, although PTH levels had been significantly higher than in the comparison group (37.12 ± 19.02 pg/mL; p = 0.001. Hypercalcemic hyperparathyroidism was diagnosed in 6% of patients with FM, and 17% of these women exhibited only high levels of PTH, featuring a normocalcemic hyperparathyroidism, with higher frequencies than those expected for their age. There was no significant association between hyperparathyroidism and FM symptoms, except for epigastric pain, which was more frequent in the group of patients concomitantly with both diseases (p = 0.012. Conclusions: A high frequency of hyperparathyroidism was noted in women with FM versus the general population. Normocalcemic hyperparathyroidism was also more frequent in patients with FM. Longitudinal studies with greater number of patients are needed to assess whether this is an association by chance only, if the increased serum levels of PTH are part of FM pathophysiology, or even if these would not be cases of FM, but of hyperparathyroidism.

  18. [The relevance of the ankle-arm index to the reclassification of cardiovascular risk in asymptomatic hypertensive middle-aged males].

    Science.gov (United States)

    Oliveras, Víctor; Martín-Baranera, Montserrat; Gracia, Maya; Del Val, José Luís; Plans, Miquel; Pujol-Moix, Núria

    2015-05-21

    The ankle-brachial index allows for the detection of subclinical cardiovascular disease and risk, by diagnosing peripheral arterial disease and arterial calcification. Asymptomatic hypertensive men, between 45-55 years and with the suspicion of low risk, could be an important population group to benefit from this technique. The aim of the study was to compare the frequency of abnormal ankle-brachial index (subclinical peripheral arterial disease and arterial calcification) between asymptomatic hypertensive and non-hypertensive men, of the same age and suspicion of low risk. Two hundred and forty-four asymptomatic men (122 hypertensive and 122 non-hypertensive), between 45 and 55 years and an REGICOR index<10, were voluntarily recruited using consecutive sampling. Complete anamnesis, physical examination, laboratory tests and ankle-brachial index determination were carried out on all patients. We detected abnormal ankle-brachial index values in 9.8% (12 cases) of the hypertensive subjects and in 1.6% (2 cases) of non-hypertensive subjects (P=.006). In the multivariate analysis, hypertension was significantly associated with an abnormal ankle-brachial index (P<.026) (odds ratio [OR] 5.9, 95% confidence interval [95% CI] 1.2-28.3), smoking (P=.018) (OR 2.7; 95% CI 1.2-6.2) and abdominal obesity (P=.005) (OR 2.8; 95% CI 1.3-5.9). The population group analyzed in this study might be considered as an overriding segment for detecting subclinical cardiovascular disease and risk with the ankle-brachial index. Further studies are needed to establish the prevalence of abnormal ankle-brachial index in this population in order to assess its efficiency. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  19. Computed tomography for the measurement of coronary calcification in asymptomatic risk patients

    Directory of Open Access Journals (Sweden)

    Pichlbauer, Ernest

    2006-05-01

    Full Text Available Background: In 2003 nearly 20% of deaths in Germany were caused by coronary heart disease (CHD. Risk models are used to estimate the ten-year-risk of a coronary event. Coronary calcification may be seen as an additional risk factor. The amount of calcium is correlated with atherosclerotic lesions, but there is no direct correlation with the probability of a plaque rupture. Coronary calcification may be measured either by electron beam computed tomography (EBCT or multi-detector computed tomography (MDCT. Objectives: The aim of this HTA report is to investigate the diagnostic validity and cost effectiveness of computed tomography techniques in measuring coronary calcification of asymptomatic risk patients. Ethical aspects are discussed. Methods: A systematic literature research was performed in 35 international databases which yielded 1080 articles. Overall 43 publications were included for assessment, according to predefined selection criteria. Results: Measuring coronary calcification offers additional information compared with traditional risk factors. Yet at present it cannot be said - according to published literature - which population groups gain most. For determining adequate calcium score thresholds standardisation for age and sex is important. When comparing the reference standard EBCT with MDCT results are inconsistent and depend on the calcium-score value as well as on the scoring method. EBCT as a triage instrument in diagnosing CHD appears to be cost-effective. Yet it is rather not cost-effective as a refinement tool for risk stratification. Discussion: Most of the literature was published in the United States and discusses the use of EBCT as well as (traditional risk stratification by the Framingham Score. Regarding coronary calcification measured by MDCT (which is more widespread in Germany than EBCT and a risk model applicable for European populations clear recommendations based on published literature cannot be made at present

  20. Development of a validated model to predict 30-day stroke and 1-year survival after carotid endarterectomy for asymptomatic stenosis using the Vascular Quality Initiative.

    Science.gov (United States)

    DeMartino, Randall R; Brooke, Benjamin S; Neal, Dan; Beck, Adam W; Conrad, Mark F; Arya, Shipra; Desai, Sapan; Aziz, Faisal; Ryan, Patrick; Cronenwett, Jack L; Kraiss, Larry W

    2017-08-01

    Carotid endarterectomy (CEA) has been shown to be an effective treatment for patients with asymptomatic carotid artery stenosis when perioperative stroke rates are low and patients survive long enough to benefit from the intervention. Our objective was to develop and to validate a simple risk prediction model for 30-day stroke and 1-year mortality to guide optimal selection of patients for CEA. Asymptomatic patients undergoing first-time elective CEA within the Vascular Quality Initiative (VQI) from 2010 to 2015 were selected. Outcome measures included any 30-day postoperative stroke and 1-year mortality. Patient demographics, comorbidities, carotid artery disease burden, and provider characteristics were evaluated to select a parsimonious clinical model for risk prediction using multivariable logistic regression. Internal validation was performed for stroke and split sample validation was done for 1-year survival to ensure generalizability. We identified 31,939 patients for inclusion in the stroke analysis (2010-2015) and 24,086 patients for the mortality analysis (2010-2014). Both the 30-day stroke rate (0.9%) and 1-year mortality rate (3.4%) varied substantially across 265 VQI centers (range, 0%-8.3% and 0%-20%, respectively). Eleven significant factors were selected for the 30-day stroke risk prediction model (area under the receiver operating characteristic curve [AUC], 0.67). Internal validation demonstrated good discrimination (bias corrected AUC = 0.652; calibration intercept and slope of 0.03 and 1.01, respectively). Similarly, 10 significant factors were selected for the 1-year mortality risk prediction model (AUC, 0.764). External validation demonstrated excellent discrimination and calibration (AUC, 0.764; 95% confidence interval, 0.72-0.80). Stroke and 1-year mortality rates after CEA for asymptomatic stenosis vary across VQI centers. We have developed a preoperative risk model that can be used to accurately estimate risk of perioperative stroke and 1

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

    Science.gov (United States)

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

    2015-08-01

    Human rhinovirus (HRV) infections are common but poorly characterized in university students. Thus, we characterized asymptomatic and symptomatic HRV infections by incidence, species diversity, and viral load of 502 university students during September and October of 2010 and 2011 from nasal swabs and electronically submitted symptom questionnaires. We tested all symptomatic students and randomly sampled participants who remained asymptomatic (n=25/week, over 8 weeks each study year) on a weekly basis by real-time PCR and sequenced HRV positives. HRV was identified in 33/400 (8.3%) and 85/92 (92.4%) of the asymptomatic and symptomatic students, respectively. We identified a higher than previously reported rate of HRV-B in both groups, although the distribution of HRV species was similar (P=0.37). Asymptomatic viral load averaged 1.2 log10 copies/mL lower than symptomatic HRV (P<0.001). In conclusion, asymptomatic HRV activity preceded peak symptomatic activity in September and October and was associated with lower viral load. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Should radiofrequency current ablation be performed in asymptomatic patients with the Wolff-Parkinson-White syndrome?

    Science.gov (United States)

    Steinbeck, G

    1993-03-01

    The exiting new method of ablation of accessory pathways using radiofrequency current applied by catheters will dramatically change our therapeutic decisions in these patients in the near future. This brief survey reviews the existing literature about the risk of the disease as well as of the procedure of catheter ablation. From these data, the risk of sudden death appears to be extremely low in asymptomatic Wolff-Parkinson-White (WPW) individuals. Side effects of catheter ablation may result from the invasive procedure as well as from radiation exposure (the latter to the patient as well as to operating physicians). While the complication rate in experienced centers is extremely low, a multicenter registry of the success and complication rate is urgently needed in view of the many centers starting with catheter ablation. Based on a subjective benefit-to-risk analysis, asymptomatic WPW individuals should be offered catheter ablation only under special circumstances (high risk profession, athletes, family history of sudden death). On the other hand, catheter ablation need not be and should not be considered generally in asymptomatic individuals with WPW pattern. Finally, this author cannot imagine that the energy, time, and money spent for mass screening and eventual catheter ablation of asymptomatic WPW individuals with its attending risks can be outweighed by the potential benefits for these asymptomatic individuals.

  3. 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.

  4. Glutamate and lipid metabolic perturbation in the hippocampi of asymptomatic borna disease virus-infected horses.

    Directory of Open Access Journals (Sweden)

    Liang Zhang

    Full Text Available Borna disease virus (BDV is a neurotropic, enveloped, non-segmented, negative-stranded RNA virus that infects a wide variety of vertebrate species from birds to humans across a broad global geographic distribution. Animal symptomatology range from asymptomatic infection to behavioral abnormalities to acute meningoencephalitis. Asymptomatic BDV infection has been shown to be more frequent than conventionally estimated. However, the molecular mechanism(s underyling asymptomatic BDV infection remain largely unknown. Here, based on real-time quantitative PCR and Western blotting, a total of 18 horse hippocampi were divided into BDV-infected (n = 8 and non-infected control (n = 10 groups. A gas chromatography coupled with mass spectrometry (GC-MS metabolomic approach, in conjunction with multivariate statistical analysis, was used to characterize the hippocampal metabolic changes associated with asymptomatic BDV infection. Multivariate statistical analysis showed a significant discrimination between the BDV-infected and control groups. BDV-infected hippocampi were characterized by lower levels of D-myo-inositol-1-phosphate, glutamate, phosphoethanolamine, heptadecanoic acid, and linoleic acid in combination with a higher level of ammonia. These differential metabolites are primarily involved in glutamate and lipid metabolism. These finding provide an improved understanding of hippocampal changes associated with asymptomatic BDV infection.

  5. Glutamate and lipid metabolic perturbation in the hippocampi of asymptomatic borna disease virus-infected horses.

    Science.gov (United States)

    Zhang, Liang; Lei, Yang; Liu, Xia; Wang, Xiao; Liu, Zhao; Li, Dan; Zheng, Peng; Zhang, Lujun; Chen, Shigang; Xie, Peng

    2014-01-01

    Borna disease virus (BDV) is a neurotropic, enveloped, non-segmented, negative-stranded RNA virus that infects a wide variety of vertebrate species from birds to humans across a broad global geographic distribution. Animal symptomatology range from asymptomatic infection to behavioral abnormalities to acute meningoencephalitis. Asymptomatic BDV infection has been shown to be more frequent than conventionally estimated. However, the molecular mechanism(s) underyling asymptomatic BDV infection remain largely unknown. Here, based on real-time quantitative PCR and Western blotting, a total of 18 horse hippocampi were divided into BDV-infected (n = 8) and non-infected control (n = 10) groups. A gas chromatography coupled with mass spectrometry (GC-MS) metabolomic approach, in conjunction with multivariate statistical analysis, was used to characterize the hippocampal metabolic changes associated with asymptomatic BDV infection. Multivariate statistical analysis showed a significant discrimination between the BDV-infected and control groups. BDV-infected hippocampi were characterized by lower levels of D-myo-inositol-1-phosphate, glutamate, phosphoethanolamine, heptadecanoic acid, and linoleic acid in combination with a higher level of ammonia. These differential metabolites are primarily involved in glutamate and lipid metabolism. These finding provide an improved understanding of hippocampal changes associated with asymptomatic BDV infection.

  6. Comparison of Mycoplasma pneumoniae genome sequences from strains isolated from symptomatic and asymptomatic patients

    Directory of Open Access Journals (Sweden)

    Emiel B.M. Spuesens

    2016-10-01

    Full Text Available Mycoplasma pneumoniae is a common cause of respiratory tract infections (RTI in children. We recently demonstrated that this bacterium can be carried asymptomatically in the respiratory tract of children. To identify potential genetic differences between M. pneumoniae strains that are carried asymptomatically and those that cause symptomatic infections, we performed whole-genome sequence analysis of 20 M. pneumoniae strains. The analyzed strains included 3 reference strains, 3 strains isolated from asymptomatic children, 13 strains isolated from clinically well-defined patients suffering from an upper (n=4 or lower (n=9 RTI, and one strain isolated from a follow-up patient who recently recovered from an RTI. The obtained sequences were each compared to the sequences of the reference strains. To find differences between strains isolated from asymptomatic and symptomatic individuals, a variant comparison was performed between the different groups of strains. Irrespective of the group (asymptomatic versus symptomatic from which the strains originated, subtype 1 and subtype 2 strains formed separate clusters. We could not identify a specific genotype associated with M. pneumoniae virulence. However, we found marked genetic differences between clinical isolates and the reference strains, which indicated that the latter strains may not be regarded as appropriate representatives of circulating M. pneumoniae strains.

  7. Comparison of Mycoplasma pneumoniae Genome Sequences from Strains Isolated from Symptomatic and Asymptomatic Patients

    Science.gov (United States)

    Spuesens, Emiel B. M.; Brouwer, Rutger W. W.; Mol, Kristin H. J. M.; Hoogenboezem, Theo; Kockx, Christel E. M.; Jansen, Ruud; Van IJcken, Wilfred F. J.; Van Rossum, Annemarie M. C.; Vink, Cornelis

    2016-01-01

    Mycoplasma pneumoniae is a common cause of respiratory tract infections (RTIs) in children. We recently demonstrated that this bacterium can be carried asymptomatically in the respiratory tract of children. To identify potential genetic differences between M. pneumoniae strains that are carried asymptomatically and those that cause symptomatic infections, we performed whole-genome sequence analysis of 20 M. pneumoniae strains. The analyzed strains included 3 reference strains, 3 strains isolated from asymptomatic children, 13 strains isolated from clinically well-defined patients suffering from an upper (n = 4) or lower (n = 9) RTI, and one strain isolated from a follow-up patient who recently recovered from an RTI. The obtained sequences were each compared to the sequences of the reference strains. To find differences between strains isolated from asymptomatic and symptomatic individuals, a variant comparison was performed between the different groups of strains. Irrespective of the group (asymptomatic vs. symptomatic) from which the strains originated, subtype 1 and subtype 2 strains formed separate clusters. We could not identify a specific genotype associated with M. pneumoniae virulence. However, we found marked genetic differences between clinical isolates and the reference strains, which indicated that the latter strains may not be regarded as appropriate representatives of circulating M. pneumoniae strains. PMID:27833597

  8. Asymptomatic urinary anomalies, hematuria and proteinuria, in patients with inflammatory bowel disease. Preliminary study.

    Science.gov (United States)

    Velciov, Silvia; Gluhovschi, Gh; Sporea, I; Trandafirescu, Virginia; Petrica, Ligia; Bozdog, Gh; Gluhovschi, Cristina; Bob, F; Gădălean, Florica; Buzaş, Roxana; Bobu, Maria; Voicu, L

    2011-01-01

    The study assesses the presence of asymptomatic urinary anomalies in patients with inflammatory bowel disease. Asymptomatic urinary anomalies are mainly due to glomerular nephritis, they being one of the forms of its manifestation, together with chronic nephrotic and nephritic syndromes. We identified urinary anomalies in 18 patients (20%) with bowel inflammatory disease that consisted of haematuria in 8 (9%) patients, isolated proteinuria in 5 (6%) patients and haematuria associated with proteinuria in 5 (6%) patients. Asymptomatic urinary anomalies were more frequent in patients with the Crohn disease than in those with ulcerative colitis. We identified RFG under 60ml/min in 4 patients with asymptomatic urinary anomalies. It is very easy to evaluate asymptomatic urinary anomalies with dipstick. This method is also required in current practice for patients with urinary anomalies for identifying the glomerular disease that might have caused them. One must take into consideration differential diagnosis with other diseases that can manifest themselves with proteinuria or isolated proteinuria. One must also take into account the fact that urinary anomalies may also be related to administration of 5-aminosalicylates.

  9. The complexities of malaria disease manifestations with a focus on asymptomatic malaria

    Science.gov (United States)

    2012-01-01

    Malaria is a serious parasitic disease in the developing world, causing high morbidity and mortality. The pathogenesis of malaria is complex, and the clinical presentation of disease ranges from severe and complicated, to mild and uncomplicated, to asymptomatic malaria. Despite a wealth of studies on the clinical severity of disease, asymptomatic malaria infections are still poorly understood. Asymptomatic malaria remains a challenge for malaria control programs as it significantly influences transmission dynamics. A thorough understanding of the interaction between hosts and parasites in the development of different clinical outcomes is required. In this review, the problems and obstacles to the study and control of asymptomatic malaria are discussed. The human and parasite factors associated with differential clinical outcomes are described and the management and treatment strategies for the control of the disease are outlined. Further, the crucial gaps in the knowledge of asymptomatic malaria that should be the focus of future research towards development of more effective malaria control strategies are highlighted. PMID:22289302

  10. Ultrasound Features of the First Metatarsophalangeal Joint in Gout and Asymptomatic Hyperuricemia: Comparison With Normouricemic Individuals.

    Science.gov (United States)

    Stewart, Sarah; Dalbeth, Nicola; Vandal, Alain C; Allen, Bruce; Miranda, Rhian; Rome, Keith

    2017-06-01

    The first metatarsophalangeal (MTP1) joint is frequently affected in gout. The aim of this study was to identify ultrasound features of the MTP1 joint in people with gout and people with asymptomatic hyperuricemia compared with normouricemic controls. Participants with gout (n = 23) and asymptomatic hyperuricemia (n = 29), and age- and sex-matched normouricemic control participants (n = 34), underwent a gray-scale and power Doppler ultrasound assessment of bilateral MTP1 joints by a single musculoskeletal radiologist. No participants had clinical evidence of joint inflammation at the time of scanning. The static images were later read by 2 musculoskeletal radiologists for the presence of the double contour sign, tophus, erosion, effusion, synovial hypertrophy, synovitis, and cartilage thickness. Compared to normouricemic control participants, participants with gout and participants with asymptomatic hyperuricemia had more frequent double contour sign (odds ratio [OR] 3.91, P = 0.011 and OR 3.81, P = 0.009, respectively). Participants with gout also had more erosion (OR 10.13, P = 0.001) and synovitis (OR 9.00, P gout compared with asymptomatic hyperuricemia (R2  = 0.65, P gout, even in the absence of flare. Although individuals with asymptomatic hyperuricemia lack ultrasound features of inflammation or structural joint changes, they demonstrate a similar frequency of urate deposition. © 2016, American College of Rheumatology.

  11. Sinusitis in patients undergoing allogeneic bone marrow transplantation - a review.

    Science.gov (United States)

    Drozd-Sokolowska, Joanna Ewa; Sokolowski, Jacek; Wiktor-Jedrzejczak, Wieslaw; Niemczyk, Kazimierz

    Sinusitis is a common morbidity in general population, however little is known about its occurrence in severely immunocompromised patients undergoing allogeneic hematopoietic stem cell transplantation. The aim of the study was to analyze the literature concerning sinusitis in patients undergoing allogeneic bone marrow transplantation. An electronic database search was performed with the objective of identifying all original trials examining sinusitis in allogeneic hematopoietic stem cell transplant recipients. The search was limited to English-language publications. Twenty five studies, published between 1985 and 2015 were identified, none of them being a randomized clinical trial. They reported on 31-955 patients, discussing different issues i.e. value of pretransplant sinonasal evaluation and its impact on post-transplant morbidity and mortality, treatment, risk factors analysis. Results from analyzed studies yielded inconsistent results. Nevertheless, some recommendations for good practice could be made. First, it seems advisable to screen all patients undergoing allogeneic hematopoietic stem cell transplantation with Computed Tomography (CT) prior to procedure. Second, patients with symptoms of sinusitis should be treated before hematopoietic stem cell transplantation (HSCT), preferably with conservative medical approach. Third, patients who have undergone hematopoietic stem cell transplantation should be monitored closely for sinusitis, especially in the early period after transplantation. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Predicting blood transfusion in patients undergoing minimally invasive oesophagectomy.

    Science.gov (United States)

    Schneider, Crispin; Boddy, Alex P; Fukuta, Junaid; Groom, William D; Streets, Christopher G

    2014-12-01

    To evaluate predictors of allogenic blood transfusion requirements in patients undergoing minimal invasive oesophagectomy at a tertiary high volume centre for oesophago-gastric surgery. Retrospective analysis of all patients undergoing minimal access oesophagectomy in our department between January 2010 and December 2011. Patients were divided into two groups depending on whether they required a blood transfusion at any time during their index admission. Factors that have been shown to influence perioperative blood transfusion requirements in major surgery were included in the analysis. Binary logistic regression analysis was performed to determine the impact of patient and perioperative characteristics on transfusion requirements during the index admission. A total of 80 patients underwent minimal access oesophagectomy, of which 61 patients had a laparoscopic assisted oesophagectomy and 19 patients had a minimal invasive oesophagectomy. Perioperative blood transfusion was required in 28 patients at any time during hospital admission. On binary logistic regression analysis, a lower preoperative haemoglobin concentration (p blood transfusion requirements. It has been reported that requirement for blood transfusion can affect long-term outcomes in oesophageal cancer resection. Two factors which could be addressed preoperatively; haemoglobin concentration and type of oesophageal resection, may be valuable in predicting blood transfusions in patients undergoing minimally invasive oesophagectomy. Our analysis revealed that preoperative haemoglobin concentration, occurrence of significant complications and type of minimal access oesophagectomy predicted blood transfusion requirements in the patient population examined. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  13. 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.

  14. 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.

  15. Number of recombinations and genetic properties of a maize population undergoing recurrent selection Número de recombinações e as propriedades genéticas de uma população de milho sob seleção recorrente

    Directory of Open Access Journals (Sweden)

    Francisco Pinheiro Lima Neto

    2009-02-01

    Full Text Available In maize recurrent selection programs, selected genotypes were recombined once to generate genetic variability for the next selection cycle. Selection generates negative gametic phase disequilibrium which reduces genetic variances, and this disequilibrium is not significantly reduced with only one generation of recombination. The objective of this research was to assess the effects of one additional generation of recombination on phenotypic and genotypic parameters in a maize population undergoing recurrent selection. Selected progenies of the EPB-4 population were subjected to one and two generations of recombination, and from each generation half- and full-sib progenies were developed and evaluated at three environments for grain yield, plant and ear heights, prolificacy, and ear placement. There were no significant changes between each progeny type with one and two generations of recombination for the means, ranges, phenotypic distribution of the traits, genetic variances, heritability coefficients, and genetic correlations for the traits assessed. The results suggest that an additional generation of recombination will not increase the effectiveness of maize recurrent selection programs.Nos programas de seleção recorrente, os genótipos selecionados são recombinados uma vez para gerar variabilidade genética para o próximo ciclo de seleção. A seleção gera desequilíbrio negativo na fase gamética, reduzindo as variâncias genéticas, e este desequilíbrio não é significantemente reduzido com apenas uma geração de recombinação. O objetivo desta pesquisa foi avaliar os efeitos de uma geração adicional de recombinação sobre parâmetros fenotípicos e genéticos em uma população de milho submetida à seleção recorrente. Progênies selecionadas da população EPB-4 foram recombinadas por uma e duas gerações, e de cada geração foram obtidas progênies de meios-irmãos e de irmãos germanos, as quais foram avaliadas em tr

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli responsible for >80% of all cases. One extreme of UTI is asymptomatic bacteriuria (ABU), which occurs as an asymptomatic carrier state that resembles commensalism. To understand the evol......Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli responsible for >80% of all cases. One extreme of UTI is asymptomatic bacteriuria (ABU), which occurs as an asymptomatic carrier state that resembles commensalism. To understand...

  17. Preoperative percutaneous coronary intervention in patients undergoing open thoracoabdominal and descending thoracic aneurysm repair.

    Science.gov (United States)

    Girardi, Leonard N; Rabotnikov, Yury; Avgerinos, Dimitrios V

    2014-01-01

    Current guidelines have recommended against coronary revascularization before noncardiac surgery in patients with asymptomatic coronary artery disease. However, myocardial infarction after thoracic aneurysm (TA) repair dramatically increases the morbidity and mortality. Revascularization with coronary artery bypass grafting before TA repair minimizes the incidence of perioperative ischemia. However, the recovery can be prolonged, and a percentage of patients will either never return for aneurysm repair or will develop a rupture during convalescence. Percutaneous coronary intervention (PCI) before TA repair might be preferable. Previous studies examining PCI before major vascular surgery included few patients with TAs. We examined the outcomes of patients undergoing PCI before TA repair. From 1997 to 2012, 592 patients underwent TA repair. Patients presenting for elective repair underwent cardiac catheterization before surgery. Those with significant single- or double-vessel coronary artery disease underwent PCI. The perioperative outcomes were examined and compared with those of patients undergoing TA repair without revascularization. A total of 44 patients (7.4%) underwent PCI with bare metal stents before surgery. No PCI-related complications occurred. Dual antiplatelet therapy was administered for 4 to 6 weeks. No instances of aneurysm rupture occurred in the interval between PCI and surgery. The incidence of stent thrombosis, myocardial infarction, and mortality for those undergoing PCI was 0. No bleeding complications occurred. PCI is safe and efficacious in patients undergoing TA repair. Aneurysm rupture did not occur in the interval before surgery. An