Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “symptomatic”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed2005

Symptomatic infrapatellar plica.

To assess the clinical outcomes of a group of patients who underwent arthroscopic infrapatellar plica (IPP) excision and to determine, whether the IPP was symptomatic or not, to identify the symptoms or signs in the patient's clinical presentation and to study the correlations between arthroscopic findings and patient's clinical presentation. A retrospective clinical study. We studied all the patients undergoing arthroscopic resection of symptomatic infrapatellar plica without other intraarticular abnormality at our department from February 1996 to April 2001. Fourteen patients with isolated IPP and with regular follow-up intervals were included in the study. Arthroscopy findings, preoperative magnetic resonance imaging (MRI) findings, and clinical presentation were correlated. The mean duration of follow-up was 36 months with a range of 24-60 months. The IPP was found to be in fenestra pattern in seven patients, separate (cordlike) pattern in five patients and vertical septum pattern in two patients. IPP in all patients was excised with a powered instrument. Two patients were rated as excellent, ten patients as good and two patients as poor results. All the patients were documented with pain, popping or snapping with flexion and extension, giving way and swelling. There was no correlation between IPP type and MRI findings with being symptomatic (P>0.05). It was found that IPP type was not a prognostic factor. Infrapatellar plica should be considered as a potential cause of knee pain with probable MRI imaging and no other evidence of internal derangement. We recommend close correlation with the clinical symptoms and exclusion of other internal derangement before suggesting infrapatellar plica as a sole cause for knee symptoms.

Adolescent↗
PubMed2006

Endoscopic resection of a symptomatic os trigonum.

The purpose of this study was to describe our technique and results of arthroscopic resection of a symptomatic os trigonum via two posterior portals in 10 cases. Between 1999 and 2005 we treated 10 patients with endoscopic resection of a symptomatic os trigonum. The age ranged between 19 and 32 years (average 25.9). The average follow-up was 25 months (6-61 months). Time interval between the onset of pain and endoscopic resection of the os trigonum was 20 months. Of the 10 patients, 9 were symptom free for activities of daily living (ADL) within 4 weeks after surgery. They resumed their professional sport activities in a period of 8 weeks. The average AOFAS ankle/hindfoot scale increased from 43 preoperative to 87 postoperatively. We observed no complication in these 10 patients. Endoscopic resection of the symptomatic os trigonum yields good results with minimal surgical morbidity and short recovery time.

Adult↗
PubMed2005

Prevalence of symptomatic pelvic organ prolapse in a Swedish population.

Our aim was to estimate the prevalence of symptomatic pelvic organ prolapse (POP) in a Swedish urban female population. The cross-sectional study design included 8,000 randomly selected female residents in Stockholm, 30-79-year old. A postal questionnaire enquired about symptomatic POP, using a validated set of five questions, and about urinary incontinence and demographic data. Of 5,489 women providing adequate information, 454 (8.3%, 95% confidence interval 7.3-9.1%) were classified as having symptomatic POP. The prevalence rose with increasing age but leveled off after age 60. In a logistic regression model that disentangled the independent effects, parity emerged as a considerably stronger risk factor than age. There was a ten-fold gradient in prevalence odds of POP with parity, the steepest slope (four-fold) being between nulliparous and primiparous women. The prevalence of frequent stress urinary incontinence was 8.9% and that of frequent urge incontinence 5.9%. Out of the 454 women with prolapse, 37.4% had either or both types of incontinence.

Adult↗
PubMed2005

Symptomatic effect of donepezil, rivastigmine, galantamine and memantine on cognitive deficits in the APP23 model.

RATIONALE: APP23 mice are a promising model of Alzheimer's disease, expressing several histopathological, cognitive and behavioural hallmarks of the human condition. A valid animal model should respond to therapeutic interventions in an equivalent manner as human patients. OBJECTIVES: To further validate the APP23 model, we examined whether cognitive deficits could be antagonised by donepezil, rivastigmine, galantamine or memantine, which are approved drugs for symptomatic treatment of dementia. METHODS: Animals were tested at an age at which untreated APP23 mice display severe deficits in visual-spatial learning. Four-month-old APP23 mice and control littermates were administered donepezil (0.3 or 0.6 mg kg(-1)), rivastigmine (0.5 or 1.0 mg kg(-1)), galantamine (1.25 or 2.5 mg kg(-1)), memantine (2 or 10 mg kg(-1)) or saline through daily i.p. injections. After 1 week of treatment, acquisition phase commenced, with daily treatment continuing during cognitive testing. RESULTS: All cholinesterase inhibitors reduced cognitive deficits with the following optimal daily doses: galantamine 1.25 mg kg(-1), rivastigmine 0.5 mg kg(-1) and donepezil 0.3 mg kg(-1). Higher dosages often did not exert beneficial effects in accordance with inverted U-shaped dose-response curves described for cholinomimetics. Symptomatic efficacy of memantine on cognition was mild, with significant amelioration manifesting during probe trial. CONCLUSIONS: This is the first study to simultaneously evaluate the efficacy of therapeutically relevant doses of these four compounds in one particular learning and memory paradigm, being the Morris water maze. The fact that symptomatic intervention was able to diminish cognitive impairment, substantially adds to the validity of the APP23 model as a valuable tool to evaluate future therapeutic approaches.

Alzheimer Disease↗
PubMed2002

Mutational and polymorphic analysis of the estradiol receptor-alpha gene in men with symptomatic vertebral fractures.

In view of the importance of estrogens in the maintenance of the skeleton in men, we have carried out mutational analysis of all the exons of the estrogen-receptor-alpha (ER-alpha) gene in 64 men (36 patients with symptomatic vertebral crush fractures and 28 control subjects). Initial screening of the ER-alpha gene, carried out by single-strand conformation polymorphism analysis followed by sequencing, showed conservative mutations in exon 4 which resulted in a single base substitutions producing GGG-->GGC transition in codon 274. We also carried out polymorphic analysis of the ER-alpha gene at the PvuII restriction site in 82 men with a range of bone density measurements (53 with symptomatic vertebral fractures and 29 controls). The frequencies of PP, Pp, and pp genotypes were 20.7%, 48.8%, and 30.5%, respectively. The distribution of the alleles was similar in the patients with symptomatic vertebral crush fractures and male control subjects. There was no association between ER-alpha genotypes and bone mineral density or arthropometric parameters. This relatively small study suggests that mutations in the ER-alpha gene are unlikely to be a common cause of osteoporosis in men with vertebral fractures. Furthermore, polymorphic variation of the ER-alpha gene appears to have little effect on the pathogenesis of osteoporosis in men.

Adult↗
PubMed2004

Extracranial-intracranial arterial bypass surgery improves total brain blood supply in selected symptomatic patients with unilateral internal carotid artery occlusion and insufficient collateralization.

It remains controversial whether extracranial-intracranial (EC-IC) arterial bypass surgery leads to a significant increase in brain blood supply, allowing the reversal of regional cerebral hypoperfusion in symptomatic patients with occlusive cerebrovascular disease and hemodynamic impairment. The aim of the present study was to determine the effects of EC-IC bypass surgery on cerebral brain-supplying blood volume flow (BVF; ml/min) from a purely hemodynamic point of view, using 2D cine phase-contrast MR imaging. Twenty-five patients with symptomatic, unilateral internal carotid artery (ICA) occlusion and hemodynamic compromise received EC-IC arterial bypass surgery. All patients underwent quantitative BVF measurements of brain-supplying arteries preoperatively and postoperatively, including the direct BVF measurement in the established EC-IC bypass after surgery. Preoperatively, total brain BVF was reduced in comparison to normal controls (595 +/- 89 vs 663 +/- 49 ml/min; [mean +/- SEM]; p = 0.039). Mean BVF through the EC-IC bypass reached 84 +/- 32 ml/min (range: 14-177 ml/min), leading to a significant net increase in total BVF of 78 +/- 43 ml/min (range: 7-136 ml/min) when compared with BVF prior to surgery (p < 0.001), with resulting postoperative BVF reaching values obtained in normal controls. EC-IC arterial bypass surgery increases total brain blood supply, allowing restoration of local perfusion in hemodynamically compromised brain tissue in patients with symptomatic ICA occlusion.

Adult↗
PubMed2006

The use of intraoperative monitoring and treatment of symptomatic microemboli in carotid artery stenting: case report and discussion.

Carotid artery stenting is a recently introduced treatment in symptomatic atherosclerotic carotid artery disease with acceptable complication rates. The major risk is perioperative embolic stroke. Transcranial Doppler ultrasonography (TCD) can be used to identify embolic signals and guide therapy. We present a case of symptomatic embolization in a 72-year-old female following carotid stent deployment complicated by haemodynamic changes. Despite concurrent dual antiplatelet medication significant symptomatic embolization occurred even after restoration of the blood pressure, and modulation of the rate of embolization was achieved using dextran-40 guided by TCD monitoring. The patient recovered from an initially profound hemiparesis and dysphasia to minor sensory changes. Microemboli are common following carotid artery stenting and there appears to be a threshold phenomenon associated with prolonged embolization and progression to cerebral infarction. TCD can be used to detect particulate microemboli and therefore may be useful in guiding antithrombotic therapy in this setting. Dextran-40 has been shown to reduce the embolic load following carotid endarterectomy and was used to good effect in this patient in terms of both embolic load and clinical outcome. This is the first case of embolization following carotid stenting successfully treated with dextran-40, and offers a further option for therapeutic intervention in microembolism detected by TCD and stresses the importance of perioperative monitoring of embolic load for postoperative stroke risk.

Aged↗
PubMed2006

Stent fracture in revascularization for symptomatic ostial vertebral artery stenosis.

INTRODUCTION: We assessed the long-term follow-up examinations and complications of percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic ostial vertebral artery (VA) stenosis. METHODS: A retrospective study was done to evaluate 12 patients with symptomatic ostial VA stenosis who underwent PTAS. Six patients were treated with the Palmaz stent and six with a balloon-expandable coronary stent. Initial angiographic follow-up examination was conducted about 12 months after PTAS in all patients. Simple radiographic, ultrasonographic and clinical follow-up examinations were scheduled every 6 months. RESULTS: Excellent dilatation was achieved in all patients without any procedural complications. Initial angiographic follow-up obtained at a mean of 13 months after PTAS detected no restenosis. However, an asymptomatic severe restenosis was detected at 24 months after PTAS in one patient (8%). During a mean follow-up of 31.5 months, three stent fractures were detected in deployed coronary stents (50%). None of the stent fractures was associated with either recurrent stroke or restenosis. No patients developed recurrent symptoms during the follow-up period. CONCLUSION: PTAS for symptomatic ostial VA stenosis is effective in preventing recurrent stroke. As the open-cell single-joint type of stent is associated with the risk of fracture, long-term follow-up examinations including simple radiography are needed.

Aged↗
PubMed1999

The diagnostic value of colour duplex ultrasound for symptomatic carotid stenosis in clinical practice.

We assessed the accuracy of colour duplex ultrasound for the detection of severe (70-99%) symptomatic carotid stenosis in a clinical setting, in order to assess whether it could make carotid angiography unnecessary. In 152 patients with a transient ischaemic attack or nondisabling ischaemic stroke in the carotid distribution, we compared the degree of colour duplex ultrasound stenosis with angiographic stenosis by receiver-operating-characteristic analysis. The angiograms were evaluated by blinded observers, and compared with routine reports of the colour duplex examination. We computed the sensitivity and specificity of colour duplex, and the number of angiograms and sonographic studies needed to prevent one stroke within 3 years, taking into account the risks of angiography, and the risks and efficacy of endarterectomy. The estimates were adjusted for nonverification bias. We found 34 patients (22%) with a severe (70-99%) symptomatic carotid stenosis. In 16 patients (11%) the symptomatic artery was occluded. The sensitivity and specificity of duplex ultrasound were 76% and 85%, respectively. The number of patients needed to undergo angiography to prevent one stroke was reduced from almost 200 to 33, when colour duplex was used as a preoperative examination. After adjustment for the effects of nonverification, the sensitivity dropped to 58% and the number of duplex studies needed to prevent one stroke would double. The number of angiograms needed after positive duplex sonography would be virtually unaffected. Were colour duplex sonography to have been the sole preoperative investigation, the number needed to diagnose to prevent one stroke within 3 years would be approximately 350, more than twice as many as with the combined diagnostic strategy. The diagnostic accuracy of colour duplex sonography in clinical practice seems less impressive than previous studies have suggested, but it remains an effective way to select patients for angiography. Its use as a single preoperative assessment cannot be recommended.

Adult↗
PubMed1999

Characteristics of symptomatic chronic subdural haematomas on high-field MRI.

We studied the frequency of various features of the appearances on high-field MRI in symptomatic patients with chronic subdural haematomas (CSDH). The ability to predict recurrence after treatment with one burr-hole procedure using MRI was evaluated. A total of 40 patients with symptomatic CSDH underwent MRI at 1.5 T. All haematomas were evacuated within a few days of the MRI examination. Symptomatic CSDH were divided into five groups according to the MRI findings: group A (11 cases), isointense or low signal on T1- and low signal on T2-weighted images; group B (18 cases), high signal on T1- and low signal on T2-weighted images; group C (5 cases), high signal on both T1- and T2-weighting; group D (1 case), low signal on T1- and high signal on T2-weighted images; group E (5 cases), heterogeneous intensity on T1- and T2-weighting throughout the haematoma cavity. The mean interval between onset of symptoms and MRI for group A was 5.0 +/- 4.1 days, which was significantly shorter than that for group B (9.4 +/- 4.4 days, P < 0.02), group C (27.8 +/- 20 days, P < 0.005) or group E (17.8 +/- 12.2 days, P < 0.01). Recurrence was seen in three haematomas of group A and one of group B. Reoperation was most closely correlated with diffuse low signal on T2-weighted images but not with a multiloculated appearance. Low signal on T2 weighting was surprisingly high (72.5%) and the age of the haematomas as estimated on the MRI correlated well with the interval between the onset of symptoms and MRI. Our findings support the causative role of recurrent bleeding in the enlargement of CSDH.

Adult↗
PubMedDate not supplied

Use of transvenous DDD pacing in a one-year-old with symptomatic hypertrophic cardiomyopathy.

Symptomatic hypertrophic cardiomyopathy (HCM) is rare in infants. Therapeutic options are limited and include beta-blocker or calcium-channel blocker therapy or surgical myotomy/myectomy. Atrioventricular sequential pacing has been utilized as an alternative to surgery in symptomatic adults with HCM. We report our results with transvenous dual chamber pacing in an infant with symptomatic HCM.

Anti-Arrhythmia Agents↗
PubMed2002

Small bowel intussusception in symptomatic pediatric patients: experiences with 19 surgically proven cases.

Nineteen cases of surgically proven symptomatic pediatric small bowel intussusceptions (SBI) were retrospectively reviewed. Clinical presentations included vomiting (89.5%), abdominal pain and/or irritable crying (89.5%), fever (52.6%), bloody stools (26.3%), palpable abdominal masses (15.8%), hematemesis (10.5%), jaundice (5.3%), and seizures (5.3%). The duration between symptom onset and hospitalization ranged between 20 and 336 hours (average 75.8 hours). Two patients with suspected appendicitis and small bowel obstruction were operated on promptly. Sonograms revealed target lesions (average diameter 2.9 cm) suggestive of intussusception in 13 out of 17 patients, with 10 lesions located in the paraumbilical or left abdominal regions. Barium enemas in 12 of these 13 patients demonstrated no colonic lesions. Diagnosis and surgery were delayed in 16 patients (average delay = 32 hours). The remaining 1 patient with positive sonographic findings underwent early surgery after computed tomographic (CT) confirmation of SBI. Surgery revealed ileoileal intussusceptions in 11 patients, jejunojejunal in 4, jejunoileal in 3, and duodenojejunal in 1. Eight patients had lead points. Bowel complications (ischemia, necrosis, or perforation) occurred in 8 patients. The duration between symptom onset and surgery in patients with bowel complications was significantly longer than for patients without complications (p = 0.0026). In conclusion, delayed diagnosis and surgical treatment in symptomatic pediatric patients with SBI were common, leading to a high rate (42%) of bowel complications. Sonographic demonstration of a 2-3 cm target lesion, especially if paraumbilical or left abdominal, is suggestive of SBI and may obviate the need for a barium enema; however, CT is helpful for confirming SBI. In symptomatic SBI, once diagnosed, early surgical referral is strongly recommended.

Adolescent↗
PubMedDate not supplied

Mid-term clinical results and patient satisfaction after uterine artery embolization in women with symptomatic uterine fibroids.

PURPOSE: To evaluate the mid-term clinical results and patient satisfaction following uterine artery embolization (UAE) in women with symptomatic fibroids. METHODS: Between August 1998 and December 2002, 135 patients had UAE for symptomatic uterine fibroids. All patients were asked to fill in a questionnaire. Questions were aimed at changes in bleeding, pain, and bulk-related symptoms. Symptoms after UAE were scored as disappeared, improved, unchanged or worsened. Adverse events were noted, such as vaginal dryness and discharge, menopausal complaints or fibroid expulsion. Patient satisfaction after UAE was assessed. Patient satisfaction of women embolized with polyvinyl alcohol (PVA) particles was compared with satisfaction of women embolized with calibrated microspheres. RESULTS: The questionnaire was returned by 110 of 135 women (81%) at a median time interval of 14 months following UAE. In 10 women additional embolization or hysterectomy had been performed. Of the 110 responders, 86 (78%) were satisfied with the result of UAE. The proportion of satisfied women was higher in the group embolized with calibrated microspheres than in women embolized with PVA, although this difference was not statistically significant (p = 0.053). CONCLUSION: UAE in women with symptomatic uterine fibroids leads to improvement of symptoms and patient satisfaction is good in the vast majority after a median follow-up period of 14 months.

Adult↗
PubMed2003

Single-session alcohol sclerotherapy in symptomatic benign hepatic cysts performed with a time of exposure to alcohol of 10 min: initial results.

The aim of this study was to evaluate the 1-year results of single-session sclerotherapy of symptomatic benign non-parasitic liver cysts performed with maximum 10 min time of ethanol exposure. During the period 1995-1999, 15 symptomatic liver cysts in nine patients--eight women and one man--were treated with 10 min time of exposure to ethanol. Ultrasound-guided puncture combined with fluoroscopy was used for catheter placement. Alcohol sclerotherapy was performed with a maximum volume of ethanol 96% of 10% of the cyst volume, never exceeding 100 ml. At follow-up the patients were examined with liver function tests, ultrasound or CT examination, clinical examination, and interview by a gastrointestinal surgeon. Ten cysts in seven patients (six women and one man; age range 44-61 years, median age 58 years), who had a follow-up of at least 1 year, were included. The original cyst volumes were 30-4110 ml (median 392 ml). After a follow-up period of 12-47 months (median 23 months), cyst volumes were 0-523 ml (median 21.5 ml) with a reduction of the median cyst volume by 95% ( p<0,005). All patients experienced relief of their clinical symptoms. Except for pain, no complications were observed. Sclerotherapy using only one session and maximum 10 min time of exposure to ethanol represents an effective treatment of symptomatic liver cysts.

Adult↗
PubMed2006

Diagnostic value of 64-slice multi-detector row cardiac CTA in symptomatic patients.

Cardiac multi-detector-row computed tomography (MDCT) angiography has shown high levels of sensitivity and especially negative predictive value regarding the diagnosis of coronary artery disease (CAD). This study was designed to determine the value of a 64-slice-MDCT scanner in comparison to invasive coronary angiography for the detection of CAD in a population of symptomatic patients. Fifty-one patients with suspected CAD underwent conventional coronary angiography and ECG-gated cardiac 64-slice-MDCT angiography with a rotation time of 330 ms, a collimation of 64x0.6 mm and a slice thickness of 0.75 mm. Blinded patient- and segment-based analysis was performed for the detection of stenoses >or=70% of the vessel lumen. 95% of all coronary segments were assessable by MDCT angiography. Patient-based (segment-based) analysis revealed a sensitivity of 97.8% (86.7%), specificity of 50% (95.2%), positive predictive value of 93.6% (75.2%) and negative predictive value of 75% (97.7%). Inter-rater agreement revealed a kappa-value of 0.558 (0.722). In this symptomatic patient group a 64-slice-MDCT scanner shows good agreement on a segment-based analysis but only moderate agreement on a patient-based analysis. The diagnostic accuracy of 64-slice-MDCT coronary angiography is negatively influenced by the high pre-test probability of this symptomatic patient collective.

Calcinosis↗
PubMed1998

Gadolinium-DTPA enhancement of symptomatic nerve roots in MRI of the lumbar spine.

Disc prolapse presenting with sciatica may be associated with enhancement of the symptomatic nerve root following magnetic resonance imaging (MRI) with intravenous gadolinium (Gd)-DTPA. Previous studies have shown, however, that this does not occur in all cases. The aim of this study was to assess the incidence of nerve root enhancement in patients with sciatica and disc prolapse and to try to identify any specific features that might be associated with the phenomenon. A total of 227 patients presenting with low back pain and/or sciatica underwent a MRI study of the lumbar spine with intravenous contrast enhancement. Nineteen of 81 (23.5 %) patients with disc prolapse demonstrated nerve root enhancement. Nerve root enhancement had a highly significant association with sequestrated disc lesions (13/19, 68 %; P < 0.0005), and was primarily seen in the symptomatic ipsilateral nerve root (16/19, 84 %). The sensitivity of nerve root enhancement associated with disc prolapse was 23.5 % with a specificity of 95.9 %, a positive predictive value of 76 % and a negative predictive value of 69.3 %. Nerve root enhancement may be indicative of the symptomatic level but its poor sensitivity negates the routine use of Gd-DTPA in MRI for sciatica.

Contrast Media↗
PubMed2006

Diagnostic value of 16-slice multidetector computed tomography in symptomatic patients with suspected significant obstructive coronary artery disease.

We investigated the diagnostic value and limitations of 16-slice multidetector computed tomography (MDCT) to detect significant obstructive coronary artery disease in symptomatic patients. A total of 43 symptomatic patients underwent conventional coronary angiography and 16-slice multidetector computed tomography for the detection of significant obstructive coronary artery disease. The diagnostic value and limitations of 16-slice multidetector computed tomography to detect significant coronary stenoses were determined by analyzing all coronary arteries and proximal segments, both including and excluding unevaluable segments. Analysis of all 592 coronary artery segments demonstrated moderate sensitivity (67%) and positive predictive value (69%), with a high specificity (95%) and negative predictive value (94%) for the detection of significant coronary artery stenoses. When the unevaluable segments had been excluded, with the analysis of all evaluable segments, proximal segments, and evaluable proximal segments, sensitivity increased (71%, 77%, and 83%, respectively), and high specificity (95%, 96%, and 96%, respectively) and negative predictive value (95%) were maintained. When we repeated the analysis taking only the patients into account, 16-slice MDCT correctly diagnosed 88% of all patients but a moderate negative predictive value (63%) was obtained. Artifacts caused by cardiac motion were the most frequent reason for unevaluable segments. Calcification was the leading cause of degraded image quality and incorrect diagnosis. Our results demonstrated that 16-slice MDCT has a moderate diagnostic value for the correct diagnosis of symptomatic patients with significant coronary artery disease. This result suggests that 16-slice MDCT may not be able to exclude significant coronary artery disease reliably in patients at high risk.

Aged↗
PubMed2005

Operative indications and neuroendoscopic management of symptomatic cysts of the septum pellucidum.

OBJECTIVE: Since there is no current consensus on the diagnostic standards or surgical indications for symptomatic cysts of the septum pellucidum (CSP), we presented our experience treating such cases with neuroendoscopic surgery in order to possibly make a contribution to the attainment of such a consensus. METHODS: In the last 5 years, we effectively treated 5 patients (4 males and 1 female) with CSP by neuroendoscopic surgery. The 3 congenital cases were young: 9, 14, and 29 years old. The 2 secondary cases were adults aged 51 and 65 years old. We were able to fenestrate, and biopsy for pathological analysis, the cyst walls of symptomatic CSP using a minimally invasive neuroendoscopic technique, with postoperative improvement in compression of adjacent structures, as well as clinical signs. CONCLUSIONS: It is necessary to consider the overall picture including clinical signs, progress of the condition, intracranial pressure, and cerebral circulation, in deciding whether surgery is indicated. Neuroendoscopic surgery is an effective, optimal, and convenient therapeutic modality for symptomatic CSP.

Adolescent↗