Although there is not one specific sign or symptom related to alcoholic hepatitis(AH),a constellation of symptoms and signs can help make the diagnosis of AH with reasonable accuracy.Documentation of chronic and activ...Although there is not one specific sign or symptom related to alcoholic hepatitis(AH),a constellation of symptoms and signs can help make the diagnosis of AH with reasonable accuracy.Documentation of chronic and active alcohol abuse is paramount in making a diagnosis of AH.Clinical presentation after abstinence for more than 3 m should raise doubts about the diagnosis of AH and dictate the need for considering other causes of liver disease,decompensation of alcoholic cirrhosis,sepsis and malignancy as the cause of patient's clinical profile.展开更多
In the present study, the authors selected points according to differentiation of symptoms and signs and applied filiform needles to treating 40 cases of hiccup who had tried treatment with Western and Chinese drugs b...In the present study, the authors selected points according to differentiation of symptoms and signs and applied filiform needles to treating 40 cases of hiccup who had tried treatment with Western and Chinese drugs but without any effect and achieved satisfactory results. After acupuncture treatment, 34 cases (85 %) were cured, 4 (10 %) improved markedly and 2(5 %) improved, with total effective rate of 100 %.展开更多
Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs i...Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs in PD have been accumulated growing attentions and its amelioration may also give beneficial effect for PD patients’ and their care givers’ quality of life. In this mini-review, I overviewed non-motor symptoms and signs in PD.展开更多
Background: Herbal dentifrices appear to have become an attractive alternative for some consumers and its use has gained appreciable acceptance in Nigeria. This could be partly due to the perception that herbal toothp...Background: Herbal dentifrices appear to have become an attractive alternative for some consumers and its use has gained appreciable acceptance in Nigeria. This could be partly due to the perception that herbal toothpastes like other herbal products are “natural”, devoid of chemicals and therefore superior to regular toothpastes. Aggressive advertisement of the products may also contribute to this new trend. Mucosal symptoms such as glossitis and intolerance to spicy foods seen in patients attending the oral diagnosis clinic are usually associated with anaemia and nutritional deficiency states. The disturbing trend of an increasing number of patients presenting with such oral mucosal symptoms associated with the use of herbal dentifrices prompted this study. This trend was observed in two isolated oral medicine clinics. Objective: To sensitize oral health, allied professionals and consumers on the possible adverse effects of regular use of some herbal dentifrices sold in Nigeria. Materials and Methods: Routine patients of two oral medicine clinics in Lagos, namely the Randle General Hospital and the Lagos University Teaching Hospital who complained of some adverse mucosal signs and symptoms following the regular use of two identified herbal toothpastes made up the study population. The study was conducted between April 2010-April 2011. A detailed history and examination was carried out on these patients and clinical photographs of oral signs observed was taken in consenting patients. Data analysis was done using the Epi-info 6 software. P values ≤ 0.05 was considered statistically significant and data was presented in table format. Results: A total of 45 patients, 9 (20%) males and 36 (80%) fe-males were seen. The age range of patients was 14 - 78 years;mean age 45.5 ± 14.9 years. The duration of use of herbal dentifrices ranged from 2 weeks - 84 months (mean 24 ± 11.5 months). Oral signs and symptoms seen include, burning mouth and peppery sensation, mucosal erythema, lichenoid reaction, xerostomia, loss of taste sensation, angio-oedema and oral and peri-oral pigmentation. In many patients, resolution of symptoms was progressive within 2 weeks of withdrawal of the herbal toothpaste and its replacement with a conventional fluoride toothpaste. Most of the patients however required further treatment. A statistically significant association was found between the use of the identified herbal dentifrices and the following mucosal signs and symptoms namely, burning mouth and peppery sensation ,loss of taste sensation, soreness, erythema and lichenoid straie (p value ≤ 0.05). There was no statistically significant association between the use of herbal toothpaste and mucosal signs and symptoms of xerostomia, angular cheilitis, mucosal itching, angio-oedema and numbness (p value > 0.0.5) Conclusion: The regular use of the herbal dentifrices identified in this study can result in oral signs and symptoms affecting taste , nutrition, aesthetics and general oral physiology in some consumers. These findings suggest that further long term clinical trials need to be conducted on the herbal dentifrices to identify the noxious agents causing these symptoms. The formulation and use of these dentifrices need to be standardized and regulated. There is also a need to formulate a treatment protocol for these patients.展开更多
Physical examination signs have not been well studied,and their accuracy and reliability in diagnosis remain unknown.The few studies available are limited in that the method of performing the sign was not stated,the t...Physical examination signs have not been well studied,and their accuracy and reliability in diagnosis remain unknown.The few studies available are limited in that the method of performing the sign was not stated,the technique used was not standardized,and the position of the appendix was not correlated with imaging or surgical findings.Some appendiceal signs were written in a non-English language and may not have been appropriately translated(e.g.,Blumberg-Shchetkin and Rovsing).In other cases,the sign described differs from the original report(e.g.,Rovsing,Blumberg-Shchetkin,and Cope sign,Murphy syndrome).Because of these studies limitations,gaps remain regarding the signs’utility in the bedside diagnosis of acute appendicitis.Based on the few studies available with these limitations in mind,the results suggest that a positive test is more likely to be found in acute appendicitis.However,a negative test does not exclude the diagnosis.Hence,these tests increase the likelihood of ruling in acute appendicitis when positive but are less helpful in ruling out disease when negative.Knowledge about the correct method of performing the sign may be a valuable adjunct to the surgeon in further increasing their pretest probability of disease.Furthermore,it may allow surgeons to study these signs further to better understand their role in clinical practice.In the interim,these signs should continue to be used as a tool to supplement the clinical diagnosis.展开更多
Objective:Osteoradionecrosis of the jaws(ORNJ)is among the most serious oral complications of head and neck cancer treatment with radiation therapy.This study aimed to examine the level of symptom distress and interfe...Objective:Osteoradionecrosis of the jaws(ORNJ)is among the most serious oral complications of head and neck cancer treatment with radiation therapy.This study aimed to examine the level of symptom distress and interference of ORNJ in head and neck cancer patients in China.Methods:A cross-sectional study was conducted to profile patient reported symptom severity.Ninetyfive hospitalized ORNJ patients were recruited.Participants completed the MD Anderson Symptom Inventory-Head and Neck Module-Chinese version.Results:The percentage of participants who reported that they experienced at least one type of symptom was 97.9%,and 85.2%patients reported interference.The 10 most severe symptoms were as follows:limited mouth opening,problem with teeth/gums,difficulty swallowing/chewing,dry mouth,oral malodor,difficulty with voice/speech,dental ulcer,tinnitus/ear obstruction,skin pain/burning/rash,and difficulty hearing.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.The interference of patients positively correlated with core symptoms(r=0.612),head and neck symptoms(r=0.709),and ORNJ symptoms(r=0.440)(P<0.01).The longer time to the onset of ORNJ after radiotherapy was positively and significantly correlated with symptom distress(r=0.479,P<0.001),and mouth opening correlated negatively with symptom distress(r=-0.298,P=0.003).Conclusions:ORNJ patients suffered mainly from limited mouth opening and other maxillofacial symptoms.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.ORNJ patients commonly had symptom distress,which influenced their quality of life.展开更多
Objective This study aimed to synthesize the available knowledge of symptom trajectories in patients with breast cancer and identify predictors associated with these trajectories.Methods Whittemore and Knafl’s integr...Objective This study aimed to synthesize the available knowledge of symptom trajectories in patients with breast cancer and identify predictors associated with these trajectories.Methods Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in four databases(PubMed,Embase,Web of Science,and CINAHL).The retrieved articles’publication time was limited to 2010 to 2020,and only peer-reviewed English articles were included.Results Twenty-seven articles were included.The findings of the relevant studies were analyzed using thematic analysis.They were grouped into two themes:symptom trajectories of patients with breast cancer(symptom trajectories in patients with breast cancer,in patients who underwent surgery,and in patients who received cancer-related treatment)and associated factors(socioeconomic factors,health characteristics,cancer-related treatment characteristics).Newly diagnosed patients tended to report high trajectories of depression and persistent sleep disturbance.Most patients who underwent surgery reported significant sleep disturbance and anxiety shortly after surgery.For patients who received cancer-related treatment,only a small proportion had a high level of physical activity after cancer-related therapy over time.A high body mass index,a low relationship quality,parental responsibilities,insufficient social support,a low educational background,and an unhealthy lifestyle may increase the risk of negative symptom trajectories in patients with breast cancer.Additionally,old patients were more likely to report cognitive impairment after chemotherapy,while young patients tended to report trajectories of persistent sexual dysfunction.Concurring symptoms and poor health status also contributed to adverse symptom trajectories.Conclusion The findings of this review add to the body of knowledge of the interindividual variability of symptom trajectories in patients with breast cancer.Despite the overall similarity in appraisal at baseline,the patients reported varied symptom trajectories over time.It is recommended that nurses consider sociodemographic,clinical and cancer-related treatment characteristics and perform targeted early preventive interventions for patients with breast cancer.展开更多
文摘Although there is not one specific sign or symptom related to alcoholic hepatitis(AH),a constellation of symptoms and signs can help make the diagnosis of AH with reasonable accuracy.Documentation of chronic and active alcohol abuse is paramount in making a diagnosis of AH.Clinical presentation after abstinence for more than 3 m should raise doubts about the diagnosis of AH and dictate the need for considering other causes of liver disease,decompensation of alcoholic cirrhosis,sepsis and malignancy as the cause of patient's clinical profile.
文摘In the present study, the authors selected points according to differentiation of symptoms and signs and applied filiform needles to treating 40 cases of hiccup who had tried treatment with Western and Chinese drugs but without any effect and achieved satisfactory results. After acupuncture treatment, 34 cases (85 %) were cured, 4 (10 %) improved markedly and 2(5 %) improved, with total effective rate of 100 %.
文摘Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs in PD have been accumulated growing attentions and its amelioration may also give beneficial effect for PD patients’ and their care givers’ quality of life. In this mini-review, I overviewed non-motor symptoms and signs in PD.
文摘Background: Herbal dentifrices appear to have become an attractive alternative for some consumers and its use has gained appreciable acceptance in Nigeria. This could be partly due to the perception that herbal toothpastes like other herbal products are “natural”, devoid of chemicals and therefore superior to regular toothpastes. Aggressive advertisement of the products may also contribute to this new trend. Mucosal symptoms such as glossitis and intolerance to spicy foods seen in patients attending the oral diagnosis clinic are usually associated with anaemia and nutritional deficiency states. The disturbing trend of an increasing number of patients presenting with such oral mucosal symptoms associated with the use of herbal dentifrices prompted this study. This trend was observed in two isolated oral medicine clinics. Objective: To sensitize oral health, allied professionals and consumers on the possible adverse effects of regular use of some herbal dentifrices sold in Nigeria. Materials and Methods: Routine patients of two oral medicine clinics in Lagos, namely the Randle General Hospital and the Lagos University Teaching Hospital who complained of some adverse mucosal signs and symptoms following the regular use of two identified herbal toothpastes made up the study population. The study was conducted between April 2010-April 2011. A detailed history and examination was carried out on these patients and clinical photographs of oral signs observed was taken in consenting patients. Data analysis was done using the Epi-info 6 software. P values ≤ 0.05 was considered statistically significant and data was presented in table format. Results: A total of 45 patients, 9 (20%) males and 36 (80%) fe-males were seen. The age range of patients was 14 - 78 years;mean age 45.5 ± 14.9 years. The duration of use of herbal dentifrices ranged from 2 weeks - 84 months (mean 24 ± 11.5 months). Oral signs and symptoms seen include, burning mouth and peppery sensation, mucosal erythema, lichenoid reaction, xerostomia, loss of taste sensation, angio-oedema and oral and peri-oral pigmentation. In many patients, resolution of symptoms was progressive within 2 weeks of withdrawal of the herbal toothpaste and its replacement with a conventional fluoride toothpaste. Most of the patients however required further treatment. A statistically significant association was found between the use of the identified herbal dentifrices and the following mucosal signs and symptoms namely, burning mouth and peppery sensation ,loss of taste sensation, soreness, erythema and lichenoid straie (p value ≤ 0.05). There was no statistically significant association between the use of herbal toothpaste and mucosal signs and symptoms of xerostomia, angular cheilitis, mucosal itching, angio-oedema and numbness (p value > 0.0.5) Conclusion: The regular use of the herbal dentifrices identified in this study can result in oral signs and symptoms affecting taste , nutrition, aesthetics and general oral physiology in some consumers. These findings suggest that further long term clinical trials need to be conducted on the herbal dentifrices to identify the noxious agents causing these symptoms. The formulation and use of these dentifrices need to be standardized and regulated. There is also a need to formulate a treatment protocol for these patients.
文摘Physical examination signs have not been well studied,and their accuracy and reliability in diagnosis remain unknown.The few studies available are limited in that the method of performing the sign was not stated,the technique used was not standardized,and the position of the appendix was not correlated with imaging or surgical findings.Some appendiceal signs were written in a non-English language and may not have been appropriately translated(e.g.,Blumberg-Shchetkin and Rovsing).In other cases,the sign described differs from the original report(e.g.,Rovsing,Blumberg-Shchetkin,and Cope sign,Murphy syndrome).Because of these studies limitations,gaps remain regarding the signs’utility in the bedside diagnosis of acute appendicitis.Based on the few studies available with these limitations in mind,the results suggest that a positive test is more likely to be found in acute appendicitis.However,a negative test does not exclude the diagnosis.Hence,these tests increase the likelihood of ruling in acute appendicitis when positive but are less helpful in ruling out disease when negative.Knowledge about the correct method of performing the sign may be a valuable adjunct to the surgeon in further increasing their pretest probability of disease.Furthermore,it may allow surgeons to study these signs further to better understand their role in clinical practice.In the interim,these signs should continue to be used as a tool to supplement the clinical diagnosis.
基金Nurturing funds for nursing young talents of Sun Yat-sen University(N2018Y02)
文摘Objective:Osteoradionecrosis of the jaws(ORNJ)is among the most serious oral complications of head and neck cancer treatment with radiation therapy.This study aimed to examine the level of symptom distress and interference of ORNJ in head and neck cancer patients in China.Methods:A cross-sectional study was conducted to profile patient reported symptom severity.Ninetyfive hospitalized ORNJ patients were recruited.Participants completed the MD Anderson Symptom Inventory-Head and Neck Module-Chinese version.Results:The percentage of participants who reported that they experienced at least one type of symptom was 97.9%,and 85.2%patients reported interference.The 10 most severe symptoms were as follows:limited mouth opening,problem with teeth/gums,difficulty swallowing/chewing,dry mouth,oral malodor,difficulty with voice/speech,dental ulcer,tinnitus/ear obstruction,skin pain/burning/rash,and difficulty hearing.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.The interference of patients positively correlated with core symptoms(r=0.612),head and neck symptoms(r=0.709),and ORNJ symptoms(r=0.440)(P<0.01).The longer time to the onset of ORNJ after radiotherapy was positively and significantly correlated with symptom distress(r=0.479,P<0.001),and mouth opening correlated negatively with symptom distress(r=-0.298,P=0.003).Conclusions:ORNJ patients suffered mainly from limited mouth opening and other maxillofacial symptoms.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.ORNJ patients commonly had symptom distress,which influenced their quality of life.
基金This research was supported by the Youth Project of National Natural Science Foundation of China(72004033)the Natural Science Foundation of China(72074054).
文摘Objective This study aimed to synthesize the available knowledge of symptom trajectories in patients with breast cancer and identify predictors associated with these trajectories.Methods Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in four databases(PubMed,Embase,Web of Science,and CINAHL).The retrieved articles’publication time was limited to 2010 to 2020,and only peer-reviewed English articles were included.Results Twenty-seven articles were included.The findings of the relevant studies were analyzed using thematic analysis.They were grouped into two themes:symptom trajectories of patients with breast cancer(symptom trajectories in patients with breast cancer,in patients who underwent surgery,and in patients who received cancer-related treatment)and associated factors(socioeconomic factors,health characteristics,cancer-related treatment characteristics).Newly diagnosed patients tended to report high trajectories of depression and persistent sleep disturbance.Most patients who underwent surgery reported significant sleep disturbance and anxiety shortly after surgery.For patients who received cancer-related treatment,only a small proportion had a high level of physical activity after cancer-related therapy over time.A high body mass index,a low relationship quality,parental responsibilities,insufficient social support,a low educational background,and an unhealthy lifestyle may increase the risk of negative symptom trajectories in patients with breast cancer.Additionally,old patients were more likely to report cognitive impairment after chemotherapy,while young patients tended to report trajectories of persistent sexual dysfunction.Concurring symptoms and poor health status also contributed to adverse symptom trajectories.Conclusion The findings of this review add to the body of knowledge of the interindividual variability of symptom trajectories in patients with breast cancer.Despite the overall similarity in appraisal at baseline,the patients reported varied symptom trajectories over time.It is recommended that nurses consider sociodemographic,clinical and cancer-related treatment characteristics and perform targeted early preventive interventions for patients with breast cancer.
