Clinical features, presenting symptoms and complications of atrial fibrillation

2000 ◽  
pp. 91-102
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Features ◽  
Presenting Symptoms

Clinical features of pharyngeal cancer: a retrospective study of 258 consecutive patients

2001 ◽  
Vol 115 (2) ◽  
pp. 112-118 ◽  
Author(s):  
A. Escribano Uzcudun ◽  
P. Bravo Fernández ◽  
J. J. Sánchez ◽  
A. García Grande ◽  
I. Rabanal Retolaza ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Head And Neck ◽  
Clinical Features ◽  
Medical Records ◽  
Performance Status ◽  
Nasopharyngeal Cancer ◽  
University Hospital ◽  
Premalignant Lesions ◽  
Pharyngeal Cancer ◽  
Presenting Symptoms

Pharyngeal cancer still presents an unsatisfactory mortality (30-40 per cent in most series, with a slightly better prognosis for nasopharyngeal cancer relative to both oropharyngeal and hypophyarngeal cancers) despite advances in treatment. Therefore, it is critical to know the clinical features of pharyngeal cancer. The purpose of this study was to investigate the most relevant clinical features of pharyngeal cancer (oropharyngeal, hypopharyngeal, and nasopharyngeal) in order to improve knowledge of this malignancy with the aim of ameliorating diagnosis and treatment.The retrospective study was based on a review of medical records from 258 consecutive patients with pharyngeal cancer (oropharyngeal, hypopharyngeal and nasopharyngeal) diagnosed at La Paz University Hospital, Madrid, Spain, between January 1 1991 and and December 31 1995. Medical records were provided by the Departments of Otorhinolaryngology, Head and Neck Surgery, Radiation Oncology, and Medical Oncology.All medical records were analysed for the following clinical variables: 1) incidence, 2) sociodemographics, 3) sites (oropharynx, hypopharynx, nasopharynx) and subsites, 4) clinical and histological staging, 5) pathlogy, 6) presenting symptoms, 7) time to diagnosis, 8) patients’ general performance status at diagnosis, 9) personal cancer history and synchronous head and neck tumours, 10) premalignant lesions, and 11) paediatric cases.Our most outstanding finding was the excessively long time that elapsed between first clinical manifestation appearance and conclusive diagnosis of pharyngeal cancer (4.7 months for pharynx, 4.5 for oropharynx, 4.4 for hypopharynx and 6.5 for nasopharynx cancers). It was found that nasopharyngeal cancer was quite different from both oropharyngeal and hypopharyngeal cancers with respect to its potential aetiology, risk factors and clinical presentation. In addition it has a better prognosis.

scholarly journals Comparison of clinical features of pulmonary cryptococcosis with and without central nervous system involvement in China

2021 ◽  
Vol 49 (2) ◽  
pp. ???
Author(s):  
Xinying Xue ◽  
Xuelei Zang ◽  
Lifeng Wang ◽  
Dongliang Lin ◽  
Tianjiao Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Central Nervous System Involvement ◽  
Pulmonary Cryptococcosis ◽  
Cns Involvement ◽  
Laboratory Findings ◽  
Logistic Regression Models ◽  
Presenting Symptoms

Objective This study aimed to compare the clinical features of pulmonary cryptococcosis (PC) in patients with and without central nervous system (CNS) involvement. Methods We retrospectively reviewed demographics, presenting symptoms, radiographic features, and laboratory findings of patients diagnosed with PC in 28 hospitals from 2010 to 2019. Risk factors for CNS involvement were analyzed using logistic regression models. Result A total of 440 patients were included, and 36 (8.2%) had CNS involvement. Significant differences in fever, headache, and chills occurred between the two groups (overall and with/without CNS involvement) for fever (17.8% [78/440]; 52.8% vs. 14.6% of patients, respectively), headache (4.5% [20/440]; 55.6% vs. 0% of patients, respectively), and chills (4.3% [19/440]; 13.9% vs. 3.5% of patients, respectively). The common imaging manifestation was nodules (66.4%). Multivariate analysis showed that cavitation (adjusted odds ratio [AOR] = 3.552), fever (AOR = 4.182), and headache were risk factors for CNS involvement. Routine blood tests showed no differences between the groups, whereas in cerebrospinal fluid the white blood cell count increased significantly and glucose decreased significantly. Conclusion In patients with PC, the risk of CNS involvement increases in patients with headache, fever, and cavitation; these unique clinical features may be helpful in the diagnosis.

scholarly journals A rare and independent association of Right Atrial Myxoma with Immune Thrombocytopenic Purpura

2019 ◽  
Vol 7 (7) ◽  
pp. 2856
Author(s):  
Karthik Raman R. ◽  
Vijay Anand Palanisamy ◽  
Mithun Sundararaja Ravikumar ◽  
Jeswin Moses ◽  
Sivakumar Pandian ◽  
...  
Keyword(s):  
Left Atrium ◽  
Clinical Features ◽  
Immune Thrombocytopenic Purpura ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Thrombocytopenic Purpura ◽  
Presenting Symptoms ◽  
Right Atrial Myxoma ◽  
Independent Association

Primary tumours of the heart are rare and the most common benign ones are myxomas.  The clinical features are varied and include a myriad of presenting symptoms like embolic, constitutional, cardiac and also symptoms due to obstruction. Right atrial myxomas are very rarely seen when compared with left atrium. Such myxomas independently co existing with Immune Thrombocytopenic Purpura (ITP) is even rarer and we now present one such case in with right atrial myxoma was associated with ITP and was managed surgically. This case emphasises the fact that ITP can co-exist with myxoma and should be borne in mind when treating such patients surgically.

Abstract TP174: Identifying Predictors for Final Diagnosis of Ischemic Events in an Emergency Department Observation Unit

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Arooshi Kumar ◽  
Koto Ishida ◽  
Ava Liberman ◽  
Cen Zhang ◽  
Shadi Yaghi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Features ◽  
Univariate Analysis ◽  
Final Diagnosis ◽  
Minor Stroke ◽  
Symptom Duration ◽  
Facial Weakness ◽  
Presenting Symptoms ◽  
History Of ◽  
Ischemic Events

Introduction: Transient neurologic events have high rates of diagnostic uncertainty. Emergency department observation units (ED-OU) allow an accelerated diagnostic work up for suspected transient ischemic attacks (TIAs). However, clinical decision support regarding which patients to admit to these units is lacking. This study aimed to identify clinical features that differentiate true ischemic events from nonischemic transient neurological attacks (NI-TNA) among patients admitted to an ED-OU for suspected TIA. Methods: A retrospective analysis was performed on consecutive patients admitted to the ED-OU at a single academic center for suspected TIA. Demographics, vascular risk factors, presenting symptoms, and details of the clinical presentation were abstracted from chart review. Final discharge diagnosis was dichotomized to either ischemic event (TIA or minor stroke, TIAMS) or NI-TNA based on the treating vascular neurologist’s final diagnosis. Standard statistical tests were used for comparison testing between the two groups. Significantly different factors with p<0.2 on univariate analysis were carried forward in a multivariable logistic regression model. Results: Of 186 consecutive patients, 101 (54%) had a final diagnosis of NI-TNA and 85 (46%) of TIAMS. The median population ABCD2 score was 4 [IQR 3-4]. On univariate analysis, older age (63 vs. 70, p<0.01), history of atrial fibrillation (AF) (12% vs. 26%, p=0.01), and facial weakness (5% vs. 14% p=0.03) were associated with TIAMS. Headache (24% vs. 12%, p=0.04) and symptom duration>60min (57% vs. 40%, p=0.02) were associated with NI-TNA. On multivariable analysis, only symptom duration>60 minutes predicted NI-TNA (OR 0.39, p=0.04) and only history of AF (OR 2.53, p=0.03) predicted TIAMS. Facial weakness was strongly predictive of TIAMS (OR 3.22, p=0.05), but not significant. Conclusion: We identified two clinical features that distinguished TIAMS from NI-TNA among patients admitted to an ED-OU for suspected TIA.These may be helpful in emergency room triage of TIAMS. Data from ED-OU can be used to identify factors associated with cerebral ischemia and improve current care pathways for patients with suspected TIA, so diagnostic evaluation is received in the most appropriate setting.

Small Intestinal Bacterial Overgrowth: Histopathologic Features and Clinical Correlates in an Underrecognized Entity

2010 ◽  
Vol 134 (2) ◽  
pp. 264-270 ◽  
Author(s):  
Paul J. Lappinga ◽  
Susan C. Abraham ◽  
Joseph A. Murray ◽  
Emily A. Vetter ◽  
Robin Patel ◽  
...  
Keyword(s):  
Clinical Features ◽  
Reference Range ◽  
Gastrointestinal Symptoms ◽  
Bacterial Overgrowth ◽  
Small Intestinal Bacterial Overgrowth ◽  
Presenting Symptoms ◽  
Intestinal Bacterial Overgrowth ◽  
Colony Forming Units ◽  
Small Intestinal ◽  
Duodenal Biopsies

Abstract Context Small intestinal bacterial overgrowth (SIBO) is a common cause of chronic diarrhea and malabsorption. Morphologic changes associated with this condition have not, to our knowledge, been studied in detail. Objective To better characterize the histopathologic changes associated with SIBO by comparing the clinicopathologic features of patients with SIBO (duodenal aspirate cultures with ≥105 colony-forming units [CFUs]/mL) to controls with cultures found to be negative (&lt;105 CFUs/mL). Design We included 67 consecutive patients with SIBO and 55 controls in the series. Each duodenal biopsy was assessed for the following features: villous to crypt ratio, intraepithelial lymphocytosis, crypt apoptoses, basal plasmacytosis, cryptitis/villitis, peptic duodenitis, erosions/ulcers, eosinophilia, and absence of goblet and Paneth cells; and correlated with clinical features and culture results. Results Decreased villous to crypt ratio (&lt;3∶1) was more frequent in SIBO than controls (24% versus 7%; P  =  .01). Duodenal biopsies from patients with SIBO were slightly less likely to be judged within reference range than were controls (52% versus 64%; P  =  .27). There were no significant differences in any of the other histologic features. Clinically, patients in the SIBO group were older than the age of controls (mean, 60 years versus 52 years; P  =  .02), and they were more likely to have one of the known predisposing factors for bacterial overgrowth (66% versus 36%; P  =  .002). Other clinical features, including presenting symptoms, were similar. Conclusions Villous blunting is the only feature more common to SIBO than to controls. More than half of biopsies from SIBO patients are histologically unremarkable. Therefore, SIBO needs to be considered as a potential etiology for gastrointestinal symptoms even when duodenal biopsies are found to be normal.

Incidence, clinical features and outcomes of atrial fibrillation and stroke in Qatar

2019 ◽  
Vol 15 (1) ◽  
pp. 85-89 ◽  
Author(s):  
Yahia Z Imam ◽  
Saadat Kamran ◽  
Naveed Akhtar ◽  
Dirk Deleu ◽  
Rajvir Singh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Clinical Features ◽  
Stroke Care ◽  
Newly Diagnosed ◽  
Limited Data ◽  
Stroke Patients ◽  
Acute Stroke Care ◽  
Low Rate

Background Atrial fibrillation is an important risk factor for stroke but there are limited data on atrial fibrillation-related stroke from the Middle East. Methods We interrogated the Qatar Stroke Database to establish the occurrence, clinical features, and outcomes of atrial fibrillation-related stroke at Hamad General Hospital, the sole provider of acute stroke care in Qatar. Results A total of 4079 patients (81.4% male, mean age 55.4 ± 13.3 years) were enrolled in the stroke database between January 2014 and 21 October 2017. Atrial fibrillation was present in 260 (6.4%) patients, of whom 106 (2.6%) had newly diagnosed atrial fibrillation. The National Institute of Health Stroke Scale (NIHSS) was significantly higher (7.9 + 7.0 (median 6; IQR 11) vs. 5.9 + 6.4 (median 4; IQR 6), P < 0.001) in atrial fibrillation patients. The modified Rankin Score (mRS) (P < 0.001) and mortality at 90-day follow-up (P = 0.002) were significantly higher in atrial fibrillation compared to non-atrial fibrillation stroke patients. Conclusion We demonstrate a low rate of atrial fibrillation and stroke in Qatar, perhaps reflecting the relatively young age of these patients. Atrial fibrillation-related strokes had higher admission NIHSS, greater disability, and higher mortality at 90 days when compared to non-atrial fibrillation strokes.

scholarly journals Interatrial block as electrocardiographic predictive sign for atrial fibrillation in patients hospitalized in Internal Medicine Departments

2019 ◽  
Vol 13 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Gianpaolo Bragagni ◽  
Chiu Hua Chen ◽  
Federico Lari ◽  
Gaetano Magenta
Keyword(s):  
Internal Medicine ◽  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Clinical Features ◽  
P Wave ◽  
Age And Gender ◽  
Interatrial Block ◽  
Group 2 ◽  
And Gender ◽  
Group 1

This study evaluated the correlation between interatrial block (IAB) and atrial fibrillation (AF) among patients admitted to our Internal Medicine Unit: 110 (group 1) were identified with electrocardiograms both in sinus rhythm and AF, and 123 (group 2) constantly in sinus rhythm. In both groups we analyzed: the presence of partial (P≥120 msec) or advanced (P>120 msec and biphasic in D2, D3, aVF) IAB, and the main electrocardiographic and clinical features. Age and gender between the two groups were similar. IAB was present in 89/110 (80.91%) in group 1 and 26/123 (21.13%) in group 2 (P=<0.01); partial in 50/110 (45.45%) and 19/123 (15.7%) in group 1 and 2 respectively (P<0.01), advanced in 39/110 (35.45%) and 7/123 (5.69%) (P<0.019). The correlation between IAB and AF was significant (P<0.001); 36 (65.4%) patients out of 55 with atrial echo dilatation had IAB and 14 (25.4%) had deep terminal negativity of P-wave in V1 (DTNPV1) >0.1 mV (P<0.01). IAB represents a reliable predictor of AF; moreover, the sensitivity of the IAB in detecting atrial dilatation is higher than the DTNPV1 >0.1 mV.

scholarly journals Clinical features of paroxysmal atrial fibrillation an observation of 94 patients.

1981 ◽  
Vol 22 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Nobuo TAKAHASHI ◽  
Akira SEKI ◽  
Kouji IMATAKA ◽  
Jun FUJII
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Features ◽  
Paroxysmal Atrial Fibrillation

Disseminated intravascular coagulation secondary to advanced prostate cancer: Clinical characteristics, management, and prognosis.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 355-355
Author(s):  
Benny Ni ◽  
Jue Wang
Keyword(s):  
Prostate Cancer ◽  
Cancer Therapy ◽  
Clinical Features ◽  
Disseminated Intravascular Coagulation ◽  
Single Case ◽  
Therapy Group ◽  
Rank Test ◽  
Entire Cohort ◽  
Intravascular Coagulation ◽  
Presenting Symptoms

355 Background: Although disseminated intravascular coagulation (DIC) is a recognized complication of prostate cancer, little is known about the clinical features and optimal management of these patients. Although anecdotal case studies indicating that the prognosis of prostate cancer associated with DIC might improve with chemotherapy, the clinical data from single case report are far from sufficient for establishment of a standardized treatment strategy. The main objective of this study was to determine the clinical features, treatment and prognosis clinical outcome of patients with prostate cancer complicated by DIC. Methods: We conducted a pooled analysis of 85 prostate cancer patients diagnosed with DIC, two treated in our institution and 83 patients from published literature between January 1976 and June 2017. Results: Eighty-five patients were included in final analysis. The median age was 68 years (range, 44 to 92 years). The majority of patients (98%) has adenocarcinoma. Two (2%) patients with small cell carcinoma. The median of PSA was 614 ng/ml (range: 0.8 – 8138). A Gleason score of 8 or higher was found in 67% of patients. Distant metastasis was reported in 98% of patients. At diagnosis of DIC, the median platelet count was 75 *109 /L (range: 3-205). Regarding the presenting symptoms of DIC, subcutaneous bleeding was reported in 64% of cases; hematuria in 27%. Invasive procedure including prostate biopsy might have been the provoking events of DIC in 25% of the cases. Seventy-one patients received cancer directed therapy including various androgen deprivation, chemotherapy, and novel androgen signaling inhibitor, whereas 13 patients received only best supportive care (BSC). The median overall survival (OS) of the entire cohort of patients was 10 months (95% confidence interval [CI], 5.3-14.7). Significantly prolonged OS was observed in the cancer therapy group, with a median survival of 12 months compared to 2 weeks in the BSC group (p < 0.001, log-rank test). Conclusions: Our analysis showed that patients with prostate cancer complicated by DIC had very poor prognosis, and active cancer therapy might improve OS of these patients.

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