简介：Sillsarecormnon;communityscreeningstudiesintheUKhaveshownprevalencesofabout10%forChlamydiaand12%forgenitalherpes.Inwomen,themorepotentiallyseriousinfectionssuchasgonorrhoeaandChlamydiaareoftenasymptorrkatic,whereasthepresenceofsymptormsuchasvaginaldisclmrgegenerallyindicatesalesspathogenic(bu!stillpotentiallydebilitating)infectionsuchasCandida.SHsareoftenmultiple,andthefindingofoneinfectionshouldpromptconsiderationoftestingforothers.

简介：Theprimarysymptomsofrespiratorydisordersarebreathlessness,chestpainandcough,whichmaybeassociatedwithsputumproduction.However,disordersofthelungscanproducedistantsymptoms(e.g.non-metastaticmanifestationsoflungcancer),andnon-respiratoryconditionssuchasanaemiaandmetabolicacidosscancauseberathlessness.Adequateassessmentofanypatientrequiresafullclinicalhistoryandexamination.Thiscontributionconsidersaspectsdirectlyrelevanttotherespiratorysystem.

简介：Symptotm:thefollowingsymptoms,volunteeredbythepatientorelicitedthroughspecificenquiry,mayindicatethepresenceofanSTI.

简介：ObjectiveTostudyconcomitantsymptomsanddiseaseconditionsinsuddendeafness.MethodsClinicaldataof418casesofsuddendeafnesstreatedinthisdepartmentfrom2000to2007werereviewed.ResultsOfthe418cases,201weremalesand217werefemales.Rightearwasinvolvedin184casesandleftearin191cases.Bilateralinvolvementwasseenin43cases.Theaverageagewas44.1years.Tinnituswasreportedin369cases(88.3%)eitherbeforeorafterhearingloss,ofwhich64.5%wasoflowpitch,27.1%ofhighpitchand8.4%ofmixedtones.Constanttinnituswasreportedin83%ofthecases,andmuffledfeelingsin33.3%ofthecases.Hearinglosswastheonlycomplaintin221cases(52.9%).Dizzinesswasreportedin77cases(18.4%)andvertigoattacksin120cases(28%).Hypertension,coronaryarterydiseaseanddiabeteswerefoundin19.6%of418casesandhyperlipidemiain54.5%of211cases.CTand/orMRIdatawereavailablein147cases,withpositivefindingsin18cases(12.3%):2withacousticneuroma(1.36%);4withemphraxisinthebasalganglia,cerebellum,temporallobeorparietallobe,and12withpoorpneumatizationofipsiorcontralateralmastoidcells.ConclusionInthiscaseseriesofsuddendeafness,low-pitchconstanttinnituswasacommoncomplaint.Mostofthestudiedcasespresentedwithsimplehearingloss.Vertigoattacksweremorecommonthandizzinessinthisgroupofpatients.Themostcommonconcomitantdisorderwashyperlipidemia,especiallyhightriglycerides.Imagingstudiesareimportantinmanagingsuddendeafnessinrulingoutacousticneuromaandotherintracranialdiseases.

简介：AIM:Toexaminefamilialaggregationofirritablebowelsyndrome(IBS)viaparentalreinforcement/modelingofsymptoms,coping,psychologicaldistress,andexposuretostress.METHODS:Mothersofchildrenbetweentheagesof8and15yearswithandwithoutIBSwereidentifiedthroughtheGroupHealthCooperativeofPugetSound.Motherscompletedquestionnaires,includingtheChildBehaviorChecklist(childpsychologicaldistress),theFamilyInventoryofLifeEvents(familyexposuretostress),SCL-90R(mo...

简介：Mostadultswithauditoryprocessingdisorder(APD)oftenhavetroubleatwork.ItispossiblethattheselisteningproblemsinadultswithAPDinfluencetheirmentalhealth.Thus,wehavetotakethesubject'spersonalityandmentalstatusintoconsiderationwhensupportingsubjectswithAPD.However,studiesonAPDinadultsarecomparativelyrare.Inthisstudy,weaimedtoevaluatetherelationshipsbetweentheresultsofauditorytests,APDsymptoms,andpsychologicalstatusinsubjectswithAPD.Thisstudyincluded22adultswhocomplainedoflisteningproblemsineverydaylife,andtheyunderwentauditoryprocessingtestsandwerequestionedregardingtheirpsychologicalcharacteristics.Fromtheresultsoftheauditoryprocessingtests,allsubjectsshowedlowscoresonatleastonetest;therefore,theyweresuspectedofhavingAPD.Especially,thescoreswerelowontheauditorymemorytest.Furthermore,subjectswithAPDshowrelativelysimilarpsychologicalcharacteristicstoeachother.However,therewasnosignificantrelationshipbetweentheresultsoftheauditoryprocessingtestsandpsychologicalcharacteristics.Wehavetotakenoticeofasubject'spsychologicalstatewhentheyperceivetheirlisteningdifficultiesasalarge-scaleproblemandfeelanxiousasaresult.Forthispurpose,weshouldtakepsychologicalcharacteristicsintoconsiderationatthetimeofthemedicalexaminationinterviewbeforeaudio-psychologicaltesting.

简介：我们决定了在prostatic演算和更低的尿道之间的关联症状(LUTS)，以及prostatic演算的预先安排的因素。为LUTS在我们的诊所介绍了的1527个病人，802经历了完全的评估，包括transrectalultrasonography，voidedbladder-3标本和国际prostatic症状分数(IPSS)。有prostatic演算的335个病人和没有prostatic演算的467个病人的一个总数分别地被划分成演算和没有演算组。严重LUTS和prostatic演算的预兆的因素用uni/multivariate分析被决定。全面IPSS分数是15.7卤9.2在演算和没有演算组织的9.2和14.1卤，分别地(P=0.013)。最大的流动率是12.1卤6.9和14.2卤8.2mLs?1在演算和没有演算组织，分别地(P=0.003)。在为预言严重LUTS的因素的univariate分析上，在年龄的差别(P=0.042)，prostatic演算(P=0.048)并且前列腺炎(P=0.018)是统计上重要的。在multivariate分析上，然而，没有因素是重要的。在为预先安排的multivariate分析上prostatic演算的因素，在年龄的差别(P<0.001)并且前列腺体积(P=0.001)是重要的。到我们的知识，有prostatic演算的病人抱怨更严重的LUTS。然而，prostatic演算不是严重LUTS的一个独立预兆的因素。因此，不仅因为prostatic演算而且因为年龄和另外的因素，有prostatic演算的人有更严重的LUTS。另外，老年和大前列腺体积是为prostatic演算的独立人士预先安排因素。

简介：我们在朝鲜良性的prostatic增生(BPH)在更低的尿道症状(LUTS)上分析了肥胖的效果病人。这是multicenter，在朝鲜在四个中心进行的代表性的、未来的学习。有对BPH第二等的LUTS的602个人的一个总数被包括。BPH/LUTSs盒子是有8削尖的国际前列腺症状分数(IPSS)的40年的人。高度，重量和腰圆周被测量。在602个病人之中，156个病人在90厘米上面有腰圆周，代表中央肥胖，并且215个病人在25kgm-2上面有一个身体团索引。腰圆周断然与前列腺体积被相关(P=0.034)。有腰圆周的人>90厘米富有经验1.36褶层与腰圆周90厘米与人相比增加了严重LUTS(95%CI0.82鈥?.41)的风险。前列腺体积断然与中央肥胖在人与紧急和nocturia被相关。在与BPH诊断的朝鲜的人的这张人口，中央肥胖而非全面肥胖似乎是LUTS的更重要的预言者与BPH相关。

简介：MemorylossandmentalconfusionarethefirstovertsignsofAlzheimer'sDisease,anincurableandfatalbrainailment.Butscientistsarestartingtofindevidenceofthediseaselongbeforesymptomsappear.

简介：

简介：AbstractImportance:Tics usually start around 4-6 years old and affect about 1% of school-age children. Premonitory urges (PUs) are sensory phenomena that precede tics and are often described as unpleasant feelings. Recent evidence supports a relationship between PUs and tic severity, but reports are conflicting. In addition, there is no report of PUs in the Chinese population.Objective:To investigate the correlation between PUs and tic symptoms in the Chinese population with tic disorders.Methods:We recruited 252 Chinese individuals with chronic tic disorders (age 5-16 years). The Yale Global Tic Severity Scale (YGTSS) was used to assess tic symptoms, and the Premonitory Urge for Tics Scale (PUTS) was used to assess PUs. We calculated Spearman correlations between PUTS and YGTSS scores, and constructed a linear regression model to predict the tic symptom severity by PUs.Results:There was a significant positive correlation between PU severity (PUTS scores) and motor tic severity, total tic severity, tic-caused impairment (YGTSS scores) (P < 0.05). PU severity was a significant positive predictor of tic symptom severity (standardized beta coefficient = 0.174, t = 2.786, P = 0.006).Interpretation:We provide evidence for a correlation between PUs and tic symptoms. PU severity predicts tic symptom severity. Further research on PUs is needed to clarify the shared brain mechanism with tics, and their role in tic expression. A suitable tool to assess PUs in younger children is also needed.

简介：无

简介：Theepidemiologyofbenignprostatichyperplasia(BPH)andmalelowerurinarytractsymptoms(LUTS)hasevolvedconsiderablyduringthepastseveralyears.ThetermLUTSdescribesadistinctphenotypeandallowsforabroadepidemiologicdescriptionofurinarysymptomsatapopulationlevel.Althoughitisbecomingthepreferredtermforstudyingurinarysymptomsinpopulations,LUTS

简介：AbstractBackground:Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MSA and the impact of sleep disturbances on disease severity.Methods:This cross-sectional study involved 165 patients with MSA. Three sleep-related symptoms, namely Parkinson’s disease (PD)-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement sleep behavior disorder (RBD), were evaluated using the PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ), respectively. Disease severity was evaluated using the Unified MSA Rating Scale (UMSARS).Results:The frequency of PD-SP (PDSS-2 score of ≥18), EDS (ESS score of ≥10), and RBD (RBDSQ score of ≥5) in patients with MSA was 18.8%, 27.3%, and 49.7%, respectively. The frequency of coexistence of all three sleep-related symptoms was 7.3%. Compared with the cerebellar subtype of MSA (MSA-C), the parkinsonism subtype of MSA (MSA-P) was associated with a higher frequency of PD-SP and EDS, but not of RBD. Binary logistic regression revealed that the MSA-P subtype, a higher total UMSARS score, and anxiety were associated with PD-SP; that male sex, a higher total UMSARS score, the MSA-P subtype, and fatigue were associated with EDS; and that male sex, a higher total UMSARS score, and autonomic onset were associated with RBD in patients with MSA. Stepwise linear regression showed that the number of sleep-related symptoms (PD-SP, EDS, and RBD), disease duration, depression, fatigue, and total Montreal Cognitive Assessment score were predictors of disease severity in patients with MSA.Conclusions:Sleep-related disorders were associated with both MSA subtypes and the severity of disease in patients with MSA, indicating that sleep disorders may reflect the distribution and degree of dopaminergic/non-dopaminergic neuron degeneration in MSA.

简介：Objective:Toexploreaneweffectiveapproachfortreatmentofthelocalirritablesymptomsandsignsresultedfrommyoporthosisoperation.Methods:263casesofradialkeratotomyoutpatientsweredividedintocontrolgroup(n=49,90eyes)andtreatmentgroup(n=214,412eyes).Patientsofcontrolgroupweretreatedwith0.5%Chloramphenicoleyedrops,3timesdaily,1-2drops/time,andwith0.5%Erythromycineeyeointmenteverynight.Intreatmentgroup,patientsweretreatedwithaoupointandhandreflectionareadigitalpressingmethodexceptwiththesameeyedropsandeyeointment.BodyacupointsusedwereCuanzhu(BL2),Yuyao(EX-HN4),Sizhukong(TE23),Sibai(ST2)andTaiyang(EX-HN5).ThehandreflexareasusedwereEyeArea,LiverArea,KidneyArea,SpleenArea,HeartAreaandLungArea.Fivedaysconstitutedatherapeuticcourse.Results:Following3courses(15days)oftreatment,themarkedlyeffectiverateandtotaleffectiverateoftreatmentgroupandcontrolgroupwere74.51%and38.89%,94.17%and66.67%respectively.Therewasasignificantdifferencebetweentwogroupsinthetotaleffectiverate(P＜0.05),showingthetherapeuticeffectoftreatmentgroupbeingbetterthanthatofcontrolgroup.Conclusion:Acupointdigitalpressingisrathereffectiveintreatmentofmyoporthosispost-operationirritablesymptomsandsigns.

简介：无

简介：AbstractGastric carcinoma is extremely rare in pregnancy and the prognosis for this malignancy tends to be dismal. We herein describe a case of gastric cancer in pregnancy to alert clinicians to this rare possibility. A 29-year-old woman developed abdominal spastic pain and diarrhea during the 26 weeks of gestation and her condition was confusing and hard to recognize. The patient was initially misdiagnosed as enterogastritis and inflammatory intestinal obstruction and was finally confirmed by exploratory laparotomy with intestinal and peritoneum metastases. Because the disease was not detected early enough and progressed rapidly, the pregnancy was terminated by cesarean section at 30 weeks of gestation, and then followed by systemic chemotherapy, but eventually succumbed to the lethal pneumonia. Therefore, it is of great significance to alert clinicians to note this rare possibility and to consider the differential diagnosis of this disease in pregnant women with a long course of gastrointestinal symptoms that cannot be explained by pregnancy alone, and cancer should be suspected and tested with sophisticated diagnostic procedures.

简介：AbstractBackground:As a congenital malformation that results in infertility and an inability to have vaginal intercourse, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome places a considerable psychological burden on patients, which results in anxiety symptoms. However, only single case studies or a few small to medium-sized cross-sectional studies were identified to focus on anxiety symptoms in MRKH patients. Thus, the aim of this study was to explore the status of anxiety symptoms and the related factors in patients with MRKH syndrome.Methods:This cross-sectional study involving 141 patients with MRKH syndrome and 178 healthy women was conducted from January 2018 to December 2018. All participants were required to complete a demographic questionnaire and the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire-9, Eysenck Personality Questionnaire-Revised, Short Scale for Chinese, and Chinese Version of the Female Sexual Function Index. The main outcome was the anxiety symptoms measured by the GAD-7. Main outcome was compared between the MRKH syndrome group and the healthy control group. Then, we explored the related factors by comparing patients with and without anxiety symptoms.Results:Of the respondents, 24.1% experienced moderate to severe anxiety symptoms. Patients with MRKH syndrome manifested more severe anxiety symptoms than healthy women. Negative self-evaluation of femininity (odds ratio [OR] 2.706, 95% confidence interval [CI] 1.010-7.247), neurotic personality traits (OR 1.100, 95% CI 1.029-1.175), and coexisting depressive symptoms (OR 4.422, 95% CI 1.498-13.049) were more prevalent in anxious patients.Conclusion:The findings stress the importance of anxiety symptom screening in MRKH patients and identify patients at risk of anxiety symptoms, providing a possible basis for future intervention.

简介：AbstractBackground:Central nervous system (CNS) symptoms after efavirenz (EFV) treatment in people living with human immunodeficiency virus (HIV) could persist and impact their quality of life. We assessed the impact of EFV-based regimen replacement with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), which is considered an alternative option for subjects who do not tolerate EFV. Most specifically, we assessed the safety and the efficacy of E/C/F/TAF and its effects on the participants’ neuropsychiatric toxicity symptoms in a real-life setting.Methods:A prospective cohort study was conducted among virologic suppressed HIV-positive participants receiving EFV-based regimens with ongoing CNS toxicity ≥ grade 2. The participants were switched to single-pill combination regimens E/C/F/TAF and followed up for 48 weeks. The neuropsychiatric toxicity symptoms were measured using a CNS side effects questionnaire, as well as the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index. The primary outcome measure was the proportion of participants experiencing grade 2 or higher CNS toxicity after EFV switch off at weeks 12, 24, and 48. Secondary endpoints included virologic and immunological responses and the effect on fasting lipids at week 48 after switch.Results:One hundred ninety-six participants (96.9% men, median age: 37.5 years, median: 3.7 years on prior EFV-containing regimens) were included in the study. Significant improvements in anxiety and sleep disturbance symptoms were observed at 12, 24, and 48 weeks after switching to E/C/F/TAF (P < 0.05). No significant change in depression symptom scores was observed. At 48 weeks after switch, HIV viral load <50 copies/mL was maintained in all of the participants, median fasting lipid levels were moderately increased (total cholesterol [TC]: 8.2 mg/dL, low-density lipoprotein cholesterol [LDL-C]: 8.5 mg/dL, high-density lipoprotein cholesterol [HDL-C]: 2.9 mg/dL, and triglyceride (TG): 1.6 mg/dL, and the TC:HDL-C ratio remained stable.Conclusions:The single-pill combination regimens E/C/F/TAF is safe and well tolerated. This study reveals that switching from EFV to E/C/F/TAF significantly reduces neuropsychiatric toxicity symptoms in people living with HIV with grade 2 or higher CNS complaints.

简介：AbstractBackground:Being able to predict with confidence the early onset of type 2 diabetes from a suite of signs and symptoms (features) displayed by potential sufferers is desirable to commence treatment promptly. Late or inconclusive diagnosis can result in more serious health consequences for sufferers and higher costs for health care services in the long run.Methods:A novel integrated methodology is proposed involving correlation, statistical analysis, machine learning, multi-K-fold cross-validation, and confusion matrices to provide a reliable classification of diabetes-positive and -negative individuals from a substantial suite of features. The method also identifies the relative influence of each feature on the diabetes diagnosis and highlights the most important ones. Ten statistical and machine learning methods are utilized to conduct the analysis.Results:A published data set involving 520 individuals (Sylthet Diabetes Hospital, Bangladesh) is modeled revealing that a support vector classifier generates the most accurate early-onset type 2 diabetes status predictions with just 11 misclassifications (2.1% error). Polydipsia and polyuria are among the most influential features, whereas obesity and age are assigned low weights by the prediction models.Conclusion:The proposed methodology can rapidly predict early-onset type 2 diabetes with high confidence while providing valuable insight into the key influential features involved in such predictions.