Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary hyperparathyroidism is the most common cause of hypercalcemia and 80-85% of the patients have parathyroid tumors. The purpose of this retrospective review was to analyse whether differences exist between patients with parathyroid tumors treated in the 1980s and 1990s. Between 1980-1997, 253 patients underwent initial surgical neck exploration for hyperfunctioning parathyroid tumors. Renal (polyuria, nocturia, renal colic due to lithiasis), rheumatologic (bone and joint pain), neurological (fatigue, memory loss, depression) and gastrointestinal (dyspepsia, anorexia, nausea) symptoms were recorded and main biochemical parameters were measured. In all patients one or more preoperative localization procedures were carried out prior to successful parathyroidectomy, and the confirmation of imaging findings was obtained after surgery. The patients were divided in two groups. Group A: 121 (47.8%) patients who underwent surgery from 1980-1989; Group B: 132 (52.2%) patients in whom parathyroidectomy was performed from 1990-1997. There were no differences (p=NS) between the two groups in average age, preoperative serum creatinine and intact-PTH levels. Symptoms were most common in Group A, and pre-operative serum calcium levels were significantly lower in Group B. Ultrasonography (n=191) sensitivity did not improve significantly (82.8% vs 82.9%), but positive predictive value (PPV) was higher (89.8% vs 96.0%). CT-scan (n=73) sensitivity was 79.2% and 82.6%, and PPV was 95.0% and 100% in Groups A and B, respectively. 201Tl/99mTc subtraction scintigraphy (n=111, Group A) was 84.6% sensitive (PPV=92.6%) whereas 99mTc-sestamibi scanning (n=90, Group B) was 85.1% sensitive (PPV=96.1%). In conclusion, the clinical features of parathyroid tumors has changed in the nineties and increasing asymptomatic pHPT rate has been found. Although sensitivity and PPV of preoperative localization procedures has improved moderately, at present noninvasive techniques may offer excellent results and should be used in all patients with suspected parathyroid tumors.
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PMID:Tumors of the parathyroid glands. Changes in clinical features and in noninvasive localization studies sensitivity. 1084 Sep 29

This survey was carried out to explore the relationship between symptoms and functional status in the elderly living at home. The setting is an urban area of Turin (Northern Italy). A cross-sectional screening for 20 symptoms was completed in 747 subjects, aged 75 and older. Dependence in basic Activities of Daily Living (ADL) and in Instrumental Activities of Daily Living (IADL), Short Portable Mental Status Questionnaire and Cumulative Illness Rating Scale were also ascertained. A discriminant analysis was performed to determine the potential value of symptoms in predicting functional impairment. The mean number of symptoms was 6.0 per subject (+/-S.D. 3.3) and dependence in ADLs was 8.2%. Amongst a 20-symptom list, six symptoms (fatigue, memory loss, indigestion, nutrition, hearing and speaking problems), either alone or in association, showed sufficient discriminatory power to identify dependence in ADLs (sensitivity=72%), mental impairment (72%), psychological distress (80%), but not dependence in IADLs (48%). Symptoms are common in the free-living elders, but their functional status is good. A short (6 items) formal screening for symptoms may be a simple way to predict functioning and to rapidly manage problems.
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PMID:Symptoms as predictors of functioning in the community-dwelling elderly. 1865 41