Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392326 (discomfort)
 22,423 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lumbosacral pain is a significant complaint in approximately one-half of all pregnancies. In 15%, the pain can be disabling. Although the mechanical and positional stresses of pregnancy have been cited as the primary source of this discomfort, in approximately 1:10,000 cases a herniated lumbar disc (HNP) can be identified as the proximal cause of pain. A 35-yr-old G4AB3PO patient presenting at 10 wk of pregnancy with severe incapacitating lumbar radiculopathy is described. Magnetic resonance imaging, selected by the patient as a diagnostic option, demonstrated a clinically suspected large midline HNP at the L5-S1 level. In the past, visualizing the presence of a HNP during pregnancy by either computerized axial tomography scan or myelography has exposed the fetus to ionizing radiation. However, magnetic resonance imaging now permits a more detailed evaluation without similar x-ray exposure. To date, no recognized biologic effect of MRI on the developing fetus has been reported. Although the long-term effects of an magnetic resonance imaging on the developing fetus have not been conclusively evaluated, its potential for accurate diagnosis and subsequent patient management, as well as planning the delivery, appears to outweigh any recognized hazard to the developing fetus.
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PMID:Magnetic resonance imaging of the lumbar herniated disc in pregnancy. 787 15

We studied 78 patients with clinically suspected central nervous system abnormalities (66 intracranial, 12 spinal) by MRI before and after administration of the nonionic contrast medium gadodiamide injection. A parallel, double-blind, randomised design was followed. Two dosages were used: 38 patients underwent studies with 0.1 mmol/kg body weight (b.w.) and 40 with 0.3 mmol/kg b.w. MRI showed abnormalities in 36 of the 38 patients receiving the lower dose and 39 of the 40 patients receiving the higher dose. In 3 patients from each group more lesions were seen following injection than before. The contrast medium improved the delineation of abnormal structures and assessment of tumour size and increased their signal intensity indices in both groups, but especially at the higher dose. Administration of gadodiamide injection provided more diagnostic information in about 75% of the patients, independently of the dose. There were no reports of discomfort, but 7 patients reported adverse events considered unrelated to the gadodiamide injection. The two doses were found to be equally safe and efficient for diagnosis.
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PMID:Gadodiamide injection at 0.1 and 0.3 mmol/kg body weight: a phase III double-blind, parallel, randomised clinical investigation of known or suspected central nervous system lesions at 1.5 T. 793 74

A 33-year-old man admitted to our hospital with an episode of chest discomfort and dyspnea. UCG, CT, MRI and DSA disclosed an annuloaortic ectasia with grade 3 aortic regurgitation and atypical coarctation of the aorta. Cabrol operation was performed with simultaneous graft bypass using a woven Dacron prosthesis between the ascending aorta and the abdominal aorta. The course of the bypass graft was arranged to pass behind the rectal muscle without laparotomy and major collateral vessels of the thorax could been kept without thoracotomy. There are only 10 reported cases of annuloaortic ectasia associated with atypical coarctation of the aorta in Japan. This is the second successful case report of one-stage surgery to the complicated cardiovascular disease.
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PMID:[A case report of one-staged surgery for annuloaortic ectasia associated with atypical coarctation of the aorta]. 846 63

To prospectively evaluate the efficacy of ultrasonography in the diagnosis of ruptured silicone gel breast implants, 98 patients (192 implants) underwent preoperative breast ultrasonography prior to silicone gel breast implant removal. The prevalence of implant rupture confirmed at surgery in this group of patients was 62 of the 192 implants (32 percent). Of the 60 implants diagnosed as ruptured by ultrasonography, 46 were confirmed as having visible defects at surgery (true positive) for a positive predictive value of 77 percent. Of the 132 implants diagnosed as intact by ultrasonography, 116 were confirmed as intact at surgery (true negative) for a negative predictive value of 88 percent. Overall, the sensitivity of ultrasonography for implant rupture was 74 percent, and the specificity was 89 percent. These findings demonstrate that ultrasonography is an effective imaging modality for the diagnosis of silicone gel breast implant rupture. Compared with mammography, ultrasonography appears to offer superior sensitivity and specificity without radiation exposure or discomfort. Although magnetic resonance imaging has shown considerable promise in the diagnosis of implant rupture, ultrasonography provides comparable sensitivity at a fraction of MRI's cost.
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PMID:Diagnosis of silicone gel breast implant rupture by ultrasonography. 894 38

Gadodiamide injection is a new nonionic paramagnetic, extracellular contrast medium. Its safety at a dose of 0.1 mmol/kg body weight was evaluated in a large European multicentre trial on adults referred for contrast-enhanced MRI of the central nervous system. Safety analysis was performed on 2102 patients, in whom adverse events during and up to 24 h after injection were recorded. Adverse events related or possibly related to gadodiamide injection were observed in 102 patients. Injection-associated reactions classified as discomfort (sensation of heat or coldness, pain or pressure at the injection site) occurred in 37 patients (1.8%) and other adverse events (e.g. headache, nausea) were observed in 65 patients (3.1%). No serious adverse event was reported. Efficacy analysis, performed on 2273 patients, and based on comparison of T1- and T2-weighted images before and T1-weighted images after injection showed that more diagnostic information was obtained after gadodiamide injection in 1424 (62.6%) patients: management of 386 (17.0%) patients was affected by the new information given and that a new diagnosis was made in 755 (33.3%) patients. Gadodiamide injection was shown to be safe and well tolerated. It represents a nonionic alternative to the current products for MRI of the central nervous system.
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PMID:Evaluation of the clinical safety of gadodiamide injection, a new nonionic MRI contrast medium for the central nervous system: a European perspective. 888 Jul 14

A 7-year-old boy presented with a 4-week history of daily headache. His parents reported that he was unable to attend school the week prior to presentation. Intermittent nausea without vomiting was reported, but no blurred vision, photophobia, or diplopia were described. There was no history of trauma or recent systemic illness. The physical examination showed mild neck discomfort, no papilledema, and normal cranial nerve, motor and sensory functioning. Both a CT scan of the sinuses and an MRI of the brain were normal. Although the opening pressure was elevated, the cerebrospinal fluid was also normal. In previous accounts of idiopathic intracranial hypertension in children, concomitant papilledema, visual symptoms and/or palsy of the sixth cranial nerve are described. This case demonstrates that idiopathic intracranial hypertension in a young child can present as a daily headache without any visual symptoms or signs.
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PMID:Idiopathic intracranial hypertension in a young child without visual symptoms or signs. 891 68

The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82%). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children.
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PMID:Clinical evaluation of gadodiamide injection in paediatric MR imaging. 892 82

We report a 46-year-old man with right side dominant parkinsonism who died suddenly two years after the onset. The patient was well until the age of 42 years in January of 1993, when he noted an onset of difficulty in using his right hand and then the right leg. Soon after he noted nocturnal urinary incontinence. In January of 1994, a local doctor prescribed 200 mg of levodopa with benserazide and 5 mg of bromocriptine. The patient noted some improvement. Cystometry revealed 300 ml of residual urine. He visited our clinic on 24th of December, 1996. He was alert and oriented. BP was 106/60. He showed masked face and small voice. He walked in stopped posture dragging his feet; retropulsion was noted. He showed moderate bradykinesia and rigidity more on the right side. No resting tremor or cerebellar ataxia was noted. Ankle jerks were somewhat exaggerated but no Babinski sign was noted. He continued to show residual urine, but orthostatic hypotension was absent. Routine laboratory examination was unremarkable, however, his cranial MRI showed atrophy of the left putamen and a T2-linear high signal intensity lesion along the lateral border of the left putamen. On January 15, 1997, he ate certain amount of rice cake and drank alcohol. After coming back home and while changing his clothes, he suddenly complained of chest discomfort and lost consciousness. He was pronounced dead in the afternoon. The patient was discussed in a neurological CPC. Opinions were divided between Parkinson's disease and striatonigral degeneration. The chief discussed arrived at a conclusion that the patient had Parkinson's disease, because he responded to levodopa to some extent and except for nocturnal incontinence he did not have wide spread autonomic failure. Postmortem examination revealed marked loss of neurons and extensive gliosis in the left putamen. The right putamen did not show such changes. The substantia nigra showed gliosis in the lateral part on both side, however, neuronal loss was not apparent. The locus coeruleus was well retained. No Lewy bodies were found. The pontine nucleus and the cerebellum were intact. However, glial cytoplasmic inclusions were seen in oligodendrocytes of the cerebral white matter and the pontine base. The heart and lungs were intact and the cause of the sudden death could not be determined. The pathologic diagnosis is striatonigral degeneration. Such a marked asymmetry of the pathologic change is quite unusual. Probably, the death in the early stage of the disease is the reason for this asymmetry.
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PMID:[A 46-year-old man with right-side dominant parkinsonism, who suffered a sudden death]. 895

The safety and efficacy of the MRI contrast medium gadodiamide injection (OMNISCAN) in children is summarised. Four open and three double-blind, multinational, multicentre comparative trials have been undertaken. Overall, 353 patients (15 days to 18 years, plus one 21 years) received gadodiamide injection, and 128 (2-18 years) received gadopentetate dimeglumine (Magnevist), intravenously at 0.1 mmol/kg body weight, to aid the identification of CNS and body lesions. Adverse events were reported in 13 (4%) patients given gadodiamide injection and 8 (6%) given gadopentetate dimeglumine; few patients reported injection-associated discomfort. The post-contrast scan gave more diagnostic information in 223 (63%) patients given gadodiamide injection (CNS and body indications). In the comparative trials, the post-contrast scan gave more diagnostic information for 91 (65%) and 82 (64%) patients given gadodiamide injection and gadopentetate dimeglumine, respectively (CNS indications only). Gadodiamide injection (0.1 mmol/kg body weight) was safe and effective in infants, children and adolescents.
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PMID:MRI in children given gadodiamide injection: safety and efficacy in CNS and body indications. 900 23

In cervical cancer the pathologic stage is determined for two reasons: choice of treatment (surgical-radiotherapy-medical) and prognostic evaluation. In early cervical carcinoma the evaluation of pelvic lymph nodes is important. The clinical noninvasive approach using ultrasound, CT, MRI, and lymphography is of limited use because of low accuracy. Therefore, the clinical evaluation has to be performed surgically. This is required in FIGO I and FIGO IIa carcinoma with circumference < 4 cm. If the pelvic nodes are negative a radical hysterectomy is indicated; but if the nodes are positive, this procedure could be avoided and the treatment of choice is pelvic radiotherapy. In some cases radical hysterectomy is performed when the pathology of the lymph nodes is not yet known and subsequent pelvic radiotherapy is performed when the nodes are positive. This sequence of events is a major cause of complications (fistula of the intestinal or the urinary tract, ileus and lymphocysts). Laparoscopic lymphadenectomy may be the method of choice to stage these tumors with minimal discomfort for the patients. This study demonstrates that laparoscopic lymphadenectomy is comparable to open lymphadenectomy in the clinical staging of cervical cancer.
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PMID:Comparison Between Abdominal and Laparoscopic Lymphadenectomy 907 51


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