MRI EVALUATION OF PATTERN OF DISC DISPLACEMENT OF TEMPOROMANDIBULAR JOINT IN UNILATERAL TEMPOROMANDIBULAR JOINT PAIN AND COMPARISON WITH CONTRALATERAL ASYMPTOMATIC TEMPOROMANDIBULAR JOINT
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Temporomandibular joints (TMJ) are a pair of synovial joints on both side of head, which helps in movement of mandible resulting in speech, facial expression & mastication.Internal derangements of TMJ are the common causes of non-traumatic pain around TMJ.There are few studies concerning this finding and MRI evaluation of TMJ in establishing the diagnosis. AIMS & OBJECTIVES:The purpose of this study is to evaluate the relationship of internal disc displacement and pattern of disc displacement with the painful TMJ using MR Imaging of painful TMJ.RESULTS: We imaged 30 TMJ of 15 patients with unilateral TMJ pain and the symptomatic TMJ was compared with asymptomatic TMJ.The position of disc was noted for both painful & asymptomatic side.DISCUSSION: In our study we imaged 30 TMJs using MRI.For all the 15 study participants, the painful TMJ was compared with contralateral asymptomatic joint.We found that anterior, anteromedial & anterolateral disc diaplcements were associated with TMJ symptoms, however the superior displacement was found to be asymptomatic.CONCLUSION: The anterior, anterolateral and anteromedial displacement of disc of TMJ is commonly associated with TMJ pain.However the superior displacement was asymptomatic.MRI is very useful in evaluating painful TMJ by assessing the disc displacement and associated findings.However the long-term association and remission of symptoms of disc displacement needs further evaluation.KEY FINDINGSAsymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur.• Manifestations of COVID-19 are highly varied and may include asymptomatic cases, who do not manifest with anysigns and symptoms despite testing positive for COVID-19 by viral nucleic acid tests. Pre-symptomatic cases areinfected individuals who are still in their incubation period, hence do not exhibit any symptoms yet but eventuallydevelop symptoms.• As of June 2020, only 586 (2.8%) of the 20,990 active cases in the Philippines were classified as asymptomatic,but it is unclear whether cases are pre-symptomatic or carriers (true asymptomatic).• Based on 36 observational studies (case reports, case series, cross-sectional and cohort studies) and 9 statisticalmodeling analysis, asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur. However, 3studies reported no transmission from pre-symptomatic and asymptomatic cases.• Studies on viral load comparing symptomatic cases with pre-symptomatic and asymptomatic cases reportedcontradicting results. The duration of viral shedding was significantly longer for symptomatic patients comparedto asymptomatic patients but similar for asymptomatic and pre-symptomatic patients.• Therewas no difference in the transmission rates of symptomatic and asymptomatic cases. However,the estimatedinfectivity and probability of transmission was higherfor symptomatic cases compared to asymptomatic cases, butresults were imprecise due to a wide confidence interval.• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recognize thepossibility of pre-symptomatic and asymptomatic transmission. According to WHO, current evidence suggestsasymptomatic cases are less likely to transmit the virus than symptomatic cases.
Asymptomatic carrier
Viral Shedding
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Dental occlusion
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Introduction: There is no specific recommendation for the management of asymptomatic vaginal mesh erosions post antiincontinence or prolapse surgery, but revision or excision may represent overtreatment. We hypothesize that asymptomatic vaginal exposures remain asymptomatic during follow-up and do not require any intervention. Methods: We evaluated a “no treatment” approach by prospectively following-up women with asymptomatic vaginal exposures after antiincontinence and pelvic organ prolapse surgery. After a 1-month course of vaginal oestrogen, they underwent the “wait and see” protocol. It consisted of no treatment. Women were followed-up every 3 months, for the first year and then every 6 months with history, clinical examination with measurement of size of the exposure, and the evaluation of possible infection signs or vaginal discharge. Results: Forty women were followed-up for a median of 33.52 months (range 8–48 months). All exposures were ≤1 cm (mean 6.5 ± 1.5 mm, range 4–10 mm), patients were asymptomatic and without pain. During the observation period, the size of the exposure did not change and all women remained asymptomatic. Discussion/Conclusion: No treatment seems to be required for asymptomatic and small vaginal mesh exposures after prolapse or incontinence surgery.
Vaginal discharge
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Introduction: The prevalence of peripheral arterial disease (PAD) ranges between 4.5% and 57% and is independently associated with cardiovascular disease burden irrespective of symptoms. Two thirds of cases are thought to be asymptomatic and may go unrecognised. Local prevalence and natural progression of asymptomatic PAD is unknown.Methods: This one year, non-interventional longitudinal study, aimed to determine prevalence and progression of asymptomatic PAD in patients with cardiovascular risk factors. Results: Of 217 patients screened, 36% had asymptomatic disease in 113 legs. Of sixty two who returned for follow-up, eight normal legs developed asymptomatic PAD, and 46%, asymptomatic at baseline showed disease progression. Initial baseline ABI showed significant change over 1 year of follow-up (p=0.001) and 21% (13) of patients eventually developed intermittent claudication. Also, 52% of baseline asymptomatic participants having at least one associated cardiovascular risk factor showed disease progression over 1 year. Those developing claudication demonstrated significant ABI deterioration. Having two or more cardiovascular risk factors significantly affected progression of asymptomatic disease, (p = 0.031). Conclusion: Study confirms high prevalence of asymptomatic PAD in our population and significant disease progression in one year.Key words: Peripheral Artery Disease, Risk Factors, Asymptomatic, Disease Progression
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Retrospective review of the Southeastern Vascular Study Group between January 2011 and December 2018 Of 8303 carotid endarterectomies (CEAs) and 1876 carotid artery stenting (CAS) procedures, slightly more than half of patients were asymptomatic in each group. Symptomatic patients had significantly higher rates of in-hospital neurologic events, myocardial infarction, and death after CEA and of neurologic events after CAS than asymptomatic patients. There was no difference in mortality among symptomatic and asymptomatic male and female patients at 3 years after CEA, but asymptomatic men had significantly higher 3-year mortality than women after CAS. Long-term mortality risk in asymptomatic men should be considered before offering CAS.
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To define characteristics of pediatric asymptomatic idiopathic intracranial hypertension (IIH).We retrospectively reviewed our Neuro-Ophthalmology database (2000-2006) for all cases of symptomatic and asymptomatic pediatric IIH.Out of 45 IIH cases, 14 (31.1%) were asymptomatic (incidental examination). When compared with children with symptomatic IIH, asymptomatic cases were younger [5.6 (1.8-15) vs 11.0 (5-17) years, P = 0.007], had lower percentage of obesity (14.3% vs 48.4%, P = 0.046), and had male predominance (71.4% vs 38.7%, P = 0.06). Asymptomatic cases required shorter duration of acetazolamide treatment [3 (0-8), vs 6 (0-20) months, P = 0.021], and resulted in complete resolution of swollen discs.We speculate that asymptomatic IIH may be more common in young children and could represent a milder form or a presymptomatic phase before evolving into classic symptomatic IIH. Further studies to assess the clinical significance of asymptomatic IIH are warranted.
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