Invisible Symptoms Research Articles

Cell death behind invisible symptoms: early diagnosis of ozone injury

A simple histo-cytochemical method, combining Evans blue staining to assess cell death and in vivo 3,3′-diaminobenzidine uptake for H2O2 localisation, has been used to evaluate O3 damages in leaf tissues of three Phaseolus vulgaris L. cultivars (Cannellino, BLF, Saxa) with different sensitivity to the pollutant. Bean plants were exposed to a single pulse of O3 (150 ± 10 mm3 m−3 × 3 h) and leaves were examined at different time-span after fumigation. Cannellino proved to be the most sensitive, showing chlorotic spots 2 h after fumigation and chlorotic lesions 24 h later. In BLF, necrotic spots appeared 4 h after fumigation and reddish necrotic lesions (bronzing) developed in further 24 h. Saxa remained symptomless up to 10 d of observation, thus appearing tolerant. The early appearance of symptoms in Cannellino correlated with H2O2 accumulation in leaf tissues and consequent extensive cell death, involving both palisade and spongy mesophyll. H2O2 accumulation was observed also in BLF, though to a lesser extent and dead cells were rare at 2 h after fumigation. However, they increased in number 24 h later, forming small groups in the palisade mesophyll. These groups further enlarged in the next 24 h, again involving only palisade mesophyll. In Saxa leaves, H2O2 accumulation was found only in the epidermal cells, though the number of dead cells was very similar to BLF, at least up to 24 h after fumigation. However, in Saxa, dead cells have been always found singly scattered through the palisade mesophyll, or forming very small groups around substomatal cavity, thus remaining invisible at a macroscopic level.

Husbands and Wives Living with Multiple Sclerosis

Multiple sclerosis (MS) frequently is diagnosed in young adults. Coping with symptoms of MS is challenging not only for the person with the disease, but also for his or her spouse. The well spouse often assumes the caregiving role. The purpose of this qualitative research was to investigate the experiences of persons whose spouses have MS. Twelve people participated in a 2-hour focus group: 8 men and 4 women. The husbands were, on average, 50 years old, and the wives averaged 55 years old. The length of time since diagnosis ranged from 2 to 11 years for the husbands and from 3 to 13 years for the wives. The focus group discussions were audiotaped and transcribed verbatim. Participants talked freely. Four major themes emerged: caregiver roles, need for information, relationship changes, and barriers. Men attempted to protect their wives' energy, intervening for them. Wives encouraged independence in their husbands. Spouses need information about MS, complementary interventions, and support. They want increased public awareness of invisible symptoms and awareness in the workplace of continuing capabilities of persons with MS. Role reversals were challenging for the women who felt that "MS is the third person in a marriage." Spouses need help to maintain appropriate boundaries. Limitations of the study include the small, economically homogeneous sample and the single encounter with the subjects. A longitudinal intervention study is needed.

Fatigue in persons with renal failure who require maintenance haemodialysis.

Fatigue is a highly prevalent symptom experienced by persons who live with chronic illness, including those with renal failure who require maintenance haemodialysis. Fatigue, however, is a non-specific and invisible symptom and is a phenomenon that is poorly understood by health care professionals. This study examined the symptom of fatigue as experienced by a group of 39 adult haemodialysis patients. The theory of unpleasant symptoms formed the conceptual framework for the study. A descriptive correlational design was utilized to examine fatigue from an inductive approach, considering relevant physiological, psychological and situational variables based on a review of the literature. Data were collected using a structured self-report questionnaire and biochemical data from retrospective monthly blood tests. The results of the study indicated that high levels of fatigue are experienced, with correspondingly low levels of vitality, in all the areas measured - general fatigue, physical fatigue, reduced motivation, reduced activity and mental fatigue, by adult haemodialysis patients. Individual variation was noted in the dimensions of fatigue predominantly expressed. Fatigue was significantly associated with the presence of symptoms such as sleep problems, poor physical health status and depression. No associations between fatigue and the biochemical and situational variables measured were noted. Further examination of the data revealed complex relationships between the physiological and psychological factors examined. Depression was significantly associated with physical health status, sleep problems, symptoms and anxiety. Correlations were also noted between symptoms and poor physical functioning, sleep problems and depression. Based on the results, a revised version of the theory of unpleasant symptoms relating to fatigue is presented.

INJURIES, FEIGNED AND REAL, WITH THEIR DIFFERENTIATION AND MEDICOLEGAL ASPECT.

Injuries may be divided into two classes: 1, those with visible signs and symptoms; 2, those with invisible symptoms. Injury to certain tissues produce evidences of molecular change which usually justify the signs present and the symptoms complained of. A solution of continuity in either soft or bony parts requires no inductive or exclusive process of reasoning for their detection. Injuries to the nervous system productive of distinct objective symptoms, motor disturbances or discoverable sensory manifestations, do not tax the examiner's ingenuity to draw conclusions. Injuries to the nervous system, non-productive of objective symptoms in which the examiner is compelled to depend entirely upon subjective symptoms to arrive at the truth, are the most trying types the physician has to cope with. The invisible symptoms are the sensory, such as pain and the paresthesia. The visible symptoms and signs are chiefly motor and atrophic. Without repeating unnecessary detail as to